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Teaching introductory statistics to postgraduate students from multidisciplinary background and with diverse mathematics ability is a huge challenge that many statistics lecturers do not deny. The large ability range can make it very difficult for lecturers to fine tune the right level for effective course delivery. Even though an introductory statistics course has been seen as a necessary component for many postgraduate programs, research has shown that students have come to perceive statistics negatively. One suggestion for improving students' attitude toward statistics is through the use of innovative instructional approaches. This paper investigates the extent to which scenario-based learning (SBL) method used in a Statistics for Research in Education course were related to improvement in postgraduate students' attitude toward statistics. Nineteen students who enrolled in the course during the first semester of 2019/2020 were taught using the SBL instructional method. Survey of Attitudes Toward Statistics-36 (SATS-36) was used to measure six statistics attitude components at the beginning and at the end of the course. Overall results show that there is a difference between mean score of attitude before and after exposure to scenario-based learning method. Scenario based learning has some positive effect on student attitude toward statistics.

This paper presents a comparative analysis of statistics education research in Malaysia and the Philippines by modes of dissemination, research areas, and trends. An electronic search for published research papers in the area of statistics education from 2000-2012 yielded 20 for Malaysia and 19 for the Philippines. Analysis of these papers showed that most were primarily empirical research published in national refereed journals or in conference proceedings. Statistics education research in Malaysia has focused on integration of technology and on affective aspects of statistics learning. In the Philippines, studies have investigated university-level statistics pedagogy, statistics academic programs and teachers' professional development. Implications for future statistics education research and teaching practice in these two countries are identified.

The focus of assessment in statistics has gradually shifted from traditional assessment towards alternative assessment where more attention has been paid to the core statistical concepts such as center, variability, and distribution. In spite of this, there are comparatively few assessments that combine the significant three types of statistical reasoning (reasoning about center, spread, and distribution) with information technology in the context of secondary school students. Hence, this paper intends to discuss the development and initial validation of a technology-based statistical reasoning assessment tool that has been created based on a previously developed statistical reasoning framework. This framework has been useful in evaluating students' statistical reasoning levels in task-based interviews. The assessment tool formulated through this study will be used to refine and validate the initial statistical reasoning framework. There are five tasks in this instrument and each item is labeled according to four key constructs. The technological tool that has been used in solving tasks is dynamic mathematics software. This technology-based statistical reasoning assessment tool can be applied for further investigation.

Most postgraduate programmes, that have research components, require students to take at least one course of research statistics. Not all postgraduate programmes are science based, there are a significant number of postgraduate students who are from the social sciences that will be taking statistics courses, as they try to complete their postgraduate studies. As postgraduate students come from varied backgrounds, from those who have left school for more than a decade, to those who just completed their undergraduate studies, postgraduate statistics course may be one of the toughest to teach. These students come into the course with preconceived thoughts and attitude, which would either increase their anxiety towards statistics, or decrease their anxiety. Previous studies have shown that students reported high level of statistics anxiety during a statistics course. Unfortunately, there are limited studies on statistics anxiety in the Malaysian postgraduate population. Therefore, this study aims to determine the level of anxiety towards statistics among postgraduate student. This study also aims to explore factors that are associated with statistics anxiety among postgraduate students at the Faculty of Education, UKM. As a secondary outcome, this study explores the type of evaluation preferred by postgraduate students in relation to a statistics course. All postgraduate students who registered for the Research Statistics course at the Faculty of Education, National University of Malaysia, during the study period were invited to participate in the study. A total of 141 students completed the questionnaire and was included in this paper. This study found that a significant (21.7%) of the students surveyed have anxiety in at least one of the statistics anxiety domain, either in anxiety towards class activities, attitude towards class, attitude towards Mathematics or self-perception of ability to perform in statistics. This study found that ethnicity was associated with higher anxiety towards class activities, with the Malays being more anxious compared to the non-Malays. Both ethnicity and bachelor's degree were associated with attitude towards class and attitude towards Mathematics. For these two domains, the male students and students from non-science based bachelor's degree, showed more anxiety compared to female students. Self-perception of ability to perform in statistics was not associated with any socio-demographic factors included in this study. Students in this study overwhelmingly preferred individual assignment as an evaluation method, followed by mid-semester examination, and the final semester examination. Least preferred were online participation and presentation.

In this paper, we describe the introduction of blogs to a class of Masters in Technical and Vocational Education students taking the MBE 1223 Statistics in Education module in Universiti Tun Hussein Onn Malaysia (UTHM). The purpose of the analysis is to elaborate on the perception of the participants towards blogs before, during and after training regarding the usefulness of their class blog. For the purpose of this study, participants will be required to handle their weekly reflective journals or their learning logs using their class blogs instead of handing them in hard copy weekly. Participants will be encouraged to blog and to provide feedback to their classmates' comments. Respondents will be required to reflect on lessons weekly and to write their reflections on the class blog. They were also required to reflect on their use of the technology in their module.

Malaysia is one of the world's highest lightning regions, making it an ideal location for studying lightning activities, as they cause many power outages on overhead transmission lines. This study presents ground flash density (GFD) mapping and statistical analysis of lightning flash data in Peninsular Malaysia, which will be used to evaluate the lightning performance of transmission lines. Using Geographical Information System (GIS) software, the GFD map and lightning flash data for statistical analysis were extracted. MATLAB was then used to perform statistical analysis and obtain the probability of peak lightning current using the generalized extreme value (GEV) distribution. This study analyzed six years of lightning flash data from 2012 to 2017 recorded by the Lightning Location System (LLS) and used the Peninsular Malaysia base map from the Department of Survey and Mapping Malaysia (JUPEM). Results show that the GFD mapping approach effectively classifies GFD distribution and identifies areas with high lightning activity. 81% of 4,536,380 lightning flashes were negative polarity, with a higher mean peak current magnitude than positive ones. More lightning activity was observed during the Southwest Monsoon (June-September) and the first Inter-Monsoon season (April-May). Pahang had the most lightning flashes due to its large land area. The GFD map overlaid on the transmission line demonstrated how lightning performance on the transmission line can be assessed. These findings are useful for utility and protection engineers to improve the performance of transmission lines. [ABSTRACT FROM AUTHOR]

Purpose: To statistically analyse sitting posture using anthropometrics data among college students in Malaysia. Design/methodology/approach: This study was conducted among 52 college students consisting of males and females. Data were analysed using a common statistical tool which is the Statistical Package of Sosial Science (SPSS). Findings: Preliminary analysis of data indicated that there are wider differences in standard deviation of eye sitting height compared to the previous study conducted. Research limitations/implications: This study was conducted at only one higher learning institution/college located at East Cost of Malaysia. Practical implications: The larger value of standard deviation discovered as statistical analysis performed using combined data among male and female participants suggested that data should be segregated. Originality/value: Result obtained could be used as a preliminary guideline to design any related item in related to sitting posture. [ABSTRACT FROM AUTHOR]

The flow field in the near wake region (up to six turbine diameters downstream) of a tidal current turbine is strongly driven by the combined wake of the device support structure and the rotor. Accurate characterisation of the near-wake region is important, but it is dominated by highly turbulent, slow-moving fluid. At present, limited number of researches has been undertaken into the characterisation of the near-wake region for a Vertical Axis Tidal Turbine (VATT) device using the Reynolds Averaged Navier Stokes (RANS) model in the shallow water environment of Malaysia. This paper presents a comprehensive statistical analysis using the Mean Absolute Error (MEA), Mean Squared Error (MSE) and Root Mean Squared Error (RMSE) on the near-wake region for shallow water application by comparing numerical solutions (i.e., different types of RANS turbulence models using Ansys Fluent) with published experimental data. Seven RANS turbulence models with a single VATT, represented by using a cylindrical object, were employed in the preliminary study. The statistical analysis performed in this study is essential in exploring and giving a detailed understanding on the most suitable RANS turbulence model to be improved, specifically on its near-wake region. In this study, the near wake region is defined as D ≤ 6, where D is the device diameter. The analysis shows that the RANS numerical solutions are unable to accurately replicate the near-wake region based on large statistical errors computed. The average RMSE of near-wake region at z/D = [2, 3, 4, 6] are 0.5864, 0.4127, 0.4344 and 0.3577 while the average RMSE at far-wake region z/D = [8, 12] are 0.2269 and 0.1590, where z is the distance from the cylindrical object along the length of domain. The statistical error values are found to decrease with increasing downstream distance from a cylindrical object. Notably, the standard k–ε and realizable k–ε models are the two best turbulent models representing the near-wake region in RANS modelling, yielding the lowest statistical errors (RMSE at z/D = [2, 3, 4, 6] are 0.5666, 0.4020, 0.4113 and 0.3455) among the tested parameters. [ABSTRACT FROM AUTHOR]

This paper proposes a new spectrum forecasting (SF) model to estimate the spectrum demands for future mobile broadband (MBB) services. The model requires five main input metrics, that is, the current available spectrum, site number growth, mobile data traffic growth, average network utilization, and spectrum efficiency growth. Using the proposed SF model, the future MBB spectrum demand for Malaysia in 2020 is forecasted based on the input market data of four major mobile telecommunication operators represented by A–D, which account for approximately 95% of the local mobile market share. Statistical data to generate the five input metrics were obtained from prominent agencies, such as the Malaysian Communications and Multimedia Commission, OpenSignal, Analysys Mason, GSMA, and Huawei. Our forecasting results indicate that by 2020, Malaysia would require approximately 307 MHz of additional spectrum to fulfill the enormous increase in mobile broadband data demands. [ABSTRACT FROM AUTHOR]

Objective: Persistent postural-perceptual dizziness (PPPD) is a chronic functional disorder where treatment should be tailored to the individual needs. While customized therapy with a physiotherapist has evidence-based benefits, it comes at a cost and the facility may not be available to some, especially in rural areas. An alternative option is a home-based treatment called MEND (Move, Eye, Neck stretching, and Deep breathing exercises) therapy. This study aimed to assess the efficacy of MEND therapy in PPPD compared to the hospital-based vestibular rehabilitation therapy (VRT). Methods: 59 PPPD patients completed the randomized-controlled study comparing MEND therapy (intervention) and hospital-based VRT (control). EuroQOL Group quality of life questionnaire (EQ-5D), Dizziness Handicap Inventory (DHI), and 21-question Depression, Anxiety, and Stress Scale (DASS-21) were monitored at baseline, 4 weeks, and 12 weeks. Results: At the end of the study, 100% patients on MEND therapy found it beneficial compared to 79.3% in the control group. The MEND therapy provided significant improvements in the physical (P = .007), functional (P = .0006), emotional (P = .0003), and total DHI (P = .0003) with a medium to large effect size. The control group showed significant improvement only in the functional elements of DHI (P = .04), and total DHI (P = .04) with a small to medium effect size. Conclusion: The MEND therapy is an effective option that incorporates all elements of therapy for PPPD. [ABSTRACT FROM AUTHOR]

Background: Influenza infection can lead to mortality and morbidity. In densely populated Kuala Lumpur, Malaysia, the transmission of influenza-like illness (ILI) is high. This study assessed the prevalence and epidemiology of influenza in the target population. Methods: A cross-sectional convenience sample study was conducted in government clinics of Cheras, Malaysia, from November 1, 2022, to February 28, 2023. Consent was sought from patients older than 18 years with symptoms of ILI (fever, cough, and onset within 10 days). A nasopharyngeal swab preceded an influenza rapid test. Logistic regression was used in SPSS 22.0 to evaluate the data. Results: Among 438 patients, 55 (12.6%) tested positive for influenza type B, 9 (2%) tested positive for type A, and 374 (85.4%) were negative. Patients in the group that was 10 years older than the younger group had 1.47 times the odds of having influenza. The odds of positive influenza rose 1.133 times per unit of body mass index (BMI). Patients with chronic lung illness were 6.7 times (95% confidence interval, 2.742-16.287) more likely to test positive for influenza. Sex and smoking history did not affect the rate of influenza infection (p > 0.05). Conclusions: An association was found between age, BMI, and chronic lung disease with influenza infection but not with sex or smoking. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to empirically examine the effect of demographic diversity on top management teams (TMTs) with regard to firm financial performance. This paper uses secondary data of listed companies in Malaysia. Relevant concepts, propositions, hypotheses and control variables are developed to suit the parametric statistical procedures. Demographic diversity is represented by ethnic diversity (the percentage of Non-Malay top managers) and gender diversity (the percentage of female top managers) and performance is measured by return on asset (ROA) and return on equity (ROE). A series of OLS regressions based on the cross-sectional data are also presented. The results fail to support our hypotheses. Hence, diversity does not seem to be relevant in TMTs with regard to financial performance. [ABSTRACT FROM AUTHOR]

(1) Background: Achieving successful tuberculosis (TB) treatment outcomes among diabetic patients is a real challenge as TB complicates control of diabetes. This study aimed to evaluate the effectiveness of an integrated dual management educational module, MID-DOTS, which uses the mmotivational interviewing (MI) technique implemented within directly observed treatment as part of a short course (DOTS) program in TB patients with diabetes (TB/DM). A randomized controlled trial was conducted in the northeastern state of Malaysia. (2) Methods: One hundred and twenty-four TB patients with diabetes received educational intervention using a MID-DOT module that used the MI technique, which was repetitively applied by TB nurses throughout a 6-month DOTS program while another 122 patients were given standard health education. Study outcomes include the proportion of patients with successful TB treatment, and changes in HbA1c and diabetic self-care scores at 6 months. (3) Results: The successful TB treatment outcome was 88% in the intervention group versus 72% in the control group (RR = 1.24; 95%CI 1.16, 1.58). A significant reduction of HbA1c (mean difference 0.82%; 95%CI 0.66, 0.98) and significantly higher diabetes self-care score (mean difference 8.49; 95%CI 7.38, 9.59) were also shown in the intervention group. (4) Conclusions: A dual TB/DM educational strategy which integrates the MI technique applied repetitively within the DOTS program is effective in increasing successful TB treatment as well as improving diabetic outcomes. [ABSTRACT FROM AUTHOR]

In this article, we provide a novel criterion for decision making by addressing the statistical analysis and modeling of health protection expenditures relative to health system of gross domestic product in a comparative study of four different countries, namely the United States, Malaysia, Egypt, and kingdom of Saudi Arabia. Researchers examined the issue of spending on health protection expenditures in relation to gross domestic product from a variety of angles, including social and statistical. Previous statistical studies also addressed the study of statistical modeling through regression approach. Here we study this issue from a different perspective, namely modeling with statistical distributions. In the statistical modeling of the data, we use an extended heavy-tailed updated version of Weibull distribution named the generalized Weibull distribution Weibull (GWD-W) model, which has good statistical properties in terms of flexibility and goodness of fit. Some distributional properties and statistical functions, including the Renyi entropy, skewness, kurtosis, the heavy-tailed behavior, regular variation, and identifiable property are given. Two important actuarial risk measures are derived. A simulation study is conducted to prove the usefulness of the two actuarial measures in finance. The estimation of the model parameters via the maximum likelihood approach is discussed. Comparison study vs some competitive statistical models is performed using the Kolmogorov-Smirnov test for a sample and some detection criteria. The discussion shows that proposed statistical modeling of health care expenditure as a percentage of gross domestic product (GDP) for health care compares well with their peers. [ABSTRACT FROM AUTHOR]

Measuring movement behaviours such as physical activity, sedentary behaviour, and sleep throughout 24 h is critical for assessing early childhood development. A valid tool based on cultural adaptation is required to achieve an appropriate result. Thus, this study aims to translate, culturally modify, and validate the movement behaviour questionnaire (MBQ) into Malay (MBQ-M) for preschool children in Kelantan, Malaysia. Permission to translate was obtained and the MBQ was translated using a ten-step process. Ten independent experts evaluated the content validity in terms of the content validity ratio (CVR), scale-level content validity index-average (SCVI-average), item-level content validity index (I-CVI), and the modified kappa statistic. The original questionnaire had modest adjustments: CVR 0.91, SCVI-average 0.93 for clarity, 0.95 for simplicity, and 0.93 for ambiguity. The SCVI-average relevance was 0.95, and the majority kappa value was excellent (>0.74). All the data imply that the overall content validity of the MBQ items is appropriate. Thirty parents assessed face validity, and the scale-level face validity index (S-FVI/Ave) for clarity (0.95) and comprehension (0.95) was satisfactory. In conclusion, the MBQ-M has satisfactory and acceptable content validity and face validity. Thus, it can be used as a valid tool to measure 24-h movement behaviours among preschool children in Malaysia. [ABSTRACT FROM AUTHOR]

The 27-item Literacy of Suicide Scale (LOSS) is a test designed to measure the respondent's suicide knowledge. The purpose of this study is to examine the psychometric properties of the Malay-translated version of the LOSS (M-LOSS) and its association to sociodemographic factors and mental health literacy. The 27-item LOSS was forward–backward translated into Malay, and the content and face validities were assessed. The version was distributed to 750 respondents across West Malaysia. Rasch model analysis was then conducted to assess the scale's psychometric properties. The validated M-LOSS and the Malay version of the Mental Health Knowledge Schedule (MAKS-M) were then distributed to 867 respondents to evaluate their level of suicide literacy, mental health literacy, and their correlation. Upon Rasch analysis, 26 items were retained. The scale was found to be unidimensional, with generally satisfying separation and reliability indexes. Sex, socio-economic status, and experience in mental health were found to significantly impact the mean score for mental health literacy. This study also found a significant mean difference for suicide literacy across school types. Furthermore, while this study observed a weak but significant negative correlation between age and suicide literacy, no correlation was found between mental health and suicide literacy. [ABSTRACT FROM AUTHOR]

Globally, physical activity levels (PAL) among able-bodied and children with a form of disability remain low. This study aims to characterize PAL and identify the demographic variables affecting children from partaking exercises to promote active lifestyles. Methods: The Physical Activity Scale for Individuals with Physical Disabilities questionnaire was used for the study. A total of 140 data responses were collected online or physically via passive snowball recruitment and quantitatively analyzed. Results: Five factors were extracted from the dimensions, consisting of household chores, household maintenance, high intensity exercise training, miscellaneous activities and school-related activities. Able-bodied children were significantly (p = 0.000) more active (median = 15.05, IQR = 13.06) than children with physical disabilities (median = 3.09, IQR = 2.58). The B40 household group reported significantly (p < 0.05, MET < 5.16/week) lower participation in health-beneficial (moderate-vigorous intensity) exercises as recommended by international guidelines. Conclusion: Children with physical disabilities reported significantly lower education achievements and PAL compared to their able-bodied counterpart. The majority of Malaysian children (69.3%) surveyed did not achieve the recommended aerobic exercise prescription. [ABSTRACT FROM AUTHOR]

Background. The CYP2C19*2 allele may be associated with a reduced antiplatelet effect for clopidogrel. Here, we assessed whether CYP2C19*2 alleles correlate with clopidogrel responsiveness following the administration of clopidogrel in healthy Malaysian volunteers. Methods. Ninety volunteers were genotyped for CYP2C19*2 and CYP2C19*3 alleles. Forty-five of 90 volunteers were included in the clopidogrel response studies and triaged into three genotypes, namely, CYP2C19*1/*1 (n = 17) CYP2C19*1/*2 (n = 21) and CYP2C19*2/*2 (n = 17). All subjects received 300 mg of clopidogrel, and platelet reactivity was assessed after a four-hour loading utilizing the VerifyNow-P2Y12 assay. Platelet activity was reported using P2Y12 reaction units (PRUs), and nonresponder status was prespecified at PRU = 230. Results. Following clopidogrel intake, CYP2C19*2/*2 carriers had a significantly higher mean PRU compared to the CYP2C19*1/*2 and CYP2C19*1/*1 (291.0 ± 62.1 versus 232.5 ± 81.4 versus 147.4 ± 87.2 PRU, P < 0.0001) carriers. Almost half of the participants (46.7%) were found to be nonresponders (3 were CYP2C19*1/*1, 11 were CYP2C19*1/*2, and 7 were CYP2C19*2/*2). Conclusion. In healthy Malaysian volunteers, CYP2C19*2 allele was associated with a decrease in platelet responsiveness to clopidogrel. However, clopidogrel nonresponders can be found not only in the carriers of CYP2C19*2/*2, but also in the carriers of CYP2C19*1/*2 and CYP2C19*1/*1. The present paper demonstrated that genotype information does not correlate with clopidogrel response, and genotyping may represent a less robust approach compared to platelet activity testing in guiding clopidogrel therapy. [ABSTRACT FROM AUTHOR]

Stevioside from Stevia rebaudiana has been reported to exert antihyperglycemic effects in both rat and human subjects. There have been few studies on these effects in vitro. In this paper, radioactive glucose uptake assay was implemented in order to assess improvements in insulin sensitivity in 3T3-L1 cells by elevation of glucose uptake following treatment with stevioside. Oil Red-O staining and MTT assay were utilized to confirm adipocyte differentiation and cell viability, respectively. Findings from this research showed a significant increase in absorbance values in mature adipocytes following Oil Red-O staining, confirming the differentiation process. Stevioside was noncytotoxic to 3T3-L1 cells as cell viability was reduced by a maximum of 17%, making it impossible to determine its IC50. Stevioside increased glucose uptake activities by 2.1 times (p < 0.001) in normal conditions and up to 4.4 times (p < 0.001) in insulin-resistant states. At times, this increase was higher than that seen in positive control group treated with rosiglitazone maleate, an antidiabetic agent. Expressions of pY20 and p-IRSl which were measured via Western blot were improved by stevioside treatment. In conclusion, stevioside has direct effects on 3T3-L1 insulin sensitivity via increase in glucose uptake and enhanced expression of proteins involved in insulin-signalling pathway. [ABSTRACT FROM AUTHOR]

Aim: Anxiety is prevalent among women with Hyperemesis Gravidarum (HG), which is associated with coping strategies and bio-psychosocial risk factors. This study aims to predict socioeconomic status (SES) and obstetric factors towards anxiety and stress-coping strategy, and to explore the significant differences in levels of anxiety on each coping strategy. Design: It was a cross-sectional survey in the Malaysian context. Methods: Forty women medically diagnosed with HG were recruited and completed Generalized Anxiety Disorder-7 (GAD-7) to assess generalized anxiety disorder and coping scale inventory using the Brief COPE questionnaire. Results: The employment status of pregnant women diagnosed with HG significantly predicted their anxiety. Household income and education level predicted emotion-focused coping strategies. None of the obstetric factors predicted the coping strategy. A significant difference was found across anxiety levels in problem-focused and dysfunctional coping strategies. The post-hoc test reveals that dysfunctional coping has the highest mean score in the severe anxiety category. Conclusion: It is essential to promote awareness about effective coping strategies for pregnant women who are diagnosed with HG. Greater efforts are needed to increase the duty of care among healthcare providers to propagate holistic and resourceful coping management with the HG that could help potential patients in the future. [ABSTRACT FROM AUTHOR]

Introduction: There are few sources of published data on intra-cluster correlation coefficients (ICCs) amongst patients with type 2 diabetes (T2D) and/or hypertension in primary care, particularly in low- and middle-income countries. ICC values are necessary for determining the sample sizes of cluster randomized trials. Hence, we aim to report the ICC values for a range of measures from a cluster-based interventional study conducted in Malaysia.Method: Baseline data from a large study entitled Evaluation of Enhanced Primary Health Care interventions in public health clinics (EnPHC-EVA: Facility) were used in this analysis. Data from 40 public primary care clinics were collected through retrospective chart reviews and a patient exit survey. We calculated the ICCs for processes of care, clinical outcomes and patient experiences in patients with T2D and/or hypertension using the analysis of variance approach.Results: Patient experience had the highest ICC values compared to processes of care and clinical outcomes. The ICC values ranged from 0.01 to 0.48 for processes of care. Generally, the ICC values for processes of care for patients with hypertension only are higher than those for T2D patients, with or without hypertension. However, both groups of patients have similar ICCs for antihypertensive medications use. In addition, similar ICC values were observed for clinical outcomes, ranging from 0.01 to 0.09. For patient experience, the ICCs were between 0.03 (proportion of patients who are willing to recommend the clinic to their friends and family) and 0.25 (for Patient Assessment of Chronic Illness Care item 9, Given a copy of my treatment plan).Conclusion: The reported ICCs and their respective 95% confidence intervals for T2D and hypertension will be useful for estimating sample sizes and improving efficiency of cluster trials conducted in the primary care setting, particularly for low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Children aged 2 to 6 years are in a crucial period of growth development, during which it is important for them to attain specific cognition related to concentration and attention so that they can perform well in school later in life. Various factors influence children’s cognition during this crucial period. However, to date, only a limited number of studies have examined the cognitive performance of underprivileged children living in poverty, particularly indigenous children (also known as Orang Asli children in Malaysia). Therefore, this cross-sectional study aimed to determine the associations between sociodemographic factors, nutritional factors (body composition and hemoglobin), and environmental factors (home environment and parasitic infections) with cognitive performance among Orang Asli children in Negeri Sembilan, Malaysia. The participants were 269 children (51% boys, 49% girls) aged 2 to 6 years (M = 4.0, SD = 1.2 years) and their mothers, from 14 Orang Asli villages. Face-to-face interviews were conducted with the mothers, and the children’s cognitive performance, operationalized as working memory index (WMI), processing speed index (PSI), and cognitive proficiency index (CPI), was assessed using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV). The children’s weight and height were measured, and their blood and stool samples were collected to assess hemoglobin level and parasitic infections, respectively. Multiple linear regression analysis showed that the father’s years of education (β = 0.262–0.342, p < 0.05), availability of learning materials at home (β = 0.263–0.425, p < 0.05), and responsiveness of the parent to the child (β = 0.192–0.331, p < 0.05) were consistently associated with all three cognitive indices (WMI, PSI, and CPI). A holistic approach involving parents, communities, and government agencies should be established to improve the cognitive performance of these underprivileged children. [ABSTRACT FROM AUTHOR]

Background: Obesity is a major health concern both in developed and developing countries. The use of herbal medicines became the subject of interest for the management of obesity due to its natural origin, cost effectiveness and minimal side effects. The present study aimed at investigating anti-obesity potential of ethanolic extract from Cosmos caudatus Kunth leaf (EECCL). Methods: In this study, the rats were randomly divided into six groups i.e., (1) Normal Diet (ND); (2) Normal Diet and 175 mg/kgBW of EECCL (ND + 175 mg/kgBW); (3) Normal Diet and 350 mg/kgBW of EECCL (ND + 350 mg/kgBW); (4) High Fat Diet (HFD); (5) High Fat Diet and 175 mg/kgBW of EECCL (HFD + 175 mg/kgBW); (6) High Fat Diet and 350 mg/kgBW of EECCL (HFD + 350 mg/kgBW). The anti-obesity potential was evaluated through analyses of changes in body weight, visceral fat weight, and blood biochemicals including total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), leptin, insulin, adiponectin, ghrelin and fecal fat content. In addition, metabolite profiling of EECCL was carried out using NMR spectroscopy. Results: Rats receiving EECCL together with HFD showed significant (p < 0.05) reduction in body weight gain compared to rats receiving HFD only. At the end of study, the body weight gain of EECCL treated rats was not significantly (p > 0.05) different with those of ND rats. Other related obesity biomarkers including plasma lipid profiles, insulin, leptin, ghrelin and adiponectin levels also showed significant improvement (p < 0.05) . Administration of EECCL caused significant (p < 0.05) increase in fecal fat excretion, which validates the hypothesis of lipase inhibition, an anti-obesity mechanism similar to standard drug of Orlistat. The ¹H-NMR spectra of EECCL ascertained the presence of catechin, quercetin, rutin, kaempherol and chlorogenic acid in the extract. Conclusion: Conclusively, EECCL showed anti-obesity properties by inhibition of intestinal lipid absorption and modulation of adipocytes markers. [ABSTRACT FROM AUTHOR]

Background Immunomodulators are substances that modify immune system response to a threat. Immunomodulators modulate and potentiate the immune system, keeping it highly prepared for any threat. The immunomodulatory effect of the traditional medicine Tinospora crispa is investigated in this work. Methods T. crispa ethanol extract was fractionated by using different solvents. The ethanol extract and effective isolated fraction were used to investigate the potential immunomodulatory effect of different T. crispa doses ranging from 25 μg/mL to 1000 μg/mL on RAW 246.7 cells by detecting intracellular INF-γ, IL-6, and IL-8 expressions. The antioxidant activity of T. crispa was evaluated through FRAP and DPPH. The total phenolic and total flavonoid contents were also quantified. Results Results show that T. crispa extract has higher antioxidant potential than ascorbic acid. The FRAP value of T. crispa extract is 11011.11 ± 1145.42 μmol Fe+2/g, and its DPPH inhibition percentage is 55.79 ± 7.9, with 22 μg/mL IC50. The results also reveal that the total phenolic content of T. crispa extract is 213.16- ± 1.31 mg GAE/g dry stem weight, and the total flavonoid content is 62.07- ± 39.76 mg QE/g dry stem weight. T. crispa crude extract and its isolated fraction significantly stimulate RAW264.7 cell viability (P ⩽ 0.05) and intracellular INF-γ, IL-6, and IL-8 expressions. The results of LC-MS show that four of the active compounds detected in the T. crispa isolated fraction are cordioside, quercetin, eicosenoic acid (paullinic acid), and boldine. Conclusions The results of this study obviously indicate that T. crispa has immunomodulatory effects through the stimulation of INF-γ, IL-6, and IL-8 expressions. LC-MS phytochemical analysis showed that the T. crispa fraction has cordioside, quercetin, eicosenoic acid (paullinic acid), and boldine, which may be responsible for the immunostimulator effect of T. crispa. [ABSTRACT FROM AUTHOR]

Background: Worldwide, the population is ageing, resulting in an associated increase in dementia prevalence. Forgetfulness in elderly people is often perceived as normal in some local cultures and thus, the early detection of dementia in primary care requires detection of symptoms other than memory complaints. This study was conducted to screen elderly patients for early dementia in primary care using a newly developed Early Dementia Questionnaire (EDQ) and comparing it with a standard assessment tool, the Mini Mental State Examination (MMSE). Methods: A cross-sectional study was conducted on a group of elderly patients using convenience sampling of consecutive patients. Elderly depression was excluded using the Geriatric Depression Scale (GDS). Exclusion criteria also included known cases of dementia. Inclusion criteria included a score of 5 or less in GDS and the presence of a reliable informant. A face-to-face interview was done using the EDQ with the patient and informant to elicit symptoms of early dementia. If the informant was not present, a telephone interview was used instead. The patient was then assessed with the Mini Mental State Examination (MMSE) using a cut-off point of 21. Results: Prevalence of dementia among 155 subjects was 52.3% by EDQ and 15.5% by MMSE. The EDQ demonstrated a sensitivity of 79.2% with specificity of 52.7%. Positive predictive value (PPV) of EDQ was 23.5% with the negative predictive value (NPV) of 93.2%. The strongest predictor of possible early dementia was complaints of memory problems (OR 26.22; 95% CI 2.03-338.14) followed by complaints of concentration problems (OR 14.33; 95% CI 5.53-37.12), emotional problems (OR 4.75; 95% CI 1.64-13.81) and sleep disturbances (OR 3.14; 95% CI 1.15-8.56). Socio-demographic factors, medical problems and smoking status were not associated with possible dementia (p>0.05), despite that 60-70% of the elderly had chronic illnesses. Conclusion: The EDQ is a promising alternative to MMSE for screening of early dementia in primary care. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to evaluate the physicochemical and antioxidant properties of Malaysian monofloral honey samples-acacia, pineapple and borneo honey-and compare them with tualang honey. Acacia and pineapple honey are produced by Apis mellifera bees while borneo and tualang honey are produced by Apis cerana and Apis dorsata bees, respectively. Methods: The physical parameters of honey, such as pH, moisture content, electrical conductivity (EC), total dissolved solids (TDS), color intensity, total sugar and apparent sucrose content, were measured. Hydroxymethylfurfural (HMF) was measured using high performance liquid chromatography, and a number of biochemical and antioxidant tests were performed to determine the antioxidant properties of the honey samples. Results: Acacia honey was the most acidic (pH 3.53), whereas pineapple honey had the lowest moisture content (14.86%), indicating that both types of honey can resist microbial spoilage more effectively when compared to tualang honey (pH 3.80 and 17.53% moisture content). Acacia honey contained the highest EC (0.76 mS/cm), whereas borneo honey had the highest (377 ppm) TDS. The mean HMF content in Malaysian honey was 35.98 mg/kg. Tualang honey, which is amber color, had the highest color intensity (544.33 mAU). Acacia honey is the sweetest, and contained the highest concentration of total sugar, reducing sugar and apparent sucrose. Tualang honey had the highest concentration of phenolic compounds (352.73 ± 0.81 mg galic acid/kg), flavonoids (65.65 ± 0.74 mg catechin/kg), DPPH (59.89%), FRAP values (576.91 ± 0.64 µM Fe (II)/100 g) and protein content (4.83 ± 0.02 g/kg) as well as the lowest AEAC values (244.10 ± 5.24 mg/kg), indicating its strong antioxidant properties. Proline, an important amino acid that is present in honey was also measured in the present study and it was found at the highest concentration in pineapple honey. Several strong correlations were found among the biochemical and antioxidant parameters of all the Malaysian honeys. Conclusion: Although Malaysian honeys are of good quality, tualang honey contains the strongest antioxidant properties by far. [ABSTRACT FROM AUTHOR]

In the setting of the new A(H1N1) outbreak, the study was conducted to assess: (1) fear of the A(H1N1) pandemic; (2) risk avoidance behavior; (3) health-protective behavior; and (4) psychosocial impact in the ethnically diverse population of Malaysia. A cross-sectional, computer-assisted telephone interview was conducted between July 11 and September 12, 2009. A total of 1,050 respondents were interviewed. Fear about the pandemic was high, with 73.2% of respondents reporting themselves as Slightly fearful/Fearful. High risk avoidance and health protective behavior were reported, with 78.0 and 99.0% reporting at least one avoidance and protective behavior respectively. Knowledge was a significant predictor for practice of healthprotective behavior across the three ethnic groups. Level of fear was significantly correlated with number of protective and avoidance behaviors. The study highlights the need for provision of accurate information that increases risk avoidance and health protective behaviors, while at the same time decreases fear or panic in the general public. [ABSTRACT FROM AUTHOR]

Period fertility rates show a recent rise in the fertility of the Malay population of Peninsular Malaysia that became evident in the late 1970s, after more than fifteen years of slow but steady declines. Detailed analysis of age-parity-specific fertility rates suggests that the recent rise is largely due to a "making up" of lower order births (first, second, and third) that had been postponed by a rapid increase in age at marriage. The period trend in higher order births and cohort trends of cumulative fertility from census data point to a continued reduction in completed Malay fertility. Regional analysis shows several states on the east coast with persistent high fertility, although the revolution in marital postponement is national in scope. [ABSTRACT FROM AUTHOR]

In the heterogeneous society of the state of Sabah, formerly the British colony of North Borneo and since 1963 a state of Malaysia, the Murut tribe has had a special place. A series of censuses showed that the country's indigenous population as a whole was growing at a slow rate, so that in the year of the most recent count, 1960, the average density of population was no more than 16 persons per square mile--only an eighth of that of Malaya. The decline of the Murut people was a well recognized phenomenon locally, not least by the Muruts themselves. It was investigated from time to time and aroused considerable comment, but no good diagnosis ever resulted, and by 1960 the most recent investigation had petered out in discouragement. Since the thesis that the Murut tribe was dying out and has now recovered is based on the results of censuses, it is necessary to consider how reliable those enumerations were. Is it possible that they were so inaccurate that the one exception to the general pattern of slow but sure growth among the indigenous peoples was no genuine exception but merely the result of poor enumeration?

Background: Dysmenorrhea is a common problem that affects female students' quality of life and academic activities. Complementary and alternative therapies (CATs) are used for the treatment of dysmenorrhea. This study investigated the practices and perceptions of female undergraduate students with dysmenorrhea towards CATs. Methods: This was a cross-sectional study conducted among undergraduate pharmacy students in a public university in Malaysia using a validated and pre-tested self-administered questionnaire. The study was conducted in November and December 2019. The data was analysed using descriptive and inferential statistical tests. Results: Of the 318 female undergraduate students invited, 219 completed the questionnaire (response rate: 68.9%) with 52% aged between 21 and 23 years. The prevalence of dysmenorrhea was 72.1%, and the prevalence of ever-use and current use of CATs was 70.3 and 54.4%, respectively. Bed rest (71.5%), hot compress/heating pad (47.5%) and massage (43.0%) were the most common CATs used by the respondents. The most common reasons for using CAT were to reduce the need for analgesics (61.4%), efficacy (37.3%) and recommendation by others (32.9%). About 23 and 9% of the respondents believed that CATs were equally "effective" and "more effective" than analgesics, respectively. Reducing the need for analgesics (AOR: 4.066, 95% CI: 2.136–7.739) and those who agreed that CATs are effective (AOR: 2.701, 95% CI: 1.337–5.457) were independently associated with the current use CATs for the treatment of menstrual pain. Conclusion: The prevalence of ever-use and current use of CATs is high among female undergraduate pharmacy students. Bed rest and heat applications are the most common CATs used. Reducing the need for analgesics and efficacy are the factors associated with the current use of CATs. Students should be educated about the safe and effective use of CATs to reduce adverse effects and improve their quality of life. [ABSTRACT FROM AUTHOR]

Background: Malaysia has been experiencing an escalation in dengue cases since the past 5 years. As the dengue vaccine pipeline continues to develop steadily with strong public interests, this study had been sought to elicit the acceptance and the willingness to pay (WTP) for hypothetical dengue vaccine in Malaysia. Methods: This study adopted the cross-sectional, contingent valuation study that involved 400 respondents in Penang, Malaysia. The double-bounded dichotomous choice via bidding game approach was employed to elicit the WTP value for two hypothetical 3-doses dengue vaccines (Vaccines A and B with 5- and 10-years' protection, respectively against dengue). A univariate logistic regression model was employed to assess the key determinants of vaccine acceptance, while the mean WTP value and its associated factors were measured by using the parametric two-part model (TPM). Results: Dengue vaccine appeared to be highly acceptable (88.4%) among the population in Penang, Malaysia. Respondents who were of Chinese ethnicity (OR 0.36, p = 0.017), with higher dengue knowledge score (OR 1.43, p = 0.016), and higher vaccination attitude score (OR 1.91, p < 0.001) were more likely to accept the vaccine. The first step logit estimation from TPM displayed that pensioners (OR 2.37, p = 0.036), respondents who were self-employed or working in the private sector (OR 1.21, p = 0.002), respondents with higher education level (OR 2.09–3.29, p < 0.05), and those who accepted the vaccine (OR 3.23, p = 0.001) were more likely to pay for the vaccine. The adjusted mean WTP value for the vaccine was MYR39.21 (USD9.45) per dose. Next, the second-stage regression from TPM revealed the key factors that significantly affected the WTP value, which were composed of age, gender, occupation, household income, dengue prevention practice, and protection duration of the vaccine. The pensioners and those with better dengue prevention practice were willing to pay more for the vaccines. Additionally, all the respondents elicited a higher WTP amount toward the vaccine with longer protection duration (Vaccine B). Conclusion: Strong acceptance toward dengue vaccine reflects the high value of the vaccine in Malaysia. The WTP estimates offer quantification of the private benefit in reducing occurrences of the disease. Besides, the people's preferences-based WTP value for the vaccine tends to complement scientific decision-making and prioritization in the management of dengue in the country. [ABSTRACT FROM AUTHOR]