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

Using the diamond dialogue to explore community ambivalence towards changing alcohol use and strengthen community action

Statement of the Problem: Alcohol related harm is considered significant in many areas in Sabah. This project aimed to provide community members with information and approaches to addressing this problem in their own area. This paper shows a unique approach to health promotion and community engagement in rural communities. Method: This project used action research methodology. A workshop for alcohol misuse was held in a rural village. At the start of the workshop four groups were formed and focus group discussions were held using the diamond dialogue technique. Responses were analysed for themes, using grounded theory methods. The position on the diamond shape was analysed by overlaying a 11 point grid, with 10 corresponding to the highest level of happiness and 0 corresponding to the lowest level of happiness. Results & Findings: The diamond dialogue was originally created as a research tool to measure the effectiveness of community level interventions on wellbeing. This tool was initially used as a way of evaluating our alcohol intervention. While being used in this way it was noted that the tool itself provided an avenue for change. It has not previously been used specifically as an intervention in itself. The respondents appeared to understand the exercise well. Five main themes were found: Family and relationships, security, health, expanding horizons, religion. Alcohol was a topic that pervaded all of these themes, with positive and negative effects. Results suggest that using the diamond dialogue created a collective motivation to change. Exploring community ambivalence towards alcohol, acceptance of both the positive and negative effects and validation of the community’s views provided a platform for engagement. This leads to “change talk” and ownership of possible solutions. Conclusion & Significance: This research suggests the diamond dialogue tool is useful both as an explorative tool and a standalone community level intervention tool. Further research is underway to further explore this conclusion and develop the tool for wider use in communities

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)

Potvrđivanje učinkovitosti testa identifikacije poremećaja uzrokovanih alkoholom (AUDIT) – verzija na Dusun jeziku u konzumenata alkohola u Sabahu, Borneo

Introduction: The Alcohol Use Disorder Identification Test (AUDIT) developed by WHO is instrumental in identifying individuals on the alcohol misuse spectrum. However there is no culturally appropriate Dusun language version in Sabahan Borneo. This study aims to develop and validate a Dusun language version of AUDIT (AUDIT-D). Methods: AUDIT was translated to Dusun and back translated to English and Malay. The first version was pilot tested in 20 participants and harmonised. The harmonised version was administered to 50 Dusun first language speakers fluent in Malay from villages in rural Sabah. Participants filled in socio-demographic questionnaires, Dusun (AUDIT-D) and Bahasa Malaysia (AUDIT-M) versions of AUDIT, and validated Bahasa Malaysia versions of the M.I.N.I. alcohol dependence subscale and CAGE. Results: ROC curves calculated AUDIT-D dependence cut-off of 9 and more, with prevalence of dependence at 46%. Factor analysis of AUDIT-D yielded a one - or three-factor solution, distinct from the AUDIT-M factor structure. Cronbach alpha coefficients for the total AUDIT-D was 0.83. Significant Spearman’s correlations existed between AUDIT-D and AUDIT-M scores (Spearman’s rho=0.999, p<.001). AUDIT-D and AUDIT-M were both significantly correlated with M.I.N.I. alcohol dependence subscales (rho=0.624 and 0.617 respectively, with p<0.0001). Both were not significantly correlated with CAGE. Conclusion: The AUDIT-D questionnaire has acceptable psychometric properties, properties and demonstrates similar factor structures to other areas with high alcohol dependence prevalence. It is suitable for the assessment and identification of alcohol use disorders in the unique Sabahan Borneo cultural landscape.Uvod: Test identifikacije poremećaja uzrokovanih alkoholom (AUDIT eng. The Alcohol Use Disorder Identification Test) kojeg je razvila Svjetska zdravstvena organizacija (WHO), od iznimne je koristi u identifikaciji pojedinaca koji boluju od poremećaja ponašanja uzrokovanih alkoholom. Doduše, ne postoji kulturološki primjerena verzija testa na Dusun jeziku u saveznoj državi Sabah na otoku Borneu, Malezija. Cilj ovog istraživanja je razviti i potvrditi verziju AUDIT test na Dusun jeziku. Metode: AUDIT test je preveden na Dusun jezik, zatim s Dusun jezika na engleski i malezijski. Prva verzija je bila pilot test koji je uključio 20 ispitanika, te je bio usklađen. Usklađena verzija testa je provedena na 50 ispitanika čiji je prvi jezik bio Dusun, te su također bili tečni u malezijskom jeziku, a bili su žitelji ruralnih sela Sabaha. Ispitanici su ispunili socio-demografske upitnike, Dusun (AUDIT-D) i Bahasa malezijske (AUDIT-M) verzije testa, usklađene verzije M.I.N.I. testa alkoholne ovisnosti na Bahasa malezijskom jeziku, te CAGE upitnik. Rezultati: ROC krivulje izračunale su graničnu ovisnost AUDIT-D od 9 i više, s prevalencijom ovisnosti od 46%. Faktorska analiza AUDIT-D dala je jedno- ili trofaktorsko rješenje, za razliku od strukture faktora u AUDIT-M testu. Cronbach alfa koeficijenti za ukupni AUDIT-D bili su 0,83. Značajne Spearmanove korelacije postojale su između AUDIT-D i AUDIT-M rezultata (Spearmanov rho = 0,999, p <0,001). AUDIT-D i AUDIT-M bili su značajno povezani s M.I.N.I. podskupinama za ovisnosti o alkoholu (rho = 0,624 i 0,617, s p <0,0001). Oba nisu pokazala značajnu povezanost s CAGE upitnikom. Zaključak: AUDIT-D upitnik ima prihvatljiva psihometrijska svojstva i pokazuje slične faktorske strukture u odnosu na druga područja s visokom prevalencijom ovisnosti o alkoholu. Prikladan je za procjenu i utvrđivanje poremećaja ponašanja uzrokovanih konzumacijom alkohola u jedinstvenom kulturnom krajoliku Sabaha

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

Occupational performance of the primary schoolchildren with special education needs in Malaysia: exploring the needs of school-based therapy service

Children’s occupational performance are activities of daily living, play/ leisure, social participation, education, and work. In developed countries, school-based therapy services are being provided for schoolchildren with special needs. The importance of these services in Malaysia is timely to be explored. This exploratory cross-sectional study identified occupational performance levels of primary schoolchildren with special needs in integrated special education programmes in Malaysia; children with intellectual disability, autism, attention deficit hyperactive disorder, Down syndrome, speech impairment, visual impairment, hearing impairment, and specific learning disorder. Researchers conducted Motor-Free Visual Perceptual Test Third Edition (MVPT-3), Beery-Buktenica Developmental Test of Visual-Motor Integration Fifth Edition (Beery-VMI), Test of Gross Motor Development – 2 (TGMD-2), Test of Hand Writing Skills-Revised (THS-R), and School Function Assessment (SFA) for 121 students. Results showed that 69.5% of the students scored very low to low average in MVPT-3 (median standard score = 70.0, Std. IQR = 37); 69.4% were very low to below average in Beery-VMI (mean standard score = 78.8, Std. deviation = 20.5); 73% were below age level raw score in TGMD-2; 72.8% were below average in THS-R (median standard score = 74.0, Std. IQR = 27.0); and 81% were below the criterion cut-off in school function. The children with below-normal MVPT, VMI, TGMD2, and THS scores, compared to the children with normal scores for these tests had significantly lower scores (p < 0.001). All the students had impairment in occupation performance at least in one area. This study recommends school-based occupational therapy and other rehabilitation services in the school system in Malaysia

Respiratory disorders associated with dust exposure among construction workers at Bornean higher learning institution teaching hospital

Respiratory disorders can occur due to dust exposure at workplace. Dust exposure which consists of silica, asbestos and other type of mineral dust are very common. The high dust exposure can increase the workers risk of having respiratory disorders. The association between dust exposure and respiratory disorders among construction workers in Sabah are not well studied. This study aims to establish the association between respiratory disorders and dust exposure among construction workers of a Bornean higher learning institution teaching hospital. A cross-sectional study was done among the said construction workers. A standardised respiratory disorders questionnaire and spirometry machine were used. Dust exposure were measured using gravimetric method after sampled using personal air sampler. Age, smoking status, and marital status was significantly associated with respiratory symptoms. A higher prevalence of respiratory symptoms was higher among males (42.7%) compared to their female counterpart (21.4%). A higher prevalence of respiratory disorders among widow/widower/divorced workers (50.0%) compared to married (45.8%) and single workers (25.0%). A higher prevalence of respiratory symptoms among workers who smoke (51.2%) compared to workers who does not smoke (22.7%) also observed. Piping workers had the highest dust exposure and followed by the cement and plastering workers

Occupational Exposure to Dust and the Relationship with the Respiratory Symptoms, Lung Function among Construction Workers of the University of Malaysia Sabah

BACKGROUND: The respiratory tract often becomes the site of injury from occupational exposure. All construction sites generate high levels of dust, typically from concrete, silica, asbestos, cement, wood, and stone, sand, and therefore, the workers are exposed to this airborne dust and increased their risk of developing respiratory disorders. Limited studies have been conducted to assess the relationship between respiratory symptoms, lung function, and occupational dust exposure among construction workers in Sabah. AIM: The objectives of this study are to determine the occupational exposure to dust and the relationship with the respiratory symptoms as well as lung function among construction workers in UMS Teaching Hospital. MATERIALS AND METHODS: This cross-sectional study consisted of construction workers working in all sections in the development of UMS Teaching Hospital. A standard respiratory questionnaire was distributed to construction workers and lung function measurement was performed using Spirometry and the results of their respiratory status were compared between workers who were exposed and unexposed to dust. Occupational dust exposure was determined by the gravimetric method using an air sampler. The total duration of the collection was 8 h and the filters with the dust samples were analyzed in the laboratory. RESULTS: The result showed three parameters that were significantly associated with respiratory symptoms, namely, age, marital status, and smoking status. Male workers had a higher prevalence (42.7%) of having respiratory symptoms compared to female workers (21.4%). Widow/widower/divorced (50.0%) had a higher prevalence of having respiratory symptoms compared to married (45.8%) or single workers (25.0%). Workers who smoke had a higher prevalence (51.2%) of having respiratory symptoms compared to non-smoker’s workers (22.7%). CONCLUSION: The highest dust exposure is the piping workstation, followed by the cement and plastering workstations. These warrant the compulsory use of personal protective equipment by construction workers during work, improving the quality of dust masks, and standardizing their usage. Effective engineering controls should also be promoted on construction sites

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