Clinical practice is an essential component of the nursing student's training. The practice allows nursing students the opportunity to relate theory into practice during nursing care to the patients. The aim of this project was to determine perceptions of clinical placement experience with respect to clinical practice, enhancement of learning and hindrance among nursing students. A total 254 participants undergoing training at Nursing College Kubang Kerian participated in this project. They were selected using the Raosoft sample size calculator. Survey questionnaires were distributed to 80 participants from first year, 88 from second year and 86 participants from third year. The questionnaire consisting of 25 items with 5-point Likert Scale responses was used to measure nursing students' perceptions towards nurses during their clinical placement experience. In addition, demographic factors such as age groups, ethnicity, educational levels and years of training were examined. The items were pilot-tested and the Cronbach Alpha values obtained for clinical practice, enhancement of learning and hindrance consisting of 0.80, 0.80 and 0.83 respectively. The final data was analysed using both descriptive and inferential statistics. Non-parametric Kruskal Wallis was used to make comparisons where sub samples were imbalanced. The level of significance was set at 0.05. The results indicate that nursing students perceived their clinical placement positively. Perceptions towards clinical practice were significantly different between nurses based on their residential areas and years of training. The results of this study revealed that there were challenges for the nursing educators, clinical instructors and other health providers in achieving a supportive clinical environment for the nursing students.
Keywords: Nursing, Clinical Placement, , Clinical Practice, Enhancement or Hindrance in learning
Mountains offer replicated units with large biotic and abiotic gradients in a reduced spatial scale. This transforms them into well-suited scenarios to evaluate biogeographic theories. Mountain biogeography is a hot topic of research and many theories have been proposed to describe the changes in biodiversity with elevation. Geometric constraints, which predict the highest diversity to occur in mid-elevations, have been a focal part of this discussion. Despite this, there is no general theory to explain these patterns, probably because of the interaction among different predictors with the local effects of historical factors. We characterize the diversity of small non-volant mammals across the elevational gradient on Mount (Mt.) Kinabalu (4,095 m) and Mt. Tambuyukon (2,579 m), two neighboring mountains in Borneo, Malaysia. We documented a decrease in species richness with elevation which deviates from expectations of the geometric constraints and suggests that spatial factors (e.g., larger diversity in larger areas) are important. The lowland small mammal community was replaced in higher elevations (from above ~1,900 m) with montane communities consisting mainly of high elevation Borneo endemics. The positive correlation we find between elevation and endemism is concordant with a hypothesis that predicts higher endemism with topographical isolation. This supports lineage history and geographic history could be important drivers of species diversity in this region.
Molecular phylogenetic analyses of the sister species Sphenomorphus stellatus and S. praesignis based on the mitochondrial genes 12S and 16S rRNA recover the former as paraphyletic with respect to the latter in that a specimen of S. stellatus from the type locality in Peninsular Malaysia is more closely related to S. praesignis than to Indochinese populations of S. stellatus. Furthermore, the phylogeny indicates that the Indochinese populations represent two species, thus resulting in four major lineages within this clade. These relationships are consistent with multivariate and univariate analyses of morphological and discrete color pattern data which statistically define and diagnose the four lineages and together with the molecular data, provide the foundation for robust, testable, species-level hypotheses. As such, S. stellatus is herein restricted to Peninsular Malaysia; S. annamiticus is resurrected for the circum-continental populations ranging through southeastern Thailand, southern Cambodia, and southern Vietnam; a new species-S. preylangensis sp. nov.-is described from an isolated mountain, Phnom Chi, from the Prey Lang Wildlife Sanctuary in central Cambodia; and the taxonomy of S. praesignis remains unchanged. The description of S. preylangensis sp. nov. underscores the necessity to conserve this remnant of lowland evergreen rainforest in the Prey Lang Wildlife Sanctuary.
This study investigates the published literature and incorporates our field data from 1997 to September 2018 to generate an inventory report of primary freshwater fishes for Perak State in Malaysia. We critically examined and enumerated 186 species from 2 classes, 16 orders, 43 families and 114 genera in 57 localities. A total of 173 fish species (91.4%) are native to Perak and 17 species (8.6%) are non-native. The provisional checklist presented herein is conservative and excludes doubtful inventory records that lack synthesis and traceability. We encountered seven taxonomic discrepancies and we also could not confidently identify eight species. These are explicitly discussed to inform future workers.
The Community Follow-up Project involves a scheme by which clinical students follow the progress of patients after discharge from hospital. The Community Follow-up Project begins with the student choosing a hospital in-ward patient during their first clinical ward based attachment and follows this patient's progress after discharge from the hospital. The students do a series of home visits and also accompany their patients for some of their follow-ups to the hospital or government clinics; to their general practitioners and even to the palliative care or social welfare centres. The students assess the physical, psychological and social impact of the illness on the patient, family and community. This project supplements students' knowledge of the natural history of disease and emphasizes the importance of communication and the use of community resources. By commitment to the patient for a duration of time, the students are able to take an active role in patients' care, understand in depth the problems faced by patients and in assessing a patient's progress, students find themselves in the role of a teacher and advisor to their patient as well. We outline the main components of this project, describe its outcome and consider areas that invite further developments.
A review of the taxonomic status of the Smooth Slug Snake (Asthenodipsas laevis) in Borneo resulted in the discovery of two previously unrecognised species from the highlands of Sabah, East Malaysia. Asthenodipsas jamilinaisi sp. nov. and A. stuebingi sp. nov. are presumed to be closely related to A. laevis based on similarities in pholidosis and patterning but can be separated from A. laevis by their dorsal scale rows of 15/15/15 vs 15/15/13 and the presence of a sharp vertebral keel. Asthenodipsas jamilinaisi sp. nov. can be further differentiated from A. stuebingi sp. nov. by the greatly enlarged size of the vertebral scales, higher number of ventrals in males (173-175 vs 165), higher number of subcaudals (53 vs 35-47) and colour pattern (dark overall with indistinct bands vs lighter head and body with clear, distinct bands and a dark neck patch). The discovery highlights the need for more careful examination of much of the herpetofauna of Borneo that still remains underestimated and understudied. There is an urgent need for continued surveys into its diversity and the collection of genetic material for integrated taxonomic revisions.
Two new intertidal oribatid mite species from the Indo-pacific region are described. Indopacifica iohanna sp. n. was found on the coasts of the Philippines and can be distinguished from its congeners by the lack of a ventral tooth on the claws. The larva and nymphs of this species show the same type of plication and setation typical for juveniles of other selenoribatid mites. Indopacifica mauritiana sp. n. was discovered on the coast of Mauritius and can be separated from its congeners by possessing only vestigial lamellar setae. A morphometric comparison of these two species and Indopacifica pantai from Thailand and Malaysia showed a clear separation between the three species. The known distribution of the genus Indopacifica stretches now from Mauritius in the West to the Philippines in the East and further occurrences within this area should be expected.
An integrative taxonomic analysis of Subdoluseps herberti from southern Thailand and Peninsular Malaysia and S. samajaya from Sarawak, East Malaysia (Borneo) recovers the former as paraphyletic with respect to the latter. The analyses recover the three southernmost populations of S. herberti in Peninsular Malaysia as conspecific and the sister lineage of S. samajaya, whereas S. herberti from Thailand and northern Peninsular Malaysia constitute the sister species to S. samajaya plus the southern three Peninsular Malaysian populations. As such, the southern populations are described herein as S. malayana sp. nov. and all three species are referred to as the S. herberti group. Clade boundaries and breaks within this group on the Thai-Malay Peninsula occurring at the Isthmus of Kra, across the Kangar-Pattani line, and between the Thai-Malay Peninsula and Borneo are consistent with phylogeographic patterns of other Sundaic taxa. The discovery of S. malayana sp. nov. continues to underscore the fact that, despite the well-studied nature of the lizard fauna of Peninsular Malaysia, much of it still remains unrealized and for conservation efforts to move forward, field research followed by expeditiously revised taxonomies must continue.
Blackflies (Diptera: Simuliidae) are ecologically and medically important insects but they have been understudied in Malaysia. Accordingly, a study on the temporal variation in diversity and community structure of preimaginal blackflies was conducted for the first time in Malaysia. A total of 865 preimaginal blackflies were collected in 120 samplings from five streams across three monsoon seasons from February 2018 until January 2019. Ten species were recorded and most frequently collected species were Simulium cheongi, Simulium vanluni and Simulium jeffreyi. Relatively common species were Simulium roslihashimi, Simulium tani complex and Simulium trangense. No significant changes of rainfall was observed between three monsoon seasons as well as the seasons with species and physiochemical parameters except acidity (pH) (P 20%) indicated that S. vanluni and S. jeffreyi were commonly associated with wider, deeper and fast-flowing streams with low conductivity and larger streambed particle. In contrast, S. cheongi was associated with smaller, slower and small streambed particle. This first extensive bimonthly study has uncovered the species community structure as well as the changes of stream physicochemical parameters over time although they were not greatly and significantly influenced by the monsoon seasons. Species distribution, richness and abundance, however, were highly determined by the stream width, depth and velocity, therefore, were vital in shaping diversity and community structure of preimaginal blackflies.
Background: Achalasia cardia, not an uncommon disease, is diagnosed based on a good history, upper endoscopy, barium swallow, and standard esophageal manometry, is often diagnosed late and best care is delayed.
Materials and Methods: Complete records of treatment naïve patients with achalasia from 1st January 2000 till 20th November 2004 were reviewed.
Results: A total of 42 patients, with average presenting age at 45±17 (range 19-83) years with 15 males:27 females with 22 Malays:15 Chinese:5 Indians, were analysis. Compared to our upper endoscopy attendees, there is a trend towards a younger age group (p>0.05) but clearly demonstrating a female preponderance (p<0.005) and towards the Malays but sparing the Indians (p< 0.05). The classical symptom of dysphagia was noted in all cases (100%). Regurgitation in 37 patients (88%), heartburn in 15 patients (36%), weight loss in 10 patients, nocturnal cough in 16 patient, retro-sternal chest discomfort in 2 patients and hemetemesis in 2 patient. One patient presented with aspiration pneumonia and another had concomitant active pulmonary tuberculosis and 9 had concomitant constipation (21%). The duration of illness before diagnosis was 66±90 (range 3-360) months and their presenting weight was 52±12 (range 33-82) kg. Barium swallow examination confidently diagnosed achalasia in 28 patients (67 %). The remaining was marked as dysmotility disorder (7 cases), possible carcinoma of the esophagus (in 2 patients) and dysmotility with possible achalasia (in 5 patients). Ten had mega-esophagus and two had epiphrenic diverticulum with no pseudo-achalasia. Standard esophageal manometry, performed in 39 cases, all demonstrated aperistalsis with one vigorous achalasia. The manometric assembly failed to pass through the
sphincter in 14 cases (36%), includes 8 patients with mega-esophagus, and LES assessment was not possible. Four cases demonstrated normal LES pressure but demonstrated incomplete relaxation (normotensive achalasia). Dilatation was performed with a 30 mm Rigiflex pneumatic dilator under fluoroscopy at 7psi for 3-30 seconds after loss of waist in 40 patients without complications and excellent symptomatic relief with 3-12 months post procedural weight gain of 7±5 (range: 0-19) kg. Six patients required a second dilatation and another required two further dilatation. The pneumatic dilatations durability during this short study was excellent at 29±11 (range 8-48) months. Similar efficacy and safety profile was noted in patients with mega-esophagus.
Conclusion: Barium swallow (especially in advanced disease) and manometry (especially in early disease) serve as essential tools for the diagnosis of achalasia and they complement each other. We report two patients presenting with hemetemesis. We obtained excellent results with pneumatic dilatation without any
complications and this extends to advanced cases of achalasia with mega-esophagus.
Citation: A Practical Guide for the Pharmacological Management of T2DM Patients Across the Cardiovascular Risk Continuum. Kuala Lumpur: Malaysian Endocrine and Metabolic Society; 2019
Citation: Wan Bebakar WM, Ismail M, Sharif J. Preliminary report of an audit of diabetes control and management (DRM-ADCM) July to December 2008. Kuala Lumpur: Diabetes Registry Malaysia; 2009
This essay considers the development of the nuclear science programme in Malaysia from a transnational perspective by examining the interactions between state agents and other external nuclear-knowledge/technology related actors and agents. Going beyond the model of knowledge diffusion that brings together concerns articulated in Harris's (2011) geographies of long distance knowledge and Reinhardt's (2011) role of the expert in knowledge transfer, the proposed three-phase model of knowledge transfer theorises the pathways undertaken by a late-blooming participant of modern science and technology as the latter moves from epistemic dependency to increasing independence despite the hurdles encountered, and the underdevelopment of many areas of its technoscientific economy. The model considers tensions stemming from the pressures of expediency for meeting national developmental goals on the one side, and the call to support the objectives of basic science on the other. The three phases of the model are epistemic transition, epistemic transplantation and localisation, and epistemic generation (ETTLG). As additional support for the proposed model, three arguments are proffered as deeper explanations of the epistemic goal by using Malaysia as a case study: knowledge transfer for political legitimization, knowledge transfer for countering agnotology, and knowledge transfer for social engineering and science diplomacy.
The enigmatic 'Spectacled Flowerpecker'-a probable new bird species from the island of Borneo-was first sighted in the Danum Valley of Sabah, Malaysia in 2009. However, the absence of a holotype specimen has prevented its formal scientific description. Since then only a handful of reports from widely disparate localities across the island have emerged, all from lowland sites and often in close association with fruiting mistletoe. Here, we report the long-awaited capture of a specimen of this putative new species and confirm its morphological and molecular distinctiveness as a novel species in the genus Dicaeum.
Tenothrips keruing sp. n. is described from Malaysia. This new species was taken from the flowers of Dipterocarpus sublamellatus (local name Keruing kerut) during the recent mass-flowering. The male of this species has a pair of stout setae on abdominal tergite IX, and there are no sternal pore plates. A key to species of Tenothrips from Indomalaysia is provided.
Introduction: The Royal College of Medicine Perak under Universiti Kuala Lumpur started its own undergraduate medical degree programme in 2007. As part of the review and evaluation of communication skills (CS) training, the performance of the two pioneer batches of final year students in CS Objective Structured Clinical Examinations (OSCEs) stations in the 2012 and 2013 were analysed.
Methods: The CS OSCE stations were analysed based on the percentage of students obtaining a satisfactory performance in each CS component. Overall performance in each CS component was considered satisfactory, if ≥ 50% of students achieved satisfactory performance or unsatisfactory, if < 50% of students achieved satisfactory performance. The two cohorts were compared for any significant statistical difference (p < 0.05) in their performance.
Results: Satisfactory performance was obtained in basic CS (courtesy, appropriate non-verbal and verbal CS), stating intention of session, recognizing patient’s cues, checking and addressing patient’s perceptions and concerns, checking patient’s understanding, breaking bad news and maintaining a professional attitude. The performance was unsatisfactory in assessing prior knowledge, discussing patient management and checking patient’s coping skills. Both the two cohorts’ performance did not differ significantly.
Conclusion: Overall the students’ performance was satisfactory except for assessing prior knowledge, discussing management and checking patients’ coping skills.
Introduction: A cross-sectioned study was carried out on 1016 drug addicts from Johor state to better understand their profile.
Method: A structured questionnaire prepared in three languages was used to collect the data which was analyzed using the Statistical Package for Social Sciences.
Result & Discussion: The overall mean age of the respondents was 33.8 (95% CI= 33.3 - 34.4) years and ranged from 16 to 61 years. ANOVA post hoc multiple comparison tests showed that there was a significant difference in the mean age between Malays and Chinese (p<0.05). The majority of the respondents were Malay (79.6%) and had secondary education (72.1%) or primary education (21.7%). The majority (79%) was either semi-skilled or unskilled. More than 70% had mores than five siblings. About 36% of the respondents had past a history of discipline problem at school. The majority (99.6%) of the drugs addicts had smoked before and more than 90% were currently smoking. More than 80% had consumed alcoholic beverages. The majority did not use condom when they had sex. Only 24% stated that they did use a needle or syringe that had previously been used by someone else. Less than 4% had either bleached or boiled the needle or syringe that had previously been used by someone else. About 17% were tested positive for HIV. The mean age at which the respondents first started injecting drugs was 21.5 (95% CI= 20.7 - 22.2) years. ANOVA post hoc multiple comparison tests showed that there was no significant difference in the mean age of the different ethnic groups at which the respondents first started injecting drugs. The majority (84.2%) of the drug addicts started injecting drugs between 10 and 20 years of age. Friends introduced 80% of the drug addicts to drugs. The common reasons given for first taking drugs was " I was curious about the feeling of taking drugs (43.6%), "my friends asked me to try" (23.4%), "to release tension" (15.6%) and 5% stated "to try for fun", and 3% that they were "depressed". The majority (64.2%) of the drug addicts spend RM 500 or more per month on drugs and more than 10% of them spend as much as RM 1000 or more per month.
Conclusion: These results indicate an urgent need for a more comprehensive prevention program involving family, schools, commmunities and the media and aimed at reducing drug abuse. Keywords: Profile, drug addicts, Malaysia