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  1. Exploring the effects of roadway characteristics on the frequency and severity of head-on crashes: case studies from Malaysian federal roads
    Hosseinpour M, Yahaya AS, Sadullah AF
    Accid Anal Prev, 2014 Jan;62:209-22.
    PMID: 24172088 DOI: 10.1016/j.aap.2013.10.001
    Head-on crashes are among the most severe collision types and of great concern to road safety authorities. Therefore, it justifies more efforts to reduce both the frequency and severity of this collision type. To this end, it is necessary to first identify factors associating with the crash occurrence. This can be done by developing crash prediction models that relate crash outcomes to a set of contributing factors. This study intends to identify the factors affecting both the frequency and severity of head-on crashes that occurred on 448 segments of five federal roads in Malaysia. Data on road characteristics and crash history were collected on the study segments during a 4-year period between 2007 and 2010. The frequency of head-on crashes were fitted by developing and comparing seven count-data models including Poisson, standard negative binomial (NB), random-effect negative binomial, hurdle Poisson, hurdle negative binomial, zero-inflated Poisson, and zero-inflated negative binomial models. To model crash severity, a random-effect generalized ordered probit model (REGOPM) was used given a head-on crash had occurred. With respect to the crash frequency, the random-effect negative binomial (RENB) model was found to outperform the other models according to goodness of fit measures. Based on the results of the model, the variables horizontal curvature, terrain type, heavy-vehicle traffic, and access points were found to be positively related to the frequency of head-on crashes, while posted speed limit and shoulder width decreased the crash frequency. With regard to the crash severity, the results of REGOPM showed that horizontal curvature, paved shoulder width, terrain type, and side friction were associated with more severe crashes, whereas land use, access points, and presence of median reduced the probability of severe crashes. Based on the results of this study, some potential countermeasures were proposed to minimize the risk of head-on crashes.
    Matched MeSH terms: Safety
  2. Analysis of developed transition road safety barrier systems
    Soltani M, Moghaddam TB, Karim MR, Sulong NH
    Accid Anal Prev, 2013 Oct;59:240-52.
    PMID: 23820073 DOI: 10.1016/j.aap.2013.05.029
    Road safety barriers protect vehicles from roadside hazards by redirecting errant vehicles in a safe manner as well as providing high levels of safety during and after impact. This paper focused on transition safety barrier systems which were located at the point of attachment between a bridge and roadside barriers. The aim of this study was to provide an overview of the behavior of transition systems located at upstream bridge rail with different designs and performance levels. Design factors such as occupant risk and vehicle trajectory for different systems were collected and compared. To achieve this aim a comprehensive database was developed using previous studies. The comparison showed that Test 3-21, which is conducted by impacting a pickup truck with speed of 100 km/h and angle of 25° to transition system, was the most severe test. Occupant impact velocity and ridedown acceleration for heavy vehicles were lower than the amounts for passenger cars and pickup trucks, and in most cases higher occupant lateral impact ridedown acceleration was observed on vehicles subjected to higher levels of damage. The best transition system was selected to give optimum performance which reduced occupant risk factors using the similar crashes in accordance with Test 3-21.
    Matched MeSH terms: Safety*
  3. Fatigue-related crashes involving express buses in Malaysia: will the proposed policy of banning the early-hour operation reduce fatigue-related crashes and benefit overall road safety?
    Mohamed N, Mohd-Yusoff MF, Othman I, Zulkipli ZH, Osman MR, Voon WS
    Accid Anal Prev, 2012 Mar;45 Suppl:45-9.
    PMID: 22239931 DOI: 10.1016/j.aap.2011.09.025
    Fatigue-related crashes have long been the topic of discussion and study worldwide. The relationship between fatigue-related crashes and time of day is well documented. In Malaysia, the possibility of banning express buses from operating during the early-hours of the morning has emerged as an important consideration for passenger safety. This paper highlights the findings of an impact assessment study. The study was conducted to determine all possible impacts prior to the government making any decision on the proposed banning. This study is an example of a simple and inexpensive approach that may influence future policy-making process. The impact assessment comprised two major steps. The first step involved profiling existing operation scenarios, gathering information on crashes involving public express buses and stakeholders' views. The second step involved a qualitative impact assessment analysis using all information gathered during the profiling stage to describe the possible impacts. Based on the assessment, the move to ban early-hour operations could possibly result in further negative impacts on the overall road safety agenda. These negative impacts may occur if the fundamental issues, such as driving and working hours, and the need for rest and sleep facilities for drivers, are not addressed. In addition, a safer and more accessible public transportation system as an alternative for those who choose to travel at night would be required. The proposed banning of early-hour operations is also not a feasible solution for sustainability of express bus operations in Malaysia, especially for those operating long journeys. The paper concludes by highlighting the need to design a more holistic approach for preventing fatigue-related crashes involving express buses in Malaysia.
    Matched MeSH terms: Safety Management/legislation & jurisprudence; Safety Management/methods
  4. Empirical analysis of gross vehicle weight and free flow speed and consideration on its relation with differential speed limit
    Saifizul AA, Yamanaka H, Karim MR
    Accid Anal Prev, 2011 May;43(3):1068-73.
    PMID: 21376903 DOI: 10.1016/j.aap.2010.12.013
    Most highly motorized countries in the world have implemented different speed limits for light weight and heavy weight vehicles. The heavy vehicle speed limit is usually chosen to be lower than that of passenger cars due to the difficulty for the drivers to safely maneuver the heavy vehicle at high speed and greater impact during a crash. However, in many cases, the speed limit for heavy vehicle is set by only considering the vehicle size or category, mostly due to simplicity in enforcement. In this study, traffic and vehicular data for all vehicle types were collected using a weigh-in-motion system installed at Federal Route 54 in Malaysia. The first finding from the data showed that the weight variation for each vehicle category is considerable. Therefore, the effect of gross vehicle weight (GVW) and category of heavy vehicle on free flow speed and their interaction were analyzed using statistical techniques. Empirical analysis results showed that statistically for each type of heavy vehicle, there was a significant relationship between free flow speed of a heavy vehicle and GVW. Specifically, the results suggest that the mean and variance of free flow speed decrease with an increase GVW by the amount unrelated to size and shape for all GVW range. Then, based on the 85th percentile principle, the study proposed a new concept for setting the speed limit for heavy vehicle by incorporating GVW where a different speed limit is imposed to the heavy vehicle, not only based on vehicle classification, but also according to its GVW.
    Matched MeSH terms: Safety*
  5. The direct and indirect effects of corruption on motor vehicle crash deaths
    Hua LT, Noland RB, Evans AW
    Accid Anal Prev, 2010 Nov;42(6):1934-42.
    PMID: 20728645 DOI: 10.1016/j.aap.2010.05.015
    Recent empirical research has found that there is an inverted U-shaped or Kuznets relationship between income and motor vehicle crash (MVC) deaths, such that MVC deaths increase as national income increases and decrease after reaching a critical level. Corruption has been identified as one of the underlying factors that could affect this relationship, primarily by undermining institutional development and effective enforcement schemes. The total effect of corruption can be decomposed into two components, a direct and an indirect effect. The direct effect measures the immediate impact of corruption on MVC deaths by undermining effective enforcement and regulations, while the indirect effect captures the impact of corruption on hindering increases in per capita income and the consequent impact of reduced income on MVC deaths. By influencing economic growth, corruption can lead to an increase or decrease in MVC deaths depending on the income level. Using data from 60 countries between 1982 and 2003, these effects are estimated using linear panel and fixed effects negative binomial models. The estimation results suggest that corruption has different direct effects for less developed and highly developed countries. It has a negative (decreasing) effect on MVC deaths for less developed countries and a positive (increasing) effect on MVC deaths for highly developed countries. For highly developed countries, the total effect is positive at lower per capita income levels, but decreases with per capita income and becomes negative at per capita income levels of about US$ 38,248. For less developed countries, the total effect is negative within the sample range and decreases with increased per capita income. In summary, the results of this study suggest that reduction of corruption is likely a necessary condition to effectively tackle road safety problems.
    Matched MeSH terms: Safety/standards*
  6. Role of sensory and cognitive conspicuity in the prevention of collisions between motorcycles and trucks at T-intersections
    Law TH, Ghanbari M, Hamid H, Abdul-Halin A, Ng CP
    Accid Anal Prev, 2016 Nov;96:64-70.
    PMID: 27505097 DOI: 10.1016/j.aap.2016.04.013
    Motorcyclists are particularly vulnerable to injury in crashes with heavy vehicles due to substantial differences in vehicle mass, the degree of protection and speed. There is a considerable difference in height between motorcycles and trucks; motorcycles are viewed by truck drivers from downward angles, and shorter distances between them mean steeper downward angles. Hence, we anticipated that the effects of motorcycle conspicuity treatments would be different for truck drivers. Therefore, this study aims to evaluate the effects of motorcycle conspicuity treatments on the identification and detection of motorcycles by truck drivers. Two complementary experiments were performed; the first experiment assessed the impact of motorcycle sensory conspicuity on the ability of un-alerted truck drivers to detect motorcycles, and the second experiment assessed the motorcycle cognitive conspicuity to alerted truck drivers. The sensory conspicuity was measured in terms of motorcycle detection rates by un-alerted truck drivers when they were not anticipating a motorcycle within a realistic driving scene, while the cognitive conspicuity was determined by the time taken by alerted truck drivers to actively search for a motorcycle. In the first experiment, the participants were presented with 10 pictures and were instructed to report the kinds of vehicles that were presented in the pictures. Each picture was shown to the participants for 600ms. In the second experiment, the participants were presented with the same set of pictures and were instructed to respond by clicking the right button on a mouse as soon as they detected a motorcycle in the picture. The results indicate that the motorcycle detection rate increases, and the response time to search for a motorcycle decreases, as the distance between the targeted motorcycle and the viewer decreases. This is true regardless of the type of conspicuity treatment used. The use of daytime running headlights (DRH) was found to increase the detection rate and the identification of a motorcycle by a truck driver at a farther distance, but effect deteriorates as the distance decreases. The results show that the detection rate and the identification of a motorcyclist wearing a black helmet with a reflective sticker increases as the distance between the motorcycle and the truck decreases. We also found that a motorcyclist wearing a white helmet and a white outfit is more identifiable and detectable at both shorter and longer distances. In conclusion, although this study provides evidence that the use of appropriate conspicuity treatments enhances motorcycle conspicuity to truck drivers, we suggest that more attention should be paid to the effect of background environment on motorcycle conspicuity.
    Matched MeSH terms: Safety
  7. Predicting crash frequency for multi-vehicle collision types using multivariate Poisson-lognormal spatial model: A comparative analysis
    Hosseinpour M, Sahebi S, Zamzuri ZH, Yahaya AS, Ismail N
    Accid Anal Prev, 2018 Sep;118:277-288.
    PMID: 29861069 DOI: 10.1016/j.aap.2018.05.003
    According to crash configuration and pre-crash conditions, traffic crashes are classified into different collision types. Based on the literature, multi-vehicle crashes, such as head-on, rear-end, and angle crashes, are more frequent than single-vehicle crashes, and most often result in serious consequences. From a methodological point of view, the majority of prior studies focused on multivehicle collisions have employed univariate count models to estimate crash counts separately by collision type. However, univariate models fail to account for correlations which may exist between different collision types. Among others, multivariate Poisson lognormal (MVPLN) model with spatial correlation is a promising multivariate specification because it not only allows for unobserved heterogeneity (extra-Poisson variation) and dependencies between collision types, but also spatial correlation between adjacent sites. However, the MVPLN spatial model has rarely been applied in previous research for simultaneously modelling crash counts by collision type. Therefore, this study aims at utilizing a MVPLN spatial model to estimate crash counts for four different multi-vehicle collision types, including head-on, rear-end, angle, and sideswipe collisions. To investigate the performance of the MVPLN spatial model, a two-stage model and a univariate Poisson lognormal model (UNPLN) spatial model were also developed in this study. Detailed information on roadway characteristics, traffic volume, and crash history were collected on 407 homogeneous segments from Malaysian federal roads. The results indicate that the MVPLN spatial model outperforms the other comparing models in terms of goodness-of-fit measures. The results also show that the inclusion of spatial heterogeneity in the multivariate model significantly improves the model fit, as indicated by the Deviance Information Criterion (DIC). The correlation between crash types is high and positive, implying that the occurrence of a specific collision type is highly associated with the occurrence of other crash types on the same road segment. These results support the utilization of the MVPLN spatial model when predicting crash counts by collision manner. In terms of contributing factors, the results show that distinct crash types are attributed to different subsets of explanatory variables.
    Matched MeSH terms: Safety
  8. Applying a random parameters Negative Binomial Lindley model to examine multi-vehicle crashes along rural mountainous highways in Malaysia
    Rusli R, Haque MM, Afghari AP, King M
    Accid Anal Prev, 2018 Oct;119:80-90.
    PMID: 30007211 DOI: 10.1016/j.aap.2018.07.006
    Road safety in rural mountainous areas is a major concern as mountainous highways represent a complex road traffic environment due to complex topology and extreme weather conditions and are associated with more severe crashes compared to crashes along roads in flatter areas. The use of crash modelling to identify crash contributing factors along rural mountainous highways suffers from limitations in data availability, particularly in developing countries like Malaysia, and related challenges due to the presence of excess zero observations. To address these challenges, the objective of this study was to develop a safety performance function for multi-vehicle crashes along rural mountainous highways in Malaysia. To overcome the data limitations, an in-depth field survey, in addition to utilization of secondary data sources, was carried out to collect relevant information including roadway geometric factors, traffic characteristics, real-time weather conditions, cross-sectional elements, roadside features, and spatial characteristics. To address heterogeneity resulting from excess zeros, three specialized modelling techniques for excess zeros including Random Parameters Negative Binomial (RPNB), Random Parameters Negative Binomial - Lindley (RPNB-L) and Random Parameters Negative Binomial - Generalized Exponential (RPNB-GE) were employed. Results showed that the RPNB-L model outperformed the other two models in terms of prediction ability and model fit. It was found that heavy rainfall at the time of crash and the presence of minor junctions along mountainous highways increase the likelihood of multi-vehicle crashes, while the presence of horizontal curves along a steep gradient, the presence of a passing lane and presence of road delineation decrease the likelihood of multi-vehicle crashes. Findings of this study have significant implications for road safety along rural mountainous highways, particularly in the context of developing countries.
    Matched MeSH terms: Safety/statistics & numerical data*
  9. Evaluating the effect of lane width and roadside configurations on speed, lateral position and likelihood of comfortable overtaking in exclusive motorcycle lane
    Ibrahim MKA, Hamid H, Law TH, Wong SV
    Accid Anal Prev, 2018 Feb;111:63-70.
    PMID: 29172046 DOI: 10.1016/j.aap.2017.10.023
    Construction of exclusive motorcycle lanes is one of the measures to reduce motorcycle fatalities. Previous studies highlighted the risk of crashes with roadside objects and the tendency of motorcyclists to ride with excessive speed on exclusive motorcycle lanes. However, the risk of same-direction crashes on exclusive motorcycle lanes was not explored in much detail, especially on the impact of lane geometry and roadside configurations. This study used naturalistic riding data to determine the effects of lane width and roadside configurations on overtaking speed, lateral position and likelihood of comfortable overtaking on tangential sections of an exclusive motorcycle lane. Twenty-nine recruited motorcyclists rode the instrumented motorcycles along a 20km stretch of an exclusive motorcycle lane along a major urban road. Results revealed that both the roadside configurations and lane width significantly affect the participants' lateral position, while the roadside configurations only affects the overtaking speed. Participants' overtaking speeds and the front motorcycles' lateral position contribute significantly to the likelihood of comfortable overtaking in exclusive motorcycle lanes. The findings highlight the importance of micro-level behavior indicators in improving the design and overall safety of the exclusive motorcycle facility.
    Matched MeSH terms: Safety*
  10. Modeling of passengers' safety perception for buses on mountainous roads
    Khoo HL, Ahmed M
    Accid Anal Prev, 2018 Apr;113:106-116.
    PMID: 29407657 DOI: 10.1016/j.aap.2018.01.025
    This study had developed a passenger safety perception model specifically for buses taking into consideration the various factors, namely driver characteristics, environmental conditions, and bus characteristics using Bayesian Network. The behaviour of bus driver is observed through the bus motion profile, measured in longitudinal, lateral, and vertical accelerations. The road geometry is recorded using GPS and is computed with the aid of the Google map while the perceived bus safety is rated by the passengers in the bus in real time. A total of 13 variables were derived and used in the model development. The developed Bayesian Network model shows that the type of bus and the experience of the driver on the investigated route could have an influence on passenger's perception of their safety on buses. Road geometry is an indirect influencing factor through the driver's behavior. The findings of this model are useful for the authorities to structure an effective strategy to improve the level of perceived bus safety. A high level of bus safety will definitely boost passenger usage confidence which will subsequently increase ridership.
    Matched MeSH terms: Safety*
  11. Diode laser contact transscleral cyclophotocoagulation for refractory glaucoma in Asian patients
    Wong EY, Chew PT, Chee CK, Wong JS
    Am J Ophthalmol, 1997 Dec;124(6):797-804.
    PMID: 9402826
    PURPOSE: To evaluate the effectiveness and safety of diode laser contact transscleral cyclophotocoagulation in Asian patients with refractory glaucoma by lower energy settings with an innovative probe featuring a glass ball tip that focused the laser beam onto the ciliary body.

    METHODS: This prospective clinical study included consecutive Asian patients with dark irides and confirmed for glaucoma. Only one eye of each patient was treated. Diode laser contact transscleral cyclophotocoagulation treatment was performed with the center of the probe placed 1.5 mm behind the limbus. About 30 pulses of 810-mm laser radiation (power, 1.8 to 2.0 W; duration, 0.3 to 0.5 second) were applied around the eye. Patients were examined at fixed postoperative intervals. Intraocular pressure levels and postoperative complications were recorded. The relation between patient and disease characteristics, total laser energy delivered, and intraocular pressure effects were analyzed.

    RESULTS: Thirty-three patients were studied, with a mean follow-up period of 9.4 months. An average 56% of patients showed a 30% or greater drop in intraocular pressure. About 38% of patients achieved sustained intraocular pressure lowering to below 22 mm Hg at 18 months. Complications were few and included transient hypotony and iritis.

    CONCLUSIONS: In Asian patients with refractory glaucoma or painful glaucomatous eyes with poor visual acuity (defined for this study as worse than 20/200), low-energy-setting diode laser contact transscleral cyclophotocoagulation by means of the glass ball probe is relatively effective and safe.

    Matched MeSH terms: Safety
  12. Fulltext Motivations for Industry Stakeholders in China, Vietnam, Thailand and Malaysia to Improve Livestock Welfare
    Sinclair M, Idrus Z, Nhiem DV, Katawatin S, Todd B, Burn GL, et al.
    Animals (Basel), 2019 Jul 04;9(7).
    PMID: 31277448 DOI: 10.3390/ani9070416
    Understanding what might motivate livestock stakeholders to improve animal welfare is useful information when developing initiatives that benefit from stakeholder engagement. This study was designed to assess the strength of motivating drivers in the development of attitudes to animal welfare, and the factors that impacted their ability to improve animal welfare. During a series of qualitative focus group sessions with livestock leaders across the same countries (Malaysia, China, Vietnam and Thailand), the current study presented livestock leaders (n = 139) with the most significant results in their country, and collected data pertaining to the meaning and applicability of these results. This data was then subject to thematic analysis to identify salient and repeated motivating factors and meanings. This process revealed a complex picture of relationships between motivators and the contexts that drive them. Figures are presented to begin illustrating these relationships. Some strong motivators were uncovered that were previously rated low in the survey (i.e., financial benefit) or not included at all (e.g., food safety). This paper also presents the opportunity to better understand the strength and relationship of extrinsic and intrinsic motivational forces behind animal welfare improvement.
    Matched MeSH terms: Food Safety
  13. The value of life and accident costing: a willingness-to-pay study amongst motorcyclists in Malaysia
    Mohd Fauzi MY, Nor Ghani MN, Radin Umar RS, Ahmad Hariza H
    Appl Health Econ Health Policy, 2004;3(1):5-8.
    PMID: 15702934
    Motorcyclists constitute a large proportion of total road casualties in Asian countries Unfortunately, studies conducted for the purpose of evaluating the cost of traffic crashes, and cost-benefit analyses of safety interventions, are almost nonexistent in these countries. The loss-of-output approach to valuing life has been used for many years, yet this method has also long been criticised as it results in significant resource misallocation. This study attempts to overcome this problem by estimating the value of a statistical life among motorcyclists using the willingness-to-pay method that is commonly used in developed countries. The study recommends adopting a value of MYR1.1 million (almost five times the previous estimate) per statistical life for public policy analysis involving motorcycle safety.
    Matched MeSH terms: Safety/economics
  14. Fulltext Tongue pyogenic granuloma excision by using ultrasonic scissors
    Irfan Mohamad, Chentilnathan, Periasamy, Yahia, Dawood
    Archives of Orofacial Sciences, 2011;6(2):1-3.
    MyJurnal
    Pyogenic granuloma is a benign lesion which is commonly found in the oral cavity. It is a reactive inflammatory process of the injured mucosa to trauma. It can appear as a sessile or pedunculated mass with smooth or lobulated surface, which sometimes can mimic malignant lesion. Excision biopsy of the lesion is the confirmatory investigation which also a treatment tool. We report a case of middle-aged lady who had pyogenic granuloma of the tongue, which was safely excised using ultrasonic scissors. This case highlights the new technique of using ultrasonic instruments for excision of benign tongue lesion, with marked reduction of blood loss and operation time.
    Matched MeSH terms: Safety
  15. "Feeling unsafe": a photovoice analysis of factors influencing physical activity behavior among Malaysian adolescents
    Saimon R, Choo WY, Bulgiba A
    Asia Pac J Public Health, 2015 Mar;27(2):NP2079-92.
    PMID: 23513006 DOI: 10.1177/1010539513480229
    Understanding the factors influencing physical activity (PA) in the Asia-Pacific region is critical, given the high prevalence of inactivity in this area. The photovoice technique explores the types of PA and factors influencing PA among adolescents in Kuching, Sarawak. A total of 160 photographs were collected from participants (adolescents, n = 22, mean age = 14.27 ± 0.7 years, and parents, n = 8, mean age = 48 ± 6.8 years). Data analysis used constant comparison methods of a grounded theory. The Analysis Grid for Environments Linked to Obesity was used to categorize PA factors. Study findings were centered on the concept of safety, facilities, parental restriction, friends, cultural traits, media, community cohesiveness, and weather. The central theme was "feeling unsafe" when being outdoors. To promote PA behavior, provision of PA facilities needs to be supported by other programs that build on peer support, crime prevention, and traffic safety, together with other educational campaigns.
    Matched MeSH terms: Safety*
  16. Safe delivery practices: experience from cross-sectional data of Bangladeshi women
    Kabir MA, Goh KL, Khan MM, Al-Amin AQ, Azam MN
    Asia Pac J Public Health, 2015 Mar;27(2):NP1170-81.
    PMID: 22426560 DOI: 10.1177/1010539512437401
    This study examines the safe delivery practices of Bangladeshi women using data on 4905 ever-married women aged 15 to 49 years from the 2007 Bangladesh Demographic and Health Survey. Variables that included age, region of origin, education level of respondent and spouse, residence, working status, religion, involvement in NGOs, mass media exposure, and wealth index were analyzed to find correlates of safe delivery practices. More than 80% of the deliveries took place at home, and only 18% were under safe and hygienic conditions. The likelihood of safe deliveries was significantly lower among younger and older mothers than middle-aged mothers and higher among educated mothers and those living in urban areas. Economically better-off mothers and those with greater exposure to mass media had a significantly higher incidence of safe delivery practices. A significant association with religion and safe delivery practices was revealed. Demographic, socioeconomic, cultural, and programmatic factors that are strongly associated with safe delivery practices should be considered in the formulation of reproductive health policy.
    Matched MeSH terms: Patient Safety/standards*
  17. Relationship between cervical spine injury and helmet use in motorcycle road crashes
    Ooi SS, Wong SV, Yeap JS, Umar R
    Asia Pac J Public Health, 2011 Jul;23(4):608-19.
    PMID: 21768134 DOI: 10.1177/1010539511413750
    Motorcycle helmets have been proven to prevent head injury and reduce fatality in road crashes. However, certain studies indicate that the helmet increases the mass to the head, and thus the potential of neck injury due to the flexion/extension of the head-neck segment in a road crash may increase. This study was conducted to evaluate the effects of motorcycle helmets and the ways in which the accidents that occurred affected the incidence of cervical spine injury. Nevertheless, it is not intended to and does not discredit the fact that helmet use prevents many motorcyclists from sustaining serious and fatal head injuries. A total of 76 cases were collected and analyzed based on the data collected from real-world crashes. The Abbreviated Injury Scale (AIS) was used to assess the severity of injury, whereas the statistical Pearson χ(2) correlation method was used for analysis. The results showed that motorcycle helmets did not affect the severity of cervical spine injury. However, when the samples were further subcategorized into different crash modes, it was found that helmets affect the incidence of a severe cervical spine injury. In frontal collisions, the use of helmets significantly reduces the severity of cervical spine injury, whereas in rear-end, side impact, and skidded accidents, the use of helmets increases the probability of a severe cervical spine injury. However, in the latter crash modes, a motorcyclist without a helmet will have to trade-off with head injury. A logistic regression model has been developed with respective crash modes and the probabilities of risk in having severe cervical spine injury have been calculated. Future designs in motorcycle helmets should therefore consider the significance of nonfrontal accidents and the interaction of helmet with other parts of the body by possibly considering the weight of the helmet.
    Matched MeSH terms: Safety
  18. Physical activity pattern of Malaysian preschoolers: Environment, barriers, and motivators for active play
    Lee ST, Wong JE, Ong WW, Ismail MN, Deurenberg P, Poh BK
    Asia Pac J Public Health, 2016 07;28(5 Suppl):21S-34S.
    PMID: 27026634 DOI: 10.1177/1010539516638155
    Children's physical activity has been correlated with child characteristics and social or physical environment. This study aimed to compare preschoolers' physical activity among various sociodemographic characteristics and to determine barriers, motivators, and environmental factors for active play. A total of 835 preschoolers were included in this analysis. Time spent on active play, quiet play, and screen time was reported by parents. Boys spent significantly more time on active play and screen time than girls. Time spent on quiet play was highest in East Coast Peninsular Malaysia and lowest in Sarawak. Some 40% of children achieved active play recommendation while 27% exceeded daily screen time recommendation. Most parents reported that their child played actively in the house area; and that the main barrier and motivator to active play were safety and child's enjoyment, respectively. These findings demonstrate that sociodemographic characteristics and environment should be considered in designing physical activity intervention programs.
    MESH: screen time
    Matched MeSH terms: Safety
  19. Physical Activity Among Adolescents in an East Malaysian Rural Indigenous Community: Exploring the Influence of Neighborhood Environmental Factors
    Saimon R, Choo WY, Chang KH, Ng CJ, Bulgiba A
    Asia Pac J Public Health, 2015 Nov;27(8 Suppl):33S-40S.
    PMID: 25900978 DOI: 10.1177/1010539515582220
    This study explores the rural environmental factors that influence adolescents' participation in physical activities (PA). Thirty-six indigenous adolescents, aged 13 to 17 years from rural communities of East Malaysia were involved in the photovoice procedures: photo-taking, selecting, contextualizing, and codifying themes. Despite being endowed with natural resources such as river, forest, hills, and so on, the adolescents and the community did not capitalize on these rich resources to promote and engage in PA. Poor maintenance of natural resources, the lack of pedestrian infrastructures and road safety, the lack of PA facilities, and negative perception of ancestors' agricultural activities were among factors that constrained adolescents' PA. Although basic amenities such as play spaces and pedestrian infrastructures are necessary to increase adolescents' PA, any intervention should make the most of the natural resources, which are cheaper, environment friendly, and sustainable.
    Matched MeSH terms: Safety
  20. Safety and Management of Toxicity Related to Aflibercept in Combination with Fluorouracil, Leucovorin and Irinotecan in Malaysian Patients with Metastatic Colorectal Cancer
    Yusof MM, Abdullah NM, Sharial MM, Zaatar A
    Asian Pac J Cancer Prev, 2016;17(3):973-8.
    PMID: 27039822
    BACKGROUND: Between October 2012 and February 2015, 25 patients with metastatic colorectal cancer (mCRC) (mean age, 57.0 ± 12.1 years) were granted access to aflibercept via the Aflibercept Named Patient Program at four centers.

    MATERIALS AND METHODS: Here we reported the initial experience of aflibercept / FOLFIRI in combination. We evaluated treatment-related adverse events (AEs), progression-free survival (PFS) and overall survival (OS).

    RESULTS: The majority of the patients experienced gastrointestinal toxicity (grade 1-2), with diarrhea (52%), mucositis (52%), and nausea/vomiting (20%) being largely observed. Neutropenia (16%) and febrile neutropenia (8%) were common grade 3-4 hematological events. Aflibercept-related toxicity was managed as per practice guidelines. No grade 5 event was reported. Median PFS was 6.12 months (95% CI, 4.80-7.20) and OS was 12 months (95% CI, 9.80-14.18). The partial response (PR), stable disease (SD), and progressive disease (PD) rates were 25% (95% CI: 23.4-27.0), 37.5% (95% CI: 31.6-43.3), and 37.5% (95% CI: 22.5-52.5), respectively.

    CONCLUSIONS: Aflibercept/FOLFIRI can be administered safely in a second line setting to Malaysian patients with mCRC, as the AEs experienced were generally reversible and manageable. The safety and efficacy outcomes were consistent with those observed in Western populations.

    Matched MeSH terms: Safety
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