Introduction: Alcohol is classified as a psychoactive substance, and its dependence is one of the three leading risk factors for death, disability, or disease. Early age alcohol use by the age of 15 is implied to be harmful due to interference in the brain development of adolescents, causing alcohol-related problems later in life. This study aims to determine the prevalence and factors associated with alcohol use among Dayak adolescents in Sarawak, Malaysia. Methods: This was a cross-sectional quantitative research approach. A total of 12 districts within the 12 divisions were selected by multistage stratified cluster sampling. Dayak housing area lists were obtained from district offices and the local councils. The respondents were selected systematically according to male and female respondent houses, and they were interviewed using an interviewer-administered questionnaire. Data were entered into Microsoft Excel and analysed through IBM SPSS Version 27.0. Results: Dayak adolescents’ mean age was 17.31 years. They were either low-risk (50.0 %), hazardous (31.0%), abstainers (11.0%), harmful (5.0%) or alcohol dependant (3.0%) drinkers. Age (p<.001), gender (p<.05), ethnicity (p<.001), religion (p<.05), employment (p<.001), level of education (p<.01), allowance (p<.001), family relationship (p<.05), and family size (p<.05) were the potential predictors of alcohol use disorder. Conclusion: Dayak adolescent alcohol drinking is prevalent and a public health problem, particularly among disadvantaged socio-economic families. The lower proportion of abstainers suggested that alcohol use among adolescents is on the rise. Hence, the results should be utilised to do targeted health promotion regarding harmful alcohol use among adolescents since early use of alcohol among adolescents may lead to more severe health and non-health outcomes in the future.

The LIM domain-containing proteins are dominantly found in plants and play a significant role in various biological processes such as gene transcription as well as actin cytoskeletal organization. Nevertheless, genome-wide identification as well as functional analysis of the LIM gene family have not yet been reported in the economically important plant sorghum (Sorghum bicolor L.). Therefore, we conducted an in silico identification and characterization of LIM genes in S. bicolor genome using integrated bioinformatics approaches. Based on phylogenetic tree analysis and conserved domain, we identified five LIM genes in S. bicolor (SbLIM) genome corresponding to Arabidopsis LIM (AtLIM) genes. The conserved domain, motif as well as gene structure analyses of the SbLIM gene family showed the similarity within the SbLIM and AtLIM members. The gene ontology (GO) enrichment study revealed that the candidate LIM genes are directly involved in cytoskeletal organization and various other important biological as well as molecular pathways. Some important families of regulating transcription factors such as ERF, MYB, WRKY, NAC, bZIP, C2H2, Dof, and G2-like were detected by analyzing their interaction network with identified SbLIM genes. The cis-acting regulatory elements related to predicted SbLIM genes were identified as responsive to light, hormones, stress, and other functions. The present study will provide valuable useful information about LIM genes in sorghum which would pave the way for the future study of functional pathways of candidate SbLIM genes as well as their regulatory factors in wet-lab experiments.

Introduction: Many factors hinder the effective responses to the HIV/AIDS epidemic. Stigma is one of the major barriers to effective responses to the HIV/AIDS epidemic. It is often considered the main reason for the low response to access proper services for prevention, treatment, and care for HIV/AIDS. In this context, we assessed the perceived level of stigmatisation towards people with HIV/AIDS among rural communities in Sarawak and determined its associated factors. Methods: This cross-sectional community-based study was conducted among the adult population aged 18 years and above among rural communities in Sarawak, Malaysia. A gender-stratified multistage cluster sampling technique was adopted to select the respondents. A total of 900 respondents were successfully interviewed using interviewer-guided questionnaires. Stepwise multiple linear regression with forward and backward selection method was used to determine the HIV/AIDS-related stigma. A p-value of ≤.05 was considered statistically significant. Results: Analysis revealed that females are more stigmatised than males (p<.05). Multivariate analysis showed that those who did not know someone had HIV and Chinese ethnicity were potential predictors in both male and female groups. Having no gainful job, and discussion of HIV/AIDS, household income less than MYR 500, history of HIV testing, knowledge on HIV transmission and exposure to HIV/AIDS information were factors that influenced HIV/ AIDS-related stigma among female respondents. On the other hand, age group 30 to 39, Bidayuh, Chinese ethnicity, and not knowing someone had HIV and media exposure on HIV were factors that influenced HIV/AIDS-related stigma among male respondents. Conclusion: HIV/AIDS-related stigma towards HIV/AIDS existed in rural communities. Enhanced health promotion related to HIV/AIDS activities in rural communities are needed to curb stigmatisation toward people with HIV/AIDS.

Background: Numerous approaches have been taken to reduce mental health issues in the population. However, mental health problems are still arising in the population, and one of the main factors is discrimination towards the mentally ill patient. This issue is inhibiting people from seeking help. This study aimed to assess community discrimination towards people with mental illness and factors affecting it. Methods: A cross-sectional study was conducted with a total of 840 respondents (420 males and 420 females) from Sarawak, Malaysia aged 21 years and above. Samples were selected by gender-stratified multistage sampling. Collection of data was done using a pre-tested questionnaire to assess the discrimination towards mental illness via face-to-face interviews. A multiple linear regression analysis was conducted to determine the factors affecting community discrimination towards mental illness. Results: Multiple linear regression analysis revealed that aged between 40 to 49 years old (p = 0.004), aged between 50 to 59 years old (p < 0.001), female respondents (p = 0.014) and having no experience with the mentally ill patient (p < 0.001) appeared to be predictors for discrimination towards mental illness. The model significantly explained 6.6% of variance of discrimination score (F (10,829) = 6.91, p < 0.001). Conclusion The findings suggested that community discrimination towards people with mental illness are still common in the rural population. Effective strategies to combat discrimination will need to be organised and implemented at the community level. Further research on this study in different settings is suggested to understand the associated factors better.
Residence Characteristics

Background: Undernutrition among children has become a major public health issue due to the high risk of morbidity and mortality involving this vulnerable age group. This study focused on the rural population, especially among the Dayak children in Sarawak, Malaysia. Methodology: This community-based cross-sectional study was conducted in Sarawak’s rural areas using a multistage stratified cluster sampling technique. Data were collected through face-to-face interviews using an interviewer-guided questionnaire. The nutritional status of the under-five children was measured according to the World Health Organization guidelines. The nutritional indicators were calculated as z-scores. Multivariate logistic regression analyses were performed using SPSS to identify the factors associated with nutritional status. Results: The prevalence of undernutrition among the under-five Dayak children in the rural areas of Sarawak was 39.6%. The analysis suggested that wasting was predominantly associated with parental education levels of primary and below, poor wealth index, environmental and sanitation issues, children with history of low birth weight, shorter duration of exclusive breastfeeding, and poor appetite. Stunting was high within the age group of <3 years old and was associated with parents’ occupation and household wealth index. Low parental education, poor wealth index, environmental and sanitation issues, poor appetite, and the children’s recent illness predicted underweight. Conclusion: These findings imply that a multi-sectoral and multi-dimensional approach is essential to address undernutrition in rural settings. Improvement on households’ socioeconomy, environment and sanitation should be emphasised to reduce undernutrition among the children.

Health literacy has shown to have some influence in preventive behaviour, including on colorectal cancer. Such a relationship, however, is not well established in Malaysia, particularly Sarawak. This study is aimed to estimate the level of health literacy and preventive practice against colorectal cancer and factors associated with it. This was a cross-sectional study conducted in Sarawak, among adults aged 50 years and above. Data was collected by face to face interviews using a validated questionnaire. Descriptive statistics were used to determine the health literacy and preventive behaviour on colorectal cancer. Multiple linear regression was used to determine the factors associated with preventive behaviour on colorectal cancer and also to examine its relationship with health literacy. A p-value of ≤0.05 was considered as statistically significant. A total of 829 respondents were included in the analysis. Mean age (standard deviation) of the respondents was 55.78 (5.01) years. A large proportion had an educational background of upper secondary school and above (41%) and from Iban ethnicity (32.4%). Only 1.1% of them had a family history of colorectal cancer. Multiple linear regression analysis revealed that gender (p<0.01), ethnicity (p<0.05), functional health literacy (p<0.05), and knowledge on colorectal cancer (p<0.05) appeared to be significant predictors for preventive behaviour on colorectal cancer. Health literacy has a positive effect on preventive behaviour on colorectal cancer. The findings assist in designing and developing targeted informational campaigns to promote preventive behaviour, particularly among low health literate group.

Body image is a complex and multifaceted construct with multiple associated factors determining its perception among adolescents. This study aimed to determine the perceived body image and its relationship with body mass index, self-esteem, body change strategy, and social network usage among rural adolescents. This study was a cross-sectional study design using a multistage random sampling technique to select adolescents aged 10 to 19 years. A total of 318 adolescents’ data were collected using a self-administered questionnaire. Data analysis was done using SPSS version 22.0 with a p-value of <0.05 was considered statistically significant. The mean (SD) age of adolescents was 14.6 (2.7) years with a male and female ratio of 1.09:1. The mean score (SD) of perceived body image was 3.63 (0.87). Multiple linear regression analysis revealed that gender, body mass index, and strategy to increase weight could predict perceived body image among adolescents. However, self-esteem did not correlate with perceived body image. Although, the body image dissatisfaction level was low among rural adolescents compared to other studies in Malaysia. However, it can still pose a threat to adolescents’ health if not addressed accordingly.

Introduction: The Coronavirus disease-2019 impacted the governments and public health systems worldwide, with the psychological impact including an increase in the level of stress, anxiety and depression. We determine the prevalence of depression, anxiety and stress using the Depression Anxiety Stress Scales (DASS-21), and to determine the psychological impact of COVID-19 pandemic amongst medical students in Sarawak, Malaysia using the revised Impact of Event Scale (IES-R). Methods: We analysed 355 medical student’s data obtained from an online survey. All the undergraduate medical students were the sample population. IBM SPSS version 22.0 was used for data analysis. A p-value of ≤.05 was considered statistically significant. Results: Analysis indicated that three-fourths of the students had no mental health issues. More than one-tenth of the students were moderately depressed (12.4%) and 4.3% severely depressed. A similar pattern of prevalence of anxiety was noted with 10% reported moderate anxiety, and 6.8% had severe anxiety. 15.8% of the students had mild stress, 4.2% moderately stressed, and 2% severely stressed. A hierarchical multiple linear regression analysis showed that hyperarousal appeared to be a predictor of depression (β=.466, p<.001), anxiety (β=.481, p<.001) and stress β=.508, p<.001). Along with hyperarousal, intrusion (β=.148, p<.05) predicts stress among the students. Conclusion: Our analysis revealed that hyperarousal symptoms related to the global pandemic of COVID-19 led to significant mental health issues among students. Therefore, urgent strategies to support the students’ psychosocial wellbeing and self-care and to strengthen their coping skills and resilience need to be implemented.

Caring for stroke survivors is inevitably a burden to caregivers. It is not uncommon for stroke survivors who are discharged from the hospital and found themselves at home without any help and care from the supposed caregivers. However, in instances where there are available and willing caregivers, a sudden and unpredictable task of caring for stroke survivors require the stroke caregivers to apply their coping strategies due to the demanding nature of looking after a survivor. This study aimed to determine coping strategies undertaken by stroke caregivers in caring for stroke survivors. This was an exploratory qualitative study and data was collected from the caregivers of stroke survivor using a semi-structured guided questionnaire. A total of 18 caregivers were included in the study. The data were collected from November 2015 until June 2016 at a selected community rehabilitation centre in Kuching, Sarawak. The qualitative data analysis revealed that the coping strategies undertaken by stroke caregivers include change of role in life, self-motivation, sharing with other people, crying, trying to forget things that happen, hoping survivors will get better, emotion suppression and self-blame. The study highlighted the experiences by the caregivers for caring for stroke patients and focused on the coping strategies undertaken by the caregivers. Better ununderstanding of these experiences does help the service providers to provide better support and resources for caregivers in caring for stroke survivors.

Since December 2019, a novel coronavirus disease (COVID-19) creates a global threat. Medical students are more susceptible to be infected by the virus. This study aimed to assess COVID-19 related knowledge, attitude towards COVID-19, and preventive behaviours against COVID-19 among medical students within the first month of the onset of the outbreak in Malaysia. We collect data from medical students using an online Google survey form. Out of 696 students, 467 responded to the questionnaire. The analysis revealed that the mean percentage of knowledge was (85.04), attitude (84.12), and preventive practice (77.75) respectively. Hierarchical multiple linear regression analysis revealed that living with family (p<0.01) and knowledge of COVID-19 (p<0.001) appeared to be important predictors of attitude toward COVID-19. However, gender (p<0.001), living status (p<0.001), frequency of travel during movement control order (p<0.01), attitude towards COVID-19 (p<0.001) have appeared significant predictors for preventive practice against COVID-19. But knowledge of COVID-19 had no impact on preventive practice against COVID-19 (p>0.05). We found a high level of COVID-19 related knowledge, attitude, and preventive practice against COVID-19 among medical students. A sustained knowledge, attitude, and preventive behavioural strategy could play an ingredient in upholding the student’s learning and practice against any disease like COVID-19.