Relationship between traditional Malaysian vegetables (ulam) intake and cognitive status among middle-aged adults from low cost residential areas

Ulam is fresh traditional Malaysian vegetables which normally consumed in raw form or after a short blanching process. It contains high antioxidants and polyphenols. However, there is limited study about the relationship between ulam consumption and cognitive status. Thus, a cross sectional study was conducted to determine the relation with cognitive function among 132 middle-aged Malays adults (45-59 years old), recruited by convenient sampling from low income residences in Klang Valley. Respondents were interviewed to obtain data on sociodemography, dietary intake and total ulam intake and also measured for anthropometric parameters at respective community centres. Cognitive status was measured using Digit Span (attention and working memory), Rey auditory verbal learning test (RAVLT) (verbal memory) and comprehensive trail making test (CTMT) (cognitive flexibility). The average ulam intake by the respondents was 15.1 ± 8.2g/day and the top five highest consumed ulam were petai (68.1%), pucuk paku (62.9%), ulam raja (56.8%), pegaga (54.6%) and kesum (44.7%).There was a significant correlation between ulam intake with Digit Span (r = 0.265, p = 0.006), total immediate recall of RAVLT (r = 0.427, p < 0.001) and CTMT (r = 0.257, p = 0.007). Analysis of multiple regression indicated that total ulam intake was a significant predictor for Digit Span (R2 = 0.152, p < 0.05), RAVLT (R2 = 0.335, p = 0.001) and CTMT (R2 = 0.310, p < 0.001). In conclusion, this study showed that ulam has the potential to protect against cognitive decline, however, randomized control trials should be conducted to determine the efficacy of the ulam as neuroprotective agent

A preliminary study on identifying the level of student engagement in blended learning

Blended learning is one of the learning methods used in any educational institution worldwide. It involves a combination of face-to-face learning and teaching with students using computer technology. Therefore, student engagement is essential to ensure the efficiency of blended learning. However, blended learning is found challenging where active collaboration between lecturers and students are highly needed to integrate learning. To overcome the issue, Polytechnic provides a Learning Management System known as the Curriculum Information Document Online System or known as CIDOS. CIDOS is a fully automated document management platform that manages the uploading, downloading, updating, and sharing digital content through a single integrated component. This study aims to determine the level of student engagement in blended learning at Polytechnic, Kota Kinabalu. A preliminary study with 125 students found that students are medium in the learning management system, which is CIDOS

Pembentukan persamaan untuk menganggar berat badan dalam kalangan warga emas di Lembah Klang

Berat badan mungkin boleh dianggarkan dengan menggunakan persamaan yang dibentuk daripada pengukuran antropometri, apabila berat badan sukar untuk diukur dalam kalangan warga emas yang terlantar. Objektif kajian ini ialah untuk membentuk persamaan menganggar berat badan dalam kalangan warga emas yang tinggal di Lembah Klang daripada beberapa pengukuran antropometri. Kajian hirisan lintang ini dijalankan dalam kalangan warga emas yang tinggal di komuniti, berumur 60 tahun dan ke atas di kawasan Lembah Klang. Subjek direkrut berdasarkan kaedah persampelan mudah. Berat badan, ketinggian berdiri, ketinggian lutut (KH), demi-span (DS), lipatan kulit subskapula (SSF), ukurlilit betis (CC), ukurlilit pinggang (WC), ukurlilit pinggul (HC), ukurlilit pertengahan lengan atas (MUAC) dan ukurlilit pergelangan tangan (WrC) diukur mengikut protokol yang standard. Validasi silang telah dilakukan. 61% daripada jumlah subjek yang dipilih secara rawak adalah untuk pembentukan persamaan manakala 39% subjek adalah subjek kawalan. Persamaan dibentuk menggunakan analisis regresi berganda secara berperingkat. Seramai 164 orang warga emas telah terlibat dalam kajian ini terdiri daripada 39.0% subjek lelaki dan 61.0% subjek perempuan. Min umur subjek ialah 68.32 ± 5.79 tahun manakala min untuk berat badan yang diukur ialah 66.46 ± 11.98 kg. Persamaan yang dibentuk untuk menganggar berat badan ialah: anggaran berat badan = 5.149 (Jantina) – 0.082 (Umur) + 0.889 (Ukurlilit pinggul) + 1.112 (Ketinggian lutut) – 72.778 (R2 = 0.848, p < 0.001). Nilai korelasi bagi 61% subjek lebih tinggi (r = 0.921) berbanding nilai korelasi untuk 39% subjek (r = 0.883). Walau bagaimanapun, perbezaan antara berat badan yang diukur dengan berat badan anggaran adalah tidak signifikan (p = 0.798). Ini menunjukkan persamaan yang dibentuk boleh menganggar berat badan dalam kalangan warga emas, kerana nilai berat badan anggaran adalah hampir sama dengan nilai berat badan yang diukur. Kesimpulannya, persamaan yang dibentuk boleh digunakan untuk menganggar berat badan dalam kalangan warga emas, kerana nilai berat badan anggaran adalah hampir dengan nilai berat badan yang diukur. Persamaan yang dibentuk boleh digunakan untuk menganggar dalam kalangan warga emas di Malaysia. Namun begitu, kajian lanjutan ke atas populasi warga emas dalam latar klinikal diperlukan untuk memastikan bahawa persamaan yang dibentuk boleh digunakan untuk latar yang berlainan seperti dalam latar klinikal

More ulam for your brain: a review on the potential role of ulam in protecting against cognitive decline

Ulam is the South East Asian traditional vegetables which contains high total phenolic content and exhibits antioxidant activity. Several studies have reported the potential of neuroprotective effect of ulam. The objective of this review article was to highlight the total phenolic content (TPC) and antioxidant activity of ulam and the roles of phenolic content that can contribute to attenuation of cognitive decline. The review includes randomized controlled trial and experimental studies from year 2007 to 2017. In this review, PRISMA method was used to report the results (n=15). Phenolic compounds, ie plants’ second metabolites of selected ulam in South East Asia were also discussed in this review, with respect to its potential for health promotion which and reducing the risk of cognitive disease. Oenanthe javanica (selom), Ocimum basilicum (daun selasih) and Anacardium occidentale L. (pucuk gajus) were ranked in the top three highest TPC among all the selected ulam. In general, Polygonum minus (kesum), Anacardium occidentale L. (pucuk gajus) and Cosmos caudatus (ulam raja) exhibited high DPPH radical scavenging activity whereas Anacardium occidentale L. (pucuk gajus) exhibited highest ferric ion reducing potential (FRAP) among all the selected ulam in South East Asia countries. Overall, some studies had shown Centella asiatica (pegaga), Oenanthe javanica (selom), Polygonum minus (kesum), Ocimum basilicum (daun selasih) and Murraya koenigii (daun kari) are beneficial in improving cognitive status and mood. The bioactive compounds in ulam may exhibit neuroprotective effects but human studies are still lacking in exploring the relationship between ulam consumption and cognitive status

Which aging group prone to have inadequate nutrient intake?: TUA study

Older adults quite often had an inadequate diet leading to micronutrient deficiencies and impaired immune response with subsequent development of degenerative diseases. This study aimed to determine the adequacy of energy and nutrient intake and its distribution among three aging groups i.e. successful aging (SA), usual aging (UA) and mild cognitive impairment (MCI). This is a cross-sectional study involving a large sample size (n = 2322) of older adults recruited through multistage random sampling from four states of Malaysia. An interview was conducted to measure dietary intake, neurocognitive status and functional status by using the Diet History Questionnaire (DHQ), Mini-Mental State Examination (MMSE), Rey Auditory Learning Test (RAVLT), Geriatric Depression Scale (GDS), Instrumental Activity of Daily Living (IADL) and Quality of Life Questionnaire. For comparison of dietary intake, a sub-sample of 173 respondents from each aging groups were matched and selected using a comparative cross-sectional approach. Women in SA group had the highest mean intake of vitamin A, calcium (p <0.05), vitamin C, riboflavin and iron (p<0.001). The same aging group also achieved the highest RNI percentage for the same nutrients. More than 80% of respondents for all aging groups did not met the recommended nutrient intake (RNI) for vitamin E, thiamin, niacin, folate, calcium and zinc. In women, MCI respondents were more likely to have an inadequate intake of vitamin A, C, riboflavin and iron followed by UA and SA. Inadequate vitamin E, niacin, folate and calcium were prevalent among all gender and aging groups. There is a need to further distinguish specific dietary patterns associated with these three aging groups to promote optimal nutrient intake for cognitive health

Mood, cognitive function and quality of life improvements in middle aged women following supplementation with Polygonum minus extract

Polygonum minus is a plant rich in flavonoids and antioxidants beneficial for reducing oxidative stress and lipid peroxidation in neuronal membranes. This randomized, double-blind, placebo-controlled study evaluated the potential benefits of P. minus extract (LineMinusTM) towards improving cognitive function, mood status and quality of life. Thirty five middle-aged women (35-55 years old) were randomized into intervention (n=17) and control group (n=18). Two capsules of P. minus (250 mg) or placebo (100 mg maltodextrin) each were taken once daily for six weeks. Cognitive tests, mood and anthropometric measurements were measured at baseline, week 3 and week 6, whilst biomarkers were measured at baseline and week 6. Parameters related to mood and quality of life including energy/fatigue, social functioning and general health significantly improved from baseline to week 6 in the intervention group (p<0.05). Mean score for cognitive tests (i.e. digit span, comprehensive trail making test (CTMT) and three domains of CNS vital sign (CNSVS)] improved significantly in both intervention and control groups (p<0.05). There was a significant decrease of mean uric acid, estimated glomerular filtration rate (eGFR), total cholesterol and glycated hemoglobin (HbA1C) in the intervention group from baseline to week 6. P. minus supplementation has the potential to improve mood and quality of life and no adverse effects were reported by the participants after 6 weeks supplementation

Influence of fruit and vegetable intake on satiety and energy intake: a review

Fruit and vegetable are the natural foods that contained various nutrients vital for good health and help in weight loss by suppressing an individual’s appetite. Therefore, this review aimed to investigate the acute effect of fruit and vegetable intake on satiety and energy intake. We included randomized controlled trial or experimental designs measuring fruit and/or vegetable intake on satiety using subjective appetite rating and appetite related hormone and energy intake among healthy adults, published in English-language. The use of extract, powder form or concentrated fruit and/or vegetable and animal study were excluded. Twelve studies were identified from Pubmed, Science Direct and Cochrane from the year 1995 to August 2017, consists of six studies on fruit and six studies on vegetable. This review discussed the preload of fruit and vegetable in promoting satiety and reducing the energy intake. Manipulating energy density rather than portion size was effective in reducing total energy intake and promotes satiety. Fruit and vegetable in solid form had a greater satiety effect and significantly reduce energy intake compared to liquid or pureed form. The variation in time interval between fruit and/or vegetable intake and the test meal may also account a significant effect on satiety up to 2 h and diminished 3 h onward. The satiety effect of fruit and vegetable would be beneficial in body weight management

Hubungan antara status mood dan fungsi kognitif dalam kalangan warga emas yang mempunyai kecelaan kognitif ringan

Terdapat beberapa bukti menyatakan bahawa status mood mampu mempengaruhi fungsi kognitif dari segi ingatan episodik, ingatan kerja dan penyelesaian masalah. Kajian ini dijalankan untuk menilai hubungan antara status mood dan fungsi kognitif dalam kalangan warga emas yang mempunyai Kecelaan Kognitif Ringan (MCI). Kajian ini melibatkan 12 orang lelaki dan 37 orang wanita dari Lembah Klang yang berusia 60 tahun ke atas. MCI ditakrif berdasarkan kriteria yang dicadangkan oleh Peterson. Fungsi kognitif subjek dinilai dengan menggunakan ujian Mini Mental State (MMS), Rey Auditory Verbal Learning (RAVL), Digit Span, Digit Symbol Substituition (DSS) dan Visual Reproduction; Manakala status mood termasuk ketegangan, kemurungan, kemarahan, kecergasan, penghargaan diri, keletihan dan kekeliruan dinilai melalui soal selidik Profile of Mood States (POMS). Jumlah skor subskala positif dan negatif serta jumlah gangguan mood (Total Mood Disturbance) juga dikira. Hasil kajian ini menunjukkan korelasi positif antara ketegangan (r = 0.325, p = 0.30), kecergarsan (r = 0.235, p = 0.036) dengan ingatan episodik lisan yang dinilai dengan ujian RAVL. Di samping itu, korelasi positif juga dapat diperhatikan antara kecergasan (r = 0.228, p = 0.035) dan skor subskala positif (r = 0.237, p = 0.025) dengan ujian DSS yang menilai kelajuan pemprosesan kognitif. Ujian regresi berganda juga menunjukkan bahawa subjek mempunyai penghargaan diri yang tinggi [OR = 0.390, 95% CI [0.069-0.711], p = 0.019) dan ketegangan (OR = 0.253, 95% CI [0.075-0.431) p = 0.007) mempunyai ingatan episodik yang lebih baik. Skor subskala positif yang lebih tinggi juga mempunyai berhubungkait dengan kelajuan pemprosesan kognitif yang lebih pantas (OR = 0.856, 95% CI [0.099-1.614], p = 0.028). Kesimpulannya, warga emas yang mempunyai mood yang lebih positif adalah lebih cenderung kepada ingatan jangka pendek yang lebih baik dan kelajuan pemprosesan yang lebih cekap

Methodology approaches and challenges in population‐based longitudinal study of a neuroprotective model for healthy longevity

Aim: The 36‐month Long‐Term Research Grant Scheme project: Towards Usual Aging – Neuroprotective Model for Healthy Longevity among Malaysian Elderly was designed to address multidimensional aspects including psychosocial, biophysical health, nutrition and dietary pattern, and auditory and visual function to highlight the magnitude of these associations in a single study. Methods: A total of 2322 respondents aged ≥60 years were recruited at baseline using the multistage sampling method, followed up at 18 months and 36 months. Results: Response rates at baseline, 18 months and 36 months were 87.8%, 77.3% and 67.1%, respectively. At baseline, the prevalence of successful aging, usual aging and mild cognitive impairment was 11%, 73% and 16%, respectively. The prevalence of single and multimorbidity at baseline were 25.9% and 50.3%, respectively. The incidence rates of mild cognitive impairment at 18 months and 36 months were 6.5 and 5.6 per 100 person‐years. The incidence rates of multimorbidity at 18 months and 36 months were 23.7 and 21.5 per 100 person‐years, respectively. Conclusions: The Long‐Term Research Grant Scheme project: Towards Usual Aging study provides an opportunity to investigate the interactions between wide ranges of aspects of the older population in a nationally representative sample of the older population

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030