Self-reported bone fracture among Malaysian adults: Baseline findings of PURE Malaysia cohort study.

INTRODUCTION: In Malaysia, studies on self-reported bone fractures are scarce. Due to the fact that bone fractures may serve as an indicator of osteoporosis in the community, this study aimed to identify the factors associated with their occurrence among adults in Malaysia. MATERIALS AND METHODS: Epidemiological data for selfreported bone fractures were obtained through direct interviews using a validated questionnaire from the Prospective Urban and Rural Epidemiology (PURE) study. RESULTS: Of 15,378 respondents, 6.63% (n=1019) reported bone fractures, with a higher proportion of men (65.8%, n=671) than women (34.2%, n=348). Higher odds of selfreporting bone fractures were seen in males (aOR, 2.12; 95%CI: 1.69, 2.65), those with a history of injury (aOR 5.01; 95%CI: 3.10, 6.32) and those who were obese (aOR: 1.46; 95% CI: 1.13, 1.89), highly active (aOR 1.25; 95%CI: 1.02, 1.53), smokers (aOR 1.35; 95%CI: 1.11, 1.65) and alcohol consumers (aOR 1.67; 95%CI: 1.20,2.32). CONCLUSION: Adopting a healthier lifestyle that includes a balanced diet and moderate physical activity is critical for weight loss, increased muscle and bone mass and better stability, which reduces the likelihood of fractures following a fall.

Psychometric properties of the Malay-translated General Practice Physical Activity Questionnaire among shipyard workers.

BACKGROUND: The General Practice Physical Activity Questionnaire (GPPAQ) is a validated and reliable screening tool to measure the level of physical activity in adults. However, it has never been translated and validated in Malaysian population. This study aimed to translate the GPPAQ into Malay language and to evaluate the psychometric properties of the Malay-translated GPPAQ among shipyard workers. METHODS: The original English version of GPPAQ was translated forward and backward into Malay version by experts. The final version of the Malay-translated GPPAQ was then tested for validity and reliability. A cross-sectional study design was performed and systematic random sampling was used to select respondents. Construct validity and internal consistency of the Malay-translated version were tested using exploratory factor analysis and Cronbach's alpha respectively. RESULTS: Sixty-two male shipyard workers participated in this study. The GPPAQ showed good factor loading values for all items (0.608-0.834). The exploratory principal component factor analysis delineates all seven items into two factors with variance of 41.65%. The Cronbach's alpha value was good with 0.81, 0.84 and 0.76 for total scale, factor 1 and factor 2 respectively. CONCLUSION: The Malay-translated version of GPPAQ has high psychometric properties. Therefore, it is a valid instrument to assess physical activity among Malaysian working population, particularly in male shipyard workers.

Cardiovascular risk assessment between urban and rural population in Malaysia.

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.

A tale of two construct validation analysis: Rasch model and exploratory factor analysis approach for Three-Factor Eating Questionnaire (TFEQ-R21) among Malaysian male workers.

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 Questionnaire- R21. 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 (∝=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.

Does the Definition Of Multisite Musculoskeletal Pain Influence Its Occurrence And The Assessement Of Physical Work Exposures?

Most people with musculoskeletal problem suffer pain at multiple body sites. The most frequent form of multisite pain studied is chronic widespread pain (CWP). Focusing solely on CWP may exclude the commoner form of multisite pain which is less wide spread. Therefore, studies on multisite pain which do not consider the spatial distribution of pain can be beneficial to tackle the overall problem of musculoskeletal pain. Nevertheless, multisite pain has been defined differently in the studies among workers. The absence of uniformed definition will jeopardize the understanding of this musculoskeletal problem. A review was thus carried out to identify how multisite pain were defined, how they influenced the reported occurrence of multisite pain and whether the definition determined the physical work exposures assessed in previous studies among worker. A systematic review was initiated by the search of electronic databases for multisite pain. Articles were included and excluded based on the selection criteria. A final of nine full text articles were reviewed. It was found that the difference in the definitions lies mainly in the body sites considered and the pain characteristics. The characteristics of pain influenced the multisite pain prevalence more than the sites.It wasdifficult to conclude whether the definition used determined the physical work exposures since only five studies were involved and three of them had similar research team which may explained the usage of similar exposures. The findings from this review, however, could not be inferred due to the small number of studies involved.

Respiratory Symptoms And Pulmonary Function Among Male Steel Workers In Terengganu, Malaysia

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

A Systematic Translation and Cultural Adaptation Process for Three-Factor Eating Questionnaire (TFEQ-R21).

INTRODUCTION: The Three-Factor Eating Questionnaire was first constructed to measure eating behavior in an English population in the United States. It has been validated and translated for various populations in different languages. The aim of this article is to describe a systematic process for translating the questionnaire from English to Malay language. METHODOLOGY: The report of the International Society for Pharmacoeconomics and Outcome Research (ISPOR) Task Force was used as the basis for the systematic translation process. The process began with preparation; followed by forward translation (2 independent translators), reconciliation, back translation (2 independent translators), back translation review, harmonization, cognitive debriefing, review of cognitive debriefing results and finalization, proofreading; and ended with the final report. Four independent Malay translators who fluent in English and reside in Malaysia were involved in the process. A team of health care researchers had assisted the review of the new translated questionnaires. RESULTS: Majority of the TFEQ-R21 items were experiencing, conceptually and semantically equivalence between original English and translated English. However, certain phrase such as "feels like bottomless pit" was difficult to translate by forward translators. Cognitive debriefing was a very helpful process to ensure the TFEQ-R21 Malay version was appropriate in term of wording and culturally accepted. A total of four redundant comments in regards to response scale wording, word confusion and wording arrangement. CONCLUSION: The systematic translation process is a way to reduce the linguistic discrepancies between the English and Malay language in order to promote equivalence and culturally adapted TFEQ-R21 questionnaire.

Needlestick injury among medical personnel in Accident and Emergency Department of two teaching hospitals.

Needlestick injury has been recognized as one of the occupational hazards which results in transmission of bloodborne pathogens. A cross-sectional study was carried out among 136 health care workers in the Accident and Emergency Department of two teaching hospitals from August to November 2003 to determine the prevalence of cases and episodes of needlestick injury. In addition, this study also assessed the level of knowledge of blood-borne diseases and Universal Precautions, risk perception on the practice of Universal Precautions and to find out factors contributing to needlestick injury. Prevalence of needlestick injury among the health care workers in the two hospitals were found to be 31.6% (N = 43) and 52.9% (N = 87) respectively. Among different job categories, medical assistants appeared to face the highest risk of needlestick injury. Factors associated with needlestick injury included shorter tenure in one's job (p < 0.05). Findings of this study support the hypothesis that health care workers are at risk of needlestick injury while performing procedures on patients. Therefore, comprehensive infection control strategies should be applied to effectively reduce the risk of needlestick injury.

Work Stress Prevalence among the Management Staff in an International Tobacco Company in Malaysia

A cross sectional study on work stress prevalence was carried out among 185 executives and managers in the head quarter of an international tobacco company. The aim of the study was to identify work stress prevalence in this company and work stressors that were associated with stress experienced by the workers. A questionnaire based on the Personal Stress Inventory by O'Donell (1984) was used. Data collected from participants included sociodemography factors, symptoms of stress and work stressors related to organizational policy, organizational structure, organizational process, and work environment. The study showed that the prevalence of stress among executives was 68.1% and managers were 67.9%. There was no significant difference in the level of stress between the executives and the managers in the company. The sociodemographic factors that were significantly associated with stress were salary, number of children and personal factors. The significant stressors in the workplace were lack of job recognition, over focusing on quality of work, heavy workload and long working hours.

Work related upper limb disorders in telecommunication workers in Malaysia.

A total of 323 workers from 5 different occupational groups in the telecommunication industry were studied in this cross sectional study, which sought to determine the prevalence of Work Related Upper Limb Disorders (WRULD) in 5 occupational groups; operators using the Video Display Terminals, switchboard operators, clerks, data entry processors and the supervisors. WRULD was also studied with regard to factors such as sex, race, height, age, stress and the discomfort perceived due to the work station design. The possibility of WRULD was determined from a self-administered questionnaire and confirmed by history and physical examination. Psychological stress and the discomfort due to the workstation were measured from the questionnaire. The overall prevalence was found to be 31.2% and the prevalence among the various occupations differed with it being the highest in the switchboard operators and data processors and the lowest in the supervisors. The older workers and the female workers were found to have higher prevalences of WRULD. It was also found that a higher stress score and a higher score of discomfort perceived at the work station were associated with higher prevalences of WRULD.

[Prevalence of hearing loss and hearing impairment among rural males in Selangor, 1993]. / Prevalens kurang pendengaran dan gangguan pendengaran penduduk lelaki luarbandar Selangor, 1993.

A cross sectional study to determine the prevalence of hearing loss and hearing impairment was conducted on 286 male subjects from a rural area. The sample was chosen by using a simple random sampling method. Prevalence of symptoms of tinnitus, ear disease, ear drum perforation and infection of external auditory meatus was 19.0 per cent, 6.7 per cent, 3.5 per cent and 0.4 per cent respectively. Air conduction audiometry tests showed the prevalences of hearing impairment of the left, right and both ears (aged 15-30 years) were 5.9%, 8.8% and 0% respectively. The prevalence of hearing loss increased with age. The higher frequencies (> 4KHz) appeared to be more affected than the lower frequencies.