Computed tomography study of cranial vault thickness in Malaysian subadult population.

Cranial vault thickness (CVT) and its variations provide valuable insights into an individual's biological attributes such as age and sex. This paper aimed to assess the correlations of CVT with age and sex and develop a regression model for age estimation in Malaysian subadults using computed tomography (CT) images. A total of 521 CT images (male/female: 279/242; age range: 0-20 years; Malay/Chinese/Indian: 221/145/155) were included in the study. Correlations of CVT measurements with age and sex, including frontal bone thickness (FBT), occipital bone thickness (OBT), left parietal bone thickness (LPBT), and right parietal bone thickness (RPBT) were assessed and regression formulae were developed for age estimation in subadults. A significant correlation between CVT measurements and age was demonstrated (p < 0.001). Age estimation was most accurate in the younger age group (< 2 years) at frontal and occipital, and accuracy decreases in the older age groups. Additionally, sexual dimorphism was evident in the frontal and parietal bone thickness within the age range of 3-6 years and 16-20 years, respectively. In conclusion, the findings suggested CVT measurements could be used to corroborate other age estimation methods for subadults.

Development of Malaysian-MIND diet scores for prediction of mild cognitive impairment among older adults in Malaysia.

BACKGROUND: Mild Cognitive impairment (MCI) is a pre-demented state in the elderly populace. The Mediterranean & Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet has shown promise in reducing the risk of MCI and Alzheimer's disease in older people. Notably, the existing MIND diet is not adapted to the specific needs of older adults in Malaysia, considering distinct food cultures and availability. Consequently, this study aimed to develop the Malaysian version of the MIND diet (MY-MINDD) scores and investigate their association with MCI in the older adult populace of Malaysia. METHODS: A comprehensive pooled data analysis was conducted on combined data from 810 participants sourced from the longitudinal Long-Term Research Grant Scheme-Towards Useful Aging (LRGS-TUA) and Fundamental Research Grant Scheme (FRGS) studies. The MY-MINDD scores were developed by incorporating existing MIND diet food groups, their corresponding scoring mechanisms, and consideration of common Malaysian foods which are proven to be beneficial and detrimental to cognitive function. To substantiate the MY-MINDD scoring system, its association with MCI was evaluated using a series of validated neuropsychological test batteries. RESULTS: MY-MINDD consists of seven food groups promote brain health and four food groups exert negative cognitive outcomes. The study participants had an average age of 67.9 ± 4.7 years. The collective MY-MINDD score for all participants was 6.4 ± 0.1 (out of a maximum 11 points), revealing a lower score in individuals with MCI at 6.0 ± 1.7 compared to those without MCI at 6.6 ± 1.6 (p < 0.001). According to hierarchical multivariate binary logistic regression analysis, being in the highest tertile of MY-MINDD score was linked to reduced odds of MCI (odds ratio (OR) = 0.43, 95% confidence interval (CI): 0.26-0.72, p < 0.001) in the fully adjusted model in comparison to the lowest tertile. CONCLUSION: The development of the MY-MINDD scores for Malaysian older population revealed that a stronger adherence to this diet is linked to a reduced risk of MCI. Further substantiation of the MY-MINDD scores using more objective measures, such as neuroimaging approaches and other neuropsychological batteries, is necessary.

The concept of cognitive readiness: potential solution and opportunity for the Malaysian army.

This paper focuses on exploring the potential solution and opportunity in the development of the Malaysian Army Transformation Plan by using the concept of Cognitive Readiness (CR). Here, the concept of CR equipped the military personnel to be cognitively ready to perform their role in military operations. The main aim of the paper is to highlight the fundamental discourse of 'what is cognitive readiness' in discovering the potential solution and opportunity in the development of the Malaysian Army Transformation Plan. The paper suggests that the strategy for transformation may start at the tactical level by focusing on enhancing the military personnel's CR. The study proposed that the Malaysian Army Organization prepare the military personnel with Knowledge, Skills and Abilities (KSA). KSA are important to boost the military personnel to have a distinctive character such as thinking critically, problem-solving and decision-making to perform effectively during military operations. In this preliminary study, the paper proposed a Framework for Tactical Cognitive Readiness (TCR) as a potential solution and opportunity for the Malaysian Army.

Agrobacterium-mediated in planta transformation of cut coleoptile: a new, simplified, and tissue culture-independent method to deliver the CRISPR/Cas9 system in rice.

BACKGROUND: Agrobacterium-mediated transformation and particle bombardment are the two common approaches for genome editing in plant species using CRISPR/Cas9 system. Both methods require careful manipulations of undifferentiated cells and tissue culture to regenerate the potentially edited plants. However, tissue culture techniques are laborious and time-consuming. METHODS AND RESULTS: In this study, we have developed a simplified, tissue culture-independent protocol to deliver the CRISPR/Cas9 system through in planta transformation in Malaysian rice (Oryza sativa L. subsp. indica cv. MR 219). Sprouting seeds with cut coleoptile were used as the target for the infiltration by Agrobacterium tumefaciens and we achieved 9% transformation efficiency. In brief, the dehusked seeds were surface-sterilised and imbibed, and the coleoptile was cut to expose the apical meristem. Subsequently, the cut coleoptile was inoculated with A. tumefaciens strain EHA105 harbouring CRISPR/Cas9 expression vector. The co-cultivation was conducted for five to six days in a dark room (25 ± 2 °C) followed by rooting, acclimatisation, and growing phases. Two-month-old plant leaves were then subjected to a hygromycin selection, and hygromycin-resistant plants were identified as putative transformants. Further validation through the polymerase chain reaction verified the integration of the Cas9 gene in four putative T0 lines. During the fruiting stage, it was confirmed that the Cas9 gene was still present in three randomly selected tillers from two 4-month-old transformed plants. CONCLUSION: This protocol provides a rapid method for editing the rice genome, bypassing the need for tissue culture. This article is the first to report the delivery of the CRISPR/Cas9 system for in planta transformation in rice.

Implementation of the energy efficiency existing ship index and carbon intensity indicator on domestic ship for marine environmental protection.

The International Maritime Organization has set a goal to achieve a 50% reduction of total annual greenhouse gas emission related to the international shipping by 2050 compared to the 2008 baseline emissions. Malaysia government has taken an initiative to investigate the assessment (cost-effectiveness) of this International Maritime Organization's short-term measure on Malaysian-registered domestic ships although this measure is only for international merchant ship. To achieve this, this paper collected the ship's data from the shipowners from 25 sample ships. Engine power limitation is the most cost-effective option, but low power limits can lead to substantially increased sailing times. Based on cost-efficiency analysis, it creates for the purpose of compliance with the operational carbon intensity indicator. It found that even if it is possible to bring an asset back into service, it may not be possible to do so in a manner that generates a profit or complies with applicable regulations. In these situations, it may be more prudent to scrap the asset rather than run the risk of having it become a stranded asset. This is especially true for older tankers. Alternatives with lengthy payback periods are not desirable for the domestic tanker fleet that is already in operation.

High pressure CO2 adsorption onto Malaysian Mukah-Balingian coals: Adsorption isotherms, thermodynamic and kinetic investigations.

CO2 sequestration into coalbed seams is one of the practical routes for mitigating CO2 emissions. The adsorption mechanisms of CO2 onto Malaysian coals, however, are not yet investigated. In this research CO2 adsorption isotherms were first performed on dry and wet Mukah-Balingian coal samples at temperatures ranging from 300 to 348 K and pressures up to 6 MPa using volumetric technique. The dry S1 coal showed the highest CO2 adsorption capacity of 1.3 mmol g-1, at 300 K and 6 MPa among the other coal samples. The experimental results of CO2 adsorption were investigated using adsorption isotherms, thermodynamics, and kinetic models. Nonlinear analysis has been employed to investigate the data of CO2 adsorption onto coal samples via three parameter isotherm equilibrium models, namely Redlich Peterson, Koble Corrigan, Toth, Sips, and Hill, and four parameter equilibrium model, namely Jensen Seaton. The results of adsorption isotherm suggested that the Jensen Seaton model described the experimental data well. Gibb's free energy change values are negative, suggesting that CO2 adsorption onto the coal occurred randomly. Enthalpy change values in the negative range established that CO2 adsorption onto coal is an exothermic mechanism. Webber's pore-diffusion model, in particular, demonstrated that pore-diffusion was the main controlling stage in CO2 adsorption onto coal matrix. The activation energy of the coals was calculated to be below -13 kJ mol-1, indicating that adsorption of CO2 onto coals occurred through physisorption. The results demonstrate that CO2 adsorption onto coal matrix is favorable, spontaneous, and the adsorbed CO2 molecules accumulate more onto coal matrix. The observations of this investigation have significant implications for a more accurate measurement of CO2 injection into Malaysian coalbed seams.

Optimizing timber transportation planning for timber harvesting using bees algorithm in Malaysia.

Suitable extraction technique and the least cost while reducing the environmental impact is the primary concern in timber transportation planning in undulate topography. Two types of extraction machines with unique characteristics to be applied in timber harvest area in Malaysia is combined for timber harvesting with the aim each machine will extract timber suitable to their ability. A Bees Algorithm (BA) was proposed to find an optimum TTP for timber extraction, forest road, and landing locations with grid cell-sized 10 m × 10 m and attributed with fixed and variable costs. The result shows the log fisher (1351 timbers) as a preferable extraction technique with total cost of RM 86,551.73 than the crawler tractor (206 timbers); the timber extraction route is 2630 m for the log fisher and 9860 m for the crawler tractor with total cost of RM 10,453.03. The model finds a suitable timber extraction technique and estimates the extraction costs. Further studies are required to compare the BA with other optimization methods for better results.

Triage: A Global Perspective.

Triage is a process by which patients are assessed, classified, and sorted based on their presenting complaint and clinical urgency, providing assurance for timely access to emergency care. The goal is to get the right person to the right place, in the right amount of time, for the right reason, and within the context of resource availability. In many countries, a standardized triage system, underpinned through the use of guidelines, is used to provide clinicians with support and guidance. Triage is a globally adopted principle, and although triage guidelines are used in many countries, no single system has been internationally adopted. This paper discusses the importance of how triage process standardization improves patient care, resource management, and benchmarking at local, national, and international levels by applying 5 internationally recognized triage systems to fictional case studies. Evaluation of similarities and differences in severity scores, with a gap analysis, occurs.

Metabolomics based biomarker identification of anti-diabetes and anti-obesity properties of Malaysian herbs.

BACKGROUND: Today, obesity affects over one-third of the global population and is hugely considered the Industrial Revolution's side effect. This multi-factorial disease is continuously spreading across developing countries, including the Middle East and Southeast Asia region, where Malaysia and Darussalam Brunei are the most affected. The sedentary lifestyle and availability of surplus foods have dramatically increased the number of individuals with type 2 diabetes in these countries. Thus, an adequate medical strategy must be developed urgently to address and remedy these diseases. Natural sources have been attracting attention, especially in Malaysia, where most land areas are under plant cover. Metabolomics, as a prophylactic technique, has been used extensively in Malaysia to investigate the potential use and benefits of herbs to combat obesity and diabetes. AIM OF REVIEW: This review aims to explain the application of the metabolomics approach in the study of anti-diabetes and anti-obesity activity of Malaysian herbs to identify the stand-up point for future advancement in using these herbs as a primary source for drug exploration. KEY SCIENTIFIC CONCEPTS OF REVIEW: This review provides an overview of using metabolomics technique in studying the anti-diabetes and anti-obesity activity of Malaysian herbs. Specific emphasis is given to the changed metabolites in both in vivo and in vitro treatment of Malaysia herbs that might be future drugs for treating diabetes and obesity.

Looking beyond history: tracing the dispersal of the Malaysian complex of crops to Africa.

In his 1959 book, Africa: Its Peoples and Their Culture History, George P. Murdock suggested that a Malaysian complex of crops dispersed to Africa in ancient times across the Indian Ocean along the Sabaean Lane. The Malaysian complex comprised bananas, sugarcane, taro, three yam species, rice, Polynesian arrowroot, breadfruit, coconut, areca palm, and betel leaf. Except for rice, arrowroot, and potentially taro, most of these crops were domesticated in the Island Southeast Asia-New Guinea region, from where they dispersed to Africa. Our reassessment of agronomic, archaeological, classical, genetic, and historical sources shows that we need to go beneath standard historical narratives to recover a much more ancient and complex history of crop introductions to Africa. Despite considerable uncertainty and fragmented research, we were able to conclude that the Malaysian complex of crops did not arrive in Africa as a complete assemblage at one time or along one route. Multiple lines of evidence suggest that these crops arrived in Africa at different times and followed different pathways of introduction to the continent.

Malaysian Society of Gastroenterology and Hepatology consensus statement on metabolic dysfunction-associated fatty liver disease.

The Malaysian Society of Gastroenterology and Hepatology saw the need for a consensus statement on metabolic dysfunction-associated fatty liver disease (MAFLD). The consensus panel consisted of experts in the field of gastroenterology/hepatology, endocrinology, bariatric surgery, family medicine, and public health. A modified Delphi process was used to prepare the consensus statements. The panel recognized the high and increasing prevalence of the disease and the consequent anticipated increase in liver-related complications and mortality. Cardiovascular disease is the leading cause of mortality in MAFLD patients; therefore, cardiovascular disease risk assessment and management is important. A simple and clear liver assessment and referral pathway was agreed upon, so that patients with more severe MAFLD can be linked to gastroenterology/hepatology care, while patients with less severe MAFLD can remain in primary care or endocrinology, where they are best managed. Lifestyle intervention is the cornerstone in the management of MAFLD. The panel provided a consensus on the use of statin, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, sodium-glucose cotransporter-2 inhibitor, glucagon-like peptide-1 agonist, pioglitazone, vitamin E, and metformin, as well as recommendations on bariatric surgery, screening for gastroesophageal varices and hepatocellular carcinoma, and liver transplantation in MAFLD patients. Increasing the awareness and knowledge of the various stakeholders on MAFLD and incorporating MAFLD into existing noncommunicable disease-related programs and activities are important steps to tackle the disease. These consensus statements will serve as a guide on MAFLD for clinicians and other stakeholders.

A qualitative exploration: Dietary behaviour of Malaysian breast cancer survivors.

OBJECTIVE: This study aimed to explore the dietary practices and factors affecting Malaysian breast cancer survivors' dietary behaviours. METHODS: We conducted an in-depth qualitative interview on 20 participants from a cohort study. An ecological framework was used to construct the semi-structured topic guide. The interviews were audio-recorded and transcribed verbatim. Thematic analysis with theoretical saturation was used in data analysis. RESULTS: The participants were found to have variable dietary practices that either followed or did not follow dietary recommendations. The social environment was critical as most women relied on family and friends for food choices; additionally, individuals in charge of food preparation had to prepare food based on their family member preferences. Furthermore, individuals had difficulty sustaining healthy dietary changes during the acute survivorship phase due to a lack of health consciousness and difficulty in healthy food access. Notably, there was a lack of dietary guidance from health care professionals, especially dietitians, in long-term survivorship care. CONCLUSION: This study highlights the lack of breast cancer survivors' healthy diet and lifestyle knowledge. A holistic multidisciplinary approach involving individual, social, physical, and macro-level environmental elements are crucial to influencing healthy eating behaviours.

Dental age estimation of Malaysian Indian children and adolescents: applicability of Chaillet and Demirjian's modified method using artificial neural network.

BACKGROUND: Recognising the importance of dental age (DA) estimation in forensic investigations, a variety of methods abound in the literature due to population-specific attributes. A reference eight-tooth method developed by Chaillet and Demirjian estimated the DA of children and adolescents. AIM: This study aims to investigate the applicability of Chaillet and Demirjian's method among Malaysian Indians aged 5.00-17.99 years. SUBJECTS AND METHODS: Dental panoramic tomographs of Malaysian Indians aged 5.00-17.99 years were statistically analysed using paired t-test and artificial neural networks multilayer perceptron (ANN-MLP). RESULTS: A total of 1015 dental panoramic tomographs were analysed. Paired t-test analysis against the reference dental maturity scores revealed underestimation of DA in boys of 1.68 years and girls of 2.56 years indicating inaccurate age estimation. A population-specific prediction model with a new set of dental maturity scores was established on Chaillet and Demirjian's scores using ANN-MLP. The new dental maturity scores showed accurate estimation of DA with differences between CA and DA being 12 and 25 days for boys and girls, respectively. Furthermore, a new DA prediction formula was developed using regression analysis following the establishment of new dental scores based on ANN-MLP. CONCLUSION: A novel Malaysian Indian-specific prediction model that demonstrated accurate DA estimation was established.

Exploration of Malaysian school-children's food preferences: what do we know?

BACKGROUND: Feeding practices exert a definite influence over children's experiences. This article aims to explore parental feeding practices and investigate the prediction domain of food preference from parent-child perspectives. METHODS: Two individual studies were conducted on Malay families with children aged 7-12 years. In Study 1, mothers (n = 17) participated in semi-structured focus group interviews on their knowledge of foods and feeding practices. In Study 2, parent-child pairs (n = 14) answered a 36-item, 5-point Likert scale Food Preference Questionnaire followed by virtual structured qualitative interviews. The interviews were digitally recorded, transcribed verbatim, back-translated and analysed according to the framework analysis technique. RESULTS: In Study 1, mothers perceived vegetables, chicken, fish and plain water as healthy foods and drinks while discretionary options were snacks, fast foods and carbonated drinks. The mothers defined healthy foods as foods handled safely with health benefits. They used 'healthy' cooking methods to prepare preferred foods and overtly controlled the child's access to discretionary food. In Study 2, the food groups reported by parent-child pair's report were consistent for the most preferred foods [snacks, median (interquartile range), parent: 4.5 (1.0) vs. child: 4.5 (0.0), p > 0.05] and least preferred food [legumes, parent: 2.0 (1.0) vs. child: 2.0 (1.0), p > 0.05]. Parents emphasized taste as the key determinant of food preference. CONCLUSION: These studies were the first to qualitatively explore parents' perceptions of foods affecting their feeding practices among the Malaysian community to highlight the cultural contribution. Key insights into children's food intake and factors influencing their food preferences were identified.

Knowledge, attitude and practice in relation to catheter-associated urinary tract infection (CAUTI) prevention: A cross-sectional study.

BACKGROUND: Healthcare-associated infection (HAI) is one of the major threats to patients' safety besides being among the principal causes of patient morbidity and mortality. Catheter-associated urinary tract infection (CAUTI) is reported to be the most common HAI worldwide. CAUTI can be prevented with appropriate practice and care by healthcare personnel, especially nurses, who play the main role in urinary catheter care. Nurses' knowledge and attitude are considered to be important factors that influence their practice. OBJECTIVES: To assess nurses' level of knowledge, attitude and perceived practice regarding CAUTI and its preventive measures. METHODS: A cross-sectional design was adopted, and a self-administered questionnaire was used to collect data. Nurses from the medical and surgical inpatient wards of a tertiary teaching hospital in Malaysia were recruited in two stages using the stratified and simple random sampling methods. A total of 301 nurses participated. Descriptive analysis, an independent t test, ANOVA and hierarchical multiple regression were employed to analyse the data using SPSS software version 25. In addition, a STROBE checklist was used to report the results of this study. RESULTS: Nurses were found to have good knowledge, a positive attitude and good perceived practice regarding CAUTI prevention. Nurses aged above 30 and who had more than ten years of experience reported higher knowledge levels. Knowledge was found to be positively correlated with attitude and perceived practice; however, attitude explained a higher variance in perceived practice of CAUTI prevention compared with knowledge. CONCLUSION: Attitude was found to have a higher significant influence on perceived practice in this study. Educators need to emphasise the inculcation of a positive attitude among nurses rather than just knowledge for CAUTI prevention. Since this study assessed perceived practice, examining nurses' actual practice and its impact on patient outcomes is recommended in future studies.

Thalassemia in Malaysia.

Malaysia is a multi-ethnic nation, comprising of Malays and other indigenous groups (67.4%), Chinese (24.6%), Indians (7.3%) and others (0.7%). Thalassemia, which includes α- and ß-thalassemia (α- and ß-thal), is one of the most common genetic disease in Malaysia. Between 4.5 and 5.0% of the Malaysian population were reported to be carriers of this disease and 3.0-40.0% were Hb E (c.79G>A) carriers. In 2013, the Malaysian Thalassaemia Registry reported a total of 5712 registered thalassemia patients, of which 1847 had Hb E/ß-thal and 2329 had ß-thal major (ß-TM). Out of the total number of registered thalassemia patients, Malays comprise 62.0%, Chinese 13.0% and Kadazan-Dusun 13.0%. There were eight common deletions and mutations of the α-thal gene, including three double gene deletions, two single gene deletions, and three nondeletional mutations. The five types of ß-thal mutations generally found in the Malay ethnic group were codon 19 (A>G) (or Hb Malay (HBB: c.59A>G), IVS-I-1 (G>T) (HBB: c0.92+1G>T), IVS-I-5 (G>C) (HBB: 92+5 G>C), and polyadenylated signal (polyA) (AATAAA>AATAGA) (HBB: c.*112A>G). The structural variant, Hb E, accounted for 76.0% of the ß-thal mutations. Malaysia was positioned among the top countries in terms of having the best healthcare in the world in 2019 and this includes free access to three iron chelation agents for the treatment of thalassemia. The Malaysian National Programme for Thalassemia Prevention and Control was launched in 2004 and consisted of mass public education campaigns, public awareness and health education, Malaysian Thalassaemia Registry, population screening, laboratory diagnosis and comprehensive patient management.

Inadequate fruits and vegetables consumption among Malaysian adults during the COVID-19 pandemic.

Background: The COVID-19 pandemic has negatively impacted the eating behaviours of people especially fruits and vegetable intake. No study has addressed the fruits and vegetables intake during the COVID-19 in Malaysia. Aim: to assess the daily intake of fruits and vegetables among Malaysian adults during the COVID-19 outbreak, perceived changes in intake, as well as factors associated with the changes in intake. Methods: A cross-sectional study was conducted through online platforms and a total of 506 participants were recruited. Semi food-frequency questionnaires were used to assess participants' fruit and vegetable intake. Socio-demographics information, knowledge, attitude and practices (KAP) of fruits and vegetables were collected. All statistical analyses were performed using SPSS. Results: The majority of participants (99.8%) did not achieve the recommended five servings per day, in which they consumed an average of 0.84 servings of fruits and vegetables per day. 46.4% of participants reported no changes in intake compared to before the outbreak. Fruits and vegetables intake was associated with physical activity level, knowledge, and beliefs of foods that may prevent/cure COVID-19. Binary logistic regression identified two significant risk factors of daily fruits and vegetables intake namely, being a non-Chinese (AOR = 1.905, 95% CI = 1.114-3.257) and having good practices scores (AOR = 2.543, 95% CI = 1.611-4.015). Conclusion: The study found a low daily intake of fruits and vegetables. The findings suggested that nutritional interventions are necessary to improve awareness on consuming more fruits and vegetables to improve overall health.

Life Satisfaction and Incumbent Voting: Examining the Mediating Effect of Trust in Government.

An emerging body of evidence suggests a causal relationship between wellbeing and incumbent voting. However, the evidence is primarily founded upon established democracies with regular turnovers of power. Moreover, the mechanism underlying this relationship is still relatively unknown. Using the intricacies of the Malaysian political context and Malaysian data from the seventh wave of the World Values Survey (WVS), this study examines the mediating role of trust in government to explain the relationship between life satisfaction and incumbent voting. Notably, the Malaysian WVS was concluded two weeks before Malaysia's fourteenth general election (GE14), which witnessed the end of the ruling coalition's six-decade hold on power since independence and subsequently ushered in the country's first-ever peaceful transfer of power. The empirical analysis indicated that the mediating role of trust in the relationship between life satisfaction and incumbent voting is supported. Further empirical analysis also showed that the mediating effect of trust was unique to the GE14 context compared to GE13, thus providing a better understanding of the role trust plays in the outcome of the election. The results provide valuable insights and implications in political science, especially for a nation emerging from its authoritarian state.

Nutritional Status of Orang Asli in Malaysia.

The national government policies and Jabatan Kemajuan Orang Asli (JAKOA) have to put more effort to improve the quality of life for Orang Asli communities. Over the years, under the government-sanctioned relocation programme, many Orang Asli groups were moved to a more developed and urban area. They were given proper facility, healthcare service to ensure the improvement of overall well-being. While undernutrition among the Orang Asli remains a major health issue, evidence has shown that overweight and obesity in this population are increasing. This observation might be attributed to an urbanised lifestyle that often leads to unhealthy dietary patterns, leading to an increased prevalence of obesity, chronic diseases, food insecurity and unhealthy diet intake. The nutritional transition should be capture for a better understanding of Orang Asli nutritional status. This review assessed the nutritional status and its related key factors among Orang Asli population in Malaysia.

The Quality of Life Impact Refractive Correction (QIRC) questionnaire: validation of the Malay-translated version of the QIRC using Rasch analysis.

BACKGROUND: The Quality of Life Impact Refractive Correction (QIRC) questionnaire is a Rasch-validated instrument to assess the quality of life of ametropes with refractive correction. The original QIRC was validated in the United Kingdom. This study aimed to validate the Malay version of the QIRC among refractive correction wearers in Malaysia using Rasch analysis. METHODS: The original 20-item QIRC was forward-backward translated into Malay in preparation for the Pilot Malay QIRC. The pilot version was pre-tested on 105 spectacle/contact lens-corrected myopes, and the results were reviewed and cross-culturally adapted to produce the Final Malay QIRC. The final version was self-administered to a new sample of 304 participants. A Rasch analysis was conducted to evaluate the items and response categories of the Pilot and the Final Malay QIRC. Test-retest reliability was also analysed on the Final Malay QIRC. RESULTS: Based on the pre-test findings, Rasch analysis revealed a multidimensional scale (functional scale [Items 1 to 13] and emotional scale [Items 14 to 20], which were separated in subsequent analysis), unordered response categories for the functional scale (Category 3 was collapsed into Category 2), one misfit item (Item 3 was removed) and six items required modification (Items 4, 6 to 9, and 12 were reworded and cross-culturally adapted). In the Final Malay QIRC, both the functional and emotional scales had ordered response categories, good person reliability (functional, 0.80; emotional, 0.81) and separation index (functional, 2.01; emotional, 2.06), well-targeted items (targeting precision: functional, 0.28 logits; emotional, 0.08 logits), and satisfactory fit statistics (infit and outfit mean square were less than 1.50 for all items). A noticeable differential item functioning (DIF) between genders was found in Item 18 (DIF contrast, 0.40 logits; p = 0.04). Test-retest reliability analysis demonstrated a high intraclass correlation coefficient (0.94) and Cronbach's alpha (0.97) with a coefficient of repeatability of ±8.14 units. CONCLUSIONS: The Malay-translated version of the QIRC has good psychometric characteristics for assessing the quality of life of refractive correction wearers in Malaysia. This translated and cross-culturally adapted Malay QIRC is a valid and reliable instrument that can be used in routine clinical practice.