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@#Introduction: Older persons are more susceptible to malnutrition. However, malnutrition identification through nutrition screening is not routinely performed in Malaysia’s health clinics due to no specific nutrition screening guideline and validated tool in this setting. This study aimed to develop a nutrition screening guideline for older patients and assess its feasibility for use by healthcare staff in health clinic setting. Methods: This study was conducted in three phases. In Phase I, needs assessment was conducted amongst healthcare staff. Development of nutrition screening guideline in Phase II involved scoping review and validation amongst six experts and twelve healthcare staff. In Phase III, twenty-two healthcare staff participated in feasibility assessment using in-depth interviews after completing nutrition screening in older patients. Interview data was analysed thematically using NVivo Software 12.0. Results: A Malay language version of nutrition screening guideline in A4-sized with 31 pages was developed and validated. Items with a content validity index ≥0.83 from experts review were retained, while <0.83 were revised accordingly. Validation amongst healthcare staff showed positive responses. The guideline was then assessed for feasibility, where 110 older patients (mean age= 68.7±6.1 years) were screened by healthcare staff using the newly developed nutrition screening guideline. Four themes emerged from in-depth interviews: 1) Ease of use; 2) Identification and management of malnutrition; 3) Acceptability; and 4) Implementation of nutrition screening. Conclusion: The newly developed and validated nutrition screening guideline is well-accepted and feasible for healthcare staff to screen older patients in health clinic setting for timely malnutrition identification and management.
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@#Introduction: Malnutrition, specifically undernutrition, in community-dwelling older adults reduces their well-being and predisposes to diseases. Therefore, timely malnutrition identification through nutrition screening is needed to identify at risk and malnourished patients. This study aimed to develop the content of nutrition screening guideline to facilitate healthcare staffs in health clinics to administer a validated nutrition screening tool specifically for older adults. Methods: A scoping review was conducted electronically using SCOPUS, PubMed, ProQuest Health & Medical Complete, and Cochrane databases. The systematic search was performed up to 31st December 2021. Search terms were created for identification of eligible and related articles. Inclusion and exclusion criteria were determined for the systematic search. The search was limited to English and Malay languages, and full text articles with no limitation of years. All data were extracted and analysed, guided by the PRISMA extension for scoping reviews (PRISMA-ScR). Results: From 728 identified articles, 18 articles were included in the analysis. Identified information for the guideline content were: introduction, aims and objectives, definition of malnutrition, prevalence of malnutrition, implementation of nutrition screening, guidance on administering items in validated tools, and guidance on anthropometric measurements. Meanwhile, format and flow charts from established guidelines served as references for the guideline development process. Conclusion: Appropriate content to develop a nutrition screening guideline has been identified based on this review. Development of a guideline based on this content can facilitate healthcare staffs to perform timely nutrition screening in older adults.
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@#Introduction: Elderly population is more likely to suffer from malnutrition, thereby requiring appropriate nutrition education as part of nutrition intervention to overcome this issue. This review aims to identify content suitable for developing a nutrition resource kit that provides nutritional guidance to combat malnutrition among malnourished and at-risk elderly in health clinics setting, particularly in Malaysia. Methods: A literature search was conducted up to 15th December 2019 in four databases: PubMed, Scopus, COCHRANE, and ProQuest Health & Medical Collection. Potential literature on nutrition education, suitable dietary guidelines and existing educational materials for elderly in the community, in English and Malay languages, were searched to identify suitable content for the nutrition resource kit. All relevant documents were included based on inclusion and exclusion criteria. Data were extracted and analysed according to the PRISMA-ScR guidelines. Results: A total of 27 documents consisting of articles, printed materials and guidelines were included for analysis. Suitable content included information related to malnutrition such as definition, signs and symptoms, cause-consequences, and nutrition management, which included food plate, serving size, menu suggestion, examples of recipes, tips to increase energy and protein intakes through food or drink, texture modification, a guide to using oral nutritional supplements, tips for maintaining nutrient content in food and drink, tips to encourage to eat, and oral health. Conclusion: A nutrition resource kit tailored for malnourished and at-risk elderly would be a beneficial nutrition intervention. There is a need to incorporate these information in the development of a nutrition resource kit to improve their dietary intake.
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@#Introduction: The elderly population are susceptible to malnutrition due to many factors. Hence, timely malnutrition identification through nutrition screening needs to be performed routinely in health clinics. However, the nutrition screening practice in health clinics need to be improvised for malnutrition identification among the elderly population. This study identifies barriers and opportunities for nutrition screening in elderly patients in health clinic settings. Method: A qualitative study was conducted among healthcare staff from urban and rural health clinics in Kuantan, Pahang, Malaysia. In-depth individual interviews were performed, audio-recorded and transcribed verbatim. Non-participant observations that act as triangulation were conducted among elderly patients (aged ≥60 years) attending the sampled health clinics. Both data from the interviews and observations were analysed thematically using NVivo software. Results: Twenty healthcare staff participated in the interviews were medical officers (n=6), medical assistants (n=8), staff nurses (n=4), and community nurses (n=2) with a mean age of 33.7±6.3 years. Twenty- one elderly patients were involved in non-participant observations. The four themes that emerged as barriers and opportunities were: time, patient factors, organisation factors and nutrition screening knowledge. Time constituted the main barrier, whilst incorporating a validated nutrition screening tool into current health screening practices was identified as the most practical approach to performing nutrition screening. Staff also highlighted the need for appropriate guidelines for implementing nutrition screening. Conclusion: This study identified appropriate approaches to implementing nutrition screening among elderly patients in health clinics. Developing a comprehensive nutrition screening guideline may facilitate healthcare staff in performing nutrition screening.
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Aims: To determine the impact of Pb on seed germination and early seedling development in A. auriculiformis species. Place and Duration of Study: The study was carried out in Department of Biology, University Putra Malaysia, between April 2016 and February 2017. Methodology: The concentrations of lead from 0 to 4 g/L (interval of 0.5 g/L) were used. Seeds were germinated in vitro condition. Different parameters were measured including germination percentage, seedling vigour index, tolerance index, germination index, mean germination time and relative injury rate. Results: The noticeable finding of this study reveals that A. auriculiformis seeds have the ability to germination and resist Pb toxicity up to 1.5 g/L. Increasing Pb concentration from 1.5 to 3.5 g/L decreased the germination percentage from 57% to 4% respectively. Conclusion: Acacia auriculiformis seeds germination in a high level of Pb (up to 1.5 g/L) indicated species resistance which probably can be used as Pb hyperaccumulator agent in areas or sites contaminated with this metal.
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This study evaluates the growth, body composition, and resistance to Aeromonas hydrophila challenge in juvenile African catfish (Clarias gariepinus) fed diets supplemented with spirulina (Arthrospira platensis). Five experimental diets containing different percentages of locally grown dried spirulina (0, 1, 3, 5 and 7%) were fed daily to catfish juveniles at 5% of their body weight. The growth and body composition of the catfish were determined up to 90 days of the study period. At day 91, the catfish were intraperitoneally injected with 107 CFU/ml of virulent A. hydrophila. Generally, the growth and body composition of the catfish in spirulina inclusion groups showed no significant difference with the control group. The survival rate following A. hydrophila challenge was significantly low in the control group compared to all of the other treatment groups. After the challenge trial, only the white blood cell count value was significantly higher in all of the groups supplemented with spirulina compared to the control group. We concluded that the locally grown spirulina do not improve growth and body composition, but it increased the catfish resistance towards A. hydrophila infection.
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Even though Arthrospira is a well-known superfood, it is not extensively commercialized in developing countries like Malaysia due to the high production cost with low biomass yield. Based on literature, the algal production cost can be discounted by reducing the cost of medium utilizing cheaper and readily available chemicals. Therefore, the present study was conducted to experiment the prospect of Arthrospira platensis cultivation in newly designed medium with commercial or industrial grade fertilizers under real environment. Consequently, growth and yield of A. platensis was investigated under outdoor condition using modified Kosaric medium (MKM) which was designed by substituting the major laboratory chemicals in standard Kosaric medium (SKM) with commercial grade baking soda, sea salt, urea, phosphoric acid, potassium hydroxide and Epsom salt. Urea as an alternative nitrogen resource to sodium nitrate was pulse-fed throughout the cultivation period. The algal growth was measured through optical density, biomass dry weight and chlorophyll a content. The algal yield was determined by calculating its productivity and specific growth rate. The growth and yield of A. platensis was significantly higher (p < 0.05) in MKM in terms of optical density with 2.541 ABS, biomass dry weight with 1.30 g L-1, chlorophyll a content with 12.96 mg L-1, productivity with 0.141 g L-1 d-1 and specific growth rate with 0.253 µ d-1 compared to SKM in eight days of cultivation period. The present finding showed the potential of MKM in lowering the medium cost up to 97% compared to SKM without compromising the algal yield under natural condition with proper cultivation techniques such as preadaptation and fed-batch addition of urea in the late evening.
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Background & objective: Sago (Metroxylin sagu) is one of the main sources of native starch. In Malaysia sago dishes are commonly eaten with sugar. However, other societies use sago as a staple food item instead of rice or potato. The study was undertaken to investigate the effect of ingestion of different physical forms of sago supplementation on plasma glucose and plasma insulin responses, as compared to the white bread supplementation in man, during resting condition. Methods: Twelve male subjects were given in random order with three different physical forms of a sago supplementation, viz., sago porridge (SR), sago paste (SP), sago gel (SG) and white bread (WB) which was repeated on separate days, at least, 1 wk apart after an overnight fast. Venous blood samples were collected at baseline and at 15, 30, 45, 60, 90, 120, 150 and 180 min after the start of each meal and were analyzed for plasma levels of glucose and insulin. Results: Plasma glucose reached peak at 45 min after supplementation of various sago meals. Plasma glucose area under the curve (AUC) for WB was significantly lower than SG but not significantly different from SR and SP. No significant difference was observed in plasma glucose AUC among the three sago meals. Plasma insulin AUC for SG was significantly higher than WB and SR. All three sago meals tested were not significantly different in their glycaemic responses. However, the insulin response was significantly lower for SR compared to SP and SG. Interpretation & conclusions: The present findings suggest that any one of the three sago meals tested in this study may be used to elucidate the effect of sago starch ingestion on exercise performance in the heat. Sago paste and sago porridge may be used for supplementation before and during exercise, whereas, sago gel may be used after endurance exercise during recovery process.