Introduction: Caregivers often experience stressful situations while in the midst of the caregiving process. Thus, various methods of coping have been widely applied and studied in previous researches. The aim of this study was to develop a novel questionnaire to assess the coping strategies employed by those who provide care to patients, and to further validate it among caregivers of schizophrenia patients in Malaysia. Methods: This study, which involved the caregivers of schizophrenia patients from a hospital in Kuala Lumpur, Malaysia, was comprised of three parts, namely in-depth interviews, a pilot study, and the validation of the developed questionnaire, known as Caregiver Cope (CgCopeTM). Results: Part A originally consisted of eight themes, and it was later modified to seven themes with four items each after discussions with some experts. Part B initially had 28 items derived from the seven themes in Part A, which were then reduced to six components after a factor analysis. Part C of the questionnaire consisted of 19 items, with six components (Distraction, Caring for patient, Venting, Religion, Recreation, and Social support) having a moderate to high reliability ranging from a Cronbach’s alpha coefficient of 0.54 to 0.82. A factor analysis showed that the six factors of coping accounted for 62.36% of the total variance. Conclusion: The CgCOPETM questionnaire is suitable for use among caregivers of schizophrenia patients. There is a need to further validate the instrument among caregivers of other patient populations.

Obesity is a risk factor for chronic diseases which can affect work productivity and physical function of employees particularly among those in security sector. The study aimed to determine the association between obesity with total days of sick leave and health related quality of life (HRQoL) among Malay male security officers. A cross-sectional study was conducted among Malay male security officers working in a Malaysian higher learning institution. Subjects were evaluated using anthropometric measurements, quality of life and number of sick leave taken within two months prior to the study. A total of 194 subjects (mean age 40.12 ± 11.41 years) were recruited. A total of 30.4% were obese, 39.7% were pre-obese and only 29.9% had normal body weight or underweight. Central obesity was observed in 57.7% of them and 87.1% shown excessive body fat percentage. Number of sick leave days was positively correlated with Body Mass Index (BMI) (r = 0.162, p = 0.024) and waist circumference (r = 0.181, p = 0.012). Score of the general health component was negatively correlated with BMI (r = -0.161, p = 0.025), waist circumference (r = -0.194, p = 0.007) and body fat percentage (r = -0.191, p = 0.008). Physical functioning score was lowest in obese subjects than normal and pre-obese subjects (p = 0.046). Score of the bodily pain component was positively correlated with waist circumference (r = 0.156, p = 0.030). Obesity is associated with number of sick leave days and quality of life in the studied group. Hence, body weight of the security staff should be monitored and appropriate intervention should be conducted to improve their work attendance and quality of life.
Obesity

Introduction: This research examined the predicting roles of reasons for living and social support on depression, anxiety and stress in Malaysia. Method: This research was carried out on a sample of 263 participants (age range 12-24 years old), from Klang Valley, Selangor. The survey package comprises demographic information, a measure of reasons for living, social support, depression, anxiety and stress. To analyse the data, correlation analysis and a series of linear multiple regression analysis were carried out. Results: Findings showed that there were low negative relationships between all subdomains and the total score of reasons for living and depression. There were also low negative relationships between domain-specific of social support (family and friends) and total social support and depression. In terms of the family alliance, self-acceptance and total score of reasons for living, they were negatively associated with anxiety, whereas family social support was negatively associated with stress. The linear regression analysis showed that only future optimism and family social support found to be the significant predictors for depression. Family alliance and total reasons for living were significant in predicting anxiety, whereas family social support was significant in predicting stress. Conclusion: These findings have the potential to promote awareness related to depression, anxiety, and stress among youth in Malaysia.
Depression ; anxiety ; Mental Health ; Social Support ; Young Adult

Aims: Melon Manis Terengganu, MMT is one of the economically important fruits in Terengganu, which contains numerous nutritional values and bioactive compounds that benefit human health. The major problem is MMT has been affected by Fusarium sp., which is the common fungus in the Cucurbitaceae family resulting in Fusarium wilt disease and lowering melon production. It may also affect the antioxidant value of MMT; however, limited study has been conducted on this issue. Hence, the objective of this study was to determine the non-enzymatic as well as enzymatic activities in response to Fusarium sp. (S2 and S4) infection. Methodology and results: In this study, MMT leaves were incubated in culture filtrate (CF) obtained from Murashige and Skoog (MS) liquid medium. The antioxidative responses were assayed at 0, 1, 3, 5, 7 and 9 days of treatment. In response to Fusarium infection, the ascorbic acid, α-tocopherol and carotenoid content were significantly stimulated at the early stages of the experiment and slowly reduced afterward. This current study also demonstrated that the CAT-specific activities were initially induced in S2 CF-treated leaves. Similar APX and gPOD specific activity patterns were observed in both S2 and S4 CFs treatments. The APX and gPOD-specific activities were induced at the later stages of infection in S4 CF-treated leaves. Conclusion, significance and impact of study: The results revealed that enzymatic and non-enzymatic antioxidants worked together to fight against stress caused by the fungal infection, with the activation of the plant defense system.

Children with Specific Learning Disorder (SLD) faces challenges in academic areas and are often negatively labelled. The learning problems in SLD children were mainly due to poor phonological skill but not much was known about the contribution of visuospatial difficulties. Therefore, this study aims to determine the relationship between phonological awareness skills and global visual-spatial abilities among Malay speaking children with SLD, and to compare children with SLD and typical readers on intellectual functioning, phonological awareness and global visual-spatial ability. An equal number of typical readers (n = 36) and children with SLD were recruited. Data were coded and analysed using Kendall’s Tau-b, independent samples t-test and Mann-Whitney U test. Results showed phonological skills have strong negative correlation with global visual-spatial ability (r = .55). The typical readers have significantly higher IQ and better phonological skills and better global visual-spatial skills as compared to the group with SLD. However, there is no conclusive evidence due to specificity of more than one area measured by the assessment tools. Nevertheless, it provides a direction for future research to look into global visual-spatial aspects of SLD to aid in educational instruction in the future, in addition to the long-standing phonology deficit theory.
Specific Learning Disorders ; dyslexia ; phonological awareness, global visual-spatial ability, intellectual functioning

Burnout and psychological distress were reported at higher rates among hospital healthcare workers. Despite this, there is a paucity of research examining the associated risk factors among workers across specialties and occupations in Asia. This paper aimed to examine the risk factors associated with burnout and psychological distress among Malaysian hospital healthcare workers from diverse medical specialties and occupations. A total of 368 doctors, nurses, assistant medical officers and hospital attendants were recruited from major medical and surgery departments in an urban general hospital. The participants were self-administered a questionnaire consisting of demographic information, Maslach Burnout Inventory-Human Services Survey and Depression Anxiety and Stress Scale. In the fully adjusted multivariate analyses, doctors were about four to five times more likely to be emotionally exhausted (aOR [adjusted Odds Ratio], 4.826; 95% CI [Confidence Interval]: 1.492-15.604, p<0.01), depressed (aOR, 5.221; 95% CI: 1.995-13.661, p<0.01) and stressed (aOR, 3.990; 95% CI: 1.473-10.809, p<0.01). Paediatric workers demonstrated three to five times higher risks of depression (aOR, 3.105, 95% CI: 1.043-9.243, p<0.05), anxiety (aOR, 3.517, 95% CI: 1.194- 10.356, p<0.05) and stress (aOR, 5.404, 95% CI: .1.628-17.942, p<0.01). Emotional exhaustion (aOR, 1.046, 95% CI: .1.013-1.079, p<0.01) and depersonalization (aOR, 1.078, 95% CI: .1.015-1.145, p<0.05) led to higher risks of psychological distress, while stress predicted higher risks of burnout (aOR, 1.153, 95% CI: 1.062-1.251, p<0.01). There were occupational and departmental differences in susceptibility to burnout and psychological distress, requiring further investigation into the unique working environments and roles of hospital healthcare workers.
Burnout ; psychological distress ; healthcare worker ; healthcare personnel ; hospital ; Malaysia

The patient-physician relationship has a pivotal impact on the inflammatory bowel disease (IBD) outcomes. However, there are many challenges in the patient-physician relationship; lag time in diagnosis which results in frustration and an anchoring bias against the treating gastroenterologist, the widespread availability of medical information on the internet has resulted in patients having their own ideas of treatment, which may be incongruent from the treating physicians’ goals resulting in patient physician discordance. Because IBD is an incurable disease, the goal of treatment is to sustain remission. To achieve this, patients may have to go through several lines of treatment. The period of receiving stepping up, top down or even accelerated stepping up medications may result in a lot of frustration and anxiety for the patient and may compromise the patient-physician relationship. IBD patients are also prone to psychological distress that further compromises the patient-physician relationship. Despite numerous published data regarding the medical and surgical treatment options available for IBD, there is a lack of data regarding methods to improve the therapeutic patient-physician relationship. In this review article, we aim to encapsulate the challenges faced in the patient-physician relationship and ways to overcome in for an improved outcome in IBD.
Anxiety ; Bias (Epidemiology) ; Communication Barriers ; Diagnosis ; Frustration ; Humans ; Inflammatory Bowel Diseases* ; Internet

Diabetes Mellitus is a disease due to reduced insulin sensitivity and secretion in the body which associated with obesity and hypertension. This study aimed to determine the influence of family support and self-motivation towards dietary compliance and glycaemic control among Type 2 Diabetes Mellitus (T2DM) outpatients. This cross-sectional study involved 35 subjects selected from Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in Cheras and Ampangan Health Clinic in Seremban. Anthropometric measurements and fasting blood glucose have been obtained. Face-to-face interview session was done to obtain socio-demographic and diet intake. Further, dietary compliance, social support and self-motivation were assessed using Summary Diabetes Self Care Activities (SDSCA), Diabetes Social Support Questionnaire Family version (DSSQ-Fa) and Treatment Self-Regulation Questionnaire (TSRQ), respectively. Only 8.6% of subjects complied with dietary counselling. Fasting blood glucose for both men (7.93 ± 1.99 mmol/L) and women (8.77 ± 3.08 mmol/L) were higher than normal range. Self-motivation (r = 0.358, p < 0.05) and family support (r = 0.460, p < 0.01) significantly correlated with dietary compliance. Self-motivation and family support are important factors which can increase compliance towards dietary counseling. Further investigation should be carried out to determine factors that may influence dietary compliance and family support towards achieving desirable glycaemic control among T2DM patients.
Diabetes Mellitus

This review aims to present an overview of current research findings on the possible relationship between phonologicalawareness and visual-spatial skills among individuals with dyslexia. Narrative review of the relevant articles wereobtained through computerized searches of databases such as PubMed, PubMed Central (PMC) and Google Scholarwhich included articles from SAGE, Taylor & Francis and Massachusetts Institute of Technology (MIT) Press from theyear 2000 to 2014. The key words were explored, both exclusively and in combination with each other, so as to provide abetter understanding of the relationship between them among individuals with dyslexia. Although it is evident that thereis a phonological deficit in individuals with dyslexia, however, it is inconclusive with regards to the visual-spatial deficitand strength. There is a consensus on the nature of phonological awareness skill deficits but not on the visual spatialabilities in dyslexia. In fact, the relationship between phonological awareness and visual spatial abilities in dyslexia isdependent on the area of visual ability measured.