1.Development of a Valid and Reliable Scale to Assess Knowledge, Attitude and Practice (KAP) on Frailty, Nutrition and Exercise among Malaysian Elderly
Nurul Izzati Mohd Suffian ; Siti Nur &lsquo ; Asyura Adznam ; Hazizi Abu Saad ; Zuriati Ibrahim ; Noraida Omar
Malaysian Journal of Medicine and Health Sciences 2023;19(No.1):62-70
		                        		
		                        			
		                        			Introduction: “Frailty Intervention through Nutrition Education and Exercise (FINE)” program is an educational program, an initiative to ameliorate frailty status among elderly due to the alarming number of frailty cases in Malaysia. 
The current study aims to develop and determine the validity and reliability of the KAP questionnaire on frailty, 
nutrition and exercise to assess the effectiveness of the “FINE” program among the Malaysian elderly. Methods: The 
KAP questionnaire was created based on the developed frailty module and education materials. Content and face 
validity were conducted before the reliability study among five health professionals and 20 elderly, while 79 elderly 
were involved in a reliability study in three different Projek Perumahan Rakyat (PPR) flats in the Kuala Lumpur area. 
Data were analysed to determine its internal consistency reliability. Results: Six items were removed during content 
and face validity, two from each domain. All items in the knowledge section were within an acceptable range of 
difficulty and discrimination following the item analysis. Yet, item-to-total correlation removes one item for attitude 
and four items for the practice domain. The analysis found that the internal consistency reliability was 0.852, 0.732 
and 0.600 for the KAP section, respectively. Conclusion: The final version of the KAP questionnaire consisted of (11) 
knowledge, nine (9) attitudes and six (6) practice items proven to be valid and reliable. Thus, it could be used to 
assess the effectiveness of the “FINE” program among the Malaysian elderly.
		                        		
		                        		
		                        		
		                        	
2.Aflatoxin Occurrence, Food Regulations, Dietary Exposure, and Risk Assessment: A Mini Review from the Malaysian Perspective
Wei Lin Chang ; Hazizi Abu Saad ; Rosita Jamaluddin ; Mohd Redzwan Sabran
Malaysian Journal of Medicine and Health Sciences 2023;19(No.1):296-306
		                        		
		                        			
		                        			Aflatoxins are ubiquitous and occur in food. Exposure to aflatoxins seriously impact the health of human and animal. 
It is concerning especially when aflatoxins are odourless, colourless, and tasteless that hardly be detected through 
naked eyes. Ingestion of aflatoxin-contaminated food contributes the major route of exposure. The present review is 
an update on the aflatoxin occurrence in food, aflatoxin regulations in food, and recent risk assessment of aflatoxin exposure in Malaysia. Peanuts and chili were more prone to aflatoxin contamination in Malaysia. The extreme 
weather experienced in Malaysia and global climatic change may worsen the aflatoxin contamination in food. The 
regulatory standards for aflatoxins imposed by Malaysia are less stringent than developed countries. The dietary exposure of aflatoxins among Malaysian was relatively high as compared with other Asia countries, ranging from 0.002 
to 34.00 ng/kg body weight/day. Nonetheless, Malaysian population had low risk of aflatoxin-related liver cancer, 
with an estimated liver cancer risk of <1 cancer case/100,000 population/year. 
		                        		
		                        		
		                        		
		                        	
3.Malnutrition and its associated factors among children under 5 years old in Putrajaya: a study protocol
Mohamad Hasnan Ahmad ; Nor Azian Mohd Zaki ; Fatimah Othman ; Azli Baharudin ; Ruhaya Salleh ; Cheong Siew Man ; Adibah Huda Mohd Zainul Arifien ; Nurin Iman Ahmad Kamal ; Noor Ani Ahmad ; Hazizi Abu Saad ; Poh Bee Koon ; Mohd Azahadi Omar ; Tahir Aris
Malaysian Journal of Nutrition 2021;27(No.1):141-151
		                        		
		                        			
		                        			Introduction: Prevalence of malnourished children in Putrajaya was unexpectedly 
high in 2016. This paper describes the study protocol for a case-control study 
conducted to identify the associated factors of malnutrition among children under 
5 years old in Putrajaya. Methods: This study involved two phases. Phase I 
was ‘screening’ where all children aged 6-59 months in 118 preschools and four 
government health clinics were measured for their weight and height. The World 
Health Organization Anthro software was used to determine the nutritional status 
of these children. Phase II was the ‘interview’ where children from screening were 
sampled into four pairs of case and control. The optimum sample size for the case 
of stunted, wasted, underweight, and overweight were 380, 335, 318, and 308, 
respectively. The same number of controls were recruited. Parents/caregivers of 
selected children were approached to obtain data on parental factors, children factors, 
food intake factors, and environmental factors that contributed to malnutrition. 
Data analysis was performed by multiple logistic regression in SPSS version 26. 
Results: Screening phase successfully measured 8,261 (50.1%) children from an 
estimated 16,500 children under 5 years old in Putrajaya. The number of children 
who were stunted, wasted, underweight, and overweight were 2,105 (25.5%), 512 
(6.2%), 1,516 (18.4%), and 248 (3.0%), respectively. As overweight was undersampled, the number of controls for overweight was doubled to increase the power 
of the study. Parents/caregivers of selected cases and controls were interviewed in 
their household or any other venues at their convenience. Conclusion: This protocol 
promises beneficial outputs to stakeholders and policy makers that can be used for 
combating malnutrition in children. 
		                        		
		                        		
		                        		
		                        	
4.Development of a tool to measure patients’ satisfaction of hospital foodservice in a government hospital
Mariem Boughoula ; Rosita Jamaluddin ; Nurul Aqmaliza Abd Manan ; Hazizi Abu Saad ; Muhammad Sharim Ab Karim
Malaysian Journal of Nutrition 2020;26(No.2):141-155
		                        		
		                        			
		                        			Introduction: Dissatisfaction towards the quality of foodservice can affect several important aspects such as nutritional intake and financial burden. The effect of dissatisfaction towards nutritional aspect can be observed via a decline in dietary intake. Therefore, reliable and valid questionnaires are important to measure patients’ satisfaction with hospital foodservice. The main purpose of this study was to investigate the construct validity and reliability of a developed questionnaire in a local setting.  Methods: A questionnaire adapted from previous studies and consisting of 27 statements from four dimensions, was administered to a total of 277 hospitalised patients in a government hospital. Factor analysis and reliability analysis were conducted using SPSS version 25.  Results: Principal component of factor analysis revealed that the final questionnaire contained four main foodservice dimensions, namely food properties, staff and meal service reliability, customisation, and physical and social aspects. The reliability analysis revealed that the Cronbach’s alpha value ranged from 0.55 to 0.84 for these foodservice dimensions. The analysis showed that the alpha value differed from one dimension to another such as food properties (α=0.84), staff and meal service reliability (α=0.67), customisation (α=0.69) and physical and social aspects (α=0.55).  Conclusion: Twenty-seven questionnaire items were retained because their factor loadings were greater than 0.35. Therefore, the questionnaire on patients’ satisfaction towards hospital foodservice was considered reliable and valid. The classification of the four dimensions provided detailed information of the satisfaction level, relationship and influence on the foodservice dimensions, which contributed to satisfaction towards hospital foodservice.
		                        		
		                        		
		                        		
		                        	
5.Associations of Sociodemographic Factors and Body Image With Body Weight Status Among Yemeni Adolescents in Selangor and Putrajaya, Malaysia
Abdulwali Ali Mareh ; Zuriati Ibrahim ; Faisal Ali ; Ahmed Al-Shahethi ; Hazizi Abu Saad
Malaysian Journal of Medicine and Health Sciences 2020;16(Supp 6, Aug):63-68
		                        		
		                        			
		                        			Introduction: Despite the high prevalence of malnutrition in Yemen, little is known on malnourished Yemeni adolescents in Malaysia.  This study aimed to assess the body weight status among Yemeni adolescents in Malaysia and its association with sociodemographic factors and body image. Methods: A cross-sectional study involving 364 Yemeni adolescents aged between 12 to 18 years were recruited from four schools in Selangor and Putrajaya, Malaysia. Sociodemographic factors and body image data were collected through face to face interview. Height and body weight were measured and body mass index (BMI) was calculated. Results: The prevalence of overweight and obesity was 23.6%, with 5.2% of thinness.  Multivariable logistic regression revealed that a family income greater than RM5,001 (OR = 3.77, p = 0.004), body shape dissatisfaction (OR = 3.54, p = 0.001) and perception of overweight/obesity (OR = 5.75, p = 0.001) were  associated with an increased risk of  being overweight and obese. Whereas a positive perception of underweight (OR = 0.23, p = 0.009) was found to be a significant protective factor against overweight and obesity.  Conclusion: Overweight and obesity are prevalent among Yemeni adolescents in Malaysia.  These findings highlight the need for regular weight status assessments amongst adolescents.  Additionally, an obesity intervention program that incorporates body image perception may improve the children’s body weight status.
		                        		
		                        		
		                        		
		                        	
            

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