Efficacy Of Calcium Supplementation And Weightbearing Exercise On Bone Mineral Density In Postmenopausal Chinese Women

The etiology of age-related bone loss is unclear but both habitually low calcium intake and lack of physical activity have been proposed as its determinants. The objective of this two-year randomized controlled trial was to evaluate the efficacy of increasing calcium intake and weight-bearing exercise on bone mineral density (BMD) in postmenopausal Chinese women who were not on hormone replacement therapy. Bone mineral density at the total body, lumbar spine L2-L4, femoral neck, Ward's triangle, trochanter and total hip were measured using dual energy X-ray absorptionmetry (DEXA) at six month intervals. Information on sociodemographic background, lifestyle factors and reproductive history were assessed using a validated questionnaire. Calcium intake was evaluated by both the three-day food record and food frequency questionnaire at baseline, 1 2 and 24 months. Exercise habits were assessed with an exercise diary and Physical Activity Scale for the Elderly (P ASE) questionnaire

Phylogenetic evidence for inter-typic recombination in the emergence of human enterovirus 71 subgenotypes

BACKGROUND: Human enterovirus 71 (EV-71) is a common causative agent of hand, foot and mouth disease (HFMD). In recent years, the virus has caused several outbreaks with high numbers of deaths and severe neurological complications. Several new EV-71 subgenotypes were identified from these outbreaks. The mechanisms that contributed to the emergence of these subgenotypes are unknown. RESULTS: Six EV-71 isolates from an outbreak in Malaysia, in 1997, were sequenced completely. These isolates were identified as EV-71 subgenotypes, B3, B4 and C2. A phylogenetic tree that correlated well with the present enterovirus classification scheme was established using these full genome sequences and all other available full genome sequences of EV-71 and human enterovirus A (HEV-A). Using the 5' UTR, P2 and P3 genomic regions, however, isolates of EV-71 subgenotypes B3 and C4 segregated away from other EV-71 subgenotypes into a cluster together with coxsackievirus A16 (CV-A16/G10) and EV-71 subgenotype C2 clustered with CV-A8. Results from the similarity plot analyses supported the clustering of these isolates with other HEV-A. In contrast, at the same genomic regions, a CV-A16 isolate, Tainan5079, clustered with EV-71. This suggests that amongst EV-71 and CV-A16, only the structural genes were conserved. The 3' end of the virus genome varied and consisted of sequences highly similar to various HEV-A viruses. Numerous recombination crossover breakpoints were identified within the non-structural genes of some of these newer EV-71 subgenotypes. CONCLUSION: Phylogenetic evidence obtained from analyses of the full genome sequence supports the possible occurrence of inter-typic recombination involving EV-71 and various HEV-A, including CV-A16, the most common causal agent of HFMD. It is suggested that these recombination events played important roles in the emergence of the various EV-71 subgenotypes

The Effects of Management Controls and National Culture on Manufacturing Performance: an Experimental Investigation

The increasing dominance of Asian manufacturing firms in the global economy has raised an important issue: whether these firms' superior manufacturing performance is caused by their management control systems, the national culture of their employees, or the interaction of these two factors. This experimental study provides a direct test of the effects of national culture and management control system on manufacturing performance. The dimension of national culture studied was individualism ( vs collectivism )because this work-related attribute has been noted as a major difference between Asian and Western cultures. In turn, the focus on cultural individualism motivated a study of two aspects of management controls: work flow interdependence and pay interdependence. The results are consistent with cultural individualism and management controls having independent, but not interactive, effects on manufacturing performance. The potential implications of these findings and suggestions for future research are discussed

Correlations between anthropometric measurements, biochemical indicators, dietary intake and Dialysis Malnutrition Score among haemodialysis patients in Sibu, Sarawak

Introduction: Malnutrition is a common problem associated with increased risk of morbidity and mortality among haemodialysis (HD) patients. Methods: This study determined the correlation between anthropometric measurements, biochemical indicators, dietary intake and dialysis malnutrition score among HD patients in Sibu, Sarawak. A total of 55 patients were recruited by purposive sampling and their biochemical parameters were retrieved from dialysis records. Anthropometric measurements and dietary intake were determined using standardised protocols while Dialysis Malnutrition Score (DMS) was computed to determine patients’ nutritional status. Results: Mean age of the patients was 53.0±12.2 years. Mean DMS was low, indicating low tendency of malnutrition among the patients. Approximately one-third of the patients had high interdialytic weight gain (IDWG), indicating a poor adherence on fluid recommendation. Mean intakes of dietary energy (DEI) and protein (DPI) were low, with only approximately 15% achieving the recommendations according to Kidney Disease Outcomes Quality Initiative (K/ DOQI). Increase in age (r=0.337, p=0.012) and dialysis vintage (r=0.403, p=0.002) were associated with poorer nutritional status while higher BMI, MUAC, and serum albumin were associated with better nutritional status. Conclusion: This study revealed a high proportion of the HD patients with poor adherence on fluid intake, and the prevalence of inadequate DEI and DPI, indicating the importance of regular dietary counselling for HD patients. In view of their non-invasive nature and close relationship with nutritional status, body mass index, mid-upper arm circumference, and serum albumin should be included as part of the comprehensive periodic nutrition assessment of HD patients

The interactional dynamics of parental identity performances : A study of narratives of first-time parents

Master'sMASTER OF ART

Correlation of cognitive impairment with constipation and renal failure

The improvement of health care support has greatly extended the average life expectancy over the last 50 years, which has increased the rate of cognitive decline consequently. The avoidance of risk factors such as toxins, stress and somatic diseases can be protective against the reduction of cognitive function in the elderly. This study aimed to determine the effects of socio-demographic factors, constipation and renal failure on cognitive status among 2322 samples who were the non-institutionalized Malaysian elderly. The multiple logistic regression analysis was applied to estimate the risk of such factors on cognitive decline in subjects. Approximately, 77.54% of samples experienced cognitive impairment. The results showed that advanced age (odds ratio (OR) = 1.03), Malay ethnic (OR = 2.15), constipation (OR = 3.31) and renal failure (OR= 4.42), significantly increased the risk of cognitive impairment in subjects (p<0.05). In addition, education (OR = 0.38) significantly reduced the risk. However, we concluded that age, Malay ethnic, constipation and renal failure increased the risk of cognitive impairment in subjects but education reduced the risk

Correlates of physical activity level among hemodialysis patients in Selangor, Malaysia.

INTRODUCTION: There is mounting evidence demonstrating the importance of adequate physical activity to promote better well-being among hemodialysis patients. Available data pertaining to the levels of physical activity and its determinants among hemodialysis patients is, however, scarce in Malaysia. The objectives of this study are hence to determine the levels of physical activity and it associated factors among hemodialysis patients. METHODOLOGY: A total of 70 subjects were recruited from three dialysis centres in Selangor. A face-to-face interview was conducted to obtain socio-demographic data and subjects' knowledge on dietary sources. Medical history, biochemical parameters and weight status were obtained from medical records. Physical activity level (PAL) was assessed using the Global Physical Activity Questionnaire (GPAQ). RESULTS: A total of 81.4% and 18.6% of the respondents had low and moderate PALs, respectively. Thus, none of the respondents had high PAL. Serum creatinine, education level, personal income and knowledge score on potassium-related medical complications were factors found to correlate significantly with PAL. Multiple linear regression analysis showed that higher PAL was predicted by a lower knowledge score on dietary sodium source, higher education and higher serum creatinine. CONCLUSION: Despite consistent documentation of the potential positive impact of physical exercise on hemodialysis outcomes, the level of physical activity remains low among these patients. It is hoped that these findings can add to the existing body of knowledge and serve as a supporting document for the formulation of appropriate interventions to improve the status of physical activity among hemodialysis patients in Malaysia

Recent developments in antiviral agents against enterovirus 71 infection

Enterovirus 71 (EV-71) is the main etiological agent of hand, foot and mouth disease (HFMD). Recent EV-71 outbreaks in Asia-Pacific were not limited to mild HFMD, but were associated with severe neurological complications such as aseptic meningitis and brainstem encephalitis, which may lead to cardiopulmonary failure and death. The absence of licensed therapeutics for clinical use has intensified research into anti-EV-71 development. This review highlights the potential antiviral agents targeting EV-71 attachment, entry, uncoating, translation, polyprotein processing, virus-induced formation of membranous RNA replication complexes, and RNA-dependent RNA polymerase. The strategies for antiviral development include target-based synthetic compounds, anti-rhinovirus and poliovirus libraries screening, and natural compound libraries screening. Growing knowledge of the EV-71 life cycle will lead to successful development of antivirals. The continued effort to develop antiviral agents for treatment is crucial in the absence of a vaccine. The coupling of antivirals with an effective vaccine will accelerate eradication of the disease

Phosphorus contents of raw chicken meat and processed chicken meat products

Introduction: The per capita consumption of chicken meat and related products has increased steadily in Malaysia, as it is affordable and can be consumed without religious constraints. There is concern for the widespread use of phosphate additives in processed meats, which may lead to hyperphosphatemia, especially among chronic kidney disease (CKD) patients. The objective of this study was to determine and compare the phosphorus content in raw chicken breast meat (RCBM) and selected processed chicken meat products. Methods: Samples of RCBM, chicken frankfurters, chicken patties and chicken nuggets of different brands were studied. The phosphorus content of the samples were determined via the dry ashing method and a Perkin-Elmer 5300DV inductively coupled plasma-optical emission spectrometer (ICP-OES). Results: The mean phosphorus content in RCBM was 209.15±3.13 mg per 100 g. Chicken nuggets contained the highest phosphorus content, followed by RCBM, chicken patties and chicken frankfurters. Compared to the RCBM, the mean phosphorus content of chicken frankfurters and chicken patties were 21.42% and 4.81% respectively lower, whilst that of chicken nuggets was 1.74% higher. The same type of chicken meat products from different brands also differed significantly in their phosphorus content. Conclusion: There were significant differences in the phosphorus content among different types of chicken meat products, and among the same chicken meat products from different brands. Caution should be exercised, especially by CKD patients, in consuming processed chicken meat products due to the risk posed to them by phosphorus content

The trans fatty acid content in human milk and its association with maternal diet among lactating mothers in Malaysia

Excessive intake of trans fatty acids (TFA) could reduce the fat density of human milk and impair the desaturation of essential fatty acids. Because the mammary glands are unable to synthesize TFA, it is likely that the TFA in human milk come from dietary intake. Thus, the aim of this study was to investigate the sources of TFA intake for lactating mothers in one of the urban areas in Selangor. In this cross-sectional study, anthropometric measurements, FFQ including 7 food groups and dietary consumption data were collected from 101 lactating mothers. Five major TFA isomers (palmitoelaidic acid (16:1t9), petroselaidic acid (18:1t6), elaidic acid (18:1t9), vaccenic acid (18:1t11) and linoelaidic acid (18:2t9,12) in human milk were measured by gas chromatography (GC). The relationship between food consumption and TFA levels was assessed using the non-parametric Spearman's rho test. The TFA content in human milk was 2.94±0.96 (SEM) % fatty acid; this is considered low, as it is lower than 4%. The most abundant TFA isomer was linoelaidic acid (1.44±0.60% fatty acid). A sub-experiment (analyzing 3 days of composite food consumption) was conducted with 18 lactating mothers, and the results showed that linoelaidic acid was the most common TFA consumed (0.07±0.01 g/100 g food). Only 10 food items had an effect on the total TFA level and the isomers found in human milk. No association was found between TFA consumption and the TFA level in human milk