Introduction:Cardiopulmonary resuscitation training in Malaysia has evolved from traditional to modern approaches, embracing technology for better outcomes. Smartphone-based training apps offer interactive learning with simulations and real-time feedback, improving cardiopulmonary resuscitation skills anytime, anywhere. This study evaluates the effectiveness of the smart-cardiopulmonary resuscitation application for healthcare practitioners. Methods:This randomized controlled pilot study was conducted with 30 healthcare practitioners at the University of Malaysia Sabah. Participants underwent a Cardiopulmonary Resuscitation Practical formal educational training program, and data were collected using a Basic Life Support questionnaire and skills assessment checklist sourced from the American Heart Association (2020). Data analysis was conducted utilizing repeated analysis of variance and the Cochran 'Q' test supported by Statistical Package for the Social Sciences statistical software. Result:The control and intervention groups showed improved knowledge and skills from pre-to post-cardiopulmonary resuscitation courses; a significant increase was observed in the intervention group compared to the control group. The F-test indicated a significant time-group effect (F-stat (df) = 16.14 (2), p = 0.01). Cochran's 'Q' test also revealed significant changes in the proportion of healthcare practitioners passing their skills assessments over time (2 = 14.90, control 01). Conclusion:The smart-cardiopulmonary resuscitation application is convenient for refreshing cardiopulmonary resuscitation skills and maintaining proficiency. While it doesn't replace formal cardiopulmonary resuscitation courses, it saves healthcare practitioners and the community time and money. Both groups showed improved cardiopulmonary resuscitation knowledge and skills, with the intervention group using the smart-cardiopulmonary resuscitation application showing higher success rates after two months. Adopting smartphone-based cardiopulmonary resuscitation training with comprehensive content is recommended.

Motivation towards physical activity (PA) among type 2 Diabetes Mellitus (T2DM) patients is one of the most important strategies for managing blood sugar levels. The Physical Activity and Leisure Motivation Scale (PALMS) was developed with eight constructs (competition, appearance, others’ expectations, affiliation, physical condition, psychological condition, mastery, and enjoyment) widely used to determine peoples’ motives for being physically active. The International Physical Activity Questionnaire (IPAQ) has been adopted to measure participants’ PA amount. The purpose of this study was to examine the relationship between the eight motives of PALMS and PA amount among T2DM patients. A combination of cross-sectional study design with self-administered questionnaires has been carried out to recruit the participants from Hospital Universiti Sains Malaysia (HUSM). Multiple linear regression analysis has been analysed to obtain the final regression model. A total of 331 participants were recruited with most of them were males:172 (52

OBJECTIVE:Rabies is a neglected zoonotic disease that can infect all mammals, including humans. We aimed to summarise the current knowledge of the incidence, risk factors and mortality of rabies in Southeast Asia.DESIGN:Systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020.DATA SOURCES:Scopus, Web of Science and PubMed were searched from 1 January 2012 to 21 February 2023.ELIGIBILITY CRITERIA:Original English language articles published between 2012 and 2023 were included.DATA EXTRACTION AND SYNTHESIS:Nine independent reviewers extracted data and assessed the risk of bias. The quality appraisal of included articles was carried out using the Mixed Methods Appraisal Tool.RESULTS:A total of eight articles were included in this analysis. In Vietnam, the incidence of rabies ranged from 1.7 to 117.2 per 100 000 population. The cumulative incidence in Sarawak was estimated at 1.7 per 100 000 population. In Indonesia, 104 human rabies cases were reported from 2008 to 2010, while in Thailand, a total of 46 rabies cases were reported in Thailand from 2010 to 2015. In the Philippines, the incidence of rabies ranged from 0.1 to 0.3 per 100 000 population. An increased risk of rabies virus infection was associated with a high population density, illiteracy, seasonal patterns and dog butchers. The case fatality rate was 100%.CONCLUSION:This study included research from Southeast Asia, which may not represent rabies infection in other regions or continents. In addition, the role of publication bias should be acknowledged as grey literature was not included. The occurrence of rabies in Southeast Asia is due to the high number of unvaccinated stray and pet dogs, working hazards (dog butchers in Vietnam), the unavailability of the rabies vaccine in rural regions and misinformation about the significance of seeking treatment after dog bites.PROSPERO REGISTRATION NUMBER:CRD42022311654.

Motivation has been reported to play a significant effect in physical activity (PA) or exercise engagement on numerous occasions. Different stages of behaviour change (SOC) (i.e., pre-contemplation, contemplation, preparation, action, maintenance, and relapse) may attribute to different levels of motivation among type-2 diabetes mellitus (T2DM) patients. Thus, this study aimed to explore the different motivations toward PA across each SOC among Malaysian T2DM patients. A combination of cross-sectional study design and purposive sampling method was adopted in recruiting the participants from Hospital Universiti Sains Malaysia (HUMS). A total of 331 participants (172 males and 159 females) with a mean (SD) age of 62.64 (10.29) completed the study questionnaires, which comprised the 40-item Physical Activity and Leisure Motivation Scale (PALMS) and the 6-item SOC Scale. Multivariate analysis of variance (MANOVA) was used to analyse the data. The results showed a significant difference in the mean score of eight motives between the six stages of change [F(df) = 3.805 (40, 1610), p < 0.001]. Mean scores for the competition (15.78), affiliation (17.11), mastery (17.89), and enjoyment were found highest at the maintenance stage. However others’ expectation (16.50), physical condition (22.50), and psychological conditions (21.00) were found highest at the stage of action. The motive of appearance (18.43) alone was found highest at the relapse stage. Hence, we conclude that different stages of change in exercise would have different motives for physical activity for T2DM patients. The motives of PA may influence an individual with T2DM to either maintain their new active lifestyle or revert to their previous sedentary behaviours.

Introduction: Numerous studies reported that healthcare providers are not as effective in rendering high-quality CPR over time, despite receiving basic life support (BLS) or advanced cardiac life support (ACLS) training. Thus, to overcome the issue and develop a more feasible implementation of CPR training model, this study aims to identify the effectiveness of a modified conventional training (MT-CPR) method. Method: This was an experimental study conducted to 72 healthcare providers in a teaching hospital in north Borneo. Subjects underwent MT-CPR and data were collected using a validated questionnaire and skills assessment checklist adopted from AHA (2020). Data then was analysed using Friedman, Wilcoxon and McNemar test aided with IBM’s Statistical Package for the Social Science (SPSS) statistic software. Result: This study reported that MT-CPR significantly improved the knowledge and skills on CPR (p-value: <0.001). However, the training module significantly incapable to retain the knowledge and skills as early as 3 months post initial MT-CPR (p-value: <0.001). There was a statistically significant difference between the MCQ test scores (pre-course, post-course, and post 3 months-course) with ꭓ2 (2) = 36.2 (2), p-value = <0.001. There is an association between post-course overall results and post 3 month overall results using McNemar test (p-value < 0.002). Conclusion: Overall, this study indicated that modified CPR training (MT-CPR) were able to develop and improve the CPR knowledge and skill. The adaptation of conventional CPR training method seen effective as it has the capability for better engagement between trainer and participants.

Background Schistosomiasis is a parasitic infection that causes significant public health problems in tropical countries. Schistosoma haematobium species are blamable for causing urinary schistosomiasis. The infected person, specifically children, may be carrying the disease. This systematic review aimed to identify the current knowledge of urinary Schistosmiasis in children or USC on its epidemiology, risk factors, and challenges to spread the understanding of controlling the disease and reducing the complications. Method In November 2021, a systematic computer-aided literature review was conducted using PubMed, SCOPUS and Web of Science, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The results were updated in February 2022. We only used papers that have at least the abstract available in English. Relevant articles were screened, duplicates were deleted, eligibility criteria were applied, and studies that met the criteria were reviewed. The keywords Human Schistosoma infections, prevalence, risk factors and challenges were included. The protocol for the review was registered with PROSPERO (registration number CRD42022311609). Pooled prevalence rates were calculated using the programme R version 4.2.1. Heterogeneity was assessed using the I2 statistic and p-value. A narrative approach was used to describe risk factors and challenges. Studies were selected and finalised based on the review question to prioritise. The quality of the included studies was assessed using the Mixed-Method Appraisal Tool (MMAT). Results A total of 248 publications met the requirements for inclusion. Fifteen articles were included in this review, with the result showing high heterogeneity. The pooled prevalence of urinary schistosomiasis in children is 4% (95% confidence interval (CI)). Age, poor socioeconomic status, education, exposure to river water, and poor sanitation are the risk factors identified in this review. Challenges are faced due to limitations of clean water, lack of water resources, and poor hygiene. Conclusion Modifiable risk factors such as poor knowledge and practices must be addressed immediately. Healthcare providers and schools could accomplish engaging in practical promotional activities. Communicating the intended messages to raise community awareness of urinary schistosomiasis is critical.

We read with great interest the article by Mohamed et al,1 recently published in the Oman Medical Journal. The article has highlighted the prevalence and risk factors of non-alcoholic fatty liver disease (NAFLD) among patients with type 2 diabetes mellitus in Bahrain. We agree that the authors have included an impressive number of covariates in determining the risk factors of NAFLD. However, we notice that in the case of metabolic syndrome, the reference used was Adult Treatment Panel III guidelines instead of the harmonized criteria which is ethnic-specific in waist circumference measures with a lower cut-off for fasting blood glucose.2 In future studies, we suggest that the authors may consider using the harmonized criteria to ensure all possible causes of metabolic syndrome are detected. In addition, the demographic data in Table 1 mentioned cardiovascular risks as one of the variables; however, we could not elicit it in the univariate analysis.1 We are wondering whether it is associated with physical activity or other variables. The authors also considered obesity as measured through body mass index (BMI) as a risk factor for NAFLD. This was confirmed by the findings of the study as an independent risk factor for NAFLD. Although BMI is robust and simple to use as an indicator of obesity, similar BMI does not necessarily mean similar proportion of body fat. Thus, the measurement of body fat percentage through bioimpedance analysis may be a better indicator of obesity.3 Future studies may consider various body composition measures to accurately define obesity. For the statistical analysis, researchers did a good job by performing all the univariate analyses and then selected the statistically significant variables to be included in the binomial logistic regression. However, there is another way to analyze the data by performing a full multiple logistic regression.4 In multiple logistic regression, the univariate analysis called simple logistic regression is required to select the possible variables that could be included in the preliminary model.4 Performing multiple logistic regression (multivariate analysis) can increase the power of statistical analysis.5 We notice some missing data for most of the measured variables, which could lead to potential bias and compromise the inferences from the research if not handled and treated appropriately. We would like to know how the researchers handled or treated the missing data.

The technology supported Brain Breaks (BB) videos are a series of structured, web-based physical activity (PA) videos designed to promote learning and health. The purpose of this study was to investigate the effect of BB videos on exercise self-efficacy (ESE) among type 2 diabetes mellitus (T2DM) patients using the Malay-versioned exercise self-efficacy scale (ESE-M). The study used a double-blind research design and was randomised into two groups: (1) The Technology Supported BB intervention group, and (2) the control group. 70 T2DM patients with a mean age of 57.6 years (SD = 8.5) were recruited from Hospital Universiti Sains Malaysia. For 4 months, participants in the intervention group were required to undertake PA every day using the BB videos (approximately 10 min). Both groups completed the ESE-M at pre-intervention, the end of the first month, the second month, the third month, and post-intervention. For the data analysis, a mixed factorial analysis of variance was used. The results showed that at the end of the intervention, the two groups’ ESE was significantly different (p < 0.001). From pre- to post-intervention, the intervention group’s ESE-M mean scores improved significantly. Technology-supported BB videos may be an effective strategy for improving ESE in T2DM patients.

Movement of highly skilled physicians from the public sector to the private sector is interrupting progress towards Universal Health Coverage (UHC) and subsequently Sustainable Development Goals (SDG). There is insufficient information to understand factors associated with turnover intention among specialist medical practitioners in Sabah, a state in Malaysia with the least number of clinical specialists for all specialties. This study intended to determine prominent factors affecting turnover intention using a cross sectional study conducted among Ministry of Health’s specialist medical practitioners across Sabah. Respondents were chosen using convenience sampling technique to complete a self-administered questionnaire consisting of sociodemographic information, work characteristics, the 10 item Warr-Cook-Wall (WCW) job satisfaction scale, a question on private sector employment offer and turnover intention. Descriptive and bivariate analyses were used to identify significant factors affecting turnover intention. A total of 101 completed questionnaires were analysed. A total of 75 (74.3%) respondents were younger than 40 years old and 57 (56.4%) of them were male. Almost one third (31.7%) of specialist medical practitioners in Sabah were actively seeking alternative employment. Factors associated with turnover intention were low job satisfaction score (t = 3.516, 95% CI 2.64-9.49, p < 0.005) and career development opportunities (x² = 5.766, p < 0.05). Turnover intention among specialist medical practitioners in Sabah was significantly associated with low job satisfaction and dissatisfaction with career development opportunity. There is a dire need for an effective retention strategy to retain these limited highly skilled health personnel

Brain Breaks® are structured physical activity (PA) web-based videos designed to promote an interest in learning and health promotion. The objective of this study was to examine its effects on decision balance (DB) which consists of the perceived benefits (Pros) and perceived barriers (Cons) of exercise in people with type 2 diabetes mellitus (T2DM). A randomised controlled trial was conducted among people with T2DM at Hospital Universiti Sains Malaysia. The intervention group received Brain Breaks videos for a period of four months. The intervention and control groups completed the validated Malay version of DB questionnaire for five times, at pre-intervention, the first month, the second month, the third month, and post-intervention. Multivariate Repeated Measures Analysis of Variance was performed for data analysis. A total of 70 participants were included (male = 39; female = 31) with a mean age of 57.6 years (SD = 8.5). The intervention group showed a significant change in the Pros and Cons factors of DB scores over time. The intervention group showed significantly higher scores for the Pros (p-value < 0.001) and lower scores for the Cons (p-value = 0.008) factors than the control group. In conclusion, the Brain Breaks video is an effective intervention to improve decisional balance in patients with T2DM to help them in deciding on behaviour change to be more physically active.

Brain Breaks videos are web-based structured physical activity (PA) videos that aim at stimulating an interest in learning and promoting health. Exercise is one of the important treatment regimens for people with type 2 diabetes mellitus (T2DM). Thus, the objective of this study was to determine the effects that Brain Breaks videos have on the motives for PA, as measured by the Physical Activity and Leisure Motivation Scale-Malay (PALMS-M), and the amount of PA, as measured by the International Physical Activity Questionnaire-Malay (IPAQ-M), in T2DM patients (the most common type of diabetes mellitus patients). This study was conducted using a randomized, double-blind design and grouped subjects under two research conditions: an experimental group given Brain Breaks videos and a control group. Purposive sampling was employed to recruit 70 T2DM patients (male = 39, female = 31) with the mean age of 57.6 (SD = 8.5) from Hospital Universiti Sains Malaysia, Kelantan. Over a four-month period, the participants in the experimental group were asked to perform PA daily based on a Brain Breaks video (10 min in duration) that was shared through a WhatsApp group. All participants from both groups answered the PALMS-M questionnaire five times: pre-intervention, the end of the first month, second month, and third month, and post-intervention. A repeated measure multivariate analysis of variance and a repeated measure analysis of variance were performed for the analyses of the data. The results demonstrated that four (appearance, others’ expectations, physical condition, and mastery) out of eight motives for PA produced a significant mean score difference between the two study groups. All eight motives for PA showed an upward trend for the experimental group during the study period, while the control group showed a downward trend for all motives during the study period. As for the amount of PA, both groups showed significant differences (p = 0.001). The amount of PA increased in the experimental group during the study period, while it decreased in the control group. Therefore, Brain Breaks videos can be considered as an effective intervention for motivating T2DM patients for PA and improving their amount of PA.

Sports courage is one of the most important attributes to help competitive athletes overcome anxiety, nervousness, and other psychological obstacles, but this field of study is still being overlooked by most athletes and coaches. The purpose of this study is to validate the Malay language version of the Sports Courage Scale (SCS-M) for Silat athletes using confirmatory factor analysis (CFA). Data were collected during 9th UPSI International Pencak Silat Championship in Malaysia. A total of 258 competitors (male = 66.7%, female = 33.3%), with a mean age of 18 years (SD = 2.6), volunteered to participate in this study. The original SCS with 50 items underwent forward and backward translations into the Malay language and was pre-tested with ten martial arts athletes. Then, Silat athletes were asked to complete the translated SCS-M questionnaire. There were five factors in the SCS-M (i.e., mastery, determination, assertiveness, venturesome, and self-sacrificial behaviour). The first hypothesised model with 50 items did not result in a good fit to the data (RMSEA = 0.06, CFI = 0.93, NFI = 0.87, NNFI = 0.93, RMR = 0.14, SRMR = 0.09). A total of 17 problematic items were identified and were removed iteratively. The final measurement model with 33 items fit the data well (RMSEA = 0.06, CFI = 0.94, NFI = 0.89, NNFI = 0.94, RMR = 0.05, SRMR = 0.07). The reliability of each subscale based on Cronbach's alpha ranged from 0.64 to 0.76. The convergent and discriminant validities were achieved for the final measurement model. The revised version of SCS-M with 33 items was considered valid and reliable for measuring the sports courage in Silat athletes in Malaysia.

Exercise self-efficacy (ESE) is one of the psychological constructs in the Transtheoretical Model (TTM). The objective of the present study is to assess the validity and reliability of the Malay version of Exercise self-efficacy scale (ESE-M) among Malaysians with type 2 diabetes mellitus (T2DM). A cross-sectional study design with convenience sampling method using a self-administered questionnaire was carried out. Participants were invited to complete the ESE-M with 18 items. Confirmatory factor analysis (CFA) was conducted and composite reliability (CR) was computed using Mplus 8. A total of 331 Malaysians with T2DM with a mean age of 63 years old (Standard Deviation = 0.57) completed the questionnaire. Most of the participants were male (52%) and Malay (89.4%). Two initial CFA models (single factor and three factors) of ESE-M scale were tested and they did not fit to the data well. Several re-specifications of the models were conducted. The final model for the ESE-M showed improvement on the value of model fit indices for the single factor model (comparative fit index (CFI) = 0.952, Tucker and Lewis index (TLI) = 0.938, standardised root mean square (SRMR) = 0.044, root mean square error of approximation (RMSEA) = 0.054) and three factors model (CFI = 0.891, TLI = 0.863, SRMR = 0.049, RMSEA = 0.081). The CR for the self-efficacy factor was 0.921 (single factor), while CR for internal feelings, competing demands and situational (three factors) were 0.762, 0.818 and 0.864, respectively. The final model of single factor ESE-M showed better fit to the data compared to the three factors ESE-M. This indicated that the single factor ESE-M is more suitable to be adopted for future study among Malaysians with T2DM.

BACKGROUND:Processes of change (POC) comprise one of the psychological constructs in the Transtheoretical Model. The objective of this study is to test the validity and reliability of the Malay version of the POC scale among university students by using a confirmatory approach.METHOD:A cross-sectional study design with a convenience sampling method using a self-administered questionnaire was carried out. University undergraduate students were approached to fill in the questionnaire, which consisted of demographic information and a POC scale. The POC scale consisted of 30 items and two main factors (i.e., cognitive and behavioural). The POC scale was translated into the Malay language using a standard procedure of forward and backward translation. Confirmatory factor analysis (CFA) was performed, and composite reliability was computed using Mplus version 8.RESULTS:A total of 620 respondents with a mean age of 20 years (standard deviation = 1.15) completed the questionnaire. Most of the participants were female (74.7%) and Malay (78.2%). The initial CFA model of the POC scale did not exhibit fit based on several fit indices (comparative fit index (CFI) = 0.880, Tucker Lewis index (TLI) = 0.867, standardised root mean square residual (SRMR) = 0.075 and root mean square error of approximation (RMSEA) = 0.058). Several re-specifications of the model were conducted and the modification included adding correlation between the items' residuals. The final model for the Malay version of the POC scale showed acceptable values of model fit indices (CFI = 0.922, TLI = 0.911, SRMR = 0.064 and RMSEA = 0.048). The composite reliability of both the cognitive and behavioural processes was acceptable at 0.856 and 0.752, respectively.CONCLUSION:The final model presented acceptable values of the goodness of fit indices, indicating that the scale is fit and acceptable to be adopted for future study.