METHODS: We assessed five process indicators: recruitment, retention, dosage, fidelity, and satisfaction for the Toybox program. Data collection was conducted via teachers' monthly logbooks, post-intervention feedback through questionnaires, and focus group discussions (FGD) with teachers, parents, and children. Data were analyzed using quantitative and qualitative data analysis methods.
RESULTS: A total of 1072 children were invited. Out of the 1001 children whose parents consented to join, only 837 completed the program (Retention rate: 88.4%). As high as 91% of the 44 teachers and their assistants engaged positively in one or more of the process evaluation data collection methods. In terms of dosage and fidelity, 76% of parents had received newsletters, tip cards, and posters at the appropriate times. All teachers and their assistants felt satisfied with the intervention program. However, they also mentioned some barriers to its implementation, including the lack of suitable indoor environments to conduct activities and the need to make kangaroo stories more interesting to captivate the children's attention. As for parents, 88% of them were satisfied with the family-based activities and enjoyed them. They also felt that the materials provided were easy to understand and managed to improve their knowledge. Lastly, the children showed positive behaviors in consuming more water, fruits, and vegetables.
CONCLUSIONS: The Toybox program was deemed acceptable and feasible to implement by the parents and teachers. However, several factors need to be improved before it can be expanded and embedded as a routine practice across Malaysia.
OBJECTIVE: This study aims to determine the accuracy of MEDAL in assessing the dietary intake of Malaysian school children, using photographs of the children's meals taken by their parents as an objective reference.
METHODS: A convenience sample of 46 children aged 10 to 11 years recorded their daily meals in MEDAL for 4 days (2 weekdays and 2 weekend days). Their parents took photographs of the meals and snacks of their children before and after consumption during the 4-day period and sent them along with a brief description of food and drinks consumed via an instant SMS text messaging app. The accuracy of the children's reports of the food they had consumed was determined by comparing their MEDAL reports to the photographs of the food sent by their parents.
RESULTS: Overall, the match, omission, and intrusion rates were 62% (IQR 46%-86%), 39% (IQR 16%-55%), and 20% (IQR 6%-44%), respectively. Carbohydrate-based items from the food categories "rice and porridge"; "breads, spreads, and cereals"; and "noodles, pasta, and potatoes" were reported most accurately (total match rates: 68%-76%). "Snack and dessert" items were omitted most often (omission rate: 54%). Furthermore, side dishes from "vegetables and mushrooms," "eggs and tofu," "meat and fish," and "curry" food groups were often omitted (omission rates: 42%-46%). Items from "milk, cheese, and yogurt"; "snacks and desserts"; and "drinks" food groups intruded most often (intrusion rates: 37%-46%). Compared to the items reported by the boys, those reported by the girls had higher match rates (69% vs 53%) and lesser omission rates (31% vs 49%; P=.03, respectively).
CONCLUSIONS: In conclusion, children aged 10 to 11 years can self-report all their meals in MEDAL, although some items are omitted or intruded. Therefore, MEDAL is a tool that can be used to assess the dietary intake of Malaysian school children.
METHODS: Data from 939 preschoolers aged 3-6 years (mean age = 4.83 ± 0.04 years, 53.7% boys) from the Second South East Asian Nutrition Surveys (SEANUTS II) Malaysia study was analyzed. Socio-demography, physical activity, sedentary behaviors, and sleep were parent-reported via questionnaire. Associations between adherence of 24-hMG and sociodemographic factors were analyzed using complex samples logistic regression.
RESULTS: Only 12.1% of preschoolers adhered to the overall 24-hMG, and 67.1%, 54.7%, and 42.7% of preschoolers adhered to physical activity, sleep, and sedentary behavior guidelines, respectively; while 6.8% did not meet any guidelines. Compared to 3-4-year olds, preschoolers aged 5-6 years had higher odds of adhering to physical activity guidelines, sedentary behavior guidelines, and overall 24-hMG, but lower odds of adhering to sleep guidelines. Chinese and Indian preschoolers were more likely to adhere to sedentary behavior guidelines than Malay preschoolers; however, Chinese preschoolers had lower odds of adhering to physical activity guidelines. Paternal tertiary education was associated with a higher likelihood of adherence to sleep guidelines.
CONCLUSION: Our findings suggest that adherence to 24-hMG among Malaysian preschoolers is associated with age, ethnicity, and paternal education level. This underscores the importance of targeted interventions and health awareness program to promote healthy movement behaviors, particularly among children under 5, ethnic minorities, and educationally disadvantaged families.
MATERIALS AND METHODS: Three groups of data were analysed from the BDTR over the 10-year period. Epidemiological data, blood parameters and dialysis are key performance indicators.
RESULTS: There are increments in prevalence and incidence of treated ESKD patients in Brunei over 10 years, especially with haemodialysis (HD). The projected prevalence and incidence showed an anticipated annual increase of 42.2 per million population (pmp) and 9.9 pmp respectively. Diabetes mellitus (DM) (79%) was the main cause of ESKD. HD (86%), peritoneal dialysis (PD) (9%) and transplant (5%) were the main modalities of kidney replacement therapy in 2020. Cumulative results over the decade showed significant improvements in serum phosphate, peritonitis rates and HD blood flow rates. PD patients have better survival rates, lower systolic blood pressure and better adequacy. PD survival (patient survival of 91%, 73% and 56% at 1, 3 and 5 years respectively) was superior to HD survival (86% and 64% at 1 and 2 years, respectively), but patient demographics (age and DM status) were different. The 2020 dataset showed satisfactory anaemia management but mineral bone disease management was sub-optimal. Seventy percent of prevalent HD patients had arteriovenous fistula access. Thirty-two percent and fifty-two percent of HD and PD patients, respectively, achieved target dialysis adequacy. Peritonitis rate was 0.3 episodes per patient year.
CONCLUSION: Brunei has a high incidence and prevalence of treated ESKD in the last decade, especially DM-related ESKD. This study has identified many specific areas to be targeted for improvements and provided evidence for further proliferation of PD and transplant preference policy.
METHODS: The Brunei Malay EQ-5D-5L was developed by culturally adapting two existing Malay versions. A total of 154 Bruneians with T2DM completed the questionnaire in two different points of time with one week apart. Known-groups validity of the utility-based EQ-5D-5L index and visual analogue scale (EQ-VAS) was evaluated by comparing subgroups of patients known to differ in health status. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC) or Cohen's kappa.
RESULTS: As hypothesized, patients known to have 'better' health had higher EQ-5D-5L index scores than those having 'worse' health in all 7 known-groups comparisons. The hypothesized difference in the EQ-VAS scores was observed in only 4 of the 7 known-groups comparisons. Kappa values ranged from 0.206 to 0.446 for the EQ-5D-5L items; the ICC value for the EQ-5D-5L index and EQ-VAS was 0.626 and 0.521, respectively.
CONCLUSIONS: The utility-based EQ-5D-5L index appears to be valid and reliable for measuring the health of Brunei patients with T2DM. The validity of the EQ-VAS in Brunei requires further investigation.
METHODS: This study was divided into two phases. Phase I tested the reliability of the Malay-VHI-10 while Phase II was a cross-sectional study with two-stage sampling. In Phase II, a self-administered questionnaire was used to collect socio-demographic and teaching characteristics, depression, anxiety and stress scale (Malay version of DASS-21); and health-related quality of life (Malay version of SF12-v2). Complex sample analysis was conducted using multivariate Poisson regression with robust variance.
RESULTS: In Phase I, the Spearman correlation coefficient and Cronbach alpha for total VHI-10 score was 0.72 (p < 0.001) and 0.77 respectively; showing good correlation and internal consistency. The ICCs ranged from 0.65 to 0.78 showing fair to good reliability and demonstrating the subscales to be reliable and stable. A total of 6039 teachers participated in Phase II. They were primarily Malays, females, married, had completed tertiary education and aged between 30 to 50 years. A total of 10.4% (95% CI 7.1, 14.9) of the teachers had voice disorder (VHI-10 score > 11). Compared to Malays, a greater proportion of ethnic Chinese teachers reported voice disorder while ethnic Indian teachers were less likely to report this problem. There was a higher prevalence ratio (PR) of voice disorder among single or divorced/widowed teachers. Teachers with voice disorder were more likely to report higher rates of absenteeism (PR: 1.70, 95% CI 1.33, 2.19), lower quality of life with lower SF12-v2 physical (0.98, 95% CI 0.96, 0.99) and mental (0.97, 95% CI 0.96, 0.98) component summary scales; and higher anxiety levels (1.04, 95% CI 1.02, 1.06).
CONCLUSIONS: The Malay-VHI-10 is valid and reliable. Voice disorder was associated with increased absenteeism, marginally associated with reduced health-related quality of life as well as increased anxiety among teachers.
DESIGN: Cross-sectional validation study.
METHODS: We used data involving 3- and 4-year-olds from 13 middle- and high-income countries who participated in the SUNRISE study. We used Spearman's rank-order correlation, Bland-Altman plots, and Kappa statistics to validate parent-reported child habitual total physical activity against activPAL™-measured total physical activity over 3 days. Additionally, we used Receiver Operating Characteristic Area Under the Curve analysis to validate existing step-count thresholds (Gabel, Vale, and De Craemer) using step-counts derived from activPAL™.
RESULTS: Of the 352 pre-schoolers, 49.1 % were girls. There was a very weak but significant positive correlation and slight agreement between parent-reported total physical activity and accelerometer-measured total physical activity (r: 0.140; p = 0.009; Kappa: 0.030). Parents overestimated their child's total physical activity compared to accelerometry (mean bias: 69 min/day; standard deviation: 126; 95 % limits of agreement: -179, 316). Of the three step-count thresholds tested, the De Craemer threshold of 11,500 steps/day provided excellent classification of meeting the total physical activity guideline as measured by accelerometry (area under the ROC curve: 0.945; 95 % confidence interval: 0.928, 0.961; sensitivity: 100.0 %; specificity: 88.9 %).
CONCLUSIONS: Parent reports may have limited validity for assessing pre-schoolers' level of total physical activity. Step-counting is a promising alternative - low-cost global surveillance initiatives could potentially use pedometers for assessing compliance with the physical activity guideline in early childhood.