Post Keynesian theory and evidence of money supply endogeneity: a review essay

Money is the life-blood of any modern market-oriented economy.The level of money supply - the quantity and velocity of money circulated in such an economy would determine its health. The central issue in managing the economy is to understand how money supply is determined.The history of modern monetary economics actually has witnessed the emergence of two opposing views pertaining to the role of central bank in controlling the supply of money in an economy.A group of economists, known as monetarists, under the influence of Milton Friedman, contended that money supply in an economy is exogenously determined. Post Keynesian however holds the view that money supply is endogenously rather than exogenously determined. Examining the theory of endogenous money as well as empirical work, the present paper has found that money supply in several countries is endogenously determined

The primary health care performance initiative (PHPCI): issues and challenges for Malaysia as a trailblazer country / Anis Safura Ramli … [et al.]

A strong and robust Primary Health Care system is essential to achieving universal health coverage and to save lives. The Global Conference on Primary Health Care 2018: from Alma-Ata towards achieving Universal Health Coverage and the Sustainable Development Goals at Astana, Kazakhstan provided a platform for low‐ and middle‐ income countries to join the Primary Health Care Performance Initiative (PHCPI). At this Global Conference, Malaysia has declared to become a Trailblazer Country in the PHCPI and pledged to monitor her Vital Signs Profiles (VSP). However, the VSP project requires an honest and transparent data collection and monitoring of the Primary Health Care system, so as to identify gaps and guide policy in support of Primary Health Care reform. This is a huge commitment and can only be materialised if there is a collaborative partnership between Primary Care and Public Health providers. Fundamental to all of these, is the controversy concerning whether or not ‘Primary Care’ and ‘Primary Health Care’ represent the same entity. Confusion also occurs with regards to the role of ‘Primary Care’ and ‘Public Health’ providers in the Malaysian Primary Health Care system. This review aims to differentiate between Primary Care, Primary Health Care and Public Health, describe the relationships between the three entities and redefine the role of Primary Care and Public Health in the PHCPI-VSP in order to transform the Malaysian Primary Health Care system

Mortality in children under 5: prevalence of congenital malformations and its associated demographic variables

Introduction Congenital malformations (CM) comprise a wide range of abnormalities of body structure or function that are present at birth and are of prenatal origin. It has contributed to a significant proportion of infant morbidity and mortality. The aims of this study were to determine the extent and investigate the relationship between CM and its associated demographic variables. Methods Data was extracted from Ministry of Health (MOH) database compiled from the reports on Stillbirth & Under 5 Mortality from year 2013 to 2014. Results Out of 9,827 child death, 2,840 (28.9%) were classified under CM as defined under ICD-10 classification. Majority of those with CMs died at neonatal stage (62.7%) and among mothers aged between 20 to 35 years old (67.3%). The mean age of mothers among CM children was 30.8±6.5 years old. Approximately 5.8%, 6.7% and 3.3 % of total CM were neural tube defects, heart defects and hydrops fetalis respectively. The prevalence of CM in males was 15% higher than females. The difference were evident between CM and age of death of children under 5 years old (p<0.001) as well as between CM and maternal age groups (p<0.001). Conclusions CM is responsible for 28.9% of total causes of child death with higher occurrence of malformation in males. A significantly higher risk of CMs among mother aged between 20 to 35 years old was observed. This emphasises the importance of raising awareness and the need to strengthen appropriate response for surveillance and prevention program of common CM in Malaysia

Prevalence and factors associated with internet addiction among adolescents in Malaysia: a cross-sectional study

Introduction: Internet is important to university students, especially for medical students who use it to search for literature and relevant information. However, some of the users are experiencing a gradual loss of the ability to reduce the duration and frequency of their internet activities, despite the negative consequences. The literature on internet usage among Malaysian medical students is limited. This study aims to determine the prevalence and factors associated with internet usage among medical students in a public university in Malaysia. Methods: This cross-sectional study was performed among all the medical students (Year 1-5). Students were assessed on their internet activities using the internet addiction questionnaires (IAT). A Multiple Logistic Regression was used for data analysis. Results: The study was conducted among 426 students. The study population consisted of 156 males (36.6%) and 270 females (63.4%). The mean age was 21.6 ±1.5 years. Ethnicity distribution among the students was: Malays (55.6%), Chinese (34.7%), Indians (7.3%) and others (2.3%). According to the IAT, 36.9% of the study sample was addicted to the internet. Using the multivariate logistic regression analysis, we have found that the use of internet access for entertainment purposes (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.05-12.00), male students (OR 1.8, 95% CI 1.01-3.21) and increasing frequency of internet usage were associated with internet addiction (OR 1.4, 95% CI 1.09- 1.67). Conclusion: Internet addiction is a relatively frequent phenomenon among medical students. The predictors of internet addiction were male students using it for surfing and entertainment purposes

Short-acting β2-agonist prescription patterns and clinical outcomes in Malaysia: A nationwide cohort of the SABINA III study

Introduction: SABINA III assessed short-acting β2-agonist (SABA) prescription patterns and their association with asthma-related outcomes globally. Herein, we examined SABA prescription and clinical outcomes in the Malaysian cohort of SABINA III. Methods: In this observational, cross-sectional study, patients (≥12 years) were recruited between July and December 2019 from 15 primary and specialty care centres in Malaysia. Prescribed asthma treatments and severe exacerbation history within 12 months prior and asthma symptom control during the study visit were evaluated. Associations of SABA prescription with asthma control and severe exacerbation were analysed using multivariable regression models. Results: Seven hundred thirty-one patients (primary care, n=265 [36.3%]; specialty care, n=466 [63.7%]) were evaluated. The prevalence of SABA over-prescription (≥3 SABA prescriptions/year) was 47.4% (primary care, 47.1%; specialty care, 47.6%), 51.8% and 44.5% among all patients and patients with mild and moderate-to-severe asthma, respectively. Altogether 9.0% (n=66) purchased SABA without a prescription; among them, 43.9% (n=29) purchased ≥3 inhalers. The mean (standard deviation) number of severe asthma exacerbations was 1.38 (2.76), and 19.7% (n=144) and 25.7% (n=188) had uncontrolled and partly controlled symptoms, respectively. Prescriptions of ≥3 SABA inhalers (vs 1–2) were associated with lower odds of at least partly controlled asthma (odds ratio=0.42; 95% confidence interval [CI]=0.27–0.67) and higher odds of having severe exacerbation(s) (odds ratio=2.04; 95% CI=1.44–2.89). Conclusion: The prevalence of SABA over-prescription in Malaysia is high, regardless of the prescriber type, emphasising the need for healthcare providers and policymakers to adopt latest evidence-based recommendations to address this public health concern

Prevalence and Factors Associated with Smartphone Addiction among Adolescents–A Nationwide Study in Malaysia

Smartphone ownership among adolescents is getting common in this decade especially in Malaysia; Adolescent are strongly devoted to their smartphone and this may lead to smartphone addiction. Studies have reported that smartphone addiction has become an emerging social and health problem especially among the youth in many countries however there is lack of study among adolescents in Malaysia. This study aimed to examine the prevalence and factors associated with smartphone addiction among adolescents in Malaysia. This was a cross-sectional study involving adolescents from 15 primary care clinics throughout the country. Respondents were assessed on their smartphone activities using the Malaysian short version of the Smartphone addiction scale (SAS-M-SV). Multiple logistic regression was used to determine the predictors of smartphone addiction among adolescents. The study was conducted among 921 adolescents with 49.6% male (n = 457). The mean age of adolescents was 16.4 ± 2.4 years. The ethnicity distribution were 74.6% Malay, 7.3% Chinese, 4.7% Indian and 13.4% other ethnicities. The prevalence of smartphone addiction was 37.1% (342/921); 37.4% in male and 36.9% in female. Based on multiple logistic regression analysis, longer duration of smartphone use per week was associated with higher odds of smartphone addiction among adolescent (odd ratio = 1.005%, 95% confidence interval = 1.000–1.009, p-value = 0.039). Smartphone addiction is present in nearly four in ten adolescents in Malaysia. Adolescents who spend longer duration in smartphone usage per week were associated with higher odds of having smartphone addiction. Parents should be more alert and vigilant about this finding. Hence, parents should limit their children from spending too much of time with smartphone in order to prevent their children from getting smartphone addiction

Prevalence and Factors Associated with Smartphone Addiction Among Adolescents-A Nationwide Study in Malaysia

Smartphone ownership among adolescents is getting common in this decade especially in Malaysia; Adolescent are strongly devoted to their smartphone and this may lead to smartphone addiction. Studies have reported that smartphone addiction has become an emerging social and health problem especially among the youth in many countries however there is lack of study among adolescents in Malaysia. This study aimed to examine the prevalence and factors associated with smartphone addiction among adolescents in Malaysia. This was a cross-sectional study involving adolescents from 15 primary care clinics throughout the country. Respondents were assessed on their smartphone activities using the Malaysian short version of the Smartphone addiction scale (SAS-M-SV). Multiple logistic regression was used to determine the predictors of smartphone addiction among adolescents. The study was conducted among 921 adolescents with 49.6% male (n = 457). The mean age of adolescents was 16.4 ± 2.4 years. The ethnicity distribution were 74.6% Malay, 7.3% Chinese, 4.7% Indian and 13.4% other ethnicities. The prevalence of smartphone addiction was 37.1% (342/921); 37.4% in male and 36.9% in female. Based on multiple logistic regression analysis, longer duration of smartphone use per week was associated with higher odds of smartphone addiction among adolescent (odd ratio = 1.005%, 95% confidence interval = 1.000–1.009, p-value = 0.039). Smartphone addiction is present in nearly four in ten adolescents in Malaysia. Adolescents who spend longer duration in smartphone usage per week were associated with higher odds of having smartphone addiction. Parents should be more alert and vigilant about this finding. Hence, parents should limit their children from spending too much of time with smartphone in order to prevent their children from getting smartphone addiction

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years