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Through education, it is hoped that students’ potential can be developed so that they have the courage to face life's problems without feeling pressured, have the will and ability, and are happy to develop themselves to be superior human beings. The objectives of this research were to describe the concepts, factors and development implications of life skill through students’ extracurricular activities at Mengkuru Nahdlatul Wathan Islamic Senior High School. This research was designed by using the qualitative method of informant finding in the field. The researcher used observation, interviews and documentation in data collection techniques. Describing the development concept of Life Skill was one of the analysis focuses in the development of education which emphasized the qualifications or skills to work. The study of life skill development through extracurricular activities of culinary art was discussed through students’ life study approach in the environment of Mengkuru Nahdlatul Wathan Islamic Senior High School starting from students’ lives, school activities, learning patterns, field practice, social activities among students and various other routines. The results of the research showed that Mengkuru Nahdlatul Wathan Islamic Senior High School tried to develop students' extracurricular activities with culinary art. In these activities, there were various kinds of menus which could provide satisfaction for students, teachers and the community, could increase students’ knowledge, and could be useful for many people.

Background Social media has become a massive encyclopedia of almost anything due to its content richness. People tell stories, write comments and feedback, and share knowledge through social media. The information available on social media enables ‘clueless’ travelers to get quick travel recommendations in the tourism sector. Through a simple query, such as typing ‘places to visit in Bali’, travelers can get many blog articles to help them decide which places of interest to visit. However, doing this reading task without a helper can be overwhelming. Methods To overcome this problem, we developed Bidirectional Encoder Representations from Transformers (BERT)-based tourism named entity recognition system, which is used to highlight tourist destination places in the query result. BERT is a state-of-the-art machine learning framework for natural language processing that can give a decent performance in various settings and cases. Our developed tourism named entity recognition (NER) model specifies three different tourist destinations: heritage, natural, and purposefully built (man-made or artificial). The dataset is taken from various tourism-related community articles and posts. Results The model achieved an average F1-score of 0.80 and has been implemented into a traveling destination recommendation system. By using this system, travelers can get quick recommendations based on the popularity of places visited in the query frame. Discussion Based on the survey that we conducted to target respondents who have never visited and have no or limited knowledge about tourist attractions in some example cities, their average interest level from the recommendation results is higher than four on a scale of 1 to 5. Thus, it can be considered a good recommendation. Furthermore, the NER model performance is comparable to another related research.

Family functioning is playing a significant role in adolescent development. Adolescence is a complicated stage where transition happed. A family is a place for them to learn for develop. This review aims to look for the relationship between family functioning and psychological well-being among b40 adolescent. Scopus database was selected to identify relevant articles. Research published between the year 2012 to 2021 was selected to look at the effect of poverty on family functioning and psychological well-being and the relationship between family functioning and psychological well-being. The findings showed that poverty is affecting family functioning and the psychological well-being of parent and child. Mental health issues that bring life pressure had caused the family to function maladaptive. The relationship between family functioning and psychological well-being is identified. Adaptive family functioning is helping in developing positive adolescent's psychological well-being. At the same time, maladaptive will cause impaired psychological well-being and also mental health problem. The implications of this article are also examined in terms of how the counsellor improves their counselling service to assist underprivileged adolescents in maintaining excellent psychological well-being. [ABSTRACT FROM AUTHOR]

Adult intussusception is rare, less common and differs from childhood intussusception in its presentation, aetiology and treatment. It is common in paediatrics of less than three years of age.1,2 Unlike in paediatric population, most adult cases presented to emergency department with intestinal obstruction, and rarely, the actual diagnosis of intussusception is made during clinical setting. Top causes of adult intussusception include malignant or benign lesions, postoperative complications such as adhesions, Meckel diverticulum and bowel inflammatory disease. 8-20% of cases are idiopathic with no lead point lesion.3 Preliminary radiograph may show signs of intestinal obstruction, but computed tomography (CT) is the gold standard imaging for intussusception. This is a case report of an adult intussusception in Hospital Tengku Ampuan Afzan, Kuantan which was not detected during clinical examination, but diagnosed by CT imaging. [ABSTRACT FROM AUTHOR]

The development of information technology is increasing rapidly. Such developments affect the speed of obtaining information. Unfortunately, there are still many needs for good and comfortable housing that has not used a good information system to facilitate housing management and data collection such as in Purimas Citra Gemilang 2 Housing, a housing that has facilities to meet the needs of its residents. In managing housing, there are often obstacles in terms of data collection management such as monthly contribution payments, registration of prospective new residents, and recording of housing residents. This is because the recording is still manual. The use of technology, especially mobile-based applications, can optimize housing implementation by providing an integrated data management system that can be accessed via smartphones. Modern housing needs an application that can support the population system. On that basis, it is hoped that the application "Housing Information System Purimas Citra Gemilang 2 Based on Mobile", can help manage housing more efficiently and effectively. The app's features are for managing homeowner data, monthly dues payments, and social activities. The stages in the design of this system are analysis, design, implementation and testing. The waterfall method is used in the design of a housing data collection information system. Housing residents can use this system as a means of communication between officers and residents and to assist housing managers in carrying out social activities and housing data collection.

This research is a pre-experimental study, namely the application of hybrid learning during the COVID-19 pandemic in low-grade science courses. The research subjects were 28 fourth semester students for the 2020-2021 academic year, STKIP PGRI Bangkalan PGSD Study Program. The design used is One Group Pretest Posttest Design. The purpose of the study was to describe hybrid learning during the COVID-19 pandemic in low-grade science courses. The results of the study, namely scientific skills experienced a significant increase in the medium category. The results of student responses to hybrid learning during the COVID-19 pandemic in the Low Grade Science course were positive. It can be said that hybrid learning during the COVID-19 pandemic in low-grade science courses is effective

Bioprotein is one of the useful products obtained from biotechnology invention. It is a promising replacement for the commercial fish feed supplement. In this study, the enrichment of the bioprotein content after solid state fermentation using palm kernel cake and seaweed by the white rot fungus: Phanerochaete chrysoporium and yeast: Candida utilis was carried out. The growth media components were selected from 11 types of media using Plackett-Burman design (hereinafter PBD) and were optimized by one-factor-at-a-time (OFAT) method with bioprotein concentration (mg/g) as the response. From the screening result using PBD, three media components, namely K2HPO4, CuSO4.5H2O and MnSO4.H2O were selected for further optimization using OFAT method because of their positive contributions to the response. The final results showed that 5.0 g/L K2HPO4, 3.0 g/L CuSO4.5H2O and 0.1 g/L MnSO4.H2O were there to be the optimum media constituents with 9.0 g/L, MgSO4.7H2O, 0.1 g/L, CaCl2.H2O, 3.0 g/L FeSO4.7H2O and 3.0 g/L peptone as fixed compositions. At this optimum concentration, the protein increment of 11% was observed as compared to the results determined in the screening using PBD. The study revealed the benefits of using mixed cultures in improving the protein concentrations which can be used as nutritious fish feed. [ABSTRACT FROM AUTHOR]

The forest areas with special-purpose (KHDTK) Lambung Mangkurat University is an important learning resource for many people, especially students. One of the biodiversity in the area that can be utilized is the diversity of Anura. For identified Anuran species, we need the field guide book according to complete with areas character, Anuran list, and supported by the content that is simple and easy to understand. Therefore the field guide book was developed in such a way using the development model by Tessmer. The result of an expert review shows that this field guide book has been very valid (88%) with criteria that can be used without revision. Attractive design, complex content, with simple language make this field guide not only can be used for students but also by the general people. Abstrak Kawasan Hutan Dengan Tujuan Khusus (KHDTK) Universitas Lambung Mangkurat merupakan sumber belajar penting bagi banyak pihak, terlebih mahasiswa. Salah satu keanekaragaman hayati di kawasan tersebut yang dapat dimanfaatkan adalah keanekaragaman Anura. Untuk melakukan identifikasi jenis diperlukan buku panduan identifikasi yang sesuai dengan karakter wilayah dan keanekaragaman anura di dalamnya serta ditunjang dengan komponen isi yang sifatnya sederhana dan mudah untuk dimengerti. Oleh karenanya, buku panduan lapangan identifikasi jenis anura ini dikembangkan sedemikian rupa menggunakan model pengembangan oleh Tessmer. Hasil penilaian ahli menunjukkan bahwa buku panduan lapangan ini memiliki kriteria sangat valid (88%) dan dapat digunakan tanpa revisi. Desain menarik, isi yang kompleks, dengan bahasa yang sederhana membuat buku panduan lapangan ini tidak hanya dapat digunakan untuk kalangan pelajar saja namun juga oleh masyarakat umum.

Informatics and Communication Technology (ICT) provides relevant agricultural information, which is essential in agricultural development attempts, in timely fashion. Aiming to find out if it is able to improve the efficiency of agricultural counseling agents, this study examined agricultural counseling agents in Luwu Regency, South Sulawesi, Indonesia. As explanatory quantitative research, simple random sampling was applied to respondents of google form questionnaire and the data were analyzed as per Structural Equation Model (SEM) and supported by smart PLS application. The result came out with R2 value of 0.868, representing the agricultural counseling agent’s proficiency and ICT application signified agricultural counseling agent’s efficiency at 86.8 %. It is therefore conclusive that agricultural counseling agent’s efficiency in extension activities relies on both their proficiency and ICT application.

The Effectiveness of the Application of Basic Physics Learning Devices Based on Critical Thinking Skills Using the Edmodo Platform on Android. The purpose of this study is to describe the effectiveness of the application of basic physics learning devices based on critical thinking skills using the Android platform Edmodo application. This research is a pre-experimental study with the research design used namely One Group Pretest Postest Design. The research subjects were 16 second semester students of the 2018 - 2019 academic year STKIP PGRI Mathematics Education Study Program Bangkalan subject matter of temperature and heat. The results of critical thinking skills at the pretest and posttest experienced a significant increase having N-Gain 0.6 in the moderate category. The results of the positive student responses to learning questionnaires were 86.4%. It can be concluded that the application of basic physics learning devices based on critical thinking skills using the android platform EDMODO application can improve students 'critical thinking skills and students' positive responses to learning so that they can be said to be effective.

ABSTRAK Bulai merupakan penyakit penting pada tanaman jagung yang disebabkan oleh jamur patogen Peronosclerospora maydis, dengan tingkat serangan mencapai 95%. PGPR diketahui pengendali patogen hayati dengan menghasilkan berbagai senyawa atau metabolit seperti siderophore, β-1,3 glukanase, kitinase, antibiotik dan sianida serta dapat meningkatkan pertumbuhan tanaman dengan meningkatkan konsentrasi AIA, giberelin dan sitokinin.Penelitian bertujuan untuk mengetahui pengaruh PGPR terhadap penyakit bulai pada tanaman jagung. Penelitian menggunakan isolat Bacillus sp.danPseudomonas sp. serta fungisida berbahan aktif dimetomorf 50%. Perlakuan isolat Bacillus sp.(UB-ABS 4 dan 5) dapat menekan penyakit sebesar 50% sedangkan Pseudomonas sp. (UB-APF2) sebesar 40%. Kandungan khlorofil tertinggi pada Pseudomonas sp. UB-APF2 sebesar 32,03. Berat segar akar tidak berbeda nyata tetapi pada berat kering akar tertinggi pada perlakuan Pseudomonas sp. (UB-APF 5) sebesar 2,56 gram dan akar terpanjang terdapat pada Pseudomonas sp. (UB-APF2) sebesar 49,77 cm. Kata kunci: Tanaman jagung, PGPR, dan Penyakit Bulai.

This research was conducted in two cycles, activities in every cycle had four stages namely planning, acting, observing, and reflecting. Indictaor of completeness in this research was 1) result of headmasters’ observation or teachers’ observation as long as guiding process has gotten mean score > 4,0, 2) reselt of teachers’ mean score in learning process was > 85% with mean score > 80,00 (good category). Result of research in cycle I mean score of headmasters’ observation (3,80), mean score of teachers’ observation (3,20) and result of target academic supervisor was (78,17). In cycle II mean score of headmasters’ observation (4,40) with percentage of completeness (100%, mean score of teachers’ observation (4,30) with percentage of completeness (100%) and mean score of target academic supervisor (85,49) with percentage of completeness (100%). Indicator of completeness had been reached, research was stated success and stopped in cycle II. Conclusion; result of research in cycle II showed improved for target teacher competence in learning process at real classroom. It suggested for other headmasters conducted similar research in effort to improve teachers’ competence, and for teachers in order to conduct learning process based on scenario which has been planned well, responsible, really in improving students learning achievement suitable with their subject.

Pneumococcal glomerulonephritis is rarely described in the literature. We report a four-year-old boy who developed acute glomerulonephritis following pneumococcal bacteraemia and submandibular lymphadenitis, and review the published literature. Two weeks after developing acute glomerulonephritis, the patient developed bronchopneumonia with left pleural effusion. However, by the fourth week of admission, his renal function had normalised and lung involvement resolved. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to address the significant knowledge gap in the literature on the implementation of Casemix system in total hospital information systems (THIS). The research focuses on validating a quantitative instrument to assess medical doctors' acceptance of the Casemix system in Ministry of Health (MOH) Malaysia facilities using THIS., Designs: A sequential explanatory mixed-methods study was conducted, starting with a cross-sectional quantitative phase using a self-administered online questionnaire that adapted previous instruments to the current setting based on Human, Organisation, Technology-Fit and Technology Acceptance Model frameworks, followed by a qualitative phase using in-depth interviews. However, this article explicitly emphasises the quantitative phase., Setting: The study was conducted in five MOH hospitals with THIS technology from five zones., Participants: Prior to the quantitative field study, rigorous procedures including content, criterion and face validation, translation, pilot testing and exploratory factor analysis (EFA) were undertaken, resulting in a refined questionnaire consisting of 41 items. Confirmatory factor analysis (CFA) was then performed on data collected from 343 respondents selected via stratified random sampling to validate the measurement model., Results: The study found satisfactory Kaiser-Meyer-Olkin model levels, significant Bartlett's test of sphericity, satisfactory factor loadings (>0.6) and high internal reliability for each item. One item was eliminated during EFA, and organisational characteristics construct was refined into two components. The study confirms unidimensionality, construct validity, convergent validity, discriminant validity and composite reliability through CFA. After the instrument's validity, reliability and normality have been established, the questionnaire is validated and deemed operational., Conclusion: By elucidating critical success factor and acceptance of Casemix, this research informs strategies for enhancing its implementation within the THIS environment. Moving forward, the validated instrument will serve as a valuable tool in future research endeavours aimed at evaluating the adoption of the Casemix system within THIS, addressing a notable gap in current literature., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This review aimed to assess the usefulness of various magnetic resonance imaging (MRI) techniques for the quantification of neonatal white matter myelination. The Scopus, PubMed, and Web of Science databases were searched to identify studies following the PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement using quantitative MRI techniques to examine samples collected from neonates to quantify myelin. Twelve studies were ultimately included. The results demonstrated that in validation studies, relaxometry is the most frequently explored approach (83.33%), followed by magnetization transfer imaging (8.33%) and a new automatic segmentation technique (8.33%). Synthetic MRI is recommended for quantifying myelin in neonates because of several advantages that outweigh a few negligible limitations.

This paper presents the observations of predation by the grouper Epinephelus quoyanus on sea turtle hatchlings in Chagar Hutang bay, Redang Island, Malaysia. Two of the eight collected specimens had hatchlings in their guts, whereas the remaining specimens had empty stomachs. This field report provides an in-depth understanding of the E. quoyanus diet and new insights into its feeding behavior., (© 2024 Fisheries Society of the British Isles.)

Aim: To determine the prevalence of group B Streptococcus (GBS) carriage among parturient women and neonates, and the relative risk of vertical transmission, the relative risk of early and late-onset GBS and the pooled incidence of early-late-onset GBS infection., Methods: A systematic search of relevant cohort studies from three electronic databases to identify all relevant studies published up to 7 November 2022. The review was conducted in accordance with PRISMA guidelines. Estimates were pooled using random-effects meta-analyses., Results: A total of 54 articles with 355 787 matched pairs of parturient women and neonates from 30 countries were included in the analysis. The pooled prevalence of GBS colonisation was 17.1% among the pregnant women and 1.0% among neonates. The pooled prevalence of vertical transmission of GBS was 4.5% and the pooled relative risk of GBS colonisation of neonates born to mothers with GBS was 9.9., Conclusion: We support the implementation of targeted intrapartum antibiotic prophylaxis for all women who are positive for GBS as well as women with risks factors for early onset GBS in their infants regardless of their GBS colonisation status., (© 2024 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Background: Social media has become a massive encyclopedia of almost anything due to its content richness. People tell stories, write comments and feedback, and share knowledge through social media. The information available on social media enables 'clueless' travelers to get quick travel recommendations in the tourism sector. Through a simple query, such as typing 'places to visit in Bali', travelers can get many blog articles to help them decide which places of interest to visit. However, doing this reading task without a helper can be overwhelming., Methods: To overcome this problem, we developed Bidirectional Encoder Representations from Transformers (BERT)-based tourism named entity recognition system, which is used to highlight tourist destination places in the query result. BERT is a state-of-the-art machine learning framework for natural language processing that can give a decent performance in various settings and cases. Our developed tourism named entity recognition (NER) model specifies three different tourist destinations: heritage, natural, and purposefully built (man-made or artificial). The dataset is taken from various tourism-related community articles and posts., Results: The model achieved an average F1-score of 0.80 and has been implemented into a traveling destination recommendation system. By using this system, travelers can get quick recommendations based on the popularity of places visited in the query frame., Discussion: Based on the survey that we conducted to target respondents who have never visited and have no or limited knowledge about tourist attractions in some example cities, their average interest level from the recommendation results is higher than four on a scale of 1 to 5. Thus, it can be considered a good recommendation. Furthermore, the NER model performance is comparable to another related research., Competing Interests: The authors declare there are no competing interests., (©2023 Fudholi et al.)

Malaysia is bounded by the South China Sea with many islands that support species megadiversity and coral reef ecosystems. This study investigates the distribution of microplastics (MPs) in the surface water around the four marine park islands (Perhentian, Redang, Kapas, and Tenggol) during COVID-19. The global pandemic has reset human activities, impacting the environment while possibly reducing anthropogenic contributions of microplastic pollution near the South China Sea islands. It was found that Pulau Perhentian recorded the most abundance of MPs (588.33 ± 111.77 items/L), followed by Pulau Redang (314.67 ± 58.08 items/L), Pulau Kapas (359.8 ± 87.70 items/L) and Pulau Tenggol (294.33 ± 101.64 items/L). Kruskal-Wallis analysis indicates a significant difference in total MPs abundance between islands. There are moderate correlations between salinity, pH, temperature and MPs variability. Among these parameters, only temperature is significant (p < 0.05) as proven by the principal component analysis and multiple linear regression analysis. Nearly 99 % of MPs are fiber type, with the majority of them being black and transparent. Micro-FTIR spectroscopy revealed polyethylene, polypropylene, polyvinyl methyl ether, polyamide, phenoxy-resins and polyurethane-acrylic are associated with MPs. The findings provide a new baseline reference for the MPs distribution on Malaysian islands, which contributes to a potential future direction regarding marine sustainability., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Zainudin Bachok reports financial support was provided by Marine Park and Resources Management Section, Department of Fisheries Malaysia (DOF), Malaysia. Yusof Shuaib Ibrahim reports article publishing charges was provided by Universiti Malaysia Terengganu., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item questionnaire developed to identify women at risk for postpartum depression (PD). EPDS symptom patterns appear to vary by nation. The EPDS items and their correlation with affirmative EPDS screens have thus far been minimally studied among Malaysians. Using positive predictive value (PPV) and negative predictive value (NPV), this study aims to evaluate the EPDS-based psychometric features of individual answer items. Methodology A cross-section of postpartum women receiving care at two tertiary care facilities in Malaysia underwent screening assessments in the course of receiving treatment. EPDS was employed with an aggregate cutoff score (≥12). EPDS items were assessed as predictors of abnormal EPDS screens. Results A total of 219 participants were screened, among which 66 were positive on the EPDS. EPDS item responses were collected (item responses 0-3: PPV = 0.07-0.78 and NPV = 0.93-0.22). A negative response to any item strongly predicted a negative EPDS screen (item entry = 0 and NPV = 0.93). Affirmative responses on items 8, 9, and 10 were particularly strong predictors of abnormal EPDS scores, while negative responses to items 3, 5, and 7 were strong predictors of negative EPDS scores. A substantial NPV for any item (response 0 and NPV items 1-10 = 0.93) and a moderate PPV for any affirmative response (responses 1-3, PPV items 1-10 = 0.60) were observed. Conclusions This is one of the few studies to examine the EPDS item responses among Malaysian women. The results suggest that depression remains prevalent in this postpartum population. Our findings reveal a robust NPV for any negative response to the individual items of the scale, a moderate PPV for any affirmative response, and a particularly robust validity for specific EPDS items. Physical complaints, rather than feelings of sadness, figure prominently in this population, suggesting a tendency among Malaysian women toward somatization., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Bied et al.)

A long-established approach, Confirmatory Factor Analysis (CFA) is used to validate measurement models of latent constructs. Employing CFA can be useful for assessing the validity and reliability of such models. The study adapted previous instruments and modified them to suit the current setting. The new measurement model is termed NENA-q. Exploratory factor analysis (EFA) revealed the instruments of the NENA-q model formed a construct of the second order with four dimensions, namely organizational contribution (OC), academic institution contribution (AIC), personality traits (PT), and newly employed nurses' adaptation (NENA). Researchers administered the questionnaires to a sample of 496 newly employed nurses working in hospitals under the Ministry of Health (MOH) for the confirmation of the extracted dimensions. The study performed a two-step CFA procedure to validate NENA-q since the model involves higher-order constructs. The first step was individual CFA, while the second step was pooled CFA. The validation procedure through confirmatory factor analysis (CFA) found the model achieved the threshold of construct validity through fitness index assessment. The model also achieved convergent validity when all average variance extracted (AVE) exceeded the threshold value of greater than 0.5. The assessment of the composite reliability (CR) value indicates all CR values exceeded the threshold value of 0.6, which indicates the construct achieved composite reliability. Overall, the NENA-q model consisting of the OC construct, AIC construct, PT construct, and NENA construct for CFA has met the fitness indexes and passed the measurements of the AVE, CR, and normality test. Once the measurement models have been validated through CFA procedure, the researcher can assemble these constructs into structural model and estimate the required parameter through structural equation modelling (SEM) procedure.

Background Postpartum depression has been linked to undesirable outcomes for mother-infant dyads, interfering with childcare and breastfeeding practices. This study aimed to determine the prevalence of depressive symptoms among mothers during the postpartum period and its association with breastfeeding and postpartum experiences. Methodology This cross-sectional study involved mothers of hospitalized infants (n = 219) at two tertiary hospitals in Klang Valley, Malaysia. Mothers were screened for postpartum depression using the Edinburgh Postnatal Depression Scale with a cut-off of ≥12 for positive screening for depression. Mothers were asked to complete questionnaires on breastfeeding experience, which included breastfeeding self-efficacy and challenges. The questionnaires also collected information on postnatal experiences, including birth outcomes, anxiety and stress levels, and social support. Multiple linear regression was used to ascertain the association of postpartum depression levels with breastfeeding and postnatal experiences. Results Overall, 30% of mothers in this study screened positive for depression. Based on multiple linear regression, a higher score of postpartum depression was significantly associated with unpleasant breastfeeding and postnatal experiences reflected by increased scores of anxiety and stress, lower infant birth weight, increased breastfeeding problems, and lower level of social support (p < 0.005). Conclusions Maternal emotions, birth outcomes, breastfeeding issues, and social support were associated with postpartum depression. Efforts should be made to increase maternal support, and screening for maternal depression during infant hospital stays should be encouraged., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2022, Mohd Shukri et al.)

Prostate cancer (PCa) is a multifactorial disease, which arises from the activation of genes related to cell proliferation and DNA synthesis. Two important genes namely hepsin (HPN) and inosine 5-monophosphate dehydrogenase type 2 (IMPDH2) were studied to understand the pathogenesis of this disease. This study aimed to determine the transcript level of PCa-related genes, HPN and IMPDH2, in archived tissues. Their functional roles were further determined using an in vitro model of PCa. Total RNA extraction was done from formalin-fixed paraffin-embedded PCa tissues, and benign prostatic hyperplasia (BPH) tissues acted as the control. Quantitative real-time polymerase chain reaction (qPCR) was performed to measure HPN and IMPDH2 expression. The functional assay was performed in a prostate cancer cell line (DU145) on these two genes by silencing their RNA. We discovered a significantly higher expression of IMPDH2 in PCa samples compared to non-cancerous tissues (P < 0.001). While HPN expression level showed a downward trend in PCa but the result was not statistically significant compared to the control. SiRNA-mediated knockdown of IMPDH2 expression in the cell line significantly decreased cell proliferation. The silencing of IMPDH2, however, did not affect cell migration, invasion, and apoptosis of the DU145 cell line. Our study demonstrated that IMPDH2 plays an essential role in clinical samples as well as in vitro models of this cancer. Inhibition of this gene through siRNA causes retardation of cell proliferation suggesting that IMPDH2 plays an essential role in prostate cancer.

Pulmonary arteriovenous malformation (PAVM) is a congenital vascular abnormality that can cause persistent cyanosis in children. PAVMs can go undetected till adulthood; however, there have been several neonatal cases reported over the years. This case report describes a classical manifestation of a child with isolated PAVM whose diagnosis was likely missed during the neonatal period. A high level of clinical awareness of this condition is crucial as early diagnosis and appropriate treatment can prevent lifethreatening complications and mortality. Diagnosis was confirmed by computed tomography pulmonary angiography and percutaneous transcatheter embolotherapy resulted in complete resolution of symptoms.

The idea of Happiness at Work is drawn from psychology and economic studies. It is often considered as a synonym with 'wellbeing' and defined as a state characterized by a high level of life satisfaction, a high level of positive emotions, and less negative emotions. This research aims to validate the Happiness at Work scale in the Indonesian context. In this study, the researchers conducted cross-cultural adaptation for the Happiness at Work scale following systematic procedures to produce the Scale of Happiness at Work in the Indonesian language. Afterward, the researchers evaluated the content validity with the help of professional judgment and measured the Content Validity Index at the item level and the scale level. Further, to examine the psychometric properties of the Happiness at Work scale, the researchers administer the questionnaire to a sample of 105 (35 male and 70 female) lecturers to conduct exploratory factor analysis to formulate the new dimensionality of the Happiness at Work scale. The results of Exploratory Factor Analysis indicated that Happiness at Work in the Indonesian context could be measured using four dimensions. To confirm that the extracted dimensions measure a single construct, the researchers administered the produced version to a sample of 370 (147 male and 223 female). Afterward, researchers conducted confirmatory factor analysis to evaluate the validity and reliability of the measurement model. This research found out that the Indonesian version of Happiness at Work measurement is reliable and valid. Thus, this study may contribute to the happiness at work literature of non-western context. In conclusion, the Indonesian-Happiness at Work scale shows robust psychometric properties that can be used for further research., Competing Interests: The authors have declared that no competing interests exist.

Objectives: To explore the views of nurses on challenges, perceived roles and improvement strategies concerning elder abuse intervention in Malaysia., Design and Sample: Eleven focus group discussions were conducted using a semi-structured interview based on the socio-ecological framework. The data were analyzed using a multistep process of thematic analysis., Results: Three themes emerged from the data analysis: (1) The predicament: being unwilling or not able to intervene (2) Bridging the older people and health system gap (3) Getting to grips with the barriers. There are multifactorial contributors identified at the individual, interpersonal, organizational, community and policy levels in each theme. These factors interact across the levels to influence nurses' capability to intervene in elder abuse., Conclusion: A framework is needed to articulate Malaysian nurses' role in elder abuse intervention in terms of personal and professional development through culturally sensitive education and the establishment of clinical guidelines in the primary care setting. Strengthening organizational support and the institution of national policy and permissive reporting laws of elder abuse will empower the primary care nurses to address elder abuse in primary care settings and communities., (© 2021 Wiley Periodicals LLC.)

Elder abuse and neglect (EAN) goes largely unrecognized and underreported globally by health care professionals. Despite acknowledging their role to intervene elder abuse, health care professionals lacked knowledge and skills in this issue. This is a single-blinded, three-armed, cluster randomized controlled trials aimed to evaluate the effectiveness of the face-to-face I mproving N urses' d E tection and manag E ment of el D er abuse and neglect (I-NEED) intensive training program and I-NEED educational video in improving primary care nurses' knowledge, attitude, and confidence to intervene EAN; 390 primary care nurses were randomized equally into two intervention groups-ITP group (intensive training program) and ITP+ group (intensive training program and educational video)-and a control group. The knowledge, attitudes, and confidence to intervene EAN were measured using questionnaires at four intervals during 6-month follow-up. A total of 269 primary care nurses participated in this study. There was a significant increase in knowledge, attitude, and confidence to intervene EAN immediately post intervention observed in both intervention groups compared to the control group ( p < .001). At the end of sixth month, there was an increase of knowledge favoring ITP group than the ITP+ group ( p < .001). There is, however, no significant difference in attitude score between ITP and ITP+ group. There is a significant difference of confidence to intervene among the participants between both intervention groups with ITP+ participants reporting higher scores post intervention ( p < .05). An intensive training module improved the knowledge, attitude, and confidence to intervene EAN. Other co-existing barriers for abuse victims getting help, resources, policy, and law of EAN need further highlights.

Irgarol 1051 and diuron are photosystem II inhibitors in agricultural activities and antifouling paints in the shipping sector. This study focused on three major ports (western, southern, and eastern) surrounding Peninsular Malaysia to construct the distribution of both biocides on the basis of the seasonal and geographical changes. Surface seawater samples were collected from November 2011 to April 2012 and pretreated using the solid-phase extraction technique followed by quantification with GC-MS and LC-MS-MS for Irgarol 1051 and diuron, respectively. Generally, the distribution of Irgarol 1051 was lowest during November 2011 and highest during April 2012, and similar patterns were observed at all ports, whereas the distribution of diuron was rather vague. The increasing pattern of Irgarol 1051 from time to time is probably related to its accumulation in the seawater as a result of its half-life and consistent utilization. On the basis of the discriminant analysis, the temporal distribution of Irgarol 1051 varied at Klang North Port, Klang South Port, and Pasir Gudang Port, whereas diuron was temporally varied only at Kemaman Port. Furthermore, Irgarol 1051 was spatially varied during November 2011, whereas diuron did not show any significant changes throughout all sampling periods. Ecological risk assessment exhibited a high risk for diuron and Irgarol 1051, but Irgarol 1051 should be of greater concern because of its higher risk compared to that of diuron. Thus, it is recommended that the current Malaysian guidelines and regulations of biocide application should be reevaluated and improved to protect the ecosystem, as well as to prevent ecological risks to the aquatic environment., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Good control of glycosylated haemoglobin A1C in diabetes patients prevents cardiovascular complications. We aim to describe the A1C trend and determine the predictors of the trend among type 2 diabetes patients in Malaysia. Longitudinal data in the National Diabetes Registry from 2013 to 2017 were analysed using linear mixed-effects modelling. Among 17,592 patients, 56.3% were females, 64.9% Malays, and the baseline mean age was 59.1 years. The U-shaped A1C trend changed marginally from 7.89% in 2013 to 8.07% in 2017. The A1C excess of 1.07% as reported in 2017 represented about 22% higher risk of diabetes-related death, myocardial infarction, and stroke, which are potentially preventable. The predictors for higher baseline A1C were non-Chinese ethnicity, younger age groups, longer diabetes duration, patients on insulin treatment, polypharmacy use, patients without hypertension, and patients who were not on antihypertensive agents. Younger age groups predicted a linear increase in the A1C trend, whereas patients on insulin treatment predicted a linear decrease in the A1C trend. Specifically, the younger adults and patients of Indian and Malay ethnicities had the poorest A1C trends. Targeted interventions should be directed at these high-risk groups to improve their A1C control.

This quasi-experimental study examined the effect of Supporting Family Doctors to Address Elder Abuse (SAFE) educational intervention among family doctors practicing at public primary care clinics in Malaysia. SAFE is an intensive, multimodal, locally tailored, and culturally sensitive face-to-face educational intervention on elder abuse. A significant mean score improvement of knowledge [Baseline: 5.33 (SD:1.33) to 6-month post-intervention: 6.45 (SD: 1.35); p<0.001] and perceived behavioral control [Baseline: 50.83 (SD: 8.87) to six-month post-intervention: 56.16 (SD: 9.56); p<0.001] observed in the intervention group compared to the control group. No significant difference in attitude, subjective norm, and practice scores between the two groups over time. SAFE educational intervention for family doctors was effective to improve but not sustainable knowledge and perceived behavioral control toward elder abuse identification and management. We recommend SAFE educational intervention as part of the continuous medical education for family doctors supplemented with a change in organization and national policy.

Background: Clinical inertia can lead to poor glycemic control among type 2 diabetes patients. However, there is paucity of information on clinical inertia in low- and middle-income countries including Malaysia. This study aimed to determine the time to treatment intensification among T2D patients with HbA1c of ≥7% (≥53 mmol/mol) in Malaysian public health clinics. The proportion of patients with treatment intensification and its associated factors were also determined., Material and Methods: This was a five-year retrospective open cohort study using secondary data from the National Diabetes Registry. The study setting was all public health clinics (n = 47) in the state of Negeri Sembilan, Malaysia. Time to treatment intensification was defined as the number of years from the index year until the addition of another oral antidiabetic drug or initiation of insulin. Life table survival analysis based on best-worst case scenarios was used to determine the time to treatment intensification. Discrete-time proportional hazards model was fitted for the factors associated with treatment intensification., Results: The mean follow-up duration was 2.6 (SD 1.1) years. Of 7,646 patients, the median time to treatment intensification was 1.29 years (15.5 months), 1.58 years (19.0 months) and 2.32 years (27.8 months) under the best-, average- and worst-case scenarios respectively. The proportion of patients with treatment intensification was 45.4% (95% CI: 44.2-46.5), of which 34.6% occurred only after one year. Younger adults, overweight, obesity, use of antiplatelet medications and poorer HbA1c were positively associated with treatment intensification. Patients treated with more oral antidiabetics were less likely to have treatment intensification., Conclusion: Clinical inertia is present in the management of T2D patients in Malaysian public health clinics. We recommend further studies in lower- and middle-income countries to explore its causes so that targeted strategies can be developed to address this issue., Competing Interests: The authors have declared that no competing interests exist.

This article provides raw datasets of the coral reefs status in Pulau Bidong, southern of South China Sea before and after being strike by the tropical storm Pabuk on January 2019. Data were collected using a rapid coral survey method called Coral Video Transect (CVT) technique. The data were collected along a 100 m transect line set up parallel to the shoreline and at a constant depth. In total, eight transects were surveyed during both periods (pre - August 2016, post - March 2019). Back in laboratory, the footage was then extracted into non-overlapping frames or still images prior to image analysis using Coral Point Count with Excel Extension (CPCe) software. The benthic coral reefs relative percentage cover was automatically generated after the image analysis and represented by five major categories; live coral (C), algae (ALG), other invertebrates (OT), dead coral (DC), and sand silt and rock (SR). Live coral cover was identified up to the genus level. This raw dataset was used in this article. The data provided in this article could be of significant use for future studies especially on coral recovery after the natural disturbances. It can provide a baseline assessment especially for coral reefs management as well as to comprehend changes in coral health status in the face of natural and anthropogenic disturbances. The data presented here support the information in the article Safuan et al. (2020)., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships which have, or could be perceived to have, influenced the work reported in this article., (© 2020 Published by Elsevier Inc.)

Background: Methotrexate (MTX), which is the anchor drug in rheumatoid arthritis (RA), targets actively proliferating cells including the oocytes and granulosa cells which may impair the ovarian reserve. The purpose of this study was to determine the effects of MTX therapy on gonadotropic hormones, i.e. follicular stimulating hormone (FSH) and luteinizing hormone (LH) in female RA patients of reproductive age., Materials and Methods: This is a cross-sectional study conducted at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC), from January 2018 to July 2018. Women with RA aged between 15 and 49 years who were on MTX therapy for at least six months, were consecutively recruited. All subjects were interviewed to gather information on their menstrual history and menopausal symptoms. The medical records were reviewed to obtain further data on the disease characteristics and RA treatment. The RA disease activity was determined using the DAS 28 scoring system. All subjects were tested for their serum FSH and LH levels., Results: A total of 40 patients were included in this study. The median dose of MTX used by the subjects was 12.5 mg weekly. The mean cumulative MTX dose was 1664.92 ± 738.61 mg. More than half (53.1%) of the subjects reported menopausal symptoms especially hot flushes. We found that FSH levels had a significant positive correlation with cumulative MTX dose [(r = 0.86), p < 0.001] and the duration of MTX therapy [(r = 0.84), p < 0.001]. Besides, there was a significant relationship between disease activity based on DAS 28 and FSH levels (p < 0.01). Age, body mass index, disease duration, and weekly MTX dose showed no associations with the FSH levels. On multivariate analysis, DAS 28 was found to be the only parameter that remained significant [β = 1.74 (95% CI 1.17-2.31), p < 0.001]. The LH levels, on the other hand, were not associated with MTX therapy or disease activity., Conclusion: Higher levels of FSH, which is an indicator of diminished ovarian reserve, have a significant positive relationship with disease activity, cumulative dose, and duration of MTX therapy in RA., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Kyaw et al.)

Umbilical artery catheterisation is considered the standard of care for arterial access in neonatal intensive care unit. It is routinely used for blood sampling and blood pressure monitoring. Unfortunately, an indwelling umbilical catheter have been associated with thrombotic complication which may result in either partial or complete occlusion of the aorta. We report here our experience in the diagnosis and treatment of a neonate with this condition.

This study investigates the presence of microplastics in surface seawater and zooplankton at five different locations off the Terengganu coast in Malaysia, southern South China Sea. A total of 983 microplastic particles, with an average abundance of 3.3 particles L -1 were found in surface seawater. An average of one plastic particle was detected in 130 individuals from 6 groups of zooplankton. These groups include fish larvae, cyclopoid, shrimps, polychaete, calanoid and chaetognath where they ingested 0.14, 0.13, 0.01, 0.007, 0.005 and 0.003 particle per individual, respectively. Microplastics in the form of fragments are the most common type of ingested microplastics that ranged between 0.02 mm (cyclopoid) - 1.68 mm (shrimp and zoea). Contrastingly, fibers, which are identified as polyamide are the main type of microplastics that dominate in seawater., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

This study aimed to determine the primary care doctors' ability to recognize elder maltreatment and their intentions to report on such conditions. About 358 primary care doctors participated in this study. Outcomes were assessed using a validated five context-relevant clinical vignettes. Primary care doctor's recognition of sexual abuse was highest (91.0%); while the lowest (70.2%) in case signifying physical abuse. Despite being able to ascertain elder maltreatment, the intention to report the event is generally low even for cases exemplifying physical abuse, emotional abuse and neglect. However, intentions to report cases of sexual and financial abuse are 86.9% and 73.5% respectively. Findings highlighted the uncertainties of primary care doctors in distinguishing the clinical findings of non-accidental injuries and injuries due to acts of maltreatment. This provides support for educational intervention and guidelines or policies to improve the knowledge and skills of primary care doctors to intervene in elder maltreatment.

Pulau Redang and Pulau Tioman have experienced huge tourism growth over the last two decades, but minimal sewage treatment may threaten the resilience of their coral reefs. This study uses stable isotope techniques to identify suitable bioindicators of sewage nutrients (δ 15 N) at these islands by measuring macroalgae (Lobophora spp.), gastropods (Drupella spp.), scleractinian coral (Acropora spp.), and leather coral (Sinularia spp.). At tourist hubs using seepage septic tank systems, enrichment of Acropora δ 15 N (Redang, +0.7‰) and Sinularia δ 15 N (Tioman, +0.4‰) compared to pristine background levels indicate enhanced sewage nutrient discharge. Carbon isotopes and survey data suggest that sedimentation did not confound these δ 15 N trends. Potential damaging effects of sewage discharge on the coral reef communities at both islands are highlighted by strong correlations between Acropora δ 15 N and regional variation in coral reef community structure, and exclusive occurrence of degraded reefs at regions of high sewage influence., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: The term early onset neonatal septicaemia (EONS) refers to invasive bacterial infections that primarily involve the blood stream of neonates during the first 3 days of life. Although early onset neonatal septicaemia is relatively uncommon, it may be associated with case fatality rates of 15-30% and substantial morbidity in surviving infants., Objectives: This study describes an unusual septicaemia cases with Janthinobacterium lividum in neonatal Intensive Care Units., Methods: Bacterial causes of early onset neonatal sepsis in Kuala Lumpur Hospital Malaysia were investigated using broad range 16S rDNA PCR and sequencing. The bacterial DNA was isolated directly from blood without pre-incubation. All samples collected were equally cultured and incubated in automated BACTEC system., Results: Two hundred and fifty two neonates were recruited in this study with mean (SD) gestational age of 35.9. Neonates with J. lividum infection lacked microbiological evidence of septicaemia as their blood culture yielded no bacterial growth. However, the PCR analysis of these samples yielded 1100bp corresponding to bacteria species., Conclusion: This study demonstrates the value of PCR in detecting bacteria where special growth requirement is involved., (© 2019 Shinkafi et al.)

Objectives: This study aims to describe the prevalence and transitions of frailty among rural-community dwelling older adults in Malaysia and to analyse factors associated with different states of frailty transition. Frailty was conceptualized using modified Fried phenotype from the Cardiovascular Health Study., Design: This is a prospective longitudinal study with 12-months follow up among older adults in Malaysia., Setting: Kuala Pilah, a district in Negeri Sembilan, which is one of the fourteen states in Malaysia., Participants: 2,324 community-dwelling older Malaysians aged 60 years and older., Results: The overall prevalence of frailty in this study was 9.4% (95% CI 7.8-11.2). The prevalence increased at least three-fold with every 10 years of age. This increase was seen higher in women compared to men. Being frail was significantly associated with older age, women, and respondents with a higher number of chronic diseases, poor cognitive function and low socioeconomic status (p<0.05). During the 12-months follow-up, our study showed that the transition towards greater frailty states were more likely (22.9%) than transition toward lesser frailty states (19.9%) while majority (57.2%) remained unchanged. Multivariate logistic regression analysis showed that presence of low physical activity increased the likelihood of worsening transition towards greater frailty states by three times (OR 2.9, 95% CI 2.2-3.7) and lowered the likelihood of transition towards lesser frailty states (OR 0.3, 95% CI 0.2-0.4)., Conclusion: Frailty is reported among one in every eleven older adults in this study. The prevalence increased across age groups and was higher among women than men. Frailty possesses a dynamic status due to its potential reversibility. This reversibility makes it a cornerstone to delay frailty progression. Our study noted that physical activity conferred the greatest benefit as a modifiable factor in frailty prevention., Competing Interests: The authors have declared that no competing interests exist.

Background: Leptospirosis is a zoonotic disease with a worldwide distribution, especially in developing countries such as Malaysia. This study was designed to explore the knowledge, attitudes, beliefs and practices (KABP) toward leptospirosis among the communities in northeastern Malaysia and to determine the sociodemographic factors associated with the KABP toward leptospirosis. A cross-sectional study using a stratified sampling method was conducted among 214 individuals in four locales in northeastern Malaysia., Methods: A cross-sectional study was conducted among 214 respondents in northeastern Malaysia using a multi-stage stratified random sampling method. The study population was divided into two groups based on geographical locations: urban and rural. All data were entered and analyzed using the IBM Statistics for Social Sciences (SPSS) version 22.0 software for Windows (IBM, Armonk, NY, USA). The continuous variables were presented using mean and standard deviation (SD), whereas the categorical variables were described using frequency and percentage. Multiple logistic regression was performed to determine the associated factors for good KABP toward leptospirosis among the respondents., Results: It was found that 52.8% of respondents had good knowledge, 84.6% had positive attitudes, 59.8% had positive beliefs, and 53.7% had satisfactory practices. There were no significant sociodemographic factors associated with knowledge and practice, except for educational status, which was significant in the attitude and belief domains. Those with higher education exhibited better attitudes (Odds Ratio (OR) 3.329; 95% Coefficient Interval (CI): 1.140, 9.723; p = 0.028) and beliefs (OR 3.748; 95% CI: 1.485, 9.459; p = 0.005). The communities in northeastern Malaysia generally have good knowledge and a high level of positive attitude; however, this attitude cannot be transformed into practice as the number of people with satisfactory practice habits is much lower compared to those with positive attitudes. As for the belief domain, the communities must have positive beliefs to perceive the threat of the disease., Conclusions: Our current health program on preventing leptospirosis is good in creating awareness and a positive attitude among the communities, but is not sufficient in promoting satisfactory practice habits. In conclusion, more attention needs to be paid to promoting satisfactory practice habits among the communities, as they already possess good knowledge and positive attitudes and beliefs.

Little is known on the knowledge, attitudes and preventive practices (KAP) of leptospirosis worldwide. This study embarked on assessing the KAP of leptospirosis among rural communities in Malaysia. A total of 444 participants (223 male; 221 female) aged between 18 and 81 years old were surveyed by using a self-administered questionnaire. A majority of participants had poor knowledge level (57.0%), unacceptable attitudes (90.3%) and unacceptable preventive practices (69.1%) on leptospirosis, and only 29.7% knew "rat-urine disease" as leptospirosis. Only 34.2% of the participants knew the bacteria could enter via wound lesions. Ethnicity and income were strongly associated with knowledge level and preventive practices, respectively ( p -values < 0.05). As for attitudes, ethnicity, income and education type were significantly associated ( p -values < 0.05). Only 36.5% of the participants were willing to see a doctor and did not mind if their house or surrounding area is dirty (59.7%). Surprisingly, only 32.9% had used rubber boots during floods. By logistic regression analysis, ethnicity was the only significant predictor for both knowledge level (an odds ratio (AOR) = 0.39, 95% confidence interval (CI) = 0.222-0.680) and preventive practices (AOR = 1.81, 95% CI = 1.204-2.734). Ethnicity (AOR = 0.40, 95% CI = 0.239-0.665), income (AOR = 1.58, 95% CI = 1.041-2.385) and education type (AOR = 3.69, 95% CI = 1.237-10.986) were strong predictors for attitudes. Among the KAP variables, attitude (AOR = 4.357, 95% CI = 2.613-7.264) was the only predictor for the preventive practices by logistic regression analysis. The KAP elements on leptospirosis are still lacking and poor health seeking behavior and attitudes are of our utmost concern. Thus, effective strategies should be planned to impart knowledge, and develop proactive approaches and good preventive modules on leptospirosis to this leptospirosis-prone community., Competing Interests: The authors declare no conflict of interest.

Our study aims at describing mortality among reported elder abuse experiences in rural Malaysia. This is a population-based cohort study with a multistage cluster sampling method. Older adults in Kuala Pilah (n = 1,927) were interviewed from November 2013 to May 2014. Mortality was traced after 2 years using the National Registration Department database. Overall, 139 (7.2%) respondents died. Fifteen (9.6%) abuse victims died compared to 124 (7.0%) not abused. Mortality was highest with financial abuse (13%), followed by psychological abuse (10.8%). There was a dose-response relationship between mortality and clustering of abuse: 7%, 7.7%, and 14.0% for no abuse, one type, and two types or more, respectively. Among abuse victims, 40% of deaths had ill-defined causes, 33% were respiratory-related, and 27% had cardiovascular and metabolic origin. Results suggest a link between abuse and mortality. Death proportions varied according to abuse subtypes and gender.

Background: The prevalence of type 2 diabetes among Malaysian adults has increased by more than two folds over the past two decades. Strategies to collaborate with the existing community partners may become a promising channel for wide-scale dissemination of diabetes prevention in the country. The objectives of this study were to determine the effects of community-based lifestyle interventions delivered to adults with prediabetes and their health-related quality of life as compared to the usual care group., Methods: This was a quasi-experimental study conducted in two sub-urban communities in Seremban, Malaysia. A total of 268 participants with prediabetes aged between 18 to 65 years old were assigned to either the community-based lifestyle intervention (Co-HELP) (n = 122) or the usual care (n = 146) groups. The Co-HELP program was delivered in partnership with the existing community volunteers to incorporate diet, physical activity, and behaviour modification strategies. Participants in the Co-HELP group received twelve group-based sessions and two individual counselling to reinforce behavioural change. Participants in the usual care group received standard health education from primary health providers in the clinic setting. Primary outcomes were fasting blood glucose, 2-hour plasma glucose, and HbA1C. Secondary outcomes included weight, BMI, waist circumference, total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, systolic and diastolic blood pressure, physical activity, diet, and health-related quality of life (HRQOL)., Results: An intention-to-treat analysis of between-groups at 12-month (mean difference, 95% CI) revealed that the Co-HELP participants' mean fasting plasma glucose reduced by -0.40 mmol/l (-0.51 to -0.28, p<0.001), 2-hour post glucose by -0.58 mmol/l (-0.91 to -0.24, p<0.001), HbA1C by -0.24% (-0.34 to -0.15, p<0.001), diastolic blood pressure by -2.63 mmHg (-3.79 to -1.48, p<0.01), and waist circumference by -2.44 cm (-4.75 to -0.12, p<0.05) whereas HDL cholesterol increased by 0.12 mmol/l (0.05 to 0.13, p<0.01), compared to the usual care group. Significant improvements were also found in HRQOL for both physical component (PCS) by 6.51 points (5.21 to 7.80, p<0.001) and mental component (MCS) by 7.79 points (6.44 to 9.14, p<0.001). Greater proportion of participants from the Co-HELP group met the clinical recommended target of 5% or more weight loss from the initial weight (24.6% vs 3.4%, p<0.001) and physical activity of >600 METS/min/wk (60.7% vs 32.2%, p<0.001) compared to the usual care group., Conclusions: This study provides evidence that a culturally adapted diabetes prevention program can be implemented in the community setting, with reduction of several diabetes risk factors and improvement of HRQOL. Collaboration with existing community partners demonstrated a promising channel for the wide-scale dissemination of diabetes prevention at the community level. Further studies are required to determine whether similar outcomes could be achieved in communities with different socioeconomic backgrounds and geographical areas., Trial Registration: IRCT201104106163N1., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences., Methods and Analysis: This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression., Ethics and Dissemination: The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and presented at conferences., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Aim: The aim of this study was to describe a trial protocol of an educational intervention for nurses to improve their awareness and practice in detecting and managing elder abuse and neglect., Background: Knowledgeable and skilful nurses are crucial amidst the growing numbers of maltreated older patients., Design: This trial is a multi-site, three-armed, community-based cluster randomized controlled trial with 6-months follow-up., Methods: This study will involve 390 community and registered nurses from government health clinics in Negeri Sembilan, Malaysia (protocol approved in October 2013). This three-phased study, premised on the Precede-Proceed Model, comprises baseline focus group discussion and survey (Phase 1), development of training module (Phase 2) and implementation and evaluation of the training (Phase 3). Eligible participants will be randomized to the control group (continuous nursing education), intervention group A (face-to-face intensive training programme) or group B (face-to-face intensive training programme and an educational video). Outcome measures include improvement in knowledge and awareness on elder abuse and neglect and the number of cases identified and managed during follow-up. Data will be collected at baseline, immediate postintervention, 3- and 6-month follow-up., Conclusion: Findings from this study will provide empirical support for the development of a training module for nurses on the detection and management of elder abuse and neglect, towards improving healthcare delivery and the well-being of vulnerable older adults. This study is funded by the University of Malaya Research Grant (RP001C-13HTM), (FL002-13SBS) and University of Malaya Grand Challenge (PEACE) Grant (GC001C-14HTM) awarded in May 2013, July 2013 and September 2014., (© 2015 John Wiley & Sons Ltd.)

Background: In order to understand trophic ecology, habitat use and migration of coral reef fish, fatty acid composition and levels were examined in the bigeye snapper Lutjanus lutjanus collected in the Malaysian South China Sea., Results: Proportions of saturated fatty acids (SAFA) ranged from 55.0% to 66.5%, with the highest proportions in fatty acids, the second highest was monounsaturated fatty acids (MUFA) ranged from 30.7% to 40.2% while the proportion of polyunsaturated fatty acids (PUFA) was the lowest ranged from 2.8% to 4.8%. Palmitic acid (16:0) was the most common in SAFA, oleic acid (C18:1ω9c) was the dominant in MUFA and linolenic acid (C18:3n3) showed the highest value in PUFA. Fatty acid concentrations, especially in SAFA and MUFA, increased with fish growth, suggesting diet and habitat shifts during the fish life history. Most of the fish had more than 1 of EPA: DHA ratio, which suggested that diets of L. lutjanus tended to be higher trophic organisms such as zooplankton and crustacean in coral ecosystem., Conclusions: The diet shift revealed by the composition and levels of the fatty acid profile revealed potential pattern in the habitat use and migration scale in coral reef environment of L. lutjanus.