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Introduction: The increasing disease burden of coronary artery disease (CAD) calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI), a common treatment for CAD. Few studies have analyzed the contemporary data on local cardiac facilities. Service expansion and budget allocation require cost evidence from various providers. We aim to compare the patient characteristics, procedural outcomes, and cost profile between a teaching hospital (TH) and a general hospital (GH)., Methods: This cross-sectional study was conducted from the healthcare providers' perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test., Results: The mean hospitalization cost was RM 12,117 (USD 3,366) at GH and RM 16,289 (USD 4,525) at TH. The higher cost at TH can be attributed to worse patients' comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost., Conclusions: The high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure sustainable and equitable cardiac service in Malaysia.

This study mainly evaluated the effects of orally administered beta 1,3/1,6-glucan and vitamin C on the nonspecific immune responses of white shrimp (Litopenaeus vannamei). In this study, we found that the white shrimp oral administration with 1 g/kg of beta 1,3/1,6-glucan effectively enhanced O2(-) production and phenoloxidase and superoxide dismutase activity. Shrimp were oral administration with 0.2 g/kg of vitamin C presented beneficial nonspecific immune responses and enzyme activity and also observed in the beta 1,3/1,6-glucan treatment groups. Consequently, we compared the alterations in the immune activity between the beta 1,3/1,6-glucan and vitamin C groups and the evidence illustrated that combination of beta 1,3/1,6-glucan and vitamin C presented an additive effect on inducing the nonspecific immune responses of white shrimp., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: An assessment of the process and outcomes of a health promotion programme is necessary for the continuous improvement of a programme., Objective: To explore the participants' perceptions of the quality and effectiveness of the 'Love Your Heart Programme'., Design: A qualitative study using semi-structured interviews with a purposive sample of participants of the 'Love Your Heart' programme. Interviews were based on an interview guide that grouped questions into four main subgroups: structure, process, immediate outcomes and impact. The interviews were audio-recorded, transcribed verbatim and analysed using the principles of grounded theory., Results: A total of 17 interviews were conducted. The participants were satisfied with the structural aspects of the programme. Different opinions arose regarding the ideal frequency and duration of the programme. The content of the seminars was thought to be too general. There was also a lack of interest in the 'Road to a Healthy Heart' booklet. All of the respondents had positive opinions about the communication skills and attitude of the health educator. The potential advantages and disadvantages of participating in the programme were discussed. Finally, the respondents expressed their satisfaction with the programme and the impact it had on them., Discussion and Conclusions: In general, the participants who were interviewed held the programme, and the health educator conducted the programme in high regard. The suggestions that were received can be used to further improve the acceptability and feasibility of the programme., (© 2011 John Wiley & Sons Ltd.)

Background: Transtheoretical Model of change has been used successfully in promoting behaviour change., Objective: To examine the relationships between health-related quality of life (HRQoL) scores with the stages of change of adequate physical activity and fruit and vegetables intake., Design: This was a cross-sectional study conducted among employees of the main campus and Engineering campus of Universiti Sains Malaysia (USM) during October 2009 and March 2010., Main Variables Studied: Data on physical activity and fruit and vegetable intake was collected using the WHO STEPS instrument for chronic disease risk factors surveillance. The Short Form-12 health survey (SF-12) was used to gather information on participants' HRQoL. The current stages of change are measured using the measures developed by the Pro-Change Behaviour Systems Incorporation., Statistical Analysis: One way ANOVA and its non-parametric equivalent Kruskal-Wallis were used to compare the differences between SF-12 scores with the stages of change., Results: A total of 144 employees were included in this analysis. A large proportion of the participants reported inadequate fruits and vegetable intake (92.3%) and physical activity (84.6%). Mean physical and mental component scores of SF-12 were 50.39 (SD = 7.69) and 49.73 (SD = 8.64) respectively. Overall, there was no statistical significant difference in the SF-12 domains scores with regards to the stages of change for both the risk factors., Conclusions: There were some evidence of positive relationship between stages of change of physical activity and fruit and vegetable intake with SF-12 scores. Further studies need to be conducted to confirm this association., (© 2011 John Wiley & Sons Ltd.)

Purpose: The objective of this study was to assess the construct validity of the EQ-5D instrument among the Malaysian population., Methods: This was a cross-sectional study conducted among Malaysian adults in three northern states of Malaysia. A pre-developed questionnaire consisting of both the EQ-5D and SF-12 items was used for data collection. Concurrent, convergent, and known group validity of EQ-5D were assessed against SF-12 and several known relationships with participants' demographic and illness characteristics., Results: A total of 596 Malaysians participated in the study. The mean EQ-5D score was 0.93 (SD = 0.13), while the mean physical component score (PCS-12) and mental component score (MCS-12) scores were 48.9 (SD = 7.4) and 49.1 (SD = 8.0), respectively. Participants with a current medical problem had lower PCS-12 and MCS-12 scores and reported more problems with all of the EQ-5D dimensions; they also had lower EQ-5D and EQ-VAS scores (P < 0.05). Convergent validity was supported by a moderately positive correlation between EQ-5D and EQ-VAS with MCS-12 and PCS-12 scores; moreover, the stronger effect sizes between PCS-12 and the physical dimensions of EQ-5D as well as between MCS-12 with anxiety/depression scores further supported the convergent validity of EQ-5D. Responses to the EQ-5D dimensions only supported two of the four known group validity hypotheses of higher quality of life among individuals who are better educated and no medical problem. No association was found between income and gender with EQ-5D score., Conclusion: This study has demonstrated acceptable construct validity of the EQ-5D among the Malaysian population.

Background: Cardiovascular diseases, the main causes of hospitalisations and death globally, have put an enormous economic burden on the healthcare system. Several risk factors are associated with the occurrence of cardiovascular events. At the heart of efficient prevention of cardiovascular disease is the concept of risk assessment. This paper aims to review the available cardiovascular risk-assessment tools and its applicability in predicting cardiovascular risk among Asian populations., Methods: A systematic search was performed using keywords as MeSH and Boolean terms., Results: A total of 25 risk-assessment tools were identified. Of these, only two risk-assessment tools (8%) were derived from an Asian population. These risk-assessment tools differ in various ways, including characteristics of the derivation sample, type of study, time frame of follow-up, end points, statistical analysis and risk factors included., Conclusions: Very few cardiovascular risk-assessment tools were developed in Asian populations. In order to accurately predict the cardiovascular risk of our population, there is a need to develop a risk-assessment tool based on local epidemiological data.

Heat treatment was utilized to anneal the semiconductor sensitizers (CdS, CdSe and CdS/CdSe) assembled on mesoporous TiO(2) films to enhance the performance of the photoelectrodes in a process of photoelectrochemical hydrogen generation. Various annealing temperatures (150, 300 and 400 degrees C) were employed and the results show that appropriately elevating the temperature (to approx. 300 degrees C) can increase the crystallinity of the CdS and CdSe, improve the charge transport characteristic of a photoelectrode and, therefore, lead to a higher performance of the TiO(2) /CdS and TiO(2) /CdSe electrodes. However, an over-annealing temperature (400 degrees C) may cause serious oxidation and/or decomposition of the sensitizers which is unfavorable to the photoelectrode. For the co-sensitized electrode, counter-diffusion of CdS and CdSe happens at the CdS/CdSe interface when the TiO(2) /CdS/CdSe electrode was co-annealed at 300 degrees C, which significantly decreases the performance of the co-sensitized electrode. This problem was solved by annealing first a TiO(2) /CdS electrode at 300 degrees C, followed by CdSe assembly and a second annealing at 150 degrees C. This electrode appears to have better performance than the others.

Microbiologically it was demonstrated that amino acids, e.g. cysteine (CySH), and other compounds, e.g. sodium thioglycollate, containing thiol groups neutralized the activity of silver nitrate against Pseudomonas aeruginosa PAO1. Amino acids with disulphide bonds were inactive, with the exception of L-cystine dimethyl ester, as were all amino acids with no sulphur groups. Iodoacetamide reacted with CySH to produce a CyS-acetamide complex that was unable to quench the activity of Ag+. Chemical analyses using cyclic voltammetry demonstrated that high coordination numbers (3.1) were obtained with thiol-containing amino acids and low numbers (0.28-0.4) with other amino acids. Both microbiologically and chemically, the results imply that interaction of Ag+ with thiol groups plays an essential role in bacterial inactivation.