The objective of this study was to describe the differences in physical activity with socio-demographic factors and its association with cardiovascular risk factors. It was a cross-sectional study among selected urban and rural Malays communities in Kuching and Samarahan. Physical activity data was obtained using International Physical Activity Questionnaire (IPAQ) short version. Assessment of cardiovascular risk factors was based on blood pressure, fasting cholesterol and glucose and body mass index (BMI). Data was analysed using SPSS version 20. A total of 223 participated with higher response from rural areas (60.1%) and females (61.9%). More than half of the respondents (58.5%) were overweight and obese, with a mean BMI of 25.9 kg/m2 (SD=4.9). About 25% of the respondents were found to have blood pressure in the at-risk range. The prevalence of at-risk blood glucose was 52.3% with a mean value of 7.3mmol/L (SD=3.46). The prevalence of at-risk cholesterol were lower with 31.8%, mean value of 3.5 mmol/L (SD=2.94). There were more active respondents living in rural area (p=0.02). Logistics regression analysis showed that urban area (OR=1.988 95% CI 1.082 to 3.652), systolic blood pressure (OR1.020 95% CI 1.003 to 1.037) and blood cholesterol (OR0.884 95% CI 0.785 to 0.996) were associated with physical activity level. Change of physical activity due to urbanization can increase the risk of obesity and other chronic diseases. Efforts to include physical activity in intervention programme should be more intensified, with more provision of suitable built environment.
The best commonly applied approach in seating ergonomics is the concept that the seat must fit the sitter.
Understanding of population anthropometry is necessary because, in the mass vehicle market, a single seat should fit
a huge portion of the population. This research work proposes some automotive seat fit parameters based on a
representative Nigerian anthropometric data, to ensure an optimum fit between the vehicle seats and the occupants,
as well as providing adequate accommodation. Anthropometric data of 863 Nigerians captured with special emphasis
on the dimensions that are applicable in automotive seat design. A comparison made between the data obtained and
that of five other countries. The proposed dimensions includes: seat cushion width (475mm); seat cushion length
(394mm); seat height (340mm); seat lateral location (583mm); seat back height (480mm); seat back width (427mm);
armrest height (246mm); headrest height (703mm); armrest surface length (345mm); backrest width (thoracic level)
(524mm); seat adjustment (186mm); backrest width (lumbar level) (475mm) and distance between armrests
(475mm). A comparison made between the proposed dimensions and those recommended by four other scholars for
other populations. Finally, an ergonomic automotive seat suitable for the Nigerian population was designed using
AutoCAD 2016 software based on the proposed established dimensions.
The aim of this study was to identify the problems of stress and health effect among the office computer users. A total of 41 office workers whose job required the use of computers. A set of constructed questionnaire were use to measure the work stress and health problems among workers. The data was analyzed by using of descriptive and inference statistic. The result showed that subjects who use computer for more than 2 hours would experienced work stress such as fatigue 29(70.7%), eye and visual symptoms such as blurring of vision 27(65.9%) and musculoskeletal pain at neck 32( 78.6%). However most of symptoms were moderate. There were a significant relationship between the time spent of using computer with problem of stress (r= 0.440, p<0.05) and eyes and visual problem (r=0.319, p<0.05). However there was no significant relationship between the work station design with stress, musculoskeletal, eye and visual problems. Therefore the longer time spent using computer will lead to health problems. Using the safety operating procedure will reduce the work stress problems.
Keys word: Work stress, health problems, computer users
Agriculture sector accounts significant numbers of injuries and fatalities in the workplace particularly related to pesticide management. Among three main pathways of pesticide exposure, dermal contact is the most common route, which exposure usually occurs during pesticide mixing/loading, application, harvesting and other farming activities. This review aims to present and discuss several vital components of pesticide dermal exposure among agriculture workers, as well as pesticide application in agriculture sector in Malaysia involving different commodity agriculture sub-sectors. Pesticide exposure was discussed from perspective of three pesticide management activities (i.e. preparation, application and cleaning) that contribute to the risk of exposure through three routes (i.e. emission, deposition, transfer). Moreover, this paper also discussed pesticide dermal exposure risk assessment methods which can be defined into exposure assessment and effect assessment. The exposure rate was affected by various factors such as application equipment, application rate and duration, type of pesticide formulation, pesticide management stage, usage of personal protective equipment, training and aptitude of the applicator as well as environmental factors (i.e. temperature, humidity, wind speed and direction). The factors mention earlier have been used to explain the exposure distribution over different parts of the body and support the fact that pesticide type was not a major factor in total exposure.
Hypertension and smoking are established and independent risk factors for cardiovascular diseases. There are important inter-relationships between these two factors that may explain the aetiology of coronary heart disease. This study was conducted to determine the prevalence of hypertension and smoking in a rural community setting in Malaysia, and to identify their associated factors. A cross sectional study was conducted among residents aged 15 years and above in Mukim Dengkil, Sepang, Selangor, Malaysia from June to October 1999. Systematic random sampling was used to select the respondents. Results: Five-hundred and seventy respondents agreed to participate giving a response rate of 86.7%. The overall prevalence of hypertension was 26.8%. The prevalence was 31.7% among males, and 23.5% among females. Factors found to be significantly associated with hypertension were males and age. The overall prevalence of smoking was 21.2%. The prevalence among males was 48.7%, where as the prevalence was only 2.6% among females. The factors associated with smoking were males, ethnicity with Malays showing the highest prevalence of 27.2% and age. However, there was no significant association between hypertension and smoking. The prevalence of hypertension in this study is high. However, the prevalence of smoking in this study was slightly lower compared to the result found by the 2nd Malaysian National Health and Morbidity Survey (NHMS2).
The unstable living situation in Iraq in the last 10 years after 2003 war affected the daily life of most Iraqis, and especially the children. The objective of this study was to explore the effects of an unstable living environment on children’s health. A community-based qualitative study was done to collect data from 20 mothers of children (age 7 to 8years old) through in-depth interview (IDI). Data was recorded using tape recorders and was later transcribed and analyzed using qualitative thematic analysis techniques. The majority of mothers interviewed said the past nine years of unstable security in the capital had affected their daily life; some mothers also expressed concern about their child’s nutritional status, their eating habits during the school day, and the unhealthy food being sold at school canteens. As a conclusion, the unstable living situations in Baghdad city after the last war had affected the cognitive and nutritional development of children. More precautions should be taken by parents to ensure their children safety in the future.
Great importance has been attributed to birth weight all over the world because it is considered as one of the best predictors of prenatal survival and a good indicator of quality life. The objective of this study was to determine the prevalence of low birth weight babies (LBW) and factors related to it in Baghdad city. A cross sectional study was carried out in four general hospitals in Baghdad city, Iraq. A total of 225 newborn babies, alive, singleton and without congenital malformation were selected randomly from these four general hospitals.The result of the study showed the prevalence rate of low birth weights was 21.3%. Mothers’ educational level, monthly family income, mothers with chronic hypertension, mothers with history of previous low birth weight infants and anemic mothers were significantly associated with low birth weight babies (P= 0.03, 0.01, 0.02,
The passing of The Occupational Safety Health Act and the subsequent release of the Institute of Medicine (IOM) report had resulted a stronger sense of awareness towards workplace and patient safety in the Healthcare Industry. The World Health Organization (WHO) recommended Interprofessional education as one of the preparative module in handling safety issues in the healthcare Industry.The aim of this paper was to evaluate the students’ knowledge, perception, attitude, interrelationship, inclusion, understanding and teamwork towards patient and workplace safety.The research was conducted by administering questionnaires to returning allied health students from their internship in the healthcare settings. The overall results indicated that 63.4% of the students Agreed, 18.3% Neutral, 17.9% Strongly Agreed and only 0.3% had Disagreed on the impact of Interprofessional education towards patient and workplace safety in the Healthcare Setting.Occupational Safety Health and Interprofessional Education are relatively new concepts in Malaysia and require a strong understanding before a strong concluding stand could be established. The researcher feels a more concurrent approach should be implemented to actually know the impact of Interprofessional education towards patient and workplace safety in the healthcare settings.
Analysis of count event data such as mortality cases, were often modelled using Poisson regression model. Maximum likelihood procedures were used by using SAS software to estimate the model parameters of a Poisson regression model. However, the Negative Binomial distribution has been widely suggested as the alternative to the Poisson when there is proof of overdispersion phenomenon. We modelled the mortality cases as the dependent variable using Poisson and Negative Binomial regression and compare both of the models. The procedures were done in SAS by using the function PROC GENMOD. The results showed that the mortality data in Poisson regression exhibit large ratio values between deviance to degree of freedom which indicate model misspecification or overdispersion. This large ratio was found to be reduced in Negative Binomial regression. The Normal probability plot of Pearson residual confirmed that the Negative Binomial regression is a better model than Poisson regression in modelling the mortality data. The objective of this study is to compare the goodness of fit of Poisson regression model and Negative Binomial regression model in the application of air pollution epidemiologic time series study by using SAS software.
Cancer of the cervix is the second most common cancer among Malaysian women. Pap smear screening can detect precursors of cervical cancer. This paper attempts to determine the factors that influence the uptake of Pap smear screening. This was a cross sectional study with 112 Malay women recruited from a public university. A questionnaire enquiring sociademographic characteristics and health seeking behaviour based on the Health Belief Model was modified, translated and pre·tested. Testeretest reliability was also conducted. The mean age of the participants was 35.8 + 9.1 years. Majority was married and had at least secondary education. Only 62% of them had ever undergone Pap smear screening. Multiple logistic regression analysis showed women who were married or divorced (OR: 50.79, 95% C1: 4.33; 596.36), older age (OR: 1.12, 95% CI: 1.03; 1.22) or perceived higher benefits of Pap smear (OR; 4.80, 95% CI: 1.14; 20.15)
were more lilcely to have undergone Pap smear screening. Measures in reducing barriers and educating the public on the benefits of Pap smear are strongly recommended.
Although only 6.3% of the 221 respondents in this crass-sectional study stated outright that the hospital food served to them was not good, a high proportion of respondents ( 62.0%) supplemented ltaspimlfoad with outside food. When the reasons for supplementation were considered, it is likely that 53.8% ( $5.5%; 95% CI ) of the patients in this study were dissatisfied with hospimlfoudfar some reasons or when particularly with regards t0 variety, attractiveness and sewing lime. The pl‘0]701’l‘i011 of respondents wha were dissatisfied with hospital faud was significantly higher (p
This was a cross-sectional study which attempt; tu determine the prevalence of breastfeeding practice among mothers in Klcmg district, Malaysia and the association between lyrcastfceding practice with place of delivery and knowledge 011 breastfeeding. Dam collection was conducted by face·t0·face interview using a premuded structured questionnaire amung mothers with fum month old infants only who attended che government clinics in Klang, A total of 508 mothers were recruited ima the study. The study showed 92.9% ever breastfed, 55.1% exclusively lareastfed fur one month and 20.5% exclusively bremtfcd for four months. Malays brcastfed the most, while
Chinese the least. Breastfeeding was more common among mothers with lower education, delivered in government hospitals and with good knowledge on breastfeeding. A high proportion uf mothers in Klang wouki initiate breastfeeding and the [neualence of exclusive breastfeeding was comparable nationally. Breastfeeding was associated with mothers delivered in government hospitals and with good knowledge on breastfeeding. Continued promotional efforts targeted at private hospitals with information on breastfeeding should result in further increase in breastfeeding prevalence.
Study site: Klinik Kesihatan, Kelang district, Selangor, Malaysia
Posture is one of the most important factor that need to be considered in any postural analysis. Awkward, extreme,
and repetitive postures can increase the risk of musculoskeletal disorders (MSDs). As observational methods are more
widely used than instrumentation-based methods to assess postural problems, this study reviews and assesses the
scientific literature of observational methods and focused on pen and paper based specifically. In order to identify the
published methods, a list of English or Malay articles dating as far back as 1990 was compiled from PubMed, Science
Direct and Google Scholar. The keywords were ergo*, posture*, method*, observational*, postural problems*, pen and
paper*, posture analysis*, indirect* and macro-ergo*. In addition, a secondary search was also performed using
bibliography of retrieved articles so that additional papers for conducting review and evaluations can be collected. A
total of 121 articles that assessed postural problems in working activities were found. However, after intensive
screening process only 6 articles were selected to be further analyzed. Posture of upper arms/shoulder, lower arms/
elbow, wrist, neck, back/trunk and leg were highlighted in this study. The limitations and the strengths of the
published pen and paper based observational method focusing on those postures were also discussed. The finding of
this review will benefit researchers in the process of understanding unsafe posture in workplace. It could also provide
to researcher on how to improve the current pen and paper based observational method for assessing postural
problems.
Motorcyclists are particularly vulnerable when compared to large vehicles on the road. This study was conducted to gather feedbacks from motorcycle deliveryman regarding their riding conditions. A self-rated questionnaire was used to determine prevalence of riding symptom and its association with Whole Body Vibration and other associated factors among motorcycle deliveryman in Malaysia. A set of questionnaire was developed, pilot tested for its reliability and validity and distributed to 100 respondents. An interview was conducted after gathering the data from the respondents through the questionnaire. Survey findings show majority of the respondents preferred to ride according to the standard riding posture. Large majority of them agreed handlebar and foot peg/rest exposed them directly to the vibration. In addition, majority of them felt discomfort at the lower back and felt fatigue after long hours of riding. These findings are in-line with past studies regarding the road users.
Tuberkulosis merupakan penyakit yang masih meigadi masalah kesihatan di seluruh dunia amnya dan di Malaysia khasnya. Kajian telah dilakukan ali Cheras, Kuala Lumpur menggunakan aplikasi GIS untuk mengenalpasti taburan geografi dan tren tuberkulosis daripada tahun 1996 sehingga tahun 2000. Kajian ini juga dilakukan untuk melihat kebolehan GIS sebagai alat surveilan penyakit beyangkit. Hasil kajian dengan menggunakan aplikasi GIS mendapati tren peningkatan tuberkulosis di kawasan·kawasan yang tertentu di Cheras. Penumpuan kes-kes tuberkulosis dapat dilihat di kawasan taburan penduduk yang kepadatan tinggi dan sederhana tinggi terutama di kawasan Kampung Pandan, kawasan penempatan Jalan Cheras dan Bandar Tun Razak. Kes—kes tersebut juga kebanyakannya adalah dalam lingkungan 100 meter ke 200 meter di antara satu sama lain. Kesimpulannya secara am, aplikasi GIS memberikan dimensi baru dalam kawalan penyakit dan ia pasti dapat digunakan dalam membantu aktiviti surveilan penyakit tuberkulosis.
A cross-sectional study on helminthiasis among rural primary schoolchildren aged 9 to 10 years Bachok, Kelaritan was perfumed. A total of 680 schoolchildren participated in the study. Stool specimens were examined for the presence of the ova of Ascaris lumbricoides, Trichuris trichiura and hoolcwonn. The worm load was then measured using the modified Stoll`s volumetric dilution
technique. The overall prevalence of helminthiasis was 77 .2%. Trichuris trichiura were the commonest type of heminth noted - 66.8%, compared with Ascaris lumlrricoides (49.7%) and hookworm (1.8%). Mixed infections with Ascaris lumlyricoides and Trichuris trichiura was the commonest type of infection 249(41 .5%) . For Ascaris lumbncoides, 34.6% had mild and 5 I .3% had moderate worm load while for Trichurb trichiura, 66.5% had mild and 30.8 % had moderate worm load. Only 14.1% and 2.7% 4 of the schoolchildren had a heavy load of Ascaris lumlwicoides and Trichuris trichiura respectively. All the schookhildren with hookworm were only mildly infected. Targeted mass treatment for rural Mahysian schoolchildren is still essential, especially in areas where poverty and malnutrition are still prevalent.
Hospital UKM is the first hospital to implement case·mix system in Malaysia. The objective of the programme is to utilise case-mix system as a tool in improving efficiency and quality of care. From July 2002 to June 2004, a total of 35,568 cases were grouped using IRDRG-Version 1.1 case-mix grouper. Out of these, 3,622 cases or 10.2 % were cardiology cases in MDC 05 (Diseases and Disorders of the Circulatory System). Medical Cardiology cases consist of 86.5% and the remaining 13.5% were Surgical Cardiology. Most of the cases were in severity level one (43.4%), 29.5 % in severity level two and 27.1% in severity level three. The mortality rates for severity level one, two and three were 1.0%, 2.6% and 11.5% respectively. Top three cardiology cases were Acute Myocardial Infarction Without Comorbidity and Complication (IRDRG 05331) (8.4%), Acute Myocardial Infarction With Major Comorbidity and Complication (IRDRG 05333) (7.6%) and Cardiac Catheterization for Ischemic Heart Disease Without Comorbidity and Complication (IRDRG 05311) (7.4%). Step-down costing was carried out to obtain the cost for each DRG group. The mean cost per episode of care for Medical Cardiology cases was RM 3,562 (SD= RM 2, 1 19) with average LOS of 6.4 days (SD= 3 .8days) . For the Surgical Cardiology cases, the mean cost per episode ofcare was RM 6,526 (SD= RM 4,585) and average LOS of5.8 days (SD= 4.1 days). The main components of cost for Medical Cardiology cases are ICU cost (28.8%), pharmacy (17.3%) and Ward Services (15.3%). In Surgical Cardiology, the biggest component of cost was for Operation Theatre (27.9%), followed by Ward Services (25 .4%) and pharmacy (8.5%). Multivariate analysis using multiple linear regression showed that factors which significantly influence the treatment cost of cardiology cases were length of stay, age of the patient, discharge outcome, case type ('surgical partition') and severity level.
Breast self-examination (BSE) is recommended globally as one of the methods in early detection of breast cancer. Little is known about nurses screening behavior related to BSE. A cross-sectional study was conducted to examine the knowledge, attitude and practice of Breast Self Examination (BSE) among nurses. A self-administered questionnaire was sent to a total of 114 nurses working in Obstetrics & Gynaecology wards and clinics of two tertiary hospitals. Among the 114 participants, 111(97.4%) practiced BSE. The mean age of the participants was 34.97(±9.104) years. The mean score of knowledge was 11.07(±1.020) and 81.1% had high knowledge of BSE. Majority (98.2%) of respondents showed good attitude towards BSE. Barriers was found to be a significant predictor and self confidence proved to be an influencing factor on BSE performance. Despite practicing BSE, the number of nurses that examined their breast monthly was only 35.1%. Age, working experience and marital status showed no significant relationship with knowledge and practice of BSE. However, BSE taught during their undergraduate programme was found to have a significant relationship with practice of BSE. Majority of nurses in this study were not complying with MOH recommendation for BSE in terms of frequency. Thus, intervention strategies should focus on educating nurses on performing BSE monthly, in accordance with the Ministry of Health guidelines. This is important as nurses play a primary role in promoting health behaviors in BSE practice and breast cancer awareness among women in this country.
Clinical coding creates a rich database that can be used for administrative functions including planning for health service programmes and preparing budget of hospitals with appropriate use of disease and procedure classification system. Clinical coding errors may occur in the diagnoses or procedure codes. The errors can be happen at any of the digits use in the classification codes. Errors in clinical coding can give a huge implication on hospital’s income if the coding system is used for reimbursement. This study aims to determine incidence of clinical coding errors among 464 patient’s medical records (PMR). An independent senior coder was appointed to review the selected PMRs and the clinical codes. Post-audit evaluation shows that 89.4%(415/464) of the records contained at least one coding error in the assignment of diagnosis or procedure codes. Error in secondary diagnosis code was the highest comprising 81.3% (377/464) of the records. Coding errors were particularly found in O&G discipline comprising 94.8% (110/116) of the selected records. These errors caused a potential loss of RM 666,461 for the hospital. The highest pre-and post audit variance of potential income was RM 568,403 for paediatric discipline. The hospital should carry out regular monitoring of quality of clinical coding in order to prevent loss of income in the future when the reimbursement of services is linked to coding of diagnosis and procedures.
Although the Ministry of Health Malaysia has been encouraging the practice of Traditional and Complementary Medicine (T&CM)1, 2 , 3, 4 but patients/clients has not been able to apply it for their need of medical treatments and sometimes it leads to negative outcomes due to lack of knowledge on T&CM and its safe applications5,6’ 7,8 Most of the western-trained physicians are ignorant of risk and benefits of T&CM9,10,11 . This study was aimed to determine the gap between knowledge regarding T&CM and perception on education in T&CM among the medical staffs in five selected hospitals in Malaysia. A cross-sectional survey was done at five public hospitals among medical staff in Malaysia by using quantitative methods. A total of 477 medical staffs were involved in this study. The study showed that the overall knowledge of T&CM among the medical staffs were poor (61.2%). Having good knowledge regarding T&CM were significantly higher in Hospital Duchess of Kent (52%, p=0.001), among the non-Malays (44%, p=0.047) and pharmacists (47.2%, p=0.030). Positive perception on health education in T&CM among medical staffs were high (85.3%) especially among females (88.1%, p=0.002) and pharmacists (93.7%, p< 0.001). The use of T&CM among the general population is relatively high in Malaysia and many patients increasingly seek the information on T&CM therapies from medical staffs. Knowledge regarding T&CM was poor in this study because most of the medical staffs have not been exposed to T&CM education. This interesting scenario between poor knowledge and high positive perception on health education in T&CM shows the demand of urgent intervention in educating the medical staffs. We recommend that medical staffs must have some basic education and knowledge about T&CM before they could offer advice to their patients. Doctors are of the utmost important in this regard because they play a very important role in patient care. Providing T&CM education to medical staff may help to integrate T&CM into the mainstream medicine.