In the Malaysia Economic Transformation Programmed (ETP) launched on 2010, palm oil industry has been highlighted as one of the key sector towards national economic development. There are a lot of concerns directed towards safety and health in the agricultural sectors where oil palm plantations are the main agricultural sectors in Malaysia. Correspondingly, several tasks by the small holders in the oil palm plantation have been shown to lead to musculoskeletal disorders which are attributed to various safety and health issues. This study intends to determine the effects of ergonomics interventions approach, highly promoted by International Labor Organization to resolve ergonomics issues specifically among oil palm plantation small holders and to improve Occupational Safety and Health aspects of the workplace. The study will be divided into two phases, the first phase of the cross-sectional design which will involve 360 male respondents working as small holders in the oil palm plantation. Questionnaires will be used to collect information on socio demographic data, occupational history, social lifestyle and prevalence of musculoskeletal disorders (MSDs) data. The second phase of the intervention study (Quasi Experimental) involve intervention program based on Participatory Action Oriented Training (PAOT) approach using qualitative observation and quantitative results of analysis during the first phase. A training program consisting of 3 primary instruments (lecture, action checklist and video), reinforcing activities (to increase knowledge, enhance understanding and associate practical application) and indicators (questionnaires and qualitative observation) were created, modified and customized to the small holders’ working in oil palm plantation. Palm oil industry provides job opportunity for more than half a million people and living opportunity for more than 1 million people (MPOB, 2011). Improving safety & health for the small holders in the oil palm plantations become the overall outcome of the ergonomics intervention. Specifically, the ergonomics Intervention will be expected to increase Knowledge, Attitude and Practice (KAP) among the small holders, to be used as a program for occupational safety & health improvement in oil palm plantations around Melaka as well as to reduce risk of developing Musculoskeletal Disorders (MSDs) due to small holder’s multi task in the oil palm plantations. As the current knowledge gap of agricultural workers such as small holders remains wide in terms of safety and health, awareness among the small holders in the rural areas is low. In addition, focus of research was generally low on agricultural workers especially of health components further increasing the knowledge gap and status of health of agricultural workers or specifically small holders in Malaysia.

Three urban public primary schools in the district of Petaling, Selangor were surveyed for obesity amongst the schoolchildren and factors related to it. The prevalence of obesity amongst primary schoolchildren, with the mean age of 8.91 years was 9.5%. In addition, it was more prevalent among the boys (p<0.05) as compared to the girls. However, there was no difference with regards to ethnicity, being breastfed, physical activity, time spent watching television or fast food intake in relation to obesity among these primary schoolchildren. A larger community study is required to determine if other specific factors and dietary energy intake are associated with obesity amongst primary schoolchildren, especially in rural or less urbanised regions.

Chronic non-communicable diseases are the new emerging epidemic, and they are thought to challenge only rich countries; cardiovascular disease, cancer, diabetes, and other non-communicable diseases (NCDs) are now the leading cause of death and disability in low-income and middle-income countries, where they killed almost 8 million people younger than 60 years in 2013. Therefore, there is a need to develop a valid and reliable tool to measure the beliefs that influence people’s general behaviour, and a used to measure beliefs about chronic disease perceived susceptibility. The purpose of this study was to develop and validate the use of perception questionnaire among the young Iraqi adults. A total of 200 young adults participated who are free from any chronic diseases under study, and are living in Baghdad. The questionnaire, validated by an expert’s panel, translated to Arabic language, and pretested. Analyses included descriptive statistics of all the study variables, reliability estimates, and construct validity using confirmatory factor analysis (CFA). Results showed that mean age of respondents was 30 years old, majority were males 71.5%, and EFA showed that factor loading was more than 0.4. CFA results show that Chi-square (df) = 1.213(2); p value (>0.05) = 0.297. Internal consistency reliability analysis on health-related behaviour; special practice, information seeking and perceived probability of diseases have good Cronbach’s α value of between 0.8 - 0.9. These findings revealed that validation is favourable and can be utilized on larger scale of sample to proceed with main study on chronic disease perceived susceptibility among healthy people.
perception ; validity ; chronic disease

A cross sectional study was conducted to determine the exposure of heat and its effect to physiological changes among male workers in an automotive manufacturing plant in Shah Alam, Selangor. Forty six workers from the foundry operation division in the factory were selected as respondents. Variables measured were the environmental temperature (WBGTin), metabolic workload, body core temperature, and blood pressure, heart rate as well as heart rate recovery. Results showed that the mean of environmental temperature (WBGTin) was 28.960C. These production workers were exposed occasionally to heat during melting process, loading silica and powder into the molds as well as when making core products into the mold. The average time of monitoring was 2 hours for intermittent exposure and 8 hours duration for overall exposure. Bonferonni Test showed significant differences of body core temperature between before the shift starts and 2 hours after the shift started (p = 0.05) and after 8 hours ( p < 0.001) respectively. A weak correlations were found between body core temperature with heart rate before the shift starts (r = 0.293, p = 0.048), and with systolic blood pressure after 8 hours (r = 0.309, p =0.036) respectively. The average heart rate was in range 51 to 98 beat per minute, indicating that there is no excessive physiological demand. The mean of body core temperature (36.37 ± 0.53 0C) and heart rate (74.50 ± 10.10 beap perminute) after 8 hours indicated a good body control of heat exposure. Three out of four work stations monitored had temperatures greater than 28 0C (ACGIH TLV). The workers were exposed to moderate heat stress during the study period; however, body core temperature, heart rate and blood pressure did not reach unacceptable level of physiological strain.

The objectives of this study are to investigate diagnostic value of two different tests amongst tests highly recommended and used for diagnosis of HAVS of the sensorineural component; Semmes Weinstein Monofilament (SWM) and Purdue Pegboard (PP) tests using vibrotactile perception threshold (VPT) test as standard objective quantitative test. For the method, a total of 176 grinders as vibration exposed respondent of a shipyard’s fabrication participated in this study. Questionnaire and vibration exposures data were collected for all respondents where 67 respondents further performed the three quantitative sensorineural testing. The result showed that mean acceleration magnitude of grinding tools used were 4.9 ms-2, exceeding recommendation by European Commission. Both cut-off point methods of mean plus two times standard deviation (mean + 2sd) and z-score (at 75th percentile) show significant difference among healthy and HAVS (p < 0.001). Correlation between SWM with VPT and PP with VPT was weak. However, results suggests progressive pathological damage to sensorineural component of the digits starts with fast-adapting II (FA II) mechanoreceptors indicated with significant correlation primarily at 125 Hz. Analyses of sensitivity and specificity found that monofilament at 0.16g force best discriminate HAVS from healthy. In the other hand, Purdue Pegboard test shows best diagnostic value of indicating HAVS at minimum insert of 16 pin and 14 pin respectively for dominant and non-dominant hand. Both Semmes Weinstein Monofilament and Purdue Pegboard tests has limited diagnostic value to be used as screening tools for early detection of HAVS.

Acute appendicitis is one of the most common differential diagnoses for acute abdominal pain made by emergency doctors. Suspected cases require surgical referral for observation or definitive intervention to prevent complications. A high index of suspicion and good clinical skills with the aid of scoring systems allows early decision making, which includes optimal pain control. The objective of this study was to identify the pain score and is relationship to the cut-off points of the Alvarado scoring system so that justifies early surgical referral or discharge for suspected acute appendicitis from the Emergency Department of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This was a cross sectional study of acute abdominal pain from June 2007 to September 2008. All patients who fulfilled the criteria and consented to the study were assessed for Alvarado score, verbal numerical pain score (VNRS) and their subsequent management. Patients with an Alvarado score of ≥7 were likely to have acute appendicitis (80.1% sensitivity and 52.63% specificity) and those with the score of ≤3 were unlikely to have acute appendicitis. The median pain score was 7.00 (IQR: 5.00-8.50) but 72.5% did not receive any analgesia. There was no direct relationship between the pain score with Alvarado score. Oligoanalgesia in patients with acute appendicitis still exist in Emergency Department of UKMMC.

Introduction: Elderly is a vulnerable population that is prone to sarcopenia which is associated with the loss of muscle mass, strength and function which are some of the diseases that affect the elderly. The association between environmental factors with sarcopenia should be explored as it has the potential to influence the health and disability of a person. At present, limited research is conducted to investigate the association that could be attributed to the complex interaction between human and environmental interactions. Hence this review is conducted to identify the environmental factors associated with sarcopenia. Methods: A systematic review was conducted using PubMed, SCOPUS, Web of Science and manual search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We used articles that had been written in English and relevant articles were then screened, duplicates were removed, eligibility criteria were applied, and studies that met the criteria were reviewed. The keywords environmental factors, pollutants food environment, neighbourhood environment, locality and sarcopenia were included. Results: Initial search generated 934 publications and 12 articles were included after the inclusion and exclusion criteria for this review. In this review, environmental factors associated with sarcopenia are divided into 3 themes that comprises of food environment (availability and physical access, economic access and food quality and safety), neighbourhood environment and pollutants. Conclusion This systematic review revealed an association between the food environment, neighbourhood environment and pollutants with sarcopenia. The findings are salient as they could aid policymakers in formulating the necessary strategy to reduce the morbidity and mortality associated with sarcopenia, especially with the increase in the ageing population globally.

Objective: The study aims to determine pattern of verbal memory and learning impairment and its associated factors among patients with bipolar I disorder in a psychiatric clinic of a university hospital. Methods: A case control study comparing verbal memory test performance in 40 patients with bipolar I disorder to that of 40 healthy normal subjects using Rey Auditory Verbal Learning Test (RAVLT). The association between demographic, clinical characteristics and poor verbal memory performance were examined. Results: Up to 92% of patients with bipolar I disorder have impaired short term working memory in this hospital-based study. They also recalled fewer words in all the RAVLT trials and had difficulties learning the word list in comparison to that of normal healthy individuals. Verbal memory and learning impairment are observed in bipolar illness in the absence of active mood symptoms while duration and severity of illness are not found to have any effect on verbal memory and learning. Conclusion: There is consistent verbal memory and learning problems in individuals with bipolar I disorder and their presence in the absence of mania, depression and mixed symptoms during the course of the illness suggests a trait related deficit.

Objective: This study aimed to determine the prevalence of obesity among patients with schizophrenia and its association with the demographic profile. Methods: This is a cross sectional study. Subjects were selected using systematic sampling. Patients attending the out patient psychiatric clinic, Hospital Universiti Kebangsaan Malaysia, who fulfilled the criteria and able to give consent were included in this study. Diagnosis of schizophrenia was made using Structured Clinical Interview (SCID) for DSM-IV. Demographic profiles of the patients were obtained and anthropometric measurements were measured and classified according to Body Mass Index (BMI) and Waist Circumference (WC) of Asian population. Results: A total of 97 patients were included. The prevalence of overweight (BMI: 23.0- 27.4 kg/m2) was 39.2% (n=38), and the prevalence of obesity (BMI: >27.0 kg/m2) was 35.1% (n=34). BMI was higher among non-Chinese (Malay and Indian, p=.03) and those who had low total household income (p=.03). Sixty-two patients (63.9%) had high WC, which was associated with male (p=.003) and non-Chinese (p=.03). Conclusions: Obesity is highly prevalent among patients with schizophrenia. The risk factors for obesity include male, non-Chinese and those with low total income. The high WC among non-Chinese and male patients suggests that they are at a higher risk of developing obesity-related physical illnesses. These findings support that obesity is a common critical issue among schizophrenic patients, and it warrants serious clinical interventions.

A cross sectional study was carried out to determine the relationship between dust exposure and pulmonary function in male steel workers in Terengganu, Malaysia. The investigation included spirometric testing and detailed personal interviews using a structured questionnaire adopted from British Medical Research Council (BRMC) Questionnaire on respiratory symptoms. Respiratory symptoms commonly reported by the male workers were morning phlegm (33.1%), shortness of breath (31.9%), chest tightness (30.4%), and morning cough (17.8%). Age and duration of employment were among the factors associated with respiratory symptoms (p<0.05 and p<0.001 respectively). Forced Expiratory Volume in 1 second (FEV1) was significantly reduced when compared to the healthy population. There was a significant decrease of FEV1 between before and after work shift (t= 3.582, p<0.001). Smoking status, age, and duration of employment were also associated with reduction of pulmonary function (p<0.01).