Land filling is the most common disposal method in most parts of the world and landfill site has always been the final destination in solid waste management hierarchy. Thus, the selection of landfill site is always an essential part in the management of solid waste. Selecting an appropriate site for landfill minimizes any unwarranted ecological and socio-economic effects. Hence, landfill site selection requires a detailed analysis of the area that must be able to meet the local authority requirement and criteria. The present study presents a feasibility assessment of landfill establishment for Khomeynishahr city in Isfahan, applying a multi criteria evaluation (MCE) method using GIS technique. Information layers related to topography, soil, water table, sensitive habitats, land use and geology maps were prepared and superposed using Boolean logic in GIS environment. Essential analysis and regulation, criteria and site selection assessment showed that because of many limitations khomeynishahr city doesn’t have adequate conditions for landfill site establishment. Khomeynishahr city has a dense population and limited area and is not suitable for landfill establishment. In this case consideration of adjacent cities and finding a common landfill site between two or more cities could be a viable solution of solving this problem.
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.
This study observed the pattern of reported dengue infections, clinical manifestations, and circulating dengue serotypes in Negeri Sembilan, Malaysia. The aim of this study was to determine the co-circulation of the four different dengue virus serotypes in Negeri Sembilan. We analyzed the surveillance data (VEKPRO) from Negeri Sembilan State Health Department and National Public Health Laboratory, Malaysia on reported dengue infections from 1st January 2010 to 31st December 2010. There were 1466 reported dengue infections, 1342 (91.5%) cases were dengue fever (DF) and 124 (8.5%) were dengue hemorrhagic fever (DHF). The mean age was 32.2± 15.8 years old and most were young adults, aged 15 years old and older. Males (p < 0.05), and those residing in Seremban district (p < 0.05) were more likely to get dengue infections. Symptoms presented upon admission were fever (100%), headache (99.9%), myalgia and arthralgia (98.8%), rash(24.2%), petechiae (16.0%),bleeding tendencies (7.0%) and neurological deficits(1.2%). All four dengue serotypes (DEN 1 – 4) were present, the pre-dominant serotype was DEN-3, noted in January, then existed together with DEN-2 until around May. DEN-1 was the most pre-dominant circulating dengue serotype afterwards, reaching a peak in December 2010. Dengue affected all age groups particularly young adults and males. Most cases reported were in urban areas and Seremban district. Most of the dengue infections occurred in the first half of the year, with the DEN-2 and DEN-3 serotypes being the most predominant.
Development of ergonomic sofa design is a design process that has the basic framework specification and type of
material that is applied on the sofa design. This is due to human consumption that is closely related to ergonomic
design of this specification which will affect human physical. To achieve this goal, a survey involving 30 respondents
of sofa makers was conducted to get feedback regarding the sofa design specifications. Survey questions emphasize
on the basic specifications and material dimensions of sofa materials used. The results of data analysis show that the
size of basic dimensions and materials is essential in designing an ergonomic sofa. The survey is very important to
find out the basic specifications in the development of ergonomic design through perception of sofa maker.
Road transport is the movement of passengers or goods on the road. To date, issues concerning the safety of students
and school institutions have continued to attract public attention. The recent spate of incidents inside and outside
the school compound has brought the issue of children safety into our attention. These include the escalating number
of road casualties. This study was conducted to observe road hazard outside the school compound and analyse the
safety risks faced by school children by using the risk matrix. The risks are calculated to include likelihood and
severity of hazard as identified in the Guideline of HIRARC 2008. The area selected was the East Coast state of
Peninsular Malaysia, with over 111 schools randomly selected in Kelantan. Results were then analysed and six
highlighted hazards were discussed. The results show that the main road posed the highest risk due to speeding
vehicles. These vehicles failed to slow down when approaching the school area. The school
administration must enhance the safety of the staff, students, and public while in the school area. In conclusion, road
safety awareness must be instilled among teachers, students, parents and road users alike.
Non-Leisure Time Physical is the main component of physical activity in Malaysia. The aim of this study is to study the associated factors related to Non-Leisure Time Physical (occupational & travel) in Malaysia. This data is from the Third National Health and Morbidity Survey, consisting of 32,575 respondents. It was a cross-sectional study among Malaysian adult, aged 18 years and was conducted using proportional to the size stratified sampling method. Chi square test and logistic regression model were used to analyse the data. The result showed that non-leisure time physical activity (NLTPA) gives more contribution to total physical activity, as compared to leisure time physical activity with percentage of 64.3% and 35.7% respectively. There was a significant association between NLTPA with age (P < 0.001), gender (P < 0.001), ethnicity (P < 0.001), education (P < 0.001), occupation (P < 0.001), income (P < 0.001), marital status (P < 0.001), region (P < 0.001). The main component of physical activity in Malaysia is NLTPA. Promoting NLTPA may have potential to increase physical activity levels in Malaysia.
Study name: National Health and Morbidity Survey (NHMS-2006)
Diabetes mellitus and its main complication, nephropathy, ajjbcts the economic wellbeing and quality of Iife of the sufferers and the population. A matched case control study was conducted in September 1998 to investigate the factors involved with nephropathy such as diabetic control, smoking, hypertension, familv history of diabetes and diabetic duration. Respondents were classyied based on the presence of microalbuminuria or macroalbuminuria, Seventy-two pairs of case and control were studied Duration of diabetes Q2 = 0.005), presence of lethargy and weakness prior to diabetes diagnosis @7 = 0.019), duration of smoking @7 = 0.014), duration of hypertension @2: 0.000), systolic hypertension Qu= 0e 025), uncontrolled diabetes with poor HbA1c level (v= 0.02Q and lack of diabetes knowledge Q2 = 0.037) were jbctors which related signyicantlv to nephropathy by univariate anahrsis. In multivariate anahrsis, systolic hypertension (p = 0.0015), lack of diabetes knowledge (17 = 0.0197), presence of lethargy symptom Q7 = 0.0027), prolonged diabetic duration @ = 0.0301) and higher body mass indices (p = 0. 0213) were predictors to diabetic nephropathy.
The objective of this study is to explore physician’s perception toward clinical pharmacy services and role of clinical pharmacists in governmental hospitals at Al-Qassim region. An observational cross-sectional survey was conducted. Results: 150 males and 39 females participated giving 75.5% (189 of 250) response rate. Physicians perceptions were found to be high (equal or more than 90% of frequency) in some clinical pharmacy services such as patients’ education and counselling, monitoring of patients’ responses to drug therapy including toxicity/side effects and provision of drug information to healthcare professionals. The physicians showed low perception (less than 76%) in the taking of patients’ medication history on admission, by clinical pharmacists. Conclusion: Physicians’ perception toward clinical pharmacy services and the role of clinical pharmacists was not found to be completely favourable. The reason of this mixed responses and to the accommodating feelings of clinical pharmacy services in clinical setting appear to relate to the state of infrastructure and environments of hospitals. The infrastructure and environments of hospitals need to be updated for an improved accommodation clinical pharmacy services.
Cancer screening is an important part of any cancer control program and the success of any screening program is partly dependent on having large numbers of the high risk population availing themselves of the service. The purpose of this study was to assess the cancer screening behavior of fulbtime employed women staff of an institute of higher learning using the Health Belief Model (HBM) construct. The results showed that the rate of reported regular cancer screening behavior (Pap smear screening, breast self examination (BSE), clinical breast examination (CBE) and mammography screening) were low. The rates for regular screening were 42.5% (Pap smear), 20.9% (BSE), 15.5% (CBE) and 9.4% (mammography). There were differences in the dimensions of the HBM between the women who reported regular screening and those that did not. The perceived barriers", "perceived benefits” and “motivation” dimensions were different in Pap smear screening, whereas the "confidence” dimension was different in BSE. Recommendations were made for a health education program targeting both women and men to increase uptake of cancer screening services by women.
The practice of diabetes self-care plays an important role in achieving and maintaining good glycaemic control. However, not all patients with insulin-treated diabetes engage in their self-care activities. There is some evidence that self-care practices in patients with insulin-treated diabetes can be understood and predicted by their health beliefs, although studies are often hampered by methodological weaknesses, and the fact that less is known about adults with insulin-treated diabetes in Malaysia. This study was conducted to examine whether health beliefs (as specified in the Health Belief Model: HBM) can predict self-care practices and glycaemic control in patients with insulin-treated diabetes in Malaysia. Longitudinal design with self-reported questionnaire measures was administered at baseline (Time 1:T1) and six months later (Time 2: T2). Participants were recruited from three endocrinology clinics in Malaysia. The measures included self-care practices (diet, insulin intake, exercise and self-blood glucose monitoring: SMBG), health beliefs and diabetes knowledge. Participants’ glycaemic control was examined based on their glycated hemoglobin (HbA1c) results. Data analysis was performed at different points of the study times; T1, T1-T2 and T2. Diabetes knowledge and demographic data were controlled for in predictive statistical analyses. A total of 159 patients with insulin-treated diabetes (aged 18-40 years) completed the measures at T1. Of these, only 108 (67.9%) completed follow-up measures at T2. However, demographic characteristics were not significantly different between those who completed and dropped out of the study (p>0.05). The HBM was significantly predictive of diet self-care at T2, insulin intake practice at T1 and HbA1c at T1-T2 andT2. Of the HBM constructs, perceived benefits significantly predicted good dietary habits at T1 (OR 1.92) and T2 (OR .23) and adherence to insulin injection at T1 (OR 3.17) and T1-T2 (OR 2.68). With the exception of perceived severity, all other HBM constructs significantly predicted HbA1c [perceived susceptibility (β .169) at T1, perceived barriers (β -.206) and perceived benefits (β -.397) at T2 and cues to action (β -.233) at T1-T2]. Health beliefs predict self-care practices and glycaemic control in young to middle-aged adults with insulin-treated diabetes in Malaysia. Diabetes educators could use this knowledge in their efforts to improve diabetes self-care in this patient groupby modifying those beliefs through their diabetes education.
Study site: Endocrinology clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Hospital Putrajaya, and Hospital Melaka, Malaysia
The paper puts forth the need for health care workers safety whilst undertaking their job on a daily basis. Presently there are number of factors that are directly linked to the safety of health care workers. However, Occupational Health is very important and useful for health workers that are exposed to their job hazards. Every year, many lives are lost because of the spread of infections in hospitals. Every hospital’s occupational health departments should ensure that all new staff are vaccinated to protect them against microorganisms carried by other patients, and with vaccinated against preventable diseases. This will help to prevent the health workers from occupational exposure to patients’ blood or any other bodily substances, including injury from sharp objects, and also guarantees that the new employees does not infect the patients with infectious diseases. Furthermore, all the new staff should be screened for blood borne pathogenic diseases.
This paper explains Needlestick and Sharp Injuries among Healthcare Workers in Saudi Hospitals. Presently there are number of factors that are responsible for health care workers injuries. Lack of secure environment and ignorance to safety measures can lead to injuries due to Needlestick and Sharp objects. There is a significant need of providing better working environment for health care workers in Saudi Arabia. Following daily practices and World Health Organization’s measures for taking the preventive steps for these injuries is necessary. Trying to avoid utilizing needles whenever secure and efficient substitutes are present, providing needle containers, avoiding re-capping and wearing gloves on both hands are some of the measures that could be taken to make sure these problems do not recur.
Falls are the most common injury causing death or long term disability particularly among children. This study aimed to identify the risk factors of the unintentional injuries due to falls in children aged less than five years in Yemen. This cross sectional study enrolled a total of 439 children under five years old from the emergency department of 6 hospitals in Sana'a city. Multistage sampling was used to select six hospitals from public and private sectors in Sana'a city. Face to face interviews were conducted by using a structured questionnaire. Simple logistic regression and multiple logistic regression were used in the analysis. The prevalence of falls among children under five years old was 21.2%. In the multivariate analysis, factors associated with falls among children were young mother (aOR= 0.9, 95% CI 0.81-0.91), working of mother (aOR= 4.5 95% CI 2.40-7.65), frequent family social gatherings (aOR= 2.7, 95% CI 1.54-4.61), number of children at home (aOR= 2.6, 95% CI 1.43-4.64), chewing khat by father (aOR= 2.4, 95% CI 1.38-4.10), presence of staircase in the house (aOR= 2.1, 95% CI 1.24-3.70), number of rooms at home (aOR= 2.2, 95% CI 1.17-3.99) and disabled children (aOR= 3.3, 95% CI 1.20-9.27). In the study, socio-economic and cultural factors such as family gathering and chewing khat were associated with home fall injury among children under 5 years old in Yemen. Health promotion program should take place to reduce the occurrence of fall injury.
Dengue Fever is a major public health issue in Malaysia. This study aimed to assess knowledge, attitude and practice regarding dengue fever and effectiveness of health education programme among 204 students of Alam Shah Science School, Cheras/Kuala Lumpur. Study design was a cross sectional study followed by an interventional (pre-post) Study. The self-administered questionnaire included questions on sociodemographic factors, knowledge, attitude and practice regarding dengue fever. Majority of respondents were Malays (96.6%), monthly family income more than RM 3000 (64.6%) and lives in urban area (64.6%). There was no significant association between knowledge status and socio-demographic factors (p-value>0.05). Most of the respondents had good knowledge (63.2%) good attitudes (79.9%) regarding dengue fever. However, practices to prevent dengue was poor (74.0%). Only about one-fifth of the respondents (18.2%) believed that dengue fever is a flu-like illness. Knowledge score was significantly increased after health education programme (p value
A cross»sectional study was conducted to determine the knowledge on family planning among Malay women who delivered at Hospital Universiti Sains Malaysia (H USM), Kelantan and their husbands. Three hundred and fifty five women were selected by systematic random sampling. An interview-guided questionnaire that included infomation on socio-demographic, obstetric and knowledge on family planning was conducted to the women and self-administered questionnaire was given to their husbands. There were 15 questions on knowledge which were validated prior to the study. More than half of the women (53.5%) and the husbands (57.7%) had poor knowledge score (less than 75%) on family planning. A majority (86.8%) of the women and 87.9% of the husbands knew the optimal age of a woman to be pregnant, but very few (3.4%) of the women and Ss 1% of the husbands could answer correctly all the questions on the effects of poor spacing. The level of knowledge on family planning among Malay women who delivered at H USM and their husbands were poor. Therefore, new and improved health education materiab and programmes are needed, to target both the women and their husbands.
Hysterectomy is one of the most common non-obstetric surgical procedures performed on women. Little is known about the factors affecting decision making process regarding hysterectomy in Malaysia. The study aimed to explore factors affecting women decision regarding hysterectomy among Malaysian women. This study has enrolled 100 women eligible for hysterectomy in the department of general gynecology ward in the university of Malaya hospital, Malaysia. A structured questionnaire was administered by interview. Descriptive analysis was used to obtain the frequencies. Chi square test and simple logistic regression test were performed to assess the association between variables. The majority of participants aged 41-50 years (52%) and married (74%). Twenty seven out of 100 participants made their decision on the operation within one month while 73 women decided after one month. Some complications were only known by the minority of patients such as injury to ureter (47%), injury to nerve (8%), incision hernia (18%), vault prolapse (21 %), and deep vein thrombosis (43%). Most of women delay their decision on the surgery (73%). Factors associated significantly with decision were ethnicity, religion, knowledge on complication, discussion with spouse and doctor.. Cultural factors, opinion of husband and doctors and knowledge of the complication play an important role in the decision of women. It is important to provide suitable information and social support for patients to help them in their decision-making. Participation and support from spouses and doctors should also be encouraged.
In August 2000, the Disease Control Unit of T erengganu noted an increase in the number of serologically confirmed cases of hepatitis A virus (HAH in Kuala Terengganu Hospital. Preliminary investigation revealed that there were an outbreak of hepatitis A in districts of Kuala Terengganu and Marang. Eventually, a total of 334 associated cases were reported among Kuala Terengganu residents and 59 cases among residents of Marang. The age of the patients range j9·om 2 years to 71 years old (median 16 years). Males accounted for ( 69.5% of cases and had a higher sex specyic attack rate (96.35/100,000) than females (42. 70/100,000). The highest attack rate (128.3/100,000} occurred among patients aged 10 — 14 years. The health staff of Kuala Terengganu and Marang District Health Ojice had investigated a total of 229 case. Most cases (62.4%) occurred amongst school children. A case control study was carried out amongst 35 cases that were matched with 71 controls by age group, class and sex, to identyy the potential source of injection. The results indicated that eating fried noodle with shelh‘ish significantly increased the risk of being infected during the outbreak (OR 16.38[4.2l-74.53]).
The increased use of health care services by elderly has placed greater pressure to an already strained health care resources. Thus, an accurate economic cost estimation for specific age-related diseases like dementia is essential. The objectives of this project are to estimate costs of treating patient dementia among Malaysian elderly in the hospital settings. Two types of data were collected: Hospital costing data (using costing template) and patient clinical data (using questionaire). The cost analysis for hospital setting was carried out using a step-down costing methodology. The costing template was used to organize costing data into three levels of cost centers in hospitals: overhead cost centers (e.g. administration, consumables, maintenance), intermediate cost centers (e.g. pharmacy, radiology), and final cost centers (all wards and clinics). In estimating the cost for each cost center, both capital cost (building, equipment and furniture cost) and recurrent cost (staff salary and recurrent cost except salary) were combined. Information on activities which reflects the workload such as discharges, inpatient days, number of visit, floor space etc., are gathered to determine an appropriate allocation factor. In addition, for each final cost center, the fully allocated costs are then divided by the total unit of in-patient days to obtain the cost of providing services on a per-patient per-day of stay basis, referred as unit cost. The unit cost is finally multiplied with the individual patient’s length of stay to obtain the cost of care per patient per admission. All these steps were simplified by using the Clinical Cost Modeling Software Version 3.0 (CCM Ver. 3.0). The mean cost of dementia cases per episode of care was RM 12,806 (SD=10,389) with the length of stay of 14.3 (SD=9.9) days per admission. The top three components of cost for the treatment of dementia were the ward services 8,040 (SD=7,512), 62.78% of the total cost, followed by the pharmacy 1,312(SD=1,098), 10.25% of the total cost and Intensive Care Unit 979 (SD=961), 7.64% of the total cost. A multivariable analysis using multiple linear regressions showed that factors which significantly influence (p<0.05) the treatment costs of dementia cases were the length of stay (p<0.001), followed by age (p=0.001), case type severe (p=0.005) and study location (p=0.032). However, the factor length of stay is the tremendous parameter. In conclusion, data collection from selected hospitals as well as patient level data from medical record unit were successfully used to estimate the provider costs of hospital for the elderly with dementia disease. Results from the project will enable an assessment on the economic impact and consequences of cognitive impairment in an aged population. A cost quantification and distributive mapping of the burden of care can assist in policy implementation through targeted intervention for at-risk groups, which will translate into savings by means of delayed onset or progression of dementia.
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.
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.