Displaying publications 1 - 20 of 55 in total

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  1. Kan KC, Subramaniam P, Shahrizaila N, Kamaruzzaman SB, Razali R, Ghazali SE
    Dement Geriatr Cogn Dis Extra, 2019 02 08;9(1):66-76.
    PMID: 31043965 DOI: 10.1159/000495107
    Background/Aims: This study aimed to investigate the validity and reliability of the Malay version of Addenbrooke's Cognitive Examination III (ACE-III) for detecting mild cognitive impairment (MCI) and dementia.

    Methods: A total of 152 participants (dementia = 53, MCI = 38, controls = 61) were recruited from two teaching hospitals. The Malay version of ACE-III was translated following the standard guidelines for cross-cultural adaptation of measure. All the participants were assessed with the Malay version of ACE-III and Mini-Mental State Examination (MMSE).

    Results: The reliability of the Malay version of ACE-III was good with Cronbach's α coefficient of 0.829 and intraclass correlation coefficient of 0.959. There was a strong positive correlation between the Malay version of ACE-III and MMSE (r = 0.806). Age (r = -0.335) and years of education (r = 0.536) exerted a significant correlation with total score performance. The cutoff score to discriminate dementia from healthy controls was 74/75 (sensitivity = 90.6%, specificity = 82.0%) whereas to discriminate MCI, the cutoff score was 77/78 (sensitivity = 63.2%, specificity = 63.9%). The diagnostic accuracy of ACE-III was higher than that of MMSE in the detection of dementia (area under the curve: ACE-III = 0.929 vs. MMSE = 0.915).

    Conclusions: The Malay version of ACE-III demonstrated to be a reliable and valid screening tool for dementia.

  2. Menon SP, Subramaniam P, Lim KG
    Med J Malaysia, 1984 Dec;39(4):297-9.
    PMID: 6544937
    Four cases of tropical myositis seen over a period of four months at the Penang General Hospital are reported here. All were young local residents in whom large amounts of pus were found deep within skeletal muscles without an obvious aetiological factor.
  3. Vasantha Kumar P, Subramaniam P, Che Din N
    Asian J Psychiatr, 2021 Jun;60:102646.
    PMID: 33873045 DOI: 10.1016/j.ajp.2021.102646
    BACKGROUND: The effects of aging and its associated cognitive decline is particularly acute in Asia given the exponential growth of older adults as a proportion of the population as a whole. Many structured cognitive interventions have been proposed to prevent the cognitive decline typically seen in older age, but their utility as a viable means of achieving these goals is questionable.

    OBJECTIVES: To summarize and synthesize evidence on the utility and methodological quality of cognitive-based interventions on cognitive performance and associated secondary outcomes among healthy older adults in Asia, as well as novel, culture-specific components of cognitive interventions across the region.

    DATA SOURCES: The PubMed/Medline, Web of Science, Scopus, and ScienceDirect databases were searched through May 2020.

    ELIGIBILITY: Studies including individuals aged 60 years and above, who had no previous history of physical and/or mental illness. Few restrictions placed on intervention design, duration and mode of delivery, provided that participants were randomized to study conditions, and intervention included components addressing at least one cognitive domain.

    RESULTS: A total of 17 studies from six countries met the eligibility criteria and were included in the final review. Evidence from those studies indicated that cognitive interventions may be most effective when the design and aims were directed towards improvement in specific cognitive domains, but evidence regarding long-term effectiveness in preventing progression to clinical-level cognitive deficits is still unclear. Several studies highlighted culture-specific activities as components of their interventions, though these will need to be further outlined and standardized clearly in future research.

  4. Zamri-Saad M, Subramaniam P, Sheikh-Omar AR, Sani RA, Rasedee A
    Vet Res Commun, 1994;18(2):119-22.
    PMID: 7975196
  5. Tan K, Chong MC, Subramaniam P, Wong LP
    Nurse Educ Today, 2018 May;64:180-189.
    PMID: 29500999 DOI: 10.1016/j.nedt.2017.12.030
    BACKGROUND: Outcome Based Education (OBE) is a student-centered approach of curriculum design and teaching that emphasize on what learners should know, understand, demonstrate and how to adapt to life beyond formal education. However, no systematic review has been seen to explore the effectiveness of OBE in improving the competencies of nursing students.

    OBJECTIVE: To appraise and synthesize the best available evidence that examines the effectiveness of OBE approaches towards the competencies of nursing students.

    DESIGN: A systematic review of interventional experimental studies.

    DATA SOURCES: Eight online databases namely CINAHL, EBSCO, Science Direct, ProQuest, Web of Science, PubMed, EMBASE and SCOPUS were searched.

    REVIEW METHODS: Relevant studies were identified using combined approaches of electronic database search without geographical or language filters but were limited to articles published from 2006 to 2016, handsearching journals and visually scanning references from retrieved studies. Two reviewers independently conducted the quality appraisal of selected studies and data were extracted.

    RESULTS: Six interventional studies met the inclusion criteria. Two of the studies were rated as high methodological quality and four were rated as moderate. Studies were published between 2009 and 2016 and were mostly from Asian and Middle Eastern countries. Results showed that OBE approaches improves competency in knowledge acquisition in terms of higher final course grades and cognitive skills, improve clinical skills and nursing core competencies and higher behavioural skills score while performing clinical skills. Learners' satisfaction was also encouraging as reported in one of the studies. Only one study reported on the negative effect.

    CONCLUSIONS: Although OBE approaches does show encouraging effects towards improving competencies of nursing students, more robust experimental study design with larger sample sizes, evaluating other outcome measures such as other areas of competencies, students' satisfaction, and patient outcomes are needed.

  6. Baharudin AD, Din NC, Subramaniam P, Razali R
    BMC Public Health, 2019 Jun 13;19(Suppl 4):447.
    PMID: 31196141 DOI: 10.1186/s12889-019-6868-0
    BACKGROUND: The main aim of this study was to determine the association between Behavioral and Psychological Symptoms of Dementia (BPSD) and caregiver burden, and the mediating role of coping strategy and personality style of caregivers to patients with dementia (PWD).

    METHODS: This cross-sectional study was conducted among 202 caregivers to PWD in home-based settings. Recruited caregivers were administered questionnaires regarding BPSD which was measured using Neuropsychiatric Inventory-Questionnaire (NPI-Q), caregiver burden using Zarit Burden Interview (ZBI), Brief COPE for coping strategies and Big-Five Inventory which measured personality traits.

    RESULTS: Majority of the caregivers were female (71.3%), aged 50 and above (55%), single (46%), married (43.6%), working full time (45%) while the rest work part time (22.3%), unemployed (7.4%) and retiree (25.2%), and majority were parents (58.9%) and spouse (18.3%). The duration of caregiving was less than a year (33.7%) while the rest are more than a year. Results demonstrated that the most frequent types of BPSD exhibited by PWD was irritability, followed by apathy and agitation. All of the types of BPSD showed to be significantly correlated to caregiver burden except for anxiety, elation and appetite. Of personality traits, only conscientiousness was found to mediate the relationship between BPSD and caregiver burden (p

  7. Mohd Zulkifly MF, Ghazali SE, Che Din N, Subramaniam P
    Malays J Med Sci, 2016 Mar;23(2):53-64.
    PMID: 27547115 MyJurnal
    This study aims to estimate the prevalence and explore the predictors for post-stroke cognitive impairment at the community level in Malaysia.
  8. Malek Rivan NF, Yahya HM, Shahar S, Ajit Singh DK, Ibrahim N, Mat Ludin AF, et al.
    Nutrients, 2021 Jan 25;13(2).
    PMID: 33503860 DOI: 10.3390/nu13020353
    This study aimed to investigate the impact of food insecurity and poor nutrient intake on the psychological health of middle-aged and older adults during the COVID-19 pandemic. A sub-sample of 535 individuals aged 52 years and above, from the earlier cohort and interventional studies (n = 4) from four selected states in Peninsular Malaysia, were recruited during the COVID-19 outbreak (April to June 2020). Telephone interviews were conducted by trained interviewers with a health sciences background to obtain participants' information on health status, physical activity, food security, and psychological health (General Health Questionnaire-12; normal and psychological distress). Univariate analyses were performed for each variable, followed by a logistic regression analysis using SPSS Statistics version 25.0. Results revealed food insecurity (OR = 17.06, 95% CI: 8.24-35.32, p < 0.001), low protein (OR = 0.981, 95% CI: 0.965-0.998, p < 0.05), and fiber intakes (OR = 0.822, 95% CI: 0.695-0.972, p < 0.05) were found to be significant factors associated with the psychological distress group after adjusting for confounding factors. The findings suggested that food insecurity and insufficiencies of protein and fiber intakes heightened the psychological distress during the COVID-19 pandemic. Optimal nutrition is vital to ensure the physical and psychological health of the older population, specifically during the current pandemic.
  9. Khan WU, Ghazala Z, Brooks HJ, Subramaniam P, Mulsant BH, Kumar S, et al.
    Schizophr Bull, 2021 Jan 23;47(1):249-257.
    PMID: 32619225 DOI: 10.1093/schbul/sbaa093
    Anticholinergic burden (ACB) from medications impairs cognition in schizophrenia. Cognition is a predictor of functional capacity; however, little is known about ACB effect on functional capacity in this population. This study assesses the relationship between ACB and functional capacity across the life span in individuals with schizophrenia after controlling for ACB effect on cognition. A cross-sectional analysis was performed with data collected from 6 academic tertiary health centers. Two hundred and twenty-three community-dwelling participants with schizophrenia or schizoaffective disorder were included in this study. Main variables were ACB, antipsychotic olanzapine equivalents, functional capacity, cognition, and negative symptoms. Simultaneous linear regression analyses were performed to assess the association between ACB, functional capacity, and cognition and then between ACB and cognition. A mediation analysis was then performed to examine whether cognition mediated ACB effect on functional capacity if there was an association between ACB and cognition. Mean age of participants was 49.0 years (SD = 13.1, range 19-79), and 63.7% of participants had severe ACB, ie, a total score of 3 or above. Regression analyses revealed that ACB, age, education, and cognition independently predicted functional capacity and that ACB predicted cognition among those aged 55 years and older. Mediation analysis showed that cognition did partially mediate the effect of ACB on functional capacity in this older cohort. In conclusion, people with schizophrenia are exposed to severe ACB that can have a direct negative impact on functional capacity after controlling for its impact on cognition. Reducing ACB could improve functional capacity and potentially real-world function in schizophrenia.
  10. Kim MY, Subramaniam P, Flicker L
    Ann Geriatr Med Res, 2018 Mar;22(1):9-19.
    PMID: 32743238 DOI: 10.4235/agmr.2018.22.1.9
    The Australian aged care system has evolved for >50 years to support frail older adults and allow them to make informed decisions about their care. Hospitals provide streamlined geriatric services from visits at the Emergency Department to discharges from acute and subacute geriatric care units. Moreover, nonhospital aged care services, including Transition Care Program, Commonwealth Home Support Program, Home Care Packages Program, and Residential Care (nursing home) are provided under the auspices of the Australian Government. These various specialized hospital and nonhospital services are integrated and coordinated by the multidisciplinary assessment team called ACAT (Aged Care Assessment Team). Korea does not have a similar amount of time to prepare a well-organized aged care system because of a rapidly increasing older population. The Korean government and aged care experts should exert vigorous efforts to improve the last journeys of the Korean older population.
  11. Toh HM, Ghazali SE, Subramaniam P
    Int J Alzheimers Dis, 2016;2016:5131570.
    PMID: 27478677 DOI: 10.1155/2016/5131570
    Cognitive stimulation therapy (CST) is an evidence-based therapy for individuals with mild-to-moderate dementia. Past reviews have only synthesized outcomes obtained through quantitative study which does not fully represent the understanding on the acceptability and usefulness of CST. Therefore, the present review aims to integrate outcomes obtained from both quantitative and qualitative studies to provide a deeper understanding on the acceptability and usefulness of CST for older adults with dementia. Findings of literature were retrieved from searches of computerized databases in relation to CST for people with dementia. Literatures were selected according to selection criteria outlined. Results obtained in previous studies pertaining to the effects of CST were discussed in relation to variables such as cognitive function, quality of life, and family caregivers' wellbeing. The review also explores the use of CST in different cultural context, the perception on its effectiveness, and individualized CST (iCST). There is considerable evidence obtained through quantitative and qualitative studies on the usefulness and acceptability of CST for older adults with dementia. Recommendations for future research are provided to strengthen the evidence of CST's effectiveness.
  12. Subramaniam P, Mohamad S, Alias Y
    Int J Mol Sci, 2010 Sep 28;11(10):3675-85.
    PMID: 21152293 DOI: 10.3390/ijms11103675
    The supramolecular structure of the inclusion complex of β-cyclodextrin (β-CD) with 1,1',2,2'-tetramethyl-3,3'-(p-phenylenedimethylene) diimidazolium dibromide (TetraPhimBr), a dicationic ionic liquid, has been investigated. The inclusion complex with 1:1 molar ratio was prepared by a kneading method. Fourier transform infrared spectroscopy (FTIR), powder X-ray diffraction (XRD) analysis, (1)H NMR and thermogravimetric analysis (TGA) confirmed the formation of the inclusion complex. The results showed that the host-guest system is a fine crystalline powder. The decomposition temperature of the inclusion complex is lower than that of its parent molecules, TetraPhimBr and β-CD individually.
  13. Sinniah A, Maniam T, Oei TP, Subramaniam P
    ScientificWorldJournal, 2014;2014:718367.
    PMID: 24672358 DOI: 10.1155/2014/718367
    The aim of this paper is to review the literature on suicide attempts in Malaysia. PsycINFO, PubMed, and Medline databases from 1845 to 2012 and detailed manual search of local official reports from the Ministry of Health and the Malaysian Psychiatric Association and unpublished dissertations from 3 local universities providing postgraduate psychiatric training were included in the current review. A total of 38 studies on suicide attempts in Malaysia were found and reviewed. Twenty-seven (76%) of the studies on suicide attempts were descriptive studies looking at sociodemographic data, psychiatric illnesses, and methods and reasons for suicide attempts. No study has been conducted on treatment and interventions for suicide attempts and the impact of culture was rarely considered. The review showed that in order for researchers, clinicians, and public health policy makers to obtain a better understanding of suicide attempts in Malaysia, more systematic and empirically stringent methodologies and research frameworks need to be used.
  14. Goh HT, Tan MP, Mazlan M, Abdul-Latif L, Subramaniam P
    J Geriatr Phys Ther, 2018 6 1;42(4):E77-E84.
    PMID: 29851747 DOI: 10.1519/JPT.0000000000000196
    BACKGROUND AND PURPOSE: Poor quality of life (QoL) is a well-recognized consequence after stroke. Quality of life is influenced by a complex interaction between personal and environmental factors. Most previous investigations of the QoL after stroke have focused on personal factors, for example, physical deficits directly resulting from stroke. The influence of environmental factors, including social participation, is relatively understudied partly due to its high variation across different sociocultural contexts. The purpose of this study was to investigate the determinants of QoL among older adults with stroke living in an urban area of a developing country.

    METHODS: This cross-sectional observational study included 75 older adults who were at least 3 months poststroke and 50 age-matched healthy controls. Depressive symptoms were quantified using the World Health Organization Quality of Life Brief version (WHOQoL-BREF). Physical function was examined using Functional Ambulation Category, grip strength, 5 times Sit-to-Stand test, and Box and Block tests. The Montreal Cognitive Assessment and visual-manual reaction time were used to index cognitive function. Depressive symptom was quantified using the Patient Health Questionnaire-9. The Barthel Index and Fatigue Severity Scale were used to quantify activity limitation. Social participation and environmental participation were assessed using the Assessment of Life Habit and Craig Hospital Inventory of Environment Factors, respectively. Linear stepwise regression models were used to determine explanators for WHOQoL-BREF domain scores.

    RESULTS: Individuals with stroke demonstrated significantly worse QoL on all WHOQoL-BREF domains compared with healthy controls. Stroke was a strong determinant for QoL and explained 16% to 43% of variances. Adding other outcome measures significantly improved the robustness of the models (R change = 12%-32%). The physical, psychological, social, and environmental domains of WHOQoL-BREF were all explained by the LIFE-H scores (β = -10.58, -3.37, 4.24, -5.35, respectively), while psychological, social, and environmental domains were explained by Montreal Cognitive Assessment scores (β = .47, 0.78, 0.54, respectively).

    CONCLUSION: Social participation and cognition were strong determinants of QoL among urban-dwelling older adults with stroke. Social and recreational activities and cognitive rehabilitation should therefore be evaluated as potential strategies to improve the well-being of older adults affected by stroke.

  15. Subramaniam P, Jabar KA, Kee BP, Chong CW, Nathan AM, de Bruyne J, et al.
    Indian J Med Res, 2018 Aug;148(2):225-231.
    PMID: 30381546 DOI: 10.4103/ijmr.IJMR_1987_16
    Background & objectives: Streptococcus pneumoniae: (pneumococcus) is a highly invasive extracellular pathogen that causes diseases such as pneumonia, otitis media and meningitis. This study was undertaken to determine the serotype diversity and penicillin susceptibility of S. pneumoniae isolated from paediatric patients in a tertiary teaching hospital in Malaysia.

    Methods: A total of 125 clinical isolates collected from January 2013 to May 2015 were serotyped using seven sequential multiplex polymerase chain reactions. The susceptibility of these isolates to penicillin was also investigated.

    Results: Serotypes detected among the isolates were serotypes 3, 6A/B, 6C, 11/A/D/F, 15A/F, 19A, 19F, 23A, 23F, 34. Serotypes 19F and 6A/B were the most prevalent serotypes detected. Most of the S. pneumoniae were isolated from nasopharyngeal samples of children below five years of age. Majority of the isolates were penicillin susceptible. Only 5.6 per cent of the isolates were non-susceptible to penicillin, mostly of serotype 19F.

    Interpretation & conclusions: Our study revealed the distribution of various serotypes in S. pneumoniae isolates obtained from children in a teaching hospital at Kuala Lumpur, Malaysia and decreasing rates of penicillin resistance among them. The shifts in serotypes and susceptibility to penicillin from time to time have been observed. Continuous monitoring and surveillance are pivotal for better infection control and management of pneumococcal infections among children.

  16. Khaing MS, Parash MTH, Shimmi SC, Kabir S, Chodanakar NC, Subramaniam P, et al.
    MyJurnal
    ABSTRACTS FOR THE 1ST INTERNATIONAL BORNEO HEALTHCARE AND PUBLIC HEALTH CONFERENCE AND 4TH BORNEO TROPICAL MEDICINE AND INFECTIOUS DISEASE CONGRESS. New Frontiers in Health: Expecting the Unexpected; Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia; On 3rd-5th September 2019
    Introduction: Since January 2010, the UMS Polyclinic, situated at Riverside Plaza, Kingfisher Park, Kota Kinabalu, Sabah, provided general medical consultation as well as specialist consultations comprising of Internal Medicine, Endocrinology (Diabetes and related problems), Dermatology, Rheumatology, Cardiology including ECG and ECHO services, Orthopedic, Ophthalmology, ENT (Ear, Nose and Throat), Obstetrics and Gynecology, Pediatrics and Psychiatry. The purpose of this study was to look into the Dermatology consultations provided by the UMS Polyclinic in order to improve health care services, by reporting on the demographic characteristics of the patients with reference to the provisional diagnosis and management offered, as well as referrals to tertiary health care centers for further managements. Methods: It was a retrospective, descriptive study which included 76 patients who visited the Dermatology Specialist Clinic at UMS Polyclinic from January to December 2018.
    Results: The 76 patients comprised of 50 males and 26 female patients with the age ranged from 2 years to 86 years, with 5 children (under the age of 12 years).The catchment population of the patients were mainly from Universiti Malaysia Sabah, Kingfisher, and also from wide areas of Kota Kinabalu with a few from Kudat,Tamparuli, Telipok, Keningau, Kinarut and Beaufort, etc. The consultations comprised of 19 varieties of dermatological problems to which were given appropraite management. The period of the year 2018 under study showed highest attendance in February with 21 patients (27.6%) followed by 13 patients (17.1%) in October with December showing 11 patients (14.5% ).
    Conclusion: A total of 32 varieties of Dermatological problems were found among the 76 patients consulted. Acne Vulgaris was found to be the highest variant with 12 cases(15.7%) with Seborrhoeic Dermatitis seen as 5 cases (6.5%) followed by 4 cases (5.2%) each of Contact Dermatitis, Allergy/Hypersensitivity, Photosensitive Dermatitis, and Vitiligo. Certain patients had to be referred to Dermatology Department at Hospital Queen Elizabeth for further management, like for skin biopsy, and also for Electro-cautery machine, Phototherapy, and Laser, as we are still waiting for few equipments.
  17. Ikbar RR, Amit N, Subramaniam P, Ibrahim N
    PLoS One, 2022;17(12):e0278635.
    PMID: 36454972 DOI: 10.1371/journal.pone.0278635
    BACKGROUND: This systematic review aims to review research manuscripts during the COVID-19 pandemic that focus on the relationship between self-efficacy, adversity quotient, COVID-19-related stress and academic performance on a range of undergraduate student.

    METHODS: The authors will perform comprehensive searches of published studies in electronic databases such as PMC, PubMed, Scopus, Cochrane Library and Web of Science by using the following search terms: 'self-efficacy' AND 'adversity quotient' AND 'stress' AND 'academic performance' AND 'student' AND 'COVID-19 pandemic'. Only full-text articles in English language are included. Two reviewers will independently conduct the article selection, data extraction, and quality assessment. Any possible disagreement will be resolved by discussion, and one arbitrator (NA) will adjudicate unresolved disagreements.

    RESULTS: This review will provide an updated overview of investigating the relationship between self-efficacy, adversity quotient, COVID-19-related stress and academic performance on a range of undergraduate student during the COVID-19 pandemic. Ultimately, based on this systematic review, we will recommend the direction for future research.

    CONCLUSION: The result of the study may help the researchers to find an updated overview of various studies in related topic.

    ETHICS AND DISSEMINATION: Data from published studies will be used. Therefore, ethical approval is not required prior to this systematic review. The results will be published in a peer-reviewed journal.

  18. Mohd Safien A, Ibrahim N, Subramaniam P, Shahar S, Din NC, Ismail A, et al.
    Gerontol Geriatr Med, 2021 08 11;7:23337214211025167.
    PMID: 34395815 DOI: 10.1177/23337214211025167
    Aim: The goal is to explore available evidence and provide greater clarity to what is described as psychosocial intervention to improve cognitive function among older population with MCI as well as identifying areas for future research. Methods: An electronic literature search of PubMed, Cochrane, Ebscohost, Medline, Scopus, and gray resource was conducted to find articles published in English language between 2010 and September 2020. This review focused on research undertaken using randomized clinical trials study design. We extracted information regarding the publication date, geographical location, study setting, intervention mechanism, type of cognitive measurement used, and outcome of the studies. References of this literature were also reviewed to ensure comprehensive search. Result: Out of 240 potential records found, a total of 27 articles were identified following the first round of screening and deletion of duplicates. Full-text article reviews and analysis in the second round of screening narrowed the selection down to four articles. Another three relevant articles obtained from references were also included making a total of seven articles in the final analysis. Findings: Psychosocial intervention strategies for improvement of cognitive function, done in various setting all over the globe, covered a range of approaches including art therapy, visual art therapy, therapeutic writing therapy, reminiscence activity, and cognitive behavioral approach. Most were conducted in weekly basis within 1-to-2-hour duration of session. Cognitive function of older adult in psychosocial intervention group was significantly improved in two studies. Three studies showed no significant improvement at all in the cognitive function, and another one reported success in improving cognitive function over time in the intervention group than in control group. One study did not describe the interaction effect. Different types of cognitive measurement also were used to quantify different domains of cognitive function in the reviewed studies. Conclusion: The idea of using psychosocial intervention for improving cognitive function has begun to increasingly accepted recently. Findings from the limited studies are encouraging, although the outcome of the cognitive function was mixed. Large-scale and longer duration of psychosocial intervention with bigger sample size is warranted for future studies.
  19. Zainal N.Z, Nor-Aziyan Y, Subramaniam P
    MyJurnal
    Introduction: Interest in mindfulness and its enhancements have quietly exploded in recent years, bringing with it the need for validated instruments to assess mindfulness in the Malaysian population. The study aims to assess the reliability, factor structure and validity of the Malay version of The Mindful Attention Awareness Scale (MMAAS) in a group of nursing students. Methods: The MMAAS was ‘forward-backward’ translated from English to Malay. Two hundred and sixty six nursing students answered the MMAAS. At the same time, they responded to the General Health Questionnaire (GHQ) and Rosenberg Self-Esteem Scale (RSES). We performed Exploratory Factor Analysis (EFA) with varimaxrotation to examine the factor structure of the MMAAS. Associations of retained factors were estimated by Spearman correlation coefficients. Results: Internal consistency reliability of MMAAS was good (Cronbach’s α = 0.851) and showed temporal stability in a 3-week period. Exploratory Factor Analysis (EFA) suggested three factors labelled as “Attention related to generaldomain”, “Attention related to the physicaldomain” and “Attention related to psychological domain”. These factors explained 52.09% of the variance. The Malay MAAS and the English version was highly correlated (r=0.82, p
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