Examining the relationship between physical literacy and resilience against COVID-19-induced negative mental states in Chinese adolescents.

Research indicates that COVID-19 has had adverse effects on the mental health of adolescents, exacerbating their negative psychological states. The purpose of this study is to investigate the impact of Physical Literacy (PL) on Negative Mental State caused by COVID-19 (NMSC) and identify potential factors related to NMSC and PL in Chinese adolescents. This cross-sectional study involved a total of 729 Chinese high school students with an average age of 16.2 ± 1.1 years. Participants' demographic data, PL data, and NMSC data were collected. PL and NMSC were measured using the self-reported Portuguese Physical Literacy Assessment Questionnaire (PPLA-Q), the Stress and Anxiety to Viral Epidemics-6 (SAVE-6), and the Fear of COVID-19 Scale (FCV-19). Adolescents in the current study demonstrated higher levels of NMSC and lower PL, with average scores of 3.45 and 2.26, respectively (on a scale of 5). Through multiple linear regression analysis, Motivation (MO), Confidence (CO), Emotional Regulation (ER), and Physical Regulation (PR) were identified as factors influencing NMSC in adolescents. The study findings contribute to providing guidance for actions aimed at alleviating NMSC among adolescents.

Psychometric properties of the Chinese version of the Exercise Self-Efficacy Scale for the Transtheoretical Model: a confirmatory analysis among Chinese children and adolescents.

BACKGROUND: Self-efficacy has been recognized as a critical component in people's participation and maintenance of physical activity. This study aims to validate the Chinese version of the Exercise Self-Efficacy Scale (ESE) among Chinese children and adolescents using confirmatory factor analysis (CFA). METHODS: A cross-sectional study was conducted on two primary and two secondary schools in central China. The ESE scale was translated into Chinese (ESE-C) using the standard forward-backward translation method. Data were analyzed using Mplus 8 for the CFA. RESULTS: The final model showed a satisfactory level of goodness-of-fit (CFI = 0.918; TLI = 0.905; SRMR = 0.043; RMSEA = 0.066), indicating a good construct validity of the ESE-C for children and adolescents in mainland China. Furthermore, the final ESE-C model achieved composite reliability values of 0.963 and average variance extraction values of 0.597, indicating sufficient convergent and discriminant validity. Besides, the Cronbach's alpha value was 0.964, demonstrating excellent internal consistency of the ESE-C scale. CONCLUSION: The ESE-C scale is a valid instrument for assessing exercise self-efficacy among children and adolescents in mainland China.

Affiliate Stigma, Resilience and Quality of Life among Parents of Children with Autism Spectrum Disorder in Two Public Hospitals in Kelantan, Malaysia.

Background: Often, the indirect impact of autism spectrum disorder (ASD) presents the family with significant challenges. One of these challenges is affiliate stigma due to parental affiliation with their child. This study aimed to explore affiliate stigma, resilience and quality of life (QoL) among parents of children with ASD. Methods: Cross-sectional study of 144 parents of children with ASD were recruited from two main tertiary hospitals in Kelantan, Malaysia, a developing country in Southeast Asia. Pearson correlation was used to examine the relationship between parental affiliate stigma, resilience and QoL. Simple and multiple linear regression analyses were used to identify the significant associated factors of affiliate stigma, resilience and QoL. Results: Correlational analyses revealed that perceived affiliate stigma demonstrated an inverse relationship with resilience and QoL. Additionally, resilience had a positive relationship with QoL. Regression analyses revealed that the father's employment status, the mother's level of education, having a disability card, the child's age at ASD diagnosis, comorbidities of the child and ASD severity perceived by parents were associated with parental affiliate stigma, resilience and QoL. Conclusion: Study findings highlight the contribution of socio-demographic characteristics of children with ASD and their families in the determination of affiliate stigma, resilience and QoL.

Psychometric Properties of the Malay Version of the Coach-Athlete Relationship Questionnaire for Coaches and Athletes.

Background: In the world of sports, motivation is an essential concept that can affect the sporting performance of athletes and help them accomplish their goals. The coach is regarded as an important individual with the ability to significantly influence the athlete's motivation. To assess the impact of the coach-athlete relationship on motivation, the objective of this study was to evaluate the psychometric properties of the Malay version of the Coach-Athlete Relationship Questionnaire (CART-Q) for coaches and athletes. Methods: A cross-sectional survey was conducted among the coaches and athletes in Malaysia. Data were collected using a convenience sampling approach over a 6-month period. The study was carried out in two phases using two independent samples of coaches and athletes to assess the construct validity and internal consistency of the Malay version of the CART-Q. The CART-Q consisted of 11 items measuring three constructs: i) closeness (four items), ii) commitment (three items) and iii) complementarity (four items). In phase 1, the subjects consisted of 211 coaches (21 years old-65 years old) from both sexes and from individual and team sports, ranging from levels 1 to 5. In phase 2, the subjects consisted of 362 athletes (12 years old-39 years old), also from both sexes and from individual and team sports. The statistical analyses performed included confirmatory factor analysis (CFA) to validate the translated version scale, composite reliability (CR), average variance extracted (AVE) and internal consistency (Cronbach's alpha). Results: In phase 1, the sample of coaches, with 190 males (90.0%) and 21 females (10.0%), had a mean age of 38.6 (SD = 8.74) years old. The major sport type was archery (19.0%). The CFA revealed adequate fit indices with all 11 items retained (root mean square error of approximation [RMSEA] = 0.059, comparative fit index [CFI] = 0.964, Tucker and Lewis Index [TLI] = 0.950, standardised root mean square residual [SRMR] = 0.037). The CR values were closeness = 0.874, commitment = 0.566 and complementarity = 0.757. The AVE values were closeness = 0.357, commitment = 0.194 and complementarity = 0.275. The Cronbach's alpha values were closeness = 0.867, commitment = 0.553 and complementarity = 0.794. In phase 2, the sample of athletes, with 175 males (48.1%) and 189 females (51.9%), had a mean age of 20.2 (SD = 3.35) years old. The major sport type was archery (11.5%). The CFA revealed satisfactory fit indices with all 11 items retained (RMSEA = 0.092, CFI = 0.948, TLI = 0.924, SRMR =.038). The CR values were closeness = 0.893, commitment = 0.786 and complementarity = 0.949. The AVE values were closeness = 0.401, commitment = 0.253 and complementarity = 0.418. The Cronbach's alpha values were closeness = 0.900, commitment = 0.772 and complementarity = 0.900. Conclusion: Overall, the study findings supported the conclusion that the Malay version of the CART-Q has adequate psychometric properties to assess the perceptions of coaches and athletes regarding their relationship.

Autonomy, Resilience and Life Satisfaction among Badminton Paralympians.

Background: People with disabilities are marginalised in mainstream culture and they also experience increased restrictions in a variety of areas, such as sport. The barriers they encounter may adversely affect their life satisfaction, especially if they have a low perceived sense of autonomy and resilience. The purpose of this study was to investigate the relationship between autonomy, resilience and life satisfaction in para-badminton athletes and the mediating role of resilience in the relationship between autonomy and life satisfaction. Methods: Data were collected from 137 para-badminton athletes (male: 65.0% and female: 35.0%). Self-reported measures were used to assess the participants' autonomy, resilience and life satisfaction levels. Results: A structural equation model analysis was performed; the model had sufficient fit indices (comparative fit index [CFI] = 0.94, root mean square error of approximation [RMSEA] = 0.06, standardised root mean square residual [SRMR] = 0.07). The findings showed that autonomy had a significant effect on resilience (ß = 0.32, P = 0.001). Further, resilience had a significant effect on life satisfaction (ß = 0.19, P = 0.011) and significantly mediated the effect of autonomy on life satisfaction (ß = 021, P = 0.033). Conclusion: This study revealed that autonomy fosters resilience among athletes, in turn allowing them to achieve greater life satisfaction. Therefore, society and sport communities should actively seek ways to improve the autonomy and resilience levels of athletes with disabilities.

Immunohistochemical expression of apolipoprotein B and 4-hydroxynonenal proteins in colorectal carcinoma patients: a retrospective study.

AIM: To assess the association of the expression of apolipoprotein B (apoB) and 4-hydroxynonenal (4HNE) with the clinicopathological data of patients with colorectal cancer (CRC). METHODS: We obtained 80 CRC histopathological specimens sent to the Pathology Laboratory of Hospital Universiti Sains Malaysia from 2015 to 2019. Data on demographic factors, body mass index (BMI), and clinicopathological characteristics were also collected. Formalin-fixed paraffin-embedded tissues were stained by using an optimized immunohistochemical protocol. RESULTS: Patients were mostly older than 50 years, male, Malay, and overweight or obese. A high apoB expression was observed in 87.5% CRC samples (70/80), while a high 4HNE expression was observed in only 17.5% (14/80) of CRCs. The expression of apoB was significantly associated with the sigmoid and rectosigmoid tumor sites (p =0.001) and tumor size 3-5 cm (p =0.005). 4HNE expression was significantly associated with tumor size 3-5 cm (p =0.045). Other variables were not significantly associated with the expression of either marker. CONCLUSION: ApoB and 4HNE proteins may play a role in promoting CRC carcinogenesis.

Master of Science in Medical Statistics Programme at Universiti Sains Malaysia: 20 Years Ongoing.

Health and medical research are important parts of the curriculum of medical and health programmes in universities and play an important role in the functioning of organisations related to health care. There is a shortage of well-trained health and medical research statisticians. This article describes the courses and structure of the Master of Science in Medical Statistics programme at Universiti Sains Malaysia (USM), as well as the graduates' achievements. It is a 2-year programme that prepares qualified and competent graduates in statistical methods and data analysis for research in health and medical sciences. The Biostatistics and Research Methodology Unit, School of Medical Sciences, USM has been running the programme since 2003. It is currently the only medical statistics programme available in Malaysia. There have been 97 graduates since 2005, with an employment rate of 96.7% and a successful subsequent doctorate rate of 21.1%. Most of the students returned to their previous employments, mainly with the Ministry of Health of Malaysia and several others became lecturers, statisticians or research officers. The employability of graduates from this programme is very high and their professional future is bright. We hope our graduates will impart their knowledge and skills to the nation.

Quality of Life and Its Association with Effort-Reward Imbalance among Medical Officers Working in Government Hospitals in Kuching, Sarawak, Malaysia.

Background: Medical officers (MOs) face multiple sources of work-related stress, including work system transition, job insecurity, dissatisfaction with income and intense working environments. This study aimed to examine the quality of life (QOL), effort-reward imbalance (ERI) and their association among MOs working in government hospitals in Kuching, Sarawak, Malaysia. Methods: This cross-sectional study was conducted among MOs from Sarawak General Hospital and Hospital Sentosa from May 2018 to March 2020. A total of 614 participants were selected through convenient sampling. An email with a link to three sets of questionnaires via Google forms including a questionnaire on sociodemographic data and job characteristics, the World Health Organization Quality of Life-Brief version (WHOQOL-BREF) (Malay version) and the effort-reward imbalance (ERI-Q) (long version) was sent to potential participants. A total of 276 MOs completed and returned the questionnaires. Data were analysed using descriptive, simple and multiple logistic regression analysis. A P-value of less than 0.05 was taken as a statistically significant result. Results: Most MOs reported no adversity in the workplace (i.e. 29% low effort/high reward, 5.1% high effort/high reward, 6.2% low effort/low reward and 23.6% high effort/low reward). More than half of MOs (54%) reported poor general QOL and were associated with a combination of active and passive on-calls (adjusted odds ratio [AOR] = 5.36, 95% confidence interval [CI]: 1.21, 23.79). Poor QOL in the physical domain was associated with the presence of chronic illness (AOR = 23.35; 95% CI: 4.25, 128.45), active on-calls (AOR = 14.75; 95% CI: 1.16, 188.35) and a combination of active and passive on-calls (AOR = 18.25; 95% CI: 1.39, 238.98). Men had a higher risk of poor QOL in the environmental domain (AOR = 2.03; 95% CI: 1.04, 3.98). Only 23.6% of MOs reported psychosocial adversity at work (high effort/low reward). High effort/low reward was associated with poor QOL in general (AOR = 4.71; 95% CI: 1.71, 13.01), physical (AOR = 4.53; 95% CI: 2.02, 10.17), psychological (AOR = 5.95; 95% CI: 2.82, 12.58) and environmental domains (AOR = 4.21; 95% CI: 1.95, 9.08). Low effort/high reward was found to have a lower likelihood of poor QOL in the social domain (AOR = 0.13; 95% CI: 0.04, 0.44). Conclusion: Higher ERI was found to be associated with poor QOL among MOs in government hospitals. Future research should focus on interventions to improve working conditions.

A Theory Planned Behaviour of Study on Improving Abdominal Bloating among the Malays Population: A Qualitative Study.

Background: Abdominal bloating (AB) is a common medical complaint known to diminish patients' quality of life. However, lifestyle and behavioural changes could mitigate its expression and severity. This study sought to explore the health beliefs, intentions and health-promoting behaviours among people with AB in Kelantan, Malaysia. Methods: The theory of planned behaviour (TPB) was employed to explore the factors that influence the management of adults with AB, namely health beliefs and intentions. An interview guide was developed by adapting the TPB and the findings of prior studies concerning the factors associated with AB management. All eligible participants took part in in-depth interviews. Results: The mean age of the participants was 32.5 years old (standard deviation [SD] = 14.19 years old) and the majority of participants were female (58.3%). The themes and sub-themes that emerged following the application of the TPB framework represented the qualitative results of this study, which indicated that the health beliefs, intentions and health-promoting behaviours observed among people with AB were closely related. Conclusion: The findings of this study suggest that the adoption of a healthy lifestyle could be an effective means of improving AB. Thus, it is vital to implement a health education programme that promotes health-related beliefs and intentions in order to trigger health-promoting behaviour among people with AB.

Measuring achievement emotions questionnaire for physical education (AEQ-PE): a confirmatory study in Malay language.

BACKGROUND: This study aimed to verify a translated Malay version of the Achievement Emotions Questionnaire for Physical Education (AEQ-PE) by assessing the level of achievement emotions in six constructs among the Malaysian primary school pupils using the Confirmatory Factor Analysis (CFA). METHODS: A total of 607 Malay pupils, comprising 240 (39.5%) boys and 367 (60.5%) girls aged between 10 and 11, were recruited from 10 schools to answer the questionnaire, which measured their views on 24 items through a five-point Likert scale. The AEQ-PE was translated into Malay language (AEQ-PE-M) using forwarding to backward translation techniques. Certain phrases were adopted in accordance with the local culture and vocabulary appropriate for primary school pupils. CFA was performed using the Mplus 8.0 software, and the final model demonstrated high reliability in terms of the composite reliability and Cronbach's alpha. RESULTS: Analysis of the CFA showed an acceptable fit indices in CFI (0.936), TLI (0.926), RMSEA = 0.039 (90% CI, 0.034, 0.045) and SRMR (0.049) of the AEQ-PE measurement model. All of the items in the original AEQ-PE version were retained and deemed suitable for Malay primary school pupils. CONCLUSION: The AEQ-PE-M with 24 items was a suitable tool for measuring the level of school children's involvement in determining achievement emotions and their motivation towards physical education.

The Effect of a Mindfulness-Based Intervention on Nurses in Kelantan, Malaysia.

BACKGROUND: Among healthcare workers, nurses have a particularly high risk of stress. Stressful conditions in the workplace increase the possibility of burnout and psychological distress. Short mindfulness-based interventions can help to decrease stress, anxiety and depression. This study aimed to explore the effectiveness of a mindfulness-based intervention in reducing perceived stress, anxiety and depression among public teaching hospital staff nurses. METHODS: Thirty-five nurses from various specialities were recruited from Hospital Universiti Sains Malaysia (HUSM). The intervention comprised a 1-day brief mindfulness-based intervention workshop and 1 h group practice session each month for 3 months together with daily follow-up via WhatsApp group. All the participants completed a self-administered sociodemographic questionnaire validated for use in a Malay population. The Depression, Anxiety and Stress Scale 21 (DASS 21) and Perceived Stress Scale 10 (PSS 10) were used to measure perceived stress, anxiety and depression before the intervention, and 3 months later upon completion of the intervention. RESULTS: There was a statistically significant reduction in the scores for stress perception (95% confidence interval [CI]: 0.06, 2.92; P = 0.04) and anxiety (95% CI: 0.06, 2.34; P = 0.04) post-intervention. CONCLUSION: A brief mindfulness-based intervention was effective in reducing perceived stress and anxiety among nurses.

Relationship Between Passion and Courage among the Experienced Male Soccer Players.

BACKGROUND: The nature of the relationship between passion and courage and its influence on soccer performance has yet to be revealed. Thus, the purpose of this study was to examine passion attributes (i.e. harmonious and obsessive inclinations) among male soccer players in relation to the level of courageous characteristics (i.e. mastery, determination, assertiveness, venturesome and sacrificial behaviour), other demographic and player characteristics. METHODS: Data were collected from 278 male soccer players aged 13-38 years (mean [M] = 17.42 ± 4.36) with the number of competitive soccer experiences ranging from 1-28 years (M = 7.51 ± 4.23 years). Participants had at least a year of experience in the sport of soccer completed the validated passion scale, sports courage scale and demographic form. RESULTS: Analyses revealed that soccer players with higher levels of total courage (P < 0.001), have more experience in soccer (P = 0.011), and their soccer level being professional (P < 0.001) had a significantly higher score in harmonious passion. There was no significant difference in obsessive passion among different level of total courage (P = 0.154). However, soccer players with more experience (P = 0.011) and higher soccer level being professional (P < 0.001) demonstrated a significant higher score in obsessive passion. CONCLUSION: In conclusion, soccer players with higher harmonious and obsessive passionate attributes had higher courage (except for mastery). In addition, the courageous and passionate traits of the soccer players played meaningful roles in indicating individual and performance variables.

The Processes of Change Scale: A Confirmatory Study of the Malay Language Version.

BACKGROUND: Processes of change (POC) comprise one of the psychological constructs in the Transtheoretical Model. The objective of this study is to test the validity and reliability of the Malay version of the POC scale among university students by using a confirmatory approach. METHOD: A cross-sectional study design with a convenience sampling method using a self-administered questionnaire was carried out. University undergraduate students were approached to fill in the questionnaire, which consisted of demographic information and a POC scale. The POC scale consisted of 30 items and two main factors (i.e., cognitive and behavioural). The POC scale was translated into the Malay language using a standard procedure of forward and backward translation. Confirmatory factor analysis (CFA) was performed, and composite reliability was computed using Mplus version 8. RESULTS: A total of 620 respondents with a mean age of 20 years (standard deviation = 1.15) completed the questionnaire. Most of the participants were female (74.7%) and Malay (78.2%). The initial CFA model of the POC scale did not exhibit fit based on several fit indices (comparative fit index (CFI) = 0.880, Tucker Lewis index (TLI) = 0.867, standardised root mean square residual (SRMR) = 0.075 and root mean square error of approximation (RMSEA) = 0.058). Several re-specifications of the model were conducted and the modification included adding correlation between the items' residuals. The final model for the Malay version of the POC scale showed acceptable values of model fit indices (CFI = 0.922, TLI = 0.911, SRMR = 0.064 and RMSEA = 0.048). The composite reliability of both the cognitive and behavioural processes was acceptable at 0.856 and 0.752, respectively. CONCLUSION: The final model presented acceptable values of the goodness of fit indices, indicating that the scale is fit and acceptable to be adopted for future study.

Validity and Reliability of Emergency Severity Index and Conventional Three-Tier Triage System in the Emergency Department, Hospital Universiti Sains Malaysia.

BACKGROUND: The study aimed to examine the reliability and validity of the existing three-tier triaging system and a new five-level emergency triaging system, emergency severity index (ESI), in the Emergency Department (ED) of Hospital Universiti Sains Malaysia (HUSM). METHODS: This study was conducted in HUSM's ED over two study periods. In the first three months, 300 patients were triaged under the three-tier triaging system, and, in the subsequent three months, 280 patients were triaged under the ESI. The patients were triaged by junior paramedics and the triage records were retained and later re-triaged by senior paramedics. The inter-rater reliability was evaluated using Cohen's Kappa statistics. The acuity ratings of the junior paramedics were compared with those of the expert panel to determine the sensitivity and specificity of each acuity level for both the ESI and the three-tier triaging system. The over-triage rate, under-triage rate, amount of resources used, admission rate and discharge rate were also determined. RESULTS: The inter-rater agreement for the three-tier triaging system was 0.81 while that of the ESI was 0.75. The ESI had a higher average sensitivity of 74.3% and a specificity of 94.4% while the three-tier system's average sensitivity was 68.5% and its specificity 87.0%. The average under-triage and over-triage rates for the ESI were 10.7% and 6.2%, respectively, which were lower than the three-tier system's average under-triage rate of 13.1% and over-triage rate of 17.1%. The urgency levels of both the ESI and the three-tier system were associated with increased admission rates and resources used in the ED. CONCLUSION: The ESI's inter-rater reliability was comparable to the three-tier triaging system and it demonstrated better validity than the existing three-tier system.

Clinical Validity and Reliability of the Malay Language Translations of Gastroesophageal Reflux Disease Questionnaire and Quality of Life in Reflux and Dyspepsia Questionnaire in a Primary Care Setting.

BACKGROUND: Gastroesophageal Reflux Disease Questionnaire (GERDQ) and Quality of Life in Reflux and Dyspepsia Questionnaire (QOLRAD) are reliable tools for evaluation of GERD. AIM: We aimed to test validity and reliability of Malay language translations of GERDQ and QOLRAD in a primary care setting. METHODS: The questionnaires were first translated into the Malay language (GERDQ-M and QOLRAD-M). Patients from primary care clinics with suspected GERD were recruited to complete GERDQ-M, QOLRAD-M, and Malay-translated 36-item short-form health survey (SF-36 or SF-36-M), and underwent endoscopy and 24-h pH-impedance test. RESULTS: A total of 104 (mean age 47.1 years, women 51.9%) participants were enrolled. The sensitivity and specificity for GERDQ-M cut-off score ≥8 were 90.2 and 77.4%, respectively. Based on this cut-off score, 54.7% had a high probability of GERD diagnosis. GERD-M score ≥8 vs. < 8 was associated with erosive esophagitis (p < 0.001), hiatus hernia (p = 0.03), greater DeMeester score (p = 0.001), and Zerbib scores for acid refluxes (p < 0.001) but not non-acid refluxes (p = 0.1). Mean total scores of QOLRAD-M and SF-36-M were correlated (r = 0.74, p < 0.001). GERDQ-M ≥8, erosive esophagitis, and DeMeester ≥14.72 were associated with impaired QOLRAD-M in all domains (all p < 0.02) but this was not seen with SF-36. CONCLUSIONS: GERDQ-M and QOLRAD-M are valid and reliable tools applicable in a primary care setting.

Human albumin infusion for treating oedema in people with nephrotic syndrome.

BACKGROUND: Oedema is a common clinical symptom in people with nephrotic syndrome and human albumin has been widely used in the treatment of oedema by increasing vascular volume and this inducing diuresis. It may be used with or without diuretics such as furosemide. However, the quantitative contribution of human albumin in treating oedema is not fully understood. If human albumin were found to be effective and safe in the treatment of oedema, it could help clinicians to develop therapeutic strategies to improve the management of diuretic resistance associated with nephrotic syndrome. OBJECTIVES: This review aimed to examine the benefits and harms of human albumin infusion for treating oedema associated with nephrotic syndrome. SEARCH METHODS: We searched the Cochrane Kidney and Transplant Register of Studies up to 23 June 2019 through contact with the Information Specialists using search terms relevant to this review. Studies in the Specialised Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and quasi-RCTs evaluating the effect of human albumin infusion compared with placebo or no intervention, human albumin with diuretics compared with diuretic alone, human albumin compared with diuretics and other treatments, clinical outcomes, death, quality of life, kidney function and adverse effects in people with nephrotic syndrome. We excluded cross-over studies but data for the first period was to be included if available. DATA COLLECTION AND ANALYSIS: Standard methods of the Cochrane Collaboration were used. Two authors independently assessed eligibility, risk of bias, study quality and extracted data. We calculated mean difference (MD) for continuous data with 95% confidence intervals (CI). We assessed the certainty of the evidence using GRADE. MAIN RESULTS: One study met our inclusion criteria (26 children with minimal change nephrotic syndrome) and 11 were excluded (nine cross-over studies, one where albumin was not used for nephrotic syndrome and one where authors did not state whether the children had oedema). Risk of bias for the included study was unclear for selection bias, high for performance and detection bias, low for attrition bias, and high for selective reporting. The included study compared albumin plus furosemide with an equal volume of dextrose. Of our prespecified outcomes, the authors reported clinical improvement as weight change, serum sodium and adverse outcomes (blood pressure). The authors reported a greater weight loss in the albumin treated group initially but no difference overall at 10 days. However, the data in the text and the figures were inconsistent so we could not confirm the authors statements (very low certainty evidence). It is uncertain whether albumin infusion improves serum sodium when compared with an equal volume of dextrose (MD 2.00 mEq/L, 95% CI -0.09 to 4.09), systolic blood pressure (MD 2.00 mmHg, 95% CI -3.52 to 7.52) or diastolic blood pressure (MD 2.00 mmHg, 95%CI -4.29 to 8.29). Death, quality of life, and kidney function were not reported. AUTHORS' CONCLUSIONS: We identified only one small study that was relevant to our review, therefore we are unable to draw any conclusions regarding the use of human albumin with or without diuretics in nephrotic syndrome. More RCTs are needed.

Psychometric properties of the health-promoting lifestyle profile II: cross-cultural validation of the Malay language version.

BACKGROUND: Health-promoting behaviour is an important concept for health education. Unfortunately, there is a dearth of validated instruments to measure levels of health-promoting behaviour in the Malaysian context. The purpose of this study was to validate a Malay-language version of the Health-Promoting Lifestyle Profile II (HPLP-II) using a confirmatory approach. METHODS: Participants were 997 university undergraduate students, with a mean age of 21 years (SD = 1.58). The majority of the participants (80.4%) were female. Health-promoting behaviour was assessed using the 52-item HPLP-II, which measures six components of health-promoting behaviour outcomes. HPLP-II was translated into the Malay language using standard forward and backward translation procedures. Participants then completed the HPLP-II Malay version (HPLP-II-M). Confirmatory factor analysis (CFA) was conducted using Mplus 8.0 software on the six domains of HPLP-II-M model. RESULTS: The CFA result based on the hypothesised measurement model of six factors was aligned with the original HPLP-II, except for two low loading items which were subsequently removed from the CFA analysis. The final CFA measurement model with 50 items resulted in a good fit to the data based on RMSEA and SRMR fit indices (RMSEA = 0.046, 90%CI = 0.045, 0.048, SRMR = 0.062). The construct reliabilities for the HPLP-II-M subscales were acceptable, ranging from 0.737 to 0.878. CONCLUSION: The HPLP-II-M with six components of health-promoting behaviour outcomes and 50 items was considered valid and reliable for the present Malaysian sample.

Psychometric Properties of the Malay Version of the Goal Content for Exercise Questionnaire among Undergraduate Students at the Health Campus, Universiti Sains Malaysia.

BACKGROUND: Understanding the individual aspirations of exercise participation is important for promoting physical activity. However, there is a lack of evidence to validate a measurement instrument for exercise-based goal content among Malaysian populations. The purpose of this study was to determine the validity and reliability of the Malay version of the Goal Content in Exercise Questionnaire (GCEQ) for a sample of Malaysian undergraduates. METHODS: The original English version of the GCEQ underwent forward and backward translation into the Malay language. A cross-sectional study was conducted. The finalised Malay version was administered to 674 undergraduate students at the Health Campus of the Universiti Sains Malaysia (USM) with a mean age of 20.27 years (SD = 1.35 years). Confirmatory factor analysis (CFA) was conducted for the psychometric evaluation. RESULTS: The measurement model consisted of 20 observed items and five latent factors. CFA demonstrated adequate fit to the data: comparative fit index = 0.929; standardised root mean square residual = 0.052; root mean square error of approximation = 0.061 (90% CI = 0.056, 0.067). The composite reliability coefficients for the five latent factors ranged from 0.777 to 0.851. All the correlations between the factors were less than 0.85, so discriminant validity was achieved. CONCLUSION: The findings suggested that the Malay version of the GCEQ is valid and reliable for assessing goal content in the exercise context of undergraduates at the Health Campus, USM.

Confirmatory Factor Analysis of the Malay-Language Transtheoretical Model of Physical Activity among Malaysian Primary School Children.

INTRODUCTION: The transtheoretical model (TTM) is an integrative model of intentional change consisting of stages of change, processes of change, decisional balance and self-efficacy. This study aimed at validating the TTM questionnaires on physical activity for Malaysian children using confirmatory factor analysis. METHODS: The participants were 381 Malay students (188 male; 193 female), aged 10-12 years old, with a mean age of 10.94 (SD = 0.81). The original version of the TTM was translated into the Malay language using forward and backward translation. Certain phrases were adapted based on the local culture and vocabulary suitable for primary school students. RESULTS: The final measurement models and their fit indices were: processes of change (CFI = 0.939, TLI = 0.925, SRMR = 0.040, RMSEA = 0.030); decisional balance (CFI = 0.897, TLI = 0.864, SRMR = 0.045, RMSEA = 0.038); and self-efficacy (CFI = 0.934, TLI = 0.915, SRMR = 0.042, RMSEA = 0.032). CONCLUSION: Care must be taken when using the TTM with children, as it has been prevalently validated with adults. The final version of the TTM questionnaire for Malay primary school children had 24 items for process of changes, 13 items for self-efficacy and 10 items for decisional balance.

Co-Curricular Activities and Motives for Participating in Physical Activity among Health Sciences Students at Universiti Sains Malaysia, Malaysia.

BACKGROUND: The purpose of the study was to compare the motives for participating in physical activity (PA) through the different types of co-curricular activities chosen by health sciences undergraduate students at Universiti Sains Malaysia (USM), Malaysia. METHODS: The participants were university students at USM's Health Campus, who were invited to volunteer and complete two measures: a demographic form, including the types of co-curricular activities in which the students chose to enrol (sports, uniform and art), and the Physical Activity and Leisure Motivation Scale (PALMS). RESULTS: A total of 588 university students (female = 79.1%, male = 20.9%) with a mean age of 19.77 (SD = 1.39) participated in the study. The results showed significant differences in the motives of affiliation (P < 0.001), appearance (P = 0.008) and physical condition (P = 0.010) across the types of co-curricular activities in which the students participated. The students who enrolled in sports generally showed higher motives of affiliation, appearance and physical condition for participating in PA than other types of co-curricular activities. CONCLUSION: The study findings can provide further insights into the motives for participating in PA among health sciences students and encouragement for students to integrate PA into their daily routines.