METHOD: A cross-sectional study was performed in March and April 2016. The outdoor temperatures were measured using the wet-bulb globe temperature (WBGT) tool. The participants completed a self-administered questionnaire containing sociodemographic factors prior to work shift; while working profile, hydration practices, and HRI symptoms at the end of work shift. The hydration status of the respondents was assessed by direct observation of their urine colour. Multiple logistic regression was performed to ascertain the effects of age, working profile, hydration practice, history of previous HRI, and hydration status on the likelihood that outdoor workers having moderate to severe HRI.
RESULTS: A total of 320 respondents completed the questionnaire. The mean (standard deviation) outdoor workplace temperature was 30.5°C (SD 0.53°C). The percentage of respondents who experienced moderate to severe HRI was 44.1%. The likelihood that outdoor workers experienced moderate to severe HRI symptoms was associated with irregular fluid intake [odds ratio (OR): 16.11, 95% confidence interval (95%CI): 4.11; 63.20]; consumption of non-plain water (OR: 5.92, 95%CI: 2.79; 12.56); dehydration (OR: 3.32, 95%CI: 1.92; 5.74); and increasing outdoor workplace temperature (OR: 1.85, 95%CI: 1.09; 3.11).
CONCLUSION: Irregular drinking pattern and non-plain fluid intake was found to have a large effect on HRI severity among outdoor workers exposed high temperatures during a heat wave phenomenon.
MATERIALS AND METHODS: A cross-sectional study was conducted from February to April in 2016 to examine the mediating effect of health literacy on the relationship between age and healthcare utilisation. A total of 452 older persons were recruited from 14 public hospitals in Malaysia.
RESULTS: The average age of the respondents was 66.69 years old, with an age range between 60 to 105 years. The findings reveal that the relationship between age and healthcare utilisation was mediated by health literacy.
CONCLUSION: The results help to improve the understanding of healthcare utilisation among the older persons in Malaysia, which is beneficial to the healthcare provider and policymakers.
METHOD: A total of 328 municipal workers were enrolled in April to March 2016 were asked to recall if they experienced eleven HRI symptoms during the previous work day. Rasch Measurement Model was used to examine the unidimensional parameters and bias for gender before identifying the threshold of HRI symptoms. We determined the threshold symptom based on the person-item map distribution on a logit ruler value.
RESULTS: A total of 320 respondents were analysed. The psychometric features HRI symptoms suggested evidence of unidimensionality and free of bias for gender (DIF size =0.57; DIF t value =1.03). Based on the person-item map distribution, the thirst item was determined as the threshold item (Cut-off point = -2.17 logit) for the preventative action purposes to group the person as mild and moderate/severe HRI groups.
CONCLUSION: Thirst item is viewed as threshold symptoms between mild and moderate or severe HRI symptoms. It is a reliable symptom to initiate behavioural response to quench the thirst by adequate fluids. Failure to recognise the thirst symptom may lead to devastating unwanted health complications.
Materials and methods: We analysed 43 patients with isolated acetabular fractures who were treated operatively with a minimum of three years follow-up. Anthropometric data, Judet-Letournel fracture pattern, surgical approach and complications were recorded. Post-operative Matta radiological outcome were evaluated for joint congruency and hip functional outcome was evaluated using Merle d'Aubgine-Postel and Harris Hip Score (HHS). All statistical analyses were analysed using SPSS version 24.0.
Results: The most frequent elementary fracture type was posterior wall (30.2%) while associated type was both columns (23.3%). Mean functional outcome of Merle d'Aubigné-Postel was 15.77 and HHS was 86.6. Thirty-three (76.7%) patients achieved satisfactory functional outcome, 19 (44.1%) patients achieved anatomic reduction (<2 mm step-off) based on Matta classification while 24 (55.8%) did not achieve the desired outcome. Fracture pattern exhibited strong association with post-operative Matta radiological outcome (p-value 0.001). However both fracture pattern and Matta radiological outcome did not exhibit association with the functional outcome group. The mean time for surgical interventions was 10.8 days and there was no significant association with final functional outcome score.
Conclusion: Fracture pattern is a strong contributing factor towards post-operative Matta radiological outcome. However, achieving the perfect anatomical reduction is not of utmost important factor to predict the good functional outcome.
MATERIALS AND METHODS: Twenty nine operations for skeletal metastasis of the femur performed in our centre between 2009 and 2015 were included in this study. We evaluated the choice of implant, complications, survival rate and functional outcome. Fourteen patients were still alive at the time of this report for assessment of functional outcome using Musculoskeletal Tumour Society (MSTS) form.
RESULTS: Plating osteosynthesis with augmented-bone cement was the most common surgical procedure (17 patients) performed followed by arthroplasty (10 patients) and intramedullary nailing (2 patients) There were a total of five complications which were implant failures (2 patients), surgical site infection (2 patients), and site infection mortality (1 patient). The median survival rate was eight months. For the functional outcome, the mean MSTS score was 66%.
CONCLUSION: Patients with skeletal metastasis may have prolonged survival and should undergo skeletal reconstruction to reduce morbidity and improve quality of life. The surgical construct should be stable and outlast the patient to avoid further surgery.