Introduction: Compliance with medical nutrition therapy is important to improve patient outcomes. The purpose of this study was to determine dietary compliance and its association with glycemic control among outpatients with poorly controlled type 2 diabetes mellitus (T2DM) in Hospital Universiti Sains Malaysia (HUSM). Methods: In this cross-sectional study, patients who had a glycosylated hemoglobin (HbA1c) level of at least 6.5%, after attending a diet counseling session at the Outpatient Dietetic Clinic, HUSM, were enrolled. Out of 150 diabetic patients reviewed between 2006 and 2008, 61 adults (32 men and 29 women) agreed to participate in this study. A questionnaire-based interview was used to collect socio-demographic, clinical and diabetes self-care data. The patient’s dietary compliance rate was determined by the Summary of Diabetes Self-Care Activities (SDSCA) measure. Anthropometric and biological measurements were also taken. Results: Only 16.4% of the respondents adhered to the dietary regimen provided by dietitians. Among the 7 dietary self-care behaviours, item number 6 (eat lots of food high in dietary fibre such as vegetable or oats) had the highest compliant rate (54.1%); whereas item number 3 (eat five or more servings of fruits and vegetables per day) had the lowest compliant rate (23.0%). There was a significant association between gender (p=0.037) and fasting blood sugar (FBS) (p=0.007) with the compliance status. Conclusion: Dietary non-compliance is still common among T2DM patients. Dietitians need to improve their skills and use more effective intervention approaches in providing dietary counseling to patients.

Introduction: This study aimed to develop demi-span equations for predicting height in the Malaysian elderly and to explore the applicability of previous published demi-span equations derived from adult populations to the elderly. Methods: A cross-sectional study was conducted on Malaysian elderly aged 60 years and older. Subjects were residents of eight shelter homes in Peninsular Malaysia; 204 men and 124 women of Malay, Chinese and Indian ethnicity were included. Measurements of weight, height and demi-span were obtained using standard procedures. Statistical analyses were performed using SPSS version 18.0. Results: The demi-span equations obtained were as follows: Men: Height (cm) = 67.51 + (1.29 x demi-span) – (0.12 x age) + 4.13; Women: Height (cm) = 67.51 + (1.29 x demi-span) – (0.12 x age). Height predicted from these new equations demonstrated good agreement with measured height and no significant differences were found between the mean values of predicted and measured heights in either gender (p>0.05). However, the heights predicted from previous published adult-derived demi-span equations failed to yield good agreement with the measured height of the elderly; significant over-estimation and underestimation of heights tended to occur (p>0.05). Conclusion: The new demi-span equations allow prediction of height with sufficient accuracy in the Malaysian elderly. However, further validation on other elderly samples is needed. Also, we recommend caution when using adult-derived demi-span equations to predict height in elderly people.

Women are likely to leave the job sector as a result of the crisis between their commitments to the career with the household interest. In response to this issue, this study aims to build a career challenge model that caters to the demand among women in this century. Hence, this study has identified the key factors to the challenges faced by female engineers in pursuing their career as an engineer through the Delphi Modified Technique. The result shows this study looking into the relationship between four independent constructs namely, life balance, childcare, leaves and gender discrimination. Meanwhile, the dependent construct of this study is career challenges faced by women. The scope of the study comprises female engineers with families and 211 respondents were selected to answer the questionnaire. The data obtained were analysed using the PLS-SEM 2.0 software via the algorithm, bootstrapping and blindfolding method. The construction process of this model involves two tests including the construction of the measurement model and the structure model. Testing the measurement model involves internal consistency namely (a) convergent validity and (b) discriminant validity in which these two validities have six analyses; (i) external loading, (ii) composite reliability, (iii) average variance extracted (AVE), (iv) Fornell-Larcker, (v) cross loading, and (vi) Heterotrait-Monotrait Ratio (HTMT). Meanwhile, the structural model testing involves the analysis of (i) Multicollinearity (Inner VIF), (ii) Path Coefficient, (iii) R square (R2), (iv) size effect (f2), and (v) Predictive Relevance (Q2). The findings indicate that gender discrimination and life balance have significant relationships in influencing career challenges. Hence, this model is expected to contribute to the literature of Human Resource Management.

Introduction: Persons with disabilities (PWD) are susceptible to malnutrition. Caregivers or teachers in rehabilitation centres may not be adequately trained in nutrition management of PWD. The aims of this study were (i) to assess the nutrition knowledge, attitude and practice among teachers in community-based rehabilitation centres for PWD; and (ii) to evaluate changes in the nutrition knowledge and attitude of the teachers before and after exposure to a training workshop on nutrition management for PWD. Methods: A cross-sectional survey was conducted using a guided self-administered Nutrition Knowledge, Attitude and Practice Questionnaire on Persons with Disabilities (KAP-nOKU), among a convenience sample of 210 teachers. Forty-five of them further participated in a nutrition training workshop and completed the post-test evaluation on knowledge and attitude of the same measures. Results: At baseline, the teachers’ average knowledge, attitude and practice scores were 13.80±3.73 for knowledge (below 50th percentile); 51.49±4.08 for attitude (above 75th percentile); and 48.08±3.61 for practice (between 50th and 75th percentile). There was significant positive correlations between knowledge and attitude (r=0.343, p<0.05), as well as between attitude and practice (r=0.147, p<0.05). After exposure to a 3-day nutrition workshop, significant improvements in the teachers’ knowledge and attitude were observed, whereby teachers’ knowledge score increased from 14.20±3.80 to 25.38±2.36 and from 51.16±3.97 to 55.20±4.41 for attitude (p<0.001). Conclusion: Nutrition intervention was associated with improvement in short term knowledge and attitude of the teachers. Sustainable interventional strategies are needed to enhance the nutrition knowledge and skills of teachers of PWD.

A 26 year-old Malay man presented with first attack of left eye optic neuritis that recovered fully with intravenous methylprednisolone after 3 weeks. He developed a second attack of optic neuritis in the right eye the following week. Lhermitte sign as well as Uthoff phenomenon were also positive. On day-3, he developed bilateral paraplegia and sensory loss at T8 level, which progressively worsen and became bedridden on day-5. MRI showed bilateral enhance-ment of the optic nerve with the presence of long multisegmental demyelinating plaque in the thoracic to lumbar spinal cord and the brainstem, sparing the brain hemisphere. He was promptly given high dose intravenous methylprednisolone followed by oral predni-solone. He was also assigned on intensive neuro-phy-siotherapy. He recovered after 3 months and was able to walk with walking aids. He recovered completely after 7 months and resumed working as site contactor. There was no relapse during the last 1 year follow-up. His final visual acuity improved to 6/9 in the right eye and 6/6 in the left eye. The visual field of the right eye showed per-sistent mild cecocentral scotoma. And diffuse depression.

Introduction: Detailed clinical information is important for the Casemix System to generate valuable Case Based Group (CBG) for malnourished geriatric patients. Clinical coding for malnutrition provides useful information on the nutritional health of patients for treatment purposes. Methods: This cross-sectional study with purposive sampling involved a total of 130 geriatric patients (>60 years) at Hospital Universiti Sains Malaysia (USM). Nutritional assessments were performed such as anthropometrics measurement, Subjective Global Assessment (SGA), and biochemical assessment. The patients’ medical records and coded data were systematically reviewed to observe the documentation of nutritional information and coding criteria based on the International Classification for Diseases (ICD-10). Results: The prevalence of malnutrition among the geriatric patients was 35.4%. Proper documentation of required nutritional information was found in less than 50% of the cases. None of the malnourished patients were documented and coded with malnutrition diagnosis, despite being given nutritional interventions. The reasons given for this omission were related to the lack of awareness (50%) and incomplete medical documentation (50%). Further analysis revealed that uncoded diagnosis, miscoding, missing, and unavailable codes for nutritional counselling and oral nutritional supplementation were the main contributors to the incomplete records. Conclusion: The quality of clinical coding for malnourished geriatric patients in the hospital should be improved. A structured assessment and standard documentation is recommended to improve the quality of healthcare provision for malnourished geriatric patients.