Background: University students frequently encounter academic, interpersonal and financial pressures, which may increase their vulnerability to psychological distress. Physical activity has been identified as a protective factor for mental health, potentially enhancing psychological resilience through improved self-control. This study aimed to examine the relationship between physical activity and psychological resilience among university students and to investigate the mediating role of self-control. Methods: A cross-sectional survey was conducted with 726 university students (mean age = 19.2 years, SD = 0.92). The participants completed the Physical Activity Rating Scale-3, the Self-Control Scale, and the Connor–Davidson Resilience Scale. Descriptive statistics, correlation analyses, regression analyses, and mediation analysis were performed using SPSS 28.0 and PROCESS 4.0. Results: Significant differences in self-control (F = 29.67, P < 0.001) and psychological resilience (F = 21.95, P < 0.001) were observed across physical activity levels. Physical activity positively predicted self-control (β = 0.269, P < 0.001) and psychological resilience (β = 0.251, p <.001). Self-control was a significant predictor of psychological resilience (β = 0.511, P < 0.001). Mediation analysis indicated that self-control partially mediated the relationship between physical activity and psychological resilience, accounting for 51.46% of the total effect. Conclusion: Physical activity enhances psychological resilience directly and indirectly through the improvement of self-control. These findings highlight the potential value of promoting regular physical activity as an effective strategy for strengthening psychological resilience and improving mental well-being among university students.
Background: Access to neurosurgical care in remote regions remains challenging because of the uneven distribution of specialists, transportation limitations, and infrastructure constraints. For many years, patients from East Coast Sabah relied on transfer to Queen Elizabeth Hospital, Kota Kinabalu, for emergency and elective neurosurgical care, often requiring long-distance evacuation. This study describes the phased development of a decentralised neurosurgical service in Tawau and evaluates associated regional service trends. Methods: This descriptive historical vignette and service evaluation reviewed aggregated neurosurgical data from Tawau Hospital, Duchess of Kent Hospital (Sandakan), and Lahad Datu Hospital from 2019 through April 2026. Service activity was analysed across three phases: the flying surgeon model, rotational specialist postings, and permanent specialist deployment. Referrals, admissions, outpatient attendance, operative activity, interhospital transfers, and mortality were evaluated descriptively. Results: The East Coast Sabah Neurosurgical Service evolved from a monthly visiting service to rotational specialist coverage and, ultimately, a permanent Tawau-based hub in 2025. Referrals, outpatient attendance, and operative workload increased progressively across the three phases. Mean annual referrals increased from 1,388 to 1,802 and reached an annualised 2,130 during early Phase 3. Annual outpatient attendance increased from 1,117 to 1,675, with an annualised total of 2,526 visits. Operative volume increased from 202 to 366, with an annualised total of 374 procedures, while the proportion of elective procedures rose from 1.9% to 16.5%. Crude inpatient mortality rates were 5.8%, 4.9%, and 3.2% across the three phases. Following establishment of the permanent hub, emergency transfers from Tawau decreased from approximately 35 per year during Phase 2 to an annualised 18 per year during early Phase 3, corresponding to a crude administrative estimate of annual government cost avoidance of approximately RM425,000 to RM680,000 through reduced emergency air evacuations. Conclusion: The phased decentralisation of neurosurgical services in Tawau was associated with expanded local capacity, improved continuity of care, and reduced reliance on transfers to a tertiary referral centre for selected neurosurgical conditions.
Background: Older adults in rural areas often face barriers to rehabilitation that affect continuity of care. This study explored barriers to and facilitators of geriatric rehabilitation in rural Malaysia. Methods: A qualitative phenomenological study involved 30 older adults aged ≥ 60 years who received rehabilitation services between 2018 and 2024, with caregiver proxies participating when necessary. Semi-structured telephone interviews were conducted in Malay, Chinese, or English and were audio-recorded. The recordings were transcribed and translated into English using an automated speech recognition model (OpenAI Whisper). Transcripts were analysed using an AI-assisted thematic analysis framework and classified into eight predefined domains based on sentence-embedding similarity with human review. Segments were manually coded as barriers or facilitators, and scored for sentiment using a rule-based tool (NLTK VADER). Inter-coder reliability was assessed using Cohen’s kappa. Results: Distance to rehabilitation services and limited transportation were the main barriers to the continuity of care. Financial costs related to travel, treatment, and assistive devices further limited attendance, and some participants reported service constraints. Strong family and community support facilitated rehabilitation engagement. Telehealth was frequently suggested as a means of providing rehabilitation guidance and maintaining continuity of care. Conclusion: Continuity of geriatric rehabilitation in rural Malaysia is constrained by long travel distances and transportation barriers. Strengthening family support and incorporating simple telehealth approaches may improve continuity of care for older adults in rural communities.
Background: Non-compliance with legal requirements related to occupational safety and health (OSH) among workers in Malaysia remains widespread. Contributing factors include insufficient enforcement workforce. Given the large number of security personnel (SP) and the overlapping nature of responsibilities, there is potential to integrate security roles with OSH functions. This study aims to identify the perception, acceptance and challenges of security-related stakeholders on the possible integration. Methods: An exploratory qualitative research was performed in Klang Valley, Malaysia. Management representatives from various security and safety organisations were invited to participate in focus group discussions (FGDs). Data were analysed using framework analysis. Voice recordings were transcribed, translated and coded using NVivo v14, and findings were interpreted based on organisational readiness for change theory. Results: Eleven representatives participated in two FGDs. The integrated enforcement concept was preferred for adoption by both groups. Although the majority of security guards are Malaysians, many foreign guards are found in commercial and private sector premises, auxiliary police and the Malaysia Volunteer Department (RELA) were limited to Malaysians. The current security training curriculum has minimal basic OSH content. There is a need to integrate OSH into security training modules while benchmarking OSH courses. Enablers consisted of the need for training and new basic modules for SP, leadership, resource optimisation, minimum qualifications and the latest technology. Conclusion: The integration of functions is favoured by management representatives of security and safety organisations. Challenges include limitations in legal requirements, and enablers focus on the need for changes in the curriculum for training and leadership support. The findings of this study support the goals of SDG 8 and OSHMP30.
Background: This study evaluated the antiproliferative and pro-apoptotic activities of green-synthesised silver nanoparticles using Strobilanthes crispus extract (AgNP-SC) against CT26 colon carcinoma cells. Strobilanthes crispus (S. crispus), rich in phytochemicals, was utilised as a natural reducing and stabilising agent during AgNP synthesis, potentially enhancing their cytotoxic potential. Methods: AgNP-SC was synthesised by reducing silver nitrate with an aqueous extract of S. crispus, with nanoparticle formation indicated by the appearance of a dark brown colour. Cytotoxicity was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Apoptotic changes were examined through acridine orange/propidium iodide (AO/PI) staining, while cell cycle distribution was analysed using flow cytometry. Gene expression of apoptotic markers was analysed using reverse transcription polymerase chain reaction (RT-PCR). Results: MTT analysis demonstrated a significant, concentration-dependent decrease in CT26 cell viability following AgNP-SC treatment, with cell viability reduced to below 50% at concentrations ≥25 µg/mL (P < 0.05). AO/PI staining revealed classical apoptotic features, including chromatin condensation, membrane blebbing, and nuclear fragmentation. Flow cytometric analysis showed a significant accumulation of cells in the G1 phase accompanied by a marked reduction in the S-phase population in treated groups compared to untreated controls (P < 0.05), indicating G1 cell cycle arrest and inhibition of DNA synthesis. RT-PCR analysis further demonstrated significant upregulation of pro-apoptotic genes (CED-3 and CED-4) and downregulation of the anti-apoptotic gene CED-9 (P < 0.05), confirming activation of the intrinsic mitochondrial apoptotic pathway. Conclusion: Green-synthesised AgNP-SC exhibits potent anticancer properties, suggesting its potential as a natural-based nanotherapeutic agent for colon cancer. Further in vivo and mechanistic studies are warranted to validate its therapeutic efficacy.
