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Fulltext Prevalence and factors associated with low back pain among tea plantation workers in Cameron Highlands, Malaysia

Abdul Hadi H

Journal of Occupational Safety and Health, 2016;13(1):1-10.
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A cross sectional study was conducted among tea plantation workers in Cameron Highlands from July to December 2006 to study the prevalence of low back pain and factors associated with it. One hundred and six tea plantation field workers participated in the study. Data was collected using self-administered questionnaire. Time motion studies were also conducted for 3 different job categories. The prevalence of back pain experienced throughout their work in the plantation was 81.1% and the prevalence of low
back pain experienced in the past 12 months was 64.2%. Feeling the need to work as fast as possible was a significant predictor of low back pain and increased the risk by 3.5 times, therefore it is suggested that both the management and workers give serious attention to this particular aspect to reduce the incidence of low back pain.
Fulltext A qualitative study on parents' reasons and recommendations for childhood vaccination refusal in Malaysia

Rumetta J, Abdul-Hadi H, Lee YK

J Infect Public Health, 2020 Feb;13(2):199-203.
PMID: 31431420 DOI: 10.1016/j.jiph.2019.07.027

BACKGROUND: Vaccine-related diseases are increasing in developing countries. This study aimed to explore parents' reasons for refusal of childhood vaccinations in Malaysia and their recommendations on addressing their concerns.
METHODS: A qualitative study design involving individual both face-to-face and online in-depth interview was used. The topic guide was developed from the Health Belief Model theoretical framework. Seven face-to-face and seven online interviews were conducted with parents in the Klang Valley (an urban area) who had refused childhood vaccination. All interviews were audio-recorded, transcribed verbatim and checked. Thematic approach was used to analyze the data. Data was collected until data saturation was reached.
RESULTS: Findings were summarized into two main categories: Personal Health Beliefs and Vaccine Related Concerns. Six personal health beliefs were identified: lack of confidence in modern medicine and health care personnel, pharmaceutical conspiracy to sell medicines, preference to a natural approach to health, personal instincts, religious beliefs and having a partner with similar beliefs. Four main vaccine-related concerns were identified: negative effects and content concerns, doubts of necessity and lack of information and knowledge regarding vaccines. Parents recommended that more empathy from healthcare professionals and evidence on safety and content purity would help them reconsider vaccination.
CONCLUSION: Parents had multiple reasons for refusing childhood vaccinations but felt that communication and empathy from healthcare professionals was lacking. Besides individual consultations with parents, addressing these concerns at multiple levels in the health care system and society may help to increase the uptake of childhood vaccinations in the future.
Validity and reliability of the english version of the sick, control, one stone, fat, food (SCOFF) in Malaysia

Wan Wahida WMZ, Lai PSM, Abdul Hadi H

Clin Nutr ESPEN, 2017 Apr;18:55-58.
PMID: 29132739 DOI: 10.1016/j.clnesp.2017.02.001

BACKGROUND & AIMS: Several questionnaires to screen for eating disorders have been validated in Malaysia. However, these tools are lengthy, and require specialist interpretation. The sick, control, one stone, fat, food (SCOFF) is easy to administer by non-specialists, but has not been validated in Malaysia. Therefore, the aim of our study was to validate the SCOFF on a non-clinical sample of tertiary students to determine if it could identify individuals with an eating disorder.
METHODS: We recruited second year tertiary students from five faculties in a university in Malaysia, from June-November 2014, who could understand English. The SCOFF and the EAT-26 were administered at baseline. Two weeks later, the SCOFF was re-administered to assess for reliability.
RESULTS: A total of 292 students were approached, and all agreed to participate (response rate = 100%). There was moderate correlation between the total SCOFF score with the EAT-26's dieting domain (spearman's rho = 0.504, p < 0.001), bulimia and food preoccupation domain (spearman's rho = 0.438, p < 0.001), and total score (spearman's rho = 0.483, p < 0.001). The internal consistency of the SCOFF was low (Cronbach alpha = 0.470). At retest, kappa scores ranged from 0.211 to 0.591. The sensitivity of the SCOFF was 77.4%, and its specificity was 60.5%. The positive predictive value was 18.9%, and its negative predictive value was 95.8%.
CONCLUSIONS: The SCOFF was found to have adequate convergent validity and stable reliability. However, its internal consistency was low. The SCOFF can still be used in clinical practice. However, its positive results should be interpreted with caution due to its low positive predictive value.
KEYWORDS: Eating disorder; Malaysia; SCOFF; Sensitivity; Specificity; Validation
Fulltext An Automated Patient Self-Monitoring System to Reduce Health Care System Burden During the COVID-19 Pandemic in Malaysia: Development and Implementation Study

Lim HM, Teo CH, Ng CJ, Chiew TK, Ng WL, Abdullah A, et al.

JMIR Med Inform, 2021 Feb 26;9(2):e23427.
PMID: 33600345 DOI: 10.2196/23427

BACKGROUND: During the COVID-19 pandemic, there was an urgent need to develop an automated COVID-19 symptom monitoring system to reduce the burden on the health care system and to provide better self-monitoring at home.
OBJECTIVE: This paper aimed to describe the development process of the COVID-19 Symptom Monitoring System (CoSMoS), which consists of a self-monitoring, algorithm-based Telegram bot and a teleconsultation system. We describe all the essential steps from the clinical perspective and our technical approach in designing, developing, and integrating the system into clinical practice during the COVID-19 pandemic as well as lessons learned from this development process.
METHODS: CoSMoS was developed in three phases: (1) requirement formation to identify clinical problems and to draft the clinical algorithm, (2) development testing iteration using the agile software development method, and (3) integration into clinical practice to design an effective clinical workflow using repeated simulations and role-playing.
RESULTS: We completed the development of CoSMoS in 19 days. In Phase 1 (ie, requirement formation), we identified three main functions: a daily automated reminder system for patients to self-check their symptoms, a safe patient risk assessment to guide patients in clinical decision making, and an active telemonitoring system with real-time phone consultations. The system architecture of CoSMoS involved five components: Telegram instant messaging, a clinician dashboard, system administration (ie, back end), a database, and development and operations infrastructure. The integration of CoSMoS into clinical practice involved the consideration of COVID-19 infectivity and patient safety.
CONCLUSIONS: This study demonstrated that developing a COVID-19 symptom monitoring system within a short time during a pandemic is feasible using the agile development method. Time factors and communication between the technical and clinical teams were the main challenges in the development process. The development process and lessons learned from this study can guide the future development of digital monitoring systems during the next pandemic, especially in developing countries.
Assessing lifetime occupational chrysotile inhalation exposure, respiratory symptoms, and lung cancer risk among brake maintenance workers in Malaysia

Yusof MZ, Zahaba M, Mohd Aris MS, Shafiee S', Abdul Hadi H, Maghpor MN, et al.

Toxicol Ind Health, 2024 Aug 20.
PMID: 39163360 DOI: 10.1177/07482337241273755

This study aimed to estimate workers' occupational lifetime exposure to chrysotile and examine the respiratory symptoms and lung cancer risk. A total of 112 workers were interviewed about their occupational histories. Exposure modeling using information on the determinants of exposure was used to estimate chrysotile emissions. The cumulative lifetime exposure was then assessed for each worker. Respiratory symptoms were obtained using a validated questionnaire. Lung cancer mortality rate was also predicted using a model. Almost all the workers were male and young (mean age = 30 years, SD = 7). The estimated lifetime occupational chrysotile inhalation exposure ranged from 0.0001 to 0.0486 f/mL.years (median = 0.0018 f/mL.years, IQR = 0.486). A high prevalence of cough symptom (11.7%), and low estimated cancer risk (<1%) were reported. In conclusion, the lung cancer risk among our cohort of workers was at a low level because of lower cumulative lifetime occupational chrysotile exposure.
Fulltext Utility and usability of an automated COVID-19 symptom monitoring system (CoSMoS) in primary care during COVID-19 pandemic: A qualitative feasibility study

Lim HM, Abdullah A, Ng CJ, Teo CH, Valliyappan IG, Abdul Hadi H, et al.

Int J Med Inform, 2021 Nov;155:104567.
PMID: 34536808 DOI: 10.1016/j.ijmedinf.2021.104567

BACKGROUND: COVID-19 telemonitoring applications have been developed and used in primary care to monitor patients quarantined at home. There is a lack of evidence on the utility and usability of telemonitoring applications from end-users' perspective.
OBJECTIVES: This study aimed to evaluate the feasibility of a COVID-19 symptom monitoring system (CoSMoS) by exploring its utility and usability with end-users.
METHODS: This was a qualitative study using in-depth interviews. Patients with suspected COVID-19 infection who used CoSMoS Telegram bot to monitor their COVID-19 symptoms and doctors who conducted the telemonitoring via CoSMoS dashboard were recruited. Universal sampling was used in this study. We stopped the recruitment when data saturation was reached. Patients and doctors shared their experiences using CoSMoS, its utility and usability for COVID-19 symptoms monitoring. Data were coded and analysed using thematic analysis.
RESULTS: A total of 11 patients and 4 doctors were recruited into this study. For utility, CoSMoS was useful in providing close monitoring and continuity of care, supporting patients' decision making, ensuring adherence to reporting, and reducing healthcare workers' burden during the pandemic. In terms of usability, patients expressed that CoSMoS was convenient and easy to use. The use of the existing social media application for symptom monitoring was acceptable for the patients. The content in the Telegram bot was easy to understand, although revision was needed to keep the content updated. Doctors preferred to integrate CoSMoS into the electronic medical record.
CONCLUSION: CoSMoS is feasible and useful to patients and doctors in providing remote monitoring and teleconsultation during the COVID-19 pandemic. The utility and usability evaluation enables the refinement of CoSMoS to be a patient-centred monitoring system.
Feasibility and acceptability of a dengue self-monitoring system to reduce treatment delay in Malaysia: A single-centre pilot randomised controlled trial

Ng WL, Ng CJ, Teo CH, Ang TF, Lee YK, Abdul Hadi H, et al.

Digit Health, 2024;10:20552076241277710.
PMID: 39247097 DOI: 10.1177/20552076241277710

OBJECTIVE: Most dengue cases are managed in an outpatient setting, where patients are advised to return to the clinic daily for monitoring. Some patients can develop severe dengue at home and fail to recognise the deterioration. An application called DengueAid was designed as a self-monitoring tool for patients to reduce delay in seeking timely treatment. This study aimed to assess the feasibility of conducting a randomised controlled trial to determine the effectiveness of the DengueAid application.
METHODS: Dengue patients were recruited from a public health clinic in Malaysia and randomised to either use the DengueAid application plus standard care for dengue or receive only the standard care. The outcomes evaluated were the (1) feasibility of recruitment, data collection and follow-up procedures; (2) preliminary clinical outcome measures; and (3) acceptability of DengueAid. Qualitative interviews were conducted for participants in the intervention arm to assess the acceptability of DengueAid.
RESULTS: Thirty-seven patients were recruited with 97% (n = 36) retention rates. The recruitment rate was low (63% refusal rate, n = 62/99) with difficulty in data collection and follow-up due to the variable interval of care for dengue in an outpatient setting. DengueAid application was acceptable to the participants, but preliminary clinical outcomes and qualitative data suggested limited utility of the application. Unwell conditions of patients and limited access to healthcare are important factors impacting the application's utility.
CONCLUSION: The feasibility trial uncovered issues with recruitment, data collection and follow-up processes. Further research and modification to the application are needed to improve its utility and usability.