The Effect of Online-Delivered Guided Imagery Relaxation on Stress and Well-Being of Primary School Children.

Background: In the context of the coronavirus (COVID-19) pandemic, effectively coping with daily stressors is crucial for children who experience restrictions on physical movement and social activities. We examined the effects of the online-delivered guided imagery relaxation (GIR) technique on the stress and well-being of primary school children. Methods: Thirty-four (N = 34) 11-year-old students were randomly assigned to either intervention (n = 17) or waitlist-control (n = 17) groups. The participants from the intervention group were required to attend a 4-week online GIR session and practice the techniques daily for 5 min-10 min. The Stress in Children (SiC) questionnaire, the Strengths and Difficulties Questionnaire-Parent Reported (SDQ-PR) and tracking form were administered pre- and post-intervention. Results: Eleven (64.7%) participants attended all sessions and eight (47.0%) completed daily practices. Mixed-model ANOVA indicated no significant difference between participants from intervention and waitlist-control groups across pre- and post-intervention time points, with P-values greater than 0.05 for stress and well-being. Conclusion: Issues regarding online intervention, including managing children's activities from a distance, Internet connectivity, and time limitations might have affected their adherence and the research outcome. Nonetheless, the online-delivered GIR technique is a promising intervention modality. However, its implementation should be improvised to be more impactful.

Neural alterations in working memory of mild-moderate TBI: An fMRI study in Malaysia.

Working memory (WM) encompasses crucial cognitive processes or abilities to retain and manipulate temporary information for immediate execution of complex cognitive tasks in daily functioning such as reasoning and decision-making. The WM of individuals sustaining traumatic brain injury (TBI) was commonly compromised, especially in the domain of WM. The current study investigated the brain responses of WM in a group of participants with mild-moderate TBI compared to their healthy counterparts employing functional magnetic resonance imaging. All consented participants (healthy: n = 26 and TBI: n = 15) performed two variations of the n-back WM task with four load conditions (0-, 1-, 2-, and 3-back). The respective within-group effects showed a right hemisphere-dominance activation and slower reaction in performance for the TBI group. Random-effects analysis revealed activation difference between the two groups in the right occipital lobe in the guided n-back with cues, and in the bilateral occipital lobe, superior parietal region, and cingulate cortices in the n-back without cues. The left middle frontal gyrus was implicated in the load-dependent processing of WM in both groups. Further group analysis identified that the notable activation changes in the frontal gyri and anterior cingulate cortex are according to low and high loads. Though relatively smaller in scale, this study was eminent as it clarified the neural alterations in WM in the mild-moderate TBI group compared to healthy controls. It confirmed the robustness of the phenomenon in TBI with the reproducibility of the results in a heterogeneous non-Western sample.

Prevalence of psychological distress among cancer patients in Southeast Asian countries: A systematic review.

Psychological distress (including depression and anxiety) is common in the first years of cancer diagnosis but can differ by country and region. The aim of the present paper was to review the prevalence of psychological distress among cancer patients in the Southeast Asia (SEA) region. A systematic literature search was carried out using several databases (i.e., PubMed, PsychARTICLES, Embase, CINAHI, Web of Sciences, Plus, Scopus, and AHMED). Papers originally published in English language were taken into consideration if they (i) were published from 2010 to 2021 and (ii) reported the prevalence of psychological distress among patients with different types of cancer. A total of 23 studies met the inclusion criteria. The most frequently employed psychometric instrument for anxiety and depression screening was the Hospital Anxiety and Depression Scale (HADS). The prevalence of anxiety (ranging from 7% to 88%) was wider than that of depression (ranging from 3% to 65.5%) among patients with different types of cancer and living in various countries in the SEA region. The overall prevalence rate of psychological distress among cancer patients from the SEA region was not fundamentally very different from that of general populations. These findings provide useful information for health professionals and cancer patients to understand the negative role of psychological distress in quality of life and health. The research findings demonstrate the importance of counselling for psychological distress among cancer patients as means of effectively resolving their psychological problems and ultimately improving the quality of oncology medical care. Clinical recommendations for cancer management should incorporate the early identification of (and therapy for) psychological distress, as well as their monitoring during treatment.

Nutritional values of Baccaurea pubera and comparative evaluation of SHS treatment on its antioxidant properties.

Baccaurea pubera is a blood red coloured fruit found exclusively in Borneo. This study was conducted to evaluate the effect of superheated steam treatment on its antioxidant properties and mineral content as well as to determine nutritional values of the fruit. The fruits were treated with superheated steam at 170 °C for 15 min prior to extraction and freeze drying. The results showed that, in comparison to the control, superheated steam treatment enhanced the total phenolic content by 147.8% (287.16 mg GAE/100 g vs. 115.87 mg GAE/100 g) and DPPH radical scavenging activity by 23.7% (66.94% vs. 54.13%). However, there were reductions, as compared to the control treatments, in total flavonoid content by 16.5% (8.29 mg QE/100 g vs. 9.93 mg QE/100 g), lycopene content by 28.6% (0.020 µg/100 g vs. 0.028 µg/100 g) and ferric reducing antioxidant power by 22.2% (844.41 mg TE/100 g vs. 1085.15 mg TE/100 g). The superheated steam treatment was also observed to reduce the mineral content of the fruit, from as little as 3.6% to as high as 52% depending upon the specific mineral.

Parent-report instruments for assessing feeding difficulties in children with neurological impairments: a systematic review.

AIM: This study aimed to review the psychometric properties and clinical application of parent-report instruments that assess feeding difficulties in children with neurological impairments. METHOD: Papers were identified through five electronic databases based on 15 keywords and were included if they met the following criteria: published in English, described the implementation of parent-report instruments, and included children with neurological impairments (either in the report or a related study population). RESULTS: In total, 1220 relevant abstracts were screened and 22 full-text articles were evaluated. The following six parent-report instruments met the inclusion criteria: (1) Screening Tool of Feeding Problems applied to children, (2) Paediatric Eating Assessment Tool, (3) Paediatric Assessment Scale for Severe Feeding Problems, (4) Montreal Children's Hospital Feeding Scale, (5) Children's Eating Behaviour Inventory, and (6) Behavioural Paediatric Feeding Assessment Scale (BPFAS). Based on comprehensive psychometric testing and consistently good results, the BPFAS was considered the most valid and reliable instrument. The BPFAS also showed good clinical applicability because it was readily available, required a short administration time, and used a simple scoring system. INTERPRETATION: We reviewed the available parent-report instruments for assessing feeding difficulties in children with neurological impairments. The BPFAS had the best psychometric properties and clinical applicability. WHAT THIS PAPER ADDS: Six parent-report instruments were suitable for assessing feeding in children with neurological impairments. The Behavioural Paediatric Feeding Assessment Scale (BPFAS) has the strongest psychometric properties. The BPFAS also has good clinical applicability.

Psychological traits underlying different killing methods among Malaysian male murderers.

Murder is the most notorious crime that violates religious, social and cultural norms. Examining the types and number of different killing methods that used are pivotal in a murder case. However, the psychological traits underlying specific and multiple killing methods are still understudied. The present study attempts to fill this gap in knowledge by identifying the underlying psychological traits of different killing methods among Malaysian murderers. The study adapted an observational cross-sectional methodology using a guided self-administered questionnaire for data collection. The sampling frame consisted of 71 Malaysian male murderers from 11 Malaysian prisons who were selected using purposive sampling method. The participants were also asked to provide the types and number of different killing methods used to kill their respective victims. An independent sample t-test was performed to establish the mean score difference of psychological traits between the murderers who used single and multiple types of killing methods. Kruskal-Wallis tests were carried out to ascertain the psychological trait differences between specific types of killing methods. The results suggest that specific psychological traits underlie the type and number of different killing methods used during murder. The majority (88.7%) of murderers used a single method of killing. Multiple methods of killing was evident in 'premeditated' murder compared to 'passion' murder, and revenge was a common motive. Examples of multiple methods are combinations of stabbing and strangulation or slashing and physical force. An exception was premeditated murder committed with shooting, when it was usually a single method, attributed to the high lethality of firearms. Shooting was also notable when the motive was financial gain or related to drug dealing. Murderers who used multiple killing methods were more aggressive and sadistic than those who used a single killing method. Those who used multiple methods or slashing also displayed a higher level of minimisation traits. Despite its limitations, this study has provided some light on the underlying psychological traits of different killing methods which is useful in the field of criminology.

Increased behavioural problems associated with corticosteroid use in children with nephrotic syndrome: a Southeast Asian perspective.

Introduction: The study was performed to determine the psychological problems in children with idiopathic nephrotic syndrome (INS) while they were on steroid therapy, as compared to healthy children. Methods: This prospective cohort study was conducted in a paediatric clinic of a tertiary hospital. Parents of the participants in the INS group and control group (comprising children without chronic illness) completed questionnaires using the Child Behavioural Checklist (CBCL). The CBCL measures a range of age-specific emotional and psychological problems, including internalising and externalising domains. Analyses of the CBCL scores between groups were done using Mann-Whitney U test. Results: A total of 140 children were recruited with an equal number in the INS and control groups. There was a significant difference in the mean total CBCL scores between the INS group and the control group, specifically in the withdrawal, somatic, anxious and aggressiveness subdomains. Similar findings were demonstrated in correlation between total psychological problems and corticosteroid dosage. In the INS group, steroid dose and cushingoid features were found to have a significant positive association with internalising psychological problems. Conclusion: Children with INS on corticosteroid treatment showed an increase in internalising and externalising scores, as compared to healthy children.

Depressive, Anxiety, and Stress Symptoms in Parents of Children Being Admitted for Febrile Seizures in a Tertiary Hospital in the East Coast of Malaysia.

Febrile seizures in children are an alarming experience for parents. This study aimed to assess the psychological functioning of parents of children when they were being admitted for treatment of febrile seizures in the hospital, the importance of which is clear, since parents are the primary custodian of their children. This is a cross-sectional study conducted on 110 participants whose child had been admitted for a febrile seizure to Hospital Universiti Sains Malaysia from September 2020 until June 2021. The depression, anxiety, and stress levels were determined based on a validated Bahasa Melayu questionnaire of the Depression Anxiety Stress Scale (DASS-21). In addition, multiple logistic regression was used to determine the associated factors related to the participants' psychological functioning. The mean age of children with febrile seizures were 21 months old, and most children showed features of simple febrile seizures (71.8%). The prevalence of anxiety, stress, and depression were 58.2%, 29%, and 23.6%, respectively. Using multiple logistic regression, child age, family history of febrile seizures, family history of epilepsy, and length of stay in the ward were found to be significantly associated with anxiety when adjusted for other variables. Otherwise, for depression and stress, no significant associated variables were found when adjusted for other variables. Anxiety was highly reported by participants when their children were admitted for febrile seizures. Several factors impacted their anxiety, including the lower the child's age was, participants with no family history of febrile seizures before, and the longer duration of hospital stay. Therefore, further study and intervention on reducing the parent's anxiety could be emphasized in the future.

Psychological distress and coping strategies among the caretakers of children with transfusion-dependent thalassemia.

Introduction: Thalassemia is a chronic childhood disease that could result in psychological distress not only to the patients but also to their caretakers. Caretakers utilize different coping strategies to reduce stress and maintain a good quality of life. Objective: The study aims to measure the level of psychological distress among caretakers of transfusion-dependent thalassemia patients and identify coping strategies used by them, as well as examine factors related to both outcome measures. Methods: Sixty-eight (N = 68) caretakers of children with transfusion-dependent thalassemia agreed to participate in the study when they were approached during their visits to one of three major hospitals in Kelantan, Malaysia, for the children's medical treatment. They completed the Malay validated Depression Anxiety and Stress Scale 21 (DASS 21) and Brief-COPE self-report, in addition to a brief study proforma. Results: The majority of the participants reported feeling psychologically well, with no related scores in depression, anxiety, and stress sub-scales. The mean score for anxiety and stress sub-scales were 3.54 (SD = 3.54) and 4.25 (SD = 3.26) respectively. The median score for the depression sub-scale was 2.00 (IQR 4.00). The three mostly utilized coping strategies were religion, acceptance, and positive reframing. Those with depressed and anxious moods were found to engage more in negative coping strategies including substance abuse, denial, and behavioral disengagement. Being female, of younger age, employed, with higher educational level, and income status was found to significantly influence the adoption of positive reframing as a coping strategy. Conclusion: Psychological distress such as elevated anxiety and depression was found among a small portion of caretakers who have children with thalassemia whose treatment required blood transfusion. They were noted to apply more maladaptive coping strategies compared to their psychologically well counterparts.

Subjective Wellbeing and Its Associated Factors among University Community during the COVID-19 Pandemic in Northern Malaysia.

Lockdown implementation during COVID-19 pandemic has caused many negative impacts in various aspect of life, including in the academic world. Routine disruption to teaching and learning environment has raised concerns to the wellbeing of university staff and students. This study aimed to examine the subjective wellbeing of the university community in Northern Malaysia during lockdown due to COVID-19 pandemic and the factors affecting it. An online cross-sectional survey involving 1148 university staff and students was conducted between March and April 2020. The research tools include the Personal Wellbeing Index (PWI) to assess subjective wellbeing and the Depression, Anxiety and Stress 21 (DASS-21) scale for psychological distress. While we found the subjective wellbeing score in our study population was stable at 7.67 (1.38), there was high prevalence of anxiety, depression, and stress with 27.4%, 18.4%, and 11.5%, respectively. The students reported higher levels of psychological distress compared to staff. The PWI score was seen to be inversely affected by the depression and stress score with a reduction in the PWI score by 0.022 (95% CI -0.037 to -0.007) and 0.046 (95% CI -0.062 to -0.030) with every one-unit increment for each subscale, respectively. Those who perceived to have more difficulty due to the lockdown also reported low subjective wellbeing. Thus, it is crucial to ensure policies and preventative measures are in place to provide conducive teaching and learning environment. Additionally, the detrimental psychological effects especially among students should be addressed proactively.

Alteration in the Functional Organization of the Default Mode Network Following Closed Non-severe Traumatic Brain Injury.

The debilitating effect of traumatic brain injury (TBI) extends years after the initial injury and hampers the recovery process and quality of life. In this study, we explore the functional reorganization of the default mode network (DMN) of those affected with non-severe TBI. Traumatic brain injury (TBI) is a wide-spectrum disease that has heterogeneous effects on its victims and impacts everyday functioning. The functional disruption of the default mode network (DMN) after TBI has been established, but its link to causal effective connectivity remains to be explored. This study investigated the differences in the DMN between healthy participants and mild and moderate TBI, in terms of functional and effective connectivity using resting-state functional magnetic resonance imaging (fMRI). Nineteen non-severe TBI (mean age 30.84 ± 14.56) and twenty-two healthy (HC; mean age 27.23 ± 6.32) participants were recruited for this study. Resting-state fMRI data were obtained at the subacute phase (mean days 40.63 ± 10.14) and analyzed for functional activation and connectivity, independent component analysis, and effective connectivity within and between the DMN. Neuropsychological tests were also performed to assess the cognitive and memory domains. Compared to the HC, the TBI group exhibited lower activation in the thalamus, as well as significant functional hypoconnectivity between DMN and LN. Within the DMN nodes, decreased activations were detected in the left inferior parietal lobule, precuneus, and right superior frontal gyrus. Altered effective connectivities were also observed in the TBI group and were linked to the diminished activation in the left parietal region and precuneus. With regard to intra-DMN connectivity within the TBI group, positive correlations were found in verbal and visual memory with the language network, while a negative correlation was found in the cognitive domain with the visual network. Our results suggested that aberrant activities and functional connectivities within the DMN and with other RSNs were accompanied by the altered effective connectivities in the TBI group. These alterations were associated with impaired cognitive and memory domains in the TBI group, in particular within the language domain. These findings may provide insight for future TBI observational and interventional research.

Disruption of white matter integrity and its relationship with cognitive function in non-severe traumatic brain injury.

Background: Impairment in cognitive function is a recognized outcome of traumatic brain injury (TBI). However, the degree of impairment has variable relationship with TBI severity and time post injury. The underlying pathology is often due to diffuse axonal injury that has been found even in mild TBI. In this study, we examine the state of white matter putative connectivity in patients with non-severe TBI in the subacute phase, i.e., within 10 weeks of injury and determine its relationship with neuropsychological scores. Methods: We conducted a case-control prospective study involving 11 male adult patients with non-severe TBI and an age-matched control group of 11 adult male volunteers. Diffusion MRI scanning and neuropsychological tests were administered within 10 weeks post injury. The difference in fractional anisotropy (FA) values between the patient and control groups was examined using tract-based spatial statistics. The FA values that were significantly different between patients and controls were then correlated with neuropsychological tests in the patient group. Results: Several clusters with peak voxels of significant FA reductions (p < 0.05) in the white matter skeleton were seen in patients compared to the control group. These clusters were located in the superior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus, and cingulum, as well as white matter fibers in the area of genu of corpus callosum, anterior corona radiata, superior corona radiata, anterior thalamic radiation and part of inferior frontal gyrus. Mean global FA magnitude correlated significantly with MAVLT immediate recall scores while matrix reasoning scores correlated positively with FA values in the area of right superior fronto-occipital fasciculus and left anterior corona radiata. Conclusion: The non-severe TBI patients had abnormally reduced FA values in multiple regions compared to controls that correlated with several measures of executive function during the sub-acute phase of TBI.

Effectiveness of Psycho-Education Intervention Programme on Coping Strategies Among Jordanian Women Diagnosed with Breast Cancer: A Randomised Controlled Trial.

OBJECTIVE: This study aimed to assess the effectiveness of a psycho-education intervention programme in improving the coping strategies of Jordanian breast cancer patients. METHODS: A double-blinded randomised control trial involving 200 participants between the ages of 20 to 65 years old breast cancer patients was performed. Apart from those who refused participation, patients with chronic diseases and extreme baseline depression scores were also excluded. The control group received standard care twice a week from the social welfare services team facilitator compared to the intervention group that received additional psycho-education intervention programme (PEIP). The coping strategies were measured using the Brief-COPE inventory consisting of 28 items. It was administered on the second and 12th week of trial. The primary end point was compared between pre- and post-intervention. The effect of the intervention between groups, time, and covariates was measured using the generalised linear mixed model (GLMM) analysis. RESULTS: The mean (SD) of adaptive coping score among the intervention group increased from 5.63 (1.3) at baseline to 6.42 (1.3) at post-intervention. The mean avoidant coping score was 3.87 (1.1) at baseline but reduced to 3.69 (0.8) post-intervention. GLMM showed that women who received the intervention reported significantly higher usage of the adaptive coping strategies after attending the programme (B=0.921, p <0.001). CONCLUSION: PEIP significantly improved knowledge of breast cancer patients. Thus, this programme may be considered as a part of the healthcare services in Jordan towards improving the adaptive coping strategies among breast cancer patients, which may point towards the potential for these services to increase adaptive coping strategies among patients in Jordan. IMPLICATIONS FOR PUBLIC HEALTH: PEIP may be considered as psychosocial intervention in public health and healthcare setting to address rising concerns on quality of care among breast cancer patients.

The Validity and Reliability of the Malay Version of the Cyberbullying Scale among Secondary School Adolescents in Malaysia.

The effect of cyberbullying among adolescents in Malaysia is not much studied. The Cyberbullying Scale (CBS) has been validated to be used among English speaking adolescents to measure cyberbullying but not in Malay language. Therefore, its validity should be established before use in the Malaysian context. Thus, the study aimed to evaluate the validity and reliability of the Malay version of the CBS (CBS-M) among secondary school students. The study was cross-sectional and involved a self-administered questionnaire with 16 items from CBS-M, and 21 items from the Depression, Anxiety, and Stress Scale (DASS-21). Participants were recruited using a multi-stage sampling method. The validity of the CBS-M was tested in two phases, namely, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Spearman's correlation was used to examine the strength of the relationship between the CBS and subscales from DASS-21 to further support the validity of CBS-M. A total of 401 respondents from Muar, Johor, participated. The mean age was 14.6 years (SD = 1.25). EFA results indicated a one-factor model of CBS-M with a total variance extracted of 33.9%. Internal consistency measured by Cronbach's alpha reached 0.87. The model was then tested using CFA. The initial model did not fit the data well. Thus, several model re-specifications were conducted on the initial model. The final measurement model of CBS-M fit the data well with acceptable fit indices (CFI = 0.946, TLI = 0.932, SRMR = 0.055, RMSEA = 0.049). The composite reliability for CBS-M was satisfactory with a value of 0.832. The CBS-M questionnaire is a valid and reliable tool for measuring cyberbullying among young adolescents in Malaysia.

Association between secondhand smoke exposure at home and cognitive performance among rural primary school children in Malaysia.

INTRODUCTION: Secondhand smoke (SHS) exposure is linked to a series of serious health problems. Children may be particularly vulnerable to the effects of SHS exposure at home. This study aimed to determine the association between SHS exposure at home and cognitive performance in school children. METHODS: A multistage sampling was performed across rural primary schools in Kuala Krai, Kelantan, Malaysia. Data were collected using self-administered questionnaires and the children aged 10-11 years (n=312) were subjected to cognitive tests including digit span, letter-number sequencing, coding, and symbol search. Cognitive performance was tested using subscales derived from the Wechsler Intelligence Scale for Children. RESULTS: The prevalence of SHS exposure at home was 55.8%, where 11.9% of children lived with one smoker, while 43.9% of children lived with ≥2 smokers. There was a significant difference in the mean score of the combined cognitive tests between SHS-exposed and non-exposed children after adjustment for sex, parental educational level, family income and academic performance [Pillai's Trace=0.084, F statistic (df)=6.803 (4302), p<0.001]. CONCLUSIONS: More than half of the primary school children in rural Kuala Krai were exposed to SHS from at least one smoker at home. There was a significant association between SHS exposure at home and cognitive performance.

Predisposing Factors and Impact of Child Victimization: A Qualitative Study.

Sexual abuse of children is increasing at an alarming rate. This study aims to describe the risk factors and the effects of sexual abuse on children. This unobtrusive qualitative study was conducted on children aged 10 to 18 years old who experienced sexual abuse and followed-up at a psychiatric clinic between the years 2019 and 2021. The information from case records was transcribed. Thematic analysis was performed. Thirty case records were reviewed. The mean age of the victims was 14.6 years; 94% of the victims had experienced vaginal penetration, and 23% of the cases involved incest. The results indicated that socio-psychological predisposing factors involving family structure and dynamic dysfunction, low intrapersonal strength, social influence, and low family socioeconomic status could lead to sexual victimization. This sexual victimization can then lead to emotional turmoil, negative effects on cognitive, academic and social function, negative parental reactions toward the incident, the creation of baby-mother relationships and love-hate relationships, and a lack of goals and hope for the future. Children who experienced sexual abuse may show rape or pregnancy symptoms but may also show entirely non-specific ones. A thorough examination of their history, including biopsychosocial aspects, is necessary to appropriately care for them.

The Psychology of Murder Concealment Acts.

The escalating trend of murder victim concealment worldwide appears worrying, and literature does not reveal any specific study focusing on victim concealment amongst convicted male Malaysian murderers. Therefore, this study was aimed at investigating the psychological traits that may underlie the act of murder concealment in Malaysia via mixed method approaches. Male murderers (n = 71) from 11 prisons were selected via purposive sampling technique. In the quantitative analysis, a cross-sectional study design using the validated questionnaire was used. The questionnaire contained murder concealment variables and four Malay validated psychometric instruments measuring: personality traits, self-control, aggression, and cognitive distortion. The independent sample t-tests revealed the significantly higher level of anger in murderers who did not commit concealment acts (8.55 ± 2.85, p < 0.05) when compared with those who did so (6.40 ± 2.64). Meanwhile, the Kruskal-Wallis H test revealed that anger and the personality trait of aggressiveness-hostility significantly varied across the different groups of murder concealment acts (p < 0.05). The qualitative data obtained via the in-depth interviews revealed two important themes for the murderers to commit murder concealment acts: (1) fear of discovery and punishment and (2) blaming others. These findings discussed from the perspectives of the murderers within the context of criminology and psychology may provide the first ever insight into the murder concealment acts in Malaysia that can benefit the relevant authorities for crime prevention and investigation efforts.

Piloting a psycho-education program for parents of pediatric cancer patients in Malaysia.

OBJECTIVE: To evaluate a psycho-educational program (PeP) for parents of children with cancer (PoCwC) in Malaysia. METHODS: Seventy-nine parents were invited to be either in an intervention (n=41) or a control group (n=38). Baseline assessment took place upon agreement of participation. Short-term effects were measured four weeks after the intervention. Control parents received standard care. Intervention parents received, in addition to standard care, 4 x 50 min sessions of information on childhood cancer and coping strategies. RESULTS: Repeated measures of ANOVAs revealed increased knowledge about cancer (p=0.01) in the intervention parents compared with standard care. Intervention parents reported reduced anxiety and increased activities with children after the program; however, differences were not significant. CONCLUSIONS: This PeP, the first of its kind in Malaysia, has significantly increased levels of knowledge among parents of seriously ill children which may point towards the potential for these services to increase coping in Malaysian PoCwC.

Barriers to unmet needs among mothers of children with disabilities in Kelantan, Malaysia: A qualitative study.

OBJECTIVES: The present study aimed to determine the barriers that deter mothers of children with disabilities from attaining their unmet needs. METHODS: In-depth interviews of 12 mothers of children with disabilities were conducted from November 2014 to January 2015 in Kelantan, Malaysia. The mothers were recruited by purposive sampling. Thematic analysis was used for identifying, analysing and reporting the data. RESULTS: Barriers to the unmet needs among mothers of children with disabilities were found to stem from the mothers' expectation and further propagated by lack of support, the role of healthcare professionals in providing care, inappropriate policies and shortage of resources required for survival and maintaining care. CONCLUSIONS: Identification of the barriers to the attainment of unmet needs among mothers of disabled children is crucial for resolving the issue of unmet needs. Deeper understanding of these barriers may facilitate positive actions toward addressing the needs of these mothers and to alleviate the stress on mothers of disabled children. A concerted effort to coordinate services across all disciplines is required to dismantle these barriers by improving the provision of health care delivery and evaluation of welfare policies and services.

A psychologist-led educational intervention results in a sustained reduction in neonatal intensive care unit infections.

UNLABELLED: Even though in the corporate world psychological science has been widely used, the formal use of evidence-based psychology in important areas of clinical medicine has been scanty at best. It was the aim of this study to determine the efficacy of a psychologist-led 2-week nurse educator training on the infection rate in the neonatal intensive care unit (NICU). MATERIALS AND METHODS: In 2007, six senior neonatal nurses underwent a training course focusing on the retrieval of evidence and knowledge of psychological principles that would allow them to share the evidence in such a way that evidence is effectively brought into practice. The course was led by a psychologist. The nurses created and delivered their own teaching modules, all focused on infection control. The rates of bacteremia, 2 years prior to intervention were analyzed and compared with the rate following the intervention for 3 years. RESULTS: The immediate output of the course included three teaching modules: hand washing, sterile procedures, and general measures to control infection. These modules were subsequently administered to the NICU nurses in regular structured continuous nursing education sessions. The psychological techniques taught in the course were applied. Bacteremia in the NICU significantly decreased in the year of the course and the subsequent years when compared to previous years (from more than 17 in 2005 and 2006 to less than 10 per 100 admissions to the NICU in 2008 and 2009). CONCLUSION: This study suggests that a psychologist-led course, followed by a structured CNE can lead to a sustainable reduction in infection rates in a NICU.