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Abstract Background Cardiovascular disease (CVD) is the leading cause of premature mortality worldwide. Despite existing research on CVD risk factors, the study of premature CVD mortality in Malaysia remains limited. This study employs survival analysis to model modifiable risk factors associated with premature CVD mortality among Malaysian adults. Method We utilised data from Malaysia’s National Health and Morbidity Survey (NHMS) conducted in 2006, 2011, and 2015, linked with mortality records. The cohort comprised individuals aged 18 to 70 during the NHMS interview. Follow-up extended to 2021, focusing on CVD-related premature mortality between ages 30 and 70. We employed six survival models: a semi-parametric Cox proportional hazard (PH) and five parametric survival models, which were Exponential, Weibull, Gompertz, log-normal and log-logistic distributions using R software. The age standardized incidence rate (ASIR) of premature CVD mortality was calculated per 1000 person-years. Results Among 63,722 participants, 886 (1.4%) experienced premature CVD mortality, with an ASIR of 1.80 per 1000 person-years. The best-fit models (based on AIC value) were the stratified Cox model by age (semi-parametric) and the log-normal accelerated failure time (AFT) model (parametric). Males had higher risk (Hazard Ratio, HR = 2.68) and experienced 49% shorter survival time (Event Time Ratio, ETR = 0.51) compared to females. Compared to Chinese ethnicity, Indians, Malays, and other Bumiputera had higher HR and lower survival times. Rural residents and those with lower education also faced increased HRs and reduced survival times. Diabetes (diagnosed: HR = 3.26, ETR = 0.37; undiagnosed: HR = 1.63, ETR = 0.63), hypertension (diagnosed: HR = 1.84, ETR = 0.53; undiagnosed: HR = 1.46, ETR = 0.68), and undiagnosed hypercholesterolemia (HR = 1.31, ETR = 0.80) increased risk and decreased survival times. Additionally, current smoking and abdominal obesity elevated risk (HR = 1.38, 1.60) and shortened survival (ETR = 0.81, 0.71). Conclusion The semi-parametric and parametric survival models both highlight the considerable impact of socioeconomic status and modifiable risk factors on premature CVD mortality, underscoring the imperative for targeted interventions to effectively mitigate these effects.

Abstract Background The influence of social determinants of health (SDH) on sustainable development goals (SDG) has gained attention in recent years. However, there is a scarcity in the availability of valid and reliable instruments to assess the multiple aspects of SDH. Hence, this study was conducted to develop a brief self-reported measure for assessing SDH. Method A cross-sectional survey was conducted among university undergraduate students in Nigeria. The study consisted of 300 participants in the EFA (males 55.7%, females 44.3%) and 430 participants in the CFA (males 54.0%, females 46.0%). Participants were selected using a convenience sampling approach to assess their perceptions regarding SDH. Content Validity Index (CVI), Face Validity Index (FVI), Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), Composite Reliability (CR), Average Variance Extracted (AVE), Cronbach’s alpha, and Intraclass Correlation Coefficient (ICC) were computed to determine the psychometric properties of the newly developed SDH scale. Results In the EFA, two factors were extracted (structural determinants of SDH and intermediary determinants of SDH), with all 20 items retained. The total variance explained by the EFA model was 61.8%, and the factor correlation was 0.178. The Cronbach’s alpha values of the two factors were 0.917 and 0.939. In the CFA, the initial model did not fit the data well based on fit indices. After several re-specification of the model, the final re-specified measurement model demonstrated adequate fit factor structure of the SDH scale with two factors and 20 items (CFI = 0.943, TLI = 0.930, SRMR = 0.056, RMSEA = 0.053, RMSEA p-value = 0.220). The CR was 0.797 for structural determinants of SDH and 0.794 for intermediary determinants of SDH. The ICC was 0.938 for structural determinants of SDH and 0.941 for intermediary determinants of SDH. Conclusion The findings indicate that the SDH scale has adequate psychometric properties and can be used to assess the perceived level of SDH. We recommended that this tool be tested in other populations with diverse age groups and other demographic characteristics.

The Recovery-Stress Questionnaire for Athletes (RESTQ-Sport-52) is a tool developed to measure the frequency of stress associated through recovery activities with strong theoretical foundations. The study aims to examine the psychometric properties of the Malay version of RESTQ-Sport-52 using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM). A cross-sectional study with purposive sampling method was employed. There were 617 undergraduate university students in Malaysia participated in the study with mean age of 20 years old (SD = 1.5). The majority of the participants were female (66.1 %), Malay (76 %) and participated in at least one sport or exercise. The RESTQ-Sport-52-M consisted of 52 items with two main sections; (1) general stress and recovery scales and (2) sport-specific stress and recovery scales. Mplus 8.3 was used to perform the CFA and ESEM analysis to examine the construct validity and reliability of RESTQ-Sport-52-M. For measurement model assessment using CFA, the final model of general-stress/recovery and sport-specific stress/recovery indicated a fit based on several fit indices. However, in the measurement model assessment using ESEM, the fit indices for model of general-stress/recovery (CFI = 0.935, SRMR = 0.037, RMSEA = 0.045) and sport-stress/recovery (CFI = 0.923, SRMR = 0.036, RMSEA = 0.044) were generally improved. The construct reliability for measurement models of RESTQ-Sport-52-M ranged from 0.76 to 0.89. The ESEM approach yielded a better fit indices compared to the CFA approach for both scales. The RESTQ-Sport-52-M (50 items) were considered a more valid and reliable questionnaire to measure recovery and stress in sports for Malaysian sample.

Abstract Background The environmental determinants of health (EDH) have a significant impact on people’s physical, mental, and social wellbeing. Everyone needs access to environmental resources of all types, including food, materials, and energy, to survive. Currently, no valid and reliable instrument exists for evaluating individuals’ perceived levels of EDH. Hence, the purpose of this study was to develop and validate the environmental determinants of health questionnaire (EDH-Q) among undergraduate students in Nigeria. Method We conducted a cross-sectional survey among undergraduate students in Nigeria to assess the psychometric properties of the newly developed Environmental Determinants of Health Questionnaire (EDH-Q). Respondents were selected using a convenience sampling approach to evaluate their perceptions of environmental determinants of health. The Content Validity Index (CVI) and Face Validity Index (FVI) were calculated to ascertain the scale’s content validity and response process validity, respectively. Additionally, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), composite reliability (CR), average variance extracted (AVE), Cronbach’s alpha, and intraclass correlation coefficient (ICC) were computed to assess the scale’s construct validity. Results The study involved 300 respondents in the EFA (males 55.7%, females 44.3%) and 430 respondents in the CFA (males 54.0%, females 46.0%). In the EFA, two constructs were identified (the natural environment and the built environment). The EFA model was able to explain 63.57% of the total cumulative variance, and the factor correlation was 0.671. The whole scale Cronbach’s alpha value was 0.947, while the two constructs’ Cronbach’s alpha values were 0.918 (natural environment) and 0.935 (built environment). In the CFA, six pairs of error covariances were included between items within the same construct to improve the fit indices of the initial proposed measurement model. The final re-specified measurement model showed that the EDH-Q, which has two constructs and 18 items, has adequate construct validity (CFI = 0.948, TLI = 0.938, SRMR = 0.046, RMSEA = 0.052, and RMSEA p-value = 0.344). The CRs were 0.845 (natural environment) and 0.854 (built environment). The ICCs were 0.976 (natural environment) and 0.970 (built environment). Conclusion The results show that the newly created EDH-Q has sufficient construct validity and may be utilized to assess participants’ perceptions of their level of EDH. Researchers should examine this instrument in populations with different age ranges and other demographic characteristics, as the present study only applied it to undergraduate students who may share similar characteristics.

Abstract Mental energy is an important factor in many domains, including athletic performance. The athletic mental energy scale (AMES) is one of the established tools available to measure athletes’ perceived mental energy state. To date, there is no validated questionnaire to assess athletic mental energy for Chinese adolescents. Therefore, purpose of this study was to validate a Chinese version of AMES (C-AMES) among the Chinese adolescents in Lanzhou, Gansu Province, China. We sampled 729 adolescents aged 14 to 18 in five middle schools in Lanzhou City, Gansu Province, China to complete the revised C-AMES. Data were analyzed for factor structure validity by performing CFA. The results showed that the fit index was acceptable (RMSEA = 0.050, CFI = 0.962, TLI = 0.951), and a six-factor model containing 18 C-AMES items had good measurement properties for athletic mental energy. We suggest future study may use C-AMES to examine the relationship between athletes’ mental energy and athletic performance and sporting behavior.

Abstract The present study examines the mediating effect of psychological factors in the structural relationships between social and physical environmental factors and the amount of physical activity among undergraduate students at Universiti Sains Malaysia. The sample consisted of 422 students with a mean age of 20.2 years (SD = 1.27). The majority of the students were female (69.7%) and Malay (81.3%). Standardized scales were used to measure the total amount of physical activity and all the study variables. The final SEM had a good fit to the data: CFI = 0.968, TLI = 0.948, SRMR = 0.036, RMSEA (90%CI) = 0.046 (0.025, 0.065), RMSEA p-value = 0.609 with 11 paths relationships. Family support had a significant effect on perceived benefits and perceived barriers. The effect of friend support on physical activity was significantly mediated by perceived benefits, self-efficacy, and psychological needs satisfaction. The effect of the availability of exercise facilities on physical activity was significantly mediated by perceived benefits and psychological needs satisfaction. Furthermore, psychological needs satisfaction mediated the effect of perceived benefits, perceived barriers, and self-efficacy on physical activity. The study findings illustrated that the application of the social-ecological model and psychological factors is important in order to understand and promote positive physical activity behaviour.

Abstract Research indicates that COVID-19 has had adverse effects on the mental health of adolescents, exacerbating their negative psychological states. The purpose of this study is to investigate the impact of Physical Literacy (PL) on Negative Mental State caused by COVID-19 (NMSC) and identify potential factors related to NMSC and PL in Chinese adolescents. This cross-sectional study involved a total of 729 Chinese high school students with an average age of 16.2 ± 1.1 years. Participants’ demographic data, PL data, and NMSC data were collected. PL and NMSC were measured using the self-reported Portuguese Physical Literacy Assessment Questionnaire (PPLA-Q), the Stress and Anxiety to Viral Epidemics-6 (SAVE-6), and the Fear of COVID-19 Scale (FCV-19). Adolescents in the current study demonstrated higher levels of NMSC and lower PL, with average scores of 3.45 and 2.26, respectively (on a scale of 5). Through multiple linear regression analysis, Motivation (MO), Confidence (CO), Emotional Regulation (ER), and Physical Regulation (PR) were identified as factors influencing NMSC in adolescents. The study findings contribute to providing guidance for actions aimed at alleviating NMSC among adolescents.

Objectives The objective of this study was to examine the psychometric properties of the Chinese version of the Academic Self-Efficacy Scale (ASES-C) and confirm its measurement invariance across gender identities. Methods In this study, 502 university students (29.68% male, 70.32% female) with a mean age of 19.93 years (SD = 1.64) voluntarily participated. The Academic Self-Efficacy Scale (ASE) was utilized as a unidimensional measure of students’ learning efficacy. The English version of ASES was translated into Chinese using a forward-backward translation procedure. Confirmatory factor analysis (CFA) and invariance testing were conducted with the single-factor model of ASES. Composite reliability (CR) and internal consistency were calculated based on Cronbach’s alpha. Results Upon re-specification of the model, CFA results for the hypothesized single-factor model with eight items indicated an acceptable fit (CFI = 0.959, TLI = 0.943, SRMR = 0.036, RMSEA = 0.065). Cronbach’s alpha and CR values were 0.785 and 0.880, respectively. Multi-group CFA results demonstrated measurement equivalence for the Chinese version of ASES across gender identities. The findings supported the measurement invariance of ASES-C for both male and female participants. Conclusion The ASES-C, consisting of one factor and eight items, is a reliable instrument for assessing Chinese university students’ self-efficacy in learning. Furthermore, it is suitable for making meaningful comparisons across gender identities.

Abstract Background Self-efficacy has been recognized as a critical component in people’s participation and maintenance of physical activity. This study aims to validate the Chinese version of the Exercise Self-Efficacy Scale (ESE) among Chinese children and adolescents using confirmatory factor analysis (CFA). Methods A cross-sectional study was conducted on two primary and two secondary schools in central China. The ESE scale was translated into Chinese (ESE-C) using the standard forward-backward translation method. Data were analyzed using Mplus 8 for the CFA. Results The final model showed a satisfactory level of goodness-of-fit (CFI = 0.918; TLI = 0.905; SRMR = 0.043; RMSEA = 0.066), indicating a good construct validity of the ESE-C for children and adolescents in mainland China. Furthermore, the final ESE-C model achieved composite reliability values of 0.963 and average variance extraction values of 0.597, indicating sufficient convergent and discriminant validity. Besides, the Cronbach’s alpha value was 0.964, demonstrating excellent internal consistency of the ESE-C scale. Conclusion The ESE-C scale is a valid instrument for assessing exercise self-efficacy among children and adolescents in mainland China.

Successful sports performance is characterized by psychological, physical, technical, and tactical factors. Of these factors, the psychological factor is typically ignored despite contributing more than 50% toward success in sporting performance. This review aimed to introduce the Kawa model as a new methodology to promote sports and physical performance through developing mental health ability. The Kawa model is developed by occupational therapists and used to promote mental health ability in individuals by enabling self-awareness of their difficulties and exploring possible solutions. It consists of the following five elements: water, river banks, rocks, driftwood, and space. This research would further explore the usage of the Kawa model in addressing various psychological issues and how these improvements can enhance sports and physical performance. The literature search was performed by using Google Scholar, PubMed, Web of Science and Scopus as a database with specific keywords. In conclusion, this research provides an overview of the potential for the use of the Kawa model in promoting mental health ability included self-awareness, self-understanding, goal-setting, self-efficacy, stress and anxiety control for sports and physical performance and lays the foundation for future research in this area.

Background The objective of this study was to investigate the inter-relationship between psychosocial variables and their impact on symptom severity and quality of life (QoL) concerning abdominal bloating. Methods The study adopted a cross-sectional design with purposive sampling. Participants who consented and met the criteria for bloating based on the Rome IV classification completed designated questionnaires. Independent variables comprised health beliefs, intentions, health-promoting behaviors, social support, depression, and anxiety, while dependent variables included bloating severity (general and within 24 h) and QoL. Structural Equation Modeling (SEM) was conducted utilizing Mplus 8.0 to analyze the relationships between these factors. Results A total of 323 participants, with a mean age of 27.69 years (SD = 11.50), predominantly females (64.7%), volunteered to participate in the study. The final SEM model exhibited good fit based on various indices (CFI = 0.922, SRMR = 0.064, RMSEA (95% CI) = 0.048 (0.041–0.054), p-value = 0.714), with 15 significant path relationships identified. The model explained 12.0% of the variance in severity within 24 h, 6% in general severity, and 53.8% in QoL. Conclusion The findings underscore the significant influence of health beliefs, intentions, behaviors, social support, depression, and anxiety on symptom severity and QoL in individuals experiencing abdominal bloating.

Abstract Background Cardiovascular disease (CVD) is a significant cause of premature mortality worldwide, with a growing burden in recent years. Despite this, there is a lack of comprehensive meta-analyses that quantify the extent of premature CVD mortality. Study addressed this gap by estimating the pooled age-standardized mortality rate (ASMR) of premature CVD mortality. Methods We conducted a systematic review of published CVD mortality studies that reported ASMR as an indicator for premature mortality measurement. All English articles published as of October 2022 were searched in four electronic databases: PubMed, Scopus, Web of Science (WoS), and the Cochrane Central Register of Controlled Trials (CENTRAL). We computed pooled estimates of ASMR using random-effects meta-analysis. We assessed heterogeneity from the selected studies using the I2 statistic. Subgroup analyses and meta regression analysis was performed based on sex, main CVD types, income country level, study time and age group. The analysis was performed using R software with the “meta” and “metafor” packages. Results A total of 15 studies met the inclusion criteria. The estimated global ASMR for premature mortality from total CVD was 96.04 per 100,000 people (95% CI: 67.18, 137.31). Subgroup analysis by specific CVD types revealed a higher ASMR for ischemic heart disease (ASMR = 15.57, 95% CI: 11.27, 21.5) compared to stroke (ASMR = 12.36, 95% CI: 8.09, 18.91). Sex-specific differences were also observed, with higher ASMRs for males (37.50, 95% CI: 23.69, 59.37) than females (15.75, 95% CI: 9.61, 25.81). Middle-income countries had a significantly higher ASMR (90.58, 95% CI: 56.40, 145.48) compared to high-income countries (21.42, 95% CI: 15.63, 29.37). Stratifying by age group indicated that the age groups of 20–64 years and 30–74 years had a higher ASMR than the age group of 0–74 years. Our multivariable meta-regression model suggested significant differences in the adjusted ASMR estimates for all covariates except study time. Conclusions This meta-analysis synthesized a comprehensive estimate of the worldwide burden of premature CVD mortality. Our findings underscore the continued burden of premature CVD mortality, particularly in middle-income countries. Addressing this issue requires targeted interventions to mitigate the high risk of premature CVD mortality in these vulnerable populations.

Physical activity (PA) is widely recognized as crucial for human health, yet the low level of PA in adolescents continues to raise major concerns. This study aims to validate the Chinese version of the Social Support Scale for Exercise (SE) and establish its reliability among Chinese adolescents. A cross-sectional study was conducted on two primary and two secondary schools in central China. Students were recruited using a random cluster sampling method, and written informed consent was provided after they were briefed on the purpose of the study. The standard forward-backward translation was applied to translate the English version of the SE into Chinese. The Social Support Scale used in this study consists of two factors: family support and friend support. Data were analyzed using Mplus 8 for the CFA, composite reliability (CR), average variance extracted (AVE), and intra-class correlation coefficients (ICC) were calculated. A total of 1422 students (boys = 838, girls = 604) with a mean age of 11 years (SD = 1.6) participated in the study. The measurement model of the translated social support scale fit the data well: CFI = .935; TLI = .929; SRMR = .038; RMSEA = .053, with a 90% confidence interval of (.051, .056; RMSEA p < .001). The composite reliability values of .935 for family support and .948 for friend support were acceptable. The intra-class correlation coefficients (ICC) based on test-retest were .928 for family support, and .904 for friend support. Hence, the Chinese version of the SE was valid and reliable, its implementation will provide researchers with a valuable tool to comprehensively assess Chinese adolescents' exercise-related social support and help develop targeted and effective interventions to improve their physical activity levels.

By engaging in one form of works, people earn means of support, establish their identities, perceive life as meaningful and establish social network with others. The quality of life is a product of several factors inherent in the work environment. Quality of life is an important topic in every organization as it determines the future of the organization. This study assessed the sociodemographic and workplace determinants of Quality of life (Qol) among quarry workers in Nigeria. A cross-sectional study was conducted among the respondents. Data were collected using self-administered questionnaires consisting of socio-demographic characteristics, Standard Nordic Musculoskeletal Questionnaire and World Health Organization Quality of life BREF questionnaires (WHOQOL-BREF). A total of 266 quarry workers involved in this study were selected through systematic random sampling technique. The data were analyzed using SPSS version 26. Simple and multiple logistic regression were used to identify the determinants of quality of life among the respondents. The result showed that majority of the respondents (74.1%) had poor quality of life with variation across four domains of physical, environmental, socio relationship and psychological. Following multiple logistic regression modeling, WRMSDs (ORadj 4.24, 95% CI [1.84, 9.77], p -value = .001) and the poor work design (ORadj 3.22, 95% CI [1.52, 6.82], p -value = .002) remained significant determinants of Qol. This study showed poor quality of life among quarry workers in Ebonyi state, Nigeria. Those with WRMSDs and had poor work design were more likely to have poor quality of life compared to those who had no WRMSDs and work in well-designed workplace.

Personality is considered to be a factor affecting athletic performance. However, inconsistency in the research results regarding size and even direction of the relationship. An evaluation of the evidence of the relationship between personality and athletic performance was conducted in order to summarize the evidence available. A systematic literature search was conducted in March 2023. Sport performance and the Big Five personality model were identified in our research. We used PubMed, Web of Science, Embase, Cochrane Library, Wang Fang (Chinese), Wei Pu (Chinese), and CNKI (Chinese) databases for the systematic literature search (Prospero registration number: CRD42022364000), screened 4,300 studies, and found 23 cross-sectional studies eligible for inclusion in this review. The results of this systematic analysis show that, besides neuroticism, openness, conscientiousness, extraversion, and agreeableness are all positively correlated with sports performance. Conscientiousness and extraversion are the two main personalities in team sports. Openness and agreeableness show different results in different sports, and it is not clear to which project they are beneficial. The value of personality as a possible predictor of athletic performance is generally positive. Therefore, professionals such as applied sports psychologists, coaching personnel, athletes, and sports administrators must comprehensively grasp the significance of personality’s role in achieving success in major competitions. Considering these facts, sports practitioners should promote personality screening and personality development programs.

Guided by the theory of planned behavior, this study aimed to determine the influence of Physical Education (PE) teachers’ attitudes, their perceived behavioral control, and the influence of subjective norms on their intention and constraints (intrapersonal, interpersonal, and structural) to offer a high-quality class based on best practices to deliver PE lessons online during the COVID-19 pandemic. This cross-sectional, multi-country survey study recruited PE teachers from five countries (China, Malaysia, the Philippines, Turkey, and the United States). A total of 928 online questionnaires were used in the analysis. In terms of the overall intention to teach online, our findings showed that American and Filipino teachers had higher levels of intention to continue teaching online. In contrast, Turkish, Malaysian, and Chinese teachers showed a lower interest. Moreover, Malaysian teachers had more intrapersonal constraints while the teachers in the other four countries were not as restrained intrapersonally. The results highlight the significant influence of perceived behavioral control and attitudes on PE teachers’ intention to deliver online courses. Constraints to online teaching had a considerably large negative impact on attitudes, subjective norms, and perceived behavioral control. Based on the results, the proposed extension to the theory of planned behavior was an appropriate framework for understanding the behavioral intent of PE teachers.

Abstract Background A good control of intraoperative bleeding is key for adequate anatomical visualization during endoscopic sinus surgery (ESS). The objective of this review was to assess the practice of hot intranasal saline irrigation (HSI) in achieving intraoperative hemostasis and good surgical field quality during ESS. Methods An electronic search was performed via PubMed, SCOPUS, Google Scholar, and Cochrane from inception to June 2022. The included trials were evaluated according to the recommendations of the Cochrane Handbook for Systematic Reviews. The primary outcome assessed was the intraoperative bleeding score of the surgical field. The mean arterial pressure, duration of the surgery, amount of blood loss and surgeon’s satisfaction score were assessed as the secondary outcomes. The risk of bias for each study was evaluated using the Cochrane risk of bias tool. Results A total of 254 records were identified after removal of duplicates. Based on the title and abstract 246 records were excluded, leaving seven full texts for further consideration. Five records were excluded following full text assessment. Three trials with a total of 212 patients were selected. Hot saline irrigation was superior to control in the intraoperative bleeding score (MD − 0.51, 95% CI − 0.84 to − 0.18; P < 0.001; I 2 = 72%; very low quality of evidence) and surgeon’s satisfaction score (RR 0.18, 95% CI 0.09 to 0.33; P < 0.001; I 2 = 0%; low quality of evidence). The duration of surgery was lengthier in control when compared to HSI (MD − 9.02, 95% CI − 11.76 to − 6.28; P < 0.001; I 2 = 0; very low quality of evidence). The volume of blood loss was greater in control than HSI (MD − 56.4, 95% CI − 57.30 to − 55.51; P < 0.001; I 2 = 0%; low quality of evidence). No significant difference between the two groups for the mean arterial pressure was noted (MD − 0.60, 95% CI − 2.17 to 0.97; P = 0.45; I 2 = 0%; low quality of evidence). Conclusions The practice of intranasal HSI during ESS is favorable in controlling intraoperative bleeding and improving the surgical field quality. It increases the surgeon’s satisfaction, reduces blood loss, shortens operative time and has no effect on intraoperative hemodynamic instability. Trial registration PROSPERO registration number: CRD42019117083.

IntroductionSince the emergence of COVID-19 in 2019, every country in the world has been affected to varying degrees. Long-term psychological pressure and anxiety will inevitably damage the physical and mental health of students. This study aimed to examine the effects of the COVID-19 pandemic on students who experienced stress and anxiety and to clarify which intervention was more effective.MethodsA comprehensive literature search was conducted between January 2020 and December 2022 using online databases such as PubMed, Web of Science, Scopus, and Google Scholar by using the following keywords in combination: “COVID-19,” “stress,” “anxiety,” “depression,” and “intervention.” The retrieved literature was screened and reviewed.ResultsA total of 2,924 articles were retrieved using subject and keyword searches. After screening through the titles and abstracts, 18 related studies were retained. Their review revealed that: (1) most studies did not use medication to control stress and anxiety; (2) the standard methods used to reduce stress and anxiety were religion, psychological counseling, learning more about COVID-19 through the media, online mindfulness courses, improving sleep quality, and physical exercise; (3) the most effective interventions were physical activity and raising awareness about COVID-19 through the media and online mindfulness programs. However, some studies show that physical activity cannot directly relieve psychological stress and anxiety.ConclusionLimited interventions are effective, but learning more about COVID-19 and using active coping strategies may help reduce stress and anxiety. The implications of COVID-19 are also discussed.

Abstract The technology supported Brain Breaks (BB) videos are a series of structured, web-based physical activity (PA) videos designed to promote learning and health. The purpose of this study was to investigate the effect of BB videos on exercise self-efficacy (ESE) among type 2 diabetes mellitus (T2DM) patients using the Malay-versioned exercise self-efficacy scale (ESE-M). The study used a double-blind research design and was randomised into two groups: (1) The Technology Supported BB intervention group, and (2) the control group. 70 T2DM patients with a mean age of 57.6 years (SD = 8.5) were recruited from Hospital Universiti Sains Malaysia. For 4 months, participants in the intervention group were required to undertake PA every day using the BB videos (approximately 10 min). Both groups completed the ESE-M at pre-intervention, the end of the first month, the second month, the third month, and post-intervention. For the data analysis, a mixed factorial analysis of variance was used. The results showed that at the end of the intervention, the two groups’ ESE was significantly different (p

A key component in the study of antisocial behaviour among adolescents is the presence of callous-unemotional (CU) traits. Among the established tools available to measure CU traits is the Inventory of Callous-Unemotional traits (ICU). To date, there is no validated questionnaire to assess CU traits for the local population. Therefore, there is a need to validate the Malay version of the ICU (M-ICU) so that research can be conducted to explore CU traits among adolescents in Malaysia. The aim of the study is to validate the M-ICU. Two phases of cross-sectional study involving 409 (phase 1 –exploratory factor analysis (EFA), n = 180; phase 2—confirmatory factor analysis (CFA), n = 229) adolescents aged between 13 to 18 years old were conducted from July until October 2020 at six secondary schools in Kuantan district. Participants were selected via multistage random sampling. The ICU was initially translated into Malay language using forward-backward translation procedure by a group of bilingual researchers. Study participants completed the final version of the M-ICU questionnaire and socio-demographic questionnaire. Data was analysed using SPSS version 26 and MPlus software for factor structure validity by performing EFA and CFA. Initial EFA revealed three factors with two items deleted. A further EFA with two factors resulted in the deletion of unemotional factor items. Cronbach’s alpha for overall scale improved from 0.70 to 0.74. CFA supported a two-factor solution with 17 items compared to the original English version that has three factors with 24 items. The findings revealed acceptable fit indices (RMSEA = 0.057, CFI = 0.941, TLI = 0.932, WRMR = 0.968). The study revealed that a two-factor model with 17 items of the M-ICU has good psychometric properties. The scale is valid and reliable to measure CU traits among adolescents in Malaysia.

Abstract Background This study aimed to verify a translated Malay version of the Achievement Emotions Questionnaire for Physical Education (AEQ-PE) by assessing the level of achievement emotions in six constructs among the Malaysian primary school pupils using the Confirmatory Factor Analysis (CFA). Methods A total of 607 Malay pupils, comprising 240 (39.5%) boys and 367 (60.5%) girls aged between 10 and 11, were recruited from 10 schools to answer the questionnaire, which measured their views on 24 items through a five-point Likert scale. The AEQ-PE was translated into Malay language (AEQ-PE-M) using forwarding to backward translation techniques. Certain phrases were adopted in accordance with the local culture and vocabulary appropriate for primary school pupils. CFA was performed using the Mplus 8.0 software, and the final model demonstrated high reliability in terms of the composite reliability and Cronbach’s alpha. Results Analysis of the CFA showed an acceptable fit indices in CFI (0.936), TLI (0.926), RMSEA = 0.039 (90% CI, 0.034, 0.045) and SRMR (0.049) of the AEQ-PE measurement model. All of the items in the original AEQ-PE version were retained and deemed suitable for Malay primary school pupils. Conclusion The AEQ-PE-M with 24 items was a suitable tool for measuring the level of school children’s involvement in determining achievement emotions and their motivation towards physical education.

The aim of this study is to examine the structural relationship in the transtheoretical model (TTM) of behavioural change constructs among undergraduate students. A cross-sectional study was carried out by randomly selecting students participating in campus co-curricular activities. Questionnaires, comprising queries on the stages of change (SOC) — an 18-item self-efficacy (SE) scale, a 10-item decisional balance (DB) scale, and 30-item processes of change (PoC) scale — were distributed to the students. Their answers were analysed using Mplus 8 software for structural equation modelling. There were 562 participants comprising 118 males (21.0 %) and 444 females (79.0 %) with average age of 19.81±1.22 SD. Most of them were involved in sports (46.3 %) and non-sports (46.6 %) programmes, and exercised at least three times per week for approximately 43 minutes per session. Minority of the undergraduate students (7.1%) are involved in uniform group. The initial hypothesized structural equation modelling showed that the data fitted well. The fit indices were within recommended values (CFI= 0.967; TLI= 0.939; SRMR= 0.034; RMSEA (CI: 90%) = 0.049 (0.028, 0.070); RMSEA p= 0.495). There were three hypothesized path relationships in this model. From the final structural model, the SOC had significant direct effects on SE (p = 0.001), DB (p < 0.001) and PoC (p < 0.001). In conclusion, the study showed a positive relationship between TTM constructs. It could act as an excellent baseline model for physical activity intervention or motivational intervention.

PURPOSE: The available data on strabismus surgery in South East Asian countries are scarce. This study aimed to identify visual outcome and factors influencing surgical outcome of horizontal strabismus surgery in a Southeast Asian cohort. MATERIALS AND METHODS: A retrospective review of patients who underwent horizontal strabismus surgery between 2013 and 2017 in Hospital Universiti Sains Malaysia was conducted. Surgery was considered successful if the post-operative deviation was within 10 prism diopters at 6 months' postoperative period. Factors influencing the outcome of surgery at 6 months were identified. Chi-square and Fisher's exact tests were used in data analysis. RESULTS: Ninety-eight patients were included. Both genders were equally affected. Exotropia (58.2%) was the most common type. About 65.3% of patients had alternating strabismus, while 51% had an angle of deviation of more than 45 prism diopters. Amblyopia was documented in 14.3% of patients. Those operated on below 10 years of age comprised 64.3%. Ninety-four patients completed follow-ups at 6 months after the surgery. The success rate was 81.6%. Approximately 92% of the patients had best-corrected visual acuities of 6/12 and better at 6 months' postoperative period. There was no significant association between age of onset, gender, presence of amblyopia, type of deviation, amount of deviation, and postoperative best-corrected visual acuity with surgical outcome at 6 months' postoperative period (P > 0.05). CONCLUSION: The success rate was good. Postoperative best-corrected visual acuity was promising. Age of onset, gender, presence of amblyopia, type of deviation, amount of deviation, and postoperative best-corrected visual acuity did not influence the outcome of horizontal strabismus surgery in our review.

Background Based on the self-determination theory, the psychological requirements for competence, autonomy, and relatedness boost beneficial exercise behaviour for healthy living. However, there is no valid, reliable Malay version scale to investigate the extent to which these psychological needs are met. The main purpose of this study was to examine the psychometric properties of a Malay version of the Psychological Need Satisfaction in Exercise (PNSE-M) scale. In addition, the purpose of this study was to confirm the measurement and structural invariance of the PNSE-M across gender. Methods The study participants included 919 students (male: 49.6%, female: 50.4%), with a mean age of 20.4 years (standard deviation = 1.5). The participants were selected through convenience sampling. The 18-item PNSE-M was used to measure psychological need satisfaction in exercise. The English version of the PNSE was translated into Malay using standard forward-backward translation. Confirmatory factor analysis (CFA) and invariance tests were performed on the three domains of the PNSE-M model. Composite reliability (CR), average variance extracted (AVE), internal consistency based on Cronbach’s alpha, and test-retest reliabilities using intraclass correlation coefficient (ICC) were also computed. Results After some model re-specification, the CFA findings based on the hypothesised measurement model of three factors and 18 items indicated acceptable factor structure (CFI = .936, TLI = .923, SRMR = .054, RMSEA = .059). The CR and AVE values were .864–.902 and .573–.617, respectively. Cronbach’s alpha was .891–.908, and the ICC was .980–.985. The findings supported the full measurement and structural invariance of the PNSE-M for both male and female participants. The CFA model matched the data well for both male (CFI = .926, SRMR = .057, RMSEA = .066) and female (CFI = .926, SRMR = .060, RMSEA = .065) participants. Conclusion The PNSE-M with three factors and 18 items is considered to be a valid, reliable instrument for university students in Malaysia. It is valid for use to make meaningful comparisons across gender.

BackgroundThis study aimed determine the structural relationship between psychological constructs of the transtheoretical model (TTM; processes of change, decisional balance, and exercise self-efficacy), motives for physical activity (PA), and amount of PA among Malaysians with type 2 diabetes mellitus (T2DM).MethodAll participants were recruited from the Hospital Universiti Sains Malaysia using a cross-sectional study design with purposive) sampling method. A total of 331 participants were recruited for the present study. Before participation in the study, they were informed that participation in the study was totally voluntary. Those who agreed to participate voluntarily were required to complete the self-administered questionnaire set, which included the processes of change, decisional balance, exercise self-efficacy, physical activity and leisure motivation, and international physical activity questionnaires. Data analysis of structural equation modeling was performed using Mplus 8.ResultsFrom the 331 participants, most of whom were male (52%) and Malay (89.4%), with a mean age of 62.6 years (standard deviation = 10.29). The final structural equation model fit the data well based on several fit indices [Root Mean Square Error of Approximation (RMSEA) = 0.059, Comparative Fit Index (CFI) = 0.953, Tucker-Lewis Index (TLI) = 0.925, Standardized Root Mean Square Residual (SRMR) = 0.031]. A total of 16 significant path relationships linked between the TTM, motives for PA, and amount of PA.ConclusionThe pros of decisional balance, others' expectations, and psychological condition were constructs that directly affected PA, whereas the other constructs had a significant indirect relationship with the amount of PA. A positive mindset is crucial in deciding a behavioral change toward an active lifestyle in people with T2DM.

Mind-body techniques, including Guided Imagery (GI) or Progressive Muscle Relaxation (PMR), may effectively manage bloating. The current study aimed to develop and validate (psychometric and psychological responses) audio-based GI and PMR techniques for bloating. Audio scripts were first developed from literature reviews and in-depth interviews of participants with bloating diagnosed based on the Rome IV criteria. Scripts were validated using psychometric (content & face validity index) and physiological approaches (brain event-related potentials & heart rate variability). 45/63 participants completed the in-depth interview, and ‘balloon’ emerged as the synonymous imagery description for bloating, of which inflation correlated with a painful sensation. The final tools consisted of narrated audio scripts in the background of a validated choice of music. Overall, the content and face validity index for PMR and GI ranged from 0.92 to 1.00. For ERP and HRV, 17/20 participants were analyzed. For ERP, there was a significant difference between GI and PMR for alpha waves (p = 0.029), delta waves (p = 0.029), and between PMR and control for delta waves (p = 0.014). For HRV, GI and PMR exhibited similar autonomic responses over controls (overall p

BackgroundThe present study aimed at validating the Malay-language version of the Behavioural Regulation in Exercise Questionnaire (BREQ-3M) using confirmatory factor analysis (CFA).MethodsData were collected from undergraduate students in the Health Campus, Universiti Sains Malaysia. A total of 674 students completed the BREQ-3M (male: 19.4%, female: 80.6%), with a mean age of 20.27 years (SD = 1.35). Behavioural regulation was assessed with the 24-item BREQ-3M. Standard forward-backward translation was performed to translate the English version of BREQ-3 into the Malay version.ResultsThe initial measurement models tested did not result in a good fit for the data. Subsequent examination of the CFA results suggested some modifications, including adding correlations between the item residuals within the same subscale and deletion of identified regulation. These modifications resulted in good fit indices (Root Mean Square Error of Approximation, RMSEA = 0.049; Comparative Fit Index, CFI = 0.949; Tucker-Lewis Index, TLI = 0.938; Standardised Root Mean Square Residual, SRMR = 0.049). The final measurement model comprised 20 items and had significant factor loadings of more than 0.50, ranging from 0.580 to 0.868. The composite reliability ranged between 0.746-0.841 for the five-factor model.ConclusionsThe 20-item translated version of BREQ-3M is valid and reliable for assessing the behavioural regulation for exercise among university students in Malaysia.PerspectiveThis study examined the psychometric properties of the Malay-language BREQ-3. It was the first to assess the measurement model in Malaysia using CFA.

Background Health management strategies may help patients with abdominal bloating (AB), but there are currently no tools that measure behaviour and awareness. This study aimed to validate and verify the dimensionality of the newly-developed Health Promoting Behaviour for Bloating (HPB-Bloat) scale. Methods Based on previous literature, expert input, and in-depth interviews, we generated new items for the HPB-Bloat. Its content validity was assessed by experts and pre-tested across 30 individuals with AB. Construct validity and dimensionality were first determined using exploratory factor analysis (EFA) and Promax rotation analysis, and then using confirmatory factor analysis (CFA). Results During the development stage, 35 items were generated for the HPB-Bloat, and were maintained following content validity assessment and pre-testing. One hundred and fifty-two participants (mean age of 31.27 years, 68.3% female) and 323 participants (mean age of 27.69 years, 59.4% male) completed the scale for EFA and CFA, respectively. Using EFA, we identified 20 items that we divided into five factors: diet (five items), health awareness (four items), physical activity (three items), stress management (four items), and treatment (four items). The total variance explained by the EFA model was 56.7%. The Cronbach alpha values of the five factors ranged between 0.52 and 0.81. In the CFA model, one problematic latent variable (treatment) was identified and three items were removed. In the final measurement model, four factors and 17 items fit the data well based on several fit indices (root mean square error of approximation (RMSEA) = 0.044 and standardized root mean squared residual (SRMR) = 0.052). The composite reliability of all factors in the final measurement model was above 0.60, indicating acceptable construct reliability. Conclusion The newly developed HPB-Bloat scale is valid and reliable when assessing the awareness of health-promoting behaviours across patients with AB. Further validation is needed across different languages and populations.

Abstract Background Health-promoting behaviour is an important concept for health education. Unfortunately, there is a dearth of validated instruments to measure levels of health-promoting behaviour in the Malaysian context. The purpose of this study was to validate a Malay-language version of the Health-Promoting Lifestyle Profile II (HPLP-II) using a confirmatory approach. Methods Participants were 997 university undergraduate students, with a mean age of 21 years (SD = 1.58). The majority of the participants (80.4%) were female. Health-promoting behaviour was assessed using the 52-item HPLP-II, which measures six components of health-promoting behaviour outcomes. HPLP-II was translated into the Malay language using standard forward and backward translation procedures. Participants then completed the HPLP-II Malay version (HPLP-II-M). Confirmatory factor analysis (CFA) was conducted using Mplus 8.0 software on the six domains of HPLP-II-M model. Results The CFA result based on the hypothesised measurement model of six factors was aligned with the original HPLP-II, except for two low loading items which were subsequently removed from the CFA analysis. The final CFA measurement model with 50 items resulted in a good fit to the data based on RMSEA and SRMR fit indices (RMSEA = 0.046, 90%CI = 0.045, 0.048, SRMR = 0.062). The construct reliabilities for the HPLP-II-M subscales were acceptable, ranging from 0.737 to 0.878. Conclusion The HPLP-II-M with six components of health-promoting behaviour outcomes and 50 items was considered valid and reliable for the present Malaysian sample.

Quarry workers are commonly afflicted with musculoskeletal disorders (MSDs). This health problem has been recognized as a significant threat to the quarry workers' safety but is rarely reported, particularly in Nigeria. Therefore, this study aimed to assess the prevalence of MSDs and their associated factors among quarry workers. Method: A cross-sectional study was conducted, and data were collected using a self-administered Standard Nordic Musculoskeletal Questionnaire. A total of 266 participants were selected through systematic random sampling method among male and female quarry workers in Ebonyi State, Nigeria. The data were analysed using SPSS version 26, and descriptive statistics were used to determine the prevalence and types of MSDs. Simple and multiple logistic regressions were used to identify the factors associated with MSDs. Results: The results revealed that majority of the respondents (89.8%) had MSDs, with the most common types being lower back pain (83.1%) and elbow pain (45.9%). Based on multiple logistic regression modelling, BMI (Adjusted OR 0.17, 95% CI 0.06,0.55, p = 0.003), age (Adjusted OR 1.14, 95% CI 1.07, 1.23, p < 0.001), work experience (Adjusted OR 2.08, CI 1.00, 4.30, p = 0.049), Vibration exposure (Adjusted OR 0.45, CI 0.27, 0.74, P = 0.002), working hour (Adjusted OR 6.84, CI 0.84, 53.4, p = 0.007) and break time (Adjusted OR 0.95, 95% CI 0.91,0.98, p = 0.006) were significantly associated with MSDs. Conclusion: MSDs are prevalent among the quarry workers in Ebonyi State, Nigeria. Thus, there is an urgent need to increase the workers' and employers' awareness of appropriate ergonomic and personal measures needed to improve the workers' safety and well-being.

BackgroundHealthy lifestyle habits formed during young adulthood may have a sustaining impact on health across later life. The current study aimed to test the theoretical model of factors (selected demographic variables, knowledge of heart disease, health belief related to cardiovascular disease (CVD), self-efficacy, cues to action, and screening intention) influencing health-promoting behaviours among Malaysian university students.MethodsIn a cross-sectional survey, the undergraduate students in Universiti Sains Malaysia were invited to complete the self-administered questionnaires. Participants were selected using a purposive sampling method. The proposed hypothesised model was analysed using a structural equation modelling with Mplus 7.3 program. A total of 788 (70.7% female) undergraduate students with a mean age of 20.2 (SD = 1.02) participated in the study. The primary outcome of knowledge, health beliefs, and health-promoting behaviours related to CVD were measured by questionnaires namely: Knowledge of Heart Disease, Health Beliefs Related to CVD, and Health Promoting Lifestyle Profiles-II.ResultsThe final hypothetical structural model showed a good fit to the data based on several fit indices: with comparative fit index (CFI) at .921, standardised root mean square residual (SRMR) at .037, and root mean square error of approximation (RMSEA) at .044 (90% CI: .032, .054). The final structural model supported 13 significant path estimates. These variables explained 12% of the total variance in health-promoting behaviours. Through perceived benefits, total knowledge had an indirect effect on health-promoting behaviours.ConclusionThe results suggest that perceived barriers, perceived benefits, family history of CVD, and screening intention enable young adults to engage in health-promoting behaviours.

BackgroundThis study examined the psychometric properties of the Korean and Malay version of the decisional balance (DB) for exercise (i.e. perceived benefits and perceived barriers) using a cross-sectional design. Also, this study assessed the measurement and structural invariance of the DB scale across countries.MethodsA cross sectional study was conducted in Malaysia and Korea. The study sample consisted of 574 Korean participants and 562 Malaysian participants. The mean age of the participants was 19.8 (SD = 1.29) for the Korean sample and 19.8 (SD = 1.22) for the Malaysian sample. Participants were invited to complete the DB scale with the 10-item and two factors (i.e., perceived benefit and perceived barriers). Confirmatory factor analysis (CFA) and invariance test were conducted on the data by using Mplus 8.3.ResultsThe CFA results based on the hypothesised measurement model of two factors and ten items showed sufficient construct validity after adding residual covariance between items within the same factor: CFI = 0.979, TLI = 0.970, SRMR = 0.036, RMSEA = 0.036 for the Korea sample, and CFI = 0.964, TLI = 0.949, SRMR = 0.055, RMSEA = 0.066 for the Malay sample. For the Korea sample, the construct reliability was 0.62 and 0.74 for perceived benefits and perceived barriers respectively. For the Malay sample, the construct reliability was 0.75 and 0.77 for perceived benefits and perceived barriers respectively. The findings presented evidence for measurement and structural invariance of the DB scale for the Korea and Malaysia samples.ConclusionThe DB scale was a valid and reliable measure for assessing exercise behaviour and for making comparisons between Korean and Malaysian samples.

Background Chronic constipation is a common symptom among the elderly, and it may affect their quality of life (QoL). A lack of available research focused on the elderly means that this effect is not well understood. This study aimed to develop and validate a new scale (Elderly-Constipation Impact Scale (E-CIS)) to measure the impact of chronic constipation on QoL among the elderly. Methods A pool of items was generated from a qualitative study, literature reviews, and expert reviews. Exploratory factor analysis (EFA) was performed on the original 40 items of the E-CIS and followed by 27 items for confirmatory factor analysis (CFA). A total of 470 elderly people with chronic constipation were involved. Results The mean age of the participants was 68.64 ± 6.57. Finally, only 22 items were indicated as appropriately representing the E-CIS, which were grouped into seven subscales: ‘daily activities’, ‘treatment satisfaction’, ‘lack of control of bodily function’, ‘diet restriction’, ‘symptom intensity’, ‘anxiety’ and ‘preventive actions’. The scale was confirmed as valid (root mean square error of approximation (RMSEA) = 0.04, comparative fit index (CFI) = 0.961, Tucker-Lewis index (TLI) = 0.952 and chi-square/degree of freedom (chiSq/df) = 1.44) and reliable (Cronbach’s alpha: 0.66–0.85, composite reliability (CR) = 0.699–0.851) to assess the impact of chronic constipation on the elderly’s QoL. Conclusions The E-CIS is useful to measure the impact of chronic constipation on the elderly’s QoL. A further test is needed to determine the validity and reliability of this scale in other elderly population.

BACKGROUND:This study examined the psychometric properties of the Malay version of the decisional balance (DB-M) for exercise (i.e. perceived benefits and perceived barriers) using a cross-sectional design. Also, this study assessed the measurement and structural invariance of the DB-M across gender. METHODS:The study sample consisted of 750 students (female: 51.7%, male: 48.3%), with a mean age of 20.2 years (SD = 1.2). Decision balance (DB) scale was assessed with the 10-item DB-M. Standard forward-backward translation was performed to translate the English version of the DB into Malay version (DB-M). RESULTS:The confirmatory factor analysis (CFA) results based on the hypothesised measurement model of two factors and ten items demonstrated adequate factor structure after the addition of some correlated item residuals (comparative fit index (CFI) = .979, Tucker and Lewis index (TLI) = .969, standardised root mean square residual (SRMR) = .037, root mean square error of approximation (RMSEA) = .047). The construct reliability and average variance extracted values were .850 and .839, and .542 and .538, for perceived benefits and perceived barriers, respectively. Meanwhile, the Cronbach's alpha was .857 and .859, and the intraclass correlation coefficient for test-retest reliability was .979 and .960 for perceived benefits and perceived barriers respectively. The findings provided evidence for measurement invariance of DB-M for the male and female samples. The final CFA model fit the data well for both male sample (CFI = .975, TLI = .964, SRMR = .040, RMSEA = .052) and female sample (CFI = .965, TLI = .949, SRMR = .044, RMSEA = .058). CONCLUSIONS:The translated version of the DB-M was valid and reliable for assessing the level of perceived benefits and perceived barriers in exercise among university students in Malaysia.

BackgroundThis study aimed to determine the validity of the Malay-translated version scales for assessing the social support and physical environment for exercise activities.MethodThe study was a cross-sectional design in nature, using self-reported questionnaires among the university students in Malaysia. Participants were selected using a convenience sampling approach. Perceptions regarding social support and physical environment were assessed using the Malay-translated version scales. The standard forward-backwards translation was conducted to translate the English version of the scales to the Malay version. Confirmatory factor analysis (CFA) was used to validate the translated version scales; composite reliability (CR) and average variance extracted (AVE) were computed.ResultsA total of 857 students participated in this study (female: 49.1%, male: 50.9%). The mean age of the participants was 20.2 (SD = 1.6). The fit indices of the initial hypothesized measurement models (social support and physical environment) were not satisfactory. Further improvements were made by adding covariances between residuals' items within the same factor for each hypothesized model. The final re-specified measurement models demonstrated adequate factor structure for the social support scale with 24 items (CFI = .932, TLI = .920, SRMR = .054, RMSEA = .061), and the physical environment scale with five items (CFI = .994, TLI = .981, SRMR = .013, RMSEA = .054). The CR was .918 for family support, .919 for friend support, .813 for perceived availability, and .771 for perceived quality. The AVEs were .560 for family support, .547 for friend support, .554 for perceived availability, and .628 for perceived quality. The intra-class correlation (ICC) based on test-retest was .920 for family support, .984 for friend support, .895 for availability of facilities, and .774 for quality of facilities.ConclusionThe Malay version of the social support scale for exercise and the physical environment scale for physical activity were shown to have adequate psychometric properties for assessing perceived social support and physical environment among the university students in Malaysia.PerspectiveThis study presented the psychometric properties of the social support and physical environment scales based on CFA and was the first to translate these scales from the original English version to the Malay version.

BackgroundThe present study was aimed at validating the Malay-language version of the Self-Efficacy for Exercise Scale (SEE-M) using confirmatory factor analysis (CFA).MethodsData were collected from undergraduate students at all campuses of the Universiti Sains Malaysia. A total of 1,605 students completed the SEE-M (female: 71.5%, male: 28.5%), with the mean age of 20.3 years (SD = 1.5). Perceived self-efficacy was assessed with the 18-item SEE-M. Standard forward-backward translation was performed to translate the English version of the Efficacy for Exercise Scale (SEE) into the Malay version (SEE-M).ResultsThe 2 initial measurement models tested (1-factor and 3-factor models) did not result in a good fit to the data. Subsequent investigation of the CFA results recommended some modifications, including adding correlations between the item residuals within the same latent variable. These modifications resulted in good fit indices for the 1-factor model (RMSEA = .059, CFI = .939, TLI = .922, SRMR = .049) and the 3-factor model (RMSEA = .066, CFI = .924, TLI = .903, SRMR = .051). The final measurement models comprised all 18 SEE-M items, which had significant factor loadings of more than .40. The test-retest results indicated that the SEE-M was stable, with an intra-class correlation of .99. The composite reliability was .886 for the 1-factor model and .670-.854 for the 3-factor model.ConclusionsThe translated version of the SEE-M was valid and reliable for assessing the level of self-efficacy for exercise among university students in Malaysia.PerspectiveThis study examining the psychometric properties of the SEE scale based on CFA was the first to assess 2 proposed models (1-factor and 3-factor models) simultaneously and to translate the original, English-language SEE into Malay.

This study’s purpose was to examine the structural relationship of the transtheoretical model (TTM) and the amount of physical activity (PA) among undergraduate students in health and medicine at Universiti Sains Malaysia. A cross-sectional study was carried out among students who took part in the co-curricular program. Co-curricular program includes activities that take place outside of the regular lectures or tutorials in the University. Students recruited through purposive sampling were informed that their participation was entirely voluntarily. Those interested completed the self-administered questionnaire, which consisted of the decisional balance, processes of change, self-efficacy, stages of change scales, and Godin leisure-time exercise questionnaire. Data were analyzed using Mplus version 8 for descriptive statistics and structural equation modeling analysis for inferential statistics. A total of 562 students participated in the study. The majority of the students was female (79.0%) and Malay (73.3%) and average of exercise sessions per week was 2.62, with a mean of 43.37 min per exercise session. The final structural model fit the data well based on several fit indices (SRMR = 0.046, RMSEA (CI: 90%) = 0.061 (0.045, 0.078), RMSEA p = 0.130). The model showed that stages of change significantly affected self-efficacy (p < 0.001), pros (benefits of exercise; p < 0.001), cons (barriers to exercise; p = 0.022), and processes of change (p < 0.001). The model also showed significant inter-relationships among the TTM constructs and supported seven hypotheses. Among all the variables examined, only processes of change significantly affected PA (p < 0.001). However, stages of change (p < 0.001) and pros (p =< 0.001) had significant indirect effects on PA via processes of change. The findings support that individuals’ stages of change affect their self-efficacy level, or the ability to make positive and negative decisions and perform behavior accordingly. The study confirms that making correct decisions and taking action accordingly can increase PA levels.

Measurement equivalence is often assumed across comparison groups, a pervasive problem related to many self-report instruments. Measurement equivalence, also known as measurement invariance, implies that a measure has the same meaning across different groups of people. In this study, we aimed to examine the measurement and structural invariance among gender of the Malay version of the Physical Activity and Leisure Motivation Scale for Youth (PALMS-Y-M). Seven-hundred-and-eighty-three secondary school students (female = 57.3%, male = 42.7%) with mean age 14.5 years (standard deviation = 1.25) from Kota Bharu, Malaysia, volunteered to participate in this study and completed the PALMS-Y-M, consisting of 28 items with seven subscales. We conducted the confirmatory factor analysis (CFA) and invariance tests on the seven motives of the PALMS-Y-M model. The hypothesized model consisted of 28 observed items and seven latent variables. We used estimator robust to maximum likelihood, MLR to examine the hypothesized measurement and structural invariance. Measurement invariance was tested for three different levels. We first established the configural invariance model, then we compared the metric invariance model and the scalar invariance model with the less restrictive model. Then structural invariance was tested for factor variance, covariance, and means. Findings provided evidence for full measurement and structural invariance of the PALMS-Y-M in males and females. The final CFA model fit the data well for males [comparative fit index (CFI) = 0.922, root mean square error of approximation (RMSEA) = 0.048, standardized root mean residual (SRMR) = 0.050] and females (CFI = 0.922, RMSEA = 0.047, SRMR = 0.053). When invariance of both factor loadings and item intercepts holds in PALMS-Y-M, underlying factors consisting of different motives for participating in PA can be meaningfully compared across gender. Accurate and valid measurement of PALMS-Y-M across comparison groups is crucial for future research that involves examining motives to physical activity in different genders and other socio-cultural variables.

Music that is carefully selected to match the requirements of activities and the characteristics of individuals has been shown to produce significant impacts on performance enhancement (Priest et al., 2004). There is also evidence that music can enhance imagery (Grocke and Wigram, 2007), although few studies have investigated the effects of music on imagery in the context of sport skills. In the present study, the effects of relaxing and arousing music during imagery on dart-throwing performance, physiological arousal indices, and competitive state anxiety, were investigated among 63 novice dart throwers. Participants had moderate-to-high imagery ability and were randomly assigned to unfamiliar relaxing music (URM), unfamiliar arousing music (UAM), or no music (NM) groups. Performance was assessed by 40 dart throws at a concentric circles dartboard before and after 12 imagery sessions over 4 weeks. Measures of galvanic skin response (GSR), peripheral temperature (PT), and heart rate (HR) were taken during imagery sessions 1 and 12, and the Competitive State Anxiety Inventory-2 Revised (CSAI-2R) was administered prior to the pre- and post-intervention performance task. Dart-throwing gain scores were significantly higher for URM than for UAM and NM, with no significant difference between UAM and NM (URM = 37.24 ± 5.66, UAM = 17.57 ± 5.30, and NM = 13.19 ± 6.14, F2,62 = 5.03, p = 0.01, η2 = 0.14). GSR, PT, and HR reflected lower arousal for URM than for UAM or NM. Significant decreases in somatic anxiety were evident for URM and UAM but not NM. Significant decreases in cognitive anxiety were evident for URM and NM but not UAM. Significant increases in self-confidence were evident for URM but not UAM or NM. Performance improved in all three conditions but URM was associated with the largest performance gain, the lowest physiological indices of arousal, and the most positive CSAI-2R profiles. Listening to relaxing music during imagery may have benefits for performance in other fine motor skills.

Childhood obesity is associated with adult cardiometabolic disease. We postulate that the underlying microvascular dysfunction begins in childhood. We thus aimed to compare retinal vascular parameters between obese and non-obese children.This was a cross-sectional study involving 166 children aged 6 to 12 years old in Malaysia. Ocular examination, biometry, retinal photography, blood pressure and body mass index measurement were performed. Participants were divided into two groups; obese and non-obese. Retinal vascular parameters were measured using validated software.Mean age was 9.58 years. Approximately 51.2% were obese. Obese children had significantly narrower retinal arteriolar caliber (F(1,159) = 6.862, p = 0.010), lower arteriovenous ratio (F(1,159) = 17.412, p < 0.001), higher venular fractal dimension (F(1,159) = 4.313, p = 0.039) and higher venular curvature tortuosity (F(1,158) = 5.166, p = 0.024) than non-obese children, after adjustment for age, gender, blood pressure and axial length.Obese children have abnormal retinal vascular geometry. These findings suggest that childhood obesity is characterized by early microvascular abnormalities that precede development of overt disease. Further research is warranted to determine if these parameters represent viable biomarkers for risk stratification in obesity.

PURPOSE: This study aims to translate the Physical Education State Anxiety Scale (PESAS) into a Chinese version and conduct an empirical analysis using existing research methods. METHODS: The subjects of this study were 755 college students, consisting of 222 males and 533 females (SD = 2.3). This study translated PESAS into Chinese using standard forward and backward translation procedures to ensure strong consistency between the translated and original versions. Confirmatory factor analysis (CFA) was carried out using Mplus 8 software. RESULTS: The CFA results of the hypothesis model of PESAS-C were consistent with those of the original PESAS. The fit indices of RMSEA and SRMR were within acceptable ranges, and no items were excluded from the three dimensions. The composite reliability of the Chinese version of PESAS ranged from 0.912 to 0.931. CONCLUSION: The PESAS-C is valid and reliable, and the 18-item content in the three dimensions of this version is suitable for assessing motor anxiety in Chinese students. [ABSTRACT FROM AUTHOR]