Displaying all 14 publications

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  1. Ramli R, Oxley J
    Injury, 2016 Nov;47(11):2442-2449.
    PMID: 27645615 DOI: 10.1016/j.injury.2016.09.022
    INTRODUCTION: In Malaysia, motorcyclists continue to outnumber other road users in injuries and deaths. The objective of this study was to determine the association between helmet fixation and helmet type with head injury and severity of head injury among Malaysian motorcyclists.

    METHODS: The study design was a prospective cross-sectional study. The participants involved injured motorcyclists who were admitted in five selected hospitals in Klang Valley, Malaysia. Participants who sustained head injury were selected as the cases while those with injury below the neck (IBN) were selected as the controls. Questionnaire comprising motorcyclist, vehicle, helmet and crash factors was examined. Diagnoses of injuries were obtained from the participants' medical records.

    RESULTS: The total subjects with head injuries were 404 while those with IBN were 235. Majority of the cases (76.2%) and controls (80.4%) wore the half-head and open-face helmets, followed by the tropical helmets (5.4% and 6.0% of the cases and controls, respectively). Full-face helmets were used by 1.2% of the cases and 4.7% of the controls. 5.7% of the cases and 6.0% of the controls did not wear a helmet. 32.7% of the cases and 77.4% of the controls had their helmets fixed. Motorcyclists with ejected helmets were five times as likely to sustain head injury [adjusted odds ratio, AOR 5.73 (95% CI 3.38-9.73)] and four times as likely to sustain severe head injury [AOR of 4.83 (95% CI 2.76-8.45)]. The half head and open face helmets had AOR of 0.24 (95% CI 0.10-0.56) for severe head injury when compared to motorcyclists who did not wear a helmet.

    CONCLUSION: Helmet fixation is more effective than helmet type in providing protection to the motorcyclists.

  2. Ramli R, Oxley J, Hillard P, Mohd Sadullah AF, McClure R
    BMC Emerg Med, 2014;14:17.
    PMID: 25086638 DOI: 10.1186/1471-227X-14-17
    The effectiveness of helmets in reducing the risk of severe head injury in motorcyclists who were involved in a crash is well established. There is limited evidence however, regarding the extent to which helmets protect riders from facial injuries. The objective of this study was to determine the effect of helmet type, components and fixation status on the risk of facial injuries among Malaysian motorcyclists.
  3. Oxley J, Ravi MD, Yuen J, Hoareau E, Hashim HH
    Ann Adv Automot Med, 2014 1 11;57:329-36.
    PMID: 24406968
    In Malaysia, motorcycle crashes constitute approximately 60 percent of all road trauma, and a substantial proportion involve children 16 years and younger. There are, however, many gaps in our knowledge on contributing factors to crashes and injury patterns amongst children killed and seriously injured in motorcycle crashes. The aim of this study was to examine fatal and serious injury motorcycle-related collisions to identify contributing factors and injury patterns amongst child motorcyclists. All identified motorcyclist fatal crashes between 2007 and 2011 (inclusive) were extracted from the national Police-reported crash database (M-ROADS) and a range of variables were selected for examination. A total of 17,677 crashes were extracted where a rider or pillion was killed and of these crashes 2,038 involved children, equating to 12 percent. Examination of crashes involving children revealed that some crashes involved more than two children on the motorcycle, therefore, overall children constituted 9.5% of fatal and 18.4% of serious injury collisions. A high proportion of child fatal or serious injury collisions involved the child as the rider (62%), and this was most common for children aged between 10 and 16 years. The majority of collisions occurred on rural roads, in speed limit zones of 50-70km/h, and approximately one-third occurred at an intersection. Collisions involving another motorcycle or a passenger vehicle contributed to 41% and 53% of the total fatalities and severe injuries, respectively. A high proportion (43.9%) of the children (25.5% riders and 18.8% pillion) sustained head injuries with 37.7% being in the 10-16 age group. Furthermore, 52.4% of the children sustaining head injuries did not wear a helmet. The implications of these findings for countermeasures within a Safe System framework, particularly interventions aimed at reducing the rate of unlicensed riding and helmet wearing, and infrastructure countermeasures are discussed.
  4. Amin NA, Quek KF, Oxley JA, Noah RM, Nordin R
    Int J Occup Environ Med, 2015 10;6(4):232-42.
    PMID: 26498051 DOI: 10.15171/ijoem.2015.632
    BACKGROUND: The Job Content Questionnaire (M-JCQ) is an established self-reported instrument used across the world to measure the work dimensions based on the Karasek's demand-control-support model.

    OBJECTIVE: To evaluate the psychometrics properties of the Malay version of M-JCQ among nurses in Malaysia.

    METHODS: This cross-sectional study was carried out on nurses working in 4 public hospitals in Klang Valley area, Malaysia. M-JCQ was used to assess the perceived psychosocial stressors and physical demands of nurses at their workplaces. Construct validity of the questionnaire was examined using exploratory factor analysis (EFA). Cronbach's α values were used to estimate the reliability (internal consistency) of the M-JCQ.

    RESULTS: EFA showed that 34 selected items were loaded in 4 factors. Except for psychological job demand (Cronbach's α 0.51), the remaining 3 α values for 3 subscales (job control, social support, and physical demand) were greater than 0.70, indicating acceptable internal consistency. However, an item was excluded due to poor item-total correlation (r<0.3). The final M-JCQ was consisted of 33 items.

    CONCLUSION: The M-JCQ is a reliable and valid instrument to measure psychosocial and physical stressors in the workplace of public hospital nurses in Malaysia.

  5. Ramli R, Oxley J, Noor FM, Abdullah NK, Mahmood MS, Tajuddin AK, et al.
    J Forensic Leg Med, 2014 Aug;26:39-45.
    PMID: 25066171 DOI: 10.1016/j.jflm.2014.06.007
    Motorcycle fatalities constitute the majority of road traffic deaths in Malaysia. The aims of this study were to describe the pattern of fatal injuries among Klang Valley fatal motorcyclists and to describe the factors associated with fatal (vs non-fatal) injuries.
  6. Oxley J, Yuen J, Ravi MD, Hoareau E, Mohammed MA, Bakar H, et al.
    Ann Adv Automot Med, 2014 1 11;57:45-54.
    PMID: 24406945
    In Malaysia, two-thirds of reported workplace-related fatal and serious injury incidents are the result of commuting crashes (especially those involving motorcyclists), however, little is known about the contributing factors to these collisions. A telephone survey of 1,750 motorcyclists (1,004 adults who had been involved in a motorcycle commuting crash in the last 2 years and 746 adult motorcyclists who had not been involved in a motorcycle crash in the last 2 years) was undertaken. The contributions of a range of behavioural, attitudinal, employment and travel pattern factors to collision involvement were examined. The findings revealed that the majority of participants were licensed riders, rode substantial distances (most often for work purposes), and reported adopting safe riding practices (helmet wearing and buckling). However, there were some concerning findings regarding speeding behaviour, use of mobile phones while riding, and engaging in other risky behaviours. Participants who had been involved in a collision were younger (aged 25-29 years), had higher exposure (measured by distances travelled, frequency of riding, and riding on high volume and higher speed roads), reported higher rates of riding for work purposes, worked more shift hours and had a higher likelihood of riding at relatively high speeds compared with participants who had not been involved in a collision. Collisions generally occurred during morning and early evening hours, striking another vehicles, and during normal traffic flow. The implications of these findings for policy decisions and development of evidence-based behavioural/training interventions addressing key contributing factors are discussed.
  7. Amin NA, Nordin R, Fatt QK, Noah RM, Oxley J
    PMID: 25852937 DOI: 10.1186/s40557-014-0023-2
    OBJECTIVE: This study examined the relationships between psychosocial work factors and risk of WRMSDs among public hospital nurses in the Klang Valley, Malaysia.

    METHODS: We conducted a cross-sectional study among 660 public hospital nurses. A self-administered questionnaire was used to collect data on the occurrence of WRMSDs according to body regions, socio-demographic profiles, occupational information and psychosocial risk factors. 468 questionnaires were returned (response rate of 71%), and 376 questionnaires qualified for subsequent analysis. Univariate analyses were applied to test for mean and categorical differences across the WRMSDs; multiple logistic regression was applied to predict WRMSDs based on the Job Strain Model's psychosocial risk factors.

    RESULTS: Over two thirds of the sample of nurses experienced discomfort or pain in at least one site of the musculoskeletal system within the last year. The neck was the most prevalent site (48.94%), followed by the feet (47.20%), the upper back (40.69%) and the lower back (35.28%). More than 50% of the nurses complained of having discomfort in region one (neck, shoulders and upperback) and region four (hips, knees, ankles, and feet). The results also revealed that psychological job demands, job strain and iso-strain ratio demonstrated statistically significant mean differences (p

  8. Yeoh SF, Ibrahim R, Oxley J, Hamid TA, Rashid SN
    Accid Anal Prev, 2016 Jul;92:1-8.
    PMID: 27022713 DOI: 10.1016/j.aap.2016.03.009
    Self-regulatory driving is a term used to describe a strategy used by older drivers to preserve mobility and safety, through the adjustment of driving behaviors to match declining physical functions. It can be regarded as a way to prolong driving, or as a process leading to the cessation of driving. Previous studies have striven to explore and understand how older drivers self-regulate their driving. This paper aims to provide an overview of the relevant theories, to explicate the factors that contribute to the adoption of self-regulated driving and the scales used to measure self-regulatory behaviors. This paper also reports on the development and psychometric testing of a Self-Regulatory Driving Practices (SRDP) scale in the Malaysian context. Based on the reviewed theories, adoption of self-regulatory driving practices is a process and involves cognitive thinking that reflects a set of actions. Existing instruments to measure self-regulatory driving practices have been developed and used to identify the behavioral components of self-regulation. Based on literature reviews and a thematic analysis from focus group discussions, a SRDP scale was developed, accommodating the Malaysian context. There were 498 surveys completed by older drivers for further psychometric testing purposes. Results revealed that the final 12-item SRDP scale (α=0.81) consists of four subscales that are planning, avoidance, reduction and alternatives. Suggestions for future research are also recommended.
  9. Ramli R, Che Man Z, Nordin R, Abdul Karim F, Rashdi MF, Oxley J, et al.
    Traffic Inj Prev, 2016 Sep;17 Suppl 1:79-85.
    PMID: 27586107 DOI: 10.1080/15389588.2016.1203428
    OBJECTIVE: Vietnamese spend hours travelling on the road using their motorcycles. Their helmets are exposed continuously to sunlight and rain. The objectives of this study were to determine the association between the effect of photo-oxidative degradation (POD) of the outer shells and helmet age on helmet damage. The micro-structural change of the outer shell was also investigated.

    METHODS: This was a prospective, cross sectional study recruiting injured motorcyclists from Hanoi, Vietnam hospital. The participants were interviewed by a trained researcher. The participants' helmets were collected post-crash. Initially, the helmets were examined for their type and external characteristics. A 3 cm × 3 cm cut was made on the helmet in the impacted and non-impacted areas (control). These areas were investigated for evidence of POD and presence of micro-cracks and material disintegration. 50 participants were enrolled. Sources of information included questionnaire and laboratory analyses. The helmet factors of interest were age of the helmet, exposure of helmet to sunlight and rain (duration/day) and history of previous impact. Laboratory analyses included Fourier Transform Infra Red (FTIR) for degradation and scanning electron microscopy (SEM) for micro-structural examination.

    RESULTS: Majority of the helmets was the open-face type, 40 (80.0%). 31 (62.0%) helmets aged less than three years (LTY) and 19 (38.0%) were three years old or more (MTY). 19 (61.3%) of the LTY helmets and 12 (63.2%) MTY helmets showed evidence of POD. The duration of helmet exposure to sunlight was between 93 to 6570 hours (mean 2347.74 hours; SD 1733.39). The SEM showed 15 helmets (30%) with micro-fractures, 21 helmets (42.0%) with material disintegration. Prolonged uv exposure to the ABS helmets resulted in changes in the helmet material in the form of material disintegration and microcracks and this association was statistically significant (p = 0.03).

    CONCLUSION: POD occurs due to routine exposure to the ultraviolet light. Prolonged uv exposure affects outer shell surface material integrity.

  10. Ang BH, Chen WS, Ngin CK, Oxley JA, Lee SWH
    Public Health, 2018 Feb;155:8-16.
    PMID: 29274898 DOI: 10.1016/j.puhe.2017.11.003
    OBJECTIVES: This study aimed to examine the reliability and validity of the English and Malay versions of the Driving and Riding Questionnaire.

    STUDY DESIGN: An observational study with a mix-method approach by utilising both questionnaire and short debriefing interviews.

    METHODS: Forward and backward translations of the original questionnaire were performed. The translated questionnaire was assessed for clarity by a multidisciplinary research team, translators, and several Malay native speakers. A total of 24 subjects participated in the pilot study. Reliability (Cronbach's alpha) and validity (content validity) of the original and translated questionnaires were examined.

    RESULTS: The English and Malay versions of the Driving and Riding Questionnaire were found to be reliable tools in measuring driving behaviours amongst older drivers and riders, with Cronbach's alpha of 0.9158 and 0.8919, respectively. For content validity, the questionnaires were critically reviewed in terms of relevance, clarity, simplicity, and ambiguity. The feedback obtained from participants addressed various aspects of the questionnaire related to the improvement of wordings used and inclusion of visual guide to enhance the understanding of the items in the questionnaire. This feedback was incorporated into the final versions of the English and Malay questionnaires.

    CONCLUSION: The findings of this study demonstrated both the English and Malay versions of the Driving and Riding Questionnaire to be valid and reliable.
  11. Hagen RM, Adamo P, Karamat S, Oxley J, Aning JJ, Gillatt D, et al.
    Am J Clin Pathol, 2014 Oct;142(4):533-40.
    PMID: 25239421 DOI: 10.1309/AJCPH88QHXARISUP
    The proto-oncogene ETS-related gene (ERG) is consistently overexpressed in prostate cancer. Alternatively spliced isoforms of ERG have variable biological activities; inclusion of exon 11 (72 base pairs [bp]) is associated with aggressiveness and progression of disease. Exon 10 (81 bp) has also been shown to be alternatively spliced. Within this study, we assess whether ERG protein, messenger RNA (mRNA), and ERG splice isoform mRNA expression is altered as prostate cancer progresses.
  12. Perks CM, Zielinska HA, Wang J, Jarrett C, Frankow A, Ladomery MR, et al.
    PMID: 27733843
    Men who develop prostate cancer (PCa) increasingly have one of the co-morbidities associated with a Western lifestyle that are characterized by hyperinsulinemia, hyperglycemia and increased expression of insulin-like growth factors-I (IGF-I) and IGF-II. Each have been associated with poor prognosis and more aggressive cancers that exhibit increased metabolism and increased glucose uptake. The insulin receptor (IR) has two splice isoforms IR-A and IR-B: IR-A has a higher affinity for IGF-II comparable to that for insulin, whereas the IR-B isoform predominantly just binds to insulin. In this study, we assessed alterations in the IR-A and IR-B isoform ratio and associated changes in cell proliferation and migration of PCa cell lines following exposure to altered concentrations of glucose and treatment with IGF-II and insulin. We observed that where IR-B predominated insulin had a greater effect on migration than IGF-II and IGF-II was more effective when IR-A was the main isoform. With regard to proliferation IGF-II was more effective than insulin regardless of which isoform was dominant. We assessed the abundance of the IR isoforms both in vivo and in vitro and observed that the majority of the tissue samples and cell lines expressed more IR-A than IR-B. Alterations in the isoforms in response to changes in their hormonal milieu could have a profound impact on how malignant cells behave and play a role in promoting carcinogenesis. A greater understanding of the mechanisms underlying changes in alternative splicing of the IR may provide additional targets for future cancer therapies.
  13. Mansor R, Holly J, Barker R, Biernacka K, Zielinska H, Koupparis A, et al.
    Oncotarget, 2020 Jun 30;11(26):2543-2559.
    PMID: 32655839 DOI: 10.18632/oncotarget.27650
    Localized prostate cancer (PCa) is a manageable disease but for most men with metastatic disease, it is often fatal. A western diet has been linked with PCa progression and hyperglycaemia has been associated with the risk of lethal and fatal prostate cancer. Using PCa cell lines, we examined the impact of IGF-I and glucose on markers of epithelial-to-mesenchymal transition (EMT), migration and invasion. We examined the underlying mechanisms using cell lines and tumour tissue samples. IGF-I had differential effects on the process of EMT: inhibiting in normal and promoting in cancer cells, whereas hyperglycamia alone had a stimulatory effect in both. These effects were independent of IGF and in both cases, hyperglycaemia induced an increase IGFBP-2(tumour promoter) and FOXA1. A positive correlation existed between levels of IGFBP-2 and FOXA1 in benign and cancerous prostate tissue samples and in vitro and in vivo data indicated that FOXA1 strongly interacted with the IGFBP-2 gene in normal prostate epithelial cells that was associated with a negative regulation of IGFBP-2, whereas in cancer cells the level of FOXA1 associating with the IGFBP-2 gene was minimal, suggesting loss of this negative regulation. IGF-I and hyperglycaemia-induced FOXA1/IGFBP-2 play important roles in EMT.
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