Occupational stress is a modern epidemic. Prevalence and predictors of occupational stress in specific workforce are critical in management of occupational stress. The aim of this review is to explore the current prevalence of occupational stress and its predictors among selected Malaysian working population based on published articles between years 2008 to 2017. A systematic search of articles published between 2008 and 2017 was conducted in several databases (ISI Web of Knowledge, PubMed, Scopus, Google scholar). A total of eleven articles met the inclusion criteria, included in the review. The current prevalence of occupational stress was between 6.0% till 71.7%. Mean prevalence of stress was 29.9%. From eight job categories, most stressful job was primary teachers and least stressful job was academician in private university. Predictors of occupational stress were: 1) organizational factors: high job demand, poor workplace condition, lack of organization support, job insecurity, long working hours, burden of career development and interpersonal conflicts 2) individual (extra-organization) factors: gender, age, marital status, number of children, coping strategies. Although the predictors of occupational stress varies among different job categories, most job categories present similar risk factors such as high job demand, poor workplace condition, lack of organization support, job insecurity, long working hours, burden of career development and interpersonal conflicts. Dual approaches involving organization and individual level pertaining towards each stressor are recommended in alleviating occupational stress among those selected workforces.

Background: An equitable and positive learning environment fosters deep self-directed learning in students and, consequently, good practice in their profession. Although demotivating weaknesses may lead to repeated day-to-day stress with a cascade of deleterious consequences at both personal and professional levels, a possible relationship between these parameters has not been reported. This study was undertaken to determine the relationship between students’ perceptions of their educational environment and their stress levels. Methods: Sixty-one first year students at the Dental Faculty, University of Malaya, Malaysia participated. The Dundee Ready Education Environment Measure (DREEM) was used to determine educational environment while self-rated perceived stress level was measured by the Depression Anxiety Stress Scale (DASS). Results: Most students (62.39%) showed positive perceptions for the total and five domains of DREEM. The highest percentage was observed for “Students perception of learning” (64.04%) while the lowest was for “Students’ social self-perception” (60.32%). At the same time, 61% of students showed high perceived stress levels. However, this was not associated with their DREEM scores. Conclusion: Although a positive perception of their educational environment was found, minor corrective measures need to be implemented. Furthermore, longitudinal studies on an annual basis would provide useful input for strategic planning purposes.

SUMMARY Introduction: This study aims for construct validation using two approaches, i.e., exploratory factor analysis and Rasch Model. Methods: A cross sectional of 313 male workers from multiple worksites had completed self-administered Malay translated version of Three-Factor Eating QuestionnaireR21. Data quality was assessed by misfit person criteria, dimensionality, summary statistic, item measure and rating (partial credit) scale followed by exploratory factor analysis and internal consistency reliability assessment. Results: The dual approaches of construct validation analysis were complement to each other. Rasch analysis supported the theoretical constructs of three eating behaviour dimensions among respondents. In contrary to exploratory factor analysis, it did show presence of a newfound factor (α=0.04) came up from the separation of the cognitive restrain and uncontrolled eating however, the correlation between the two respective sub-factors were fair (r=0.39) and weak (r= -0.08). Both analyses had detected three problematic items but those items were psychometrically fit for used for current study setting. The data had adequate psychometric properties. Cronbach’s alpha for cognitive restraint, uncontrolled eating and emotional eating were 0.66, 0.79 and 0.87 respectively. Rating scale quality was conformed to standard criteria. Conclusion: Malay version TFEQ-R21 with promising psychometric properties and valid measures for eating behaviour dimensions among male workers aged between 20 to 60 years old is now available. Further development should focus on the items in relation to Malaysian cultural adaptation before its use for daily practice in future setting.
Psychometrics

Introduction: Cardiovascular disease (CVD) caused significant burden to Malaysia as it accounted for 36% of total deaths. This study aims to evaluate the burden of cardiovascular risk factors among Malaysian adult and assess the difference between urban and rural population in the selected communities. Methods: This study is part of the ongoing Prospective Urban Rural Epidemiology (PURE) database, whereby the baseline data were collected since June 2008. CVD risk was measured using INTERHEART risk score which comprised of eleven risk factors i.e. age and gender, family history of heart attack, smoking status, exposure to second hand smoke, diabetes mellitus, hypertension status, waist-hip ratio, self-reported stress, depression, dietary habits and physical activity status. Results: Majority of the studied participants had low cardiovascular risk (57%). Participants from rural area were generally older, had lower educational status, higher prevalence of smokers, obesity, hypertension, diabetes, and more likely to be depressed. In comparison, urbanites had lower physical activities and more likely to be stressful. Mean INTERHEART score among rural participants were higher, especially for male, in comparison to urbanite (11.5±5.83 vs. 10.01±5.74, p<0.001). Conclusion: Contradict to common beliefs, participants in rural areas generally have higher cardiovascular risk factors compared to their urban counterparts. The rural population should be targeted for focused preventive interventions, taking account the socioeconomic and cultural context.

Background: The General Practice Physical ActivityQuestionnaire (GPPAQ) is a validated and reliable screeningtool to measure the level of physical activity in adults.However, it has never been translated and validated inMalaysian population. This study aimed to translate theGPPAQ into Malay language and to evaluate thepsychometric properties of the Malay-translated GPPAQamong shipyard workers.Methods: The original English version of GPPAQ wastranslated forward and backward into Malay version byexperts. The final version of the Malay-translated GPPAQwas then tested for validity and reliability. A cross-sectionalstudy design was performed and systematic randomsampling was used to select respondents. Construct validityand internal consistency of the Malay-translated versionwere tested using exploratory factor analysis andCronbach’s alpha respectively.Results: Sixty-two male shipyard workers participated inthis study. The GPPAQ showed good factor loading valuesfor all items (0.608-0.834). The exploratory principalcomponent factor analysis delineates all seven items intotwo factors with variance of 41.65%. The Cronbach’s alphavalue was good with 0.81, 0.84 and 0.76 for total scale, factor1 and factor 2 respectively.Conclusion: The Malay-translated version of GPPAQ hashigh psychometric properties. Therefore, it is a validinstrument to assess physical activity among Malaysianworking population, particularly in male shipyard workers.

Air pollution has been widely known to have an influence on health of the general population. Air pollution can result from natural causes, human activities and transboundary air pollution. Weather and climate play crucial role in determining the pattern of air quality. In recent years, air pollution and recurrent episodes of haze has become a major concern in Malaysia. Surveillance data on concentrations of main air pollutants such as carbon dioxide, (CO2), Nitrogen Dioxide (NO2), Ozone (O3), sulphur dioxide (SO2) and particulate matter (PM10) were found to be higher during the haze days and this may have an impact on health of the community as reflected by an increase in hospital admissions particularly the respiratory and cardiovascular diseases.

survey questionnaire is deciding the appropriate items in a construct. Retaining irrelevant items and removing important items will certainly mislead the direction of a particular study. This article demonstrates Fuzzy Delphi method as one of the scientific analysis technique to consolidate consensus agreement within a panel of experts pertaining to each item's appropriateness. This method reduces the ambiguity, diversity, and discrepancy of the opinions among the experts hence enhances the quality of the selected items. The main purpose of this study was to obtain experts' consensus on the suitability of the preselected items on the questionnaire. Methods: The panel consists of sixteen experts from the Occupational and Environmental Health Unit of Ministry of Health, Vector-borne Disease Control Unit of Ministry of Health and Occupational and Safety Health Unit of both public and private universities. A set of questionnaires related to noise and chemical exposure were compiled based on the literature search. There was a total of six constructs with 60 items in which three constructs for knowledge, attitude, and practice of noise exposure and three constructs for knowledge, attitude, and practice of chemical exposure. The validation process replicated recent Fuzzy Delphi method that using a concept of Triangular Fuzzy Numbers and Defuzzification process. Results: A 100% response rate was obtained from all the sixteen experts with an average Likert scoring of four to five. Post FDM analysis, the first prerequisite was fulfilled with a threshold value (d) ≤ 0.2, hence all the six constructs were accepted. For the second prerequisite, three items (21%) from noise-attitude construct and four items (40%) from chemical-practice construct had expert consensus lesser than 75%, which giving rise to about 12% from the total items in the questionnaire. The third prerequisite was used to rank the items within the constructs by calculating the average fuzzy numbers. The seven items which did not fulfill the second prerequisite similarly had lower ranks during the analysis, therefore those items were discarded from the final draft. Conclusion: Post FDM analysis, the experts' consensus on the suitability of the pre-selected items on the questionnaire set were obtained, hence it is now ready for further construct validation process.

Introduction: Married couples often do influence each other’s emotions and behaviors. The effect of this interpersonal marriage relationship on job demands and job performance toward work-family conflict (WFC) is still under research. This article aims to determine the effects of married couple’s job factors (emotional job demands and job performance) on wife’s WFC.Method: A total of 120 dyads in private sectors were recruited via private invitations to social gatherings. Packets of self-administered questionnaires were given included emotional domain of Demand-Induced Strain Compensation, Spielberger Trait Anger Scale, work-family conflict and job performance measures. Dyadic analysis using Actor-Partner Interdependence Model was used. Results: The emotional demand of wife significantly contribute higher effect (ES= 0.34 (95%CI: 0.23, 0.45); p<0.001) compared to emotional demand of husband on wife’s WFC (ES= 0.14 (95%CI: 0.03, 0.25); p=0.011). The job performance of wife significantly contribute higher effect (ES= 0.29 (95%CI: 0.17, 0.40); p<0.001) compared to job performance of husband on the wife’s WFC (ES= 0.17 (95%CI: 0.06, 0.29); p=0.003). Both wife and husband influenced each other pertaining to emotional demands (r=0.35, 95%CI: 0.22, 0.48) and job performance (r=0.51, 95%CI: 0.38, 0.64) on the wife’s WFC. Overall, the APIM model explains of 22.9% and 25.1% of the total of non-independence of emotional job demands and job performance toward WFC, respectively. Conclusion: Wife’s WFC was influenced by both herself and her partner’s emotional job demands and performance. All resources should be channeled to working wives to prevent any health and job outcomes resulted from the work-family conflict.

Occupational sharps injury remains a never-ending issue faced by healthcare workers (HCWs). There were several types of post-exposure management available. Thus, it was hoped that a narrative overview could further illuminate this. Methodology: A search was conducted to review published and unpublished studies through searches of online databases (i.e., PubMed/MEDLINE, Google Scholar, Google search and Science Direct) on occupational sharps injury management, including bloodborne diseases, post-exposure management and rationale of the follow-up interval. Results: Working in a healthcare setting, sharps appeared to be an inevitable hazard faced every day by individual HCWs. While PEP was available for HIV and Hepatitis B, none was available for Hepatitis C, albeit the latter seemed to have curative treatment for it. Conclusion: We hoped that this narrative overview could provide an impetus towards the understanding of post-exposure management in our local healthcare setting.

Introduction: The continue rise in temperatures due to climate change increases the risk of heat-related illness (HRI) among outdoor workers. This study aims to evaluate the effects of hydration practices on the severity of HRI during a heat wave episode among municipal workers in Negeri Sembilan. Method: A cross-sectional study was performed in March and April 2016. The outdoor temperatures were measured using the wet-bulb globe temperature (WBGT) tool. The participants completed a self-administered questionnaire containing sociodemographic factors prior to work shift; while working profile, hydration practices, and HRI symptoms at the end of work shift. The hydration status of the respondents was assessed by direct observation of their urine colour. Multiple logistic regression was performed to ascertain the effects of age, working profile, hydration practice, history of previous HRI, and hydration status on the likelihood that outdoor workers having moderate to severe HRI. Results: A total of 320 respondents completed the questionnaire. The mean (standard deviation) outdoor workplace temperature was 30.5°C (SD 0.53°C). The percentage of respondents who experienced moderate to severe HRI was 44.1%. The likelihood that outdoor workers experienced moderate to severe HRI symptoms was associated with irregular fluid intake [odds ratio (OR): 16.11, 95% confidence interval (95%CI): 4.11; 63.20]; consumption of non-plain water (OR: 5.92, 95%CI: 2.79; 12.56); dehydration (OR: 3.32, 95%CI: 1.92; 5.74); and increasing outdoor workplace temperature (OR: 1.85, 95%CI: 1.09; 3.11). Conclusion: Irregular drinking pattern and non-plain fluid intake was found to have a large effect on HRI severity among outdoor workers exposed high temperatures during a heat wave phenomenon.