Displaying publications 1 - 20 of 69 in total

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  1. Ahmad AL, Chong MF, Bhatia S
    J Hazard Mater, 2009 Nov 15;171(1-3):166-74.
    PMID: 19573986 DOI: 10.1016/j.jhazmat.2009.05.114
    The discharge of palm oil mill effluent (POME) causes serious pollution problems and the membrane based POME treatment is suggested as a solution. Three different designs, namely Design A, B and C distinguished by their different types and orientations of membrane system are proposed. The results at optimum condition proved that the quality of the recovered water for all the designs met the effluent discharge standards imposed by the Department of Environment (DOE). The economic analysis at the optimum condition shows that the total treatment cost for Design A was the highest (RM 115.11/m(3)), followed by Design B (RM 23.64/m(3)) and Design C (RM 7.03/m(3)). In this study, the membrane system operated at high operating pressure with low membrane unit cost is preferable. Design C is chosen as the optimal design for the membrane based POME treatment system based on the lowest total treatment cost.
  2. Hameed BH, Salman JM, Ahmad AL
    J Hazard Mater, 2009 Apr 15;163(1):121-6.
    PMID: 18667269 DOI: 10.1016/j.jhazmat.2008.06.069
    In this work, the adsorption of 2,4-dichlorophenoxyacetic acid (2,4-D) on activated carbon derived from date stones (DSAC) was studied with respect to pH and initial 2,4-D concentration. The experimental data were analyzed by the Freundlich isotherm, the Langmuir isotherm, and the Temkin isotherm. Equilibrium data fitted well with the Langmuir model with maximum adsorption capacity of 238.10 mg/g. Pseudo-first and pseudo-second-order kinetics models were tested with the experimental data, and pseudo-first-order kinetics was the best for the adsorption of 2,4-D by DSAC with coefficients of correlation R(2)>or=0.986 for all initial 2,4-D concentrations studied. The results indicated that the DSAC is very effective for the adsorption of 2,4-D from aqueous solutions.
  3. Tan IA, Ahmad AL, Hameed BH
    J Hazard Mater, 2009 May 30;164(2-3):473-82.
    PMID: 18818013 DOI: 10.1016/j.jhazmat.2008.08.025
    The adsorption characteristics of 2,4,6-trichlorophenol (TCP) on activated carbon prepared from oil palm empty fruit bunch (EFB) were evaluated. The effects of TCP initial concentration, agitation time, solution pH and temperature on TCP adsorption were investigated. TCP adsorption uptake was found to increase with increase in initial concentration, agitation time and solution temperature whereas adsorption of TCP was more favourable at acidic pH. The adsorption equilibrium data were best represented by the Freundlich and Redlich-Peterson isotherms. The adsorption kinetics was found to follow the pseudo-second-order kinetic model. The mechanism of the adsorption process was determined from the intraparticle diffusion model. Boyd plot revealed that the adsorption of TCP on the activated carbon was mainly governed by particle diffusion. Thermodynamic parameters such as standard enthalpy (DeltaH degrees ), standard entropy (DeltaS degrees ), standard free energy (DeltaG degrees ) and activation energy were determined. The regeneration efficiency of the spent activated carbon was high, with TCP desorption of 99.6%.
  4. Tan IA, Ahmad AL, Hameed BH
    J Hazard Mater, 2008 Jun 15;154(1-3):337-46.
    PMID: 18035483
    Adsorption isotherm and kinetics of methylene blue on activated carbon prepared from coconut husk were determined from batch tests. The effects of contact time (1-30 h), initial dye concentration (50-500 mg/l) and solution temperature (30-50 degrees C) were investigated. Equilibrium data were fitted to Langmuir, Freundlich, Temkin and Dubinin-Radushkevich isotherm models. The equilibrium data were best represented by Langmuir isotherm model, showing maximum monolayer adsorption capacity of 434.78 mg/g. The kinetic data were fitted to pseudo-first-order, pseudo-second-order and intraparticle diffusion models, and was found to follow closely the pseudo-second-order kinetic model. Thermodynamic parameters such as standard enthalpy (DeltaH degrees), standard entropy (DeltaS degrees) and standard free energy (DeltaG degrees) were evaluated. The adsorption interaction was found to be exothermic in nature. Coconut husk-based activated carbon was shown to be a promising adsorbent for removal of methylene blue from aqueous solutions.
  5. Hameed BH, Din AT, Ahmad AL
    J Hazard Mater, 2007 Mar 22;141(3):819-25.
    PMID: 16956720
    Bamboo, an abundant and inexpensive natural resource in Malaysia was used to prepare activated carbon by physiochemical activation with potassium hydroxide (KOH) and carbon dioxide (CO(2)) as the activating agents at 850 degrees C for 2h. The adsorption equilibrium and kinetics of methylene blue dye on such carbon were then examined at 30 degrees C. Adsorption isotherm of the methylene blue (MB) on the activated carbon was determined and correlated with common isotherm equations. The equilibrium data for methylene blue adsorption well fitted to the Langmuir equation, with maximum monolayer adsorption capacity of 454.2mg/g. Two simplified kinetic models including pseudo-first-order and pseudo-second-order equation were selected to follow the adsorption processes. The adsorption of methylene blue could be best described by the pseudo-second-order equation. The kinetic parameters of this best-fit model were calculated and discussed.
  6. Ahmad AL, Sumathi S, Hameed BH
    Water Res, 2005 Jul;39(12):2483-94.
    PMID: 15985277
    The adsorption of residue oil from palm oil mill effluent (POME) using chitosan powder and flake has been investigated. POME contains about 2g/l of residue oil, which has to be treated efficiently before it can be discharged. Experiments were carried out as a function of different initial concentrations of residue oil, weight dosage, contact time and pH of chitosan in powder and flake form to obtain the optimum conditions for the adsorption of residue oil from POME. The powder form of chitosan exhibited a greater rate compared to the flake type. The results obtained showed that chitosan powder, at a dosage of 0.5g/l, 15min of contact time and a pH value of 5.0, presented the most suitable conditions for the adsorption of residue oil from POME. The adsorption process performed almost 99% of residue oil removal from POME. Equilibrium studies have been carried out to determine the capacity of chitosan for the adsorption of residue oil from POME using the optimum conditions from the flocculation at different initial concentrations of residue oil. Langmuir and Freundlich adsorption models were applied to describe the experimental isotherms and isotherm constants. Equilibrium data fitted very well with the Freundlich model. The pseudo first- and second-order kinetic models and intraparticle diffusion model were used to describe the kinetic data and the rate constants were evaluated. The experimental data fitted well with the second-order kinetic model, which indicates that the chemical sorption is the rate-limiting step, i.e. chemisorption between residue oil and chitosan. The significant uptake of residue oil on chitosan was further proved by BET surface area analysis and SEM micrographs.
  7. Chin JY, Ahmad AL, Low SC
    J Environ Manage, 2023 Oct 01;343:118231.
    PMID: 37247545 DOI: 10.1016/j.jenvman.2023.118231
    The surge in the use of antibiotics, especially in aquaculture, has led to development of antibiotic resistance genes, which will harm environmental and public health. One of the most commonly used antibiotics in aquaculture is oxytetracycline (OTC). Employing photocatalysis, this study compared OTC degradation efficiency of two different types of common photocatalysts, TiO2 and graphitic carbon nitride (GCN) in terms of their photochemical properties and underlying photocatalytic mechanism. For reference purpose, self-synthesized GCN from urea precursor (GCN-Urea) and commercial GCN (GCN-Commercial) were both examined. OTC adsorption-photocatalysis removal rates in pure OTC solution by TiO2, GCN-Urea and GCN-Commercial were attained at 95%, 60% and 40% respectively. Photochemical properties evaluated included light absorption, band gap, valence and conduction band positions, photoluminescence, cyclic voltammetry, BET surface area and adsorption capability of the photocatalysts. Through the evaluations, this study provides novel insights towards current state-of-the-art heterogeneous photocatalytic processes. The electron-hole recombination examined by photoluminescence is not the key factor influencing the photocatalytic efficacies as commonly discussed. On the contrary, the dominating factors governing the higher OTC degradation efficiency of TiO2 compared to GCN are the high mobility of electrons that leads to high redox capability and the high pollutant-photocatalyst affinity. These claims are proven by 86% and 40% more intense anodic and cathodic cyclic voltammetry curve peaks of TiO2 as compared to both GCNs. OTC also demonstrated 1.7 and 2.3 times higher affinity towards TiO2 than GCN-Urea and GCN-Commercial. OTC removal by TiO2 in real aquaculture wastewater only achieved 50%, due to significant inhibition effect by dissolved solids, dissolved organic matters and high ionic contents in the wastewater.
  8. Ahmad AL, Sugumaran J, Shoparwe NF
    Membranes (Basel), 2018 Dec 14;8(4).
    PMID: 30558199 DOI: 10.3390/membranes8040131
    In this study, the antifouling properties of polyethersulfone (PES) membranes blended with different amounts of ZnO nanoparticles and a fixed ratio of N-methyl-2-pyrrolidone (NMP)-acetone mixture as a solvent were investigated. The properties and performance of the fabricated membranes were examined in terms of hydrophilicity, porosity, pore size, surface and cross-section image using scanning electron microscopy (SEM), surface roughness using atomic force microscopy (AFM), pure water flux, and humic acid filtration. Addition of ZnO as expected was found to improve the hydrophilicity as well as to encourage pore formation. However, the agglomeration of ZnO at a higher concentration cannot be avoided even when dissolved in a mixed solvent. The presence of highly volatile acetone contributed to the tight skin layer of the membrane which shows remarkable antifouling ability with the highest flux recovery ratio and negligible irreversible fouling. ZnO NPs in acetone/NMP mixed solvent shows an improvement in flux and rejection, but, the fouling resistance was moderate compared to the pristine membrane.
  9. Pang WY, Ahmad AL, Zaulkiflee ND
    J Environ Manage, 2019 Nov 01;249:109358.
    PMID: 31450197 DOI: 10.1016/j.jenvman.2019.109358
    The aim of this study is to evaluate the performance and antifouling properties of polyethersulfone (PES) membrane incorporated with dual nanofiller, zinc oxide (ZnO) and multi-walled carbon nanotube (MWCNT). The synergistic effect of the these nanofillers in PES membrane is studied by blending different ratio of ZnO/MWCNT nanofiller into the PES membrane. The fabricated membranes were characterized in terms of cross-section and surface morphology, surface hydrophilicity, pore size and porosity. The filtration performance of the membranes was tested using 50 mg/L humic acid (HA) solution as model solution. SEM image and gravimetric evaluation reported that the incorporation of both MWCNT and ZnO into the PES membrane improved porosity significantly up to 46.02%. Lower water contact angle of PES membrane incorporated with equal ratio of MWCNT and ZnO (PES 3) revealed that it has neat PES membrane properties and more hydrophilic membrane surface than single filler. PES 3 outperform other membranes with excellent HA permeate flux of 40.00 L/m2.h and rejection of 88.51%. Due to hydrophilic membrane surface, PES 3 membrane demonstrate efficient antifouling properties with lower relative flux reduction (RFR) and higher flux recovery ratio (FRR). PES 3 also showed notable antibacterial properties with less bacterial attached to the membrane compared to neat PES membrane (PES 0).
  10. Azlan AA, Hamzah MR, Tham JS, Ayub SH, Ahmad AL, Mohamad E
    PMID: 34063294 DOI: 10.3390/ijerph18094860
    Health literacy is progressively seen as an indicator to describe a nation's health status. To improve health literacy, countries need to address health inequalities by examining different social demographic factors across the population. This assessment is crucial to identify and evaluate the strengths and limitations of a country in addressing health issues. By addressing these health inequalities, a country would be better informed to take necessary steps to improve the nation's health literacy. This study examines health literacy levels in Malaysia and analyses socio-demographic factors that are associated with health literacy. A cross-sectional survey was carried out using the HLS-M-Q18 instrument, which was validated for the Malaysian population. Multi-stage random sampling strategy was used in this study, utilising several sampling techniques including quota sampling, cluster sampling, and simple random sampling to allow random data collection. A total of 855 respondents were sampled. Our results showed that there were significant associations between health literacy and age, health status, and health problems. Our findings also suggest that lower health literacy levels were associated with the younger generation. This study's findings have provided baseline data on Malaysians' health literacy and provide evidence showing potential areas of intervention.
  11. Mohd Din AT, Hameed BH, Ahmad AL
    J Hazard Mater, 2009 Jan 30;161(2-3):1522-9.
    PMID: 18562090 DOI: 10.1016/j.jhazmat.2008.05.009
    The liquid-phase adsorption of phenol onto coconut shell-based activated carbon, CS850A was investigated for its equilibrium studies and kinetic modeling. Coconut shell was converted into high quality activated carbon through physiochemical activation at 850 degrees C under the influence of CO(2) flow. Beforehand, the coconut shell was carbonized at 700 degrees C and the resulted char was impregnated with KOH at 1:1 weight ratio. In order to evaluate the performance of CS850A, a series of batch adsorption experiments were conducted with initial phenol concentrations ranging from 100 to 500 mg l(-1), adsorbent loading of 0.2g and the adsorption process was maintained at 30+/-1 degrees C. The adsorption isotherms were in conformation to both Langmuir and Freundlich isotherm models. Chemical reaction was found to be a rate-controlling parameter to this phenol-CS850A batch adsorption system due to strong agreement with the pseudo-second-order kinetic model. Adsorption capacity for CS850A was found to be 205.8 mg g(-1).
  12. AbdulKadir WAFW, Ahmad AL, Boon Seng O
    Membranes (Basel), 2021 Mar 23;11(3).
    PMID: 33807017 DOI: 10.3390/membranes11030228
    The hydrophobic membranes have been widely explored to meet the membrane characteristics for the membrane distillation (MD) process. Inorganic metal oxide nanoparticles have been used to improve the membrane hydrophobicity, but limited studies have used nano clay particles. This study introduces halloysite nanotube (HNT) as an alternative material to synthesis a hydrophobic poly(vinylidene fluoride) (PVDF)-HNT membrane. The PVDF membranes were fabricated using functionalized HNTs (e.g., carnauba wax and 1H,1H,2H,2H-perfluorooctyl-trichlorosilane (FOTS)). The results were determined by Fourier transform infrared-attenuated total reflection, scanning electron microscope, goniometer and porometer to determine the desired hydrophobic membrane for direct contact membrane distillation (DCMD). The addition of FOTS-HNT (fs-HNT) and carnauba wax-HNT (fw-HNT) in the PVDF membrane enhanced the water contact angle (CA) to 127° and 137°, respectively. The presence of fw-HNT in the PVDF membrane exhibited higher liquid entry pressure (LEP) (2.64 bar) compared to fs-HNT in the membrane matrix (1.44 bar). The PVDF/fw-HNT membrane (Pfw-HNT) obtained the highest flux of 7.24 L/m2h with 99.9% salt removal. A stable permeability in the Pfw-HNT membrane was obtained throughout 16 h of DCMD. The incorporation of fw-HNT in the PVDF membrane had improved the anti-wetting properties and the membrane performance with the anti-fouling effect.
  13. Wan Jusoh WZA, Abdul Rahman S, Ahmad AL, Mohd Mokhtar N
    Data Brief, 2019 Jun;24:103910.
    PMID: 31193576 DOI: 10.1016/j.dib.2019.103910
    This paper focus to examine the best molecular interaction between Polyamide Thin Film Composite (PA TFC) layers with different properties of the support membrane. The support membrane of Nylon 66 (N66) and Polyvinylidene fluoride (PVDF) was chosen to represent the hydrophilic and hydrophobic model respectively in the Molecular Dynamic (MD) simulation. The Condensed-Phase Optimized Molecular Potential for Atomistic Simulation Studies (COMPASS) force field was used with the total simulation runs were set 1000 picoseconds run production ensembles. The temperature and pressure set for both ensembles were 298 K and 1 atm respectively. The validity of our model densities data was check and calculated where the deviation must be less than 6%. The comparison between hydrophobic and hydrophilic of the support membrane data was examined by the distance and magnitude of intensity of the Radial Distribution Function (RDF's) trends.
  14. Ahmad AL, Tan LS, Shukor SR
    J Hazard Mater, 2008 Feb 28;151(1):71-7.
    PMID: 17587496
    In order to produce sufficient food supply for the ever-increasing human population, pesticides usage is indispensable in the agriculture sector to control crop losses. However, the effect of pesticides on the environment is very complex as undesirable transfers occur continually among different environmental sections. This eventually leads to contamination of drinking water source especially for rivers located near active agriculture practices. This paper studied the application of nanofiltration membrane in the removal of dimethoate and atrazine in aqueous solution. Dimethoate was selected as the subject of study since it is being listed as one of the pesticides in guidelines for drinking water by World Health Organization. Nevertheless, data on effectiveness of dimethoate rejection using membranes has not been found so far. Meanwhile, atrazine is classified as one of the most commonly used pesticides in Malaysia. Separation was done using a small batch-type membrane separation cell with integrated magnetic stirrer while concentration of dimethoate and atrazine in aqueous solution was analyzed using high performance liquid chromatography (HPLC). Four nanofiltration membranes NF90, NF200, NF270 and DK were tested for their respective performance to separate dimethoate and atrazine. Of all four membranes, NF90 showed the best performance in retention of dimethoate and atrazine in water.
  15. Che HX, Yeap SP, Osman MS, Ahmad AL, Lim J
    ACS Appl Mater Interfaces, 2014 Oct 8;6(19):16508-18.
    PMID: 25198872 DOI: 10.1021/am5050949
    The synthesis of nanocomposite with controlled surface morphology plays a key role for pollutant removal from aqueous environments. The influence of the molecular size of the polyelectrolyte in synthesizing silica-iron oxide core-shell nanocomposite with open shell structure was investigated by using dynamic light scattering, atomic force microscopy, and quartz crystal microbalance with dissipation (QCM-D). Here, poly(diallydimethylammonium chloride) (PDDA) was used to promote the attachment of iron oxide nanoparticles (IONPs) onto the silica surface to assemble a nanocomposite with magnetic and catalytic bifunctionality. High molecular weight PDDA tended to adsorb on silica colloid, forming a more extended conformation layer than low molecular weight PDDA. Subsequent attachment of IONPs onto this extended PDDA layer was more randomly distributed, forming isolated islands with open space between them. By taking amoxicillin, an antibiotic commonly found in pharmaceutical waste, as the model system, better removal was observed for silica-iron oxide nanocomposite with a more extended open shell structure.
  16. Albazee E, Alenezi A, Alenezi M, Alabdulhadi R, Alhubail RJ, Ahmad Al Sadder K, et al.
    Cureus, 2023 Feb;15(2):e34734.
    PMID: 36755770 DOI: 10.7759/cureus.34734
    Hemorrhoidectomy is one of the most common surgical interventions to remove the third and fourth degrees of prolapse hemorrhoid. We carried out this systematic review and meta-analysis of the randomized controlled trials (RCTs) to comprehensively evaluate the efficacy of harmonic scalpel (HS) versus bipolar diathermy (BD) methods in terms of decreasing intraoperative and postoperative morbidities among patients undergoing hemorrhoidectomy. Suitable citations were found utilizing digital medical sources, including the CENTRAL, Web of Science, PubMed, Scopus, and Google Scholar, from inception until December 2022. Only RCTs that matched the inclusion requirements were selected. We used the updated Cochrane risk of bias (ROB) tool (version 2) to assess the quality of the involved citations. The Review Manager (version 5.4 for Windows) was used to perform the pooled analysis. Data were pooled and reported as mean difference (MD) or risk ratio (RR) with a 95% confidence interval (CI) in random-effects models. Overall, there was no significant difference between HS and BD in terms of decreasing intraoperative morbidities like operative time, intraoperative blood loss, mean duration of hospital stay, and mean duration of first bowel movement (P>0.05). Similarly, the rate of postoperative complications like pain, bleeding, urinary retention, anal stenosis, flatus incontinence, and wound edema; was similar in both groups with no significant difference (P>0.05). In conclusion, our pooled analysis revealed there was no substantial difference between HS and BD in terms of intraoperative and postoperative endpoints. Additional RCTs with larger sample sizes are needed to consolidate the power and quality of the presented evidence.
  17. Low SC, Shaimi R, Thandaithabany Y, Lim JK, Ahmad AL, Ismail A
    Colloids Surf B Biointerfaces, 2013 Oct 1;110:248-53.
    PMID: 23732801 DOI: 10.1016/j.colsurfb.2013.05.001
    Protein adsorption onto membrane surfaces is important in fields related to separation science and biomedical research. This study explored the molecular interactions between protein, bovine serum albumin (BSA), and nitrocellulose films (NC) using electrokinetic phenomena and the effects of these interactions on the streaming potential measurements for different membrane pore morphologies and pH conditions. The data were used to calculate the streaming ratios of membranes-to-proteins and to compare these values to the electrostatic or hydrophobic attachment of the protein molecules onto the NC membranes. The results showed that different pH and membrane pore morphologies contributes to different protein adsorption mechanisms. The protein adsorption was significantly reduced under conditions where the membrane and protein have like-charges due to electrostatic repulsion. At the isoelectric point (IEP) of the protein, the repulsion between the BSA and the NC membrane was at the lowest; thus, the BSA could be easily attached onto the membrane/solution interface. In this case, the protein was considered to be in a compact layer without intermolecular protein repulsions.
  18. Yeap SP, Ahmad AL, Ooi BS, Lim J
    Langmuir, 2012 Oct 23;28(42):14878-91.
    PMID: 23025323 DOI: 10.1021/la303169g
    A detailed study on the conflicting role that colloid stability plays in magnetophoresis is presented. Magnetic iron oxide particles (MIOPs) that were sterically stabilized via surface modification with poly(sodium 4-styrene sulfonate) of different molecular weights (i.e., 70 and 1000 kDa) were employed as our model system. Both sedimentation kinetics and quartz crystal microbalance with dissipation (QCM-D) measurements suggested that PSS 70 kDa is a better stabilizer as compared to PSS 1000 kDa. This observation is mostly attributed to the bridging flocculation of PSS 1000 kDa decorated MIOPs originated from the extended polymeric conformation layer. Later, a lab-scale high gradient magnetic separation (HGMS) device was designed to study the magnetophoretic collection of MIOPs. Our experimental results revealed that the more colloidally stable the MIOP suspension is, the harder it is to be magnetically isolated by HGMS. At 50 mg/L, naked MIOPs without coating can be easily captured by HGMS at separation efficiency up to 96.9 ± 2.6%. However, the degree of separation dropped quite drastically to 83.1 ± 1.2% and 67.7 ± 4.6%, for MIOPs with PSS 1000k and PSS 70k coating, respectively. This observation clearly implies that polyelectrolyte coating that was usually employed to electrosterically stabilize a colloidal system in turn compromises the magnetic isolation efficiency. By artificially destroying the colloidal stability of the MIOPs with ionic strength increment, the ability for HGMS to recover the most stable suspension (i.e., PSS 70k-coated MIOPs) increased to >86% at 100 mM monovalent ion (Na(+)) or at 10 mM divalent ion (Ca(2+)). This observation has verified the conflicting role of colloidal stability in magnetophoretic separation.
  19. Hameed BH, Mahmoud DK, Ahmad AL
    J Hazard Mater, 2008 Oct 1;158(1):65-72.
    PMID: 18308467 DOI: 10.1016/j.jhazmat.2008.01.034
    In this paper, the ability of coconut bunch waste (CBW), an agricultural waste available in large quantity in Malaysia, to remove basic dye (methylene blue) from aqueous solution by adsorption was studied. Batch mode experiments were conducted at 30 degrees C to study the effects of pH and initial concentration of methylene blue (MB). Equilibrium adsorption isotherms and kinetics were investigated. The experimental data were analyzed by the Langmuir, Freundlich and Temkin models of adsorption. The adsorption isotherm data were fitted well to Langmuir isotherm and the monolayer adsorption capacity was found to be 70.92 mg/g at 30 degrees C. The kinetic data obtained at different concentrations have been analyzed using a pseudo-first-order, pseudo-second-order equation and intraparticle diffusion equation. The experimental data fitted very well the pseudo-second-order kinetic model.
  20. Mohamad EMW, Kaundan MK, Hamzah MR, Azlan AA, Ayub SH, Tham JS, et al.
    BMC Public Health, 2020 Apr 28;20(1):580.
    PMID: 32345285 DOI: 10.1186/s12889-020-08704-7
    BACKGROUND: The European Health Literacy Survey Questionnaire (HLS-EU-Q47) is becoming a widely used tool to measure health literacy (HL), including in Malaysia. There are efforts to reduce the 47-item scale to parsimonious short item scales that still reflect the assumptions and requirements of the conceptual model. This study used confirmatory factor analysis to reduce the 47-item scale to a short scale that can offer a feasible HL screening tool with sufficient psychometric properties.

    METHODS: A cross-sectional survey was conducted on the Malaysian population based on ethnic distribution to ensure that the short version instrument reflects the country's varied ethnicities. The survey was administered by well-trained interviewers working for the Ministry of Health Malaysia. A total of 866 responses were obtained. Data was analysed using multi-factorial confirmatory factor analysis (CFA) with categorical variables.

    RESULTS: The analysis resulted in a satisfactory 18-item model. There were high correlations among the 18 items. The internal consistency reliability was robust, with no floor/ceiling effects. These results represented equivalence and consistency among the responses to items, suggesting that these items were homogenous in measuring Malaysian health literacy. The strong convergent and discriminant validity of the model makes the proposed 18 items a suitable short version of the health literacy instrument for Malaysia.

    CONCLUSIONS: The researchers propose the 18-item instrument to be named HLS-M-Q18. This short version instrument may be used in measuring health literacy in Malaysia as it achieved robust reliability, structural validity and construct validity that fulfilled goodness-of-fit criteria.
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