Displaying publications 1 - 20 of 46 in total

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  1. Fulltext The feasibility, reliability and validity of the Malay McGill Quality of Life Questionnaire--Cardiff Short Form (MMQOL-CSF) in Malaysian advanced cancer population
    Lua PL, Salek MS, Finlay IG, Boay AGI, Rahimah MS
    Med J Malaysia, 2005 Mar;60(1):28-40.
    PMID: 16250277
    Health-related quality of life (HRQoL) assessment is important in healthcare outcomes. This study aimed to determine the feasibility, reliability and validity of the Malay McGill Quality of Life Questionnaire--Cardiff Short Form (MMQOL-CSF) in advanced cancer population. Patients either completed the MMQOL-CSF alone or in addition to its long version. The study recruited 116 participants (average age = 44 years old). On average, MMQOL-CSF was completed in 5.4 minutes. Most domains showed evidence of reliability (Cronbach's alpha = 0.76-0.92). Correlation with its long version was moderate to strong (r(s) = 0.54-0.87). The MMQOL-CSF was a feasible, reliable and valid HRQoL instrument in this population.
  2. Fulltext Prevalence and Predictors of Malnutrition Risk among Post-Stroke Patients in Outpatient Setting: A Cross-Sectional Study
    Wong HJ, Harith S, Lua PL, Ibrahim KA
    Malays J Med Sci, 2020 Jul;27(4):72-84.
    PMID: 32863747 MyJurnal DOI: 10.21315/mjms2020.27.4.7
    Background: The present study examined the prevalence and predictors of malnutrition risk among post-stroke patients.

    Methods: Post-stroke patients who attended the outpatient clinics in three hospitals of Peninsular Malaysia were enrolled in the study. The risk of malnutrition was assessed using the Malnutrition Risk Screening Tool-Hospital. Data including demographic characteristics, clinical profiles, dietary nutrients intake, body mass index (BMI) and hand grip strength were collected during the survey. The crude odds ratio (OR) and adjusted odds ratio (AOR) were reported for univariate and multivariate logistic regression analyses, respectively.

    Results: Among 398 patients included in the study, 40% were classified as high-risk for malnutrition. In the multivariable logistic regression, tube feeding (AOR: 13.16, 95% confidence interval [CI]: 3.22-53.77), loss of appetite (AOR: 8.15, 95% CI: 4.71-14.12), unemployment (AOR: 4.26, 95% CI: 1.64-11.12), wheelchair-bound (AOR: 2.23, 95% CI: 1.22-4.09) and BMI (AOR: 0.87, 95% CI: 0.82-0.93) were found to be significant predictors of malnutrition risk among stroke patients.

    Conclusion: The risk of malnutrition is highly prevalent among post-stroke patients. Routine nutritional screening, identification of risk factors, and continuous monitoring of dietary intake and nutritional status are highly recommended even after the stroke patient is discharged.

  3. Fulltext Adiponectin, Leptin and Objectively Measured Physical Activity in Adults: A Narrative Review
    Nurnazahiah A, Lua PL, Shahril MR
    Malays J Med Sci, 2016 Nov;23(6):7-24.
    PMID: 28090175 MyJurnal DOI: 10.21315/mjms2016.23.6.2
    The objective of this study was to compile and analyse existing scientific evidences reporting the effects of objectively measured physical activity on the levels of adiponectin and leptin. Articles related to the effects of objectively measured physical activity on the levels of adiponectin and leptin were searched from the Medline and PubMed databases. The search was limited to 'objectively measured' physical activity, and studies that did not objectively measure the physical activity were excluded. Only English articles were included in the search and review. A total of 18 articles encompassing 2,026 respondents met the inclusion criteria. The eligible articles included all forms of evidence (e.g., cross-sectional and intervention). Seventeen and 11 studies showed the effects of objectively measured physical activity on adiponectin and leptin, respectively. Five and four cross-sectional studies showed the effects of objectively measured physical activity on adiponectin and leptin, respectively. Two out of five studies showed a weak to moderate positive association between adiponectin and objectively measured physical activity, while three out of four studies showed a weak to moderate inverse association between leptin and objectively measured physical activity. For intervention studies, six out of 12 studies involving adiponectin and five out of seven studies involving leptin showed a significant effect between the proteins and objectively measured physical activity. However, a definitive conclusion could not be drawn due to several methodological flaws in the existing articles and the acute lack of additional research in this area. In conclusion, the existing evidences are encouraging but yet not compelling. Hence, further well-designed large trials are needed before the effectiveness of objectively measured physical activity in elevating adiponectin levels and in decreasing leptin levels could be strongly confirmed.
  4. Fulltext The impact of nutrition education interventions on the dietary habits of college students in developed nations: a brief review
    Lua PL, Wan Putri Elena WD
    Malays J Med Sci, 2012 Jan;19(1):4-14.
    PMID: 22977369 MyJurnal
    The purpose of this review is to provide a summary of studies on the effectiveness nutrition education interventions used by college students. Electronic databases such as Medline, Science Direct, CINAHL (EBSCOhost), and Google Scholar were explored for articles that involved nutrition education interventions for college students and that were published between 1990 and 2011. Fourteen studies, which involved a total of 1668 college students as respondents, were identified and met the inclusion criteria. The results showed that there were 3 major forms of nutrition education interventions: web-based education, lectures, and supplement provisions. Dietary intake measures were used in almost all studies and were primarily collected with food records, recall, food frequency questionnaires, and dietary habit questionnaires. The outcome measures varied among the studies, with indicators such as consumption of food, nutrition knowledge, dietary habits, physical activity, and quality of life. Methodological issues were also identified. In general, college students experienced significant changes in their dietary habits after the interventions were employed. The highlighted methodological issues should be considered to improve the quality of similar research in future.
  5. Fulltext Nutrition quality of life among female-majority Malay undergraduate students of health sciences
    Lua PL, Wan Putri Elena WD, Mohd Razif S
    Malays J Med Sci, 2012 Oct;19(4):37-49.
    PMID: 23785251 MyJurnal
    BACKGROUND: University students generally tend to engage in problematic eating behaviours, including unhealthy dieting, skipping meals, and high intake of fast food, although they are aware of the negative consequences. Eating behaviours have been shown to be interestingly related to quality of life (QoL). Our study aimed to 1) assess general nutrition quality of life (NQoL) status and 2) compare NQoL status based on gender, financial resources, study courses, year of study, and body mass index (BMI) profiles.
    METHODS: This study was conducted among undergraduates of health sciences in a local public university in Terengganu. Students completed the Malay version of NQoL (6 domains; 50 items; Likert-type responses 1-5). Data analysis was carried out by using SPSS 16.0, utilising descriptive and parametric statistics.
    RESULTS: A total of 241 students were enrolled [age = 19.7 (0.1) years; female (83.0%); Malay (96.7%)]. Social/Interpersonal Factors [3.84 (0.43)] emerged as the best component, while Food Impact [3.10 (0.40)] was the worst. Across all variables, only gender and study courses showed significantly different NQoL. Females scored better than males in Self-Efficacy (confidence in food selection ability) (P < 0.05). Nursing students also experienced significantly greater NQoL (mean = 3.58, 95% CI = 3.47, 3.68) than radiography students in Self-Efficacy (p < 0.05). Medical laboratory technology students had a significantly more favourable NQoL rating (mean = 3.62, 95% CI = 3.47, 3.76) than nursing students in Self-Image (p < 0.05). Study courses significantly influenced the NQoL status of students with Good NQoL, while those with Poor NQoL were mostly influenced by gender and financial resources (p < 0.05).
    CONCLUSION: These outcomes indicate that specific demographic characteristics seemed to make a difference in the NQoL of undergraduate students.
    KEYWORDS: health sciences; nutrition; quality of life; undergraduates
    Study site: public university, Terengganu, Malaysia
    Scales & Questionnaires: Nutrition Quality of Life instrument (NQoL)
  6. A Qualitative Exploration of Weight Loss Experiences through Hypnotherapy
    Roslim NA, Ahmad A, Mansor M, Aung MMT, Hamzah F, Lua PL
    Int J Clin Exp Hypn, 2023;71(3):235-249.
    PMID: 37378644 DOI: 10.1080/00207144.2023.2227237
    Hypnotherapy has been gaining recognition as an alternative treatment for excess weight problems. This qualitative study aims to explore individuals' experiences of losing weight through hypnotherapy and their perceived barriers and facilitators for healthy lifestyle changes. Semistructured interviews were conducted with 15 participants (11 women and 4 men; mean age of 23 years) who recorded having lost ≥5% weight after undergoing 3 hypnotherapy sessions previously at a public university in Terengganu, Malaysia. Each interview was audiotaped, transcribed, and analyzed using thematic analysis. The themes that emerged were the usefulness of hypnotherapy, barriers, and facilitators of healthy lifestyle changes. All participants contended that hypnotherapy played a role in their weight-loss journey through increased mindful eating and enhanced motivation to make lifestyle modifications. Barriers to healthy lifestyle changes included high costs of healthy foods and lack of support for healthy food sources in social and family settings. Hypnotherapy is essential as an adjunct tool in assisting weight loss. However, additional efforts are needed to improve support in the weight management journey.
  7. Does hypnosis result in greater weight loss compared to conventional approach?
    Roslim NA, Ahmad A, Mansor M, Aung MMT, Hamzah F, Shahril MR, et al.
    Am J Clin Hypn, 2022 Feb 02.
    PMID: 35108492 DOI: 10.1080/00029157.2021.2010642
    Hypnosis has been increasingly used in recent years as an alternative treatment to maintain well-being. Yet, limited evidence is available regarding its role in weight management, especially in Malaysia. Hence, this quasi-experimental study was conducted to evaluate the effectiveness of hypnosis on weight loss and body composition (body mass index, waist circumference and body fat percentage) among staff and students of a public university in Terengganu, Malaysia. Participants with body mass index (BMI) ≥ 25.0 kg/m2 were randomly assigned to either intervention group (IG = 53) or control group (CG = 54), for 12 weeks. All participants received health education (diet + exercise + behavioral recommendations) with those in IG had additional three hypnotherapy sessions, once a month. Body weight was measured at week 1, 7, and 12 while body compositions were measured at weeks 1 and 12. Descriptive, univariate, and repeated-measures analysis of covariance (ANCOVA) were utilized. A total of 104 participants completed the trial (mean age = 26.28 ± 8.01; female = 82.2%; BMI = 31.39 ± 4.89). A significant weight loss was observed in the intervention (-4.61%) and control (-3.04%) groups (mean difference = -1.57; 95%CI: -2.59, -0.54; p = .003) after 12 weeks. Participants that frequently practiced self-hypnosis lost more weight (-6.27%; t(50) = -5.331, p < .001). Body fat percentage and waist circumference did not significantly change from baseline in both groups. Essentially, the positive outcomes indicated the promising potential of hypnosis as an alternative tool in facilitating weight loss efforts for those in need.
  8. Fulltext Feasibility and acceptability of mobile epilepsy educational system (MEES) for people with epilepsy in Malaysia
    Lua PL, Neni WS
    Telemed J E Health, 2012 Dec;18(10):777-84.
    PMID: 23078181 DOI: 10.1089/tmj.2012.0047
    Telemedicine innovations, including short message service (SMS), have been used to address a range of health concerns in a variety of settings. Practical, safe, and cost-effective, this simple tool can also potentially improve patients' understanding toward their own diseases via knowledge enhancement. This study was designed to develop and assess the feasibility and acceptability of an SMS-based epilepsy educational program for epilepsy patients.
  9. The interactive animated epilepsy education programme (IAEEP): how feasible, acceptable and practical is the technology to children?
    Lua PL, Neni WS, Lee JK, Abd Aziz Z
    Technol Health Care, 2013;21(6):547-56.
    PMID: 24284547 DOI: 10.3233/THC-130758
    Being well-informed and knowledgeable about their illnesses would be a great advantage to children with epilepsy (CWE). Subsequently, an effective education programme which could secure interest and simultaneously improve their awareness, knowledge and attitudes (AKA) is essential in enhancing well-being and health outcomes.
  10. A 12-month evaluation of health-related quality of life outcomes of methadone maintenance program in a rural Malaysian sample
    Lua PL, Talib NS
    Subst Use Misuse, 2012 Aug;47(10):1100-5.
    PMID: 22545914 DOI: 10.3109/10826084.2012.679840
    This paper focuses on the evaluation of addiction program effectiveness which involves changes in health-related quality of life (HRQoL) profile. This study was conducted from 2007 until 2010 at a rural methadone maintenance treatment center in Malaysia to assess HRQoL outcomes before and after treatment. Fifty-seven respondents completed the WHOQOL-BREF at baseline, 6 months, and 12 months postintervention. Data were analyzed using nonparametric techniques (SPSS 15). Significant and positive HRQoL impacts were demonstrated. Future studies with larger sample are encouraged. This study was supported by the Ministry of Health Malaysia.
  11. Fulltext Awareness, knowledge and attitudes towards epilepsy among rural populations in East Coast Peninsular Malaysia: a preliminary exploration
    Neni SW, Latif AZ, Wong SY, Lua PL
    Seizure, 2010 Jun;19(5):280-90.
    PMID: 20466567 DOI: 10.1016/j.seizure.2010.04.006
    This study was carried out to gauge the preliminary insight regarding epilepsy among the rural society. The purposes of this study were: (1) to determine general level of awareness, knowledge and attitudes (AKA) towards epilepsy among rural communities, (2) to compare the AKA level based on socio-demographic characteristics and (3) to investigate rural cohort's perception of the best epilepsy treatment, preference for epilepsy information delivery and preference for mode of transportation to seek medical treatment. This prospective, cross sectional study included a sample of 615 rural residents enrolled via cluster sampling in East Coast region of Peninsular Malaysia (mean age=41.6+/-18.02, female=56.6%, married=65.5%, Malay=94.0%, monthly income < or = RM 500=56.9%). The Total AKA level was generally low (2.66+/-0.7). Gender-wise no significant difference was shown regarding AKA level (p>0.05). However, respondents with higher education significantly possessed better attitudes and higher Total AKA level compared to those with lower education level (p<0.001). Employed respondents reported significantly more favourable attitudes than unemployed respondents (p=0.011). Additionally, higher income rural cohorts possessed both significantly better attitudes and better AKA. These rural communities perceived modern medicine as the best epilepsy treatment (56.60%), preferred to obtain direct epilepsy-related information from health personnel (60.4%) and chose to use their own car to seek medical treatment in hospital (76.30%). The outcomes of this preliminary study signified the need to devise a dedicated epilepsy education program for implementation among rural residents. Increased AKA level in the society could enhance the people's acceptance, reduce stigmatisation and improve health-related quality of life (HRQoL) for epilepsy patients and their family.
  12. Fulltext Comparison of concurrent validity of different malnutrition screening tools with the Global Leadership Initiative on Malnutrition (GLIM) among stroke survivors in Malaysia
    Wong HJ, Harith S, Lua PL, Ibrahim KA
    Sci Rep, 2023 Mar 30;13(1):5189.
    PMID: 36997594 DOI: 10.1038/s41598-023-31006-y
    Individuals with stroke are at high malnutrition risk in both the acute and chronic phases. This study aimed to assess the validity of different malnutrition screening tools for stroke patients in rehabilitation phase. Participants in this study were 304 stroke patients from three hospitals in the East-Coast region of Peninsular Malaysia from May-August 2019. The concurrent validity of the Malnutrition Risk Screening Tool-Hospital (MRST-H), Mini Nutritional Assessment-Short Form (MNA-SF), Malnutrition Screening Tool (MST), Malnutrition Universal Screening (MUST) and Nutritional Risk Screening (NRS-2002) was assessed with the diagnostic criteria for malnutrition proposed by the Global Leadership Initiative on Malnutrition (GLIM-DCM). Sensitivity, specificity, positive predictive value, negative predictive value, and the area under the curve were computed. MUST and MRST-H demonstrated good validity regardless of different age groups (> 80% sensitivity and specificity); meanwhile, MST and MNA-SF had fair validity, yet NRS-2002 had poor to fair validity with GLIM-DCM. Only MRST-H and NRS-2002 were significantly correlated with all anthropometric indices, dietary energy intake, and health-related quality of life in both age groups. In conclusion, MRST-H and MUST showed good concurrent validity with GLIM-DCM and can be considered as appropriate malnutrition screening tool in discriminating malnutrition among stroke individuals attending rehabilitation centre in Malaysia regardless of their age groups.
  13. Health-related quality of life improvement via telemedicine for epilepsy: printed versus SMS-based education intervention
    Lua PL, Neni WS
    Qual Life Res, 2013 Oct;22(8):2123-32.
    PMID: 23329469 DOI: 10.1007/s11136-013-0352-6
    BACKGROUND: Improving health-related quality of life (HRQoL) among people with epilepsy (PWE) has become the focus of various treatment programmes and behavioural interventions which continue to be challenging to both patients and healthcare professionals.

    AIMS AND OBJECTIVES: To investigate the impact of SMS-based epilepsy education programme on PWE's HRQoL status and to determine the predictors for good HRQoL.

    METHODS: Eligible epilepsy out-patients from three public hospitals in East Coast Peninsular Malaysia were randomized into two groups: intervention (IG) and control (CG). Patients in the CG were supplied with only printed epilepsy educational module, while those in the IG additionally received short message service (SMS) from the Mobile Epilepsy Educational System (MEES). The Malay Quality of Life in Epilepsy Inventory-30 (MQOLIE-30) was utilized for HRQoL assessment. Descriptive statistics, paired t test, analysis of covariance and multiple logistic regression were employed for data analyses (SPSS 16).

    RESULTS: One hundred and forty-four PWE were recruited for the study (age = 30.5 ± 11.8; unmarried = 60.4 %; education level ≤ SPM/Cambridge O' level = 76.4 %; illness duration > 5 years = 51.1 %). After controlling for possible confounders, IG exhibited positive changes in HRQoL profile compared to CG particularly in Seizure Worry, Overall Quality of Life, Emotional Well-Being, Social Functioning and Overall Score (p < 0.05). After adjusting for covariates, being employed and receiving additional SMS-based epilepsy education programme emerged as the significant predictors of good HRQoL among PWE.

    CONCLUSION: Receiving continuous SMS-based epilepsy information from the MEES seemed to generate positive impacts on PWE's overall HRQoL. This study has provided a basis for future innovations to inspire efforts in ensuring the welfare and HRQoL of PWE and their families.

    Study site: Eligible epilepsy out-patients from three public hospitals in East Coast Peninsular Malaysia
  14. The feasibility, reliability and validity of the McGill Quality of Life Questionnaire-Cardiff Short Form (MQOL-CSF) in palliative care population
    Lua PL, Salek S, Finlay I, Lloyd-Richards C
    Qual Life Res, 2005 Sep;14(7):1669-81.
    PMID: 16119179 DOI: 10.1007/s11136-005-2817-8
    In terminally-ill patients, effective measurement of health-related quality of life (HRQoL) needs to be done while imposing minimal burden. In an attempt to ensure that routine HRQoL assessment is simple but capable of eliciting adequate information, the McGill Quality of Life Questionnaire-Cardiff Short Form (MQOL-CSF: 8 items) was developed from its original version, the McGill Quality of Life Questionnaire (MQOL: 17 items). Psychometric properties of the MQOL-CSF were then tested in palliative care patients consisting of 55 out-patients, 48 hospice patients and 86 in-patients: The MQOL-CSF had little respondent burden (mean completion time = 3.3 min) and was evaluated as 'very clear' or 'clear' (98.2%), comprehensive (74.5%) and acceptable (96.4%). The internal consistency reliability was moderate to high (Cronbach's alpha = 0.462-0.858) and test-retest reliability (Spearman's r(s)) ranged from 0.512-0.861. Correlation was moderate to strong (0.478-0.725) between items in the short form and their analogous domains in the MQOL. Most MQOL-CSF items showed strong associations with their own domain (r(s) > or = 0.40). Scores from MQOL-CSF significantly differentiated between patients with differing haemoglobin levels (p < 0.05). Construct validity was overall supported by principal component analysis. It is concluded that the MQOL-CSF is a feasible tool with favourable psychometric properties for routine HRQoL assessment in the palliative care population.
    Study site: out-patient palliative care clinic; a hospice centre and hospital inpatient wards, United Kingdom
  15. Lipid profiles and lifestyle habits of stroke survivors in the east coast region of peninsular Malaysia: Preliminary findings
    Wong HJ, Harith S, Lua PL, Ibrahim KA
    Nutr Health, 2023 Dec;29(4):695-705.
    PMID: 35763460 DOI: 10.1177/02601060221097459
    Background: Stroke survivors are at high risk for recurrent cardiovascular events if no prevention strategies are undertaken. Aim: This study aimed to investigate the fasting serum lipid profiles and lifestyle habits in stroke survivors, and the factors associated with suboptimal lipid profiles. Methods: A cross-sectional retrospective study was conducted in three public hospitals in Malaysia. Stroke survivors' data regarding the socio-demographic characteristics, clinical profiles, fasting serum lipid profiles, dietary adherence, and physical activity levels were acquired. Binary logistic regression was used to examine the factors associated with suboptimal lipid goals. Results: A total of 104 stroke survivors were recruited from patients attending the neurology and rehabilitation departments. Only 22% of the stroke survivors attained the targeted low-density lipoprotein cholesterol level (LDL-C < 1.8 mmol/L). Meanwhile, more than two thirds of patients achieved the targeted total cholesterol, triglyceride, and high-density lipoprotein cholesterol goals. Patients with a longer stroke duration (Adjusted odds ratio, AOR 3.33, 95% confidence intervals, CI: 1.09, 10.13, p  =  0.034), elevated blood pressure (AOR 4.74, 95% CI: 1.65, 13.62, p  =  0.004), chronic kidney disease (AOR 3.30, 95% CI: 1.05, 10.34, p  =  0.041), abdominal obesity (AOR 3.14, 95% CI: 1.20, 8.21, p  =  0.020), excessive energy intake (AOR 2.72, 95% CI: 1.07, 6.91, p  =  0.036), and excessive saturated fatty acids intake (AOR 2.85, 95% CI: 1.02, 7.93, p  =  0.045) were significantly associated with suboptimal lipid profiles. Conclusion: The lipid goals attainment was low, particularly the LDL-C levels among Malaysian stroke survivors. Greater efforts are warranted to fully utilise the lipid-lowering therapy and the lifestyle changes in these high-risk patients.
  16. Fulltext 'Energy-Dense, High-SFA and Low-Fiber' Dietary Pattern Lowered Adiponectin but Not Leptin Concentration of Breast Cancer Survivors
    Shahril MR, Zakarai NS, Appannah G, Nurnazahiah A, Mohamed HJJ, Ahmad A, et al.
    Nutrients, 2021 Sep 24;13(10).
    PMID: 34684340 DOI: 10.3390/nu13103339
    Dietary pattern (DP) and its relationship with disease biomarkers have received recognition in nutritional epidemiology investigations. However, DP relationships with adipokines (i.e., adiponectin and leptin) among breast cancer survivors remain unclear. Therefore, we assessed relationships between DP and high-molecular weight (HMW) adiponectin and leptin concentration among breast cancer survivors. This cross-sectional study involved 128 breast cancer survivors who attended the oncology outpatient clinic at two main government hospitals in the East Coast of Peninsular Malaysia. The serum concentration of HMW adiponectin and leptin were measured using enzyme-linked immunosorbent assay (ELISA) kits. A reduced rank regression method was used to analyze DP. Relationships between DP with HMW adiponectin and leptin were examined using regression models. The findings show that with every 1-unit increase in the 'energy-dense, high-SFA, low-fiber' DP z-score, there was a reduction by 0.41 μg/mL in HMW adiponectin which was independent of age, BMI, education level, occupation status, cancer stage, and duration since diagnosis. A similar relationship with leptin concentration was not observed. In conclusion, the 'energy-dense, high-saturated fat and low-fiber' DP, which is characterized by high intake levels of sugar-sweetened drinks and fat-based spreads but low intake of fruits and vegetables, is an unhealthy dietary pattern and unfavorable for HMW adiponectin concentration, but not for leptin. These findings could serve as a basis in developing specific preventive strategies that are tailored to the growing population of breast cancer survivors.
  17. Fulltext Body weight satisfaction: association with weight control practices among type 2 diabetic patients
    Noor SZ, Lua PL, Nik MM
    Malays J Nutr, 2011 Apr;17(1):55-66.
    PMID: 22135865 MyJurnal
    The recommendation to lose weight has been the guiding principle in the treatment of type 2 diabetic patients. However, to facilitate this process, it is vital to understand factors associated with personal feelings about body weight and related behaviour.
  18. Fulltext Chocolate: food for moods
    Wong SY, Lua PL
    Malays J Nutr, 2011 Aug;17(2):259-69.
    PMID: 22303579 MyJurnal
    Chocolate is a popular food and its consumption has long been associated with enjoyment and pleasure. The effect of chocolate on mood too has long been recognised. Chocolate is thought to have interactions with neurotransmitters which contribute to mood modulation and appetite regulation. However, the evidence in chocolate and mood studies remains highly controversial. As more is known about the influence of chocolate on mood, the reasons for these effects appear increasingly complex and inter-related.
  19. Fulltext Nutritional status and health-related quality of life of breast cancer patients on chemotherapy
    Lua PL, Salihah NZ, Mazlan N
    Malays J Nutr, 2012 Aug;18(2):173-84.
    PMID: 24575665 MyJurnal
    Nutritional decline is typically accepted as a consequent of the course of treatment for cancer. This study aimed to (1) assess body weight status and dietary intake of breast cancer patients on chemotherapy and (2) to correlate Body Mass Index (BMI), energy and protein intake with health-related quality of life (HRQoL) profile.
  20. A randomised controlled trial of an SMS-based mobile epilepsy education system
    Lua PL, Neni WS
    J Telemed Telecare, 2013 Jan;19(1):23-8.
    PMID: 23390210 DOI: 10.1177/1357633X12473920
    We evaluated an epilepsy education programme based on text messaging (SMS). Epilepsy outpatients from three hospitals in Malaysia were randomised into two groups: intervention and control. Patients in the control group were supplied with printed epilepsy educational material while those in the intervention group also received text messages from the Mobile Epilepsy Educational System (MEES). A total of 136 patients completed the study (mean age 31 years; 91% Malay; 51% with an illness duration of more than 5 years). A between-group analysis showed that the awareness, knowledge and attitudes (AKA) about epilepsy did not significantly differ between the groups at baseline (P > 0.05). The intervention patients reported better AKA levels during follow-up compared to the control patients (P < 0.05). A within-group analysis showed that in intervention patients, there were significant improvements in all AKA domains with larger effect sizes (P < 0.01) while control patients also exhibited significant improvement in most domains except for Awareness but with smaller effect sizes. After controlling for possible confounding variables (age, gender, educational qualification, monthly income and baseline mean for each domain), the intervention group still reported significantly higher AKA than the control group particularly in Awareness (P < 0.001) and Total AKA (P = 0.003). There was also significantly better medication adherence and clinic attendance in the intervention group (P < 0.05). The results suggest that the addition of the MEES to conventional epilepsy education is effective in improving AKA.
    Study site: Neurology clinics, public hospitals, Terengganu, Pahang, Kelantan, Malaysia
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