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  1. Ramli R, Oxley JA
    Traffic Inj Prev, 2019;20(3):332-335.
    PMID: 30995129 DOI: 10.1080/15389588.2018.1557640
    Objectives: We encountered an unusual facial laceration wound in relation to motorcycle helmet visor use during our clinical practice. We aimed to assess the prevalence of this unusual facial injury among motorcyclists who sustained facial injuries in selected hospitals and to determine the possible mechanism involved. Methods: We used our prospective cross-sectional substudy involving injured motorcyclists presenting at major trauma hospitals in Southern Klang Valley, Malaysia, between March 2010 and March 2011. of 391 subjects with facial injuries, 2 male motorcyclists sustained this laceration. The wounds were assessed and we believed that each was associated with the helmet visor. One of the visors was collected and the edge was inspected using scanning electron microscopy (SEM). Results: The prevalence of this unusual injury was 0.51% (95% confidence interval, 0.002-0.012) among motorcyclists who sustained facial injuries. Both cases were involved in a head-on collision with their colliding partners and their helmets were intact throughout the crash. The visor in case 1 was intact, but the visor in case 2 was broken. SEM analysis showed that the visor in case 1 had a potential cutting surface. We postulated that with helmet rotation in the forward and downward position and with some degree of visor bending or with a dislodged visor, the sharp-edged visor could potentially severely lacerate the face. Conclusion: This injury affects facial aesthetics and early referral to the facial surgery team is advocated. Documentation of the mechanism of injury, the patient's helmet and visor is obligatory, so that this information can be delivered to the regional road safety authority for preventive measures.
  2. Nur Azma Amin, RM Noah, Oxley JA, Quek KF, Rusli BN
    MyJurnal
    Introduction: Work-related musculoskeletal disorders (WRMSDs) is an alarming occupational health concern
    worldwide. Nurses are among the professional at high risk of WRMSDs. Objective: This study explores
    the prevalence WRMSDs and the association with work engagement among nurses. Methods: This
    cross-sectional study used self-administered survey was disseminated to female nurses working at the
    hospitals in the Klang Valley, Malaysia. The Standardized Nordic Musculoskeletal Questionnaire (N-SNMQ)
    was used to determine the annual prevalence of WRMSDs. Level of work engagement was assessed
    using Utrecht Work Engagement (M-UWES). Multivariate logistic regression was performed to assess
    the association between WRMSDs and work engagement. Results: This study received high response
    rate (83.3%) with annual prevalence of 73.1%. Most common WRMSDs was reported in neck (48.9%)
    followed by feet (47.2%) while least was documented in arms and elbows (6.6%). After covariates
    adjustment (age, years of employment), the adjusted logistic regression analyses highly engaged nurses
    (AOR:0.71-0.74, 95%CI 0.56 – 0.95) were found to be unlikely sustained of WRMSDs. Conclusion: The
    findings of this study addressed high prevalence of WRMSDs among nurses. High work engagement
    could facilitate to reduce risk of WRMSDs, hence offer preventive strategies, making a substantial impact
    on reducing WRMSDs.
  3. 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.

  4. Amin NA, Quek KF, Oxley JA, Noah R, Nordin R
    Int J Occup Environ Med, 2018 04;9(2):69-78.
    PMID: 29667644 DOI: 10.15171/ijoem.2018.1158
    BACKGROUND: Emotional distress is becoming a great concern and is more common in both developed and developing countries. It is associated with several disease conditions.

    OBJECTIVE: To determine the prevalence of self-perceived emotional distress and its relation to work-related musculoskeletal disorders (WRMSDs) in nurses.

    METHODS: A self-administered questionnaire survey was carried out on 660 female nurses working in public hospitals in the Klang Valley, Malaysia. The validated Malay version of the standardized Nordic musculoskeletal questionnaire (M-SNMQ) was used to identify the annual prevalence of WRMSDs; perceived emotional distress was assessed using the validated Malay short version, depression, anxiety, and stress (M-DASS) instrument. In addition, socio-demographic and occupational profiles of the participants were considered. Factors associated with WRMSDs were identified using logistic regression analysis.

    RESULTS: A total of 376 nurses completed the survey (response rate 83.3%). 73.1% of the nursing staffs experienced WRMSDs in at least one anatomical site 12 months prior to the study. 75% of nurses expressed emotional distress. Of these, over half also reported anxiety and stress. Multiple logistic regression analysis showed that stress and anxiety significantly increased the risk of WRMSDs by approximately twofold.

    CONCLUSION: There were significant associations between emotional distress and WRMSDs. Future longitudinal studies are therefore needed to investigate and identify the sources of emotional distress (non-occupational and occupational) to be used to establish preventive strategies to reduce the risk of WRMSDs.

  5. Ang BH, Oxley JA, Chen WS, Yap KK, Song KP, Lee SWH
    J Safety Res, 2019 09;70:243-251.
    PMID: 31848001 DOI: 10.1016/j.jsr.2019.07.004
    INTRODUCTION: The ability to remain safe behind the wheels can become arduous with aging, yet important for sustaining local travel needs. This review aimed to explore safe mobility issues involving older adults and gain a broad understanding of older drivers' self-regulatory driving practices and motivators behind such behavioral changes, including strategies adopted to reduce or cease driving while maintaining safe mobility.

    METHODS: A systematic literature search was performed on 11 online databases for quantitative studies describing self-regulation of driving amongst older adults aged 60 years and above from database inception until December 2018. Data were described narratively and, where possible, data were pooled using random-effects meta-analysis.

    RESULTS: Of the 1556 studies identified, 54 studies met the inclusion criteria and 46 studies were included in the meta-analyses. All included studies examined car drivers only. Older adults who were single or female were found to be at higher odds of driving cessation. Physical fitness, mental health, social influence, and support systems received by older adults were important driving forces influencing mobility and adjustments made in their travel patterns.

    CONCLUSIONS: Driving self-regulation amongst older adults is a multifaceted decision, impacting mobility and mental health. Therefore, future interventions and support systems should not only create opportunities for retaining mobility for those who have ceased driving, but also promote better psychological and social well-being for regulators and for those who are transitioning from driving to non-driving status. Practical applications: (a) Engage and educate older adults about self-regulation, including strategies that can be adopted and non-car mobility options available. (b) Expand the research focus to explore potential interactions of factors facilitating or hindering the transition process to develop a more comprehensive framework of self-regulation. (c) Encourage ongoing research to formulate, monitor, and evaluate the effectiveness of policies and interventions implemented. (d) Expand the research horizon to explore and understand the perspectives of older adults from developing countries.

  6. Ang BH, Oxley JA, Chen WS, Yap MKK, Song KP, Lee SWH
    PLoS One, 2020;15(5):e0232795.
    PMID: 32413053 DOI: 10.1371/journal.pone.0232795
    INTRODUCTION: There is growing evidence to suggest the importance of self-regulatory practices amongst older adults to sustain mobility. However, the decision to self-regulate driving is a complex interplay between an individual's preference and the influence of their social networks including spouse. To our best knowledge, the influence of an older adult's spouse on their decisions during driving transition has not been explored.

    MATERIALS AND METHODS: This qualitative descriptive study was conducted amongst married older adults aged 60 years and above. All interview responses were transcribed verbatim and examined using thematic approach and interpretative description method.

    RESULTS: A total of 11 married couples were interviewed. Three major themes emerged: [1] Our roles in driving; [2] Challenges to continue driving; and, [3] Our driving strategies to ensure continued driving. Older couples adopted driving strategies and regulated their driving patterns to ensure they continued to drive safely. Male partners often took the active driving role as the principal drivers, while the females adopted a more passive role, including being the passenger to accompany the principal drivers or becoming the co-driver to help in navigation. Other coping strategies include sharing the driving duties as well as using public transportation or mixed mode transportation.

    DISCUSSION: Our findings suggest spouse play a significant role in their partners' decision to self-regulate driving. This underscores a need to recognise the importance of interdependency amongst couples and its impact on their driving decisions and outcomes.

  7. 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.
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