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Introduction Yeast beta-glucan (YBG) are recognised for enhancing the immune system by activating macrophages, a key defence mechanism. Given the global prevalence and impact of upper respiratory tract infections (URTIs) on productivity and healthcare costs, YBG has shown promise as a potential therapeutic and preventive strategy for recurrent respiratory tract infections. However, little is known regarding the efficacy of YBG at lower dosages in relation to URTI, fatigue, immune response and uncertainties of how they affect the gut microbiota composition.Methods and analysis This 12-week randomised, double-blinded, placebo control, parallel-group clinical trial aims to evaluate the efficacy of YBG 1,3/1,6 on respiratory tract infection, fatigue, immune markers and gut health among adults with moderate stress. The study involves 198 adults aged 18–59 years with moderate stress levels as assessed using Perceived Stress Scale 10 (score 14–26) and Patient Health Questionnaire 9 (score ≥9); and had symptoms of common colds for the past 6 months as assessed using Jackson Cold Scale. These participants will be randomised into three groups, receiving YBG 1,3/1,6 at either 120 mg, 204 mg or a placebo. The outcomes measures include respiratory infection symptoms, fatigue, mood state and quality of life assessed using Wisconsin Upper Respiratory Symptoms Scale, Multidimensional Fatigue Inventory, Profile of Mood State and Short Form 36 Health Survey Questionnaire, respectively. In addition, full blood analysis and assessment of immune, inflammatory and oxidative stress biomarkers will be taken. Secondary outcome includes gut microbiota analysis using stool samples via 16S rRNA sequencing.Ethics and dissemination The research protocol of the study was reviewed and approved by the Research Ethics Committee of Universiti Kebangsaan Malaysia (UKM/PPI/111/8/JEP-2023–211). The findings will be disseminated to participants, healthcare professionals and researchers via conference presentations and peer-reviewed publications.Trial registration number ISRCTN48336189

Abstract Hartal Doktor Kontrak (HDK) Movement first surfaced in June 2021 following prolonged dissatisfaction towards the contract appointment policy of medical doctors in Malaysia. On the 26th of July 2021, an unprecedented strike (Hartal) was organised by contract doctors across Malaysia. It generated major media attention. This study sought to evaluate how the HDK movement was framed in the mainstream media and to analyse the framing trend in conjunction with the chronology of HDK movement events. A total of 109 news articles in two major national newspapers were analysed from 1st June 2021 until 28th February 2022 using quantitative content analysis method. The five-dimension media frame (responsibility, human interest, conflict, morality, and economic consequences) by Semetko & Valkenburg was applied to determine the trend of media framing. MANOVA test was performed to scrutinise the differences in frame portrayal before and after Hartal. Overall, the responsibility frame was the most used (76.2%) both pre- and post-strike, with the most frequently highlighted items being solutions to the HDK issue and the roles played by the government. The human interest frame and conflict frame followed next, with at least one item of each frame being featured in 33.0 and 32.1% of all news articles. Despite more news articles published post-strike, the aggregate mean scores of all the frames were higher during the pre-strike period, demonstrating how media framing in the earlier period significantly affected the subsequent events of the HDK movement and its impact on the contract appointment policy. In this case, media framing set an agenda for stakeholders to implement necessary policy changes to prevent subsequent strikes and to seek long-term solutions. Lastly, this study presents a novel approach to evaluating certain controversial matters that may not be suitably addressed by the conventional research method such as primary quantitative data collection or qualitative interviews.

Unregulated university cafeterias may be serving food and beverages high in fat or sugar. Traffic light labelling (TLL) has been able to guide students in making healthier choices. Therefore, the aim of this study was to assess the healthiness level of food and beverages served in university cafeterias by profiling it against TLL and calorie density to evaluate student’s perception towards the implementation of TLL. This pilot observational study was conducted in three universities; two public university and one private institution within Klang Valley. A total of 166 foods and beverages were analysed for calories, fat, saturated fat, sodium, and sugar by using a nutritional software, Nutritionist Pro (TM). Analysed data for each food/beverage were further profiled into TLL and calorie density by using an excel spreadsheet. Food and beverages analysed were those sold in canteen and cafeterias combined those frequently consumed, reported in a food frequency questionnaire (FFQ). A total of 192 students completed a questionnaire containing three sections: personal profile, a short FFQ of their usual intake and their perception towards implementation of TLL in their institutions. 8.1% of all food items were categorised as green (healthy food), whereas 41.9% were amber (moderately healthy food), and 50% were red (unhealthy food). Almost half of the beverages (46.7%) were found to be unhealthy. However, when all foods were profiled for calorie density, more than half (61.8%) were categorised as moderately healthy food. In addition, most of the respondents (88%) showed a positive perception towards the implementation of TLL in the cafeteria. A large number of meals sold in two universities cafeterias were unhealthy and requires dietary modification. TLL implementation was beneficial for tertiary students as it may help guide the students to choose healthier options of cooked meals and packaged foods and beverages.