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The Use of Benzodiazepines among Kratom (Mitragyna Speciosa Korth.) Users

Singh D, Narayanan S, Grundmann O, Boyer EW, Vicknasingam B

J Psychoactive Drugs, 2019 06 20;52(1):86-92.
PMID: 31218929 DOI: 10.1080/02791072.2019.1632505

The leaves from Mitragyna speciosa (Korth.) trees, also known as kratom, are traditionally used in Southeast Asia as a mild psychotropic agent. We investigated the demographic characteristics of persons who used both kratom cocktail and benzodiazepines (BZO) in a sample drawn from a rural area in Penang, Malaysia, and the reasons for BZO use. Seventy-seven participants who currently use a kratom cocktail along with BZO were recruited through snowball sampling for this cross-sectional study. The participants were male, and the majority were Malays (99%, n = 76/77), single (57%, n = 44/77) and employed (91%, n = 70/77). BZO was used with kratom cocktail 1) to increase euphoria; 2) to reduce dependence on methamphetamine; 3) to promote sleep; 4) to ease methamphetamine-associated psychological symptoms and 5) to decrease the craving for kratom. There were no significant differences in the intake of kratom use (p = .751), BZO use duration (p = .259), frequency (p = .188) and quantity (p = .888) of BZO use in the last 7 days, and quantity of BZO use in the last 30 days (p = .337) between kratom users and kratom poly-drug users. An awareness of the health consequences of the co-use of kratom with BZO is needed to prevent untoward health incidents.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Healthcare Student Attitudes Toward Vulnerable Patient Populations: Potential Impact For Perpetuating Suboptimal Care [Thesis]

Jin H

Citation: Jin H. Healthcare Student Attitudes Toward Vulnerable Patient Populations: Potential Impact For Perpetuating Suboptimal Care. PhD Thesis. Yale University, United States, 2013.
Objective: Stigma endorsed by healthcare providers has been found to be a barrier to care for vulnerable populations, including HIV-infected, people who inject drugs (PWID), and men who have sex with men (MSM) in multiple clinical contexts. We therefore sought to better understand the extent to which stigma is levied toward these three populations by medical and dental students.
Design: This cross-sectional study assessed the attitudes of 1,296 medical and dental students towards HIV-infected, PWID, and MSM patients.
Methods: Students were asked to score their attitudes towards these patient groups using a feeling thermometer, indicating their attitudes on a sliding scale from 0, meaning very negative, to 100, meaning very positive.
Results: The mean attitude score towards the general patient population (M = 76.50, SD = 20.35) was significantly higher than the scores for HIV-infected patients (M = 54.04, SD = 20.99), PWID patients (M = 37.50, SD = 24.41), and MSM patients (M = 32.13, SD = 29.33).Further, certain demographic variables, most notably religion, ethnicity, and personally knowing someone of these populations, were associated with significant differences in attitudes.
Conclusion: Healthcare students represent the next generation of clinicians who will be responsible for HIV prevention and treatment efforts in the future. Our findings suggest that negative attitudes towards these patients is extremely high, and it is therefore crucial to design interventions to ameliorate the negative attitudes of medical students towards vulnerable populations.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Universiti Sains Malaysia (USM) pre-clinical medical students’ guidance and counselling needs questionnaire: a confirmatory factor analysis

Mohd Zarawi Mat Nor, Najib Majdi Yaacob

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):118-123.
MyJurnal

Introduction: The USM Pre-clinical medical students’ guidance and counselling needs questionnaire (USM-MS- GCN-Q) is an English-language guidance and counselling needs questionnaire which was developed specifically for pre-clinical medical students. The aim of this study is to highlight the construct validity of USM-MSGCN-Q among pre-clinical medical students. Methods: In June 2017, a cross-sectional study on 208 pre-clinical medical students was conducted in Universiti Sains Malaysia (USM). This self-administered USM-MSGNC-Q consisted of four constructs and 20 items with a 5-point Likert scale within each item. A confirmatory factor analysis was em- ployed to test the hypothesized measurement model. Results: The final measurement model fitted the data well. The four-factor model initially consisted of 20 items however, it was reduced to 18 items with the goodness of fit indices suggesting good model fit (RMSEA 0.89, GFI .915 and ChiSq/df 2.642). Internal consistency reliability (Cronbach’s alpha) was 0.879 for self-leadership skills, 0.929 for communication skills, 0.871 for learning skills, and 0.870 for psychological coping skills. The overall Cronbach’s value was 0.922. Respective composite reliability values were 0.879,0.952,0.879 and 0.835 while the Average Variance Extracted values were 0.729, 0.911, 0.595 and 0.630. Conclusion: This study has confirmed that self-leadership, communication, learning and psychological coping skills were the components of guidance and counselling needs which influences the effectiveness of guidance and coun- selling sessions with pre-clinical medical students.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Prevalence and associated factors of depression, anxiety and stress among doctors in North Borneo

Syarifah Nurul Ain, Chua Sze Hung, Aida Nurbaini Arbain, Sarah Marilyn Amin, Teoh Eu Vin, Ferro Firdaus Ibrahim, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):124-131.
MyJurnal

Introduction: Doctors are known to deal with high occupational stress, causing increased risk of depression, anxi- ety and stress.Nevertheless, the prevalence and associatedfactors of depression, anxiety and stress among registered doctorsworking in 24 public hospitals in Sabah, Malaysia are not known yet. Methods: This cross-sectional study was conducted using convenient sampling from September-October 2018. The data of 21-item Depression Anxiety Stress Scale (DASS-21) was collected via online link anonymously. Results: Among 314 doctors, majority of them were females (62.1%), mean age 29 (SD 2.72), non-Sabahan (82.8%), Malays (46.8%), not married (78.3%) and medical officers (93.6%). Prevalence of severe/extremely severe anxiety symptoms was 27.4%,depression (22.9%) and stress (18.5%). Doctors perceiving themselves to be depressed, anxious and/or stressed were more likely to develop the corresponding symptoms. Females and Chinese were twice more likely to report anxiety symptoms. Being married had protective effect against depressive symptoms, while working in same hospital for longer time had a significant but weak protective effect against anxiety and stress symptoms. Conclusions: Mental health issue among doctors is substantial and need to be addressed effectively for the benefit of their life, patients and country.

Matched MeSH terms: Cross-Sectional Studies
Fulltext An assessment of the level of awareness, attitudes, and opinions of the medical students concerning HIV and AIDS in Malaysia

Verma RK, Wong S, Chakravarthi S, Barua A

J Clin Diagn Res, 2014 Apr;8(4):HC10-3.
PMID: 24959464 DOI: 10.7860/JCDR/2014/7829.4286

INTRODUCTION:Human Immunodeficiency virus infection (HIV) and Acquired Immunodeficiency Syndrome (AIDS) has become one of the most serious health problems in the world. Medical students awareness, attitudes and opinions must be assessed as they are leading health care professionals who provide treatment and care to the HIV and AIDS individuals. This survey was conducted to assess the level of awareness, attitudes and opinions of third year till fifth year medical students concerning HIV and AIDS from universities around Klang Valley area, Malaysia.
MATERIALS AND METHODS:A total of 327 medical students of third to fifth been took part in the survey. Self prepared and self validated questionnaire was used to assess the study outcomes. Students were asked to fill the consent forms before filling the questionnaires. The results were analyzed by using SPSS version 17. A cross-sectional study among medical students was performed. Data was analyzed with non-parametric spearman's correlation test to find the difference at p-value < 0.05.
RESULTS: A great majority knew that HIV can be spread via tattoo or body piercing (89.3%), from mother to child (97.9%), being a homosexual (93.3%) and even having circumcision for protection (71.9%). Also, they were aware that HIV cannot be transferred via sneezing and cough (95.1%), swimming pools (89.0%), and toilet seats (89.6%). However, only a few were aware of other modes of transmission, such as visiting the barbers (41.3%) , and having blood splashed on outer body surface including mouth and eyes (49.2%). Only a few negative attitudes were shown such as being unsure about keeping close vicinity to HIV patients and being unsure of whether HIV negative people should be allowed to marry HIV positive patients (median=3).
CONCLUSION: An optimal plan of education with awareness campaign and preclinical experiences should be made in the future curriculum to increase the knowledge, confidence and minimize phobia among students.
KEYWORDS: Cross-sectional study; Prevention; Transmission
Study site: Two universities in Klang Valley, Malaysia

Matched MeSH terms: Cross-Sectional Studies
Fulltext Determinants of childhood vaccination in Nagaland, India: a cross-sectional study with multilevel modelling

Kim YE

BMJ Open, 2021 04 14;11(4):e045070.
PMID: 33853801 DOI: 10.1136/bmjopen-2020-045070

OBJECTIVES: Childhood vaccination coverage in Nagaland has lagged almost all states in India for more than two decades. This study aims to find drivers and barriers of childhood vaccination in Nagaland from the perspective of demand, supply and local health governance.
DESIGN: A cross-sectional study was designed using a survey conducted by the Directorate of Health and Family in 2015.
SETTING: Households, community-based health centres and health committees were surveyed.
PARTICIPANTS: 285 children aged under 2 years with vaccination cards and data on households, health centres and health committees were included.
OUTCOMES: Variables indicating whether a child received each of bacillus calmette-guérin (BCG), diphtheria-tetanus-pertussis (DTP3), oral polio (OPV3) and measles vaccination and all of them were outcome variables. Associated factors were identified using multilevel logistic regressions.
RESULTS: Antenatal care at least three times was significantly associated with BCG, DTP3, OPV3 and full vaccination with adjusted ORs ranging from 2.4 (95% CI 1.1 to 5.1) to 3.3 (1.1 to 9.9). The availability of bus to health centre was slightly significant for BCG and OPV3 with the adjusted ORs of 2.0 (0.9 to 4.5) and 2.1 (0.9 to 4.8), respectively. Health committees' budget provision to health centres was significant for OPV3 and full vaccination with the respective adjusted ORs of 15.7 (1.0 to 234.1) and 15.9 (1.2 to 214.7), the wide 95% CIs of which were driven by a small sample size. Health committees' review of expenditure of health centres was significant for measles and full vaccination with the adjusted ORs of 4.0 (1.4 to 11.4) and 5.2 (1.4 to 19.4), respectively.
CONCLUSION: This study suggests that enhancing the utilisation of antenatal care and providing reliable transportation between villages and health centres are required to improve childhood vaccination coverage. Also, the significant association of budget administration of health committees suggests that supporting local health committees for effective financial management is important.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Factors associated with attitude and practice in disaster management among critical care nurses in the east coast hospitals of Malaysia: a cross-sectional study

Siti Aminah Ismail, ZakiraMamat @ Mohamed, Nik Hisamuddin Nik Ab. Rahman, Nur Syahmina Rasudin

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):6-0.
MyJurnal

Introduction: The east coast hospitals of Malaysia are regularly stricken by flood disaster and nurses make up the majority of frontline responders in disaster. So, they should equip themselves with knowledge and skills related to disaster management. The objective of this study was to explore the factors associated with attitude and practice in disaster management among critical care nurses in the east coast hospitals of Malaysia. Methods: This was a quanti- tative study with a descriptive cross-sectional study design that were involved 250 critical care nurses from the east coast hospitals of Malaysia by used stratified random sampling method. Data were collected by using a validated questionnaire. Multiple logistic regression analysis was used to determine the factors associated with attitude and practice in disaster management. Results: A majority of the critical care nurses had a positive attitude (92.4%, n=231) and adequate practice (80%, n= 200) in disaster management. Among the selected factors studied, attending disaster training/ education was significantly associated with attitude (AOR 4.23, 95% CI: 1.474, 12.144, p = 0.007) and practice (AOR 4.203, 95% CI: 2.102, 8.402, p = 0.000). Disaster response experience had a significant association with practice (AOR 2.697, 95% CI: 1.122, 6.479, p = 0.027) but no significant association with attitude. Level of education, years of service and workplace showed no significant association with attitude and practice in disaster management. Conclusion: This study revealed that disaster training/ education was one of the factors that would ensure positive attitude and adequate practice in disaster management among critical care nurses in the east coast hospitals of Malaysia. Therefore, it is recommended for disaster management programme to be included in continu- ing education training for critical care nurses to ensure them to be well-prepared and respond competently when disaster happen.

Matched MeSH terms: Cross-Sectional Studies
Fulltext The prevalence risk of anxiety and its associated factors among university students in Malaysia: a national cross-sectional study

Mohamad NE, Sidik SM, Akhtari-Zavare M, Gani NA

BMC Public Health, 2021 03 04;21(1):438.
PMID: 33663451 DOI: 10.1186/s12889-021-10440-5

BACKGROUND: Anxiety disorder is one of the most common mental health problems worldwide, including Malaysia, and this issue has gained concern and attention from many, including experts and authorities globally. While average levels of stress and worry may help to motivate students to perform well in their studies, excessive feelings will increase their level of anxiety.
METHODS: A cross-sectional study was conducted at selected government and private universities throughout Malaysia. A total of 1851 students participated in this study. The students were asked to complete self-administered questionnaires, including socio-demographic, academic, and psychosocial characteristics. The Generalized Anxiety Disorder-7 (GAD-7) questionnaire was used to measure the prevalence risk of anxiety among the students. Chi-square analysis was conducted to find the relationship between the variables and anxiety, and multivariate logistic regression analysis was used to identify the predictors.
RESULTS: The response rate was 97.90%, where 1821 out of 1860 students participated in the study. The prevalence risk of anxiety in this study was recorded at 29%. The data revealed that academic year, financial support for the study, alcohol consumption, poor sleep quality, body mass index (BMI), having a good friend in the university, having doubt regarding the future, actively involved in the society, and having problems with other students and lecturer(s) were significantly associated with risk of anxiety; with the academic year as the primary predictor.
CONCLUSIONS: The findings highlight the current prevalence risk of anxiety among university students in Malaysia. The outcome of this study can serve as the evident baseline data and help with the development of specific interventions in addressing and managing the issue appropriately.

Matched MeSH terms: Cross-Sectional Studies
Fulltext The journey and glitches: a study on burnout and turnover syndrome among the nursing students in one of the nursing institutions of higher learning in Malaysia

Hamidah H, Azila T, Kelvin J M, NurulIzzatie M, Khadijah N Roslih

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):11-0.
MyJurnal

Introduction: Burnout is a psychological syndrome experienced by an individual who is exposed to chronic stress. It is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. It is often associ- ated with feelings of hopelessness and difficulties in dealing with work efficiency. As for students, going-through the process of learning is a complex stressful phenomenon causing of poor academic performance. The aim of the study was to explore causes of student nurses’ burnout followed by the intention to leave the program. Methods: This is a cross sectional study with total of 127 respondents selected based on Krejci Morgan (1970) sample size calculation from year 1 till year 3 nursing students. Maslach Burnout Inventory (2016) was used to measure the burnout-self test comprised of emotional exhaustion, depersonalization and personal achievement. Twenty-two (22 items) with 7- points scale measuring responses of “Never (0)” to “Every day (7).” For Part B, three open ended questions applied to the intention of leaving the program. Results: A total of 35% of students had the intention of leaving the nursing program and 54% occurred during the first and second year of the study. Stress and financial struggles triggered the intention of quitting the program and 68% felt the study was breaking them down. Conclusion: Pursuing the program despite of the glitches worth the fights, 99 % of respondents acknowledged that this program is worth their future profession. Through this program they learnt to handle their emotional problem calmly and look after patients and colleague’s problem effectively. Nursing is a field of knowledge of humanities, exclusively in the care of patients and Nursing has been able to educate and transform the society who were insufficient in lives into useful human beings.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Learning critical thinking and critical thinking disposition among year 3 diploma nursing students of UMS

Norkiah Binti Arsat, Segaran Ramodran, Farah RazeeraVidy, Nor Hafiqah Binti Mohd Taib, Dylela Lee Geem

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):33-0.
MyJurnal

Introduction: Nursing students have been educated with critical thinking in client care. However, nursing students are often considered to be lacking in critical thinking especially during their clinical experience. This is likely due to lack of knowledge of critical thinking as the opportunities for learning critical thinking (LCT) are limited and less en- couraged to use critical thinking during the teaching and learning process. Therefore, it contributes to poor learning outcomes.The aim of this study was to identify level of LCT and critical thinking disposition (CTD) among diploma nursing student of UMS. Methods: A cross sectional survey design using purposive sampling methods. Sixty (60) of 66 year3 nursing students completed aCTD Inventory for Chinese Medical College Students (CTDI-M) by Wang et al (2019) and The LCT Inventory (LCTI) and the Teaching Critical Thinking Inventory (TCTI) developed by van Zyl, M.A., Bays, C.L., & Gilchrist, C. (2013).Approval to conduct study obtained from Dean of faculty of Medicine and Health Sciences, UMS. Results: The data were analyzed through descriptive method using SPSS for window 21.0. Total score for CTD ranging from a low (M= 1.5) to a high (M=5.00), Mean value 3.86, (SD +/- .572). Total high-level CDT 58(96.7%). Total LCT scores ranging from a low (M=2.00) to high (M=5.00) and Mean value 4.02, (SD +/- .711). Total high level LCT 54(90%). The two subscale categories were analyzed for perceived LCT. Respondents reported significantly high level of both instructor helped in LCT 51(85%) and 56 (93.3%) provides support and encourage- ment in LCT, mean value 4.19 (SD+/-.713). Conclusion: The level of CTD and LCT was high, shows that nursing students perceive themselves as having a high level of critical thinking motivation, instructor providing guidance to assist and encourage to learn using critical thinking.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Loneliness among elderly in community residence at Pontian District, Johore

Rohani Mamat, Hussein S Z, Shamsudin K

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):44-0.
MyJurnal

Introduction: Loneliness is a major social problem among the elderly that has gone through almost all countries in the world. Even though loneliness is seen as the health-threatening but, the loneliness assessment is still marginal- ized in routine medical check-up for every senior citizen. Methods: This is a sequential explanatory mixed-method study with a cross-sectional community survey was conducted among 380 community residence elderly followed by in-depth interview among eight respondents. This study aims to measure the loneliness and to explore loneliness experienced by older adults. Data were collected using the short form of Social and Emotional Loneliness Scale for Adults (SELSA-S) and data were analysed using SPSS (version 23.0) for windows. In the qualitative study, eight re- spondents were interviewed face-to-face and data were analysed using thematic analysis Braun and Clarke (2006). Results: The results revealed that 37.2% of respondents had loneliness. Bivariate analyses showed the age, level of education and marital status were significantly associated with loneliness. The results of multiple logistic regression discovered gender (OR=1.75,95%CI:1.04-2.93; p=0.03) and marital status (OR=2.24,95%CI: 1.33-3.77;p= 0.002) were a significant predictor of loneliness. In a qualitative study, the result showed two main themes were recorded as causes of loneliness among the elderly are ‘changing the lifestyles’ and ‘ineffective communications. The sub-themes included ‘loss of someone who significant’, ‘limited physical mobility’, ‘all alone’ and ‘no support’. Conclusion: The issue of loneliness needs critically to be addressed even though Malaysia has not reached the ‘aging population’, but the loneliness prevalence experienced by the older adult has similarities with other countries that have attained that status.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Universiti Malaysia Sabah`s medical and nursing undergraduate student`s satisfaction towards rural community outreach health promotion posting in Ranau, Sabah

Segaran Ramodran, Billy Bryan Jafrin, Mellonna Ignatia Jeffrey Liew, Nurul MadihahMohd Raeh, Juecella Joyce Jalius

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):45-0.
MyJurnal

Introduction: EC1773 is a community outreach program conducted annually by Universiti Malaysia Sabah (UMS). It serves as a platform for nursing and medical students to collaborate hands-on health promotion for rural commu- nities. As of date, there has been no empirical study to gauge student`s post-program satisfaction. This study aims to evaluate satisfaction among students who have undergone the UMS-led community out-reach program and identify gaps for improvement. Methods: The study entailed a cross-sectional design involving 165 (N) nursing(n=65) and medical students (n=100) who had completed a 10-day rural outreach program. Ethical approval was obtained from the Research Ethics Committee of UMS as well-informed consent from respondents. A 25- item questionnaire requir- ing Likert-scale responsewas used to evaluatethe level of satisfaction across 5 sub-categories namely; pre-departure preparation & briefing;onsite facilities and logistics; teamwork; community participation and learning achievements. Results: Among 165 nursing -medical students in the study, 88% (n=146) were satisfied and 12% (n=19) were dis- satisfied with the UMS-led outreach program. Sub-category items rated as satisfactory were community participation 96% and learning achievements 91%. Poor satisfaction highlighted by respondents regarding the out-reach program were inadequacy of facilities and poor logistics 62% and quality of pre-departure preparation and briefing 66%. Nursing students reported significantly higher dissatisfaction (p=0.04) regarding teamwork and adequacy of onsite facilities and logistics. Conclusion: Findings from this study infers that student’s post-evaluation towards the UMS-led outreach is generally satisfactory but has specific shortfalls that need to be addressed.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Knowledge and certainty about medication administration among nursing students in University Malaysia Sabah

Li Tsu Chong, Josephine Magdeline Joseph, Nur Atikah Binti Mohd Taib, Nurfirna Suzleyna Binti Mohd Salleh, Jennefer Henry

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):46-0.
MyJurnal

Introduction: Medication error always happens among the nurses either the trained out staffs nor in nursing students. These errors may harm any patient that is involved and it may lead tolegislation issue. Therefore, this study aims to identify nursing students knowledge and assurance in medication administration. Methods: This study using a cross-sectional survey design using a convenience sampling method. Ethical approval was obtained from The Fac- ulty of Medicine and Health Sciences Ethical Committee. Adapted questionnaire divided into three sections with 14 multi-choice questions for each section (pharmacology, drug management and drug calculation) score (0-14) and Self perceived certainty on their correct answer were scored (1-high certainty, 2-moderate and 3-low certainty). Questionnaires were distributed through the online google form to Diploma of Nursing students of year two and three of Faculty Medicine and Health Science of University Malaysia Sabah. Result reported in mean (+SD). Results: Total of71 students volunteered responded to the survey. 42.3% of respondents (n=30) are the Year Two students and 57.7% (n=41) are the Year Three students.In knowledge about pharmacology mean score was 9.33 (2.37) and their certainty mean score was 1.9 (0.55), Drug management mean score was 8.42 (2.55) and their certainty mean score was 1.90 (0.45), While for their drug calculation mean score was 8.04 (3.03) and certainty mean score was
2.13 (0.51). Conclusion: Knowledge in drug management and drug calculation both were below the appropriate score (less than 9) respectively. These indicate that more practices and training on the medication administration should be done to the students in order familiar with the context of medication administration. Their certainty level found moderate indicate that their confidence level on medication administration should be reinforced. Nursing educators need to facilitate the students in their learning process and training periods to gain their confidence before their graduation.

Matched MeSH terms: Cross-Sectional Studies
Fulltext International Chinese student’s satisfaction towards university Malaysia Sabah’s nursing mobility program

Segaran Ramodran, Soong Shui Fun, Cynthia Francis, Dayang Natasha, Myra Yusrrie

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):34-0.
MyJurnal

Introduction: Promotion of internationalization of higher education is a strategic marketing in public and private Ma- laysia universities.University Malaysia Sabah (UMS) hosted the international nursing mobility programme involving 15 nursing students from Hunan and Yangtze University of China. Students from China obtained hands-on learn- ing experience and exposed to indigenous health practices in Sabah. After 12 weeks of the programme, although casual face-value audit of the mobility program was deemed adequate, there was a need to objectively gauge the Chinese student’s satisfaction and identify issue of contention that can be remedied. This study is to evaluate Chi- nese international nursing students’ satisfaction during their mobility posting tenure in UMS and identify issues of discontentment for improvement. Methods: the study entailed a cross sectional survey involving a convenient sam- ple of all 15 nursing students from China who had completed the 12-week UMS-nursing mobility programme. The study tool consisted of a 25-item questionnaire which used Likert-like statements to anchor level of satisfaction on 5 sub-domains itemsnamely; arrival orientation; logistic arrangements; learning opportunities; cultural experience and perceived worth-for-money. Results: Cumulative ratings counts from 15 Chinese international students who had participated in the UMS-nursing mobility program in this study rated the following sub-domains as satisfactory and highly satisfactory: (i) learning experience (88%), (ii) Sabah’s cultural experience (90%), (iii) worth for money (88
%). Sub-domains rated as dissatisfactory or strongly dissatisfactory by the China students were: (i) adequacy of 1st - day arrival orientation (72%), (ii) quality of logistic arrangement (72%). Conclusion: Findings imply that the China students were satisfied with the overall learning experience during the UMS-nursing mobility programme. However, areas of grievances such as the conduct of the 1st - day arrival orientation and logistics management of the UMS-mo- bility program needs to be addressed.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Resilience among undergraduate nursing students in University Malaysia Sabah

Mazlinda M, Azra F A, Segaran Ramodran, Marlinah P, Adawiyah N R, Randall M, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):35-0.
MyJurnal

Introduction: Resilience is an important coping mechanism that nurses need to inculcate as they often faced with numerous psychosocial conflicts and stressors in providing day to day patient care. Student nurses are particularly vulnerable to psychosocial stressors and studies indicates that poor resilience is associated with poor academic performance, burn out, depression and high risk of drop out. This study was to examine the level of resilience and associated factors among nursing students in University Malaysia Sabah. Methods: The study entailed a descriptive cross-sectional survey assessing the level of resilience involving student nurses. Ethical clearance for this study was obtained from REC UMS and as well as respondent’s consent. A total of 100(N) nursing students was selected through stratified sampling by year of study (year 1, n=35; year 2 n=35; and year 3 n=30). Sample selection randomization for each year of study was done using full name list generated using Microsoft excel. The study tool consists of a validated instrument (reliability α= 0.82) benchmarked from a previous study which captured respondent`s demo- graphics and a 28-item inquiry related to resilience. Data analysis use descriptive statistics and Fisher`s-Exact test for correlates. Results: In this study among 100 nursing students 82% (n=82) had high resilience score (cut-off mean score more than 3.5) and 18% low resilience score (cut-off mean score lower than 3.4). Comparing distribution of resilience scores, respondents with low resilience scores were higher among thefirst-year nursing student and stu- dents of family origin from rural settings. Conclusion: Findings imply that most nursing students in this study have a high level of resilience and a small cohort of the student nurses have low resilience vulnerable to stressors and risk poor achievement and drop out. There is a need to address nursing students with poor resilience and this paper will discuss some pragmatic strategies.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Barriers, strength and weakness of pre-pregnancy clinic services in Sarawak: a qualitative analysis from provider perspectives

Abdul Rahim N, Rahman MM

Malaysian Journal of Public Health Medicine, 2018;18(1):149-157.
MyJurnal

Pre-pregnancy Clinic (PPC) services is one the plausible efforts towards achieving the Millennium Development Goals. However, various issues still need to be addressed for improvement of the services. Considering this view, an attempt was made to explore the barriers, strength and weakness of current practice of pre-pregnancy clinic services in Sarawak, since the programme has been implemented in this state from the year 2011. This cross-sectional study was conducted at nine selected health care facilities throughout Sarawak. A multistage sampling procedure was adapted to select the health care facilities. An unstructured open-ended questionnaire was administered to get the in-depth perceived views and current practice of pre-pregnancy clinic services. A total of 322 health care providers from nine selected health care facilities gave their feedback. In the present paper, a qualitative analysis was done for the openended questions to get in-depth views of barriers, strength and weakness of pre-pregnancy clinic services. The results of the study were narrated in textual form and a thematic analysis was done manually. The identified themes for perceived barriers to the provision of pre-pregnancy care were perception, attitude and acceptance of PPC services, socio-economic issues, services and client factors. The perceived weaknesses of the services are listed under two main themes: working environment and service factors, while, the strength of services produced three thematic areas which are preparation for pregnancy, prevention of mortality and morbidity and comprehensive services. Though prepregnancy services are beneficial for society wellbeing, various issues still need to be considered for the improvement of the quality of services. Lack of awareness, no ministerial guidelines or Standard Operating Procedures (SOP) and knowledge pertaining to the services were few of the main areas which need to be pondered upon. Promotional activities and campaigns should be geared up ensuring availability the services to the general population.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Correlation of cAMP response element binding and brain derived neurotrophic factor protein levels in adolescents with adequacy fruit intake: a cross sectional study

Siti Noor Syarma Mohd Sharif, Mohd Adzim Khalili Rohin, Norhayati Abd Hadi

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):176-184.
MyJurnal

Introduction: cAMP Response Element Binding (CREB) and Brain Derived Neurotrophic Factor (BDNF) protein levels tend to be a critical mediator for the beneficial effects of diet on neurogenesis and cognitive function. Increased fruit intake has been associated with improved cognitive function. However, in Malaysia, most adolescents still haven't met the recommended intake of fruits and far less is known on how their adequacy of fruit intake can be affected to their protein levels of CREB and BDNF. Methods: A cross sectional study was done on 352 students aged 14 and 16 years old involving 11 secondary schools in Kuala Terengganu, Marang and Hulu Terengganu Districts. A validated MyUM adolescent FFQ was used for fruit intake assessment. Blood sample to determine the level of CREB and BDNF proteins. Results: A total of 53.7% of adolescents consumed an adequate intake ( 2 servings/day) of fruits. Serum level BDNF was significantly (p

Matched MeSH terms: Cross-Sectional Studies
Fulltext Does traditional asian vegetables (ulam) consumption correlate with brain activity using fMRI? A study among aging adults from low-income households

You YX, Shahar S, Mohamad M, Yahya HM, Haron H, Abdul Hamid H

J Magn Reson Imaging, 2020 04;51(4):1142-1153.
PMID: 31386268 DOI: 10.1002/jmri.26891

BACKGROUND: Working memory and cognitive flexibility are supported by the dorsolateral prefrontal cortex (DLPFC). Aging adults from low-income households are individuals with a high risk of cognitive decline who incorporate ulam in their daily diet.
PURPOSE: To examine relationship between ulam consumption and the working memory and cognitive flexibility among aging adults from low-income households who are more susceptible to cognitive decline.
STUDY TYPE: Cross-sectional.
POPULATION/SUBJECTS: Thirty-two aging adults (45-75 years old).
FIELD STRENGTH/SEQUENCE: Task-based fMRI, 3.0T, T1 -weighted anatomical images, T2 *-weighted imaging data.
ASSESSMENT: The dietary and ulam consumption were assessed using the respective validated Dietary History and semiquantitative Food Frequency questionnaires. Working memory and cognitive flexibility were evaluated by using neuropsychological batteries (ie, mini-mental state examination [MMSE], Digit Span, and Rey auditory verbal learning test [RAVLT]) and task-based fMRI (N-back and Stroop Color Word Test [SCWT]). Brodmann's areas 9 and 46 were the regions of interest (ROIs) of DLPFC activation.
STATISTICAL TESTS: Multiple linear regression used to understand the relationship between ulam consumption and the working memory and cognitive flexibility, while analysis of covariance (ANCOVA) was used to compare the difference of working memory and cognitive flexibility among four percentiles of ulam consumption, after age, gender, and education years adjustments. Significance was decided by two-sided, P

Matched MeSH terms: Cross-Sectional Studies
Fulltext Cross-Cultural Adaptation and Psychometric Properties of the Malay Version of the Communication Skills Attitude Scale (CSAS) among Medical Students in Malaysia

Mohamad-Isa MZ, Mohamed-Yassin MS, Badlishah-Sham SF, Baharudin N, Ramli AS

Int J Environ Res Public Health, 2021 04 05;18(7).
PMID: 33916335 DOI: 10.3390/ijerph18073778

Communication is one of the fundamental skills in the medical profession. The Communication Skills Attitude Scale (CSAS) is a widely used questionnaire to measure the attitudes of medical students toward learning communication skills. It has been adapted and translated into many languages. The objective of this study was to adapt and translate the CSAS into the Malay language and determine its psychometric properties in medical students. This is a cross-sectional study involving 218 first-year Universiti Teknologi MARA students. Content validation, cross-cultural adaptation, translation, and face validation of the 26-item CSAS were performed according to established guidelines. Principal component analysis with direct oblimin rotation was used to determine the underlying structure of the CSAS-Malay. The reliability was assessed using Cronbach's α coefficient for internal consistency and using the intraclass correlation coefficient for the test-retest reliability. Although the contents of the CSAS-Malay and the original version were conceptually equivalent, item 11 was removed during the content validation stage due to a low item content validity index (I-CVI < 1.00). Two subscales were derived from the remaining 25 items, which were the Positive Attitude Scale and the Negative Attitude Scale. Items 1 and 15 were removed due to poor factor loadings. The total variance explained by the final two-factor solution with three items removed was 30.8%. Cronbach's α coefficients for both the Positive and Negative Attitude Scales in the final questionnaire were 0.815 and 0.614, respectively. It also showed a good reproducibility with intraclass correlation coefficient (ICC) values of 0.725-0.950 for all the items. This study provided preliminary information about the psychometric properties of the CSAS-Malay. The final 23-item questionnaire had a good construct validity, an acceptable internal consistency, and at least a moderate test-retest reproducibility. It can be used to assess the attitudes of medical students toward learning communication skills. Future research to improve the generalizability of the questionnaire should include medical students from other universities with diverse backgrounds.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Healthcare Utilization and Knee Osteoarthritis Symptoms among Urban Older Malaysian

Kamsan SS, Singh DKA, Tan MP, Kumar S

Int J Environ Res Public Health, 2021 04 04;18(7).
PMID: 33916628 DOI: 10.3390/ijerph18073777

Knee osteoarthritis (OA) is a prevalent chronic disorder in the older population. While timely management is important to minimize the consequences of knee OA, information on the utilization of healthcare services among this population remains limited. Therefore, the objectives of this study were to determine the healthcare utilization and its associated factors in older persons with knee OA. Cross-sectional data from 1073 participants aged 60 years and above from the Malaysian Elders Longitudinal Research (MELoR) study were included. The utilization rate of healthcare services was quantified. Factors related to the utilization of healthcare services were determined using logistic regression analysis. Healthcare utilization among participants with knee OA was significantly higher than those without knee OA (p < 0.01). Outpatient usage was higher (p < 0.01) in comparison to inpatient and pharmacotherapy. Being married and having an income were significantly associated with seeking outpatient care (OR: 11.136, 95% CI: 1.73-52.82, p < 0.01) and pharmacotherapy (OR: 10.439, 95% CI: 1.187-91.812, p < 0.05), while females were less likely to utilize inpatient care services (OR: 0.126, 95% CI: 0.021-0.746, p < 0.05). The higher rate of healthcare utilization among older persons with knee OA indicates the increased healthcare needs of this population, who are commonly assumed to suffer from a benign disease.

Matched MeSH terms: Cross-Sectional Studies

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