Comparing the sensitivity and specificity of otoacoustic emission screeners in diagnosing noise-induced hearing loss from air conduction pure tone audiogram in a hearing conservation programme

One of the key components of hearing conservation programme is the yearly pure tone audiogram (PTA) obtained from workers who are at risk of developing noise-induced hearing loss from occupational noise exposure. Although it is the current gold-standard for assessing one’s hearing threshold, a number of limitations are associated with the PTA. It is not an objective test, it is time consuming, it needs trained technician and a sound-proof room (or at least a very quiet ambience) and it is deemed not sensitive enough to detect subtle changes in the cochlea due to early exposure to noise as it assesses the whole auditory pathway and not just the cochlea, where damage from noise mainly occur. A likely alternative would be otoacoustic emission (OAE), an objective test that measures the emission of outer hair cells which ideally would reflect early damages from sound, and takes only fraction of the time to do PTA to complete. Our objective is to see whether screening OAE can be used instead of PTA for early detection of NIHL. A total of 72 workers from a quarry in Kuantan recently underwent PTA, TEOAE, DPOAE and DDPOAE. The association between PTA and OAE (right and left ear) was tested using McNemar’s test and the proportion between the pass and refer cases of OAE and PTA findings was noted to be significant. We will then report on the sensitivity and specificity of different types of OAE as stated above when compared to PTA as gold-standard

Knowledge, attitude and practice regarding Type 2 diabetes mellitus among outpatients in a health center in East-Coast of Peninsular Malaysia

Introduction: Type 2 diabetes mellitus (T2DM) is becoming a global epidemic and a threat to the world population. Methods: This cross-sectional study was carried out to assess the knowledge, attitude, and practice (KAP) regarding T2DM among outpatients of a health center in East-Cost of Peninsular Malaysia. A total of 104 participants aged above 18 years were selected using purposive sampling by the researcher to answer an interviewer-guided questionnaire. The total scores for each KAP were computed to find the associations using SPSS. Results: There were significant correlations between knowledge and practice (r=0.481, p<0.001) and between age of participants with knowledge (r=0.562, p<0.001) and practice regarding T2DM (r=0.607, p<0.001). Besides, there was also a significant difference in terms of knowledge and practice regarding T2DM between different sexes and education levels. However, while making a comparison between Malays and other races, the significant difference was only found for practice regarding T2DM. The attitude was found to be similar in all groups. T2DM can be prevented by having accurate knowledge, adopting a positive attitude and practicing a healthy lifestyle. Conclusion: Therefore, policies and campaigns which may change people’s knowledge, attitudes, and practices for preventing T2DM should be properly formulated and implemented to tackle this health issue

Knowledge, attitude and practice regarding hypertension among residents in a housing area in Selangor, Malaysia

Background and aims. Hypertension is becoming a global epidemic and threat to the world population. This cross-sectional study was carried out at a housing area in Selangor, Malaysia to study the knowledge, attitude and practice (KAP) regarding hypertension among the residents. Methods. A total of 110 respondents aged 18 years old and above were selected by convenience sampling. Data was collected using a structured interviewer-guided questionnaire with Likert-scale choices of answers. Results. All respondents were Malay with the mean age of 41 years [Standard Deviation (SD)=11.828]. The total mean and SD of knowledge, attitude and practice scores were 74.33 (SD=6.25), 44.22 (SD=5.05) and 27.55 (SD=2.86), respectively. There were significant positive correlations between knowledge with attitude (r=+0.393; p<0.001) and practice (r=+0.378; p<0.001). However, there was no significant correlation between attitude and practice (r=+0.120; p=0.212). There were significant fair positive correlations between age with knowledge (r=+0.402; p<0.001), attitude (r=+0.265; p=0.005) and practice (r=+0.337; p<0.001) regarding hypertension. Meanwhile, gender, educational level, employment status and family history had no significant association with knowledge, attitude and practice regarding hypertension. Conclusion. This study revealed that KAP regarding hypertension were associated with age, but not with other socio-demographic characteristics studied. The awareness, prevention and control programs of hypertension in their community should be increased, so that the residents could enjoy and maintain the healthy lifestyle

Factors associated with HbA1c levels in poorly controlled type 2 diabetic patients in North-East Malaysia

Objective: A study was conducted at all the health centres in Kelantan in North-East Malaysia to determine the common factors associated with poor controlled of type 2 diabetic patients. Design: A cross-sectional study Materials and Methods: A total of 208 patients with poor diabetic control (HbA1c levels of more than 6.5%) were selected by stratified random sampling from all health centres in Kelantan. Socio-demographic data, physical examination, and fasting blood were taken from the patients to determine the related associated factors using multiple linear regression. Results: The levels of HbA1c in the poorly controlled diabetic patients were significantly associated with fasting blood glucose (b=0.236, 95%CI=0.189,0.283), educational level (primary education: b=-0.965, 95%CI=-1.550,-0.380; secondary and tertiary education: b=-0.625, 95%CI=-1.228,-0.021), marital status (b=0.933, 95%CI=0.426,1.440) and patients receiving their care in health centres with Family Medicine Specialist (b=-0.495, 95%CI=-0.913,-0.076). Conclusion: Fasting blood glucose and being married were associated with higher levels of HbA1c, while having had formal education and receiving diabetic care in health centres with Family Medicine Specialist were associated with lower levels of HbA1c in poorly controlled type 2 diabetic patients in Kelantan

Knowledge, Attitude and Practice Regarding Pertussis among a Public University Students in Malaysia

Objective: To study the knowledge, attitude, and practice (KAP) regarding pertussis among students in a public university in Malaysia. Material and Methods: This study was a cross-sectional study using convenience sampling to recruit 171 respondents. The data was collected using a self-administered questionnaire comprised of four different parts: the socio-demographic data, the knowledge, the attitude and the practice towards the prevention of pertussis. The data were analyzed using correlation, independent t- test, and ANOVA&nbsp; according to the different study objectives and types of data. Results: More than half of the respondents (67.8%) indicated that they had heard about pertussis. The school or university (59.6%) was the most common source of information, followed by Internet (46.2%). The most of the respondents (43.9%) possessed moderate knowledge regarding pertussis and knew that Bordetella pertussis is the causative agent of pertussis (76.0%). A significant positive correlation between knowledge regarding pertussis with age (p=0.023) was observed, however, there was no association between age with attitude and practice (p=0.272 and 0.131, respectively). Gender and marital status did not influence the KAP regarding pertussis; nevertheless, significantly different between different faculties. Conclusion: Students from the Faculty of Medicine had the highest knowledge scores, while the students from the Faculty of Nursing had the most top attitude and practice scores compared to students from another faculty. The students from the public university generally had a good level of KAP regarding pertussis

The research methodology for malnutrition risk identification and dietary practices among community living elderly

Introduction: Nutrition screening is an initial procedure to identify malnutrition, whilst subsequent nutrition intervention is warranted for at risk individuals. However, none of nutrition screening studies conducted among Malaysian elderly accompanied by individualized nutrition intervention. The objective here is to describe the methodology to determine malnutrition risk and nutritional status of elderly in community at baseline and after 3 months of nutrition intervention; and to assess perception of elderly on their dietary practices. Materials and Methods: Elderly aged ≥60 years will be recruited as participants at several FELDA in Terengganu and Pahang with the calculated sample size of 416. Nutrition screening will be performed to identify malnutrition risk using a validated nutrition screening tool for elderly in community; the Mini Nutritional Assessment-Short Form. Dietary intake will be assessed using diet history method and individualized nutrition intervention will be provided to improve nutritional status. Nutrition screening and assessment will be repeated after three months for malnourished and at risk elderly. In-depth individual interview will be conducted to assess perception on dietary practices particularly prophetic food intake. Quantitative and qualitative data will be analysed using IBM SPSS software and NVivo software, respectively. Results: Nutritional status of the elderly is anticipated to improve after 3 months of nutrition intervention and the elderly will perceive that their dietary practices are good. Conclusion: This research is at the forefront to provide individualized nutrition intervention following nutrition screening among Malaysian community elderly. It can potentially prevent further health complications associated with malnutrition through timely malnutrition identification and nutrition intervention

Knowledge, attitude, and practice regarding cholera among non-academic staff of International Islamic University Malaysia Kuantan Medical Campus

Background: Cholera is a water and food-borne infectious disease caused by Vibrio cholerae. Cholera usually causes fatality in the case of severe infections. Furthermore, cholera outbreaks are still recurring over time, especially in many developing countries. Cholera outbreak may be due to lack of basic knowledge, awareness and preventive attitude among public. The objectives of this study are to evaluate the knowledge, attitude and practice (KAP) regarding cholera among non-academic staff of IIUM Kuantan community, to find the related factors of KAP regarding cholera and to find the association between KAP regarding cholera. Methods: This was a questionnaire-based cross-sectional study. This study used convenience sampling. The sample size for this study is 100 and was analyzed by using SPSS software using various tests. Those tests were independent t-test, Mann-Whitney test, Kruskal Wallis test and correlation test. There are six independent variables affecting knowledge, attitude and practice regarding cholera which are genders, marital statuses, and categories of occupation, different faculties, age-groups and level of education. Results: Categories of occupations showed no significant difference between administrative and clinical staff knowledge (p=0.360) and practice (p=0.437) level. Respondent’s attitude however showed significant difference (p=0.034) between clerk and clinical staff. As for other sociodemographic variables, the results showed no significant difference for knowledge, attitude and practice level. The results showed low positive correlation between knowledge and practice regarding cholera (r=0.338), between attitude and practice regarding cholera (r=0.331) and between knowledge and attitude (r=0.233). Conclusions: KAP practice scores were at an acceptable level

Dietary intake is compromised among elderly living in agricultural settlements

Purpose – This study aims to investigate dietary intake among elderly living in agricultural settlements in comparison with a recent nutritional recommendation. Design/methodology/approach – This cross-sectional study was carried out among elderly living in five agricultural settlements in Kuantan, Pahang, Malaysia. Participants were interviewed on sociodemographic information such as age, gender, marital status, smoking status, household income, education level and living status. Data on individual dietary intake were obtained through diet history method. Dietary intake data were analyzed using Nutritionist Pro software and compared to the recommended nutrient intakes (RNI) for Malaysia version 2017. Statistical analyses were performed using SPSS software version 21. Findings – A total of 413 participants (male 32.4 per cent and female 67.6 per cent) with the mean age of 69.4 ± 7.9 years participated in this study. Dietary intake results demonstrated that participants did not meet the Malaysian RNI for energy and most nutrients (p<0.05). This study also found that energy, carbohydrate, protein, fat, folate and iron intake were significantly higher in male than female (p<0.05). Meanwhile, calcium and vitamin A intake were significantly higher in female than male (p<0.05). Research limitations/implications – Integrated nutrition education and health promotion programme with a multidisciplinary approach are essential to be designed and executed to improve dietary intake of the elderly, which can further lead to appropriate dietary practices and knowledge improvement related to healthy food choices. Factors associated with inadequate dietary intake and awareness on the importance of adequate nutrients intake among the elderly warrant further investigation. Originality/value – This research is at the forefront, which indicated that the dietary intake of elderly individuals living in the agricultural settlement was inadequate in comparison to the latest recommendation. Strategies to improve their intakes need to be developed and implemented accordingly to improve nutritional status and prevent adverse effects to health

Prevalence and intervention of malnutrition risk of Malaysian elderly living in the community: A literature review

Introduction: Malnutrition among the elderly is a concern around the globe, including in Malaysia due to its negative effects to health. The aims of this review are to identify prevalence of malnutrition risk in Malaysian elderly living in the community; and to identify the types of nutrition intervention provided to the elderly following malnutrition risk identification. Methods: Literature searches were undertaken using online databases and a manual search. Main keywords used for literature search strategy were malnutrition, elderly and Malaysia. Inclusion criteria for the literature searches are studies performed in Malaysian community, using either nutrition screening or assessment tool and elderly aged ≥60 years old. Exclusion criteria are studied among hospitalized elderly, conducted in nursing homes, validation and development studies of nutrition screening tool. Results: Four published studies were eligible to be included in the review. The studies showed that prevalence of malnutrition in the Malaysian elderly living in the community is approximately 1.3% - 36.3%. A range of 25.3% to 48.5% elderly was reported to be at malnutrition risk. All of the identified studies were cross-sectional studies; whilst none of the studies provided nutrition intervention to the elderly. Conclusions: Alarming rates of malnutrition risk of Malaysian elderly living in the community has been identified. Appropriate nutrition intervention for malnourished and at risk elderly should be targeted to improve nutritional status and prevent health deterioration. Further evaluation of effectiveness of nutrition intervention following malnutrition risk identification is warranted in future studies

Malnutrition risk and perception on dietary practices among elderly living in agricultural settlements: A mixed-methods research

Purpose – This research aims to identify malnutrition risk and perception of malnourished and at-risk elderly individuals on their dietary practices. Design/methodology/approach – In Phase 1, a cross-sectional study was conducted among 413 elderly individuals aged 60 years and above in agricultural settlements in Kuantan, Pahang, Malaysia. Malnutrition risk was assessed using the Mini Nutritional Assessment Short-Form (MNA-SF). In Phase 2, in-depth semi-structured interviews were conducted among 21 elderly individuals identified in Phase 1. The interviews ceased when data saturation was achieved. Findings – 25.7 per cent (n = 106) of elderly individuals were identified as malnourished and at-risk (MNA-SF score = <12). Age, smoking, income and living status were significantly associated with malnutrition risk (p < 0.05). Thematic analysis revealed four themes that represent elderly individuals’ perception on their dietary practices: the impact of aging on dietary intake; food restriction according to health condition; poor dietary intake due to feeling of loneliness; and perceived benefits of foods for health. Research limitations/implications – Strategies from multidisciplinary healthcare professionals to eliminate improper dietary practice are required for the maintenance of health, functional independence and quality of life among the elderly. Originality/value – This research is at the forefront in reporting the elderly individuals’ perception on dietary practice in agricultural settlement. Attention to individual’s health issues and the associated factors that may influence their dietary practices is essential to provide appropriate interventions to achieve optimum nutritional status and healthy aging