Body weight can be estimated using equations developed from the anthropometric measurements when body weight is difficult to measure for example among bedridden older adults. This study has developed the equation to estimate body weight among older adults resided in Klang Valley from several anthropometric measurements. A cross sectional study was carried out among community dwelling older adults aged 60 years old and above in Klang Valley area. Subjects were recruited through convenience sampling method. Weight, height, knee height (KH), demi span (DS), subscapular skinfold (SSF), calf circumference (CC), waist circumference (WC), hip circumference (HC), mid upper arm circumference (MUAC) and wrist circumference (WrC) were measured according to the standard protocol. Cross validation was performed. 61% from total subjects were selected randomly for the development of equation meanwhile, 39% subjects as control subjects. Equation was generated using stepwise multiple regression analysis. A total of 164 older adults involved in this study which consist of 39.0% men and 61.0% women. Mean age of the subjects was 68.32 ± 5.79 years meanwhile mean of measured body weight was 66.46 ± 11.98 kg. Predictive equation obtained was: estimated body weight = 5.149 (Sex) – 0.082 (Age) + 0.889 (Hip circumference) + 1.112 (Knee Height) – 72.778 (R2 = 0.848, p < 0.001). Correlation coefficient for 61% subjects were higher (r = 0.921) compared to the correlation coefficient for 39% subjects (r = 0.883) (p < 0.001). However, the differences between measured and estimated body weight was not significant (p = 0.798). This showed that the equation developed was able to estimate body weight among older adults, because the value of estimated body weight was closed to the value of measured body weight. The equation developed can be used to estimate body weight among Malaysian older adults. However, further study is warranted to explore this equation into the different settings such as clinical setting.
The expansion of ageing population has gained much public attention on the importance of healthy and successful ageing,
which is absence of major chronic diseases, preserved physiological and cognitive functioning and active engagement
with life. Previous studies have found there was a significant correlation between physical fitness with cognition. However,
the relationship between physical fitness with successful and unsuccessful cognitive ageing groups are very limited. This
study was aimed to identify the significant physical fitness components that contribute in reducing risk of cognitive decline
represented as different cognitive ageing groups. A total of 300 community-based elderly aged 60 and above from the
states of Selangor, Perak and Kelantan were recruited using multistage random sampling method in this cross-sectional
study. Cognitive function of subjects was categorized into three groups, namely Mild Cognitive Impairment (MCI) (n
= 100), Usual Ageing (UA) (n = 100) and Successful Ageing (SA) (n = 100) based on defined criteria. Senior Fitness
Tests included 2-minute step, handgrip strength, chair stand, chair sit-and-reach, 8 foot up-and-go and back scratch
were measured to determine the cardiorespiratory fitness; muscle strength; agility and flexibility of subjects. SA group
had significantly better performance than non-SA groups in all fitness components, except for chair sit-and-reach. After
controlling for age, gender, education years and smoking status, handgrip strength and chair stand tests were associated
with a reduced risk of MCI by 7% [OR: 0.93, 95% C.I: 0.88-0.99, p < 0.05] and 15% [OR: 0.85, 95% C.I: 0.75-0.95, p <
0.01], respectively. These findings suggest that older adults with higher upper and lower body muscular strength could
serve as protective factors for cognitive impairment. Further research is warranted to evaluate the mechanism of physical
and cognitive decline such as Motoric Cognitive Risk Syndrome (MCR) in more detailed for the purpose for promoting
healthy and successful ageing.
Urinary incontinence (UI) is a common disorder among older adults, with a global prevalence between 2% to 58%. UI has been associated with social isolation, increased morbidity and reduced quality of life (QoL). The aim of this study was to investigate the sociodemographic, clinical, cognitive and physical function risk factors of UI among Malaysian community dwelling older adults. This study is part of a larger scale population based longitudinal study on neuroprotective model for healthy longevity among older adults (LRGS TUA). A total of 1560 Malaysian community dwelling older adults aged 60 years and above were screened in this phase III LRGS study. Participants sociodemographic and clinical history were obtained. Mini Mental State Examination (MMSE), Rey Auditory Verbal Learning Test (RAVLT) and Digit Span tested cognitive function. Timed Up and Go Test (TUG), Hand Grip Strength Test, Chair Stand Test and Lawton Instrumental Activities of Daily Living tested physical function. The overall prevalence of UI was 15.7% (n = 245) in this study, with 11.8% (n = 88) in men and 19.3% (n = 157) in women. Logistic regression analysis showed that TUG (Adjusted odds ratio [OR], 1.071; 95% confidence interval [CI], 1.02-1.13), MMSE (OR, 0.93; CI, 0.90-0.97), weight (OR, 1.02; CI, 1.00-1.03), and constipation (OR 0.60; CI, 0.46-0.78) (p < 0.005) were significant risk factors of UI. The results indicate, decreased physical and cognitive function; increase in weight and having constipation increased the risk of UI. Maintaining optimum mobility, cognitive function, body weight and constipation prevention are vital in the prevention and management of UI among older adults.
Falls is a global health concern due to its many negative consequences in older adults. Early falls screening and prevention is important among older adults. We developed Falls Screening Mobile Application (FallSA) as a self falls screening tool among older adults. FallSA was developed using data of physical performance test, demographic information and questions to inform falls risk from a larger population based longitudinal study on neuroprotective model for healthy longevity among older adults (LRGS TUA). The aim of this study was to determine validity and reliability of FallSA as a self-screening tool to inform falls risk among Malaysian older adults. This cross sectional study was conducted among 91 community dwelling older adults aged 60 years and above. FallSA was validated against Physiological Profile Assessments (PPA), a comprehensive falls risk assessment tool. Participants used FallSA to test their falls risk by repeating the test twice between an hour. Validity and test–retest reliability of FallSA was examined by using Spearman correlation, Kappa, Sensitivity and Specificity, Intra correlation coefficient (ICC), Cronbach alpha and Bland-Altman. Concurrent validity test was significant with moderate correlation rs = 0.518, p < 0.001, moderate agreement K = 0.516, p < 0.001 and acceptable Sensitivity: 80.4% and Specificity: 71.1%. Reliability of FallSA was shown to be good (ICC: 0.948, CI: 0.921-0.966), good internal consistency α = 0.948, p < 0.001 and good agreement was indicated by small mean differences and narrow limits of agreement (LoA). The results of this study suggest that FallSA was a valid and reliable tool to inform falls risk among Malaysian older adults. Further prospective studies are required to determine the accuracy of FallSA to correctly classify older adults into fallers and non-faller groups.
Older adults who walk in their neighbourhood with greater street connectivity are reported to have lower limb physical performance decline. There is limited information regarding the association between built environment characteristics and physical performance in older adults. The aim of this study was to examine the association between built environment characteristics, physical performance, falls risk and functional mobility among older adults. Sixty four (27 men and 37 women) community dwelling older adults aged 60 years and above (mean 67.4 ± 7.1 years) from senior citizen clubs in Kuala Lumpur, Malaysia participated in this cross-sectional study. Built environment characteristics were assessed using an adapted Neighbourhood Environment Walkability Scale (NEWS). Physical performance and falls risk was measured using Short Physical Performance Battery (SPPB) and Profile Physiological Profile Assessment (PPA) respectively. Timed Up and Go (TUG) and gait speed tests were used to assess functional mobility. There was a significant correlation between built environment and physical performance (r = 0.43, p < 0.001) and functional mobility measured using gait speed test (r = 0.27, p < 0.05) among older adults. Built environment was identified as a significant determinant of physical performance (R2 = 0.19, p < 0.001). Built environment characteristics is an important external factor in preserving physical performance in older adults. Programmes and policies for a more favourable built environment characteristics in the neighbourhoods should be encouraged to promote and maintain physical performance among older adults.
Applied Behavior Analysis (ABA) is a technique used to teach children with autism a variety of skills. In ABA, children with autism often do not receive reinforcers because they have difficulty performing their targeted behaviors, which consequently leads to challenging behaviors. Objectives of this study are to increase spontaneous request and decrease challenging behavior among children with autism by introducing a secondary reinforcer during therapy based on ABA model. Secondary reinforcer has lower reinforcing value than the primary reinforcer. When the children tried but were unable to produce their targeted behavior, they were given the secondary reinforcer. The children were divided into two groups, five children in the intervention group and four children in the control group, and they were taught specific target requesting behavior (TRB) to request for a preferred item. Three children in the intervention group recorded an increase in spontaneous request and a reduction in challenging behaviors. Only two children from the control group recorded an increase in spontaneous request and a decrease in challenging behaviors. However, only children from the intervention group were able to maintain their performance during the generalization sessions. The results suggest that children respond differently to specific prompts and interventions. Future studies should focus on how prompts affect children’s performance and also on reinforcer selection. Bigger scale studies are still needed to further determine the effectiveness of a secondary reinforcer in assisting the learning of requesting skill and in reducing challenging behaviors among children with autism during therapy based on ABA model.
Kehilangan jisim tulang adalah lebih ketara selepas menopaus. Jangka masa menopaus dan umur yang meningkat dikaitkan dengan penurunan jisim tubuh tanpa lemak, peningkatan lemak badan dan peningkatan berat badan. Kajian ini melihat sumbangan relatif jisim tubuh tanpa lemak dan lemak badan ke atas ketumpatan mineral tulang (KMT) di kalangan 139 wanita Cina posmenopaus sihat di Kuala Lumpur. KMT di kawasan seluruh tubuh, tulang belakang ( L2-L4), leher femur dan keseluruhan tulang pinggul diukur dengan alat dual-energy X-ray absorptiometry (DxA). Hasil kajian mendapati 80% daripada wanita posmenopaus Cina mempunyai jisim tulang yang rendah (osteopenia) manakala 8% daripada mereka mengalami osteoporosis di bahagian tulang belakang atau tulang pinggul. Secara keseluruhan, lemak badan mempunyai korelasi yang positif dengan KMT di semua bahagian diukur (keseluruhan tubuh, r = 0.265, p < 0.001; tulang belakang r = 0.214, p < 0.05, leher femur, r = 0.254, p < 0.001; keseluruhan tulang pinggul r = 0.332, p < 0.001). Jisim tubuh tanpa lemak juga mempunyai korelasi yang positif dengan KMT kebanyakan kawasan diukur (keseluruhan tubuh, r = 0.239, p < 0.001; leher femur r = 0.365, p < 0.001; keseluruhan tulang pinggul r = 0.352, p < 0.001) kecuali tulang belakang. Analisis regresi menunjukkan lemak badan dapat meramal KMT pada keseluruhan badan (p < 0.0001) dan tulang belakang (p < 0.005) manakala jisim tubuh tanpa lemak dapat meramal KMT pada tulang femur dan tulang pinggul (p < 0.0001). Hasil kajian menunjukkan kedua-dua lemak tubuh dan jisim tubuh tanpa lemak memainkan peranan dalam mempengaruhi KMT, di mana lemak badan memainkan peranan yang lebih di kalangan wanita posmenopaus. Oleh itu, wanita posmenopaus perlu elakkan mempunyai berat badan yang terlalu rendah (kurang lemak badan) dan mengekalkan jisim tubuh tanpa lemak untuk mencegah osteoporosis.
Children with dyslexia are commonly associated with gross motor difficulties. However, this non-literacy symptom is often overlooked as an important feature of dyslexia. Therefore, the aims of this study were to determine gross motor skills status among children with dyslexia and to compare the gross motor skills between younger and older children. A cross-sectional study was conducted on children with dyslexia from government schools and Dyslexia Association Malaysia. The participants were divided into two groups, namely younger (4 to 10 years) and older children (11 to 17 years old), and were recruited randomly. The gross motor skills were measured using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) (subtests: Body Coordination, and, Strength and Agility) and the Movement Assessment Battery for Children, Second Edition (MABC-2) (subtest: Aiming and Catching). Standard scores and percentile rankings were used for statistical analysis. A total of 82 children with dyslexia were recruited for this study, consisted of younger (n = 57) and older groups of children (n = 25). The younger children were found to have a significantly lower performance in gross motor skills in Body Coordination (Mdn = 48, IQR = 26-63), compared to the older children, (Mdn = 54, IQR = 30-77), with a small effect size (r = -.25). There were no significant different for other findings. The older children were found to demonstrate the highest level of gross motor skills. This study may suggest the need for an early intervention program for young age children with dyslexia. Future studies that assess gross motor skills using longitudinal design are recommended to investigate the changes in gross motor performance over time.
From 101 records relating to health kept in the National Archives of Malaysia for the period 1946–1981, 30 records were chosen using purposive criterion-based sampling on dimensions of universal health coverage (UHC) and health system governance. From those 30, document review was performed on 13 records that were selected based on relevance to analysis of the evolution of private and public health institutions and their roles in achieving UHC from 1946 to 1981. UHC relates to the ability of patients to access good quality service with high population coverage of health care at low financial risk. Malaya was a former Western Pacific nation ruled by the British colonial government. Initially, the government bore the cost of medicines and passages between the United Kingdom and Malaya for Red Cross and St. John’s ambulance teams to serve in rural areas in Malaya. This was later replaced by home grown Rural Health Teams trained in purpose built Rural Health Centres beginning with the first such training school in Jitra under the Rural Health Scheme. The Rural Health Scheme was implemented from 1953 to 1956 and marked an ambitious period of utilising limited resources to expand human resource and establish District Health Centres, Sub-District Health Centres, Midwives’ Houses and Maternal and Child Health Centres across the rural landscape of Malaya. After analysis, it was found that the British colonial government’s efforts in improving public health through the Rural Health Scheme had provided the foundation for achieving UHC in Malaysia today.
This study in the management of dysphagia or swallowing disorders involved 72 contactable Speech-Language Pathologists (SLP) in Malaysia. A survey was undertaken to identify the patterns of dysphagia management by SLPs in Malaysia by identifying the percentage of SLPs in Malaysia who have managed swallowing disorders, the approximate number of patients, assessment and therapy techniques used, other professional involvement and the factors that influenced the confidence levels of the SLPs in managing swallowing disorders. Fifty percent (50%) of the forty four SLPs (61.6%) who responded to the survey had previously managed swallowing disorders. It was estimated that 5% (430 of 8268) of patients referred to the SLPs in Malaysia presented with dysphagia and were subsequently managed for their swallowing problems. The oromotor examination was carried out most frequently (100%) for evaluation of dysphagia while the compensatory technique proved to be the most frequently used management technique (77.3%). Most referrals to the SLPs were received from the neurosurgeon (59.1%); the otorhinolaryngologist was most referred to by the SLPs (50%). By using the Chi-squared analysis, it was found that clinical training in dysphagia at the undergraduate or post-graduate levels influenced the confidence levels of the SLPs in managing dysphagia cases (χ2 = 10.063 with p value = 0.007).
Salmonella spp. is a pathogenic microbial contaminant in beef of worldwide importance. It has the ability to colonize
the gastrointestinal tract of animals without producing any clinical sign. It may lead to infections in human when the
contaminated meat was consumed. The main objective of this study was to evaluate the contamination of Salmonella spp.
on beef carcasses and meat contact surfaces at selected abattoirs in Selangor, Malaysia. A total of 152 swabs from beef
carcasses (n = 104) and meat contact surfaces (n = 48) were collected from the selected abattoirs in October 2015 to
June 2016. The collected samples were examined for total viable count and prevalence of Salmonella spp. Salmonellapositive
samples were confirmed by routine biochemical tests and Gram staining. The results showed that all samples
contained an average viable count of 4.56 ± 1.23 Log CFU/cm2
. The overall prevalence of Salmonella spp. was 21.05%
which beef carcasses and meat contact surfaces contributed 11.18% and 9.87%, respectively to the overall prevalence.
The prevalence of Salmonella spp. on meat contact surfaces was higher than that on beef carcasses could be attributed
to poor hygienic practices at the abattoirs. However, despite a lower prevalence of Salmonella spp. on the beef carcasses,
beef could still be a potential vehicle for foodborne infections. This study suggests implementation of preventive measures
and good hygienic practices at abattoirs in order to avoid cross-contamination on beef prepared for retail markets.
The study aimed to develop Mandarin speech perception tests for Malaysian Chinese children. Two tests were developed which were the Syllabic Pattern Perception Test (SPPT) and the Tone Perception Test (TPT). Both tests were designed for children aged between three to six years-old. A total of 80 normal hearing children aged 3 years to 6 years and 11 months from several kindergartens around Kuala Lumpur and Ipoh participated in this study. Results showed that the mean scores for the SPPT did not differ significantly across age (p > 0.05), possibly due to a ceiling effect. Although the SPPT showed relatively low test-retest and inter-rater Spearman correlation coefficients (r = 0.68 for correct syllable pattern response and r = 0.38 for correct item response), the scores were highly repeatable in both test-retest and interrater conditions. For the TPT, the mean scores of five and six year old children were significantly higher than three year old subjects while the mean score of four year old subjects was significantly poorer than the six years old. The test-retest and inter-rater reliability were high and the coefficients approximated 0.80 (p < 0.05). For both tests, gender and dialects or languages used as the second language did not have significant effect on the test scores. Content validity evidence was also collected from a group of panelists. In conclusion, SPPT and TPT are reliable and valid Mandarin speech tests to be used on Malaysian Chinese children who speak Mandarin.
Cochlear implant (CI) is the main intervention option for people with severe and profound sensorineural hearing loss.
The purpose of this study was to investigate the auditory performance of a group of prelingually deafened paediatric
cochlear implant users using direct speech perception measures (objective) and a parental questionnaire (subjective)
and to identify significant demographic factors that might contribute to their performance. A total of 48 children from the
Cochlear Implant Program under the Malaysian Ministry of Health with hearing age of 12 to 89 months (mean = 42.60
± 19.46 months) participated in this study. The speech perception test was conducted using selected tests from the Malay
version of the Evaluation of Auditory Response to Speech (EARS) while parental views of the children’s performance were
collected using the Malay version of the Parents’ Evaluation of Aural/Oral Performance of Children (PEACH) questionnaire.
The recorded speech stimuli were presented to the children in a free field at approximately 65 dB SPL in a sound treated
room. The speech perception test results were then categorized using the Malay version of the Categories of Auditory
Performance Index (My-CAPI) with 10 categories ranging from ‘0’ to ‘9’. Results showed that most of the children (N = 20,
41.7%) were performing at category 2 of My-CAPI (limited closed set speech perception) with three children achieved the
maximum category 9 (advanced open-set sentences in noise). Communication mode was the only demographic factor that
significantly correlated with the My-CAPI and PEACH scores (p < 0.01). Pearson correlation coefficient showed a strong
relationship between the PEACH scores and My-CAPI levels (p < 0.01; r = 0.71) suggesting that the PEACH questionnaire
can be used as an indicator of the auditory performance if the speech perception tests cannot be performed. The findings
suggest that the majority of the CI children tested in this study had not achieved satisfactory auditory performance and that the use of oral communication mode was the main
factor associated with better auditory outcomes.
Despite a vast number of studies that were focused on the roles of superior temporal gyrus (STG) and cerebellum as sensory
area, little is known about their involvement in cognitive function such as attention and perception. The present fMRI
study aimed to identify this cognitive role from brain activation profile of STG and cerebellum obtained from an arithmetic
addition task. Eighteen healthy right hand dominance male adults participated in this study. They were instructed to solve
single-digit addition tasks in quiet and noisy background during the fMRI scan. Both the in-quiet and in-noise addition
tasks activated the bilateral STG and cerebellum (lobule VI and lobule VII) significantly but differentially. In both quiet
and noisy conditions, STG activation is dominant in the left hemisphere while cerebellum showed a right hemisphere
dominance. Bilateral STG and cerebellum (lobule VI) activation decreasedin noise, conversely cerebellum (lobule VII)
activation increased in noise. These asymmetrical activation indicated hemispheric lateralization and differential behaviors
of both brain areas in different environment while performing simple arithmetic addition task.
In this study, the asymmetry of the main effects of action, background and tonal frequency during a pitch memory processing
were investigated by means of brain activation. Eighteen participants (mean age 27.6 years) were presented with low and
high frequency tones in quiet and in noise. They listen, discriminate and recognize the target tone against the final tone
in a series of four distracting tones. The main effects were studied using the analysis of variance (ANOVA) with action (to
wring (rubber bulb) vs. not to wring), background (in quiet vs. in noise) and frequency (low vs. high) as the factors (and
levels respectively). The main effect of action is in the right pre-central gyrus (PCG), in conformation with its contralateral
behavior. The main effect of background indicated the bilateral primary auditory cortices (PAC) and is right lateralized,
attributable to white noise. The main effect of frequency is also observed in PAC but bilaterally equal and attributable to
low frequency tones. Despite the argument that the temporo-spectral lateralization dichotomy is not especially rigid as
revealed by the main effect of frequency, right lateralization of PAC for the respective main effect of background clearly
demonstrates its functional asymmetry suggesting different perceptual functionality of the right and left PAC.
Difficulty of understanding speech in noise among the elderly necessitates the need for Auditory Training which has made a renewal of interest in the last decade with the auditory training applications. This interest is perhaps spurred by advances in computer-based technology. In computer-based auditory training, speech signals are considered as auditory training stimuli where input speech signals need to be verified prior to training as the speech signals are mixed with noise signals. Computer-based Auditory Training System can be embedded with input speech verifying module. Input speech verifying module is employed with speech and noise separator simulator. This simulator needs to guarantee accurate separation of speech from noise signals. Therefore, in this research, Exploratory Projection Pursuit (EPP) technique under semi-Blind Source Separation (BSS) method is intended to separate the speech source signals which are mixed with competing speech (multitalker speech babble). This training uses Malay language based sentences which differ in word length and hence number of sample values. The experimental simulation considers two-channel random, linear mixing of speech sources and competing speech. The aim of this study is to evaluate the performance of source separation using the anticipated EPP technique for various sample values of speech signals which varies in time duration due to word length dissimilarity. Simulation results show that EPP technique is feasible for source separation. As a consequence, high correlation value of r ≥ 0.99 is obtained between extracted speech signal and original speech signal for all categories of speech signals. It is further verified by the maximum nongaussianity of extracted speech signal which has high kurtosis value of 32 approximately.
Older adults residing in community, as well as those who are residing in institutional or care home may experience various cognitive, health and physical impairments that may affect their independence. Continuous supports are needed to manage most of their personal care activities which are usually managed by their family members, often without proper training or guidance. To date, there is no personal care module that can be used as a guideline by family members and paid caretakers. Therefore, this study aims to develop and validate a personal care module as a guideline in assisting older adults with more significant disabilities. This study was a three-phase study, involving (1) development of the personal care module, (2) focus group discussion with healthcare experts and (3) face and content validity by the expert reviewers. A total of 10 older adults participated in semi structured interview in phase one and 13 occupational therapists were involved as experts in evaluating the module in phase two and three, having between 5 to 25 years of working experiences. The finding reported a high content validity in the developed module ranging from 0.88 to 1.00 on six domains of personal hygiene, bathing, dressing, feeding, bed mobility and stairs climbing. This study provides a preliminary support for the developed personal care module as a valid instrument to be used as a guideline in managing personal care activities of older adults with more significant disabilities.
Kualiti merupakan elemen terpenting dalam proses pengeluaran atau perkhidmatan yang dihasilkan oleh sesebuah organisasi kepada pelanggan. Kualiti perkhidmatan merujuk kepada ukuran bagaimana sesuatu perkhidmatan yang disampaikan sepadan dengan jangkaan pengguna. Kajian ini bertujuan untuk mengenal pasti kualiti perkhidmatan kesihatan awam yang dapat diakses oleh buruh asing. Pengukuran kualiti perkhidmatan kesihatan dalam kajian ini dapat dibahagikan kepada tiga aspek iaitu keadaan perkhidmatan kesihatan, tempoh masa menunggu dan layanan kakitangan hospital terhadap buruh asing. Dapatan kajian menunjukkan sebilangan besar buruh asing berpuas hati dengan kualiti perkhidmatan kesihatan yang diterima oleh mereka.
This is a follow-up study to assess the socio demographic profile of a sample of 28,605 women seeking pregnancy terminations at a private clinic in Penang over a seven year period as compared to an earlier study in 1995 of a sample of 23,986 women over a six and a half year period at the same clinic. This study was conducted using computerized patient medical records and paper reports generated from the computer data. The earlier 1995 study showed that the profile of a typical abortion client was a Chinese (60%), housewife (45%) in her late twenties (47%) with a monthly household income of less than RM1,200 (58%), having her first abortion (51%) and who had used contraception before (78%). For the seven year period from 1998-2005, the follow-up profile of a woman seeking an abortion in the same clinic in urban Malaysia was one with a monthly household income of less than RM2,000 (100%) in her late twenties (54%) who had used contraception in the past (85%). It is noted that the percentage of Malay respondents has increased (34%). The percentage of women who had a prior abortion at this clinic or elsewhere has also increased (68%), as compared to the preliminary study. Non-use of contraception remained an issue and traditional methods still outweighed the use of more effective contraceptive methods. In conclusion, fewer housewives and more Malay and Indonesian factory workers contributed to the clinic client profile over these seven years compared to that of the earlier study in 1995.
The aims of this study are (1) to determine the scattered radiation dose levels in routine fluoroscopy procedures and (2) to compare them with the equivalent chest x-rays and also (3) to monitor common techniques and radiation safety measures taken by the medical officers. The study covered a sample of 105 fluoroscopic procedures performed by 18
medical officers. Each officer wore a personal pocket dosimeter inside the lead gown during each procedure. A digital dosimeter was placed near the detector of the fluoroscopy unit while a survey meter was positioned at the control panel area to record the dose levels. There were 14 types of examination included in this study. The total number of images
captured was found to be the highest in barium swallow examination with 115 images, almost five times higher compared to the common practices. The longest screening time was observed in barium enema examination which is 9.15 seconds. The median of the scattered dose level was the highest in barium meal examination (165.50 µSv) which is equivalent
to 8.28 times of average dose impart by chest x-ray examinations. The number of images and the length of screening time depend on the competency levels of the medical officers. They capture as many images as possible to avoid missing any abnormalities, therefore it will always be better if the fluoroscopist is consulted during each case. They should also
consistently practice essential protection by minimizing exposure time, maximizing distance from the source tube and utilizing the radiation shielding.