Objective: To determine the effect of Ashwagandha extract on sleep. Methods: A comprehensive search was conducted in CENTRAL, MEDLINE, SCOPUS, Google Scholars, World Health Organization Trials Portal, ClinicalTrials.gov, Clinical Trial Registry of India, and AYUSH Research Portal for all appropriate trials. Randomized controlled trials that examined the effect of Ashwagandha extract versus placebo on sleep in human participants 18 years old and above were considered. Two authors independently read all trials and independently extracted all relevant data. The primary outcomes were sleep quantity and sleep quality. The secondary outcomes were mental alertness on rising, anxiety level, and quality of life. Results: A total of five randomized controlled trials containing 400 participants were analyzed. Ashwagandha extract exhibited a small but significant effect on overall sleep (Standardized Mean Difference -0.59; 95% Confidence Interval -0.75 to -0.42; I² = 62%). The effects on sleep were more prominent in the subgroup of adults diagnosed with insomnia, treatment dosage ≥600 mg/day, and treatment duration ≥8 weeks. Ashwagandha extract was also found to improve mental alertness on rising and anxiety level, but no significant effect on quality of life. No serious side effects were reported. Conclusion: Ashwagandha extract appears to has a beneficial effect in improving sleep in adults. However, data on the serious adverse effects of Ashwagandha extract are limited, and more safety data would be needed to assess whether it would be safe for long-term use.

Awareness of body image perception among children and adolescents has been rising during recent years. The objectives of this study were to identify body image dissatisfaction and its associated factors among primary-school students. A cross-sectional study was conducted in seven randomly selected primary schools, involving students aged 11 to 12. A guided self-administered questionnaire, which included sociodemographic data, body mass index (BMI) parameters, and body image perception (Childress Contour Drawing Rating Scale), was used. This study involved 776 primary-school students. Approximately 60.1% of students had body image dissatisfaction, which was significantly (p < 0.001) associated with sex and Body Mass Index (BMI). Females had 2.07 times higher rates of body image dissatisfaction (b = 0.73, OR = 2.07, 95% CI 1.53, 2.81, p < 0.001) compared to their male counterparts when adjusted for other variables. Overweight/obese students had 4.06 times greater body image dissatisfaction (b = 1.40, OR = 4.06, 95% CI 2.70, 6.10, p < 0.001) compared to students with normal BMI when adjusted for other variables. This study highlights a high prevalence of body image dissatisfaction that is correlated with sex and BMI among primary-school students.

Purpose: – A successful food safety intervention must be based on firm theories and a consideration of all relevant variables. The purpose of this paper is to examine the extent of improvement in food safety knowledge and practices of food handlers in primary school canteens through food safety training. Design/methodology/approach: – A list of 98 primary schools was randomized into intervention and control groups using a multistage sampling method. The training programme for the intervention group and questionnaires for evaluating knowledge and practices were developed. On-site observations were done to assess hygienic practices during the handling of raw food and cooking equipment. In total, 16 school canteens participated in this study. Findings: – Knowledge about personal hygiene and related to rules for preparing safe food was significantly improved after the food safety intervention. Some of the improvement was sustained for up to 12 weeks after the intervention. The self-reported practice score of food safety and hygiene in the intervention group was significantly higher at post1 and post2 compared to baseline. A significant within-group and between-group improvement was demonstrated for the observed behaviour of raw food handling and equipment sanitation. Originality/value: – The originality of this study is to provide a new framework for the design and implementation of food safety intervention in school canteens targeted towards a specific enabling factor for behavioural change. Provision of food safety training grounded by the theory of planned behaviour was associated with significantly improved food safety knowledge and behaviour amongst food handlers.

Diabetes is a primarily self-manageable condition. Healthcare professionals usually offer education, treatment, and support, but patients themselves are responsible for the daily management of their condition. Increasing the effectiveness of self-management support may have a considerable impact on health care, especially for elderly people. The aim of this study was to describe diabetes self-care among elderly diabetics and to determine its associated factors. This report describes a cross-sectional study involving 143 elderly diabetes patients in the outpatient department of the Hospital Universiti Sains Malaysia (HUSM). Self-care activities assessed in this study included dietary control, physical activity, self-monitoring of blood glucose, medication adherence, and situational related adherence behaviour, all of which were obtained using the validated Malay Elderly Diabetes Self-Care Questionnaire (MEDSCaQ). The mean (±SD) age of the subjects was 67.9 (±5.4) years old. A majority was Malay, with a mean HbA1c of 8.4 (±1.9). The mean diabetes self-care score was 26.5 (±8.0). Factors with a positive impact on diabetes self-care included being non-Malay (β = 5.275, p = 0.002), having family as care givers (β = 8.995, p = 0.004), having a higher level of family support (β = 0.159, p = 0.042), and possessing acceptable (β = 4.375, p = 0.001) or good knowledge of diabetes (β = 5.893, p = 0.004). The presence of neuropathy negatively impacted self-care, while diabetes nephropathy had a positive impact on self care (β = -4.053, p = 0.003). Elderly individuals with type 2 diabetes in HUSM have a moderate score of diabetes self-care practice based on the MEDSCaQ. Determinants for good diabetes self-care include race, social support, having care-takers during periods of illness, diabetes knowledge, and diabetic microvascular complications.

Chronic diseases pose significant threats to persons’ well-being and mental health leading to stress, anxiety and depression without effective resilience strategies. However, experiences to gain resilience in living with chronic disease in the context of Asian countries remain insufficiently explored. This review seeks to provide a comprehensive summary of qualitative evidence that explores the lived experience that cultivates resilience in chronic diseases among adults within Asian countries. A comprehensive review of five databases - Web of Sciences, Ebsco (Medline), PubMed, Science Direct, and Scopus was carried out, following the Joanna Brings Institute (JBI) standards and employing PRISMA Extension for Scoping Review (PRISMA-ScR) reporting guideline. The review encompassed studies published in English from January 2013 to December 2023. Four reviewers assessed the literature’s eligibility and extracted relevant lived experiences to address the research question based on prior studies. Subsequently, a content analysis was performed. Of the 3651 articles screened, 12 were included in this review. Three key themes emerged: (1) Sociocultural norms shaped resilience, delved into the culturally-mediated childhood development, traditional cultural beliefs, social relationships and supports and spirituality (2) Positive emotions nurtured resilience highlighted optimistic about becoming healthy, self-efficacy in self-care, endurance during hardship, self-reflection on health, acceptance of having disease, and appreciation of life while (3) Problem-solving strategies fostered resilience underlined improve disease literacy, ability to deal with disease challenges and engage in meaningful activities. Our review addresses important research gaps on sociocultural norms that shaped resilience in chronic disease despite a small number of research. Therefore, this warrants further studies on how the traditional cultures and beliefs influence resilience among the Asian population living with chronic disease. Further research should thoroughly describe the qualitative methodologies and theoretical framework to provide more comprehensive information on the experience of resilience in chronic disease.

The objective of this cross-sectional study was to determine the factors associated with the attitudes toward premarital sexual activities among school-going adolescents in Kelantan, Malaysia. It was conducted among 1032 secondary school students using a self-administered validated questionnaire. Multiple logistic regression revealed that the risk factors for having permissive attitudes toward practice of premarital sexual activities were male students (odds ratio [OR] = 1.83; 95% confidence interval [CI] = 1.34-2.48), being less religious (OR = 2.02; 95% CI = 1.49-2.73), and younger age group of students (13 to 14 years old; OR = 1.42; 95% CI = 1.05-1.92). Having good knowledge on sexual and reproductive health was a protective factor against permissive sexual attitude (OR = 0.27; 95% CI = 0.20-0.36). In conclusion, male and young adolescents were at risk of having permissive attitudes toward sexual behaviors, but good knowledge on sexual and reproductive health and being more religious may protect them from it.