Determinants of voluntary smoke- free home among non- smoking women in Alor Gajah, Melaka

Introduction: Second hand smoke exposure to cigarette smoke leads to many medical conditions including asthma and lung cancer. Women are the most vulnerable adults of passive smoking at home. Even though Malaysia had its own smoke- free policy, the smoke- free home is voluntary in nature. Thus, this study was aimed to explore the practice of voluntary smoke- free- home among women in Alor Gajah and its determinants. Methods: A cross-sectional study based on multistage sampling was conducted among 180 non- smoking women in areas implemented Community Intervention Program (KOSPEN), which emphasized on healthy lifestyle, in Alor Gajah, Melaka from April 2018 to May 2018. Data on sociodemographic characteristic, characteristic of second hand smoke (SHS) exposure at home, knowledge, attitude and avoidance behaviour from SHS were collected using questionnaires. The data were then analysed using IBM Statistical Package for Social Science (SPSS) version 24.0 involving descriptive and inferential statistics. Results: Majority of the respondents practised smoke- free home (72.8%). The predictors of smoke- free home were those who attained higher education (AOR= 11.939, 95% CI 1.175- 121.277), did not live with any children (AOR= 3.546, 95% CI 0.985- 12.765) and lived with smokers other than their husband (AOR= 3.793, 95% CI 1.192- 12.076). Conclusion: Education level and household factors were significant predictors of smoke- free home. Thus, few measures were suggested to increase tobacco bans at home among women including periodic health programs, community empowerment programs and creating smoke- free housing

Predictors of practices related to dengue fever prevention among international students in Universiti Putra Malaysia, Serdang

Background: Dengue fever is a vector-borne, notifiable and preventable communicable disease. This study aim to determine the practices and the contributing factors related to dengue fever prevention among the international students in Universiti Putra Malaysia, Serdang. Materials and Methods: A cross sectional study was conducted using cluster sampling proportionate to size. Data were collected using a validated, self-administered questionnaire which consist of six sections namely socio-demographics factors, knowledge, attitude, influence of mass media, previous history of dengue fever and practices related to dengue fever prevention. Data was analyzed using IBM Statistical Package for Social Science (SPSS) version 21.0 comprising descriptive, bivariate and multivariate analysis and level of significance was set P<0.05. Result: A total of 641 respondents were involved with the response rate of 95.7%. The mean age of the respondents was 33.41±6.56 years old. Majority of the respondents were Asian (74.6%), male (65.5%), married (61.5%), had poor knowledge (45.9%), showed negative attitude (51.6%) and demonstrated good practices related to dengue fever prevention practices (53.7%). The significant predictor for poor practices were negative attitude towards practice (aOR=3.705, 95%CI=2.532–5.421, P<0.001), low influence of mass media towards practice (aOR=0.274, 95%CI=0.188–0.399, P<0.001), poor knowledge (aOR=0.169, 95%CI=0.090–0.319, P<0.001) and moderate knowledge on dengue fever (aOR=0.439, 95%CI=0.234–0.825, P<0.010). Conclusion: The findings revealed good practices among the respondents despite their poor knowledge and negative attitude towards dengue fever. Therefore knowledge based health education and cultivating positive attitude should be further reinforced to strengthen the dengue fever preventive practice

Predictors and association of hepatitis C virus infections among people who injects drug in Negeri Sembilan

Introduction: Hepatitis C virus (HCV) infection is known as contributing to high morbidity and mortality globally. Major liver complications such as liver failure and liver cancer which can lead to fatality have been associated with persistent HCV infection. Globally, it is estimated that 5.6 million chronically infected HCV are among people who inject drugs (PWID). Malaysia has estimated that 59% HCV infections were among PWID. The aim of this study is to determine the prevalence of HCV infection and its predictors among PWID in Negeri Sembilan. Methods: A cross-sectional study based on random proportion to size sampling was conducted among 212 out of 1414 registered Methadone Maintenance Therapy (MMT) clients with PWID attending health clinics in Negeri Sembilan from February 2018 to July 2018. Data were collected using questionnaires administered through face-to-face interviews. Data were analyzed using Statistical Package of IBM SPSS Statistics Version 23 and p-value of <0.05 is considered significant. Independent T test and Chi-square test(χ2) were used to determine the associations between the variables, and multiple logistic regressions for the predictors. Results: Majority of the respondents were infected with HCV infection (89%). HCV infection were associated with their age(p<0.001), low education level(p=0.022), HIV infection(p=0.001), and higher frequency(p=0.001) with longer duration(p=0.026) of drug injections and needle sharing(p=0.001). The predictors of HCV were older age [AOR 1.07, 95% CI(1.032, 1.110)] and higher frequency of injections[AOR 5.98, 95% CI(3.110,11.476)]. Conclusion: HCV infection is prevalent among PWIDs. Hence, effective and efficient preventive measures should be targeted to the identified predictors

Factors associated with Knowledge of Healthy Community, Empowers Nation (KOSPEN) and its implementation among community health volunteers in Kulim district, 2017

Introduction: The increasing burden of Non-Communicable Diseases and their prevalence has led Ministry of Health (MOH) Malaysia to introduce a community empowerment program “Komuniti Sihat, Perkasa Negara” acronymed as KOSPEN in July 2013. Thirty thousand community health volunteers have been trained nationwide up to May 2015. Objective: To identify the factors associated with knowledge on KOSPEN and its implementation among community health volunteers in Kulim District. Methods: A cross-sectional study based on simple random sampling was conducted among community health volunteers Kulim District. Volunteers participated in this study were 194. Data collected using self-administered questionnaire. All data collected were analysed using IBM SPSS version 22 involving descriptive and inferential statistics with significance level set at 0.05. Results: The study found that level of knowledge on KOSPEN is associated with employment status (p=0.02) and awareness level (p<0.001) among the community health volunteers. The level of implementation is associated with age (p=0.025), education level (p=0.007) and employment status (p=0.017) of the community health volunteers. Employment status (aOR=2.133, 95% CI=1.056-4.306, p=0.035) and awareness level (aOR=6.119, 95% CI=2.701-13.867 p<0.001) were predictors of level of knowledge on KOSPEN. Level of implementation of KOSPEN by the community health volunteers could be predicted by education level (aOR=4.085, 95% CI=1.299-12.851 p=0.016). Conclusion: Generally the KOSPEN volunteers had good knowledge on KOSPEN and implementation of KOSPEN program. However, there are still misconceptions among the KOSPEN volunteers regarding their functions and role. Therefore it is important to empower the volunteers with awareness on their roles, functions and good knowledge

Predictors of upper limb disorders among a public university workers in Malaysia

Background: Upper Limb Disorder (ULD) includes a wide range of musculoskeletal diseases and syndromes, which are usually associated with pain and discomfort. The major forms of musculoskeletal disease that account for significant work-related morbidity include upper limb disorders. The main objective of this study was to determine the prevalence and associated factors of upper limb disorders among a public university worker. Methodology: A cross sectional study design and simple random sampling was used to select six out of fifteen faculties. A total 271 participants were selected from the list of workers name during 20th of May 2014 to 1st of September 2014. Data were collected by face-to-face interview based on standardizes Nordic questionnaire. Weight was measured with a digital (TANITA Weighing Scale) and height by using (SECA206 bodymeter). Results: The results of this study showed that the response rate was 86%, the prevalence of ULDs among staffs of public university in Malaysia was 67.2% in different body regions, while neck had the highest prevalence 147 (54.2%) and elbows had the lowest prevalence 35 (13%). In addition, significant association were found between ULDs with age, smoking, BMI, exercise and duration of employment (P<0.05). Logistic regression analysis indicated that BMI and exercise were significant predictors of ULDs. Conclusion: The prevalence of upper limb disorders among public university workers is high (67.2%). The major risk factors responsible for ULDs was BMI and exercise among public university workers, so workers should be educated on how to maintain an optimal BMI through the consumption of appropriate meals and regular exercise recommended in order to prevent ULDs and other related musculoskeletal problems

Interventions to reduce HIV-related stigma in the healthcare settings: a scoping systematic review

HIV-related stigma will discourage the efforts in preventing new infections and engaging people to receive treatment, care and support programmes. Identifying the valuable interventions programmes to reduce HIV-related stigma in a healthcare setting is vital in order to deliver the best health services. A scoping systematic review was conducted. Articles were searched based on Pubmed and ScienceDirect search engines. The key words used were HIV stigma, intervention and healthcare. Published English articles in the past ten years involving HIV stigma intervention studies, and studies that involved healthcare workers in a healthcare setting were included. Reviewed articles, systematic review and meta-analysis articles were excluded. Primary screening of titles and abstract of 85 articles were done. Secondary screening of 19 articles resulted in 8 articles, included in this manuscript. Most of the reviewed articles showed, application of the Integrated Theoretical Model in the intervention programme as a guide and utilising combined intervention components are effective tools in delivering the intervention programme. The stigma reduction-intervention programme should focus on the intervention components as a whole including training of HCW, role plays, group discussions, games, sharing of information and contacts with PLHIV as well presentations and lectures. An integrative model of behavioural prophecy is perceived and it is particularly essential for interventions that focus on creating and fortifying the aim in conducting the chosen behaviour

Study on outcome of smoking cessation attempt at Quit Smoking Clinic in a health clinic

Smoking is the leading preventable cause of non-communicable disease mortality worldwide. Therefore, effort for the effective measure in smoking cessation is important. However, the central problem in the nicotine addiction treatment is relapse. A retrospective cohort study was done at Tanglin Quit Smoking Clinic to determine the outcome of smoking cessation and its predictors. A cohort of 770 smokers between 2008 and 2015 were identified through simple random sampling. Smokers were defined as current smoker, while smoking abstinence is defined as cessation more than 6 months and relapse as any smoking episode even a puff since the quit date. Majority were Malays, Muslims and had secondary or higher education. The mean initiating age for smoking was 17.6 years old, with majority smoke between 11 to 20 sticks, and had high nicotine dependence score (43%). At the end of the study 52.5% of them abstinence from smoking. The predictors for smoking cessation were number of quit attempt (1 to 10 times) (AOR = 1.582, 95% CI = 1.012-2.472) and pharmacotherapy (AOR = 0.711, 95% CI=0.511-0.989). More frequent follow up was required during the first crucial 6 months to prevent relapse. Number of follow up can enhance not only the medication compliance but also motivational aspect to smokers to reduce relapse rates. Healthcare provider should give extra attention to the potential relapser especially to those who attempt for the first time

Improving emotional health and self-esteem of Malaysian adolescents living in orphanages through life skills education program: a multi-centre randomized control trial

Generally speaking, institutionalised children and adolescents are at greatly increased risk of serious mental and behavioural problems, up to seven times more than their peers. Life skills- based interventions using peer enforcement have been introduced as effective program to improve adolescents’ emotional and behavioral health. Therefore, the current randomized control study aimed to determine, if a life skills-based intervention could improve the emotional health and self-esteem among Malaysian adolescents in orphanages. Overall, 271 male and female adolescents (13–18 years old) from 8 orphanages in Klang valley, Malaysia participated in the study. Comparing the intervention to control group within 3 points of time, the finding of the study showed that immediately after finishing the interventional sessions (post-test), the mean scores of depression (F = 33.80, P<0.001, η2 = 0.11), anxiety (F = 6.28, P = 0.01, η2 = 0.02), stress (F = 32.05, P<0.001, η2 = 0.11) and selfesteem (F = 54.68, P<0.001, η2 = 0.17) were significantly decreased compared to the pretest values. However, there was no significant difference between two groups in the depression mean scores (F = 2.33, P = 0.13). Regarding to the interaction between group and test a significant change was seen in the mean score of all 4 variables including depression (F = 31.04, P0.001). These results provide preliminary approve for LSE to enhance emotional health and self-esteem in orphanages

Systematic review on the effectiveness of using Carbon monoxide measurement in smoking cessation intervention

Introduction:Carbon monoxide measurement is one of the biomedical risk assessments in smoking cessation. With the advancement in medical devices, risk assessment among smoker using carbon monoxide can be an effective intervention for quit smoking. A systematic review was conducted on the effectiveness of using carbon monoxide measurement in smoking cessation intervention. Material and methods:A systematic review and narrative synthesis were done using PRISMA guideline. A broad database search on English literature was conducted including Medline, PubMed, Scopus and Science Direct from 2008 till 2017. Additional studies were also searched through snowballing technique by searching the bibliographies of selected studies. Five studies met the criteria with two studies were done in clinical settings while the other was done at population settings. The studies were conducted in the United States of America, United Kingdom and South Korea. All study were two-arm randomized controlled trials with variation in the outcome measurement mainly intention to quit, quit attempt and smoking abstinence. There was also variation in the duration of follow up ranging from 1 week to 12 months. Results:Only three studies found statistically significant increased in motivation or intention to quit smoking but only at 1 month follow up. All five study found no significant difference in frequency of quit attempt or smoking abstinence. Most of the studies recruited participants based on voluntary participation thus limiting the generalizability of the results. Conclusions:The present review has found limited studies on the effect of carbon monoxide measurement intervention forquit smoking. It may only be beneficial at the motivational level and not translated into behaviouralchanges. However, the effect too was short term and not sustained in the long term

A cluster randomised controlled trial on effectiveness of carbon monoxide measurement feedback among college smoker : a study protocol

Introduction: For the last 30 years, tobacco smoking has continued to be the leading cause of premature deaths in Malaysia. Majority of the smokers in Malaysia are at the pre- contemplation and contemplation stages. Therefore, for the purpose of increasing smoking cessation among this group, the strategies that motivate them to quit smoking have to be reviewed. Objective: This study aims to evaluate the effectiveness of carbon monoxide measurement feedback and the standard brief motivation adopted to encourage the smoker to quit. Methods: A single-blind, cluster randomised controlled trial was conducted at ten tertiary colleges in Selangor. The study recruited young adult smokers at the pre- contemplation and contemplation stages. The subjects in the control group received a standard brief motivational strategy. On the other hand, the intervention group received additional carbon monoxide measurement and a motivational feedback module. A follow up was conducted at the first, third and sixth month to measure changes in smoking cessation stage. Subsequently, the secondary outcomes of a mean number of cigarette consumption and quit smoking attempt were analysed. A total of 160 subjects were required to detect the expected difference of 17% in primary outcomes between the groups. This study utilised Generalised Estimating Equations (GEE) to handle the clustering effects. Conclusion: Biomedical risk assessment feedback mechanism by using carbon monoxide is a promising aid to motivate the smoker to quit. This mechanism is a relatively easy, quick and non-invasive technique. Thus, it can be utilised as a reinforcement relating to the harmful effect of smoking. Besides, it can also increase the smokers’ self- efficacy and decisional balance to adopt behavioural changes