Sociodemographic factors have received considerable attention in the literature with regards its relationship with caries. However, the related information among children ages 12-17 is fairly limited. Birth order has been consistently found to be associated with diseases hypothesized to have an infectious aetiology but only few studies have examined its relationship with dental caries. The aims of this study were to determine the association of birth order and the sociodemographic background of subjects with caries and high caries experience among 16-year-old schoolchildren in Tumpat district, Kelantan. This was a case-control study. A total of 1087 16-year-old schoolchildren were examined intraorally for their caries status. They were categorized into three groups namely caries free (DMFS=0) mild caries (DMFS= 1-7) and high caries (DMFS ≥8) group based on DMFS score. Cases were the caries group and the controls were the caries free group. In each group, 163 subjects were selected by using simple random sampling. A questionnaire was used to obtain personal information of the subjects, birthweight and sociodemographic background. Analysis involved was ordinal logistic regression. The factor that was found to have association with caries and high caries experience determined using multiple ordinal logistic regression analysis was educational level of parents (OR=1.55, 95% CI: 1.06; 2.28). This study showed that birth order was not a significant factor associated with caries experience. Among the sociodemographic factors, only parent’s educational level was found to be associated with caries and high caries experience.
A total of 306 Malaysian university students and staff were surveyed to ascertain the physical and emotional effects of the polluted haze on them. All subjects completed self-reported questionnaires. Analysis of the results indicated that the majority of subjects reduced their outdoor activities and sports, and also reported an increase in emotional and physical health problems. The results indicated that there was a general increase in emotional problems such as feeling depressed, lacking in energy, not feeling like doing anything, feeling anxious and afraid, difficulty sleeping, feeling agitated and irritable, and having no appetite. There was also an increase in physical symptoms such as itchy or red eyes, itchy or running nose, dry throat/cough, headaches, nausea, and fever. This study indicated that emotional and behavioural problems are just as common during the haze, when compared with physical health problems. The study also suggests that there are a broad range of problems which health care and human resource departments need to be aware of and take precautions to minimize during a haze.
This paper reports the nutrition knowledge of Malaysian elderly, as part of a nationwide study to evaluate the status of nutrition knowledge, attitude and practice (KAP) of food and nutrition among various communities in Malaysia. A total of 906 elderly, age ranging between 60 to 96 years old, with mean age 67.4 ± 6.7 years representing all states in Malaysia participated in the study. An interview administered questionnaire was used to assess the nutrition knowledge and to collect demographic data of the elderly. Subjects were in the 60-65 years (51%) and more than 65 years (49%) age category. There were 46% Malays, 32% Chinese, 6% Indians while the remaining 16% comprised of other minority groups in Malaysia such as Iban, Kadazan, Melanau, Orang Asli and others. More than half of the elderly (54%) had no formal education, 36% completed primary schooling and only 9% finished secondary education. Overall 73% elderly were categorized as having poor nutrition knowledge, 18% moderate and only 9% good. The minority groups had the highest percentage of poor nutrition knowledge (91%) while the Chinese had the highest percentage of good nutrition knowledge (11%). More female (78%) than male (67%) had poor nutrition knowledge, in contrast to more male (10%) than female (8%) with good nutrition knowledge. Chi square test showed that there was a significant correlation between educational status and nutrition knowledge. This was reflected in the results which showed that 81% elderly with no formal education were categorized in the poor nutrition knowledge group. Majority of the elderly did not know about foods to be consumed most (88%), or to be eaten least (87%). Only a quarter to a third of the elderly responded correctly to questions on nutrient function and content. The question on foods with high salt was well responded by the elderly (65%). It is quite discouraging to show that a majority of Malaysian elderly had poor nutrition knowledge. This study indicated that appropriate nutrition education interventions need to be implemented to improve the shortcomings of nutrition knowledge among the Malaysian elderly.
Osteoporosis is a global health problem both in the developed and developing countries. Patient education forms an important part in the management of osteoporosis. The objective of this study was to evaluate knowledge about osteoporosis and its correlates among women aged ≥ 40 years attending an urban health centre in India and to identify their sources of information on osteoporosis. Knowledge about osteoporosis was assessed using the Osteoporosis Questionnaire (OPQ) in 243 women over 40 years of age, attending an urban health centre in the city of Mumbai located in the state of Maharashtra in western India. This exploratory cross-sectional study was conducted over a period of eight months. The OPQ analysis was performed using SPSS for Windows Version 13.0. The scores were expressed as mean ± SD (Standard Deviation). The one sample-t test was used to study the differences in the mean scores between socio-demographic variables. The mean total OPQ score was 0.91 (SD ± 5; range -9 to 10; maximum possible score 20). There was a significant difference in the total OPQ scores by the level of education and family history of osteoporosis (p
Dengue is one of the main vector-borne diseases affecting tropical countries and spreading to other countries at the global scenario without cease. The impact of climate variability on vector-borne diseases is well documented. The increasing morbidity, mortality and health costs of dengue and dengue haemorrhagic fever (DHF) are escalating at an alarming rate. Numerous efforts have been taken by the ministry of health and local authorities to prevent and control dengue. However dengue is still one of the main public health threats in Malaysia. This study was carried out from October 2009 by a research group on climate change and vector-borne diseases. The objective of this research project is to assess the community vulnerability to climate variability effect on dengue, and to promote COMBI as the community responses in controlling dengue. This project also aims to identify the community adaptive measures for the control of dengue. Various research methodologies were applied in this research project in different localities. Site visits, review on surveillance data and mapping on Aedes population, dengue cases and climate variability, community survey on the knowledge prevalence , opinions and practices (KOP) and mosquito ecology were carried out during pre- and post intervention phases. Community vulnerability towards Aedes and dengue were mapped out applying GIS. A series of workshops, group discussions and activities such as COMBI activities to promote Aedes control were conducted involving the Ledang communities, the health district officers and UKM researchers. These activities also included interventions and documentation of community responses and their adaptive capacities towards dengue. Trends on Aedes population, dengue cases and community surveys pre and post-interventions, the processes for dengue control activities were analysed. The research findings could provide understanding on the community vulnerability to dengue against climate variability, their responses and adaptive measures. The community advocacy on combats against Aedes is a possible effective solution in dengue control. This research could provide other dimensions in public health management to address the impacts of climate change on vector-borne diseases.
Background and Objectives: Unmet need for contraception is the gap between women's reproductive intentions and their contraceptive behavior. This community based interventional study was carried out to determine the unmet needs for contraception, the reasons for this and to assess the impact of interventional measures on acceptance of contraception.
Subjects and Methods: This study was conducted in 52 villages in the state of Maharashtra, India, among 363 married women selected by cluster sampling. Data was collected using an interview guide. An intervention was done for the women who had an unmet need and an assessment of the change was done subsequently. Data was analyzed by using SPSS.
Results The prevalence of contraceptive usage was 59.2% and the prevalence of unmet need for contraception was 44% (160). The unmet need for spacing births was 53.8%, 38.7% for limiting births and 7.5% women were dissatisfied with the current contraceptive method. The reasons ranged from side effects to contraceptives to source of obtaining contraceptives. Age of the respondents, education and number of living children showed statistically significant association with unmet needs. Post intervention, the contraceptive prevalence rate increased significantly 85.7% and there was a significant reduction in the unmet needs for spacing and limiting births, equally there was a significant reduction of dissatisfaction with using contraception.
Conclusion: Improvement in the use of contraception and addressing the unmet need for contraception requires community involvement and ongoing, sustained efforts by health workers to ensure quality care to the beneficiaries.
Contact time was defined as the time spent by health personnel with a patient. The study was conducted for four months in 2007 to assess the contact time and to determine the appropriate contact time as perceived by patients attending clinics of various clinical disciplines as well as Out-Patient Departments and Emergency Departments at Ministry of Health Hospitals. This study was a cross-sectional study carried out on out-patients who came to the hospitals’ clinics for treatment. Information was gathered through self-administered questionnaires, distributed at twenty-one hospitals. The respondents were selected using stratified random sampling method. Out of 21,750 questionnaires distributed, 13,463 patients responded, a response rate of 61.9%. This study shows that the average contact time increases from small hospitals (8 minutes) to bigger hospitals (15 minutes). The contact time also varies between the clinics of various disciplines. Obstetrics and Gynecology (O&G) clinics and Pediatric clinics had the longest average contact time of 20 minutes and 15 minutes respectively. The percentage of patients who were satisfied with the contact time corresponded with the type of clinics and hospitals which had the longest contact time. Thus, it is suggested that clinics and hospitals, whenever possible try their best to follow the duration of contact time as perceived appropriate by the patients.
Study site: Out-Patient Departments and Emergency Departments at Ministry of Health Hospitals (21)
Smoking among school children is becoming a serious problem in developing countries, including Bangladesh. The early initiation of smoking needs urgent intervention to protect this vulnerable group and preventing them to be addicted. This study aims to determine the age at initiation of smoking and factors affecting it. A two-stage cluster sampling was used with a selection of schools on probability proportional to enrolment size followed by stratified random sampling of government and private schools and then a random start in classes VIII, IX and X of each school targeting the students aged 13 years and above. Data collected from secondary school students using self-administered structured questionnaire. All analyses were performed with SPSS version 20.0. Missing value was treated by multiple imputations. A total of 6877 data were analysed in which 84.7% were non-smoker, 9.5% were ever smoker and 5.8% were current smokers. Among the ever smoker (n=823), 38% were current smokers, 56.5% former and 5.5% were recent quitters. The mean (SD) age at initiation of smoking was 10.9 (0.2) years. Multinomial regression analysis revealed that class grade, peer pressure and offered free cigarette appeared to be significant predictors of smoking initiation (p0.05). Promotion of smoking resistance skills among children and teens through comprehensive approaches designed to enhance general personal competence by teaching an array of personal and social life skills is recommended.
A cross sectional study was carried out to determine the relationship between dust exposure and pulmonary function in male steel workers in Terengganu, Malaysia. The investigation included spirometric testing and detailed personal interviews using a structured questionnaire adopted from British Medical Research Council (BRMC) Questionnaire on respiratory symptoms. Respiratory symptoms commonly reported by the male workers were morning phlegm (33.1%), shortness of breath (31.9%), chest tightness (30.4%), and morning cough (17.8%). Age and duration of employment were among the factors associated with respiratory symptoms (p
Hospital information systems have evolved with the recent widespread, involving technology and target functions, and this involves the critical computer systems from multiple perspectives. Healthcare organizations increasingly use information technology as a basis for improving productivity and user satisfaction. A research had been done about the level of satisfaction in using the Hospital Information System. Data was obtained by using a set of questionnaires that have been tested for reliability and validity. The staff are comprised of two (2) categories: Nurses (community nurses / Head nurse / staff nurse, nurse managers and others) while the second category consists of administrative officers (administrative officers, administrative assistants and clerks) in selected departments. Variables consist of sociodemographic factors, occupational factors and perception factors. A total of 152 respondents identified using stratified sampling method. The factors studied were age, gender, marital status, level of qualifications, length of service, knowledge of the system, attitude towards the use of the system, behavioral intention to use the system and compatibility with work. Majority of respondents were females (88.2%). The level of satisfaction among the staff in using the hospital information system is high (88.8%) compared to the dissatisfied staff in UKMMC (11.2%). In overall, the staffs in UKMMC are satisfied using the hospital information system available now but there are always a room for improvement so that the system can be used more intensively.
The level of patient satisfaction is important for service quality in hospitals. This study aims to measure the level of patient satisfaction at University Kebangsaan Malaysia Medical Centre (UKMMC) and the factors affecting it. A cross-sectional study was conducted on 520 respondents at the outpatient department in four clinics in UKMMC by using self-administered questionnaires. Respondents were selected using a systematic sampling method based on the list of patient appointments. The level of patient satisfaction was measured using the PSQIII domain. Less than half of the respondents were satisfied with the overall service provided (41.0%), while the others (59.0%) were not satisfied. Based on the domain studied, the level of satisfaction varies widely: the highest satisfaction were interpersonal relationships (75.8%) followed by the registration process (73.8%), technical quality (71.3%), communication (66.7%), physical facilities (64.6%), accessibility (60.2%), and financial (47.3%). The level of patient satisfaction was low and financial domain should be given more attention to in order to ensure an increase in patient satisfaction levels.
Study site: Surgery, Orthopaedic, Obstetric and Gynaecology, and Medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Accidental needle-stick injuries (NSIs) are a hazard for health-care workers and general public health. Orthopaedic surgeons may be more prone to NSIs due to the prevalence of bone spikes in the operative field and the use of sharp orthopaedic instruments such as drills, saws and wires. A hospital-based cross sectional study was conducted in the orthopedic wards of Melaka General Hospital. The prevalence of NSIs was 32 (20.9%) and majority of it occurred during assisting in operation theatre 13(37.4%). Among them six (18.8%) were specialist, 12(37.5%) medical officer, 10 (31.2%) house officer and four staff nurses (12.5%). Among the respondents 142 (92.8%) had been immunized against Hepatitis B and 148 (96.7%) participants had knowledge regarding universal precaution. The incidence of NSI among health care workers at orthopaedics ward was not any higher in comparison with the similar studies and it was found out that the prevalence was more in junior doctors compared with specialist and staff nurses and it was statistically significant.
Background: Circumcision though not mentioned in the Quran is believed to be a compulsory practice among the Muslims. In Malaysia, although there are several methods of circumcision available and traditional circumcision is still popular.
Methods: A cross-sectional survey was carried out in a small fishing village of Kedah to study the methods of circumcision available to the villagers. This was followed with an in-depth interview conducted with ‘Tok Mudim’, a practitioner of traditional method of circumcision.
Results: Forty three of the eligible 71 subjects participated in the study giving the response rate as 60.5%. The most common age for circumcision was 9 years old. Despite private clinics being the most common place of circumcisions, there was an increasing number of boys going to the ‘Tok Mudim’ for circumcision. A Mass Circumcision Ceremony is traditionally practiced. The ‘Tok Mudim’ described the procedure in detail and was of the opinion that the reason traditional method is still popular was because of the fear of injections and impotency among the parents. Most common complication faced by the ‘Tok Mudim’ was bleeding and infection.
Discussion and Conclusion: Till the community shifts entirely to using modern medicine, there is a need to integrate traditional practitioners into the system. Training the ‘Tok Mudim’ to use modern instruments and aseptic techniques should be considered.
Background: To assess the effect of cement vertebroplasty on the activity of daily living of elderly patients who have sustained a vertebral osteoporotic fracture.
Patients and Methods: Seven patients with clinically significant and radiologically proven osteoporotic vertebral compression fractures suitable to be treated with percutaneous cement vertebroplasty were recruited. Evaluation was based on pre- and postprocedure activity by clinical documentation (including interview) and by a self-developed questionnaire (including quality of life).
Results: Following the procedure, 54% of patients resumed their activities of daily living with minimal pain while 46% of patients were able to do so without any pain (p
Background: Nosocomial infection is among the leading problem in many major hospitals resulting in soaring cost expenditure in managing its affect.Hand washing practice is a crucial preventive way to contain such mischief but many ignored its importance. This is perhaps due to lack of appropriate role modeling from senior practitioners.
Subjects and methods: Our study examined the prevalence of hand washing practice among medical students from year 3 to 5 and compared it to their knowledge and level of awareness on its importance in clinical practice. 142 students were randomly observed during their clinical work in the wards on this practice and questionnaires were later distributed to 268 students from all semesters on their knowledge on the technique and awareness on its importance.
Results: Out of 142, almost 80% washed their hands but only 41.6% performed effective hand washing. In contrary, 80 to 90% showed good level of knowledge and awareness as well as perception about its importance in clinical practice.
Conclusions: The contradictory findings between the actual practice of hand washing and knowledge as well as awareness suggest that enforcement on the practice is necessary. This requires motivation and cooperation from all health alliances and higher authority in the health system. Remedial measures are much needed in order to contain high incidence of nosocomial infection in our local practice.
Appreciation of learning styles can be of use to help both educators and students to enhance the effectiveness of an educational experience. It has been noticed that some students at this College are not very good at expressing themselves in either written or spoken English. Our study aimed to identify the student’s learning styles; assess whether there is any correlation between learning style, baseline demographic data and self rated proficiency in English language; and assess their associations with the assessment performance.
A group of third year medical students voluntarily participated in a questionnaire study to provide us with their learning styles, demographic information and self-rated proficiency in English language. This data was compared to the students’ performance in the assessment at the end of their junior clinical rotations.
This cohort of students (60% Malay, 35% Chinese and 5% Indian) who were mostly visual learners, considered themselves proficient in English. Students with predominantly Visual learning styles and those with poorer English, score significantly lower during their clinical long case examinations. These two predictors appear to be independent of each other.
These results may suggest that our current teaching modalities may disadvantage students with predominant visual learning styles. It also suggests that the long case clinical examination may favour those with more verbal learning styles.
This study was done in all UNIMAS medical students from year 1 to year 5 in the year 2004. A questionnaire was used. 290 students participated with a response rate of 72.5%. There were more male students snoring than female (ratio 5.9:1.3). The habitual snoring percentages for all years, first year and final year medical students are 7.2, 9.9 and 3.6 respectively and these are comparatively and relatively low with other studies reported in the last 10 years, and the reasons for this are unknown. However it was interesting to note in this study and others that there are relatively more snoring medical students in the first year than subsequent years. Significant positive correlation of snoring was found with the factors of gender, weight, height and sleep apnoea, all having p<0.0005, but no significant correlation was found in others including examination results.
Abstract: A total of 307 Malaysian children and their parents were surveyed to ascertain the prevalence of mental health problems amongst urban primary and secondary school children. The results indicated that secondary school children report slightly higher rates of depressive symptoms, whereas primary school children report higher rates of social problems. There was also a discrepancy between child and parents reports of children’s emotions and behaviours. Children’s self-reports of aggressive behaviours where higher than their parents’ reports. Alternatively, parents reported lower levels of their childrens’ emotional problems, as compared with the childrens’ self-report. When gender was taken into consideration, females were reported to be more aggressive, withdrawn, and have more attention problems when compared with males.
Background: Having a validated questionnaire in any field would nurture a research path in that particular area. The aim of this study was to validate the Depression Anxiety Stress Scales 21-item (DASS-21) Bahasa Malaysia (BM) version among clinical subjects who were diabetic patients. Objectives: To determine the reliability and construct validity of the BM DASS by looking at internal consistency and exploratory factor analysis respectively. Methods: The BM DASS was administered to a total of 153 diabetic patients. These patients were selected when they came to 15 retail pharmacies all over the Klang Valley. Results: The BM DASS-21 had very good Cronbach’s alpha values of 0.75, 0.74 and 0.79, respectively for depression, anxiety and stress subscales. For construct validity, it also had good factor loading values for 17 out of 21 items (.31 to .75). Conclusions: The results of this study entrenched the evidence that the BM DASS-21 had excellent psychometric properties and therefore it is suitable to be used for the Malaysian clinical population.
Recommend that the following measures be applied universally: CPR training should emphasize the very low risk of disease transmission. Training in the use of barrier mask should be included; Oral barrier devices should be made freely available in hospital and in public areas e.g. hotels, theaters, health clubs and restaurants. A survey among health personnel in Malaysia conducted in 2005 found that nearly half of the 4989 subjects were either not confident at all or unsure about their ability in giving first-aid and CPR.13 The investigators however did not look at fear of infection in particular.