The concept of district health management in Malaysia

Background: In Malaysia, public health services sector are administered by the Ministry of Health through its central headquarters to the state and district offices. The District Health Offices particularly manage and coordinate the delivery of an effective, efficient and affordable health services in the districts throughout Malaysia. Materials and Methods: The information and statistics used in this article are based on the data collected from reports, articles, and publications by the Ministry of Health Malaysia and journals published pertaining to the District Health Management in Malaysia. Result: A District Health Office is entrusted with two major roles; to deliver public health services and to manage resources within a district. Led by a Public Health Physician, it acts as a body to oversee the execution of the national health policies and strategies at the ground level and serves to enforce existing health related legislation. It is also responsible in disease monitoring and surveillance and also the achievement of specific health indicators for each activity. There are six major services provided by the District Health Office, namely the Family Health, Disease Control, Occupational Health, Food Quality Control, Health Education, as well as Environmental Health and Water Supply Services. Conclusion: A District Health Office functions as the basic operational level in Malaysia healthcare system. Being the backbone in government healthcare system, it is essential to provide a well organised and integrated health service in delivering quality healthcare services to the population

Daily Energy Intake from Meals and Afternoon Snacks: Findings from the Malaysian Adults Nutrition Survey(MANS)

Meal and snack patterns are associated with energy and nutrient intakes and consequently health and nutritional status. The aim of this paper is to describe the percentage of daily energy intake from meals and afternoon snack among Malaysian adults. The study included a representative sample of adults aged 18- 59 years (n=7349) from a nationwide Food Consumption Survey conducted by the Ministry of Health. Information on dietary intake was obtained using a one day 24-hour diet recall (24-HDR). Dietary data on 6886 adults were analysed using Nutritionist ProTM and statistical analysis was carried out using the SPSS 13.0. The median percentage of daily energy intake is reported only for adults consuming meals and afternoon tea and by socio-demographic characteristics as well as body mass index (BMI) status. More than 80% of Malaysian adults consumed morning meals, lunch and dinner and 54% reported having afternoon tea. The median percentage of energy intake from morning meals, lunch, dinner and afternoon tea was 29.9%, 30.5%, 32.4% and 17%, respectively. There were variations in the median percentage of energy from meals and snacks according to the socio-demographic variables and BMI status. It is important to understand the eating patterns of Malaysians as the information can assist in efforts to address obesity and diet-related chronic diseases among adults

Energy and nutrient intakes: findings from the Malaysian Adult Nutrition Survey (MANS)

Nutrition surveys based on a representative sample of the Malaysian adult population have hitherto not been reported. In 2003, the Ministry of Health, Malaysia, conducted the Malaysian Adult Nutrition Survey (MANS), the first and largest nutrition survey in the country which aimed to provide detailed quantitative information on nutritional status, food and nutrient intakes, and physical activity pattern on a nationwide representative sample of adult subjects between the ages of 18 and 59 years. The survey covered four zones in Peninsular Malaysia (Central, Southern, Northern and East Coast), Sabah and Sarawak. This paper presents the mean and selected percentiles of energy and nutrient intake of 6886 subjects by selected demographic and socioeconomic characteristics. Energy contributions by macronutrients and dietary adequacy in relation to the Recommended Nutrient Intake for Malaysians are also described. Information on dietary intake was collected by trained nutritionists using a one day 24-hour diet recall. Dietary data were analysed using Nutritionist Pro, a diet analysis software and statistical analysis was carried out using the SPSS ver. 13.0. In most of the demographic and socioeconomic groups, males had higher mean energy (1776 kcal) and nutrient intake and percent achievement of RNI than females (1447 kcal). The proportions of calories derived from macronutrients were within the recommendations for a healthy diet. Intake of micronutrients such as iron, calcium and vitamin A was about 50% of RNI particularly in women. Sodium intake of Malaysians, not reported in earlier studies, is also made available. Under-reporting using the EI/BMR ratio was found in half of the population studied. The present study provides the first national estimates of energy and nutrient intake of the Malaysian adult population. Regular nutrition surveys are needed at the national level to provide valuable information on trends in food and nutrient intake, particularly among age and ethnically diverse subgroups of the population

Effect of Different S AC Based Nanoparticles Types on the Reflow Soldering Process of Miniaturized Component using Discrete Phase Model Simulation

The wetting formation and nanoparticles dispersion on adding nanoparticles to the lead free solder Sn-3.0Ag-0.5Cu (SAC305) is methodically investigated using Discrete Phase Model (DPM) simulation and applied on a 01005 capacitor component. Different types of nanoparticles, namely titanium dioxide (TiO2), nickle oxide (NiO) and Iron (III) oxide (Fe2O3) with varying weight percentages, 0.01wt%, 0.05wt% and 0.15wt% that is doped in SAC305 are used. The study of two-way interactions between multiphase volume of fluid (VOF) and discrete phase model (DPM) shows excellent capability in tracking the dispersed nanoparticles immersed in the wetted molten solder. In this study, real reflow profile temperature setup will be used to mimic the conventional reflow process. Based on the findings, the fillet height managed to achieve the minimum required height set by IPC standards. As the concentration of the nanoparticles doped in the molten solder increases, higher time is required for the wetting process. In general, the doped NiO nanoparticles at 0.05wt% has the lowest wetting time compared to other cases. The study of the instantaneous nanoparticles trajectory tracking was also conducted on a 3D model and 2D cross sectional view to identify the exact movement of the particles. Additionally, it was also observed that the velocity and pressure distribution increases as the weight percentage of the nanoparticles increases

A comprehensive review of hydroxyapatite-based coatings adhesion on metallic biomaterials

Metallic biomaterials have been employed in replacing and reconstructing the structural parts of the human physical structure due to their high mechanical properties, superior biocompatibility, and high corrosion resistance. The most common metallic biomaterials that have been used in implants include magnesium, stainless steel, cobalt-based alloy, titanium, and titanium-based alloy. Hydroxyapatite (Ca10(PO4)6(OH)2) is one of the ceramic biomaterials considered as ideal materials for coating on metallic biomaterials as it possesses almost the closest similarity in chemical composition and excellent biocompatibility with natural bone tissue. Recently, the HAp-based coating has increasingly drawn attention to improve the adhesion quality in metallic biomaterials. This study comprehensively reviews the current progress in the adhesion qualities of HAp-based coatings on metallic biomaterials specifically for the biomedical application. It has been observed that a surface that meets the minimum unique characteristics will enhance the bonding force between the coating and metallic biomaterial as the substrate. Critical factors of coating/substrate materials, coating techniques, and coating thickness that determine the adhesion quality are thoroughly identified and discussed. The surface structure and microstructure of HAp-based coating are also reviewed to confirm the findings

Relationship of an adherence score with blood pressure control status among patients with hypertension and their determinants: Findings from a nationwide blood pressure screening program

This study aimed to examine the relationship of adherence with blood pressure (BP) control and its associated factors in hypertensive patients. This cross‐ sectional nationwide BP screening study was conducted in Malaysia from May to October 2018. Participants with self‐ declared hypertension completed the Hill‐ Bone Compliance to High Blood Pressure Therapy Scale (Hill‐ Bone CHBPTS) which assesses three important domains of patient behavior to hypertension management namely medication taking, appointment keeping and reduced salt intake. Lower scores indicate better compliance while higher scores indicate otherwise. Participant's body mass index and seated BP were measured based on standard measurement protocol. Determinants of adherence to treatment were analyzed using multiple linear regression. Out of 5167 screened subjects, 1705 were known hypertensives. Of these, 927 (54.4%) answered the Hill‐ Bone CHBPTS and were entered into analysis. The mean age was 59.0 ± 13.2 years, 55.6% were female and 42.2% were Malays. The mean Hill‐ Bone CHBPTS score was 20.4 ± 4.4 (range 14‐ 47), and 52.1% had good adherence. The mean systolic BP and diastolic BP were 136.4 ± 17.9 and 80.6 ± 11.6 mmHg, respectively. BP was controlled in 58.3% of those with good adherence compared to 50.2% in those with poor adherence (p = .014). Based on multiple linear regression analysis, female gender (β = −0.72, 95% confidence interval [CI] −1.30, −0.15, p = .014), older age (β = −0.05, 95% CI −0.07, −0.03, p < .001), and individuals with primary or lower educational level (β = −0.91, 95% CI −1.59, −0.23, p = .009) had better adherence to BP management. Interventional programs targeted at the less adherent groups are needed in order to improve their adherence and BP control

Youth–adult partnership: exploring contributions to empowerment, agency and community connections in Malaysian youth programs

Youth–adult partnership (Y–AP) has emerged as a key practice for enacting two features of effective developmental settings: supportive adult relationships and support for efficacy and mattering. Previous studies have shown that when youth, supported by adults, actively participate in organizational and community decision-making they are likely to show greater confidence and agency, empowerment and critical consciousness, and community connections. Most of the extant research on Y–AP is limited to qualitative studies and the identification of organizational best practices. Almost all research focuses on Western sociocultural settings. To address these gaps, 299 youth, age 15 to 24, were sampled from established afterschool and community programs in Malaysia to explore the contribution of Y–AP (operationalized as having two components: youth voice in decision-making and supportive adult relationships) to empowerment, agency and community connections. As hypothesized, hierarchical regressions indicated that program quality (Y–AP, safe environment and program engagement) contributed to agency, empowerment and community connections beyond the contribution of family, school and religion. Additionally, the Y–AP measures contributed substantially more variance than the other measures of program quality on each outcome. Interaction effects indicated differences by age for empowerment and agency but not for community connections. The primary findings in this inquiry replicate those found in previous interview and observational-oriented studies. The data suggests fertile ground for future research while demonstrating that Y–AP may be an effective practice for positive youth development outside of Western settings

Production of Extra-Cellular Proteases from Marine Bacillus Sp. Cultured in Media Containing Ammonium Sulfate as the Sole Nitrogen Source

Useful bacterial strains can be used to increase mineralize activity of an aquatic system. These bacteria can specifically degrade targeted compound by producing extra-cellular enzymes. Three species of Bacillus i.e. B. subtilis, B. pumilus and B. licheniformis acquired from shrimp ponds were tested for their ability to utilize ammonia and produce extracellular enzymes. These bacteria were grown in artificial seawater (30 ppt salinity and pH 7.6) supplemented with decreasing yeast extract concentration but increasing ammonium sulfate concentration. All three bacteria grew in artificial seawater containing only 0.01% yeast extract and 1% ammonium sulfate. However, only B. pumilus and B. licheniformis were able to grow in the medium containing only 1% ammonium sulfate as a sole energy source. Bacterialgrowth reduced when alkaline proteases activities was maximum from culture filtrates of all three bacterial cultures during 24 hour culturing in artificial seawater containing 0.01% yeast extract and 1% ammonium sulfate at 30 C when assayed at pH 9. Bacterial growth increased when acid proteases activities was maximum from culture filtrates of all three bacterial cultures during 48 hour culturing in artificial seawater containing 0.01% yeast extract and 1% ammoniumsulfate at 30 C when assayed at pH 5