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The purpose of the present study was to (1) translate and validate the PEACH + Rating Scale in Malay and (2) establish normative curves as a function of age and examine test-retest reliability for the Malay and English versions of PEACH+. This is a cross-sectional study that used a convenient sampling technique. One hundred and fifty-seven parents of typically developing children aged between 4 months and 7 years participated in the study. Forty-nine completed the Malay PEACH + in a pen-to-paper format (Aim 1). One hundred and eight parents completed PEACH + online (69 completed the Malay version and 39 the English version), and 20 of them completed the questionnaire twice (Aim 2). The PEACH + in Malay showed high internal consistency and item-total correlation. The normative data revealed that scores for frequency of auditory behaviour increased rapidly with age until about 20 months and reached an asymptote of around 90% by about 40 months of age. A similar trend was observed for ease of listening scores, which asymptoted around 85%. The validated Malay PEACH + Rating Scale can be used as a guide to monitor auditory functional performance and listening efforts of Malaysian children in real-world environments. [ABSTRACT FROM AUTHOR]

Aims: The aims of this project were to establish the outcomes for dental implant research that are important to people with lived experience (PWLE) and to achieve consensus with those developed by dental professionals (DPs) for a core outcome set (COS). This paper reports the process, outcomes and experiences of involving PWLE in developing a COS for dental implant research: the Implant Dentistry Core Outcome Sets and Measures project. Materials and Methods: Overall methods were guided by the Core Outcome Set Measures in Effectiveness Trials (COMET) initiative. Initial outcome identification was achieved from focus groups with PWLE employing calibrated methods across two low‐middle‐income countries (China and Malaysia) and two high‐income countries (Spain and the United Kingdom). Following consolidation of the results, the outcomes were incorporated into a three‐stage Delphi process with PWLE participation. Finally, consensus between PWLE and DPs was achieved using a mixed live and recorded platform. The experiences of PWLE involvement in the process was also evaluated. Results: Thirty‐one PWLE participated in four focus groups. Thirty‐four outcomes were suggested across the focus groups. Evaluation of the focus groups revealed a high level of satisfaction with the engagement process and some new learning. Seventeen PWLE contributed to the first 2 Delphi rounds and 7 to the third round. The final consensus included 17 PWLE (47%) and 19 DPs (53%). Out of the total of 11 final consensus outcomes considered essential by both PWLE and health professionals, 7 (64%) outcomes mapped across to ones that PWLE initially identified, broadening their definition. One outcome (PWLE effort required for treatment and maintenance) was entirely novel. Conclusions: We conclude that engaging PWLE in COS development can be achieved across widely different communities. Furthermore, the process both broadened and enriched overall outcome consensus, yielding important and novel perspectives for health‐related research. [ABSTRACT FROM AUTHOR]

Background: Stress amidst the COVID-19 pandemic is becoming more prevalent. This paper aimed to describe the validation process of the Malay Perceived Stress Scale modified for COVID-19 (PSS-10-C) amongst Malaysian youths. Methods: The cross-sectional validation study design was employed in this study. In Phase I, the scale was translated into Malay by using the forward-backward method. In Phase 2, principal axis factoring and confirmatory factor analysis were conducted in Study 1 (n = 267) and Study 2 (n = 324), respectively. Results: A two-factor solution, comprising 'distress' and 'coping' domains was derived (cumulative variance = 65.2%) in Phase 2. Concurrent validity evaluated via the Beck Hopelessness Scale revealed a moderate positive correlation (0.528). In Study 2 (n = 324), the confirmatory factor analysis showed that the two-factor model achieved acceptable model fit indices, including χ²/df ratio = 2.57; root mean square error of approximation (RMSEA) = 0.07; 95% CI = 0.05, 0.09; Tucker-Lewis Index (TLI) = 0.95 and Normed Fit Index (NFI) = 0.94. The Cronbach's alpha scale score was 0.855 for the study samples. Conclusion: The Malay PSS-10-C is a valid and reliable scale to be used amongst Malaysian youths. [ABSTRACT FROM AUTHOR]

Background: Many published studies in Malaysia have examined and assessed self care among type 2 diabetes mellitus (T2DM) patients using the Summary of Diabetes Self Care Activities (SDSCA) scale. The current paper is a meta-analysis of related studies that also examines how gender and ethnicity influence and shape T2DM self care practices in Malaysia. Methods: We undertook a bibliographic search for studies conducted and published in Malaysia on T2DM adults using the SDSCA scale. This is a two-stage individual participant meta-analysis of SDSCA which synthesised the overall and subscale score based on gender and ethnic groups as well as the correlation between SDSCA and HbA1c. Results: We examined 11 studies that utilised SDSCA to analyse 3,720 T2DM patients. The overall SDSCA score was 33.46 (47.8% of the 7-day week). The subscale score for general diet, specific diet, exercise, blood glucose self-monitoring and foot care were 4.80, 4.09, 2.87, 1.80 and 3.21, respectively. A small but statistically significant better self care in some gender or ethnic groups was noted. The SDSCA diet subscale and HbA1c showed statistically significant correlation. Conclusion: The finding suggested Malaysian T2DM patients were deficient in exercise and blood glucose self-monitoring. In fact, overall self care among Malaysian adult T2DM patients appears to be suboptimal across gender and the three main ethnic groups. Greater efforts are therefore needed to educate Malaysian adult T2DM patients to improve their self care practices. [ABSTRACT FROM AUTHOR]

Aims: To examine the pertinent issues discussed by endometriosis patients in Malaysia on MyEndosis Facebook group as an alternative platform for online support. Methods: Using thematic analysis based on three frameworks, 120 posted messages and comments were examined from MyEndosis Facebook group—a support group for women with endometriosis from January to July 2014. Results: Results showed the issues discussed were (a) personal struggles, (b) medication and treatment, (c) alternative medication, (d) side effects, and (e) medication recommended by doctors. While using this social medium, users found (a) emotional support, (b) esteem support, (c) information support, (d) network support, and (e) tangible assistance in their engagement with others. Conclusion: The analysis suggested that users' interactions were structured around information, emotion, and community building, which many doctors and nurses were not aware of. The group was shaped as a social network where peer users share social support, cultivate companionship, and exert social influence. SUMMARY STATEMENT: What is already known about the topic? There are no studies of Malaysian women with endometriosis seeking alternative support online and limited knowledge of their use of Facebook as an alternative platform for discussion on non‐communicable diseases.MyEndosis has created a pleasant and non‐judgemental environment that encourages well‐being and ease for patients to discuss and manage their endometriosis related issues. What this paper adds? Social media such as Facebook provide an integral platform for patients with endometriosis in Malaysia where the topic is still a taboo subject of discussion.This study provides insight into the usage of Facebook by patients as a platform for discussion and social support.Online patient interaction connects women with a similar condition and helps build a compassionate, courteous, and respectful community. The implications of this paper: There are many opportunities to improve understanding and research on how patients with endometriosis cope.Offering doctors and nurses an effective communication platform like Facebook will allow them to accurately assess patients' struggles with endometriosis, identify coping mechanisms, and develop appropriate discussion strategies. [ABSTRACT FROM AUTHOR]

This paper reported the quality of life (QoL) of 260 Malaysian parents with autism spectrum disorder (ASD) and factors which influencing it. About half of these parents reported to having good QoL. The factors identified in the double ABCX model showed that perceived social support and sense of coherence (SOC) were mediated by coping strategies and had a positive direct and indirect effect on parents' QoL. These finding reiterate the importance of social support, coping skills, and strong SOC reflection skills in influencing the QoL of parents with ASD child. We therefore suggest parents to utilize the widely available social and organization supports to gain good QoL, which is also important for the wellbeing of their child. [ABSTRACT FROM AUTHOR]

In the context of the escalating burden of diabetes in low and middle-income countries (LMICs), there is a pressing concern about the widening disparities in care and outcomes across socioeconomic groups. This paper estimates health poverty measures among individuals with type 2 diabetes mellitus (T2DM) in Malaysia. Using data from the National Diabetes Registry between 2009 and 2018, the study linked 932,855 people with T2DM aged 40–75 to death records. Cox proportional hazards models were used to estimate the 5-year survival probabilities for each patient, stratified by age and sex, while controlling for comorbidities and area-based indicators of socio-economic status (SES), such as district-level asset-based indices and night-time luminosity. Measures of health poverty, based on the Foster-Greer-Thorbecke (FGT) measures, were employed to capture excessive risk of premature mortality. Two poverty line thresholds were used, namely a 5% and 10% reduction in survival probability compared to age and sex-adjusted survival probability of the general population. Counterfactual simulations estimated the extent to which comorbidities contribute to health poverty. 43.5% of the sample experienced health poverty using the 5% threshold, and 8.9% were health poor using the 10% threshold. Comorbidities contribute 2.9% for males and 5.4% for females, at the 5% threshold. At the 10% threshold, they contribute 7.4% for males and 3.4% for females. If all patients lived in areas of highest night-light intensity, poverty would fall by 5.8% for males and 4.6% for females at the 5% threshold, and 4.1% for males and 0.8% for females at the 10% threshold. In Malaysia, there is a high incidence of health poverty among people with diabetes, and it is strongly associated with comorbidities and area-based measures of SES. Expanding the application of health poverty measurement, through a combination of clinical registries and open spatial data, can facilitate simulations for health poverty alleviation. • Novel health poverty measures applied to T2DM in Malaysia using early mortality risk. • Administrative dataset comprising 1M adults combined with death records and SES. • Male gender, older age and area deprivation drive health poverty. • Nighttime luminosity reveals regional patterns in health poverty. • Combining luminosity data and medical datasets enhances risk stratification in LMICs. [ABSTRACT FROM AUTHOR]

Current suicide risk assessments for predicting suicide attempts are time consuming, of low predictive value and have inadequate reliability. This paper aims to develop a predictive model for suicide attempts among patients with depression using machine learning algorithms as well as presents a comparative study on single predictive models with ensemble predictive models for differentiating depressed patients with suicide attempts from non-suicide attempters. We applied and trained eight different machine learning algorithms using a dataset that consists of 75 patients diagnosed with a depressive disorder. A recursive feature elimination was used to reduce the features via three-fold cross validation. An ensemble predictive models outperformed the single predictive models. Voting and bagging revealed the highest accuracy of 92% compared to other machine learning algorithms. Our findings indicate that history of suicide attempt, religion, race, suicide ideation and severity of clinical depression are useful factors for prediction of suicide attempts. [ABSTRACT FROM AUTHOR]

Background/Purpose: Visual impairment is a disability more commonly caused by diseases that lead to several disadvantages to the daily activities amongst those blind. For almost a century since the white cane was first introduced, the cane has remained as the most reliable tool for those affected by blindness. Methods: By using a combination of the capabilities of Internet of Things (IoT) and existing devices, such as mobile phones, an InWalker system is proposed to expand the functionality of the typical white cane, so as to introduce several new features that enhance the safety and confidence amongst people who are blind. As such, this paper explores the existing works and projects to comprehend the motivation and the standard practices for each proposed feature. Each of the strength and drawback has been assessed thoroughly to refine the scope of this project. Results: The proposed project, InWalker, is an intelligent system that has an embedded board system with various sensors to enhance the usability of white cane. The inputs from the sensor are processed on a microcontroller, which then pass the data to a smartphone via Bluetooth for additional features, such as global positioning system (GPS) tracking and SMS services. Conclusions: Based on the initial user testing, the proposed system has successfully fulfilled most of the users' need. Visual impairment is a disability more commonly caused by diseases that lead to several disadvantages amongst those blind. The white cane has been seen as the most reliable tool for the visual impaired. This tool could be further improved with the integration of additional sensors that works with today's mobile devices. The proposed system, InWalker, is able to improve the overall quality of life among people who are blind through several features: obstacle detection, GPS tracking and a light illumination in dark environments for increased safety. [ABSTRACT FROM AUTHOR]

Background: School counselling interventions have a substantial impact on students' educational and personal development. Individual and small group counselling, classroom guidance and consultation activities seem to contribute directly to students' success in the classroom and beyond. Aim: This paper attempted to study impact of counselling services in universities in Melaka state, Malaysia. Method: The research was carried out in four universities in Melaka, with a total sample of 564 students. Findings: The results showed that all research variables tested (awareness, resources, counsellor, management policy and effectiveness of counselling) were rated more highly in public universities than in private universities, with each variable achieving a p‐value of <.05. Implications: All research variables tested (awareness, resources, counsellor, management policy and effectiveness of counselling) were rated more highly in public universities than in private universities. It is possible that this is because public universities follow Act 580 of the Counselling Act, which makes it compulsory for public universities to have counsellors, while this is not the case for private universities. Employing a counsellor is an additional cost and it may be that there is more reluctance to invest in the welfare of students in the private sector. [ABSTRACT FROM AUTHOR]

Secure, affordable housing is strongly linked to wellbeing in older age. This paper reports on a study of childless and poor older Malaysians who are potentially a vulnerable group in relation to accumulating such housing resources for older age. Childless is defined as a person without biological, step or adopted children, and poverty is defined following the national guideline. The research explores the cumulative advantages and disadvantages over the lifecourse that may influence their routes to attaining, or failing to attain, secure and stable housing in older age. Semi-structured interviews with a purposive sample of 34 childless and poor older Malaysians in Kuala Lumpur, Malaysia, were analysed using a lifecourse perspective to identify the events/experiences that had shaped their housing arrangements in old age. Housing arrangements are hierarchical in structure and can be categorised into four types: home-ownership, public-rental, private-rental and informal housing arrangements. The capacity to afford secure housing (i.e. public rental or ownership) decreased with ill-health and reduced opportunities to work. Structural and policy factors such as eligibility for public housing had also contributed to shaping current housing arrangements. Family poverty, low levels of education and, consequently, reduced employment opportunities affected the ability to accumulate the financial resources needed to afford housing in older age. Some individual decisions and situational disadvantages also contributed to reductions in housing choice. From the social and cultural context, some participants with greater networks had more choices and advantages in the accumulation of housing resources. Initiatives to provide retirement entitlements for workers have not favoured those in low-level informal employment or have come too late to assist those who are now older people. In conclusion, more disadvantages than advantages were accumulated earlier in their life, impacting on their ability to have affordable, secure and stable housing in older age. [ABSTRACT FROM AUTHOR]

Depression or Major Depressive Disorder (MDD) is a mental illness which negatively affects how a person thinks, acts or feels. MDD has become a major disease affecting millions of people presently. The diagnosis of depression is questionnaire based and is not based on any objective criteria. In this paper, feature extracted from EEG signal are used for the diagnosis of depression. Alpha, alpha1, alpha2, beta, delta and theta power and theta asymmetry was used as feature. Alpha1, alpha2 along with theta asymmetry was also used as a feature. Multi-Cluster Feature Selection (MCFS) was used for feature selection when feature combination was used. The classifiers used were Support Vector Machine (SVM), Logistic Regression (LR), Naïve-Bayesian (NB) and Decision Tree (DT). Alpha2 showed higher classification accuracy than alpha1 and alpha power in all applied classifier. From t-test it was found that there was a significant difference in the theta power of left and right hemisphere of normal subjects, but there was no significant difference in depression patients. Average theta asymmetry in normal subjects is higher than MDD patients but the difference in theta asymmetry in normal subjects and MDD patients is not significant. The combination of alpha2 and theta asymmetry showed the highest classification accuracy of 88.33% in SVM. [ABSTRACT FROM AUTHOR]

This paper analyzes traces of masculinity by examining Malaysian sports news, centralizing the discussion on emotions in sports news discourse. Specifically, it compares the depictions of male and female athletes in newspaper texts and (co)-construct masculinity and varying notions of emotion through corpus-assisted discourse analysis, including the ways in which these depictions on 'emotion' can help social workers in sport. By extracting a specialized corpus known as Malaysian Sports News, manual qualitative analysis paired with corpus linguistics techniques is used. The results will reveal sporadic examples of emotion-centered expressions that describe sports as a depiction of stereotypes of masculinity. We begin by locating past studies and making their connections, adapting some of the many research rigors by paying attention to specific findings that have been reworked in other important, global perspectives of social work. By focusing on corpus-assisted discourse analysis of athletes in newspapers, convergence and divergence between male and female athlete reporting highlighting implications of masculinities on social workers in sports and the recent 2018 APA Guidelines on Boys and Men can be established. [ABSTRACT FROM AUTHOR]

Non-communicable diseases (NCDs) are a global health burden that affects a broad scope of individuals worldwide. Pharmacists, as members of the multidisciplinary team, play a significant role in promoting public awareness towards potential risk factors for NCDs. This study aims to gauge the knowledge of NCDs risk factors among pharmacy students of a Malaysian public university. This paper also outlines perspectives of pharmacy students on the strategies to raise the awareness of NCDs risk factors. A descriptive cross-sectional study was conducted in the Faculty of Pharmacy, International Islamic University Malaysia. Self-administered questionnaires were pretested and validated before being distributed to pharmacy students across different years of study. The data indicated an average level of knowledge towards risk factors of NCDs among study participants with no significant differences in knowledge between male and female genders (p = 0.583). However, there is a significant difference in knowledge concerning the year of study (p < 0.001); as positive correlation can be seen between the level of education and the knowledge of NCDs risk factor. Most of the students (75%) were unaware of the planning by the Ministry of Health (MOH) to control NCDs. Reinforcement of NCDs-related education activities is imperative in order to increase the overall awareness concerning the risk factors of NCDs among future pharmacy practitioners. Further collaborations between educational institutions and the MOH were proposed to help raise awareness of NCDs risk factors among the younger population. [ABSTRACT FROM AUTHOR]

Malaysia is a multi-ethnic country with Malay, Chinese and Indian being the dominant ethnic groups. This paper investigates the three ethnic cultures in Malaysia by examining the individual-level values of managers and professionals. Based on 528 responses to a Schwartz Value Survey ( SVS) questionnaire, the paper identifies partial convergence of the value systems of Malay, Chinese and Indian people. It was found that the three ethnic groups do not differ significantly in the individualistic value dimensions of Self-enhancement and Openness-to-change. However, Malays are found to be more conservative and less self-transcendent than Chinese or Indians, while Chinese and Indians attribute the same importance to these two sets of values. [ABSTRACT FROM AUTHOR]

Objectives: To briefly describe the postpartum practices among the three major ethnic groups in Malaysia and to identify commonalities in their traditional postpartum beliefs and practices. Methods: This narrative review collated information on traditional postpartum practices among Malaysian mothers through a literature search for published research papers on traditional postpartum practices in Malaysia. Results: This review shows that Malaysian mothers have certain postpartum practices that they considered to be important for preventing future ill health. Despite the perceived differences in intra-ethnic postpartum practices, most Malaysian mothers, although from different ethnicities, share similarities in their postpartum regimens and practices in terms of beliefs and adherence to food taboos, use of traditional postpartum massage and traditional herbs, and acknowledgment of the role of older female family members in postpartum care. Conclusions: Health care providers should be aware of multiethnic traditional postpartum practices and use the commonalities in these practices as part of their postpartum care regimen. [ABSTRACT FROM AUTHOR]

This paper examines the experiences of mothers caring for a child with Down syndrome in the Malaysian ( Sarawak) context. Qualitative interviews were conducted with 26 biological mothers of children with Down syndrome aged 18 years and below. They were accessed through selected child health clinics, community-based rehabilitation centres and schools using purposive sampling within two regions in Sarawak, one of the two Borneo States of Malaysia. Major themes emerging within the context of care demands were children's health, developmental delays, daily needs and behaviour issues. The insights obtained into the care demands experienced by mothers of children with Down syndrome have several implications for practice by care professionals. [ABSTRACT FROM AUTHOR]

Intelligent tutoring and personalization are considered as the two most important factors in the research of learning systems and environments. An effective tool that can be used to improve problem-solving ability is an Intelligent Tutoring System which is capable of mimicking a human tutor's actions in implementing a one-to-one personalized and adaptive teaching. In this paper, a novel Flowchart-based Intelligent Tutoring System ( FITS) is proposed benefiting from Bayesian networks for the process of decision making so as to aid students in problem-solving activities and learning computer programming. FITS not only takes full advantage of Bayesian networks, but also benefits from a multi-agent system using an automatic text-to-flowchart conversion approach for engaging novice programmers in flowchart development with the aim of improving their problem-solving skills. In the end, in order to investigate the efficacy of FITS in problem-solving ability acquisition, a quasi-experimental design was adopted by this research. According to the results, students in the FITS group experienced better improvement in their problem-solving abilities than those in the control group. Moreover, with regard to the improvement of a user's problem-solving ability, FITS has shown to be considerably effective for students with different levels of prior knowledge, especially for those with a lower level of prior knowledge. [ABSTRACT FROM AUTHOR]

Lesson planning imposes a significant burden on teachers as they need to prepare different lesson plans for different classes according to various constraints. SmartLP, a case-based lesson planning system, has been implemented as a means of assisting teachers in constructing quality lesson plans more quickly. SmartLP enables teachers to retrieve previous lesson plans and customise them according to their constraints as they should be tailored to accommodate differences in students, teachers and the facilities available. An evaluation study was designed to examine the effectiveness of a Case Based Reasoning ( CBR) approach through its cycle of retrieve, reuse, revise and retain in assisting teachers in constructing lesson plans and to assess the effects, in terms of time and quality, the system had on lesson plan preparation. This paper presents the results of the study. The study revealed that all the lesson plans constructed with SmartLP took significantly less time than lesson plans constructed without. In addition, where the planning tasks had greater similarities to the cases in the case base, they took even less time to be constructed. No significant difference in the quality of the plans, measured by a scoring system, was noticed between the control and experimental groups. [ABSTRACT FROM AUTHOR]

Aim To examine the practical applicability of the 'hard' and 'soft' constraints associated with the 'nurse rostering problem' as defined in operations management research literature and thereby investigate the objectivity of the rostering process. Background In practice, rostering nursing staff is often unrecognized, unrewarded and undervalued; yet, despite four decades of research, operations management has little to offer in terms of faster, safer, fairer or more effective rosters. This paper contrasts the theoretical perceptions of roster 'constraints' with the subjective, often political, rules governing practical rosters. Design Using both qualitative and quantitative data, this inductive study compares the practical process of rostering with that theorized in the nurse rostering problem. Methods This research spanned 4 years examining the rosters from 28 wards in 14 hospitals. Interviews with senior nursing staff regarding staff levels and with ward managers regarding rules defining the roster were complemented by analysis of actual roster data to establish the number and type of unfilled shifts and rule breakages. Interviews were analysed using thematic content analysis and roster data were evaluated using the HealthRoster™ e-rostering system. Findings Often the rules governing how nursing staff are scheduled are undocumented, tacit and informal. Furthermore, the roster process can be highly politicized, leading to forms of 'information anarchy' or 'information feudalism' on the ward. Conclusions Hospital managers must understand that roster design has a major impact on ward performance and must develop clear roster policies that define staff levels, skill mix, shift patterns and the rules used in preparing the roster. [ABSTRACT FROM AUTHOR]

Background: Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services. Methods: A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached. Results: Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on ‘as needed’ basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS’ perceived 4 important ‘needs’ in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family and caregiver support. Conclusions: Post discharge stroke care guidelines and access to rehabilitation services at primary care is needed for post stroke patients residing at home in the community. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to explore the benefits and barriers influencing participation for athletes with disabilities from a developing country (Malaysia). Two independent studies were undertaken: Study 1 included a sample of 123 athletes (95 males, 28 females) who participated in the 2006 Far East and South Pacific Games for the Disabled (FESPIC Games); Study 2 involved focus group discussions with 14 elite athletes. The athletes ranged in age from 15 to 59 years. Data were collected through a questionnaire (Study 1) and focus group discussions (Study 2). The primary reasons for participation in sport were achievement/challenge (58%) and competency/skill development (41%). The main barriers faced by the athletes were structural (facilities, equipment, funding) and the negative attitude from the government, public and media. However, despite these difficulties the majority of athletes were keen to continue to compete. Further work is required to ensure athletes with disabilities are provided with similar opportunities to athletes without disabilities. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the quality of life ( QOL) among mothers with a child with Down syndrome using The World Health Organization Quality of Life scale instrument. A convenience sample of 161 mothers was accessed through the various institutions which provide interventional or educational programmes to children with disabilities within two of the regions of the Borneo State of Malaysia ( Sarawak). Nearly half of the group of mothers perceived their QOL as neither poor nor good ( n = 73). An overall QOL score of 14.0 ± 1.84 was obtained. The highest and lowest domain scores were found for social relationship domain (Mean = 14.9 ± 2.1) and environmental support domain (Mean = 13.3 ± 2.1) respectively. Correlation analysis of selected background variables (i.e. locality, education, income and marital status) and overall QOL indicated rho (161) = 0.22-0.28 ( P < 0.01). Inverse correlation between maternal age and overall QOL score was indicated, with rho (161) = −0.17 ( P < 0.05). Linear regression analysis indicated that the combination of these few variables together accounted for 14.5% of the QOL variability in the sample. Findings point to implications for priorities of care provisions by policy-makers and care professionals in their practice. [ABSTRACT FROM AUTHOR]

Mandatory child abuse and neglect reporting laws apply to teachers in many countries of the world. However, such laws have not yet been introduced for teachers in Malaysia, and there is debate about whether the laws should be extended to teachers at all. This paper aimed to investigate the level of support among teachers to assume mandatory reporting duties and to identify factors determining this support in Malaysia. A total of 668 teachers from 14 randomly selected public primary schools completed an anonymous self-administered questionnaire. Results showed that 44.4 per cent of the respondents supported legislation requiring teachers to report child abuse. Teachers of Indian ethnicity, those with a shorter duration of service in teaching (< 5 years), the availability of knowledgeable and supportive school staff and a higher level of commitment to reporting were significant factors affecting teachers' support for mandatory reporting. This study provides important insights into factors influencing teachers' support for the introduction of mandatory reporting legislation for teachers in Malaysia. Teachers do not unanimously support these laws and there is a lack of clarity about what such laws will mean for teachers. The data highlight the need for specific training programmes to raise teachers' awareness, build their confidence and enhance their willingness to report child abuse. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages Malaysia does not currently have mandatory child maltreatment reporting requirements for teachers., Factors influencing teachers' support for the introduction of mandatory reporting include an attitude of commitment to the duty and the availability of other knowledgeable and supportive school staff., There is a need for specific training programmes to raise teachers' awareness, build their confidence, and enhance their willingness to engage with issues relating to child maltreatment. [ABSTRACT FROM AUTHOR]

Problem In Malaysia, human immunodeficiency virus (HIV) infection is highly concentrated among people who inject opioids. For this reason, the country undertook a three-phase roll-out of a methadone maintenance treatment (MMT) programme. In Phase 3, described in this paper, MMT was implemented within prisons and retention in care was assessed. Approach After developing standard operating procedures and agreement between its Prisons Department and Ministry of Health, Malaysia established pilot MMT programmes in two prisons in the states of Kelantan (2008) and Selangor (2009) -- those with the highest proportions of HIV-infected prisoners. Community-based MMT programmes were also established in Malaysia to integrate treatment activities after prisoners' release. Local setting Having failed to reduce the incidence of HIV infection, in 2005 Malaysia embarked on a harm reduction strategy. Relevant changes Standard operating procedures were modified to: (i) escalate the dose of methadone more slowly; (ii) provide ongoing education and training for medical and correctional staff and inmates; (iii) increase the duration of methadone treatment before releasing prisoners; (iv) reinforce linkages with community MMT programmes after prisoners' release; (v) screen for and treat tuberculosis; (vi) escalate the dose of methadone during treatment for HIV infection and tuberculosis; and (vii) optimize the daily oral dose of methadone (> 80 mg) before releasing prisoners. Lessons learnt Prison-based MMT programmes can be effectively implemented but require adequate dosing and measures are needed to improve communication between prison and police authorities, prevent police harassment of MMT clients after their release, and improve systems for tracking release dates. [ABSTRACT FROM AUTHOR]

Background. The CYP2C19*2 allele may be associated with a reduced antiplatelet effect for clopidogrel. Here, we assessed whether CYP2C19*2 alleles correlate with clopidogrel responsiveness following the administration of clopidogrel in healthy Malaysian volunteers. Methods. Ninety volunteers were genotyped for CYP2C19*2 and CYP2C19*3 alleles. Forty-five of 90 volunteers were included in the clopidogrel response studies and triaged into three genotypes, namely, CYP2C19*1/*1 (n = 17) CYP2C19*1/*2 (n = 21) and CYP2C19*2/*2 (n = 17). All subjects received 300 mg of clopidogrel, and platelet reactivity was assessed after a four-hour loading utilizing the VerifyNow-P2Y12 assay. Platelet activity was reported using P2Y12 reaction units (PRUs), and nonresponder status was prespecified at PRU = 230. Results. Following clopidogrel intake, CYP2C19*2/*2 carriers had a significantly higher mean PRU compared to the CYP2C19*1/*2 and CYP2C19*1/*1 (291.0 ± 62.1 versus 232.5 ± 81.4 versus 147.4 ± 87.2 PRU, P < 0.0001) carriers. Almost half of the participants (46.7%) were found to be nonresponders (3 were CYP2C19*1/*1, 11 were CYP2C19*1/*2, and 7 were CYP2C19*2/*2). Conclusion. In healthy Malaysian volunteers, CYP2C19*2 allele was associated with a decrease in platelet responsiveness to clopidogrel. However, clopidogrel nonresponders can be found not only in the carriers of CYP2C19*2/*2, but also in the carriers of CYP2C19*1/*2 and CYP2C19*1/*1. The present paper demonstrated that genotype information does not correlate with clopidogrel response, and genotyping may represent a less robust approach compared to platelet activity testing in guiding clopidogrel therapy. [ABSTRACT FROM AUTHOR]

Objective. Obesity prevalence is unequally distributed across gender and ethnic group in Malaysia. In this paper, we examine the role of socioeconomic inequality in explaining these disparities. Design. The body mass index (BMI) distributions of Malays and Chinese, the two largest ethnic groups in Malaysia, are estimated through the use of quantile regression. The differences in the BMI distributions are then decomposed into two parts: attributable to differences in socioeconomic endowments and attributable to differences in responses to endowments. Results. For both males and females, the BMI distribution of Malays is shifted toward the right of the distribution of Chinese, i.e., Malays exhibit higher obesity rates. In the lower 75% of the distribution, differences in socioeconomic endowments explain none of this difference. At the 90th percentile, differences in socioeconomic endowments account for no more than 30% of the difference in BMI between ethnic groups. Conclusions. Our results demonstrate that the higher levels of income and education that accrue with economic development will likely not eliminate obesity inequality. This leads us to conclude that reduction of obesity inequality, as well the overall level of obesity, requires increased efforts to alter the lifestyle behaviors of Malaysians. [ABSTRACT FROM AUTHOR]

Background: The paper examined the quality of life of haematological cancer patients according to their socio-demographic profiles and clinical diagnoses. Methods: This cross-sectional study was conducted at the tertiary referral centre of Ampang Hospital, Kuala Lumpur, involving 105 patients. The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) questionnaire was used to measure their quality of life. Results: The study involved patients diagnosed with all types of haematological cancer, including non-Hodgkin lymphoma (NHL), acute myelogenous leukaemia (AML), acute lymphoblastic leukaemia (ALL), Hodgkin lymphoma (HL), and multiple myeloma (MM), with a response rate of 83.3%. The patients with ALL, HL, without NHL, and without MM were younger than other patients. There were significant differences in quality of life scores in different socio-demographic groups and types of cancer diagnosis. The global quality of life of the female patients was much better than that of the male patients. Patients who were 40 years old or younger had a better global quality of life and physical functioning, as well as fewer symptoms of constipation, nausea, and vomiting. Employed patients were in less pain but showed greater impairments of cognitive function than did unemployed patients. Patients who earned a monthly wage of RM1000 or less had reduced physical function, more symptoms of pain, and more financial difficulties compared with patients who earned more. Patients with AML tended to have better physical functioning than did patients with MM, whose physical functioning was impaired. Comparatively, more symptoms of dyspnoea were found in ALL and HL patients than in other types of lymphoma. Compared with other patients, those with ALL had a greater loss of appetite, and other lymphoma patients had fewer symptoms of pain. Patients with NHL had impaired role functioning and more constipation compared with other patients. The results were all statistically significant (P < 0.05). Conclusion: The quality of life of haematological cancer patients is affected by sociodemographic factors and clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients. [ABSTRACT FROM AUTHOR]

Aim: To investigate semantic equivalence between two translated versions of the heart quality of life (HeartQoL) questionnaire produced by the forward‐backward and dual‐panel methods. Methods: The forward‐backward and dual‐panel versions of HeartQoL were self‐administered among 60 participants who met the inclusion criteria of being a native Bahasa Malaysia‐speaking Malay, aged 18 and older, having an indexed diagnosis of ischaemic heart disease and being cognitively fit. The administration sequence of the two versions was randomized. Additionally, three sociolinguists, who were blinded to translation processes and survey findings, rated the translated versions against the source version on three aspects of semantic equivalence. Results: Textual content in both translated versions was considerably similar (n = 9/14 items, ≈64%). The overall results from weighted kappa, raw agreement, intraclass correlations, and Wilcoxon signed‐rank as well as experts' ratings were confirmative of semantic equivalence between the forward‐backward and dual‐panel versions of the HeartQoL. However, some mixed findings were indicative of potential gaps in both translated versions against the source version. Conclusion: Both the forward‐backward and dual‐panel methods produced semantically equivalent versions of HeartQoL; but translation alone is insufficient to narrow the subtle gaps caused by differences in culture and linguistic style. SUMMARY STATEMENT: What is already known about this topic? The lack of empirical evidence and consensus creates uncertainties surrounding best practices on establishing equivalence between a translated questionnaire and its source.There is a lack of supportive evidence on the extent to which the forward‐backward and dual‐panel methods of translation produce semantically equivalent versions of the source questionnaire.What this paper adds? The forward‐backward and dual‐panel methods of translation are potentially comparable with each other as they have produced semantically equivalent versions of the heart quality of life (HeartQoL) questionnaire.Feedback from sociolinguists reveals potential gaps in both versions and offers insights to enhance translation equivalence.The implications of this paper: Translation of questionnaires for use in nursing research and practice can employ either the forward‐backward and dual‐panel methods or both.Regardless of methods used and the personnel involved in the translation process, the potential sources of equivalence gaps may persist. This warrants further examination using the quantitative and qualitative approaches of inquiry. [ABSTRACT FROM AUTHOR]