Introduction: Coronary heart disease (CHD) is the leading cause of death in Malaysia. This study aims to explore the treatment experiences of patients with recurrent coronary heart disease during hospital admission and after discharge. This research also attempts to understand patients’ adherence to the prescribed treatment. Method: The main sample for this study includes inpatients and outpatients with recurrent CHD who have undergone second- ary prevention treatment at certain tertiary hospitals which were purposively sampled. The transcripts of one-to-one semi-structured interviews (N=22) were analyzed using the Interpretative Phenomenological Analysis (IPA). Results: Three themes emerged in the analysis of treatment adherence among multi-ethnic patients with CHD: (i) doctor-pa- tient relationships; (ii) information-seeking behaviour; and (iii) psychosocial beliefs. Other factors that influence treat- ment adherence include patients’ cultural, religious, or spiritual beliefs-based complementary alternative medicines (CAM), if these factors were inadequately addressed by their respective heath professional. Conclusion: The results demonstrate that for future cardiac rehabilitation program development, health professionals must not only focus on the patient’s care improvement but must also be knowledgeable on the patient’s preferred alternative treatment.
Introduction: Colorectal cancer (CRC) arises from the cumulative effects of genetic and epigenetic alterations. Cur- rent treatment of metastatic CRC relies on combination of chemotherapy and targeted therapies such as anti-EGFR therapies. The success of targeted therapies relies on the detection of actionable targets and predictive biomarkers of resistance. The study aims to determine mutations in common actionable targets and predictive biomarkers of re- sistance to anti-EGFR therapies in Malaysian CRC patients. Methods: Mutations in 10 CRC tissues were determined by next-generation sequencing with a panel of 7 cancer-related genes covering all exons in KRAS, BRAF, PIK3CA, PTEN, TP53, NRAS, and EGFR genes. Immunohistochemistry was used to determine mismatch repair (MMR) status. Results: Of the ten samples, 5 and 4 samples harboured two and one mutation, respectively and one had no mu- tation. All were missense mutations and were in five genes, namely, KRAS, PIK3CA, TP53, BRAF, and EGFR. They were, G12D, G12V, G12A, G13D, and V14I in KRAS, E545K, K733R, and D1056N in PIK3CA, G199V, D259Y, and R282W in TP53, V600E in BRAF and G696R in EGFR. Deficient mismatch repair (dMMR) was detected in three samples, of which two had KRAS mutation. Conclusion: Mutations in KRAS codon 12 and 13, BRAF and PIK3CA which predict resistance to anti-EGFR therapies and three TP53 mutations were found. This is the first report of EGFR mutation in Malaysian CRC patients. It is predicted to be a pathogenic variant. dMMR, one of the biomarkers for treatment with immune checkpoint inhibitor was also detected.
Introduction: This study is part the Investigator Initiated Research (IIR) project under the mental health suicide and para suicide cluster. Self-harm is an important predictor of suicide and leaves a significant long-lasting psychological effect. Despite the increasing prevalence of rate of self-harm, very little research had been done in Asian countries. The objective of this study is to determine the prevalence of self-harm in selected hospitals, demographic profiles and factors associated with development of self-harm. Methods: This is a multi-centred cross sectional study. Six months of data collection was performed between the 1st November 2013 and 30th April 2014. All cases that were identified to have carried out Self-Harm were interviewed using The World Health Organization (WHO) SUPRE-MISS Ques- tionnaire Annexe 1 which had been adapted to the Malaysian culture by the research committee members. Results: A total of 99 samples were obtained for this study. They mostly came from low socioeconomic background. Majority of the patients were females, and this was consistent with studies worldwide. Poisoning by pesticides was the most frequent method of choice and about 30% of the patients had previous attempts. Conclusion: Sociodemographic factors play a significant role in self-harm. It is important to know the sociodemographic profile to identify which group of people are at risk and intervention can be focused.
Introduction: Parents of a disabled child might require extra basic needs which most of the time are unmet due to several factors. Thus, understanding the unmet needs could help the respective institution to provide and prioritise the needs required. Methods: A cross-sectional study was conducted between September to December 2013 to de- termine the proportion of unmet needs among parents of children with disabilities at support institutions in Kelantan, Malaysia. Biological parents of disabled children aged between 2 to 18 years old were included in the study. A 35- item validated Malay version of the Family Needs Survey was used in this study. A scoring of 4-point Likert scale was used; the prevalence of unmet needs was determined based on the proportion of those who scored “3” from each domain. Results: A total of 226 parents were involved in the present study. The mean age of parents and children were 44.6 (8.99) and 10.2 (4.85) years old respectively. The most common type of disabilities was learning disability (n=151, 66.8%). The unmet need for information has the highest prevalence (97.8%), followed by the unmet need for social support (93.8%). Conclusion: Parents with disabled children require information to guide them in managing their children. Findings from this study may better enable policymakers to devote resources in assisting parents, and service providers in designing appropriate interventions in fulfilling the unmet needs of these parents.
Introduction: Diabetes mellitus is a major risk factor for chronic kidney disease (CKD). Thus, making routine screen- ing among the diabetic group is necessary in order to reduce the burden of the disease. As such, various risk pre- diction models including QKidney model have been developed for early detection of CKD. However, the Qkidney model has not been validated in Malaysia. This study aimed to evaluate the performance of QKidney model in pre- dicting a 5-year risk of developing CKD in a cohort of type 2 diabetes mellitus (T2DM) patients in the primary care setting. Methods: A total of 377 T2DM patients attended the primary care clinic at the town of Rawang, aged 30-74 years old, and free of CKD outcomes at baseline were recruited and followed-up for 5 years. Their CKD risk was calculated using the QKidney model. The predictive performance of QKidney model was assessed through discrimi- nation and calibration analyses. Results: At the end of the 5-year follow-up, a total median QKidney score was 3.9% (IQR: 5.9). The median QKidney score of male participants (7.3%) was significantly higher than that of the females (3.0%) (p < 0.001). The QKidney model has a moderate discrimination in which the area under the receiver operat- ing characteristic curve was 0.748, with good calibration (χ2 = 13.039, p = 0.111). Conclusion: It was found that the QKidney model had a moderate discriminative ability with good calibration. When taken together, it was suggested that the QKidney model could be utilized to predict a moderate-to-severe CKD risk in Malaysians with T2DM.
Introduction: This study was conducted to determine the association between knowledge, attitude and practice among Kuantan community towards anti-smoking campaign. An anti-smoking campaign can be referred to as a series of ads programs that are introduced through various objective approaches to give awareness to people on the negative impacts of smoking behavior. The objectives of this study are (i) to investigate the association between so- cio-demographic data (gender, income, education level) and level of knowledge towards anti-smoking campaign; (ii) to find out the association between socio-demographic data (gender, income, education level) and level of attitude against anti-smoking campaigns; (iii) to study the association between socio-demographic data (gender, income, education level) and level of practice towards anti-smoking campaigns; and (iv) to find out the correlation between level of knowledge with level of attitude, level of knowledge with level of practice, and level of attitude with level of practice towards anti-smoking campaigns. Methods: A descriptive cross-sectional study was conducted among adult Kuantan community and convenience sampling was used to collect the data. A validated questionnaire was used to collect data. Statistical analysis of the data was carried out using SPSS and association of variables was an- alysed using Chi-square test. Results: This study found that level of knowledge did not affect the attitude level of the community. However, level of knowledge did affect the level of practice towards the anti-smoking campaign. Conclusion: It revealed that respondents with high level of knowledge also had good level of practice towards an- ti-smoking campaign.
Introduction: Iron deficiency anaemia (IDA) is the most common nutritional anaemia in the world that affects in- dividuals in both developed and developing countries including Malaysia. The prevalence of IDA among school- children is crucial to know as IDA may contribute to poor mental and school academic performance. Hence, the objective of the study was to diagnose the present prevalence of IDA and to analyse the association with probable risk factors. Methods: This cross-sectional study was carried out from August 2017 to February 2018 among 261 school children, who aged between 8 to 10 years in Kudat, Sabah, were selected through simple random sampling. After getting informed consent from the parents or guardians of the participants self-administered validated question- naire was used to gather information regarding socio-demographic data, knowledge, attitude and practice towards iron deficiency anaemia and Food Frequency Questionnaires. The blood sample was collected for confirmation of anaemia through serum haemoglobin (Hb) concentration and determination of iron status through serum ferritin, serum iron and serum TIBC and stool samples were collected for children identified with anaemia for soil-transmit- ted helminths analysis. Results: Out of 82 anaemic students, 36 were suffering from iron deficiency anaemia. The BMI status, the presence of soil-transmitted helminths and level of knowledge regarding IDA had highly significant (p
Introduction: The large clinical spectrum of haemoglobin E-beta (HbE/β) thalassaemia leads to the investigation of complex mechanisms involved in erythropoiesis. DNA methylation in LARP2 is one of the potential epigenetic mod- ifiers not fully explored in HbE/β and β-thalassaemia major. This study aimed to analyse DNA methylation profile and gene expression of LARP2 using peripheral blood (PB) in nucleated red blood cells (NRBCs) for the source of DNA of HbE/β- and β-thalassaemia major patients. Methods: PB were collected from 33 transfusion-dependent thalassemia patients from Hospital USM and Hospital RPZII, Kelantan, Malaysia. DNA methylation profile and gene expression of LARP2 were examined by bisulphite sequencing PCR and quantitative real-time PCR respectively. Results: Par- tial DNA methylation of LARP2 was observed in 43% (9/21) HbE/β- and 17% (2/12) β-thalassaemia major patients. LARP2 expression (1.49±26.60) in HbE/β-thalassaemia was not significant against normal controls and β-thalassae- mia major (p>0.05). In contrast, LARP2 expression (6.8±16.42) in β-thalassaemia major showed a significant up-reg- ulation against normal controls (p
Introduction: To develop quality cabin crews, trainings involve simulation-based education (SBE) with structured debriefings – a significant component which plays a critical role in optimising learning outcomes. Previous studies have empirically tested the efficacy of the DIAMOND-structured debriefing model and found significant improve- ment and retention of the cabin crews’ knowledge and skills. This study was aimed to explore the elements of the DIAMOND-structured debriefing model that have been known to promote the acquisition and retention of knowl- edge and skills in basic life support (BLS). Methods: A qualitative study was conducted with a random sample of 16 individual cabin crew members who participated in an in-depth interview with 13 open-ended questions for 45 – 60 minutes. The interviews were transcribed and independently analysed using inductive thematic analysis. Results: The codes which have emerged during data analysis were clustered into three themes: (1) Cognitive, with three sub- themes: engagement, learning environment, and ability to reflect; (2) Methodology, with three sub-themes: concept of debriefing, techniques of questioning, and additional elements; as well as (3) Psychosocial, with five sub-themes: attitude, self-awareness, relationships, self-confidence, and work culture. Several suggestions have emerged, such as the implementation of the model. Conclusion: The DIAMOND-structured debriefing model was a method to reduce cognitive load, which in turn allowed individuals to organise their knowledge, reflect individually and collectively, as well as structure their ideas. It has showed that the elements has a positive impact on the cabin crews’ acquisition and retention of knowledge and skills which will improve the performance and patient safety.
Dysphagia is a significant health issue and it gives a substantial impact on the individual’s quality of life. This study aims to explore the quality of life of patients with dysphagia in head and neck cancer population. Twenty patients with dysphagia who were attending to oncology clinic in Hospital Universiti Sains Malaysia for their medical treatment on the head and neck cancer involved in the study. The Swallowing Activity and Participation Profile (SAPP) was used to gather information on the patients’ swallowing ability and psychosocial domains (personal, social and working, and emotional). The results indicated that the swallowing ability was significantly related to the personal, social and working, and emotional domains. The Mann-Whitney test showed no statistically significant difference in the personal domain and in the social and working domain of men and women. Yet the result revealed a statistically significant difference in the emotional domain of men (M = 10.42) and women (M = 14.63). On the whole, this study positively conform that the quality of life of patients with dysphagia among head and neck cancer population was truly affected.
Walking 10,000 steps daily is associated with beneficial health outcomes. Recent systematic reviews have suggested that pedometers may be an effective motivational tool to promote walking. The aim of this study was to study the effectiveness of a 10-week, pedometer-based walking intervention to improve physical activity, body composition and metabolic health indices in a sample of suburban community-dwelling adults not meeting current physical activity recommendations. After screening, 34 overweight/obese individuals (mean age: 46 ± 8 years, mean BMI: 28.3 ± 4.2 kg/m2) were accepted into the walking program conducted by the Health Promotion Community Centre, Bangi. Subjects were instructed to increase their steps by 3000 steps daily above their baseline values for 10 weeks. Daily step count, body weight, BMI, waist circumference, as well as blood pressure, fasting glucose and lipids were evaluated at baseline and following the 10-week intervention. Thirty-one participants completed the program with 100% adherence. The average daily steps recorded during the 10-week intervention was 9693 ± 2196 steps per day. Mean daily steps increased from 8679 ± 2567 steps in Week 1 to 10,766 ± 3200 steps in Week 10 (p = 0.040). Overall, there were reductions in body weight (-1.13%, p = 0.010), waist circumference (-3.5%, p = 0.001) and BMI (-1.41%, p = 0.008) as well as fasting blood glucose (-8.5%, p = 0.003) and systolic blood pressure (-4.8%, p = 0.007) following the intervention. The findings of this study demonstrated that a goal-driven, pedometer-based walking intervention for 10 weeks resulted in a modest reduction in body weight and improved metabolic health outcomes in overweight/obese, community-dwelling adults.
Alzheimer's disease (AD) impairs memory and learning related behavioural performances of the affected person. Compared with the controls, memory and learning related behavioural performances of the AD model rats followed by hippocampal proteomics had been observed in the present study. In the eight armed radial maze, altered performance of the AD rats had been observed. Using liquid chromatography coupled tandem mass spectrometry (LC-MS/MS), 822 proteins had been identified with protein threshold at 95.0%, minimum peptide of 2 and peptide threshold at 0.1% FDR. Among them, 329 proteins were differentially expressed with statistical significance (P < 0.05). Among the significantly regulated (P < 0.05) 329 proteins, 289 met the criteria of fold change (LogFC of 1.5) cut off value. Number of proteins linked with AD, oxidative stress (OS) and hypercholesterolemia was 59, 20 and 12, respectively. Number of commonly expressed proteins was 361. The highest amount of proteins differentially expressed in the AD rats were those involved in metabolic processes followed by those linked with OS. Most notable was the perturbed state of the cholesterol metabolizing proteins in the AD group. Current findings suggest that proteins associated with oxidative stress, glucose and cholesterol metabolism and cellular stress response are among the mostly affected proteins in AD subjects. Thus, novel therapeutic approaches targeting these proteins could be strategized to withstand the ever increasing global AD burden.
MeSH terms: Alzheimer Disease; Animals; Cholesterol; Chromatography, Liquid; Glucose; Hippocampus; Hypercholesterolemia; Memory; Oxidative Stress; Proteomics; Rats; Tandem Mass Spectrometry
This article discussed the findings of previous studies on emotional intelligence in Royal
Malaysia Police. Based on the review, emotional intelligence related to job stress, job
satisfaction, job commitment, work-life balance, and psychological well-being of police
officers. Review concludes that no significant differences in emotional intelligence by
demographic factors like salary, working department, age, marital status, length of service,
and job position. Police department has to organise training and seminars to enhance the
emotional intelligence level of police officers. More studies have to be done on emotional
intelligence in the police department, thus the findings will be helpful for the organisation’s
development.
This study sought to develop and validate an instrument measuring cyberbullying among
Malaysian youths. Exploratory factor analysis (EFA) was employed to determine the best
sub-factors and items for the instrument, while confirmatory factor analysis (CFA) was
performed to test and validate the measurement model. Results from EFA on 38 items
showed that the items were pooled into four sub-factors. Meanwhile, results from CFA
indicated that eight items had to be discarded in order to confirm that the model was fit.
Overall, the final version of the instrument consisted of four cyberbullying sub-factors,
namely, impersonation (13 items), cyberstalking and harassment (nine items), flaming (four
items), and elimination (four items).
This study aims to explore the first rater officers’ perspectives on the application of
performance appraisal attributes in performance appraisal system in a higher education
institution in Sarawak. Six attributes were focused on the study namely clarification of the
system, justification of the system, control criteria, employee participation, system
management, and credibility of the assessor. The study uses a qualitative methodology using
semi-structured interview techniques and data analysis in thematic approach. Three
common issues are the limitation of the system’s availability, insufficient scoring
distribution towards lecturers who are involved in administrative work and limited
capability of the server. Along with that, two critical issues are the subjective judgment of
personality traits and limited utilization of the system. The implication raised based on the
issues is work processes are interrupted, employee dissatisfaction and organizational image
are affected. In conclusion, the issues within the performance appraisal system need to be
taken seriously to avoid conflicts.
Leaders affect employees’ performance in the organization by their leadership style, which
is dependent to the degree of favor by their followers. It is vital for the organization to
identify the most effective leadership styles which will boost performance in the
organization. This research studied the type of leadership trait most preferred in the
telecommunication sector. This qualitative study used the Full Range Leadership Model to
identify and suggest the preferred traits of a leader. The sampling method used was
purposive. Interview guides were used as the research tool. A total of six (6) informants
were interviewed. The results showed transformational leadership style is the most preferred
by all the informants as the employees found that the traits of the transformational leader
bring more positive impacts on their work performance.
Self-directed learning (SDL) is becoming a prominent issue discussed in the workplace
learning topic. Each of the employees needs to be aware that organizations need people who
do not only believe the importance of learning but they must have initiative and capability
to learn effectively. This study aims to examine the antecedent factor of the emergence of
SDL in the workplace. This study using qualitative research design, particularly case study
approach conducted in a prominent motorcycle-manufacturing company in Indonesia that
intentionally set the organizational direction toward a learning organization. A total of thirty
staff and managers were purposively selected and interviewed using a semi-structured
approach. The Data gathered were analyzed using the content analysis technique. Findings
indicate three factors as the antecedent to the emergence of SDL in the workplace, namely:
personal factors, organizational factors, and family support. Discussion and
recommendations based on research findings will be explained later.
Malays consist of multi sub-ethnic group believed to have different ancestral origins based on their migrations centuries ago. The DNA profiling for every individual in Malaysia is not recorded, making Malaysia lacking in genetic data of its own citizens. This research aimed to study the geographic-ancestry origin of two Malay sub-ethnic population; Kelantan- Malay and Jawa-Malay by looking into the variation of TPA-25 insertion in each population. It specifically studied on several areas of Peninsular Malaysia in the region of Kelantan, Selangor and Johor as the representative of main areas with high percentage of Kelantan- Malay and Jawa-Malay populations. All the data were obtained from an application of TPA-PCR method, forensic parameter (F-statistic) and survey questionnaire that polled genetically on their ancestry origin in each sub-ethnic population. The research showed that population with high percentage of heterozygous allele (Tt) of TPA-25 insertion was likely to have high possibility of genetic drift occurrence. Jawa- Malay showed the highest percentage of heterozygous allele (Tt) with approximately 48% of the population. The FIS value of Kelantan-Malay and Jawa-Malay populations were recorded positive with the values of 0.678 and 0.366 respectively. Moreover, the FIT value recorded was 0.535 which suggested that these two populations were deficits of heterozygotes.
Centella asiatica is one of the traditional herbs consumed by many communities due to its wide range of applications such as treating Parkinsonism, promoting memory enhancement, and preventing oxidative stress. This study was conducted to investigate the neuroprotective potential of aqueous C. asiatica extract (CAE) against neurodegeneration induced by chronic stress. Administration of CAE at three different dosages (200 mg/kg/day, 400 mg/ kg/day and 800 mg/kg/day) was conducted for a period of 21 days along with exposure to chronic stress using restrainer and forced swimming regimes. The administration of CAE significantly improved the thickness of dentate gyrus and reduced the amount of neuronal cell death at dentate gyrus and CA3 (p
This study aimed to evaluate surface roughness (SR) changes with surface treatments and shear bond strength (SBS) of two prefabricated and one laboratory-made composite veneer systems. The prefabricated groups, Edelweiss (EDL) and Componeer (CMP) while, SR Nexco (NEX) was a laboratory-made group. A total of hundred twenty samples, comprising 40 samples for each group were divided into four subgroups of surface treatment (n=10): (a) no treatment (control), (b) 9% hydrofluoric acid (HF), (c) abrasion with a high-speed diamond bur and (d) sandblast with aluminum trioxide (Al2O3) particles. A profilometer was used to evaluate the SR before and after surface treatments applications. Stereo electron microscope was utilized to assess changes occurred on the surface texture of the veneers. For SBS test, the prepared veneer was uploaded over an epoxy resin mould. Two cylindrical adhesive resins were bonded binary and perpendicular over the inner surface of the veneer and tested using Universal Testing Machine (SHIMADZUTM, Japan). Data was analyzed using One-way ANOVA, post-hoc student’s t-test and Duncan test with p