Exploring the trend of age-standardized mortality rates from cardiovascular disease in Malaysia: a joinpoint analysis (2010-2021).

INTRODUCTION: Cardiovascular disease (CVD) is a major health concern worldwide, particularly in low- and middle-income countries. The COVID-19 pandemic that emerged in late 2019 may have had an impact on the trend of CVD mortality. This study aimed to investigate the trend and changes in CVD mortality rates in Malaysia, using age-standardized mortality rates (ASMR) from 2010 to 2021. METHODS: The Malaysian population and mortality data from 2010 to 2021 were obtained from the Department of Statistics Malaysia (DOSM). ASMRs from CVD per 100,000 population were calculated based on the World Health Organization (2000-2025) standard population using the direct method. The ASMRs were computed based on sex, age groups (including premature mortality age, 30-69 years), and CVD types. The annual percent change (APC) and average annual percent change (AAPC) of the ASMR with corresponding 95% confidence intervals (95% CI) were estimated from joinpoint regression model using the Joinpoint Regression Program, Version 4.9.1.0. RESULTS: Throughout the study period (2010-2021), ASMRs for CVD exhibited an increase from 93.1 to 147.0 per 100,000, with an AAPC of 3.6% (95% CI: 2.1 to 5.2). The substantial increase was observed between 2015 and 2018 (APC 12.6%, 95% CI: 5.4%, 20.3%), with significant changes in both sexes, and age groups 50-69, 70 years and over, and 30-69 (premature mortality age). Notably, the ASMR trend remained consistently high in the premature mortality age group across other age groups, with males experiencing higher rates than females. No significant changes were detected before or after the COVID-19 pandemic (between 2019 and 2021), except for females who died from IHD (10.3% increase) and those aged 0-4 (25.2% decrease). CONCLUSION: Overall, our analysis highlights the persistently high burden of CVD mortality in Malaysia, particularly among the premature mortality age group. These findings underscore the importance of continued efforts to address CVD risk factors and implement effective prevention and management strategies. Further research is needed to fully understand the impact of the COVID-19 pandemic on CVD mortality rates and to inform targeted interventions to reduce the burden of CVD in Malaysia.

Impacts of clinical psychiatric posting experience on specialization intention and associated factors among Nursing Science students.

BACKGROUND: Globally, there is increasingly high prevalence of mental disorders across all age groups and social classes with more being projected by 2030, but without commensurate resources for mental health care delivery especially in developing countries. PURPOSE: This study examined the impacts of clinical psychiatric posting on career choice in psychiatry among nursing students in Ebonyi state, Nigeria. METHODS: A prospective cohort research design was used and data were collected using attitude towards psychiatry (ATP), mental illness clinician attitude scale (MICA-4) and researcher developed questionnaires on career choice in pre and post clinical posting approach. This study was conducted between November, 2023 to May 2024. A sample size of 400 students (with data collected before posting and after posting) were involved in the study. Data were coded, cleaned and analyzed using SPSS version 26. McNemar Test was used to determine effects of clinical posting on career choices in psychiatry. Simple and multiple logistic regressions were used to analyze data on determinants of career choices in psychiatry. The hypotheses (Null and alternative hypotheses) were tested at p-value < 0.05. RESULTS: Psychiatric and mental health nursing was one of the least preferred specialty, 21(6%) respondents showed interest before clinical posting and 25(7.1%) after the posting. Commonly preferred specialty was pediatric nursing (20.5%), community health nursing (17.1%) and midwifery (17.7%). McNemer test showed no statistically significant differences in choice of psychiatry before and after clinical posting. Key determinants of career choices were interest in psychiatry (AOR = 16.06(95% CI = 1.10, 14.96) P = 0.009), interest in community services (AOR = 4.01(95% CI = 1.32, 12.20)P = 0.014), family influence(AOR = 13.76(95% CI = 1.74, 108.57)p = 0.013) and job satisfaction(AOR = 0.10(95% CI = 0.03, 0.26)P < 0.001). CONCLUSION: The researcher therefore concluded that clinical psychiatric posting has no significant impacts on career choices in psychiatry among nursing students in Nigeria. Interest of the students, family influence and job satisfaction were significantly associated with career choices among the respondents.

The global estimate of premature cardiovascular mortality: a systematic review and meta-analysis of age-standardized mortality rate.

BACKGROUND: Cardiovascular disease (CVD) is a significant cause of premature mortality worldwide, with a growing burden in recent years. Despite this, there is a lack of comprehensive meta-analyses that quantify the extent of premature CVD mortality. Study addressed this gap by estimating the pooled age-standardized mortality rate (ASMR) of premature CVD mortality. METHODS: We conducted a systematic review of published CVD mortality studies that reported ASMR as an indicator for premature mortality measurement. All English articles published as of October 2022 were searched in four electronic databases: PubMed, Scopus, Web of Science (WoS), and the Cochrane Central Register of Controlled Trials (CENTRAL). We computed pooled estimates of ASMR using random-effects meta-analysis. We assessed heterogeneity from the selected studies using the I2 statistic. Subgroup analyses and meta regression analysis was performed based on sex, main CVD types, income country level, study time and age group. The analysis was performed using R software with the "meta" and "metafor" packages. RESULTS: A total of 15 studies met the inclusion criteria. The estimated global ASMR for premature mortality from total CVD was 96.04 per 100,000 people (95% CI: 67.18, 137.31). Subgroup analysis by specific CVD types revealed a higher ASMR for ischemic heart disease (ASMR = 15.57, 95% CI: 11.27, 21.5) compared to stroke (ASMR = 12.36, 95% CI: 8.09, 18.91). Sex-specific differences were also observed, with higher ASMRs for males (37.50, 95% CI: 23.69, 59.37) than females (15.75, 95% CI: 9.61, 25.81). Middle-income countries had a significantly higher ASMR (90.58, 95% CI: 56.40, 145.48) compared to high-income countries (21.42, 95% CI: 15.63, 29.37). Stratifying by age group indicated that the age groups of 20-64 years and 30-74 years had a higher ASMR than the age group of 0-74 years. Our multivariable meta-regression model suggested significant differences in the adjusted ASMR estimates for all covariates except study time. CONCLUSIONS: This meta-analysis synthesized a comprehensive estimate of the worldwide burden of premature CVD mortality. Our findings underscore the continued burden of premature CVD mortality, particularly in middle-income countries. Addressing this issue requires targeted interventions to mitigate the high risk of premature CVD mortality in these vulnerable populations.

Psychometric Properties of the Self-Efficacy Scale among Undergraduate Students in Malaysia.

BACKGROUND: Self-efficacy (SE) is a person's belief in his or her own capability to perform and accomplish a task that could produce a favourable outcome, despite facing obstacles. This study aimed to confirm the validity and reliability of an SE scale among undergraduate students at the Health Campus of the Universiti Sains Malaysia. METHODS: A cross-sectional study was conducted among the undergraduate students using a self-administered questionnaire. After using a purposive sampling method, 562 students completed the questionnaire. Mplus 8 was employed to conduct the confirmatory factor analysis on the psychometric properties of Bandura's 18-item SE scale with three factors (internal feeling, competing demands and situational). Then, the composite reliability was calculated for each factor. RESULTS: Most of the students were Malay (73.3%) females (79.0%) who exercised 2.62 times a week for an average of 43.37 min per session. The final measurement model was obtained after removing six problematic items, and the model was deemed fit based on several indices [Root Mean Square Error of Approximation (RMSEA) = 0.067, Standardised Root Mean Square Residual (SRMR) = 0.004, Comparative Fit Index (CFI) = 0.924]. The composite reliability values of the three factors were acceptable (0.65 to 0.84). CONCLUSION: The simplified 12-item SE scale with three factors displayed good fit indices with regard to the data, and they were considered to be acceptable for the current sample.

The Incontinence Praying Ability and the Incontinence Quality of Life Questionnaires for Muslim Women: A Confirmatory Study of the Malay Language Versions.

BACKGROUND: The aim of the present study was to determine the validity and reliability of the Malay versions of the Incontinence Praying Ability (I-PA) and the Incontinence Quality of Life (I-QoL) questionnaires among childbearing-aged Muslim women. METHODS: This cross-sectional study included 338 childbearing-aged Muslim women (mean age: 31.1 years; SD = 5.57) who attended clinics at Hospital Universiti Sains Malaysia. Confirmatory factor analysis was conducted to determine the construct validity of the Malay versions of the I-PA and the I-QoL, while composite reliability was used to examine their internal consistency reliability. RESULTS: The hypothesised models of the I-PA and the I-QoL consisted of 10 items with one latent variable and 22 items with three latent variables, respectively. The hypothesised models of the I-PA and the I-QoL did not have good fit. Modifications included co-varying the residual terms for items within the subscales, which resulted in improved fit indices for the I-PA (CFI = 0.976 TLI = 0.961, RMSEA = 0.068) and the I-QoL (CFI = 0.948, TLI = 0.938, RMSEA = 0.063). The composite reliability of the I-PA was 0.93, and the I-QoL ranged from 0.91 to 0.94. CONCLUSION: The Malay versions of the I-PA and I-QoL were considered to be valid, reliable questionnaires measuring incontinence QoL among Muslim women of childbearing age.

Validation of the Malay Version of the Affiliate Stigma Scale among Caregivers of Patients with Mental Illness.

BACKGROUND: Caregivers of patients with mental illness are exposed to stigma. The internalisation of this stigma among caregivers is known as affiliate stigma and can be measured by the Affiliate Stigma Scale (ASS). The aim of this study was to validate the Malay version of the ASS. METHODS: A cross-sectional study was performed from May to December 2017 with 372 caregivers of patients with mental illness. The ASS was first translated into Malay using standard forward and backward translation procedures. The final version of the ASS-Malay (ASS-M) was completed by participants. The data analyses involved assessment of construct validity by exploratory factor analysis, confirmatory factor analysis and construct reliability. RESULTS: The final model of the ASS-M consists of four factors with 21 items, as compared to the original version, which has three factors with 22 items. The results showed that the final model has good model fit based on RMSEA (0.065) and SRMR (0.055) and a satisfactory composite reliability (affective = 0.827, cognitive = 0.857, behaviour = 0.764, self-esteem = 0.861). CONCLUSION: The study showed that the four-factor, 21-item ASS-M model has good psychometric properties. The scale is valid and reliable for measuring affiliate stigma among caregivers of patients with mental illness in Malaysia.

Validation of Malay Version of Body Self- Image Questionnaire-Short Form among Malaysian Young Adults.

BACKGROUND: Body self-image questionnaire-short form (BSIQ-SF) is developed to measure body image perceptions. Due to the cultural, language and environmental differences between western and eastern population, the validity and reliability need to be established. The aim of this study was to determine validity and reliability of Malay version BSIQ-SF. METHODS: A cross-sectional study involved web-based survey was employed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was performed using SPSS version 22 and Mplus 7.3. RESULTS: There were 688 young adults in Malaysia with mean age of 23.67 (SD = 0.188) and mean body mass index (BMI) of 23.34 (SD = 0.27) participated in the study. Exploratory factor analysis performed and the number domains reduced from nine to four, namely 'Negative Affect', 'Attractiveness Evaluation', 'Physical Functionality Awareness' and 'Height Dissatisfaction'. CFA further confirmed the structure of the model with adequate goodness-of-fit values [CFI = 0.927, TLI = 0.913, SRMR = 0.075, RMSEA = 0.053 (95% CI: 0.047, 0.060)]. CONCLUSION: The revised 21-item of the Malay version BSIQ-SF was a valid and reliable instrument to measure body image perceptions among Malaysian young adults.

Knowledge, attitude, and practice regarding malnutrition amongst patients with chronic kidney disease in China: A qualitative study.

BACKGROUND: Chronic kidney disease (CKD) can be complicated by malnutrition, which has adverse implications on patients' health outcomes and quality of life. CKD patients from different sociocultural contexts may have varying perceptions of knowledge, attitudes, and practices of malnutrition. However, information on the perception of malnutrition in patients with CKD is limited. This study aimed to explore and describe the knowledge, attitude, and practice of patients with CKD disease regarding malnutrition. MATERIALS AND METHODS: A qualitative-descriptive design was used. Thirteen participants were selected through a purposive sampling technique among malnourished CKD patients from a hospital in Xi'an Provincial Hospital of Traditional Chinese Medicine between November 2022 and January 2023. Data were collected through face-to-face semistructured interviews until data saturation. All participants were informed about the study. Data obtained were analyzed by content analysis. RESULTS: Three main categories and seven subcategories were extracted from the data analysis: 1) knowledge (basic knowledge acquisition and understanding, knowledge misconceptions, and confusion, nutrition knowledge, and culture collision); 2) attitude (negative attitudes and adverse situations, positive attitude and self-awareness); 3) practice (disadvantageous and passive practice, favorable practice). CONCLUSION: This study provided insight into the knowledge, attitude, and practice of malnutrition in patients with CKD. Our findings can serve as important baseline data for the development of future interventions that can help reduce the risk of malnutrition, slow disease progression, and improve the quality of life in patients with CKD.

Career Intentions and the Determining Factors among Health Science Students: A Systematic Review.

BACKGROUND: Health systemsneed adequate personnelin order to function; improvements in health-care services delivery, and coverage and the enjoyment of standard healthcare as a right, depend on the availability, mixture, quality, and accessibility of the health-care workforce. PURPOSE: This review aimed to synthesize reliable evidence ondetermining factors among health science students' career choices to enhance policy advocacy for better health-care delivery. METHOD: We sourced empirical studies from Scopus, PubMed, ScienceDirect and Google Scholar. From a total of 9,056 researcharticlesfrom 2010 to 2022, 27 studies with a total of 45,832 respondents met the inclusion criteria. RESULTS: The majority of the studies were of medical students; internal medicine was the commonest choice (64.3%), with psychiatry and public health receiving lesser attention. In the four available studies of nursing students, midwifery was not chosen at all. There is a paucity of studies on this all-important concept for nursing students. The determining factors of choice of specialty were in four themes: personal, socioeconomic, professional, and educational/policy. Among the barriers to choosing particular specialties were low prestige among colleagues, stigma, long working hours, and poor public recognition. CONCLUSION: The career choices of health science students do not reflect an adequate mix of health-care team members to meet the health-care needs of the world. Reforms of policy and educational training are needed.

Design of InnoPrimers-Duplex Real-Time PCR for Detection and Treatment Response Prediction of EBV-Associated Nasopharyngeal Carcinoma Circulating Genetic Biomarker.

Nasopharyngeal carcinoma (NPC) is an epithelial tumor with high prevalence in southern China and Southeast Asia. NPC is well associated with the Epstein-Barr virus (EBV) latent membrane protein 1 (LMP1) 30 bp deletion by having its vital role in increased tumorigenicity and decreased immune recognition of EBV-related tumors. This study developed an InnoPrimers-duplex qPCR for detection of NPC blood circulating LMP1 30 bp deletion genetic biomarker for early diagnosis and treatment response prediction of NPC patients. The analytical and diagnostic evaluation and treatment response prediction were conducted using NPC patients' whole blood (WB) and tissue samples and non-NPC cancer patients and healthy individuals' WB samples. The assay was able to detect as low as 20 ag DNA per reaction (equivalent to 173 copies) with high specificity against broad reference microorganisms and archive NPC biopsy tissue and FNA samples. The diagnostic sensitivity and specificity were 83.3% and 100%, respectively. The 30 bp deletion genetic biomarker was found to be a good prognostic biomarker associated with overall clinical outcome of NPC WHO type III patients. This sensitive and specific assay can help clinicians in early diagnosis and treatment response prediction of NPC patients, which will enhance treatment outcome and lead to better life-saving.