METHODS: This three-phase study was conducted among Malaysian population. Phase 1 involved forward and backward translations of the Scale to Malay language by four professional bilingual translators. In Phase 2, the new M-COVID-19-BS instrument was piloted on 30 participants who suggested minor lexical modifications. Phase 3 consisted of online recruiting of Malaysian citizens to answer a composite questionnaire comprising the M-COVID-19-BS, Copenhagen Burnout Inventory (CBI), World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF), and Fear of COVID-19 Scale (FCV-19S). Data were statistically analyzed.
RESULTS: The composite four-part questionnaire in Malay was answered by N = 225 Malaysian citizens. The M-COVID-19-BS instrument demonstrated a good internal consistency (Cronbach's alpha = 0.926) and had a unidimensional factor structure. M-COVID-19-BS scores positively correlated with the three CBI subscales, showing evidence of convergent validity. Negative correlation was reported between M-COVID-19-BS and WHOQOL-BREF, achieving discriminant validity. M-COVID-19-BS also exhibited moderate positive correlations with the FCV-19S, thus supporting its concurrent validity.
CONCLUSIONS: Results demonstrate that M-COVID-19-BS is a valid and reliable instrument to assess burnout symptoms related to COVID-19 among Malay-speaking populations either collectively or as a self-care tool to detect burnout symptoms without needing to further burden the already overwhelmed Malaysian healthcare system.
METHODS: The probiotic characteristics of Ld45E were evaluated by examining its morphology, pH tolerance, adhesive ability onto HeLa cells, hemolytic activity, antibiotic susceptibility, and autoaggregation ability. Then, the antimicrobial activity of Ld45E was determined using Ld45E culture, cell-free supernatant, and crude bacteriocin solution. Co-aggregation and competition ability assays against various pathogens were conducted. The immunoregulatory effects of Ld45E were analyzed by measuring the proinflammatory cytokine IL-17. A p-value less than 0.05 was considered statistical significance.
RESULTS: Ld45E is 3-5 mm in diameter and round with a flat-shaped colony. pH 4 and 4.5 were the most favorable range for Ld45E growth within 12 h of incubation. Ld45E showed a strong adhesion ability onto HeLa cells (86%) and negative hemolytic activities. Ld45E was also sensitive to ceftriaxone, cefuroxime, ciprofloxacin, and doxycycline. We found that it had a good autoaggregation ability of 80%. Regarding antagonistic properties, Ld45E culture showed strong antimicrobial activity against GBS, E. coli, and Klebsiella spp. but only a moderate effect on C. parapsilosis. Cell-free supernatant of Ld45E exerted the most potent inhibitory effects at 40 °C against all genital pathogens, whereas bacteriocin showed a robust inhibition at 37 °C and 40 °C. The highest co-aggregation affinity was observed with GBS (81%) and E. coli (40%). Competition ability against the adhesion of GBS (80%), E. coli (76%), Klebsiella (72%), and C. parapsilosis (58%) was found. Ld45E was able to reduce the induction of the proinflammatory protein IL-17.
CONCLUSIONS: Ld45E possessed antimicrobial and immunoregulatory properties, with better cell-on-cell activity than supernatant activity. Thus, Ld45E is a potential probiotic candidate for adjunct therapy to address vaginal infections.
RESULTS: Two fungal isolates (UM 1400 and UM 1020) from human specimens were identified as Daldinia eschscholtzii by morphological features and ITS-based phylogenetic analysis. Both genomes were similar in size with 10,822 predicted genes in UM 1400 (35.8 Mb) and 11,120 predicted genes in UM 1020 (35.5 Mb). A total of 751 gene families were shared among both UM isolates, including gene families associated with fungus-host interactions. In the CAZyme comparative analysis, both genomes were found to contain arrays of CAZyme related to plant cell wall degradation. Genes encoding secreted peptidases were found in the genomes, which encode for the peptidases involved in the degradation of structural proteins in plant cell wall. In addition, arrays of secondary metabolite backbone genes were identified in both genomes, indicating of their potential to produce bioactive secondary metabolites. Both genomes also contained an abundance of gene encoding signaling components, with three proposed MAPK cascades involved in cell wall integrity, osmoregulation, and mating/filamentation. Besides genomic evidence for degrading capability, both isolates also harbored an array of genes encoding stress response proteins that are potentially significant for adaptation to living in the hostile environments.
CONCLUSIONS: Our genomic studies provide further information for the biological understanding of the D. eschscholtzii and suggest that these wood-decaying fungi are also equipped for adaptation to adverse environments in the human host.
METHODS: This qualitative study employed the hermeneutic phenomenological study design. Purposive sampling strategies were used to recruit Malaysians that had direct experiences with friends, family members and their community who were hesitating or refusing to accept the COVID-19 vaccines. A semi-structured interview guide was developed based on the expert knowledge of the investigators and existing literature on the topic. A series of focus group interviews (FGIs) was conducted online facilitated by a multidisciplinary team of experts. The group interviews were transcribed verbatim and analysed.
RESULTS: Fifty-nine participants took part in seven FGIs. We found that "incongruence" was the overall thematic meaning that connected all the 3 main themes. These themes comprise firstly, the incongruence between the aims and implementation of the National Immunization Program which highlighted the gap between realities and needs on the ground. Secondly, the incongruence between Trust and Mistrust revealed a trust deficit in the government, COVID-19 news, and younger people's preference to follow the examples of local vaccination "heroes". Thirdly, the incongruence in communication showed the populace's mixed views regarding official media and local social media.
CONCLUSIONS: This study provided rich details on the complex picture of the COVID-19 immunization program in Malaysia and its impact on vaccine hesitancy and refusal. The inter-related and incongruent factors explained the operational difficulty and complexity of the NIP and the design of an effective health communication campaign. Identified gaps such as logistical implementation and communication strategies should be noted by policymakers in implementing mitigation plans.
METHODS: We obtained the validity and reliability evidence for the SAS-M-SF using a group of 307 pre-university students in Universiti Putra Malaysia (UPM), Serdang, Selangor, Malaysia with a mean age of 18.4±0.2 years (70.4% female and 29.6% male). A questionnaire containing the Malay version of Smartphone Addiction Scale (SAS-M), the Malay version of the short form Smartphone Addiction Scale (SAS-M-SF), and the Malay version of the Internet Addiction Test (IAT-M) was administered on the adolescents.
RESULTS: The SAS-M-SF displayed good internal consistency (Cronbach's α=0.80). Using principle component analysis, we identified a 4-factor SAS-M-SF model. A significant correlation between the SAS-M-SF and the IAT-M was found, lending support for concurrent validity. The prevalence of smartphone addiction was 54.5% based on cut-off score of ≥36 with a sensitivity of 70.2% and a specificity of 72.5%.
CONCLUSIONS: The 10-item SAS-M-SF is a valid and reliable screening tool for smartphone addiction among adolescents. The scale can help clinicians or educators design appropriate intervention and prevention programs targeting smartphone addiction in adolescents at clinical or school settings.
METHOD: This online-based cross-sectional study was conducted among 1280 healthcare providers aged ≥18 years from 30 primary care clinics in the state of Selangor, Malaysia. The Fear of COVID-19 Scale was used to assess the level of fear, and the results were analysed using multiple linear regression.
RESULTS: The mean age of the respondents was 36 years, and the mean working experience was 11 years. The majority of the respondents were women (82.4%) and Malays (82.3%). The factors that were significantly correlated with higher levels of fear were underlying chronic disease (ß=1.12, P=0.002, 95% confidence interval [CI]=0.08, 3.15), concern about mortality from COVID-19 (ß=3.3, P<0.001, 95% CI=0.19, 7.22), higher risk of exposure (ß=0.8, P<0.001, 95% CI=0.14, 5.91), concern for self at work (ß=2.8, P=0.002, 95% CI=0.08, 3.10) and work as a nurse (ß=3.6, P<0.001, 95% CI=0.30, 7.52), medical laboratory worker (ß=3.0, P<0.001, 95% CI=0.12, 4.27) and healthcare assistant (ß=3.9, P<0.001, 95% CI=0.17, 5.73). The level of fear was inversely correlated with a higher work-related stress management score (ß=-0.9, P<0.001, 95% CI=-0.14, -5.07) and a higher sleep quality score (ß=-1.8, P<0.001, 95% CI=-0.28, -10.41).
CONCLUSION: Family physicians should be vigilant and identify healthcare providers at risk of developing COVID-19-related fear to initiate early mental health intervention.
MATERIAL AND METHODS: We performed literature search using 4 databases from Medline, Cinahl, PubMed and Scopus from inception up to March 15, 2021 and selected relevant cross-sectional studies. Publication bias was assessed using funnel plot. Random effects model was used to estimate the pooled prevalence while risk factors were reported in odds ratio (OR) with 95% CI.
RESULTS: We included 148 studies with 159,194 HCPs and the pooled prevalence for depression was 37.5% (95%CI: 33.8-41.3), anxiety 39.7(95%CI: 34.3-45.1), stress 36.4% (95%CI: 23.2-49.7), fear 71.3% (95%CI: 54.6-88.0), burnout 68.3% (95%CI: 54.0-82.5), and low resilience was 16.1% (95%CI: 12.8-19.4), respectively. The heterogeneity was high (I2>99.4%). Meta-analysis reported that both females (OR = 1.48; 95% CI = 1.30-1.68) and nurses (OR = 1.21; 95%CI = 1.02-1.45) were at increased risk of having depression and anxiety [(Female: OR = 1.66; 95% CI = 1.49-1.85), (Nurse: OR = 1.36; 95%CI = 1.16-1.58)]. Females were at increased risk of getting stress (OR = 1.59; 95%CI = 1.28-1.97).
CONCLUSION: In conclusion, one third of HCPs suffered from depression, anxiety and stress and more than two third of HCPs suffered from fear and burnout during the COVID-19 pandemic in Asia.
METHODS: A cross-sectional study was carried out using a systematic random sampling method in hypertensive patients who attended two government primary care clinics in Sarawak. The STOP-Bang questionnaire was used to screen for OSA, and social-demographic data was captured with a questionnaire. Multiple logistic regressions were used to examine the determinants of the OSA.
RESULTS: A total of 410 patients were enrolled in this study. The mean age of study population patients was 56.4 years, with more than half being female. The mean blood pressure was 136/82. The prevalence of probable OSA among patients with hypertension was 54.4%. According to multiple logistic regression analyses, smoking (odds ratio [OR] 14.37, 95% confidence interval [CI] 3.335-61.947), retirees (OR 3.20, 95% CI 1.675-6.113), and being Chinese (OR 2.21, 95% CI 1.262-3.863) had a significant positive association with probable OSA.
CONCLUSIONS: Because of the high prevalence of probable OSA among patients with hypertension, primary care physicians should be more vigilant in identifying hypertensive patients with OSA risk. Early detection and intervention would reduce disease complications and healthcare costs.
METHODS: A web-based cross-sectional study was conducted among 1280 healthcare providers aged 18 years and older from 30 primary care clinics in Selangor, Malaysia. In this study, the Copenhagen Burnout Inventory was used to assess burnout. The results were analyzed using multiple logistic regression.
RESULTS: The prevalence of personal burnout was 41.7%, followed by work-related burnout (32.2%) and client-related burnout (14.5%). The determinants for personal burnout in this study were younger age, being a doctor, higher COVID-19 exposure risk, do not know where to seek help, inability to handle stress, poorer sleep quality score, higher total COVID-19 fear score, higher total stress score, and lower total BRS score. The determinants of work-related burnout were younger age, being a doctor, longer years of working, higher COVID-19 exposure risk, do not know where to seek help, lower altruistic score, poorer sleep quality score, higher total stress score, and lower total brief resilience score (BRS) score. The determinants of client-related burnout were doctor, single/divorced, more than one attachment site, and higher satisfaction toward the infection control, inability to handle stress, higher total depression score, and lower total BRS score.
CONCLUSION: Every fourth out of ten suffered from personal burnout, one-third from work-related burnout, and one-seventh from client-related burnout among healthcare providers during the COVID-19 pandemic. Healthcare systems must take care of healthcare workers' physical and emotional depletion, reducing the risk of burnout.
METHODS: Included trials were assessed using Cochrane risk of bias instrument. We performed meta-analysis with random-effects model and random errors were evaluated with TSA. We performed the search for the eligible randomized controlled trial (RCT) through Medline, Cinahl, Cochrane Central Register of Controlled Trials and also PubMed.
RESULTS: A total of 370 subjects sourced from seven eligible RCTs were entered into the analysis. The pooled results demonstrated the significant reduction with the use of qigong of the systolic blood pressure [weighted mean difference (WMD), - 10.66 mmHg (95% confidence interval (CI) = - 17.69,-3.62, p