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@#Peer-assisted learning (PAL) is a potential approach for clinical education that can reduce the burden of clinical supervision and enhance learning. This study aims to identify opportunities for PAL through investigating how speech language therapy students perceive and already participate in PAL within a range of clinical practicum settings. The Speech Sciences students across all years at one institution were invited to participate in a cross-sectional survey that was adapted and revised from Tai et al. (2014). Speech Sciences students reported they applied PAL as part of their learning strategy in their clinical practicums, but still relied on supervisors as the main source of. PAL occurred more frequently in contexts where students already had some clinical experience and spent substantial amounts of time together. Students agreed that PAL enhanced their learning and emphasized a few advantages of PAL, such as having the opportunity to share their ideas, experiences, and knowledge, and providing a positive learning environment without pressure. Confidence to provide information or feedback to peers was cited as a shortcoming in PAL. PAL is a viable teaching approach that can be used in speech-language therapy clinical education program to reduce the supervisory burden. The findings from our study show that PAL is largely self-initiated among speech-language therapy students. However, PAL must be tailored to suit different clinical education year levels and clinical settings to benefit. Case discussion may be one area where scaffolded PAL activities could represent a feasible first step to increasing PAL.
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@#Introduction: Intervention approaches that integrate human coaching into technology are considered as a convenient, accessible and scalable method to reach a larger population at risk. The objective of this paper is to present the protocol for a randomised controlled trial that evaluates the efficacy of a lifestyle intervention programme via a mobile phone app (MyDiPP), which aims to prevent diabetes among adults at risk of developing diabetes. Methods: MyDiPP intervention is to be delivered for 12 months with multiple approaches (weight loss, dietary modification, physical activity, and quality of life). Eligible adults aged 18-65 years, overweight/obese (body mass index, BMI ≥ 23kg/m2), and at high risk of type 2 diabetes [American Diabetes Association (ADA) Diabetes Risk Score ≥5, or haemoglobin A1c (HbA1c) of 5.6-6.2%], will be randomly assigned to one of two study groups (intervention or usual care control groups) in a 1:1 ratio using simple randomisation. Results: Changes in weight and HbA1c level (primary outcomes), and changes in physical activity level, dietary intake, and quality of life (secondary outcomes) will be assessed at 6 and 12 months. Conclusion: This study protocol describes the first digital therapy for diabetes prevention in Malaysia, which will determine whether the effect of this intervention is larger than the effect of usual care in reducing body weight and HbA1c level, and improving dietary intake, physical activity, and quality of life of high-risk individuals. Results from this trial may be useful for preventing type 2 diabetes mellitus in Malaysia.
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@#Introduction: Sex shapes immune response with possible consequence on tumor immune escape. Acute lymphoblastic leukemia (ALL) predominates in males while ovarian cancer (OC) occurs in females. NK cells essential for tumor killing may have male preponderance. Association of sex, NK cell activity and malignancies is unclear. We hypothesize that sex differentially affects KIR expressions in sex-biased cancers. Method: Expression of inhibitory (KIR2DL1-5 and KIR3DL1-3) and activating (KIR2DS1-2 and 4-5 and KIR3DS1) genes in B-, T-cell ALL, OC and normal controls were determined by reverse-transcription polymerase-chain-reaction. Result: All normal males (but not females) expressed the framework genes and generally maintained haplotype A, except KIR3DL1. Normal females expressed more activating KIRs. Frequencies of KIR2DL1, 2DL4 and 2DS2 were significantly reduced among ovarian cancer patients. Sex difference in frequencies of KIR expression was not detected in ALL as majority were undetectable except framework gene KIR3DL2, was more frequent among T-ALL. Conclusion: Cancers may be associated with reduced KIR expression and influence of sex requires investigation.
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@#Speech sound disorders adversely affect speech intelligibility. It is important to address speech errors early to reduce the impact on long term communication skills. Parental involvement has been shown to increase the effectiveness of speech therapy because parents were able to carry out speech therapy tasks consistently with their children in the comfort of their own homes. This study aimed to explore the usability of an interactive board game as therapy tool in children with speech sound disorders. In Phase I, market survey and website search regarding existing board games were conducted. In Phase II, board game prototypes using the motor approach for speech intervention were developed. Finally, in Phase III, the usability of the board game was examined. Nineteen respondents comprising eight experienced speech-language therapists and eleven parents of children diagnosed with speech sound disorder participated in the study. Participants used the interactive board game with a child with speech sound disorder for a period of one week and completed a questionnaire. Findings show that majority of the participants (94.7%) were satisfied with the board game as a tool for speech therapy. Additionally, 89.4% of the participants agreed that the board game is fun, and all children choose to play the board game again. Suggestions to improve the board game were documented. Further research is warranted to examine the efficacy of this approach on speech therapy outcomes.
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Objectives: Autologous peripheral blood stem cells transplantation [APBSCT] is a therapeutic option which can be used in various hematological, neoplastic disorders including lymphoproliferative disease [LPD]. Differences in patient populations and treatment modalities in different transplant centers mean it is important to improve the knowledge of the different factors affecting engraftment after APBSCT for the success of this procedure. We sought to determine the factors influencing neutrophil and platelet engraftment after APBSCT in patients with LPD
Methods: We conducted a retrospective review of 70 patients with LPD [35 with lymphoma and 35 with multiple myeloma] who had undergone APBSCT between January 2008 and December 2016. Data obtained included disease type, treatment, and stem cell characteristics. Kaplan-Meier analysis was performed for probabilities of neutrophil and platelet engraftment occurred and was compared by the log-rank test. The multivariate Cox proportional hazards regression model was used for the analysis of potential independent factors influencing engraftment. A p-value < 0.050 was considered statistically significant
Results: Most patients were ethnic Malay, the median age at transplantation was 49.5 years. Neutrophil and platelet engraftment occurred in a median time of 18 [range 465] and 17 [range 666] days, respectively. The majority of patients showed engraftment with 65 [92.9%] and 63 [90.0%] showing neutrophil and platelet engraftment, respectively. We observed significant differences between neutrophil engraftment and patient's weight [< 60/>/= 60 kg], stage of disease at diagnosis, number of previous chemotherapy cycles [< 8/>/= 8], and pre-transplant radiotherapy. While for platelet engraftment, we found significant differences with gender, patient's weight [< 60/>/= 60 kg], pre-transplant radiotherapy, and CD34+ dosage [< 5.0/>/= 5.0 × 106/kg and < 7.0/>/= 7.0 × 106/kg]. The stage of disease at diagnosis [p = 0.012] and pre-transplant radiotherapy [p = 0.025] were found to be independent factors for neutrophil engraftment whereas patient's weight [< 60/>/= 60 kg, p = 0.017], age at transplantation [< 50/>/= 50 years, p = 0.038], and CD34+ dosage [< 7.0/>/= 7.0 × 106/kg, p = 0.002] were found to be independent factors for platelet engraftment
Conclusions: Patients with LPD who presented at an early stage and with no history of radiotherapy had faster neutrophil engraftment after APBSCT, while a younger age at transplantation with a higher dose of CD34+ cells may predict faster platelet engraftment. However, additional studies are necessary for better understanding of engraftment kinetics to improve the success of APBSCT
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@#Branchial apparatus anomalies usually manifest in teenage or early adult life. Infection complicates second branchial pouch anomalies usually presented as a neck lump or discharging sinus. It is the most common form of anomalies compared to another branchial pouch aberrant. However, it is extremely rare to find a complete branchial fistula with both internal and external openings. Misdiagnosis usually occurs leading to inappropriate and suboptimal treatment. Here, we report of a case of complete second branchial pouch fistula and discuss the clinical presentation and surgical management of such lesion.
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@#Programmes in the Health Sciences are less pursued by students compared to competative programmes such as medicine,pharmacy, and dentistry. This study aimed to investigate the perception of Form Five students towards a career in HealthSciences in four dimensions including characteristics that are considered as “important” in the selection of a careerchoice, the level of knowledge in professions within the field of Health Sciences, students’ perception towards a career inthe field of Health Sciences and their possible career choice in the field of Health Sciences. This is a cross-sectional studythat included 188 students from 10 secondary schools around Kuala Lumpur. The results showed that the respondentsprioritized career characteristics that provided “job satisfaction”(97.8%), “job security” (96.8%), “interesting” (95.2%),“helping other people” (92.4%), “doing something good for society” (92.1%) and “high salary” (88.6%). Respondentsalso reported high level of knowledge for the profession of Medicine (93.1%), Pharmacy (84.0%), Dentistry (76.6%),Nursing (74.8%) and Forensic Science (71.3%). Respondents knew the least about Speech-Language Therapy (28.0%),Audiology (27.0%) and Occupational Therapy (19.3%) professions. Differences in terms of gender and ethnicity were alsoidentified through this study. Respondents’ perception towards the professions were influenced by the level of familiarity,ethnicity and gender. Respondents were found to be less familiar and have misperception towards less-known professions,and this affect respondents’ consideration to pursue these professions as careers.
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Objectives: Implemented in 2010, 1 Malaysia Clinic [1MC] is the latest innovation in public primary healthcare services in Malaysia to serve the urban population. This study aimed to assess the level of satisfaction and its associated factors using the SERVQUAL [SERV-service, QUAL-quality] instrument. We also sought to compare the difference of mean score between expectation and perception of SERVQUAL dimension among patients attending 1MC in Kota Bharu district, Malaysia
Methods: This cross-sectional study included all nine 1MCs in the Kota Bharu district, Malaysia, and used the validated SERVQUAL questionnaire from Ministry of Health, Malaysia. The primary data was collected in January 2017. The sample size was proportionate to the average daily patient attendance for each clinic, and a simple random sampling method was applied to reduced selection bias. Satisfaction level was determined by the mean gap score of expectation and perception of the SERVQUAL dimension
Results: A total of 386 patients were involved in this study [184 male and 202 female]. Most were from the low socioeconomic group. Less than half of the patients were satisfied with the clinic services. The tangible dimension [service quality [SQ] gap: -0.25] was the most critical dimension among all five SQ dimensions assessed. The factors included low education level [adjusted odds ratio [adj. OR] 1.87; 95% confidence interval [CI]: 1.06, 2.67; p = 0.024], monthly household income less than RM 3000 [adj. OR 2.97; 95% CI: 1.72, 5.51; p < 0.001], and frequency >/= 3 visits [adj. OR 2.23; 95% CI: 1.44, 3.45; p < 0.001] had significant association with high level of satisfaction
Conclusion: 1MC has achieved its objective to increase the accessibility of health services among the low-income population in urban settings. However, most patients were not satisfied with certain parts of the services. Thus, proper evaluation of the service gap is required for improvement of the service
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The Indian ethnic group remains underrepresented despite the continued advancement in the field of speech and language therapy (SLT) in Malaysia. This study aims to investigate the perception of Malaysian Indian Pre-university students towards a career in the health sciences and specifically for the SLT profession. This was a cross-sectional study that employed convinience sampling method to recruit participants. A total of 110 Indian pre-university students from urban cities of Kuala Lumpur and Johor were recruited. The findings showed majority of the respondents (>90%) placed importance on a career that provided “high salary,” “job stability,” and “career’s social standing in the community.” Almost all respondents recognize the medical, pharmacy and nursing profesion compared to only <3% who were familiar with the occupational therapy, audiology and SLT profession. Respondents perceived the SLT profession as “suited for females,” “interesting” and provided “opportunities to meet people.” None of the respondents perceived SLT as a profession that “suited for males,” “high salary” and “a scientic course.” Only 5% of respondents would consider a career in SLT. Findings from this study can be used to increase awareness and to change inaccurate perceptions regarding health science profession especially SLT amongst the Indian ethnicity.
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Language Therapy , Speech TherapyABSTRACT
Soluble HLA (sHLA) are potential tumour markers released in order to counter immune surveillance. sHLA-class II is less known especially in acute lymphoblastic leukaemia (ALL). This study aimed to investigate soluble, surface and allelic expression of HLA Class II (sHLA-DR) in B-cell ALL patients and compare with soluble expression in normal individuals. A sandwich enzyme-linked immunosorbent assay (ELISA) was developed to measure soluble HLA-DRB1 in plasma. Flow cytometric analysis was performed to determine median fluorescence intensity in HLA-DR surface expression. HLA-DNA typing by polymerase chain reaction, sequence specific oligonucleotides, PCRSSO was performed to determine HLA-DRB1 type in ALL samples. Results showed sHLA-DRB1 (mean±SEM) was significantly increased (p=0.001) in plasma of ALL patients (0.260 ±0.057 μg/mL; n=30) compared to healthy controls (0.051 ± 0.007µg/mL; n=31) of Malay ethnicity. However, these levels did not correlate with percentage or median fluorescence intensity of HLA-DR expressed on leukemia blasts (CD19+CD34 ± CD45(lo)HLA-DR+) or in the normal B cell population (CD19+CD34- CD45(hi)HLA-DR+) of patients. No significant difference was observed in gender (male/female) or age (paediatric/adult). Only a trend in reduced sHLA was observed in patients carrying HLA-DR04. These results have to be validated with a larger number of samples.
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Introduction: Little is known about the treatment outcomes of children with cleft lip and/or palate (CLP) receiving surgical care for primary lip and palate closure in Malaysia. Objectives: This study examined the speech and hearing status of Malay-speaking children with CLP residing in Kuala Lumpur. Methods: Parents whose children were between the age of 5 and 7 years were recruited via the Cleft Lip and Palate Association of Malaysia (CLAPAM) registry. Parents completed a survey and the children completed a speech and hearing assessment at the Audiology and Speech Sciences Clinic, Universiti Kebangsaan Malaysia. Outcomes: Speech measures include nasality rating, nasalance scores, articulation errors and speech intelligibility rating, while hearing measures include hearing thresholds and tympanometry results for each child. Results: Out of 118 registered members who fulfilled the inclusion criteria, 21 agreed to participate in the study. The overall speech and hearing status of children in this sample were poor. Only four (19%) participants had normal speech intelligibility rating and normal hearing bilaterally. In terms of overall cleft management, only four (19%) participants were seen by a cleft team while seven (33%) had never had their hearing tested prior to this study. Conclusion: Participants in this sample had poor outcomes in speech and hearing and received uncoordinated and fragmented cleft care. This finding calls for further large scale research and collaborative efforts into improving and providing centralised, multidisciplinary care for children born with CLP.
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Soluble HLA (sHLA) are potential tumour markers released in order to counter immune surveillance. sHLA-class II is less known especially in acute lymphoblastic leukaemia (ALL). This study aimed to investigate soluble, surface and allelic expression of HLA Class II (sHLA-DR) in B-cell ALL patients and compare with soluble expression in normal individuals. A sandwich enzyme-linked immunosorbent assay (ELISA) was developed to measure soluble HLA-DRB1 in plasma. Flow cytometric analysis was performed to determine median fluorescence intensity in HLA-DR surface expression. HLA-DNA typing by polymerase chain reaction, sequence specific oligonucleotides, PCRSSO was performed to determine HLA-DRB1 type in ALL samples. Results showed sHLA-DRB1 (mean+SEM) was significantly increased (p=0.001) in plasma of ALL patients (0.260±0.057 μg/mL; n=30) compared to healthy controls (0.051±0.007μg/mL; n=31) of Malay ethnicity. However, these levels did not correlate with percentage or median fluorescence intensity of HLA-DR expressed on leukemia blasts (CD19+CD34+/-CD45loHLA-DR+) or in the normal B cell population (CD19+CD34- CD45hiHLA-DR+) of patients. No significant difference was observed in gender (male/female) or age (paediatric/adult). Only a trend in reduced sHLA was observed in patients carrying HLA-DR04. These results have to be validated with a larger number of samples.
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Sekolah Menengah Sains Tengku Muhammad Faris Petra (SMSTMFP) and Sekolah Kebangsaan Kubang Kerian (3) (SKKK3) were selected by the Department of Neurosciences, Universiti Sains Malaysia (USM), in 2011 to be a ‘school-based Neuroscience Club’ via the ‘Knowledge Transfer Programme (KTP) – Community’ project. This community project was known as “The Brain Apprentice Project”. The objectives of this project were to promote science and the neurosciences beyond conventional classroom teachings whilst guiding creativity and innovation as well as to assist in the delivery of neuroscience knowledge through graduate interns as part of the cultivation of neuroscience as a fruitful future career option. All of the planned club activities moulded the students to be knowledgeable individuals with admirable leadership skills, which will help the schools produce more scientists, technocrats and professionals who can fulfil the requirements of our religion, race and nation in the future. Some of the activities carried out over the years include the “My Brain Invention Competition”, “Mini Brain Bee Contest”, “Recycled Melody” and “Brain Dissection”. These activities educated the students well and improved their confidence levels in their communication and soft skills. The participation of the students in international-level competition, such as the “International Brain Bee”, was one of the ways future professionals were created for the nation. The implementation of Neuroscience Club as one of the organisations in the school’s co-curriculum was an appropriate step in transferring science and neuroscience knowledge and skills from a higher education institution, namely USM, to both of the schools, SMSTMFP and SKKK3. The club members showed great interest in all of the club’s activities and their performance on the Ujian Pencapaian Sekolah Rendah (UPSR) or Primary School Achievement Test and Sijil Pelajaran Malaysia (SPM) or Malaysian Certificate of Education examinations improved tremendously.
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Acute mastoiditis complicated with subperiosteal abscess is a rare clinical entity in adult population. It is however a recognized risk in diabetes patient. We report a case of a young lady who was newly diagnosed as diabetes at presentation, presented with features of mastoiditis with subperiosteal abscess and adjacent intracranial abscess extension