Validation of the Malay version of Epworth sleepiness scale for children and adolescents (MESS-CHAD).

BACKGROUND: Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) is a valid and reliable eight-item self-administered questionnaire for the assessment of excessive daytime sleepiness and is commonly used to screen sleep-disordered breathing for children and adolescents. The cross-sectional study aimed to translate and cross-culturally adapt ESS-CHAD into a Malay version of Epworth Sleepiness Scale for Children and Adolescents (MESS-CHAD) for the Malaysian population, and to assess the validity and reliability of MESS-CHAD. METHODS: Forward-backward translation method was used to translate and cross-culturally adapt ESS-CHAD. Three linguistic experts and two paediatricians content validated the translated version. Face validity was conducted through audio-recorded semi-structured in-depth interviews with 14 native Malay-speaking children and adolescents followed by thematic analysis. The revised questionnaire was then proofread by a linguistic expert. A total of 40 subjects answered the MESS-CHAD twice, 2 weeks apart, for test-retest reliability and internal consistency. For criterion validity, 148 eligible subjects and their parents answered MESS-CHAD and the Malay version of Sleep-Related Breathing Disorder scale extracted from the Paediatric Sleep Questionnaire (M-PSQ:SRBD) concurrently. Variance Inflation Factor (VIF) and P values of the model's outer weight and outer loading were analysed using SmartPLS software to assess the indicator's multicollinearity and significance for formative construct validity. RESULTS: Intraclass Correlation Coefficient (ICC) ranging from 0.798 to 0.932 and Cronbach's alpha ranging from 0.813 to 0.932 confirmed good to excellent test-retest reliability and internal consistency, respectively. Spearman Correlation Coefficient value of 0.789 suggested a very strong positive correlation between MESS-CHAD and M-PSQ:SRBD. VIF ranging from 1.109 to 1.455 indicated no collinearity problem. All questionnaire items in MESS-CHAD were retained as the P value of either outer model weight or outer model loading was significant (P < 0.05). CONCLUSION: ESS-CHAD has been translated and cross-culturally adapted into Malay version for the Malaysian population, and found to be valid and reliable.

The Struggle to Fit in: A Qualitative Study on the Sense of Belonging and Well-being of Deaf People in Ipoh, Perak, Malaysia.

The sense of belonging plays an important role in a person's well-being. It also acts as a protective factor against mental distress. Deaf people struggle to fit into the dominant hearing society due to communication barriers. The multi-languages used in Malaysian families add to this communication challenge. Communication breakdown leaves the deaf person socially excluded while a poor sense of belonging also increases their vulnerability to mental health issues. Hence, this study explored the deaf person's sense of belonging and well-being through their social experiences in Malaysia. Baumeister's need-to-belong theory served as the theoretical framework of this study. An Ethnographic approach with in-depth interviews and participant observation was used to explore the social experiences of six Chinese deaf adults, aged 20-37, residing in Ipoh. Their hearing parents were interviewed as well to obtain parents' perspective of the child's well-being in the earlier years. Participants were selected using the purposive and snowballing sampling method. Upon data saturation, thematic analysis was used to identify themes, patterns, and interpret its meanings. The main themes that emerged from the data was the "struggle to fit in", "emotional effect", and "quality social connections". Findings of this study can be used in the formation of policies and strategies to ensure that deaf individuals are not excluded from their communities. Cultivating an inclusive community and developing the deaf community offers a better sense of belonging, which would help increase well-being of deaf people. Future research may focus on deaf identity and well-being of deaf youth in Malaysia.

The association between weight gain at different stages of pregnancy and risk of gestational diabetes mellitus.

AIMS/INTRODUCTION: Women with excessive gestational weight gain (GWG) are at a higher risk for complications during pregnancy, such as preeclampsia. However, the association between excessive GWG and gestational diabetes mellitus (GDM) remains unclear. MATERIALS AND METHODS: We retrospectively reviewed 8,352 women from our obstetric database with singleton pregnancies who gave birth after 28 completed weeks of gestation between January 1, 2012, and December 31, 2016, excluding pregnancies complicated by fetal anomalies, fetal death, and overt diabetes. Diagnosis of GDM was based on the criteria recommended by the International Association of Diabetes and Pregnancy Study Groups. We used two classification methods to define excessive GWG: a weight gain above the 90th percentile of the population, or exceeding the upper range recommended by the Institute of Medicine, stratified by pre-pregnancy body mass index. Statistical analysis was performed using multiple logistic regression to determine the association between excessive GWG and the risk of GDM. RESULTS: Overall, 1,129 women (13.5%) were diagnosed with GDM. There was no difference in GWG between women with and without GDM in the first trimester and before GDM screening. Women with GDM had significantly less GWG in the second trimester, after GDM screening, and throughout the whole gestation than women without GDM. No correlation was found between excessive GWG in the first and second trimesters, before GDM screening, and the later development of GDM. CONCLUSIONS: Our results indicate that excessive GWG prior to GDM screening is not associated with an increased risk of GDM.