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Breast cancer awareness and factors associated with breast screening uptake among women in Kelantan
Get PDFBackground: Breast cancer remains a significant public health challenge, both globally and in Malaysia. Late presentation of breast cancer often results in lower survival rates and higher mortality due to the advanced stage of the disease at diagnosis. Early detection through screening methods is crucial for improving survival rates. Despite this, the breast screening uptake in Kelantan remains low.
Objective: To investigate breast cancer awareness, perceived barriers to healthcare-seeking, breast screening uptake and factors associated with breast screening uptake among women in Kelantan.
Methods: A cross-sectional study was conducted using convenience sampling to select 242 women in Kelantan between November 2023 and June 2024. The Breast Cancer Awareness Measure Malaysia (BCAM-M) questionnaire, which consists of 60 items across six domains: sociodemographic, awareness of breast cancer signs and symptoms, awareness of risk factors, barriers to healthcare-seeking, breast self-examination practices, and breast screening uptake, was used for data collection. This study defined breast screening uptake as having ever undergone a clinical breast examination (CBE). Descriptive statistics and logistic regression analyses were performed to identify the factors associated with breast screening uptake.
Results: Of 242 participants, 59.5% (95% CI 53.28, 65.73) were aware of breast cancer signs and symptoms, 17.4% (95% CI 12.55, 22.16) were aware of age-related risks, and 22.7% (95% CI 17.41, 28.04) were aware of breast cancer risk factors. Perceived barriers to healthcare-seeking were reported by 10.3% of participants, and 80.2% resided within five kilometres of a healthcare facility. Additionally, 40.5% (95% CI 46.0, 51.0) practised BSE regularly, 60.3% (95% CI 54.12, 66.54) had undergone a CBE, and 25.9% (95% CI 17.79, 34.01) of women aged 40 years and above had undergone a mammogram. Factors significantly associated with breast screening uptake were being married (AOR 4.78; 95% CI 2.20, 10.40), being divorced (AOR 4.99; 95% CI 1.35, 18.50), healthcare-seeking within two months (AOR 3.68; 95% CI 1.98, 6.85), ever heard of CBE (AOR 7.41; 95% CI: 2.55, 21.54), and residing within five kilometres of a healthcare facility (AOR 2.39; 95% CI 1.17, 4.89).
Conclusion: The findings help health sectors design tailored interventions for specific identified groups to increase breast cancer awareness and screening uptake. Implementing these targeted strategies could enhance early detection, higher survival rates, and reduce breast cancer mortality
Prevalence and factors associated with serologically confirmed yaws infection among orang asli population in Hulu Terengganu, Malaysia
Get PDFBackground: Yaws, caused by Treponema pallidum subspecies pertenue, is a major public health concern in tropical regions, affecting primarily children and marginalized communities, such as the Orang Asli in Hulu Terengganu, Malaysia. This reemerging neglected tropical disease poses a challenge to the global elimination efforts endorsed by the World Health Organization (WHO), highlighting the need for local epidemiological data to guide eradication strategies, thereby informing targeted interventions aligned with WHO's elimination goals.
Objectives: To assess the prevalence and identify associated factors of serologically confirmed yaws infections among the Orang Asli population in Hulu Terengganu, Malaysia.
Methodology: Using secondary data from the Terengganu State Health Department's Event Based Surveillance Database, a cross-sectional analysis was performed on 249 Orang Asli persons. The relationships between yaws infection and characteristics like age, gender, marital status, and comorbidities were investigated using Multiple Logistic Regression.
Result: The study found that the prevalence of yaws infection in Hulu Terengganu, Malaysia is 17.3%, (95% CI: 0.128, 0.225) or 17,300 per 100,000 population in 2020. Age was the only significant predictor of yaws infection, with an adjusted odds ratio (AOR) of 0.977 (95% CI: 0.959, 0.995; p=0.012) per additional year, demonstrating that the risk of infection is decreasing with increment of age. No significant associations were found for gender, marital status, education level, and employment status with yaws infection.
Discussion and Conclusion: The high prevalence of yaws infection among Orang Asli in Hulu Terengganu highlights the need for focused public health interventions, enhanced surveillance, and research efforts, particularly within indigenous and marginalized communities. The study’s findings support the need for implementation of targeted prevention and treatment programs towards the risky population in Malaysia
Time to non-persistence of sodium-glucose co-transporter 2 inhibitors and its prognostic factors among patients with type 2 diabetes in Universiti Malaya Medical Centre
No full textIntroduction: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have emerged as a new guideline-directed medical therapy (GDMT) for managing cardiovascular-kidney-metabolic (CKM) syndrome. Understanding the pattern of SGLT2i treatment persistence can help prevent unwarranted non-persistence of this GDMT and simultaneously, develop interventions to mitigate its negative consequences. This study aimed to evaluate the treatment persistence time on SGLT2i and to identify the prognostic factors for SGLT2i persistence time among adults with type 2 diabetes (T2D) at the Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia. Methods: This was a retrospective cohort study involving adults aged 18 years and above with T2D who were initiated with SGLT2i between January 2016 and December 2021. The study outcome was time to SGLT2i non-persistence, defined as the time to first 90-day gap after the estimated end date of pharmacy supply. Kaplan-Meier estimate was used for median SGLT2i persistence time, life table analysis was used for obtaining persistence rates and Cox Proportional Hazard regression was used to identify the prognostic factors for the time to treatment persistence. Results: This study involved 602 adults with T2D, with the majority being male (52.0%). The mean age of patients was 60.1 years (standard deviation (SD) = 10.7). The median treatment persistence time was 40.5 months (95% confidence interval (CI): 34.6, 54.0). Treatment persistence rates reduced from 94.5% at 6 months to 78.0% at 1 year, and 62.7% at 2 years. Patients with baseline estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2 had an adjusted hazard ratio (AHR) of 1.57 (95% CI 1.20, 2.04; p = 0.001) for non-persistence of SGLT2i, compared to those with eGFR ≥60 ml/min/1.73m2. The use of DPP4i had an AHR of 0.75 (95% CI 0.57, 0.98; p = 0.042) for non-persistence of SGLT2i. Conclusions: Half of the patients discontinued SGLT2i within 3.5 years. Those with baseline eGFR <60 ml/min/1.73m2 and without concomitant DPP4i use were significantly associated with SGLT2i non-persistence. This study provides valuable insights into the time to SGLT2i non-persistence in adults with T2D and the underlying factors to facilitate more personalised diabetes management to optimise health outcomes
Characterization Of Hemicellulose-Carboxymethyl Cellulose Blend Biofilm Fabricated From Oil Palm Trunk
Get PDFThe use of synthetic polymers is not essential due to environmental issues. Hence, the green materials have been extracted from biomass waste to produce a biopolymer in order to replace the synthetic polymer. Oil palm trunk (opt) is a solid waste that is abundantly available throughout the year. Due to this concern, hemicellulose film (hc) and carboxymethyl cellulose (cmc) were successfully prepared from oil palm trunk (opt) in this research study. Hc and cmc were blended by the solution casting method to produce blend biofilm at 0%, 20%, 40%, 60%, and 80 % hc and cmc loading. The cmc used was compared between commercial cmc (cmc-c) and the extracted opt cmc (cmc-t). The raw material and biofilm sample were characterized by chemical composition, fourier transmission infrared spectroscopy (ftir), energy-dispersive x-ray spectroscopy (sem-edx), x-ray diffraction (xrd), thickness, visual transparency, contact angle, solubility, moisture content, tensile strength, scanning electron microscopy (sem), differential scanning calorimetry (dsc), thermogravimetric analysis (tga) and biodegradability analysis. According to the results, chemical composition showed that the vascular bundle had more cellulose while the parenchyma had more hc. Moreover, the ftir of parenchyma and vascular bundle were successfully identified. Then, the sem-edx and xrd revealed the element in cmc, and the crystallinity of cellulose reduced when the chemical structure was interrupted by the addition of carboxymethyl group. Then, the result of hc-cmc blend biofilm revealed that the thickness increased while the visual transparency contact angle decreased
Understanding Teachers' Use Of Humor In The Efl Classroom: A Case Study In Guilin, China
Get PDFHumor, as a complex trans-disciplinary phenomenon involving linguistics, psychology, sociology, and anthropology, has been challenging to establish a clear role in education. Language instructors may consider humor as a teaching tool but not a core of teaching, although researchers and practitioners have verified that humor has multiple functions and benefits in language learning. While its potential for facilitating l2 development and its importance in the lives of l2 users is steadily gaining recognition, but a discrepancy exists between the evidence of humor's benefits and its limited use in practice. Previous studies examined the benefits of the use of humor in language classrooms, but few have queried a deep understanding of the role of humor from teachers’ perspectives. Addressing how and why chinese efl teachers elect to integrate or abstain from using humor in the classroom is imperative to elucidating how localized constructs of appropriateness and efficacy shape instructional choices within sociocultural contexts. This qualitative case study explores the use of humor in chinese efl classes and thus hopes to offer inspiration on the implications of using humor in teaching english. This study purposefully selected three teachers in a private secondary school in guilin, china, based on the teachers’ years of teaching and research convenience. I
Proportion and factors associated with severe zoonotic malaria infection in Pahang from 2011 until 2022
No full textIntroduction: Malaria remains a global public health challenge, with zoonotic malaria caused by the Plasmodium knowlesi parasite posing a significant threat in Southeast Asia, particularly in Malaysia. Severe zoonotic malaria, a disease stage characterized by life-threatening complications, is a major concern. This study aims to determine the proportion and factors associated with severe zoonotic malaria infection in Pahang, Malaysia, from 2011 to 2022.
Methodology: This cross-sectional study utilized secondary data from the VEKPRO malaria database, including 487 zoonotic malaria cases reported in Pahang between 2011 and 2022. Descriptive statistics were employed to determine the proportion of severe cases of zoonotic malaria, while multiple logistic regression identified factors associated with severe infection of zoonotic malaria.
Results: Among the 487 cases analyzed, 97 (19.9%) were classified as severe zoonotic malaria infections, and 390 (80.1%) were uncomplicated. Key factors significantly associated with severe infection included age, occupation, and delay in diagnosis. Individuals over 60 years old had a significantly higher risk of severe infection (Adjusted OR: 18.49, 95% CI: 2.17–157.59) compared to those under 15. Forest-related occupations were also a significant risk factor (Adjusted OR: 2.21, 95% CI: 1.32–3.71) compared to non-forest-related jobs. Additionally, a diagnosis delay of more than 4 days substantially increased the risk of severe zoonotic malaria (Adjusted OR: 5.18, 95% CI: 2.65–10.14).
Conclusions: The high proportion of severe zoonotic malaria cases in Pahang underscores significant public health concerns. Critical risk factors such as older age, forest-related occupations, and delayed diagnosis require targeted public health interventions. Enhancing diagnostic facilities and ensuring prompt healthcare access, especially in rural areas, are crucial to reducing the severity of zoonotic malaria
The Impact Of Ceo Characteristics And Ownerships On Risk-Taking Behaviour Among Publicly Listed Family Companies In Malaysia
Get PDFThis study aims to examine the effects of chief executive officer (CEO) characteristics and CEO ownership on the risk-taking behaviour among publicly listed family companies in Malaysia. Risk-taking behaviour can be examined by employing the debt-to-equity (D/E) and debt-to-asset (D/A) ratios as measurement variables. The characteristics of a CEO are assessed based on factors such as the age, level of education, gender, and generational of the CEO. CEO ownership level is measured by CEO ownership. Feasible generalized least squares (FGLS) are adopted for the analysis of debt-to-equity ratio (D/E) and debt-to-asset ratio (D/A). By analysing a sample of 65 Malaysian family companies traded on the Bursa Malaysia during the period of 2014 till 2020, the findings show that CEO undergraduate degree, CEO postgraduate degree and CEO generation is significantly related to risk-taking behaviour using debt-to-equity ratio (D/E). Whereas, CEO gender, CEO undergraduate degree and CEO professional qualification is significantly associated to risk-taking behaviour using debt-to-asset ratio (D/A). This study provides evidence to all the companies hiring CEOs that the educational background of CEOs plays a crucial role in explaining the variances in risk-taking behaviour observed across family-owned businesses. This finding aligns with the principles of the upper echelons theory (UET). It is encouraged for the future research to increase the sample size to obtain a more accurate result. The present study provides practical evidence to the academicians, policymakers specifically in Malaysia and all related parties in emerging economies
Hybrid Deep Networks Based On Periodshift Cosine Annealing For Customer Retention Prediction In Telecom Industry
Get PDFIn the dynamic landscape of Customer Retention Prediction (CRP), the
imperative to strategically direct marketing and promotion efforts towards targeted
customers has never been more crucial. Identifying potential churn indicators and
continually exploring innovative retention methods becomes paramount. However, a
major challenge is customers terminating their services are rarely known among the
loyal ones leading to an imbalance problem. Conventional Machine Learning (ML),
with its prevalent reliance on feature extraction and data sampling methods, including
cost-sensitive techniques, grapples with issues such as overfitting, computational
complexity, and an undue emphasis on rare cases. Deep Learning (DL) techniques
applied to CRP is promising for automatic feature extraction compared to the
handcrafted method used in ML. However, non-cost-sensitive nature, appropriately
chosen Learning Rate (LR) for better convergence, and quality feature learning in DL
models still pose challenges. This thesis introduces a Class Imbalance Ratio Weight
(CIRW) designed to tackle the imbalance problem in DL classifiers without incurring
additional computational costs or loss of data symmetry. Additionally, it proposes a
novel Period-Shift Cosine Annealing Learning Rate (ps-CALR) method to address LR
dynamics during DL model training, thereby enhancing generalization. Finally, a
hybrid DL model, combining an improved multilayer perceptron and a onedimensional
convolutional neural network, is developed to learn improved features for
customer retention analysis
Mobilising Erp In A Gbs Company In Malaysia: An Interpretive Case Study
Get PDFIn today’s dynamic global business landscape, the mobilisation of Enterprise Resource Planning (ERP) systems has become a critical organisational challenge, particularly in Global Business Services (GBS) setting. This interpretive case study delves into the complex dynamics of ERP mobilisation within a multinational manufacturing company based in Malaysia from 2019 to 2023. Through a comprehensive exploration of the case, this study aims to shed light on the complex interplay between technological integration, organisational change, and the responses of key actors, specifically employees involved in the ERP system mobilisation. Drawing on Actor-Network Theory (ANT) as the primary theoretical framework, this study investigates how ERP systems become active actors within the network of the organisation. It goes beyond traditional notions of technology adoption and highlights the roles played by both human and non-human elements of actors in shaping the mobilisation process. The study unveils the progression of ERP system mobilisation within the case company disguised as MOLECULE which has MOLECULE’s GBS as its GBS centre. Recently, this company went through a merger and acquisition agreement
Identification And Characterisation Of Enoyl-Coa Hydratases (Phaj/Maoc) From Non-Mcl Pha Accumulating Bacteria For The Production Of P(3hb-Co-3hhx) Copolymer In Transformant Strains
Get PDFPolyhydroxyalkanoate (PHA) is a biodegradable plastic produced naturally by microorganisms, where it serves as carbon storage and is completely biodegradable in the natural environment. There are two types of PHA, which are short-chain-length PHA (SCL-PHA), consisting of monomers with 3 to 5 carbons, and medium-chain-length PHA (MCL-PHA), consisting of monomers with 6 to 14 carbons. The poly[(R)-3-hydroxybutyrate-co-(R)-3-hydroxyhexanoate] [P(3HB-co-3HHx)] copolymer is composed of both SCL- and MCL-PHA, which has a close resemblance to some conventional plastics and displays promising potential as a substitute for non-biodegradable plastics such as single-use plastic. Enoyl-CoA hydratases (PhaJ/MaoC) are the enzymes essential in the β-oxidation cycle of fatty acid metabolism that can increase the supply of 3HHx monomer compositions in the production of the copolymer. The properties of the copolymer may be altered by varying the 3HHx molar composition. To date, there is a lack of effective enoyl-CoA that can increase the supply of 3HHx monomer to produce P(3HB-co-3HHx); therefore, this study aims to identify and characterise more effective enoyl-CoA hydratases to overcome this problem. In this study, the bioinformatic analysis was done to screen for functional PhaJs or MaoCs from non-MCL-PHA accumulating bacteria such as Burkholderia sp. USM, Jeongeupia sp