A series of comprehensive focus group discussions with active firefighters revealed that inconsistencies in incorporating a rigorous physical training program during work hours contributed significantly to the challenges of maintaining functional fitness, particularly strength. This article outlines a process for identifying the specific exercises required to enhance strength, drawing on the expertise and experience of physical trainers. Modified nominal group technique (mNGT) sessions were conducted to identify and rank exercises for five functional strengths (i.e., pushing, pulling, lifting, carrying, and dragging). A total of six physical trainers from the firefighter academy were interviewed to 1) identify the skeletal muscles involved in the functional movements using a visual aid; 2) generate ideas for exercises via brainstorming; 3) privately rank the displayed list of exercises for each muscle group involved in each functional movement; and 4) design a physical training programme for beginner, intermediate and advanced levels by manipulating loads. Males dominated the expert group (66.7%) and had a mean of 11.50 (SD 5.20) years of experience in physical training. The mNGTs yielded three top-ranking exercises for each functional strength: 1) Pushing: the push-up, sit-up, and jumping jack; 2) pulling: the push-up, jumping jack, and sit-up; 3) lifting: the jumping jack, push-up, and jumping squat; 4) carrying: the push-up, plank, and sit -up; and 5) dragging: the jumping jack, sit-up, and jumping squat. Then each exercise was designed for the beginner, intermediate, and advanced levels by manipulating loads (i.e. additional weight or number of repetitions). This study demonstrated that mNGT is an effective tool for identifying the three top-ranking exercises that address firefighter recruits’ functional strength. The experts chose multi-joint exercises targeting agonist and antagonist skeletal muscle groups and mimicking movements of daily work life. The exercises, corroborated by previous empirical evidence, provide opportunities for common skeletal muscle groupings to be targeted simultaneously to increase cardiovascular adaptations over a shorter period. The physical exercise is now ready to be implemented for piloting purposes among firefighter recruits.

Introduction: Commuting accidents (CAs) caused significant detrimental impacts on the Fire and Rescue Department of Malaysia (FRDM). Therefore, this study aims to identify factors of CA by mainly focusing on environmental factors Methodology: The qualitative data was obtained from FRDM accident investigation reports from five states (Kedah, Selangor, Kuala Lumpur, Negeri Sembilan and Johor) between 2017-2021. The data were analysed using content analysis. Results: Four environmental factors that contribute to CA were identified. The factors were environmental conditions (rainfall, strong wind, light glare, and insufficient lighting), time (twilight and night time), road physical conditions (hilly road, curvy, steep, and narrow road, weak manhole cover, soft ground, wet and slippery road), and road environment (traffic congestion and sudden animal crossing) Conclusion These findings provide environment-related hazards input for risk assessment and management of CA in FRDM, as well as valuable information for future research. Therefore, it has the potential to improve road safety for firefighters, the general public, and animals

Deletions and amplifications of genes often occur during multistep progression from oral precancer, seen as oral epithelial dysplasia (OED) to cancerous stage. These genetic alterations could be used as markers to aid in detection of oral squamous cell carcinomas (OSCC). This study explored the use of multiplex ligation-dependent probe amplification (MLPA) technique in detecting OSCC and OED specific genetic alterations. MLPA was used to detect gains and losses of 106 genes in DNA extracted from frozen tissue samples of 10 OSCC and 10 noncancer patients. Two biopsies of OED were analyzed to explore the alterations in oral potentially malignant disorders. There were significant differences (p<0.001) in the number of alterations in OSCC and dysplasia compared to non-cancer samples respectively. The most frequently altered genes in OSCC were PTP4A3, RECQL4, ATM, and KLK3 (60%). Five genes (MYC, SLA, TNFRSF1A, MESDC1, MIF) were altered in 50% of OSCC samples. These nine genes were specific to OSCC samples (p<0.05). Some genes, including MYB, MET, CASP2, SLA and PTEN occurred in 50% of OED samples. MLPA was able to detect genetic alterations, that are present only in the OSCC samples and showed potential to be used as an adjunctive tool in early diagnosis of OSCC.

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: Community health workers/volunteers (CHW) are health workers who are trained but do not possess a formal professional certificate. They are members of the community who live and work in that particular community. This study aimed to determine factors associated with not performing health screening activities by volunteers under KOSPEN; a community-based intervention programme, initiated by Ministry of Health Malaysia in October 2013. Methods: Data from the “Evaluation of the implementation of KOSPEN programme in Malaysia 2016” was used,a cross-sectional study which was carried out in randomly selected KOSPEN localities throughout Malaysia. The response rate was 94.9%. A pre-tested, self-administered questionnaire was used. Descriptive statistics andlogistic regression analysis was applied using Statistical Package for Social Sciences (SPSS) version 20. Results: 700 volunteers were included in this study. Majority were female (65.7%), aged 50-59 years (30.9%), had secondary education (65.3%), employed (55.7%.) and married (80.4%). Several issues were identified by the volunteers; funding (47.2%), module content and comprehensibility (11.4% respectively), submitting returns (17%). Multivariate logistic regression showed that volunteers who never attended training (aOR 2.79; 95% CI:1.66, 4.67) and who felt the content of the training module was inadequate (aOR 2.693; 95% CI: 1.46, 4.98) were more likely did not perform screening activities in the community. Conclusion Volunteers who were not trained and those who felt the content of the training module was inadequate did not carry out screening activities. These findings will be useful for stakeholders to make improvements to the programme for a more successful implementation.

Introduction: Adherence to anti-retroviral therapy (ART) regimens remains a difficult issue. Thus, it was hoped that the use of phone reminders would improve adherence. Methods: The Cochrane database was searched using selected keywords for this meta-analysis. We included randomised, controlled trials (RCTs) that utilised interventions with phone reminder and reported adherence outcomes, as the proportion of prescribed pills taken, the scores on an adherence questionnaire, or the follow-up rate. Two independent authors screened titles of article for inclusion, extracted the relevant data, and assessed articles for risk of bias. Results: Seven RCTs published between 2010 and 2017 were selected for inclusion in this review. The sample size ranged from 76 to 631 participants. Most RCTs used short message service (SMS) and phone call reminders as interventions. The rate of adherence was 1.17-fold greater among those who received phone reminders than those who did not, which was statistically significant (Z = 2.86, p = 0.004). Those who received phone reminders showed a 17% higher likelihood for adherence compared with those who did not receive any phone reminder interventions. Conclusions Phone reminders remain significantly effective means for improving adherence.

Introduction: Psychosocial stressors appear to alter the state of mind and adoption of overeating behaviour, resulting in high body mass index. This study was conducted to determine the magnitude of psychosocial stressors on male employees' well-being. Method: This study used secondary data retrieved from a cross-sectional study involving 492 male employees' completed data. Eligible participants completed validated questionnaires of the Psychosocial Safety Climate (PSC-12) scale, short version Demand Induced Strain Compensation (DISQ 2.1), Oldenburg Burnout Inventory - Emotional Exhaustion domain and the Three Eating Factor Questionnaire (TEFQ) -Uncontrolled Eating domain; assessing psychosocial safety climate, job demands and job resources, emotional exhaustion, and uncontrolled eating behaviour, respectively. Body mass index (BMI) was calculated based on weight and height. The research statistical model was tested by two-steps of assessment replicating partial least squares structural equation modelling (PLS-SEM). Result: The results show that psychosocial stressors (psychosocial safety climate, job demands and job resources) had significant effects on emotional exhaustion (β= -0.149, p=0.004; β= 0.223, p<0.001; β= -0.127, p=0.013). Emotional exhaustion predicted by work stressors may act as a chain reaction which could result in uncontrolled eating (β=0.138, p=0.005) and high BMI (β=0.185, p<0.001). Emotional exhaustion does mediate the relationship between PSC and uncontrolled eating behaviour (β= -0.021 [95% boot CI bias corrected: -0.048, -0.002]). Conclusion: The psychosocial stressors at work are significant factors for emotional exhaustion, which further signifies the positive effect on uncontrolled eating behaviour and BMI among Malaysian male employees.

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.

Introduction: The heat-related illness (HRI) is a continuum illness ranging from minor health effects to life-threatening medical emergencies when the pathological effects of heat load are not prevented. The aim of this study was to demonstrate the threshold HRI symptom for deciding to take simple preventative actions both by the individual workers and employers.

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.