A concern in breast cancer involves changes in weight which may adversely affect the prognosis of patients. This
study intended to evaluate weight changed uring chemotherapy and its association with prognostic outcome
measured as event-free survival (EFS)among breast cancer patients. A total of63 women diagnosed with breast cancer
and have been treated by anthracycline-based chemotherapy between 2005 and 2011were included.A weight change
(WC) was calculated based on relative percentage of weight changes from baseline to post-chemotherapy and
categorized into either weight change (WC >5%) or stable (±5% WC).Survival probabilities were estimated using the
Kaplan-Meier (SPSS 20). Upon treatment completion, 42.9% of the women experienced weight changes. A small
weight reduction was observed (61.1 ± 11.6kg to 60.2 ± 11.9kg; -0.8 ± 4.0kg; p=0.106). The median EFS of women who
experienced weight change was shorter (median 61.0 months) compared to those who maintained their weight
(median 89.0 months) (p=0.044). In this study, weight changes during breast cancer chemotherapy were associated
with poorer prognosis in comparison to women who maintained their weight.
The prevalence of occupational stress among academician is increasing in developed and developing countries. The job is not only to teach, but also involve in doing research, publications, consultation and administrative work. This study aims to assess the prevalence of occupational stress among academic staff in a research university and to investigate the association and correlation between stress and job factors which are career development, research, teaching and interpersonal relationship. One research university in Malaysia was selected randomly. A cross-sectional study was conducted and the respondents were recruited by using a randomized stratified sampling method. A total of 380 self-administered and validated Depression, Anxiety and Stress Scale-21 (DASS-21) and Stress Sources Questionnaires (SSQ) were distributed among academic staff between March to May 2012. The statistical analyses used were χ2, independent–t test and Pearson Correlation. Response rate was 81.1%. Stress prevalence was 22.1%. All socio-demographic factors showed no association with stress except ethnic group. Teaching, research and career development had significant association with stress among academic staff (p<0.05). Overall result showed career development, that include university condition and required publications for promotion were the greatest source of stress among the academicians. Occupational stress showed positive linear relationship to career development, research and teaching. There was a fair positive relationship between occupational stress and career development, research and teaching. It is recommended to organize continuous stress assessment program to identify and evaluate the current level of stress at the university level. This data could be a foundation for implementing prevention and control measures to reduce stress in the workplace.
Keywords: academic staff, lecturer, occupational stress, research, teaching, career development, interpersonal relationship, research university, job stress
Cardiovascular disease (CVD) is the leading cause of death in Malaysia and many parts of the world. Potentially modifiable risk factors for CVD include diabetes mellitus, hypertension, abdominal obesity, smoking and psychosocial stress. Over the last several decades, efforts to prevent or treat CVD risk factors have resulted in significantly lower rates of CVD-related mortality. However, many patients have never achieved adequate control of CVD risk factors despite them being identified. The aims of this study were to measure the prevalence of cardiovascular diseases and to determine its associated factors. A cross sectional study was carried out in a rural area of Malaysia from March 2011 to November 2011 on 1489 respondents aged 18 and above who were selected via convenient sampling. The survey was conducted via a face-to-face interview using a standardized self administered questionnaire. Prevalence of cardiovascular disease identified was 72 cases (4.8%). Overall, the prevalence of modifiable risk factors were predominant compared to non modifiable, with abdominal obesity (51.2%) hypertension (39.5%) and psychosocial stress (33.8%) being among the highest. However, the prevalence of other modifiable risk factors was relatively low with smoking (25.2%), and diabetes mellitus (10.9%) respectively. Respondent with diabetes mellitus and hypertension were 4 times more likely to have cardiovascular disease and those who are obese had associated 2.5risks towards cardiovascular disease. Therefore, community health intervention measures should be mobilized,specifically on prevention and control of lifestyle-related risk factors.
Diagnosis-related group (DRG) system is patient classification system designed to produce limited number of classes
which are relatively similar in terms of resource consumption and clinical characteristics. The aim of this study was to
assess the level of knowledge, attitude and practice (KAP) of Turkish health care providers toward DRG system
implemented in Turkey.A total of 238 healthcare providers were randomly selected from two urbanand one rural hospital
in Turkey.A questionnaire was used for data collection; contacting 32 items (10 items about knowledge, 12 items about
attitude and 10 items about the practice) and its validity and reliability were confirmed. Data analysis was performed
using chi-square and multivariate logistic regression.In this study,only one third of healthcare providers showed good
knowledge (35.7%) and good practice (37.4%) about DRG system,compared to 54.2% of them showed good attitude.There
was significant difference between age, gender, occupation groups and whether the respondents have attended a
workshop for DRG system in terms of KAP (p > 0.05).These results indicated the need for further actions to implement
DRG system in terms of creation of suitable environment and increasing awareness among healthcare providers,
especially male, medical doctors, nurses, elderly, and those who have never attended a workshop, in addition to regular
review to ensure the program would reach its targets.
Hepatitis B virus (HBV) infection is an upcoming public health problem in Malaysia. This study analysed the
trend of Hepatitis B (HB) cases from 2003 to 2012 and project the cases for an 18-year period (2013–2030).
Based on the national data of annual reported cases and the Malaysian population projections (2010–2040),
trend/regression lines were fitted to analyse the trend and estimated HB incidence. The number of HB
cases decreased for six consecutive years and began to increase from 2010 onwards. During the 10-year
period (2003–2012), the highest number of HB cases was reported in Sabah, followed by Pahang and
Wilayah Persekutuan; the lowest was reported in Perlis. The exponential curve shows a decrease of HB
cases by an average of 6.3%. However, the polynomial curve shows fluctuations in the trend, with a higher
degree of R-square (0.8655). Most states appear to be at moderate vulnerability to HBV infection (Kedah,
Perak, Negeri Sembilan, Terengganu, Sabah, and Sarawak), except for Melaka, Wilayah Persekutuan, and
Selangor, which were at high risk of HB incidences. Overall, the estimated HB cases indicate that the
number of cases and the incidence rates will increase in the future in all states, except for Penang. As the
estimated HB cases and incidence rates show an increasing pattern, the government should strengthen
their strategies in the management of HB and take preventive measures such as educating the public
through awareness programmes, conducting compulsory blood screening, and sustaining the Expanded
Programme on Immunization effectively.
This cross sectional study investigated the test –retest reliability of the Malay Version Job Content
Questionnaire (M- JCQ) among electricity linemen. The M-JCQquestionnaire was administered to 10
electricity linemen working in private sub-contract company. The data were collected at two occasions
with one week interval of time between each sessions. Intraclass Correlation Coefficient (ICC) and Bland
Altman plot were used to analyze the reliability of the M-JCQ. The ICC for the ‘psychological demand’,
‘decision latitude’, ‘work related social support’ and ‘job insecurity’ scale were 0.96, 0.52, 0.99 and 0.55
respectively. The Bland Altman plot indicated that the tests and retest score for all the four scales had an
acceptable agreement. These findings indicated that the M- JCQ is reliable and consistent for assessing
work related psychosocial risk factors among electricity linemen.
Lower back, neck and shoulder pain are the most prevalent musculoskeletal problems affecting office workers worldwide, and they have both personal and socioeconomic consequences as well. Several hypotheses regarding the underlying mechanisms and the maintenance behind office work-related musculoskeletal disorders have been presented. There is some evidence, based on epidemiological studies as well as studies upon smaller groups of subjects, that individuals who sit and work for a long time not only show cognitive impairment at the workplace, but also suffer from poorer and fragmented daytime sleep, in addition to increased risks of developing various psychological, physiological and medical impairments and musculoskeletal disorders. The related physical mechanisms behind musculoskeletal disorders are discussed in the context of new findings. The main causes, as well as varying levels in severity of musculoskeletal disorders,not to mentionthe link between such disorders in the neck, shoulder and lower back regions and physical activity among office workers are also stated. The main objective of this review paper is to conduct a systematic review to identify musculoskeletal disorders and how these disorders are
correlated with physical activity among office workers. The results of this review indicate that the musculoskeletal disorder is a critical issue among office workers and the main cause is related to the absence of physical activity as well as the subjects’ sedentary lifestyle. As a practical message, regular physical activity can be effective in the prevention and decrease of physical discomfort among office workers who suffer from musculoskeletal pain.
Patients with chronic heart failure suffer from undesirable effects in their daily activities. Effective self-care management in conjunction with social support gives improved the wellbeing of patients with chronic heart failure. This study determines social support and self-care management among patients with chronic heart failure. A cross-sectional study was conducted at the Cardiology Clinic in Hospital Serdang, Selangor from April 2014 to June 2014. A questionnaire consisting of demographic characteristics, MOS Social Survey and Self-Care Heart Failure Index (SCHFI) was distributed to a total of 113 respondents. The results show moderately high level of social support (3.51±0.89) and level of self-care management (160.49±44.39). For instance, social support and self-care management were not statistically significant with the demographic characteristics (p>0.05). There was a positive correlation between social support and self-care management (r=0.263, p<0.05) and the findings suggest that social support should be considered a predictor in self-care management of patients with chronic heart failure.
Keywords: social support, self-care management, patient(s), chronic heart failure
Study site: Cardiology Clinic in Hospital Serdang, Selango
The association between nutrition and cancer in general had been a controversial issue between scientists in the last
three decades, because some argued that there is a relationship and some nutrients can help in preventing cancer
occurrence, although this has not been a consistent finding by other studies. Studies were identified through a
systematic review of literature available on PubMed in between 1st January 2010 to 31st December 2013. We
included all studies that assessed nutrition or diet with occurrence or mortality of breast cancer. Out of 42 articles,
we included 8 articles in our screening and discussion. Among these 8 studies, there were 2 case-controls, 3 cohort
and 3 randomized control trials (RCT) studies. Although most studies reported that nutrition isassociated with
decreased risk, some reported the contrary,whereas others reported no relation. It was demonstrated a conflict
between the included papers in regards of the association between nutrition and breast cancer. These finding needs
to be re-evaluated in future studies.
Realizing the huge potential of e-learning in casemix education and since there was no e-learning program on casemix and clinical coding available globally. International Centre for Case-mix and Clinical Coding (ITCC) proposed to establish a universal case-mix education programs through providing an e-learning program (ELP) for case-mix and clinical coding and evaluate its success. The aim of this study is to describe the process of development of e-learning program for casemix system and clinical coding. The introduction of course about casemix and clinical coding was redesigned for elearning program by applying ADDIE model (refer to Analysis, Design, Development, Implementation, and Evaluation).A total number of 57 learners attended to the course from around the world (40 different countries). The mean age of subjects was 34.70±8.66 years. Regarding profession, the largest percentiles (40.4%) of e-learners were belonging to academic sector and healthcare sector. All of the participants felt satisfied or very satisfied with the program. There was a significant difference between pre-test and post-test for e-learners knowledge score at the 0.05 alpha levels. The findings of the evaluation of the case-mix e-learning program indicated that e-learners found the educational performances of the case-mix online program to be satisfactory. With the advent of modern computer networking systems, organizations can employ these systems to enhance learning and performance improvement of case mix system.
The incidence of hip fractures is increasing within the aging population.We determined the risk factors of in-hospital mortality following hip fracture across major hospitals in Malaysia. This is a retrospective cohort review from 18 hospitals across Malaysia in National Orthopaedic Registry of Malaysia (NORM) . We collected demographic data, prefracture co-morbidities, previous hip fracture, pre-fracture walking ability, fracture type and stability, mechanism of injury, type of management (operative or non-operative), operation types and grade of surgeon. Between 2008 and 2009, 685 patients were admitted with a hip fracture to 18 government hospitals with orthopaedic service. The overall in-hospital mortality was 2.2%. We found more in-hospital mortality in elderly patients and patients with eye and hearing problems as pre-fracture morbidity. In conclusion, patients who were elderly with multiple comorbidities especially those with eye and hearing impairment were had higher risk for immediate mortality
Globally, the health of the indigenous people is lagging behind as compared to the mainstream population in countries in which they live. Despite improved overall prosperity and population longevity, social and health inequalities seem to persist in this underprivileged community. Failure in delivering effective health promotion toward the indigenous community is determined by a range of factors. This includes the absence of culturally sensitive awareness among the healthcare workers, ineffective communication of the healthcare providers, poor access to health service, lack of culturally specific health promotional materials, lack of involvement by indigenous healthcare workers, lack of community based programs and inefficiency of indigenous health data collection. Effective interventions for indigenous health require a trans-disciplinary and holistic approach that incorporates indigenous health beliefs and engages with the social and cultural drivers of health.Such culturally congruent health promotion strategies are hoped to narrow down the existing wide gap of health outcomes that contribute to inequalities between indigenous communities and the mainstream population.
Nowadays, community pharmacist plays an important role in medication counseling, patients’ side effects monitoring and
drug information delivery. The need of patient counseling has become a vital part of the pharmacy practice and
pharmaceutical care. Through Continuing Pharmacy Education (CPE) program, pharmacists can develop into professions in
different areas including drug delivery, drug information, technology and patient education. This study was conducted to
evaluate the perception of community pharmacists towards patient counseling and continuing education program in
Sabah and Sarawak, East Malaysia. A cross-sectional study design utilizing questionnaires was prepared by an extensive
literature review. The research was carried out in four major areas in Sarawak; Sibu, Kuching, Bintulu and Miri and in
three major areas Sabah; Kota kinabalu, Sepilok, Tawau by convenience sampling method. Descriptive analysis was
conducted using SPSS version 18. Perception of community pharmacists towards patients counseling and continuing
education program was analysed using scaling method. A cut-off score of 25.8 was used to indicate the perception of
community pharmacists. The Pharmacists scored a cut-off point of 25.8 and above were considered to have good
perception. A sample of 174 community pharmacists from Sabah and Sarawak were participated in this study. All of the
respondents except one had positive perception towards patient counseling and continuing education program. Overall,
almost all the community pharmacists had positive perception towards patient counseling and continuing education
program in Sabah and Sarawak, East Malaysia. Further research is needed to evaluate perception of community
pharmacists in different states of Malaysia and explore more on continuing education program in Malaysia.
The aim of this study was to develop a new validated questionnaire to assess the health impact of divorce on women. A
cross sectional study was undertaken in a district in Terengganu, using a newly developed self-administered Malay
language questionnaire comprising of six domains and 82 items. The questionnaire was constructed based on the
literature review and discussions with experts. Exploratory factor analysis was applied in construct validity and internal
consistency was used for reliability analysis. A total of 51 respondents were involved in this study. All the consented
divorcees were Malays. The mean (SD) age for the divorced women was 35.8 (10.00). Majority (82.4%) of them had
secondary education. All the final three domains demonstrated Keiser-Meyer-Olkin (KMO) of more than 0.6, significant
Bartlett’s test of Sphericity and Cronbach’s alpha of more than 0.80. The overall Cronbach’s alpha was excellent (0.920).
The final questionnaire consisted of two domains. Factor loading for all items in each subdomains were satisfactory. The
final functional somatic symptoms domain consisted of 6 subdomains and 19 items with factor loading from 0.402 to
0.914. For emotional instability domain, the final items were 13 items with factor loading from 0.548 to 0.878. The
questionnaire was valid and reliable to be used for functional somatic symptoms and emotional instability domains. It is
useful to assess the health impact and related intervention of divorced women. A confirmatory factor analysis may
further confirm the final model.
Vitamin A, C and E intake has been shown to play a role in the etiology of breast cancer, but the findings have been
inconsistent and limited to developed countries with higher cancer incidence. Therefore, the aim of this study is to
examine the association of premenopausal and postmenopausal breast cancer risk with vitamin A, C and E intake from
dietary sources. This is a population based case-control study conducted in Malaysian population among 382 breast cancer
patients and 382 control group. Dietary intake was assessed via an interviewer-administered food frequency
questionnaire. Logistic regression was used to compute odds ratios (OR) with 95% confidence intervals (CI) and a broad
range of potential confounders were included in analysis. The results of this study shows a significant decreased risk of
breast cancer among premenopausal (ORQ4 to Q1=0.38, 95% CI, 0.12 – 0.55, p-trend=0.001) and postmenopausal (ORQ4 to
Q1=0.26, 95% CI, 0.03 – 0.75, p-trend=0.017) women was observed in the highest quartile of beta-carotene intake.
Meanwhile, a higher intake of vitamin C showed significantly lowered risk only for premenopausal women (ORQ4 to
Q1=0.13, 95% CI, 0.03 – 0.32, p-trend=0.001). As a conclusion, beta-carotene intake was independently related to pre- and
postmenopausal breast cancer risk, while vitamin C intake was associated with decreased risk among premenopausal
women only. However, no association was observed for vitamin A especially retinol and vitamin E intake from dietary
Our study aimed to assess the knowledge, attitudes and practice behaviours of primary healthcare professionals in government Maternal and Child Healthcare Clinics (MCHC) on the association between oral health and pregnancy outcomes namely pre-term and/or low birth weight (PT/LBW) infants and to identify the barriers of utilisation of oral healthcare services by pregnant mothers. Questionnaires were distributed to government healthcare professionals working at all seven government MCHC in the Manjung District, Malaysia. 136 out of 158 questionnaires were returned completed yielding a 92% response rate. The questionnaire covers respondents characteristics, attitude and practice behaviours related to oral health and barriers faced when referring pregnant mothers to the dental clinic. 65% of respondents noticed dental/ gum problems in the pregnant mothers that they encountered. The two most frequent response for outcome of delivery linked to gum/ dental problems were premature delivery (49%) responses and low birth weight (27%). Although 95% of the respondents believed that regular dental check-ups is compulsory for pregnant mothers, only 69% regularly refer pregnant mothers for dental check-ups. There was a significance between healthcare professionals that receive continuing dental education and their referrals of antenatal mothers for dental check-ups .
Study site: Maternal and Child Health Clinics (Klinik Kesihatan), Manjung District, Perak, Malaysia.
Lifestyles such as unhealthy dietary habits, physical inactivity and smoking are considered fundamental risk factors for cardiovascular disease. Preventive activities have been shown to reduce mortality and morbidity from cardiovascular disease. This study aimed to determine the prevalence of cardiovascular lifestyle risks and cardiovascular preventive activities among healthy government servants in Kuala Terengganu, Malaysia. A cross-sectional study was done from June to September 2013 among 121 government servants working at the Federal Complex, Kuala Terengganu. A questionnaire which consists of socio-demographic data, International Physical Activity Questionnaire (IPAQ), the dietary component of WHO STEPS and cardiovascular screening activities were used as tools. Clustering of cardiovascular lifestyle risks was defined as the presence of two or more of smoking, physical inactivity and unhealthy diet. Optimal cardiovascular screening is defined as having done the required screening for hypertension, diabetes, dyslipideamia and obesity. The study response rate was 90.9% (110 of 121). Prevalence of smoking, physical inactivity and unhealthy diet were 20%, 50% and 87% respectively. The prevalence of clustering of cardiovascular lifestyle risks was 57%. The prevalence of optimal cardiovascular screening for age was 49%. The prevalence of cardiovascular lifestyle risks among government servants in Kuala Terengganu is still high. About half of them did not have the optimal screening for cardiovascular disease. Measures need to be done to promote healthy lifestyle behaviors in the community. Effort should be made at the primary care level and public health to screen those with multiple cardiovascular lifestyle risks in order to optimize cardiovascular disease prevention.
Diabetic retinopathy (DR) may result in progressive visual impairment and blindness which affects the diabetic patients‟ morbidity and quality of life significantly. The objective of this study was to determine the proportions and prognostic factors of DR severity among Type 2 diabetes mellitus patients. A cross sectional study was conducted at the Ophthalmology Clinic in a tertiary hospital using the medical record database from 2005 to 2011. A total of 216DR patients were randomly selected. The study outcome was DR severity which was classified into four grading based on the International Clinical Diabetic Retinopathy Scale. Descriptive statistics and Ordinal Logistic Regression were applied using Stata SE/11. The mean (SD) age of DR
in this study was 56.06 (9.98) years old with almost equal sex ratio. Proportion of mild non proliferative diabetic retinopathy (NPDR) was 48.6% (95% CI: 40.0, 60.0), moderate NPDR was 28.2% (95%CI: 22.0, 40.0), severe NPDR was 6.9% (95% CI: 4.0, 11.0) and proliferative diabetic retinopathy (PDR) was 16.2% (95%CI: 10.0, 22.0). Diabetic patients that suffered from diabetes mellitus for more than 10 years, having nephropathy, every increased of HbA1c by 1% and higher total cholesterol were at increased risk of worsening DR.
Note: content of full text inconsistent with title and abstract. Author informed.
Floods can lead to direct economic and property losses and result not only in physical injuries and deaths but
also in psychological trauma. Post-traumatic stress disorder (PTSD) is a commonly used indicator to evaluate
psychological injuries after disaster. This study aimed to determine the relationship between PTSD prevalence
and related perceived severity of post flood impact by economical, non-economical and flood status severity
domains besides relevant socio-demographic factors according to gender specific analysis. This cross-sectional
study was conducted among community in Kampung Hulu Takir, Kuala Terengganu, Malaysia in 2015 two
weeks after flood. It included a total of 98 males and 110 females aged 18 years and above. Data was
collected by interview-guided questionnaire to determine the prevalence of PTSD. SPSS version 21.0 was used
for analysis of the relationship between socio demographic factors, perceived economic, non-economic and
flood severity with PTSD. Finally chi square test was used to assess the predictors of PTSD according to
gender. The prevalence of PTSD was 9.2% in males and 10.9% in females, giving a total of 10.1%. Significantly
higher prevalence of PTSD was found in severely perceived economic and flood impact categories (33.3% and
23.8% in males; 23.8 % and 37.5% in females) and giving in overall 44.0% and 31.3 % respectively. Effective
PTSD management strategies targeting females post flood victims who severely perceived economically and
nature flood impact should be implemented in order to prevent further consequences of PTSD.
Job satisfaction is defined as pleasurable or positive emotional state which results from the appraisal of one’s job or job experience. It is often determined by how well outcome meet or exceed expectations. There are many factors which are related to job satisfaction among family physicians. Data on satisfaction among family physicians varies from country to country. This study aimed to determine the level of job satisfaction among family physicians in Malaysia and its associated factors. A cross sectional study was performed among 117 family physicians in Malaysia between July 2012 and December 2012. A questionnaire consists of socio-demographic characteristic, professional and health clinic characteristics and Warr-Cook-Wall job satisfaction scale was used. The results showed that 85% of Malaysian family physicians are satisfied with their job. They are mostly satisfied with hours of work, colleagues and fellow workers, and freedom to choose own method of working. They are least satisfied with physical working condition, rate of pay and recognition. Female gender and less number of health clinics in-charged were associated with increased in overall job satisfaction. Most of the family physicians in Malaysia are satisfied with their job. However there are certain areas that should be looked into which are physical working condition, rate of pay and recognition. Malaysian family physicians should receive equal career opportunity, promotion and salary scale like other specialties