Objective: The assay for anti-cyclic citrullinated peptide (anti-CCP) antibody is a recent test of interest due to low diagnostic specificity of rheumatoid factor in the diagnosis of rheumatoid arthritis. To determine the sensitivity and specificity of anti-CCP antibodies in rheumatoid arthritis patients using American College of Rheumatology (ACR) criteria as a gold standard.
Design: A cross sectional study was conducted from January 2008 to December 2008 on 100 patients with rheumatoid arthritis and 153 patients with arthritis or arthralgia but not fulfilling ACR criteria for rheumatoid arthritis.
Materials and Methods: Serum from each subject was tested for anti-CCP antibodies and IgM rheumatoid factor (IgM RF) by an enzyme linked immunosorbent assay (ELISA). Sensitivity and specificity of the tests were evaluated using the ACR criteria as the gold standard. Data was analyzed using SPSS version 12.0 software. The association between the two categorical variables were tested using chi-square test. The differences between the two groups were tested using independent t-test. Results: The sensitivity of anti-CCP antibodies was 71% with 94.8% of specificity. For rheumatoid factor the sensitivity was 85% and the specificity was 74.5%. Positive predictive value for anti-CCP antibodies was 89.9% whereas for rheumatoid factor it was 68.5%. The sensitivity of ACR criteria with inclusion of anti- CCP antibodies was 100% and specificity of 94.8% (95%CI: 91.3%, 98.2%).
Conclusion: Anti-CCP antibody has a higher diagnostic accuracy compared to the RF. Anti-CCP antibody is a useful laboratory marker to support the diagnosis of rheumatoid arthritis and to differentiate patients with rheumatoid arthritis from rheumatoid arthritis-like symptoms. Therefore, it is suggested that anti-CCP antibodies should be included as another laboratory supportive criterium besides RF test in ACR criteria in the diagnosis of RA.
Study site: family medicine clinic, rheumatology clinic and immunology laboratory of Hospital Universiti Sains Malaysia (HUSM), Kubang Kerian, Kelantan, Malaysia
After World War II, Japan became a major recipient of foreign aid from the USA. As Japan's economy improved in the 1960s, it played a significant role as a global aid donor in world politics through its Official Development Assistance (ODA). This commitment continued into the 1990s when Japan, as one of the leading proponents of the concept of human security, began providing humanitarian aid to more countries across the globe. To better understand the notion of human security in international politics, this paper examines Japan's endorsement of the concept in its foreign policy strategy. This paper provides an overview and critical assessment of Japan's Grant Assistance for Grass-Roots Human Security Projects (GGP) in the state of Sabah in East Malaysia from 2000 to 2021. This paper argues that different contexts and circumstances in the state of Sabah require further study, especially for understanding Japan's focus and concern in the area of basic human security needs, as enshrined in the GGP philosophy. Despite Japan's GGP objective as part of its foreign policy to promote human development, the execution of its foreign aid in Sabah does have issues. This paper concludes that the implementation of Japan's GGP necessitates greater inclusion, particularly for other vulnerable groups and underdeveloped areas in Sabah. Despite Japan's GGP objective as part of its foreign policy to promote human development, the execution of its foreign aid in Sabah does have issues. This paper concludes that the implementation of Japan's GGP necessitates greater inclusion, particularly for other vulnerable groups and underdeveloped areas in Sabah.
The Malaysian government has introduced the National COVID-19 Immunisation Programme (PICK) as a new mechanism to address the transmission of coronavirus disease 2019 (COVID-19). Unfortunately, the number of PICK registrations is still unsatisfactory and is now even lower. The low level of participation of the Sabah (East Malaysia) population significantly impacts the PICK registrations. Therefore, this study aims to identify the factors that cause vaccine hesitancy among the people of Sabah. This study seeks to identify these trends based on zone and district boundaries. A total of 1024 respondents were sampled in this study. Raw data collected through the survey method were analysed using K-means clustering, principal component analysis (PCA), and spatial analysis. The study discovered that factors including confidence, authority, mainstream media, complacency, social media, and convenience are the top causes of vaccine hesitancy among respondents. This study also revealed that the Sabah population's key variables causing vaccine hesitancy to vary by region (zones and districts). The conclusion is significant as a source of supporting data for stakeholders seeking to identify the Sabah population's constraints in each region and therefore, it would help improve PICK management's performance in Sabah.
The outbreak of the pandemic Covid-19 has transformed the education system in most countries worldwide. Following the lockdown measures in Malaysia, the Malaysian education system has fully transformed from conventional learning to online learning or known as e-learning as an alternative to minimize social contacts and physical communication to curb the transmission of Covid-19. In this regard, this study aims to identify the challenges faced by students in higher learning institutions throughout Malaysia during the implementation of the e-learning program. This study is based on a large sampling consisting of 2394 students from both public and private universities. The result from this study is analyzed through inferential methods such as the Spatial Analysis, the Principal Component Analysis, and the Mann-Whitney U test and through descriptive methods using the frequency analysis and the percentage analysis. Findings from this study suggest that location significantly influenced the challenges faced by students throughout the implementation of e-learning in higher learning institutions. For example, students in rural areas which can be identified as "vulnerable groups" are more likely to face both technical and connection with the internet access, tend to have a declining focus on learning and are prone to physical health problems, facing social isolation and low digital literacy compared to students in urban areas. Based on geographical analysis, students in Sabah, Perlis, and Melaka are most at risk of facing e-learning challenges. An anomaly case of students in Kuala Lumpur, however, posed another different result compared to other cities as they confront similar challenges with students in rural areas. This study provides the nuances of location and its implications for vulnerable groups that may put them at disadvantage in the e-learning program. Findings from this study will help to inform the relevant authorities and policymakers in improving the implementation of e-learning in Malaysia, especially towards the vulnerable groups so that it can be delivered more systematically and efficiently.
The Malaysian Government has initiated the National COVID-19 Immunisation Programme, known as PICK, to be a national strategy for addressing the spread of the coronavirus disease (COVID-19) pandemic across the country. Although the government intensified public awareness to increase program registration, the total number that registered in the state of Sabah, located in East Malaysia, was relatively low during August 2021, accounting for only 42.9% as compared to that of Peninsular Malaysia. Therefore, this paper examines the public perception toward the PICK program in Sabah based on 4 main components: safety, communication, psychology, and milieu. This study is based on the empirical findings drawn from 1024 respondents across Sabah using online Google Form surveys. This study adopts 5 methodologies for data analysis by using K-means clustering, mean score, Mann-Whitney U test, spatial analysis, and frequency analysis. It has been revealed that the percentage of respondents (categorized as Cluster 1) who have a negative perception toward the vaccination program is higher (55.9%) than those who have a positive perception (44.1%). This study further discovered that Cluster 1 has shown high skepticism regarding the vaccination program, which can be explained through the communication component (M = 3.33, SD = 0.588), especially Co2, Co3, Co1, and Co4. Following the communication factor, a chain of negative perceptions also affects other components such as safety, psychology, and milieu among Cluster 1, all of which contribute to poor participation in the PICK program. The study outcomes are extremely useful for informing local authorities to establish policies related to public interests, primarily in the areas of public health. Understanding the community's perspectives and their obstacles in participating in such programs may assist local authorities in developing or implementing public policies and campaigns that ensure such related public programs can be conducted more effectively in the future.
Amid the outbreak of the COVID-19 pandemic in the year 2020, educational platforms have been forced to change and adapt from conventional physical learning to virtual learning. Nearly all higher learning institutions worldwide are forced to follow the new educational setting through virtual platforms. Sabah is one of the poorest states in Malaysia with the poorest infrastructure, with the technology and communication facilities in the state remaining inept. With the changes in virtual platforms in all higher education institutions in Malaysia, higher learning institutions in Sabah are expected to follow the lead, despite the state lagging in its development. This has certainly impacted the overall productivity and performance of students in Sabah. Therefore, this study aims to explore the challenges of the implementation of virtual learning among students in Sabah. More specifically, this study seeks to identify vulnerable groups among students based on their geographical location. To achieve the objective of this study, a survey has been conducted on a total of 1,371 students in both private and public higher learning institutions in Sabah. The sample selection for this study was determined using a purposive sampling technique. Based on Principal Component Analysis (PCA), it was found that there are five challenges in virtual learning faced by students in higher learning institutions in Sabah. These are the unconducive learning environment (var(X) = 20.12%), the deterioration of physical health (var(X) = 13.40%), the decline of mental health (var(X) = 12.10%), the limited educational facilities (var(X) = 10.14%) and social isolation (var(X) = 7.47%). The K-Means Clustering analysis found that there are six student clusters in Sabah (Cluster A, B, C, D, E & F), each of which faces different challenges in participating in virtual learning. Based on the assessment of location, almost half of the total number of districts in Sabah are dominated by students from Cluster A (9 districts) and Cluster B (4 districts). More worryingly, both Cluster A and Cluster B are classified as highly vulnerable groups in relation to the implementation of virtual learning. The results of this study can be used by the local authorities and policymakers in Malaysia to improve the implementation of virtual learning in Sabah so that the education system can be more effective and systematic. Additionally, the improvement and empowerment of the learning environment are crucial to ensuring education is accessible and inclusive for all societies, in line with the fourth of the Sustainable Development Goals (SDG-4).
During the COVID-19 era, most countries, including Malaysia, have shifted from face-to-face teaching systems to online teaching programs. The aim of this study is to identify the main challenges that higher education students face during e-learning based on their residential location throughout Peninsular Malaysia. This study further examines the readiness of higher education students to apply e-learning. Therefore, a cross-sectional survey approach is used to fulfil the outlined objectives. Accordingly, 761 public (95.3%) and private (4.7%) higher education students residing in Peninsular Malaysia are sampled in this study. The survey was administered online for 37 days, from 21 October 21 to 6 December 2021, using either WhatsApp or Facebook. The raw data is inferentially (Principal Component Analysis, K-Means Clustering, Kruskal Wallis, and spatial analysis) and descriptively (mean, standard deviation & percentage) analyzed. It has been revealed that six clusters of students in Peninsular Malaysia face various challenges while following the e-learning program. Most states in Peninsular Malaysia are dominated by students in Cluster D (Terengganu, Perlis, Penang, Selangor, WP Kuala Lumpur, and WP Putrajaya) and Cluster B categories (Melaka, Johor, Kelantan, and Kedah). Students in the Cluster D category tend to suffer from physical health disorders and social isolation, while students in the Cluster B category face problems with decreased focus in learning, mental health disorders, and social isolation. The outcomes further indicate that the more challenges students face during e-learning programs, the lower their willingness to continue with the program. The results of this study are significant in addressing the challenges of e-learning, which will help stakeholders address and strengthen student abilities.