Effects of Alcohol towards Quality of Life in the Indigenous Groups of the West Coast Division, Sabah, Malaysia

Alcohol consumption has consequences for the health and quality of life of individuals and communities. It is a problem among some of the Indigenous groups of Sabah and Sarawak with some of the highest prevalence of risky drinking in Malaysia. Alcohol is considered to be part of the culture of some of these Indigenous groups and a way to maintain the connection to their culture and traditions. However, drinking too much on a single occasion and drinking regularly over time is not a part of the culture. Therefore, this study aimed to investigate the positive and negative effects of alcohol on quality of life (QoL) of an Indigenous community of Sabah. A total of 56 villagers from the West Coast Division of Sabah were interviewed in focus group discussions using the diamond dialogue tool. Data were analysed using thematic analysis and revealed that alcohol consumption has both beneficial and adverse effects on health, behavioural, social, economic and psychological factors, depending on the drinking patterns. These harmful results suggest that awareness and harm-reduction programmes may help to empower the Indigenous groups of Sabah to reduce alcohol-related harm

Knowledge, attitude and practice towards sexual and reproductive health including comprehensive sexuality education among first year students of university Malaysia Sabah (UMS), Malaysia

This study aims to assess knowledge, attitude and behavior in sexual and reproductive health (SRH) including comprehensive sexuality education (CSE) among 439 first year students; 213 sciences and 226 arts students from 5 Faculties of University Malaysia Sabah (2016-2017). Exposure of Malaysian students to sexual education is limited to science subjects which are only being taught at upper elementary and secondary high school levels. Arts students are less exposed to sexual education across Malaysia as it is delivered in Basic Science subject only. It was a university-based, cross-sectional, descriptive study. Pretested self- administered questionnaire was anonymously completed by all participants and was conducted from November 2016 to January 2017. Students’ demographic characteristics from Science and Arts streams were same except females, Sabah ethnics and Malays were more in Arts. Awareness of HIV/AIDS, Condom, Wet dream, COC pills and abortion services were more in Science students and statistically significant. 34.3 % and 81.2% of Science students agreed that CSE should be introduced in primary and secondary school but not statistically significant. 22 out of 439 students were sexually active. Science students had more knowledge about SRH and favourable attitude towards sexuality education but less favourable behaviour of watching and reading pornographic materials. It was concluded that there were gaps in knowledge, attitude and behaviour of SRH and need to remedy these by giving appropriate CSE classes to first-year university students in an elective module according to their culture and religious beliefs in accord with International Technical Guidance on Sexuality Education (ITGSE)

Inculcating collaborative practice among healthcare professionals: initiative from hospital Universiti Malaysia Sabah

Introduction: Collaborative working culture is an important milestone to be inculcated in a hospital setting. In the process of preparation for the upcoming teaching hospital of Universiti Malaysia Sabah (HUMS), the organisational value of innovative, collaborative, compassionate, empowering, and sustainable needs to be inculcated to the both management and clinical staffs. The objective of this study was to assess the efficacy of a collaborative practise workshop in staff. Methods: A two days experiential learning workshop was conducted to deliver and inculcate the organisational value of HUMS to 32 existing and newly recruited healthcare professionals, which include doctor, nurses, assistant medical officer, dental assistant, pharmacist, and radiographer. The topics consisted of principles of collaborative practice, skill of validation, feedback-giving method, approach for value identification and goal setting, reflective practice, public communication during crisis, shared decision making, and organisational problem solving. Different delivery methods include round table discussion, role play, and group work were used. Innovative real time practice of giving feedback to the management was performed directly to the hospital chief executive officer and chief clinical officer. Results: Immediate feedback from the participants found that the candidates found the course was enriching and it helped them to develop an alternative perspective on how to get work done. The staffs expressed their idea, concern, and expectation more openly with the method learned using what they had learnt. The limitation included the challenge of transition from previous working culture to new environment without further supervision. Conclusions: Further systematic evaluation using more detailed assessment tool is needed to understand the long term efficiency and translatability of the learning outcomes into clinical practice once the hospital is ready

Occupational lung disease: A narrative review of lung conditions from the workplace

Occupational lung diseases are lung conditions caused or made worse by materials when a person is exposed to a workplace. The diagnosis of an occupational disease is important for workers’ decision to continue work and for their eligibility under compensation programmes. We revisit the existing lung diseases that are closely associated with the occupation at the workplace namely occupational asthma, silicosis, black lung disease, farmers’ lung disease, asbestos-linked disease, and hypersensitivity pneumonitis. Occupational lung diseases contribute toward global health and economic impacts. Prevention and control of occupational lung diseases require a collaborative effort among employers, workers, occupational physicians, pulmonary physicians, industrial hygienists, and members from other disciplines

Widespread pandemic, wide-ranging response: student-led virtual telemedicine and digital community-based healthcare provision in a university healthcare Centre in response to coronavirus quarantine measures

Introduction: Isolation and border control measures, with home quarantine measures, are essential to stem the spread of the newly emergent novel Covid-19. Such measures are doomed to fail if reliant on traditional isolation methods, which entail small numbers of overworked healthcare staff screening and surveilling large numbers of well individuals who are potential false positives. Innovative method employed by Hospital UMS to overcome these logistics difficulties. Methods: A total of 440 returning China students to UMS were planned for home quarantine measures for 14 days. In the intervening 14 days, groups of ten quarantined individuals were assigned to 1 Manda¬rin-speaking medical student liaison officer (LO). LOs performed assessment toolkit for 14 consecutive days virtually via WhatsApp and WeChat and reported back to NCOV central command if any symptoms ensued. Results: 45 China students have been put on home quarantine. Two (2) students with symptoms were monitored virtually till resolution of symptoms. Also, five (5) students with uncontactable phone numbers required tracking down, using var¬ious methods eg: retrieval from close contacts through wide-bore virtual search. No cases so far have been positive for NCOV or have required referral to tertiary hospitals. Qualitatively, such methods are a vital public health inter¬vention, as task shifting happens to semi-professionals. Hospital UMS first trial of two cherished founding principles: community-based rather than healthcare-facility center healthcare delivery, and judicious use of digital health com¬munications, applications, and rudimentary telemedicine. Conclusion: Student-led virtual telemedicine and digital health delivery has potential in public health crises like NCOV, freeing frontline healthcare staff to devote energies to their specialties of screening and treatment. Integration of video and biometrics to incorporate true telemedicine, allowing individuals to be “hospitalized” in a community setting in situations of low risk

The Public Health Intervention for International Students at Universiti Malaysia Sabah, Malaysia

Background: COVID-19 pandemic that started in Wuhan, Hubei Province, China, has spread globally, and Sabah is one of the states in Malaysia that is affected by it. The outburst in social media on discrimination against the people from China impacted the international students from China. Thus, University Malaysia Sabah (UMS) had to play a role in mitigating the COVID-19 pandemic and protecting its students. This article aimed to describe the actions taken by UMS for its international student from China during the early phase of the COVID-19 pandemic. Methods: This study used a cross-sectional design where all 379 students from China in UMS were screened from February 2020 until March 2020 during the early phase of COVID 19. Results: During this study period, 0.5% of the students were classified as Persons under Investigation (PUI), while 99.5% were classified as Person under Surveillance (PUS). Conclusion: The public health interventions included surveillance, contact tracing, monitoring, quarantine, isolation, social distancing, mental health support, and mental health intervention activities. These actions to control the pandemic reduce the state health department's health burden and help the students in need

The ability to refuse drink and improve wellbeing

The motivational interviewing approach is a client-cantered counselling style for eliciting behaviour change by helping clients to explore and resolve ambivalence. It has been shown to be more effective than other treatments for reducing risky behaviours and increasing client engagement and compliance with the treatment. Building their strength and motivation to refuse from heavy drink as well to improve well-being becomes the aim of this study. Purposive sampling by using Alcohol Use Identification Test (AUDIT) was employed to recruit hazardous and harmful drinkers among the indigenous communities of Sabah. A quasi-experimental design using pre-test and post-test was chosen for this study to assess the effectiveness of Motivational Enhancement Intervention. A total of 56 villagers in the West Coast Division of Sabah have participated in this study. Data were analysed by using IBMSPSS version 26.0. The study found that there was a significant difference reported in drinking refusal self-efficacy and subjective wellbeing in the experimental group before and after intervention. These findings are significant to provide direction for the next action plan for intervention purposes aims to reduce the alcohol-related harm among the indigenous communities of Sabah

Knowledge, attitude and practice of contraception by doctors and women in Kota Kinabalu, Sabah

Introduction: Over the past decade researchers have come up with reliable data to confirm the relationship between an increased availability of effective contraception and reduction in induced abortion rate. In Malaysia, the contraception prevalence rate according to the Malaysian Population and Family Survey in 1966 was 8.8 percent. It increased substantially to 36 percent in 1974 and further to 52 percent in 1984, but has leveled off since then to about 52% in 2004.lhe latest but unpublished data reported in 2014 showed 55%. The negative effect of this situation can be seen in the increasing report of babies 'abandonment, maternal mortality due to unsafe abortion and probably many other adverse effects associated with unintended pregnancy, although data on the latter is scarce. There is limited research on unmet contraceptive use in Sabah. The aim of this study is to determine the knowledge, attitudes and practices related to contraception among women and doctors. The findings of this study can provide k1eas for planning and implementing appropriate maternal health service delivery programs. Methods: This study uses descriptive as well as analytical community based cross sectional study. The clinics are selected using random systematic sampling method. A total of 240 women and 60 doctors were selected from either private or public clinic in Kota Kinabalu. The instrument used was face to face Interview and self-administered questionnaires for patients and doctors respectively. Statistical analysis was done using SPSS version 21. Results: Majority of the doctors (80%) felt that contraception is extremely important, and routinely discuss (63%) It with their patients. Oral contraceptive pill (97%) Is the most common type of contraceptive available in the doctor clinics. About 68% of doctors cited that abstinence plays a major part in their contraceptive advice. The average correct answer by doctors on knowledge is 62%. Almost an the women surveyed (98.8%) have heard of contraception from health professionals. Toe main reason for using is for spacing of pregnancy and many stops or did not use because of fear of side-effect. Women attending the public dink: appear to know more about female and male sterilization and intrauterine e011traceptive device compared to those attending private clinics. Conclusion: This study showed that both patients and doctors agreed the Importance r:I contraception. The low uptake of contraception appears to be due to concern of side-effects. It Is surprising to find out that 68% of doctors cited abstinence as major part of their contraceptive advice. The basic contraceptive knowledge of primary care doctors appears inadequate. Further and larger sample size Is needed to reinforce this study

Alcohol toolkit: empowering Sabah indigenous communities to reduce alcohol-related harm

Alcohol misuse compromises the quality of life of individuals, families, communities and whole societies in a variety of ways. Malaysia acknowledges the problems, implementing policies and health promotion activities in line with the World Health Organization Global Strategy to reduce the harmful use of alcohol by 10% between 2010 and 2025. Sabah, one of two Malaysian states on the island of Borneo, has more than 30 different indigenous ethnic groups. Alcohol production and consumption have traditional and unique roles in the cultural practices of many of these groups, making one common programme difficult to implement. Preliminary research suggests that alcohol is a serious problem in indigenous communities in Sabah. It also shows lack of knowledge on recommended limits for alcohol consumption and understanding of alcohol-related harm. The objective of this action-research is to produce a toolkit that will transfer knowledge and empower communities to adopt safer drinking and reduce alcohol-related harm. It must be attractive, appropriate, easily understood and be able to be tailored to suit different communities. The alcohol tool-kit was developed by a group of academicians using evidence-based information. Qualitative research methods were used to evaluate the initial alcohol tool-kit. A purposive sample of 45 village representatives was selected and divided into 5 groups for focus group discussion. Their feedback was recorded and transcribed verbatim. The alcohol tool-kit was edited accordingly. All participants agreed the alcohol tool-kit was important and can empower communities to reduce alcohol-related harm directly improving their quality of life. The amended alcohol tool-kit will be recommended for health promotion material and evaluated from time to time

A staff-initiated quality improvement project: from paper to web report

Introduction: Continuous quality improvement of system is essential to improve efficiency of working environ¬ment. Limited financial allocation in low resource setting results in the vicious circle of having inadequate money to purchase a new system and print paper documents that are required for the operation of clinic. A staff-initiated system improvement with the name of “PRW UMS Staff Portal” was attempted to break-free from the vicious cycle. Methods: An online system covering different aspects of routine clinical work of healthcare workers was created in Dec 2019 and implemented in Feb 2020 using Google SiteTM by the nurses of a local university community clinic, which included: submission of daily reports of nurses and assistant medical officers, submission of reports of all programmes conducted by the clinic, surveillance of health status of working staffs, announcement and request of working roster, archiving of documents, and medication inventory. The system could only be accessed using official working email for general documents while accesses to sensitive documents were restricted to relevant staffs to pro¬tect privacy and confidentiality of information. Qualitative interviews were performed with all nursing staff involved. Results: Qualitative feeling of improvement in coordination of workflow was reported by all 23 staffs working in the clinic in view of the easy access of system using smartphone and computer at workstation. It also reduced the need to move away from the working station in order to access, replenish, or submit the printed documents and reports. Significant amount of paper and printing were saved monthly. Conclusions: Despite positive feedback from the staffs, the system requires further improvement in terms of function and security. Further evaluation on cost-efficiency of the system can be done to promote the system to other universities