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  1. Feng B, Ng LL
    Front Psychol, 2023;14:1134242.
    PMID: 37213367 DOI: 10.3389/fpsyg.2023.1134242
    Immersive virtual reality (IVR) technology is being used to help EFL learners overcome their difficulties with their language skills, especially writing skills. Past studies showed that the instrument that provides immersion will positively affect learners' written performance. In line with that, this study aims to investigate the vocabulary usage and writing performance of learners who learn vocabulary via IVR versus those who learn from conventional classroom-based instruction. A total of 144 Chinese-speaking English learners, who were divided into experimental group (N = 69) and control group (N = 75), experienced the treatments related to the writing tasks. The results show that the learners in the experimental group wrote more informatively and presented more details. Comparative analysis revealed that learners using IVR performed significantly better on target word usage, lexical density, distribution richness, and completion of task than those in the conventional classroom. Based on the results, it would seem that the positive transfer of learning may be related to the experience of exploring in a virtual environment. The immersion of IVR and the sense of presence and embodiment enable learners to benefit from their immersive experience which aids the use of vocabulary in their writing. The implication of the study demonstrated the impact of the technological factors, whereby what causes the improvement in writing performance is due to the learners' virtual experience and their sense of embodiment.
  2. Lee SK, Ng LL, Lee SI
    Med J Malaysia, 1980 Jun;34(4):423-5.
    PMID: 7219276
    The juice of the banana trunk produces a nondepolarising neuromuscular block. Oxygenation of
    the extract enhances its potency. Reversal with anticholinesterase is transient. Partial reversals in isolated preparations indicate there could be both specific and non-specific binding which could account for blockade after washing. It could be specifically bound to ACh receptors in an irreversible way. Its action appears similar to that of alpha-BuTX from the venom of the banded krait. Purification of the extract and subsequent investigations will support present findings and present the characteristics fully.
  3. Han Y, Zhao S, Ng LL
    Front Psychol, 2021;12:752793.
    PMID: 34803833 DOI: 10.3389/fpsyg.2021.752793
    Students experience different levels of autonomy based on the mediation of self-regulated learning (SRL), but little is known about the effects of different mediation technologies on students' perceived SRL strategies. This mixed explanatory study compared two technology mediation models, Icourse (a learning management system) and Icourse+Pigai (an automatic writing evaluation system), with a control group that did not use technology. A quasi-experimental design was used, which involved a pre and post-intervention academic writing test, an SRL questionnaire, and one-to-one semi-structured student interviews. The aim was to investigate 280 Chinese undergraduate English as a foreign language (EFL) students' academic writing performance, lexical complexity, and perceptions of self-regulated strategies in academic writing. One-way ANCOVA of writing performance, Kruskal-Wallis test of lexical complexity, ANOVA of the SRL questionnaire, and grounded thematic content analysis revealed that, first, both Icourse and Icourse+Pigai provided significant support for the development of SRL strategies vs. the control group, although there was no significant difference between the two groups. Second, Icourse+Pigai-supported SRL was more helpful for improving students' academic writing performance because it enabled increased writing practice and correction feedback. Third, Icourse+Pigai-supported SRL did not significantly improve students' lexical complexity. In conclusion, we argue that both learning management systems and automated writing evaluation (AWE) platforms may be used to assist students' SRL learning to enhance their writing performance. More effort should be directed toward developing technological tools that increase both lexical accuracy and lexical complexity. We conclude that the technical tools used in this study were positively connected to the use of SRL techniques. However, when creating technologically mediated SRL activities, students' psychological study preferences should be considered.
  4. Law CW, Roslani AC, Ng LL
    Med J Malaysia, 2009 Jun;64(2):163-5.
    PMID: 20058579 MyJurnal
    Early diagnosis of rectal cancer is important for prompt treatment and better outcome. Little data exists for comparison or to set standards. The primary objective of this study is to identify factors resulting in delays in treatment of rectal cancer, the correlation between the disease stage and diagnosis waiting time, treatment waiting time and duration of symptoms. A five year retrospective audit was undertaken in University of Malaya Medical Centre (UMMC). There were 137 patients recruited and the median time to diagnosis was nine days after the first UMMC Surgical Unit consultation with a mean of 18.7 days. Some 11% had to wait more than four weeks for diagnosis. The median time from confirmation of diagnosis to surgery was 11 days with a mean of 18.6 days. Sixty-two percent of patients were operated upon within two weeks of diagnosis and more than 88% by four weeks. However, 10% of them had delayed surgery done four weeks after diagnosis. Long colonoscopy waiting time was the main cause for delay in diagnosis while delay in staging CTs were the main reason for treatment delays.
  5. Tan CH, Chiang PC, Ng LL, Chee KT
    Br J Psychiatry, 1994 Sep;165(3):381-3.
    PMID: 7994510
    BACKGROUND: The objective was to investigate the occurrence and characteristics of oculogyric spasm (OGS) in an Asian country.

    METHOD: All 2035 Asian (88% Chinese, 7% Malays and 5% Indonesians) psychiatric in-patients in the state psychiatric hospital in Singapore were surveyed for occurrence of oculogyric spasm (OGS) over a two-month period.

    RESULTS: Thirty-four patients (1.7%) developed OGS (53% male and 47% female). All the 34 patients had been on maintenance antipsychotic drugs for more than five months. Eighteen patients had recurrent attacks. The mean chlorpromazine equivalent daily dose for those patients with recurrent OGS was 511 mg. This was significantly higher (P < 0.05) than the 277 mg daily dose received by those without recurrent OGS. Most (68%) of the attacks occurred between 1400-2000 h suggesting that OGS may have a diurnal variation.

    CONCLUSIONS: OGS presenting as tardive dystonia may be due to a relative increase in cholinergic activity.

  6. Loh SY, Ong L, Ng LL, Chew SL, Lee SY, Boniface G
    Asian Pac J Cancer Prev, 2011;12(6):1489-95.
    PMID: 22126487
    BACKGROUND: Increasing survivorship warrants evidence-based intervention to help women manage living effectively with breast cancer. Breast cancer survivors may have many medical and psychosocial issues in the post- treatment period. Qualitative research was carried out to assess survivors' overall experience and if intervention helps in survivorship care. This paper reports exploration of benefit-findings from participation in an earlier 4-week self management intervention.

    METHODS: We used a grounded theory approach to analyze three focus groups conducted between May and August 2010 in Kuala Lumpur. We used random sampling to recruit the informants (n=21), all of whom had earlier participated in the 4 week self-management program held two years previously.

    FINDINGS: The women reported positive experience and growth with the self management program. Self-efficacy appears as an important underlying theme for successful experiences. The lack of proactive plans to provide bereavement support to surviving women was a key negative experience.

    CONCLUSION: The intervention successfully brought women together to work in close partnership with health professionals on ways to self manage the medical, emotional and role task as they live indefinitely with breast cancer, a new chronic illness. The beneficial effect from the 4 week intervention was expressed by women even at 2 years after the program. Having successfully developed a tightly knitted group, a major oversight was the lack of professional support on bereavement for grieving members when close friends passed away.

  7. Tan FL, Loh SY, Su TT, Veloo VW, Ng LL
    Asian Pac J Cancer Prev, 2012;13(11):5791-7.
    PMID: 23317258
    INTRODUCTION: Return-to-work (RTW) can be a problematic occupational issue with detrimental impact on the quality of life of previously-employed breast cancer survivors. This study explored barriers and facilitators encountered during the RTW process in the area of cancer survivorship.

    MATERIALS AND METHODS: Six focus groups were conducted using a semi-structured interview guide on 40 informants (employed multiethnic survivors). Survivors were stratified into three groups for successfully RTW, and another three groups of survivors who were unable to return to work. Each of the three groups was ethnically homogeneous. Thematic analysis using a constant comparative approach was aided by in vivo software.

    RESULTS: Participants shared numerous barriers and facilitators which directly or interactively affect RTW. Key barriers were physical-psychological after-effects of treatment, fear of potential environment hazards, high physical job demand, intrusive negative thoughts and overprotective family. Key facilitators were social support, employer support, and regard for financial independence. Across ethnic groups, the main facilitators were financial-independence (for Chinese), and socialisation opportunity (for Malay). A key barrier was after-effects of treatment, expressed across all ethnic groups.

    CONCLUSIONS: Numerous barriers were identified in the non-RTW survivors. Health professionals and especially occupational therapists should be consulted to assist the increasing survivors by providing occupational rehabilitation to enhance RTW amongst employed survivors. Future research to identify prognostic factors can guide clinical efforts to restore cancer survivors to their desired level/type of occupational functioning for productivity and wellbeing.

  8. Chiu HF, Ng LL, Nivataphand R, Yong KC, Lengkong Y, Buenaventura RD, et al.
    Int J Geriatr Psychiatry, 1997 Oct;12(10):989-94.
    PMID: 9395930
    A common phenomenon in South-East Asia is ageing of the population. This article describes the various stages of development of psychogeriatrics in Hong Kong, Singapore, Malaysia, Thailand, Indonesia and the Philippines. It is only in the last few years that more systematic development of psychogeriatric services has begun under the pressure of an ageing population. The model of service delivery in Hong Kong can serve as an example of development of psychogeriatric services in South-East Asia.
  9. Tan CH, Low BL, Ng LL, Khoo YM, Lee HS
    Ther Drug Monit, 1993 Apr;15(2):108-12.
    PMID: 8099240
    Nineteen acutely disturbed psychotic Asian patients were treated with a single intramuscular injection of 50 mg of zuclopenthixol acetate in Viscoleo. Patients were assessed clinically before and after treatment using the Brief Psychiatric Rating Scale (BPRS). Serum zuclopenthixol and the inactive geometric isomer trans(E)-clopenthixol were determined by high-performance liquid chromatography after intramuscular injection. All patients improved, with the BPRS being significantly reduced (p < 0.001) at 72 h after injection. Adverse effects were generally few. The mean +/- SEM serum zuclopenthixol concentrations at 24, 48, and 72 h were 19.9 +/- 2.8, 31.5 +/- 4.5, and 17.8 +/- 2.9 micrograms/L, respectively. trans(E)-Clopenthixol concentrations ranged from negligible to 39.5 micrograms/L. This study confirms that a single intramuscular injection of 50 mg is adequate for managing severely disturbed psychotic patients for the first 3 days. The serum zuclopenthixol concentrations attained in the Asian patients were higher than those reported in Caucasian psychiatric patients. In some patients, a considerable amount of zuclopenthixol had been transformed to trans(E)-clopenthixol.
  10. Subramaniam M, Abdin E, Vaingankar JA, Picco L, Seow E, Chua BY, et al.
    Ann Acad Med Singap, 2017 Mar;46(3):91-101.
    PMID: 28417133
    INTRODUCTION: The objectives of this current study were to: 1) examine the prevalence and correlates of diabetes mellitus (DM) among older adults (aged 60 years and above) in a multi-ethnic population; 2) examine the prevalence and correlates of comorbid DM and depression among them; and 3) assess the effect of comorbid depression on disability, cognition and healthcare utilisation.

    MATERIALS AND METHODS: Data for the current study came from the Well-being of the Singapore Elderly (WiSE) study; a single phase, cross-sectional survey conducted among Singapore residents aged 60 years and above. A total of 2565 respondents completed the survey; depression was assessed using the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT) while a diagnosis of DM was considered if respondents stated that a doctor had diagnosed them with DM.

    RESULTS: DM was reported by 25.5% of the population. The prevalence of depression was significantly higher in those diagnosed with DM than those without DM (6% vs 3%). After adjusting for sociodemographic correlates, smoking and other chronic conditions, DM remained significantly associated with depression and subsyndromal depression. However, after including measures of functioning and cognitive impairment as covariates, DM was not significantly related to depression and subsyndromal depression. Those with comorbid DM and depression were more likely to be of Indian and Malay ethnicity, aged 75 to 84 years (versus 60 to 74 years) and widowed.

    CONCLUSION: Given the significant association of certain sociodemographic groups with comorbid depression among those with DM, targeted interventions for prevention and early diagnosis in these groups should be considered.

  11. Kandiah N, Ong PA, Yuda T, Ng LL, Mamun K, Merchant RA, et al.
    CNS Neurosci Ther, 2019 02;25(2):288-298.
    PMID: 30648358 DOI: 10.1111/cns.13095
    BACKGROUND: The Ginkgo biloba special extract, EGb 761® has been widely used in the treatment of neuropsychiatric disorders, including Alzheimer's disease (AD).

    METHODS: To guide clinical practice in the Asian region, the Asian Clinical Expert Group on Neurocognitive Disorders compiled evidence-based consensus recommendations regarding the use of EGb 761® in neurocognitive disorders with/without cerebrovascular disease.

    RESULTS: Key randomized trials and robust meta-analyses have demonstrated significant improvement in cognitive function, neuropsychiatric symptoms, activities of daily living (ADL) and quality of life with EGb 761® versus placebo in patients with mild-to-moderate dementia. In those with mild cognitive impairment (MCI), EGb 761® has also demonstrated significant symptomatic improvement versus placebo. World Federation of Societies of Biological Psychiatry guidelines list EGb 761® with the same strength of evidence as acetylcholinesterase inhibitors and N-methyl-D-aspartate (NMDA) antagonists e.g. memantine (Grade 3 recommendation; Level B evidence). Only EGb 761® had Level B evidence in improving cognition, behaviour, and ADL in both AD and vascular dementia patients. Safety analyses show EGb 761® to have a positive risk-benefit profile. While concerns have been raised regarding a possible increased bleeding risk, several randomized trials and two meta-analyses have not supported this association.

    CONCLUSIONS: The Expert Group foresee an important role for EGb 761® , used alone or as an add-on therapy, in the treatment of MCI and dementias, particularly when patients do not derive benefit from acetylcholinesterase inhibitors or NMDA antagonists. EGb 761® should be used in alignment with local clinical practice guidelines.

  12. Kandiah N, Chan YF, Chen C, Dasig D, Dominguez J, Han SH, et al.
    CNS Neurosci Ther, 2021 Feb;27(2):149-162.
    PMID: 33352000 DOI: 10.1111/cns.13536
    BACKGROUND: Mild cognitive impairment (MCI) is a neurocognitive state between normal cognitive aging and dementia, with evidence of neuropsychological changes but insufficient functional decline to warrant a diagnosis of dementia. Individuals with MCI are at increased risk for progression to dementia; and an appreciable proportion display neuropsychiatric symptoms (NPS), also a known risk factor for dementia. Cerebrovascular disease (CVD) is thought to be an underdiagnosed contributor to MCI/dementia. The Ginkgo biloba extract, EGb 761® , is increasingly being used for the symptomatic treatment of cognitive disorders with/without CVD, due to its known neuroprotective effects and cerebrovascular benefits.

    AIMS: To present consensus opinion from the ASian Clinical Expert group on Neurocognitive Disorders (ASCEND) regarding the role of EGb 761® in MCI.

    MATERIALS & METHODS: The ASCEND Group reconvened in September 2019 to present and critically assess the current evidence on the general management of MCI, including the efficacy and safety of EGb 761® as a treatment option.

    RESULTS: EGb 761® has demonstrated symptomatic improvement in at least four randomized trials, in terms of cognitive performance, memory, recall and recognition, attention and concentration, anxiety, and NPS. There is also evidence that EGb 761® may help delay progression from MCI to dementia in some individuals.

    DISCUSSION: EGb 761® is currently recommended in multiple guidelines for the symptomatic treatment of MCI. Due to its beneficial effects on cerebrovascular blood flow, it is reasonable to expect that EGb 761® may benefit MCI patients with underlying CVD.

    CONCLUSION: As an expert group, we suggest it is clinically appropriate to incorporate EGb 761® as part of the multidomain intervention for MCI.

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