Exploring the associations between social support and symptoms of posttraumatic stress disorder among Malaysian and Australian trauma survivors

Background: Social support is an important feature in understanding posttraumatic stress disorder (PTSD) and its treatment. Non-clinical research has identified distinct profiles of culturally appropriate social support. Despite this, little research has examined cultural influences on social support in the context of PTSD.Objective: This study examined cultural differences in the associations between social support and symptoms of PTSD.Method: The study employed a cross-sectional design. Australian (n = 91) and Malaysian (n = 91) trauma survivors completed an online survey assessing PTSD symptomatology and social support (explicit and implicit social support, perceived helpfulness of support provider, attitudes towards professional help-seeking). A quasi-experimental paradigm assessed the influence of mutual (i.e. the sharing of support between relationship partners) and non-mutual support (i.e. where one person constantly receives support, while the other person constantly provides support) on negative emotion and subjective distress.Results: First, explicit social support was negatively associated with PTSD symptoms for the Australian group but not the Malaysian group. Second, perceived helpfulness of support from family was negatively associated with PTSD symptoms for the Malaysian group but not the Australian group. Third, the Malaysian group reported significantly greater distress for non-mutual support and significantly fewer negative emotions and distress for mutual support than the Australian group. Fourth, the Malaysian group reported that they were significantly more open to acknowledging psychological problems and the possibility of seeking professional help for these problems than the Australian group.Conclusions: As the PTSD social support literature continues to evolve, it is essential that cultural influences are considered given the important theoretical and clinical implications.

A Randomized Clinical Trial Testing a Parenting Intervention Among Afghan and Rohingya Refugees in Malaysia

Refugee families experience uncertainty and stress when residing in countries of first asylum, such as Malaysia, and may benefit from supportive parenting interventions. In the greater Kuala Lumpur, Malaysia area we piloted an eight-week parenting program with 79 Rohingya and Afghan mothers in nine separate groups. Participants were randomized to an intervention group or a waitlist control group and those in each arm completed a 3-month follow-up assessment. Program content addressed positive discipline, strengthening family relationships, adapting to a new environment, and improving health and emotional well-being. Measures assessed included child intensity and parenting self-efficacy from the Child Adjustment and Parent Efficacy Scale; positive parenting, inconsistent discipline, and poor supervision from the Alabama Parenting Questionnaire-Short Form; family intimacy and family conflict from the Family Functioning Scale, and emotional well-being from the Refugee Health Screening-15. Participating in the intervention led to beneficial changes in child intensity, parenting self-efficacy, family intimacy, family conflict, and emotional distress for the treatment group, and all changes except for emotional distress were maintained over time. However, the intervention did not lead to changes in positive parenting, inconsistent discipline, or poor supervision in the treatment group. Findings point to the potential benefits of parenting programs for refugee communities in transitory settings and contribute to the limited body of literature examining such programs.

Knowledge and Attitudes of Maintaining Bone Health among Post-Menopausal Women in Malaysia

Introduction

Public awareness of osteoporosis is low among women in the developing countries. Health education was shown to be effective in improving knowledge and awareness on maintaining bone health. This study aims to identify the level of knowledge and attitudes among post-menopausal women in Malaysia on achieving bone health throughout the menopausal transition period.

Methods

A total of 116 post-menopausal female patients of orthopedic menopause clinic were recruited using a purposive sampling approach. Data on osteoporosis awareness and knowledge were collected using validated structured questionnaires Osteoporosis Prevention and Awareness Tool and Osteoporosis Attitude Knowledge Test. The chi-square test was used to determine the association between post-menopausal women's socio-demographic characteristics and their knowledge and attitude towards maintaining bone health.

Results

Participants' age ranged between 49 and 82 years (61.84, SD=7.87). The knowledge of osteoporosis varied significantly by age (p=0.014) and education (p=0.001) among the studied population. No significant diffrences were found for participants' attitude towards bone health.

Conclusion

This study showed that the age and education levels have significantly different knowledge of bone health.

Connecting science, policy, and implementation for landscape-scale habitat connectivity

We examined the links between the science and policy of habitat corridors to better understand how corridors can be implemented effectively. As a case study, we focused on a suite of landscape-scale connectivity plans in tropical and subtropical Asia (Malaysia, Singapore, and Bhutan). The process of corridor designation may be more efficient if the scientific determination of optimal corridor locations and arrangement is synchronized in time with political buy-in and establishment of policies to create corridors. Land tenure and the intactness of existing habitat in the region are also important to consider because optimal connectivity strategies may be very different if there are few, versus many, political jurisdictions (including commercial and traditional land tenures) and intact versus degraded habitat between patches. Novel financing mechanisms for corridors include bed taxes, payments for ecosystem services, and strategic forest certifications. Gaps in knowledge of effective corridor design include an understanding of how corridors, particularly those managed by local communities, can be protected from degradation and unsustainable hunting. There is a critical need for quantitative, data-driven models that can be used to prioritize potential corridors or multicorridor networks based on their relative contributions to long-term metacommunity persistence.

Surveillance of adult Aedes mosquitoes in Selangor, Malaysia

OBJECTIVE

To determine the effectiveness of using sticky traps and the NS1 dengue antigen kit for the surveillance of Aedes mosquitoes for dengue control.

METHODS

Apartments were selected in a dengue-endemic area, and sticky traps were set to capture adult Aedes mosquitoes. NS1 dengue antigen kit was used to detect dengue antigen in mosquitoes, and positive mosquitoes were serotyped using real-time RT-PCR.

RESULTS

The sticky traps were effective in capturing Aedes aegypti, and a minimum of three traps per floor was sufficient. Multiple serotypes were found in individual mosquitoes.

CONCLUSION

The sticky trap and the NS1 dengue antigen test kit can be used as surveillance tool in dengue control programmes. This proactive method will be better suited for control programmes than current reactive methods.

Parental reports of behavioural outcome among paediatric leukaemia survivors in Malaysia: a single institution experience

OBJECTIVES

To determine the behavioural impact of chemotherapy in survivors of acute lymphoblastic leukaemia (ALL) treated with chemotherapy only and to identify treatment-related or sociodemography-related factors that might be associated with behavioural outcome.

METHODS

We examined 57 survivors of childhood ALL, who were off treatment for at least 2 years and were in remission, aged 4-18 years, and 221 unrelated healthy controls. The Child Behaviour Checklist (CBCL) parent report was used either in English or in Bahasa Malaysia (the national language of Malaysia) to assess the behavioural outcome.

RESULTS

Childhood ALL survivors had significantly higher scores on externalising behaviour on the CBCL parent report than did controls. Higher problem scores were found in ALL survivors with single parents on 'total problems' (P = 0.03) and subscales 'withdrawn' (P = 0.03), 'social problems' (P < 0.01) and 'delinquent behaviour' (P = 0.03) than in survivors with married parents. Significant associations were seen between a lower education level of the father and the variables representing internalising (withdrawn, anxious/depressed) and externalising (aggressive behaviour). We observed trends on higher scores in all scales in ALL survivors with single parents than in controls with single parents or with fathers with low education level, especially primary education only.

CONCLUSIONS

Malaysian childhood ALL survivors had a significantly increased risk for externalising behavioural problems, and there was a trend towards increased risk of problems in many other behavioural scales. Understanding the sociocultural dimension of patients' health is important to be able to design the most appropriate remedy for problem behaviours detected in this multi-ethnic population.

Exploring intentions to discriminate against patients living with HIV/AIDS among future healthcare providers in Malaysia

OBJECTIVES

Stigma towards people living with HIV/AIDS (PLWHA) is strong in Malaysia. Although stigma has been understudied, it may be a barrier to treating the approximately 81 000 Malaysian PLWHA. The current study explores correlates of intentions to discriminate against PLWHA among medical and dental students, the future healthcare providers of Malaysia.

METHODS

An online, cross-sectional survey of 1296 medical and dental students was conducted in 2012 at seven Malaysian universities; 1165 (89.9%) completed the survey and were analysed. Socio-demographic characteristics, stigma-related constructs and intentions to discriminate against PLWHA were measured. Linear mixed models were conducted, controlling for clustering by university.

RESULTS

The final multivariate model demonstrated that students who intended to discriminate more against PLWHA were female, less advanced in their training, and studying dentistry. They further endorsed more negative attitudes towards PLWHA, internalised greater HIV-related shame, reported more HIV-related fear and disagreed more strongly that PLWHA deserve good care. The final model accounted for 38% of the variance in discrimination intent, with 10% accounted for by socio-demographic characteristics and 28% accounted for by stigma-related constructs.

CONCLUSIONS

It is critical to reduce stigma among medical and dental students to eliminate intentions to discriminate and achieve equitable care for Malaysian PLWHA. Stigma-reduction interventions should be multipronged, addressing attitudes, internalised shame, fear and perceptions of deservingness of care.