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Adolescence is the developmental process of becoming an adult. This journey of physical and psychological maturation is filled with challenges and hormonal chaos, and teenagers experience unhappiness at times. From a psychological perspective, this study aimed to examine the association between motivation, self-esteem and happiness; and to explore the mediating role of motivation in the association between self-esteem and happiness among adolescents in Malaysia. 480 secondary school students were recruited using a multistage cluster sampling method and answered the Malay versions of the Subjective Happiness, Brief Motivation and Rosenberg Self-esteem scales. Both self-esteem and motivation were found positively correlated to happiness. The hypothetical mediating role of motivation on the association between self-esteem and happiness was also supported, indicating that individuals with higher self-esteem have higher motivation which may result in greater happiness. Since the direct association between self-esteem and happiness remained significant, a partial mediation of adolescents' motivation between self-esteem and happiness is indicated. The results showed that perceived self-esteem plays a role in predicting happiness and the presence of motivation enhances happiness, providing an insight to nurture happier adolescents for parents and educators in Malaysia. [ABSTRACT FROM AUTHOR]

Objective: This study assesses the prevalence of musculoskeletal (MSK) pain in patients attending primary care clinics in a medium-sized town in Malaysia and examines the interventions given for the symptoms and the level of the associated disabilities. Method: This investigation comprises a cross-sectional descriptive study of all patients visiting two primary care clinics aged 18 years and above. Patients presenting with joint pain answered a questionnaire assessing demographic data, disabilities (measured by the Stanford HAQ-DI), and treatment options. Results: Of 1,074 patients surveyed, 202 (18.8%) had MSK complaints. The mean age of those with MSK pain was 56.1 years. Incidence increased with age, reaching 78.8% of those over 48 years of age. The knee was the most common site of MSK pain (52.2%), with 20.3% requiring referral for specialist assessment. The median HAQ score was 0.375 and 89.6% of those surveyed had mild disability. Conclusion: MSK pain is a common problem among patients visiting primary care clinics. The most common site of MSK pain was the knee. On formal assessment, the majority of these patients exhibited mild disability. A significant proportion of patients still required specialist referral. This finding would suggest a need for further training on the management of MSK disease at the primary care level to avoid over-burdening the secondary care services. [ABSTRACT FROM AUTHOR]

Dengue has become a global public health problem. Despite reactive efforts by the government in Malaysia, the dengue cases are on the increase. Adequate knowledge, positive attitude and correct practice for dengue control are essential to stamp out the disease. Hence, this study aims to assess the factors associated with dengue knowledge, attitude and practice (KAP), as well as the association with dengue IgM and IgG seropositivity. A community-based cross-sectional study was conducted in a closed, dengue endemic area with multi-storey dwellings. Five hundred individuals (aged 18 years and above) were approached for pre-tested KAP and seroprevalences assessment. The study showed only half of the total participants have good knowledge (50.7%) but they had insufficient knowledge about dengue during pregnancy. 53.2% of people had poor attitude and 50.2% reported poor practice for dengue control. Out of 85 respondents who agreed to participate in the dengue seroprevalence study, 74.1% (n = 63) were positive for dengue IgG and 7.1% (n = 6) were positive for dengue IgM. Among all sociodemographic variable, race is the only independent predicator for all KAP levels (P < 0.05). In conclusion, proactive and sustainable efforts are needed to bring a behavioural change among communities in order to fight dengue outbreaks in endemic areas. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the leading cause of death among women worldwide. Studies have identified breast density as a controversial risk factor of breast cancer. Moreover, studies found that breast density reduction through Tamoxifen could reduce risk of breast cancer significantly. To date, no study on the association between breast density and breast cancer has been carried out in Malaysia. If breast density is proven to be a risk factor of breast cancer, intervention could be carried out to reduce breast cancer risk through breast density reduction. Purpose: To determine if density of breast is an independent risk factor which will contribute to development of breast cancer. Materials and Methods: A prospective cohort study is carried out in two hospitals targeting adult female patients who presented to the Breast Clinic with symptoms suspicious of breast cancer. Participants recruited were investigated for breast cancer based on their symptoms. Breast density assessed from mammogram was correlated with tissue biopsy results and final diagnosis of benign or malignant breast disease. Results: Participants with dense breasts showed 29% increased risk of breast cancer when compared to those with almost entirely fatty breasts (odds ratio [OR] 1.29, 95% CI 0.38‐4.44, P =.683). Among the postmenopausal women, those with dense breasts were 3.1 times more likely to develop breast cancer compared with those with fatty breasts (OR 3.125, 95% CI 0.72‐13.64, P =.13). Moreover, the chance of developing breast cancer increases with age (OR 1.046, 95% CI 1.003‐1.090, P <.05). In contrast, the density of breast decreases with increasing age (P <.05) and body mass index (P =.051). The proportion of high breast density whether in the whole sample size, premenopausal, or postmenopausal group was consistently high. Conclusion: Although results were not statistically significant, important association between breast density and risk of breast cancer cannot be ruled out. The study is limited by a small sample size and subjective assessment of breast density. More studies are required to reconcile the differences between studies of contrasting evidence. [ABSTRACT FROM AUTHOR]

• Most people living in dengue hotspots are exposed to dengue without their knowledge. • Inapparent dengue is already widespread when dengue-positive Aedes mosquitoes are detected. • People living with dengue patients are likely to have been exposed to dengue without their knowledge. • Current diagnostic tools have limited ability to detect inapparent dengue. • Early and proactive dengue surveillance and control are needed, taking into account of asymptomatic transmission. The public health burden of dengue is most likely under reported. Current dengue control measures only considered symptomatic dengue transmission. Hence, there is a paucity of information on the epidemiology of inapparent dengue. This study reports that many people have been unknowingly exposed to dengue infection. Almost 10% and 70% of individuals without any history of dengue infection and living in a dengue hotspot, in Selangor, Malaysia, were dengue IgM and IgG positive respectively. When dengue-positive mosquitoes were detected in the hotspot, 11 (6.3%) of the 174 individuals tested were found to have dengue viremia, of which 10 were asymptomatic. Besides, upon detection of a dengue-infected mosquito, transmission was already widespread. In a clinical setting, it appears that people living with dengue patients have been exposed to dengue, whether asymptomatic or symptomatic. They can either have circulating viral RNA and/or presence of NS1 antigen. It is also possible that they are dengue seropositive. Collectively, the results indicate that actions taken to control dengue transmission after the first report of dengue cases may be already too late. The current study also revealed challenges in diagnosing clinically inapparent dengue in hyperendemic settings. There is no one best method for diagnosing inapparent dengue. This study demonstrates empirical evidence of inapparent dengue in different settings. Early dengue surveillance in the mosquito population and active serological/virological surveillance in humans can go hand in hand. More studies are required to investigate the epidemiology, seroprevalence, diagnostics, and control of inapparent dengue. It is also crucial to educate the public, health staff and medical professionals on asymptomatic dengue and to propagate awareness, which is important for controlling transmission. [ABSTRACT FROM AUTHOR]