Worldwide prevalence of obesity among children and adolescents increased substantially over decades. Addressing potential risk factors of obesity among adolescents is very important for a successful intervention program in this population. The present study aimed to identify the sociodemographic determinants of obesity among school adolescents in Terengganu. A cross-sectional survey involving 3,798 school adolescents age 12 years old from 136 government primary schools in Kuala Terengganu and Besut districts were carried out from November 2014 to June 2015. For the purpose of this paper, the data for 2,842 school adolescents classified as either normal BMI (< +1SD) (n= 2,305) or obese (+2SD) (n= 537) based on WHO cut-off points were taken for analysis. Sociodemographic information on subjects and their parents were obtained from self-reported questionnaire. Anthropometric measurements were conducted by Physical Education teachers and uploaded into a specific developed database. The prevalence of obesity was relatively high in both genders in this study. Binary logistic regression analysis found gender, parental BMI, household income, household size and maternal working status were independently associated with obesity among school adolescents in this population. In the final model, being male, having working mother, and having obese parents were identified to be potential risk factors for obesity whilst having large household size lower the risk of obesity among these adolescents. Prevention programs are needed to increase awareness about the risk factors of obesity in adolescent and interventions should now focus on family member as well mainly the parents.
Health system reform has been a major concern for different countries. The aim of this research was to develop a reliable and valid questionnaire suitable to assess the consequences of health reform process from people's perspective. An extensive literature review used to extract a set of statements as possible indicators for health system reform. Expert panel used to determine the content validity rate (CVR) and the content validity index (CVI). The first version produced in Turkish language and pre-piloted with 20 heads of household. Qualified committee used to translate the Turkish version to English version. Group of eighteen academics and graduate students recruited to tests both versions for parallel test validity. The construct validity of the questionnaire was determined using principal components analysis with Varimax rotation method (PCA). Internal consistency and questionnaire's reliability were calculated by Cronbach's alpha and the test–retest reliability test. A 17- items questionnaire was developed through the qualitative phase. The Bartlett's test was significant (p < 0.001), and the KMO value (0.842) showed that using principal component analysis (PCA) was suitable. Eigenvalues equal or higher than 1 were considered significant and chosen for interpretation. By PCA, 4 factors were extracted (accessibility, attitude and preference, quality of care and availability of resources) that jointly accounted for 85.2% of observed variance. The Cronbach's alpha coefficient showed excellent internal consistency (alpha=0.97), and test-retest of the scale with 2-weeks intervals indicated an appropriate stability for the scale (Intra-class coefficient = 0.96). The findings showed that the designed questionnaire was valid and reliable and can be used easily to assess the consequences of health reform process by comparing the situation before and after the reform from people's perspective.
There is high expectation from the population on part of the healthcare providers. These include; skilful and timely medication administration; and knowledge, honesty, listening skills, availability and professional attitude. The aim of this paper is to evaluate the expectation of population with regards to the healthcare providers in Turkey. A cross- sectional study was conducted in Turkey, including both rural and urban population, carried out from October 2011 till January 2012. A total of 540 household heads were selected using multistage random sampling technique. Data was collected using modified self-administered 16-items QUOTE (Quality of Care Through the Patients’ Eyes) questionnaire. The questionnaire measures communication/ accessibility, organizational skills and professional skills. The response rate was (77.1%) and data was analyzed by using SPSS version 16.0. All the aspects measured using QUOTE questionnaire were found to be important by the majority of respondents, but with varying degrees of priority. The quality aspects related to the professional skills of physicians was ranked first followed by communication/ accessibility and last but not the least is the organizational skills of health care providers. This study explored the Turkish people priorities and expectations regarding healthcare providers. The public priorities and expectation were different across population. This may reflect the need to understand people's expectations before providing the services to avoid complaints that may occur after the services have been rendered.
Indonesian government secures the access of the poor towards health services through subsidised schemes. This study is aimed to describe the pattern of health expenditure by households and to describe the pattern of health service utilisation across household’s socioeconomic level in the city of Padang after seven years of the introduction of subsidised schemes. A household survey was conducted involving 918 households, with multistage random sampling method. The proportion of out-of-pocket (OOP) health spending as a share of household’s capacity to pay was regressive across consumption quintiles. The proportion of households with catastrophic health expenditure was 1.6% while 1.1% faced impoverished health expenses. Among those who need health care, the utilisation among the rich was higher than the poor. Health insurance schemes in Padang provides financial protection, however with regards to household’s capacity to pay, the poor has the higher burden of health payment. The gap on health service utilisation between the poor and the better-offs was still apparent for outpatient services and it has been narrowed for inpatient care. This study suggests that the subsidised schemes for the poor are highly needed and the possibility of the leakage of subsidies to the rich should be considered by the government.
Dengue fever is the most common vector-borne disease and major concern issues in Malaysia. Thus, the present study aimed to evaluate factors influencing knowledge, attitude, and practices regarding dengue fever among patients in Hospital Taiping. A total of 300 patients were incorporated into a descriptive, public based cross-sectional study. The questionnaires were formulated to include several questions on demographic data, knowledge, attitudes, and practices concerning dengue fever. Most of the respondents were from the age group of more than 35 (43.3%). The largest representations of the participants were Malay (59.3%), married (65.7%), SPM is the highest education level (53.3%), and 60.7% of the participants were conscious about dengue fever eruption. Television/radio was voted as the frequent source of information (97.3%). There is no significant relationship between knowledge score and socio-demographic factors. However, around 57.0% of the respondents believe that abdominal pain is not a symptom of dengue fever and 32% convinced that blood transfusion can transmit dengue. No significant correlation was found between attitude and practice score to socio-demographic characters. However, a good practice towards dengue fever is associated with good knowledge (65.4 %) nevertheless it did not influence their attitude. Moreover, the attitude seems to be poor regardless of knowledge level (44.0%). Therefore, more prevention practices to raise the awareness of population toward dengue fever such as health campaigns and health education in school level should be initiated. These activities will aid in fertilizing better attitude and prevention practice towards dengue fever and bring down its incidence in Malaysia.
The Short Form Health Survey SF-36 is a well-known generic health-related quality of life measure that has widely been used worldwide. However, given the cultural, social and ethnic differences in some countries, it might not follow the intended structure of the instrument. Hence, this study aims to determine the psychometric properties of the Malay version of Short Form Health Survey (SF-12) among postpartum mothers. A cross-sectional study was conducted among 1-month postpartum mothers attending Obstetric and Gynecology clinic, Universiti Sains Malaysia Hospital, Kelantan, Malaysia. Reliability was estimated using internal consistency and the factor structure was extracted by performing confirmatory factor analysis using SPSS v. 20 and AMOS v. 20. A total of 108 women responded. The mean (SD) score for the Physical Component Summary (PCS) score and Mental Component Summary (MCS) score were 43.3 (7.08) and 42.4 (6.87) respectively. The Cronbach alpha for PCS-12 was 0.749 and MCS-12 was 0.701. Spearman correlations of individual items and the SF-12 component summary scores showed PF, RP, BP and GH items correlated higher with the PCS score, whereas the VT, SF, RE, and MH items correlated higher with the MCS score lending support to its good convergent validity. The confirmatory factor solution showed final model with two factors structure and six items each with acceptable factor loadings, satisfactory absolute and parsimonious fitness (RMSEA=0.1, x2/df=2.4). The psychometric tests of the Malay version of SF-12 generally showed acceptable validity and reliability among postpartum women.
Study site: Obstretic and gynecology Hospital Universiti Sains Malaysia (HUSM)
The rapid development in the health sector has spurred many healthcare organizations to improve their productivity and quality, particularly in terms of service. Clinical Pathways was introduced with the objective of improving the quality of care and services in health; while at the same time eyeing the possibility of reducing the medical expenses. It can be defined as a document based tool that links the best available evidence and clinical practice and provides recommendations, the process and time frame for the clinical management of healthcare. A cross sectional study was carried out at University Kebangsaan Malaysia Medical Centre (UKMMC) Malaysia with the aim to evaluate the level of knowledge about Clinical Pathways (CP) and to ascertain its level of practice in the implementation of CP among healthcare workers at UKMMC; and to establish correlated determinant factors. The study involved a total of 127 respondents; majority of whom were female (77.2%), aged between 32 and 45 years (51.2%), working as nurses (71.7%), and having working experience of six years or longer (52.0%) at UKMMC. The findings reveal that 52.8% of respondents agreed that there is a proper implementation of the Clinical Pathways (CP) programme at UKMMC; and that 52.0% of the respondents have a higher level of knowledge about CP and 70.1% of them practiced it well. The findings also unravel two factors (position and working experience) as the predictors of respondents’ level of knowledge about CP, and position as a predictor representing the practice of it at UKMMC. It can be safely surmised that most of the respondents have a higher level of knowledge about Clinical Pathways and that they practice it well in their daily task as healthcare workers.
Increasing prevalence of chronic diseases is a major contributor for rapid rise in healthcare cost in developing countries since the last decade. It was estimated that around 54% of deaths in developing countries are due to chronic non-communicable diseases which is predicted to rise by 65% by 2030. Diabetes mellitus is among the most prevalent chronic diseases suffered by more than 180 million people worldwide. By 2030 it is estimated that around 400 million people in the world will be afflicted with diabetes. Annual deaths attributable to diabetes are probably as high as 3 million with more than 80% occur in developing countries. India, China and Indonesia are three countries in the Asian region with most number of people with diabetes. The total number of cases in these three countries is expected to increase more than double from 61 million in 2000 to 163 million in 2030. China and India will suffer cumulative GDP loss of 13.8% and 16.7% respectively, over the next ten year period. Assessing economic burden of diabetes is a challenging task for researchers because identification of direct and indirect cost of the disease is often complex since patients with diabetes also suffers from other complications and co-morbidities. In conclusion, the heavy economic burden of diabetes pose major challenges to health policy makers in developing countries to assess the current approach in managing this chronic disease. Serious efforts should be made on focusing and up-scaling activities on health promotion and prevention of diabetes so that to provide a more cost-effective solution to this condition with huge and increasing economic loss.
Student's feedback is one of the most important considerations in health profession quality management. One of the most popular approaches for receiving feedback from students within individual institutions is the Student Satisfaction Approach. The aim of this study was to measure the satisfaction with educational services among health profession students and the determinants of satisfaction. Cross-sectional study was conducted in the main campus of the High Institute of Health Sciences in Yemen, including its eight branches. A self-directed questionnaire was distributed to 327 students who were randomly selected. The participation rate was very high: 94% (309/327); 57.9% were male and 42.1% were female. Overall, 59% of students were totally satisfied, 35% were partially satisfied; however only 6% of them were not satisfied. Results showed that personal development was the highest component of satisfaction among students, while the research subjects showed less–satisfaction with the learning resources. The findings provide valuable insights and offer recommendations for improvement in terms of quality management in health profession education.
Hospital information systems have evolved with the recent widespread, involving technology and target functions, and this involves the critical computer systems from multiple perspectives. Healthcare organizations increasingly use information technology as a basis for improving productivity and user satisfaction. A research had been done about the level of satisfaction in using the Hospital Information System. Data was obtained by using a set of questionnaires that have been tested for reliability and validity. The staff are comprised of two (2) categories: Nurses (community nurses / Head nurse / staff nurse, nurse managers and others) while the second category consists of administrative officers (administrative officers, administrative assistants and clerks) in selected departments. Variables consist of sociodemographic factors, occupational factors and perception factors. A total of 152 respondents identified using stratified sampling method. The factors studied were age, gender, marital status, level of qualifications, length of service, knowledge of the system, attitude towards the use of the system, behavioral intention to use the system and compatibility with work. Majority of respondents were females (88.2%). The level of satisfaction among the staff in using the hospital information system is high (88.8%) compared to the dissatisfied staff in UKMMC (11.2%). In overall, the staffs in UKMMC are satisfied using the hospital information system available now but there are always a room for improvement so that the system can be used more intensively.
A cross-sectional study was done to determine the prevalence of violence among 15-year-old adolescents and to identify associated protective or risk factors. The study involved 758 adolescents, 384 males and 3 74 females in the District of Kuala Terengganu and Besut, Terengganu. About 39.0% of adolescents under study were ever involved in violence. Percentage of girls were slightly higher 19.8% as compared to boys 19.2%. About 30% of the violent adolescents were from Kuala Terengganu and 9.1% from Besut. There was no significant relationship between violence and ethnic groups. Family total income above poverty line was significant protective towards violent behaviour < 0.01, OR 0.61, CI 0.45 - 0.82). Using univariate analysis, selected parental factors were protective against violence, such as good parental connection (p < 0.01), presence of parental regulation (p < 0.001), religious parents (p < 0.05) and parents who had dinner everyday with adolescents (p < 0.01, OR 0.59, CI 0.43 - 0.80). Adolescent who perceived to have interest in learning (p < 0.001, OR 0.32, CI 0.17 - 0.59) were less likely to involve in violence. Adolescent who felt well connected to their school (p < 0.01), and perceived themselves religious (P < 0.001) were more likely to be non-violent. Those who felt satisfied with day to day life were less likely to be involved in violence (p < 0.001, OR 0.52, CI 0.37 - 0.71). On the contrary, adolescents who ever had the feeling to run away from home (p < 0.001), had 3 times risk of violence, ever smoked cigarette had 2.4 times risk (p < 0.001, CI 1.55 - 3.69) ever been bullied by peers were 2.3 times risk (p < 0.001, CI 1.46 - 3.60) to violence. Same factors remained significant in multivariate analysis. Such factors were total family income below poverty line (p < 0.001, OR 1.82,CI 1.28 - 2.59), parental regulation (p < 0.05, OR 0.34, CI 0.13 - 0.89), had dinner every night and frequently (p < 0.01, OR 0. 62, CI 0.43 - 0.89), and adolescents' religiosity (p < 0.05, OR 0.81, CI 0.66 - 0.98) were protective, whereas ever· smoke cigarettes (12 < 0.01, OR 2.24,Cl 1.38 - 3.62), being bullied by peers (o < 0.01, OR 2. 09, C1 1.26 - 3.45), and frequently felt depressed previous one year (p < 0.001, OR 3.01,CI 1.79 - 5.07) were risk factors. The findings of the study will serve as baseline in planning adolescent health programme specifically to prevent violence behaviour from developing right from young, in the home and in the school environment.
Mobile phone distraction is a global issue in road safety perspective especially involving the pedestrians. A lot of
research findings had suggested that the use of mobile phone increase the risk for pedestrians while crossing the
road, but there have been very few studies that could explain the said threat in Malaysia’s situation. This study aims
to identify the distracted pedestrian behaviour via the video recording method. More than 300 samples were
observed as involved in mobile phone distractions while crossing the roads from a total of approximately 1,500
analysed samples. The study also found that the highest mode of distraction observed among pedestrians was the
“handheld usage” (conversing) as compared to the “hands-free” and “application usage” modes. In addition, the
distractions had significantly affected the time to cross and the observed road users who were involved in
“application usage” took longer time to cross. These results provide a prevalence material that may be useful in the
development of countermeasures.
The objective of this study was t0 determine the relationship between scores on McCarthy Scales of Children's Abilities (MSCA) and academic peU’ormance of school children. A total ofI12first and second graders aged 6 to 8 I/2 years old hom two primary schools in Kuala Lumpur, Malaysia were selected as subjects for this study. This selection was based on a random sampling stratyied proportionalhr according to school and sex. The MSCA was administered to 59 male and 53 female students. The test battery was translated from English to Malay and adapted to suit the local situation. Academic performance was measured using the mean percent of the total score on all the subjects (English, Malay, Mathematics and Islamic Religion) in the jinal examinations at the end of the year. T—test results indicated no signdicant dfference between MSCA scores and academic scores of maleandkmale students. The results revealed that all the scores on the MSCA and the General Cognitive Index were signyicantbr correlated with academic pejormance, The General Cognitive Index accounted for [0.4% ofthe variation in academic performance. T he findings appear to support that intelligence scores may be used to predict children 's academic performance in the early years of primary education.
Cat fleas were reported to attack human in RPR Batu Kawa, a housing area about 3 km from Kuching town, resulting in an outbreak. A total of 19 people (10 adults and 9 children) were attacked by fleas. They presented with red spots, slightly raised (swollen) and irritation of skin, mostly found on the ankles and legs. The first 4 cases were reported on 29 September 2007 and the last case was on 17 November 2007. The remaining 12 cases which represent the majority of cases reported on 4th October 2007. The study conducted based mainly on field investigation and flea sampling from animals on field at that moment to find out the causes of the disease spread. Flea samples from human and cats were found to be Ctenocephalides felis; which is the most prevalent species in the world. However, no fleas were found on dog, rabbit and rat. This is the first reported case in Kuching; the study was carried out to determine the cause and the epidemiological pattern of the disease. This is important, because cat flea might attack human especially if house owners fail to monitor their pets and practice proper sanitation method to avoid the presence of cat flea larvae at home.
A cross sectional survey on the assessment of coronary heart disease risks was conducted on a group of security guards in a public university. The objectives were to assess the risk of coronary heart disease (CHD) among the security staff and to provide advice on CHD prevention and practice of a healthy lifestyle. A face»t0»face questionnaire was used to conduct the survey. The main outcome measure was the coronary heart disease (CHD) risk score estimates. The handings showed that 61 participants ( 5 3 .0%) have very high CHD risk factors, while the rest, 38.3% and 8.7% have moderate and low CHD risk factors respectively. With increasing age, there is an increase in total risk score among the target groups. The percentage increases almost 2-fold between the 21-30 and the 31-40 age groups. Majority of the security staff had high CHD risk factors and more efforts and preventive measures must be taken to overcome this situation. Personalised advice was given to participants based on their CHD risks estimates.
This survey elucidated the perceptions and implementation 0f orthodontic Clinical Practice Guidelines (CPGs) by all ortlmduntistc and dental officers in the Ministry of Health Mahysia (MOH). Two different set: uf xelf-administered questionnaires were targeted at first·year dental officers (FYDO), dental officcrx (DO) and administrative Senior Dental Officers (SDO) in one group and unhocluntists in another group. Only 30% responded from a total of 1,327 MOH dental officers, with no participation from three States. Majority (89%) of officers have heard of CPG: although some were unsure of their purpose and usage. About 69% have read orthodontic CPG; of whom 87% have read other MOH dental CPG:. About 78.6% found CPGs 'gaud to excellenf but 16,0% did not answer this question. Same comments received included: language was confusing, inadequate details and pictures, need improvement, irrelevant, need CPG: for other orthodontic problems, need more knowledge first and requests for mare copies. Only 27.7% used them often, 53% occasionally and 15% hardly follow CPG:. About 82% felt that they were encouraged to use CPGx in their workplace and the majority (86%) knew where they were kept especially SDC: and DO; About 90% in the orthndonzist group have received hard copies of orthodontic CPGs but the majority (76%) has not seen them on the website. Although all felt that CPG; were useful to officers and encouraged their use, only 62.5% have introduced CPGs to their officers. There was generally more awareness and usage of CPGS among SDOs compared with DOs and FY DO; The dissemination and availability of orthodontic CPG: is reasonably good. However, the implementation by mthodontists and administrative officers can be improved for better awareness, understanding and usage by dental officers, especially FYDOs.
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)
Aesthetic value of the automotive car seat has been one of the selling points of each car besides
providing functions such as being safe, supportive as well provides comfort to the occupants. Other
criteria considered besides the aesthetic element are cushion foam and self-adjustment factor.
Ergonomics is not a new issue because most of the existing seat design today have already practiced it.
Existing car seat manufacturers have considered anthropometry data. The average upon 95th percentile of
human measurement had been deliberated. However, issues such as time spent driving and seat design
issue have arisen upon the search of comfort and rising of musculoskeletal disease such as back pain. As a
solution, this study would propose an automotive car seat design of ergonomic evolution, which would
create comfort by manipulating the seat cushion foams. The proposed seat cushion foam would be use to
replace the existing polymers with beanbag foam. This is inspire by the nature of beanbag, fitting up and
providing comfort to the occupants of various body sizes and shapes. Malaysian anthropometry
measurements are required for design of car seat, which later compared with the existing seats of
commercial vehicle. The literature review showed the pressure mapping technique of respondent seating
on the existing car seat. The most sensitive compartments where discomfort are experienced studied and
placed with sachets filed with beanbag beads. This experiment conducted many times over a few
respondents by using the pressure mat to find out, if there are any changes in terms of comfort. This
design of new car seat with a manipulation cushion foam replaced with beanbag foam could be a niche to
eliminate discomfort to all range body sizes and shapes.
The level of patient satisfaction is important for service quality in hospitals. This study aims to measure the level of patient satisfaction at University Kebangsaan Malaysia Medical Centre (UKMMC) and the factors affecting it. A cross-sectional study was conducted on 520 respondents at the outpatient department in four clinics in UKMMC by using self-administered questionnaires. Respondents were selected using a systematic sampling method based on the list of patient appointments. The level of patient satisfaction was measured using the PSQIII domain. Less than half of the respondents were satisfied with the overall service provided (41.0%), while the others (59.0%) were not satisfied. Based on the domain studied, the level of satisfaction varies widely: the highest satisfaction were interpersonal relationships (75.8%) followed by the registration process (73.8%), technical quality (71.3%), communication (66.7%), physical facilities (64.6%), accessibility (60.2%), and financial (47.3%). The level of patient satisfaction was low and financial domain should be given more attention to in order to ensure an increase in patient satisfaction levels.
Study site: Surgery, Orthopaedic, Obstetric and Gynaecology, and Medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Comparison of rates of smoking across countries revealed that students are more likely to begin smoking in medical school than to give it up and increase their cigarette consumption rather than decrease it. A cross-sectional survey of all consenting medical students in a private medical university in north Malaysia was conducted in 2008 to determine the prevalence and smoking habits among them. A self administered questionnaire which was returned to the investigators in a sealed envelope was used. Results were tabulated and analysed with SPSS version 13.0 software. The response rate was 83.3% (508/610). The prevalence rate for current smokers was 5.3% (27/508) and for ever smokers 9.3% (47/508). Factors significantly associated with smoking were gender (p<0.001), age group (p<0.001) and family income (p=0.003). The odds of being a smoker was 14 folds high when a family member smoked and the odds of being an ever smoker was almost 6 folds more when a family member smoked. Friends were the most common influence to start smoking and the most common reason to stop smoking among ever smokers. The reasons for not smoking among the never smokers were health concerns and the distasteful smell of cigarettes. A module on how to help medical students to stop smoking should be included in the curriculum of every medical school. This will not only help them become good educators but will prevent them from picking up the habit. Educational intervention should also include family members who smoke.
Key words: smoking, medical students, university, Malaysia