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  1. Fulltext Evaluation of psychometric properties of the malay version perceived stress scale in two occupational settings in malaysia
    Al-Dubai S, Ganasegeran K, Barua A, Rizal A, Rampal K
    Ann Med Health Sci Res, 2014 Jul;4(Suppl 2):S104-7.
    PMID: 25184074 DOI: 10.4103/2141-9248.138023
    BACKGROUND: The 10-item version of Perceived Stress Scale (PSS-10) is a widely used tool to measure stress. The Malay version of the PSS-10 has been validated among Malaysian Medical Students. However, studies have not been conducted to assess its validity in occupational settings.
    AIM: The aim of this study is to assess the psychometric properties of the Malay version of the PSS-10 in two occupational setting in Malaysia.
    SUBJECTS AND METHODS: This study was conducted among 191 medical residents and 513 railway workers. An exploratory factor analysis was performed using the principal component method with varimax rotation. Correlation analyses, Kaiser-Meyer-Olkin, Bartlett's test of Sphericity and Cronbach's alpha were obtained. Statistical analysis was carried out using statistical package for the social sciences version 16 (SPSS, Chicago, IL, USA) software.
    RESULTS: Analysis yielded two factor structure of the Malay version of PSS-10 in both occupational groups. The two factors accounted for 59.2% and 64.8% of the variance in the medical residents and the railway workers respectively. Factor loadings were greater than 0.59 in both occupational groups. Cronbach's alpha co-efficient was 0.70 for medical residents and 0.71 for railway workers.
    CONCLUSION: The Malay version of PSS-10 had adequate psychometric properties and can be used to measure stress among occupational settings in Malaysia.
    KEYWORDS: Factor structure; Malaysia; Occupational; Perceived stress scale; Psychometric properties; Validity
  2. Fulltext Emotional burnout, perceived sources of job stress, professional fulfillment, and engagement among medical residents in Malaysia
    Al-Dubai SA, Ganasegeran K, Perianayagam W, Rampal KG
    ScientificWorldJournal, 2013;2013:137620.
    PMID: 24367238 DOI: 10.1155/2013/137620
    This study was the first to explore factors associated with emotional burnout (EB) among medical residents in Malaysia. A cross-sectional study was conducted in a universal sample of 205 medical residents in a Malaysian general hospital. The self-administered questionnaire used consisted of questions on sociodemographics and work characteristics, sources of job stress, professional fulfillment, engagement, and EB. EB was measured using the emotional exhaustion subscale, the Maslach Burnout Inventory (MBI). Mean (±SD) age of the respondents was 26.5 (±1.6). The most common source of job stress was "fear of making mistakes." Most of the participants were dissatisfied with the increase of residentship period from one year to two years. A high level of EB was reported by 36.6% of the respondents. In multivariate analysis, the most important correlates of EB were sources of job stress, professional fulfillment, and engagement. A high prevalence of EB was found among medical residents. Sociodemographic characteristics, performance pressure, and satisfaction with policies were significantly associated with EB. Although this study was limited by its cross-sectional design, its findings posit a sufficient foundation to relevant authorities to construct, amend, and amalgamate existing and future policies. Nothing will sustain you more potently than the power to recognize in your humdrum routine, as perhaps it may be thought, the true poetry of life-the poetry of the common place, of the common man, of the plain, toil-worn woman, with their loves and their joys, their sorrows and their grief.SirWilliam Osler, Aphorisms from the Student Life (Aequanimitas, 1952).
  3. Fulltext Prevalence and associated factors of burnout among doctors in Yemen
    Al-Dubai SA, Rampal KG
    J Occup Health, 2010;52(1):58-65.
    PMID: 19907108
    OBJECTIVES: This study aimed to determine the level and factors contributing to burnout among doctors in Sana'a City, Yemen and to determine the relationship between burnout and psychological morbidity.

    METHODS: This was a cross-sectional study of 563 working doctors in the four main hospitals in Sana'a City, Yemen. The 12-item version of the General Health Questionnaire (GHQ12) was used as a measure of psychological morbidity and the 22-item Maslach Burnout Inventory (MBI) was used to measure emotional exhaustion, depersonalization, and personal accomplishment. Sources of job stress were determined using a 37-item scale questionnaire. The questionnaire elicited information about socio-demographic and work characteristics.

    RESULTS: On the MBI, 356 doctors showed high emotional exhaustion (63.2%), 109 showed high depersonalization (19.4%) and 186 showed low personal accomplishment (33.0%). Sixty six doctors (11.7%) were identified as experiencing a high degree of burnout (high emotional exhaustion and depersonalization and low personal accomplishment). The prevalence of high degree of burnout was significantly higher in those with duration of work or=40 h/wk (OR=2.1, 95% CI 1.25-3.62) and in those who had psychological morbidity (OR=5.3, 95% CI 2.22-12.39). Thirteen out of 37 sources of stress were significantly associated with high degree of burnout. In multivariate analysis, the significant predictors of high burnout were: dealing with patient's psychosocial problems, feeling of isolation, disturbance of home/family life by work, not chewing khat, long working hours and psychological morbidity.

    CONCLUSION: The prevalence of high degree of burnout as well as emotional exhaustion in Yemeni doctors was higher than those reported internationally and was associated with psychological morbidity and many important sources of job stress.
  4. Fulltext Stress and coping strategies of students in a medical faculty in malaysia
    Al-Dubai SA, Al-Naggar RA, Alshagga MA, Rampal KG
    Malays J Med Sci, 2011 Jul;18(3):57-64.
    PMID: 22135602 MyJurnal
    Stress may affect students' health and their academic performance. Coping strategies are specific efforts that individuals employ to manage stress. This study aimed to assess the perception of stress among medical students and their coping strategies.
  5. Fulltext Factor Structure and Reliability of the Malay Version of the Perceived Stress Scale among Malaysian Medical Students
    Al-Dubai SA, Alshagga MA, Rampal KG, Sulaiman NA
    Malays J Med Sci, 2012 Jul;19(3):43-9.
    PMID: 23785249 MyJurnal
    BACKGROUND: The Perceived Stress Scale 10 (PSS-10) is a validated and reliable instrument to measure global levels of perceived stress. This study aims to assess the internal consistency, reliability, and factor structure of the Malay version of the PSS-10 for use among medical students.
    METHODS: The original English version of the PSS-10 was translated and back-translated into Malay language. The Malay version was distributed to 242 Bachelor of Medical Science students in a private university in Malaysia. Test-retest reliability was assessed in 70 students. An exploratory principal component factor analysis with varimax rotation was performed. Reliability was tested using the intraclass correlation coefficient (ICC).
    RESULTS: All 242 students participated in the initial questionnaire study (validity and factor structure), and 70 students participated in the test-retest reliability of the study. Exploratory factor analysis yielded 2 factors that accounted for 57.8% of the variance. Cronbach's alpha coefficients for the 2 factors were 0.85 and 0.70, respectively. The reliability test showed an ICC of 0.82 (95% CI: 0.70, 0.89).
    CONCLUSION: The Malay version of the PSS-10 showed adequate psychometric properties. It is a useful instrument for measuring stress among medical students in Malaysia.
    KEYWORDS: Malaysia; medical; psychological; reliability and validity; stress; students
  6. Fulltext Evaluation of the nutrition and health components in the future planning for food and nutrition in Kuala Selangor. [Penilaian komponen pemakanan dan kesihatan rancangan amalan makanan dan pemakanan di Kuala Selangor]
    Ali O, Rampal KG, Lubis SH
    Med J Malaysia, 1984 Sep;39(3):234-8.
    PMID: 6544926
    A study was carried out to study lite prevalence of hypertension amongst rural Malays living in two villages in Kuala Selangor district. Simple random sampling of households was carried out and all members 15 years and above were examined. Out of 359 persons examined, 92 (25.6%) had hypertension. A significant increase in prevalence was observed with increasing age and in smokers. Prevalence rates did not differ significantly in the two sexes and with income. Only 38 of the hypertensives were known cases. It was found that 78. 7% of them had been detected within less than five years and 81.6% had undergone medical treatment. It is proposed that preventive programmes in hypertension be introduced in rural health services and a national prevalence survey be conducted.
  7. Fulltext [The prevalence of visual impairment in Kuala Selangor]
    Ali O, Rampal KG
    Med J Malaysia, 1988 Sep;43(3):232-6.
    PMID: 3266522
  8. Lower back pain and its association with whole-body vibration and manual materials handling among commercial drivers in Sabah
    Awang Lukman K, Jeffree MS, Rampal KG
    Int J Occup Saf Ergon, 2019 Mar;25(1):8-16.
    PMID: 28978270 DOI: 10.1080/10803548.2017.1388571
    A cross-sectional study was undertaken to determine the prevalence of lower back pain (LBP) and its association with whole-body vibration (WBV) and manual materials handling (MMH). We studied 110 commercial vehicle drivers using a self-administered questionnaire and the VI-400Pro human vibration monitor. Prevalence of LBP was 66.4%. The percentage of drivers who had frequent manual handling of heavy loads was 45.5% and those who handled heavy loads in awkward postures accounted for 86.4%. Daily vibration A(8) averaged on the z axis was 0.25 (0.06) m·s-2 and at vector sum was 0.29 (0.07) m·s-2. Daily vibration exposures on the z axis, frequent manual handling of heavy loads and awkward posture during MMH were significantly associated with LBP. Drivers who are exposed to WBV and frequently handle heavy loads manually and with awkward postures probably have more LBP than drivers who are exposed to only one of these risk factors.
  9. Fulltext The prevalence of musculoskeletal problems and risk factors among women assembly workers in the semiconductor industry
    Chandrasakaran A, Chee HL, Rampal KG, Tan GLE
    Med J Malaysia, 2003 Dec;58(5):657-66.
    PMID: 15190650
    A cross-sectional study to determine work-related musculoskeletal problems and ergonomic risk factors was conducted among 529 women semiconductor workers. Overall, 83.4% had musculoskeletal symptoms in the last one year. Pain in the back (57.8%), lower leg (48.4%) and shoulder (44.8%) were the three most common musculoskeletal problems. Significant associations were found between prolonged standing and upper and lower leg pain, between prolonged sitting and neck and shoulder pain and between prolonged bending and shoulder arm, back and upper leg pain. The study therefore showed a clear association between work-related musculoskeletal pain and prolonged hours spent in particular postures and movements.
  10. Fulltext Influence of gender and oral health knowledge on DMFT index: a cross sectional study among school children in Kaski District, Nepal
    Chapain KP, Rampal KG, Gaulee Pokhrel K, Adhikari C, Hamal D, Pokhrel KN
    BMC Oral Health, 2023 Feb 01;23(1):59.
    PMID: 36726123 DOI: 10.1186/s12903-023-02755-z
    BACKGROUND: Oral health problems are highly prevalent among school children in Nepal. Poor oral health condition may be influenced by various factors. However, little is known about the sociodemographic and awareness related factors on oral health problems among school children in Nepal. Therefore, this study aimed to assess the association of gender and knowledge on DMFT index among school children.

    METHODS: A cross-sectional study was conducted among school children of Grade Seven in 12 schools of Kaski district in Nepal. Schools were randomly selected from the urban and semi-urban areas in the district. Data were collected covering oral health knowledge, socio-demographic characteristics, oral health condition and practices. The factors of poor oral health condition and practices were examined using t-test, one-way ANOVA, and multiple linear regression.

    RESULTS: Of the total participants (n = 669), 54.9% were females and their mean DMFT score was 1.82 (SD = 1.07). Total decayed score was higher among those who did not have knowledge that fluoride prevents decay compared to those who had knowledge about it (Being aware of fluoride prevents decay: Mean = 1.21 (SD = 1.54) versus not being aware of that: mean = 2.13 (SD = 2.13); p = 0.029). Females were more likely to have higher DMFT scores compared to males (β-coefficient = 0.43, 95% CI 0.13, 0.73, p = 0.005). In addition, higher knowledge score was negatively associated with higher DMFT score (β-coefficient = - 0.09, 95% CI - 0.20, -0.01, p = 0.047).

    CONCLUSION: Being female students and those having lower level of knowledge on oral health attributed to higher DMFT index. Periodic dental check-up coupled with oral health education on regular brushing, use of fluoridated paste, tongue cleaning and care of gum diseases are recommended in schools.

  11. Relation between sick leave and selected exposure variables among women semiconductor workers in Malaysia
    Chee HL, Rampal KG
    Occup Environ Med, 2003 Apr;60(4):262-70.
    PMID: 12660374
    To determine the relation between sick leave and selected exposure variables among women semiconductor workers.
  12. Ergonomic risk factors of work processes in the semiconductor industry in Peninsular Malaysia
    Chee HL, Rampal KG, Chandrasakaran A
    Ind Health, 2004 Jul;42(3):373-81.
    PMID: 15295910
    A cross-sectional survey of semiconductor factories was conducted to identify the ergonomic risk factors in the work processes, the prevalence of body pain among workers, and the relationship between body pain and work processes. A total of 906 women semiconductor workers took part in the study. In wafer preparation and polishing, a combination of lifting weights and prolonged standing might have led to high pain prevalences in the low back (35.0% wafer preparation, 41.7% wafer polishing) and lower limbs (90.0% wafer preparation, 66.7% wafer polishing). Semiconductor front of line workers, who mostly walked around to operate machines in clean rooms, had the lowest prevalences of body pain. Semiconductor assembly middle of line workers, especially the molding workers, who did frequent lifting, had high pain prevalences in the neck/shoulders (54.8%) and upper back (43.5 %). In the semiconductor assembly end of line work section, chip inspection workers who were exposed to prolonged sitting without back support had high prevalences of neck/shoulder (62.2%) and upper back pain (50.0%), while chip testing workers who had to climb steps to load units had a high prevalence of lower limb pain (68.0%). Workers in the assembly of electronic components, carrying out repetitive tasks with hands and fingers, and standing in awkward postures had high pain prevalences in the neck/shoulders (61.5%), arms (38.5%), and hands/wrists (30.8%).
  13. Work-related musculoskeletal problems among women workers in the semiconductor industry in Peninsular Malaysia
    Chee HL, Rampal KG
    Int J Occup Environ Health, 2004 Jan-Mar;10(1):63-71.
    PMID: 15070027 DOI: 10.1179/oeh.2004.10.1.63
    A cross-sectional study to identify the prevalence of musculoskeletal problems and work-related risk factors was conducted among 906 women semiconductor workers. Highest prevalences were pain in the lower limbs, neck/shoulders, and upper back, and highest exposures were prolonged (> or = four hours per workshift) hand/wrist movement, standing, and lifting with hands. After logistic regression, lower-limb pain was significantly associated with standing, neck/shoulder pain with sitting and lifting, upper-back pain with climbing steps, low back pain with hand/wrist movement, and hand/wrist pain with lifting. Neck/shoulder pain was significantly higher for workers with shorter working durations, while lower-limb pain was significantly higher for workers with longer working durations. End-of-line assembly workers had significantly higher odds ratios for pain at all sites, while middle-of-line workers had higher odds ratios for pain in neck/shoulders and upper back, and wafer-fabrication workers had higher odds ratios for pain in low back and lower limbs.
  14. Fulltext Relationship between selected health problems and exposures among women semiconductor workers in Malaysia
    Chee HL, Rampal KG
    Med J Malaysia, 2003 Aug;58(3):387-98.
    PMID: 14750379
    A study conducted between 1998-2001 on the semiconductor industry in Penang and Selangor found that irregular menstruation, dysmenorrhea and stress were identified as the three leading health problems by women workers from a checklist of 16 health problems. After adjusting for confounding factors, including age, working duration in current factory, and marital status, in a multiple logistic regression model, wafer polishing workers were found to experience significantly higher odds of experiencing irregular menstruation. Dysmenorrhea was found to be significantly associated with chemical usage and poor ventilation, while stress was found to be related to poor ventilation, noise and low temperatures.
  15. Lead levels in new enamel household paints from Asia, Africa and South America
    Clark CS, Rampal KG, Thuppil V, Roda SM, Succop P, Menrath W, et al.
    Environ Res, 2009 Oct;109(7):930-6.
    PMID: 19656507 DOI: 10.1016/j.envres.2009.07.002
    In 2006 a report on the analysis for lead in 80 new residential paints from four countries in Asia revealed high levels in three of the countries (China, India and Malaysia) and low levels in a fourth country (Singapore) where a lead in paint regulation was enforced. The authors warned of the possible export of lead-painted consumer products to the United States and other countries and the dangers the lead paint represented to children in the countries where it was available for purchase. The need for a worldwide ban on the use of lead in paints was emphasized to prevent an increase in exposure and disease from this very preventable environmental source. Since the earlier paper almost 300 additional new paint samples have been collected from the four initial countries plus 8 additional countries, three from Asia, three from Africa and two from South America. During the intervening time period two million toys and other items imported into the United States were recalled because the lead content exceeded the United States standard. High lead paints were detected in all 12 countries. The average lead concentration by country ranged from 6988 (Singapore) to 31,960ppm (Ecuador). One multinational company sold high lead paint in one country through January 2007 but sold low lead paint later in 2007 indicating that a major change to cease adding lead to their paints had occurred. However, the finding that almost one-third of the samples would meet the new United States standard for new paint of 90ppm, suggests that the technology is already available in at least 11 of the 12 countries to produce low lead enamel paints for domestic use. The need remains urgent to establish effective worldwide controls to prevent the needless poisoning of millions of children from this preventable exposure.
  16. The lead content of currently available new residential paint in several Asian countries
    Clark CS, Rampal KG, Thuppil V, Chen CK, Clark R, Roda S
    Environ Res, 2006 Sep;102(1):9-12.
    PMID: 16782088
    Worldwide prohibitions on lead gasoline additives were a major international public health accomplishment, the results of which are still being documented in parts of the world. Although the need to remove lead from paints has been recognized for over a century, evidence reported in this article indicates that lead-based paints for household use, some containing more than 10% lead, are readily available for purchase in some of the largest countries in the world. Sixty-six percent of new paint samples from China, India, and Malaysia were found to contain 5000 ppm (0.5%) or more of lead, the US definition of lead-based paint in existing housing, and 78% contained 600 ppm (0.06%) or more, the limit for new paints. In contrast, the comparable levels in a nearby developed country, Singapore, were 0% and 9%. In examining lead levels in paints of the same brands purchased in different countries, it was found that some brands had lead-based paints in one of the countries and paints meeting US limits in another; another had lead-free paint available in all countries where samples were obtained. Lead-based paints have already poisoned millions of children and likely will cause similar damage in the future as paint use increases as countries in Asia and elsewhere continue their rapid development. The ready availability of lead-based paints documented in this article provides stark evidence of the urgent need for efforts to accomplish an effective worldwide ban on the use of lead in paint.
  17. Job strain and its associated factors among lecturers in the School of Medical Sciences, Universiti Sains Malaysia and Faculty of Medicine, Universiti Kebangsaan Malaysia
    Huda BZ, Rusli BN, Naing L, Winn T, Tengku MA, Rampal KG
    Asia Pac J Public Health, 2004;16(1):32-40.
    PMID: 18839865
    A cross-sectional study to assess job strain and its associated factors among lecturers of the School of Medical Sciences, Universiti Sains Malaysia (USM) and Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) was undertaken between August 2001 and May 2002. The original English version of the Job Content Questionnaire (JCQ) version 1.7 (revised 1997) by Robert Karasek based on the Job Strain Model was self-administered to 73 (response rate 58.4%) and 80 (response rate 41.7%) lecturers in the medical faculties of USM and UKM respectively. The prevalence of job strain (defined by low decision latitude and high psychological demand) in USM and UKM was 23.3% and 17.5%, respectively; the difference was not significant (p 2 0.05). Analysis showed that the associated factors of job strain in USM lecturers were psychological stressors (adjusted OR 1.2, 95% CI: 1.0, 1.4), created skill (adjusted OR 0.4, 95% CI: 0.2, 0.8), working in clinical-based departments (adjusted OR 18.9, 95% CI: 1.6, 22.7). The risk factors of job strain in UKM lecturers were created skill (adjusted OR 0.3, 95% CI: 0.1, 0.9), psychological stressors (adjusted OR 1.2, 95% CI: 1.0, 1.5) and co-worker support (adjusted OR 0.3, 95% CI: 0.1, 0.9). We conclude psychological stressors and created skill were nonprotective and protective, respectively, against job strain in both USM and UKM lecturers.
  18. Fulltext Job dissatisfaction in lecturers in School of Medical Sciences Universiti Sains Malaysia and Faculty of Medicine Universiti Kebangsaan Malaysia
    Huda BZ, Rusli BN, Naing L, Tengku MA, Winn T, Rampal KG
    Med J Malaysia, 2004 Jun;59(2):242-51.
    PMID: 15559176 MyJurnal
    Job dissatisfaction in doctors and teachers is known to have direct consequences on the quality of service and teaching for patients and students respectively. A cross-sectional study to assess dissatisfaction in lecturers of School of Medical Sciences, Universiti Sains Malaysia (USM) and Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) was undertaken between August 2001 and May 2002. The original English version of the Job Content Questionnaire (CQ) version 1.7 (revised 1997) by Robert Karasek was self-administered to 73 (response rate 58.4%) and 80 (response rate 41.7%) lecturers in the medical faculties of USM and UKM, respectively. The prevalence of job dissatisfaction in USM and UKM lecturers were 42.6% and 42.9%, respectively; the difference was not significant (p>0.05). Risk factors of job dissatisfaction in USM lecturers were decision authority (p<0.001) and psychological job demand (p<0.001). Significant risk factors of job dissatisfaction in UKM lecturers were skill discretion (p<0.01) and psychological job demand (p<0.001). We conclude that psychological job demand was a risk factor of job dissatisfaction in both USM and UKM lecturers; in USM, decision authority was protective, while in UKM, skill discretion was protective against job dissatisfaction.
  19. A study of job strain and dissatisfaction among lecturers in the School of Medical Sciences Universiti Sains Malaysia
    Huda BZ, Rusli BN, Naing L, Tengku MA, Winn T, Rampal KG
    Southeast Asian J. Trop. Med. Public Health, 2004 Mar;35(1):210-8.
    PMID: 15272771
    Job stress has now become one of the most significant health and safety issues in the workplace and one of the least understood areas of organizational cost. A cross-sectional study to assess job strain and dissatisfaction in lecturers of the School of Medical Sciences, Universiti Sains Malaysia (USM) was undertaken between August 2001 and May 2002. The original English version of the Job Content Questionnaire (JCQ) version 1.7 (revised 1997) by Robert Karasek was self-administered to 73 (response rate 58.4%) lecturers in School of Medical Sciences USM. The prevalence of job strain (defined by low decision latitude and high psychological demands) in USM was 23.3%. The risk factors of job strain in the lecturers were psychological stressors (adjusted OR 1.2, 95% CI 1.0, 1.4), created skill (adjusted OR 0.4, 95% CI 0.2, 0.8) and working in clinical-based departments (adjusted OR 18.7, 95% CI 1.6, 22.7). The prevalence of job dissatisfaction was 42.6%. Associated factors of job dissatisfaction in USM lecturers were decision authority (p < 0.001) and psychological job demand (p < 0.001). We conclude that psychological stressors and created skill were non-protective and protective, respectively, against job strain in USM lecturers. Clinical-based lecturers experienced higher job strain compared to non-clinical-based lecturers. Psychological job demand was strongly associated with job dissatisfaction, and decision authority was protective against job dissatisfaction.
  20. Fulltext Societal risk perception of death among workers in a security company in Malaysia
    Jefferelli SB, Rampal KG, Aziz AJ, Agus Salim MB
    Med J Malaysia, 2003 Dec;58(5):653-6.
    PMID: 15190649 MyJurnal
    How people perceive risk influences their behaviour towards these risks. We do not know how workers perceive risk of dying from diseases or accidents. This study was conducted among 198 workers of a security company in Malaysia. The workers were asked to score on a Likert scale of 1 to 5 the perceived risk of death of Malaysians from selected causes of death. The highest perceived risks of death were, in order of ranking, motor vehicle accidents, cancer and diabetes mellitus whereas according to the certified causes of death in Malaysia the highest risks of death among the selected items were cardiovascular disease, cancer and stroke. The difference in perception and mortality data needs be addressed.
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