MATERIALS AND METHODS: A retrospective review of patients who underwent horizontal strabismus surgery between 2013 and 2017 in Hospital Universiti Sains Malaysia was conducted. Surgery was considered successful if the post-operative deviation was within 10 prism diopters at 6 months' postoperative period. Factors influencing the outcome of surgery at 6 months were identified. Chi-square and Fisher's exact tests were used in data analysis.
RESULTS: Ninety-eight patients were included. Both genders were equally affected. Exotropia (58.2%) was the most common type. About 65.3% of patients had alternating strabismus, while 51% had an angle of deviation of more than 45 prism diopters. Amblyopia was documented in 14.3% of patients. Those operated on below 10 years of age comprised 64.3%. Ninety-four patients completed follow-ups at 6 months after the surgery. The success rate was 81.6%. Approximately 92% of the patients had best-corrected visual acuities of 6/12 and better at 6 months' postoperative period. There was no significant association between age of onset, gender, presence of amblyopia, type of deviation, amount of deviation, and postoperative best-corrected visual acuity with surgical outcome at 6 months' postoperative period (P > 0.05).
CONCLUSION: The success rate was good. Postoperative best-corrected visual acuity was promising. Age of onset, gender, presence of amblyopia, type of deviation, amount of deviation, and postoperative best-corrected visual acuity did not influence the outcome of horizontal strabismus surgery in our review.
Methods: This study was conducted in HUSM's ED over two study periods. In the first three months, 300 patients were triaged under the three-tier triaging system, and, in the subsequent three months, 280 patients were triaged under the ESI. The patients were triaged by junior paramedics and the triage records were retained and later re-triaged by senior paramedics. The inter-rater reliability was evaluated using Cohen's Kappa statistics. The acuity ratings of the junior paramedics were compared with those of the expert panel to determine the sensitivity and specificity of each acuity level for both the ESI and the three-tier triaging system. The over-triage rate, under-triage rate, amount of resources used, admission rate and discharge rate were also determined.
Results: The inter-rater agreement for the three-tier triaging system was 0.81 while that of the ESI was 0.75. The ESI had a higher average sensitivity of 74.3% and a specificity of 94.4% while the three-tier system's average sensitivity was 68.5% and its specificity 87.0%. The average under-triage and over-triage rates for the ESI were 10.7% and 6.2%, respectively, which were lower than the three-tier system's average under-triage rate of 13.1% and over-triage rate of 17.1%. The urgency levels of both the ESI and the three-tier system were associated with increased admission rates and resources used in the ED.
Conclusion: The ESI's inter-rater reliability was comparable to the three-tier triaging system and it demonstrated better validity than the existing three-tier system.
Materials and Methods: The questionnaire was first translated into the Malay language (RDAS-M). In this cross-sectional study, healthy married Malay women in Kota Bharu, Kelantan, were recruited from January to April 2018. Participants were asked to complete the RDAS-M that consists of three domains, that is, dyadic consensus, dyadic satisfaction, and dyadic cohesion with a total of 14 items. The concept, content, and construct validity using exploratory factor analysis (EFA) and reliability of the RDAS-M were assessed.
Results: Of the 164 recruited participants, 150 consented to participate. The mean age of the participants was 34.1 years (standard deviation [SD], 9.5 years), ranging from 20 to 57 years. All 14 items were considered comprehensible by more than 95% of the subjects. Based on EFA, total variance extracted was 69.08%, and the original three factors were retained. The Malay version of the RDAS was valid based on factor loadings for dyadic consensus, dyadic satisfaction, and dyadic cohesion, which ranged from 0.64 to 0.80, 0.79 to 0.98, and 0.37 to 0.78, respectively. The internal consistency was good with coefficient α of 0.87 for dyadic consensus, 0.93 for dyadic satisfaction, and 0.78 for dyadic cohesion.
Conclusions: The Malay version of the RDAS is easy to understand, and is a reliable and valid instrument for married women. It is also comparable with the original version of the RDAS in terms of structure and psychometric properties.
METHOD: The study was a cross-sectional design in nature, using self-reported questionnaires among the university students in Malaysia. Participants were selected using a convenience sampling approach. Perceptions regarding social support and physical environment were assessed using the Malay-translated version scales. The standard forward-backwards translation was conducted to translate the English version of the scales to the Malay version. Confirmatory factor analysis (CFA) was used to validate the translated version scales; composite reliability (CR) and average variance extracted (AVE) were computed.
RESULTS: A total of 857 students participated in this study (female: 49.1%, male: 50.9%). The mean age of the participants was 20.2 (SD = 1.6). The fit indices of the initial hypothesized measurement models (social support and physical environment) were not satisfactory. Further improvements were made by adding covariances between residuals' items within the same factor for each hypothesized model. The final re-specified measurement models demonstrated adequate factor structure for the social support scale with 24 items (CFI = .932, TLI = .920, SRMR = .054, RMSEA = .061), and the physical environment scale with five items (CFI = .994, TLI = .981, SRMR = .013, RMSEA = .054). The CR was .918 for family support, .919 for friend support, .813 for perceived availability, and .771 for perceived quality. The AVEs were .560 for family support, .547 for friend support, .554 for perceived availability, and .628 for perceived quality. The intra-class correlation (ICC) based on test-retest was .920 for family support, .984 for friend support, .895 for availability of facilities, and .774 for quality of facilities.
CONCLUSION: The Malay version of the social support scale for exercise and the physical environment scale for physical activity were shown to have adequate psychometric properties for assessing perceived social support and physical environment among the university students in Malaysia.
PERSPECTIVE: This study presented the psychometric properties of the social support and physical environment scales based on CFA and was the first to translate these scales from the original English version to the Malay version.
METHODS: A comprehensive literature search was conducted between January 2020 and December 2022 using online databases such as PubMed, Web of Science, Scopus, and Google Scholar by using the following keywords in combination: "COVID-19," "stress," "anxiety," "depression," and "intervention." The retrieved literature was screened and reviewed.
RESULTS: A total of 2,924 articles were retrieved using subject and keyword searches. After screening through the titles and abstracts, 18 related studies were retained. Their review revealed that: (1) most studies did not use medication to control stress and anxiety; (2) the standard methods used to reduce stress and anxiety were religion, psychological counseling, learning more about COVID-19 through the media, online mindfulness courses, improving sleep quality, and physical exercise; (3) the most effective interventions were physical activity and raising awareness about COVID-19 through the media and online mindfulness programs. However, some studies show that physical activity cannot directly relieve psychological stress and anxiety.
CONCLUSION: Limited interventions are effective, but learning more about COVID-19 and using active coping strategies may help reduce stress and anxiety. The implications of COVID-19 are also discussed.
METHODS: An electronic search was performed via PubMed, SCOPUS, Google Scholar, and Cochrane from inception to June 2022. The included trials were evaluated according to the recommendations of the Cochrane Handbook for Systematic Reviews. The primary outcome assessed was the intraoperative bleeding score of the surgical field. The mean arterial pressure, duration of the surgery, amount of blood loss and surgeon's satisfaction score were assessed as the secondary outcomes. The risk of bias for each study was evaluated using the Cochrane risk of bias tool.
RESULTS: A total of 254 records were identified after removal of duplicates. Based on the title and abstract 246 records were excluded, leaving seven full texts for further consideration. Five records were excluded following full text assessment. Three trials with a total of 212 patients were selected. Hot saline irrigation was superior to control in the intraoperative bleeding score (MD - 0.51, 95% CI - 0.84 to - 0.18; P < 0.001; I2 = 72%; very low quality of evidence) and surgeon's satisfaction score (RR 0.18, 95% CI 0.09 to 0.33; P < 0.001; I2 = 0%; low quality of evidence). The duration of surgery was lengthier in control when compared to HSI (MD - 9.02, 95% CI - 11.76 to - 6.28; P < 0.001; I2 = 0; very low quality of evidence). The volume of blood loss was greater in control than HSI (MD - 56.4, 95% CI - 57.30 to - 55.51; P < 0.001; I2 = 0%; low quality of evidence). No significant difference between the two groups for the mean arterial pressure was noted (MD - 0.60, 95% CI - 2.17 to 0.97; P = 0.45; I2 = 0%; low quality of evidence).
CONCLUSIONS: The practice of intranasal HSI during ESS is favorable in controlling intraoperative bleeding and improving the surgical field quality. It increases the surgeon's satisfaction, reduces blood loss, shortens operative time and has no effect on intraoperative hemodynamic instability.
TRIAL REGISTRATION: PROSPERO registration number: CRD42019117083.
METHODS: This questionnaire is divided into two parts. Part A is to evaluate the clinicians' awareness towards cognitive errors in clinical decision making while Part B is to evaluate their perception towards specific cognitive errors. Content validation for both parts was first determined followed by construct validation for Part A. Construct validation for Part B was not determined as the responses were set in a dichotomous format.
RESULTS: For content validation, all items in both Part A and Part B were rated as "excellent" in terms of their relevance in clinical settings. For construct validation using exploratory factor analysis (EFA) for Part A, a two-factor model with total variance extraction of 60% was determined. Two items were deleted. Then, the EFA was repeated showing that all factor loadings are above the cut-off value of >0.5. The Cronbach's alpha for both factors are above 0.6.
CONCLUSION: The CATChES questionnaire tool is a valid questionnaire tool aimed to evaluate the awareness among clinicians toward cognitive errors in clinical decision making.
Method: A cross-sectional study design with a convenience sampling method using a self-administered questionnaire was carried out. University undergraduate students were approached to fill in the questionnaire, which consisted of demographic information and a POC scale. The POC scale consisted of 30 items and two main factors (i.e., cognitive and behavioural). The POC scale was translated into the Malay language using a standard procedure of forward and backward translation. Confirmatory factor analysis (CFA) was performed, and composite reliability was computed using Mplus version 8.
Results: A total of 620 respondents with a mean age of 20 years (standard deviation = 1.15) completed the questionnaire. Most of the participants were female (74.7%) and Malay (78.2%). The initial CFA model of the POC scale did not exhibit fit based on several fit indices (comparative fit index (CFI) = 0.880, Tucker Lewis index (TLI) = 0.867, standardised root mean square residual (SRMR) = 0.075 and root mean square error of approximation (RMSEA) = 0.058). Several re-specifications of the model were conducted and the modification included adding correlation between the items' residuals. The final model for the Malay version of the POC scale showed acceptable values of model fit indices (CFI = 0.922, TLI = 0.911, SRMR = 0.064 and RMSEA = 0.048). The composite reliability of both the cognitive and behavioural processes was acceptable at 0.856 and 0.752, respectively.
Conclusion: The final model presented acceptable values of the goodness of fit indices, indicating that the scale is fit and acceptable to be adopted for future study.
Methods: Thirty-five nurses from various specialities were recruited from Hospital Universiti Sains Malaysia (HUSM). The intervention comprised a 1-day brief mindfulness-based intervention workshop and 1 h group practice session each month for 3 months together with daily follow-up via WhatsApp group. All the participants completed a self-administered sociodemographic questionnaire validated for use in a Malay population. The Depression, Anxiety and Stress Scale 21 (DASS 21) and Perceived Stress Scale 10 (PSS 10) were used to measure perceived stress, anxiety and depression before the intervention, and 3 months later upon completion of the intervention.
Results: There was a statistically significant reduction in the scores for stress perception (95% confidence interval [CI]: 0.06, 2.92; P = 0.04) and anxiety (95% CI: 0.06, 2.34; P = 0.04) post-intervention.
Conclusion: A brief mindfulness-based intervention was effective in reducing perceived stress and anxiety among nurses.