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Introduction: Drowning is one of the cases that contribute to a high number of death cases as unintentional injury cases worldwide. The victims of this issue are higher among primary school children. Cardiopulmonary resuscitation (CPR) can be performed for drowning victims who showed an absence of breathing and pulse to regain their consciousness and their life. Furthermore, providing the knowledge and practice of CPR should not only be limited to adults but also the children including at the primary level. Objectives: This study aimed to identify knowledge and the practice of CPR for drowning victims before and after the intervention given. Methods: A pre-post interventional study design with a purposive sampling method was conducted at the primary school. The studied participants were primary school children who live near the coastal areas. Developed self-administered questionnaires and CPR educational videos were used in this study to identify the knowledge and practice of the studied participants. The data were analysed by using IBM SPSS statistics version 25.0. Results: The studied participant's ages were 10 and 11 years old. They were capable of comprehending the information delivered to them. Both knowledge and practice of CPR for drowning victims were increased after the educational video intervention was given to them. Conclusion: The findings showed that although they lacked knowledge and practice of CPR for drowning victims before the intervention, they were able to show improvements in their total score for both parts after the intervention. Educating the children as early as 10 years old regarding CPR for drowning victims was capable to be carried out in the local setting. Hence, the implementation of CPR courses in the curriculum of school children starting from the primary level may happen in the future.

BACKGROUND: Breast cancer turns a person’s life upside down, affecting every aspect of an individual including the psychological domain, such as feelings of phobia, isolation, anger, irritability, confusion, and most frequently anxiety. Some studies reported that rituals practice in Islam have an impact on the psychological health breast cancer patient. AIM: The aim of the study was to explore the experience of psychological alteration among patients with advanced breast cancer. METHODS: A qualitative study utilizing the content analysis approach was organized. Twenty Muslims with breast cancer during chemotherapy treatment with a mean age of 47.1 years who dealt with their psychological responses during treatment were invited to participate in a semi-structured interview, before and after applying Islamic-based practice therapy. This study conducted between February and June 2018 in the outpatient unit of chemotherapy in one of the Indonesia’s teaching hospitals. The generated data were transcribed verbatim and the content analysis approach was used for data reduction, data names, obtaining analytical code, and determining categories and themes. RESULTS: Four themes emerged from the data analysis before the researchers using the Islamic-based practice therapy: (1) Self-blaming, (2) feeling sad, (3) feeling fear and uncertain, and (4) living with a new body. However, the results after applying the Islamic-based practice therapy emerged three themes: (1) Closer to God, (2) peace of mind, and (3) inner strength. CONCLUSION: Overall, in the view of breast cancer patients, the psychological experience of using the Islamic-based practice therapy could change to positive responses by making them feel closer to God, having good inner strength, and a peaceful mind in dealing with their day-to-day conditions. Hence, understanding the patient’s experience will assist the nurses to promote professional abilities and improve nursing care delivery related to different cultural backgrounds and spiritual dimensions of Muslims patients.

This study was conducted to examine the association between physical activity (PA) and body weight status among adolescents in rural and urban areas. This cross-sectional study involved 257 adolescents aged 13-19 years, randomly selected from secondary schools around Kelantan, Malaysia. Body weight and height were measured and body mass index (BMI) was calculated. The students completed the International Physical Activity Questionnaire - Short Form, to assess their physical activity. Ethical clearance was obtained from respected bodies. Adolescents in the urban area had significantly higher BMI (p-value

This literature review conducted to explore the best available intervention for diabetic foot care. Online databases (ProQuest, CINAHL, Science Direct and Google Scholar) were searched to retrieve relevant articles. The keywords diabetic foot care, diabetic foot care program, diabetic foot care intervention, diabetic foot education were used for data retrieval and PICO analysis. After screening analysis was completed, only 15 (from 7423) articles, published within 2007-2017, were included in a qualitative synthesis of the data. The articles were categorized as: systematic review (n=1), randomized control trial (n=3), quasi-experimental (n=3), pre-test-post-test (n=4), cohort (n=2), cross-sectional (n=1) and surveys (n=1). Themes synthesized from the analysis were: effective approach (group or individual), project leader, specialized skills required and adaptation of technology. A combination of identified approaches would help design a technology-friendly program for managing diabetic foot care.

Objective This study was conducted to evaluate the feasibility of simulation-based exercise programme among overweight adult in higher learning institutes. Method A quasi-randomized controlled trial was conducted recruiting students from two different higher learning institutions in Kuantan, Pahang, Malaysia. Students are selected after fulfilling the criteria such as body mass index (BMI) of ≥23 kg/m2, no chronic diseases that may influence by exercise, no significant changes in body weight within two months and not taking any medications or supplements. One institution was purposely chosen as a simulation-based group and another one control group. In the simulation-based group, participants were given a booklet and CD to do aerobic and resistance exercise for a minimum of 25 min per day, three times a week for 10 weeks. No exercise was given to the control group. Participants were measured with the International Physical Activity Questionnaire (IPAQ), BMI, waist circumference (WC), body fat percentage before and after 10 weeks of simulation-based exercise. Results A total of 52 (control: 25, simulation-based: 27) participants involved in the study. There was no baseline characteristics difference between the two groups (p > 0.005). All 27 participants in the simulation-based group reported performing the exercise based on the recommendation. The retention rate at three months was 100%. No adverse events were reported throughout the study. Better outcomes (p Conclusions The findings of this study indicate that the simulation-based exercise programme may be feasible for an overweight adult in higher learning institutes. As a feasibility study this is not powered to detect significant differences on the outcomes. However, participants reported positive views towards the recommended exercise with significant improvements in body mass index, body fat percentage and reduced the waist circumference.

Objective The objective of this study was to assess the level of knowledge and practice of body mechanics towards preserving musculoskeletal health in daily routine activities of HCPs (medical officers, staff nurses, community health nurses, assistant medical officers, physiotherapists, and assistant nurses) from Hospital Tengku Ampuan Afzan, Pahang. Method A cross-sectional study was conducted with convenience sampling employed across five different departments. The departments were a department of medical, surgical, orthopedics, emergency and rehabilitation. The samples were selected according to a minimum of two years of clinical experience without any history of low back surgery. An instrument consists of socio-demographic background, knowledge on body mechanics and Owestry Low Back Pain Disability Index Questionnaire was used in this study. Results A total of 139 HCPs were recruited including medical officers, staff nurses, community health nurses, assistant medical officers, physiotherapists, and assistant nurses. A self-administered questionnaire pertaining to knowledge revealed that 73.4% of HCPs had inadequate knowledge of musculoskeletal body mechanics. Among all, 90.6% (minimal: 9.4%, moderate: 43.2%, severe: 42.4%, crippled: 5.0%) of HCPs showed moderate to crippled disability using Oswestry Disability Index classifications indicating the poor practice of body mechanics while working. Conclusion The findings of this study indicate that a lack of knowledge among healthcare professionals lead to the inadequate practice of preserving musculoskeletal health while carrying out duty in caring patients. It is suggested that enforcing and emphasizing health education for healthcare professionals is urgently needed towards reducing the risk of the musculoskeletal problem among healthcare professionals.

Objective: Behavioural modification required transition process to occur. There is limited data discussed on self-transition process to occur. Thus, this paper is aimed to examine self-transition concept for better understanding in managing Type 2 Diabetes Mellitus client. Methods: A Walker & Avant guideline was employed during concept analysis carried out. 20 articles have been extracted from CINAHL, ProQuest and Science Direct with duration of published paper within 2000 to 2016. Keywords of transition, transitions, self-transition and self-transition were used in extracting relevant articles. Results: Trust and empowerment are required antecedents prior to self-transition occurrence. There are four different attributes namely as challenges, availability of support system, vulnerability and self-regulatory/self- efficacy. Consequence of self-transition will lead to behavioural modification which may occurs through self -evaluation or epiphanies. Sustainability is another aspect that should be considered in maintaining behavioural modification. Conclusion: Self-transition will occur with the assistance of self-regulatory/self- efficacy based on the availability of support system. Furthermore, challenges and vulnerability will assist in shaping a person self-transition. Indeed, trust and empowerment are the antecedents prior to the development of individual self-transition. Successfulness of self-transition occurrence depends on sustainability of resources and perceptive behavioural modification changes either through self- evaluation or epiphanies.

LETTER TO EDITOR Challenges for Education in Nursing Nursing challenges have evolved over time, but the profession itself remains true to those who are motivated to serve others. Nurses are responsible for more than just patient care; they are also responsible for the promotion of health care and personal well-being. Nursing education, the role in community care, the development of areas of specialisation, and nursing leadership all require periodic transformation in line with rapid technological change, the world's growing elderly population, and the current twists and challenges in providing the best possible care. Nurses have an impact on people of all ages, ethnic groups, backgrounds, and communities while working tirelessly to meet the sick and vulnerable's physical, emotional, and spiritual needs. Nursing is a profession that requires someone who is resilient, dedicated, and empathetic in order to provide care to the community. According to WHO recommendations, nursing education should be standardised around the world, with minimum qualifications at Bachelor’s degree. Advanced degree programmes, such as a have expanded the offerings and reach of modern-day nurses, providing them with the skills needed to meet evolving nursing challenges. Nurses must brace themselves for upcoming challenges, which may worsen as the world's population grows. As a result, the specialisation curriculum should include more areas involving clinical experience for various specialties and treatment of acute and chronic diseases, and public health. This is exacerbated by an increase in the number of patients with a wide range of problems and symptoms that necessitate the specialisation of advanced clinical skills, the complexity of work, and the dedication to patient care. In the face of various challenges, a lack of nursing expertise will limit treatment to patients and even weaken treatment care. Nurses with specialisations in developing countries have been able to provide the best possible care to patients with a high rate of success. However, in order to be a successful nurse, each nurse must have certain strengths, interests, and expertise In order to prepare for becoming a developed country and facing future challenges, such nursing strategies and directions must be prepared in accordance with WHO recommendations. Today, nursing is a vast and varied field with a plethora of opportunities for those interested in pursuing it as a career. Nursing challenges are unique due to the level of investment nurses have in their work. They get to know their patients, are concerned about their needs, and contribute significantly to their patients' recovery. Despite the daily challenges of nursing, they make a difference in the lives of the many people they touch. References

The main objective of aerospace industry is to produce all electric aircraft (AEA) equipped by electrical devices in coming developments. Electrical machines that provide higher torque densities are gaining more interest for researchers to obtain sustainable direct-drive electrical propulsion system for aircraft applications. In addition to lesser weight and higher torque density, a machine should be “fault tolerant” to applied in aerospace applications. A novel machine for high starting torque, identified as flux switching machine (FSM) was established over the last decade. FSMs comprise all effective sources on stator including robust rotor structure. These machines exhibited higher “torque-to-weight ratios” and reliability. Nonetheless, the challenge of developing a machine suitable for aircraft applications goes far beyond electromagnetic design and much deeper into the field of mechanical systems than traditional ones. Thus, a new double stator (DS) hybrid excitation (HE) FSM design employing segmented rotor is proposed and analyzed in this research work. The suggested design for DS HE-FSM comprises of six field excitation coils (FECs) and six permanent magnets (PMs) as their excitation sources. In this research, investigation of DS HE-FSM is accomplished with respect to flux linkage, back EMF, cogging torque and torque analysis based on 2D FEA.

Objective The objective of this study is to identify the need for basic first aid knowledge and skills among adolescents. Method A cross-sectional study using multistage sampling was conducted among 375 secondary school students in Kuantan, Pahang, Malaysia. The survey was adapted from a Hong Kong Red Cross survey. A back to back translation of this instrument was carried out by two bilingual medical experts with Cronbach's alpha 0.8. The data were analyzed using SPSS (Statistical Package for the Social Sciences) in terms of descriptive analysis, and an independent t-test and chi-square test were carried out. Results There were 149 respondents from the lower form (grade level) and 226 respondents from the upper form. The majority of respondents (81.6%) were Malay. An independent t-test revealed a significant association between knowledge and attitude, as students who scored higher on first aid questions showed a more positive attitude towards first aid (1.475%). There were also significant associations between race and experience learning first aid. Conclusions Adolescents receive minimal first aid education. Thus, there is an urgent need to educate adolescents more in first aid to promote a safer community and to prevent any further injuries.