Displaying publications 141 - 160 of 292 in total

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  1. Ahmad Nawawi Mohd Amin, Wan Hasrulnizzam Wan Mahmood, Seri Rahayu Kamat, Ilyana Abdullah
    MyJurnal
    The purpose of this paper is to prepare a conceptual framework of hybrid lean and ergonomics for assembly manufacturing process based. The research used PDCA approach as a basis in linking the relationship between lean manufacturing and ergonomics. Comprehensive literature review identify the lean ergonomics issues, best practices, and also the way to improve the ergonomic conditions in the workplace, especially those impacting employees on the assembly process. The findings show that the job design strategies for reducing extreme injuries influence by repetitive tasks. Selections of lean tools and technique, human factors analysis and lean performance measure are the key point on the stages of the PDCA conceptual framework for lean ergonomics in working assembly process. This paper also demonstrates by continuous improvement applied between the elimination of waste and increased productivity and the impacts on the ergonomic conditions to carry out operations and consequently by improving the productivity and well-being of its employees based on implementation of PDCA conceptual frameworks.
    Matched MeSH terms: Workplace
  2. Eusof Izzudin MP, Al–Bedri A, Subramaniam V, Matthews P, Cheong AT
    MyJurnal
    Depressive disorders are common. As compared to the general population, healthcare personnel are hypothesized to have an above than average risk to develop this condition. The aim of this study is to assess the prevalence of this condition and its contributing factors amongst primary healthcare personnel.
    Methods: A cross-sectional study was conducted by universally sampling 179 primary healthcare personnel at nine primary healthcare centers across Kuala Lumpur and Selangor in May 2015. Depressive symptoms were screened using self-administered Patient Health Questionnaire-9 (PHQ-9) questionnaire. Socio-demographic and work profile data were also assessed.
    Results: 92.7% of the 179 personnel agreed to participate. Near half of the respondents were staff nurses (49%), followed by doctors (22%), assistant medical officers (10%), attendants (10%) and the remaining were pharmacists, dieticians, and laboratory technicians (9%). Depression was found to be present in 38% of the participants with one-third found to have moderate to severe depression. Bivariate analysis show that males (p=0.043), assistant medical officers (p=0.048), and working more than 10 hours per day (p=0.019) are significant risk factors. Further analysis by logistic regression shows that working more than 10 hours per day increases the odds of depression by 3.1 (OR 3.1, 95% CI 1.1-8.7, p=0.03).
    Conclusions: A high prevalence of depression was found within the healthcare personnel population at the primary healthcare centres studied. Being a male, employed as an assistant medical officer, and, prolonged hours at the workplace is a significant risk factor for depression.
    Matched MeSH terms: Workplace
  3. Abdul Rohim Tualeka, Juliana Jalaludin
    MyJurnal
    The production of ammonia has been increasing over the past few years. Unfortunately, the production does not follow the safety control of ammonia on workers. Indonesia still adopts chemical standard from other countries. Therefore, it requires an ammonia standard at the highest dose without effect or no observed adverse effect level (NOAEL) in the workplace. This research aims to determine standard at the highest dose of without effect through the expression of CD8 cells as well as analysis of histological alteration CD8 lymphocyte between exposed to ammonia group and control. Methods: The study was a laboratory experimental research with a post-test only control group design. The research used Rattus novergicus species as many as 24. NOAEL was determined by middle dose with a location between the smallest and the largest dose. The doses of ammonia were given through inhalation. The histological alteration of CD8 between ammonia in exposed and the control group were analyzed by using the Kruskal Wallis test. Results: NOAEL was found through CD8 located in group 3 with 0.0154 dose mg/kg body weight. There was a differential expression of CD8 lymphocyte cells in the white mice lung between exposed to ammonia group and control (p=0.042). Conclusion: The expression of CD8 lymphocyte cells in the white mice lung exposed to ammonia differs significantly with the number of the expression of CD8 lymphocyte cells in white mice lung at control group. NOAEL was 0.0154 mg/kg body weight of white mice.
    Matched MeSH terms: Workplace
  4. Nursyafiqah Zainal, Irniza Rasdi, Suhainizam Muhamad Saliluddin
    MyJurnal
    Workplace violence become a global concern and perceived as a very serious safety and health hazard especially in healthcare setting. The aim of this study was to determine the prevalence of workplace violence and its associated risk factors among healthcare workers in public hospital. Methods: This was a cross-sectional study which involved 136 randomly selected respondents among doctors and nurses in a public hospital in Kuala Lumpur. Data was gathered through a self-administered questionnaire consisted of two standardized questionnaire; Workplace Violence (WPV) and Job Content Questionnaire (JCQ-27). Results: The response rate was 91%. The prevalence of reported WPV was 71.3% where nurses (73.2%) had slightly higher prevalence than doctors (69.2%). The most common forms of WPV was verbal abuse (70.6%), followed by bullying/mobbing (29.4%), physical violence (11.0%), and sexual harassment (6.6%). The perpetrators were mostly among relatives of patients and visitors followed by the patients. Multiple logistic regression shows that respondents working in Accident and Emergency (A&E) Department was 17 times more likely to report workplace violence than those working in Pediatric Department. Also, for every 1 year younger, respondents were 5 times more likely to experience workplace violence controlling for other factors. Conclusion: The prevalence of workplace violent among respondents were high and most common among young workers, especially nurses and those working in A&E Department. Hence, further assessment should be carried out to reduce the identified risk factors and to find ways of solving this issue.
    Matched MeSH terms: Workplace; Workplace Violence
  5. Muhammad Ajib Abd R, Rozmi I, Noh A, Norhayati I, Faizah I
    Jurnal Psikologi Malaysia, 2018;32:104-113.
    Occupation is the most important element in changing the quality-of-life continuity and the recovery of drug addicts. This study aimed to measure the level of employment sustainability among ex-clients from the National Anti-Drug Agency (AADK). This study used a quantitative approach with a cross-sectional design. A total of 130 AADK ex-clients who were in employment were selected as respondents for this study. Our findings show that the majority of AADK ex-clients can survive relatively well enough for between 1 to 2 years depending on the factors of wages, work environment, interests and skills. The finding of this study implies that former clients tend to remain only 1 to 2 years in employment if their wages and jobs are not in line with their will. The findings also found that there was a significant relationship between the job-person fit and job satisfaction with motivation. Hence, this study is capable to modify the perceptions and views of employers towards clients' initiative for being persistent at the workplace as well as improving existing policies in providing incentives to clients for being consistent on the job.
    Matched MeSH terms: Workplace
  6. Lim KH, Lim HL, Teh CH, Kee CC, Heng PP, Cheah YK, et al.
    Tob Induc Dis, 2018;16.
    DOI: 10.18332/tid/95188
    Introduction: Understanding the prevalence of secondhand smoke (SHS) exposure and the associated factors is beneficial for the formulation of effective measures to reduce exposure to SHS. The purpose of this study was to determine SHS exposure at home and workplace, and its associated factors among non-smoker Malaysian adults. Methods: Data were extracted from the Global Adult Tobacco Survey-Malaysia (GATS-M) that involved a representative sample of 5112 Malaysian adults. Logistic regression analyses were performed to examine the association between SHS exposure, sociodemographic factors, knowledge on the danger of SHS, and smoking restrictions at home and at work among non-smokers. Results: Among non-smoker Malaysians, age ≥15 years, 27.9% (equivalent to approximately 4.21 million non-smokers) and 33.9% (equivalent to approximately 1.37 million non-smokers) reported that they were exposed to SHS at home and the workplace, at least once a month, respectively. Women (AOR=2.12, 95% CI: 1.61.2.78), young individuals (AOR=3.06, 95% CI: 1.48.6.33), Malays (AOR=2.39, 95% CI: 1.56.3.64) or other Bumiputra ethnic groups (AOR=2.40, 95% CI: 1.39.4.19) and those who worked as other than government employees were more likely to report SHS exposure at home (non-government employee: AOR=1.88, 95% CI: 1.06.3.36). Respondents with a total smoking restriction at home did not report any SHS exposure at home. Similarly, those whose workplace had smoking restrictions were less likely to report SHS exposure at the work compared to their counterparts whose workplace had partial (AOR=3.08, 95% CI: 1.84.5.15) or no smoking restrictions (AOR=15.33, 95% CI: 6.75.34.86). Conclusions: A substantial proportion of Malaysian adults were exposed to SHS at home and at work. The findings emphasize the need for policies on smoking restrictions at work and the need to promote the adoption of a completely smoke-free home, among the Malaysian population.
    Study name: Global Adults Tobacco Survey (GATS-2011)
    Matched MeSH terms: Workplace
  7. Shariat A, Cleland JA, Danaee M, Kargarfard M, Sangelaji B, Tamrin SBM
    Braz J Phys Ther, 2018;22(2):144-153.
    PMID: 28939263 DOI: 10.1016/j.bjpt.2017.09.003
    OBJECTIVE: To evaluate the effectiveness of exercise, ergonomic modification, and a combination of training exercise and ergonomic modification on the scores of pain in office workers with neck, shoulders, and lower back pain.

    METHODS: Participants (N=142) in this randomized controlled trial were office workers aged 20-50 years old with neck, shoulders, and lower back pain. They were randomly assigned to either the ergonomic modification group, the exercise group, the combined exercise and ergonomic modification group, or the control group (no-treatment). The exercise training group performed a series of stretching exercises, while the ergonomic group received some modification in the working place. Outcome measures were assessed by the Cornell Musculoskeletal Disorders Questionnaire at baseline, after 2, 4, and 6 months of intervention.

    RESULTS: There was significant differences in pain scores for neck (MD -10.55; 95%CI -14.36 to -6.74), right shoulder (MD -12.17; 95%CI -16.87 to -7.47), left shoulder (MD -11.1; 95%CI -15.1 to -7.09) and lower back (MD -7.8; 95%CI -11.08 to -4.53) between the exercise and control groups. Also, significant differences were seen in pain scores for neck (MD -9.99; 95%CI -13.63 to -6.36), right shoulder (MD -11.12; 95%CI -15.59 to -6.65), left shoulder (MD -10.67; 95%CI -14.49 to -6.85) and lower back (MD -6.87; 95%CI -10 to -3.74) between the combined exercise and ergonomic modification and control groups. The significant improvement from month 4 to 6, was only seen in exercise group (p<0.05).

    CONCLUSION: To have a long term effective on MSDs, physical therapists and occupational therapists should use stretching exercises in their treatment programs rather than solely rely on ergonomic modification.

    CLINICAL TRIAL ID: NCT02874950 - https://www.clinicaltrials.gov/ct2/show/NCT02874950.

    Matched MeSH terms: Workplace
  8. Maakip I, Oakman J, Stuckey R
    J Occup Rehabil, 2017 Jun;27(2):228-238.
    PMID: 27339144 DOI: 10.1007/s10926-016-9650-5
    Purpose Workers with musculoskeletal pain (MSP) often continue to work despite their condition. Understanding the factors that enable them to remain at work provides insights into the development of appropriate workplace accommodations. This qualitative study aims to explore the strategies utilised by female Malaysian office workers with MSP to maintain productive employment. Methods A qualitative approach using thematic analysis was used. Individual semi-structured interviews were conducted with 13 female Malaysian office workers with MSP. Initial codes were identified and refined through iterative discussion to further develop the emerging codes and modify the coding framework. A further stage of coding was undertaken to eliminate redundant codes and establish analytic connections between distinct themes. Results Two major themes were identified: managing the demands of work and maintaining employment with persistent musculoskeletal pain. Participants reported developing strategies to assist them to remain at work, but most focused on individually initiated adaptations or peer support, rather than systemic changes to work systems or practices. A combination of the patriarchal and hierarchical cultural occupational context emerged as a critical factor in the finding of individual or peer based adaptations rather than organizational accommodations. Conclusions It is recommended that supervisors be educated in the benefits of maintaining and retaining employees with MSP, and encouraged to challenge cultural norms and develop appropriate flexible workplace accommodations through consultation and negotiation with these workers.
    Matched MeSH terms: Workplace/organization & administration*
  9. Isahak M, Loh MY, Susilowati IH, Kaewboonchoo O, Harncharoen K, Mohd Amin N, et al.
    Asia Pac J Public Health, 2017 May;29(4):315-327.
    PMID: 28569111 DOI: 10.1177/1010539517699060
    Quality of life is associated with several factors, including personal living styles and working conditions. This article aims to investigate the factors associated with quality of life among small and medium enterprises (SME) workers in 4 countries of the Association of Southeast Asian Nations (ASEAN), namely Malaysia, Indonesia, Thailand, and Vietnam. A total of 2014 workers from food and textile industries were asked to answer a questionnaire about their sociodemographic characteristics, working environment and conditions, and quality of life. Results from showed that lifestyle (ie, alcohol intake and exercising), working characteristics (ie, shift work, working hours, and working days) and workplace conditions were associated with SME workers' quality of life (ie, physical, psychological, social, and environmental domain). Among the 16 types of workplace conditions, "sitting on the chair" and "slippery floor" most affect their quality of life . It is important for these variables to be taken into account in promoting workers' well-being and quality of life.
    Matched MeSH terms: Workplace/statistics & numerical data*
  10. Maakip I, Keegel T, Oakman J
    Appl Ergon, 2017 Apr;60:52-57.
    PMID: 28166899 DOI: 10.1016/j.apergo.2016.11.004
    Prevalence and predictors associated with musculoskeletal disorders (MSDs) vary considerably between countries. It is plausible that socio-cultural contexts may contribute to these differences. We conducted a cross-sectional survey with 1184 Malaysian and Australian office workers with the aim to examine predictors associated with MSD discomfort. The 6-month period prevalence of self-reported MSD discomfort for Malaysian office workers was 92.8% and 71.2% among Australian workers. In Malaysia, a model regressing level of musculoskeletal discomfort against possible risk factors was significant overall (F [6, 370] = 17.35; p 
    Matched MeSH terms: Workplace/psychology
  11. LILY LIM, ZABIDAH PUTIT, CHANG CHING THON
    MyJurnal
    A qualitative study was conducted to assess the nursing students’ experiences of their clinical practice at one public university in Sarawak, Malaysia. Purposive sampling was used to recruit nine undergraduate nursing degree students at a medical faculty. An in-depth interview based on an open-ended questionnaire was used to collect data. The open-ended questionnaire was used to assess the students’ expectation, feelings, challenging experiences related to work culture, knowledge and skills in patient care, teaching learning supports, people interpersonal relationship, students’ role and their coping mechanism in clinical practice. Data were analysed using content analysis approach facilitated by Nvivo software (Version 8.) The themes emerged from the data analysis included (a) Gaining insight into the reality of clinical working environment and (b) challenges. The subthemes illustrated the students’ challenges were interpersonal relationship with people at the work place, different ward environment, theorypractice gap and insufficient clinical practice, and anxiety. The participants also reported experiencing anxiety due to challenges; however, after a period of time, they learnt to cope with them. The students were able to use different coping mechanism such as internal and external motivation, and this increased their confidence as they progressed in their learning. The learning difficulties faced by nursing students during clinical placement show that a supportive learning environment is important. This study proposed practical strategies to empower students in clinical learning and increase their self-esteem and confidence. In order to improve quality of students’ clinical education, adequate and effective work collaboration between nursing education and health care services are recommended. Future research should focus on how to create a supportive clinical learning environment in local setting
    Matched MeSH terms: Workplace
  12. Thevi T, Reddy SC
    MyJurnal
    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.
    Matched MeSH terms: Workplace
  13. Tan AKG, Yen ST
    DOI: 10.1007/s10389-016-0754-3
    Aim: To investigate cigarette consumption patterns exhibited by non-smokers, occasional smokers, and daily smokers in Malaysia.
    Subjects and methods: A sample of 4204 individuals from the 2011 Malaysian Global Adult Tobacco Survey is analyzed. A zero-inflated ordered probit model is used to accommodate the ordinal nature of smoking outcomes with excessive zero observations of non-smokers.
    Results: Socio-demographic characteristics are closely associated with consumption patterns of non-smokers, occasional smokers, and daily smokers. Specifically, urbanites, government employees, and Malays exhibit greater tendencies to be daily smokers and lower propensities to be non-smokers than others. Education is a deterring factor in cigarette smoking as higher education up to the tertiary level raises the propensity of being a non-smoker by 8.16 percentage points. The role of ethnicity is highlighted as individuals of Malay and other ethnic backgrounds are more likely to smoke daily, while exhibiting lower propensities of being non-smokers. Males are more likely to engage in occasional or daily smoking than females. Employment in government or non-government sectors increases the probability of daily smoking.
    Conclusions: Our results suggest the need to include measures to cope with internal or external cues among smokers with specific socio-demographic characteristics. Cessation interventions should focus on daily smokers in urban surroundings with low education levels and those of Malay ethnic origins. Anti-smoking measures in line with occasional smoking may include ameliorating the male attitude toward smoking and policies to prohibit workplace indulgence.
    Study name: Global Adults Tobacco Survey (GATS-2011)
    Matched MeSH terms: Workplace
  14. Nurulain M, Syed Ismail S, Emilia Z, Vivien H
    Malaysian Journal of Public Health Medicine, 2017;17 Special(1):123-132.
    Agriculture sector accounts significant numbers of injuries and fatalities in the workplace particularly related to pesticide management. Among three main pathways of pesticide exposure, dermal contact is the most common route, which exposure usually occurs during pesticide mixing/loading, application, harvesting and other farming activities. This review aims to present and discuss several vital components of pesticide dermal exposure among agriculture workers, as well as pesticide application in agriculture sector in Malaysia involving different commodity agriculture sub-sectors. Pesticide exposure was discussed from perspective of three pesticide management activities (i.e. preparation, application and cleaning) that contribute to the risk of exposure through three routes (i.e. emission, deposition, transfer). Moreover, this paper also discussed pesticide dermal exposure risk assessment methods which can be defined into exposure assessment and effect assessment. The exposure rate was affected by various factors such as application equipment, application rate and duration, type of pesticide formulation, pesticide management stage, usage of personal protective equipment, training and aptitude of the applicator as well as environmental factors (i.e. temperature, humidity, wind speed and direction). The factors mention earlier have been used to explain the exposure distribution over different parts of the body and support the fact that pesticide type was not a major factor in total exposure.
    Matched MeSH terms: Workplace
  15. Zuliza M, Irniza R, Emilia Z
    Malaysian Journal of Public Health Medicine, 2017;17 Special(1):133-139.
    The aim of this study was to determine the prevalence of sick building syndrome (SBS) and other factors contributing to probable mental health problems among university laboratory staffs. A cross-sectional study was conducted among 264 laboratory staffs in UPM. Data was collected using validated self-administrated questionnaires consists of Job Content Questionnaire (JCQ), General Health Questionnaire (GHQ) and SBS. Data was analyzed using SPSS version 22.0. In total, about 28% of the participants reported having probable mental health problems. The prevalence of SBS was 31.4%. After controlling for confounders, the significant factors for probable mental health problems were job insecurity (AOR 2.33, 95% CI 0.212- 0.867), job demand (AOR 1.12, 95% CI 0.445-0.921), fatigue (AOR 0.94, 95% CI 0.162-1.425), drowsiness (AOR 0.75, 95% CI 1.023-4.647) and household income (AOR 0.339, 95% CI0.166-0.995).Results visibly showed that psychosocial factors and symptoms of SBS at their working environment contribute to probable mental health problems among laboratory staffs. The strongest predictors in this study were job insecurity. Hence, further assessment and preventive measures should be carried out to reduce the risk factors of probable mental health problems and to improve working environment among university laboratory staffs.
    Matched MeSH terms: Workplace
  16. Kaewboonchoo O, Isahak M, Susilowati I, Phuong TN, Morioka I, Harncharoen K, et al.
    Asia Pac J Public Health, 2016 Jul;28(5):438-49.
    PMID: 27273897 DOI: 10.1177/1010539516651957
    Work ability is related to many factors that might influence one's capacity to work. This study aimed to examine the work ability and its related factors among small and medium enterprises (SME) workers in 4 Association of Southeast Asian Nations (ASEAN) countries. The participants in this study included 2098 workers from food and textile industries in Indonesia, Malaysia, Thailand, and Vietnam. A cross-sectional survey of anonymous self-administrated questionnaire was designed to collect information on sociodemographic factors, work environment and ergonomic condition, musculoskeletal disorders, and work ability. Bivariate correlation coefficient and multiple linear regression analyses were used to predict the work ability. Results of this study confirm that work ability in 4 ASEAN countries was similar to that in European countries, and that the sociodemographic factors, work environment and ergonomic condition, and musculoskeletal disorder (MSD) were associated with work ability. These factors are important for considering occupational health and safety policy to promote work ability in food, textile, and other SME workers.
    Matched MeSH terms: Workplace
  17. Dahlan ND, Gital YY
    Appl Ergon, 2016 May;54:169-76.
    PMID: 26851476 DOI: 10.1016/j.apergo.2015.12.008
    The study was done to identify affective and sensory responses observed as a result of hysteresis effects in transient thermal conditions consisting of warm-neutral and neutral - warm performed in a quasi-experiment setting. Air-conditioned building interiors in hot-humid areas have resulted in thermal discomfort and health risks for people moving into and out of buildings. Reports have shown that the instantaneous change in air temperature can cause abrupt thermoregulation responses. Thermal sensation vote (TSV) and thermal comfort vote (TCV) assessments as a consequence of moving through spaces with distinct thermal conditions were conducted in an existing single-story office in a hot-humid microclimate, maintained at an air temperature 24 °C (± 0.5), relative humidity 51% (± 7), air velocity 0.5 m/s (± 0.5), and mean radiant temperature (MRT) 26.6 °C (± 1.2). The measured office is connected to a veranda that showed the following semi-outdoor temperatures: air temperature 35 °C (± 2.1), relative humidity 43% (± 7), air velocity 0.4 m/s (± 0.4), and MRT 36.4 °C (± 2.9). Subjective assessments from 36 college-aged participants consisting of thermal sensations, preferences and comfort votes were correlated against a steady state predicted mean vote (PMV) model. Local skin temperatures on the forehead and dorsal left hand were included to observe physiological responses due to thermal transition. TSV for veranda-office transition showed that no significant means difference with TSV office-veranda transition were found. However, TCV collected from warm-neutral (-0.24, ± 1.2) and neutral-warm (-0.72, ± 1.3) conditions revealed statistically significant mean differences (p < 0.05). Sensory and affective responses as a consequence of thermal transition after travel from warm-neutral-warm conditions did not replicate the hysteresis effects of brief, slightly cool, thermal sensations found in previous laboratory experiments. These findings also indicate that PMV is an acceptable alternative to predict thermal sensation immediately after a down-step thermal transition (≤ 1 min exposure duration) for people living in a hot-humid climate country.
    Matched MeSH terms: Workplace/psychology*
  18. Nazar GP, Lee JT, Arora M, Millett C
    Nicotine Tob Res, 2016 May;18(5):1230-9.
    PMID: 26610936 DOI: 10.1093/ntr/ntv261
    INTRODUCTION: In high-income countries, secondhand smoke (SHS) exposure is higher among disadvantaged groups. We examine socioeconomic inequalities in SHS exposure at home and at workplace in 15 low- and middle-income countries (LMICs).
    METHODS: Secondary analyses of cross-sectional data from 15 LMICs participating in Global Adult Tobacco Survey (participants ≥ 15 years; 2008-2011) were used. Country-specific analyses using regression-based methods were used to estimate the magnitude of socioeconomic inequalities in SHS exposure: (1) Relative Index of Inequality and (2) Slope Index of Inequality.
    RESULTS: SHS exposure at home ranged from 17.4% in Mexico to 73.1% in Vietnam; exposure at workplace ranged from 16.9% in Uruguay to 65.8% in Bangladesh. In India, Bangladesh, Thailand, Malaysia, Philippines, Vietnam, Uruguay, Poland, Turkey, Ukraine, and Egypt, SHS exposure at home reduced with increasing wealth (Relative Index of Inequality range: 1.13 [95% confidence interval [CI] 1.04-1.22] in Turkey to 3.31 [95% CI 2.91-3.77] in Thailand; Slope Index of Inequality range: 0.06 [95% CI 0.02-0.11] in Turkey to 0.43 [95% CI 0.38-0.48] in Philippines). In these 11 countries, and in China, SHS exposure at home reduced with increasing education. In India, Bangladesh, Thailand, and Philippines, SHS exposure at workplace reduced with increasing wealth. In India, Bangladesh, Thailand, Philippines, Vietnam, Poland, Russian Federation, Turkey, Ukraine, and Egypt, SHS exposure at workplace reduced with increasing education.
    CONCLUSION: SHS exposure at homes is higher among the socioeconomically disadvantaged in the majority of LMICs studied; at workplaces, exposure is higher among the less educated. Pro-equity tobacco control interventions alongside targeted efforts in these groups are recommended to reduce inequalities in SHS exposure.
    IMPLICATIONS: SHS exposure is higher among the socioeconomically disadvantaged groups in high-income countries. Comprehensive smoke-free policies are pro-equity for certain health outcomes that are strongly influenced by SHS exposure. Using nationally representative Global Adult Tobacco Survey (2008-2011) data from 15 LMICs, we studied socioeconomic inequalities in SHS exposure at homes and at workplaces. The study showed that in most LMICs, SHS exposure at homes is higher among the poor and the less educated. At workplaces, SHS exposure is higher among the less educated groups. Accelerating implementation of pro-equity tobacco control interventions and strengthening of efforts targeted at the socioeconomically disadvantaged groups are needed to reduce inequalities in SHS exposure in LMICs.
    Study name: Global Adults Tobacco Survey (GATS-2011)
    Matched MeSH terms: Workplace/economics*
  19. Hisham R, Ng CJ, Liew SM, Hamzah N, Ho GJ
    BMJ Open, 2016 Mar 09;6(3):e010565.
    PMID: 26962037 DOI: 10.1136/bmjopen-2015-010565
    OBJECTIVE: To explore the factors, including barriers and facilitators, influencing the practice of evidence-based medicine (EBM) across various primary care settings in Malaysia based on the doctors' views and experiences.
    RESEARCH DESIGN: The qualitative study was used to answer the research question. 37 primary care physicians participated in six focus group discussions and six individual in-depth interviews. A semistructured topic guide was used to facilitate both the interviews and focus groups, which were audio recorded, transcribed verbatim, checked and analysed using a thematic approach.
    PARTICIPANTS: 37 primary care doctors including medical officers, family medicine specialists, primary care lecturers and general practitioners with different working experiences and in different settings.
    SETTING: The study was conducted across three primary care settings-an academic primary care practice, private and public health clinics in Klang Valley, Malaysia.
    RESULTS: The doctors in this study were aware of the importance of EBM but seldom practised it. Three main factors influenced the implementation of EBM in the doctors' daily practice. First, there was a lack of knowledge and skills in searching for and applying evidence. Second, workplace culture influenced doctors' practice of EBM. Third, some doctors considered EBM as a threat to good clinical practice. They were concerned that rigid application of evidence compromised personalised patient care and felt that EBM did not consider the importance of clinical experience.
    CONCLUSIONS: Despite being aware of and having a positive attitude towards EBM, doctors in this study seldom practised EBM in their routine clinical practice. Besides commonly cited barriers such as having a heavy workload and lack of training, workplace 'EBM culture' had an important influence on the doctors' behaviour. Strategies targeting barriers at the practice level should be considered when implementing EBM in primary care.
    Study site: klinik kesihatan, general practice clinics, Klang Valley, Malaysia
    Matched MeSH terms: Workplace*
  20. Gopalakrishnan V, Umabalan T, Affan M, Zamri AA, Kamal A, Sandheep S
    Med J Malaysia, 2016 02;71(1):8-11.
    PMID: 27130736
    INTRODUCTION: Being a houseman in Malaysian hospitals can be very stressful. Stress can affect decision making to a great extent while addressing the needs of the patient in an emergency setting. This necessitated a study to find out the main sources of stress among housemen.
    METHODS: This was a cross-sectional descriptive study carried out among 55 housemen using a questionnaire on sources of stress. The data was analysed using SPSS version 17.
    RESULTS: A total of 16 factors leading to stress were studied among the housemen. Poor work and social life balance, annoying non-clinical personnel and medico-legal threats were among the top causes of stress.
    CONCLUSION: The factors leading to stress among housemen should be considered for effective working of the hospital and improving the workplace atmosphere for the housemen.
    Matched MeSH terms: Workplace*
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