Lin Naing

Working conditions, self-perceived stress, anxiety, depression and quality of life: A structural equation modelling approach

BackgroundThe relationships between working conditions [job demand, job control and social support]; stress, anxiety, and depression; and perceived quality of life factors [physical health, psychological wellbeing, social relationships and environmental conditions] were assessed using a sample of 698 male automotive assembly workers in Malaysia.MethodsThe validated Malay version of the Job Content Questionnaire (JCQ), Depression Anxiety Stress Scales (DASS) and the World Health Organization Quality of Life-Brief (WHOQOL-BREF) were used. A structural equation modelling (SEM) analysis was applied to test the structural relationships of the model using AMOS version 6.0, with the maximum likelihood ratio as the method of estimation.ResultsThe results of the SEM supported the hypothesized structural model (χ2 = 22.801, df = 19, p = 0.246). The final model shows that social support (JCQ) was directly related to all 4 factors of the WHOQOL-BREF and inversely related to depression and stress (DASS). Job demand (JCQ) was directly related to stress (DASS) and inversely related to the environmental conditions (WHOQOL-BREF). Job control (JCQ) was directly related to social relationships (WHOQOL-BREF). Stress (DASS) was directly related to anxiety and depression (DASS) and inversely related to physical health, environment conditions and social relationships (WHOQOL-BREF). Anxiety (DASS) was directly related to depression (DASS) and inversely related to physical health (WHOQOL-BREF). Depression (DASS) was inversely related to the psychological wellbeing (WHOQOL-BREF). Finally, stress, anxiety and depression (DASS) mediate the relationships between job demand and social support (JCQ) to the 4 factors of WHOQOL-BREF.ConclusionThese findings suggest that higher social support increases the self-reported quality of life of these workers. Higher job control increases the social relationships, whilst higher job demand increases the self-perceived stress and decreases the self-perceived quality of life related to environmental factors. The mediating role of depression, anxiety and stress on the relationship between working conditions and perceived quality of life in automotive workers should be taken into account in managing stress amongst these workers.

Comparison of two methods of dental age estimation in 7–15-year-old Malays

BACKGROUND Numerous methods of age estimation have been proposed. The Demirjian method is the most frequently used, which was first applied in a French Canadian population in 1973. The Willems method is a modification of the above and was applied in a Belgian population in 2002. OBJECTIVES The objectives of this study were to test the applicability of the two methods, namely Demirjian and Willems, for age estimation in a Malay population, and to find the correlation between body mass index and the difference between the dental age and the chronological age. MATERIALS AND METHODS A cross-sectional study involving 214 boys and 214 girls, selected by a simple stratified random sampling method was carried out. The orthopantomograph was used to score the seven left mandibular teeth, and the calculated maturity score was used to obtain the Demirjian dental age. Willems dental age was estimated using the tables proposed in the Willems method. Results. The Demirjian method overestimated the age by 0.75 and 0.61 years, while the Willems method overestimated the age by 0.55 and 0.41 years among boys and girls, respectively. In boys, the body mass index was significantly correlated to the difference in age using the Willems method. CONCLUSION Further modification of either method is indicated for dental age estimation among the Malay population.

Assessment of Urinary Cotinine as a Marker of Nicotine Absorption from Tobacco Leaves: A Study on Tobacco Farmers in Malaysia

Assessment of Urinary Cotinine as a Marker of Nicotine Absorption from Tobacco Leaves: A Study on Tobacco Farmers in Malaysia: Mayumi Onuki, et al. Department of Public Health, Graduate School of Medicine, The University of Tokyo—To assess dermal absorption of nicotine from tobacco leaves in relation to Green Tobacco Sickness (GTS), urinary cotinine concentrations were measured in 80 male tobacco‐growing farmers and in 40 healthy males (controls) who did not handle wet tobacco leaves in Kelantan, Malaysia. Among non‐smokers, urinary cotinine levels in farmers were significantly higher than those of controls; farmers with urinary cotinine of 50 ng/ml/m2 or above showed eye symptoms more frequently than those below this level (p<0.05). Farmers who did not wear protective equipment had subjective symptoms more frequently than those who used the equipment (p<0.05); some of these symptoms were seen more frequently in organophosphate (Tamaron) users than in non‐users. As tobacco farmers evidence a risk of nicotine poisoning from tobacco leaves, assessment including GTS together with effects of pesticides will be necessary.

Identification of psychosocial factors of noncompliance in hypertensive patients

This cross-sectional study was aimed to identify the predictors of medication noncompliance in hypertensive patients. The study was conducted at the Family Medicine Clinic, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, which is a university-based teaching hospital. All hypertensive patients aged 40 or over-registered from January to June 2004, who had been on treatment for at least 3 months, were screened. Previously validated self-administered questionnaires were used to assess the compliance and psychosocial factors. A total of 240 hypertensive patients were recruited in the study. Of these, 55.8% were noncompliant to medication. Logistic regression showed that age (adjusted odds ratio (OR): 0.96; 95% confidence interval (CI): 0.92–0.997; P: 0.035), patient satisfaction (adjusted OR: 0.97; 95% CI: 0.93–0.998; P: 0.036) and medication barrier (adjusted OR: 0.95; 95% CI: 0.91–0.987; P: 0.009) were significant predictors of medication noncompliance. Therefore, younger age, poor patient satisfaction and medication barrier were identified as independent psychosocial predictors of medication noncompliant in hypertensive patients.

A global call for action to include gender in research impact assessment

Global investment in biomedical research has grown significantly over the last decades, reaching approximately a quarter of a trillion US dollars in 2010. However, not all of this investment is distributed evenly by gender. It follows, arguably, that scarce research resources may not be optimally invested (by either not supporting the best science or by failing to investigate topics that benefit women and men equitably). Women across the world tend to be significantly underrepresented in research both as researchers and research participants, receive less research funding, and appear less frequently than men as authors on research publications. There is also some evidence that women are relatively disadvantaged as the beneficiaries of research, in terms of its health, societal and economic impacts. Historical gender biases may have created a path dependency that means that the research system and the impacts of research are biased towards male researchers and male beneficiaries, making it inherently difficult (though not impossible) to eliminate gender bias. In this commentary, we – a group of scholars and practitioners from Africa, America, Asia and Europe – argue that gender-sensitive research impact assessment could become a force for good in moving science policy and practice towards gender equity. Research impact assessment is the multidisciplinary field of scientific inquiry that examines the research process to maximise scientific, societal and economic returns on investment in research. It encompasses many theoretical and methodological approaches that can be used to investigate gender bias and recommend actions for change to maximise research impact. We offer a set of recommendations to research funders, research institutions and research evaluators who conduct impact assessment on how to include and strengthen analysis of gender equity in research impact assessment and issue a global call for action.

The Female Sexual Response Cycle: Do Malaysian Women Conform to the Circular Model?

INTRODUCTION The concept of a sexual response cycle (SRC) for women has gained interest lately with the reintroduction of terms with new definitions and a new model for the sexual response, especially the Bassons circular model. AIM To determine the correlations among the SRCs phases (i.e., sexual desire, sexual arousal, orgasm, sexual satisfaction, and sexual pain) in Malaysian women, in order to validate the circular model of womens SRC. METHODS Principal component analysis (PCA), a factor analysis technique with varimax rotation method, was used to explore the correlation structure of items in female respondents who scored on the Malay version of Female Sexual Function Index (FSFI). The number of factors or components to obtain was decided using Kaisers criteria. MAIN OUTCOME MEASURE To measure the correlation between female SRCs domain. RESULTS A total of 230 married women aged 18-70 years old participated in this study. Factor loadings using PCA with varimax rotation divided the sexual domains into three components based on Kaisers criteria with eigenvalues of 6.11, 5.59, and 3.50, respectively. Sexual desire, sexual arousal, and lubrication were highly correlated, and therefore, they fall in one component, reflecting one construct, whereas orgasm and sexual satisfaction fall in another component. The third component was formed by the pain items. CONCLUSION The strong correlation between sexual desire/arousal/lubrication means that they were the same and may support the contemporary theory of circular model of SRC in women.

Cost Effectiveness Analysis of Using Multiple Neuromodalities in Treating Severe Traumatic Brain Injury in a Developing Country Like Malaysia

OBJECTIVE The aim of this study was to determine the cost-effectiveness of using baseline neuromonitoring (BNM) compared with multimodality monitoring (M3) for severe traumatic brain injury (TBI). METHODS Sixty-two patients with severe TBI underwent a prospective observational study where they were divided into two groups of patients receiving treatment with M3 (32 patients) and BNM (30 patients). The macro and micro costings were performed on each patient. The Barthel Index score after 1 year was used as an outcome measurement tool for both groups. The cost-effectiveness (CE) ratio was calculated using the Poisson regression model. RESULTS The costs of equipment and consumables between the groups was statistically significant (p < 0.001) after correcting for age and severity of injury. Other cost categories were not significantly different. The crude CE ratios were 168.66 (95% CI: 168.32, 169.03) and 144.16 (95% CI: 143.87, 144.45) for BNM and M3 respectively. The two crude CE ratios were significantly different (p < 0.001). It was calculated by controlling or adjusting age, gender, Glasgow Coma Score, Marshalls classification at admission and type of injury. The adjusted CE ratios were 171.32 (95% CI: 170.97, 171.68) and 141.50 (95% CI: 141.26, 141.79) for BNM and M3, respectively. The two adjusted CE ratios were significantly different ( p< 0.001). CONCLUSION The application of M3 for severe TBI was more cost-effective than BNM. All calculations were made at 3.8 Malaysian Ringgit (MYR) to the United States dollar (USD).

Influence of the Angiotensin II Type I Receptor Gene 1166A > C Polymorphism on BP and Aortic Pulse Wave Velocity Among Malays

Angiotensin II type 1 receptor (AGT1R) gene 1166A > C polymorphism has been shown to be associated with essential hypertension and aortic stiffness as measured by carotid femoral pulse wave velocity (PWV). This study was carried out to investigate the association of the 1166A > C polymorphism with blood pressure (BP) and PWV among Malay hypertensive and normotensive subjects.

Job Strain and its Associated Factors among Lecturers in the School of Medical Sciences, Universiti Sains Malaysia and Faculty of Medicine, Universiti Kebangsaan Malaysia

A cross-sectional study to assess job strain and its associated factors among lecturers of the School of Medical Sciences, Universiti Sains Malaysia (USM) and Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) was undertaken between August 2001 and May 2002. The original English version of the Job Content Questionnaire (JCQ) version 1.7 (revised 1997) by Robert Karasek based on the Job Strain Model was self-administered to 73 (response rate 58.4%) and 80 (response rate 41.7%) lecturers in the medical faculties of USM and UKM respectively. The prevalence of job strain (defined by low decision latitude and high psychological demand) in USM and UKM was 23.3% and 17.5%, respectively; the difference was not significant (p ≥ 0.05). Analysis showed that the associated factors of job strain in USM lecturers were psychological stressors (adjusted OR 1.2, 95% CI: 1.0, 1.4), created skill (adjusted OR 0.4, 95% CI: 0.2, 0.8), working in clinical-based departments (adjusted OR 18.9, 95% CI:1.6, 22.7). The risk factors of job strain in UKM lecturers were created skill (adjusted OR 0.3, 95% CI: 0.1, 0.9), psychological stressors (adjusted OR 1.2, 95% CI: 1.0,1.5) and co-worker support (adjusted OR 0.3, 95% CI: 0.1, 0.9). We conclude psychological stressors and created skill were non-protective and protective, respectively, against job strain in both USM and UKM lecturers. Asia Pac JPublic Health 2004; 16(1): 32- 40.

Development and validation of a new Prescription Quality Index

AIMS The aims were to develop and validate a new Prescription Quality Index (PQI) for the measurement of prescription quality in chronic diseases. METHODS The PQI were developed and validated based on three separate surveys and one pilot study. Criteria were developed based on literature search, discussions and brainstorming sessions. Validity of the criteria was examined using modified Delphi method. Pre-testing was performed on 30 patients suffering from chronic diseases. The modified version was then subjected to reviews by pharmacists and clinicians in two separate surveys. The rater-based PQI with 22 criteria was then piloted in 120 patients with chronic illnesses. Results were analysed using SPSS version 12.0.1 RESULTS Exploratory principal components analysis revealed multiple factors contributing to prescription quality. Cronbachs α for the entire 22 criteria was 0.60. The average intra-rater and inter-rater reliability showed good to moderate stability (intraclass correlation coefficient 0.76 and 0.52, respectively). The PQI was significantly and negatively correlated with age (correlation coefficient -0.34, P<0.001), number of drugs in prescriptions (correlation coefficient -0.51, P<0.001) and number of chronic diseases/conditions (correlation coefficient -0.35, P<0.001). CONCLUSIONS The PQI is a promising new instrument for measuring prescription quality. It has been shown that the PQI is a valid, reliable and responsive tool to measure quality of prescription in chronic diseases.