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  1. Nor MZ
    J Taibah Univ Med Sci, 2019 Dec;14(6):495-501.
    PMID: 31908636 DOI: 10.1016/j.jtumed.2019.09.007
    Objective: The study aimed to develop a preliminary medical teachers' faculty development programme (FDP) needs questionnaire through two rounds of Delphi technique.

    Methods: This study utilised the Delphi study between April to June 2019. Face-to-face interviews and a literature review were conducted to propose a set of domains and items for the FDP needs of medical teachers. Two rounds of the Delphi technique were incorporated to obtain a consensus for the proposed questionnaire by 10 expert panels from their respective fields. The consensus was pre-defined as a mean score of four or above and with a percent agreement of 75%.

    Results: Initially, four domains and 26 items were proposed. Finally, a total of six domains and 38 items were endorsed by the expert panels. The selected domains included six competencies, including teaching, assessment, research, curriculum, publication, and public service. These domains consisted of seven, nine, six, seven, four, and five items, respectively.

    Conclusion: This study developed the first preliminary FDPs needs questionnaire specifically designed for medical teachers. It would be an effective instrument to measure the needs of the FDPs in medical education.

  2. Ab Latif R, Mat Nor MZ
    Malays J Med Sci, 2020 Dec;27(6):115-127.
    PMID: 33447139 DOI: 10.21315/mjms2020.27.6.11
    Background: Concept mapping has been established as a learning strategy that encourages critical thinking and creativity among students, leading to the development of a concept mapping guideline designed to guide nurse educators in using this teaching strategy.

    Objectives: This paper illustrates the development of a guideline to build a concept mapping based-learning strategy. Called the Rusnani concept mapping (RCM) protocol guideline, it was adapted from the Mohd Afifi learning model (MoAFF) and the analysis, design, development, implementation and evaluation (ADDIE) model, integrated with the Kemp model.

    Methods: This model uses the five phases of analysis, design, development, implementation and evaluation. The validity of the guideline was determined by using content and face validity and the Delphi technique. Content validity for this RCM guideline was established using expert review. This formula suggested that if the content validity is greater than 70%, it shows good content validity, and if it is less than 70%, the content validity is low and it is advisable to recheck the content according to the objective of the study.

    Results: The reliability of the RCM was 0.816, showing that the RCM guideline has high reliability and validity.

    Conclusion: It is practical and acceptable for nurse educators to apply RCM as an effective and innovative teaching method to enhance the academic performance of their nursing students.

  3. Ab Latif R, Mat Nor MZ
    Malays J Med Sci, 2019 Mar;26(2):88-98.
    PMID: 31447612 MyJurnal DOI: 10.21315/mjms2019.26.2.10
    Introduction: Consistent with the significant of the stress issue in education, this study aimed to survey type of stressors and identifies the coping strategies used by diploma nursing students during clinical practices.

    Methods: A descriptive cross-sectional study was carried out at the Kubang Kerian Nursing College, Kelantan which involved 346 respondents using simple random sampling method. The inclusion criteria were year one, two and three of nursing students who have clinical posting and voluntarily joining the study. Perceived Stress Scale (PSS) and Brief COPE inventory were utilised in the data collection. Higher mean score indicates higher degree of stress.

    Results: Clinical assignments and workload were the main stressor (mean = 3.19, SD = 1.09). Religion approach was the most coping strategy applied (mean = 3.30, SD = 0.71). Pearson's correlation coefficient test found that six domains of stressors during clinical practices (taking care of patients; clinical educators/instructors and ward staff; clinical assignments and workload; peers and nursing students from other college; lack of professional knowledge and skills and clinical environment) were statistically significant correlation with coping strategies, where P-value < 0.05.

    Conclusion: Clinical assignment was the main stressor among nursing students; therefore, successful activities should be promoted to help them in managing clinical assignment and enhancing knowledge in religion.

  4. Abusafia AH, Roslan NS, Mohd Yusoff D, Mat Nor MZ
    J Taibah Univ Med Sci, 2018 Aug;13(4):370-376.
    PMID: 31435349 DOI: 10.1016/j.jtumed.2018.04.003
    Objective: The aim of this study was to evaluate academic dishonesty among nursing students at a public university in Malaysia.

    Methods: This study utilized a descriptive and cross-sectional design to evaluate academic dishonesty among nursing students using a purposive sampling method. The participants of this study consisted of 201 students from diploma (Year 2 and 3) and degree (Year 2 to Year 4) nursing programmes. A self-administered, validated questionnaire was used for data collection. Institutional ethics committee clearance was obtained prior to commencement of the study.

    Results: The results of this study showed that 82.1% and 74.6% of nursing students had engaged at least once in an act of academic dishonesty in an academic or clinical setting, respectively. The most frequent form of academic dishonesty in an academic setting was plagiarism (77.1%). There was a significant association between gender and academic dishonesty in a clinical setting (p 

  5. Said AH, Md Nor MZ, Che Yusof MD
    PMID: 37814671 DOI: 10.51866/cr.278
    Gastroschisis may lead to serious congenital disability, as prolonged exposure to the amniotic fluid could compromise the mesenteric blood flow and irritate the foetal intestinal wall. The consequences of gastroschisis include spontaneous preterm birth, growth restriction and foetal demise. Awareness of this disease is essential, as a high mortality rate is linked to inadequate initial therapy. Early detection of the disease, mainly by primary care physicians as the initial point of contact, is crucial to improve the course of the condition through early monitoring and referral to tertiary care centres. With this case report, we hope to highlight the need of detecting gastroschisis before to the third trimester of pregnancy for better readiness, especially in primary care settings located far from tertiary centres.
  6. Md Nor MZ, Said AH, Che Man M, Yusof MZ
    Med J Malaysia, 2024 Jan;79(1):34-41.
    PMID: 38287755
    INTRODUCTION: Patient satisfaction is widely used to monitor the quality of health care services. A significant patient load may influence health care services and patient satisfaction. Klinik Kesihatan Bandar Kuantan, Pahang (KKBK) has the highest patient loads in Pahang state, followed by Klinik Kesihatan Beserah and Klinik Kesihatan Kurnia. There are up to 700 attendees at KKBK per day, representing a population of 209679. KKBK had receives several complaints and patient unhappiness with its health care services, despite the administration's efforts to improve the clinics healthcare delivery. Thus, this study aimed to measure patients' satisfaction towards health care services at Pahang's highest patient loads primary care clinic.

    MATERIALS AND METHODS: A cross-sectional study was conducted at Klinik Kesihatan Bandar Kuantan, Kuantan, Pahang. Patients were selected using stratified random sampling, and 201 participants were selected. The selected participants were asked to fill up the self-administered validated questionnaires consisting of background characteristics and Patient Satisfaction Questionnaire 18 (PSQ-18). Data collection period was from March 2022 to August 2022. Descriptive analysis was used to describe the background characteristics of respondents and the score of patient satisfaction. Multiple linear regression was used to determine the factors associated with patient satisfaction while adjusting for cofounders.

    RESULTS: A total of 201 eligible data points were analysed in the study. The respondent mean age was 47.1 ± 16.9. Most respondents were Malay (68.7%), having secondary education (54.2%) and predominantly from the B40 income class (88.1%). The overall mean patient satisfaction score was 3.83 ± 0.31. There were significant associations between overall satisfaction with patient education level (B = -0.144; 95% CI -0.246, -0.042; p = 0.006), waiting time (B = -0.371; 95% CI -0.534, -0.209; p = 0.001) and consultation duration (B = -0.154; 95% CI -0.253, -0.055; p = 0.0020). It was found that patients with secondary education were less satisfied compared to patients with primary education level on health care services they received. Meanwhile, those who were not happy with the waiting time and consultation duration showed less satisfaction with overall healthcare services.

    CONCLUSION: Despite serving the most significant number of patients in Pahang state, most of the patient were satisfied by the health care services at Klinik Kesihatan Bandar Kuantan. However, it is recommended to improve the waiting time and the consultation time in this clinic.

  7. Ahmad A, Bahri Yusoff MS, Zahiruddin Wan Mohammad WM, Mat Nor MZ
    J Taibah Univ Med Sci, 2018 Apr;13(2):113-122.
    PMID: 31435313 DOI: 10.1016/j.jtumed.2017.12.001
    Objectives: Community-based education (CBE) has an impact on the types of medical students produced at the end of medical training. However, its impact on professional identity development (PID) has not been clearly understood. This study thus explores the effect of the CBE program on PID.

    Methods: A qualitative phenomenological study was conducted on a group of Universiti Sains Malaysia medical students who had finished the Community and Family Case Study (CFCS) program. Data were gathered through focused group discussions and student reflective journals. Participants were sampled using the maximal variation technique of purposive sampling. Three steps of thematic analysis using the Atlasti software were employed to identify categories, subthemes, and themes.

    Results: Personal, role, social, and research identities were generated that contribute to the PID of medical students through the CFCS program. The results indicate that the CFCS program nurtured personal identity through the development of professional skills, soft skills, and personal values. Pertaining to role identity, this is related to patient care in terms of primary care and interprofessional awareness. Pertaining to social identity, the obvious feature was community awareness related to culture, society, and politics. A positive outcome of the CFCS program was found to be its fostering of research skills, which is related to the use of epidemiology and research methods.

    Conclusion: The findings indicate that the CFCS program promotes PID among medical students. The current data highlight and provide insights into the importance of integrating CBE into medical curricula to prepare future doctors for their entry into the profession.

  8. Hassan II, Nik Hussain NH, Sulaiman Z, Abdul Kadir A, Mat Nor MZ
    Enferm Clin, 2020 03;30 Suppl 2:190-193.
    PMID: 32204142 DOI: 10.1016/j.enfcli.2019.07.075
    OBJECTIVE: This study explores how menopausal women perceived supports provided by their husbands.

    METHODOLOGY: Total of 13 menopausal women recruited using a combination of purposive and snowball techniques from two sources, tertiary hospital and local communities in the state of Kelantan, Malaysia. The in-depth semi-structured interview guided was used to explore how they perceived supports provided by their husbands. The data were then analysed using a thematic analysis.

    RESULTS: Five (5) themes have emerged which comprises of emotional, instrumental, appraisal, guidance, and sexual supports. One of which was a new theme (sexual intimacy support) that had not been existed previously in other literature reviews.

    CONCLUSION: Majority of menopausal women perceived the supports provided by their husband were negative, rather than positive supports that they had hoped. These findings suggest that an education program tool for husbands as a support person is much needed to ensure women walk through the menopause phase in a more meaningful life.

  9. Katibi KK, Mohd Nor MZ, Yunos KFM, Jaafar J, Show PL
    Membranes (Basel), 2023 Jul 20;13(7).
    PMID: 37505045 DOI: 10.3390/membranes13070679
    Fruit juice is an essential food product that has received significant acceptance among consumers. Harmonized concentration, preservation of nutritional constituents, and heat-responsive sensorial of fruit juices are demanding topics in food processing. Membrane separation is a promising technology to concentrate juice at minimal pressure and temperatures with excellent potential application in food industries from an economical, stable, and standard operation view. Microfiltration (MF) and ultrafiltration (UF) have also interested fruit industries owing to the increasing demand for reduced pressure-driven membranes. UF and MF membranes are widely applied in concentrating, clarifying, and purifying various edible products. However, the rising challenge in membrane technology is the fouling propensity which undermines the membrane's performance and lifespan. This review succinctly provides a clear and innovative view of the various controlling factors that could undermine the membrane performance during fruit juice clarification and concentration regarding its selectivity and permeance. In this article, various strategies for mitigating fouling anomalies during fruit juice processing using membranes, along with research opportunities, have been discussed. This concise review is anticipated to inspire a new research platform for developing an integrated approach for the next-generation membrane processes for efficient fruit juice clarification.
  10. Katibi KK, Yunos KF, Che Man H, Aris AZ, Bin Mohd Nor MZ, Binti Azis RS
    Polymers (Basel), 2021 Jan 27;13(3).
    PMID: 33513670 DOI: 10.3390/polym13030392
    Water is a critical resource necessary for life to be sustained, and its availability should be secured, appropriated, and easily obtainable. The continual detection of endocrine-disrupting chemicals (EDCs) (ng/L or µg/L) in water and wastewater has attracted critical concerns among the regulatory authorities and general public, due to its associated public health, ecological risks, and a threat to global water quality. Presently, there is a lack of stringent discharge standards regulating the emerging multiclass contaminants to obviate its possible undesirable impacts. The conventional treatment processes have reportedly ineffectual in eliminating the persistent EDCs pollutants, necessitating the researchers to develop alternative treatment methods. Occurrences of the EDCs and the attributed effects on humans and the environment are adequately reviewed. It indicated that comprehensive information on the recent advances in the rejection of EDCs via a novel membrane and membrane bioreactor (MBR) treatment techniques are still lacking. This paper critically studies and reports on recent advances in the membrane and MBR treatment methods for removing EDCs, fouling challenges, and its mitigation strategies. The removal mechanisms and the operating factors influencing the EDCs remediation were also examined. Membranes and MBR approaches have proven successful and viable to eliminate various EDCs contaminants.
  11. Katibi KK, Yunos KF, Man HC, Aris AZ, Mohd Nor MZ, Azis RS
    Polymers (Basel), 2021 Oct 31;13(21).
    PMID: 34771339 DOI: 10.3390/polym13213781
    Recently Bisphenol A (BPA) is one of the persistent trace hazardous estrogenic contaminants in the environment, that can trigger a severe threat to humans and environment even at minuscule concentrations. Thus, this work focused on the synthesis of neat and magnetic biochar (BC) as a sustainable and inexpensive adsorbent to remove BPA from aqueous environment. Novel magnetic biochar was efficiently synthesized by utilizing palm kernel shell, using ferric chloride and ferrous chloride as magnetic medium via chemical co-precipitation technique. In this experimental study, the influence of operating factors comprising contact time (20-240 min), pH (3.0-12.0), adsorbent dose (0.2-0.8 g), and starting concentrations of BPA (8.0-150 ppm) were studied in removing BPA during batch adsorption system using neat biochar and magnetic biochar. It was observed that the magnetically loaded BC demonstrates superior maximum removal efficiency of BPA with 94.2%, over the neat biochar. The functional groups (FTIR), Zeta potential, vibrating sample magnetometer (VSM), surface and textural properties (BET), surface morphology, and mineral constituents (FESEM/EDX), and chemical composition (XRD) of the adsorbents were examined. The experimental results demonstrated that the sorption isotherm and kinetics were suitably described by pseudo-second-order model and Freundlich model, respectively. By studying the adsorption mechanism, it was concluded that π-π electron acceptor-donor interaction (EAD), hydrophobic interaction, and hydrogen bond were the principal drives for the adsorption of BPA onto the neat BC and magnetic BC.
  12. Mohamad Mazlan M, Talib RA, Chin NL, Shukri R, Taip FS, Mohd Nor MZ, et al.
    Foods, 2020 Jul 31;9(8).
    PMID: 32751949 DOI: 10.3390/foods9081023
    Single-screw extrusion of a fibrous-structured meat analog from soy proteins added with low-grade oyster mushroom was successful. Satisfactory extrudates were obtained at a barrel temperature of 140 °C, screw speed range of 100-160 rpm, and oyster mushroom addition at 0%, 7.5%, and 15% via factorial experiments. Single-screw extrusion equipped with a slit die successfully produced expanded oyster mushroom-soy protein extrudates. However, the increase in the oyster mushroom content significantly decreased (p ≤ 0.05) the expansion ratio of the extrudate from 1.26 to 0.98. This result indicated that adding more oyster mushroom restrained the expansion ratio. The extrudates had a medium density range (max of 1393.70 ± 6.30 kg/m3). By adding oyster mushroom, the extrudates attained a higher moisture content (range = 34.77% to 37.93%) compared with the extrudates containing the protein mixture only (range = 26.99% to 32.33%). The increase in screw speed and oyster mushroom significantly increased (p ≤ 0.05) the water absorption index. The increase in the texturization index was significantly influenced (p ≤ 0.05) by oyster mushroom addition rather than the screw speed. A defined fibrous structure supported the high texturization index and small shape of air cells observed in the extrudates.
  13. Yusree FIFM, Peter AP, Mohd Nor MZ, Show PL, Mokhtar MN
    Foods, 2021 Nov 09;10(11).
    PMID: 34829028 DOI: 10.3390/foods10112748
    In recent years, downstream bioprocessing industries are venturing into less tedious, simple, and high-efficiency separation by implementing advanced purification and extraction methods. This review discusses the separation of proteins, with the main focus on amylase as an enzyme from agricultural waste using conventional and advanced techniques of extraction and purification via a liquid biphasic system (LBS). In comparison to other methods, such as membrane extraction, precipitation, ultrasonication, and chromatography, the LBS stands out as an efficient, cost-effective, and adaptable developing method for protein recovery. The two-phase separation method can be water-soluble polymers, or polymer and salt, or alcohol and salt, which is a simpler and lower-cost method that can be used at a larger purification scale. The comparison of different approaches in LBS for amylase purification from agricultural waste is also included. Current technology has evolved from a simple LBS into microwave-assisted LBS, liquid biphasic flotation (LBF), thermoseparation (TMP), three-phase partitioning (TPP), ultrasound-assisted LBS, and electrically assisted LBS. pH, time, temperature, and concentration are some of the significant research parameters considered in the review of advanced techniques.
  14. Zainudin AM, Ghulam Rasool AH, Mat Nor MZ, Hassan NB, Muhamad R, Wan Mohamed WMI
    Malays J Med Sci, 2024 Apr;31(2):98-112.
    PMID: 38694587 DOI: 10.21315/mjms2024.31.2.9
    BACKGROUND: Many patients with type 2 diabetes mellitus (T2DM) do not achieve the desired glycaemic control despite being treated with insulin. Studies found this due to an improper understanding of insulin function, its intensification process and patients' negative perspective on insulin. We developed an education module to enhance adherence to insulin therapy.

    METHODS: This study applied a mixed design. It was conducted in three phases: i) Phase I: literature search and focus group discussions (FGDs), ii) Phase II: module development and iii) Phase III: content and face validation of Universiti Sains Malaysia-Insulin Adherence Module (USM-IAM). FGDs were used to gather patients' opinions. All researchers repeatedly discussed about the module content and arrangement, the words and images used, and the grammar in producing the final draft. Specialists and target audience performed content and face validation of the module.

    RESULTS: Thirty-six participants were involved in the FGDs. Data saturation was achieved at the 4th FGD. Three themes emerged from qualitative data analysis and were incorporated into the module. USM-IAM was finalised with five units. The content validity index (CVI) was 0.92, while face validity agreements were between 86% and 97%.

    CONCLUSION: The CVI and face agreement for USM-IAM exceed the cut-off point for a sound module. It has good potential to be used as a resource for educating patients in enhancing insulin adherence.

  15. Sattar K, Yusoff MSB, Arifin WN, Mohd Yasin MA, Mat Nor MZ
    Med Educ Online, 2023 Dec;28(1):2165892.
    PMID: 36621960 DOI: 10.1080/10872981.2023.2165892
    BACKGROUND: Mental wellbeing issues among medical students are common, and their relationship to medical professionalism is debated. Few studies have attempted to link such issues with undergraduate medical education. This review aimed to advance the knowledge on this matter by exploring the relationship between mental wellbeing and medical professionalism in undergraduate medical education.

    METHODS: We collected the literature about mental wellbeing and medical professionalism (published from 1 January 1986 to 31 March 2021) from the Web of Science, PubMed, Scopus and ScienceDirect databases using the search terms 'mental wellbeing' and 'medical professionalism'.We included all peer-reviewed articles in which mental wellbeing and medical professionalism in the undergraduate medical education context were the central topics regardless of the age range, nationality, race and gender of the participants.

    RESULTS: From the 13,076 Iinitially found articles, 16 were included. These 16 articles were from nine countries in four different continents, which all together helped us find answer to our research question using extracted points relating to the main study themes (mental wellbeing and medical professionalism). Under theme 1 (mental wellbeing), six subthemes emerged: burnout, stress, depression, disappointment, depersonalisation and conscientiousness. Theme 2 (medical professionalism), on the other hand, had five subthemes: empathy, academic performance, compassion, unprofessional behaviour and professionalism. A significant inverse association was found between empathy and burnout. Academic performance was also related to burnout. At the same time, empathy was found to have a varied association with stress. Moreover, compassion was found to alleviate burnout and nurture professional gratification.

    CONCLUSION: The medical professionalism attributes were found to deteriorate as the mental wellbeing issues grow. This can harm medical students' overall health, current learning abilities and future attitudes towards their patients. Explicit primary research is thus required to examine and intervene in the cause-effect relationship between medical professionalism and mental wellbeing.

  16. Guraya SS, Guraya SY, Rashid-Doubell F, Fredericks S, Harkin DW, Bin Mat Nor MZ, et al.
    Ann Med, 2024 Dec;56(1):2398202.
    PMID: 39263743 DOI: 10.1080/07853890.2024.2398202
    BACKGROUND: There has been an alarming surge in the usage of social networking sites (SNSs) by healthcare professionals (HCPs) without adherence to the principles of professionalism. The widespread use of SNSs in medical practices has been coupled with reports of breaches of professional behaviors. Despite the benefits of SNSs, skepticism prevails about a clearly defined role for SNSs within medicine based upon the core principles of professionalism. Thus, there is a need to understand the manifestations of professionalism in the digital context, classically known as e-professionalism. This study systematically examines HCPs' perceptions of e-professionalism to advance a thorough understanding of e-professionalism.

    METHODS: This concept analysis was performed using the principle-based approach of Penrod and Hupcey. In January 2023, we searched the databases of PubMed and ISI Web of Science for English-language articles specific to 'e-professionalism' in the medical field. The final selected research corpus of 63 articles was analyzed in this study.

    RESULTS: A comprehensive analysis of the selected articles highlighted that e-professionalism is an epistemologically mature and distinct concept by a standard definition. However, inconsistencies in conceptual meanings were reported due to varied interpretations despite digital literacy. The pragmatic utility showed a lack of sound methodological and philosophical paradigms. Perhaps the rapid technological advancements and manifestations have hampered linguistic maturity. However, logically, e-professionalism is perceived as an extension of conventional professionalism but with a focus on a distinct framework with a set of attributes to be digitally relevant.

    CONCLUSION: This study identifies a scarcity of research about the collective perspective of essential stakeholders, underpinning the need to further explore e-professionalism due to its emerging complex nature within the digital context. There is also a recognition that a framework is essential to guide future HCPs to yield a profound understanding and to provide remediation strategies in the rapidly advancing medical field in digital realm.

  17. Mohd Basri MS, Abdul Karim Shah NN, Sulaiman A, Mohamed Amin Tawakkal IS, Mohd Nor MZ, Ariffin SH, et al.
    Polymers (Basel), 2021 Oct 12;13(20).
    PMID: 34685262 DOI: 10.3390/polym13203503
    According to the Food Wastage Footprint and Climate Change Report, about 15% of all fruits and 25% of all vegetables are wasted at the base of the food production chain. The significant losses and wastes in the fresh and processing industries is becoming a serious environmental issue, mainly due to the microbial degradation impacts. There has been a recent surge in research and innovation related to food, packaging, and pharmaceutical applications to address these problems. The underutilized wastes (seed, skin, rind, and pomace) potentially present good sources of valuable bioactive compounds, including functional nutrients, amylopectin, phytochemicals, vitamins, enzymes, dietary fibers, and oils. Fruit and vegetable wastes (FVW) are rich in nutrients and extra nutritional compounds that contribute to the development of animal feed, bioactive ingredients, and ethanol production. In the development of active packaging films, pectin and other biopolymers are commonly used. In addition, the most recent research studies dealing with FVW have enhanced the physical, mechanical, antioxidant, and antimicrobial properties of packaging and biocomposite systems. Innovative technologies that can be used for sensitive bioactive compound extraction and fortification will be crucial in valorizing FVW completely; thus, this article aims to report the progress made in terms of the valorization of FVW and to emphasize the applications of FVW in active packaging and biocomposites, their by-products, and the innovative technologies (both thermal and non-thermal) that can be used for bioactive compounds extraction.
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