Correlates and Consequences of Delayed Marriage in Malaysia

This paper aims to examine the correlates of age at first marriage and the consequences of late marriage. Data for this paper were drawn from the 2014 Malaysian Population and Family Survey. Simple cross-tabulation and multiple classification analysis were used for the analysis. Age at marriage of women varied across socio-economic groups. Among the ethnic groups, the Other Bumiputera entered marriage earliest, followed by the Malays, Indians and Chinese. Age at marriage was positively associated with urbanisation, educational level, and women’s autonomy in marriage. The assumption of modern norms and ideas, and escalating cost of marriage are important determinants of marriage postponement. Late marriage has a direct impact on demographic outcomes, resulting in ultra-low fertility for some groups of the population. Marriage postponement has positive socio-economic outcomes for individuals. However, postponing marriage beyond the prime reproductive age may result in some reproductive health problems.

Reliability Testing of Self-Care of Heart Failure Index v6.2 Chinese Instrument Among Heart Failure Patients

Objective: Self-Care of Heart Failure Index (SCHFI) v6.2 Chinese is an instrument used to assess the ability of self-care behaviour among heart failure patients. It has been validated in Taiwan, however, it is yet to be validated in Malaysia. As a multi-ethnic country, Chinese language has been one of the major languages in Malaysia. Therefore, this study was conducted to examine the reliability of Self-Care of Heart Failure Index (SCHFI) v6.2 Chinese among Malaysian population. Design: A successive independent sample design was used throughout a 4-months data collection period. Setting: Eighty heart failure patients from University of Malaya Medical Centre and National Heart Institute were recruited through purposive sampling. The two hospitals were chosen because they have specialized heart clinics that eased the data collection. The out-patients were screened by the cardiologists for their eligibility to participate in this study. Measures: The samples were administered with SCHFI v6.2 Chinese. The item endorsement index, internal consistency and item-total correlation of SCHFI v6.2 Chinese were examined. Results: The maintenance subscale of SCHFI showed a low internal consistency (Cronbach α = .52) while the management and confidence subscales showed an acceptable internal consistency (Cronbach α = .67 and .90 respectively). Conclusion: SCHFI v6.2 Chinese is a reliable instrument to be used among the Malaysian population.

HEALTH-RELATED QUALITY OF LIFE (HRQoL) OF ACADEMICIANS IN PUBLIC UNIVERSITIES, MALAYSIA

This empirical paper presents findings from a study concerning the Health-Related Quality of Life (HRQoL) of academicians in Malaysian publicly-funded universities. The main objective of the study was to compare the Health-Related Quality of Life (HRQoL) of the academicians in the selected public universities with the key indicators of the overall and the eight health domains of general Malaysian population norms. A structured e-mail survey was created that includes a link to the validated Short Form 36 (SF-36) items. An e-mail was sent to all respondents of nine randomly selected public universities using registered organisational e-mail to collect the data. Descriptive analysis was used to analyse the data. The percentage of responses was 34.55% and 1235 data were deemed to be usable. The ratio of men to women was 1:1.42. The overall mean score of the Health-Related Quality of Life (HRQoL) in the study was juxtaposed with the overall mean score of the recommended Malaysian general population norms of 65.0. The accumulated score was 50.60, which is lower than the recommended value. All mean scores of the eight-health domain were also lower than recommended mean scores of the general Malaysian population for each health domain. Moreover, gender analysis indicated that male academicians had higher Health-Related Quality of Life (HRQoL) for all the health domains except for Role-Physical (RP) and Social Functioning (SF). Given the lower Health-Related Quality of Life (HRQoL) among academicians than the general population, fair attention should be given by the government and policy-makers to the state of their health, physically and mentally, to ensure continuous improvements in education.

DEVELOPMENT AND CONSTRUCT VALIDATION OF QUESTIONNAIRE ASSESSING THE ADULT IMMUNISATION PERCEPTIONS AMONG MALAYSIAN POPULATION

Introduction: Immunisations are one of the most effective public health interventions, reducing or eliminating the burden of many infectious diseases. This study aims to establish the construct validity of a newly developed adult immunisation perceptions questionnaire among Malaysians. Methods: The Adult Immunisation Perceptions-Questionnaire (AIP-Q) was created following literature reviews on The Health Belief Model. Primarily, 64 questions were pooled, followed by face validity by experts, pretested via 20 healthcare personnel and later translate into the Malay language. A total of 305 respondents were selected for the construct validation process. Varimax rotation method used in the analysis for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) done using AMOS software. Results: Ten constructs were produced as predicted in EFA: health believes, experience, knowledge, attitude, perceived severity, perceived susceptibility, perceived benefits, perceived barriers, and 2 cues for action. Thirteen items with low factor loading and unrelated to the recovered domains were removed from being included in CFA. In path analysis, the scale fitted ?2/df=1.943 (n=305) =p<0.001, CFI=0.908, IFI=0.909, TLI=0.901 and RMSEA=0.056. Strong factor loading was found across the final items, ranged from 0.53 to 0.94 with a good reliability test (Cronbach Alpha, AVE and CR values) for all constructs. Conclusion: The final AIP-Q consists of 10 domains with 45 items that give a promising psychometric property. This questionnaire can measure the perceptions of adult immunisation among the Malaysian population and can be utilized for the nationwide study.

Genetic Testing for Cancer Risk: Is the Community Willing to Pay for It?

With the increasing number of cancer cases worldwide, genetic testing for familiar cancers seems inevitable, yet little is known on population interest and the monetary value for cancer genetic risk information. The current study aimed to determine the willingness to undergo and pay for cancer genetic testing among the Malaysian population. A self-administered questionnaire was distributed to cancer patients and their family members in the oncology and daycare units in several government hospitals. Of 641 respondents (354 patients, 287 family members), 267 (41.7%) were willing to undergo cancer genetic testing. The median that respondents were willing to pay was USD 48.31 (MYR 200.00) IQR USD 96.91 (MYR 400), while 143 (22.3%) respondents were willing to pay a shared cost with the insurance company. Regression analysis identified independent positive predictors of willingness to pay as respondent’s status as a family member, high education level, and willingness to undergo cancer genetic testing in general, while in patients, female gender and high level of education were identified as independent positive predictors. Generally, the population needs more information to undergo and pay for cancer genetic testing. This will increase the utilization of the services offered, and with cost-sharing practices with the provider, it can be implemented population-wide.

Evidence of new intragenic HBB haplotypes model for the prediction of beta-thalassemia in the Malaysian population

This study sought to determine the potential role of HBB haplotypes to predict beta-thalassemia in the Malaysian population. A total of 543 archived samples were selected for this study. Five tagging SNPs in the beta-globin gene (HBB; NG_000007.3) were analyzed for SNP-based and haplotype association using SHEsis online software. Single-SNP-based association analysis showed three SNPs have a statistically significant association with beta-thalassemia. When Bonferroni correction was applied, four SNPs were found statistically significant with beta-thalassemia; IVS2-74T>G (padj = 0.047), IVS2-16G>C (padj = 0.017), IVS2-666C>T (padj = 0.017) and 3’UTR + 314G>A (padj = 0.002). However, 3'UTR + 233G>C did not yield a significant association with padj value = 0.076. Further investigation using combined five SNPs for haplotype association analysis revealed three susceptible haplotypes with significant p values of which, haplotypes 1-2-2-1-1 (p = 6.49 × 10−7, OR = 10.371 [3.345–32.148]), 1-2-1-1-1 (p = 0.009, OR = 1.423 [1.095–1.850] and 1-1-1-1-1 (p = 1.39 × 10−4, OR = 10.221 [2.345–44.555]). Three haplotypes showed protective effect with significant p value of which, 2-2-1-1-1 (p = 0.006, OR = 0.668 [0.500–0.893]), 1-1-2-2-1 (p = 0.013, OR = 0.357 [0.153–0.830]) and 1-1-2-1-1 (p = 0.033, OR = 0.745 [0.567–0.977]). This study has identified the potential use of intragenic polymorphic markers in the HBB gene, which were significantly associated with beta-thalassemia. Combining these five SNPs defined a new haplotype model for beta-thalassemia and further evaluation for predicting severity in beta-thalassemia.

Stature estimation study based on pelvic and sacral morphometric among Malaysian population

Background Virtual anthropology in estimating stature through multislice computed tomography scanning is important for forensic cases and mass disasters. Regression formulae generated directly from other post-cranial skeleton parts can be applied for estimating stature. Literatures have revealed that scoring of pelvic shape in both sexes is significantly correlated with stature. Hereafter, this study aims to correlate the pelvic and sacral morphometric with stature based on sex and ancestry among the Malaysian population from the selected samples of 373 CT images at Kuala Lumpur Hospital. The three-dimensional pelvic girdles were first segmented from CT images through Mimics Research 17.0 software. Inter-landmark distances were measured with Microsoft 3D Builder and their respective indexes were computed. Results This study showed that the auricular lengths, ilium dimension and acetabulum were the most useful stature estimator at R > 0.5. The combination of pelvic parameters, sacral parameters and indexes had contributed to a higher R2 value of the regression models. Conclusions Pelvic morphometric was generally a better stature estimator compared to sacral morphometric. The population-specific formula produced from this study should only be realistic within the Malaysian population. This helps to enhance the existing references for stature estimation especially when incomplete human remains are discovered.