Organizational safety climate and workplace violence among primary healthcare workers in Malaysia

Workplace violence (WPV) has become a global safety and health concern in recent times particularly in the healthcare sector. In addition, low levels of organisational safety climate (OSC) have been associated with higher occurrence of occupational related health outcomes. Hence, the objective of this study was to determine the association between organisational safety climate and workplace violence among government primary healthcare workers. A cross-sectional study among a stratified random sample of 838 primary healthcare workers (HCW) from the nine district health offices under the Selangor state health department. Two standardized self-administered questionnaires were used to obtain data on WPV and OSC. Logistic regression models used to estimate the association between OSC and WPV. Prevalence of WPV was 68.5% whereby verbal abuse was the most common type (65%) followed by bullying (27%), physical violence (6%) and sexual harassment (2%). Nurses (29.7%) were the most affected by WPV. The main perpetrators were relatives of patients (38%). Low level of OSC was also associated with WPV (OR=3.04, 95% CI=1.45-6.41). The results of this study confirmed that safety climate is associated with WPV. Hence, interventions and efforts to prevent WPV among HCW should also include improving organizational safety factors

The prevalence of visual defect among commercial vehicle drivers in Selangor, Malaysia

A cross-sectional survey of commercial vehicle drivers who were renewing their own licences was conducted at the Selangor Road Transport Department office in Padang Jawa between 1 February 2002 and 28 February 2002, using questionnaire and medical examination. The objective was to determine the prevalence of myopia, colour vision deficiency and visual field defect among the commercial vehicle drivers. The respondents that reported visual defect at the time of interview was compared with those detected by the author through medical examination. Out of the 223 respondents, 21 (9.4%) reported to have myopia by the questionnaire survey. Through the visual examination there were 63 (28.3%) with myopia (visual acuity worse than 6/12), six (2.6%) had a visual field defect and 14 (6.3%) had red-green colour deficiency. The visual defect detected during the study among the commercial vehicle drivers,which were missed at the time of the routine medical examination were significant. The process of the statutory medical examination should be reviewed

Work related musculoskeletal disorders of the neck and upper limb.

Work-related musculoskeletal disorders of the neck and upper limb (WRULDs) are an important concern in the workplace and a costly healthcare problem. WURLDs remain one of the most common occupational illnesses in Western countries. This thesis focuses on two important aspects of WRULDs; the first is the identification of risk factors associated with WRULDs among nurses, in particular neck, shoulder and hand or wrists pain, and their relationship with nurses’ perceived work ability, and the second is the conduct of a Cochrane systematic review to investigate interventions for the prevention of WRULDs. The first publication looks at a novel approach to identifying the risk of neck and shoulder pain in hospital-based nurses. The pain at individual sites; i.e., neck pain alone, shoulder pain alone, and neck and shoulder pain, were individually compared with those reporting no neck or shoulder pain, allowing the risk factors for the individual sites to be estimated. The second paper looks at risk factors for wrist or hand pain among nurses. Although the wrist and hand functions are important in both activities of daily living and work function, especially among nurses, the research on wrist or hand pain is limited compared to the body of research on pain in other sites of the body. The third paper investigates the relationship between multisite musculoskeletal pain and reduced work ability among nurses. Work ability is a measure of a worker’s capacity to perform their work based on the work content and job demand. The fourth and fifth papers consist of the Cochrane protocol and systematic review investigating the ergonomic design and training for the prevention of work-related musculoskeletal disorders of the upper limb and neck in adults. The first part of the thesis found that the risk factors for neck pain alone, shoulder pain alone, and neck and shoulder pain together were different. Somatisation tendency, health beliefs and mental and physical health and wellbeing were associated with neck and shoulder pain, whereas neck pain alone was more consistently associated with demographic and anthropometric factors, and shoulder pain alone with health beliefs. Wrist and hand pain was found to be prevalent in hospital nurses, and to be associated with both physical and psychosocial factors, including somatisation tendency. Musculoskeletal pain in one or more anatomical sites was found to predict reduced self-perceived work ability, with work ability reducing as the number of painful sites increased. Preventing musculoskeletal disorders among nurses should be set as a priority, and besides focusing on ergonomic factors, psychosocial factors also need to be considered in interventions. The Cochrane systematic review demonstrated moderate quality evidence that the use of an alternative mouse with an arm support board for VDU users was effective in reducing the incidence of neck/shoulder disorders but there was only low quality evidence in reducing symptoms of upper limb and neck/shoulder discomfort. There was also very low to moderate quality evidence that the other ergonomic intervention did not demonstrate any benefit in terms of preventing WRULDs. The findings have important implications for determining ergonomic interventions and education to be implemented in occupational settings in the prevention of work-related musculoskeletal disorders of the neck and upper limb

Work related musculoskeletal disorders of the neck and upper limb.

Work-related musculoskeletal disorders of the neck and upper limb (WRULDs) are an important concern in the workplace and a costly healthcare problem. WURLDs remain one of the most common occupational illnesses in Western countries. This thesis focuses on two important aspects of WRULDs; the first is the identification of risk factors associated with WRULDs among nurses, in particular neck, shoulder and hand or wrists pain, and their relationship with nurses’ perceived work ability, and the second is the conduct of a Cochrane systematic review to investigate interventions for the prevention of WRULDs. The first publication looks at a novel approach to identifying the risk of neck and shoulder pain in hospital-based nurses. The pain at individual sites; i.e., neck pain alone, shoulder pain alone, and neck and shoulder pain, were individually compared with those reporting no neck or shoulder pain, allowing the risk factors for the individual sites to be estimated. The second paper looks at risk factors for wrist or hand pain among nurses. Although the wrist and hand functions are important in both activities of daily living and work function, especially among nurses, the research on wrist or hand pain is limited compared to the body of research on pain in other sites of the body. The third paper investigates the relationship between multisite musculoskeletal pain and reduced work ability among nurses. Work ability is a measure of a worker’s capacity to perform their work based on the work content and job demand. The fourth and fifth papers consist of the Cochrane protocol and systematic review investigating the ergonomic design and training for the prevention of work-related musculoskeletal disorders of the upper limb and neck in adults. The first part of the thesis found that the risk factors for neck pain alone, shoulder pain alone, and neck and shoulder pain together were different. Somatisation tendency, health beliefs and mental and physical health and wellbeing were associated with neck and shoulder pain, whereas neck pain alone was more consistently associated with demographic and anthropometric factors, and shoulder pain alone with health beliefs. Wrist and hand pain was found to be prevalent in hospital nurses, and to be associated with both physical and psychosocial factors, including somatisation tendency. Musculoskeletal pain in one or more anatomical sites was found to predict reduced self-perceived work ability, with work ability reducing as the number of painful sites increased. Preventing musculoskeletal disorders among nurses should be set as a priority, and besides focusing on ergonomic factors, psychosocial factors also need to be considered in interventions. The Cochrane systematic review demonstrated moderate quality evidence that the use of an alternative mouse with an arm support board for VDU users was effective in reducing the incidence of neck/shoulder disorders but there was only low quality evidence in reducing symptoms of upper limb and neck/shoulder discomfort. There was also very low to moderate quality evidence that the other ergonomic intervention did not demonstrate any benefit in terms of preventing WRULDs. The findings have important implications for determining ergonomic interventions and education to be implemented in occupational settings in the prevention of work-related musculoskeletal disorders of the neck and upper limb

N95 respirator hybrid decontamination method using Ultraviolet Germicidal Irradiation (UVGI) coupled with Microwave-Generated Steam (MGS).

The Coronavirus Disease 2019 (COVID-19) pandemic has induced a critical supply of personal protective equipment (PPE) especially N95 respirators. Utilizing respirator decontamination procedures to reduce the pathogen load of a contaminated N95 respirator can be a viable solution for reuse purposes. In this study, the efficiency of a novel hybrid respirator decontamination method of ultraviolet germicidal irradiation (UVGI) which utilizes ultraviolet-C (UV-C) rays coupled with microwave-generated steam (MGS) against feline coronavirus (FCoV) was evaluated. The contaminated 3M 1860 respirator pieces were treated with three treatments (UVGI-only, MGS-only, and Hybrid-UVGI + MGS) with variable time. The virucidal activity was evaluated using the TCID50 method. The comparison of decontamination efficiency of the treatments indicated that the hybrid method achieved at least a pathogen log reduction of 4 logs, faster than MGS and UVGI. These data recommend that the proposed hybrid decontamination system is more effective comparatively in achieving pathogen log reduction of 4 logs

E-Cigarette Users’ Attitudes on the Banning of Sales of Nicotine E-Liquid, Its Implication on E-Cigarette Use Behaviours and Alternative Sources of Nicotine E-Liquid

The banning of sales of nicotine e-liquid in e-cigarette shops has been implemented in several states in Malaysia. The distribution of nicotine e-liquid can only be allowed by licensed pharmacies or registered medical practitioners. This study aimed to evaluate e-cigarette users’ responses to the control policy in a cross-sectional survey of 851 e-cigarette users by utilizing a self-report questionnaire that assessed (1) attitudes on regulation policy of e-cigarette banning; (2) e-cigarette use behaviors; and (3) sources of e-liquid after the regulation policy has been implemented. Participants from the state of Selangor where the banning policy was implemented were surveyed. The majority (95.8%) opposed the banning and believed e-cigarettes should be sold to anyone aged 18 years or above as with tobacco cigarettes, only a minority believed that nicotine e-liquid should only be available for sale over the counter in pharmacy stores (14.6%) and in clinics with a doctor’s prescription (11.8%). The majority (44.2%) reported that they would continue their e-cigarette use as before the banning policy, while 20% plan to completely stop e-cigarette usage without replacing it with any alternatives. The vast majority (87.9%) was still able to obtained nicotine e-liquid from e-cigarette shops in spite of the ban and the second most common source was from online purchase (63.1%). The sales of nicotine e-liquid from black-market were evidenced as many reported obtaining zero nicotine e-liquid from the black market (54.4%). Self- or home-made (30.8%) nicotine e-liquid was also reported. Majority of respondents that self-made e-liquid were from the average monthly income group (below MYR3000). Obtaining nicotine from the pharmacy was least preferred (21.4%). Provision of professional advice to nicotine e-liquid users along with the ban may lessen the likelihood of users switching to tobacco cigarettes or other nicotine alternatives. Banning of sales of nicotine e-liquid in e-cigarette shops resulted in a boom in the black market supplying nicotine e-liquid and, self- or home-made nicotine e-liquid. Enforcing regulations and monitoring black market sales is warranted. Efforts to educate e-cigarette users of the danger of sourcing nicotine e-liquid from the black market and self- or home-made nicotine e-liquid are essential

Rapidly scalable and low-cost public health surveillance reporting system for COVID-19

Objective Data-driven innovations are essential in strengthening disease control. We developed a low-cost, open-source system for robust epidemiological intelligence in response to the COVID-19 crisis, prioritising scalability, reproducibility and dynamic reporting.Methods A five-tiered workflow of data acquisition; processing; databasing, sharing, version control; visualisation; and monitoring was used. COVID-19 data were initially collated from press releases and then transitioned to official sources.Results Key COVID-19 indicators were tabulated and visualised, deployed using open-source hosting in October 2022. The system demonstrated high performance, handling extensive data volumes, with a 92.5% user conversion rate, evidencing its value and adaptability.Conclusion This cost-effective, scalable solution aids health specialists and authorities in tracking disease burden, particularly in low-resource settings. Such innovations are critical in health crises like COVID-19 and adaptable to diverse health scenarios

Depressieve klachten, cortisol, visceraal vet en metabool syndroom

Background: Severe dengue infection often has unpredictable clinical progressions and outcomes. Obesity may play a role in the deterioration of dengue infection due to stronger body immune responses. Several studies found that obese dengue patients have a more severe presentation with a poorer prognosis. However, the association was inconclusive due to the variation in the results of earlier studies. Therefore, we conducted a systematic review and meta-analysis to explore the relationship between obesity and dengue severity. Methods: We performed a systematic search of relevant studies on Ovid (MEDLINE), EMBASE, the Cochrane Library, Web of Science, Scopus and grey literature databases. At least two authors independently conducted the literature search, selecting eligible studies, and extracting data. Meta-analysis using random-effects model was conducted to compute the pooled odds ratio with 95% confidence intervals (CI). Findings: We obtained a total of 13,333 articles from the searches. For the final analysis, we included a total of fifteen studies among pediatric patients. Three cohort studies, two case-control studies, and one cross-sectional study found an association between obesity and dengue severity. In contrast, six cohort studies and three case-control studies found no significant relationship between obesity and dengue severity. Our meta-analysis revealed that there was 38 percent higher odds (Odds Ratio = 1.38; 95% CI:1.10, 1.73) of developing severe dengue infection among obese children compared to non-obese children. We found no heterogeneity found between studies. The differences in obesity classification, study quality, and study design do not modify the association between obesity and dengue severity. Conclusion: This review found that obesity is a risk factor for dengue severity among children. The result highlights and improves our understanding that obesity might influence the severity of dengue infection

Decontamination Methods of N95 Respirators Contaminated with SARS-CoV-2

In the preparation and response to the COVID-19 pandemic, a sufficient supply of personal protective equipment (PPE), particularly the face mask, is essential. Shortage of PPE due to growing demand leaves health workers at significant risk as they fight this pandemic on the frontline. As a mitigation measure to overcome potential mask shortages, these masks could be decontaminated and prepared for reuse. This review explored past scientific research on various methods of decontamination of the N95-type respirators and their efficiency against the SARS-CoV-2 virus. Ultraviolet germicidal irradiation (UVGI) and hydrogen peroxide vapor (HPV) show great potential as an effective decontamination system. In addition, UVGI and HPV exhibit excellent effectiveness against the SARS-CoV-2 virus on the N95 respirator surfaces

The secondary analysis on the association between obesity and dengue severity comparing with non-obese, normal weight, and underweight groups.

<p>The secondary analysis on the association between obesity and dengue severity comparing with non-obese, normal weight, and underweight groups.</p