BackgroundThis study aimed to estimate potential reductions in case incidence of colorectal cancer attributable to the modifiable risk factors such as alcohol consumption, overweight and physical inactivity amongst the Malaysian population.MethodsGender specific population-attributable fractions (PAFs) for colorectal cancer in Malaysia were estimated for the three selected risk factors (physical inactivity, overweight, and alcohol consumptions). Exposure prevalence were sourced from a large-scale national representative survey. Risk estimates of the relationship between the exposure of interest and colorectal cancer were obtained from published meta-analyses. The overall PAF was then estimated, using the 2013 national cancer incidence data from the Malaysian Cancer Registry.ResultsOverall, the mean incidence rate for colorectal cancer in Malaysia from 2008 to 2013 was 21.3 per 100,000 population, with the mean age of 61.6 years (±12.7) and the majority were men (56.6%). Amongst 369 colorectal cancer cases in 2013, 40 cases (20 men, 20 women), 10 cases (9 men, 1 woman) or 20 cases (16 men,4 women) would be prevented, if they had done physical exercises, could reduce their body weight to normal level or avoided alcohol consumption, assuming that these factors are causally related to colorectal cancer. It was estimated that 66 (17.8%;66/369) colorectal cancer cases (42 men, 24 women) who had all these three risk factors for the last 10 years would have been prevented, if they could control these three risk factors through effective preventive measures.ConclusionsFindings suggest that approximately 18% of colorectal cancer cases in Malaysia would be prevented through appropriate preventive measures such as doing regular physical exercises, reducing their body weight to normal level and avoiding alcohol consumption, if these factors are causally related to colorectal cancer. Scaling-up nationwide public health campaigns tailored to increase physical activity, controlling body weight within normal limits and avoid alcohol intake are recommended. Future studies with other site-specific cancers and additional risk factors are needed.

BackgroundHuman chromosomes are capped and stabilized by telomeres. Telomere length regulates a ‘cellular mitotic clock’ that defines the number of cell divisions and hence, cellular life span. This study aimed to synthesize the evidence on the association between peripheral blood leucocytes (PBL) telomere length and the risk of colorectal cancer (CRC).MethodsWe searched relevant studies in electronic databases. When two or more observational studies reported the same outcome measures, we performed pooled analysis. All the analyses were performed on PBL using PCR. The odds ratio (OR) and its 95% confidence interval (CI) were used to assess the strength of association.ResultsSeven studies (with 8 datasets) were included in this meta-analysis; 3 prospective studies, 3 retrospective studies and 1 study with a separate prospective and retrospective designs. The pooled analysis of 4 prospective studies (summary OR 1.01, 95% CI: 0.77–1.34, I 2:30%) and 4 retrospective studies (summary OR 1.65, 95% CI: 0.96–2.83, I 2:96%) showed no relationship between PBL telomere length and the CRC risk. A subgroup analysis of 2 prospective studies exclusively on females also showed no association between PBL telomere length and the CRC risk (summary OR, 1.17, 95% CI:0.72–1.91, I 2:57%).ConclusionThe current analysis is insufficient to provide evidence on the relationship between PBL telomere length and the risk of CRC. Findings suggest that there may be a complex relationship between PBL telomere length and the CRC risk or discrepancy between genetics, age of patients and clinical studies. Future well powered, large prospective studies on the relationship between telomere length and the risk of CRC, and the investigations of the biologic mechanisms are recommended.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2997-3) contains supplementary material, which is available to authorized users.

Background:The high employability of pharmacy graduates across various sectors such as in the community pharmacies and hospital settings, the pharmaceutical industries and academia has lent credence to the versatility of their professional training. Therefore, the aim of this study was to gauge the perception of International Medical University (IMU) pharmacy graduates on the applicability and relevance of the chemistry knowledge and practical skills acquired from their professional education in their working place. Methods: The survey was designed based on the pharmacy curriculum of IMU. Qualitative and quantitative responses were collected and analysed by three independent investigators who were not the respondents, and not lecturing in any part of the Chemistry curriculum. The study was completed when the qualitative feedback from respondents reached saturation. Results: Almost equal numbers of pharmacists from the different pharmacy disciplines: (1) industrial and regulatory, (2) hospital and clinical, (3) community and (4) academia, participated in this study. Most of the chemistry topics were rated as essential by the graduates. Some topics were rated very relevant (more than 80%) whereas only up to 30% of the graduates agreed on the essentiality of some topics to their profession. Conclusion: The study concluded that most of the current chemistry content is still essential in nurturing competent pharmacists for their respective disciplines. The outcomes of this study will be used as evidence to support the need for conducting a curriculum review, to better prepare graduates for their future employment.

Each nursing student comes to nursing with a lay image of nursing portrayed by nurses they have seen. This lay perception of nursing that a nursing student holds is transformed to a more professional understanding that is acquired in nursing schools. This process is known as professional socialization. It is a process of learning the norms, attitudes, behaviours, skills, roles, and values of the profession. It involves the internalization of the values and norms of the profession in the individual's own behaviour and self-concept. The ultimate goal of professional socialization is to internalize a professional identity of the profession. Professional socialization sets in to reduce the tension from the scenario of reality shock and facilitate adaptation during the transition process. This paper serves as a concept paper with the main purpose of introducing and explaining the concept of professional socialization in nursing to help the readers in gaining further understanding of the concept, especially within the local context. The first author has also incorporated her own personal reflections with regards to her socialization process to nursing.

IMU), public health physicians, and consultant paediatricians (Infectious Diseases).The objectives of this public health policy dialogue were to review the evidence and best practices in PCV vaccination, deliberate on issues and processes of policy decision, implementation, monitoring and evaluation that need to be put in place, and provide recommendations to relevant stakeholders on the way forward. It was a closed-door event and attendance was by invitation only.