Accepted 21 July 2011.
Introduction The extensive and intensive use of pesticides in agricultural practices has exposed farmers to various hazards resulting in varying degrees of health
Methods We conducted a cross-sectional study among paddy farmers in Sabak Bernam district, Malaysia. The objective of this study was to gather baseline information on chlorpyrifos blood level and its relationship with pesticides exposure symptoms.
Results We detected chlorpyrifos in farmers’ blood in 7 percent of the respondents, with mean 7.29 nanogram per millilitre blood (sd 5.84 nanogram per millilitre). The percentage of farmers who experienced at least one pesticide exposure symptoms was 75 percent. However, we found no significant association between chlorpyrifos blood level and its exposure symptoms. The farmers had low scores on safe practice of pesticide use even though they have high marks on knowledge and attitude. We found no significant association between the scores on knowledge, attitude and practice on pesticide use and the chlorpyrifos blood level.
Conclusions The presence of pesticide exposure symptoms proved that most of the farmers were exposed to hazardous effects of pesticides. Specific trainings on safe use and handling of pesticides should be given on regular basis to these farmers to ensure they are protected from hazardous effects of pesticides exposure.
Accepted 23 August 2011.
Introduction There is a strong correlation between stress and the quality of care provided by informal carers. In this regard, an accurate understanding about factors
contributing to stress among informal carers is crucial in order to find appropriate interventions to solve their problems.
Methods A pilot study was conducted in October 2009 in the Klang Valley area, to test the instrument liability in the local context. In-depth interviews were conducted with two informal caregivers who are providing full-time care for their chronically-ill family members.
Results Informal caregivers face multiple types of stress. A variety of factors such as financial problems, an unsupportive community, fatigue, the unavailability of social services to assist them and their inability to accept the fact that their loved ones are terminally ill, contribute to their stress.
Conclusions Differences in factors contribute to stress, and lead to the adoption of different styles of coping strategies: emotion and problem focused coping.
Introduction The prevalence of Type 2 diabetes mellitus (T2DM) is increasing worldwide
and many of these affected individuals remain unidentified. Undiagnosed
T2DM may impose substantial public health implications because these
individuals remain untreated and at risk for complications. The objective of
this study was to determine the national prevalence of undiagnosed T2DM
and to identify the associated risk factors.
Methods A nationwide cross-sectional study was conducted involving 17,783
respondents. Two-stage stratified sampling design was used to select a
representative sample of the Malaysian adult population. Structured
validated questionnaires with face to face interviews were used to obtain
data. Respondents, who claimed that they were not having diabetes, were
then asked to perform a fasting blood glucose finger-prick test by Accutrend
Results The prevalence of undiagnosed T2DM was 8.9% (n=1587). The highest
percentage of undiagnosed T2DM was found among males (10.2%), 55-59
years old (13.4%), highest education attainers of primary school (11.1%),
Indians (10.3%), married (10.3%), working (8.9%) and living in the urban
areas (9.2%). Multivariate analyses showed that factors associated with
undiagnosed T2DM were gender, age group, ethnicity, marital status, obesity
Conclusion This study found an increasing trend of undiagnosed T2DM in Malaysia
compared to 2006. This finding is alarming as risk factors associated with
undiagnosed diabetes were related to most of the socio-demographic factors
studied. Therefore, early diabetic screening is crucial especially among adults
aged 30 and above to prevent more serious complications of this disease.
Introduction During haze, at what level should Air Pollutant Index (API) showed, public
or private school be closed is not without controversy and is very much
debated. Therefore, the aim of this paper is to objectively quantify the
potential inhaled dose of PM10 associated with exposure at school and home
microenvironments during haze. The result of the health risk assessment will
be used to propose the API level for closing the school during haze episode.
Methods A hypothetical haze exposure scenario was created using the breakpoints of
PM10 concentration for calculation of API and respective inhaled dose during
haze. To determine the potential inhaled dose, we have considered many
factors that include time spent for specific physical intensity at school and
home microenvironments, age-specific and physical intensity-specific
inhalation rate (m3/min), and the indoor/outdoor ratio of PM10. To calculate
risk quotient (RQ), the inhaled dose was compared with the health reference
dose computed based on the concentration of PM10 in the Malaysian
Ambient Air Quality Standard.
Results When considering the specific exposure at each microenvironment (school
and home), the potential inhaled dose of PM10 was substantially lower when
school is closed for both primary and secondary school. The calculated risk
quotient (RQ) indicates that primary school children are likely to be affected
at slightly lower PM10 concentration (equivalent to API of 197) as compared
to secondary school children. Short duration of high physical activity
intensity during school breaks has contributed to a large proportion of inhaled
dose among school children indicating the important to avoid physical
activities during haze.
Conclusion Based on the assessment, taking into account the uncertainty of risk
assessment methodology, we proposed school to be closed when API reach
190 for both primary and secondary schools. These findings and
recommendations are only valid for naturally ventilated school and applicable
in the context of the current API calculation system and the existing
Recommended Air Quality Guideline values in Malaysia.
Introduction Prolonged mechanical ventilation among cardiac surgery patient has been
found to be correlated with negative clinical outcome and increased
healthcare resources utilization. Prolonged mechanical ventilation (PMV)
was defined as the accumulative duration of 24 hours or more of
postoperative endotracheal intubation starting from transfer of the patient to
cardiac ICU. This study is aimed to identify the risk factors preoperative,
intra operative and postoperative for prolonged ventilation among cardiac
patients in AL-Thawra Modern General Hospital (TMGH).
Methods Observational study design was conducted during a two-month period (from
1 August 2014 to 30 September 2014). It was among 70 patients who were
admitted to cardiac surgery intensive care unit in Al-Thawra Modern General
Hospital and selected by convenient sampling. The soci-demographic
characteristic and clinical patient data were collected using short
questionnaire developed by researcher. All patients had the same anesthetic
and postoperative management. Statistical analysis was performed with SPSS
version 20 and using bivariate analysis and multivariate logistic regression.
The p-value of < 0.05 was found to be statistically significant.
Results Incidence of prolonged mechanical ventilator post cardiac surgery was 37.1%
(26/70) through bivariate analysis, multivariate logistic regression. Low
Ejection fraction of Left Ventricle was inversely related to mechanical
ventilation time (AOR= 0.872) with 95% confidence interval [0.790 - 0.963],
hemodynamic instability were associated with prolonged mechanical
ventilation time (AOR=16.35) with 95% confidence interval [2.558 -
Conclusion Low ejection fraction of Left Ventricle and Hemodynamic Instability post
operation were identified risk factors for prolonged mechanical ventilation
post cardiac surgery.
Air pollution has been widely known to have an influence on health of the general population.
Air pollution can result from natural causes, human activities and transboundary air pollution.
Weather and climate play crucial role in determining the pattern of air quality. In recent years,
air pollution and recurrent episodes of haze has become a major concern in Malaysia.
Surveillance data on concentrations of main air pollutants such as carbon dioxide, (CO2),
Nitrogen Dioxide (NO2), Ozone (O3), sulphur dioxide (SO2) and particulate matter (PM10)
were found to be higher during the haze days and this may have an impact on health of the
community as reflected by an increase in hospital admissions particularly the respiratory and
Introduction Overweight and obesity is a major public health problem in Malaysia. This study aims to determine the prevalence of overweight and obesity among the Malaysian adult population and their association with socio-demographic characteristics (gender, ethnic, and age groups).
Methods A total of 17,257 adults aged 18 years and older (8,252 men, 9,005 women)
were assessed for BMI status, with a response rate of 97.8%, through a household survey from the National Health and Morbidity Survey (NHMS), conducted in all states of Malaysia in 2011.
Results All socio-demographic factors were consistently associated with higher chance of being overweight (except gender and location) and obesity (except location and household income). The identified risk of overweight were
Indian (aOR: 1.8, 95% CI: 1.2-2.8), aged 50-59 years (aOR: 2.8, 95% CI: 2.0-3.9), widower (aOR: 1.6, 95% CI: 1.3-2.0), subject with secondary education (aOR: 1.2, 95% CI: 1.0-1.4), Homemaker/unpaid worker (aOR:
1.3, 95% CI: 1.1-1.4), and with high household income group (aOR: 1.3, 95% CI: 1.2-1.6). The identified risk of obesity were women (aOR: 1.4, 95% CI: 1.2-1.6), Indian (aOR: 1.7, 95% CI: 0.9-3.2), aged 30-39 years (aOR: 3.6,
95% CI: 2.4-5.5), widower (aOR: 1.2, 95% CI: 0.9-1.6), subjects with primary education (aOR: 1.2, 95% CI: 0.9-1.6), Homemaker/unpaid worker (aOR: 1.3, 95% CI: 1.1-1.6), and with middle household income group (aOR: 1.3, 95% CI: 1.2-1.6).
Conclusions Our data indicate a high prevalence of overweight and obesity in the
population. Several sociodemographic characteristics are associated with both overweight and obesity. This study highlights the serious problem ofoverweight and obesity among Malaysia adults. Documentation of these problems may lead to research and policy agendas that will contribute both to our understanding and to the reduction of these problems.
Study name: National Health and Morbidity Survey (NHMS-2011)
Introduction The risk factors associated with mental health among adolescents are usually
described by researchers at an individual level. Neighbourhood factors and
health have opened a new insight into the field of epidemiology. The aim of
this study was to assess the reliability and validity of a newly developed
Neighbourhood Factors on Mental Health Questionnaire among Malaysian
Methods A cross-sectional study was conducted in four secondary schools in Kuala
Lumpur, Malaysia using a newly developed questionnaire which comprised
of two main domains and seven items. Exploratory factor analysis and
Cronbach‟s alpha were used to measure the instrument‟s construct validity
Results A total of 106 adolescents participated in this research. The majority of
adolescents were 13 years old (40.6%), female (55.7%), Malays (68.9%),
have parents who only studied until secondary school (66.0%) and lived in
flats (32.1%). Bartlett‟s Test of Sphericity was significant (Chi-square =
Introduction Physical activity assessment in children is the first step in assessing the
relationship between activity and health, as well as the determinants of
childhood physical activity and changes in activity level.Physical Activity
Questionnaire for Older Children (PAQ-C) is self- administered
questionnaire to assess physical activity among older children. The objective
of this study was to determine the validity and reliability of Physical Activity
Questionnaire for Older Children in Malay language PAQ-C (M).
Methods The validation study was done among 73 students aged 10 to 17 years old.
The PAQ-C was translated into Malay language using forward and backward
translation. The evaluation of the psychometric properties included internal
consistency, test-retest reliability and criterion validity. Reliability of PAQ-C
(M) was determined using Cronbach alpha and intra-class correlation
coefficient (ICC). The PAQ-C (M) was administered twice in one week
interval to assess test-retest reliability. Criterion validity was assessed
between PAQ-C (M) and 3 Day Physical Activity Recall (3DPAR).
Results The internal consistency of PAQ-C (M) assessment calculated in this study
was α = 0.75 and α = 0.77 for assessments one and two, respectively. The
ICC between individual items of PAQ-C (M) was 0.59 to 0.91, indicating
moderate to good correlation. The Spearmen correlation coefficient between
PAQ-C (M) and 3DPARwas acceptable (r=0.60, p
Introduction Following the reveal of borderline iodine sufficiency among the Sarawakians
from the 2008 National Iodine Deficiency Disorders (IDDs) survey, a
mandatory universal salt iodization (USI) was implemented in Sarawak
thereafter. This study aimed to determine the current status of USI in
Sarawak after a 3-year implementation of USI from 2008 to 2011.
Methods The IDD survey was conducted between Jun 2011 to July 2011 involving six
districts in Sarawak (Sarikei, Mukah, Kapit, Sibu, Bintulu and Miri). The
schools were selected via multistage proportionate-to-population size
sampling technique and the children were randomly selected via systematic
sampling. A total of 19 schools and 661 children were recruited into the
survey. Thyroid size was determined by palpation and was and graded
according to the classification of the World Health Organization (grade 0-2).
The iodine excretion level in spot morning urine was measured using inhouse
microplate method. The urinary iodine concentration (UIC) values
were compared by Kruskal-Wallis test and Chi-square tests were used to
compare categorical variables.
Results A total of 610 school children were participated in the study (92.3%). The
TGR of grade 1 and 2 was found to be 0.3% (n = 2). Overall the median UIC
level was 154.2 (IQR, 92.7 - 229.8) μg/L, with the highest median UIC been
observed in Sarikei [178.0 (IQR, 117.6 - 308.9) μg/L], followed by Mukah
[174.8 (IQR, 99.0 - 224.3) μg/L)], Miri [158.6 (IQR, 92.3 - 235.4) μg/L],
Sibu [147.0 (IQR, 89.8 - 221.4) μg/L], Bintulu [142.3 (IQR, 52.8 - 245.1)
μg/L] and Kapit [131.0 (IQR, 88.6 - 201.9) μg/L]. One in every ten child was
of iodine deficient (UIC < 50μg/L) while a third of the child (32%) were of
adequate level of UIC.
Conclusion The present findings indicate that the mandatory USI successfully improves
the iodine level of children in Sarawak. However, regular and proper
monitoring of the UIC level in the communities is needed to prevent
excessive iodine intake.
Introduction: In maternal healthcare, pre-pregnancy weight is used to predict pregnancy outcomes. Since no recorded data on pre-pregnancy weight, perceived weight is used alternatively. This study examines the relationship between perceived and actual weight among non-pregnant urban Malaysian women of childbearing age and identifies differences in perceived and actual weight by selected socio-demographic characteristics.
Methods: A cross-sectional study was conducted between April and June 2013 among urban Malaysian women attending public health clinics in the Klang Valley. Information on height, perceived current weight and time when their weight was last taken were obtained and actual weight was the average of two measurements (TANITA-HD-323-digital-scale). Socio-demographic data collected were age, ethnicity, education level, marital and employment status and total household income.
Results: Mean age of 371 women in this study was 28.81±5.65, 82.2% were Malays, 62.8% had tertiary education, over 75% were married and employed, with more than half from middle-income households. Overall, the mean perceived and actual weight was 59.29±11.59 and 59.20±11.90 respectively. Pearson‟s Correlation test showed a very strong positive correlation between perceived and actual weight (r=0.957;p<0.0001), ranging between 0.852 to 0.994 among subgroups; 258 (69.5%) perceived their weight accurately (±2.0 kg of actual weight), 49 (13.2%) under and 64 (17.3%) overestimated their weight.Main outliers were among younger women, Malays, tertiary educated, employed, middle-income and had weight last measured a month or more ago.
Conclusion: Strong correlation between perceived and actual weight among women in this study reassured weight perception can be used more confidently in patients‟ history taking and future research among urban Malaysian women using public health services.
Introduction Physical activity reduces risk of non-communicable diseases. Physical
activity prevalence is low due to barriers to physical activity. This study was
conducted to translate the Barrier to Physical Activity (BPA) questionnaire
into Malay and assess the reliability and validity of the translated version
Methods The Malay version of BPA was developed after translating the English
version of BPA through back to back translation process. The Malay BPA
was distributed among 306 volunteered nurses from 5 government hospitals
in Selangor state. Factor analysis, Cronbach’s alpha test and test – retest
reliability was conducted to determine psychometric properties of BPA.
Results Chronbach’s alpha coefficient was 0.79 for perceived benefits items and 0.51
for perceived barrier items (overall was 0.73). The ICC was 0.88 (95% CI:
0.78-0.93) for test-retest testing after 7 days. Two factors components were
yielded through exploratory factor analysis with eigenvalues of 3.9 and 2.0
respectively. Both the factors accounts for 31.4 % of the variance. Factor 1
included 14 items and explained 19.9% of the variance. Factor 2 consisted of
5 items and explained 11.5% of variance. CFA yielded two factor structures
with acceptable goodness of fit indices [x2/df = 23.99; GFI = 0.82, SRMR =
0.09; PNFI = 0.49 and RMSEA = 0.10 (90%CI = 0.09-0.11)].
Conclusions The Malay version of BPA had demonstrated satisfactory level of validity
and reliability to assess barriers to physical activity. Therefore, this
questionnaire is valid in assessing barriers to physical activity among
Introduction There is a strong and increased worldwide interest on the aspects of
prevention of oral disease and oral health promotion in dental education.
However, some studies imply that dental students are not knowledgeable
enough in this issue. This study aimed to evaluate the knowledge of, attitude
towards and practice on preventive dentistry among senior dental students in
Methods Self-administered questionnaires were distributed among senior dental
students in six dental schools in Yemen. The questionnaire obtained personal
information, and questions about knowledge on preventive dental care,
attitudes towards and practice on preventive dentistry.
Results Among 346 students who filled the questionnaire, a total of 91.6% has good
knowledge about fissure sealant effectiveness, only 34.7% knows about the
importance of fluoride toothpaste compared to brushing technique in
preventing caries, with significant gender difference (p=0.005). Odds of good
knowledge among non-Qat chewers was 1.9 (95%CI: 1.26-4.42).
Multivariable regression analysis indicated that female gender was associated
with higher positive attitudes (OR: 2.03, 95%CI:1.21-3.36,p=0.007).
Attitudes were significantly associated with Qat chewing (OR = 1.95,
95%CI: 1.04-3.66, p=0.03), type of university (OR = 0.59, 95%CI: 0.36-0.94,
p=0.02), and mothers' level of education (OR = 1.91, 95%CI: 1.05-3.47,
p=0.03). There was a high percentage of competency in practicing preventive
measures among students (80.9%).
Conclusions Dental education should emphasize the overall aspects of preventive dentistry
with early exposure of preventive dental training in order to improve
students' knowledge and attitudes and consequently practice on preventive
Introduction An Analysis of a Survey Questionnaire on health care workers’ knowledge and practices regarding of infection control and complains them to apply universal precautions. Health care workers are at substantial risk of acquiring blood borne pathogen infections through exposure to blood or other products of patients. To assess of infection control among health care workers in Sana'a healthcare centers, Yemen.
Methods A cross-sectional study was conducted in the health center to assess knowledge and practices regarding of infection control among 237 health workers in Sana,a city. A structured self-administered questionnaires were used and data was analyzed using SPSS version 20 and the associations were tested with chi-square, with p-value of < 0.05.
Results The health care workers in public centers ware (51.1%) and (48.9%) of them works in private centers. One hundred and seventeen (49.4%) respondents had poor infection control knowledge, 113 (43.5%) had fair knowledge, and 17 (7.2%) had good knowledge. The knowledge was significantly associated with type of center (P < 0.018), such that the public center had the highest proportion with poor knowledge. And nurses and midwife having the highest proportion with fair knowledge of infection control. Eight (3.4%) respondents had a poor practice of universal precautions, 93 (39.2%) had fair practice, and 136 (57.4%) good practice. The practice was significantly associated with the profession, level of education and work experience (P < 0.001), (P < 0.006), (P < 0.001) respectively, and nurses and midwives as the profession with the highest proportion with good practice.
Conclusion We conclude that the practices and knowledge of universal precautions were low and that's need for intensive programmes to educate health care workers on various aspects of standard precautions and infection control programmes and policies.
Introduction Family satisfaction is referred to the extent in which family members feel
happy and fulfilled with each other. However, there has been lack of
evidences on the family satisfaction scale within the Malaysian context.
Therefore, the aim of this study was to assess validity of the Malay version of
the Olson’s Family Satisfaction Scale. This is to allow Malaysian researchers
to bring family satisfaction in line with the different field of studies.
Methods This study was conducted among 567 Malaysian working women. Data were
collected using self-administrated questionnaires. This study conducted
exploratory and confirmatory factor analysis, convergent validity and internal
consistency using Cronbach’s alpha.
Results The findings of this study support the uni-dimensionality of the Malay
version of the family satisfaction scale. The 10 items of the scale account for
68.1% of the total variance and the un-rotated factor loadings ranged from
0.76 to 0.87. Confirmatory factor analysis was run and supported the
structure of family satisfaction scale. The results of confirmatory factor
analysis using AMOS 21 in the current study reported the following indices:
RMSEA= 0.06, CFI= 0.94, NFI= 0.94, TLI= 0.93. The convergent validity
(average variance extracted= 0.65) and the internal consistency (Cronbach’s
alpha= 0.94) of this construct were adequately supported.
Conclusions The findings support the factor structure, convergent validity and the internal
consistency of the examined construct. Therefore, Malay version of the
family satisfaction scale is a valid and reliable instrument among Malaysian
Introduction Helminthiasis is a common parasitic condition particularly among children in
rural areas in developing countries where poor hygiene standard is practiced.
The study aimed to determine the prevalence of helminthiasis among Indian
preschoolers in urban areas in Penang and its associated factors.
Methods A total of 194 urban Indian preschoolers aged 4 to 6 years old were selected
randomly from 11 kindergartens in the state of Penang for this cross sectional
study. Data collection was carried out in 2 phases. First, microscopic stool
examinations were done to examine the presence of helminths. Second, self
administered questionnaires which inquired about human, environment and
socioeconomic factors were completed by the parents/guardians.
Results The overall prevalence of helminthiasis was 7.2% and the most frequently
encountered infective agent was Ascaris lumbricoides (57.1%) and followed
by the tapeworms (42.86%). The logistic regression indicated that habitual
thumb sucking (AOR= 5.6. 95%CI: 1.73-18.39) and families owning
domestic pets (AOR= 3.2; 95%CI: 1.03-10.14) were the significant
contributing factors to helminthiasis among the Indian pre-schoolers in urban
Penang. Although the prevalence of helminth infection among the urban
Indian preschoolers is lower than rural area, it is still a public health concern.
Children habitual thumb sucking and rearing domestic pets at home were the
significant contributing factors in helminthiasis.
Conclusion Prevention strategy should focus on health education and promotion among
adults and children, awareness on domestic animal hygiene and maintaining
good environmental sanitation. Multi agency collaboration is clearly
essential, especially between state health, education and veterinary
departments in curbing this disease.
Introduction This paper aims to investigate the potential pesticide dermal contamination
among the agricultural community by observing the microenvironmental and
macroactivity interaction between farm children and adult farmer.
Methods A 24 hours timeline activity was observed and recorded in the agricultural
farming village, Kuala Selangor. In this study, 2 homes were monitored for 2
days following a pesticide application. A total of 2 adult farmers and 5
children (7-10 year old) were recruited to participate in this study. Twentyfour
hour videotape segments and time-activity diaries were collected during
Results The microenvironment and macroactivity interaction were modelled in this
study. By considering only the potential dermal exposure pathway, the
different biological vulnerability and exposure pattern to pesticides were
observed. Finding showed a greater extent of interaction between human and
its environment, where adult farmers are the main contributor of
environmental contaminants, and children is one of the vulnerable receivers
of the contaminants’ residuals from the environment.
Conclusion The daily activities and behaviors practiced by the agricultural community
were among the contributing factors which help to highlight the pesticide
dermal contamination pathway in the farming village. This study
recommends the necessary to consider the microenvironment and
macroactivity of the target community when assess their exposure levels to
the environment contaminants.
Introduction Anxiety and depression were known to bring detrimental outcome in patients
with ischemic heart disease (IHD). Notwithstanding their high prevalence
and catastrophic impact, anxiety and depression were unrecognized and
untreated. The aim of this study was to determine the prevalence of anxiety
and depression among IHD patients and the association of this condition with
clinical and selected demographic factors.
Methods This was a cross-sectional study on 100 IHD patients admitted to medical
ward in UKMMC. Patients diagnosed to have IHD were randomly assessed
using Hospital Anxiety and Depression Scale (HADS) and Perceived Social
Support (PSS) Questionnaire. Socio-demographic data were obtained by
direct interview. Fifteen percent of IHD patients in this sample were noted to
have anxiety, fourteen percent noted to have depression while thirty two
percent was noted to have both anxiety and depression. Patients’ age group
and the duration of illness were found to have significant association with
anxiety. Socio-demographic data were obtained by direct interview.
Results Fifteen percent of IHD patients in this sample were noted to have anxiety,
fourteen percent noted to have depression while thirty two percent was noted
to have both anxiety and depression. Patients’ age group and the duration of
illness were found to have significant association with anxiety. The other
clinical and selected demographic factors such as gender, race, marital status,
education level, occupation, co-existing medical illness and social support
were not found to be significantly associated with anxiety or depression
among the IHD patients.
Conclusions In conclusion, proper assessment of anxiety and depression in IHD patients,
with special attention to patients’ age and duration of illness should be
carried out routinely to help avert detrimental consequences.
Introduction Validation of instruments is essential when assessing physical activity (PA).
The aim of this study was to validate a Malay language version of the
International Physical Activity Questionnaire (IPAQ-M) against Actical
accelerometer and to determine its reliability and validity.
Methods A total of 90 Malay adults aged 35-65 years old participating in The
Malaysian Cohort project were recruited for this study. The IPAQ-M is
comprised of 12 items, covering vigorous, moderate, walking, sitting and
sleeping activities, and was administered on two occasions (Day 1 and Day 9)
by interviewing the participants. Participants wore the Actical accelerometer
for seven consecutive days between the two interview sessions.
Results Validity tests showed that time spent in moderate-vigorous physical activity
(MVPA) (min wk-1) from IPAQ-M was significantly correlated with MVPA
from accelerometer (=0.32, p
Introduction Cardiovascular diseases are a major component of non-communicable
diseases and include coronary heart disease, stroke and peripheral vascular
disease. Public health strategies to address cardiovascular disease require
three elements: surveillance, health promotion, and individual health care.
Methods Surveillance includes monitoring of mortality and morbidity as well as
surveys to monitor risk factors levels in the community. Data on mortality
from cardiovascular diseases are readily available and analysed by age and
sex specific rates looking are secular trends, geographical and ethnical group
variations and international comparisons. However many deaths from
cardiovascular disease occur suddenly and the cause of death may be
registered without autopsy or any other validation. Cardiovascular morbidity
information is more difficult to collate and interpret as it is closely related to
availability and access to health care. Periodic surveys of cardiovascular risk
factors are essential in monitoring the underlying trends in blood pressure,
smoking, cholesterol, obesity, and diabetes as they predict future trends, and
support planning for prevention and healthcare.
Results Prevention and health promotion activities are informed by the levels and
trends in cardiovascular disease and its risk factors. There has been debate
about population health promotion and individual health care strategies, but
both are necessary. Cigarette smoking, nutrition and physical exercise are the
main behaviours to be addressed but these are complex and require
multifaceted approaches. Education alone is insufficient to change health
behaviours and health promotion needs to look to changing attitudes.
Legislation, taxation and other fiscal interventions have been shown to be
effective however these can be difficult for legislators as there are other
competing interests, particularly in the area of nutrition and tobacco. Creating
health promoting environments that make healthy behaviour choices easier
can be beneficial.
Conclusions Health care interventions are also effective in reducing the burden of
cardiovascular disease. A balanced approach of health promotion and
individual health care is recommended in the development of a strategy for