Spirituality, religiosity, and the quality of life among elderly adults in Malaysia

Malaysian older adults will be accounted for 10% of the population by 2020 as the consequence of the global ageing demographic revolution. Malaysian studies showed poor quality of life (QOL) among Malaysian older adults despite their long life expectancy. Studies showed the positive relationship between religiosity, spirituality, and QOL. However, previous studies did not distinguish spirituality from religiosity and it has presented insufficient persuasiveness of findings. This study aims to investigate spirituality and religiosity as the predictors for QOL. Quantitative and cross-sectional survey designs were used in this study. 180 participants from aged 60 to 88 were recruited. This study used multiple linear regression analysis to examine the predictors of religiosity and spirituality on QOL. The result showed only spirituality predicted QOL among elderly adults, but not religiosity. The findings of the study implied the importance of internalising spiritual virtues instead of focusing on religious activities which may not improve QOL among older adults significantly

Factors Affecting Employee Commitment to Change in Malaysia Service Organizations: The Moderating Impact of Organization Culture

Organizational change has been receiving tremendous concern lately as the everchanging environment causes companies to succumb to changes. Employee commitment towards change is detrimental in an organizational change. This research aims to investigate the factors that affect employee commitment to change and to examine the moderating effect of organization culture in service organizations. A total of 190 responses was collected from the employees working in the service organizations in Malaysia. Smart PLS 3.0 was used for data analysis. The proposed research model was assessed based on path modeling and bootstrapping. The findings found that among the four factors, only quality of relationship with the manager, fit of change with vision, and job motivation are significantly related to employee commitment to change. Moreover, the results have found no empirical evidence to support the moderating role of organization culture. The implications, limitations and future research were further discussed in this research

Induction of cell cycle arrest and apoptosis by copper complex Cu(SBCM)₂ towards oestrogen-receptor positive MCF-7 breast cancer cells

Copper complexes have the potential to be developed as targeted therapy for cancer because cancer cells take up larger amounts of copper than normal cells. Copper complex Cu(SBCM)2 has been reported to induce cell cycle arrest and apoptosis towards triple-negative breast cancer cells. Nevertheless, its effect towards other breast cancer subtypes has not been explored. Therefore, the present study was conducted to investigate the effect of Cu(SBCM)₂ towards oestrogen-receptor positive MCF-7 breast cancer cells. Growth inhibition of Cu(SBCM)₂ towards MCF-7 and human non-cancerous MCF-10A breast cells was determined by MTT assay. Morphological changes of Cu(SBCM)2-treated-MCF-7 cells were observed under an inverted microscope. Annexin V/PI apoptosis assay and cell cycle analysis were evaluated by flow cytometry. The expression of wild-type p53 protein was evaluated by Western blot analysis. The intracellular ROS levels of MCF-7 treated with Cu(SBCM)₂ were detected using DCFH-DA under a fluorescence microscope. The cells were then co-treated with Cu(SBCM)₂ and antioxidants to evaluate the involvement of ROS in the cytotoxicity of Cu(SBCM)2. Docking studies of Cu(SBCM)2 with DNA, DNA topoisomerase I, and human ribonucleotide reductase were also performed. The growth of MCF-7 cells was inhibited by Cu(SBCM)2 in a dose-dependent manner with less toxicity towards MCF-10A cells. It was found that Cu(SBCM)₂ induced G2/M cell cycle arrest and apoptosis in MCF-7 cells, possibly via a p53 pathway. Induction of intracellular ROS was not detected in MCF-7 cells. Interestingly, antioxidants enhance the cytotoxicity of Cu(SBCM)2 towards MCF-7 cells. DNA topoisomerase I may be the most likely target that accounts for the cytotoxicity of Cu(SBCM)₂

Machine learning identifies clusters of longitudinal autoantibody profiles predictive of systemic lupus erythematosus disease outcomes

OBJECTIVES: A novel longitudinal clustering technique was applied to comprehensive autoantibody data from a large, well-characterised, multinational inception systemic lupus erythematosus (SLE) cohort to determine profiles predictive of clinical outcomes. METHODS: Demographic, clinical and serological data from 805 patients with SLE obtained within 15 months of diagnosis and at 3-year and 5-year follow-up were included. For each visit, sera were assessed for 29 antinuclear antibodies (ANA) immunofluorescence patterns and 20 autoantibodies. K-means clustering on principal component analysis-transformed longitudinal autoantibody profiles identified discrete phenotypic clusters. One-way analysis of variance compared cluster enrolment demographics and clinical outcomes at 10-year follow-up. Cox proportional hazards model estimated the HR for survival adjusting for age of disease onset. RESULTS: Cluster 1 (n=137, high frequency of anti-Smith, anti-U1RNP, AC-5 (large nuclear speckled pattern) and high ANA titres) had the highest cumulative disease activity and immunosuppressants/biologics use at year 10. Cluster 2 (n=376, low anti-double stranded DNA (dsDNA) and ANA titres) had the lowest disease activity, frequency of lupus nephritis and immunosuppressants/biologics use. Cluster 3 (n=80, highest frequency of all five antiphospholipid antibodies) had the highest frequency of seizures and hypocomplementaemia. Cluster 4 (n=212) also had high disease activity and was characterised by multiple autoantibody reactivity including to antihistone, anti-dsDNA, antiribosomal P, anti-Sjögren syndrome antigen A or Ro60, anti-Sjögren syndrome antigen B or La, anti-Ro52/Tripartite Motif Protein 21, antiproliferating cell nuclear antigen and anticentromere B). Clusters 1 (adjusted HR 2.60 (95% CI 1.12 to 6.05), p=0.03) and 3 (adjusted HR 2.87 (95% CI 1.22 to 6.74), p=0.02) had lower survival compared with cluster 2. CONCLUSION: Four discrete SLE patient longitudinal autoantibody clusters were predictive of long-term disease activity, organ involvement, treatment requirements and mortality risk

Comprehensive organic emission profiles, secondary organic aerosol production potential, and OH reactivity of domestic fuel combustion in Delhi, India

Domestic solid fuel combustion is a major source of organic compounds to the atmosphere in gas and aerosol phases; however, large uncertainties exist in the current understanding of the gas-to-particle partitioning and the drivers of the reactivity of these emissions. This study developed comprehensive, model-ready organic emission profiles for domestic solid fuel combustion sources collected from Delhi, India. It also examined the organic species responsible for secondary organic aerosol (SOA) production potential and hydroxyl radical (OH) reactivity of these emissions. The profiles spanned the entire volatility range, including non-methane volatile organic compounds (NMVOCs, effective saturation concentration, C* = 3 × 106 to 1011 μg m−3), intermediate-volatility organic compounds (IVOCs, C* = 300 to 3 × 106 μg m−3), semi-volatile organic compounds (SVOCs, C* = 0.3–300 μg m−3) as well as low- and extremely low-volatility organic compounds (L/ELVOCs, where LVOC C* ≤ 0.3 μg m−3). The profiles predicted that IVOCs would contribute significantly to SOA production and that the combustion of fuel wood and charcoal released some of the smallest proportions of SVOCs. A model was developed to examine SOA production from burning emissions which estimated that phenolics would contribute 10–70% of the SOA. Furanics were the most important reactive species, contributing 9–48% of the OH reactivity and 9–58% of the SOA. Different combustion sources were also compared, with emissions from fuel wood, crop residue, cow dung cake and municipal solid waste (MSW) burning shown to be 30, 90, 120 and 230 times more reactive with the OH radical than emissions from liquefied petroleum gas (LPG) fuel. This study also estimated 3–4 times more SOA from cow dung cake combustion and 6–7 more from MSW combustion than fuel wood under comparable combustion conditions. The results of this study suggest that emissions from the combustion of domestic solid fuel sources in Delhi have the potential to significantly degrade local and regional air quality. As a result, more effective mitigation strategies are required to limit the impacts of solid fuel combustion on human health in countries like India

A Genome-Wide Association Study of Diabetic Kidney Disease in Subjects With Type 2 Diabetes

dentification of sequence variants robustly associated with predisposition to diabetic kidney disease (DKD) has the potential to provide insights into the pathophysiological mechanisms responsible. We conducted a genome-wide association study (GWAS) of DKD in type 2 diabetes (T2D) using eight complementary dichotomous and quantitative DKD phenotypes: the principal dichotomous analysis involved 5,717 T2D subjects, 3,345 with DKD. Promising association signals were evaluated in up to 26,827 subjects with T2D (12,710 with DKD). A combined T1D+T2D GWAS was performed using complementary data available for subjects with T1D, which, with replication samples, involved up to 40,340 subjects with diabetes (18,582 with DKD). Analysis of specific DKD phenotypes identified a novel signal near GABRR1 (rs9942471, P = 4.5 x 10(-8)) associated with microalbuminuria in European T2D case subjects. However, no replication of this signal was observed in Asian subjects with T2D or in the equivalent T1D analysis. There was only limited support, in this substantially enlarged analysis, for association at previously reported DKD signals, except for those at UMOD and PRKAG2, both associated with estimated glomerular filtration rate. We conclude that, despite challenges in addressing phenotypic heterogeneity, access to increased sample sizes will continue to provide more robust inference regarding risk variant discovery for DKD.Peer reviewe

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Believe it or not? : a field study of the perceived credibility of strongly and weakly-branded print and Internet sources.

Determination of whether the credibility of a source (online / offline) is related to its brand namei.e. no signficant difference between online and offline sources with a strong brand name and vice versa

Drug Abuse from Social Work Perspectives

Social work plays a crucial role in restoring societal functions. This paper advocates for integral theory as a defining framework for the identity of social work. In the context of Malaysia, a nation characterized by its multicultural landscape and grappling with a two-century-long issue of drug abuse, the application of integral theory becomes particularly relevant. Through an in-depth case study, this paper aims to illustrate the practicality and efficacy of integral theory in addressing the complex challenges posed by drug abuse in Malaysia. The discussion delves into various facets, including social identities, ego development, ethnopharmacology, and the political climate of Malaysia, providing a comprehensive understanding of the ongoing drug abuse issue. By examining these elements, the paper seeks to underscore how integral theory can serve as a transformative lens for social work in Malaysia. Crucially, this exploration contends that integral theory is not merely a practical tool for establishing the identity of social work; it should also be regarded as the future trajectory of social work. As societal issues evolve, the holistic and inclusive approach offered by integral theory positions social work to effectively navigate the complexities and nuances inherent in addressing drug abuse and other pressing challenges in the years to come

Instruments measuring integrated care: A systematic review of measurement properties

Policy Points: Investigations on systematic methodologies for measuring integrated care should coincide with the growing interest in this field of research. A systematic review of instruments provides insights into integrated care measurement, including setting the research agenda for validating available instruments and informing the decision to develop new ones. This study is the first systematic review of instruments measuring integrated care with an evidence synthesis of the measurement properties. We found 209 index instruments measuring different constructs related to integrated care; the strength of evidence on the adequacy of the majority of their measurement properties remained largely unassessed. CONTEXT: Integrated care is an important strategy for increasing health system performance. Despite its growing significance, detailed evidence on the measurement properties of integrated care instruments remains vague and limited. Our systematic review aims to provide evidence on the state of the art in measuring integrated care. METHODS: Our comprehensive systematic review framework builds on the Rainbow Model for Integrated Care (RMIC). We searched MEDLINE/PubMed for published articles on the measurement properties of instruments measuring integrated care and identified eligible articles using a standard set of selection criteria. We assessed the methodological quality of every validation study reported using the COSMIN checklist and extracted data on study and instrument characteristics. We also evaluated the measurement properties of each examined instrument per validation study and provided a best evidence synthesis on the adequacy of measurement properties of the index instruments. FINDINGS: From the 300 eligible articles, we assessed the methodological quality of 379 validation studies from which we identified 209 index instruments measuring integrated care constructs. The majority of studies reported on instruments measuring constructs related to care integration (33%) and patient-centered care (49%); fewer studies measured care continuity/comprehensive care (15%) and care coordination/case management (3%). We mapped 84% of the measured constructs to the clinical integration domain of the RMIC, with fewer constructs related to the domains of professional (3.7%), organizational (3.4%), and functional (0.5%) integration. Only 8% of the instruments were mapped to a combination of domains; none were mapped exclusively to the system or normative integration domains. The majority of instruments were administered to either patients (60%) or health care providers (20%). Of the measurement properties, responsiveness (4%), measurement error (7%), and criterion (12%) and cross-cultural validity (14%) were less commonly reported. We found <50% of the validation studies to be of good or excellent quality for any of the measurement properties. Only a minority of index instruments showed strong evidence of positive findings for internal consistency (15%), content validity (19%), and structural validity (7%); with moderate evidence of positive findings for internal consistency (14%) and construct validity (14%). CONCLUSIONS: Our results suggest that the quality of measurement properties of instruments measuring integrated care is in need of improvement with the less-studied constructs and domains to become part of newly developed instruments.status: publishe