Designing and Validating a New Asian Family Scale

Introduction: All available family scales are designed for western countries and there is no validated family scale which is specifically devised for Asian population. The difference in culture and family values warrants the formulation of a specific Asian family scale to cater the regional needs. The objectives are to devise and validate a new family scale and eventually to validate it for Malaysian population. Method: The development of the questionnaire can be divided into 5 stages; identifying the domains of Asian family values, items identification for each domain and language review, pretest the pre-final version, pilot study and validation. Respondents were recruited from different ethnic groups and cultural backgrounds to represent the Malaysian population. They were selected by using stratified quota sampling from various health centres in the district of Kuantan, Malaysia. Results: A total of 588 participants enrolled in the validation stage with various ethnic backgrounds. Bartlet’s KMO value is 0.93. From 43 items, 67% had good factor loading (>0.4) and 13 items were finally dropped. Total Cronbach’s alpha values of 0.9 with 5 domains were identified by using exploratory factor analysis. There are 6 items in each domain. Conclusion: This new scale has good psychometric properties and it is a valid family scale for Malaysians. Further psychometric evaluation will further enhance the evidence for other populations in Asia

Norms for Eating Disorder Examination Questionnaire (EDE-Q) among Secondary School Students in Kuala Lumpur, Malaysia

Introduction: The Eating Disorder Examination Questionnaire (EDE-Q) has been widely used as a tool to detect eating disorders. We aimed to identify the EDE-Q normative data among secondary school students in Kuala Lumpur, Malaysia. Methods: This is a cross-sectional study involving four secondary schools in an urban area. The respondents of secondary school students were selected using stratified sampling. Results: There were 298 teenagers 12 to 17 years of age who participated in the study. The EDE-Q mean scores ± standard deviation was 1.27 ± 1.08 for the total score (Global Score), 0.78 ± 0.95 for Restraint Domain, 1.02 ± 1.03 for Eating Concern, 1.76 ± 1.55 for Shape Concern and 1.54 ± 1.43 for Weight Concern. Conclusion: Mean values obtained from this study were relatively lower when compared to western populations. Shape Concern and Weight Concern had higher scores compared to the other domains. These values are useful for EDE-Q interpretation in Malaysia

Immunosuppressive potential of human amnion epithelial cells in the treatment of experimental autoimmune encephalomyelitis

BACKGROUND: Multiple sclerosis (MS) is an autoimmune inflammatory disease of the central nervous system (CNS). In recent years, it has been found that cells such as human amnion epithelial cells (hAECs) have the ability to modulate immune responses in vitro and in vivo and can differentiate into multiple cell lineages. Accordingly, we investigated the immunoregulatory effects of hAECs as a potential therapy in an MS-like disease, EAE (experimental autoimmune encephalomyelitis), in mice. METHODS: Using flow cytometry, the phenotypic profile of hAECs from different donors was assessed. The immunomodulatory properties of hAECs were examined in vitro using antigen-specific and one-way mixed lymphocyte proliferation assays. The therapeutic efficacy of hAECs was examined using a relapsing-remitting model of EAE in NOD/Lt mice. T cell responsiveness, cytokine secretion, T regulatory, and T helper cell phenotype were determined in the peripheral lymphoid organs and CNS of these animals. RESULTS: In vitro, hAECs suppressed both specific and non-specific T cell proliferation, decreased pro-inflammatory cytokine production, and inhibited the activation of stimulated T cells. Furthermore, T cells retained their naïve phenotype when co-cultured with hAECs. In vivo studies revealed that hAECs not only suppressed the development of EAE but also prevented disease relapse in these mice. T cell responses and production of the pro-inflammatory cytokine interleukin (IL)-17A were reduced in hAEC-treated mice, and this was coupled with a significant increase in the number of peripheral T regulatory cells and naïve CD4+ T cells. Furthermore, increased proportions of Th2 cells in the peripheral lymphoid organs and within the CNS were observed. CONCLUSION: The therapeutic effect of hAECs is in part mediated by inducing an anti-inflammatory response within the CNS, demonstrating that hAECs hold promise for the treatment of autoimmune diseases like MS

Gaps in cancer care in a multi-ethnic population in Sarawak, Borneo: A central referral centre study.

BACKGROUND: The state of Sarawak on the island of Borneo in East Malaysia, in working towards developing and strengthening cancer services through a holistic patient-centred approach, must focus on the comprehensive needs of cancer patients by taking into account the psycho-social, cultural and spiritual aspects of Sarawak's multi-ethnic, multi-cultural population. METHODS: A 42-item survey questionnaire was developed and validated with a total of 443 patients. The perceived importance of information provided and level of patient satisfaction were assessed with a 5-point Likert scale in 10 domains (Diagnosis, Surgery, Radiotherapy, Systemic therapy, Clinical trials, Pain management, Treatment monitoring, Psychosocial support, Sexual care and fertility issues, and Financial support). A Spearman's rank correlation test was applied to determine the correlation between response in both item and domain categories for perceived importance and satisfaction. RESULTS: Overall, patients were more satisfied with information related to cancer diagnosis, treatment and surgery but less satisfied with information pertaining to sexual aspects of care and family planning, psycho-social support and financial support. The majority of patients were satisfied with the level of treatment-related information received but preferred the information to be delivered in more easily comprehendible formats. Sexual aspects of care and family planning, psychosocial support and treatment monitoring post-discharge were perceived as important but seldom addressed by health care professionals due to lack of professional counsellors, social workers and clinical nurse specialists. Many patients face financial toxicity following a cancer diagnosis, particularly when diagnosed with advanced cancer requiring complex multi-modality treatment. CONCLUSION: Cancer patients in Sarawak have various unmet information needs. Written information and educational videos in local indigenous languages may be more suitable for Sarawak's multi-ethnic population. Sexual aspects of care and family planning are challenging but essential topics to discuss, in particular due to the high prevalence of breast and cervical cancer amongst young women of reproductive age in Sarawak. Financial assessment and information on support services offered by government and non-government organisations should be provided to eligible patients. A holistic needs assessment of each patient at time of diagnosis and support through their cancer journey requires a multi-disciplinary team of medical, nursing and allied health professionals including clinical nurse specialists, pharmacists, counsellors, physiotherapists, occupational therapists, speech and language therapists, dieticians and social workers