Mental Health of University Students in Northern Malaysia

Context/Background: Today, poor mental health is one of the most neglected diseases although it is one of the leading causes of disabilities in both developed and developing countries. This mental health issue be-comes a problem among university students too. This study was aimed to determine the prevalence and asso-ciated factors of depression, anxiety, and stress (DAS) among university students. Methodology: A cross-sectional study was carried out in a private university of northern Malaysia during 2020. A random sample of 161 students were included and DASS-21 was used to determine the prevalence of DAS. Multiple logistic regression analysis was performed to examine the associated factors. Results: The prevalence of DAS among students were 34.8%, 42.2%, and 33.5%, respectively. In contrast to years 2 and 4, the prevalence of all types of mental disorders were lower in years 1 and 3. The students’ living area, residence, academic year, and parental income were significantly associated with anxiety whereas the age group of the students and parent’s income did so for depression. The variables; age group, academic year and parent’s income were identified as significant determinants for the presence of stress among students. Conclusions: The significant extent of the mental health problems was detected among university students in Malaysia. Despite the small sample, this analysis indicates that opportunities exist to improve campus-based mental health education and psychological support among university students.

A Systematic Review on Caregiver’s Burden Among Caregivers of Dementia Patients in Malaysia

@#Introduction: Increasing prevalence of dementia and the associated caregiving burden are expected due to longer life expectancy. This review aimed to critically assess dementia-driven caregiving burden and the associated factors in Malaysia. Methods: A systematic search using several combinations of keywords was conducted in Ovid Medline, PubMed, Science Direct, ProQuest, and Ebscohost databases. The primary outcome was the score or level of caregiver burden, while the secondary outcome was the factors associated with such burden. The quality of the individual articles was assessed using the Newcastle–Ottawa Scale and the Joanna Briggs Institute checklist. Results: The systematic search resulted in seven studies being reviewed, consisting of six cross-sectional studies and one quasi-experimental study. Using the Zarit Burden Interview, two studies reported moderate caregiver burden with mean scores of 35.4 (15.08) and 46.0 (17.0). High levels of burden or strain were reported using the Caregiver Strain Index in other studies. The three main associated factors with burden identified in these studies were the presence of behavioural and psychological symptoms of dementia (BPSD), higher education level, and lack of social support. Conclusion: Moderate to severe caregiving burden level were found to be experienced by dementia caregivers in this country. High education, lack of support, as well as taking care of patient with BPSD being the most prominent factors associated with burden. Therefore, burden should be regularly assessed among the dementia caregivers especially among those with lack of social support and manage family members with BPSD, as to prevent adverse outcome from dementia caregiving.

Prevalence of Burnout and Its Associated Factors among Medical Students in a Public University in Selangor, Malaysia: a CrossSectional Study

@#Introduction: Burnout is a growing trend among medical students worldwide. The aim of this study was to determine the prevalence and factors associated with burnout among medical students at a public university in Malaysia. Methods: A cross-sectional study was conducted among 1st through 5th year medical students at a public university using a simple random sampling method in recruiting participants. In this study, The Maslach Burnout Inventory-General Survey for Student (MBI-SS) was used and burnout is defined as severely emotionally exhausted and severely depersonalised. Results: A total of 328 medical students were recruited with a with response rate of 88.6%. The burnout prevalence was 10.1%. Based on multivariate logistic regression, presence of smartphone addiction with adjusted (odds ratio (OR) 7.37, 95% confidence interval (CI) = 1.67, 32.49), course choice not based on personal interest or due to family pressure (OR 2.72, 95% CI = 1.08, 6.85) and the presence of family relationship problems (OR = 3.58, 95% CI = 1.27, 10.04) are more likely to be associated with burnout among the medical students. Conclusion: Our study has shown that every tenth medical students suffers from burnout. Medical students who are addicted to smartphone, have chosen medical course against individual interest or because of family pressure and have family relationship problems are at risk of getting burnout. Intervention is required to address this issue for the future well-being of medical students.

Poverty related diseases amongst Malaysia’s low-income community: a review

@#Poverty, as proven by several studies, is a driving force behind poor health and hygiene practices. This review attempts to outline common communicable and non-communicable diseases that disproportionately affect Malaysia’s 2.91 million low-income households. The current study also looks into the government’s housing and healthcare programmes for this demographic to improve their health and well-being. The initial examination yielded incredibly little research on this marginalised community, with event reporting typically generalised to the Malaysian community as a whole rather than analysing disease incidences based on household income, which would better reflect povertydriven diseases. As a result, there is an acute need for more accurate information on the epidemiology of diseases among the poor in order to address this public health issue and provide conclusions that can drive policy designs.

Growth patterns of urban Malaysian children under 24 months of age in Selangor, Malaysia

@#Introduction: To identify the growth patterns of young children during the first two years of life according to gestational age, birth weight, and growth status at 24 months of age. Methods: This was a retrospective cohort study of 4,570 young children in Selangor. Data were extracted from children’s health records in government health clinics. Growth data were analysed using the Anthro Plus software that utilises the World Health Organization growth standards. Results: Generally, wasting prevalence was the highest at birth and 24 months, but stunting was more predominant from 1 to 21 months. Weight-for-age z-scores (WAZ), lengthfor-age z-scores (LAZ), and weight-for-length z-scores (WLZ) from birth to 24 months were within -3.00 to 0.00 standard deviation (SD) for pre-term low birth weight children, –1.50 to 0.00 SD for pre-term normal birth weight children, and –2.50 to 0.50 SD for full-term low birth weight children. While WAZ, LAZ, and WLZ from birth to 24 months for underweight/stunted/wasted children were within –2.50 to 0.50 SD, the values for overweight/obese (OV/OB) children were within –1.00 to 2.00 SD. For normal children, WAZ, LAZ, and WLZ exhibited comparable trends, with values within –1.00 to 0.00 SD from birth to 24 months. Conclusion: While stunting and wasting persisted as the most common forms of malnutrition in this sample of young children, the prevalence of OV/OB increased by 24 months. Interventions to promote child growth should focus not only on the prevention of undernutrition, but also on OV/OB.

Assessment of Daytime and Nighttime Ground Level Ozone Pollution in Malaysian Urban Areas

@#Introduction: Ozone (O3 ) is a significant component of photochemical smog as a typical secondary which is formed via nitrogen oxide photochemical interactions with volatile organic compounds (VOCs). This research discerns the complex influence of meteorological parameters and air pollutants influencing O3 concentrations. Methods: Data were acquired from 1 January 2018 until 31 December 2020 that including ozone (O3 ), nitrogen oxide (NOx), nitric oxide (NO), sulphur dioxide (SO2 ), nitrogen dioxide (NO2 ), carbon monoxide (CO), particulate matter (PM10, PM2.5), wind speed, solar radiation, temperature, and relative humidity (RH). Data were analysed using descriptive statistics in terms of line graphs. Results: The results demonstrate that the O3 concentration peaked around 14:00 hours and dropped at night (20:00 hours) owing to the lack of sunshine and redox processes. Conclusion: In conclusion, ozone precursors played an important role in ozone formation and the findings of this research are valuable for policymakers and other interested parties

Profiling of Aedes Mosquito Breeding Sites at Residential Construction Sites in Malaysia

@#Introduction: Poor waste management led to mosquito breeding grounds. Previous research found that construction sites are the mosquito breeding area thus it’s important to understand how construction sites affect mosquito breeding. Methods: This study utilized a prospective study to determine the characteristic of breeding preference in residential construction sites. On-field breeding preference survey was conduct in the selected project site in 12 weeks (1st October 2021 until 31st December 2021). Wet container inspection was carried out according to types of the residential construction building and progress of the site. All possible wet materials and containers was inspected and record accordingly in the form during the surveillance. Results: Result shows that the most preferred containers found was building floor (41.68%), others such as planter box that use for landscape purpose, drainage system, building mould and lift wells. The results of the research indicate that prospective containers with water and breeding sites at high rise construction sites were found to be more than those at low rise construction sites. Conclusion: Overall, substantially fewer water containers were discovered in low rise projects compared to high rise projects. Construction management need encourage all the workers to do best management practice such as proper waste disposal and removal of the water and possible wet container and conduct awareness among the workers.

Prevalence of Sleep Quality among Academic Staff of a Private University in Malaysia

@#Introduction: Poor sleep quality is frequently related to poor mental health and is a common medical disorder. It may differ by population, but limited studies have been done in Malaysia. This study was conducted to measure the prevalence of poor sleep quality among academic staff at Universiti Tunku Abdul Rahman (UTAR) Kampar Campus. Methods: In total, 344 randomly selected academic staff were approached to answer the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Results: Unexpectedly, 42.7 % of them were affected by poor sleep quality (global PSQI score >5). The average actual sleep duration was recorded at 6.68 hours. Age and global PSQI scores were not significantly correlated. Female staff had poorer subjective sleep quality (P= 0.027). The elder age group (P= 0.012) and associate professors and professors (P= 0.006) consumed more sleep medications. Non-Ph.D. holders had poorer subjective sleep quality (P= 0.008) and sleep latency (P= 0.032) as well as global PSQI score (P= 0.045) compared to Ph.D. holders. Conclusion: Prevalence of poor sleep quality was higher than expected among academic staff. This may affect workplace functioning and burden the staff with more health issues related to poor sleep quality.

Impact of Coronavirus Disease 2019 Lockdown on Back Pain Intensity, Prevalence and Associated Risk Factor Among Adults in Malaysia

@#Introduction: Low back pain (LBP) is a common musculoskeletal disorder (MSD) that leads to a variety of negative consequences. The prevalence of LBP was found to be high worldwide. Individuals have been forced to remote studying or working conditions during the coronavirus disease 2019 (COVID-19) pandemic, exposing them to the risk factors of LBP to a greater extent. This is a cross-sectional study conducted among 623 adults and aimed to assess LBP intensity and prevalence among adults in Malaysia before and during the COVID-19 lockdown and to identify the association between demographic, physical and psychological factors with LBP. Methods: A self-administered questionnaire composed of 36 questions regarding demographic characteristics, physical activities and psychological aspects was distributed to the public. Pearson’s Chi-square and Fisher Exact tests were performed using collected data to assess the association between LBP intensity and various risk factors. Results: The prevalence of LBP increased from 64.4% before the lockdown to 83.5% during the lockdown. LBP intensity significantly increased during the lockdown. Before lockdown, factors associated with LBP intensity included gender and stress level. While during the lockdown, age, gender, occupation, time spent on computer use, ergonomics as well as stress level affected the intensity of LBP. Conclusion: The present study showed that the COVID-19 lockdown has contributed to the increase in both the prevalence and intensity of LBP among Malaysians. The identified risk factors include age, gender, occupation, duration of sitting and computer use, adherence to ergonomic recommendations, and stress level.

Naja species Bite Injury- Pathophysiology of Envenomation and Multidisciplinary Approach in Management

@#Cobra bite envenomation is one of the commonest causes of snake related injuries in Malaysia. Local tissue injury following a cobra bite is a complex sequalae of envenomation that is attributed to various peptides and enzymes including cytotoxin, metalloproteases, phospholipase A2 and hyaluronidase. This case involves a young construction worker who was bitten by an unidentified snake on the dorsum of his left foot. He presented with typical features of local and systemic envenomation of a Naja species. Remote Envenomation Consultancy Services was consulted and the appropriate antivenom was administered. The patient underwent wound debridement and subsequent skin grafting. Follow up at outpatient clinic showed good skin graft uptake and recovery. Managing a significant Naja species bite envenomation can be a lengthy process requiring expertise from various subspecialties. Timely and seamless multidisciplinary approach in managing a Naja species envenomation ensures a favorable outcome with minimal complication..

Testing Occupational Hazard Self-Evaluation Module (OHSEM) Intervention among Workers of SME (Manufacturing) in Northern Malaysia

@#Introduction: Workplace accidents have been a persistent problem in Malaysia’s manufacturing industry, particularly for small and medium-sized enterprises (SMEs). Employee behavior has been identified as a significant contributing factor to these accidents, and research has suggested that improving safety knowledge and attitudes can enhance safety behavior. Despite this, there have been no empirical intervention studies in Malaysia to investigate the effectiveness of safety intervention programs aimed at improving SME worker safety behavior. Therefore, this study aimed to assess the efficacy of the Occupational Hazard Self-Evaluation Module (OHSEM) intervention in enhancing safety knowledge, attitudes, and behavior (KAB) among SME workers in the manufacturing sector. Methods: A quasi-experimental design with control group was utilized to evaluate the effectiveness of the OHSEM intervention. The intervention was implemented over a 12-week period on production workers in the experimental group, while the control group received no intervention. A self-administered questionnaire was distributed to 88 production workers in both groups before and after the intervention to measure the improvement of safety KAB. Descriptive analysis and an independent t-test were used to analyse the data. Results: The post-test results showed that safety KAB for the control group was moderate (mean = 2.11), while the mean score in the experimental group was high (m=4.17). Furthermore, the t-test result revealed a significant difference in safety KAB mean scores between the experimental and control groups. Conclusion: This study provides empirical evidence on the effectiveness of the OHSEM intervention in enhancing safety KAB in SMEs in the Malaysian SME (manufacturing) sector.

Application of Sendai Framework for Disaster Risk Reduction in Food Security During Flood Disaster in Malaysia: A Narrative Review

@#Disaster risk reduction (DRR) plays essential roles in ensuring food security to avoid adverse social, economic and financial implications to the disaster victims. This article aims to review existing DRR strategies in food security during flood disasters and recommend strategies that can be adapted into policies in Malaysia according to the Sendai Framework. Sendai Framework provides comprehensive, globally recognized priority themes in DRR while highlighting governmental and stakeholders’ responsibility. A literature review was carried out by searching available published literatures from online databases and selected information used in this review is taken from articles, journals, reports, national reports, news, and thesis regarding the topic from November 2021 to January 2022. This review revealed that DRR strategies of food security during flood disasters in Malaysia lack one out of 14 work areas in four priorities in the Sendai Framework, which is the national-level risk and vulnerability assessment system and tools. This article proposed 19 recommendations to improve eight work areas across all four priority areas to enhance national food security during flood disasters.

Morphology of Mandibular Condyle in The Population of Sarawak: A Retrospective Cross-sectional Study Using Digital Panoramic Radiograph

@#Introduction: The morphology of the condyles changes naturally with age, gender, face type, occlusal force, functional load, malocclusion type, and the right and left sides. Although condylar shape and size differ throughout populations, there have been few investigations on condylar morphology, particularly in the Malaysian population. Methods: This retrospective, observational, cross-sectional survey was conducted at the Oral and Maxillofacial Surgery Clinic of Sarawak General Hospital from September 2021 to March 2022, involving radiographic assessment of condylar morphology from 893 panoramic radiographs. Age, gender, ethnicity and dentition status using Eichner index were extracted from the data. Descriptive statistics were used. Pearson’s chi-square test was used to determine the association between the independent variables (age, gender, ethnicity and dentition status) and the shape of the mandibular condyle. A p-value of < 0.05 was considered statistically significant. Results: Only 450 panoramic radiographs were included in this study. The condyles were outlined and grouped into four categories, namely pointed (40.2%), round (32.8), angled (18.8), and flat (8.2%). Condylar morphology was found to be significantly associated with gender (p<0.005) and insignificant with other independent variables. Conclusion: The findings suggest that the most prevalent condylar morphology among the Sarawak population is the pointed shape, in contrast with other previous studies that reported the round shape condylar morphology as the majority shape.

Determinants of Premarital Sexual Behavior Among the Late Adolescents in Pahang, Malaysia

@#Introduction: Premarital sexual behaviour remains an important sexual and reproductive health issue among adolescents in Malaysia. It is also a prohibited act and considered sinful among the Muslims community. This study aimed to identify the determinants of premarital sexual behaviour among the late adolescents age group in Pahang, Malaysia. Methods: An observational study was conducted among eligible late adolescents, which were recruited using probability sampling method. Only those aged 18 to19 years old, and previously attended the public secondary schools in Malaysia were included, with non-Malaysian, married and those who were absent during the data collection day were excluded. Data was collected using a valid and reliable set of questionnaires measuring the personal (demographic profile, knowledge and attitude), behavioural (premarital sexual behaviour and high-risk activities) and environmental (subjective norms and perceived parental communication) factors. Multiple logistic regression analysis was conducted to identify the determinants of premarital sexual behaviour. Results: A total of 390 adolescents aged 18 and 19 years old participated in this study, with 82.3% of respondents reported never had premarital sexual behaviour. Multiple logistic regression showed that the male and engagement in high-risk activities had higher odds in premarital sexual behaviour respectively (AOR =11.649, 95% CI: 3.615,37.536, p <0.001; AOR=19.224, 95% CI: 7.820,47.262, p <0.001). Conclusion: Male gender and engagement in high-risk activities remained important risk factors towards the ongoing concern related to premarital sexual behaviour among adolescents in Malaysia. Failure to address this issue should be explored and improve accordingly.

Entrepreneurial Intention of Medical Students in Malaysia: Does Socio-Demographic Profile Matter?

@#Introduction: Though there are abundant studies on entrepreneurial intention among students pursuing higher education, there is a lacuna in understanding the entrepreneurial intention of medical students. In the present scenario of increasing unemployment among young medical graduates, this quantitative study was conducted with an aim to examine the level of entrepreneurial intention among medical students and the socio-demographic factors influencing it. Methods: The participants were 318 medical students of a private university in Malaysia. A cross-sectional study design with a validated adapted questionnaire was used to collect data. The data was analysed using descriptive and inferential statistics. Results: A moderately high level of entrepreneurial intention was found among the study population. Regression analysis revealed a statistically significant impact of gender and marital status on their entrepreneurial intention while ethnicity, year of study, household income or educational loan did not have a significant influence. Conclusion: Medical students in Malaysia showed a moderately high inclination towards an entrepreneurial career. Non-economic factors like gender and marital status proved to be stronger influencers of entrepreneurial intention than economic factors. This may help policy makers plan strategies to sustain their entrepreneurial intentions and facilitate for more entrepreneurial activities among young doctors in the futu

Recommendation for Improvement in COVID-19 Vaccine Program in Malaysia: An Online Nationwide Qualitative Survey

@#Introduction: Maintaining high levels of vaccinations is important for public health success in any vaccination planning. Success requires a better understanding of the public’s perceptions of diseases and consequent decisions about vaccinations. This study aims to gather exploratory qualitative data on public opinion on the Malaysian Government’s COVID-19 immunization campaigns. Methods: Open-ended question on Google Form was advertised online between 2 to 17 December 2020. The questionnaire form was deactivated when saturation has been reached. The free text questions were analysed by qualitative thematic analysis by all authors on a Microsoft Excel spreadsheet. Results: Six hundred and sixty-one participants replied to the online questionnaire. Four themes emerged from the thematic analysis on suggestions for future National COVID-19 Immunisation Program. First, COVID-19 vaccine administration policy; secondly, knowledge dissemination and plan to address obstacles of public acceptances towards the vaccine proactively; thirdly, better implementation programs by the government and fourthly, using local research expertise for vaccine development and alternative medicines. Participants believe all this are essential in increasing their trust and uptake for the government’s future national COVID-19 Immunisation Program. Conclusion: This study highlights the suggestions made by the public for the Malaysian Government. These findings will help develop education and intervention strategies for new vaccine introduction to combat the COVID-19 pandemic in Malaysia.

Risk Perception and Emergency Preparedness Against Flood Affected Participants From the Primary Health Care Centre, Malaysia: A Comparison Between Genders

@#Introduction: Flooding has become a major natural disaster in Malaysia in recent decades. There may be a gender difference in many aspects related to flood response and practice. This study aimed to examine the gender gap in knowledge, attitudes, and practice of flood preparedness in Malaysia. Method: This cross-sectional study was conducted among patients attending the primary care clinic at Universiti Sains Malaysia health campus, Kelantan. A validated questionnaire was used for data collection. Results: 328 subjects were recruited, 56.1% of them were females. The female respondents were younger than the males (36 vs. 41 years old). However, females have better knowledge, and practice on flood preparedness compared to male respondents. Among those, women were more aware of the local emergency plan than males (p=0.01). More female respondents kept their vaccination and personal medical records in a waterproof container or sealed plastic bag during past and future flood preparations (3-5 day supply of non-perishable food) than male respondents (p<0.05). In addition, with the practice of keeping a one-week supply of medication, and having their medical records in a waterproof container along with a first-aid kit (p=0.001). For future flood preparation, more women would filter the cloudy water through clean clothes for boiling (p=0.035). The determinants of good preparedness for future floods for female were older-age (p=0.001), blue-collar (p=0.043); whereas male were lower household income (p=0.014), being blue collar (0.014) and white collar (0.039) compared with student/retiree based on multivariate logistic regression. Conclusion: Our study reported that the determinants of good preparedness for future floods were older-age, blue-collar and having a lower-household income.

Distance Learning: Perceived Constraints Towards the New Norms in Learning Anatomy During COVID-19 Pandemic

@#Introduction: The unprecedented COVID-19 pandemic has led to unavoidable new norms, including increasing demands for online learning. In view of the potential constraints to virtually learn anatomy among medical students, this study was conducted to identify the level of exposure towards online anatomy learning as well as the perceived constraints among medical students in a public university in Malaysia. Methods: A cross sectional study utilizing online survey was conducted during the movement control order (MCO) enforcement in Malaysia between March and October 2020 among all consented medical students at a public university in the Klang Valley area. The data was collected using a validated self-administered questionnaire which was distributed using Google Form application. Results: A total of 281 medical students consented and completed the online survey, with 94.3% students had low level of exposure towards online anatomy learning. Year of study and accessibility towards computing facilities and internet connection were significantly associated with online anatomy learning, with the non-clinical students are 19.9 (aOR= 19.888, B=2.990, 95%CI: 2.484-159.220) times more likely to have higher exposure towards online anatomy learning respectively. Conclusion: A very high proportion of medical students having low exposure towards online anatomy learning was observed in this study, which was predicted among the clinical students. Strengthening the utilization of online learning should be seriously considered in parallel with the new norms and the many uncertainties with COVID-19 pandemic, to ensure continuity of effective and quality learning.

Screen Media Dependency and Its Associated Factors Among Preschool Children in Kuala Lumpur

@#Introduction: Excessive screen time among young children is associated with screen dependency. At this moment, there is a lack of data on screen dependency among young children in Malaysia. This study aimed to measure the prevalence of screen dependency and its associated factors among preschool children in Kuala Lumpur. Methods: A cross-sectional study was carried out at registered preschools in Kuala Lumpur. 300 parents of preschool children aged 4 to 6 years old who fulfilled the inclusion and exclusion criteria were recruited via simple random sampling. The Screen Dependency Scale (SDS) were used to assess their dependency to screen media. Univariate and multivariate statistics were analysed using IBM SPSS version 27. Results: The prevalence of screen dependency among preschool children in Kuala Lumpur was 65.7%. Multivariate logistic regression analysis identified that using the screen to resolve children’s quarrels (aOR 2.855, 95% CI 1.187 - 6.868), children who use smartphones (aOR 2.735, 95% CI: 1.244 - 6.013), children’s screen time exceeds 2 hours over the weekend (aOR 2.261, 95% CI: 1.058 - 4.830) and having a television in the bedroom (aOR 5.562, 95% CI: 1.591 - 19.442) were predictors for screen dependency. While active co-use mediation (aOR 0.505, 95% CI: 0.302 - 0.845) were protective. Conclusion: The prevalence of screen dependency was high among preschool children in Kuala Lumpur. Active screening at health care clinics or in schools is essential to identify early children with risk factors for screen dependency.

Professional Identity of Medical Students of Malaysia: Influence of Demographic Factors

@#Introduction: In medical education one of the main goal is to facilitate the development of professional identity of medical students. It is influenced by sociocultural factors whose influence has been examined by the empirical scholarship on professional identity research in a robust way. The current research studied the influence of gender, ethnicity and year of study on the professional identity of medical students using a validated instrument. Methods: The quantitative research approach using the cross sectional survey design is adopted in the present study. The instrument for the measurement of professional identity was developed using the items adapted from previous research. Stratified random sampling was used to collect the data from 318 participants. The reliability and construct validity of the instrument was evaluated using Smart PLS 3. Data was analysed, for descriptive and inferential statistics using SPSS version 26. Result: Ethnicity, gender and year of study had an impact on the professional identity of medical students. Indian ethnicity had significantly higher positive influence. The female students had higher professional identity than male medical students. As the students’ progressed to higher level of their training their professional identity progressively decreased. Conclusion: The medical students trained with similar curricular activities and the learning experiences develop different levels of professional identity. The level of professional identity developed by the medical students in deferent gender, ethnicity, and year of study differes. The sociocultural factors need to be considered when designing activities aimed at development of medical students’ professional identity.