Effectiveness of an integrated-Weight Management Programme (i-WMP) in Reducing Body Weight among Noncommunicable Disease Patients in Malaysian Government Primary Care Clinics: A Randomised Controlled Trial

@#Introduction: Obesity is a global issue called as “globesity”. Overweight and obesity may lead to many noncommunicable diseases (NCDs). Primary care is the first centre to monitor and follow-up the progress of NCD patients. Therefore, the objective of this study was to determine the effectiveness of an integrated-Weight Management Programme (i-WMP) to reduce body weight among NCD patients from two Government primary care clinics from Hulu Langat District. Methods: This study was single-blinded randomised controlled trial by design. There were 244 eligible patients were randomised into intervention (n = 122) or wait-list control group (n = 122). The i-WMP was developed based on the behaviour change wheel through the operationalization of behaviour change techniques. The duration of this intervention programme was four weeks. Data collected at week 0, week 4, and week 12. The software IBM SPSS was used to analyse the data. Generalized linear mixed model analysis with intention-to-treat principle was applied. Results: The retention rate was 74.2%. Findings showed that the i-WMP was significantly effective in reducing not only body weight as primary outcome but also secondary outcomes such as waist-to-height ratio, waist circumference, body mass index, and total sitting time. It also improved effectively other secondary outcomes such as participants’ knowledge, attitude, and practice towards dietary and towards physical activity. However, no significant changes were reported for body fat percentage and total physical activity metabolic equivalent of task-minutes/week. Conclusion: Implications surrounding the implementation of i-WMP in the primary care clinics are recommended.

Effectiveness of a Pelvic Floor Muscle Exercise Intervention in Improving Knowledge, Attitude, Practice, and Self-Efficacy among Pregnant Women: A Randomized Controlled Trial / 가정의학회지

Background@#The awareness and practice of pelvic floor muscle exercise (PFME) in the prevention and reduction of the rate of urinary incontinence among pregnant women was considerably poor, despite the increased prevalence of urinary incontinence during pregnancy across Malaysia. There healthcare providers do not give adequate attention to the potential impact of PFME on urinary incontinence and there is limited local intervention addressed urinary incontinence during pregnancy. The objective of this study was to determine the effectiveness of a newly developed PFME intervention in terms of knowledge, attitude, practice, self-efficacy, and urinary symptoms. @*Methods@#A single-blinded, two-armed, randomized control trial was included pregnant women from 18 to 20 weeks of gestation and was conducted at the Maternity Hospital of Kuala Lumpur. The intervention group received PFME in addition to the usual perinatal care. The data were collected using validated questionnaires at 4 time points: baseline, post-intervention in the early third trimester, late third trimester, and early postnatal period. The intervention effects were analyzed using a generalized estimating equation. @*Results@#The primary analysis included pregnant women who had at least one follow-up; 122 women (71.8%) in the intervention group had significant improvement in knowledge, attitude, practice, and self-efficacy, as well as in the severity of urinary incontinence over time. However, improvement was not observed in self-reported urinary incontinence. @*Conclusion@#PFME can be considered an effective initial intervention to provide information about urinary incontinence prevention to pregnant women.

Malaysia’s third COVID-19 wave – a paradigm shift required

@#The first case of COVID-19 was reported in Malaysia on the 25 January 2020. By the 20 January 2021, the cumulative numbers reported confirmed cases of COVID-19 had reached 169,379 including 630 deaths. Malaysia has been hit by three waves of COVID-19. This article reports on the three waves, the current situation and some of the possible factors associated. It outlines the need to reassess the overall situation, re-strategize the approach in order to contain the spread. The first COVID-19 wave lasted from 25 January to 16 February 2020, the second wave occurred between the 27 February 2020 and the 30 June 2020. The current third wave began on 8th September 2020.The sudden surge of cases in the third wave was mainly due to the two largest contributors, namely the Benteng Lahad Datu cluster in Sabah state and Kedah's Tembok cluster. The current situation is critical. The daily confirmed cases of COVID-19 continue to soar. The challengers faced by healthcare workers and other front liners is tremendous. Non-communicable diseases such as cardiovascular diseases, diabetes and cancer are the leading cause of death in Malaysia. A paradigm shift in the approach is required to ensure the sustainability of the normal healthcare services provided by the government especially for the lower income groups. There is also a need to expedite the tabling of Tobacco Control Bill in coming parliament session which is long overdue. H.E. the King of Malaysia has called on all Malaysians to put aside political, racial and religious differences and show the spirit of loyalty, humanitarianism and steadfastness in fighting the COVID-19 pandemic.

Battling COVID-19 pandemic waves in six South-East Asian countries: A real-time consensus review

@#health concerns, triggering an escalated burden to healthsystems worldwide. The pandemic has altered people’sliving norms, yet coherently escalating countries’ socio-economic instability. This real-time consensus review aimsto describe the epidemiological trends of COVID-19pandemic across six South-East Asian nations, and country-specific experiences on pandemic preparedness, responsesand interventions.Methods: Consensus-driven approach between authorsfrom the six selected countries was applied. Countryspecific policy documents, official government mediastatements, mainstream news portals, global statisticsdatabases and latest published literature available betweenJanuary-October 2020 were utilised for information retrieval.Situational and epidemiological trend analyses wereconducted. Country-specific interventions and challengeswere described. Based on evidence appraised, a descriptiveframework was considered through a consensus. Theauthors subsequently outlined the lessons learned,challenges ahead and interventions that needs to be in placeto control the pandemic. Results: The total number of people infected with COVID-19between 1 January and 16 November 2020 had reached48,520 in Malaysia, 58,124 in Singapore, 3,875 in Thailand,470,648 in Indonesia, 409,574 in Philippines and 70,161 inMyanmar. The total number of people infected with COVID-19 in the six countries from January to 31 October 2020 were936,866 cases and the mortality rate was 2.42%. Indonesiahad 410,088 cases with a mortality rate of 3.38%, Philippineshad 380,729 cases with a mortality rate of 1.90%, Myanmarhad 52,706 cases with a mortality rate of 2.34%, Thailand had3,780 cases with a mortality rate of 1.56%, Malaysia had31,548 cases with a mortality rate of 0.79%, and Singaporehad 58,015 cases with a mortality rate of 0.05% over the 10-month period. Each country response varied depending onits real-time situations based on the number of active casesand economic situation of the country. Conclusion: The number of COVID-19 cases in thesecountries waxed and waned over the 10-month period, thenumber of cases may be coming down in one country, andvice versa in another. Each country, if acting alone, will notbe able to control this pandemic. Sharing of information andresources across nations is the key to successful control ofthe pandemic. There is a need to reflect on how thepandemic affects individuals, families and the community asa whole. There are many people who cannot afford to beisolated from their families and daily wage workers whocannot afford to miss work. Are we as a medical community,only empathising with our patients or are we doing ourutmost to uphold them during this time of crisis? Are thereany other avenues which can curb the epidemic whilereducing its impact on the health and socio-economiccondition of the individual, community and the nation?

From the MJM Editors’ Desk: Common errors authors make in submission to the Medical Journal of Malaysia

@#Proper understanding the ‘Instructions to authors’ for a particular journal is the key towards successful submission of a manuscript which will lead to it being published. Common errors that are frequently made by authors in their submission to the Malaysia Journal of Malaysia (MJM) that lead to rejection of their submission or requiring major revisions or minor revisions are listed and discussed in this article. Outright rejection prior to even a peer review process may be made for an article due to: it is poorly written or when there is suspicion on the authenticity of the submission, which contains elements that are suspected to be plagiarised, it is a duplicate submission or not in the format required by the MJM. The editor in charge of the issue makes a recommendation to the Editor in Chief for the final decision.

COVID-19 Pandemic update

@#The COVID-19 outbreak has resulted in a health crisis that is unprecedented. The global and local status of COVID-19 outbreak is a rapidly evolving situation. When the pandemic erupted even the super powers and high-income countries struggled on how to tackle the crisis in their own countries. They were all startled with the sudden turn of events and no country was prepared for this catastrophic event that has posed the world with new challenges, not only, for the governments and healthcare workers but also humanity. This editorial addresses issues as of first of May 2020.

Coronavirus disease (COVID-19) pandemic

@#The Coronavirus disease (COVID-19) pandemic (caused by the virus SARS-CoV-2) is the greatest threat not only to global health but also has far reaching socio economic impact on nearly all the countries in the world. The first 4 cases of COVID-19 was first reported on the 29th December 2019, all linked to Huanan (Southern China) seafood wholesale market. 1,2 On the 31st December 2019, the World Health Organization (WHO) China Country Office was informed of a pneumonia of unknown cause, detected in the city of Wuhan in the Hubei province, China

Self-esteem among cancer patients receiving chemotherapy in selected government state hospitals, Peninsular Malaysia

@#Introduction: The number of cancer cases in Malaysia has increased from 32,000 cases in 2008 with to 37,000 in 2012 (check figures in text). This number is expected to rise to 56,932 by 2025. Cancer patients undergoing chemotherapy experience low to moderate level of self-esteem. Objectives: To determine the self-esteem among oncology patients receiving chemotherapy in selected government state hospitals, Peninsular Malaysia. Methods: A cross-sectional study was conducted using selfadministered questionnaires. 953 respondents were given questionnaires which included socio-demographic profile, physical effect, depression, anxiety, quality of life and self esteem. Inferential analysis was done by using Independent T-test or Pearson’s Correlation and the level of significance was p<0.05. Multivariate logistic regression was then used to determine the predictors using Statistical Package for Social Sciences software version 22.0 Results: All 953 respondents selected participated in this study. The overall mean self-esteem in this study was 22.67, SD=4.98. The significant predictors of self-esteem where pvalue was <0.05 were age; gender; marital status; working status; anxiety; depression; nausea; anemia; hair loss; skin and nail changes; overall quality of life and psychological domain of quality of life. The finding of this study indicates that predictors of selfesteem among patients undergoing chemotherapy should be taken into account to improve their quality of life. Guidelines on how to manage self-esteem in a chemotherapy patient can be done using this study as the baseline

Prevalence of overweight/obesity and its associated factors among secondary school students in semi urban area in Malaysia

@#Introduction: This cross-sectional study aimed to determine the prevalence of overweight and obesity and factors associated among secondary school students in Batang Padang District, Perak, Malaysia. Methods: Out of the 7247 students in the ten selected schools studied, a total of 6248 students (2928 males, 3320 females) took part. A validated self-administered questionnaire was used. Data was analysed using SPSS version 22. Multivariable logistic regression was used to determine the adjusted odd ratio. Results: The prevalence of overweight and obesity was 16.0% and 11.5% respectively. Obesity/overweight was significantly (p<0.05) associated with gender, age, ethnicity, education level of father, education level of mother, physical activity, disordered eating, smoking status, body size perception and body part satisfaction. The multivariable analysis results showed that the odds of being overweight/obesity were higher in males compared to females (OR 1.56, 95%CI: 1.37, 1.77). The results also showed that the odds of being overweight/obesity were highest among those in age group 12 and 13 years and among Malay ethnicity. The odds of overweight/obesity were higher in those who was dissatisfied with their body parts, (OR 1.96, 95%CI: 1.71, 2.25), dissatisfied with their body size (OR: 4.25, 95%CI: 3.60, 5.02), low physical activity (OR 1.23, 95%CI: 1.06, 1.44), current smokers (OR 1.38, 95%CI: 1.07, 1.78) and at risk of having eating disorder (OR: 1.39, 95%CI 1.22, 1.59). Conclusion: The overall prevalence of overweight and obesity is high. The findings from this study can be used by policy makers to plan an integrated intervention program in schools.

Knowledge, Attitude and Preventive Practices Regarding Tuberculosis and Its Predictors among HIV Patients in General Hospital, Minna; North-Central; Nigeria

@#Introduction: Tuberculosis is the commonest cause of death among HIV patients in Nigeria. Though tuberculosis is common among HIV patients, their knowledge about transmission and prevention is poor. Objective: To determine knowledge, attitude and preventive practices regarding tuberculosis and its predictors among HIV patients receiving treatment. Methods: A cross sectional study was carried out involving 226 randomly selected HIV patients receiving care at General Hospital, Minna. Study duration was from June 2015 to July 2017. Data on socio-demographic characteristics, psychosocial factors, knowledge, attitude and preventive practices regarding tuberculosis was collected using a self-administered, WHO modified, pretested and validated questionnaires. Data collected was analysed using SPSS version 22. Results: Out of 226 respondents, 60(26.5%) had poor knowledge, 123(54.4%) had negative attitude and 48(21.2%) had poor preventive practices regarding tuberculosis. The predictors of knowledge were age (B=0.087, 95%CI=0.031, 0.143, p=0.002), depression (B=-0.444, 95%CI=-0.673,-0.214, p<0.001) monthly income (B=-0.058, 95%CI=-0.095, -0.021, p=0.002) and marital status (B=-1.276, 95%CI=-2.525,-0.025, P=0.046). The predictors of attitude were anxiety (B=-0.395, 95%CI=-0.584, -0.206, p<0.001), cigarette smoking (B=4.473, 95%CI=0.992, 7.954, p=0.012) and duration of HIV infection (B=0.371, 95%CI=0.110, 0.631, p=0.005). The predictors of practice were depression (B=-0.176, 95%CI=-0.276, -0.076, p=0.001), cigarette smoking (B=2.200, 95%CI=0.926, 3.474, p=0.001) and duration of HIV infection (B=0.098, 95%CI=0.003, 0.194, p=0.043). Conclusion: Overall, knowledge and practices regarding tuberculosis prevention were good, but attitude was poor. The predictors of knowledge, attitude and preventive practices were age, depression, anxiety, cigarette smoking, monthly income, marital status and duration of HIV infection.

Prevalence and predictors of pediculosis capitis among primary school children in Hulu Langat, Selangor

Introduction: Pediculosis capitis infestation is endemic in both developing and developed countries leading to various physical, economical and psychological consequences. Our main objective was to determine the prevalence and predictors of pediculosis capitis among primary school children in Hulu Langat District, Malaysia. Methods: An analytic cross-sectional study using cluster random sampling method was carried out in Hulu Langat District, Malaysia. Self-administered pretested questionnaires were used to collect the data. Hair and scalp examination was also carried out. Multivariate logistic regression was used to control for potential confounding and determine the predictors. Results: The overall mean age of the 1,336 respondents was 9.3 years. Majority were males (52.8%), Malays (79.5%) and 81.3% of the fathers had secondary or tertiary education as compared to 77.3% for the mothers. The overall prevalence of pediculosis capitis was 15.3%. The prevalence of pediculosis was significantly higher among females (28.4%) than males (3.7%, p=0.001). Multivariate logistic regression analysis showed that age 10 years or more (Odds Ratio (OR) = 2.34, 95% Confidence Interval (CI) = 1.673 to 3.272), female gender (OR = 10.26, 95% CI = 6.620 to 15.903), history of contact with an infested person (OR = 2.11, 95% CI = 1.506 to 2.960), Indian compared to Chinese (OR = 3.55, 95% CI = 1.282 to 9.860), Malay to Chinese (OR = 2.59, 95% CI = .994 to 6.774) were associated with pediculosis capitis. Conclusions: Prevalence of pediculosis capitis among children aged 7 - 12 years in Hulu Langat District was high. There is a need for screening and treatment of pediculosis capitis in primary schools.

Knee Pain and Functional Disability of Knee Osteoarthritis Patients Seen at Malaysian Government Hospitals

Introduction: Osteoarthritis (OA) is the main cause of knee pain. It also affects individual’s physical functioning. Anti- inflammatory drugs and knee replacement are the mainstay methods in the management of knee OA in Malaysia. However, patients with knee OA often suffer pain. The general objective of the study is to evaluate the effectiveness of a cognitive behavioural intervention module on knee pain, functional disability and psychological outcomes among knee OA patients attending Orthopedics Clinics in Hospital Putrajaya and Hospital Serdang, Malaysia. This study aims to determine the baseline level of knee pain and functional disability among knee OA patients. Methods: Baseline results on the knee pain and functional disability were obtained from a two arm parallel- group randomized controlled study. Three hundred patients aged 35 to 75 years diagnosed with knee OA were recruited. A set of pre tested and validated Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire was used in this study. Results: Mean baseline of KOOS pain was 56.09 (SD=21.75) and 52.26 (SD=22.08) for the intervention and control groups respectively. Participants in the intervention and control groups had a mean KOOS function in daily living of 61.11 (SD=21.20) and 56.72 (SD=22.13) respectively. Overall mean baseline of KOOS function in sport and recreation was 35.30 (SD=27.38). Conclusions: Majority of participants had moderate level of knee pain and functional disability in daily living. However, participants had more extreme symptoms of functional disability in sport and recreation. Therefore, interventions to reduce knee pain and functional disability symptoms in knee OA are needed.

Prevalence and Predictors of Water Pipe (Shisha) use among Iranian High School Children

Introduction: Water pipe use is becoming increasingly common among Iranian adolescents. This study examined the prevalence and predictors of water pipe use among public high schoolchildren aged 14-17 in Iran. Methods: A cross-sectional study was conducted among 1st, 2nd and 3rd grade public high schoolchildren in Sanadaj City, capital of Kurdistan province of Iran during the academic year 2012-2013. Cluster sampling was used to select a sample from 8 public high schools. The data were collected using validated self-administrated questionnaire that included questions on water pipe use, socio-demographic characteristics, smoking-related knowledge, attitude toward smoking, normative believes regards perceived prevalence water pipe use among peer and adults, perception of harm, self-esteem and refusal skill. A multivariate logistic regression analysis was performed to assess predictors of water pipe use. Results: A total of 1837 students participated in this study. Students’ ages ranged from 14 to 17 years (mean age±15.09; SD±0.82 years). The overall prevalence of ever water pipe use was 36.2% (43.1% in male and 29.2% in female, (p<0.001). Age, gender, living arrangement, pocket money, academic grade, parental history of smoking, attitude, and normative believes regards perceived prevalence water pipe use among peer and adults were predictors of water pipe use among study participants. Conclusions: The overall prevalence of water pipe is high among high school children in Sanandaj. Age, gender, pocket money, academic grade, parents smoking, attitude toward smoking and normative believes were identified as the most important predictors increasing the risk of water pipe use in the studied students.

Prevalence and Predictors of Intestinal Worm Infections Among Semai Aboriginal Tribe School Children in Tapah, Malaysia

Introduction: Worm infection is one of the major global public health problems especially among rural communities. Objectives: to determine the prevalence of intestinal worm infection and factors associated among Semai Aboriginal children aged between 6 to 13 years in Tapah, Malaysia. Methods: A cross-sectional study design was used in this study. The estimated sample size was 508. Data was collected using a validated pretested questionnaire. Faecal samples were also examined. Data was analysed using SPSS version 22. Results: The response rate was 80.9%. The overall mean age of the 411 respondents was 10.1 years(95% CI = 9.89, 10.22). Majority (71.5%) were poor. Prevalence of intestinal worm infections was 60.8% and 57.2% had multiple infections. The multiple logistic regression analysis showed that those with poor hygiene practices were 2.18 times the odds of worm infection when compared with children with good hygiene practices (95% CI = 1.4, 3.4). Similarly, poor attitudes towards prevention of worm infection increased the odds of having worm infection by 1.62 times among Orang Asli children. Children living without toilets had 2.45 times higher odds as compared with those who had proper toilets. Absence of river near by these areas where there is no safe water supply also increases the risk of worm infection among children by 1.84 times among Orang Asli children. Conclusions: the prevalence of worm infection is still very high among rural Aboriginal community. Current control measures should be reassessed to enable introduction of effective measures to reduce the worm infection among Orang Asli children.

Visual Status following Contact Lens Related Microbial Keratitis

Introduction: A hospital based case control study was conducted in government hospitals on contact lens patients diagnosed with microbial keratitis. Methods: The objective of this study is to determine the visual outcomes of contact lens related microbial keratitis. The visual outcomes which comprised of visual acuity, keratometry readings, corneal topography findings and contrast sensitivity examinations was determined after three months from the first presentation at the hospitals. Results: The mean LogMAR visual acuity during presentation was 0.96 ± 0.73 or a Snellen equivalent 6/60 (n=76) and mean LogMAR visual acuity after three months was 0.10 ± 0.48 or a Snellen equivalent 6/7.5 (n=76) with a significant difference (t=11.22, df=78, p=0.001). Best fit curve for the cases had a regression coefficient, r=0.350 ± 0.063 (95% CI = 0.224, 0.447, df=78, p=0.001. The visual acuity in cases and controls was 0.10 ± 0.48 and -0.10 ± 0.14 respectively (t= -3.61, df=154 p=0.001) after three months which showed improvement. There was a reduction in the corneal uniformity index and corneal asphericity in the cases. The Corneal Uniformity Index (CU index) in cases was 63.03 ± 26.38 (n=76) and in controls, 80.13 ± 11.30 (n=77), (t= -5.22, df=151, p=0.001). There was also a reduction in the contrast sensitivity function at all spatial frequencies in the cases which was significantly different. Conclusion: Microbial keratitis reduced the vision, corneal uniformity index, asphericity and contrast sensitivity after three months in eyes of patients diagnosed with the condition.

Risk Factors Associated with Contact Lens Related Microbial Keratitis

Introduction: Microbial keratitis is one of the most challenging complications of contact lens (CL) wear. Proper CL practice plays an important role to reduce the risk for contact lens related microbial keratitis (CLRMK). Methods: This multi-centre case-control study was conducted from January 2008 until June 2009 to determine the risk factors associated with CLRMK. Cases were defined as respondents who were treated for CLRMK, whilst controls were respondents who were contact lens wearers without microbial keratitis. Ninety four cases were compared to 94 controls to determine the risk factors for CLRMK. Results: The predictors for CLRMK were: Not washing hands with soap before handling CL (aOR 2.979, CI 1.020, 8.701 p=0.046), not performing rubbing technique whilst cleaning the CL (aOR 3.006, CI 1.198, 7.538 p=0.019) and, not cleaning the lens case with multipurpose solution daily (aOR 3.242 CI 1.463, 7.186 p=0.004). Sleeping overnight with the CL in the eye (aOR 2.864, CI 0.978, 8.386 p=0.049) and overall non-compliance with lens care procedures (aOR 2.590, CI 1.003, 6.689 p=0.049) contributed significantly to CLRMK. Conclusion: Health education and promotion in contact lens care are important and should be conducted by eye care practitioners to reduce the occurrence of CLRMK.

Outcome of chemotherapy counseling by pharmacists on psychological effects and self esteem among oncology patients in a Government Hospital in Malaysia

SUMMARY Introduction: Chemotherapy is the most common form of treatment among cancer patients. It is also known to cause many physical and psychological side-effects. Objective: This study developed, implemented and evaluated the outcome of a chemotherapy counseling module among oncology patients by pharmacists based on their psychological effects (depression, anxiety) and selfesteem. Methods: A randomized, single blind, placebo controlled study was conducted among 162 patients undergoing chemotherapy in a government hospital in Malaysia. Intervention: Counseling sessions were conducted using the 'Managing Patients on Chemotherapy' module for oncology patients undergoing chemotherapy at each treatment cycle. Outcome: The outcome of repetitive chemotherapy counseling using the module was determined at baseline, first follow-up, second follow-up and third follow-up. Results: The findings revealed that there was significant improvement in the intervention group as compared to the control group with large effect size on depression (p = 0.001, partial Ƞ 2 = 0.394), anxiety (p = 0.001, partial Ƞ 2 = 0.232) and self-esteem (p = 0.001, partial Ƞ 2 = 0.541). Conclusion: Repetitive counseling using the ‘Managing Patients on Chemotherapy’ module was found to be effective in improving psychological effects and self-esteem among patients undergoing chemotherapy.

Prevalence and Predictors of Suicidality Among Medical Students in A Public University

Background: Undergraduate medical students have been the most distressed group among the student population. Depression and anxiety have been found to be more prevalent in this group of students compared to others. Objective: This study was conducted to determine the prevalence and predictors of suicidality among undergraduate medical students in a public university. Methods: This was an analytical cross-sectional study, conducted in a public university in Selangor, Malaysia. Data were collected using self-administered questionnaires from January to February 2013, and analysed using the Statistical Package for Social Sciences Software (version 21). Results: Out of 625 undergraduate medical students, 537 (85.9%) participated in the study. The prevalence of the suicidality among undergraduate medical students was 7.0%. The significant predictors of suicidality based on multiple logistic regression were the respondent’s lifetime suicide attempts (Adjusted Odds Ratio, AOR 10.4, 95% CI 2.7 to 40.9); depression (AOR 5.9, 95% CI 1.5 to 23.0); breaking off a steady love relationship (AOR 5.4, 95% CI 1.3 to 22.4); hopelessness (AOR 4.9, 95% CI 1.1 to 21.6); and something valued being lost or stolen (AOR 4.4, 95% CI 1.2 to 15.9). Conclusion: These findings indicate that mental health care services should be strengthened at university level. The results show a need for an intervention programme to reduce suicidality among the undergraduate medical students.

Prevalence of Tobacco Use and its Socio-demographic Determinants among Saudi Female School Adolescents in Jeddah

Tobacco use among females is a rising public health issue. Further insight into the smoking epidemic can be gained from studying a specific subgroup of interest within the population. Determining predictors of each tobacco smoking type is necessary for planning tobacco specific intervention programmes. The aim of this study was to determine the prevalence of ever tobacco use and its associated socio-demographic factors among Saudi female adolescents aged 12 to 19 in Jeddah. A cross-sectional analytical study was conducted among female students from intermediate and high secondary schools in Jeddah during the academic year 2012-2013. Sampling with probability proportionate to size was used to select a sample of 5,150 students from 40 schools. The data were collected using validated self-administrated questionnaire that required information on tobacco use behaviours and selected socio-demographic characteristics. A total of 5,073 students participated in this study of whom 51.6% were from intermediate grades, and 83.1% from public schools. The prevalence of ever tobacco use was 44.2% (36.2% water pipe and 30.9% cigarettes). The significant predictors of ever tobacco use were student’s age, mother’s education, family structure, residence location and monthly student’s allowance. In conclusion, ever tobacco used is highly prevalent among female adolescents in Jeddah. Designing intervention programmes aimed at preventing Saudi female adolescents from smoking should include all forms of tobacco use.

Prevalence of Job stress and its Associated Factors among Universiti Putra Malaysia Staff

Introduction: Stress in the work place is a global major risk factor to worker’s health, which triggers the workers to be poorly motivated and less productive. Objectives: The objective of the study was to determine the prevalence of job stress and its associated factors among Universiti Putra Malaysia staff. Methods: This is a cross sectional study involving 511 academic and non-academic staff of Universiti Putra Malaysia in Serdang. Probability proportionate to size was used for calculating the required sample size. Results: The overall prevalence of stress was 21.7% (21.0% among male and 23.0% among female). The variables found to be significantly associated with stress were: Job demand, coworker support, depression, anxiety, focus and venting of emotion and self-blame (p<0.05). The findings revealed that UPM staffs are exposed to a range of specific stressors such as work stressor: job demand, lack of social support such as co-worker support and supervisor support, psychological stressors such as depression and anxiety, coping such as focus and venting of emotion and self-blame. Work stressor such as job demand was the main predictor of stress (p value = 0.001). Conclusion: The overall prevalence of job stress was 21.7%. The predictors job stress were job demand, lack of support from co-worker and supervisor, depression, anxiety and use of avoidance focused coping.