Kesan pendedahan konsep kepelbagaian budaya terhadap tahap kompetensi dalam kalangan pelajar prasiswazah sains rehabilitasi

Kompetensi budaya adalah penting bagi anggota kesihatan profesional dalam menyediakan perawatan dan khidmat yang bersesuaian kepada individu daripada pelbagai latar belakang budaya. Pendidikan yang berstruktur dapat meningkatkan tahap kompetensi budaya dalam kalangan anggota kesihatan profesional. Objektif kajian ini adalah untuk menilai tahap kompetensi budaya dan perubahannya dalam kalangan pelajar prasiswazah setelah mengikuti kursus elektif Kepelbagai Budaya. Seramai 152 orang pelajar prasiswazah Tahun 3 dari Program Fisioterapi, Audiologi, dan Sains Pertuturan di Universiti Kebangsaan Malaysia telah melengkapkan satu soal selidik yang menilai kompetensi budaya sebelum dan selepas tamat kursus tersebut. Lebih daripada 80% pelajar mempunyai pengalaman bekerjasama dengan individu yang berbeza latar belakang budaya. Tahap kompetensi budaya para pelajar meningkat secara signifikan setelah mengikuti kursus. Kajian ini membuktikan keperluan bimbingan kepada pelajar di peringkat prasiswazah dalam membentuk anggota kesihatan profesional yang kompeten secara menyeluruh dalam menyediakan khidmat kepada pelbagai golongan masyarakat

Cabaran dalam pembelajaran kursus neurologi, strategi mengatasinya dan cadangan penambahbaikan dalam kalangan pelajar sains rehabilitasi di Universiti Kebangsaan Malaysia

Neurologi telah dikenalpasti sebagai kursus yang mencabar dalam pengajian perubatan dan sains kesihatan. Persepsi pelajar perlu diterokai bagi mengenalpasti isu berkaitan pembelajaran kursus neurologi. Namun, kajian melibatkan pelajar sains rehabilitasi masih terhad. Kajian kualitatif ini bertujuan meneroka persepsi pelajar sains rehabilitasi terhadap kursus neurologi dan pembelajarannya di Universiti Kebangsaan Malaysia (UKM). Sejumlah 12 pelajar cemerlang dari empat disiplin sains rehabilitasi iaitu fisioterapi, terapi cara kerja, sains pertuturan serta audiologi telah menyertai kajian ini. Semua peserta menjalani perbincangan kumpulan fokus (PKF) selama satu jam dan sebanyak dua sesi di satu bilik senyap di Fakulti Sains Kesihatan, UKM. Sesi PKF dilaksanakan oleh seorang penyelidik pelajar terlatih dan menggunakan protokol temubual yang telah diuji. Skop perbincangan merangkumi persepsi terhadap kursus neurologi, cabaran dalam proses pembelajarannya dan strategi bagi mengatasi cabaran. Data terakam dari PKF ditranskripsi secara verbatim dan dianalisis menggunakan pendekatan analisis bertema. Hasil analisis menunjukkan neurologi sememangnya dianggap kursus paling sukar dalam pengajian sains rehabilitasi. Cabaran yang dihadapi pelajar termasuklah melalui sesi kuliah yang membosankan, sesi amali yang tidak mencukupi, cabaran sepanjang penempatan klinikal dan situasi peperiksaan yang mencabar. Peserta kajian menggunakan beberapa strategi tersendiri bagi mengatasi cabaran yang dialami. Penambahbaikan terhadap beberapa aspek pengajaran telah dicadangkan bagi mengurangkan cabaran dan tahap kesukaran kursus neurologi. Kesimpulannya, neurologi dilihat sebagai kursus yang mencabar dan pendekatan pengajaran sedia ada perlu ditambahbaik bagi meningkatkan keberhasilan pembelajaran kursus ini

Does neurophobia exist among rehabilitation sciences students? A survey at Universiti Kebangsaan Malaysia

Neurophobia, defined as ‘the fear of neural sciences and neurology’ is reported among medical students, which threatened their performance in neurology course. This phenomenon has not been studied among rehabilitation sciences students despite the significance of neurology as an area for rehabilitation. In this study we aim to assess the perceptions of neurology course and the possibility of neurophobia existence among rehabilitation sciences students of Universiti Kebangsaan Malaysia (UKM). We also aimed to identify learning methods which are regarded as useful among the students. A survey using self-administered questionnaires was conducted among 73 students from School of Rehabilitation Sciences of the university. Questions in the questionnaire were adapted from previous studies, in which neurophobia was indicated by poor knowledge and low confidence level in managing neurology course. Results showed that the percentage of participants who perceived having good knowledge of neurology was significantly higher than the percentage who claimed of having poor knowledge level (90.4% versus 9.6%, p < 0.01). Similarly, the percentage of participants who claimed having high confidence to handle neurology cases was higher than the percentage who expressed lack of confidence (79.2% versus 20.8%, p = 0.03). However, neurology course was perceived as difficult by majority of the participants (78.1%) when compared to other courses. Majority of the participants (97.3%) perceived clinical teaching as a useful method of learning rehabilitation science courses including neurology followed by problem-based learning (90.4%). While limited exposure to neurology cases was claimed as the main reason to why neurology is difficult. In conclusion, although neurology is perceived as a difficult course among rehabilitation sciences students, the students did not report lack of knowledge and confidence in the course. This implies that neurophobia does not exist among UKM rehabilitation students. Enhancement of learning methods may assist in reducing the level of difficulty of neurology course among the students

A review of riverbank and coastal erosion protection structure

Riverbank and coastal erosion are not new issues; it has been occurring globally for a long time. They are the most critical and unpredictable hazard issue, causing the loss of valuable property and land, posing a threat to the closest residents and having an economic impact. This review paper discusses the causes and consequences of riverbank and coastal erosion, and the dominant erosion processes involved. This paper further reviews the effectiveness of the protection method that was successfully being used to protect riverbank and coastal against repeated erosional attacks in Malaysia and its limitations. The last part of this paper reviews the potential of geobag as a rapid protection structure to the riverbank and coastal erosion. This method could prove to be an alternative to traditional rock-fill methods or bioengineering techniques, which are often quite complex and costly

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Pengadaptasian skala Integratif perkembangan kanak-kanak normal 16 – 30 bulan

Skala perkembangan kanak-kanak barat seringkali digunakan di Malaysia sebagai panduan utama ibu bapa dan golongan profesional dalam memantau perkembangan kanak-kanak kerana kurangnya data rujukan yang dilaporkan serta wujud anggapan bahawa perkembangan kanak-kanak di Malaysia setara dengan perkembangan kanak-kanak di negara Barat. Walau bagaimanapun, berdasarkan kajian-kajian lepas timbul keraguan mengenai kesesuaian skala perkembangan kanak-kanak barat menilai perkembangan komunikasi kanak-kanak di Malaysia. Oleh itu, kajian rintis ini bertujuan untuk membentuk data rujukan yang boleh dijadikan panduan bagi menilai perkembangan komunikasi kanak-kanak tahap bertatih di Malaysia. Kajian ini melibatkan pengadaptasian The Integrated Scales of Development (Cochlear Ltd. 2003) bagi kanak-kanak bertatih yang berusia 16 hingga 30 bulan yang terbahagi kepada tiga subskala berdasarkan umur iaitu subskala 16 hingga 18 bulan, 19 hingga 24 bulan dan 25 hingga 30 bulan. Penilaian kesahan dan kebolehpercayaan telah dilakukan ke atas skala yang diadaptasi. Berdasarkan penilaian kesahan, dua item telah digugurkan daripada subskala 16-18 bulan dan lapan item digugurkan daripada setiap subskala 19-24 bulan dan subskala 25-30 bulan. Ujian kebolehpercayaan alfa Cronbach telah dilakukan dan didapati hanya subskala 16-18 bulan mempunyai nilai kebolehpercayaan yang tinggi (α = 0.872), manakala kedua-dua subskala 19-24 bulan dan subskala 25-30 bulan mempunyai kebolehpercayaan yang rendah (α = 0.626 dan α = 0.628) masing-masing. Secara keseluruhannya, hasil adaptasi skala ini sesuai digunakan sebagai panduan bagi memantau perkembangan komunikasi kanak-kanak dan bukannya sebagai alat penilaian yang utama

Assessments of aphasia: Practices and challenges faced by Malaysian speech language therapists

Aphasia assessment is crucial in diagnosing aphasia, determining the extent of language impairment, and identifying factors that may support or restrict aphasia recovery to design an appropriate plan of care for people with aphasia. Speech-language therapists (SLTs) play a major role in conducting aphasia assessments. Little is known about the practices of SLTs in assessing aphasia in low-resource regions. The present study aims to identify aphasia assessment practices among Malaysian SLTs and related challenges, as well as strategies for improving aphasia assessments from SLTs’ perspectives. A total of 32 SLT participants who have been practicing in Malaysia completed an online survey to gather their background information, data pertaining to practices and challenges in conducting aphasia assessments, and suggestions for improving aphasia assessments. Descriptive analyses were conducted for all numerical data. Suggestions for improving aphasia assessment practices were analysed qualitatively using the thematic content analysis approach. SLT practices in aphasia assessment were found to be consistent in certain aspects, but not all. Two major challenges were identified: (a) linguistic barriers between clinicians and clients/caregivers, and (b) a lack of standardized assessment tools for aphasia evaluations. Participants suggested “Internal Strategies” and “External Strategies” for improving aphasia assessment practices

Parents' perception on the use of augmentative and alternative communication by children with complex communication needs in Malaysia

Children with developmental disabilities who have complex communication needs (CCN) frequently need to use augmentative and alternative communication (AAC) to communicate effectively and efficiently. Speech–language pathologists (SLPs) often work closely with parents and other professionals when deciding on the best AAC system to introduce to these children. This study aimed to describe the use of AAC by children with CCN in Malaysia as reported by their parents. An online survey distributed for this study was completed by 235 parents. Most of the parents of children with CCN who participated in this study reported that their children used low-tech AAC systems. A majority of respondents were satisfied with their child’s AAC system. Parental satisfaction was positively associated with the frequency of use and whether the use of AAC helped parents understand the child better. Challenges reported by parents when using AAC and the reason some families abandoned the use of AAC were similar. Examples of challenges include parents having limited time and the child lacking the motivation to use the AAC system. The findings of this study suggest the importance of SLPs actively involving parents in the selection of their children’s AAC system so they are agreeable with the system introduced and continuously supporting children and their families to encourage and sustain the use of AAC. Implications for rehabilitationSpeech–language pathologists (SLPs) can create communication opportunities for the child to use augmentative and alternative communication (AAC) and experience success, teach parents how to incorporate AAC into the family’s daily routine and activities, and reduce the demands on parents by preparing the AAC materials and programming the AAC system where possible.SLPs can provide ongoing support to school teachers to equip them with the necessary knowledge and skills to support the use of AAC in the classroom. Speech–language pathologists (SLPs) can create communication opportunities for the child to use augmentative and alternative communication (AAC) and experience success, teach parents how to incorporate AAC into the family’s daily routine and activities, and reduce the demands on parents by preparing the AAC materials and programming the AAC system where possible. SLPs can provide ongoing support to school teachers to equip them with the necessary knowledge and skills to support the use of AAC in the classroom.</p

Determinants of functional status among survivors of severe sepsis and septic shock: One-year follow-up

RATIONALE: Sepsis is a leading cause of intensive care unit (ICU) admissions worldwide and a major cause of morbidity and mortality. Limited data exist regarding the outcomes and functional status among survivors of severe sepsis and septic shock. OBJECTIVES: This study aimed to determine the functional status among survivors of severe sepsis and septic shock a year after hospital discharge. METHODS: Adult patients admitted between April 2007 and March 2010 to the medical-surgical ICU of a tertiary hospital in Saudi Arabia, were included in this study. The ICU database was investigated for patients with a diagnosis of severe sepsis or septic shock. Survival status was determined based on hospital discharge. Patients who required re-admission, stayed in ICU for less than 24 hours, had incomplete data were all excluded. Survivors were interviewed through phone calls to determine their functional status one-year post-hospital discharge using Karnofsky performance status scale. RESULTS: A total of 209 patients met the eligibility criteria. We found that 38 (18.1%) patients had severe disability before admission, whereas 109 (52.2%) patients were with severe disability or died one-year post-hospital discharge. Only one-third of the survivors had good functional status one-year post-discharge (no/mild disability). After adjustment of baseline variables, age [adjusted odds ratio (aOR) = 1.03, 95% confidence interval (CI) = 1.01-1.04] and pre-sepsis functional status of severe disability (aOR = 50.9, 95% CI = 6.82-379.3) were found to be independent predictors of functional status of severe disability one-year post-hospital discharge among survivors. CONCLUSIONS: We found that only one-third of the survivors of severe sepsis and septic shock had good functional status one-year post-discharge (no/mild disability). Age and pre-sepsis severe disability were the factors that highly predicted the level of functional status one-year post-hospital discharge