Lactobacillus plantarum DR7 improved upper respiratory tract infections via enhancing immune and inflammatory parameters: A randomized, double-blind, placebo-controlled study.

The aims of this study were to investigate the effects of Lactobacillus plantarum DR7 isolated from bovine milk against upper respiratory tract infections (URTI) and elucidate the possible mechanisms underlying immunomodulatory properties. The DR7 strain (9 log cfu/d) was administered for 12 wk in a randomized, double-blind, and placebo-controlled human study involving 109 adults (DR7, n = 56; placebo, n = 53). Subjects were assessed for health conditions monthly via questionnaires, and blood samples were evaluated for cytokine concentrations, peroxidation and oxidative stress, and gene expression in T cells and natural killer (NK) cells. The administration of DR7 reduced the duration of nasal symptoms (mean difference 5.09 d; 95% CI: 0.42-9.75) and the frequency of URTI (mean difference 0.32; 95% CI: 0.01-0.63) after 12 and 4 wk, respectively, compared with the placebo. The DR7 treatment suppressed plasma proinflammatory cytokines (IFN-γ, TNF-α) in middle-aged adults (30 to 60 yr old), while enhancing anti-inflammatory cytokines (IL-4, IL-10) in young adults (<30 yr old), accompanied by reduced plasma peroxidation and oxidative stress levels compared with the placebo. Young adults who received DR7 showed higher expression of plasma CD44 and CD117 by 4.50- and 2.22-fold, respectively, compared with the placebo. Meanwhile, middle-aged adults showed lower expression of plasma CD4 and CD8 by 11.26- and 1.80-fold, respectively, compared with the placebo, indicating less T-cell activation. In contrast, both young and middle-aged adults who received DR7 showed enhanced presence of nonresting and mature NK cells compared with those who received the placebo. We postulate that DR7 alleviated the symptoms of URTI by improving inflammatory parameters and enhancing immunomodulatory properties.

A comparative study on the psychological health status of pre-clinical medical students enrolled through different admission tests.

OBJECTIVE: This study was conducted at the end of the second year of the pre-clinical program to assess differences in psychological status of students enrolled by multiple mini interview (MMI) and personal interview (PI). METHODS: We adopted a comparative cross-sectional study on pre-clinical medical students who appeared in two different admission tests. The stress, anxiety, and depression levels of students were measured by the depression, anxiety, stress scale (DASS-21), and their burnout level was measured by the Copenhagen Burnout Inventory. RESULTS: The stress, anxiety, and depression scores between MMI and PI were not significantly different (p-value > 0.05). The personal, work and client burnout scores between MMI and PI were not significantly different (p-value > 0.05). The prevalence of stress (MMI = 39%, PI = 36.9%), anxiety (MMI = 78%, PI = 67.4%), depression (MMI = 41%, PI = 36.2%) and burnout (MMI = 29%, PI = 31.9%) between MMI and PI cohorts was not significantly different (p-value > 0.05). These results showed similar levels of stress, anxiety, depression, and burnout in students at the end of the pre-clinical phase. CONCLUSIONS: This study showed similar psychological health status of the pre-clinical students who were enrolled by two different admission tests. The prevalence of stress, anxiety, burnout, and depression among the pre-clinical medical students was comparable to the global prevalence. The results indicate that medical schools can consider implementing either MMI or PI to recruit suitable candidates for medical training.

Probiotic Lactobacillus plantarum P8 alleviated stress and anxiety while enhancing memory and cognition in stressed adults: A randomised, double-blind, placebo-controlled study.

BACKGROUND & AIMS: To investigate the effects of probiotic in alleviation of stress in stressed adults, along our focus to identify and justify strain specificity on selected health benefits with a precisely targeted population. METHODS: This 12-weeks randomized, double-blind and placebo-controlled study investigated the effects of a probiotic (Lactobacillus plantarum P8; 10 log CFU daily) on psychological, memory and cognition parameters in one hundred and three (P8 n = 52, placebo n = 51) stressed adults with mean age of 31.7 ± 11.1 years old. All subjects fulfilled the criteria of moderate stress upon diagnosis using the PSS-10 questionnaire. RESULTS: At the end of study, subjects on P8 showed reduced scores of stress (mean difference 2.94; 95% CI 0.08 to 5.73; P = 0.048), anxiety (mean difference 2.82; 95% CI 0.35 to 5.30; P = 0.031) and total score (mean difference 8.04; 95% CI 0.73 to 15.30; P = 0.041) as compared to placebo after 4-weeks, as assessed by the DASS-42 questionnaire. Although plasma cortisol levels were only marginally different between placebo and P8 (mean difference 3.28 ug/dl; 95% CI -7.09 to 0.52; P = 0.090), pro-inflammatory cytokines such as IFN-γ (mean difference 8.07 pg/ml; 95% CI -11.2 to -4.93; P < 0.001) and TNF-α (mean difference 1.52 pg/ml; 95% CI -2.14 to -0.89; P < 0.001) showed higher reduction as compared to placebo over 12-weeks. These were accompanied by enhanced memory and cognitive traits such as social emotional cognition and verbal learning and memory upon administration of P8 as compared to the placebo, with different effects in women as compared to men. CONCLUSIONS: The present data illustrated that L. plantarum P8 is a feasible and natural intervention for the alleviation of selected stress, anxiety, memory and cognitive symptoms in stressed adults. TRIAL REGISTRATION: Approved by the JEPeM-USM Review Panel on Clinical Studies (Approval number USM/JEPeM/16050195) and was registered at ClinicalTrials.gov (identifier number NCT03268447).

The outcomes that an interview-based medical school admission process has on academic performance, psychological health, personality traits, and emotional intelligence.

OBJECTIVES: This study investigated the outcomes that an interview-based medical school admission process has on academic performance, psychological health, personality traits, and emotional intelligence. METHODS: A comparative cross-sectional study was conducted on the interviewed and non-interviewed cohorts. Their examination marks were obtained from the academic office, psychological health was measured by DASS-21, personality traits were measured by USMaP-15, and emotional intelligence was measured by USMEQ-17. RESULTS: The interviewed cohort performed significantly better in the clinical examination than the non-interviewed cohort. Conversely, the non-interviewed cohort performed significantly better in the theoretical examination. Depression, anxiety, and stress level between the two cohorts showed no difference. The interviewed cohort demonstrated more desirable personality traits, higher emotional intelligence, and social competence than the non-interviewed cohort. DISCUSSION: This study provides evidence to support the claim that the interview-based admission process has favourable outcomes on clinical performance, emotional intelligence, and personality traits. Several insights gained as a result of this study are discussed.

Psychometric properties of the mentor behaviour scale in a sample of Malaysian medical students.

OBJECTIVES: To determine the psychometric properties of the Mentor Behaviour Scale (MBS), a 15-item inventory that evaluates four supportive mentor behaviours in terms of construct validity and internal consistency. METHOD: A cross-sectional study was carried out on a sample of medical students in their final year at Universiti Sains Malaysia. Confirmatory factor analysis (CFA) was performed using AMOS 22 to assess construct validity. Reliability analysis was performed using SPSS 22 to assess internal consistency. RESULTS: A total of 159 final year medical students participated. CFA showed that the original four-factor model with 15 items achieved acceptable values for the goodness of fit indices, suggesting a good model fit (X2 = 198.295, ChiSq/df = 2.418, RMSEA = 0.095, GFI = 0.867, CFI = 0.953, NFI = 0.923, TLI = 0.940). The Cronbach's alpha values of the mentoring relationship structure, engagement, and competency support domains were 0.96, 0.90 and 0.88, respectively. For autonomy support, the Cronbach's alpha value was 0.62. CONCLUSION: MBS demonstrates a satisfactory level of construct validity and a high level of internal consistency in measuring supportive mentor behaviours in a medical school setting. This result suggests that MBS can be used as a mentorship evaluation tool for feedback in the context of a Malaysian medical school.

Investigating validity evidence of the Malay translation of the Copenhagen Burnout Inventory.

INTRODUCTION: The Copenhagen Burnout Inventory (CBI) is a recent burnout measure with a focus on fatigue and exhaustion. It has three factors: personal burnout, work-related burnout, and client-related burnout. This study aimed to translate the CBI into the Malay language and to validate the translated version among a group of medical students. METHODS: The forward-backward translation was performed as per standard guidelines. The Malay version of CBI (CBI-M) was distributed to 32 medical students to assess face validity and later to 452 medical students to assess construct validity. The data analysis was performed by Microsoft Excel, SPSS and AMOS. RESULTS: The face validity index of CBI-M was more than 0.8. The three factors of CBI-M achieved good levels of goodness-of-fit indices (Cmin/df = 2.99, RMSEA = 0.066, GFI = 0.906, CFI = 0.938, NFI = 0.910, TLI = 0.925). The composite reliability values of the three factors ranged from 0.84 to 0.87. The Cronbach's alpha values of the three factors ranged from 0.83 to 0.87. CONCLUSIONS: This study supports the face and construct validity of the CBI-M with a high internal consistency.

Development and validation of a Chinese translated questionnaire: A single simultaneous tool for assessing gastrointestinal and upper respiratory tract related illnesses in pre-school children.

OBJECTIVES: Children are prone to contagious illnesses that come from peers in nurseries, kindergartens, and day care centres. The administration of probiotics has been reported to decrease the episodes of such illnesses, leading to decreased absences and consumption of antibiotics. With less emphasis on, and preferences for, blood collection from young subjects, quantifiable data are merely obtained from surveys and questionnaires. Malaysia has a population which is 25% ethnic Chinese. We aimed to develop a single tool that enables simultaneous assessments of both gastrointestinal and respiratory tract-related illnesses among young Chinese children. METHODS: The English-language validated questionnaires using data about demographics and monthly health records were translated into the Chinese language. Both forward and backward translated versions were validated. RESULTS: The developed demographic and monthly health questionnaires showed an overall item-level content validity index (I-CVI) of 0.99 and 0.97, respectively; while the translated Chinese versions showed I-CVI of 0.97 and 0.98, respectively. Item-level of response process validity index of 1.00 for this questionnaire was obtained from 30 respondents inferring that the items were clear and comprehensible. CONCLUSIONS: This study showed acceptable levels validity in the Chinese translated version, illustrating a valid and reliable tool to be used for simultaneous assessment of gastrointestinal and respiratory tract-related illnesses in young children that is applicable for Malaysia's Chinese population and other Chinese-speaking nations.

Associations of pass-fail outcomes with psychological health of first-year medical students in a malaysian medical school.

OBJECTIVES: The demanding and intense environment of medical training can create excessive pressures on medical students that eventually lead to unfavorable consequences, either at a personal or professional level. These consequences can include poor academic performance and impaired cognitive ability. This study was designed to explore associations between pass-fail outcome and psychological health parameters (i.e. stress, anxiety, and depression symptoms). METHODS: A cross-sectional study was conducted on a cohort of first-year medical students in a Malaysian medical school. The depression anxiety stress scale 21-item assessment (DASS-21) was administered to them right after the final paper of the first-year final examination. Their final examination outcomes (i.e. pass or fail) were traced by using their student identity code (ID) through the Universiti Sains Malaysia academic office. RESULTS: A total of 194 (98.0%) of medical students responded to the DASS-21. An independent t-test showed that students who passed had significantly lower stress, anxiety, and depression symptoms than those who failed the first-year final examination (P <0.05). Those who experienced moderate to high stress were at 2.43 times higher risk for failing the examination than those who experienced normal to mild stress. CONCLUSION: Medical students who failed in the final examination had higher psychological distress than those who passed the examination. Those who experienced high stress levels were more likely to fail than those who did not. Reducing the psychological distress of medical students prior to examination may help them to perform better in the examination.