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This study investigated the effects of work from home (WFH) on language educators in Malaysian universities gauging specifically their perceptions on its advantages and disadvantages during the COVID-19 pandemic. A mixed-methods research design was employed involving 152 language educators. The results revealed that although the overall mean scores were rather neutral, language educators were more inclined toward positive effects of WFH, most notably in terms of saving communing time and being closer to family. However, the negative effects were missing colleagues and feeling glued to the computer. The results also shed interesting insights into Malaysian language educators' high confidence in focusing on their tasks and using tools to fulfill their teaching and work-related responsibilities. The outcome from this study is a guiding model that not only informs the literature on the feasibility of WFH in the higher education context but also highlights pertinent areas of concern for its future planning and implementation.

Background: One of the many challenges faced by universities in developing countries is to equip graduates with practical skills and knowledge for the demanding workforce. The traditional textbook-oriented lecture lacks up-to-date industrial practices. Purpose: This study highlights the development of a university-industry collaboration model for producing work-ready engineering graduates. An experienced practising engineer from Universiti Tunku Abdul Rahman's Industry Advisory Panel representing Techkem Group was invited as a guest lecturer for two undergraduate engineering elective courses. Besides conventional lectures and tutorial sessions, the invited guest lecturer with vast industrial exposure also demonstrated actual engineering equipment working principles to the undergraduate students. Sample: A total of 80 final year students and 10 lecturers took part to provide the feedback. Design and methods: Feedback from students and lecturers was analyzed to determine the acceptance level towards incorporating industrial practice knowledge in these elective courses. Results: The integration of current industrial practices into these courses has shown encouraging response from both students and lecturers with scoring between 80.8 and 93.3 points out of the maximum 100 points. Conclusions: Positive results from the respondents have paved the path for the future development of such collaboration. Corporate social responsibility engagement by the industry as well as initiative to improve the teaching and learning process for elective courses by the university are essential aspects for a mutually beneficial collaboration in this model.

Based on the cross-channel connections between auditory and pictorial representations, it has been proposed that the presentation of coherent narration along with the picture and text content may enhance children's story comprehension and vocabulary learning. The authors tested 40 four- to five-year-old Malaysian prereaders (17 Malays, 23 Chinese) for story comprehension while observing their eye movements to determine the degree to which the presence of pictures and/or text aids understanding of the narration and influences looking patterns. Both Malay and Chinese prereaders showed no interest in the printed text that was presented alongside the picture on the same page, which is consistent with earlier findings. This suggests that ethnic origins have little influence on how prereaders direct their visual attention to the relevant information for story comprehension. When there was no narration, they fixated longer on the text and less on the image, indicating that a significant amount of mental effort was required to process the words without verbal information. Regardless of stimulus congruency, storytelling performance affected how much children focused on target objects and keywords. More intriguingly, it was found that in Malay prereaders, there was a correlation between story comprehension and vocabulary skills across tasks. Additionally, Malay prereaders who performed well looked at the displayed stimuli longer than Chinese prereaders who performed well, especially when a narrator was presented alongside the visual stimulus. These novel findings are discussed along with their implications for multimedia learning and future research directions.

Many studies have been conducted on the development of young children; however, not many have explored the cognitive processes of prereaders. The eye-tracker has been used with success to investigate the cognitive processes of young children abroad, but such studies are lacking in Malaysia. This study used an experimental procedure created with eye-tracking technology on 22 prereaders (aged 5 to 6) in a Malaysian kindergarten. The prereaders were exposed to four conditions: (1) listening to narration and viewing a congruent picture with text, (2) listening to narration and viewing an incongruent picture with text, (3) viewing a picture with text without narration, and (4) listening to narration and viewing a text. The main objective of this project is to test which content of pictures helps the students understand the narration and the text, and how they use visual attention to build a better understanding. The findings revealed that children strongly preferred pictures to texts, but when the narration was not present, they spent more time looking at the text.

Background: Malay herbal medicine (MHM) is a popular medication and supplementation among Malaysian mothers during pregnancy and postpartum. It is expected to improve the baby's health, increase breastmilk production, promote slimming and uterine involution, and improve the mother's general health. Recent increases in reports of heavy metal contamination have raised safety concerns. Objective: This pilot exploratory study employed a comparative cross-sectional design to investigate the types of MHM ingested during pregnancy and postpartum, their possible heavy metal contamination and associated health risks. Method: This study involved 167 healthy postpartum Malay women. Findings: MHM consumption was significantly associated with the mother's number of pregnancies and children (p < 0.05) as well as her pre-pregnancy weight (p < 0.05). Mothers who consume MHM were twice as likely (95% CI 1.077–3.963) to experience threatened abortion. Heavy metals were detected in the three most widely consumed MHM samples. The mean concentration of heavy metals in these samples were 47.44 ± 67.74 μg/kg for As, 25.34 ± 2.48 μg/kg for Cd, 3685.87 ± 5683.36 μg/kg for Cr and 194.33 ± 195.19 μg/kg for Pb. The calculated non-carcinogenic hazard health risks (HQ) and health index (HI) were less than one, suggesting no adverse health impacts under the exposure conditions studied. Conclusion: While the HQ and HI values indicate no immediate health risks, the potential transfer from mother to foetus during pregnancy and from mother to infant during breastfeeding warrants further investigation. Additional studies are essential to confirm our findings and monitor the health of mothers and infants. [ABSTRACT FROM AUTHOR]

Introduction: Although COVID-19 has entered the endemic phase, individuals infected with COVID-19 are required to adhere to home quarantine measures. By exploring the public's knowledge and attitude towards recommended home quarantine measures, their readiness in containing potential COVID-19 outbreak can be determined. This study aimed to assess the public knowledge and attitude towards home quarantine instructions and their association with history of COVID-19 infections. Methods: This was a web-based cross-sectional study conducted among the public in Malaysia between August to October 2022. All Malaysian adults over 18 years of age were included. Knowledge on home quarantine instructions and COVID-19 warning signs were measured using "True," "False," or "I'm not sure", while attitude towards home quarantine instructions was measured using a five-point Likert Scale. The questionnaire was initially constructed in English and then translated into the national language, Bahasa Malaysia. Face and content validation were performed. The internal consistency of the questionnaire was found to be satisfactory. Results: 1,036 respondents were analyzed, comprised mostly of females (743, 71.6%) with a history of COVID-19 (673, 64.9%). In the knowledge domain, more than 80% of the respondents answered 9 out of 11 home quarantine instructions statements correctly. 457 (44.1%) were unaware or unsure about the minimum distance of the infected individual's bed from the rest of the occupants in a shared bedroom. The respondents reported relatively weaker knowledge in identifying uncommon warning signs of COVID-19 deterioration, including anuria (162, 44.5%), ingestion problems (191, 52.5%), and immobility (195, 53.6%). In the attitude domain, more than 90% of respondents answered correctly in 8 out of 9 questions. Respondents with a previous history of COVID-19 infections had better knowledge than COVID-19 infection-naïve individuals towards both home quarantine instructions and COVID-19 warning signs. Conclusion: Most respondents had good knowledge and attitude towards home quarantine instructions, with those previously infected with COVID-19 showing greater awareness of uncommon warning signs. However, there was a notable lack of awareness regarding physical distancing within shared rooms, appropriate disinfectant use and mobility limitation within the household. This study highlights the knowledge gaps to be improved in future educational campaigns. [ABSTRACT FROM AUTHOR]

Technological innovations may bring unintended consequences despite their potential usefulness. Responsible innovation (RI) has gained increasing popularity in high‐tech nations as a means to mitigate potentially disruptive technological developments. Unfortunately, existing RI research has not sufficiently elucidated the sustainability performance of firms, leading to ambiguous theoretical underpinnings, relationships, and practical applicability. This study aims to address these concerns and provide directions for future research on RI. Based on the resource‐based view, the research introduces RI as a distinctive competency of a firm to investigate the mechanisms driving sustainability performance, measured in three areas: financial, social, and environmental. The study presents the antecedents of RI as a driving force that can enable businesses to gain a sustainable competitive advantage (SCA) and improve sustainability performance. Data were collected from 190 innovative manufacturing firms in Malaysia. First, structural equation modeling (SEM) was utilized to investigate the antecedents that significantly influence RI. In the second phase, artificial neural network (ANN) analysis was employed to rank the significant predictors identified through SEM. Furthermore, the RI dimensions that lead to SCA and sustainability performance were also ranked using ANN, offering practical strategic business directions for managers. [ABSTRACT FROM AUTHOR]

Sustainably managing municipal solid waste (MSW) is a global challenge since the existing MSW processing procedure releases greenhouse gases and is economically unfriendly. An emissions trading scheme (ETS) is a market-based approach for policymakers to reduce sectoral carbon emissions while maintaining economic efficiency. Hitherto, no waste optimisation framework links ETS to carbon reduction and identifies the trade-offs between the cost of carbon credit trading and waste expenses, rendering doubt of ETS's effectiveness in the waste sector. In this study, an MSW-ETS framework is developed to analyse the potential impact of ETS on the MSW management system incorporating multiple waste types, disposal and treatment facilities, and waste-based products. A multi-objective optimisation model is integrated with the MSW-ETS framework to achieve mutual environmental and economic benefits. Malaysia is selected as an illustrative case study considering its unsustainable MSW disposal and the recent carbon trading plans announced by the government. Simulation of the carbon prices alters Malaysia's MSW management configuration at 363 MYR/tonne CO2-eq, providing insights on developing the carbon price floor for a Malaysian ETS. Six MSW management configurations under different scenarios that can achieve up to 160% GHG emissions reduction were also proposed. The MSW-ETS framework integrated with the multi-objective optimisation model could be replicated by other countries planning to phase the waste sector into ETS coverage. [ABSTRACT FROM AUTHOR]

This study is an investigation into factors that encourage and/or inhibit the use of social media in the academic learning process between Australian and Malaysian students at higher learning institutions. Push-pull-mooring theory was used as a guide, resulting in seven independent variables ("convenience", "social influence", "academic reasons", "ease of use", "social networking", "barriers", and "e-learning perception"), and one dependent variable (teaching and learning benefit). The study included a survey of 524 respondents (N[subscript Australia] = 214; N[subscript Malaysia] = 310). Path modeling analysis revealed three common factors between students from both countries: academic reasons, barriers, and social networking. However Malaysian students revealed a significant greater emphasis on academic reasons and barriers compared to their Australian counterparts. No significant difference was noted for social networking, suggesting that the use of social media as a means to maintain social interaction is popular regardless of cultural differences. Alternatively, significant effects were observed for convenience and e-learning perception among Australian students, while ease of use was found to have significant impact on Malaysian students. The findings suggest that cultural differences and the education system will impact the use of social media as an online learning tool.

Global environmental concerns have garnered significant attention in recent times. Concerns about encouraging more ecologically friendly production to lessen the effects of pollution have been raised by industrial operations that cause environmental pollution. The adoption of an environmental management system in Malaysian firms, however, has received little attention. This paper explores the mediating effect of Environmental, Social and Governance (ESG) framework on the relationship between ISO 14001 Environmental Management System (EMS) and ESG performance of Malaysian companies. Partial Least Squares Structural Equation Modeling (PLS-SEM) using SmartPLS 4 was employed to assess the relationship through a conceptual model developed for this purpose. A total of 86 completed responses were collected from the targeted respondents in Malaysia of different industries. With ESG framework as a mediator, ISO 14001 EMS has an insignificant relationship with ESG performance, and the R2 value of ESG performance is 0.243. When the ESG framework is removed, ISO 14001 EMS has a significant relationship with ESG performance, and the f-square value is 0.176. This effect size is considered medium. The results provide an empirical proof for Malaysian companies to adopt the ISO 14001 EMS as a business tool, with ESG framework as a mediator in order to enhance their ESG performance. The study's conclusions highlight the implications of using ISO 14001 EMS as a tool for businesses in Malaysia to improve ESG performance. [ABSTRACT FROM AUTHOR]

Background: Translation into clinical practice for use of intravenous thrombolysis (IVT) for the management of ischemic stroke remains a challenge especially across low- and middle-income countries, with regional inconsistencies in its rate. This study aimed at identifying factors that influenced the provision of IVT and the variation in its rates in Malaysia. Methods: A multiple case study underpinning the Tailored Implementation for Chronic Diseases framework was carried out in three public hospitals with differing rates of IVT using a multiple method design. Twenty-five in-depth interviews and 12 focus groups discussions were conducted among 89 healthcare providers, along with a survey on hospital resources and a medical records review to identify reasons for not receiving IVT. Qualitative data were analysed using reflective thematic method, before triangulated with quantitative findings. Results: Of five factors identified, three factors that distinctively influenced the variation of IVT across the hospitals were: 1) leadership through quality stroke champions, 2) team cohesiveness which entailed team dynamics and its degree of alignment and, 3) facilitative work process which included workflow simplification and familiarity with IVT. Two other factors that were consistently identified as barriers in these hospitals included patient factors which largely encompassed delayed presentation, and resource constraints. About 50.0 – 67.6% of ischemic stroke patients missed the opportunity to receive IVT due to delayed presentation. Conclusions: In addition to the global effort to explore sustainable measures to improve patients' emergency response for stroke, attempts to improve the provision of IVT for stroke care should also consider the inclusion of interventions targeting on health systems perspectives such as promoting quality leadership, team cohesiveness and workflow optimisation. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is a major cause of cancer-related mortality worldwide. It is the second leading cause of cancer death in men and women in Malaysia and poses a major burden on society. Aims: To determine the overall survival rate of patients diagnosed with CRC and factors contributing to survival. Methods: Data were obtained from the Malaysia National Cancer Registry. All patients with CRC were identified, and a total of 15,515 patients were screened. A total of 5,675 CRC patients were included from January 1, 2012, to December 31, 2016. Sex, age groups, ethnic groups, stage at diagnosis, cancer sites, and status of treatment received were analysed. The Kaplan--Meier analysis was performed to estimate the 1-, 3-, and 5-year survival of CRC. The log-rank test was conducted to compare the survival between sex, age groups, ethnic groups, stage at diagnosis, cancer sites, and status of treatment received. Multiple Cox regression was conducted to determine the risk of CRC death. Results: Of 5,675, a total of 2,055 had died, 3,534 were censored, and another 86 were still alive within 5 years of CRC diagnosis. The 1-, 3-, and 5-year survival rates were 68.5%, 34.7%, and 18.4%, respectively with a median survival time of 24 months. Significant differences in survival rates of CRC were observed between age groups (p < 0.001), ethnic groups (p < 0.001), stages at diagnosis (p < 0.001), treatment status (p = 0.003), and treatment modalities (p < 0.001). No significant difference was observed in survival rates of CRC between sex (p = 0.235) and cancer sites (p = 0.410). Those who were 80 years old and above were found to be at higher risk of CRC death compared to those below 80 years old (adjusted hazard ratio (HR): 1.24, 95% CI 1.14-1.36). The risk of CRC death was also found four times higher among those with stage IV compared to those with stage 0 (adjusted HR: 4.28, 95% CI 3.26-5.62). Conclusion: In general, Malaysian patients with CRC had low survival rates. National health policies should focus on enhancing awareness of CRC, encouraging early screening, and developing strategies for early detection and management to reduce CRC-associated mortality. [ABSTRACT FROM AUTHOR]

Based on World Resource Institute (WRI)'s 2023 report, the loss of tropical primary forests in 2022 has increased, resulting in a total of 41 thousand km² being lost. Despite facing ongoing challenges in conserving existing forest areas, Malaysia has managed to keep rates of primary forest loss at nearly record-low levels. The Malaysian Government is committed to maintaining at least 50 percent of Malaysia's land mass under forest and tree cover. As of 2020, the country's forest cover is 54.58 %, exceeding the targeted goal. This paper aims to identify the effectiveness of implementing sustainable forest management practices and multiple land use policies to mitigate forest loss using Malaysia as a case study. A case study approach was used to describe the implementation of sustainable forest management practices and multiple land use policies to mitigate forest loss in Malaysia. The study reviewed government websites, land-use policies, legislative documents, journal articles, guidelines on sustainable forest management, and official press releases to gather information. Malaysia has stabilised its deforestation rates by implementing Sustainable Forest Management (SFM) including Selective Management System (SMS), Reduced Impact Logging (RIL), forest management certification, enhancement of forest law, enforcement and governance, and research and development. The country also effectively implemented various land-use policies to mitigate forest loss and promote sustainable land management practices. The analysis shows that the ongoing demand for food, transportation, and infrastructure development will continuously put the pressure on forest and resulting in controlled annual forest loss. It is essential for Malaysia implementing additional efforts to enhance its conservation efforts while striking a balance between development needs and the conservation of existing forest areas. [ABSTRACT FROM AUTHOR]

This study aims to quantify the preferences of patients with advanced cancer for quality of life (QoL) outcomes versus survival extension in Malaysia. The secondary aim of this study is to explore the change in preferences over time. A discrete choice experiment was developed to include 7 attributes valued in cancer management: physical, psychological and social functioning, pain control, survival, place of death, and cost. Patients were recruited via convenience sampling from 2 Malaysian public hospitals. The survey questionnaire was administered to patients within 6 months of their cancer diagnosis with a follow-up 3 months later. Conditional logit regression was used to estimate the preference weight, relative attribute importance, and willingness to pay. One hundred valid responses were collected at baseline and 45 at follow-up. Respondents placed higher values on QoL improvements from severe to moderate or mild levels and to achieve home death over survival extension from 6 to 18 months. However, additional improvements (from moderate to mild) in some of the QoL outcomes were not valued as highly as life extension from 12 to 18 months, showing that it was vital for patients to avoid being in "severe" health dysfunction. Improving physical dysfunction from severe to mild yielded 3 times as much value as additional 1-year survival. After 3 months, the respondents' preferences changed significantly, with increased relative attribute importance of physical functioning, pain control, and cost. As QoL outcomes are valued more than survival, palliative care should be introduced as early as possible to alleviate suffering related to advanced cancer. • Patients with advanced cancer had substantially higher preference weights for quality-of-life outcomes (physical, psychological and social functioning, minimal pain, and death at home) over an additional 1-year of survival. • Longitudinal analysis of discrete choice experiment showed that patients' preferences change over time, making it imperative to involve them in the decision-making process constantly. • Although access to novel life-extending treatment is indispensable, early integration of palliative and supportive care into cancer care is equally essential to alleviate suffering related to physical dysfunction and pain. [ABSTRACT FROM AUTHOR]

Background: Polypharmacy and the use of potentially inappropriate medications (PIMs) are prevalent among older patients admitted to hospitals, posing a heightened risk of adverse drug events. This trial aims to evaluate the effectiveness of a pharmacist-led deprescribing intervention in reducing medications, PIM and improving clinical outcomes, using the locally developed Malaysian Potentially Inappropriate Prescribing Screening tool in Older Adults (MALPIP). Methods: This is an 18-month cluster-randomized, open-label, parallel-arm controlled trial conducted at 14 public hospitals in the Perak state of Malaysia. Patients aged 60 and above, who have at least one medication and one comorbidity are eligible. A stratified-cluster randomization design is employed, with 7 hospitals assigned to the control arm and 7 hospitals assigned to the intervention arm. The MALPIP screening tool will be used in the intervention group to review the medications. If PIM is detected, the pharmacists will discuss with doctors and decide whether to stop or reduce the dose. The primary outcomes of this trial are the total number of medications and number of PIM. The secondary outcomes include fall, emergency department visits, readmissions, quality of life and mortality. Outcomes will be measured during enrolment, discharge, 6, 12, and 18 months. Discussion: This REVMED trial aims to test the hypothesis that a pharmacist-led deprescribing intervention initiated in the hospital will reduce the total number of medications and PIM 18 months after hospital discharge, reducing fall, emergency department visits, readmissions, mortality and lead to improvement in quality of life. Trial findings will quantify the clinical outcomes associated with reducing medications and PIM for hospitalized older adults with polypharmacy. Trial registration number: This trial was prospectively registered at clinicaltrials.gov (NCT05875623) on the 25th of May 2023. NCT05875623 Clinicaltrials.gov URL: NCT05875623 registered on 25th July 2023. [ABSTRACT FROM AUTHOR]

Previous cross‐cultural eye‐tracking studies examining face recognition discovered differences in the eye movement strategies that observers employ when perceiving faces. However, it is unclear (1) the degree to which this effect is fundamentally related to culture and (2) to what extent facial physiognomy can account for the differences in looking strategies when scanning own‐ and other‐race faces. In the current study, Malay, Chinese and Indian young adults who live in the same multiracial country performed a modified yes/no recognition task. Participants' recognition accuracy and eye movements were recorded while viewing muted face videos of own‐ and other‐race individuals. Behavioural results revealed a clear own‐race advantage in recognition memory, and eye‐tracking results showed that the three ethnic race groups adopted dissimilar fixation patterns when perceiving faces. Chinese participants preferentially attended more to the eyes than Indian participants did, while Indian participants made more and longer fixations on the nose than Malay participants did. In addition, we detected statistically significant, though subtle, differences in fixation patterns between the faces of the three races. These findings suggest that the racial differences in face‐scanning patterns may be attributed both to culture and to variations in facial physiognomy between races. [ABSTRACT FROM AUTHOR]

Background: Despite advancements in hepatitis C virus (HCV) treatment, low uptake among hard-to-reach populations remains a global issue. The current study aimed to assess the feasibility of a modified same-day test-and-treat model in improving HCV care for people who inject drugs (PWID) living in resource-constrained rural areas. Methods: A pilot study was conducted in four primary healthcare (PHC) centers in Malaysia. The model's key features included on-site HCV ribonucleic acid (RNA) testing using a shared GeneXpert® system; noninvasive biomarkers for cirrhosis diagnosis; and extended care to PWID referred from nearby PHC centers and outreach programs. The feasibility assessment focused on three aspects of the model: demand (i.e., uptake of HCV RNA testing and treatment), implementation (i.e., achievement of each step in the HCV care cascade), and practicality (i.e., ability to identify PWID with HCV and expedite treatment initiation despite resource constraints). Results: A total of 199 anti-HCV-positive PWID were recruited. They demonstrated high demand for HCV care, with a 100% uptake of HCV RNA testing and 97.4% uptake of direct-acting antiviral treatment. The rates of HCV RNA positivity (78.4%) and sustained virologic response (92.2%) were comparable to standard practice, indicating the successful implementation of the model. The model was also practical, as it covered non-opioid-substitution-therapy-receiving individuals and enabled same-day treatment in 71.1% of the participants. Conclusions: The modified same-day test-and-treat model is feasible in improving HCV care for rural PWID. The study finding suggests its potential for wider adoption in HCV care for hard-to-reach populations. [ABSTRACT FROM AUTHOR]

Introduction: Handgrip strength (HGS) measures the maximum voluntary force of the hand, which has been used to assess individual health status indirectly. Although several factors related to HGS have been identified, studies among adults in Malaysia are lacking. This study aimed to provide the normative reference HGS values and determine its predictor factors among healthy adults of Malay ethnic in Malaysia. Methodology: This study was a part of the Prospective Urban Rural Epidemiology (PURE) study carried out among adults aged between 35 to 70 years old residing in urban and rural Malaysian communities. A standardised questionnaire was used to assess the socio-demographic information and physical activity level of respondents who provided written informed consent to participate in this study. HGS was measured using Jamar's dynamometer. A total of 3,446 healthy adults of Malay ethnic were included in this study. Descriptive data were used to derive the normative reference values for HGS using means and standard deviations stratified by age and gender. The predictors of HGS were determined using a general linear model (GLM). Results: Mean HGS ranged from 38.48 (± 9.40) kg for the dominant hand of men aged 35–40 years to 16.53 (± 5.69) kg for the non-dominant hand of women aged 61–70 years. The ANOVA indicated that there was a significant descending trend of HGS as age increased for both genders (p < 0.05). The ANOVA also revealed that participants working in blue- or white-collar jobs had higher HGS than their counterparts who are homemakers (p < 0.05). The GLM shows that, age, occupation type, socio-economic status (SES), physical activity level and BMI significantly predicted dominant HGS among male and meanwhile, only age, SES and BMI significantly predicted dominant HGS among female. Conclusion: HGS normative values provided herein can serve as a guide for interpreting HGS measurements obtained from healthy Asian adults especially Malay ethnic. The clinicians and researcher can use the established HGS reference values as comparison in their patients or participants. Furthermore, during a rehabilitation process, the clinicians and researchers could use the normal score ranges to document the progress of HGS and provide feedback to the patients. Further study with prospective study design is needed to determine the causal effect association of the predictors and HGS. [ABSTRACT FROM AUTHOR]

Despite a plethora of studies identifying the various stressors responsible for stress incursion, many undergraduates still fail to cope with them, especially if there is a lack of necessary psychosocial resources. The purpose of this study is to examine the contribution of three psychosocial resources on stress reduction among undergraduates using a partial least squares-structural equation modelling approach. Based on cognitive adaptation theory (CAT), dispositional optimism, perceived academic control, and self-esteem were incorporated into the model to analyse the hypothesised relationships with stress. A survey-based cross-sectional study involving 147 undergraduates from a Malaysian public university was conducted. The questionnaire consists of four scales; namely Life Orientation Test-Revised, Perceived Academic Control Scale, Rosenberg's Self-Esteem Scale, and Perceived Stress Scale. SmartPLS 3.0 was applied to understand the role of each psychosocial resource on stress. First-year undergraduates were found to have the highest level of perceived stress as compared to students in the other years of study. The results indicated an acceptable level of the measurement model. The structural model also showed moderate predictive relevance. Although self-esteem was not found to predict stress, both dispositional optimism and perceived academic control were found to negatively predict stress. Moreover, importance-performance map analysis (IPMA) indicated that university management should focus on dispositional optimism and invest additional effort in prioritising perceived academic control. Findings from this study will provide valuable insights into the role of psychosocial resources for undergraduate students to cope with stress. [ABSTRACT FROM AUTHOR]

Background: This study aimed to describe the clinical characteristics and severity of young infants hospitalized with COVID‐19 and study the relationship between breastfeeding and maternal COVID‐19 vaccination on the severity of COVID‐19. Methods: A retrospective, observational study was performed among infants aged 6 months and below hospitalized for COVID‐19 in a tertiary state hospital in Malaysia between February 1 and April 30, 2022. The primary outcome was "serious disease," defined as pneumonia requiring respiratory support or dehydration with warning signs. Multivariate logistic regression was used to determine independent predictors for serious disease. Results: A total of 102 infants were included in the study; 53.9% were males with a median age of 11 weeks (interquartile range: 5–20 weeks). Sixteen patients (15.7%) had pre‐existing comorbidities, including preterm birth. Fever was the most common presenting symptom (82.4%), followed by cough (53.9%), and rhinorrhea (31.4%). Forty‐one infants (40.2%) presented with serious disease, warranting either respiratory support or intravenous fluid therapy for dehydration. Recent maternal COVID‐19 vaccination was associated with a reduced risk of serious disease on univariate analysis but was not significant after multivariate adjustment (adjusted odds ratio [aOR] 0.39; 95% CI: 0.14–1.11; p = 0.08). Exclusive breastfeeding was protective against serious COVID‐19 in young infants, independent of other confounding factors (aOR 0.21, 95% CI: 0.06–0.71; p = 0.01). Conclusion: COVID‐19 is a serious disease with non‐specific clinical manifestations in young infants. Exclusive breastfeeding could play an important protective role. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the clinicopathological patterns and survival outcomes of patients with young-onset colorectal cancer (CRC) in Malaysia.Methods: A total of 206 patients with young-onset CRC (age < 50 years at diagnosis) and 1,715 patients with late-onset CRC (age ≥ 50 years at diagnosis) diagnosed during 2002-2016 were included. The clinicopathological characteristics of patients with young-onset CRC were compared with those of patients with late-onset CRC during 2009-2013. Kaplan-Meier survival analysis was performed to determine the overall survival (OS) and disease-specific survival (DSS) in these patients.Results: The overall proportion of young-onset CRC was 10.7%. The mean age for young-onset CRC was 39.5 ± 7.4 years, with a male-to-female ratio of 1.2:1. There were more Malay patients with young-onset CRC than late-onset CRC (44.0% vs. 19.9%, p = 0.004). Most CRCs were diagnosed at an advanced stage in both groups. However, young-onset CRC showed more aggressive tumour characteristics, such as poorer differentiation and mucinous subtype. Despite such differences, the OS and DSS in both groups were similar (five-year OS for young-onset CRC vs. late-onset CRC: 44.2% vs. 49.0%, p = 0.40; five-year DSS for young-onset CRC vs. late-onset CRC: 48.8% vs. 57.6%, p = 0.53; mean survival of young-onset CRC vs. late-onset CRC: 4.9 years vs. 5.4 years, p = 0.15). Advanced stage at diagnosis and the treatment modality used were independent prognostic factors.Conclusion: The unique ethnic and histological differences between patients with young- and late-onset CRC suggest that young-onset CRC may represent a distinct entity. However, despite such differences, both groups were equivalent. [ABSTRACT FROM AUTHOR]

Fracture-related infection is a serious complication in orthopedic surgery with severe consequences for the patient. We evaluated whether a novel noble metal nail-coating technology can prevent bacterial adhesion and biofilm formation without interfering with bony union. In this retrospective, single-center case series, we described the incidence of fracture-related infections and bony union achievement in patients who had Gustilo type IIIa or IIIb femoral or tibial fractures treated with noble metal alloy-coated titanium nails. Patients were treated between January 2017 and January 2019 at the Sultanah Aminah Hospital, Johor Bahru, Malaysia. Information on fracture-related infections and bone healing assessments was collected from patient records. Additionally, three independent experts retrospectively reviewed patient X-ray images from follow-up visits to further evaluate bony union achievement. Thirty-five patients were included. Infection developed in 3/35 (8.6%) patients; all cases were resolved by antibiotic therapy. Radiographs were available for 32 patients; these confirmed the presence of bone healing in 30/32 (93.8%) patients. However, according to patient records, bony union was achieved in all patients. No safety issues were recorded. This case series suggests that a noble metal alloy-coated titanium nail can prevent infection and facilitate bony union achievement in patients undergoing surgery for severe open fractures. [ABSTRACT FROM AUTHOR]

Introduction: Translation of evidence into clinical practice for use of intravenous thrombolysis in acute stroke care has been slow, especially across low- and middle-income countries. In Malaysia where the average national uptake was poor among the public hospitals in 2018, one hospital intriguingly showed comparable thrombolysis rates to high-income countries. This study aimed to explore and provide in-depth understanding of factors and explanations for the high rates of intravenous stroke thrombolysis in this hospital. Methods: This single case study sourced data using a multimethod approach: (1) semi-structured in-depth interviews and focus group discussions, (2) surveys, and (3) review of medical records. The Tailored Implementation of Chronic Diseases (TICD) framework was used as a guide to understand the determinants of implementation. Twenty-nine participants comprising the Hospital Director, neurologists, emergency physicians, radiologists, pharmacists, nurses and medical assistants (MAs) were included. Thematic analyses were conducted inductively before triangulated with quantitative analyses and document reviews. Results: Favorable factors contributing to the uptake included: (1) cohesiveness of team members which comprised of positive interprofessional team dynamics, shared personal beliefs and values, and passionate leadership, and (2) facilitative work process through simplification of workflow and understanding the rationale of the sense of urgency. Patient factors was a limiting factor. Almost two third of ischemic stroke patients arrived at the hospital outside the therapeutic window time, attributing patients' delayed presentation as a main barrier to the uptake of intravenous stroke thrombolysis. One other barrier was the availability of resources, although this was innovatively optimized to minimize its impact on the uptake of the therapy. As such, potential in-hospital delays accounted for only 3.8% of patients who missed the opportunity to receive thrombolysis. Conclusions: Despite the ongoing challenges, the success in implementing intravenous stroke thrombolysis as standard of care was attributed to the cohesiveness of team members and having facilitative work processes. For countries of similar settings, plans to improve the uptake of intravenous stroke thrombolysis should consider the inclusion of interventions targeting on these modifiable factors. [ABSTRACT FROM AUTHOR]

Acute pharyngitis (AP) is a common reason for private primary care consultations, thus providing an avenue for widespread antibiotic intake among the community. However, there is limited data on the antibiotic prescription appropriateness and resistance information in the Malaysian private primary care setting, therefore, this study aimed to investigate the prevalence of isolated viruses and bacteria, antibiotic resistance patterns, antibiotic prescription patterns and appropriateness by general practitioners (GPs) and factors affecting antibiotic resistance and antibiotic prescription patterns. To investigate, a cross-sectional study was conducted among 205 patients presenting with AP symptoms at private primary care clinics in central Malaysia from 3rd January 2016 to 30th November 2016. Throat swabs were collected from 205 AP patients for two purposes: (i) the detection of four common respiratory viruses associated with AP via reverse-transcription real-time PCR (qRT-PCR); and (ii) bacterial identification using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). Bacterial isolates were then subjected to antibiotic susceptibility screening and McIsaac scoring was calculated post-prescription based on GP selection of criteria. Generalized estimating equations analysis with multiple logistic regression was conducted to identify factors associated with presence of virus and antibiotic prescription. The results showed that 95.1% (195/205) of patients had at least one of the four viruses, with rhinovirus (88.5%) being the most prevalent, followed by adenovirus (74.9%), influenza A virus (4.6%) and enterovirus (2.1%). A total of 862 non-repetitive colonies were isolated from the culture of throat swabs from 205 patients who were positive for bacteria. From a total of 22 genera, Streptococcus constitutes the most prevalent bacteria genus (40.9%), followed by Neisseria (20%), Rothia (13.0%), Staphylococcus (11%) and Klebsiella (4.9%). Only 5 patients carried group A beta-hemolytic streptococci (GABHS). We also report the presence of vancomycin-resistant S. aureus or VRSA (n = 9, 10.1%) among which one isolate is a multidrug-resistant methicillin-resistant S. aureus (MDR-MRSA), while 54.1% (n = 111) were found to carry at least one antibiotic-resistant bacteria species. Application of the McIsaac scoring system indicated that 87.8% (n = 180) of patients should not be prescribed antibiotics as the majority of AP patients in this study had viral pharyngitis. The antibiotic prescription appropriateness by applying post-prescription McIsaac scoring was able to rule out GABHS pharyngitis in this sample with a GABHS culture-positive sensitivity of 40% (n = 2/5) and specificity of 90% (180/200). In conclusion, antibiotic-resistant throat isolates and over-prescription of antibiotics were observed and McIsaac scoring system is effective in guiding GPs to determine occurrences of viral pharyngitis to reduce unnecessary antibiotic prescription. [ABSTRACT FROM AUTHOR]

Silage produced in tropical countries is prone to spoilage because of high humidity and temperature. Therefore, determining indigenous bacteria as potential inoculants is important to improve silage quality. This study aimed to determine bacterial community and functional changes associated with ensiling using amplicon metagenomics and to predict potential bacterial additives associated with silage quality in the Malaysian climate. Silages of two forage crops (sweet corn and Napier) were prepared, and their fermentation properties and functional bacterial communities were analysed. After ensiling, both silages were predominated by lactic acid bacteria (LAB), and they exhibited good silage quality with significant increment in lactic acid, reductions in pH and water-soluble carbohydrates, low level of acetic acid and the absence of propionic and butyric acid. LAB consortia consisting of homolactic and heterolactic species were proposed to be the potential bacterial additives for sweet corn and Napier silage fermentation. Tax4fun functional prediction revealed metabolic pathways related to fermentation activities (bacterial division, carbohydrate transport and catabolism, and secondary metabolite production) were enriched in ensiled crops (p < 0.05). These results might suggest active transport and metabolism of plant carbohydrates into a usable form to sustain bacterial reproduction during silage fermentation, yielding metabolic products such as lactic acid. This research has provided a comprehensive understanding of bacterial communities before and after ensiling, which can be useful for desirable silage fermentation in Malaysia. [ABSTRACT FROM AUTHOR]

Ambient air pollution is a significant contributor to disease burden, leading to an estimated 4.2 million premature deaths and 103.1 million disability-adjusted life years (DALYs) annually worldwide. As industrialization and urbanization surge in Asia, air pollution and its corresponding health issues follow suit. Findings on disease burden in developing countries are extremely scanty. This study aimed to determine the concentration of PM2.5 and its impact on respiratory health of outdoor workers in Malaysia. A 2-cycled 3-month cohort study involving 440 participants was conducted. Workers' health status was assessed via (1) Total Ocular Symptom Score (TOSS), (2) Total Nasal Symptom Score (TNSS), (3) St. George's Respiratory Questionnaire (SGPQ), and (4) Asthma Control Test (ACT). The maximum PM2.5 concentration was measured at 122.90 ± 2.07 µg/m3 during third week of August 2016. Meanwhile, the minimum concentration was measured at 57.47 ± 3.80 µg/m3 and 57.47 ± 1.64 µg/m3 during fourth week of July 2016 and first week of August 2017 respectively. Findings revealed that TOSS, TNSS, and SGPQ changes were significantly (p < 0.05) associated with the concentration of PM2.5. Outdoor workers were more significantly (p < 0.05) affected by changes in PM2.5 compared to indoor workers with a moderate correlation (r value ranged from 0.4 to 0.7). Ironically, no significant association was found between ACT assessment and PM2.5. Collectively, our findings suggested that changes in the concentration of PM2.5 threatened the respiratory health of outdoor workers. The existing policy should be strengthened and preventive measures to be enforced safeguarding health status of outdoor workers. [ABSTRACT FROM AUTHOR]

Low‐intensity shockwave therapy (LiSWT) has emerged as a promising non‐invasive treatment modality for erectile dysfunction (ED) yet the well‐designed randomized clinical trials are still lacking to prove its claimed benefits. A randomized, prospective, double‐blinded sham‐controlled study was conducted to evaluate the effectiveness and safety profile of short course LiSWT on vasculogenic ED patients. The International Index of Erectile Function‐5 (IIEF‐5) and Erection Hardness Score (EHS) questionnaires were used for evaluation. Patients underwent weekly sessions for 4 weeks and were re‐assessed at 1, 3 and 6 months post therapy. Fifty one patients were recruited and randomized into sham and treatment arms. The mean IIEF‐5 scores were significantly improved in the treatment arm compared to worsening of scores in the sham arm after 1 month (14.1 vs. 9.3 p < 0.001), 3 months (14.9 vs. 8.6, p < 0.001) and 6 months (14.2 vs. 7.9, p < 0.001) post treatment. A significant improvement of EHS was demonstrated at 1 month (2.4 vs. 1.8, p = 0.001, 3 months 2.7 vs. 1.7, p < 0.001) and 6 months (2.7 vs. 1.6, p < 0.001) in the treatment arm compared to sham arm. The success rate based on IIEF score increment more than five points was 26% in treatment arm and 0% in sham arm. Improvement in EHS score ≥3 in the treatment versus sham arm was 63% and 4%, respectively. There was no adverse effect reported. This 4‐week LiSWT protocol reflects better treatment compliance, and it prevents further deterioration of erectile function among this cohort of patients. This study proves that LiSWT is a well‐tolerated treatment with modest improvements in erectile function and hardness, among patients with vasculogenic ED. [ABSTRACT FROM AUTHOR]

Introduction: Upper respiratory tract infection (URTI) is commonly encountered at the primary care level. Its management is particularly challenging due to the similarity of its symptoms to coronavirus disease 2019 (COVID-19) infection. Our study evaluated the profiles and antibiotic use of patients seeking care from a dedicated community-based URTI clinic during the COVID-19 pandemic. Methods: A cross-sectional study was conducted. Data were obtained from the medical records of patients visiting the URTI clinic at the Alor Setar Primary Healthcare Centre between March and April 2020. Results: Overall, 587/4388 (13.3%) patients received treatment at the URTI clinic. Most patients were male (60.6%) and aged between 20 and 39 years (35.5%). Their most common symptoms were cough (68.4%), fever (31.6%), runny nose (24.6%), and sore throat (24.1%). Most patients were diagnosed with acute nasopharyngitis (52.5%), acute pharyngitis (18.6%), or acute tonsillitis (5.3%). The symptomatic medication prescription rate was 96.5%. Only 26 of the 435 patients diagnosed with URTI received antibiotics, yielding an antibiotic use rate of only 6.0% for URTI relative to overall drug use. Acute tonsillitis was more common in children <12 years old (p<0.001), while a cough and runny nose were more commonly indicative of acute nasopharyngitis than other conditions (p<0.001). Sore throat was more likely to be a symptom of acute pharyngitis (p<0.001) and acute tonsillitis (p<0.001). Conclusion: Despite the challenges faced during the COVID-19 pandemic, the findings suggest that patients with URTI-like symptoms were properly managed, and the rate of antibiotic usage remained reasonable. [ABSTRACT FROM AUTHOR]

With the sudden change of environment and limited studies on the effects of COVID-19 lockdown among university students, this study therefore aims to examine the effects of COVID-19 lockdown on physical activity level and mental health among university students in Malaysia. This is a cross-sectional study involving university students studying in Klang Valley, Malaysia. Demographics information, living status during COVID-19, physical activity level and mental health status were obtained through online questionnaire via Microsoft forms. Paired T-test was used to compare the effect of physical activity level and mental health status during COVID-19 lockdown. Data on falls was available for 383 participants with 254 (66.3 %) women and 129 (33.7%) men. Overall, the metabolic equivalent task (MET) of vigorous, moderate, mild, and total MET has decreased during COVID-19 lockdown as compared to before COVID-19 lockdown. Approximately an increment of 6% of participants reported having depression and anxiety during COVID-19 lockdown. In conclusion, significant impact on physical activity level and mental health was found in our study. Our study findings could therefore assist educational institutions and policymakers in forming strategies to improve student's overall health, yet further longitudinal studies should be performed to examine the long-term effects of COVID-19 lockdown. [ABSTRACT FROM AUTHOR]

With the increasing demand for giant clams in the ornamental trade as well as habitat destruction of coral reefs, giant clam populations have been threatened across the Indo‐Pacific. This study documents the population status and genetic diversity of giant clams in Perhentian Islands Marine Park (PMP), a Marine Protected Area (MPA) on the east coast of Peninsular Malaysia, plus Rhu Island, an adjacent island outside the MPA.Of the 13 reef sites surveyed across an area of 11,200 m2, two giant clam species were recorded: Tridacna squamosa and Tridacna maxima, with average densities of 1.5 ± 2.2 and 5.2 ± 6.0 ind. 100 m−2, respectively. The size‐class survey revealed a higher number of T. maxima recruits (88 recruits) as compared to T. squamosa (only three recruits), suggesting a disparity in recruitment in the area.The genetic diversity of T. squamosa (n = 83) and T. maxima (n = 104) was explored using the mitochondrial cytochrome c oxidase I (COI) and 16S rRNA gene markers. Interestingly, a higher genetic diversity was detected in COI than 16S for both species. No significant genetic differentiation was detected between the populations of PMP and Rhu Island, while a low but significant genetic structure was detected in both species across the sites of PMP (COI datasets, AMOVA, T. squamosa, FCT = 0.14, P < 0.05; T. maxima, FCT = 0.11, P < 0.05).In general, the results of this study revealed healthy giant clam populations in PMP, but the decline warrants urgent attention to integrating conservation strategies such as restoration programmes in conjunction with a sustainable giant clam fishery. Given the relatively high genetic diversity of T. maxima at Rhu Island, expansion of the current MPA is needed for better conservation coverage. [ABSTRACT FROM AUTHOR]

Background: Chronic pain has a major impact on a patient's quality of life, affecting physical and psychological functioning. It has debilitating consequences on social and economic aspects too. This study aimed to explore the status of health-related quality of life (HRQoL) of Malaysian patients suffering from chronic non-malignant pain.Methods: Four hospitals offering pain clinic services were involved in this multicentre cross-sectional study conducted between June and September 2020. Adult patients who had been diagnosed with non-malignant chronic pain lasting for at least three months and able to communicate in English or Malay language were recruited in this study. Participants were informed about the study and were made aware that their participation was entirely voluntary. A battery of questionnaires consists of the EuroQol-5 dimensions-5 levels questionnaire (EQ-5D-5L) and the EuroQol visual analogue scale (EQ VAS), the Pain Self-Efficacy questionnaire (PSEQ) and the Pain Catastrophizing Scale (PCS) were self-administered by the patients. Besides, a structured questionnaire was used to collect their socio-demographic information, pain condition, sleep quality and working status. Participants' usage of pain medications was quantified using the Quantitative Analgesic Questionnaire (QAQ).Results: A total of 255 patients participated in this study. A median EQ-5D index value of 0.669 (IQR: 0.475, 0.799) and a median EQ VAS score of 60.0 (IQR: 50.0, 80.0) were recorded. Malay ethnicity (Adj. B: 0.77; 95% CI: 0.029, 0.126; p = 0.002) and a higher level of self-efficacy (Adj. B: 0.008; 95% CI: 0.006, 0.011; p < 0.001) were predictors of a better HRQoL, while suffering from pain in the back and lower limb region (Adj. B: -0.089; 95% CI: - 0.142, - 0.036; p = 0.001), the use of a larger amount of pain medications (Adj. B: -0.013; 95% CI: - 0.019, - 0.006; p < 0.001), and a higher degree of pain magnification (Adj. B: -0.015; 95% CI: - 0.023, - 0.008; p < 0.001) were associated with a poorer HRQoL.Conclusions: These findings suggested that Malay ethnicity and a higher level of self-efficacy were predictors of a better HRQoL in patients with chronic pain, whereas pain-related factors such as higher usage of medication, specific pain site and pain magnification style were predictors of poorer HRQoL. [ABSTRACT FROM AUTHOR]

Background: Malaysia has an estimated hepatitis C virus (HCV) prevalence of 1.9% among its adult population and a history of providing HCV treatment in the public sector. In 2019, Malaysia launched a 5-year national strategic plan for viral hepatitis control and has been expanding HCV testing and treatment to the primary care and community levels, while actively engaging key populations in services for hepatitis care. The Ministry of Health (MoH) is seeking to specifically understand how to better target HCV services at men who have sex with men (MSM); HCV self-testing could increase the uptake of HCV testing among this group. Methods: We aim to integrate HCV antibody self-testing into an existing online platform used for HIV self-testing, to evaluate the acceptability and impact of an online HCV self-testing programme in Malaysia. This is a non-blinded parallel group quasi-randomised superiority study comparing HCV self-testing via an online distribution model with the standard care, which involves attending a clinic for facility-based HCV antibody testing (control, 2:1). Participants will be randomised to either the HCV self-testing via online distribution arm, in which either an oral fluid- or bloodbased HCV self-test kit will be mailed to them, or the control arm, where they will be provided with information about the nearest centre with HCV testing. The primary outcome is the number and proportion of participants who report completion of testing. Secondary outcomes include the number and proportion of participants who (a) receive a positive result and are made aware of their status, (b) are referred to and complete HCV RNA confirmatory testing, and (c) start treatment. Acceptability, feasibility, attitudes around HCV testing, and cost will also be evaluated. The target sample size is 750 participants. Discussion: This study is one of the first in the world to explore the real-world impact of HCV self-testing on key populations using online platforms and compare this with standard HCV testing services. The outcomes of this study will provide critical evidence about testing uptake, linkage to care, acceptability, and any social harms that may emerge due to HCV self-testing. [ABSTRACT FROM AUTHOR]

Purpose: Sustainable development concern, coupled with changes in the talent landscape, has led to a heightened focus on green human resource management (GHRM). Drawing on attribution theory and conservation of resources theory, this study examined GHRM, leader–member exchange (LMX) and core self-evaluations (CSE) in relation to work engagement together with human resource management (HRM) performance attributions as a mediator. Design/methodology/approach: Partial least squares structural equation modelling (PLS-SEM) was used to analyse the data collected from 110 respondents working in ISO 14001 certified organisations in Malaysia. Findings: Results revealed that GHRM and LMX were positively related to HRM performance attributions that were intended to improve employee performance. However, CSE was not found to be related to HRM performance attributions. Consequently, HRM performance attributions were positively related to work engagement. Furthermore, GHRM and LMX had positive indirect effects on work engagement through HRM performance attributions as a mediator. Research limitations/implications: Since the data collected were from Malaysia only, it limits the generalisability of the results to other regions. Practical implications: The findings suggest that organisations should adopt GHRM and train its leaders to forge stronger social bonds with their subordinates to elicit higher work engagement by positively influencing employee attributions on the motives of HRM practices. Originality/value: This study contributes to the acknowledged gap on GHRM and HRM attributions by examining the non-green employee outcomes of GHRM and the antecedents of HRM performance attributions. This study also contributes by integrating attribution theory with conservation of resources theory to provide the mediation mechanism in linking GHRM and LMX towards higher work engagement through HRM performance attributions as a mediator; thus empirically illustrating the resource gain spirals. [ABSTRACT FROM AUTHOR]

Dengue is a mosquito-borne disease that causes high mortality and fatality rate among humans. The disease and the virus are spread through female Ae. aegypti and Ae. albopictus. 176 Modified Sticky Ovitraps (MSO) were installed in six blocks of high-rise apartment buildings in Petaling Jaya, Selangor. The specimens were collected throughout a duration of 26 weeks. NS1 dengue antigen kit was used to detect dengue antigen in mosquitoes, and positive mosquitoes were serotyped using Reverse Transcriptase-PCR, followed by Multiplex-PCR. The relationship between the number of Aedes mosquitoes and meteorological parameters was also determined. The association between the number of Aedes spp. captured, dengue cases, and positive specimens was also evaluated in this study. A total of 243 adult mosquitoes were successfully captured using MSO, with 95.1% (231) of the mosquitoes being Ae. aegypti, while 4.1% (10) and 0.8% (2) were Ae. albopictus and a mixed Aedes species, respectively. The molecular detection of the dengue virus showed that only 2 individual specimens of Ae. aegypti were positive, with one specimen being a dual serotype of DEN-II and IV, and another specimen was DENV-II. The weekly number of Aedes spp. captured correlated positively with Tmax, Tmin, and Tmean, and correlated negatively with RF and RH. The significant and useful data obtained from this study can be utilized in dengue vector management by local health authorities. [ABSTRACT FROM AUTHOR]

Background: While the availability of generic direct-acting antivirals (DAAs) opens the door for large-scale treatment, the care for people living with hepatitis C virus (HCV) in Malaysia is shifting toward a tripartite partnership between the public health system, correctional settings and civil society organizations (CSOs). This study aimed to explore the barriers to scaling up HCV treatment in Malaysia from the perspective of key stakeholders.Methods: Eighteen focus-group discussions (FGDs) were conducted with 180 individuals, who actively engaged in coordinating, executing or supporting the implementation of the national strategic plan for HCV. An analytical framework was adapted to guide the data collection and thematic analysis. It covered four key aspects of HCV treatment: geographical accessibility, availability, affordability and acceptability.Results: Movement restrictions in times of coronavirus disease 2019 (COVID-19) outbreaks and being marginalized translated into barriers to treatment access in people living with HCV. Barriers to treatment initiation in health and correctional settings included limited staffing and capacity; disruption in material supply; silos mentality and unintegrated systems; logistical challenges for laboratory tests; and insufficient knowledge of care providers. Although no-cost health services were in place, concerns over transportation costs and productivity loss also continued to suppress the treatment uptake. Limited disease awareness, along with the disease-related stigma, further lowered the treatment acceptability.Conclusions: This study disclosed a series of supply- and demand-side barriers to expanding the treatment coverage among people living with HCV in Malaysia. The findings call for strengthening inter-organizational collaborations to overcome the barriers. [ABSTRACT FROM AUTHOR]

Background: During the early phase of the COVID-19 pandemic, antibiotic usage among COVID-19 patients was noted to be high in many countries. The objective of this study was to determine the prevalence of antibiotic usage and factors affecting antibiotic usage among COVID-19 patients during the early phase of the COVID-19 pandemic in Malaysia. Methods: This was a cross-sectional study that involved reviewing medical records of COVID-19 Malaysian patients aged 12 and above who were diagnosed with COVID-19 and received treatment in 18 COVID-19 hospitals from February to April 2020. A minimum sample of 375 patients was required. A binary logistic regression analysis was performed to determine factors associated with antibiotic usage. Variables with p < 0.05 were considered statistically significant. Results: A total of 4043 cases were included for analysis. The majority of the patients (87.6%) were non-smokers, male (65.0%), and had at least one comorbidity (37.0%). The median age was 35 years (IQR: 38). The prevalence of antibiotic usage was 17.1%, with 5.5% of them being prescribed with two or more types of antibiotics. The most frequent antibiotics prescribed were amoxicillin/clavulanic acid (37.8%), ceftriaxone (12.3%), piperacillin/tazobactam (13.3%), azithromycin (8.3%), and meropenem (7.0%). Male patients (adjusted OR 1.53), who had a comorbidity (adjusted OR 1.36), associated with more severe stage of COVID-19 (adjusted OR 6.50–37.06), out-of-normal range inflammatory blood parameters for neutrophils, lymphocytes, and C-reactive protein (adjusted OR 2.04–3.93), corticosteroid use (adjusted OR 3.05), and ICU/HDU admission (adjusted OR 2.73) had higher odds of antibiotic use. Conclusions: The prevalence of antibiotic usage in the early phase of the COVID-19 pandemic was low, with amoxicillin/clavulanic acid as the most common antibiotic of choice. The study showed that clinicians rationalized antibiotic usage based on clinical assessment, supported by relevant laboratory parameters. [ABSTRACT FROM AUTHOR]

The uptake of the immunochemical faecal occult blood test (iFOBT) in many countries with an opportunistic colorectal cancer (CRC) screening programme remains suboptimal. This study aimed to determine the rate, associated factors and reasons of refusal to perform the iFOBT test offered under an opportunistic CRC screening programme in semi-urban communities. This cross-sectional study was conducted among the average-risk individuals living in semi-urban areas, who sought care from public primary care centres across Kedah state, Malaysia. The information regarding the sociodemographic and clinical characteristics of individuals who were offered the iFOBT between January and April 2019, along with their willingness to perform the test, was gathered. The factors associated with the refusal were further explored using the logistic regression analysis. The individuals offered the iFOBT (n = 920) were mainly female (52.4%) and had a mean age of 58.7±10.6 years. The refusal rate of the iFOBT was 32.2%. Patients who did not have hypertension (adjusted OR: 3.33; 95% CI: 2.44, 4.54), did not have CRC symptoms (adjusted OR: 3.15; 95% CI:1.26, 7.89), had the test offered by either medical assistants (adjusted OR: 2.44; 95% CI: 1.71, 3.49) or nurses (adjusted OR: 2.41; 95% CI 1.65, 3.51), did not have diabetes (adjusted OR: 1.99; 95% CI: 1.42, 2.77),and were not active smokers (adjusted OR: 1.74; 95% CI: 1.22, 2.47), were more likely to refuse the iFOBT. The common reasons of refusing the test included "feeling not ready for the test" (21.6%) and "feeling healthy" (14.9%). The iFOBT was refused by one-third of the average-risk individuals from semi-urban communities. The associated factors and reasons of refusal found in this study could guide policymakers in developing targeted interventions to boost the uptake of CRC screening in Malaysia. [ABSTRACT FROM AUTHOR]

This study presents how a cluster of tributary watersheds was evaluated for geomorphology and ecosystem service economic value baselines. Tributary watersheds, although small, were focused herein as they are practical for community-based conservation. Based on the Market-Price Method, the watersheds were estimated to be worth USD49.59 ha−1 year−1 at the time of this study and USD58.13 ha−1 year−1 in 2026. The watersheds were able to meet water demand of 20.94 megalitre day−1 required by the 93,084 local populations during the worst-case scenario induced by a peak El Niño and Southern Oscillation event in 2016. Collectively, the watersheds were contributing 703.87 megalitre day−1; thus, water shortages are not expected in near future, unless if they are compromised. The data acquired are also compared with studies elsewhere, and some insights on other baseline metrics, risk factors and humanizing watershed conservation are discussed. [ABSTRACT FROM AUTHOR]

Of late, disruptive innovation in financial services is driving the tremendous growth of cryptocurrency, with Bitcoin being the most popular virtual currency of interest among investors. Notwithstanding the volatility of the cryptocurrencies, Bitcoin preserves a core group of committed users. Despite concerns over security threats of digital transactions, little is known about Bitcoin users' perceived security and trust in the Bitcoin system. As such, this paper aims to examine the underlying security features that lead to users' perceived security and trust, and the role of perceived security and trust in explaining Bitcoin use. Structural equation modelling was used to analyse self-report questionnaires from 109 Bitcoin users. Technical protections, transaction procedures and security statements are the determinants of perceived security and trust towards Bitcoin. Nonetheless, findings of the importance-performance map analysis (IPMA) indicated that perceived security, perceived trust and technical protections are the areas of focus for increasing Bitcoin use. This paper offers several fruitful implications which could ultimately lead to the discussion on sustainability of cryptocurrency in financial markets. [ABSTRACT FROM AUTHOR]

The aims of this study were (1) to identify the Malaysian university students' attitude towards Collaborative Learning (CL) in the classroom at university level, and (2) to identify the lecturers' perception of using CL in their classrooms. The participants, 160 bachelor students and 5 lecturers, were selected randomly from a private university in Malaysia. A pilot study was done to determine the reliability of the questionnaire when compared against the Cronbach Alpha of 0.857. The data was collected in two stages, first from the students (following the quantitative procedure) and second, from the lecturers (following the qualitative procedure). For this study, two instruments were used and they are questionnaires and interviews. At the qualitative stage, the instrument was an interview, and at the quantitative stage, it was a questionnaire. The questionnaire was analyzed through SPSS. The transcriptions of five lecturers' interviews were analyzed using thematic analysis. The resultsrevealed that most of the students had a positive attitude towards the CL method and felt that it was beneficial for them, on the contrary, only few students had negative attitude towards CL due to their preferences which was they preferred individual work to group work. The lecturers preferred the CL method because it helped their students to use social skills and interactions during the learning process. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to identify the key variables which determine intentions to visit coffee/tea tourism plantations particularly those adopting sustainable practices. Also, this study ascertained the perception of risk in travelling due to the fear of Covid-19 on travel intentions to such coffee/tea tourism destinations. Design/methodology/approach: Using the theory of planned behaviour as a basis for this study's framework, data was gathered from 302 eco-conscious Generation Y and Z consumers via an online survey. Partial least squares were then applied to analyse the data. Findings: Learning and relaxation motives were important in determining consumers' attitudes towards sustainable coffee/tea tourism. The intention to engage in sustainable coffee/tea tourism is most strongly affected by the risk of travelling, followed by attitude. Research limitations/implications: The addition of contemporary variables was given to the theory of planned behaviour's core constructs to better reflect consumers' attitude and behaviour towards a growing form of tourism under unprecedented times. Practical implications: Travel or tourism operators will have first-hand insights on the factors that drive intentions to visit sustainable coffee and tea destinations, thus enabling more strategic action to be undertaken to reach the targeted young consumers. Originality/value: This study examines young, environmental-conscious consumers' perspectives on novel travel destinations which adopt sustainable practices. Risk in travelling was assessed which is necessary given Covid-19 has severely disrupted consumers' travel patterns. [ABSTRACT FROM AUTHOR]

Stingless bee honey is a type of popular honey in Malaysia. In this study, a total of 30 stingless bee honey samples were exclusively collected from the beekeepers, honeybee suppliers, and honeybee farms in Malaysia. The quality of stingless bee honey is evaluated against the standard, while the near‐infrared (NIR) spectroscopy technique is implemented for detecting adulterated honey. One out of thirty (30) honey samples does not fulfill the requirements of moisture content and hydroxymethylfurfural content, according to Standard of Malaysia, whereas only five (5) honey samples fulfill the requirement of the pH value. Furthermore, the NIR spectra data interpretation using principal component analysis (PCA) combined with logistic regression shows that the accuracy of above 98% is obtained for both train dataset and test dataset. This high accuracy of honey adulteration identification using the NIR spectrometer shows its promising immediate application for rapid nondestructive fraud detection in honey. Novelty impact statement: There are two main contributions from this research: firstly, the result of physicochemical analysis that one out of thirty (30) kelulut honey samples does not fulfill the requirements of moisture content and hydroxymethylfurfural content, according to Standard of Malaysia, whereas only five (5) honey samples fulfill the requirement of the pH value; secondly, the implementation of the NIR scanning using a handheld device, which is considerably new and promising for in situ application in the future of honey authentication particularly in Malaysia. [ABSTRACT FROM AUTHOR]

Background: Caregivers' knowledge, practice and adherence in medication administration who care for children with chronic illness requiring long-term pharmacological treatments are factors associating with children medication safety at home. This study aimed to determine the medication-related knowledge, administration practice and adherence among caregivers of chronically ill children in Malaysia. This cross-sectional study was conducted at the paediatric outpatient clinic of a tertiary public hospital. Caregivers of chronically ill children, who engaged in medication administration at home for at least 3 months, were conveniently recruited. Their medication-related knowledge and administration practice were evaluated based on a checklist, while their adherence to medication administration was assessed using a validated 5-point scale. The associated factors were also explored.Results: Of the 141 participants, most were mothers (90.8%) and had a full-time job (55.3%). Most of them had adequate medication-related knowledge (71.6%) and an appropriate administration practice (83.0%). The majority of them (83.0%) also rated themselves as adherent to medication administration. The participants with a child above 5 years of age (91.2%) were found to have a better practice than those with younger children (75.3%) in medication administration (p = 0.012). However, those with a child taking two (adjusted OR: 12.53) or three (adjusted OR: 8.29) medications, getting their refills from private health institutions apart from this hospital (adjusted OR = 7.06) and having multiple illnesses (adjusted OR = 21.25) were more likely to be not adherent to medication administration.Conclusion: Caregivers of chronically ill children in Malaysia generally have sufficient knowledge and an appropriate practice of medication administration at home. Yet, strategies to improve the adherence to medication administration, particularly in those who care for children with complicated health conditions, are warranted. [ABSTRACT FROM AUTHOR]