Difficulty of understanding speech in noise among the elderly necessitates the need for Auditory Training which has made a renewal of interest in the last decade with the auditory training applications. This interest is perhaps spurred by advances in computer-based technology. In computer-based auditory training, speech signals are considered as auditory training stimuli where input speech signals need to be verified prior to training as the speech signals are mixed with noise signals. Computer-based Auditory Training System can be embedded with input speech verifying module. Input speech verifying module is employed with speech and noise separator simulator. This simulator needs to guarantee accurate separation of speech from noise signals. Therefore, in this research, Exploratory Projection Pursuit (EPP) technique under semi-Blind Source Separation (BSS) method is intended to separate the speech source signals which are mixed with competing speech (multitalker speech babble). This training uses Malay language based sentences which differ in word length and hence number of sample values. The experimental simulation considers two-channel random, linear mixing of speech sources and competing speech. The aim of this study is to evaluate the performance of source separation using the anticipated EPP technique for various sample values of speech signals which varies in time duration due to word length dissimilarity. Simulation results show that EPP technique is feasible for source separation. As a consequence, high correlation value of r ≥ 0.99 is obtained between extracted speech signal and original speech signal for all categories of speech signals. It is further verified by the maximum nongaussianity of extracted speech signal which has high kurtosis value of 32 approximately.
Neurophobia, defined as ‘the fear of neural sciences and neurology’ is reported among medical students, which threatened their performance in neurology course. This phenomenon has not been studied among rehabilitation sciences students despite the significance of neurology as an area for rehabilitation. In this study we aim to assess the perceptions of neurology course and the possibility of neurophobia existence among rehabilitation sciences students of Universiti Kebangsaan Malaysia (UKM). We also aimed to identify learning methods which are regarded as useful among the students. A survey using self-administered questionnaires was conducted among 73 students from School of Rehabilitation Sciences of the university. Questions in the questionnaire were adapted from previous studies, in which neurophobia was indicated by poor knowledge and low confidence level in managing neurology course. Results showed that the percentage of participants who perceived having good knowledge of neurology was significantly higher than the percentage who claimed of having poor knowledge level (90.4% versus 9.6%, p < 0.01). Similarly, the percentage of participants who claimed having high confidence to handle neurology cases was higher than the percentage who expressed lack of confidence (79.2% versus 20.8%, p = 0.03). However, neurology course was perceived as difficult by majority of the participants (78.1%) when compared to other courses. Majority of the participants (97.3%) perceived clinical teaching as a useful method of learning rehabilitation science courses including neurology followed by problem-based learning (90.4%). While limited exposure to neurology cases was claimed as the main reason to why neurology is difficult. In conclusion, although neurology is perceived as a difficult course among rehabilitation sciences students, the students did not report lack of knowledge and confidence in the course. This implies that neurophobia does not exist among UKM rehabilitation students. Enhancement of learning methods may assist in reducing the level of difficulty of neurology course among the students.
Diabetes is often associated with dysfunction in activities of daily living (ADL), especially among older adults. Hospitalisation of older adults is often followed by decline in functional status affecting their quality of life and well-being after discharge. The objective of this study was to determine the functional independence in carrying out basic activities of daily living, its relationship with quality of life, and the factors influencing the quality of life in hospitalised older adults with diabetes. This cross sectional study was carried out on 104 diabetic patients (mean age: 67.5 ± 9.2 years) who were receiving in-patient treatment. Face-to-face interviews were carried out to determine functional independence using Modified Barthel Index (MBI) as well as quality of life using the World Health Organization’s Quality of Life instrument (WHOQOL-BREF). Results showed that only 37.5% (n = 39) respondents were catergorised as being fully-independent. Among the domains in MBI, using the stairs recorded the lowest score followed by mobility. The physical domain in quality of life also recorded the lowest score compared to other domains of quality of life. There were significant (p < 0.05), positive correlations between the overall MBI scores and all domains of quality of life; physical (rs = 0.70), psychology (rs = 0.50), social (rs = 0.33) and environmental (rs = 0.25). Hierachical multiple regression analysis showed MBI scores had significant influence on all domains of quality of life, with the largest influence on the physical domain i.e. 36% [F(1, 92) = 82.14, p < 0.01, R2 = .36]. As a conclusion, hospitalisation reduces the functional independence in carrying out basic activities of daily living as well as the physical aspect of quality life in older adults with diabetes. Therefore, it is important to provide rehabilitation in activities of daily living while the elderly diabetics while undergoing in-patient treatment in order to maintain quality of life after discharge.
Older adults who walk in their neighbourhood with greater street connectivity are reported to have lower limb physical performance decline. There is limited information regarding the association between built environment characteristics and physical performance in older adults. The aim of this study was to examine the association between built environment characteristics, physical performance, falls risk and functional mobility among older adults. Sixty four (27 men and 37 women) community dwelling older adults aged 60 years and above (mean 67.4 ± 7.1 years) from senior citizen clubs in Kuala Lumpur, Malaysia participated in this cross-sectional study. Built environment characteristics were assessed using an adapted Neighbourhood Environment Walkability Scale (NEWS). Physical performance and falls risk was measured using Short Physical Performance Battery (SPPB) and Profile Physiological Profile Assessment (PPA) respectively. Timed Up and Go (TUG) and gait speed tests were used to assess functional mobility. There was a significant correlation between built environment and physical performance (r = 0.43, p < 0.001) and functional mobility measured using gait speed test (r = 0.27, p < 0.05) among older adults. Built environment was identified as a significant determinant of physical performance (R2 = 0.19, p < 0.001). Built environment characteristics is an important external factor in preserving physical performance in older adults. Programmes and policies for a more favourable built environment characteristics in the neighbourhoods should be encouraged to promote and maintain physical performance among older adults.
A speech test that emphasizes on fricatives and affricates with high-frequency components is recommended for testing individuals with high-frequency hearing loss. Validation of the frequency-lowering feature in modern hearing aids are also important. There has been no recorded speech material in Malaysia that focuses on Mandarin fricatives and affricates. Therefore, the objective of this study was to develop a nonsense word test that contains Mandarin sibilant fricatives and affricates. A total of 180 vowel-consonant-vowel (vcv) nonsense syllables were recorded from a female and a male talker. These vcv syllables included six targeted Mandarin fricatives and affricates in three vowel contexts. Perceptual and acoustic analysis were conducted and selected vcv syllables were validated by 24 native Mandarin talkers with normal hearing through identification testing. Hundred and three syllables were rated as having a good or excellent sound quality and free from at least one of the idiosyncrasy elements. The average percentage of correct identification of vcv tokens for the female and male talkers were 85.38% and 82. 73%, respectively. Syllables that received the highest correct identification scores above the group mean were taken as the best exemplars. In total, 29 best exemplars were selected from 180 vcv syllables for the development of the Mandarin fricative-affricate nonsense word test. Future studies should include the development of performance-intensity function for individuals with normal hearing and a test manual so that the test can be used by non-native Mandarin clinicians.
Knee osteoarthritis (OA) is a common chronic joint disease that results in pain and disability in many people. Cultural practice may influence patients’ views about their condition, its related issues and management. The aim of our study was to explore the perspective about knee OA and its related issues among Malaysian patients with knee OA. Twelve patients diagnosed with knee OA (8 females and 4 males) attending physiotherapy sessions at a University Hospital, mean age (SD): 67.1(9.4) years and median visual analog scale score of 5/10 participated in this qualitative study. One to one in-depth interviews were conducted, audio recorded and later transcribed verbatim. Three main themes were identified from the transcribed data; knee pain and its’ related issues (reason and aggravating factors of knee pain, coping strategies), impact of knee pain (impact on daily activities and emotions) and physiotherapy management (effects and expectations of physiotherapy, compliance and adherence towards home exercises). Most participants expressed that their knee pain was aggravated by certain movements that had an effect on their daily activities namely squatting. The findings also suggested that physiotherapy management was perceived as secondary prevention rather than a cure. Findings from this study provides information about the perceptions and related issues of patients with knee OA. This information may help health professionals in tailoring patient-centered care and provide better management.
Study site: Physiotherapy department, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Enhancement of physical function had been shown in older adults who actively participate in physical activities, particularly in the form of aerobic training with addition of progressive resistance training (PRT). However, it is quite challenging and risky for most older adults to exercise in standing position without any support. Chair Based Exercise (CBE) is an alternative mode of exercise for older adult to facilitate exercise participation and increase safety. Its effect when combined with resistance training is unknown to date. Therefore, the aim of this study was to evaluate the outcome of CBE with PRT on physical performances among older adults. A total of 18 older adults (13 females (72%)) and 5 males (28%)), aged 60 to 83 years with mean age (SD) 72.67 (6.17) years completed the study. All subjects performed CBE with PRT intervention twice weekly for 8 weeks, with individually-tailored exercise progressions. Pre and post measurements of physical performance were performed using Six MinutesWalk Test (6MWT), Five Times Sit to Stand (FTSTS) and Hand Grip Strength (HGS) test. Significant improvement in 6MWT (p < .001), HGS Right hand (p = .043), HGS Left hand (p < .001), FTSTS (p < .001) was shown after the eight-week intervention. Adding PRT into seated exercises results in further improvement in physical performance of older adults. CBE-PRT may be recommended as an exercise routine for older adults living in the community.
MeSH terms: Aged; Exercise Therapy; Female; Hand; Humans; Male; Posture; Exercise; Hand Strength; Resistance Training
Previous studies explain the time course of withdrawal symptoms among smokers pre and post quit attempt, either with or without the help of medication. Studies showed that male Muslim smokers could quit smoking during Ramadan since fasting relate to the changes in psychosomatic, daily activities and nicotine withdrawal symptoms. This study aimed to investigate the time course of withdrawal symptoms among smokers who used nicotine patch to quit smoking during fasting in Ramadan. A total of 40 eligible Muslim males who tried to quit smoking was selected and provided with smoking cessation counseling for the duration of 8 to 10 weeks while on nicotine patch. Participants level of withdrawal symptoms was recorded by using nine items of Minnesota Nicotine Withdrawal Scale over a period of 60 days. Participant’s carbon monoxide reading and body weight were measured within six months including pre and post-Ramadan fasting. Over four weeks of the fasting month, the measured withdrawal symptoms such as urge to smoke (P ≤ 0.001), depressed mood (P ≤ 0.001), irritability/frustration or anger (P ≤ 0.05), anxiety (P ≤ 0.05), difficulty concentrating(P ≤ 0.001), restlessness (P ≤ 0.001), difficulty going to sleep (P ≤ 0.001) and impatient (P ≤ 0.05) significantly decreased except appetite by the end of week 4. Time course analyses demonstrated that all outcome measures showed good effects during cessation in fasting month. The point prevalence abstinence at first month of quitting was 67.5% which is higher in fasting month. This has shown positive clinical implications in managing smoking cessation program during Ramadan with the aid of nicotine patch.
This review aims to present an overview of current research findings on the possible relationship between phonological awareness and visual-spatial skills among individuals with dyslexia. Narrative review of the relevant articles were obtained through computerized searches of databases such as PubMed, PubMed Central (PMC) and Google Scholar which included articles from SAGE, Taylor & Francis and Massachusetts Institute of Technology (MIT) Press from the year 2000 to 2014. The key words were explored, both exclusively and in combination with each other, so as to provide a better understanding of the relationship between them among individuals with dyslexia. Although it is evident that there is a phonological deficit in individuals with dyslexia, however, it is inconclusive with regards to the visual-spatial deficit and strength. There is a consensus on the nature of phonological awareness skill deficits but not on the visual spatial abilities in dyslexia. In fact, the relationship between phonological awareness and visual spatial abilities in dyslexia is dependent on the area of visual ability measured.
Taking care of children with Autism Spectrum Disorder (ASD) could be a demanding task for parents. Consequently, parents of children with ASD may experience parenting stress and depression symptoms. This study examined parenting stress and depression symptoms among parents of children and adolescents with ASD. This study also examined the role of child characteristics (e.g., age, child quality of life and problem behavior) on parenting stress and depression symptoms and the effect of parenting stress on parental depression. A total of 78 parents were examined using a questionnaire survey. The result indicated that parents caring a younger age group of children with ASD have higher levels of depression symptoms compared to parents caring for older group of children with ASD. The result also revealed a significant difference in level of depression symptoms between parents with higher levels of parenting stress and parents with lower parenting stress. Only the children age significantly predicts depression symptoms in parents of children with ASD. This indicates that children age is potential to affect mental health among parents of children with ASD.
MeSH terms: Problem Behavior; Autism Spectrum Disorder; Adolescent; Child; Depression; Depressive Disorder; Empathy; Humans; Mental Health; Parents; Quality of Life; Surveys and Questionnaires; Parenting
Tahfiz education has been well accepted by Muslims in Malaysia. Memorizing the Quran through rote learning can assist in improving the brain ability to process, store information and build memory. In addition, dietary intakes were reported to contribute in the process of memorizing the Quran and to increase the levels of intelligence (IQ) among huffaz students. This cross-sectional study was conducted to measure and to determine the correlation between IQ and dietary intake as well as between IQ and the level of trace elements among students in selected tahfiz schools and non-tahfiz school in Selangor. Questionnaires were used to obtain demographic data. Dietary intake was assessed via 3 days dietary record. Levels of trace elements in the nail samples were analyzed by using ICP-MS. Test for intelligence using WASI-II was conducted to measure the students’ IQ. The results showed that there was a moderate positive correlation between IQ and carbohydrate (r = 0.425, p < 0.001, a weak positive correlation between IQ and energy (r = 0.260, p < 0.05), vitamin B6 (r = 0.189, p < 0.05), vitamin B12 (r = 0.207, p < 0.05) and vitamin C (r = 0.211, p < 0.05). The levels of trace elements in nail samples showed no correlation with IQ, whereas there were moderate positive correlations between IQ and dietary zinc (r = 0.375, p < 0.001) as well as between IQ and dietary iron (r = 0.303, p < 0.001). There was also a moderate positive correlation between IQ and the level of memorization (r = 0.375, p < 0.001). The results of stepwise multiple linear regression showed that al-Quran memorization influence the level of IQ by 20 %. As a conclusion, dietary intake of certain nutrients including energy, vitamins and selected trace elements can potentially improve memorization activities and also IQ.
The global prevalence of overweight and obesity among children has increased rapidly in the recent decades, including in Malaysia. Thus, development of effective interventions to prevent childhood obesity in Malaysia is urgently needed. This paper describes the study design of a 12-week multi-component, school-based nutrition education programme aimed at managing childhood obesity. The objective of Juara Sihat™ is to determine the effectiveness of a nutrition education programme in improving anthropometric status, knowledge, attitude and practice (KAP) of nutrition, eating habits and physical activity level among overweight and obese children. This quasi-experimental study involves two primary schools in Kuala Lumpur with similar demographic characteristics. Eligibility criteria of research participants are overweight and obese children aged 9 to 11 years. The main components of the Juara Sihat™ intervention are nutrition education classes on healthy eating and active lifestyle; physical activity sessions; and active involvements of parents and teachers. The control school does not receive any interventions. The primary outcome is BMI-for-age z-score, while other outcomes include waist circumference, body fat percentage, KAP of nutrition score, dietary intake, physical activity level, sedentary behaviour and biochemical profile. Outcome measures will be assessed at three intervals: baseline, post-intervention 1 (3-month follow-up), and post-intervention 2 (6-month follow-up). The Juara Sihat™ programme represents a promising approach to examining the effectiveness of a school-based childhood obesity intervention with strong empowerment of Parents’ and Teachers’ Association (PTA). We anticipate that this study may provide insights towards the development of more effective strategies in formulating childhood obesity interventions.
Rising global prevalence and incidence of obesity lead to increased cardiovascular-renal complications and cancers. Epidemiological studies reported a worldwide trend towards suboptimal sleep duration and poor sleep quality in parallel with this obesity epidemic. From rodents and human models, it is highly plausible that abnormalities in sleep, both quantity and quality, impact negatively on energy metabolism. While excess dietary intake and physical inactivity are the known drivers of the obesity epidemic, promotion of healthy sleep habits has emerged as a new target to combat obesity. In this light, present review focuses on the existing literature examining the relationship between sleep physiology and energy homeostasis. Notably, sleep dysregulation perturbs the metabolic milieu via alterations in hormones such as leptin and ghrelin, eating behavior, neuroendocrine and autonomic nervous systems. In addition, shift work and trans-meridian air travel may exert a negative influence on the hypothalamic-pituitary-adrenal axis and trigger circadian misalignment, leading to impaired glucose tolerance and increased fat accumulation. Amassing evidence has also suggested that uncoupling of the circadian clock can increase the risk of adverse metabolic health. Given the importance of sleep in maintaining energy homeostasis and that it is potentially modifiable, promoting good sleep hygiene may create new avenues for obesity prevention and treatment.
Citation: National Health Morbidity Survey 2017: Adolescent Nutrition Survey. Kuala Lumpur: Institute for Public Health, Ministry of Health, Malaysia, 2017
Study name: National Health and Morbidity Survey (NHMS-2017)
MeSH terms: Adolescent; Health Surveys; Humans; Malaysia
Citation: National Health Morbidity Survey 2017: Adolescent Health Survey. Kuala Lumpur: Institute for Public Health, Ministry of Health, Malaysia, 2017
Study name: National Health and Morbidity Survey (NHMS-2017)
MeSH terms: Adolescent; Health Surveys; Humans; Malaysia
Introduction: Understanding the prevalence of secondhand smoke (SHS) exposure and the associated factors is beneficial for the formulation of effective measures to reduce exposure to SHS. The purpose of this study was to determine SHS exposure at home and workplace, and its associated factors among non-smoker Malaysian adults. Methods: Data were extracted from the Global Adult Tobacco Survey-Malaysia (GATS-M) that involved a representative sample of 5112 Malaysian adults. Logistic regression analyses were performed to examine the association between SHS exposure, sociodemographic factors, knowledge on the danger of SHS, and smoking restrictions at home and at work among non-smokers. Results: Among non-smoker Malaysians, age ≥15 years, 27.9% (equivalent to approximately 4.21 million non-smokers) and 33.9% (equivalent to approximately 1.37 million non-smokers) reported that they were exposed to SHS at home and the workplace, at least once a month, respectively. Women (AOR=2.12, 95% CI: 1.61.2.78), young individuals (AOR=3.06, 95% CI: 1.48.6.33), Malays (AOR=2.39, 95% CI: 1.56.3.64) or other Bumiputra ethnic groups (AOR=2.40, 95% CI: 1.39.4.19) and those who worked as other than government employees were more likely to report SHS exposure at home (non-government employee: AOR=1.88, 95% CI: 1.06.3.36). Respondents with a total smoking restriction at home did not report any SHS exposure at home. Similarly, those whose workplace had smoking restrictions were less likely to report SHS exposure at the work compared to their counterparts whose workplace had partial (AOR=3.08, 95% CI: 1.84.5.15) or no smoking restrictions (AOR=15.33, 95% CI: 6.75.34.86). Conclusions: A substantial proportion of Malaysian adults were exposed to SHS at home and at work. The findings emphasize the need for policies on smoking restrictions at work and the need to promote the adoption of a completely smoke-free home, among the Malaysian population.
Study name: Global Adults Tobacco Survey (GATS-2011)
The accurate determination of reducing ends of malto-oligosaccharides is essential for calculating the enzyme activities of starch debranching enzymes. The suitability of the 3,5-Dinitrosalicylic acid (DNS) method, the Dygert method, and the Bicinchoninic acid (BCA) method for accurate determination of reducing ends from malto-oligosaccharides of different chain lengths is compared. The results showed that BCA assay was much more accurate than the other assays. The results for the BCA assay showed that different malto-oligosaccharides gave observed (measured) values that were significantly similar to the expected (predetermined) values. In contrast, the DNS and Dygert assays underestimated the amount of reducing sugar present for glucose. Furthermore, both DNS and Dygert methods showed increasing degree of overestimation of the amount of reducing sugar present with the increasing length of the malto-oligosaccharide sugar chains. The BCA assay can suitably quantify reducing sugars even in mixtures of oligosaccharides with different chain lengths. Thus, enzyme activities can be measured without bias towards higher values for enzymes that preferentially cleave the longer chain lengths.
The aims of this study are to isolate and characterize acid soluble collagen (ASC) and pepsin soluble collagen (PSC) extracted from silver catfish (Pangasius sp.) skin. Isolated ASC and PSC collagen were characterized in terms of chemical composition (moisture, protein, fat and ash content), protein concentration, functional group, solubility, and morphological properties as compared to commercial collagen. Yields of ASC and PSC were 4.27% and 2.27%, respectively. The chemical compositions of raw skin were 34.64%, 2.81%, 3.68%, and 0.31%, while the chemical compositions of ASC and PSC were 94.21%, 3.48%, 0.81%, 59.15%, and 88.25%, 3.46%, 0.92%, and 29.24%, for moisture, protein, fat, and ash, respectively. ASC and PSC had protein concentrations of 2.27 mg/mL and 2.70 mg/mL, respectively. Functional group analysis revealed that both isolated collagens exhibited Amide A, II and III as a fingerprint for collagen structure. The highest solubility was found at pH 4 for ASC, pH 1 for PSC, and pH 5 for commercial collagen. The morphology of the isolated collagens was porous and they contained fibril. In conclusion, the characteristics of the isolated ASC and PSC from silver catfish (Pangasius sp.) skin indicate that value-added collagen can be produced from the alternative source of freshwater fish.
The aim of the present study is to report on the physicochemical characterization of shortfin scad (Decapterus macrosoma) waste hydrolysate (SWH) enzymatically prepared using alcalase. The characterization incorporates chemical composition (moisture, protein, fat, ash), protein concentration, molecular weight (SDS- PAGE), amino acid composition, solubility and structure properties of shortfin scad waste hydrolysate (SWH) via Fourier transform infrared (FTIR) spectroscopy. SWH contains an average of 5.06 ± 0.47% moisture, 73.08 ± 1.54% protein, 7.55 ± 0.90% fat and 10.40 ± 0.13% ash, with a high protein concentration (30.80mg/ ml). The SDS-PAGE result showed that molecular weight of SWH was less than 17kDa. The amino acid composition of SWH was found to be high in glutamic acid/glutamine (12.39 ± 0.59%) and aspartic acid/asparagine (7.89 ± 0.18%), followed by glycine (7.15 ± 0.39%), lysine (6.80 ± 0.15%), arginine (6.38 ± 0.08%), and leucine (5.99 ± 0.10%). Fourier transform infrared (FTIR) spectra showed that SWH presented a similar structure to that shortfin scad waste (SW). In addition, protein solubility in SWH increased to 92.98% by increasing pH level (pH 4 to pH 10). These findings demonstrate the promising potential of shortfin scad waste hydrolysate for the application as natural bioactive sources due to high protein content and concentration, lower molecular weight, high solubility, and high percentage of essential amino acids which fulfil adult human requirements.