Sociodemographic, nutritional, and environmental factors are associated with cognitive performance among Orang Asli children in Malaysia

Children aged 2 to 6 years are in a crucial period of growth development, during which it is important for them to attain specific cognition related to concentration and attention so that they can perform well in school later in life. Various factors influence children's cognition during this crucial period. However, to date, only a limited number of studies have examined the cognitive performance of underprivileged children living in poverty, particularly indigenous children (also known as Orang Asli children in Malaysia). Therefore, this cross-sectional study aimed to determine the associations between sociodemographic factors, nutritional factors (body composition and hemoglobin), and environmental factors (home environment and parasitic infections) with cognitive performance among Orang Asli children in Negeri Sembilan, Malaysia. The participants were 269 children (51% boys, 49% girls) aged 2 to 6 years (M = 4.0, SD = 1.2 years) and their mothers, from 14 Orang Asli villages. Face-to-face interviews were conducted with the mothers, and the children's cognitive performance, operationalized as working memory index (WMI), processing speed index (PSI), and cognitive proficiency index (CPI), was assessed using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV). The children's weight and height were measured, and their blood and stool samples were collected to assess hemoglobin level and parasitic infections, respectively. Multiple linear regression analysis showed that the father's years of education (β = 0.262-0.342, p < 0.05), availability of learning materials at home (β = 0.263-0.425, p < 0.05), and responsiveness of the parent to the child (β = 0.192-0.331, p < 0.05) were consistently associated with all three cognitive indices (WMI, PSI, and CPI). A holistic approach involving parents, communities, and government agencies should be established to improve the cognitive performance of these underprivileged children

The role of negative automatic thoughts as a mediator in the relationship between maternal attachment and depressive symptoms among late adolescents of Pakistan

Introduction: Negative automatic thoughts refer to subconscious thinking patterns in response to irrational and self-defeating stimuli. Individuals who are depressed tend to have biased negative automatic thoughts. Therefore, there is a need to refine our understanding of what contributes to the development of adolescent depressive symptoms. The current study examined the mediating role of negative automatic thoughts in the link between maternal attachment and depressive symptoms among late adolescents in Pakistan. Methods: This cross-sectional study focused on 936 (males=423, females=513) students aged 17 to 19 years old, who were selected through multistage cluster sampling technique. Respondents answered self-report questionnaires which assessed maternal attachment, depressive symptoms, and negative automatic thoughts. Structural equation modelling was utilised to analyse the relationships among the research variables. Results: The findings indicated that 39.3% had negative automatic thoughts; whereas, 5.6% experienced severe depressive symptoms. Correlational analysis showed that maternal attachment had a negative association with depressive symptoms and negative automatic thoughts. In contrast, depressive symptoms were positively related to negative automatic thoughts. Structural analysis revealed that negative automatic thoughts partially mediated the association of maternal attachment with depressive symptoms among late adolescents. Findings specifically demonstrated that those with insecure maternal attachment tend to have negative automatic thoughts, which subsequently lead to depressive symptoms. Conclusion: In conclusion, findings highlight the importance of secure attachment to the mother and positive automatic thoughts in combating depressive symptoms; thus ensuring a healthy psychological development for adolescents

Outcome of chemotherapy counseling by pharmacists on psychological effects and self esteem among oncology patients in a government hospital in Malaysia

Introduction: Chemotherapy is the most common form of treatment among cancer patients. It is also known to cause many physical and psychological side-effects. Objective: This study developed, implemented and evaluated the outcome of a chemotherapy counseling module among oncology patients by pharmacists based on their psychological effects (depression, anxiety) and selfesteem. Methods: A randomized, single blind, placebo controlled study was conducted among 162 patients undergoing chemotherapy in a government hospital in Malaysia. Intervention: Counseling sessions were conducted using the 'Managing Patients on Chemotherapy' module for oncology patients undergoing chemotherapy at each treatment cycle. Outcome: The outcome of repetitive chemotherapy counseling using the module was determined at baseline, first follow-up, second follow-up and third follow-up. Results: The findings revealed that there was significant improvement in the intervention group as compared to the control group with large effect size on depression (p = 0.001, partial η2 = 0.394), anxiety (p = 0.001, partial η2 = 0.232) and self-esteem (p = 0.001, partial η2 = 0.541). Conclusion: Repetitive counseling using the ‘Managing Patients on Chemotherapy’ module was found to be effective in improving psychological effects and self-esteem among patients undergoing chemotherapy

Development and validation of pelvic floor muscles exercise intervention for urinary incontinence among pregnant women

Introduction: The prevalence of urinary incontinence among pregnant women is high in Malaysia. However, healthcare providers appear to pay little attention to it along with a limited local intervention that addresses the continence health during pregnancy. This study aims to develop and validate intervention with pelvic floor muscle exercise (PFME) for pregnant women. Materials and methods: The development of PFME intervention was guided by the Medical Research Council Framework for Developing and Evaluating Complex Intervention (MRC Framework). This involved four phases: identification of current research evidence, expert opinion, validation via focus group discussions with physiotherapists and pregnant women, and piloting the intervention using a single group pre-post design among 30 pregnant women at Maternity Hospital Kuala Lumpur to assess the feasibility of the intervention by evaluating changes in knowledge and attitude. The qualitative approach was used to analyse the first three phases, while non-parametric methods were used to analyse the pilot prepost test results. Results: Based on research evidence and guidelines found during the literature review, a PFME intervention was developed using a new paradigm incorporating two theories, the Health Belief Model and Motivational Interviewing that have been shown to be important in continence promotion and exercise adherence. The contribution of the panel of experts in refining the intervention to meet the local context, endorses the achievement of the intervention's content validity. While, the focus group discussion with pregnant women and physiotherapists revealed the face-validity of the intervention. The findings of the pilot pre-testing showed that PFME knowledge (p<0.001) and attitude (p=0.011) improved significantly immediately following the intervention. Conclusions: Evidently, this is a pioneer study that illustrates the development of a Malaysian context-adapting PFME intervention on the basis of recommended steps using the MRC Framework. Incorporating a theory-based and rigorous validation approach into the development of the PFME intervention brought novel perspectives to the intervention. Given the promising preliminary results of the pre-testing pilot study, the PFME intervention could be implemented in the planned randomised control trial to validate the robustness of the results

Effectiveness of chemotherapy counselling on self-esteem and psychological effects among cancer patients in Malaysia: randomized controlled trial

Objectives: The aim of this study was to implement and evaluate the outcomes of chemotherapy counselling based on the "Managing Patients on Chemotherapy" module on self-esteem and psychological affect (anxiety, depression) of cancer patients by pharmacists in ten selected government hospitals in Peninsular Malaysia. Methods: A randomized control trial was conducted among 2120 cancer patients from April 2016 to January 2017 in ten selected government hospitals in Peninsular Malaysia. Cancer patients were randomly assigned to intervention and control groups. The intervention group received chemotherapy counselling by pharmacists based on the "Managing Patients on Chemotherapy" module. The outcomes were assessed at baseline, 1st, 2nd and 3rd follow-ups after counselling. In the course of data analysis; independent sample t-test, chi-square and two-way repeated measures ANOVA were conducted. Results: Mean scores of self-esteem in the intervention group had significant difference in comparison with those of the control group in the 1st, 2nd and 3rd follow-ups after counselling (P < 0.0001). Also, among those with depression and anxiety at baseline, there was reduction in depression and anxiety scores after the 1st, 2nd and 3rd follow-ups after counselling (p < 0.05). Conclusion: Repetitive counselling by pharmacists based on the "Managing Patients on Chemotherapy" module had positive effect on improving self-esteem and psychological affect of cancer patients undergoing chemotherapy in Peninsular Malaysia. Practice implications: This module can be used for all Malaysian cancer patients undergoing chemotherapy to improving self-esteem and psychological affect

Quality of life among cancer patients undergoing chemotherapy in government hospitals in Peninsular Malaysia

Introduction: To determine the quality of life (physical health, psychological, social relationships and environment domains) among cancer patients undergoing chemotherapy in government hospitals in Peninsular Malaysia. Methods: The data were collected using self-administered questionnaires. Descriptive statistics were conducted to obtain frequency and percentage of variables. Independent sample T-test and One way ANOVA were used to determine the association between variables. Multiple linear regression model was used to determine the significant predictors. The predictors of each domain was analysed separately. Results: Quality of life among cancer patients undergoing chemotherapy in this study was determined by four domains which were physical health, psychological, social relationships and environment. The overall mean score for physical health was 52.60, psychological was 52.55, social relationships was 50.79 and environment was 51.16. The significant predictors of physical effect domain were monthly income, cancer stage, social support, nausea and vomiting. The significant predictors of psychological do-main were race, marital status, cancer stage, nausea and vomiting. The significant predictors of social relationships domain were race, educational level, social support, nausea and vomiting. The significant predictors of environment domain were race, marital status, hopelessness level, nausea and vomiting. Conclusion: The quality of life among chemotherapy cancer patients is important to be observed. Based on the predictors found in this study, appropriate interventions can be taken to improve the quality of life outcomes and the response towards the treatment

Reliability and factor structure of the General Health Questionnaire-12 among university students

The 12- item General Health Questionnaire (GHQ-12) has been translated into many languages and widely used in different settings and countries. Its reliability and psychometric properties were extensively studied in many population groups which suggested that it measures psychological distress in multidimensional construct. Objective: The objective of this study was to assess the reliability and factor structure of the Bahasa Malaysia version of the GHQ-12 among university students attending a health program at a Malaysian public university. Method: The cross sectional survey was conducted on 306 undergraduate students aged between 18 to 27 years old who visited the booth set up for mental health screening at a health program. The screening was conducted using a self-administered, validated Bahasa Malaysia version of GHQ-12 questionnaire. Results: Using exploratory factor analysis, the Bahasa Malaysia version of GHQ-12 was found to have a three factor structures namely depressive symptoms, self-esteem and perceived abilities which accounted for 58% of the item variance. The overall Cronbach’s alpha coefficient of the scale was found to be high (0.84) with each factor having acceptable inter-item consistency ranging from 0.61 to 0.82. Conclusion: The findings of the study show that the Bahasa Malaysia version GHQ-12 is reliable and has good structural characteristics. It can assess a few domains of the psychological status of university students. It also helps in providing more information on the domain which may become a focus target of intervention in the prevention of mental illness

Prevalence of psychological stress among undergraduate students attending a health programme in a Malaysian University

Psychological stress among undergraduate students is associated with poor academic results, physical ill-health and psychiatric disorders. The objectives of the study were to determine the prevalence of psychological stress and its associated factors among undergraduate students attending a health programme in a local university. This is a cross-sectional study among undergraduate students attending a health programme in a local university. The 12-item General Health Questionnaire (GHQ-12) was used to determine the presence of psychological stress at a cut-off point of 4 and above. Analysis was conducted to determine any association between gender, ethnicity, year of study in the university, recent health-seeking contact with a doctor, and psychological stress among the participants. The prevalence of psychological stress among undergraduate students attending a health program in a Malaysian University was 49.3%. There was no significant association with any of the socio-demographic factors studied (p>0.05). The prevalence of psychological stress in this study was significantly high, and irrespective of gender, ethnicity, year of study in the university, and recent health-seeking contact with a doctor. Hence, the findings of this study show that it may be a useful strategy to integrate such health programs regularly in activities of colleges and universities, with the aim of promoting mental health and wellness among the students

Prevalence and predictors of depression among oncology patients receiving chemotherapy in government hospitals in Peninsular Malaysia

Introduction: Cancer-patients undergoing chemotherapy experience a high level of depression. The objective of this study was to determine the prevalence and predictors of depression in cancer-patients receiving chemotherapy in government hospitals in Peninsular Malaysia. Methods: This research was started with a cross-sectional study among 1356 patients undergoing chemotherapy in 10 government state hospitals in the Peninsular Malaysia. The data were collected using self-administered questionnaires including socio-demographic characteristics, severity of cancer, depression through Patient Health Questionnaire (PHQ-9), social support using the Multidimensional Scale of Perceived Social Support (MSPSS) and hopelessness using the Beck Hopelessness Scale (BHS).The research also con-ducted the descriptive statistics to obtain variable percentages and frequencies. Inferential analysis was also conducted by using chi-square or Fisher’s exact test in determining the relations among variables at the level of significance where p<0.05.Simple logistic regression was applied in determining the crude odd-ratio and variables with p value, where p<0.25, were entered into the multivariate logistic regression model to identify the significant predictors of depression. The best predictor was based on adjusted odds ratio. Results: The prevalence of depression was 34.00%. The significant predictors of depression were age, gender, education level, pain due to chemotherapy, depressed due to cancer, treatment with any anti-depressant, worried of the adverse effect due to cancer treatment, involvement in any cancer support society, level of social support and level of hopelessness. Among all predictors, level of social support was identified as the highest risk of prediction for depression. Conclusion: Findings of the study indicate that the health care services should focus on the management and intervention of depression in cancer-patients

Depression, anxiety and quality of life in stroke survivors and their family caregivers: a pilot study using an actor/partner interdependence model

Background:Depression and anxiety are common in stroke survivors as well as their family caregivers. However, it is not known whether each person's emotional distress contributes to their partner's quality of life (QOL). Objective:This study aimed to examine the effect of depression and anxiety on QOL in stroke survivor-caregiver dyads using dyadic analysis technique - the Actor-Partner Interdependence Model (APIM).Methods:This was a cross-sectional pilot study with a total of 30 participating dyads (30 stroke survivors and 30 family caregivers) from Hospital Rehabilitasi Cheras, Kuala Lumpur, Malaysia. This pilot study was conducted over a period of 3 months, between December 2014 and February 2015. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS). QOL was assessed using the Short Form-12 Health Survey (SF-12). All analyses were carried out using IBM SPSS version 22. Dyadic data were analysed using multilevel modelling (MLM).Results:Depression was uniquely associated with an individual's own QOL. Survivors and caregivers with higher depression had poorer physical component summary (PCS) scores and mental component summary (MCS) scores. Stroke survivor's depression exerted a significant actor effect on their PCS (b=-1.42, p=0.001) and MCS (b=-1.52, p<0.001). Caregiver's depression exerted a significant actor effect on their PCS (b=-2.53, p<0.001) and MCS (b=-1.51, p=0.004). Caregivers' anxiety negatively influenced their own MCS (b=-0.58, p=0.031). Furthermore, depression exerted a significant partner effect on PCS in stroke survivors (b=-1.19, p=0.003). Caregivers' depression was also related to their stroke survivors' poorer QOL, particularly PCS. Conclusion:The findings suggest that depression affects the QOL of both stroke survivors and caregivers, not only emotionally but also physically. This dyadic study also has evidence pointing to depression in caregivers and its association with stroke survivors' physical QOL