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Purpose>One major challenge for urban planners and policymakers is how to strengthen and establish connections between humans and the environment. Evidence suggests that the physical characteristics of the environment enhance both place identity and user satisfaction. This study aims to investigate the mediating role of place identity in the relationship between place quality and user satisfaction in two waterfronts in Penang, Malaysia. However, only few studies have examined the impact of place quality on user satisfaction in waterfronts as natural outdoor recreation spaces.Design/methodology/approach>A sample of 300 users was analysed via structural equation modelling, and results show that place quality is a second-order construct with three main dimensions.Findings>These results support the theoretical findings in the literature that associate high place quality and place identity with user satisfaction. These results also support the mediating role of place identity in the relationship between place quality and satisfaction and can help policymakers create inclusive and attractive waterfronts that catalyse place identity and user satisfaction.Originality/value>Place quality is an essential need for urban life with significant and extensive effects on the lives of residents nowadays. Organising physical activities can help attract more users to waterfronts and consequently increase their level of satisfaction. Local authorities, non-governmental organisations and local communities should also help in monitoring and maintaining the waterfronts.

Urban development in Malaysia is inseparable from its existence, which began on the river banks. The design of river banks often changes with time and the level of urbanization. As a result, the physical environment of the river bank will indirectly affect the identity of the place. In fact, the revitalization that has been done able to establish the identity of the area. Relationship functional and emotional elements between human and place create meaning, this process is known as place attachment. Physical changes that occur results in a change of meaning and place attachment may decrease gradually. In the context of urban design, some discussions led to the physical element of interest and activity to develop place identity and atmosphere, but a study of open space areas have received less attention. The aim of this study is to verify the ability of place attachment and the factors that influence user’s perception in the context of open space on the waterfronts in Malaysia. Furthermore, to find out the cause (causal) between the places attachments, meaning the place and the characteristics that influence the level of public engagement. The objectives identified in this study are; (i) to determine the form of emotional and functional attachment of open space or place in the development of the waterfront; (ii) to identify the reasons that affect the place attachment especially on the meaning and importance of the place; (iii) to identify the level of place attachment with the user’s roles in the open spaces and; (iv) to identify the characteristics of open space along the waterfront, which influences by user’s engagement. A mixture of qualitative and quantitative approach are used in this research and covers two main areas of urban design and environmental psychology. Surveys and in-depth interviews conducted with users of selected two study areas, namely Kuching Waterfront (KW) in Sarawak and Lumut Waterfront (LW) in Perak. Observation’s also been used to obtain the physical and visual characteristics. The results showed that the place attachment is influencing users perception of public space at the river bank. Besides its physical quality, the place is also known for attachment and its significance to the user. Results from the study show several factors that influence the form and the level of engagement of the attachment, user familiarity with the place, place dependency, user background, and role. Therefore, this study contributes to human relationship with the place and give importance implications to urban planners, urban designers, and architects to create a better and well-organized place.

More than half of the energy consumption in buildings is utilized for the heating and/or cooling of the indoor environment. The building envelope plays a key role in controlling the effects of external weather and, therefore, is linked with many passive design strategies. Thermal energy storage (TES) and phase change materials (PCMs) are efficient techniques, which can store a high density of thermal energy. The PCMs attract many researchers to implement them in the components of buildings for thermal management. In building walls, they were implemented in different positions and have achieved different results. This paper aims to review the related literature that examines PCMs’ application in different positions within the building walls to locate their optimum position and the influential parameters. It was found that the optimum positions of PCMs are highly dependent on performing a daily complete melting/freezing cycle to be ready for the following day. Many parameters can influence this, including climate and weather conditions and the application target, PCMs’ melting temperature and heat of fusion, PCMs’ amount, the thermal properties of the wall’s materials, a mechanical heating/cooling or free-running indoor environment, and wall orientation. An optimization process using the simulation tools is suggested so that the optimum position of the PCMs can be located.

Bone fractures represent a significant health issue and impose a considerable burden on healthcare systems globally. However, data pertaining to bone fractures, especially among reproductive-age women in Malaysia, are very limited. Micronutrients like calcium, magnesium and phosphorus play vital roles in bone health, influencing bone mineral density and fracture risk. The objective of this study was to determine the prevalence of bone fractures among reproductive-age women and the association with dietary micronutrient intakes. In this cross-sectional study, a total of 1,730 participants of reproductive-age women from the Malaysia Prospective Urban and Rural Epidemiological (PURE) study were recruited. The participants' dietary intakes were assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Selected micronutrients in the participants' diets were calculated using the Malaysian food composition and the US Department of Agriculture food composition databases. The association between micronutrient intakes, comorbidities and physical activity levels with bone fractures were evaluated to identify predictors of bone fractures among reproductive-age women. The prevalence of bone fractures among Malaysian reproductive-age women was low (3.7%). The multiple logistic regression analysis showed that none of the micronutrients was associated with bone fractures. However, factors of diabetes and passive smoking in this study showed 2.6- and 4.0-times-higher odds of having bone fractures, respectively (AOR 2.580; 95% CI: 1.173-5.672) and (AOR 4.012; 95% CI: 2.265-7.107). It was found that the majority of women in this study were taking lower micronutrient intakes of calcium, magnesium, and vitamin K than the Malaysia recommended nutrient intakes (RNI). Although this study showed that a low micronutrient intake is not significantly associated with bone fractures, it is recommended that future studies focus on controlled trials or prospective data analyses to establish causal relationships and the optimal micronutrient requirements for maintaining strong and healthy bones in women of reproductive age.

Background The incidence of type 2 diabetes mellitus (T2DM) is rising rapidly in Malaysia. Modifying dietary intake is key to both the prevention and treatment of T2DM. This study aims to investigate the pattern of macronutrient intake among T2DM patients in Malaysia. Methods This study was carried out on adults aged between 35 and 70 years, residing in urban and rural Malaysian communities. A series of standardised questionnaires was used to assess the sociodemographic information, dietary intake and physical activity level of 15,353 respondents who provided informed consent to participate in this study. Blood sampling (finger prick test) and physical examination were performed to obtain blood glucose and anthropometric data, respectively. The Chi-square test was used to assess differences in the trends of macronutrient intake among T2DM patients. Results The total number of participants diagnosed with T2DM in this study was 2254. Of these, 453 (20.1%) were newly diagnosed, 1156 (51.3%) were diagnosed for ≤5 years and 645 (28.6%) were diagnosed for > 5 years. Male patients show that there were significant differences among the three groups of T2DM according to the following variables: age, BMI, residency, participant comorbidity of hypertension, family history of T2DM and hypertension, and active smoker. Meanwhile, female patients show significant differences among the three groups of T2DM according to the following variables: age, BMI, marital status, education level, residency, participant comorbidity of hypertension and family history of T2DM. Most of the male patients consumed appropriate proportions of carbohydrate (458, 60.7%) and protein (618, 81.9%). However, female patients did not show any significant differences of the macronutrients intake among the three groups of T2DM patients. Conclusions The pattern of dietary intake among T2DM patients in this study showed consumption of carbohydrate and protein within the range of Malaysian RNI, coupled with high fat intake. Compliance with the Recommended Nutrient Intake (RNI) was satisfactory for both carbohydrate and protein but not for fat. The pattern indicated a preference for fat rather than protein when carbohydrate intake was restricted.

Background Vitamin deficiency could increase the prevalence of type 2 diabetes mellitus (T2DM). Thus, this study aimed to determine the association between dietary vitamin intake and the prevalence of T2DM among the Malaysian adult population. Methods This cross-sectional study involved 9,314 participants from Prospective Urban and Rural Epidemiology Study (PURE) conducted in Malaysia. The participants comprised of 43% (4003) males and 57% (5311) females with mean age of 51.2 ± 9.4 years old. Participants were classified into the T2DM group if they reported having been diagnosed with T2DM or had a glucose level of ≥ 7 mmol/L (fasting blood glucose) or ≥ 11.1 mmol/L (non-fasting blood glucose). A validated food frequency questionnaire was used to measure the participants’ usual dietary intake. The intake of dietary vitamins A, B6, B9, B12, C, E, and K was calculated based on nutrient databases. Results The T2DM prevalence was 16.9% among Malaysian adult population. The prevalences of inadequate dietary vitamin intake were elevated for vitamins A (22.8%) and C (28.8%), and notably high for vitamins B6 (98.3%), B9 (100.0%), B12 (80.5%), E (91.3%), and K (82.2%). The intake of dietary vitamins B6, B9, B12, C, E, and K was significantly lower among T2DM patients compared to those without T2DM (p-value < 0.05) when adjusted for covariates. Additionally, higher intake of dietary vitamins A, B6, B9, B12, C, E, and K was significantly associated with a reduced prevalence of T2DM (p-value < 0.05) when adjusted for covariates. Conclusion This study found an alarming deficiency of vitamins A, B6, B9, B12, C, E, and K in the dietary intake among the Malaysian adult population regardless of T2DM status. The dietary vitamin deficiency (vitamins B6, B9, B12, E, and K) was more susceptible among those with T2DM compared to non-T2DM. This study indicated that higher dietary vitamin intake (vitamins A, B6, B9, B12, C, E, and K) could benefit by reducing the prevalence of T2DM. Therefore, an adequate intake of dietary vitamins is crucial for this study population to reduce the prevalence of T2DM.

This study aims to investigate the association between dietary vitamin (A, B 6 , B 9 , B 12 , C, E, and K) intake and hypertension (HPT) among Malaysian adult population. This is a cross-sectional analysis of baseline data from a population-based cohort of 10,031 participants from the Malaysia arm of the Prospective Urban and Rural Epidemiology (PURE) study. Participants were classified as having HPT if they reported a diagnosis of high blood pressure (systolic blood pressure (SBP)/diastolic blood pressure (DBP) > 140/90). Participants’ usual dietary intake was assessed using a validated food frequency questionnaire. Vitamin (A, B 6 , B 9 , B 12 , C, E, and K) intake was calculated using nutrient databases. The Mann-Whitney U test was used to assess differences in vitamin intake between the HPT groups. This study found that the prevalence of HPT among 10,031 respondents was 43.5%. The overall dietary intake of vitamins A and C was adequate, but the intake of vitamins B 6 , B 9 , B 12 , E, and K was inadequate compared to Malaysia’s Recommended Nutrient Intakes (RNI). The intake of vitamins A, B 6 , B 9 , B 12 , E, and K was significantly lower among patients with HPT compared to those without HPT ( p -value < 0.001). This study found that the Malaysian adult population is not receiving sufficient intake of vitamins B 6 , B 9 , B 12 , E, and K from their diet. Improving vitamin intake can be achieved through nutrition education, a diet that includes a variety of healthy foods, and food fortification and supplementation.

Hypertension (HPT) is the leading modifiable risk factor for cardiovascular diseases and premature death worldwide. Currently, attention is given to various dietary approaches with a special focus on the role of micronutrient intake in the regulation of blood pressure. This study aims to measure the dietary intake of selected minerals among Malaysian adults and its association with HPT. This cross-sectional study involved 10,031 participants from the Prospective Urban and Rural Epidemiological study conducted in Malaysia. Participants were grouped into HPT if they reported having been diagnosed with high blood pressure [average systolic blood pressure (SBP)/average diastolic blood pressure (DBP) ≥ 140/90 mm Hg]. A validated food frequency questionnaire (FFQ) was used to measure participants' habitual dietary intake. The dietary mineral intake of calcium, copper, iron, magnesium, manganese, phosphorus, potassium, sodium, and zinc was measured. The chi-square test was used to assess differences in socio-demographic factors between HPT and non-HPT groups, while the Mann–Whitney U test was used to assess differences in dietary mineral intake between the groups. The participants’ average dietary intake of calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, sodium, and zinc was 591.0 mg/day, 3.8 mg/day, 27.1 mg/day, 32.4 mg/day, 0.4 mg/day, 1431.1 mg/day, 2.3 g/day, 27.1 µg/day, 4526.7 mg/day and 1.5 mg/day, respectively. The intake was significantly lower among those with HPT than those without HPT except for calcium and manganese. Continuous education and intervention should be focused on decreasing sodium intake and increasing potassium, magnesium, manganese, zinc, and calcium intake for the general Malaysian population, particularly for the HPT patients.

Introduction Handgrip strength (HGS) measures the maximum voluntary force of the hand, which has been used to assess individual health status indirectly. Although several factors related to HGS have been identified, studies among adults in Malaysia are lacking. This study aimed to provide the normative reference HGS values and determine its predictor factors among healthy adults of Malay ethnic in Malaysia. Methodology This study was a part of the Prospective Urban Rural Epidemiology (PURE) study carried out among adults aged between 35 to 70 years old residing in urban and rural Malaysian communities. A standardised questionnaire was used to assess the socio-demographic information and physical activity level of respondents who provided written informed consent to participate in this study. HGS was measured using Jamar’s dynamometer. A total of 3,446 healthy adults of Malay ethnic were included in this study. Descriptive data were used to derive the normative reference values for HGS using means and standard deviations stratified by age and gender. The predictors of HGS were determined using a general linear model (GLM). Results Mean HGS ranged from 38.48 (± 9.40) kg for the dominant hand of men aged 35–40 years to 16.53 (± 5.69) kg for the non-dominant hand of women aged 61–70 years. The ANOVA indicated that there was a significant descending trend of HGS as age increased for both genders ( p  < 0.05). The ANOVA also revealed that participants working in blue- or white-collar jobs had higher HGS than their counterparts who are homemakers ( p  < 0.05). The GLM shows that, age, occupation type, socio-economic status (SES), physical activity level and BMI significantly predicted dominant HGS among male and meanwhile, only age, SES and BMI significantly predicted dominant HGS among female. Conclusion HGS normative values provided herein can serve as a guide for interpreting HGS measurements obtained from healthy Asian adults especially Malay ethnic. The clinicians and researcher can use the established HGS reference values as comparison in their patients or participants. Furthermore, during a rehabilitation process, the clinicians and researchers could use the normal score ranges to document the progress of HGS and provide feedback to the patients. Further study with prospective study design is needed to determine the causal effect association of the predictors and HGS.

Introduction: Oil palm phenolic (OPP) is an antioxidant aqueous palm oil by-product and contains a high amount of phenolics. OPP has been proven to have many therapeutical benefits, and one of them is as an antihyperlipidemic agent. The previous phase 1 clinical trial proved OPP was safe to be orally consumed by healthy volunteers and yielded a good lipid profile. Thus, this phase 2 clinical trial was conducted to determine the effectiveness of OPP in improving the lipid profile among hyperlipidemic subjects. Methods: A parallel, placebo-controlled, randomized, double-blinded clinical trial was conducted for 2 months on 50 hyperlipidemic subjects aged 20–50 years old. The subjects were randomly distributed to two treatment arms with 25 participants each: control/placebo (11 males and 14 females) and 250 mg of OPP (10 males and 15 females). The subjects were required to consume one capsule per day for 60 days. Fasting blood sampling for routine blood profile (hematology, liver function, renal function, and lipid) analysis and a medical examination were conducted at baseline, day 30, and day 60. t -test analysis was used to compare the difference between two test groups. Results: The baseline lipid profile between control group (TC, 5.78 ± 0.52 mmol/L; LDL, 3.88 ± 0.51 mmol/L; HDL, 1.30 ± 0.25; TG, 1.30 ± 0.82), and 250 mg OPP (TC, 5.76 ± 0.54 mmol/L; LDL, 3.82 ± 0.59 mmol/L; HDL, 1.37 ± 0.34; TG, 1.25 ± 0.54) is insignificant. No serious adverse events (SAEs) were reported. No abnormality in fasting blood parameters in all groups was found. Compared to the control group among male participants, the 250 mg OPP group showed an improved serum triglyceride level. There were no statistically significant changes in all blood parameters from day 1 to day 60 with the exception of triglyceride level. Conclusion: The absence of SAEs reported and no abnormal findings in biochemistry and hematology results suggested that the 250 mg OPP was safe to be taken by hyperlipidemic patients with a high probability of reducing triglyceride level in hyperlipidemic male patients The outcomes from this phase II trial suggest that by incorporating OPP supplements into the diet may be a promising strategy for individuals with hyperlipidemia to improve their lipid profiles and reduce cardiovascular risk. However, more research is needed to fully understand the mechanisms of action and establish the long-term efficacy and safety of OPP supplementation in larger scale. Limitation: Small samples size hence lack of diversity (25 subjects per groups) and early sharing of treatment-response results. Clinical Trial Registration: clinicaltrials.gov , identifier NCT04573218.