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This paper reported the quality of life (QoL) of 260 Malaysian parents with autism spectrum disorder (ASD) and factors which influencing it. About half of these parents reported to having good QoL. The factors identified in the double ABCX model showed that perceived social support and sense of coherence (SOC) were mediated by coping strategies and had a positive direct and indirect effect on parents' QoL. These findings reiterate the importance of social support, coping skills, and strong SOC reflection skills in influencing the QoL of parents with ASD child. We therefore suggest parents to utilize the widely available social and organization supports to gain good QoL, which is also important for the wellbeing of their child.

Child maltreatment, which encompasses harmful behaviour such as physical, sexual, psychological, and neglect, remains a global concern. In global efforts to prevent violence against women and girls, a strategic shift has emerged to actively engage men as key stakeholders. There is a growing recognition that men must be placed at the centre of these efforts. This study aimed to determine the predictors of child maltreatment perpetration in Sarawak based on retrospective recall of men's childhood adversities, men's gender roles, men's attitudes, and men's attachment styles. This cross-sectional study was conducted in Sarawak, Malaysia, from August 2022 to January 2023. The research used multistage cluster sampling to recruit 800 married men. The study findings showed 33.6% of the men admitted to having perpetrated one or more different forms of maltreatment on their children. Neglectful behaviours were the most prevalent with 27.3%, followed by physical and psychological perpetration. Through hierarchical logistic regression, men's childhood adversities were a critical predictor (AOR = 1.0, 95% CI:.1.0, 1.1, p <.001). Men with avoidant attachment styles were less likely to admit to perpetration (AOR = 0.5, 95% CI:0.3, 0,8, p =.002). In conclusion, this study emphasises the need for prevention activities like childhood adversities screening among men to improve their well-being and help them heal from past trauma. [ABSTRACT FROM AUTHOR]

Background: Despite the importance of employment on individual well-being, the literature on the positive impact of work participation, specifically for individuals with Down syndrome, is scant. Aim: We conducted in-depth interviews to explore how people with Down syndrome perceive employment benefits in Malaysia. Method: Forty-five participants were interviewed, including six individuals with Down syndrome, ten family members, six employers and co-workers, 22 community members, and a policy maker. Result: Three themes emerged from reflexive thematic analysis: (1) personal growth, (2) employer incentives, and (3) improving social acceptance. Conclusion: The findings emphasise that fostering a positive attitude towards the employment of individuals with Down syndrome would benefit them and contribute to society. Relevant bodies could utilise the findings to develop effective employment policies for the community. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol is classified as a psychoactive substance, and its dependence is one of the three leading risk factors for death, disability, or disease. Early age alcohol use by the age of 15 is implied to be harmful due to interference in the brain development of adolescents, causing alcohol-related problems later in life. This study aims to determine the prevalence and factors associated with alcohol use among Dayak adolescents in Sarawak, Malaysia. Methods: This was a cross-sectional quantitative research approach. A total of 12 districts within the 12 divisions were selected by multistage stratified cluster sampling. Dayak housing area lists were obtained from district offices and the local councils. The respondents were selected systematically according to male and female respondent houses, and they were interviewed using an interviewer-administered questionnaire. Data were entered into Microsoft Excel and analysed through IBM SPSS Version 27.0. Results: Dayak adolescents' mean age was 17.31 years. They were either low-risk (50.0 %), hazardous (31.0%), abstainers (11.0%), harmful (5.0%) or alcohol dependant (3.0%) drinkers. Age (p<.001), gender (p<.05), ethnicity (p<.001), religion (p<.05), employment (p<.001), level of education (p<.01), allowance (p<.001), family relationship (p<.05), and family size (p<.05) were the potential predictors of alcohol use disorder. Conclusion: Dayak adolescent alcohol drinking is prevalent and a public health problem, particularly among disadvantaged socio-economic families. The lower proportion of abstainers suggested that alcohol use among adolescents is on the rise. Hence, the results should be utilised to do targeted health promotion regarding harmful alcohol use among adolescents since early use of alcohol among adolescents may lead to more severe health and non-health outcomes in the future. [ABSTRACT FROM AUTHOR]

Several vaccines have been fast-tracked through clinical trials to mitigate the progression of the SARS‑CoV‑2 pandemic. We analyzed sequential blood samples from 314 recipients of Comirnaty and CoronaVac in East Malaysia for the spike-binding IgG (IgG-S), nucleocapsid-binding IgG (IgG-N), spike-binding IgM (IgM-S) and serum vitamin D (VitD). A subset of samples was analyzed for the neutralizing antibodies (Ig-RBD). Results showed that IgG-S due to Comirnaty was significantly higher than CoronaVac. IgM-S was detected in 80.0% Comirnaty and 69.5% CoronaVac recipients, while IgG-N was detected in 58.1% CoronaVac but not in Comirnaty recipients. All IgG-S-positive vaccines possessed detectable Ig-RBD after the second dose but with a weak to moderate correlation. The serum VitD levels did not influence the antibody magnitude in both vaccines. In essence, SARS-CoV-2 vaccination is an IgG-S-dominant event, Comirnaty was more effective than CoronaVac in mounting IgG-S and Ig-RBD responses, independent of the patient's VitD level. [ABSTRACT FROM AUTHOR]

Introduction: Many factors hinder the effective responses to the HIV/AIDS epidemic. Stigma is one of the major barriers to effective responses to the HIV/AIDS epidemic. It is often considered the main reason for the low response to access proper services for prevention, treatment, and care for HIV/AIDS. In this context, we assessed the perceived level of stigmatisation towards people with HIV/AIDS among rural communities in Sarawak and determined its associated factors. Methods: This cross-sectional community-based study was conducted among the adult population aged 18 years and above among rural communities in Sarawak, Malaysia. A gender-stratified multistage cluster sampling technique was adopted to select the respondents. A total of 900 respondents were successfully interviewed using interviewer-guided questionnaires. Stepwise multiple linear regression with forward and backward selection method was used to determine the HIV/AIDS-related stigma. A p-value of ≤.05 was considered statistically significant. Results: Analysis revealed that females are more stigmatised than males (p<.05). Multivariate analysis showed that those who did not know someone had HIV and Chinese ethnicity were potential predictors in both male and female groups. Having no gainful job, and discussion of HIV/AIDS, household income less than MYR 500, history of HIV testing, knowledge on HIV transmission and exposure to HIV/AIDS information were factors that influenced HIV/AIDS-related stigma among female respondents. On the other hand, age group 30 to 39, Bidayuh, Chinese ethnicity, and not knowing someone had HIV and media exposure on HIV were factors that influenced HIV/AIDS-related stigma among male respondents. Conclusion: HIV/AIDS-related stigma towards HIV/AIDS existed in rural communities. Enhanced health promotion related to HIV/AIDS activities in rural communities are needed to curb stigmatisation toward people with HIV/AIDS. [ABSTRACT FROM AUTHOR]

This study intended to determine visual health of the school children and investigate its relationship with screen time. This was a school-based cross-sectional study using multistage cluster sampling. A self-reported and interviewer-administered questionnaire were used to compile screen time information. Children presenting visual acuity was evaluated with Snellen chart and non-cycloplegic refraction was performed to those acuities worse than 6/12. Data analysis was performed using SPSS version 22. A p-value =0.05 with 95% CI was considered as statistically significant. About 87% children had normal or near normal visual acuity and 13% had visual impairment. The prevalence of refractive error was 22.8%. Astigmatism was the most prevailing type of refractive error, 10%. The children spent on average of 13.82 hours per week on screen time. Television is the most popular electronic devices. Boy spent more time on gaming consoles than girl. There was no statistically significant relationship between refractive error and screen time (p=0.581). The prevalence of refractive error among school children was 23%. The children spent nearly 14 hours per week on screen time. There was no statistically significant relationship between refractive error and screen time. Periodical children vision screening is paramount for early detection of vision impairment and provide possible intervention. [ABSTRACT FROM AUTHOR]

Introduction: The Coronavirus disease-2019 impacted the governments and public health systems worldwide, with the psychological impact including an increase in the level of stress, anxiety and depression. We determine the prevalence of depression, anxiety and stress using the Depression Anxiety Stress Scales (DASS-21), and to determine the psychological impact of COVID-19 pandemic amongst medical students in Sarawak, Malaysia using the revised Impact of Event Scale (IES-R). Methods: We analysed 355 medical student's data obtained from an online survey. All the undergraduate medical students were the sample population. IBM SPSS version 22.0 was used for data analysis. A p-value of ≤.05 was considered statistically significant. Results: Analysis indicated that three-fourths of the students had no mental health issues. More than one-tenth of the students were moderately depressed (12.4%) and 4.3% severely depressed. A similar pattern of prevalence of anxiety was noted with 10% reported moderate anxiety, and 6.8% had severe anxiety. 15.8% of the students had mild stress, 4.2% moderately stressed, and 2% severely stressed. A hierarchical multiple linear regression analysis showed that hyperarousal appeared to be a predictor of depression (β=.466, p<.001), anxiety (β=.481, p<.001) and stress β=.508, p<.001). Along with hyperarousal, intrusion (β=.148, p<.05) predicts stress among the students. Conclusion: Our analysis revealed that hyperarousal symptoms related to the global pandemic of COVID-19 led to significant mental health issues among students. Therefore, urgent strategies to support the students' psychosocial wellbeing and self-care and to strengthen their coping skills and resilience need to be implemented. [ABSTRACT FROM AUTHOR]

Objective: Voluntary HIV testing is one of the key strategies in the HIV/AIDS prevention and control program. New National Strategic Plan for 2016-2030 in Malaysia, adapt three zeros viz. 'zero new infections of HIV/AIDS, zero discrimination and zero AIDS-related deaths'. This study aimed to determine the predictors of voluntary HIV testing in Sarawak. Materials and methods: A cross-sectional study was conducted with a total of 900 respondents (450 males and 450 females) from the state of Sarawak, aged 18 years and above, who were selected by gender-stratified multistage cluster sampling. Data were obtained by face-to-face interview using a pretested questionnaire. Binary logistic regression analysis was done to determine the potential predictors for voluntary HIV testing. Results: The prevalence of HIV testing was higher among female respondents (26%) compared to male respondents (14.2%), and the difference was statistically significant (p < 0.001). Binary logistic regression analysis revealed that household income more than MYR 1501 (p = 0.009), not living with a partner (p < 0.001) and discussion on HIV/AIDS (p = 0.019) appeared to be predictors for the male respondents, while, ethnicity was statistically significant for female respondents (p < 0.001). Conclusion: The utilisation of HIV testing was low in both males and females. Thus, the finding of this study could be considered when designing HIV education and screening program in Sarawak. [ABSTRACT FROM AUTHOR]

Objective: This national study assessed the economic impact of treating patients with antimicrobial resistance (AMR) pathogens within Malaysia's Ministry of Health (MoH) hospitals., Design: A cross-sectional study design and top-down costing approach, analysing Malaysian diagnosis-related group (DRG) data for AMR patients admitted to MoH hospitals from 2017 to 2020., Setting and Participants: A total of 1190 cases were identified using International Statistical Classification of Diseases-10 version 2010 codes for AMR pathogens., Outcome Measures: The study aims to estimate direct healthcare costs for treating AMR patients. Costs per admission were calculated based on each patient's length of stay (LOS). A binary logistic regression model identified cost determinants, with significant factors (p<0.05) further analysed using a multivariate multiple logistic regression. ORs with 95% CIs were determined, and treatment costs were categorised as above or below the annual national base rate., Results: Findings showed that costs are influenced by the volume of cases identified through DRG codes and LOS, which averaged between 21.7 and 36.4 days. Median admission costs for AMR patients ranged from RM12 476.28 (IQR RM 15 655.93) to RM19 295.11 (IQR RM20 200.28). Both LOS and total costs increased annually, from RM3 711 046.10 in 2017 to RM9 700 249.08 in 2019. Patients over 56 years old and those with severity levels II and III were more likely exceeding the national base rate., Conclusions: These findings, explaining 9.3% of the variance in the regression model, can inform policies to reduce the economic burden of AMR and improve patient outcomes, highlighting the need for a comprehensive strategy to address this global health threat., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Objectives: Adolescent suicide is a significant global public health concern. Although numerous studies have investigated factors that influence the risk of suicide among adolescents around the world, limited data are available in the Malaysian context, especially among the diverse ethnic communities of Sarawak. This study aimed to determine the factors associated with the risk of suicide among adolescents in Sarawak, Malaysia., Methods: A community-based cross-sectional study was conducted among 1,344 adolescents in Sarawak using face-to-face interviews. Hierarchical binary logistic regression analysis was performed to identify factors that determine the risk of suicide among adolescents., Results: Two predictive models were constructed. Both models revealed that being female (OR=1.578, 95 % CI: 1.191, 2.092, p=0.001), having Malay ethnicity (OR=1.733, 95 % CI: 1.236, 2.429, p=0.001) and having a disease significantly increased the risk of suicide (OR=1.895, 95 % CI: 1.221, 2.942, p=0.004). In particular, Model 2, which showed a better fit, found that occasional religious practice (OR=1.610, 95 % CI: 1.126, 2.303, p=0.009), poor parental relationships (OR=1.739, 95 % CI: 1.035, 2.922, p=0.037) and higher addiction (OR=1.015, 95 % CI: 1.008, 1.022, p=0.001), depression (OR=1.919, 95 % CI: 1.241, 2.968, p=0.003), and stress (OR=2.707, 95 % CI: 1.689, 4.340, p=0.001) scores were significantly associated with an increased risk of suicide., Conclusions: This study sheds light on multiple factors that contribute to the risk of suicide among adolescents in Sarawak. These findings underscore the importance of holistic prevention strategies, including psychological and social dimensions, to mitigate the risk of suicide in this population. Further research is warranted to understand the complex interplay of these factors and guide the development of targeted interventions., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Multiple choice questions, used in medical school assessments for decades, have many drawbacks such as hard to construct, allow guessing, encourage test-wiseness, promote rote learning, provide no opportunity for examinees to express ideas, and do not provide information about strengths and weakness of candidates. Directly asked, directly answered questions like Very Short Answer Questions (VSAQ) are considered a better alternative with several advantages., Objectives: This study aims to compare student performance in MCQ and VSAQ and obtain feedback. from the stakeholders., Methods: Conduct multiple true-false, one best answer, and VSAQ tests in two batches of medical students, compare their scores and psychometric indices of the tests and seek opinion from students and academics regarding these assessment methods., Results: Multiple true-false and best answer test scores showed skewed results and low psychometric performance compared to better psychometrics and more balanced student performance in VSAQ tests. The stakeholders' opinions were significantly in favour of VSAQ., Conclusion and Recommendation: This study concludes that VSAQ is a viable alternative to multiple-choice question tests, and it is widely accepted by medical students and academics in the medical faculty.

Background: Disclosure of HIV-positive status is an essential prerequisite for the prevention and care of person living with HIV/AIDS as well as to tackle hidden epidemic in the society., Objective: To determine the intention to disclose the HIV/AIDS status among adult population in Sarawak, Malaysia, and factors affecting thereof., Methods: This cross-sectional community-based study was conducted among adult population aged 18 years and above in Sarawak, Malaysia. A gender-stratified multistage cluster sampling technique was adopted to select the participants. A total of 900 respondents were successfully interviewed by face-to-face interview using interview schedule. Stepwise binary logistic regression models were fitted in SPSS version 22.0 to identify the factors associated with the disclosure of HIV/AIDS status. A p value less than 0.05 was considered as statistically significant., Results: The mean (SD) age of male and female respondents was 41.57 (13.45) and 38.99 (13.09) years, respectively. A statistically significant difference of intention to disclosure of HIV status was found between males and females ( p < 0.05). A stepwise binary logistic regression analysis revealed that age, occupation, knowledge on HIV transmission, and content of discussion about HIV/AIDS appeared to be potential predictors for male respondents to disclose HIV status, while ethnicity and content of discussion on HIV/AIDS were found to be important predictors among the female respondents ( p < 0.05)., Conclusion and Recommendation: Though the study did not depict the national prevalence of disclosure of HIV/AIDS status, the findings of the study would provide an important basic information for programme intervention, policy, and future research agenda.