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Objective: To determine the factor structure of the Health Promoting Behaviours (HPB) component of Health Promoting Lifestyle Profile-II among undergraduate students in Universiti Sains Malaysia (USM) by confirmatory factor analysis (CFA). Methods: A cross sectional study was conducted among undergraduate students. The data was collected in the USM campus using a proportionate cluster sampling method. The HPB questionnaire was handed to students in the lecture hall and collected immediately when the lecture finished. CFA was conducted using robust maximum likelihood estimation due to violation of multivariate normality assumption. A three-factor model was tested for measurement model validity and construct validity. Results: A total of 788 students participated in the study. CFA of a 21-item, three-factor model yielded an adequate goodness-of-fit values. The measurement model also showed a good convergent and discriminant validity after model re-specification. Conclusion: The health promoting behaviours scale was proven to have a valid measurement model and reliable constructs. It was deemed suitable for use to measure the health promoting behaviours components of a healthy lifestyle among Malaysian undergraduate students. It was recommended to further conduct cross-validation studies in other Malaysian public universities to provide additional empirical evidence to support its use. [ABSTRACT FROM AUTHOR]

Introduction: In Malaysia, the problem of marital distress is rising and rapidly becoming an important public health concern. One of the major shortcomings in marital distress management is inadequate marital evaluation. There are, however, very limited localised tools to evaluate marital distress among local married women. Objectives: We aimed to translate the original (English) version of the Revised Dyadic Adjustment Scale (RDAS) into a Malay version by the standard procedure and evaluate its psychometric properties. Materials and Methods: This cross-sectional study was conducted among 150 healthy married Malay women in Kota Bharu, Kelantan from January to April 2018. The Revised Dyadic Adjustment Scale (RDAS) consists of three domains related to marital which are dyadic consensus, dyadic satisfaction and dyadic cohesion with a total of 14 questions. The comprehensibility of the questions was assessed using forward-backward translation. The concept, content and construct validity, and reliability for each question were also evaluated. Results: Of 150 consented participants, the mean age was 34.1 years (SD 9.5, range: 20 - 57). All 14 questions were considered comprehensible by more than 95% of the subjects. The Malay version of the RDAS was valid based on factor loading for dyadic consensus, dyadic satisfaction, and dyadic cohesion which ranged from 0.64 - 0.80, 0.79 - 0.98, and 0.37 - 0.78, respectively. The internal consistency was good with the coefficient alpha of three factors demonstrated: dyadic consensus of 0.87, dyadic satisfaction of 0.93 and dyadic cohesion of 0.78 internal consistency of the items. Conclusion: The Malay version of the RDAS was shown to be easy to understand, reliable and proven as a highly valid tool for married women assessment. This version is comparable with the original version of the RDAS in terms of structure and psychometric properties. [ABSTRACT FROM AUTHOR]

Introduction: The first "1000 days" is a critical period of opportunity for interventions to prevent stunting and other health problems. This paper describes a study protocol of a mobile phone-based nutrition education (MiNd) intervention on maternal, infant and young child nutrition. Methods: This is a six-months quasi-experimental intervention consisting of three phases; (i) Phase 1 - development of MiNd intervention modules, (ii) Phase 2 - evaluation of the effectiveness of MiNd intervention, and (iii) Phase 3 - a qualitative study exploring perceptions and experiences of the intervention. Discussion: Assessment of anthropometry, dietary intake, food security, mental health, knowledge, attitude, and practice (KAP) of food intake during pregnancy and breastfeeding will be evaluated during pre and post intervention. This is the first comprehensive mobile phone-based nutrition intervention study on pregnancy, lactation, and infant growth in Malaysia. The findings will be useful in modulating health intervention programme to prevent stunting and other health issues nationwide. [ABSTRACT FROM AUTHOR]

Introduction: The global population has been grappling with varying degrees of stress and anxiety as COVID-19 pandemic and subsequent impacts. Physical activity has long been recognized for its potential to enhance mental well-being, and numerous studies have explored the relationship between physical activity and both physical and mental health. However, consensus regarding the effectiveness of physical activity as an intervention to alleviate psychological issues associated with the COVID-19 pandemic remains limited. The purpose of this study was to conduct a systematic review of the relationship between stress, anxiety, depression, and physical activity during the COVID-19 pandemic and physical activity as an intervention for enhancing psychological well-being. Methods: In order to compile pertinent research findings, an extensive review of the literature spanning from January 2020 through December 2022 was carried out using reputable online databases, which encompassed PubMed, ScienceDirect, Web of Science, and Scopus. Diverse combinations of search terms, including "COVID-19," "Stress," "Anxiety," "Depression," and "Physical activity," were utilized. Furthermore, the effectiveness of physical activity in promoting both physical and mental well-being was also explored. Results: The extant body of research reveals that physical activity exerts a beneficial impact on both physical and mental well-being. However, at present, there are only 13 studies on the improvement of anxiety, depression, and stress during the COVID-19 pandemic using physical activities intervention, and the conclusions are inconsistent. Conclusion: At present, it is impossible to prove that physical activity intervention can improve the adverse psychological state caused by COVID-19. [ABSTRACT FROM AUTHOR]

Background: The study aimed to examine the reliability and validity of the existing three-tier triaging system and a new five-level emergency triaging system, emergency severity index (ESI), in the Emergency Department (ED) of Hospital Universiti Sains Malaysia (HUSM). Methods: This study was conducted in HUSM's ED over two study periods. In the first three months, 300 patients were triaged under the three-tier triaging system, and, in the subsequent three months, 280 patients were triaged under the ESI. The patients were triaged by junior paramedics and the triage records were retained and later re-triaged by senior paramedics. The inter-rater reliability was evaluated using Cohen's Kappa statistics. The acuity ratings of the junior paramedics were compared with those of the expert panel to determine the sensitivity and specificity of each acuity level for both the ESI and the three-tier triaging system. The over-triage rate, under-triage rate, amount of resources used, admission rate and discharge rate were also determined. Results: The inter-rater agreement for the three-tier triaging system was 0.81 while that of the ESI was 0.75. The ESI had a higher average sensitivity of 74.3% and a specificity of 94.4% while the three-tier system's average sensitivity was 68.5% and its specificity 87.0%. The average undertriage and over-triage rates for the ESI were 10.7% and 6.2%, respectively, which were lower than the three-tier system's average under-triage rate of 13.1% and over-triage rate of 17.1%. The urgency levels of both the ESI and the three-tier system were associated with increased admission rates and resources used in the ED. Conclusion: The ESI's inter-rater reliability was comparable to the three-tier triaging system and it demonstrated better validity than the existing three-tier system. [ABSTRACT FROM AUTHOR]

Background: The purpose of the study was to compare the motives for participating in physical activity (PA) through the different types of co-curricular activities chosen by health sciences undergraduate students at Universiti Sains Malaysia (USM), Malaysia. Methods: The participants were university students at USM's Health Campus, who were invited to volunteer and complete two measures: a demographic form, including the types of co-curricular activities in which the students chose to enrol (sports, uniform and art), and the Physical Activity and Leisure Motivation Scale (PALMS). Results: A total of 588 university students (female = 79.1%, male = 20.9%) with a mean age of 19.77 (SD = 1.39) participated in the study. The results showed significant differences in the motives of affiliation (P < 0.001), appearance (P = 0.008) and physical condition (P = 0.010) across the types of co-curricular activities in which the students participated. The students who enrolled in sports generally showed higher motives of affiliation, appearance and physical condition for participating in PA than other types of co-curricular activities. Conclusion: The study findings can provide further insights into the motives for participating in PA among health sciences students and encouragement for students to integrate PA into their daily routines. [ABSTRACT FROM AUTHOR]

Background: Many questionnaires have been developed to measure dental anxiety and fear. Among them is the Index of Dental Anxiety and Fear Scale (IDAF-4C+), which consists of a dental anxiety and fear module (IDAF-4C), a phobia module (IDAF-P) and a stimulus module (IDAF-S). The objective of this research was to report the adaptation and validation of the IDAF-4C+ for Malaysian secondary school children. Methods: This was a cross-sectional validation study. The original English version of the IDAF-4C+ was translated into Malay, back-translated, and then sent for content validation via an expert validation and face validation by the target student population. Three hundred and seventy questionnaires were then distributed among 16-year-old school children. Confirmatory factor analysis (CFA) was conducted for the IDAF-4C module using a bootstrapped maximum likelihood estimator. Spearman's rank correlation was used to assess the relationship between the IDAF-S and IDAF-4C modules. Intraclass correlation (ICC) was used to determine the stability of the IDAF-S and IDAF-4C modules, while kappa values were used for the IDAF-P module. Results: The response rate was 86.5% for CFA and 76.9% for stability. CFA showed the existence of only one factor with a reliability estimate of 0.921, obtained via Raykov's procedure. All items in the IDAF-S module were significantly correlated with the IDAF-4C module (P < 0.001). The IDAF-S and IDAF-4C modules were stable, as determined via a two-way mixed model with absolute agreement, a single measure and a Case 3 ICC (A, 1). The IDAF-P module showed satisfactory stability, as assessed via kappa values. Conclusion: The Malay version of the IDAF-4C+ is valid and reliable in measuring dental anxiety and fear among Malaysian secondary school children. [ABSTRACT FROM AUTHOR]

Introduction: The study aimed to examine the structural relationship of major depressive disorder (MDD), anxiety disorder, various mental diseases, quality of life, coping methods, and other variables in patient with brain pathology and hematological cancer patients. Methods: A total of (n=215) samples were included in the structural equation modeling (SEM) analyses. The analyses were done with brain pathology patients (110) and haematological cancer patients (105). Results: In the current study, the multivariate normality kurtosis was 9.112 with c.r = 3.950 obtained in this SEM model. In the SEM model, the global health status towards MDD can explain about 30% of the variance. The global health status score was found to have a significant positive association with self-distraction coping styles, gender, and emotional functioning. Gender has a significant positive association with global health status, indicating that male patients have improved overall health. In terms of severity of MDD the positive correlation was found with panic disorder life time. Emotional functioning, self distraction and global health status were shown to have a significant and inverse relationship with the severity of MDD (p<0.05). Conclusion: The severity of MDD was found to have a strong and detrimental association with cancer types indicating the brain pathology patients tends to have more severity of depression compared to haematological cancer patients. [ABSTRACT FROM AUTHOR]

Objective: This study was designed to evaluate the diagnostic performance of STOPBANG score and mandibulohyoid distance (MHD) towards difficult laryngoscopy among obstructive sleep apnea patients. Cross-Sectional Study Methodology: Forty-one patients who had STOP-BANG scores of >3 and required tracheal intubation for general anesthesia were recruited in this cross-sectional study. MHD was measured through lateral cephalometry. After induction of anesthesia, an anesthesiologist who was blinded to patient's profile performed a laryngoscopy and evaluated the Cormack-Lehane grading. Sensitivity, specificity, positive and negative predictive values were determined for STOP-BANG and MHD. Binary logistic regression, receiver operating characteristics (ROC) and correlation analyses were employed. Results: Body mass index, neck circumference, and Mallampati scores were higher in the difficult laryngoscopy group. MHD was longer in difficult laryngoscopy group (25.40 ± 5.67 mm) than easy laryngoscopy group (20.17 ± 4.28 mm; p = 0.002). STOPBANG score was higher in difficult laryngoscopy group (5.86 ± 0.96 vs. 4.30 ± 0.98; p < 0.001). The combination of MHD and STOP-BANG score improved the quality of diagnostic test in predicting the laryngoscopy status with area under ROC of 87.6%, compared to each isolated parameter (i.e., MHD = 75.7%, STOP-BANG = 85.5%). Both MHD and STOP-BANG scores were significantly positive correlated (r = 0.42, p = 0.006). Conclusions: STOP-BANG score and MHD were useful in predicting difficult intubation. The diagnostic performance improved further when combining both parameters. [ABSTRACT FROM AUTHOR]

Introduction: Honey postulated may have an estrogenic effect on the retinal estrogenic receptors. The aim of the study is to compare the mean macular thickness, retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) parameters with and without honey cocktail supplement in post-menopausal women. Methods: A randomised interventional study was conducted from March 2014 to July 2015. A total of 60 post-menopausal women were selected and randomised into 2 groups: honey cocktail (20 mg/day) and control. Macular thickness, RNFL thickness and ONH parameters were measured using optical coherence tomography at baseline and at 3 months post honey cocktail supplementation. Results: The mean global macular thickness and RNFL thickness were significantly thicker in post-menopausal women with honey cocktail at 3 months post supplement (p = 0.002 and 0.033 respectively). There was a significant increase in the mean change of global macular thickness and RNFL thickness in honey cocktail group at 3 months post supplement (p < 0.001 and < 0.001 respectively). Although there was no significant difference in the ONH parameters at 3 months post supplement between the two groups but there was significant increase in the mean change of rim area (p = 0.003), and significant reduce in the mean change of cup area (p = 0.001) and cup-disc-ratio (p <0.001) in honey cocktail group at 3 months post supplement. Conclusion: Honey cocktail supplement showed structural changes in the macular thickness, RNFL thickness and OHN parameters of post-menopausal women. [ABSTRACT FROM AUTHOR]

Background: Self-efficacy (SE) is a person's belief in his or her own capability to perform and accomplish a task that could produce a favourable outcome, despite facing obstacles. This study aimed to confirm the validity and reliability of an SE scale among undergraduate students at the Health Campus of the Universiti Sains Malaysia. Methods: A cross-sectional study was conducted among the undergraduate students using a self-administered questionnaire. After using a purposive sampling method, 562 students completed the questionnaire. Mplus 8 was employed to conduct the confirmatory factor analysis on the psychometric properties of Bandura's 18-item SE scale with three factors (internal feeling, competing demands and situational). Then, the composite reliability was calculated for each factor. Results: Most of the students were Malay (73.3%) females (79.0%) who exercised 2.62 times a week for an average of 43.37 min per session. The final measurement model was obtained after removing six problematic items, and the model was deemed fit based on several indices [Root Mean Square Error of Approximation (RMSEA) = 0.067, Standardised Root Mean Square Residual (SRMR) = 0.004, Comparative Fit Index (CFI) = 0.924]. The composite reliability values of the three factors were acceptable (0.65 to 0.84). Conclusion: The simplified 12-item SE scale with three factors displayed good fit indices with regard to the data, and they were considered to be acceptable for the current sample. [ABSTRACT FROM AUTHOR]