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  1. Abdullah B, Idris S, Md Jaafar SA, Ghazali NLA, Mat Liki NS, Aminuddin AA
    Med J Malaysia, 2023 Nov;78(6):768-773.
    PMID: 38031219
    INTRODUCTION: The aim of this study is to determine the level of awareness of pelvic organ prolapse (POP) and factors that influence the attitude towards the treatment of POP among Malaysian women.

    MATERIALS AND METHODS: This was a cross-sectional study of 400 women from registered non-government organisations (NGOs) in Malaysia who voluntarily answered questionnaires distributed through Google form via emails. Data were analysed using descriptive statistics, independent t-test and one-way ANOVA test.

    RESULTS: Four hundred respondents participated in this study. The mean age was 40.42 years old (SD=12.566). The mean score for the studied population was 4.96 (SEM 0.124). Only 58 (14.5%) respondents obtained a score of eight or more, and 235 (58.8%) respondents scored between 4 and 7. The rest of 107 (26.7%) respondents scored 3 and less. There were statistically significant differences in the mean score for level of awareness between marital statuses, menopausal status, number of children and occupation. There were only 273 (68%) respondents who will seek treatment if they experience symptoms of POP. The most frequent reasons for not seeking treatment were unawareness of the availability of medical treatment for POP (69 %).

    CONCLUSION: Majority of the respondents have an inadequate level of awareness on POP. Although more than half of the respondents will seek treatment if they experience symptoms of POP, concerns raised by those who chose not to seek treatment should be addressed by a more effective public awareness programme. This includes the unawareness of the availability of medical treatment and the embarrassment to see medical practitioners.

    Matched MeSH terms: Cross-Sectional Studies
  2. Vu H, Khanh Tuong TT, Hoang Lan N, Quoc Thang T, Bilgin K, Hoa T, et al.
    Clin Ter, 2023;174(1):42-47.
    PMID: 36655643 DOI: 10.7417/CT.2023.5007
    BACKGROUND: Many non-invasive methods have been studied for assessing the severity of fatty liver disease and carotid intima-media thickness (CIMT). However, the correlation between hepatic steatosis and CIMT has not been fully studied, either globally or in Vietnam. This study investigated the association between nonalcoholic fatty liver disease (NAFLD) and CIMT.

    METHODS: A cross-sectional study was performed on 125 patients at the Cardiology Department, the Emergency Interventional Cardiology Department, and the Internal Cardiology Clinic of Thong Nhat Hospital.

    RESULTS: Among the 125 patients in our study population, NAFLD was diagnosed in 56%, and the mean CIMT was 0.89 ± 0.48 mm. Normal CIMT was measured in 21% of patients, whereas 79% had an elevated CIMT. The NAFLD rates were significantly different between patients with normal and increased CIMT, at 26.9% and 69.6%, respectively (p = 0.001).

    CONCLUSIONS: Our study revealed a strong association between NAFLD and CIMT. NAFLD is currently considered a feature of metabolic syndrome, and an increase in the prevalence of NAFLD might result in an increase in the incidence of cardiovascular disease.

    Matched MeSH terms: Cross-Sectional Studies
  3. Wider W, Tanucan JCM, Lin J, Jiang L, Udang LN
    PLoS One, 2023;18(12):e0294658.
    PMID: 38117775 DOI: 10.1371/journal.pone.0294658
    The first year of university is one of the most difficult times in a student's life due to numerous changes that occur. This cross-sectional study explores the concept of parental and peer attachment, which has been researched for its ability to predict students' success in higher education. Yet, less research has investigated the mechanisms underpinning the relationship between attachment and university adjustment among first-year students. Hence, the aim of this study was to examine the impact of parent and peer attachment on first-year university students, and understand how these attachments can facilitate university adjustment through identity exploration. This investigation is underpinned by Bowlby and Ainsworth's attachment theory and Arnett's emerging adulthood theory. Data were collected from 568 first-year students at a public university in Sabah, Malaysia, via adapted questionnaires. Structural equation modelling was employed using SmartPLS Software 3.0 to analyse the data. The study found that identity exploration mediates the relationship between parental trust, peer communication, and university adjustment. The findings of this study provide valuable insights for professionals working with emerging adult clients, especially those in higher education institutions, aiming to enhance the adjustment level among first-year students.
    Matched MeSH terms: Cross-Sectional Studies
  4. Haryanto, Amrullah S, Pratama SF, Agustini F, Pasmawati, Khairillah YN, et al.
    Med J Malaysia, 2024 Jan;79(1):60-67.
    PMID: 38287759
    INTRODUCTION: Research on diabetic foot ulcers (DFU) infection is limited to the first wound. Therefore, this study aimed to evaluate the relationship between wound classification (Wagner and SHID), and foot care against severity infection of DFU recurrent that may contribute to an increased susceptibility to infection among individuals with recurrent DFUs.

    MATERIALS AND METHODS: A cross-sectional design was used in this study involving 245 participants of type 2 diabetes mellitus (T2DM) was conducted at a Kitamura Wound Care Clinic, PKU Muhammadiyah, located in Pontianak, West Kalimantan, Indonesia, between September 2022 and February 2023. The Kruskal-Wallis test was used to assess the relationship between the foot care practices and infection status. A linear regression test to examine the independent risk factors.

    RESULTS: Wounds' characteristics regarding foot care practice group were significantly including more than 5 months wound heal from previous wounds (p = 0.045), the percentage of wound site on dorsal was higher in the foot care practice group (p < 0.001), the percentage had no deformity feet was higher in the foot care practice group (p < 0.001), the percentage had no previous amputation feet was higher in the foot care practice group (p < 0.001). Also, the percentage had grade three was higher in the foot care practice group (p < 0.001), the percentage had grade three was higher in the foot care practice group (p < 0.001), and the percentage had mild infection status was higher in the foot care practice group (p < 0.001). The predictors of diabetic foot infection were Wagner and SHID classification and foot care (p < 0.001, p < 0.001, and p < 0.01) respectively.

    CONCLUSION: This study demonstrated that foot-care behaviour in diabetic patients in Indonesia is poor. In addition, this study also has shown Wagner grading, SHID grading, and foot-care are predictors of infection in recurrent DFUs.

    Matched MeSH terms: Cross-Sectional Studies
  5. Bellato A, Sesso G, Milone A, Masi G, Cortese S
    J Am Acad Child Adolesc Psychiatry, 2024 Feb;63(2):216-230.
    PMID: 36841327 DOI: 10.1016/j.jaac.2023.01.017
    OBJECTIVE: To systematically investigate if there is a significant association between markers of autonomic functioning and emotional dysregulation (ED) in children and adolescents.

    METHOD: Based on a preregistered protocol (PROSPERO: CRD42021239635), PubMed, Web of Knowledge/Science, Ovid MEDLINE, Embase, and APA PsycInfo databases were searched until April 21, 2021, to identify empirical studies reporting indices of autonomic nervous system (ANS) functioning in youths meeting DSM (version III, IV, IV-TR, 5 or 5-TR) or International Classification of Diseases (ICD) (version 9 or 10) criteria for any psychopathological/neurodevelopmental condition and assessed for ED with a validated scale. Eligible outcomes included correlation coefficients between ED and ANS measures or differences in ANS measures between youths with and without ED. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS) and the Newcastle-Ottawa Scale (NOS) for cohort studies. Random-effects meta-analyses were used for data synthesis.

    RESULTS: There were 12 studies (1,016 participants) included in the descriptive review and 9 studies (567 participants) included in the meta-analyses. No evidence of a significant association between ED and altered cardiac or electrodermal functioning was found. However, exploratory meta-regressions suggested a possible association between reduced resting-state cardiac vagal control and increased ED.

    CONCLUSION: This study did not find evidence of an association between ED and autonomic dysfunction. However, preliminary evidence that reduced vagal control at rest might be a transdiagnostic marker of ED in young people was found. Additional studies comparing autonomic measures in youths with and without ED are needed and should also assess the effects of interventions for ED on ANS functioning.

    STUDY PREREGISTRATION INFORMATION: Systematic Review and Meta-Analysis: Is Autonomic Nervous System Functioning Atypical in Children and Adolescents With Emotional Dysregulation? https://www.crd.york.ac.uk/prospero/; CRD42021239635.

    Matched MeSH terms: Cross-Sectional Studies
  6. Alawadhi B, Alsaber A, Shatawan I, Al-Herz A, Setiya P, Saleh K, et al.
    Int J Rheum Dis, 2023 Dec;26(12):2430-2440.
    PMID: 37784239 DOI: 10.1111/1756-185X.14928
    BACKGROUND: Rheumatoid arthritis (RA) is a chronic, autoimmune disease that mostly affects the synovial joints. It has been hypothesized that dietary and other environmental and lifestyle factors contribute to the development of RA and its severity.

    OBJECTIVE: The present study aims to measure the effect of the Mediterranean diet (MedDiet) on the disease activity scores (DAS28) among patients with RA.

    METHODS: Adult patients who satisfied the American College of Rheumatology (ACR) classification criteria for RA from major hospitals in Kuwait were evaluated. A cross-sectional study conducted on 754 RA patients visits aged (21-79) years. Patients were evaluated using the DAS28. Patients' levels of adherence to the MedDiet are assessed using a validated 14-item Questionnaire (paper or web-based). The data was analyzed using both multivariate and univariate statistics. Multivariate logistic regression was used to analyze the statistical relationship between MedDiet and RA disease activity.

    RESULTS: The finding suggests that a MedDiet can have a positive impact on DAS28 among patients with RA. In the DAS28 cohort (DAS28 

    Matched MeSH terms: Cross-Sectional Studies
  7. Wu X, Zhang W, Li Y, Zheng L, Liu J, Jiang Y, et al.
    PLoS One, 2024;19(1):e0295118.
    PMID: 38166098 DOI: 10.1371/journal.pone.0295118
    BACKGROUND: As an important factor affecting personal health, anxiety has always been valued by people. Prior research has consistently shown that personality traits is associated with anxiety level,but little is known about the inner mechanism of this relationship. To fill the gap, the present research aims to explore the chain mediating role of general self-efficacy and academic burnout in the relationship between big five personality and anxiety.

    METHODS: This cross-sectional study was performed from September to November 2022. Self-reported questionnaires including the Big Five Personality Questionnaire, General Self-Efficacy Scale, College Student's academic burnout Scale, Generalized Anxiety Scale and demographic characteristics were distributed to 2505 college students in a university in Hebei Province, of which 2,471 were valid. Statistical analysis was carried out through SPSS26.0 and SPSS PROCESS macro.

    RESULTS: Results showed four of the big five personality characters (i.e., extraversion, agreeableness, conscientiousness, and openness) were negatively correlated with anxiety. Neuroticism was positively correlated with anxiety. Moreover, general self-efficacy was found to be negatively correlated with academic burnout and anxiety; academic burnout was positively correlated with anxiety. Finally, general self-efficacy and academic burnout mediated the relationship between personality traits (i.e., extraversion, agreeableness, neuroticism, openness) and anxiety.

    CONCLUSIONS: Personality traits (i.e., extraversion, agreeableness, neuroticism, and openness) could influence anxiety through the chain mediating effects of general self-efficacy and academic burnout. Interventions focusing on anxiety reduction may be successful in increasing general self-efficacy and decreasing students' academic burnout.

    Matched MeSH terms: Cross-Sectional Studies
  8. Vreeman RC, Yiannoutsos CT, Yusoff NKN, Wester CW, Edmonds A, Ofner S, et al.
    BMJ Open, 2023 Mar 13;13(3):e069399.
    PMID: 36914183 DOI: 10.1136/bmjopen-2022-069399
    OBJECTIVES: To assess access children with HIV have to comprehensive HIV care services, to longitudinally evaluate the implementation and scale-up of services, and to use site services and clinical cohort data to explore whether access to these services influences retention in care.

    METHODS: A cross-sectional standardised survey was completed in 2014-2015 by sites providing paediatric HIV care across regions of the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium. We developed a comprehensiveness score based on the WHO's nine categories of essential services to categorise sites as 'low' (0-5), 'medium', (6-7) or 'high' (8-9). When available, comprehensiveness scores were compared with scores from a 2009 survey. We used patient-level data with site services to investigate the relationship between the comprehensiveness of services and retention.

    RESULTS: Survey data from 174 IeDEA sites in 32 countries were analysed. Of the WHO essential services, sites were most likely to offer antiretroviral therapy (ART) provision and counselling (n=173; 99%), co-trimoxazole prophylaxis (168; 97%), prevention of perinatal transmission services (167; 96%), outreach for patient engagement and follow-up (166; 95%), CD4 cell count testing (126; 88%), tuberculosis screening (151; 87%) and select immunisation services (126; 72%). Sites were less likely to offer nutrition/food support (97; 56%), viral load testing (99; 69%) and HIV counselling and testing (69; 40%). 10% of sites rated 'low', 59% 'medium' and 31% 'high' in the comprehensiveness score. The mean comprehensiveness of services score increased significantly from 5.6 in 2009 to 7.3 in 2014 (p<0.001; n=30). Patient-level analysis of lost to follow-up after ART initiation estimated the hazard was highest in sites rated 'low' and lowest in sites rated 'high'.

    CONCLUSION: This global assessment suggests the potential care impact of scaling-up and sustaining comprehensive paediatric HIV services. Meeting recommendations for comprehensive HIV services should remain a global priority.

    Matched MeSH terms: Cross-Sectional Studies
  9. Yang M, Al Mamun A, Gao J, Rahman MK, Salameh AA, Alam SS
    Sci Rep, 2024 Jan 03;14(1):339.
    PMID: 38172184 DOI: 10.1038/s41598-023-50436-2
    Addressing the growing popularity of mobile health (m-Health) technology in the health industry, the current study examined consumers' intention and behaviour related to the usage of digital applications based on the unified theory of acceptance and use of technology (UTAUT). In particular, this study quantitatively assessed the moderating role of perceived product value and mediating role of intention to use m-Health application among Indonesians. This study adopted a cross-sectional design and collected quantitative data from conveniently selected respondents through an online survey, which involved 2068 Telegram users in Indonesia. All data were subjected to the analysis of partial least square- structural equation modeling (PLS-SEM). The obtained results demonstrated the moderating effect of perceived product value on the relationship between intention to use m-Health application (m-health app) and actual usage of m-Health app and the mediating effects of intention to use m-Health app on the relationships of perceived critical mass, perceived usefulness, perceived convenience, perceived technology accuracy, and perceived privacy protection on actual usage of m-Health app. However, the intention to use m-Health app did not mediate the influence of health consciousness and health motivation on the actual usage of m-Health app. Overall, this study's findings on the significance of intention to use m-Health app and perceived product value based on the UTAUT framework serve as insightful guideline to expand the usage of m-Health app among consumers.
    Matched MeSH terms: Cross-Sectional Studies
  10. Subramaniam Y, Loganathan N, Subramaniam T
    J Environ Manage, 2024 Feb;351:119646.
    PMID: 38042078 DOI: 10.1016/j.jenvman.2023.119646
    Governance has become indispensable within the healthcare sector, but previous studies have not explored the potential environmental benefits linked to healthcare governance. Thus, this study focuses on the role of governance in moderating healthcare and environmental emissions in 159 low, lower-middle, upper-middle and high-income countries. To do so, cross-sectional autoregressive distributed lag (CS-ARDL) techniques were applied using panel data from 1999 to 2021, followed by the computation of threshold and marginal effect of governance on healthcare and environmental emissions nexus. Findings revealed that, with the exception of high-income countries in the short run, governance has an insignificant impact on healthcare and emissions nexus in low-, lower-middle and upper-middle-income countries. Surprisingly, the findings imply that, in the long run, countries with greater levels of governance are likely to have lesser environmental impacts related to healthcare. There was also evidence indicating that low, lower-middle, upper-middle and high-income countries must reach a certain level of governance before realising the benefits of healthcare. Therefore, to achieve lower environmental impacts from healthcare, countries must promote effective governance policies that can incentivise and enforce sustainable practices and technologies in the healthcare sector.
    Matched MeSH terms: Cross-Sectional Studies
  11. Marzo RR, Su TT, Ismail R, Htay MNN, Essar MY, Chauhan S, et al.
    Front Public Health, 2022;10:998234.
    PMID: 36187686 DOI: 10.3389/fpubh.2022.998234
    INTRODUCTION: It is clear that medical science has advanced much in the past few decades with the development of vaccines and this is even true for the novel coronavirus outbreak. By late 2020, COVID-19 vaccines were starting to be approved by national and global regulators, and across 2021, there was a global rollout of several vaccines. Despite rolling out vaccination programs successfully, there has been a cause of concern regarding uptake of vaccine due to vaccine hesitancy. In tackling the vaccine hesitancy and improving the overall vaccination rates, digital health literacy (DHL) could play a major role. Therefore, the aim of this study is to assess the digital health literacy and its relevance to the COVID-19 vaccination.

    METHODS: An internet-based cross-sectional survey was conducted from April to August 2021 using convenience sampling among people from different countries. Participants were asked about their level of intention to the COVID-19 vaccine. Participants completed the Digital Health Literacy Instrument (DHLI), which was adapted in the context of the COVID Health Literacy Network. Cross-tabulation and logistic regression were used for analysis purpose.

    RESULTS: Overall, the mean DHL score was 35.1 (SD = 6.9, Range = 12-48). The mean DHL score for those who answered "Yes" for "support for national vaccination schedule" was 36.1 (SD 6.7) compared to 32.5 (SD 6.8) for those who either answered "No" or "Don't know". Factors including country, place of residence, education, employment, and income were associated with the intention for vaccination. Odds of vaccine intention were higher in urban respondents (OR-1.46; C.I.-1.30-1.64) than in rural respondents. Further, higher competency in assessing the relevance of online information resulted in significantly higher intention for vaccine uptake.

    CONCLUSION: Priority should be given to improving DHL and vaccination awareness programs targeting rural areas, lower education level, lower income, and unemployed groups.

    Matched MeSH terms: Cross-Sectional Studies
  12. Kariippanon KE, Chong KH, Janssen X, Tomaz SA, Ribeiro EHC, Munambah N, et al.
    Med Sci Sports Exerc, 2022 Jul 01;54(7):1123-1130.
    PMID: 35142711 DOI: 10.1249/MSS.0000000000002886
    PURPOSE: There is a paucity of global data on sedentary behavior during early childhood. The purpose of this study was to examine how device-measured sedentary behavior in young children differed across geographically, economically, and sociodemographically diverse populations, in an international sample.

    METHODS: This multinational, cross-sectional study included data from 1071 children 3-5 yr old from 19 countries, collected between 2018 and 2020 (pre-COVID). Sedentary behavior was measured for three consecutive days using activPAL accelerometers. Sedentary time, sedentary fragmentation, and seated transport duration were calculated. Linear mixed models were used to examine the differences in sedentary behavior variables between sex, country-level income groups, urban/rural settings, and population density.

    RESULTS: Children spent 56% (7.4 h) of their waking time sedentary. The longest average bout duration was 81.1 ± 45.4 min, and an average of 61.1 ± 50.1 min·d-1 was spent in seated transport. Children from upper-middle-income and high-income countries spent a greater proportion of the day sedentary, accrued more sedentary bouts, had shorter breaks between sedentary bouts, and spent significantly more time in seated transport, compared with children from low-income and lower-middle-income countries. Sex and urban/rural residential setting were not associated with any outcomes. Higher population density was associated with several higher sedentary behavior measures.

    CONCLUSIONS: These data advance our understanding of young children's sedentary behavior patterns globally. Country income levels and population density appear to be stronger drivers of the observed differences, than sex or rural/urban residential setting.

    Matched MeSH terms: Cross-Sectional Studies
  13. Kashtanov A, Molotok E, Yavorovskiy A, Boyarkov A, Vasil'ev Y, Alsaegh A, et al.
    PMID: 35162851 DOI: 10.3390/ijerph19031828
    Working in intensive care units (ICUs) is stressful and potentially leads to various psycho-emotional disorders. Today, this issue represents a serious concern to the healthcare sector and affects the quality of healthcare provided. This study aimed to assess and compare the psycho-emotional state in COVID-19 and non-COVID-19 hospitals' ICU healthcare workers (HCWs). From January to July 2021, we conducted an anonymous cross-sectional web survey of ICU physicians and nurses (N = 1259) of various hospitals in a metropolis with a population of over 10 million people. The statistical distributions of non-COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 14.6%, average 30.8%, and high 54.6%); depersonalization levels (low 11.6%, average 16.5%, and high 71.9%); and reduced personal accomplishment levels (low 23.5%, average 40.3%, and high 36.2%). The statistical distributions of COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 16.5%, average 31.5%, and high 52%); depersonalization levels (low 7.4%, average 9.4%, and high 83.1%); and reduced personal accomplishment levels (low 25.4%, average 45.4%, and high 29.1%). This study found a strong correlation between emotional exhaustion, aggression, and depersonalization in non-COVID-19 ICU HCWs and also found a correlation between their age, aggression, emotional exhaustion, and occupational stress.
    Matched MeSH terms: Cross-Sectional Studies
  14. Taleb S, Vahedian-Azimi A, Karimi L, Salim S, Mohammad F, Samhadaneh D, et al.
    BMC Psychiatry, 2024 Jan 22;24(1):61.
    PMID: 38254016 DOI: 10.1186/s12888-023-05088-x
    BACKGROUND: In light of several recent studies, there is evidence that the coronavirus disease 2019 (COVID-19) pandemic has caused various mental health concerns in the general population, as well as among healthcare workers (HCWs). The main aim of this study was to assess the psychological distress, burnout and structural empowerment status of HCWs during the COVID-19 outbreak, and to evaluate its predictors.

    METHODS: This multi-center, cross-sectional web-based questionnaire survey was conducted on HCWs during the outbreak of COVID-19 from August 2020 to January 2021. HCWs working in hospitals from 48 different countries were invited to participate in an online anonymous survey that investigated sociodemographic data, psychological distress, burnout and structural empowerment (SE) based on Depression Anxiety and Stress Scale 21 (DASS-21), Maslach Burnout Inventory (MBI) and Conditions for work effectiveness questionnaire (CWEQ_II), respectively. Predictors of the total scores of DASS-21, MBI and CWEQ-II were assessed using unadjusted and adjusted binary logistic regression analysis.

    RESULTS: Out of the 1030 HCWs enrolled in this survey, all completed the sociodemographic section (response rate 100%) A total of 730 (70.9%) HCWs completed the DASS-21 questionnaire, 852 (82.6%) completed the MBI questionnaire, and 712 (69.1%) completed the CWEQ-II questionnaire. The results indicate that 360 out of 730 responders (49.3%) reported severe or extremely severe levels of stress, anxiety, and depression. Additionally, 422 out of 851 responders (49.6%) reported a high level of burnout, while 268 out of 712 responders (37.6%) reported a high level of structural empowerment based on the DASS-21, MBI, and CWEQ-II scales, respectively. In addition, the analysis showed that HCWs working in the COVID-19 areas experienced significantly higher symptoms of severe stress, anxiety, depression and higher levels of burnout compared to those working in other areas. The results also revealed that direct work with COVID-19 patients, lower work experience, and high workload during the outbreak of COVID-19 increase the risks of negative psychological consequences.

    CONCLUSION: Health professionals had high levels of burnout and psychological symptoms during the COVID-19 emergency. Monitoring and timely treatment of these conditions is needed.

    Matched MeSH terms: Cross-Sectional Studies
  15. Zamli AH, Misnan NA, Lim SY, Zohdi WNWM, Baharum N, Andiappan K
    Asia Pac J Public Health, 2023 Nov;35(8):516-523.
    PMID: 37798930 DOI: 10.1177/10105395231203118
    Although post-COVID-19 condition (PCC) is a major public health concern, studies on PCC in Southeast Asia are lacking. This study aimed to describe PCC symptoms and its functional impact among COVID-19 survivors undergoing outpatient rehabilitation in Malaysia. We evaluated 3037 patients with confirmed COVID-19, referred between November 2020 and September 2022, 3 to 6 months after infection. PCC was diagnosed in 71.1%. Fatigue and dyspnea were the most common symptoms. The PCC patients had reduced respiratory, ambulatory, and musculoskeletal function, and higher fatigue and pain scores, and were less likely to return to work (odds ratio [OR] = 0.55) compared with non-PCC patients. Recognition of PCC symptoms and its functional impact can guide early, tailored, rehabilitation interventions.
    Matched MeSH terms: Cross-Sectional Studies
  16. 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.

    Matched MeSH terms: Cross-Sectional Studies
  17. Rahman AA, Mohamad N, Imran MK, Ibrahim WP, Othman A, Aziz AA, et al.
    Malays J Med Sci, 2011 Oct;18(4):63-8.
    PMID: 22589674 MyJurnal
    No previous study has assessed the impact of childhood disability on parents and family in the context of Malaysia, and no instrument to measure this impact has previously been available. The objective of this cross-sectional study was to determine the reliability of a Malay version of the PedsQL™ Family Impact Module that measures the impact of children with disabilities (CWD) on their parents and family in a Malaysian context.
    Matched MeSH terms: Cross-Sectional Studies
  18. Baharuddin KA, Mohamad N, Nik Abdul Rahman NH, Ahmad R, Nik Him NA
    Malays J Med Sci, 2010 Jan;17(1):17-22.
    PMID: 22135521 MyJurnal
    BACKGROUND: Pain management in the Emergency Department is challenging. Do we need to ask patients specifically about their pain scores, or does our observational scoring suffice? The objective of this study was to determine the inter-rater differences in pain scores between patients and emergency healthcare (EHC) providers. Pain scores upon discharge or prior to ward admission were also determined.
    METHODS: A prospective study was conducted in which patients independently rated their pain scores at primary triage; EHC providers (triagers and doctors) separately rated the patients' pain scores, based on their observations.
    RESULTS: The mean patient pain score on arrival was 6.8 ± 1.6, whereas those estimated by doctors and triagers were 5.6±1.8 and 4.3±1.9, respectively. There were significant differences among patients, triagers and doctors (P< 0.001). There were five conditions (soft tissue injury, headache, abdominal pain, fracture and abscess/cellulites) that were significantly different in pain scores between patients and EHC providers (P<0.005). The mean pain score of patients upon discharge or admission to the ward was 3.3 ± 1.9.
    CONCLUSIONS: There were significant differences in mean patient pain scores on arrival, compared to those of doctors and triagers. Thus, asking for pain scores is a very important step towards comprehensive pain management in emergency medicine.
    KEYWORDS: emergency medicine; neurosciences; pain assessment; pain management; pain score
    Study site: Emergency department, Hospital Kuala Lumpur
    Matched MeSH terms: Cross-Sectional Studies
  19. Nagaratnam S, Rajoo S, Bidin MBL, Rahim NSC, Tharmathurai S, Arip M, et al.
    J ASEAN Fed Endocr Soc, 2023;38(2):20-27.
    PMID: 38045672 DOI: 10.15605/jafes.038.02.13
    OBJECTIVE: The primary objective was to assess beta-cell function of recently-diagnosed young-onset type 2 diabetes mellitus (T2DM) individuals using basal and stimulated C-peptide levels. The secondary objective was to examine the association between C-peptide with metabolic factors and diabetes complications.

    METHODOLOGY: A cross-sectional study was conducted for young-onset T2DM individuals aged 18-35 years with a disease duration of not more than 5 years. Plasma C-peptide was measured before and after intravenous glucagon injection. Demographic data, medical history and complications were obtained from medical records and clinical assessment. Continuous data were expressed as median and interquartile range (IQR). Categorical variables were described as frequency or percentage. Multivariable linear regression analysis was used to determine factors associated with C-peptide levels.

    RESULTS: 113 participants with young-onset T2DM with a median (IQR) age of 29.0 (9.5) years and 24 (36) months were included in this study. The median (IQR) basal and stimulated C-peptide was 619 (655) pmol/L and 1231 (1024) pmol/L. Adequate beta-cell function was present in 78-86% of the participants based on the basal and stimulated C-peptide levels. We found hypertension, obesity and diabetic kidney disease (DKD) to be independently associated with higher C-peptide levels. In contrast, females, smokers, those on insulin therapy and with longer duration of disease had lower C-peptide levels.

    CONCLUSION: Most recently diagnosed young-onset T2DM have adequate beta-cell function. Elevated C-peptide levels associated with obesity, hypertension and diabetic kidney disease suggest insulin resistance as the key driving factor for complications.

    Matched MeSH terms: Cross-Sectional Studies
  20. Low HJ, Cheah OK, Ng BH, Siti Nidzwani MM, Wan Rahiza WM, Liu CY
    Med J Malaysia, 2024 Nov;79(6):764-769.
    PMID: 39614796
    INTRODUCTION: Anaesthesiology is a high-demand speciality with 24-hour on-call shifts, which can lead to significant stress and impaired sleep quality among anaesthetists. Nonpharmacological interventions like acupuncture have been widely explored for stress relief. This study aims to evaluate the impact of transcutaneous electrical acupoint stimulation (TEAS) on physiological parameters, specifically heart rate variability (HRV) and sleep quality, in anaesthesiology trainees following 24-hour on-call duty.

    MATERIALS AND METHODS: A total of 38 anaesthesiology trainees, following 24-hour ICU on-call shifts, were recruited for this single-centre cross-sectional clinical trial. The participants were required to complete two 24-hour on-call duties. Demographic data and baseline sleep quality assessments were collected following the first on-call duty. Upon completion of the second on-call shift, participants underwent 20 minutes of TEAS at bilateral PC6 (Neiguan), LI4 (Hegu), LR3 (Taichong), and ST41 (Jiexi) points. Heart rate variability (HRV) parameters, blood pressure, and heart rate were recorded before and after TEAS. Post-TEAS sleep quality was assessed following an overnight rest.

    RESULTS: The results demonstrated a significant reduction in systolic blood pressure compared to baseline (109.5±8.9 vs 111.9±10.1 mmHg, p = 0.006), as well as a significant decrease in diastolic blood pressure (69.3±8.0 vs 70.9±9.0 mmHg, p = 0.037) and heart rate (65.8±9.2 vs 67.4±9.8 bpm, p = 0.034). There was significant improvement in all aspects of sleep quality (p < 0.001). However, no statistically significant changes were observed in heart rate variability (HRV) parameters, including high-frequency (HF) power, lowfrequency (LF) power, and the LF/HF ratio.

    CONCLUSION: TEAS may offer potential benefits in managing cardiovascular stress and improving sleep quality in highstress environments, such as post-call recovery. Nevertheless, its impact on autonomic nervous system regulation, as reflected by HRV, appears limited.

    Matched MeSH terms: Cross-Sectional Studies
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