Client satisfaction upon health services is important for public especially for those who have to undergo treatment for tuberculosis (TB) noted for its difficult regime. The purpose of this study is to measure client dissatisfaction level towards TB treatment & services among TB patients in government outpatient health services and the factors that influenced it. This study was carried out in all the districts of West Coast Division of Sabah. It was conducted from June 2002 to November 2002. Study design is cross-sectional, with population samples taken on those who are currently receiving outpatient TB treatment in government health facilities. Questionnaires forms were used as study tool and filled by either by respondent or through the help of trained interviewer. The outcome is based on the total score obtained through Likert scales to determine the proportion of dissatisfied group from the respondents. A total of 488 patients took part in this study. Results of study showed overall percentage of 31.8% dissatisfaction level towards TB
treatment & services, while dissatisfaction towards TB treatment and upon health services alone were 54.3% and 24.0% respectively. The predictive factors for client dissatisfaction towards TB treatment and services are those without education, longer waiting time and have opinion of insufficient number of health staff.
Key words: Tuberculosis, client satisfaction, TB treatment, services, Sabah.
Study site: Outpatient clinics, hospitals, Sabah, Malaysia
Diabetes mellitus is the most common endocrine defect among children. Good diabetes management is important to give better health for both the children and the whole family. The goal of this study was to identify the level of mother involvement in children type·1 Diabetes Mellitus management, to identify factors related with mother involvement and to determine the relationships between mother
involvement and glycemic control. A cross·sectional study was carried out with 92 respondents selected by universal sampling from mothers who had diabetic children aged 5-15 years old and from medical visit appointment at University Kebangsaan Malaysia Medical Centre (UKMMC) and Putrajaya Hospital (HP1). Data was obtained through medical record and self reporting questionnaire. The study shown that 58.6% mothers had high involvement and 41.4% mothers had low involvement. Mothers' education level had a significant (p=0.0Z) relationship with a level of mother involvement. Most mothers gave high involvement in diet management (64.1%) and blood glucose monitoring (52. 7%), however most mothers gave low involvement in exercise management (63.0%) and insulin injection (60.9%). Mothers involvement in four management tasks were not statistically significant (p>0,05) with glycemic control. Mothers involvement in children diabetic management was high. There was high mother involvement in children's insulin injection and dietary intake and low mother involvement in children`s blood glucose monitoring and exercise, This study abo showed that there was no significant relationship between level of mother involvement and glycemic control.
The objective of this study was to evaluate compliance :0 the cliencs’ charter in a dental clinic and factors that may afect the updating of the charter. Our clients’ charter states that registration time is within IO minutes and waiting-mom time before being seen by the dentist is within 30 minutes. Convenience sampling was carried our over two weeks. Only patients above 12 years treated by dental officers were included. Data recorded included registration and wrziting-room time, treatment time, punctualiry afpaniems and workload of ajcicers. There were a total of 532 patients (407 walk»in/outpatients, 125 appointments). Results show that the mean waiting-mom time for all paticnm was nor compliant to the clients' charter (42.7 x 23.8 min for walking flll 44.9 : 32.7 min for appointments). Only 33% were seen within 30 min whilst about 23% waited for more than 60 minutes. All The mean registration time (17.9 1- 12.8 min) was ncmcomplianr everyday except on Thursdays where there were very few patients. Waiting time for elderly patients was not statistically significant from the younger patients. About 36% of appointment ariems were seen within 30 minutes; althou h hal 0 them were late, Exmzctivns, dentures and examination and diagnosis took the shortest time wrzh about 88%, 91% and 98% completed within 30 minutes respectwely. There was variable individual speed and number of patients managed by different operators, although the majority was flrsnyear dental officers. Factors that may contribute waiting time included number of patients per day, operator and punctualizy of patients.
The furnishings provided by the Institute of Higher Learning (IHL) are not suitable with the diverse student’s body
shapes. This could leads to lack of comfort in usage of the furnishings as well as affecting the effectiveness of the
delivery of the lectures. Therefore, the objectives of this study are to evaluate the student’s comfort level in the
current seat of the Lecture Theatre (LT) and to gather student’s anthropometry data. Two hundred and twenty one
students were involved in this study from one of the IHL in Selangor. A few similar design of LT were chosen for this
study. The Standard Nordic Questionnaire was used to identify the comfort level of students. Eleven body parts
measurements of all participated students were collected by using measurement apparatus such as callipers and
ruler. Based on the findings, it showed that the current seat in LT is uncomfortable to be used, in line with the
results from surveys and mismatch of the seat and student measurement data.
Indicators, whether referred to as ecological, biological or environmental, help us in assessing environmental conditions. Hypothetically, joint influences are predicted of the parameters associated with the number of water-borne, food-borne and vector-borne cases in study areas. Regression analysis of the dependent variables in water—borne diseases such as Cholera, Typhoid, Dysentery and Hepatitis indicated that the total coly°orm, fecal colform, residual chlorine, mean monthly rainfall and temperature influence almost hay of the cases in the 3 District of Serernban. Thus, coordinated monitoring of physical, chemical and biological parameters is needed to continue to build databases and to develop models integrating environnrental and social conditions, consequences and costs.
Children are much more likely than adults to get serious injuries in car crashes due to their softer bones, weaker neck muscle and fragile bodies. Child restraint system (CRS) can help in reduce injury and prevent fatality in the event of a crash. Thus the aim of this paper is to gauge the prevalence of CRS usage among guardians of children age below 11 years old. A survey to addressed guardians knowledge on CRS usage, practice and their views on fitting child restraints system to their vehicles were carried out among parents and carers who are caring children aged 11 years old and below. Seventy-four percent (74%) out of 500 respondents cited they have used CRS, however only 40% of them is currently using CRS with their children. Respondent in Kuala Lumpur and younger guardians reported twice likely to use CRS. In addition, graduate respondents are 1.5 times more likely to use CRS for their children. In conclusion, high incorrect usage rate and understanding of the CRS could promote additional injury towards the children in a car crash. Many initiatives could be introduced before the implementation of the CRS law in Malaysia such as awareness, community-based programs and CRS clinics that aim to guide guardians on the correct and effective way of installing the CRS device in their car.
Lane Change Assistance (LCA) system in cars can potentially mitigate blind spot related crashes; but its effectiveness
largely depends on driver acceptance and proper use. Although still in early stages, the volume of cars equipped with
LCA system is expected torise in the near future as the technology has been considered in the New Car Assessment
Program for Southeast Asian Countries (ASEAN NCAP) 2017 Rating Scheme. Therefore, this study is initiated to assess
user acceptance of and experience with LCA-equipped cars. Self-administered questionnaires were distributed to
owners of LCA-equipped cars at selected service centres in the Klang Valley from November 2016 to February 2017.
From a total of 276 valid responses, results revealed that most owners greatly considered LCA system when
purchasing their cars and agreed that the systems had positively altered their driving behaviours i.e. regularly using
the turn signal and checking the side mirrors. Nevertheless, about 20% of the respondents stated theirannoyance and
distraction by the LCA systems due to unnecessary warnings from various sources, aside from getting too many
warnings during traffic congestion. The study findings provide some practical implications that can aid the industry
and relevant stakeholders in gauging the issue and actual situations concerning the use of LCA system in Malaysia.
Accidental poisoning in children is a preventable condition. It is a problem mainly in children aged 1 to 4 years. This is a descriptive study of accidental poisoning in children below 12 years old admitted to Hospital Seremban from October 15, 1994 to October 14, 1995. A major cause of household accidental poisoning was kerosene ingestion (25%) followed by ingestion of medications (22%), liniment methyl salicylate (12 %), mothballs (12%) and hypochlorinate solution (9%). There was a higher incidence of poisoning in males (50.8%), among Indians (41.2%) and in children from lower social classes (67%). A greater proportion of the accident occurred when the child was taken care by the parents (53 %) and in the house (80%). Most of the poison was ingested from its original package (81%). The immediate action taken was sending the child to the hospital (75%) without carrying out other actions such as washing the child’s mouth. The delay of sending the child to hospital was due to husband not at home (57%). Most of the cases (72.1 %) were discharged well within 1-2 days following admission.
Acoustics issues such as noise in the workplace remains one of the most prevalence occupational hazard especially in
the manufacturing industry with heavy machineries. Increasing mechanization in all industries and most trades has
since proliferated the noise problem. In Malaysia, much has been studied and is known about the auditory effects of
noise. However less attention has been given to the non-auditory effects of noise such as annoyance, stress, and work
performance, and concern about such effects is a relatively recent phenomenon. In view of this, this study aims to
determine the level of noise from different type of machines and tools in a manufacturing plant and also the effects
of noise to the employees. A structured questionnaire was used to assess the effects of noise on the workers and
sound level meter was used to measure the noise level at selected work areas. The results of this study showed that
nearly all the identified work areas exceeded the action level of 85 dB(A) and four of these areas noise levels’ are
more than 90 dB(A) which is the permissible exposure limit according to the Factories and Machinery (Noise
Exposure) Regulations 1989. For the questionnaire, it was found that annoyance topped the noise effects list with
51.4%, followed by stress with 40.0%, hearing deterioration (14.3%) and job performance deterioration (2.9%). As a
conclusion, noise control or preventive measures are suggested in order to minimize the health risks from noise
exposure.
Aspek pantang larang dalam pemakanan dan perkhidmatan bomoh merupakan entiti unik dalam budaya masyarakat Orang Asli. Satu kajian irisan lintang di kalangan masyara/cat Orang Asli pinggiran (di Pos Betau) dan pedalaman (Pos Sinderut) Kuala Lipis telah dijalankan pada 25hb September hingga 6 Oktober 1999 bagi mengetahui pola pemakanan dan amalan pantang larang dalam aspek pemakanan yang mempengaruhi tahap pemakanan seseorang. Seramai 255 orang responden telah ditemuduga oleh kakitangan terlatih menggunakan borang soal selidik berpandu dimana 15 orang dari kawasan pinggiran dan 104 orang dari pedalaman. Hasil kajian menuruukkan Orang Asli pinggiran lebih kerap mengombil makanan dalam sehari (p
A qualitative research was carried out in Besut and Kuala Terengganu to identyy adolescents’ health problems and needs jiom adolescent perspective, and to establish a priority area in the development of Adolescent Health Clinic in the district. A total of 61 adolescents were selected and divided into four groups and stratified according to age, 13-15 years old and 16 - 17 years old. Generally all participants wished to live in an environment free hom negative health risk factors. The obstacles they perceived were mainly related to lack of care or too much control by their parents. Some of them perceived that their parents in general had inadequate knowledge and skills on parenting. Among local behavioural problems mentioned were loafing, running away from home, vandalism, school absenteeism, aggressive behaviour, substance abuse, pre-marital sexual activities, "bohsia", “bohjan" and even involvement in crimes. More than hah' agreed that counselling service is important for adolescents, and it should be made available in the community preferably outside the schools. They perceived an adolescent friendly health clinic concept as an important concept that should be introduced. To them adolescent friendly health clinic is a clinic run by professionals who are knowledgeable, caring, good listeners, non—judgemental, and who exercise confidentiality. The clinic preferably should be situated in a location which is away from the present health facilities to avoid the image of a place for sick people. Clinic hours preferably during weekends, should provide appropriate technologies and situated in a comfortable ambience. Adolescent participation in the clinic was also mentioned as an important entity for adolescent friendly health services.
A cross sectional study was carried amongst adolescent school children in Barat Daya, in 2000. This was to determine the characteristic features of adolescents in the district and to look into their sexual activities, substance use and psychosocial problems with the aim to plan an appropriate adolescent health program. Some 400 students from Form 2 and Form 4 were selected by purposive stratifed and systematic sampling. The study was carried out by trained nurses with an interview using a structured questionnaire. The majority of the respondents were Malays (78.8%) with a household income of less than RM2, 000.00 per if month. Family relations and parental influence were found to be strong. Mental health characteristics scored negatively significantly in this study and those particularly at risk were those who performed poorly in schools. Most claimed not to be involved in high risk behaviour though they knew of friends who did so. Adolescent health services in the district should take an integrated approach with other stakeholders. Health information should be easily available and focus should be given to poor achievers in school.
Chemical industry is one of the important industries in the world. However, incidents happened due to the release of hazardous materials, toxic and poisonous chemicals in the chemical industries can cause fatal to human and destruction of the environment. Learning from the Bhopal disaster's experience, chemical industries have developed a program - Responsible Care, aiming to regain public trust through improving the environment, health and safety performances. Malaysia has adopted Responsible Care program since 1994 under the stewardship of the Chemical Industries Council of Malaysia (CICM). Six codes of management practices have been developed by the CICM, covering distribution, community awareness and emergency response, pollution prevention, process safety, employee health & safety and product stewardship. It has been more than 20 years since its inception. However, to date, there are only 125 companies have signed the pledge to adopt Responsible Care program. The CICM has also conducted several initiatives to encourage participation of chemical companies to adopt Responsible Care program in Malaysia. Therefore, it is the aim of this paper to review the current status of Responsible Care program in Malaysia and also deliberate the way forward of this program.
The Aging Male Symptoms Scale (AMS) measures health-related quality of life in aging men. The objective of this paper is to describe the translation and validation of the AMS into Bahasa Melayu (BM). The original English version of the AMS was translated into BM by 2 translators to produce BM1 and BM2, and subsequently harmonized to produce BM3. Two other independent translators, blinded to the English version, back-translated BM3 to yield E2 and E3. All versions (BM1, BM2, BM3, E2, E3) were compared with the English version. The BM pre-final version was produced, and pre-tested in 8 participants. Proportion Agreement, Weighted Kappa, Spearman Rank Correlation Coefficient, and verbatim responses were used. The English and the BM versions showed excellent equivalence (weighted Kappa and Spearman Rank Coefficients, ranged from 0.72 to 1.00, and Proportion Agreement values ranged from 75.0% to 100%). In conclusion, the BM version of the AMS was successfully translated and adapted.
Anthropometric Test Devices (ATDs) of different nominal percentile values have long been used as human surrogates in automotive crash testing. The Hybrid III family, which is one of the widely used ATDs in frontal crash test, was designed based on the anthropometry dimensions of US adults. Thus, this paper aims to assess the anthropometric differences between Malaysian adults and Hybrid III dummies in terms of 5th percentile (small female), 50th percentile (midsize male) and 95th percentile (large male). A series of anthropometric parameters of Malaysian adults was obtained from a database of 1321 subjects with 708 males and 613 females. The results revealed that the current midsize male population differs from the ATD’s statures and body weights by about 35 and 40 percentile points, respectively. This demonstrates that the current ATDs are not truly representative of the current Malaysian adults, which may potentially lead to different injury responses in road traffic crashes. Thus, car manufacturers may as well consider this discrepancy issue in developing their future models especially with regards to safety.
A study was conducted at Greentown Health Clinic, Ipoh to assess and classify asthma by levels of control based on the Global Initiative for Asthma (GINA). The secondary objective was to identify those patients whose control was suboptimal. A total of 102 patients were included in this study based on random sampling between 25th April 2008 and 6th June 2008. Standard Asthma Control Questionnaires were used to classify asthma and levels of control. Baseline Peak Expiratory Flow Rate (PEFR) measurements and PEFR at audit visits were also recorded. All data were analysed using SPSS version 13. The study showed that only 39.2 % of the patients were classified as having controlled asthma, 34.3 % had asthma that was partly controlled and 26.5 % of the patients had uncontrolled asthma. Among those patients who had inadequate asthma control, more than half of them had nocturnal attacks and exacerbations. These findings demonstrate the need by the attending doctor to improve assessment of the patient’s control of asthma by actively questioning the patients and subsequently improving management to achieve optimal control of asthma.
Study site: Klinik Kesihatan Greentown, Ipoh, Perak, Malaysia
An investigation was undertaken 0f a malaria outbreak in Felda Neram 1 in the district of Kemaman,
Terengganu. Thirty-eight malaria cases of Plasmodium falciparum with one death were reported from that locality. The outbreak peaked between the epidemiological week of 42 and 44. A total of 2300 persons were surveyed with population coverage of 90%. Overall Slide Positive Rate was 1.5%. Out of 38 cases, 19 were Malays and the rest were Indonesian workers. Seventy-nine percent (30/38) had a history of fever within nine weeks prior to the survey. Thirty persons were found to be febrile on the.date of the survey of which 42% (14/30) were smears positive. Blood smears showed 65.7% (25/38) had an asexual parasitemia and 34.2% (13/38) cases were gametocytaemic. The males0”emales ratio was 1:7. Younger age groups were more ajfected. All patients were given radical malaria treatment. F orty-three percent (16/38) had a second course of radical treatment. The outbreak was caused by the re-entry of an Indonesian worker with malaria to the locality. Factors such as delayed detection and notyication and inadequate surveillance were instrumental for the outbreak.
A diarrhoea outbreak had occurred among neonates delivered in a private hospital in Kedah from 15 August to 8 September 2002 involving 27 (55.1%) cases out of a total of 49 deliveries. Thirteen of them (48.1%) were admitted to either government or private hospitals for treatnzent while fourteen of them (51.9%) were managed at home. The main presenting feature was frequent yellowish to greenish watery stool not associated with vomitting. Investigations include active case finding, environmental inspection, sampling of stool specimens, identifying causative agents and identuying human carriers. All the diarrhoea eases (100%) were noted to have received infant formula feeding while in the private hospital. Staphylococcus aureus was isolated hom the milk scoop which was used for milk preparation. Nasal swabs of four (50%) nursing personnel were also positive for Staphylococcus aureus. One of them was positive for methycilline resistant Staphylococcus aureus (MRSA). The milk and water samples showed no signuicant bacterial contamination. Stool samples of these cases were negative for Rotavirus, Vibrio sp., Salmonella sp., Shigella sp. and Entamoeba coli. This outbreak of diarrhoea was noted to have a strong association with infant formula feeding in the hospital. Breastfeeding should be continuously promoted. Baby friendly hospital initiatives in private hospital settings need to be initiated.
On March 17, 2003 the Kelantan Health Department was notihed about a possible typhoid outbreak following a wedding party. An investigation was carried out to identiy the source and recommend control measures. Active case detection, yield investigation and case»control study were conducted. Cases were symptomatic attendees with a stool or blood culture positive for Salmonella
typhii. Each control had a negative culture and denied symptoms. Of the more than 1 OOO guests, 477 experienced fever; 152 met the case definition. The party hostess was found to be an Salmonelb typhii carrier. Syrup prepared with untreated well water was identified as the most likely source for this outbreak, with an odds ratio 14.0 (95% C1: 2.9, 104.1). This was a common source
outbreak of typhoid. We recommend that all food handlers at large parties be screened for typhoid and other foodborne diseases and samples of higherisk foods should be kept for few days after each event in case they are needed for testing.
Working in prolonged standing position among industrial workers has been shown to be associated with different
potentially serious health outcomes, namely lower back pain, leg pain, fatigue, discomfort, and other health issues.
Personalisation of insole offers a solution that will provide a perfect fit and comfort to the shoes wearer based on
the ergonomic considerations. It works in a way that it alters the pressure away from painful areas by increasing the
surface area that supports the weight of the body and evenly distributes it to the whole plantar area. Survey was
conducted among workers at a manufacturing industry company to study on the level of pain experienced by them
together with their foot anthropometry. Then, the foot pressure of each of the workers was collected by using
pressure measurement device (F-scan). Combination of these data was used to design the customized insole that is
fit for the worker. The personalised insoles were fabricated by using Additive Manufacturing technology. After that,
the insoles were validated by using the F-scan and Electromyogram (EMG) to ensure their effectiveness in reducing
pressures on the foot and muscle activity hence improving the comfort of the shoe wearer. At the end of the
experiment, it was found that the insole is able to reduce the peak pressure of four out of five areas of the worker’s
foot with the reduction of pressure percentage ranging from 6% to 28%.