Reflection is a process of reviewing an experience of practice in order to describe, analyse and evaluate information. This leads to critical reflection which one can view and focus on self-experience within the context of his/her own life. Objective: The study aims to understand palliative care values with the use of reflective diary following home visit to patients who require palliative care.
Method: Interview was performed during the house visit by the undergraduate medical students. This outreach house visits were supervised under community palliative care nurse. The students were required to develop a learning activity, using assessment of palliative care patients’ needs, through qualitative questionnaire. This was recorded in the reflective diary upon return of such activity. The questions asked covered explorative learning and holistic medical tasks such as the impact of patient’s life from emotional, psychosocial, medical and spiritual perspective. Guided questioning was done to avoid
unnecessary communication issues that may aggravate emotional distress. Students were asked to probe using vetted and agreed questions, and explore multidimensional issues in relation to culturally naïve Kelantanese population.
Result: Enjoyful learning experience was recorded. The reality of thisdealing with patients with chronic disease has put forth a positive intention to perform better as future doctors.
Conclusion: Reflective diary is an effective tool in community palliative care learning. It documents patients’ plight and students’ sense of responsibility to community. This has invaluable and indirect learning impact as part of the students’ soft skills development.
Fatigue due to driving is an important aspect in maintaining drivers’ performance and safety. There are many studies linking fatigue to reduction in performance and increase in accident risk. There are also some signs linking road and vehicle vibrations to fatigue, but this not been thoroughly investigated. Experiments have been made to detect and quantify levels of driving fatigue in human, usually involving driving over long distance of highway or normal roads. However, these methods are quite time consuming, high cost, hard to control and also potentially high risk. With the development of better display, computing power and motion technologies, driving simulators are becoming more and more realistic each year. With this insight, it is proposed that these driving simulators can be used as a tool to study human fatigue, where they can counter the above shortcomings significantly. This paper will review different methods conducted in past published works to investigate the viability and validity of using driving simulators as a tool for studying vibration matters and its effects on human fatigue. In this paper, there were twenty past studies have been reviewed in term of its simulator design and its study design. The selection is based on these keywords; simulator, fatigue, vibration, human and driver and all papers were filtered from 1990s to current year.
Introduction: In view of high healthcare expenditure, Malaysia also faces problems in healthcare financing. The policy option is to establish a national health financing scheme. However, it is a problem to develop mechanisms to cover social insurance package to more than one third of the population working in informal sector such as farmers. Therefore, there is an urgent need to assess the ability and willingness of the farming community. The main objective was to study the ability and willingness in the farming community to contribute to national healthcare financing scheme.
Methodology: This a cross sectional study involved 400 farmers in Selangor. A total of 92.3% farmers were able to pay for the healthcare.
Results: Willingness to contribute to The national healthcare financing scheme were RM2.00 per month.
Conclusion: The education level influenced the ability to pay while the educational level and per capita income influenced willingness to pay.
Background: A randomised clinical trial was carried out to study the cost-effectiveness of continuous venovenous hemofiltration using high volume and standard volume.
Methods: Study was done through interviews involving patients or their relatives and document review on patients’ treatment and progress note during the hemofiltration therapy in the Intensive Care Unit, Hospital University Kebangsaan Malaysia. Study also involved secondary data analysis and a structured questionnaire survey to assess the treatment and medical cost incurred by the hospital during the continuous venovenous hemofiltration therapy.
Results: The result of this study showed that the continuous venovenous hemofiltration given at high volume 4-6 litres/hour is more cost effective than standard volume of 2 litres/hour. The Sequential Organ Failure Assessment (SOFA) score reduction in the high volume hemofiltration is 3.0 units over 24 hours. This reduction is higher than the standard volume hemofiltration which is only 0.5 unit over 24 hours.
Conclusions: High volume hemofiltration is more cost effective than standard volume therapy, where only RM 5,552 compared to RM 23,512 is needed for every one unit of SOFA score reduction respectively.
Helicobacter pylori has been implicated as an aetiologic agent for type B chronic gastritis, peptic ulcer and gastric cancer. It is considered the most common bacterial infection in the world with approximately 50% of the population being infected. The majority of infected individuals are asymptomatic, with some developing gastritis only. However, chronic infection with H. pylori without antibiotic treatment predisposes infected individuals to the development of gastric cancer. The aim of this study is to determine active H. pylori infection among patients with symptoms of dyspepsia using three combinations of diagnostic methods. In this report, we studied 1,376 consecutive patients who underwent upper gastrointestinal endoscopy at Universiti Kebangsaan Malaysia Medical Center (UKMMC) for dyspepsia from the period January 1999 to December 2002. The classification of patient’s diagnosis was assessed by endoscopic and histological examination. The H. pylori status was determined by rapid urease test, histological examination or H. pylori culture. Presence of H. pylori infection was confirmed in 30.8% of patients with dyspepsia. H. pylori infection was more prevalent in older patients and in males compared to females. Patients with severe gastroduodenal diseases were more commonly infected with H. pylori. There was a significant difference in H. pylori prevalence among the different ethnic groups. Indians had the highest infection rate (45.4%), followed by Chinese (36.8%) and the lowest were seen in Malays (18.3%). This finding on determination of active H. pylori infection among patients with dyspepsia is consistent with serological studies that showed racial differences in H. pylori prevalence. However, the pattern of H. pylori infection does not reflect the prevalence of severe gastroduodenal diseases among different ethnic groups.
Introduction: Attitudes towards animal welfare are important in influencing how animals are treated. Studies of attitudes towards animal welfare in veterinary students are scarce. It is hope that the findings will enhace a diverse research in the future in order to explore variety of factors in relation to animal welfare since such study is currently limited.
Objective: The study is to determine the associations of gender,year of study and empathy level of undergraduate DVM students in UPM into their attitude towards animal welfare.
Method: Questionnaires were given to 440 Doctor of Veterinary Medicine undergraduate students in UPM to study the associations between gender,year of study and empathy level with attitudes towards animal welfare. Data were collected from respondents through two sets of self guided questionnaires. Interpersonal Reactivity Index (IRI) which assessed empathy level where only two sub-scales from the IRI were used. Empathic Concern (EC) and Perspective Taking (PT). Animal Attitude Scales (AAS) were used to assess attitudes towards animal welfare. Data collected were analysed using Statistical Package for Social Science (SPSS) version 20.
Result: 367 (83.4%) out of 440 students participated in this study. Antu-animal welfare attitude (74.9%) was the highest compared to the pro-animal welfare attitude (25.1%). Analysis showed a significant difference (p0.005) between gender and attitudes towards animal welfare (p=0.057) as well as between empathy level and attitudes towards animal welfarefor empathic concern sub-scale (p=0.194) and perspective taking sub-scale (p=0.320).
Conclusion: Majority of sudents were categorized as anti-animal welfareand the attitudes were significantly different among years of study. Female and malestudents have nomsignificant differences in their attitudes towards animal welfare. Students with ggod and poor empathy level also have no significant difference in their attitudes towards animal welfare.
Background : Two of the most common indicators of institutional healthcare quality are Hospital Accreditation Status and Patient Satisfaction. However, the relationship between them is not well understood. In Malaysia, only 20.48% hospitals have been accredited. This is very much less compared to hospitals in America, Europe, Australia and certain Asian countries whereby 90% of their hospitals have already been accredited.
Objective : The objective of this study was to compare the extent to which a patient’s satisfaction is related to hospital accreditation status, to examine the relationship between patient satisfaction and hospital work load and to determine factors that influence patients’ satisfaction.
Methodology : A cross-sectional study was conducted whereby 150 patients from each accredited and non-accredited hospital involved in this study group giving a total of 300 samples. `SERVQUAL’ instrument was used in this study. Patients were interviewed at 2 different times - during admission and upon discharge.
Result : Results showed 34.7% patients were satisfied with services in accredited hospital and 30.6% patients were satisfied with services in non-accredited hospital. `Corporate Culture’ component showed the lowest satisfaction score among the entire dimension in both categories hospitals. Patient satisfaction was noted to be reduced with increase in hospital work load. Other factors which significantly influence patient satisfaction include level of education, employment status and patient income. There was no significant difference in patient satisfaction between accredited and non-accredited hospital in all dimension measured.
Conclusion : Therefore there is no difference of patients’ satisfaction with regards to services provided by accredited and non-accredited hospitals.
The present study was carried out to determine the concentrations of selected metal elements (lead, copper, manganese, zinc and iron) in 51 samples of commercial drinking water and tap water available in Malaysia. The results indicated that low metal elements were found in the studied water samples. Lead, manganese, zinc and iron were not detected in some of the studied samples, except copper. The concentrations of the metal elements in the studied samples were well below the maximum permitted concentrations as recommended. Therefore these drinking water are safe for consumption and do not pose adverse effect to the health of consumers due to metal toxicity.
β-tricalcium phosphate (β-TCP) powders were synthesized by using various particles sizes (40 nm – 780 μm) calcium carbonate (CaCO3) and phosphoric acid (H3PO4) at room temperature (25 ˚C). The synthesized powders were characterized by using X-Ray Diffraction (XRD) method. The purity of β-TCP powders were determined from XRD pattern while the crystallite size of β-TCP powders were calculated by using Scherrer equation. Results shows that the purity of β-TCP powders were ranged from 20.33 % to 81.94 % while the crystallite size of β- TCP powders were ranged from 0.04391 μm to 0.06751 μm. From this work, particle size of CaCO3 will influenced the purity but not the mean crystallite size of synthesized β-TCP.
The blended wing body (BWB) aircraft has a unique design. The main body and wing of BWB are
merged to increase the lift force on the aircraft. However, BWB has poor stability arising from the absence of the tail. Hence, a small horizontal stabilizer called as canard has been incorporated in front of the main wing to improve BWB’s stability. Computational Fluid Dynamics (CFD) simulations conductedm to obtain the aerodynamics parameters of the BWB i.e. lift, drag and moment coefficients, showed that overall, the canard is beneficial to the BWB aerodynamics performance.
Construction industry is one of the major contributors towards Malaysian economy and socio-economy. It is an important
industry gearing Malaysia towards developed nation status. However, fatalities in this industry are a crucial problem. Number of
fatalities in this industry is the highest compare to other industries registered in Malaysia. The contributing factors can be separated
into immediate (human and worksite elements) and underlying (management and external). Occupational safety and health (OSH)
management is a challenge in the construction industry due to its hazardous nature. A framework of construction OSH management
consisting of policy, process, personnel and incentive elements were tested. 13 respondents from 13 residential projects comprising of
high-rise and low-rise in Pulau Pinang were interviewed. It was found that the immediate factors are being more recognized by the
respondents compare to the underlying factors. Human element is perceived as the most significant contributor, while the external
element is the least significant. In terms of construction OSH management, process and personnel elements are the most significant in
developing an effective OSH management programme.
Introduction The availability of obesity specific quality of life measurement tool is limited. The Malay version of Impact of Weight on Quality of Life-Lite is an obesity specific quality of life questionnaire which has been translated for use in Malaysia. The aim of this study is to evaluate the validity and reliability of this questionnaire to measure quality of life among different body mass index (BMI) groups.
Methods One hundred and twenty subjects with different BMI categories who attended an outpatient government clinic were recruited for this study. The translated Malay version of IWQOL-Lite was used to assess the impact of weight on quality of life of respondents. Content validity, criterion validity and construct validity were used to assess the questionnaire validity while internal consistencies and test-retest reliability were used to assess the questionnaire reliability.
Results The Malay version of IWQOL-Lite showed good psychometric properties. The content validity was agreed upon by expert panels. The mean score of all IWQOL-Lite domains were able to discriminate between different BMI groups. Good internal consistency was demonstrated by Cronbach alpha of 0.936. Test-retest reliability ranged from 0.828 to 0.932. The physical function score (IWQOL-Lite) correlated positively with Physical Component Summary of Short Form-36 questionnaire. Exploratory factor analysis found that the questions loaded on their respective five domains.
Conclusions The results suggested that the Malay version of IWQOL-Lite is a valid and reliable tool to measure quality of life among obese and overweight subjects in Malaysia.
Entomologi forensik adalah satu bidang ilmu yang menggunakan serangga sebagai bahan bukti untuk menganggarkan selang masa kematian atau selang post-mortem (PMI). Penentuan PMI tersebut berdasarkan kepada saiz dan peringkat perkembangan serangga. Chrysomya villeneuvi merupakan salah satu spesies langau yang boleh dijadikan sebagai petunjuk yang baik untuk menganggarkan PMI apabila ia ditemukan pada mayat. Kajian ini bertujuan untuk menghasilkan suatu data asas dan graf perkembangan bagi lalat Ch. villeneuvi pada suhu yang berbeza. Data yang diperoleh juga digunakan untuk membangunkan jadual jam darjah terkumpul (ADH). Justifikasi kajian dijalankan kerana data perkembangan lalat spesies ini belum dibangunkan di Malaysia. Penentuan PMI terpaksa dilakukan dengan berpandukan kepada data perkembangan Ch. megacephala. Ini akan menyebabkan pengiraan PMI menjadi kurang tepat. Kajian terdahulu juga hanya melibatkan kajian berkaitan morfologi dan tingkah laku spesies ini. Kajian perkembangan telur, larva dan pupa lalat Ch. villeneuvi dijalankan pada suhu bawah 25, 27, 30, 33 dan 37ºC di makmal dengan menggunakan kebuk pertumbuhan serangga. Sumber asal lalat dewasa diperoleh dengan meletakkan bangkai tikus di Pusat Penyelidikan Universiti Malaya, Batu 16, Gombak. Lalat dewasa dipelihara di makmal untuk dijadikan sumber koloni. Lebih kurang 150 biji telur dibiakkan dengan meletakkannya ke dalam bekas yang mengandungi 200 g hati lembu sebagai sumber makanan untuk larva yang baru menetas. Lima ekor larva diukur panjangnya setiap tiga jam untuk mendapatkan satu nilai purata untuk setiap suhu. Pemprosesan slaid dan pengambilan foto larva dilakukan untuk mengetahui peringkat perkembangan larva. Ch. villeneuvi mengambil masa selama 9.40 ± 0.02 hari pada suhu 25ºC, 9.34 ± 0.04 hari (27ºC), 9.00 ± 0.07 hari (30ºC), 7.95 ± 0.02 hari (33ºC) dan 7.51 ± 0.02 hari (37ºC) untuk melengkapkan satu kitar hidup. Pada suhu pembiakan yang berbeza, terdapat perbezaan signifikan (p<0.001) ke atas masa perkembangan kitar hidup lalat Ch. villeneuvi. Semakin tinggi suhu dan nilai ADH, semakin pendek satu kitar hidup lalat Ch. villeneuvi. Kajian ini menyatakan tentang tempoh peringkat dalam kitar hidup berdasarkan suhu membantu dalam pembangunan data ADH. Penyiasat forensik di Malaysia boleh menganggarkan PMI berdasarkan graf perkembangan dan data ADH yang diperoleh daripada kajian ini apabila Ch. villeneuvi ditemui pada mayat.
The Malacca Straits is located between Peninsula Malaysia and Sumatra Island. This investigation used equation of motion (Navier-Stokes equation) with the following driving forces: tides, wind of National Centers for Environmental Prediction (NCEP) for year of 2007, salinity and temperature. The equation of motion was solved by means of Hamburg Shelf Ocean Model (HAMSOM). The results for both southwest and northeast monsoon were explained and discussed. The simulation results both for February and August 2007 were relatively similar. Current surface simulation in the Malacca Straits agrees well with the current pattern of previous works. The magnitude of current was between 10-70 cm/s to the northwest. While at the layer 30-50 m in the Malacca Straits, the currents have the magnitude of 10-30 cm/s towards northwest. For the bottom current, the current speed was 0-20 cm/s towards northwest. For the surface and 30-50 m layer, generally the current magnitudes were greater in February compared to those in August. While for the bottom layer, the current magnitudes between February and August were relatively the same.
Rowing has two stroke phases: the drive phase and recovery phase. The objective of our study was to evaluate the changes of drive to recovery ratio during rowing on a dynamic ergometer. Ten male national junior rowers participated in the study. Three-dimensional motion was recorded using nine infrared cameras. Rowing motions were captured in ten strokes for every 500m section of 2000m rowing time trial on a dynamic ergometer. Two-way ANOVA was performed to compare the duration of drive and recovery phases across 500m sections of 2000m time trial. The findings showed that there were no significant interactions between drive and recovery phases and distance covered. However, there was significant interaction between the duration of the recovery phase and distance covered. Participants were consistent in maintaining the duration of drive and recovery phase at 500m, 1000m, and 1500m; in the final 500m section, the rowers sprinted as fast as possible with high stroke rates. Drive to recovery ratio across 2000m dynamic ergometer rowing was 1:1. From the study, the strategy to minimise time to completion may be managed by adjusting the time spent during drive and recovery phases in each section of the 2000m time trial. Crew pairings can be conducted according to personal drive to recovery ratio to enhance rowing synchronisation.
This paper demonstrates the performance experiment and numerical prediction of the copper based hair cell for
underwater sensing. Generally, the hair cell consists of the single cantilever that attached perpendicular to the substrate
and integrated with strain gage (Kyowa type: KFG-1N-120-C1-11). The hair cell sensor was simulated using different
flow rates to study the pressure and the strain distribution acting on the sensor by using computational fluid dynamic
and finite element analysis approach. High performance sensor can be achieved by increasing the length of the hair cell
and also using low Young Modulus material. The hair cell has been fabricated for dimension of 8000 μm length, 2000
μm width and 100 μm thickness, where the copper was chosen due to its mechanical properties. The response time for
a sensor to respond completely to a change in input is about 50 m/s and the sensitivity in terms of output voltage and
input flow rate is 0.2 mV/ms-1. Also, the result obtained in the simulation is aligned with the experimental result. The
experiment for moving object detection proved that this sensor is able to detect the moving object and it is necessary for
underwater applications, especially for monitoring and surveillance.
Cymbopogan citratus fibre (CCF) is an agricultural waste plant derived from a natural cellulosic source of fibre that can be used in various bio-material applications. This paper beneficially prepared thermoplastic cassava starch/palm wax blends incorporated with Cymbopogan citratus fibre (TCPS/PW/CCF) bio-composites at different CCF concentrations of 0, 10, 20, 30, 40, 50 and 60 wt%. In contrast, palm wax loading remained constant at 5 wt% concentration using the hot moulding compression method. TCPS/PW/CCF bio-composites were characterised in the present paper via their physical and impact properties. The addition of CCF significantly improved impact strength by 50.65% until 50 wt% CCF loading. Furthermore, it was observed that the inclusion of CCF resulted in a little decrement in biocomposite solubility compared to neat TPCS/PW biocomposite from 28.68% to 16.76%. Water absorption showed higher water resistance in the composites incorporating 60 wt.% fibre loading. The TPCS/PW/CCF biocomposites with different fibre contents had 11.04-5.65% moisture content, which was lower than the control biocomposite. The thickness of all samples decreased gradually with increasing fibre content. Overall, these findings provide evidence that CCF waste can be utilised as a high-quality filler in biocomposites due to its diverse characteristics, including improving the properties of biocomposites and strengthening their structural integrity.
Current study reported a facile method to investigate the effects of stacking sequence layers of hybrid composite materials on ballistic energy absorption by running the ballistic test at the high velocity ballistic impact conditions. The velocity and absorbed energy were accordingly calculated as well. The specimens were fabricated from Kevlar, carbon, and glass woven fabrics and resin and were experimentally investigated under impact conditions. All the specimens possessed equal mass, shape, and density; nevertheless, the layers were ordered in different stacking sequence. After running the ballistic test at the same conditions, the final velocities of the cylindrical AISI 4340 Steel pellet showed how much energy was absorbed by the samples. The energy absorption of each sample through the ballistic impact was calculated; accordingly, the proper ballistic impact resistance materials could be found by conducting the test. This paper can be further studied in order to characterise the material properties for the different layers.
The drinking and mineral water samples obtained from different geographical locations had concentrations of the selected minerals lower than the standard limits, except for manganese, arsenic, and fluoride. The concentrations of manganese and arsenic in two mineral water samples were slightly higher than the standard international recommended limits. One mineral water sample had a fluoride concentration higher than the standard limits, whereas manganese was not detected in nine drinking and mineral water samples. Most of the selected minerals found in the tap water samples were below the international standard limits, except for iron and manganese. The concentrations of iron and manganese in the tap water samples were higher than the standard limits, which were obtained from one and three of the studied locations, respectively. The potable water obtained from various manufacturers and locations in Peninsular Malaysia is safe for consumption, as the minerals concentrations were below the standard limits prescribed by the Malaysian Food Regulations of 1985. The data obtained may also provide important information related to daily intake of these minerals from drinking water.
A young man with HIV presented with biliary peritonitis secondary to spontaneous common bile duct perforation. Investigation revealed that the perforation was due to Mycobacterium tuberculosis. Tuberculosis of the bile duct is uncommon and usually presents with obstructive jaundice due to stricture. Bile duct perforation due to tuberculosis is extremely rare. Its management is discussed.