Rapid Rural Appraisal (RRA) is a systematic, semi-structured activity carried out in the field by a multidisciplinary team that is designed to obtain new information and hypotheses about rural life. This article reports the results of an RRA conducted in Kampung Paris 1 (KGP1), Kinabatangan, Sabah under the Annual Health Promotion Program of the School of Medicine, Universiti Malaysia Sabah. A systematic random sampling was used to recruit the villagers and data was obtained through compilation of pre-existing data, field observation, structured interviews with key informants and villagers. Cardiorespiratory diseases were prevalent in KGP1. Common water sources such as rain water collected in dug wells in KGP1 were unhygienic. Dangerous toxic fumes were produced by the burning of municipal wastes nearby village houses. The villagers of KGP1 were exposed to various farm animals, which may harbor zoonoses. Health care services are limited in KGP1. Villagers who were not poor (>RM897) represented 48% of the population, followed by the poor (RM503-897), 20% and the hardcore poor (1.00 person per bedroom. Poor water hygiene, polluted air from open burning, exposure to farm animals, poverty, poor education, overcrowding and inadequate health care services were among the few possible factors affecting the health of villagers in KGP1. Formal rigorous research should be conducted in the future to facilitate specific health interventions in areas of need such as KGP1.
Introduction There is a strong and increased worldwide interest on the aspects of
prevention of oral disease and oral health promotion in dental education.
However, some studies imply that dental students are not knowledgeable
enough in this issue. This study aimed to evaluate the knowledge of, attitude
towards and practice on preventive dentistry among senior dental students in
Methods Self-administered questionnaires were distributed among senior dental
students in six dental schools in Yemen. The questionnaire obtained personal
information, and questions about knowledge on preventive dental care,
attitudes towards and practice on preventive dentistry.
Results Among 346 students who filled the questionnaire, a total of 91.6% has good
knowledge about fissure sealant effectiveness, only 34.7% knows about the
importance of fluoride toothpaste compared to brushing technique in
preventing caries, with significant gender difference (p=0.005). Odds of good
knowledge among non-Qat chewers was 1.9 (95%CI: 1.26-4.42).
Multivariable regression analysis indicated that female gender was associated
with higher positive attitudes (OR: 2.03, 95%CI:1.21-3.36,p=0.007).
Attitudes were significantly associated with Qat chewing (OR = 1.95,
95%CI: 1.04-3.66, p=0.03), type of university (OR = 0.59, 95%CI: 0.36-0.94,
p=0.02), and mothers' level of education (OR = 1.91, 95%CI: 1.05-3.47,
p=0.03). There was a high percentage of competency in practicing preventive
measures among students (80.9%).
Conclusions Dental education should emphasize the overall aspects of preventive dentistry
with early exposure of preventive dental training in order to improve
students' knowledge and attitudes and consequently practice on preventive
Introduction The aim of this study was to examine the aspect of information disclosure by
doctor-investigator during the process of obtaining informed consent in
Methods This research employed a mixed-method data collection that is library
research and interview. A qualitative methodology and analysis were used in
an open-ended, face-to-face interviews with 17 patient-subjects. The
interview questions were based on information that needed to be disclosed to
patient-subjects during the process of obtaining informed consent. Each
interview took place in Kajang Hospital and National Heart Institute and
lasted 25-30 minutes. Interviews were conducted in Bahasa Melayu and
English. The interviews were tape-recorded, and the main points from the
interviews were jotted down to ensure that all information was adequately
gathered. Interviewed occurred in Kajang Hospital and National Heart
Institute. The participants were patients who had been referred to the Kajang
Hospital and National Heart Institute. They were recruited (8 from Kajang
Hospital and 9 from National Heart Institute) by their own doctors to
participate in a study to evaluate the safety and effectivenes of the
investigational stent after been diagnosed with coronary artery disease and
also in a study to investigate drug for antidepressant. respectively.
Results The study revealed that doctor-investigators fail to disclose full information
to patient-subjects. Instead, doctor-investigators only disclosed information
which they thought were necessary for the patient-subjects to know. The
study also showed that there were doctor-investigators who did not disclose
information at all to the patient-subjects.
Conclusions This study implies that the aspect of information disclosure in the process of
obtaining informed consent in clinical trials is rather poor and did not fulfill
the criterion of good medical practice. A random monitoring task to be
conducted by the research ethics commitees during the informed consent
process is suggested.
Intake and Output (I/O) records in hospitals were often found to be incomplete and illegible. The form used to record I/O is not user-friendly - i.e., they feature miniscule boxes, 'total' lines that do not correspond with shift changes and lack of instructions. Complaints often received from Specialists & Doctors regarding calculation errors or no totalling of I/O. Moreover, Nursing Sisters objective rounds often saw incompleteness of I/O chart. This study aims to identify the types of mistakes in recording the existing I/O chart. The second aim is to find out whether shift totalling of I/O chart helps in reducing mistakes. We try to determine whether the identified mistakes were repeated in the new I/O Chart. This study was conducted from October till December 2010 in 9 selected wards in Sibu Hospital. Data collection was divided into 3 phases. A pre-implementation audit using a checklist was carried out. The compliance rate of completeness of documentation of I/O Chart was 63%. A one month trial of new I/O chart was being done in the selected 9 wards. Post implementation audit showed a significant improvement of compliance rate (88%). Feedback from health care workers (N=110) showed that, 89% of doctors (n=17) and 60% of nurses (n=93) in the sample prefer to use the new format as more practical and relevant to the changing shift of nurses and doctors' ward round. It is suggested to implement the new format to increase compliance rate of documentation of I/O charting. Briefing should be given to nurses periodically and the new format should be introduced to nursing students in nursing colleges.
Dengue is a disease propagated by vectors namely Aedes spp. mosquitoes. One of the effective approaches to control dengue is through integrated vector management and intervention programs. COMBI or Communication for Behavioral Impact is a strategic approach to control the Aedes population as well as dengue cases. This study was conducted at Taman Desa Kolej, Nilai, Negeri Sembilan, an suburban residential area to determine the effectiveness of COMBI, by using questionnaire and entomological survey as well as implementation of an intervention program. We carried out activities such as the establishment of COMBI promoter team, clean up events, talk shows with the residential community and distributed pamphlets containing information about dengue. Results indicated significant difference (p
Introduction Tong Nibong is a Bidayuh village located at Sarawak Kalimantan border.
Since the year 2004 to 2009, a total of 537 cases of malaria were recorded in
Serian District of which 14 cases were reported from Kampung Tong
Nibong. Community empowerment programme for malaria infection
prevention showed tremendous improvement in implementation. This
intervention study aims to gauge the effectiveness of community
empowerment approach in malaria elimination programme in Kampung Tong
Methods An intervention study was conducted with pre and post data collection. Data
was collected using validated questionnaire by face to face interview.
Universal sampling method was used to select respondents from head of
household and post data was collected after intervention activities were
carried out within a year of study period.
Results The study showed significant difference on level of knowledge of
respondents on vector of malaria between pre and post data with a P < 0.05.
There was significant difference between pre and post data on practices on
control and prevention of malaria with a P < 0.05. The same goes to level of
positive attitude of respondents towards malaria control.
Conclusions In conclusion, the study can be considered successful because there is
significant difference in knowledge, attitude and practice among the
respondents between pre and post data. This indicates that community
empowerment (voluntary participation) measures can be implemented in high
risk or endemic areas where malaria is a persistent problem to the community
and health institutions faces many limiting factors.
Introduction In light of the important role of health-promoting expenditure in health, the
objective of this study was to investigate the socio-demographic determinants
of health-promoting expenditure such as purchase of medical equipment and
services, food supplements and health education services and products among
Methods Third National Health and Morbidity Survey (NHMS III) consisting of 28771
observations was used for analysis. It was the latest nationally representative
cross-sectional population-based survey conducted by the Ministry of Health
Malaysia from April 2006 to January 2007. A censored regression model
(Tobit) was applied to examine the factors affecting health-promoting
Results The results showed that age, income, gender, ethnicity, education, marital
status, employment status and location of residence were able to affect healthpromoting
expenditure. In particular, individuals who were younger, poor,
males, Indian/others, less educated, unmarried, unemployed and residing in
rural areas tended to spend less money on health promotion compared to
Conclusions This study reached a conclusion that socio-demographic factors were
significantly associated with individual’s preferences for health promotion.
Therefore, the government should devote its attention to these factors when
formulating nationwide health policies.
Introduction Cardiovascular diseases are a major component of non-communicable
diseases and include coronary heart disease, stroke and peripheral vascular
disease. Public health strategies to address cardiovascular disease require
three elements: surveillance, health promotion, and individual health care.
Methods Surveillance includes monitoring of mortality and morbidity as well as
surveys to monitor risk factors levels in the community. Data on mortality
from cardiovascular diseases are readily available and analysed by age and
sex specific rates looking are secular trends, geographical and ethnical group
variations and international comparisons. However many deaths from
cardiovascular disease occur suddenly and the cause of death may be
registered without autopsy or any other validation. Cardiovascular morbidity
information is more difficult to collate and interpret as it is closely related to
availability and access to health care. Periodic surveys of cardiovascular risk
factors are essential in monitoring the underlying trends in blood pressure,
smoking, cholesterol, obesity, and diabetes as they predict future trends, and
support planning for prevention and healthcare.
Results Prevention and health promotion activities are informed by the levels and
trends in cardiovascular disease and its risk factors. There has been debate
about population health promotion and individual health care strategies, but
both are necessary. Cigarette smoking, nutrition and physical exercise are the
main behaviours to be addressed but these are complex and require
multifaceted approaches. Education alone is insufficient to change health
behaviours and health promotion needs to look to changing attitudes.
Legislation, taxation and other fiscal interventions have been shown to be
effective however these can be difficult for legislators as there are other
competing interests, particularly in the area of nutrition and tobacco. Creating
health promoting environments that make healthy behaviour choices easier
can be beneficial.
Conclusions Health care interventions are also effective in reducing the burden of
cardiovascular disease. A balanced approach of health promotion and
individual health care is recommended in the development of a strategy for
Air pollution has been widely known to have an influence on health of the general population.
Air pollution can result from natural causes, human activities and transboundary air pollution.
Weather and climate play crucial role in determining the pattern of air quality. In recent years,
air pollution and recurrent episodes of haze has become a major concern in Malaysia.
Surveillance data on concentrations of main air pollutants such as carbon dioxide, (CO2),
Nitrogen Dioxide (NO2), Ozone (O3), sulphur dioxide (SO2) and particulate matter (PM10)
were found to be higher during the haze days and this may have an impact on health of the
community as reflected by an increase in hospital admissions particularly the respiratory and
Carpal tunnel syndrome (CTS) is a hand disorder which indicates the presence of symptoms such as pain, numbness, and muscle weakness among the patient. CTS is an occupational related disorder which can occur in any profession. However, it can be prevented and managed. The aims of the research were to determine the prevalence of acquiring CTS among nurses who worked in the wards and occupational risk factors involving the upper limbs during nursing tasks performance. The specific aims were to determine the relationship between the prevalence of acquiring CTS and individual factors (age, gender, race, educational level, duration of work and medical history), relationship between the prevalence of acquiring CTS and occupational risk factors in nursing tasks. Nurses profession was chosen as they are performing multitask involving upper limbs especially the wrist joints. Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was used to determine the level of severity in CTS. Occupational risk factors were assessed by using the Rapid Upper Limb Assessment (RULA). This research was a cross sectional mode which was carried out at a government university medical centre from November through December 2010. Eighty nurses were involved in the research. The respondents were required to fill in the socio-demographic information sheet. Those having CTS were required to fill in the BCTQ. Assessments were performed by observing of the job activity through RULA. The results showed that the prevalence for nurses acquiring CTS is 7.5%. The RULA assessment also indicated that the risk factor was in the highest level with a score of 7. No relationship was shown between the prevalence of CTS and race, gender, educational level and medical history. Significant relationship was indicated by the prevalence of CTS and occupational risk factors. In conclusion, a significant prevalence of CTS related to age of more than 30 years old, Malay races compared to Indian, working experience of more than 10 years and respondents with right hand dominant. Occupational risk factors also indicated among the active nurses. Therefore, it is important for us to modify the work environment, work flow, work methodology and ergonomic factors in order to prevent the nurses from acquiring CTS. Furthermore, education about the condition of CTS should be implemented and reinforced especially among the higher risk nurses.
Accepted 13 January 2012.
Introduction The purpose of this study is to explore the reasons of Shisha smoking among teenagers in Ipoh, Perak.
Methods Data was collected using in-depth face to face interview. Purposive convenient sampling was used to select volunteer respondents from one of the Shisha restaurant located at Ipoh. The interviews were conducted for 15-20 minutes, recorded using video tape. The data obtained was transcribed and coded for the purpose of thematic analysis.
Results All respondents were influenced by peers in their first attempt in Shisha smoking. Other reasons attracting them to continue smoking Shisha include appealing smell and the flavoured taste of Shisha, easy to access, perceived that Shisha was not addictive and its’ cheaper price. In terms of perception on health risk, all respondents believed that Shisha was less harmful compared to cigarette smoking.
Conclusions More educational programme, health talk about risk of Shisha should be developed and conducted to rectify the misconception about health risk of Shisha smoking. The target population should be focus on male teenagers who smoke Shisha in order to control the widespread Shisha smoking in Malaysia.
Developmental disabilities in young children are common, and the prevalence is estimated as high as 0.1-1.75% in the children population for each disabilities. With increasing awareness and health expectation, more children with Developmental disabilities are presenting to health care professionals, and at earlier age. Literatures also suggested the importance of early intervention programme in determining the outcome of this group of children. Therefore, it is vital for health professionals who have direct contact with young children are competent in detecting children with possible Developmental disabilities, and have the basic knowledge about some of the common disorders in order to discuss the issues with the parents. It is also important to work with the various resources available in the local community, such as non-governmental organisations for children with special needs, schools offering special education programmes and inclusive classes, and the allied health who provide cares to this group of young children and their family. A lot of information are also available online, and may be offered to help parents gaining more understanding regarding these Developmental disabilities.
Introduction Children with cerebral palsy (CP) are often prescribed Rehabilitation and Seating Systems (RSS) to assist in daily activities, posture improvement and prevention of muscular-skeletal complications. In Sarawak, a special project to produce RSS was started under a partnership of a Japanese physiotherapist, health department and the community using local material.Aim To document the RSS project and to determine usefulness and costaffordability of these systems for cerebral palsy children and their families.
Methods The details of RSS manufactured were retrieved from the clinic notes and secretary file. Parents of children who received the seating systems between July 2004 and September 2008 were invited to complete a 5-point Global Parental Perception Questionnaire (GPPQ) between December 2008 and January 2009.
Results 277 RSS were manufactured between July 2004 and February 2011 (which included modified wheel chair, wooden chair, corner chair, buggy chair and standing frame), and used by children all over Sarawak. Parents of 73 children who used the seating systems completed the 5-points GPPQ. Ten families required full sponsorship. Children spent more time sitting up and brought outdoor more often after the systems became available. Majority of parents reported positive experience in their children with sitting ability, smiles, interaction with people, learning skills and easiness of doing physiotherapy. No change was noted with passing of motion drooling / oral secretion. Most parents agreed that the cost was affordable and worth paying.
Conclusions A community based initiative to manufacture RSS by using locally available material and skill, at affordable price for the parents was feasible and useful for the family/children with CP.
Belaga District, in the heart of Borneo, is probably the most remote district in Sarawak. Although Belaga town is now accessible by land (50% are timber camp unsealed road) from Bintulu, the journey takes 5 hours and transport cost is high. Accessibility to Belaga by river is also subject to weather conditions and the town often gets cut off during the dry season and also during the wet season. All these pose immense challenges to the delivery of health care services to the people of Belaga and greatly reduce their accessibility to even basic health services. Access to specialist services is even more challenging as it is only available in Sibu and Bintulu; and visiting clinics in Belaga are infrequent due to the shortage of specialists and difficult transport. (Copied from article).
Introduction Food labeling regulation has been implemented to enable consumers,
including those with chronic diseases to make healthy informed choices
before purchasing pre-packaged foods. The purpose of this study is to
determine the prevalence of obese adults in Malaysia who practice reading
food labels. It explored types of labels read and understanding of the
Methods Findings presented in this study were captured from the secondary analysis of
National Health and Morbidity Survey’s (NHMS, 2006) food label study
which focused only on obese adults (BMI > 30 kg/m2) aged 18 and above.
This nation-wide cross sectional study was conducted from April to August
2006 using an interview-based questionnaire. Complex data analysis was
done using Stata version 12.0.
Results There were 4565 obese respondents with the mean age of 33 ± 9.7 (18 – 60
years old). About 54.7% completed high-school and 9.9% were higher degree
holders. Prevalence of obese adults who claimed to read label was 80.5%
(95%CI: 79.3, 81.6). Findings showed significant results in reading and
understanding labels among all age group categories, Malay, Indian and other
Bumiputras, all education categories and married respondents. Expiry date
was the highest percentage being read (74.5%), followed by fat content
(15.3%), vitamin (11.8%) and carbohydrate (10.9%).
Conclusions The obese population in Malaysia claimed to read and understand the food
label but did not focus on specific macronutrients related to their health
condition. Findings can be used to implement effective education
programmes targeting the relevant groups to instill an awareness to read,
understand and use the label information as one of the means in combating
Introduction The risk factors associated with mental health among adolescents are usually
described by researchers at an individual level. Neighbourhood factors and
health have opened a new insight into the field of epidemiology. The aim of
this study was to assess the reliability and validity of a newly developed
Neighbourhood Factors on Mental Health Questionnaire among Malaysian
Methods A cross-sectional study was conducted in four secondary schools in Kuala
Lumpur, Malaysia using a newly developed questionnaire which comprised
of two main domains and seven items. Exploratory factor analysis and
Cronbach‟s alpha were used to measure the instrument‟s construct validity
Results A total of 106 adolescents participated in this research. The majority of
adolescents were 13 years old (40.6%), female (55.7%), Malays (68.9%),
have parents who only studied until secondary school (66.0%) and lived in
flats (32.1%). Bartlett‟s Test of Sphericity was significant (Chi-square =
Accepted 10 August 2011.
Introduction Cervical cancer (CC) is the second most prevalent female cancer in Malaysia. Almost 70% of its’ causal factors are attributable to oncogenic human papillomavirus (HPV) types 16, 18 and other risk factors. HPV genotypes distributions are also noted to differ by geographical area.
Methods This was cross sectional study conducted in 2007, to determine the influencing factors of HPV positivity and prevalence of HPV infections among patients with cervical cancer in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Patients’ paraffin-embedded cervical tissues kept in the Pathology Department from 1999 to 2007 were randomly selected. A total of 81 medical records with complete information were chosen as samples and patients were contacted for consent. Tissue samples were further derived for PCR DNA for HPV genotyping. Analyses included descriptive statistics; bivariate χ2 test and correlation were used to determine relationship between factors and HPV positivity. Significance level of less than 0.05 was taken as statistically significant.
Results Mean age of cancer diagnosis was at 52 ± 12.2 years. Women of Chinese ethnicity was the highest ethnicity to be HPV positive at 65.4% and squamous cell carcinoma was more commonly found (59.3%) compared with other types of cancers. The prevalence of HPV positivity was 92.6% with type 16 being the most common (74.1%), followed by type 33 (30.9%) and 18 (22.2%). Multiple HPV infections were a common finding at 54.3%. Factors thought to influence positivity i.e. age of intercourse, number of sexual partners, number of parity, smoking status of patients and their partners, oral contraceptive usage, presence of chronic illnesses and cancer stage were not significantly associated with HPV positivity. Increased CC severity level was not associated with increased number of HPV infections (Pearson correlation 0.58; p =0.607).
Conclusions High HPV positivity at 92.6% was found among ICC patients. Factors thought to influence HPV positivity were not significant. The top three HPV genotypes were type 16 followed by type 33 and 18. However, local women HPV serotypes findings need to be replicated in a larger population sample.
Introduction Family satisfaction is referred to the extent in which family members feel
happy and fulfilled with each other. However, there has been lack of
evidences on the family satisfaction scale within the Malaysian context.
Therefore, the aim of this study was to assess validity of the Malay version of
the Olson’s Family Satisfaction Scale. This is to allow Malaysian researchers
to bring family satisfaction in line with the different field of studies.
Methods This study was conducted among 567 Malaysian working women. Data were
collected using self-administrated questionnaires. This study conducted
exploratory and confirmatory factor analysis, convergent validity and internal
consistency using Cronbach’s alpha.
Results The findings of this study support the uni-dimensionality of the Malay
version of the family satisfaction scale. The 10 items of the scale account for
68.1% of the total variance and the un-rotated factor loadings ranged from
0.76 to 0.87. Confirmatory factor analysis was run and supported the
structure of family satisfaction scale. The results of confirmatory factor
analysis using AMOS 21 in the current study reported the following indices:
RMSEA= 0.06, CFI= 0.94, NFI= 0.94, TLI= 0.93. The convergent validity
(average variance extracted= 0.65) and the internal consistency (Cronbach’s
alpha= 0.94) of this construct were adequately supported.
Conclusions The findings support the factor structure, convergent validity and the internal
consistency of the examined construct. Therefore, Malay version of the
family satisfaction scale is a valid and reliable instrument among Malaysian
Osteoporosis-related fractures have been recognized as a major health problem, particularly in the elderly with a high morbidity and mortality rate. The aims of the study were to identify knowledge and perception toward calcium intake among students at UiTM and to explore the differences between genders in dietary calcium intake. A cross sectional study was conducted through 336 students aged 18 to 34 years old. The participants were randomly chosen from the student’s enrolment list. A modified questionnaire was used to obtain the knowledge and perception of the participants. More than half of the participants have low knowledge regarding dietary calcium intake (58.6%), positive view towards the benefits of calcium intake and low perception towards the barrier of calcium intake. Chi square analysis showed a significant difference between male and female for knowledge (p=0.034) and barrier (p=0.002) for calcium intake. Intervention programs should be adopted to increase the knowledge among young adults to improve their health and prevent risk factors. So, health education specifically on calcium intake will be very useful to improve the knowledge and behavior of students.