Walking 10,000 steps daily is associated with beneficial health outcomes. Recent systematic reviews have suggested that pedometers may be an effective motivational tool to promote walking. The aim of this study was to study the effectiveness of a 10-week, pedometer-based walking intervention to improve physical activity, body composition and metabolic health indices in a sample of suburban community-dwelling adults not meeting current physical activity recommendations. After screening, 34 overweight/obese individuals (mean age: 46 ± 8 years, mean BMI: 28.3 ± 4.2 kg/m2 ) were accepted into the walking program conducted by the Health Promotion Community Centre, Bangi. Subjects were instructed to increase their steps by 3000 steps daily above their baseline values for 10 weeks. Daily step count, body weight, BMI, waist circumference, as well as blood pressure, fasting glucose and lipids were evaluated at baseline and following the 10-week intervention. Thirty-one participants completed the program with 100% adherence. The average daily steps recorded during the 10-week intervention was 9693 ± 2196 steps per day. Mean daily steps increased from 8679 ± 2567 steps in Week 1 to 10,766 ± 3200 steps in Week 10 (p=0.040). Overall, there were reductions in body weight (-1.13%, p=0.010), waist circumference (-3.5%, p=0.001) and BMI (-1.41%, p=0.008) as well as fasting blood glucose (-8.5%, p=0.003) and systolic blood pressure (-4.8%, p=0.007) following the intervention. The findings of this study demonstrated that a goal-driven, pedometer-based walking intervention for 10 weeks resulted in a modest reduction in body weight and improved metabolic health outcomes in overweight/obese, community-dwelling adults.

Walking is the simplest form of physical activity. 10,000 steps daily is associated with significant improvement in health outcomes. However, the extent of awareness regarding walking and whether or not 10,000 steps daily are being exercised by many are still unclear. The aim of this study is to investigate the level of knowledge, attitude and practice (KAP) on walking among university employees. A cross sectional study was conducted in Universiti Kebangsaan Malaysia (Kuala Lumpur Campus) involving 127 academic and administrative employees. All participants wore a pedometer for three continuous working days to determine daily steps and completed a validated KAP and sociodemographic questionnaires. Results showed that participants recorded an overall mean (± SD) of 7506 ± 3764 steps/day. According to pedometer thresholds proposed by Tudor-Locke and Bassett, 29% males and 22% females were classified as ‘sedentary’ (<5000 steps/day), while 24% males and 13% females were classified as ‘active’ (>10,000 steps/day). The mean ± SD for knowledge, attitude and practice scores were 10.9 ± 2.0 (84%), 33.0 ± 2.4 (66%) and 12.90 ± 3.8 (72%) respectively. Academic employees had higher knowledge scores on walking activity compared to administrative employees (p<0.05). Females had better attitude scores compared to males (p<0.05). The scores for practice in employees aged 29-35 years were higher than in those aged 51-58 years (p<0.05). Daily steps correlated positively with practice scores. Age group, job types and modes of transportation were significant factors in predicting daily steps (p<0.05). In conclusion, a majority of the university employees (33%) in this study were categorized as ‘low active’ despite being aware of the recommended 10,000 steps/day. Interventions aimed to increase walking activity are perhaps useful among university employee.
Walking ; pedometer ; knowledge ; attitude ; practice

Stress is a common problem among university students and studies showed that involvement in exercise could help in reducing stress. However, information regarding the effect of high intensity progressive resistance training (PRT) using a resistant tube on stress among inactive and moderate active young male university students is limited. Hence, the aim of this study is to examine the effect of high intensity PRT using a resistant tube on psychological stress level, cortisol, DHEA and physical fitness in this population. A total of 30 male university students were participated in this quasi-experiment study. Intervention group (n = 14, age: 21.50 ± 1.37 yr) was participaned to carry out high intensity PRT by using resistant tube 3 times per week for 10 weeks; control group (n = 16, age: 21.29 ± 1.86 yr) was asked to continue their current lifestyle as usual. Before and after 10 weeks of intervention, psychological stress was measured by using PSS and SLSI questionnaires; cortisol and DHEA level were measured by using ELISA method. Timed up-and-go (TUG) used to examine dynamic balance and handgrip strength test used to measure muscle strength. Findings showed that the increased of DHEA level after 10 weeks of intervention was significantly difference between control and intervention groups (p < 0.05). There was no significant group difference in changes over time in anthropometric and body composition measurements, stress scores, cortisol level and physical fitness. High intensity PRT using resistant tube may be beneficial in increasing DHEA level among young male adults, which can act as a stress biochemical indicator.
Stress, Psychological

The paediatric rehabilitation service in Malaysia is shifting from the traditional child-focused approach to a family-centred approach. At present, there is a lack of an evaluation tool to assess to the quality of paediatric rehabilitation services, and whether the services are in line with the principles of the family-centred service. This study was undertaken to assess validity and reliability of the Malay version of the Measure of Processes of Care 20-item (MPOC-20) questionnaire in evaluating family-centered approach in children rehabilitation services in Kuala Lumpur. The original English version of the MPOC-20 was translated into Malay language, before it was administered to 102 parents of children receiving rehabilitation service at the Occupational Therapy Unit, UKM Medical Centre. The component structure of the MPOC-20 Malay version was examined using principal component analysis with Varimax rotation to explore the factor structures after translation. Cronbach’s alpha was calculated to determine the internal consistency reliability of the factors identified in the MPOC-20 Malay version. The resultant four-factor model explained 64 % of the variance in the Malay MPOC-20 responses. All four factors were similar to the five factors described in the original MPOC-20. All the 20 items were retained, with relocation of some items into a new factor. The Malay version of the MPOC-20 showed good internal consistency with Cronbach’s alpha values ranging from 0.75 to 0.90. This study demonstrates that the Malay version of the MPOC-20 is valid and reliable, and is suitable for evaluation of the quality of child rehabilitation services in the Malaysian context.
Early Intervention (Education)

The emergence of research about the biological effects of electromagnetic field (EMF) have growing concern among researchers. The aim of this study was to investigate the effects on the brain of rats periodically exposed to 0.1 mT EMF. Total 24 adult male Sprague Dawley rats were subdivided randomly to 4 groups: 2 control groups (C1 6 hours: 6 h/ day for 5 days; C2 20 hours: 20 h/day for 5 days) and 2 treatment groups which exposed to 0.1 mT EMF (T1 6 hours: 6 h/day for 5 days; T2 20 hours: 20 h/day for 5 days). A significant decrease in the pyramidal cell number was higher as the exposure duration to EMF was extended (T1, p<0.05; T2, p<0.001). The total numbers of pyramidal cells for T1 was 15.18 % lower than of the total found in C1; and in concurring to the pattern, the number of pyramidal cells in T2 was 33.54 % lower than the total in C2. Similarly, there was a significant decrease of the Purkinje cell number as the duration exposure to EMF, extended (T1, p<0.05; T2, p<0.001). The total numbers of Purkinje cells for T1 was 11.20 % lower than C1, in T2 was 16.19 % lower than in C2. There were significant differences between the thickness of granular layer and molecular layer in the control groups and treatment groups. We also report a significant difference in the levels of norepinephrine in T2, 10.71 % higher than C2. Cumulatively, these results suggested that exposure to EMF can exert negative effect on rats brains.
Electromagnetic Fields

Postprandial hyperglycemia is independently related to cardiovascular disease. Garlic, ginger, lemon, honey and applecider vinegar are known to have anti-glycemic properties. However, the effectiveness of combination of these naturalproducts on reducing postprandial glycemia is uncertain. The aim of the present study was to investigate the glucoseloweringeffect of a novel mixture consisting of apple cider vinegar, garlic, ginger, lemon, and honey; alone and incombination with exercise in response to a high-carbohydrate meal in non-diabetic individuals. Ten, female subjects (meanage: 25 ± 2.67 years, mean BMI: 22.6 ± 3.5 kg/m2) participated in this randomised, cross-over intervention consisting offour trials: control (CON), mixture only (MIX), exercise only (EX), and exercise + mixture (EX-MIX). All trials involvedconsumption of a high-carbohydrate breakfast, then followed by rest in CON, consumption of natural product mixturein MIX, brisk-walking exercise in EX, and combination of mixture and exercise in EX-MIX. Blood glucose was measuredat fasting, and at 30, 60, 90, 120 minutes post meal. Postprandial glucose response was calculated as area under theglucose curve. Two-way repeated measures ANOVA showed a significant group and time interaction (p < 0.001). Comparedto CON, postprandial glucose responses were 8%, 13% and 15% lower in MIX (p = 0.049), EX (p = 0.001) and EX-MIX(p = 0.005) respectively. Postprandial glucose was 8% lower in EX-MIX compared to MIX (p = 0.002). In conclusion,consuming natural product mixture containing garlic, ginger, lemon, honey and apple cider vinegar reduced postprandialglycemia to a certain extent, however, combining mixture with exercise produced a greater attenuation effect comparedto consuming mixture alone. This finding is indicative of a potential benefit of the novel mixture as a complementarymanagement of hyperglycemia in high-risk individual

Hibiscus sabdariffa Linn. (roselle) is a polyphenol rich fruit. This study aimed to identify the neuroprotective effect of roselle on LPS-induced cell proliferation and nitric oxide-induced free radical in microglia and neuroblastoma cells. MTT assay was used to identify the appropriate concentration of roselle and LPS for microglia and neuroblastoma cells proliferation study. Griess assay were used to determine the level of nitric oxide accumulated based on the reaction of Griess to estimate the activity of iNOS in nitric oxide production. The results showed that roselle at the concentration of 50 μg/mL and 100 μg/mL and LPS at concentration of 1 μg/mL does not give cytotoxic effect towards microglia C8-B4 and neuroblastoma LN18 cells. The roselle treatment at 50 μg/mL and 100 μg/mL showed a protective effect on LPS-induced microglia C8-B4 cells. However, in neuroblastoma LN18 cells, no protective effect was seen on both 50 μg/mL and 100 μg/mL of roselle treatment following induction with 1 μg/mL of LPS. On the other hand, the production of nitric oxide (NO) was reduced when LPS-induced microglia C8-B4 cells were treated with 50 μg/mL of roselle. Treatment of roselle at concentration 100 μg/mL on LPS-induced neuroblastoma LN18 cells also reduced the production of nitric oxide. As a conclusion, roselle had the ability to give neuroprotective effect by the inhibition of LPS induction activity on microglia activation for normal and cancer cells at different concentrations.
Hibiscus

Ficus deltoidea or ‘mas cotek,’ is a uterotonic herb traditionally consumed by women to improve menstrual circulation,assist labour, remove retained placenta and treat postpartum bleeding. The aim of the study was to elucidate the mechanismof F. deltoidea in uterine contraction. Crude extracts from 2 different variants of F. deltoidea were used in the study; F.deltoidea var. Deltoidea (FDD) and F. deltoidea var. Angustifolia (FDA). This study was conducted ex vivo on the strips ofisolated rats uterus treated with either FDD or FDA aqueous extract with increasing concentrations ranging from 10 µg/ml until 1280 µg/ml at time intervals of 5 minutes between doses. The frequency and intensity of the uterine contractionswere monitored via Powerlab software. Maximum contractions for both extracts were identified, recorded and the uterinestrips samples at maximum contraction were selected and homogenized in order determine the role of prostaglandinF2α (PGF2α) in the mechanism of uterine contraction. Other than that, phosphorylated 42/44 (p42/44) of mitogenactivated protein kinase (MAPK) expression was also detected via immunoblotting. The results showed that the maximumcontraction induced by FDD was at the concentration of 320 µg/ml, whereas for FDA was at 960 µg/ml. Both FDD andFDA increased the intensity of uterine strips contractions and there were notable trend of increased PGF2α expression aswell. Further analysis revealed that the uterine contractions involved the MAPK pathway through the phosphorylation ofp42/44 protein. In conclusion, Ficus deltoidea of both variants have the ability to stimulate uterine contraction throughthe mechanism of MAPK pathway.

Diabetes is often associated with dysfunction in activities of daily living (ADL), especially among older adults.Hospitalisation of older adults is often followed by decline in functional status affecting their quality of life and well-beingafter discharge. The objective of this study was to determine the functional independence in carrying out basic activitiesof daily living, its relationship with quality of life, and the factors influencing the quality of life in hospitalised olderadults with diabetes. This cross sectional study was carried out on 104 diabetic patients (mean age: 67.5 ± 9.2 years) whowere receiving in-patient treatment. Face-to-face interviews were carried out to determine functional independence usingModified Barthel Index (MBI) as well as quality of life using the World Health Organization’s Quality of Life instrument(WHOQOL-BREF). Results showed that only 37.5% (n = 39) respondents were catergorised as being fully-independent.Among the domains in MBI, using the stairs recorded the lowest score followed by mobility. The physical domain in qualityof life also recorded the lowest score compared to other domains of quality of life. There were significant (p < 0.05),positive correlations between the overall MBI scores and all domains of quality of life; physical (rs = 0.70), psychology(rs = 0.50), social (rs = 0.33) and environmental (rs = 0.25). Hierachical multiple regression analysis showed MBI scoreshad significant influence on all domains of quality of life, with the largest influence on the physical domain i.e. 36% [F(1,92) = 82.14, p < 0.01, R2 = .36]. As a conclusion, hospitalisation reduces the functional independence in carrying outbasic activities of daily living as well as the physical aspect of quality life in older adults with diabetes. Therefore, it isimportant to provide rehabilitation in activities of daily living while the elderly diabetics while undergoing in-patienttreatment in order to maintain quality of life after discharge.

Introduction: Awareness for paediatric palliative care has resulted in the impetus for paediatrician-led palliative care services across Malaysia. However, there is paucity of local data on patients receiving hospital-based paediatric palliative care. We aim to review the clinical spectrum of patients referred to these services. Methods: An observational study of children aged between 0-18 years receiving palliative care at 13 hospitals between 1st January and 31st December 2014 was carried out. Results: There were 315 patients analysed, 90 (28.6%) and 46 (14.6%) were neonates and adolescents respectively. The main ICD-10 diagnostic categories for all patients were identified to be ‘Congenital malformations, deformations and chromosomal abnormalities’ 117 (37.1%), ‘Diseases of nervous system’ 76 (24.1%) and ‘Neoplasms’ 60 (19.0%). At referral 156 (50%) patients had holistic needs assessments. Patients with ‘Diseases of nervous system’ were assessed to have significantly more physical needs than the other two diagnostic categories. Majority of patients who knew of their diagnosis and prognosis were those with malignancy. Over a fifth of referrals were at their terminal admission. Of 144 who died, 111 (77.1%) had advanced care plans. There was bereavement follow-up in 98 (68.1%) patients. Conclusion: Patients referred for palliative care have varied diagnoses and needs. To ensure all paediatricians are competent to deliver quality care to all children, further education and training initiatives is imperative.
Palliative Care