Mild Joint Symptoms Are Associated with Lower Risk of Falls than Asymptomatic Individuals with Radiological Evidence of Osteoarthritis

Osteoarthritis (OA) exacerbates skeletal muscle functioning, leading to postural instability and increased falls risk. However, the link between impaired physical function, OA and falls have not been elucidated. We investigated the role of impaired physical function as a potential mediator in the association between OA and falls. This study included 389 participants [229 fallers (≥2 falls or one injurious fall in the past 12 months), 160 non-fallers (no history of falls)], age (≥65 years) from a randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT). Physical function was assessed using Timed Up and Go (TUG) and Functional Reach (FR) tests. Knee and hip OA were diagnosed using three methods: Clinical, Radiological and Self-report. OA symptom severity was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The total WOMAC score was categorized to asymptomatic, mild, moderate and severe symptoms. Individuals with radiological OA and ‘mild’ overall symptoms on the WOMAC score had reduced risk of falls compared to asymptomatic OA [OR: 0.402(0.172–0.940), p = 0.042]. Individuals with clinical OA and ‘severe’ overall symptoms had increased risk of falls compared to those with ‘mild’ OA [OR: 4.487(1.883–10.693), p = 0.005]. In individuals with radiological OA, mild symptoms appear protective of falls while those with clinical OA and severe symptoms have increased falls risk compared to those with mild symptoms. Both relationships between OA and falls were not mediated by physical limitations. Larger prospective studies are needed for further evaluation

Medical professionalism from a socio-cultural perspective: Evaluating medical residents communicative attitudes during the medical encounter in Malaysia

Context: The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care. Aims: We aimed to determine factors affecting communication skills learning attitudes among medical residents in Malaysia. Settings and Design: Cross-sectional survey, in a Malaysian public health hospital. Materials and Methods: A total of 191 medical residents across medical and surgical based rotations were included. We assessed the validated communication skills attitude scale among medical residents from different rotations. Statistical Analysis: Statistical Package of Social Sciences (SPSS®) (version 16.0, IBM, Armonk, NY) was used. Cronbach′s alpha was used to test the internal consistency of the scale. Descriptive analysis was conducted for all variables. Bivariate analysis was employed across the socio-demographic variables. Results: Majority of the residents believed that communication skills training should be made compulsory in Malaysia (78.5%). Medical residents agreed that acquiring good communication skills is essential to be a good doctor. However, the majority cited time pressures for not being able to learn communication skills. Significant differences in communication skills learning attitude scores were found between Malays and Chinese. Conclusion: The majority of medical residents had a positive attitude toward communication skills learning. Socio-demographic factors influenced communication skills learning attitude among medical residents. Incorporating communicative skills modules during hospital Continuous Medical Education for medical residents is essential to cultivate communicative skills attitudes for effective doctor-patient relationship during the routine medical encounters

The prevalence of medication nonadherence in post-myocardial infarction survivors and its perceived barriers and psychological correlates: a cross-sectional study in a cardiac health facility in Malaysia

Kurubaran Ganasegeran, Abdul Rashid Department of Public Health Medicine, Penang Medical College, George Town, Malaysia Background: Although evidence-based practice has shown the benefits of prescribed cardioprotective drugs in post-myocardial infarction (MI) survivors, adherence rates remain suboptimal. The aim of this study was to determine the prevalence and factors associated with medication nonadherence among post-MI survivors in Malaysia.Materials and methods: This cross-sectional study was conducted from February to September 2016 among 242 post-MI survivors aged 24–96 years at the cardiology outpatient clinic in a Malaysian cardiac specialist center. The study utilized an interviewer-administered questionnaire that consisted of items adapted and modified from the validated Simplified Medication Adherence Questionnaire, sociodemographics, health factors, perceived barriers, and novel psychological attributes, which employed the modified Confusion, Hubbub, and Order Scale and the Verbal Denial in Myocardial Infarction questionnaire.Results: The prevalence of medication nonadherence was 74%. In the multivariable model, denial of illness (AOR 1.2, 95% CI 0.9–1.8; P=0.032), preference to traditional medicine (AOR 8.7, 95% CI 1.1–31.7; P=0.044), lack of information about illness (AOR 3.3, 95% CI 1.1–10.6; P=0.045), fear of side effects (AOR 6.4, 95% CI 2.5–16.6; P<0.001), and complex regimen (AOR 5.2, 95% CI 1.9–14.2; P=0.001) were statistically significant variables associated with medication nonadherence.Conclusion: The relatively higher medication-nonadherence rate in this study was associated with patient-, provider-, and therapy-related factors and the novel psychological attribute denial of illness. Future research should explore these factors using robust methodological techniques to determine temporality among these factors. Keywords: medication nonadherence, myocardial infarction, perceived barriers, psychology&nbsp

Evaluation of Psychometric Properties of the Malay Version Perceived Stress Scale in Two Occupational Settings In Malaysia

Background: The 10‑item version of Perceived Stress Scale (PSS‑10) is a widely used tool to measure stress. The Malay version of the PSS‑10 has been validated among Malaysian Medical Students. However, studies have not been conducted to assess its validity in occupational settings. Aim: The aim of this study is to assess the psychometric properties of the Malay version of the PSS‑10 in two occupational setting in Malaysia. Subjects and Methods: This study was conducted among 191 medical residents and 513 railway workers. An exploratory factor analysis was performed using the principal component method with varimax rotation. Correlation analyses, Kaiser‑Meyer‑Olkin, Bartlett’s test of Sphericity and Cronbach’s alpha were obtained. Statistical analysis was carried out using statistical package for the social sciences version 16 (SPSS, Chicago, IL, USA) software. Results: Analysis yielded two factor structure of the Malay version of PSS‑10 in both occupational groups. The two factors accounted for 59.2% and 64.8% of the variance in the medical residents and the railway workers respectively. Factor loadings were greater than 0.59 in both occupational groups. Cronbach’s alpha co‑efficient was 0.70 for medical residents and 0.71 for railway workers.Conclusion: The Malay version of PSS‑10 had adequate psychometric properties and can be used to measure stress among occupational settings in Malaysia.Keywords: Factor structure, Malaysia, Occupational, Perceived stress scale, Psychometric properties, Validit

Awareness and Knowledge of Oral Cancer among University students in Malaysia

Objectives: This study aimed to assess the level of knowledge of oral cancer and its associated factors among university students in Malaysia. Methods: A cross sectional study was conducted among 200 university students in Malaysia. A self administered questionnaire was used to collect data. It included questions on socio-demographic data, awareness and knowledge of oral cancer. Results: Mean age of the respondents was 21.5+/-2.5 and the age ranged from 18 to 27 years. The majority of the respondents were aware of oral cancer (92.0) and recognized the followings as signs and symptoms of oral cancer: ulcer and oral bleeding (71.0), followed by swelling (61.5). A satisfactory knowledge was observed on the following risk factors; smoking (95.5), poor oral hygiene (90.5), family history (90.0), alcohol (84.5) and poor fitting dentures (83.0). However, unsatisfactory knowledge was observed about hot/spicy food (46.5), obesity (36.0), old age (31.5), dietary factor (29.0) and smokeless tobacco (25.5). Knowledge of oral cancer was associated significantly with age (p<0.01), year of study (p<0.01) and course of study (p<0.01). Conclusion: Instead of satisfactory awareness and knowledge of oral cancer and its clinical presentations, inadequate knowledge was observed about its risk factors. There is a need to introduce oral cancer education among university students

The relationship between risky work behaviors and self-reported knee pain among Malaysian railway workers

Background: Knee pain is one of the most common musculoskeletal pains at workplace and its prevalence ranges from 10 to 60%. Risky work behaviors are established risk factors. They result in functional impairment, disability and reduce quality of life. Objectives: This study aims to determine the relationships between risky work behaviors and knee AL-Dubai et al.; BJMMR, 10(3): 1-9, 2015; Article no.BJMMR.19097 2 pain among Malaysian railway workers. Materials and Methods: A cross-sectional study was carried out on 513 railway workers across eight states within Peninsular Malaysia. Socio-demographics, risky work behaviors, occupational safety and history of knee pain were obtained by direct interviews using a structured closed ended questionnaire. Descriptive, bivariate and multiple logistic regression analyses were performed. Results: The prevalence of self-reported knee pain over the past one year was 31.6%. Multivariate analysis yielded six significant predictors of knee pain: Socio-demographics (tertiary education); risky work behaviors (lifting or carrying heavy objects, working in uncomfortable position of knee joint, repeated flexion and extension of knee joint, continuous sitting work); and occupational safety (applying Personal Protective Equipment - PPE during work). Conclusion: The significant associations between knee pain and risky work behaviors in railway workers point to urgent need for preventive measures, particularly in high risk occupations