Ocular injuries or trauma to the eye can be caused by variety of objects resulting in a spectrum of lesions in the eye. We did a Pubmed/Google/Science Direct search to review the spectrum of ocular injuries in Malaysia. In our review, we included 28 papers providing information on ocular injuries which were published from Malaysia during the period 1991-2016 in different medical journals. Prevalence was more among males with an average age of 35 years. Among adults they were more common in the workplace but in children it occurred at home. Few wore protective glasses at work. The mode of injury was due to sharp objects hitting the eye, motor vehicle and domestic accidents, firecrackers, chemicals and rarer causes like superglue and durian fruit. Prognostic factors for outcome were the initial visual acuity, length of the wound, associated factors like hyphaema, intraocular foreign body and vitreous prolapse. Missing the diagnosis of perforation of the eyeball is possible without eliciting a proper history. Protective devices must be worn to prevent injuries. Display of health education charts showing the effect of injuries in the eye and their preventive measures in health centres, private hospitals, schools, factories and sports centres will increase the awareness of public about the ocular injuries. It is important to diagnose the tissues involved in ocular trauma by the general practitioners and primary care physicians and refer the patients to the Ophthalmologist urgently for treatment to salvage vision. Compensation mechanisms should then be put forth in terms of rehabilitation and for monetary loss.
With economic growth and significant technological advances in the health sector, many countries have developed aggregate outcomes in terms of both health services and individual well-being. Life expectancy has seen a remarkable increase of more than fifty per cent between 1950 and 2009. Achievement is uneven, however, and some groups are better able to access health services than others. In our review, we explore the need and how to maximize health equity, efficiency and effectiveness. Methodology is the review and web surfing on public health, social science, humanity and development literature. The increasing gap in health inequality, however, calls for further reform of the health system to achieve both equity and efficiency. Health is essential for survival and human capability. Good health enables people to participate in society. A new approach to efficient and cost-effective health service provision is community participation in health development. Participation can increase the skills and knowledge of local people, thus providing opportunities to improve their lives (empowerment). Analysis suggests four functional changes to achieve equity and efficiency in maximizing health outputs: reforms targeting universal coverage to achieve universal access to health; people-centred service delivery through concentrating on health services based on need; public policy change targeting integrated and multi-system health planning; and collective health system and community response to achieve health for all.
The passing of The Occupational Safety Health Act and the subsequent release of the Institute of Medicine (IOM) report had resulted a stronger sense of awareness towards workplace and patient safety in the Healthcare Industry. The World Health Organization (WHO) recommended Interprofessional education as one of the preparative module in handling safety issues in the healthcare Industry.The aim of this paper was to evaluate the students’ knowledge, perception, attitude, interrelationship, inclusion, understanding and teamwork towards patient and workplace safety.The research was conducted by administering questionnaires to returning allied health students from their internship in the healthcare settings. The overall results indicated that 63.4% of the students Agreed, 18.3% Neutral, 17.9% Strongly Agreed and only 0.3% had Disagreed on the impact of Interprofessional education towards patient and workplace safety in the Healthcare Setting.Occupational Safety Health and Interprofessional Education are relatively new concepts in Malaysia and require a strong understanding before a strong concluding stand could be established. The researcher feels a more concurrent approach should be implemented to actually know the impact of Interprofessional education towards patient and workplace safety in the healthcare settings.
This study is aimed at seat design optimization for high-speed train based on the Malaysians sitting anthropometry
data focusing on seat fit parameters. An analysis of anthropometry data composed of 15 dimensions that are
required in seat design was done with 50 male subjects. These data were collected through direct measuring
methods with standard equipment. According to the Malaysian automotive seat fit parameters, the backrest width,
backrest height, cushion width, and cushion length were established based on these anthropometric dimensions:
interscye breadth (5th percentile female and 95th percentile male), hip breadth (95th percentile female), sitting
shoulder height (5th percentile female), and buttock-popliteal length (5th percentile female), respectively. This
study uses the CATIA software to design and analyse the proposed seat design. The fit parameters proposed for the
new design are seat height, 380mm; cushion width, 450mm; backrest width, 450mm and backrest height, 850mm.
The CATIA human activity analysis (based on Rapid Upper Limb Analysis, RULA) was also executed. From the study,
the new conceptual seat design gives the most optimized fit when compared to the current seat.
Although only 6.3% of the 221 respondents in this crass-sectional study stated outright that the hospital food served to them was not good, a high proportion of respondents ( 62.0%) supplemented ltaspimlfoad with outside food. When the reasons for supplementation were considered, it is likely that 53.8% ( $5.5%; 95% CI ) of the patients in this study were dissatisfied with hospimlfoudfar some reasons or when particularly with regards t0 variety, attractiveness and sewing lime. The pl‘0]701’l‘i011 of respondents wha were dissatisfied with hospital faud was significantly higher (p
Fecal occult blood test (FOBT) screening has been shown to decrease the incidence and mortality of colorectal cancer (CRC). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the immunochemical fecal occult blood test (i-FOBT) in diagnosing CRC were assessed among the patients in a tertiary referral hospital in Malaysia. A total sample of 814 patients aged 16 to 85 years old who performed i-FOBT and endoscopic screenings was obtained. The patients were recruited for a retrospective investigation. Sensitivity, specificity, PPV, and NPV were derived for the CRC screenees. Out of the 814 patients screened using i-FOBT, half of them were above 59 years old (49.6%), and 36% had positive i-FOBT. Gender distribution was almost equal, where 53.4% of the patients were female, and 46.6% were male. Majority of the patients were Malays (56.6%), followed by Chinese (24.0%), Indians (16.5%), and others (2.9%). Among the 71 patients referred for colonoscopy, 57.7% and 42.3% corresponded to positive and negative i-FOBT cases, respectively. Polyps were found to be most common among the patients (25.6%), 7.0% were found positive for invasive CRC, and 35.2% had normal colonoscopic findings. There was a significant association between colonoscopic finding and positive i-FOBT (p=0.001). The sensitivity, specificity, PPV, and NPV for CRC detection were 66.7%, 43.0%, 9.8%, and 93.3%, respectively. The results indicate that i-FOBT is a useful tool in the detection of abnormalities in the lower gastrointestinal tract and therefore serves as a cornerstone for potential large-scale screening programmes.
This was a cross-sectional study which attempt; tu determine the prevalence of breastfeeding practice among mothers in Klcmg district, Malaysia and the association between lyrcastfceding practice with place of delivery and knowledge 011 breastfeeding. Dam collection was conducted by face·t0·face interview using a premuded structured questionnaire amung mothers with fum month old infants only who attended che government clinics in Klang, A total of 508 mothers were recruited ima the study. The study showed 92.9% ever breastfed, 55.1% exclusively lareastfed fur one month and 20.5% exclusively bremtfcd for four months. Malays brcastfed the most, while
Chinese the least. Breastfeeding was more common among mothers with lower education, delivered in government hospitals and with good knowledge on breastfeeding. A high proportion uf mothers in Klang wouki initiate breastfeeding and the [neualence of exclusive breastfeeding was comparable nationally. Breastfeeding was associated with mothers delivered in government hospitals and with good knowledge on breastfeeding. Continued promotional efforts targeted at private hospitals with information on breastfeeding should result in further increase in breastfeeding prevalence.
Study site: Klinik Kesihatan, Kelang district, Selangor, Malaysia
The Aging Male Symptoms Scale (AMS) measures health-related quality of life in aging men. The objective of this paper is to describe the translation and validation of the AMS into Bahasa Melayu (BM). The original English version of the AMS was translated into BM by 2 translators to produce BM1 and BM2, and subsequently harmonized to produce BM3. Two other independent translators, blinded to the English version, back-translated BM3 to yield E2 and E3. All versions (BM1, BM2, BM3, E2, E3) were compared with the English version. The BM pre-final version was produced, and pre-tested in 8 participants. Proportion Agreement, Weighted Kappa, Spearman Rank Correlation Coefficient, and verbatim responses were used. The English and the BM versions showed excellent equivalence (weighted Kappa and Spearman Rank Coefficients, ranged from 0.72 to 1.00, and Proportion Agreement values ranged from 75.0% to 100%). In conclusion, the BM version of the AMS was successfully translated and adapted.
Chronic low back pain is a common preventable occupational health illness affecting most workers. Large amount of financial and benefit cost had been spent by the developed countries to prevent, treat and rehabilitate a large number of workers who are exposed to hazards that are attributed to low back pain. Efforts on primary prevention of low back pain had been challenging due to difficulties in affirming work- relatedness of chronic back pain among workers. As such, efforts have to be focused on existing literatures to propose acceptable variables to develop the definition of workrelatedness specific to chronic low back pain. Such identified variables or factors could be used to develop a set of criteria in defining work- related chronic back pain. Literature search using specific work- related and chronic low back pain key words were used. Comparable articles were judged and a summarized result was obtained. These variables could be grouped into individual characteristics, health behaviours, physical conditions at work, work organizations and ergonomic factors. With proper methodology and statistical analysis, tools could be developed to aid physicians in determining work- related chronic low back pain among employees.
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.
A study was undertaken amongst private primary care providers in three urban centres of Malaysia to understand the organizational structure of the facilities and to assess the cost of running such services. A total of 150 clinics were involved in the study. Data was collected through interviews with owners of the clinics using semi-structured questionnaires. Solo-practitioners owned 64.7% of the clinics while 35.3% of them were owned by group practice. This study showed that the mean number of patients visited the clinics daily was 49.3 with the average operating hours of 79.4 hours/week (range 28.0 - 168.0 hours/week). Group practice clinics operates 23.9 hours longer than solo-practice clinics. Group practice clinics were more likely to offer 24 hours service than solo-practice clinics. Most of the clinics were manned by a single doctor (57.3%), 30.0 % had two doctors and only 12.7% were run by more than two doctors. On average, group practice employed greater number of supporting staff than solo-practice clinics (6.0 vs 4.3 people). The mean annual cost to run each facility was found to be RM 444,698. The mean cost per patient was found to be RM 32.09 for solo-practice clinics and RM 38.55 for group practice. Wages represented the highest proportion in the recurrent cost (61.1%) followed by drugs (29.2%) and consumables (2.7%). Building cost (67.9%) and equipment cost (25.9%) were the major capital costs for the clinics. This study could serve as a basis to reimburse private primary care providers in the future health financing scheme in Malaysia. To improve efficiency and contain cost in primary care settings, efforts should be targeted towards cost of wages and drugs utilised by the providers in their daily practice.
Key words: Private practice; primary care; costs; Malaysia.
As the Malaysian population ages, the burden of age-related cognitive disorders such as dementia and Alzheimer’s disease will increase concomitantly. This is one of the sub-study under a research project titled by quantify the cost of age-related cognitive impairment in Malaysia, which was undertaken to develop a clinical pathway for Mild Cognitive Impairment (MCI) and Dementia. The clinical pathway (CP) will be used to support the costing studies of MCI and Dementia. An expert group discussion (EGD) was conducted among selected experts from six (6) government hospitals from different states of Malaysia, Ministry of Health, and United Nations University, International Institute for Global Health, UKM and UPM. The expert group includes psychiatrist specialists and public health medicine specialists. A total of 15 participants took part in the EGD. The group was presented with the different approach in managing MCI and Dementia. Finally, the group came to the consensus agreement on the most appropriate and efficient ways of managing the two conditions. In the EGD, an operational definition for MCI and Dementia was agreed upon and a pathway was developed for the usual practice in the Malaysian health system. A typical case used, as a reference is a 60-year-old patient referred to a memory clinic with complaint of “forgetfulness”. After three outpatient visits in the clinic, the diagnosis of MCI and Dementia could be clinically established. The clinical pathways covered all active clinical and non-clinical management of the patient over a period of one year. The experts identified the additional resources required to manage these patients for the whole spectrum of lifetime based on the expected life expectancy. The Clinical pathway (CP) for MCI and Dementia was successfully developed in EGD with strong support from practitioners in the health system. The findings will help the researchers to identify all-important clinical activities and interventions that will be included in the costing study.
Occupational cancers, including mesothelioma and lung cancer are linked to the use of asbestos. Annually, at least 100,000 global deaths are attributed to asbestos exposure putting a heavy burden on national budgets. Expenses incurred on treatment of asbestos related diseases (ARDs) reduce households and national resource savings, while ARDs culminate in terminal burdens. The objective of this study is to measure the economic burden of ARDs and to assess the economic impact of asbestos consumption. The health and economic burden of asbestos was estimated in macro-global consumption-production model using production function frontier-based and generalized least squared approach for asbestos products and cost tabulation. Production, in metric tons (Mt) was adopted as a dependent variable among explanatory variables, including consumption. Information on treatment cost of asbestos related diseases (mesothelioma, asbestosis and lung cancer) was obtained from costing information and published literatures. Annual total economic burden of asbestos is at USD 11.92 billion. Out of this cost, USD 4.34 billion per annum is the economic burden of managing three common ARDs. The cost of compensation for patients suffering ARDs is USD 4.28 billion. From the remaining USD 3.3 billion, USD 2.93 billion is the value of asbestos consumed in 2003 and USD372.15 million is the loss of earning due to hospital visits and admissions. For every USD 1 spent on consumption of asbestos, global economy has to absorb almost USD 4 due to health consequences of ARDs. Banning of asbestos production and usage in production of goods has far-reaching impacts on household welfare, health and economic development. The insights revealed are expected to inform decision makers the need to ban all forms of asbestos, especially in developing countries where usage is increasing.
Caregivers may experience the need for information, social support, a range of services and financial support in caring for children with disabilities. However, some of these needs are unmet. This study aims to determine the perceived unmet needs among caregivers of children with disabilities at the Community-based Rehabilitation centre (CBR). A cross-sectional study was carried out among a total of 337 caregivers, who were recruited from 12 CBR centres in Selangor. The unmet needs were assessed using Family Needs Survey (FNS) questionnaire, which included six subscales of needs such as need for information, social support, community services, explaining to others, financial support and family functioning. Caregivers identified the need for information that the child might receive in the future as their greatest need (94.4%) and the least was the need for getting more counseling or help in getting a job (16.3%). The mean score for the overall unmet needs was 18.67 (SD=7.623). Out of six subscales of FNS, the need for information had the highest rating which was 98.3%, followed by need for social support (93.4%), need for community services (84.0%), need for financial support (79.9%), need for family functioning (61.8%) and need for explaining to others (46.2%). The unmet needs varied within the subscales. Therefore, more effective intervention programs are needed in community-based rehabilitation centres to match or reduce those varied unmet needs in order to allow caregivers to provide better care for their children with disabilities.
The trend of using nonprescription substances for weight-loss management is common. There are several factors associated with the use of nonprescription substances. This study aimed to determine prevalence and factors associated with the use of nonprescription substances for weight-loss management among university students. A cross sectional study was conducted from August until October 2013 among 358 postgraduate students aged 22 - 45 years in Universiti Kebangsaan Malaysia (UKM). A validated self-administered questionnaire was distributed by multistage sampling to the students. The prevalence of using nonprescription substances among university students was 27.9% (n=100). There were significant association between use of nonprescription substances with age (t=2.41, p=0.017), peer influence (t=7.06, p
We compared the determinant factors of depression; among faculties in university, among junior and senior students, and gender differences among representative samples of faculties in university. Centre for Epidemiological Studies Depression (CES-D) consisting for 20 questions was used to assess the status of well-being of students. A total of 240 students participated and completed the assessment forms. The results were then compared and analyzed using the IBM SPSS Statistics version 21. There was no effect of faculty on depression (p=0.854). The association between year of study and depression was not statistically significant (p≥0.05). Likewise, the association between gender and depression was statistically not significant (p≥0.05). The study revealed absence of statistically significant effect of faculty on depression. It was also found that gender and depression as well as year of study and depression were not statistically significant.
Posture is one of the most important factor that need to be considered in any postural analysis. Awkward, extreme,
and repetitive postures can increase the risk of musculoskeletal disorders (MSDs). As observational methods are more
widely used than instrumentation-based methods to assess postural problems, this study reviews and assesses the
scientific literature of observational methods and focused on pen and paper based specifically. In order to identify the
published methods, a list of English or Malay articles dating as far back as 1990 was compiled from PubMed, Science
Direct and Google Scholar. The keywords were ergo*, posture*, method*, observational*, postural problems*, pen and
paper*, posture analysis*, indirect* and macro-ergo*. In addition, a secondary search was also performed using
bibliography of retrieved articles so that additional papers for conducting review and evaluations can be collected. A
total of 121 articles that assessed postural problems in working activities were found. However, after intensive
screening process only 6 articles were selected to be further analyzed. Posture of upper arms/shoulder, lower arms/
elbow, wrist, neck, back/trunk and leg were highlighted in this study. The limitations and the strengths of the
published pen and paper based observational method focusing on those postures were also discussed. The finding of
this review will benefit researchers in the process of understanding unsafe posture in workplace. It could also provide
to researcher on how to improve the current pen and paper based observational method for assessing postural
problems.
Prolonged sitting is one of the factors for back discomfort. Sitting in the same position for long periods of time is worse.
This experimental based study was conducted to achieve three objectives. There were to 1) identify whether is there any
differences between perceived body discomfort among respondents before and after upright sitting, 2) identify whether
is there any differences between perceived body discomfort among respondents before and after slump sitting and 3)
compare the level of perceived body discomfort among respondents after two sitting postures. Thirty young and healthy
adults were recruited as study respondents. Each respondent was asked to sit in a posture either upright or slump for 30
minutes. Respondents were then rated their body discomfort using Borg CR-10 scale before and after sitting. Another
sitting posture was carried out after one day interval. There is a significant difference between perceived body
discomfort among respondents before and after upright and slump sitting. Body discomfort of upright sitting was shown
significantly greater than slump sitting. Although, slump sitting caused less discomfort than upright, but it proven by
previous studies did not provide benefit to occupational safety and health practice in preventing occupational health
related disease.
Increasing physical activity level during and after treatment is recommended by the American Cancer Society because of the many benefits namely reducing fatigue and improves psychological distress which leads to an improvement in the quality of life. This study is aimed to compare physical activity level and body composition between oncology patients who are still undergoing treatment and those on medical follow-up. Patients were recruited based on convenience sampling from the Oncology Outpatient Clinics of Universiti Kebangsaan Malaysia Medical Center (UKMMC). Anthropometric measurements and body compositions were measured using calibrated tools while physical activity level were assessed using Global Physical Activity Questionnaire (GPAQ). Medical treatment history was obtained from patients medical records. A total of 53 patients (n=38 were undergoing treatment and n=15 was on follow-up) consisting of Malays (54.7%) and Chinese (45.3%) and with mean age of 55.3 ± 9.3 years. Most patients were previously diagnosed with ovarian cancer (39.6%) and colon cancer (18.9%) patients and they were at cancer stage III (18.8%). Body mass index (BMI) and percent fat mass were significantly different (p<0.05) between patients undergoing treatment (22.8 ± 2.7 kg/m2, 28.7 ± 7.2%) and on follow-up (26.2 ± 5.5 kg/m2, 37.1 ± 11.9%). Majority of the patients undergoing treatment were categorized under low physical activity compared to those on follow-up (p<0.05). Physical activity level measured as METS-minutes/week is also found to be significantly different (p<0.05) between patients on treatment and follow-up. As a conclusion, cancer patients undergoing treatment have low physical activity, with lower BMI and fat mass compared to those on follow-up. This is consistent with their nature of living where during treatment the patients will resting while coping with side effects of treatments.
Teenage pregnancy carries serious impacts on adolescent health. This study aimed to examine the effects of pregnancy on adolescents and to explore how they cope with the problems they faced during the pregnancy. It involved 26 adolescents residing in a government shelter home in Kuala Lumpur. A self-administered questionnaire containing a mixture of open- and closed-ended questions was used. Among physical (sleeping problem and self-care problem), psychological (emotional difficulties and low self-efficacy) and social (stigma and discrimination, financial difficulty, friendship problem and school dropout) problems, emotional difficulties were the most common problems, whereas stigma and discrimination was the least common. Young adolescents aged less than 16 years old were significantly associated with poor self-care (p=0.01). To cope with their problems, the adolescents generally used avoidance, withdrawal, and social support, particularly from parents and peers. Doctors were the least popular among all. In conclusion, holistic and individualised care is needed. Strategies to reduce emotional problem experienced by pregnant adolescents should be implemented. The available healthcare services for teenage pregnancy should also be promoted.