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Introduction: Advance care planning (ACP) is a process of shared decision-making about future health-care plans between patients, health care providers, and family members, should patients becomes incapable of participating in medical treatment decisions. ACP discussions enhance patient's autonomy, focus on patient's values and treatment preferences, and promote patient-centered care. ACP is integrated as part of clinical practice in Singapore and the United States. Aim: To assess the clinical impact of education provision on determining ACP decisions among end-stage renal disease patients on regular hemodialysis at University Malaya Medical Centre (UMMC). To study the knowledge and attitude of patients toward ACP and end-of-life issues. Materials and Methods: Fifty-six patients were recruited from UMMC. About 43 questions pretest survey adapted from Lyon's ACP survey and Moss's cardiopulmonary resuscitation (CPR) attitude survey was given to patients to answer. An educational brochure is then introduced to these patients, and a posttest survey carried out after that. The results were analyzed using SPSS version 22.0. Results: Opinion on ACP, including CPR decisions, showed an upward trend on the importance percentage after the educational brochure exposure, but this was statistically not significant. Seventy-five percent of participants had never heard of ACP before, and only 3.6% had actually prepared a written advanced directive. Conclusion: The ACP educational brochure clinically impacts patients' preferences and decisions toward end-of-life care; however, this is statistically not significant. Majority of patients have poor knowledge on ACP. This study lays the foundation for execution of future larger scale clinical trials, and ultimately, the incorporation of ACP into clinical practice in Malaysia.

Objectives: This paper explores health care pro - fessionals’ potential attitude toward organ donation if the presumed consent system were to be im - plemented in Malaysia, as well as factors associated with this attitude. Materials and Methods: We used self-administered questionnaires to investigate the attitude of 382 health care professionals from the University of Malaya Medical Center between January and February 2014. The responses were analyzed using logistic regression. Results: Of the 382 respondents, 175 (45.8%) stated that they would officially object to organ donation if the presumed consent system were to be imple - mented, whereas the remaining 207 (54.2%) stated that they would not object. The logistic regression showed that health care professionals from the Malay ethnic group were more likely to object than those from Chinese (adjusted odds ratio of 0.342; P =.001) and Indian and other (adjusted odds ratio of 0.341; P =.003) ethnic groups. Health care professionals earning 3000 Malaysian Ringgit or below were more likely to object than those earning above 3000 Malaysian Ringgit (adjusted odds ratio of 1.919; P =.006). Moreover, respondents who were initially unwilling to donate organs, regardless of the donation system, were more likely to object under the presumed consent system than those who were initially willing to donate (adjusted odds ratio of 2.765; P

Aim. To validate the accuracy of estimated glomerular filtration rate (eGFR) equations in Malay population attending our hospital in comparison with radiolabeled measured GFR.Methods. A cross-sectional study recruiting volunteered patients in the outpatient setting. Chromium EDTA (51Cr-EDTA) was used as measured GFR. The predictive capabilities of Cockcroft-Gault equation corrected for body surface area (CGBSA), four-variable Modification of Diet in Renal Disease (4-MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations were calculated.Results. A total of 51 subjects were recruited with mean measured GFR 42.04 (17.70–111.10) ml/min/1.73 m2. Estimated GFR based on CGBSA, 4-MDRD, and CKD-EPI were 40.47 (16.52–115.52), 35.90 (14.00–98.00), and 37.24 (14.00–121.00), respectively. Higher accuracy was noted in 4-MDRD equations throughout all GFR groups except for subgroup of GFR ≥ 60 ml/min/1.73 m2where CGBSA was better.Conclusions. The 4-MDRD equation seems to perform better in estimating GFR in Malay CKD patients generally and specifically in the subgroup of GFR < 60 ml/min/1.73 m2and both BMI subgroups.

Background The aim of this paper is to look into the factors influencing Malaysian Muslims' decision to become deceased organ donors in Malaysia. Material and methods We approached 900 Malaysian Muslims and 779 participated in our survey, conducted in Kuala Lumpur and its suburb. We examined their willingness to become donors and the willing donors were asked why they did not pledge to become donors. Non-donors were asked why they refuse to become donors. Results The survey found the main reason for Malaysian Muslims not pledging their organs was due to their lack of information on organ donation and/or their lack of confidence in the government's ability to properly administer organ donation procedures. Another interesting finding is that religion is not a main deterrent to organ donation. Conclusions The survey suggests that Malaysia can explore many ways to encourage organ donation without having to resort to the highly controversial financial incentive option. A key to Malaysia's success or failure to increase organ donation rate lies in its ability to persuade its Muslim population (its largest population) to donate organs. This can be done by adopting a segmented, focused, and highly localized form of public education and by leveraging on existing networks involving local religious and community leaders as well as government and non-governmental institutions.

This study examines the marketing of a high-involvement product, namely, houses in Malaysia, by focusing on the relationship between customer orientation, an important component of the marketing concept, and buyers' satisfaction. Using multi-item scales to measure these two constructs and employing factor analysis and stepwise regression for data analyses, the results and marketing implications drawn suggest the usefulness of these scales for developing well-defined, comprehensive and strategic marketing plans as well as providing a useful framework for formulating effective marketing strategies to enhance customer satisfaction.