KNOWLEDGE AND ATTITUDE TOWARDS GERIATRIC HEALTH AND THE ASSOCIATED FACTORS AMONG MEDICAL STUDENTS OF INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA

Comprehensive care towards geriatric health can be sustained by having good knowledge and attitude among the providers. Hence, this research aims to measure the knowledge and attitude of the final year medical students towards geriatric health and determine the associated factors. A cross-sectional study was conducted among the students using structured questionnaires of Geriatric-Attitude-Scale and Palmore-Facts-on-Aging-Quiz was used. Data was analysed using Mann Whitney U test, Chi square test and Spearman correlation coefficient analysis for the association between the score and studied variables. Median score of students’ knowledges is at 14.00 (IQR 13.00) and mean score for attitude is 48.52 (+5.53) respectively. Place of residence (P= 0.01) and presence of grandparents (P= 0.04) were the significant factors that affected knowledge of students towards geriatrics while number of siblings (P= 0.05) influenced attitudes of students towards geriatrics. Improvement of current geriatric curriculum should be done with more refined implementation of gerontology course in the basic medical learning.

ASSESSING COMPLIANCE WITH SMOKE FREE LAWS IN BATU BURUK, TERENGGANU: A DIRECT OBSERVATION

Batu Buruk beach has been gazetted as a non-smoking zone by the Minister of Health under the initiative of Terengganu state government via their program known as ‘Terengganu Bebas Asap Rokok’ (TBAR). The smoking bans at Batu Buruk was enforced in order to preserve and protect the public from the dangers of cigarette smoke as well as to keep the city's environment clean and healthy. The objectives of this study were to assess the status of compliance to legislation and identify the potential aspects of violations in Batu Buruk, Terengganu, a gazetted smoke-free area. A cross-sectional study using direct observation was conducted includes all indoor and outdoor public areas in Batu Buruk Beach. Data were collected using a standard checklist which was constructed based on the provisions of the law governing exposure to tobacco smoke as stated in Control for Tobacco Products Regulation (CTPR) 2004. The study revealed that the average overall compliance with smoke-free policy was low (66.2%). The average compliance for indoor (67.4%) was higher as compared with outdoor (58.9%). Thirteen smokers were discovered smoking outdoor in the area during the study. None of the owners provides smoking aid at their premises. Although the beach has been gazetted as a non-smoking zone for more than two years, it is disappointing that overall compliance was still minimal and smoking activities are still happening in the area. Along with intense health promotion activities, continuous enforcement, close monitoring and periodic evaluation would improve and ensure the successfulness of the programme.

THE INFLUENCE OF MORAL JUDGMENT ON PHYSICIANS' PRESCRIPTION BEHAVIOUR

Pharmaceutical promotion towards physicians’ prescription behaviour is strongly interrelated. Identifying and addressing the ethical challenges in physicians’ prescription behaviour to increase the ethical predisposition of prescribing medicines is prioritized in global health and development plans. Hence, the importance of ethics in the professionalism of healthcare practitioners is now a growing concern. The main objective of this research is to investigate the influence of moral judgment on physicians' prescription behaviour. A survey has been conducted among 152 medical practitioners from private healthcare facilities in the metropolitan area of Kuala Lumpur and Selangor states of Malaysia. The principal component analysis method in EFA and structural equation modelling technique in CFA has been used to analyze the data and validate the model. The study found that physicians’ moral equity factor has a significant and positive influence on physicians’ prescription behaviour whereas their relativism and contractualism factors were not significant. The empirical evidence obtained from this study would make significant contributions to advancing the current knowledge of ethical prescription behaviour. Recommendations to physicians for more ethical prescription practices have been discussed at the end of this paper.

SPATIAL ANALYSIS OF CERVICAL CANCER INCIDENCE IN IRAQ DURING 2010-2015

Cervical cancer is the most common cancer in Iraq. This study aimed to examine the spatial pattern and high-risk clusters of cervical cancer in different areas of Iraq (except the Kurdish region) during the period 2010-2015. The age-adjusted incidence rates (AAIRs), age-specific incidence rates (ASIRs), and annual percent changes (APCs) were calculated for 2010–2015. We used three techniques of spatial statistical analysis which are Global spatial autocorrelation, Getis-Ord Gi* statistic, and Anselin Local Moran’s statistic to investigate spatial clustering and outliers. Over the period 2000-2015, 1037 cases were diagnosed with AAIR of incidence of (3.521 per 100,000). Depending on AAIRs, we found cervical cancer incidence was highest (8.212 per 100,000) in the age group of 60-69 years old. The APC of cervical cancer age-specific rates has significantly risen for the age groups 60-69 only. We identified spatial high-risk clusters for incidence. The cluster was mainly located in the center of Iraq (Baghdad, Najaf, Kerbala, and Babil provinces), the central-eastern part of Iraq (Diyala province), and the southern part of Iraq (Basrah province). While the provinces in the northern and northeastern parts of Iraq, as well as the western province, had relatively lower AAIRs from cervical cancer. A spatial cluster pattern for the incidence of cervical cancer in Iraq was revealed, which will be valuable for improving the allocation of health resources in Iraq.

PREVALENCE OF TYPE 2 DIABETES MELLITUS AND ITS ASSOCIATION WITH SOCIOECONOMIC STATUS IN KANDAHAR CITY: A CROSS-SECTIONAL STUDY

Diabetes mellitus is a chronic disease with a life long duration and generally of gradual progression. Beside the upward trend in the prevalence rate, diabetes and its complications also have a significant economic impact on countries and their health systems. This study was aimed to assess the prevalence of type 2 diabetes mellitus (T2DM) and its association with socioeconomic status (SES) in the urban population of Kandahar city. A population-based cross-sectional study was conducted from January 2019 to May 2019 in the urban area of Kandahar province. A total of 1308 subjects, 837 (64%) women and 471 (36%) men, were included in the study. Data on sociodemographic characteristics, medical history, dietary intake and physical activity were collected in a standardized questionnaire. Diagnosis of diabetes was established according to the WHO criteria. Mean age (SD) was significantly higher in men than in women (50.3 (14.4) vs. 44.9 (11.4) years). The difference in BMI was not significant between men and women (28.1 vs. 28.7 kg/m2). Majority of the study population was aged 40-54 years (46.3%), married (86.7%), illiterate (87.4%), and obese (39%). 6.6% were tobacco smokers, higher in men (13.6%) than in women (2.6%). The prevalence of diabetes mellitus, hypertension, obesity and central obesity was 15.2%, 25.5%, 39%, and 67.1%, respectively. In this study population, it could be suggested that socioeconomic factors are associated with T2DM and socioeconomic status is worth further investigation nationwide to properly understand the role of SES.

SMOKING BEHAVIORS AND ATTITUDES TOWARDS THE SMOKE-FREE CAMPUS POLICY: A SYSTEMATIC REVIEW

We conducted this systematic review to document the published literature related to smoking behaviors and attitudes towards the smoke-free campus policy. Studies on universities that had implemented the smoke-free campus policy were included in this review. The search for published articles from January 2010 to December 2020 involved three main electronic databases: Ovid MEDLINE, ScienceDirect, and Scopus. We searched the databases with the following Boolean string: [(smoke-free OR tobacco-free) AND (campus OR university OR college) AND (knowledge* OR attitude* OR practice*)]. Seventeen studies were included in this review. The majority (n = 8) were from the United States, followed by Saudi Arabia (n = 2) and one each from Israel, Lebanon, Australia, Canada, the United Kingdom, Spain, and China. Eight studies reported a positive impact of the policy on smoking behavior (plan to quit smoking, attempt to quit smoking, reduce smoking). However, 11 studies reported that respondents were still exposed to second-hand smoke and that cigarette butts were still scattered around the university area. Nine studies reported negative attitudes towards smoking, and seven of 12 studies reported positive attitudes towards the policy. Overall, the smoke-free campus policy had mixed impacts. Nevertheless, we found that attitude towards a smoke-free campus and smoking behavior has a good impact.

A QUANTITATIVE STUDY ON EVIDENCE OF VARICOSE VEINS AMONG DIFFERENT OCCUPATIONAL BACKGROUNDS IN THE CITY OF MOSUL IRAQ

The present study focuses on evidence of varicose veins (VV) in subjects on different parameters like occupations, gender, and smoking habits etc. in the City of Mosul, Iraq. A quantitative study was performed at Mosul Teaching Hospital between November 2019 and February 2020. Total sample size was 1052 in numbers. Subjects were mainly among different occupations like Nurses, address, Policemen, and teachers. Selected subjects were physically examined on general parameters who agreed to engage in this study. The rate of overall VV prevalence among different occupational backgrounds in the City of Mosul was found to be 200/1052 (19%). It was observed that the percentage of men (49%) and women (51%) and the mean age of the participants was (39.1+3.1). The entire study analyses the effects of various parameters like obesity (BMI), gender, age, smoking habit, and alcohol consumption etc on prevalence of VV. Additionally study also concludes that more occupational standing which has significant contributions in prevalence of VV can be prevented by sitting or walking at frequent intervals whenever is appropriate. So, by improving clinical practices the incidences of vascular diseases may be reduced.

DETECTION OF SARS-COV-2 FROM SURFACE OF PATIENTS’ LEFTOVER FOOD PACKAGES AT A COVID-19 QUARANTINE CENTRE

In healthcare facilities, food waste and its packaging are mostly managed as non-infectious general waste. However, waste from SARS-CoV-2 positive patients, are treated as medical waste as they may be contaminated by the virus. We investigated the possibility of SARS-CoV-2 contamination from positive COVID-19 patients to their leftover food packages at a quarantine centre. Food packages surface was swabbed using prewetted cellular foam, placed into viral transport media and analysed using real time reverse transcription polymerase chain reaction. SARS-CoV-2 RNA was detected in two samples (4.5%) from asymptomatic patients who were at day-2 positive SARS-CoV-2 with cycle threshold (Ct) value (RdRp/E), 34.96/35.72 and 37.1/36.48 respectively. Detection of SARS-CoV-2 supports that there is contamination to the waste. These poses risk of exposure as SAR-COV-2 survive on the surfaces, thus, safe handling and disposal of food waste should be maintained. However, further study involving viral culture should be explored to determine the viability of the SARS-CoV-2 from leftover food packages

OUT OF POCKETS SPENDING AMONG BREAST CANCER WOMEN RECEIVING OUT-PATIENT TREATMENT IN A TERTIARY TEACHING HOSPITAL IN KUALA LUMPUR MALAYSIA

There is lack of information about the estimates of out-of-pocket (OOP) spending among women diagnosed with breast cancer and effects on their family’s financial situation in Malaysia. This study is to determine estimates of out-of-pocket spending among women with breast cancer in HCTM and identify factors that significantly associated with high OOP spending. This cross-sectional study assessed out of pockets spending among breast cancer women in HCTM for breast cancer as out-patient. Sampling unit is a woman who has been diagnosed breast cancer and receiving treatment and follows up in HCTM. A 189 breast cancer women were identified for a 6 months period between July to December 2017. Only those patients who received at least 6 months treatment in HCTM were recruited. Out of pocket spending for treatments for adjuvant therapy and follow up, consultations with other practitioners, care taker fee, equipment and traditional/complementary treatment were collected by face-to-face interview using structured questionnaires. The dependent variable was OOP, analyzed using SSPS v23 for descriptive analysis and both univariate and multivariate analysis.173 out of 186 women were recruited and only 172 were considered for cost calculation (participation rate, 93.0 %) in this study. Total out of pocket spending for breast cancer treatment in 2017 was RM 1,037,446.23 with women’s total means out of pocket spending was RM6031.66 (SD =/- 495.58). The highest percentage of cost component contributed by cost of adjuvant therapy, RM334,056.00 (30.2%) followed by traditional/complementary medicine, RM268,278.00 (24.3%), other expenses/private hospital, RM224,887.00 (20.4%), transportation RM 79,772.52 (7.2%), chemotherapy RM67,300.00 (6.1%), dressing RM54,850.00 (5.0%), equipment/prosthesis RM50,550.00 (4.6%) and care taker cost RM24,661.43 (2.2%). Out of pockets costs from breast cancer in HCTM for 2017 are a burden for women and their family. Financial support provides assistance to the out-of-pocket spending in breast cancer treatment and is able to reduce the financial burden among patients and families.

KNOWLEDGE, ATTITUDE, AND PRACTICE REGARDING COVID-19 AMONG PRIMARY SCHOOL STUDENTS IN KEDAH, MALAYSIA: A CROSS-SECTIONAL STUDY

Since, children are affected by the coronavirus in the same way as adults, examining the children's knowledge, attitude, and practice (KAP) on COVID-19 would help in building a pandemic-resilient society. Therefore, the present study aims to investigate the knowledge, attitude, and practice regarding COVID-19 among primary school students. This online, cross-sectional study was conducted from May 18 to 20, 2021 among students aged 9 to 12 years old and having access to WhatsApp messenger on their smartphones. The study participants were selected from 17 primary schools in Kedah, Malaysia by convenience , and the Google form invitation link was shared by the schools’ guidance and counselling teachers. Analysis revealed higher females (53%) and majority aged 12 years (27.8%) out of 1207. 56% of respondents possessed good knowledge on COVID-19 (M=4.21, SD=1.16) with 73.75% overall correct responses. Children demonstrated positive attitudes (M=3.64, SD=0.67) but had a higher perceived risk of becoming infected with COVID-19 (M=3.60, SD=1.23). For practices, low scores were discovered on avoid visiting crowded places (M=2.51, SD=1.22). Knowledge has a significant effect on children’s attitudes (Beta=0.17, p<0.001) and practices (Beta=0.25, p<0.001). Comparatively, females scored lower COVID-19 knowledge than males (Beta= -0.01, p=0.65). While age was significantly associated with increased knowledge (Beta=0.13, p<0.001), whereof, year 6 students (12 years; M=4.69, SD=1.23) scored the highest. Since knowledge is a critical tool in comprehending any phenomenon, and influencing one’s attitude and practice towards it, much effort is warranted to enhance the effectiveness of government strategies and mitigate the COVID-19 outbreak.