Pengurus Cemerlang dalam Organisasi Pendidikan

This study proposed to find out whether there exist a) differences in management role dimensions among Master Teachers in the state of Kedah Darul Aman according to demographic characteristics, b) differences in excellent manager among Master Teachers in Kedah Darul Aman according to demographic characteristics, c) relationship between management role dimensions and excellent manager among Master Teachers in Kedah Darul Aman and whether d) management role dimensions had any influence on excellent manager. Samples of the study are 39 male and 25 female Master Teachers in Kedah Darul Aman chosen from judgement sampling method. Questionnaire used as research instrument consisted of 3 close-ended items and 68 Likert-scaled items. Hypotheses were tested using t-Test, One-Way Variant Analysis (ANOVA), Pearson Correlation and Multiple Regression. Results revealed a) there was no difference in management role dimensions according to gender, b) there was no difference in communication, counseling and facilitating according to age, c) there exists significant difference in motivating according to age, d) there was no difference in communication, counseling and motivating according to tenure, f) there was no significant difference in excellent manager according to demographic characteristics (gender, age, tenure), g) there was no significant relationship between management role dimensions and excellent manager, and h) role as motivator showed significant influence over excellent management. Suggestions are forwarded based on the result to boost excellence among school teachers either as educators or as organizational manager

Pharmacogenetics in warfarin therapy

Warfarin is a challenging drug to dose accurately, especially during the initiation phase because of its narrow therapeutic range and large inter-individual variability. Therefore, the aim of this thesis was to investigate the use of pharmacogenetics and clinical data to improve warfarin therapy. Genetic variants in cytochrome P450 2C9 (CYP2C9) and vitamin K epoxide reductase (VKORC1) are known to influence warfarin dose. Therefore we developed a pharmacogenetic dosing algorithm to predict warfarin stable dose prospectively in a British population based on 456 patients who started warfarin in a hospital setting and validated it in 262 retrospectively recruited patients from a primary care setting. The pharmacogenetic algorithm which included CYP2C9*2, CYP2C9*3 and VKORC1-1693 together with body surface area, age and concomitant amiodarone use, explained 43% of warfarin dose variability. The mean absolute error of the dose predicted by the algorithm was 1.08 mg/day (95% CI 0.95-1.20). 49.6% of patients were predicted accurately (predicted dose fell within 20% of the actual dose). The HAS-BLED score, a bleeding risk score has recently been suggested for use in the management of patients with atrial fibrillation. We validated HAS-BLED performance in predicting major bleeding using a prospective cohort with 6 months follow-up (n=482) (c-statistic 0.80 95% CI (0.71-0.90). Factors significantly associated with major bleeding in our cohort (p≤0.1) were concurrent amiodarone use, labile INR, concurrent clopidogrel use, bleeding predisposition, concurrent aspirin use and CYP2C9*3. Adding a genetic covariate (CYP2C9*3) to the HAS-BLED score did not significantly improve its performance in predicting major bleeding. Considering CYP2C9*3 is a rare allele, our study was underpowered and requires further investigation in a larger cohort. A retrospective study of 97 Caucasian children was conducted to gain greater understanding of the factors that affect warfarin anticoagulant control and response in children. Results from multiple regression analysis of genetic and non-genetic factors showed that indication for treatment (Fontan or non-Fontan group), VKORC1 -1693, and INR group explained 20.8% of variability in proportion time in which INR measurements fell within the target range (PTTR); CYP2C9*2 explained 6.8% of the variability in INR exceeding target range within the first week of treatment; CYP2C9*2, VKORC1 -1693, age and INR group explained 41.4% of warfarin dose variability and VKORC1 -1693 explained 8.7% of haemorrhagic events. The contributions of CYP2C9 and VKORC1 polymorphism were small in the above outcomes. We therefore went onto explore other genetic markers using genome-wide scanning. Two SNPs on chromosome 5, rs13167496 and rs6882472 were found to be significantly associated at a genome-wide significance level with PTIR. However, none of SNPs were significantly associated with warfarin stable dose, INR values exceeding the target range within the first week of treatment and bleeding complications. Because of our small sample size, these findings will need to be validated in a replication cohort. Finally, we have validated and evaluated the performance of Genie HyBeacon®, a point of care therapy (POCT) instrument to genotype 135 samples for CYP2C9*2, CYP2C9*3 and VKORC1 -1693. We showed that the instrument accuracy was >98% (agreement with ABI Taqman® genotyping), it was relatively simple to use and had a good turn-around time (1.6 hours) making it suitable for clinical use. In conclusion, the results presented in this thesis demonstrate how knowledge of pharmacogenetics may help in assessing improvement in the quality of care of patients on warfarin. However, for personalized medicine to be widely adopted in clinical practice, payers need evidence of clinical- and cost-effectiveness. How such evidence is produced and evaluated varies in different healthcare settings, which further increases the challenge of implementing personalised medicine into the clinic

A novel conceptual framework of Health Information Systems (HIS) sustainability

Sustainable technology means technology is capable of being maintained over a long span of time; independent of shifts in both hardware and software. Effective implementation and use of Health Information Systems (HIS) for years to come are crucial as sustainable HIS. Numbers of studies have discussed various factors contributes towards barriers for successful implementation of HIS. However, very few studies discussed factors on HIS sustainability. Through critical analysis of existing literature on success, failure, and challenges of HIS adoption, this paper identifies four crucial factors that shape the sustainable HIS. The importance of strong leadership support, proper contingency planning, and practice, continuous vendor support, and protection of security and privacy issues are identified by classifying all the factors within these four constructs, and with it, we argue these factors crucial for sustainable HIS. This paper proposes a novel conceptual framework which incorporated all these constructs as HIS sustainability factors. This paper also described the theoretical basics behind the development of the model and methodology to be employed to validate the proposed model

The influence of social support on cognitive impairment in the elderly

BackgroundIn Malaysia, as a result of urbanization and due to the migration of the youth from rural to urban areas, more elderly are now living on their own leading to poor social support and reduced social interactions which may result in negative consequences to the cognitive function of the elderly.AimsTo determine the influence of social support on cognitive impairment among elderly Malaysians.Methods This cross sectional study was conducted using a representative sample for Penang, Malaysia. The Elderly Cognitive Assessment Questionnaire (ECAQ) was used to screen for cognitive impairment and Oslo-3 Social Support Scale (OSS-3) was used to measure social support.Results A total of 2005 elderly participated in the study, 10.8 per cent had borderline cognitive impairment whereas 4.8 per cent were cognitively impaired with borderline dementia. Most of the participants had moderate social support (63.6 per cent) and 16.3 per cent had poor social support. There is about a threefold higher odds of being cognitively impaired among those who have poor social support (OR 3.1 [2.0-4.8]. a OR 2.6 [1.2-5.4]). Attributable risk analysis showed that 65 per cent risk of cognitive impairment in the sample was due to poor social support whereas in the population it was 24.0 per cent.ConclusionThe rapid urbanization and the changes brought along with it are likely to affect social support and eventually the cognitive health of the elderly

The technology factors as barriers for sustainable Health Information Systems (HIS) – a review

Information system is widely adopted in many fields including healthcare. Healthcare organizations now consider increased efficiency, improved patient care, quality of services, and safety. Hence Health Information System (HIS) is basically introduced to transform the traditional way of data collection and organization in hospitals, to a modern way of systematic collection, maintaining and dissemination of data. Its implementation is to support medical practitioners and administrative staff in securing patients’ health information in a digital-based record, to efficiently and effectively improve performance in the health system or any of its component parts. However, despite its numerous benefits, some of barriers still hinder its successful implementation and adoption, which needs to be addressed. This study discussed these barriers related to technology using the IS Success Model. This review paper becomes necessary in order to highlight the barriers that led to technical difficulties facing HIS implementation in hospitals, so as to suggest possible solutions that will improve services rendered in health industry based on finding

Optimisation of Anthocyanin Co-pigmentation from Butterfly Pea (Clitoria ternatea) Flower and its Application in Gummy

In contrast to natural food colours, food manufacturers have increasingly used synthetic food colours to achieve attributes such as low cost, excellent appearance, high colour intensity, increased colour stability, and consistency. Furthermore, natural colourants such as anthocyanins have been linked to potential health advantages such as dietary antioxidants. Pea Flower (Clitoria ternatea) was utilized in this research because the high quantity of polyacylated anthocyanins known as ternatins in blue pea flowers which is a distinctive property of anthocyanins found in blue pea flowers. The purpose of this research is to improve anthocyanin thermal stability via co-pigmentation process from Butterfly Pea flower and to analyse the physicochemical features of gummy. The potential of Response Surface Methodology (RSM) for optimising anthocyanin co-pigmentation from Butterfly Pea (Clitoria ternatea) flower was investigated in this study. The effect of two test variables on the half-life of anthocyanin was studied in a specific range of pH 3-6 and anthocyanin to metal ratio (1:1 to 1:100). The data from the experiment were analysed using the RSM of MINITAB Software (Version 19), and the optimum half-life of anthocyanin of 191 minutes was established and verified. The optimal conditions were stated to be pH 3.75 and an anthocyanin:metal ratio of 1:75. A significant regression equation or model with a correlation value of 95.38% was also achieved at the 5% level. For the application of gummy, three types of gummies (synthetic blue incorporated gummy (F1), anthocyanin incorporated gummy (F2) and co-pigmented anthocyanin incorporated gummy (F3)) were produced to analyse its physicochemical qualities. The physicochemical qualities of F3 gummy were reported to retain the physicochemical since the pH values, water activity, moisture content, and textural properties were not significantly different (p>0.05). However, due to the % difference in polymeric colour present, the colour in terms of hue angle was noted to have a significant difference between F1, F2, and F3

Prognostic Factors for Bladder Cancer Patients in Malaysia: A Population-Based Study

Background: Malaysia has the third highest crude mortality rates of bladder cancer within Southeast Asia. We aimed to identify the prognostic factors for bladder cancer patients in Malaysia. Methods: A retrospective population-based study was conducted among patients diagnosed between 2007 and 2011. Death date until 31 December 2016 was updated. Cox proportional hazard regression analysis was performed to examine clinical variables as prognostic factors of death. Results: Identified prognostic factors of 1828 analyzed patients were age groups, ethnicity, morphology, stage, and surgery. As compared to patients aged 15–44, the adjusted Hazard Ratio for those aged 45–54, 55–64, 65–74, and ≥75 were 1.59, 1.87, 2.46, and 3.47, respectively. Malay and other ethnic groups had 1.22- and 1.40-times the risk of death compared to Chinese. Patients with squamous cell carcinoma were at 1.47-times the hazard of death compared to urothelial carcinoma patients. Stages II, III and IV patients had 2.20-, 2.98-, and 4.12-times the risk of death as compared to stage I. Patients who did not receive surgery were at 50% increased hazard of death. Conclusion: Early detection and/or surgery, especially for those more than 75 years old, Malay, and squamous cell carcinoma could potentially improve survival. The findings could inform national cancer control programs

Persepsi kepuasan pelanggan terhadap produk sistem perbankan Islam (SPI) bank Islam dan konvensional

Sisrem perbankan Islam (SPI) merupakan salah satu bidang dalam pengurusan muamalat Islam. Perkembangan di Malaysia berdasar kepada kesedaran permintaan masyarakat terhadap suaru sistem yang bebas daripada unsur gharar dan riba. Selain itu, kerajaan juga memberi galakan dan menerapkan nilai Islam dalam sektor awam dan juga swasta. Kini,terdapat tiga buah institusi perbankan Islam di Malaysia iaitu Bank Islam Malaysia Berhad (BIMB), Bank Muamalat Malaysia Berhad (BMMB) dan Bank Kerjasama Rakyat Malaysia (Syed Mohd.Ghazali Wafa, Muhamad Nasri, & Mohd Hizam, 2003).Jumlah bank Islam tersebut bertambah pada tahun 2005 dengan RHB bank Islam, Bank Tijari dan akan terus bertambah mengikut kelulusan bank negara. Sementara itu, semua bank konvensional juga menawarkan produk SPI sekali gus mewujudkan persaingan dengan bank Islam

Kandungan Timbal Pada Air, Sedimen, Dan Rumput Laut Sargassum sp. Di Perairan Jepara, Indonesia

Concentration of Lead in the Seawater, Sediment, and the Seaweed Sargassum sp. in Jepara waters, Indonesia   The increasing human activities led to an increase in waste disposal which eventually accumulates and decrease the water quality of rivers and seas. One of the pollutant resulted by human activities is heavy metal. The presence of heavy metals in the waters could directly harm the bioorganisms and indirectly affect human health by food chains. The purpose of this research is to investigate the lead content (Pb) in the water, sediment, and seaweed Sargassum sp., as well as to determine the status of pollution in Teluk Awur waters, Jepara. The research was conducted in November 2017 and January 2018 using descriptive method. Sampling sites were decided by Purposive Sampling Method. Analysis of lead content was conducted using AAS (Atomic Absorption Spectrophotometry). The results showed that the lead content of seawater in Teluk Awur, Jepara, was within 0.003 mg/L and not on the level of concern, according to KepMen LH No. 51/2004. The range of lead content in the sediment was 47- 68,35 mg/kg and considered as polluted, according to NRCC GBW07313. The range of lead content in the seaweed Sargassum sp. was 0.22-0.79 mg/kg and has exceeded the quality standard  specified by PerBPOM No. 23/2017.   Meningkatnya  kegiatan  manusia  menyebabkan  peningkatan  pembuangan  limbah  yang pada akhirnya bermuara ke sungai maupun laut, yang mengakibatkan perairan laut menjadi tercemar. Salah satu pencemar akibat aktivitas   manusia   adalah   logam   berat   timbal yang dapat membahayakan kehidupan organisme perairan secara langsung, maupun tidak langsung terhadap kesehatan manusia. Tujuan penelitian ini adalah untuk mengetahui kandungan logam berat Pb pada air, sedimen, dan rumput laut Sargassum sp. serta untuk mengetahui status pencemaran di Perairan Teluk Awur, Jepara. Penelitian dilakukan pada bulan November 2017 dan Januari 2018. Metode penelitian yang digunakan  adalah  metode  deskriptif.  Penentuan  lokasi  penelitian  dilakukan dengan Purposive Sampling Method. Analisis logam berat Pb dilakukan dengan menggunakan AAS (Atomic Absorption Spectrophotometry). Hasil penelitian menunjukan kandungan logam berat Pb di Perairan Teluk Awur, Jepara, pada air laut yaitu 0,003 mg/L dan masih belum tercemar menurut KepMen LH No.51/2004. Kandungan logam berat Pb pada sedimen yaitu berkisar 47 - 68,35 mg/kg dan telah tercemar menurut NRCC GBW07313. Kandungan logam berat Pb pada rumput laut Sargassum sp. yaitu berkisar 0,22 - 0,79 mg/kg dan telah melebihi baku mutu yang ditentukan oleh PerBPOM No. 23 Tahun 201