Publications by authors named "Keivan Ahmadi"

23 Publications

  • Page 1 of 1

Antimicrobial Resistance, Pharmacists, and Appreciative Inquiry: Development of a Novel Measurement Tool.

Antibiotics (Basel) 2020 Nov 11;9(11). Epub 2020 Nov 11.

School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK.

Antimicrobial resistance (AMR) is a threat to achieving the United Nation's (UN) sustainable development goals (SDGs). The behavior of stakeholders has directly influenced the extent of AMR and understanding underpinning knowledge and attitudes is an important step towards understanding these behaviors. The aim of this study was to develop and validate a novel questionnaire, utilizing the theory of Appreciative Inquiry, to measure knowledge and attitudes around antibiotic resistance amongst community pharmacists throughout Thailand. A survey tool was developed using the Appreciative Inquiry theory, and was piloted in a non-probability sample of practicing community pharmacists. Descriptive and inferential statistics were applied and the tool validated, using a three-step psychometric validation process. A total of 373 community pharmacists participated in the study. The survey tool was found to be valid and reliable. The "Knowledge" domain of the survey tool showed an acceptable level of reliability (Cronbach's alpha 0.64); while the "Attitude" domain showed an excellent reliability level (Cronbach's alpha 0.84). This new survey tool has been designed to measure attitudes and knowledge of antibiotic resistance by utilizing the Discovery phase of Appreciative Inquiry theory amongst community pharmacists in Thailand. This survey tool has the potential to be used by other researchers across different settings.
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http://dx.doi.org/10.3390/antibiotics9110798DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7696492PMC
November 2020

Smoking Cessation Amid the Coronavirus 2019 Pandemic: Making Every Contact Count.

Chronic Obstr Pulm Dis 2020 Oct;7(4):300-302

Lincoln Medical School, Universities of Nottingham and Lincoln, Lincolnshire, United Kingdom.

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http://dx.doi.org/10.15326/jcopdf.7.4.2020.0171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883904PMC
October 2020

Randomised controlled trial of pharmacist-led patient counselling in controlling hypoglycaemic attacks in older adults with type 2 diabetes mellitus (ROSE-ADAM): A study protocol of the SUGAR intervention.

Res Social Adm Pharm 2020 Jul 29. Epub 2020 Jul 29.

Lincoln Medical School, Universities of Nottingham and Lincoln, University of Lincoln, LN6 7TS, Lincoln, UK.

Introduction: Hypoglycaemia is one of the most serious adverse effects of diabetes treatment. Older adults are at the highest risk to develop hypoglycaemia. Several studies have established the important positive role of educational interventions on achieving glycaemic control and other clinical outcomes, however, there is still a lack in studies that evaluate the impact of such type of interventions on hypoglycaemia risk in elderly patients with type 2 diabetes. The purpose of this research is to evaluate the effectiveness of pharmacist-led patient counselling on reducing hypoglycaemic attacks in older adults with type 2 diabetes mellitus.

Methods: and analysis: This study is an open-label, parallel controlled randomised trial, which will be conducted in the outpatient clinics at the largest referral hospital in the north of Jordan. Participants who are elderly (age ≥ 65 years), diagnosed with type 2 diabetes mellitus, and taking insulin, sulfonylurea, or any three anti-diabetic medications will be randomly assigned to intervention (SUGAR Handshake) and control (usual care) groups. The SUGAR Handshake participants will have an interactive, individualised, medications-focused counselling session reinforced with a pictogram and a phone call at week six of enrolment. The primary outcome measure is the frequency of total hypoglycaemic events within 12 weeks of follow up. Secondary outcomes include the frequency of asymptomatic, symptomatic, and severe hypoglycaemic events, hypoglycaemia incidence, and time to the first hypoglycaemic attack. We will also conduct a nested qualitative study for process evaluation.

Ethics And Dissemination: The Human Research Ethics Committee of the University of Lincoln and the Institutional Review Board of King Abdullah University Hospital approved this protocol. The findings of this study will be presented in international conferences and published in a peer-reviewed journal.

Trial Registration Number: The study protocol has been registered with ClinicalTrials.gov, NCT04081766.
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http://dx.doi.org/10.1016/j.sapharm.2020.07.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387288PMC
July 2020

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017.

Authors:
Roy Burstein Nathaniel J Henry Michael L Collison Laurie B Marczak Amber Sligar Stefanie Watson Neal Marquez Mahdieh Abbasalizad-Farhangi Masoumeh Abbasi Foad Abd-Allah Amir Abdoli Mohammad Abdollahi Ibrahim Abdollahpour Rizwan Suliankatchi Abdulkader Michael R M Abrigo Dilaram Acharya Oladimeji M Adebayo Victor Adekanmbi Davoud Adham Mahdi Afshari Mohammad Aghaali Keivan Ahmadi Mehdi Ahmadi Ehsan Ahmadpour Rushdia Ahmed Chalachew Genet Akal Joshua O Akinyemi Fares Alahdab Noore Alam Genet Melak Alamene Kefyalew Addis Alene Mehran Alijanzadeh Cyrus Alinia Vahid Alipour Syed Mohamed Aljunid Mohammed J Almalki Hesham M Al-Mekhlafi Khalid Altirkawi Nelson Alvis-Guzman Adeladza Kofi Amegah Saeed Amini Arianna Maever Loreche Amit Zohreh Anbari Sofia Androudi Mina Anjomshoa Fereshteh Ansari Carl Abelardo T Antonio Jalal Arabloo Zohreh Arefi Olatunde Aremu Bahram Armoon Amit Arora Al Artaman Anvar Asadi Mehran Asadi-Aliabadi Amir Ashraf-Ganjouei Reza Assadi Bahar Ataeinia Sachin R Atre Beatriz Paulina Ayala Quintanilla Martin Amogre Ayanore Samad Azari Ebrahim Babaee Arefeh Babazadeh Alaa Badawi Soghra Bagheri Mojtaba Bagherzadeh Nafiseh Baheiraei Abbas Balouchi Aleksandra Barac Quique Bassat Bernhard T Baune Mohsen Bayati Neeraj Bedi Ettore Beghi Masoud Behzadifar Meysam Behzadifar Yared Belete Belay Brent Bell Michelle L Bell Dessalegn Ajema Berbada Robert S Bernstein Natalia V Bhattacharjee Suraj Bhattarai Zulfiqar A Bhutta Ali Bijani Somayeh Bohlouli Nicholas J K Breitborde Gabrielle Britton Annie J Browne Sharath Burugina Nagaraja Reinhard Busse Zahid A Butt Josip Car Rosario Cárdenas Carlos A Castañeda-Orjuela Ester Cerin Wagaye Fentahun Chanie Pranab Chatterjee Dinh-Toi Chu Cyrus Cooper Vera M Costa Koustuv Dalal Lalit Dandona Rakhi Dandona Farah Daoud Ahmad Daryani Rajat Das Gupta Ian Davis Nicole Davis Weaver Dragos Virgil Davitoiu Jan-Walter De Neve Feleke Mekonnen Demeke Gebre Teklemariam Demoz Kebede Deribe Rupak Desai Aniruddha Deshpande Hanna Demelash Desyibelew Sagnik Dey Samath Dhamminda Dharmaratne Meghnath Dhimal Daniel Diaz Leila Doshmangir Andre R Duraes Laura Dwyer-Lindgren Lucas Earl Roya Ebrahimi Soheil Ebrahimpour Andem Effiong Aziz Eftekhari Elham Ehsani-Chimeh Iman El Sayed Maysaa El Sayed Zaki Maha El Tantawi Ziad El-Khatib Mohammad Hassan Emamian Shymaa Enany Sharareh Eskandarieh Oghenowede Eyawo Maha Ezalarab Mahbobeh Faramarzi Mohammad Fareed Roghiyeh Faridnia Andre Faro Ali Akbar Fazaeli Mehdi Fazlzadeh Netsanet Fentahun Seyed-Mohammad Fereshtehnejad João C Fernandes Irina Filip Florian Fischer Nataliya A Foigt Masoud Foroutan Joel Msafiri Francis Takeshi Fukumoto Nancy Fullman Silvano Gallus Destallem Gebremedhin Gebre Tsegaye Tewelde Gebrehiwot Gebreamlak Gebremedhn Gebremeskel Bradford D Gessner Birhanu Geta Peter W Gething Reza Ghadimi Keyghobad Ghadiri Mahsa Ghajarzadeh Ahmad Ghashghaee Paramjit Singh Gill Tiffany K Gill Nick Golding Nelson G M Gomes Philimon N Gona Sameer Vali Gopalani Giuseppe Gorini Bárbara Niegia Garcia Goulart Nicholas Graetz Felix Greaves Manfred S Green Yuming Guo Arvin Haj-Mirzaian Arya Haj-Mirzaian Brian James Hall Samer Hamidi Hamidreza Haririan Josep Maria Haro Milad Hasankhani Edris Hasanpoor Amir Hasanzadeh Hadi Hassankhani Hamid Yimam Hassen Mohamed I Hegazy Delia Hendrie Fatemeh Heydarpour Thomas R Hird Chi Linh Hoang Gillian Hollerich Enayatollah Homaie Rad Mojtaba Hoseini-Ghahfarokhi Naznin Hossain Mostafa Hosseini Mehdi Hosseinzadeh Mihaela Hostiuc Sorin Hostiuc Mowafa Househ Mohamed Hsairi Olayinka Stephen Ilesanmi Mohammad Hasan Imani-Nasab Usman Iqbal Seyed Sina Naghibi Irvani Nazrul Islam Sheikh Mohammed Shariful Islam Mikk Jürisson Nader Jafari Balalami Amir Jalali Javad Javidnia Achala Upendra Jayatilleke Ensiyeh Jenabi John S Ji Yash B Jobanputra Kimberly Johnson Jost B Jonas Zahra Jorjoran Shushtari Jacek Jerzy Jozwiak Ali Kabir Amaha Kahsay Hamed Kalani Rohollah Kalhor Manoochehr Karami Surendra Karki Amir Kasaeian Nicholas J Kassebaum Peter Njenga Keiyoro Grant Rodgers Kemp Roghayeh Khabiri Yousef Saleh Khader Morteza Abdullatif Khafaie Ejaz Ahmad Khan Junaid Khan Muhammad Shahzeb Khan Young-Ho Khang Khaled Khatab Amir Khater Mona M Khater Alireza Khatony Mohammad Khazaei Salman Khazaei Maryam Khazaei-Pool Jagdish Khubchandani Neda Kianipour Yun Jin Kim Ruth W Kimokoti Damaris K Kinyoki Adnan Kisa Sezer Kisa Tufa Kolola Soewarta Kosen Parvaiz A Koul Ai Koyanagi Moritz U G Kraemer Kewal Krishan Kris J Krohn Nuworza Kugbey G Anil Kumar Manasi Kumar Pushpendra Kumar Desmond Kuupiel Ben Lacey Sheetal D Lad Faris Hasan Lami Anders O Larsson Paul H Lee Mostafa Leili Aubrey J Levine Shanshan Li Lee-Ling Lim Stefan Listl Joshua Longbottom Jaifred Christian F Lopez Stefan Lorkowski Sameh Magdeldin Hassan Magdy Abd El Razek Muhammed Magdy Abd El Razek Azeem Majeed Afshin Maleki Reza Malekzadeh Deborah Carvalho Malta Abdullah A Mamun Navid Manafi Ana-Laura Manda Morteza Mansourian Francisco Rogerlândio Martins-Melo Anthony Masaka Benjamin Ballard Massenburg Pallab K Maulik Benjamin K Mayala Mohsen Mazidi Martin McKee Ravi Mehrotra Kala M Mehta Gebrekiros Gebremichael Meles Walter Mendoza Ritesh G Menezes Atte Meretoja Tuomo J Meretoja Tomislav Mestrovic Ted R Miller Molly K Miller-Petrie Edward J Mills George J Milne G K Mini Seyed Mostafa Mir Hamed Mirjalali Erkin M Mirrakhimov Efat Mohamadi Dara K Mohammad Aso Mohammad Darwesh Naser Mohammad Gholi Mezerji Ammas Siraj Mohammed Shafiu Mohammed Ali H Mokdad Mariam Molokhia Lorenzo Monasta Yoshan Moodley Mahmood Moosazadeh Ghobad Moradi Masoud Moradi Yousef Moradi Maziar Moradi-Lakeh Mehdi Moradinazar Paula Moraga Lidia Morawska Abbas Mosapour Seyyed Meysam Mousavi Ulrich Otto Mueller Atalay Goshu Muluneh Ghulam Mustafa Behnam Nabavizadeh Mehdi Naderi Ahamarshan Jayaraman Nagarajan Azin Nahvijou Farid Najafi Vinay Nangia Duduzile Edith Ndwandwe Nahid Neamati Ionut Negoi Ruxandra Irina Negoi Josephine W Ngunjiri Huong Lan Thi Nguyen Long Hoang Nguyen Son Hoang Nguyen Katie R Nielsen Dina Nur Anggraini Ningrum Yirga Legesse Nirayo Molly R Nixon Chukwudi A Nnaji Marzieh Nojomi Mehdi Noroozi Shirin Nosratnejad Jean Jacques Noubiap Soraya Nouraei Motlagh Richard Ofori-Asenso Felix Akpojene Ogbo Kelechi E Oladimeji Andrew T Olagunju Meysam Olfatifar Solomon Olum Bolajoko Olubukunola Olusanya Mojisola Morenike Oluwasanu Obinna E Onwujekwe Eyal Oren Doris D V Ortega-Altamirano Alberto Ortiz Osayomwanbo Osarenotor Frank B Osei Aaron E Osgood-Zimmerman Stanislav S Otstavnov Mayowa Ojo Owolabi Mahesh P A Abdol Sattar Pagheh Smita Pakhale Songhomitra Panda-Jonas Animika Pandey Eun-Kee Park Hadi Parsian Tahereh Pashaei Sangram Kishor Patel Veincent Christian Filipino Pepito Alexandre Pereira Samantha Perkins Brandon V Pickering Thomas Pilgrim Majid Pirestani Bakhtiar Piroozi Meghdad Pirsaheb Oleguer Plana-Ripoll Hadi Pourjafar Parul Puri Mostafa Qorbani Hedley Quintana Mohammad Rabiee Navid Rabiee Amir Radfar Alireza Rafiei Fakher Rahim Zohreh Rahimi Vafa 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Morteza Shamsizadeh Kiomars Sharafi Mehdi Sharif Mahdi Sharif-Alhoseini Hamid Sharifi Jayendra Sharma Rajesh Sharma Aziz Sheikh Chloe Shields Mika Shigematsu Rahman Shiri Ivy Shiue Kerem Shuval Tariq J Siddiqi João Pedro Silva Jasvinder A Singh Dhirendra Narain Sinha Malede Mequanent Sisay Solomon Sisay Karen Sliwa David L Smith Ranjani Somayaji Moslem Soofi Joan B Soriano Chandrashekhar T Sreeramareddy Agus Sudaryanto Mu'awiyyah Babale Sufiyan Bryan L Sykes P N Sylaja Rafael Tabarés-Seisdedos Karen M Tabb Takahiro Tabuchi Nuno Taveira Mohamad-Hani Temsah Abdullah Sulieman Terkawi Zemenu Tadesse Tessema Kavumpurathu Raman Thankappan Sathish Thirunavukkarasu Quyen G To Marcos Roberto Tovani-Palone Bach Xuan Tran Khanh Bao Tran Irfan Ullah Muhammad Shariq Usman Olalekan A Uthman Amir Vahedian-Azimi Pascual R Valdez Job F M van Boven Tommi Juhani Vasankari Yasser Vasseghian Yousef Veisani Narayanaswamy Venketasubramanian Francesco S Violante Sergey Konstantinovitch Vladimirov Vasily Vlassov Theo Vos Giang Thu Vu Isidora S Vujcic Yasir Waheed Jon Wakefield Haidong Wang Yafeng Wang Yuan-Pang Wang Joseph L Ward Robert G Weintraub Kidu Gidey Weldegwergs Girmay Teklay Weldesamuel Ronny Westerman Charles Shey Wiysonge Dawit Zewdu Wondafrash Lauren Woyczynski Ai-Min Wu Gelin Xu Abbas Yadegar Tomohide Yamada Vahid Yazdi-Feyzabadi Christopher Sabo Yilgwan Paul Yip Naohiro Yonemoto Javad Yoosefi Lebni Mustafa Z Younis Mahmoud Yousefifard Hebat-Allah Salah A Yousof Chuanhua Yu Hasan Yusefzadeh Erfan Zabeh Telma Zahirian Moghadam Sojib Bin Zaman Mohammad Zamani Hamed Zandian Alireza Zangeneh Taddese Alemu Zerfu Yunquan Zhang Arash Ziapour Sanjay Zodpey Christopher J L Murray Simon I Hay

Nature 2019 10 16;574(7778):353-358. Epub 2019 Oct 16.

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.
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http://dx.doi.org/10.1038/s41586-019-1545-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800389PMC
October 2019

Use of Central Nervous System (CNS) Medicines in Aged Care Homes: A Systematic Review and Meta-Analysis.

J Clin Med 2019 Aug 23;8(9). Epub 2019 Aug 23.

Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK.

Background: Both old age and institutionalization in aged care homes come with a significant risk of developing several long-term mental and neurological disorders, but there has been no definitive meta-analysis of data from studies to determine the pooled estimate of central nervous system (CNS) medicines use in aged care homes. We conducted this systematic review to summarize the use of CNS drugs among aged care homes residents.

Methods: MEDLINE, EMBASE, CINAHL, Scopus, and International Pharmaceutical Abstracts (IPA) databases were searched (between 1 January 2000 and 31 December 2018) to identify population-based studies that reported the use of CNS medicines in aged care homes. Pooled proportions (with 95% confidence interval), according to study location were calculated.

Results: A total of 89 studies reported the use of CNS medicines use in aged care. The pooled estimate of CNS drugs use varied according to country (from 20.3% in Ireland to 49.0% in Belgium) and region (from 31.7% in North America to 42.5% in Scandinavia). The overall pooled estimate of psychotropic medicines use was highest in Europe (72.2%, 95% CI, 67.1-77.1%) and lowest in ANZ region (56.9%, 95% CI, 52.2-61.4%). The pooled estimate of benzodiazepines use varied widely from 18.9% in North America to 44.8% in Europe. The pooled estimate of antidepressants use from 47 studies was 38.3% (95% CI 35.1% to 41.6%) with highest proportion in North America (44.9%, 95% CI, 35.3-54.5%).

Conclusion: The overall use of CNS drugs varied among countries, with studies from Australia-New Zealand reported the lowest use of CNS drugs. The criteria for prescribing CNS drugs in clinical practice should be evidence-based. The criteria should be used not to prohibit the use of the listed medications but to support the clinical judgement as well as patient safety.
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http://dx.doi.org/10.3390/jcm8091292DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780105PMC
August 2019

E-cigarettes: further flavours of controversy within the controversy.

Lancet Respir Med 2018 01 5;6(1):16-17. Epub 2017 Dec 5.

London School of Hygiene and Tropical Medicine, London, UK.

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http://dx.doi.org/10.1016/S2213-2600(17)30467-8DOI Listing
January 2018

Implementing professionalism by deprofessionalized strategies: A moral quandary.

Curr Pharm Teach Learn 2017 Jan - Feb;9(1):9-11. Epub 2016 Oct 26.

Department of Pharmacy Practice, School of Pharmacy, International Medical University (IMU), Kuala Lumpur, Malaysia.

Monetary fine proceedings has been one of the methods of upholding professionalism amongst health care professionals. Professionalism as a concept is multifaceted and fragmented and it has become symbolic to the extent that, unfortunately, some traits of professionalism showcase the whole concept. It seems fair to interpret the symbolic views on the concept of professionalism as means to capitalize on certain aspects of professions such as commercial profitability for the employer and respected status for the profession. Evaluation of professionalism is often implicit and inadequate; and assessing professionalism by relying on abstract and idealized definitions implies that professionalism is a compounded composite of certain set of stable traits. We suggest to refer to the theory of values-based practice so as to achieve collocated views on professionalism among employers and health academics. Instead of capitalizing on certain traits of professionalism to project the whole concept of professionalism, we may need to relook at the traits of professionalism as values. It is extremely crucial to internalize the values of the health profession in the future health professionals, so that the future health professionals imbibe the professionalism through dialog and democratic methods of sharing values during the course of professional development.
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http://dx.doi.org/10.1016/j.cptl.2016.08.032DOI Listing
July 2018

Publish or Perish: A Mandate With Negative Collateral Consequences.

Acad Med 2017 02;92(2):140

Lecturer, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia. Senior lecturer, School of Pharmacy, University of Lincoln, Lincolnshire, United Kingdom;

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http://dx.doi.org/10.1097/ACM.0000000000001517DOI Listing
February 2017

E-cigarettes: controversies within the controversy.

Lancet Respir Med 2016 11 12;4(11):868-869. Epub 2016 Oct 12.

Lincoln Institute for Health, University of Lincoln, Lincoln, UK.

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http://dx.doi.org/10.1016/S2213-2600(16)30312-5DOI Listing
November 2016

A latent trait approach to measuring HIV/AIDS related stigma in healthcare professionals: application of mokken scaling technique.

BMC Med Educ 2016 May 30;16:155. Epub 2016 May 30.

Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia.

Background: The attitudes of healthcare professionals towards HIV positive patients and high risk groups are central to the quality of care and therefore to the management of HIV/AIDS related stigma in health settings. Extant HIV/AIDS stigma scales that measure stigmatising attitudes towards people living with HIV/AIDS have been developed using scaling techniques such as principal component analysis. This approach has resulted in instruments that are often long. Mokken scale analysis is a nonparametric hierarchical scaling technique that can be used to develop unidimensional cumulative scales. This technique is advantageous over the other approaches; as the scales are usually shorter, while retaining acceptable psychometric properties. Moreover, Mokken scales also make no distributional assumptions about the underlying data, other than that the data are capable of being ordered by item and by person. In this study we aimed at developing a precise and concise measure of HIV/AIDS related stigma among health care professionals, using Mokken scale analysis.

Methods: We carried out a cross sectional survey of healthcare students at the Monash University campuses in Malaysia and Australia. The survey consisted of demographic questions and an initial item pool of twenty five potential questions for inclusion in an HIV stigma scale.

Results: We analysed the data using the mokken package in the R statistical environment providing a 9-item scale with high reliability, validity and acceptable psychometric properties, measuring and ranking the HIV/AIDS related stigmatising attitudes.

Conclusion: Mokken scaling procedure not only produced a comprehensive hierarchical scale that could accurately order a person along HIV/AIDS stigmatising attitude, but also demonstrated a unidimensional and reliable measurement tool which could be used in future studies. The principal component analysis confirmed the accuracy of the Mokken scale analysis in correctly detecting the unidimensionality of this scale. We recommend future works to study the generalisability of this scale in a new population.
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http://dx.doi.org/10.1186/s12909-016-0676-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4885119PMC
May 2016

The health professionals' right to refuse: is it good, bad or ugly?

Int J Pharm Pract 2015 Feb;23(1):92

Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Selangor, Malaysia; Department of Pharmacy Practice, School of Pharmacy, International Medical University (IMU), Kuala Lumpur, Malaysia.

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http://dx.doi.org/10.1111/ijpp.12121DOI Listing
February 2015

A novel nonparametric item response theory approach to measuring socioeconomic position: a comparison using household expenditure data from a Vietnam health survey, 2003.

Emerg Themes Epidemiol 2014 12;11. Epub 2014 Aug 12.

Global Public Health, School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia ; School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia.

Background: Measures of household socio-economic position (SEP) are widely used in health research. There exist a number of approaches to their measurement, with Principal Components Analysis (PCA) applied to a basket of household assets being one of the most common. PCA, however, carries a number of assumptions about the distribution of the data which may be untenable, and alternative, non-parametric, approaches may be preferred. Mokken scale analysis is a non-parametric, item response theory approach to scale development which appears never to have been applied to household asset data. A Mokken scale can be used to rank order items (measures of wealth) as well as households. Using data on household asset ownership from a national sample of 4,154 consenting households in the World Health Survey from Vietnam, 2003, we construct two measures of household SEP. Seventeen items asking about assets, and utility and infrastructure use were used. Mokken Scaling and PCA were applied to the data. A single item measure of total household expenditure is used as a point of contrast.

Results: An 11 item scale, out of the 17 items, was identified that conformed to the assumptions of a Mokken Scale. All the items in the scale were identified as strong items (Hi > .5). Two PCA measures of SEP were developed as a point of contrast. One PCA measure was developed using all 17 available asset items, the other used the reduced set of 11 items identified in the Mokken scale analaysis. The Mokken Scale measure of SEP and the 17 item PCA measure had a very high correlation (r = .98), and they both correlated moderately with total household expenditure: r = .59 and r = .57 respectively. In contrast the 11 item PCA measure correlated moderately with the Mokken scale (r = .68), and weakly with the total household expenditure (r = .18).

Conclusion: The Mokken scale measure of household SEP performed at least as well as PCA, and outperformed the PCA measure developed with the 11 items used in the Mokken scale. Unlike PCA, Mokken scaling carries no assumptions about the underlying shape of the distribution of the data, and can be used simultaneous to order household SEP and items. The approach, however, has not been tested with data from other countries and remains an interesting, but under researched approach.
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http://dx.doi.org/10.1186/1742-7622-11-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4132525PMC
August 2014

A need to rethink and mold consensus regarding pharmacy education in developing countries.

Am J Pharm Educ 2013 Aug;77(6):112

School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.

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http://dx.doi.org/10.5688/ajpe776112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748293PMC
August 2013

Professionalisation and social attitudes: a protocol for measuring changes in HIV/AIDS-related stigma among healthcare students.

BMJ Open 2013 May 28;3(5). Epub 2013 May 28.

Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Sunway campus, Malaysia.

Introduction: HIV/AIDS-related stigma affects the access and utilisation of health services. Although HIV/AIDS-related stigma in the health services has been studied, little work has attended to the relationship between professional development and stigmatising attitudes. Hence, in this study, we will extend earlier research by examining the relationship between the stage of professional development and the kinds of stigmatising attitudes held about people living with HIV/AIDS.

Methods And Analysis: A serial cross-sectional design will be combined with a two-point in time longitudinal design to measure the levels of stigma among healthcare students from each year of undergraduate and graduate courses in Malaysia and Australia. In the absence of suitable measures, we will carry out a sequential mixed methods design to develop such a tool. The questionnaire data will be analysed using mixed effects linear models to manage the repeated measures.

Ethics And Dissemination: We have received ethical approval from the Monash MBBS executive committee as well as the Monash University Human Research Ethics Committee. We will keep the data in a locked filing cabinet in the Monash University (Sunway campus) premises for 5 years, after which the information will be shredded and disposed of in secure bins, and digital recordings will be erased in accordance with Monash University's regulations. Only the principal investigator and the researcher will have access to the filing cabinet. We aim to present and publish the results of this study in national and international conferences and peer-reviewed journals, respectively.
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http://dx.doi.org/10.1136/bmjopen-2013-002755DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3669716PMC
May 2013

Impact of pharmacists' intervention on identification and management of drug-drug interactions in an intensive care setting.

Singapore Med J 2012 Aug;53(8):526-31

School of Pharmacy, University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia.

Introduction: The primary and secondary objectives of this study were to identify and assess the risks associated with the occurrence of drug-drug interactions (DDIs) and to determine the value of pharmacists' interventions in the management of clinically significant DDIs, respectively.

Methods: A prospective, case-control study was carried out on patients admitted to the intensive care unit (ICU), and involved a review of patients' medication chart daily by the pharmacist and the clinical parameters. All identified DDIs were carefully analysed in order to provide recommendations on the management of clinically significant DDIs.

Results: The majority of DDIs were categorised as Type-C severity level (n = 305, 75.9%). 'Substitution' was recommended in 34 cases of clinically significant DDIs, 'dosage adjustment' in 17 (4.2%) and 'stop or avoid' in 13 (3.2%). The number of drugs prescribed (p = 0.001, rS = 0.539) and length of ICU stay (p = 0.001, rS = 0.364) were significantly associated and positively correlated with the occurrence of DDIs. Patients with DDIs had a longer length of ICU stay than those without DDIs (9.5 days vs. 2.4 days, p = 0.001). No significant difference was found between patients aged below 50 years and those above 50 years (odds ratio 0.488, 95% confidence interval 0.166-1.434) in terms of the risk of DDIs.

Conclusion: A large number of DDIs were identified in this study, but only a small number were clinically significant. Pharmacists' participation in daily ward rounds could play an important role in the detection and management of clinically significant DDIs.
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August 2012

Patient-reported adverse drug reactions and drug-drug interactions: a cross-sectional study on Malaysian HIV/AIDS patients.

Med Princ Pract 2011 29;20(3):265-70. Epub 2011 Mar 29.

Department of Pharmacy Practice and Community Oral Health, School of Pharmacy and Dentistry, International Medical University, Kuala Lumpur, Malaysia.

Objective: This study aimed to explore the adverse drug reactions (ADRs) reported by patients and to identify drug-drug interactions (DDIs) among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients.

Subjects And Methods: This cross-sectional study was conducted at the Medication Therapy Adherence Clinic, Hospital Sungai Buloh, an HIV/AIDS referral centre. The patients were randomly selected and were encouraged to describe ADRs caused specifically by any of the prescribed antiretroviral drugs (ARDs). Sociodemographic characteristics were recorded from the patients' medical records. In addition data on antiretroviral treatment (ART), DDIs and other conventional medication were also documented.

Results: A total of 325 randomly selected HIV/AIDS patients with a mean age of 22.94 years participated in the study. The most frequently prescribed ARDs were lamivudine (64.6%), zidovudine (40.6%) and efavirenz (42.5%). Commonly reported ADRs were fatigue (54.8%), allergic reactions (41.5%), weight loss (41.5%), dry mouth (35.1%) and memory loss (35.1%). Female (87.8%), non-complementary and alternative medicine (CAM) users (87.3%) and participants below 50 years old (81.1%) were identified as having a higher prevalence of ADRs compared to males (79.6%), CAM users (78.7%) and participants aged 50 years or more (77.5%). Patient age was found to be significantly associated (p = 0.048) with the ADRs. In addition, a total of 44 cases of DDIs belonging to category D were also found in this study.

Conclusions: This study enabled us to identify the most common ADRs and DDIs associated with the use of ART. Safe and effective treatment depends on the healthcare providers' knowledge of the same.
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http://dx.doi.org/10.1159/000321274DOI Listing
September 2011

Influences on Malaysian pharmacy students' career preferences.

Am J Pharm Educ 2010 Nov;74(9):166

School of Pharmacy and Health Sciences, International Medical University, No 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.

Objectives: To identify and evaluate factors affecting the career preferences of fourth-year bachelor of pharmacy (BPharm) students in Malaysia in the presence of a 4-year period of mandatory government service.

Methods: A validated self-administered questionnaire was used in this cross-sectional study to collect data from final-year BPharm students enrolled at 3 government-funded universities and 1 private university in Malaysia. Both descriptive and inferential statistics were used for data analysis.

Results: Three hundred fourteen students responded (213 from public universities and 101 from the private university). Approximately 32% of public university students and 37% of private university students ranked their own interest in pharmacy as the reason for undertaking pharmacy degree studies; 40.4% of public and 19.8% of private university respondents stated that they would enter a nonpharmacy-related career upon graduation if given the choice. Public university students ranked hospital pharmacy as their choice of first career setting (4.39, p = 0.001), while private students ranked community pharmacy first (4.1, p = 0.002). On a scale of 1 to 5, salary received the highest mean score (3.9 and 4.0, p = 0.854) as the extrinsic factor most influencing their career choice.

Conclusions: Final-year students at Malaysian public universities were most interested in hospital pharmacy practice as their first career step upon graduation, while private university students were most interested in community pharmacy. The top 3 extrinsic factors rated as significant in selecting a career destination were salary, benefits, and geographical location.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2996756PMC
http://dx.doi.org/10.5688/aj7409166DOI Listing
November 2010

Reasons, perceived efficacy, and factors associated with complementary and alternative medicine use among Malaysian patients with HIV/AIDS.

J Altern Complement Med 2010 Nov 25;16(11):1171-6. Epub 2010 Oct 25.

Department of Pharmacy Practice, School of Pharmacy and Health Sciences, International Medical University, Kuala Lumpur, Malaysia.

Objectives: The primary objective of this study was to evaluate the pattern of use, reasons for use, and perceived effect of complementary and alternative medicine (CAM), accompanied by identification and comparison of the factors that are potentially associated with CAM use.

Design: This cross-sectional study was carried out in 325 randomly sampled patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), at HIV/AIDS referral clinics in the Hospital Sungai Buloh, Malaysia. Simple random sampling was used, where randomization was done using patients' medical record numbers.

Subjects And Methods: Semistructured face-to-face interviews were conducted using 38 questions pertaining to type, pattern, perceived efficacy, adverse effects, and influential factors associated with CAM use. In addition, CD4 count and viral load readings were recorded.

Results: Of 325 randomly sampled patients with HIV/AIDS, 254 of them were using some forms of CAM, resulting in a utilization rate of 78.2%. Vitamins and supplements (52.6%), herbal products (33.8%), and massage (16.6%) were the top three most frequently used CAM modalities. Sociodemographic factors including education level (p = 0.021, r(s) = 0.148), monthly income (p = 0.001, r(s) = 0.260), and family history of CAM use (p = 0.001, r(s) = 0.231) were significantly associated and positively correlated with CAM use. However, the majority of these patients (68%) did not disclose CAM use to health care professionals. About half of those who rated their health as good or very good perceived it as a result of CAM use.

Conclusions: This study confirmed the range of 30%-100% CAM use among individuals infected with HIV/AIDS. Although, on the one hand some types of CAM reduced viral load and enhanced the immune system, on the other hand some forms of CAM produced a detrimental effect on the virological suppression, opening this platform to more research and investigation in order to optimize the use of CAM among patients with HIV/AIDS.
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http://dx.doi.org/10.1089/acm.2009.0657DOI Listing
November 2010

Awareness of school students on sexually transmitted infections (STIs) and their sexual behavior: a cross-sectional study conducted in Pulau Pinang, Malaysia.

BMC Public Health 2010 Jan 30;10:47. Epub 2010 Jan 30.

School of Pharmacy and Health Sciences, International Medical University, Kuala Lumpur, Malaysia.

Background: Sexually transmitted Infections (STIs) rank among the most important health issues for the people especially the young adults worldwide. Young people tend to engage in sexual activity at younger ages in the past decade than in the 1970s, and 1980s. Knowledge is an essential precursor of sexual risk reduction. A cross-sectional study was conducted in Pulau Pinang, Malaysia, to produce the baseline information about school students' awareness and perception about sexually transmitted Infections (STIs) and their sexual activity to help establish control and education programmes.

Methods: Students from form 4 (aged between 15 to 16 years), form 5 (aged between 16 to 17 years) and form 6 (aged between 18 to 20 years) in their class rooms were approached and asked to complete self administered and anonymous pre-validated questionnaires. SPSS for windows version 13 was used to analyze the results statistically and results were presented in tabular form.

Results: Data was collected from 1139 students aged between 15 to 20 years, 10.6% of which claimed that they never heard about STIs. Sexual experience related significantly with gender, race, and education level. Approximately 12.6% claimed to have sexual experience of which 75.7% had their sexual debut at 15-19 years and 38.2% were having more than 3 partners. Sexual experience was found to be significantly associated with gender (p = 0.003), ethnicity (p = 0.001) and education level (p = 0.030). However, multiple partner behaviour was significantly associated only with gender (p = 0.010). Mean knowledge score was 11.60 +/- 8.781 and knowledge level was significantly associated with religion (p = 0.005) education level (p = 0.000), course stream (p = 0.000), socioeconomic class (p = 0.000) and sexual experience (p = 0.022).

Conclusions: It was concluded that school students have moderate level of knowledge about STIs although they are sexually active. Interventions such as reinforcing the link between STIs and HIV/AIDS, assessing the current status of sexuality education in schools and arranging public talks and seminars focusing on STIs prevention education are needed to improve their awareness.
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http://dx.doi.org/10.1186/1471-2458-10-47DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824738PMC
January 2010