Co-prescription of opioids with benzodiazepine and other co-medications among opioid users: differential in opioid doses

Purpose: This study investigated the patterns of opioid co-prescription with benzodiazepine and other concomitant medications among opioid users. Opioid dose in each type of co-prescription was also examined. Patients and methods: This cross-sectional study was conducted among opioid users receiving concomitant medications at an outpatient tertiary hospital setting in Malaysia. Opioid prescriptions (morphine, fentanyl, oxycodone, dihydrocodeine and tramadol) that were co-prescribed with other medications (opioid + benzodiazepines, opioid + antidepressants, opioid + anticonvulsants, opioid + antipsychotics and opioid + hypnotics) dispensed from January 2013 to December 2014 were identified. The number of patients, number of co-prescriptions and the individual mean opioid daily dose in each type of co-prescription were calculated. Results: A total of 276 patients receiving 1059 co-prescription opioids with benzodiazepine and other co-medications were identified during the study period. Of these, 12.3% of patients received co-prescriptions of opioid + benzodiazepine, 19.3% received opioid + anticonvulsant, 6.3% received opioid + antidepressant and 10.9% received other co-prescriptions, including antipsychotics and hypnotics. The individual mean opioid dose was <100 mg/d of morphine equivalents in all types of co-prescriptions, and the dose ranged from 31 to 66 mg/d in the coprescriptions of opioid + benzodiazepine. Conclusion: Among the opioid users receiving concomitant medications, the co-prescriptions of opioid with benzodiazepine were prescribed to 12.3% of patients, and the individual opioid dose in this co-prescription was moderate. Other co-medications were also commonly used, and their opioid doses were within the recommended dose. Future studies are warranted to evaluate the adverse effect and clinical outcomes of the co-medications particularly in long-term opioid users with chronic non-cancer pain

Latar Belakang Dan Pemikiran Ahli Majlis Penasihat Syariah (Mps) Di Malaysia Dan Implikasinya Terhadap Pembinaan Produk Pembiayaan Perumahan

The need to establish the Shariah Advisory Committee (MPS) in the Islamic banking institutions (IPI) as well as the monitoring by the Bank Negara Malaysia MPS at the national level has made the IPI Shariah governance framework more comprehensive. Nevertheless, the debate on the decisions and practices of Islamic banking products are still ongoing. The question is, why do these disputes arise when the verification and approval on the products are made by competent bodies? Based on the application of two different Shariah concepts in the home financing product that is bai` bithaman ajil (BBA) and musharakah mutanaqisah (MM), this study attempts to examine the implications of the background and thoughts of the members of the MPS on the practice of developing Islamic banking products. The review of the overall background of all MPS members in locally owned IPI were carried out using secondary data obtained from documents while aspects of their thoughts were examined through an empirical study. All data were analyzed using content analysis. The study found that the background of the MPS members were dominant in the field of religious studies followed by areas of Islamic law (Shariah) and the field of Islamic transactions (muamalat). In terms of experience, only 11.1 per cent of the members have served in MPS for a period 10 years and more and most of them are from the education sector. An analysis of the application of the Shariah concept in home financing shows the MM concept is more acceptable than the BBA concept

Student’s habits and preferences in digital game : a case of designing an educational game for primary schools student

The embedded technology in learning for primary school students is seen as a paradigm shift in education. However, in developing countries, technology is more actively utilised in higher education and secondary schools rather than primary school. Digital game, on the other hand, is much preferred by primary school students after their school time. Educational games or even entertainment games can be found online or in the market, however, most of the designs are not user centric. This paper will further discuss the initial study phase which was done to; (1) identify student’s habits towards digital game usage; (2) identify digital game design preferences by students and; (3) purposive sampling findings. This investigation is to identify interested and capable students in engaging future digital game design activities. In order to further investigateon students’ habits and game design preferences, we will use the first phase of PDEduGame framework process. Hence, a preliminary investigation was done with 287 primary school students aged 10 to 11 years old. The Islamic Religious Primary School (KAFA) in Selangor District was selected for this investigation purposes. The next part of this study is the elaboration on the methodology used during the investigation. Some teachers were interviewed to support the investigation. The results from the investigation will be further discussed and elaborated in the descriptively. Finally, from the results, we suggest the input generated for the initial study stage for the second stage of the participatory design framework process

The characterization of recycled concrete aggregate as filter in removal of phosphorus

Phosphorus (P) is one of the key nutrients that lead to eutrophication problem in surface water. However, the existing conventional wastewater treatment system to remove phosphorus is expensive and require a complex process. Therefore, a system using low cost and environmental friendly should be practiced to overcome this problem. Recycled concrete aggregate (RCA) used as a filter system emerged as an alternative technology for phosphorus removal. This can overcome the problem of construction site waste by converting the waste into something valuable products. Thus, this study aim to investigate the physical and chemical characteristic of RCA that influenced adsorption of P. RCA was analyzed using Scanning Electron Microscopy (SEM) and Energy-dispersive X-ray spectroscopy (EDX) testing to determine chemical composition. Results shows that RCA is highly contained with Aluminium, Calcium and Magnesium elements that enhanced the Phosphorus adsorption

KEBERKESANAN PENGAPLIKASIAN KERANGKA KECEMERLANGAN PERNIAGAAN MALAYSIA

Model perniagaan dirangka bagi membantu peniaga merancang dan menguruskan aktiviti perniagaan agar dapat bertahan dan berkembang. Bagi memastikan operasi perniagaan berjalan lancar, pembentukan dan pemilihan model perniagaan yang jelas amat diperlukan bagi perkembangan perniagaan. Model perniagaan adalah perancangan bagaimana syarikat mencari wang melalui pembelian dan penjualan barangan dan perkhidmatan. Di Malaysia, Kerangka Kecemerlangan Perniagaan Malaysia (MBEF) telah diperkenal dan digunakan bagi meningkatkan produktiviti perniagaan sebagai panduan kepada para peniaga ke arah kecemerlangan dalam perniagaan. Model perniagaan MBEF ini diharapkan dapat membantu para peniaga untuk mengembangkan perniagaan yang dijalankan. Oleh itu, kajian ini bertujuan untuk melihat sejauh mana keberkesanan model MBEF yang diaplikasikan dalam perniagaan di Malaysia. Kajian ini menggunakan pendekatan kualitatif dengan reka bentuk penerokaan. Data dikumpulkan melalui kaedah analisis dokumen dan temu bual dengan semi struktur. Data kemudiannya dianalisis menggunakan kaedah analisis kandungan. Dapatan kajian menunjukkan MBEF berupaya membantu syarikat seperti Sophia Taha Holdings Sdn Bhd (STHSB) dan Afy Haniff Group (M) Sdn Bhd dalam pengeluaran produk dan penyediaan perkhidmatan terbaik. MBEF juga membuktikan pemilihan model perniagaan yang tepat mampu mengoptimumkan keuntungan, menambah baik sistem pengurusan serta membantu perkembangan perniagaan ke peringkat global. The business model is designed to assist merchants in planning and managing business activities in order to ensure the survival and longevity of their businesses. The formation and selection of a good business model are crucial for business development in order to provide the smooth running of the business. A company's business model describes how it produces money by buying and selling goods and services. In Malaysia, the Malaysian Business Excellence Framework (MBEF) has been introduced and is being used to boost business productivity and steer merchants toward business excellence. The MBEF business model is expected to assist traders in expanding their operations. As a result, this research aims to see how effective the MBEF model is in Malaysian companies. This is a qualitative study with an exploratory study design. Data was gathered through document analysis and semi structured interview. The data were analyzed using content analysis method. The findings show that MBEF can help businesses like Sophia Taha Holdings Sdn Bhd (STHSB) and Afy Haniff Group (M) Sdn Bhd produce high-quality products and provide excellent service. MBEF also demonstrates that selecting a suitable business model may increase profitability, improve management processes, and aid global business expansion. &nbsp;Model perniagaan dirangka bagi membantu peniaga merancang dan menguruskan aktiviti perniagaan agar dapat bertahan dan berkembang. Bagi memastikan operasi perniagaan berjalan lancar, pembentukan dan pemilihan model perniagaan yang jelas amat diperlukan bagi perkembangan perniagaan. Model perniagaan adalah perancangan bagaimana syarikat mencari wang melalui pembelian dan penjualan barangan dan perkhidmatan. Di Malaysia, Kerangka Kecemerlangan Perniagaan Malaysia (MBEF) telah diperkenal dan digunakan bagi meningkatkan produktiviti perniagaan sebagai panduan kepada para peniaga ke arah kecemerlangan dalam perniagaan. Model perniagaan MBEF ini diharapkan dapat membantu para peniaga untuk mengembangkan perniagaan yang dijalankan. Oleh itu, kajian ini bertujuan untuk melihat sejauh mana keberkesanan model MBEF yang diaplikasikan dalam perniagaan di Malaysia. Kajian ini adalah berbentuk penerokaan menggunakan pendekatan kualitatif. Data dikumpul dari pelbagai dokumen dan dianalisis menggunakan kaedah analisis tematik. Dapatan kajian menunjukkan MBEF berupaya membantu syarikat seperti Sophia Taha Holdings Sdn Bhd (STHSB) dan Afy Haniff Group (M) Sdn Bhd dalam pengeluaran produk dan penyediaan perkhidmatan terbaik. MBEF juga membuktikan pemilihan model perniagaan yang tepat mampu mengoptimumkan keuntungan, menambah baik sistem pengurusan serta membantu perkembangan perniagaan ke peringkat global. Kata kunci: model perniagaan, kerangka kecemerlangan perniagaan Malaysia (MBEF), Malaysia, perniagaa

The efficiency in executing the laws and their enforcement regarding pig's waste management: a case study on the Nipah virus outbreak in Negeri Sembilan / Nurul'ain Shafie … [et al.]

Nowadays, pork is the most consumed meat by the people all around the world. Due to this fact, there is an increase demand of pork and intensive pigs rearing have to be done in order to meet the consumers need. The usual problem with the intensive pigs rearing is the improper pig's waste management which eventually will lead to other problems such as environmental pollution and affecting the public's health. This research focuses on the laws and their execution regarding pig's waste management and also to figure out the link between pig's waste management and the outbreak of Nipah virus in Negeri Sembilan in 1999. The final outcome from this research is that the laws and their execution regarding pig's waste management are sufficient and there is no connection between pig's waste management and the outbreak of Nipah virus

Mathematics teachers’ preparation program: Determining the balance between contents in mathematics and pedagogy

Teacher educators in the university need to know what types of knowledge and what levels of knowledge acquisition are necessary to become effective mathematics teachers; and what contexts are most conducive to learning how to teach. One theoretical model of teacher knowledge suggests seven domains of teachers' professional knowledge: knowledge of subject matter, pedagogical content knowledge, knowledge of other contents, knowledge of the curriculum, knowledge of learners, knowledge of educational aims, and general pedagogical knowledge (Shulman & Grossman, 1988; Wilson et al., 1987). Graham et al. (2000) found that in most institutions, content courses are typically taught in the mathematics departments and methods by the faculty of education. He asserted that division may foster a perspective that methods are unrelated to content or that content is more important than method. A study was conducted to identify the emphasis in the contents of the mathematics education curriculum in Malaysian universities. Based on the types of mathematics education programs offered, students preparedness to become teachers are revealed based on their confidence to teach, pedagogical content knowledge, views of mathematics, aspects that need be emphasized in teaching and their perceived importance of aspects to be incorporated in teaching

Performance of Recycled Aggregate Concrete Containing Micronised Biomass Silica

This paper presents a study on Micronised Biomass Silica (MBS) that was produced from the controlled burning of waste Rice Husk. The MBS was used as pozzolan material to enhance the performance of Recycled Aggregate Concrete (RAC). Various percentages by mass of Micronised Biomass Silica were applied in the normal and recycled aggregate concrete cube samples. Compressive strength and water permeability tested on the samples at the age of 7, 14, 28 and 90 days showed that concrete containing MBS has attained higher compressive strength. Furthermore, the test on MBS also showed its ability to enhance the concrete water permeability. Lengthen to this; the study established a good correlation between the MBS content with compressive strength and water permeability coefficient

Factors associated with prescription opioid overdose deaths in patients with non-cancer pain: a literature review

Opioid analgesics have increasingly been prescribed in the treatment of non -cancer pain and this trend has accompanied increasing rates of opioid overdose deaths (ODs). Little is known about the factors that may predispose an individual to being at risk for fatal overdose from prescription opioids. This review examined factors associated with prescription opioid overdose deaths in patients with non-cancer pain. A comprehensive literature search was conducted for studies published from 2004 to 2014 using databases such as Science Direct, PubMed, Web of Science, Cochrane review and Scopus. Articles were included if they were original research studies written in English that reported deaths with prescription opioid overdose in patients with non-cancer pain. A total of 18 studies met the inclusion criteria and were included. Fndings from the review demonstrated that concomitant use of opioids with benzodiazepines (polysubstance use) was the main factor associated with opioid ODs. Codeine and oxycodone were more commonly reported to cause opioid ODs and opioid doses of more than 100 mg per day in morphine equivalents have higher risk to cause ODs. Other factors included male patients, middle aged and having mental illness. Prescription opioid overdose deaths were primarily caused by concomitant use of opioid with benzodiazepines. Further research is required to examine the trend and patterns of this co-prescribing. The guidelines on opioid prescribing and education on opioids for both patients and physicians should be emphasized to reduce fatalities from overdose while enhancing the safe prescribing of opioids