Stroke Rehabilitation Treatment Line Performance: Discrete-Event Simulation Lessons from Queen Elizabeth I Hospital

The application of Discrete-Event Simulation (DES) modelling in Malaysia is gradually increasing with the aim of decreasing inpatient treatment lines’ at public funded hospitals. Major premise behind this application is that such simulation models may be exploited in monitoring stroke treatment flows. The objective of this research-in-progress paper is to demonstrate the feasibility of applying DES modelling in understanding treatment line performance of stroke patients in a general inpatient rehabilitation ward at a major tertiary hospital in Kota Kinabalu, Sabah

Developing Virtual Data Warehouse for Rehabilitation Registry in Sabah, Borneo: Towards Big Data Analytics and Geomapping

Clinical registry, defined as an organised system for the collection, storage, retrieval, analysis, and dissemination of information on individuals with a condition that predisposes to the occurrence of a health-related event, are designed through data repository or data warehouse. Data repository is described as a real-time database that consolidates data from a variety of clinical sources that offers a comprehensive source for storage and retrieval of relevant clinical information needed. However, data warehouse is a data repository that concentrates on data queries and data analytics. Rehabilitation registry in Malaysia is still at its infancy with lack of data sharing and integration. As rehabilitation is a subspecialty concerned with the prevention, diagnosis, and rehabilitation of disabling conditions, a registry would allow identification of patients’ demographics, clinical and functional outcomes improvement, benchmarking the delivery of rehabilitation services, and research purposes. The application of virtual data warehouse, cloud computing, big data analytics and geomapping for clinical registries have been implemented well in countries like China and United Kingdom. The main objectives of this research-in-progress paper are to demonstrate the feasibility of developing and designing virtual data warehouse framework based on cloud computing technology, in an attempt towards big data analytics and geomapping implementation for inpatient rehabilitation registry in Sabah, Malaysia

Accessibility of antenatal services at primary healthcare facilities in Punjab, Pakistan

Introduction: Almost one-fifth of the world\\u27s population constitutes women of reproductive age who are repeatedly exposed to pregnancy and childbearing. Many are often at high risk of illness and mortality during pregnancy and require maternal healthcare services for early detection of complications. More than 0.5 million women die every year worldwide due to pregnancy-related complications. Almost 0.03 million of them are in Pakistan. Maternal healthcare in Pakistan is poor and results in high rates of morbidity and mortality. This paper evaluates the accessibility of antenatal care (ANC) services in primary healthcare settings in the Punjab province of Pakistan during the period June 2010-August 2011. Methods: The paper uses a cross-sectional study including mix methods (qualitative and quantitative).Nine districts were included in the project; one from each administrative tier or division. Nineteen health facilities, including two rural health centres (RHCs) and 17 basic health units (BHUs) were randomly selected from each district. The total sample was 171 health facilities. The qualitative assessment was carried out through focus-group discussions (FGDs) and in-depth interviews with clients, providers, and health managers. Results: The reasons for the gaps in service accessibility were the distant location of facilities, a lack of transport, and inconvenient facility working hours. The issues of service accessibility were further exacerbated by socio-cultural factors such as low levels of client awareness, a lack of decision-making by clients, and the influence of spiritual healers and quacks. Health managers further pointed out weak co-ordination between vertical programmes and routine integrated health services, and a lack of human resources in distantly located facilities.Conclusion: In order to increase the accessibility of ANC services, facility working hours must be extended and adjusted according to the convenience of clients in primary healthcare (PHC) facilities. The utilisation of ANC services can also be increased through client awareness and gender empowerment for ANC decision-making

Pengaruh personaliti lima faktor terhadap tingkah laku kewargaan organisasi (TKO) dalam kalangan guru

Studies on the organisational citizenship behaviour (OCB) is still new in Malaysia, especially among teachers. The importance of OCB in an organisation has been proven to improve individual performance and productivity. Meanwhile, personality plays an important role in influencing OCB. Therefore, this study will identify whether a teacher's personality influences OCB. This quantitative study was carried out by collecting data from a questionnaire distributed to 287 people that consists of teachers from SBT (High Performance Schools) and daily schools in primary schools around Putrajaya. The Big Five Inventory Instrument by John and Srivastava (1999) is used to measure the five-factor personality and the measurement scale of Organizational Citizenship Behavior (OCB) by Podsakoff et al. (1990) to measure OCB. Data was analysed by multiple regression using Statistical Package for Social Science version 23. The results showed that neuroticism, agreeableness and openness influenced OCB among teachers as a whole. The impact of this study can help the MOE identify the characteristics of the candidate teachers who match the OCB required in the selection and placement of teachers. The MOE can also devise self-awareness intervention modules to maintain and improve OCB among teachers. Future studies need to examine the influence of personality upon the more specific OCBs so that the performance of teachers is always maintained at its peak

Persepsi pekerja terhadap kesatuan sekerja: satu kajian di hotel di Johor Bahru

Pertikaian di antara majikan dan pekerja sering berlaku sekiranya wujud ketidakpuasan atau ketidakadilan terhadap sesebuah keputusan majikan terhadap pekerjanya. Kebiasaannya, pihak pekerja akan menyuarakan dan menyalurkan pendapat mereka melalui kesatuan sekerja yang bertindak sebagai wakil rasmi untuk berunding secara kolektif dengan majikan (Mariam, 1993). Kesatuan sekerja juga merujuk kepada satu pertubuhan yang berdikari, yang akan membuat perundangan kolektif dan terpisah dengan majikan yang berperanan untuk mengekalkan dan meningkatkan keadaan, persekitaran dan syarat pekerjaan dan menggunakan haknya untuk mencapai tujuan dan keperluan pekerja (Green, 1994; Mankiw, 2001). Berdasarkan senario di Malaysia, kesatuan sekerja merujuk kepada satu persatuan atau gabungan pekerja atau majikan yang bekerja di Malaysia dan keahliannya hendaklah terdiri daripada pekerja atau majikan dalam ketukangan, pekerjaan dan perindustrian yang tertentu atau yang seakan-akan sama. (Akta Kesatuan Sekerja 1959). Manakala menurut Poon (2002), kesatuan sekerja merujuk kepada satu pertubuhan pekerja atau majikan yang ditubuhkan untuk memajukan, memelihara dan memperbaiki kepentingan sosial, ekonomi serta politik ahli-ahlinya melalui tindakan kolektif

The invisible evil twin of an adrenal adenoma / Aimi Fadilah M … [et al.]

Primary aldosteronism (PA) causes a persistently elevated blood pressure (BP) due to excessive release of the hormone aldosterone from the adrenal glands. Classically, it is called Conn’s syndrome and is described as the triad of hypertension and hypokalemia with the presence of unilateral adrenal adenoma. It can be cured with surgical resection of the aldosterone-secreting adenoma leading to resolution of hypertension, hypokalemia and increased cardiovascular risk associated with hyperaldosteronism. We present a case of a man with previous ischemic heart disease (IHD) who presented with resistant hypertension. Investigations for secondary causes of hypertension revealed an elevated aldosterone level and saline suppression test confirmed the diagnosis of PA. Radiological examination revealed a left adrenal adenoma and a normal right adrenal gland. However, adrenal venous sampling showed lateralization of aldosterone secretion towards the right. He subsequently underwent a laparoscopic right adrenalectomy which improved his BP control promptly. This case highlights the importance of recognizing the need to investigate for secondary causes of hypertension. It also underscores the importance of dynamic tests, which may not be easily accessible to most clinicians but should pursue, to allow a definitive diagnosis and effective treatment

Analysing practice for prosthetic restoration among Major lower Limb Amputees with diabetes:from Northern Borneo Perspective

Diabetes is high in the agenda of public health issues with significant prevalence of diabetic-related amputations. Prosthetic restoration post-amputation is imperative to reduce disability, but its success is influenced by several factors. This study analysed the practice, and the determining factors affecting prosthetic restoration among major lower limb amputees with diabetes in Sabah. Methods: Retrospective cross-sectional study among 65 major lower limb amputees with diabetes referred for rehabilitation medicine services at Queen Elizabeth Hospital from0 1st January 2015 to 31st December 2017. Demographics data, pre-morbid diseases, levels of amputation and practice on prosthetic restoration (suitability for restoration, duration from prosthetic application to restoration, funding issue) are primary evaluated factors. Results: Forty-nine, fifteen and one amputees had below knee amputation, above knee amputation and hip disarticulation respectively. Forty-three amputees (66.2%) were deemed suitable for prosthetic restoration but only 27 were prosthetically restored, with mean duration from prosthetic application to restoration of 5.92±2.189 months. Having additional pre-morbid diseases did not reduced the likelihood of suitability for prosthetic restoration compared to those only with diabetes (p=0.082). Funding issue is the key factor affecting prosthetic restoration with higher likelihood for restoration among those eligible through governmental agencies funding (p=0.027). Conclusion: In Sabah, low rate of suitability for prosthetic restoration is observed among major lower limb amputees with diabetes. A larger study is warranted to investigate causes of such low rate of suitability for prosthetic restoration among this specific population in the effort to reduce public health burden from major lower limb amputation-related disability

Comparative analysis of Malaysian and Indonesian retirement plan

In Malaysia, the Employee Provident Fund (EPF) was established Under the Employees Provident Fund Act 1991 as a social security organisation that offers members trustworthy and efficient savings management and it is open to both personnel. In contrast, the Private Pension Administrator (PPA) developed the Private Retirement Scheme (PRS), a retirement programme, to address retirees' insufficient resources for meeting their retirement expenses in light of rising living standards and longer life expectancies. Having to see the similar aspects between EPF and PRS in terms of creating savings and their importance towards securing a certain degree of comfort for retirees, the purpose of this study is to provide a thorough explanation of how these two retirement plans can benefit all Malaysian private employees.. Similar to Malaysia, all private sector workers in Indonesia are also required to participate in retirement plan. Thus, the purpose of this study is to evaluate the similarities and differences between Malaysia's and Indonesia's retirement plan. This research employs a qualitative approach, by conducting library-based research on the relevant materials including, but not limited to statutory provisions, case laws, law textbooks, journal articles, newspapers, conference proceedings, and seminar papers. At the end of the discussion, the findings show that both countries have their own retirement plans and have the same goal which is to provide facilities to all private-sector workers

X-ray Diffraction, Electronic Circular Dichroism, and Quantum Mechanics (TD-DFT) Investigations on 4 Dehydroxyaltersolanol A, a Secondary Metabolite from Endophytic Fungus Nigrospora oryzae

Background and objectives: A tetrahydro anthraquinone derivative, 4-dehydroxyaltersolanol A, has been obtained from Nigrospora oryzae, which was isolated from Uncaria borneensis Havil as an endophytic fungus. This is a recently described compound whose stereochemistry was assumed from biogenetic considerations. However, using ECD spectral analysis in combination with TD-DFT calculations, its stereochemistry could be determined unambiguously. Method: In the current research, the selected TH1P45 culture was analysed using semi-preparative HPLC, which led to the isolation of six secondary metabolites, including 4-dehydroxyaltersolanol A (1). We have further presented full evidence of the stereochemistry of compound 1. With the help of quantum calculations, we also determined the mechanism by which this compound degrades in solution. Results: The analysis of TH1P45 culture led to the isolation of six secondary metabolites, including 4-dehydroxyaltersolanol A, three anthraquinone derivatives (macrosporin, bostrycin and altersolanol B), and two pyrones (pestalopyrone and hydroxypestalopyrone). Conclusion: A full evidence of the stereochemistry of compound 1 with the help of the combination of X-ray crystallography, ECD, and TD-DFT quantum calculations, allowed unambiguously assigning the absolute stereochemistry of 4 dehydroxyaltersolanol A as 1S,2R,3S as correctly assumed by Proksh and collaborators from biogenetic considerations

Parameter selection in data-driven fault detection and diagnosis of the air conditioning system

Data-driven fault detection and diagnosis system (FDD) has been proven as simple yet powerful enough to identify soft and abrupt faults in the air conditioning system, leading to energy saving. However, the challenge of data driven FDD is to obtain reliable operation data from the actual building. Therefore, a lab-scaled centralised chilled water air conditioning system was successfully developed in this paper. All necessary sensors were installed to generate reliable operation data for the data- driven FDD. Nevertheless, if a practical system is considered, the number of sensors required would be extensive as it depends on the number of rooms in the building. Hence, parameters impact in the dataset were also investigated to identify critical parameters for fault classifications. The analysis results had identified four critical parameters for data- driven FDD: the rooms' temperature, TTCx, supplied chilled water temperature, TCHWS, supplied chilled water flow rate, VCHWS, and supplied cooled water temperature, TCWS. Results showed that the data-driven FDD successfully diagnosed all six conditions correctly with the proposed parameters for more than 92.3% accuracy; only 0.6% - 3.4% differed fromthe original dataset's accuracy. Therefore, the proposed parameters can reduce the number of sensors used for practical buildings, thus reducing installation costs without compromising the FDD accuracy