COVID-19 has trickle-down psychological effects on multiple strata of society, particularly university students. Apart from the worry of contracting or spreading COVID-19, Malaysian university students were also locked down on their campuses, suffering significant psychological distress. Hence, an online mindfulness intervention was proposed to alleviate psychological distress and improve psychological flexibility and mindfulness. This was a quasi-experimental study with university students as participants. Intervention group participants were instructed to complete online questionnaires which covered basic demographics and instruments assessing depression, anxiety, stress, mindfulness, psychological flexibility, and fear of COVID-19 before and after the one-hour intervention. The control group also completed before and after questionnaires and were subsequently crossed over to the intervention group. Repeated measures ANOVA was conducted to assess time*group effects. 118 participants were involved in this study. There were significant differences in anxiety (F(1,116) = 34.361, p < 0.001, partial eta-squared = 0.229) and psychological flexibility between the two groups (F(1,116) = 11.010, p = 0.001, partial eta-squared = 0.087), while there were no differences in depression, stress, mindfulness, or fear of COVID-19. The results of this study corroborate the efficacy of online single-session mindfulness therapy as a viable short-term psychological intervention under financial and time constraints. Since university students are in the age group with the highest incidence of depressive and anxiety disorders, it is crucial to utilize resources to address as many students as possible to ensure maximum benefit.

COVID-19 stress and fear of COVID-19 is an increasingly researched construct in the general population. However, its prevalence and association with sociodemographic factors and psychological process variables has not been explored in frontline workers under surveillance in a Bornean population. This study was a cross-sectional study using a sociodemographic questionnaire incorporating two specific epidemiological risk variables, namely specific questions about COVID-19 surveillance status (persons under investigation (PUI), persons under surveillance (PUS), and positive cases) and the nature of frontline worker status. Furthermore, five other instruments were used, with three measuring psychopathology (namely depression, anxiety and stress, fear of COVID-19, and stress due to COVID-19) and two psychological process variables (namely psychological flexibility and mindfulness). Kruskal–Wallis and Mann–Whitney tests were performed to assess if there were significant differences in psychopathology and psychological process variables between sociodemographic and epidemiological risk variables. Hierarchical multiple regression was further performed, with depression, anxiety, and stress as dependent variables. There were significant differences in the fear of COVID-19 between positive cases, PUI, and PUS. The fear of COVID-19 scores were higher in positive cases compared to in PUS and PUI groups. Upon hierarchical multiple regression, mindfulness and psychological flexibility were significant predictors of depression, anxiety, and stress after controlling for sociodemographic and epidemiological risk factors. This study demonstrates that exposure to COVID-19 as persons under investigation or surveillance significantly increases the fear of COVID-19, and brief psychological interventions that can positively influence mindfulness and psychological flexibility should be prioritized for these at-risk groups to prevent undue psychological morbidity in the long run.

The COVID-19 pandemic has had considerable psychological health impacts across the globe. This study aimed to establish the psychological process variables underlying psychopathology in Malaysian public university students during the national Movement Control Order (MCO). The aim was to craft structured and sustainable psychological support programs with these students. We conducted a cross-sectional study involving Malaysian university students subjected to the Malaysian MCO. Structured questionnaires measuring sociodemographic factors, measures of depression, anxiety, stress, psychological mindedness, psychological flexibility and state mindfulness were employed. A total of 515 students participated in this study with 12 students (2.3%) being quarantined at the time. Many of them scored ‘moderate’ or above on the Depression, Anxiety and Stress Scale (DASS) with 20.2%, 25.0% and 14.2%, respectively. Quarantined students had higher depressive symptoms, with female students scoring significantly higher for depression, anxiety, and stress. Multiple regressions suggested gender and quarantine status predicted depression scores. However, only gender significantly predicted anxiety and stress. Psychological flexibility and psychological mindedness (Insight subscale) are significantly correlated with depression, anxiety, and stress, with psychological mindedness predicting all three psychopathologies. This study demonstrates that gender, psychological flexibility, and psychological mindedness are key demographic and psychological factors impacting students. Targeting psychological flexibility and psychological mindedness may enable timely prevention and intervention programs for our students to support their mental and physical health as we move through, and out of, the pandemic.

COVID-19 has affected almost every country in the world, which causing many negative implications in terms of education, economy and mental health. Worryingly, the trend of second or third wave of the pandemic has been noted in multiple regions despite early success of flattening the curve, such as in the case of Malaysia, post Sabah state election in September 2020. Hence, it is imperative to predict ongoing trend of COVID-19 to assist crucial policymaking in curbing the transmission. Generalized logistic growth modelling (GLM) approach was adopted to make prediction of growth of cases according to each state in Malaysia. The data was obtained from official Ministry of Health Malaysia daily report, starting from 26 September 2020 until 1 January 2021. Sabah, Johor, Selangor and Kuala Lumpur are predicted to exceed 10,000 cumulative cases by 2 February 2021. Nationally, the growth factor has been shown to range between 0.25 to a peak of 3.1 throughout the current Movement Control Order (MCO). The growth factor range for Sabah ranged from 1.00 to 1.25, while Selangor, the state which has the highest case, has a mean growth factor ranging from 1.22 to 1.52. The highest growth rates reported were in WP Labuan for the time periods of 22 Nov - 5 Dec 2020 with growth rates of 4.77. States with higher population densities were predicted to have higher cases of COVID-19. GLM is helpful to provide governments and policymakers with accurate and helpful forecasts on magnitude of epidemic and peak time. This forecast could assist government in devising short- and long-term plan to tackle the ongoing pandemic.

Introduction: Performance anxiety is a transdiagnostic construct similar in both sports and clinical medical examinations. Given that acceptance and commitment therapy (ACT) and other similar therapies have transdiagnostic evidence in improving the performance of athletes, the same approach can be adopted for medical students in improving their performance during clinical examinations. This pilot study aimed to assess the efficacy of a brief ACT-based intervention in improving transdiagnostic performance anxiety in clinical medical students through assessing changes in psychopathology scores (depression, anxiety, and stress) and psychological process variables (psychological flexibility, cognitive fusion, and mindfulness). Methods: Final-year medical students were randomized into intervention and control groups. A one-day ACT-based intervention was delivered to an intervention group, with the control group crossing over one month post intervention. Both groups filled in sociodemographic questionnaires and questionnaires measuring psychological flexibility, cognitive fusion, mindfulness, depression, anxiety, and stress at three time points: T1 (before intervention), T2 (immediately after intervention), and T3 (one month post intervention). Repeated measures ANOVA was employed to assess the change between the intervention and control groups over time. Results and Conclusions: There was a significant change in anxiety scores from T1 to T3. In addition, there were significant improvements in mindfulness, cognitive fusion, and psychological flexibility scores over time in the intervention group compared with the control group. This pilot study builds on small single-sample evidence bases for the efficacy of an ACT-based intervention in non-sports performance enhancement, suggesting that larger-scale randomized trials of similar interventions in clinical medical students may prove equally efficacious.

Introduction: Neuromelioidosis is a rare complication of melioidosis caused by Burkholderia pseudomallei, a Gram-negative bacterium commonly found in soil and surface water. Although cerebral involvement of melioidosis comprises only 4% of total complications, it significantly impacts mortality and morbidity. This study aims to perform a systematic review on various neurological complications of melioidosis in the Asia-Pacific region within the previous 5 years. Method: Systematic search was performed in PubMed, Web of Science databases and Google Scholar on neuromelioidosis complications published from 2015-2019. Results: Central nervous system (CNS) complications comprise 5% of all cases of melioidosis. 16 selected articles were analysed based on its risk factors like diabetes mellitus, chronic renal and lung disease, alcohol abuse, and immunosuppression. Neuromelioidosis is detected 6-14 days after the first presentation and confirmed by detailed investigations. Radioimaging helps to differentiate neuromelioidosis from other diagnoses such as meningitis or brain abscess. The majority of literature recommended 2-week intensive Ceftazidime or Meropenem therapy, followed by 3–6 months Trimethoprim and Sulfamethoxazole oral eradication therapy. Conclusion: Neuromelioidosis is rare, with relatively nonspecific CNS clinical features. Patients or travelers from endemic areas with risk factors should be treated cautiously. Radioimaging modalities aid early microbiological sampling and appropriate antibiotic therapy.