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Timing and risk factors associated with relapse among smokers attempting to quit in Malaysia

Yasin SM, Moy FM, Retneswari M, Isahak M, Koh D

Int J Tuberc Lung Dis, 2012 Jul;16(7):980-5.
PMID: 22507850 DOI: 10.5588/ijtld.11.0748

Many smokers attempt to quit smoking, but very few succeed.
Fulltext Smokers can quit regardless of motivation stage in a worksite smoking cessation programme in Malaysia

Yasin SM, Retneswari M, Moy FM, Koh D, Isahak M

Asian Pac J Cancer Prev, 2011;12(9):2193-8.
PMID: 22296355

BACKGROUND: There is an unclear relationship between smoker's early motivation and success rates. Here we aimed to explore the correlates of motivation and smoking abstinence and relapse in worksite smoking cessation programmes.
METHODS: This prospective cohort study involved employees from two major public universities in Malaysia. Participants were actively recruited into a smoking cessation programme. At the start of treatment, participants were administered a questionnaire on sociodemographic variables, smoking habits and 'stage of change'. Behaviour therapy with free nicotine replacement therapy (NRT) was given as treatment for two months. A similar stage of change questionnaire was given at six months, and their smoking status was determined.
RESULTS: There were 185 smokers from both Universities, who joined the programme. At six months, 24 smokers reported sustained abstinence while the others had relapsed. Prior to the programme, the majority of smokers were seriously planning on quitting (59.5%--preparation stage), but over a third had no plans to quit (35.5%--contemplation stage). There was no significant difference noted in changes of motivation stage among the relapsers and the non quitters. In addition, logistic regression showed that sustained abstinence was not predicted by pre-session motivation stage, but this did predict higher relapse for the participants, compared to those in the preparation stage.
CONCLUSION: It is possible to help smokers in the lower motivation groups to quit, provided extra caution is taken to prevent relapse. Healthcare providers' recruitment strategies for cessation programmes should thus encompass smokers in all motivation stages.
Fulltext Relationship between symptoms and objective measures of airway obstruction in asthmatic patients

Liam CK, Goh CT, Isahak M, Lim KH, Wong CM

Asian Pac J Allergy Immunol, 2001 Jun;19(2):79-83.
PMID: 11699724

The objective of this study was to determine the relationship between asthma symptoms and the degree of airway obstruction as measured by the forced expiratory volume in one second (FEV1) and peak expiratory flow rate (PEFR) in a group of 64 asthmatic patients with clinically stable disease attending a university-based urban asthma clinic. Asthma symptoms did not correlate with the degree of airway obstruction as measured by prebronchodilator PEFR (total asthma symptom score vs PEFR: r = -0.214, p = 0.104, n = 59) and only correlated poorly with prebronchodilator FEV1 (total asthma symptom score vs FEV1: r = -0.256, p = 0.041, n = 64). These results lend support to the recommendation that airway obstruction should be measured objectively when assessing patients with chronic persistent asthma.
Study site: Asthma clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Individual antecedents of workplace victimisation: The role of negative affect, personality and self-esteem in junior doctors' exposure to bullying at work

Samsudin EZ, Isahak M, Rampal S, Rosnah I, Zakaria MI

Int J Health Plann Manage, 2020 Sep;35(5):1065-1082.
PMID: 32468617 DOI: 10.1002/hpm.2985

Previous studies have indicated that junior doctors commonly experience workplace bullying and that it may adversely impact medical training and delivery of quality healthcare. Yet, evidence on the precursors of bullying among them remains elusive. Drawing on the individual-disposition hypothesis, the present paper examined the relationships of negative affect, personality and self-esteem with workplace bullying among junior doctors. Multilevel analysis of a universal sample (n = 1074) of junior doctors working in the central zone of Malaysia using mixed effects logistic regression was performed. The results indicate that participants with moderate (AOR 4.40, 95% CI 2.20-8.77) and high degree (AOR 13.69, 95% CI 6.46-29.02) of negative affect as well as high degree of neuroticism (AOR 2.99, 95% CI 1.71-5.21) have higher odds of being bullied compared to their counterparts. The findings present evidence that individual traits are associated with junior doctors' exposure to bullying. While victim blaming should be avoided, this suggest that antibullying measures with an interpersonal focus should be considered when developing antibullying initiatives targeted at junior doctors. This includes primary intervention such as cognitive training, secondary interventions such as resource enhancement building and conflict management skills training, and tertiary interventions such as counselling.
Perceptions on radioprotective garment usage and underlying reasons for non-adherence among medical radiation workers from public hospitals in a middle-income Asian setting: A qualitative exploration

Mohd Ridzwan SF, Bhoo-Pathy N, Isahak M, Wee LH

Heliyon, 2019 Sep;5(9):e02478.
PMID: 31687573 DOI: 10.1016/j.heliyon.2019.e02478

Background: Radioprotective garments protect medical radiation workers from exposure to radiation at workplace. However, previous studies have found poor adherence to the use of radioprotective garments.
Objectives: We explored the perceptions and practices related to the use of radioprotective garments among medical radiation workers in public hospitals, and sought to understand the reasons for non-adherence.
Design and setting: A qualitative approach was applied by conducting face-to-face in-depth interviews with 18 medical radiation workers from three university hospitals using a semi-structured interview guide.
Results: Five themes emerged with respect to perceptions on the use of radioprotective garments: (i) the dilemmas in practising radiation protection, (ii) indication of workers' credibility, (iii) physical appearance of radioprotective garments, (iv) practicality of radioprotective garment use, and (v) impact on workflow. Actual lack of radioprotective garment use was attributed to inadequate number of thyroid shield and other garments, radioprotective garments' unsightly appearance including being dirty and defective, impracticality of using radioprotective garments for some nuclear medicine procedures, disruption of workflow because of workers' limited movements, attitudes of workers, and organisational influences.
Conclusion: Medical radiation workers demonstrated a definitive practice of using radioprotective aprons, but often neglected to use thyroid shields and other garments. Availability and hygiene are reported as the core issues, while unclear guidelines on practical use of radioprotective garments appear to lead to confusion among medical radiation workers. To the best of our knowledge, this is the first qualitative study of its kind from a middle-income Asian setting.
Organisational antecedents of workplace victimisation: The role of organisational climate, culture, leadership, support, and justice in predicting junior doctors' exposure to bullying at work

Samsudin EZ, Isahak M, Rampal S, Rosnah I, Zakaria MI

Int J Health Plann Manage, 2020 Jan;35(1):346-367.
PMID: 31659793 DOI: 10.1002/hpm.2926

Workplace bullying is a pervasive phenomenon among junior doctors that may negatively impact their training and abilities to deliver quality healthcare, yet evidence on the factors of bullying among them remains lacking. This study examined the role of organisational climate, culture, leadership, support, and justice in junior doctors' exposure to workplace bullying on the basis of the work environment hypothesis, which suggests that workplace psychosocial factors are the main antecedents of bullying at work. Multilevel analysis of a universal sample (n = 1074) of junior doctors working in the central zone of Malaysia, using mixed effects logistic regression, was conducted. Analysis indicates that junior doctors working in departments with neutral and positive organisational climate, moderate and high degree of clan culture, moderate and high degree of adhocracy culture, moderate degree of hierarchy culture, moderate degree of production and achievement-oriented leadership style, moderate and high degree of organisational support, moderate degree of procedural justice, moderate and high degree of interactional justice, and high degree of distributive justice have lower odds of bullying compared with their counterparts. The results present evidence that all aspects of the organisation influence junior doctors' exposure to bullying and should be considered when developing antibullying initiatives targeted at them.
Beliefs, Facilitating Factors, and Barriers in Using Personal Dosimeter among Medical Radiation Workers in a Middle-Income Asian Setting

Mohd Ridzwan SF, Bhoo-Pathy N, Wee LH, Isahak M

Ann Work Expo Health, 2021 10 09;65(8):940-954.
PMID: 34037205 DOI: 10.1093/annweh/wxab025

This qualitative study explores the medical radiation workers' (MRWs) beliefs with the support of the theory of planned behaviour's constructs regarding the use of personal dosimeters in order to identify the facilitating factors and barriers to practising good personal dose monitoring. The exploration was conducted through semi-structured face-to-face interviews with 63 MRWs from the public, private, and university hospitals. Belief statements from the informants were organized under the behavioural, normative, and control belief, as guided by the theory. A thematic analysis found that a majority of informants acknowledged the benefits of using dosimeters. However, several factors influenced the actual usage. The informants were hesitant to use the dosimeter as the loss of the device involved an expensive penalty. They also mentioned that delayed dosimeter supplies due to late budget approval in the hospitals and some other reasons had got them disconnected from the monitoring system. The workers' attitudes and social norms highly induced their dosimeter usage as well; some perceived themselves to be at low risk for high exposure to radiation, and forgetfulness was also mentioned as a reason for lack of adherence. Device physical factor influenced low dosimeter use too. This study highlighted some unique findings in Asian settings. A better understanding of the underlying reasons for the lack of dosimeter use will be useful in developing strategies to increase good practices in personal radiation monitoring.
A systematic review of financial implications of air pollution on health in Asia

Jaafar H, Razi NA, Azzeri A, Isahak M, Dahlui M

Environ Sci Pollut Res Int, 2018 Oct;25(30):30009-30020.
PMID: 30187406 DOI: 10.1007/s11356-018-3049-0

Economic losses due to health-related implications of air pollution were huge and incurred significant burdens towards healthcare providers. The objective of this study is to systematically review published literature on the financial implications of air pollution on health in Asia. Four databases: PubMed, Scopus, NHS Economic Evaluation Database (NHS EED), and Web of Science (WoS) were used to identify all the relevant articles. It was limited to all articles that had been published in the respected databases from January 2007 until March 2017. Twenty-four articles were included in this review. Five of the 24 studies (20.8%) reported financial implications of air pollution-related disease through value of statistical life (VOSL) which ranged from USD180 million to USD2.2 billion, six (25%) studies used cost of illness (COI) to evaluate air pollution-related morbidity and found that the cost ranged from USD5.4 million to USD9.1 billion. Another six studies (25%) used a combination of VOSL and COI for both mortality and morbidity valuation and found that the financial implications ranging from USD253 million to USD2.9 billion. Thirteen (54.2%) studies reported healthcare cost associated with both hospital admission and outpatient visit, five (20.1%) on hospital admission only, and one (4.2%) on outpatient visit only. Economic impacts of air pollution can be huge with significant deterioration of health among the Asians.
Neighborhood-Level Stress and Circadian Cortisol: A Systematic Review and Meta-Analysis

Hosseini F, Adha N, Zainol R, Isahak M, Nemati N

Iran J Public Health, 2014 Oct;43(10):1324-34.
PMID: 26060694

The main objective was to find association between basal cortisol and neighborhood-level stress. Systematic searches, including electronic and hand searches, were conducted. The most recent date of the search was July 26, 2013. Primary observational studies included if they considered stress related outcomes in the neighborhood context. Using the EndNote X7 advanced search option; the authors examined the abstracts and titles of the 18,092 articles to exclude obviously irrelevant studies, gray literature, discussion papers, reviews and, studies with no complete data. Two authors independently extracted data from the original reports into pre-designed data extraction forms based on the Data Extraction Template of the Cochrane Consumer and Communication Review Group (CCCRG). Ten studies with a total of 2,134 participants were synthesized and analyzed. Two studies out of ten received expanded meta-analysis. The overall effect size (95% CI) for cortisol level for residents in neighborhoods with lower stress compared to inhabitants from higher was 0.12 (0.01, 0.23). This review is demonstrating a link between psychosocial or physical stress and cortisol obtained from saliva. However, living in high disorder neighborhoods results in higher level of cortisol. This represents a biological indicator of psychosocial/physical stress exposure (i.e., neighborhood disorder) that reflects variances in stress exposure levels.
Workplace Bullying Among Junior Doctors in Malaysia: A Multicentre Cross-Sectional Study

Samsudin EZ, Isahak M, Rampal S, Rosnah I, Zakaria MI

Malays J Med Sci, 2021 Apr;28(2):142-156.
PMID: 33958968 DOI: 10.21315/mjms2021.28.2.13

Background: Research suggests that junior doctors often experience workplace bullying, which may have adverse impacts on medical training and delivery of quality healthcare. However, evidence among local population has not been established. The present study aims to examine the prevalence of workplace bullying among Malaysian junior doctors and explore its associated sociodemographic and employment factors.
Methods: A multicentre cross-sectional study was conducted in 12 government hospitals accredited for housemanship training within the central zone of Malaysia. The study included a total of 1,074 house officers who had been working for at least 6 months in various housemanship rotations. The Negative Acts Questionnaire-Revised (NAQ-R) was used to examine workplace bullying.
Results: The 6-month prevalence of workplace bullying among study participants was 13%. Work-related bullying such as 'being ordered to do work below your level of competence', person-related bullying such as 'being humiliated or ridiculed in connection with your work', and physically intimidating bullying such as 'being shouted at or being the target of spontaneous anger' were commonly reported by study participants. Medical officers were reported to be the commonest perpetrators of negative actions at the workplace. Study participants who graduated from Eastern European medical schools (adjusted odds ratio [AOR] 2.27; 95% confidence interval [CI]: 1.27, 4.07) and worked in surgical-based rotation (AOR 1.83; 95% CI: 1.13, 2.97) had higher odds of bullying compared to those who graduated from local medical schools and worked in medical-based rotation, whereas study participants with good English proficiency (AOR 0.14; 95% CI: 0.02, 0.94) had lower odds of bullying compared to those with poor English proficiency.
Conclusion: The present study shows that workplace bullying is prevalent among Malaysian junior doctors. Considering the gravity of its consequences, impactful strategies should be developed and implemented promptly in order to tackle this serious occupational hazard.
Work Ability and Its Related Factors Among Workers in Small and Medium Enterprises: Comparison Among Four ASEAN Countries

Kaewboonchoo O, Isahak M, Susilowati I, Phuong TN, Morioka I, Harncharoen K, et al.

Asia Pac J Public Health, 2016 Jul;28(5):438-49.
PMID: 27273897 DOI: 10.1177/1010539516651957

Work ability is related to many factors that might influence one's capacity to work. This study aimed to examine the work ability and its related factors among small and medium enterprises (SME) workers in 4 Association of Southeast Asian Nations (ASEAN) countries. The participants in this study included 2098 workers from food and textile industries in Indonesia, Malaysia, Thailand, and Vietnam. A cross-sectional survey of anonymous self-administrated questionnaire was designed to collect information on sociodemographic factors, work environment and ergonomic condition, musculoskeletal disorders, and work ability. Bivariate correlation coefficient and multiple linear regression analyses were used to predict the work ability. Results of this study confirm that work ability in 4 ASEAN countries was similar to that in European countries, and that the sociodemographic factors, work environment and ergonomic condition, and musculoskeletal disorder (MSD) were associated with work ability. These factors are important for considering occupational health and safety policy to promote work ability in food, textile, and other SME workers.
Testing the transtheoretical model in predicting smoking relapse among Malaysian adult smokers receiving assistance in quitting

Yasin SM, Retneswari M, Moy FM, Taib KM, Isahak M, Koh D

Asian Pac J Cancer Prev, 2013;14(4):2317-23.
PMID: 23725134

The role of The Transtheoretical Model (TTM) in predicting relapse is limited. We aimed to assess whether this model can be utilised to predict relapse during the action stage. The participants included 120 smokers who had abstained from smoking for at least 24 hours following two Malaysian universities' smoking cessation programme. The smokers who relapsed perceived significantly greater advantages related to smoking and increasing doubt in their ability to quit. In contrast, former smokers with greater self-liberation and determination to abstain were less likely to relapse. The findings suggest that TTM can be used to predict relapse among quitting smokers.
Prevalence and associated factors of stress in the Malaysian Police Force

Masilamani R, Bulgiba A, Chinna K, Darus A, Isahak M, Kandiben S, et al.

Prev Med, 2013;57 Suppl:S57-9.
PMID: 23352959 DOI: 10.1016/j.ypmed.2013.01.008

This study aims to determine the prevalence of stress and the associated socio-demographic and work factors among police personnel in Metropolitan Kuala Lumpur, Malaysia.
The Association Between E-Cigarette Use Behaviors and Saliva Cotinine Concentration Among Healthy E-Cigarette Users in Malaysia

Wong LP, Mohd Salim SN, Alias H, Aghamohammadi N, Hoe VCW, Isahak M, et al.

J Addict Nurs, 2020 6 4;31(2):102-109.
PMID: 32487936 DOI: 10.1097/JAN.0000000000000335

Electronic cigarettes (e-cigarettes) have rapidly increased in popularity within the last 2 years in Malaysia. The study aims to understand the association between e-cigarette use behaviors and salivary cotinine (a CYP2AA metabolite of nicotine) concentration to inform the development of future e-cigarette control policies. A convenience sample of saliva from 144 e-cigarette users was obtained between November and December 2015. The study participants used refill liquid containing between 0 and 12 mg/ml of nicotine. The overall median cotinine concentration of the study participants was 81.1 ng/ml (interquartile range = 8.5-195.8). Among the zero-nicotine and single e-cigarette users, the median cotinine level was 51.1 (interquartile range = 8.20-125.35) ng/ml. Factors significantly associated with a higher salivary cotinine concentration were dual use of e-cigarettes and tobacco cigarettes, regular and daily e-cigarette use, a longer duration of e-cigarette use, using a higher amount of e-liquid, and a shorter duration to finish a refill. Multivariate analysis revealed that e-cigarette use of 1-6 and 6-12 months (but not 1 month and below) was significantly associated with a higher cotinine concentration. Cotinine found in zero-nicotine e-liquids implies the importance of stringent regulatory governance for the consistency of labeled nicotine content of e-cigarette liquid in the market. Zero-nicotine e-cigarette users should also be informed of the likelihood of environmental exposure to tobacco smoke. Future studies conducted on larger samples are warranted to validate the association between duration of e-cigarette use and salivary cotinine concentration as well as to investigate underlying mechanisms.
Job Stress and Nurses Well-Being: Prayer and Age as Moderators

Achour M, Binti Abdul Ghani Azmi I, Bin Isahak M, Mohd Nor MR, Mohd Yusoff MYZ

Community Ment Health J, 2019 10;55(7):1226-1235.
PMID: 31111298 DOI: 10.1007/s10597-019-00410-y

There is increasing popularity among researchers, scholars, and policymakers concerning the efficacy of prayer as a coping strategy for job stress. This study examines the moderating effects of prayer and age on the relationship between job stress and nurses' well-being in UMMC. Three hundred (300) Muslim nursing staff working at the University of Malaya Medical Centre were sampled. Data were collected via questionnaires. The findings of this study show that the effect of job stress on well-being is significant for nurses and that prayer of nurses contributed to alleviating job stress and enhancing well-being. This study is limited to nurses in one public hospital in a developing country. Thus, it would be more interesting if the study could be extended to other public and private institutions in a Muslim country, and a comparison could be done between other religions as well.
Prevalence of cataract and factors associated with cataract surgery uptake among older persons in Malaysia: A cross-sectional study from the National Eye Survey II

Yap JF, Ng QX, Wai YZ, Isahak M, Salowi MA, Moy FM

Trop Doct, 2022 Jan 31.
PMID: 35098808 DOI: 10.1177/00494755221076649

Nationally-representative evidence is limited on factors affecting uptake of cataract surgery in Malaysia. We found the prevalence of cataract among older persons to be 26.8%. The two most common barriers were 'need not felt' (43.5%) and 'fear of surgery or poor result' (16.2%). Reluctance for surgical intervention was greater outside the Central zone.
A cross sectional study on hand-arm vibration syndrome among a group of tree fellers in a tropical environment

Su AT, Maeda S, Fukumoto J, Miyai N, Isahak M, Yoshioka A, et al.

Ind Health, 2014;52(4):367-76.
PMID: 24739764

This study aimed to explore the clinical characteristics of hand arm vibration syndrome (HAVS) in a group of tree fellers in a tropical environment. We examined all tree fellers and selected control subjects in a logging camp of central Sarawak for vibration exposure and presence of HAVS symptoms utilizing vibrotactile perception threshold test (VPT) and cold water provocation test (CWP). None of the subjects reported white finger. The tree fellers reported significantly higher prevalence of finger coldness as compared to the control subjects (OR=10.32, 95%CI=1.21-87.94). A lower finger skin temperature, longer fingernail capillary return time and higher VPT were observed among the tree fellers as compared to the control subjects in all fingers (effect size >0.5). The VPT following CWP of the tree fellers was significantly higher (repeated measures ANOVA p=0.002, partial η(2)=0.196) than the control subject. The A (8) level was associated with finger tingling, numbness and dullness (effect size=0.983) and finger coldness (effect size=0.524) among the tree fellers. Finger coldness and finger tingling, numbness and dullness are important symptoms for HAVS in tropical environment that may indicate vascular and neurological damage due to hand-transmitted vibration exposure.
A comparison of hand-arm vibration syndrome between Malaysian and Japanese workers

Su AT, Fukumoto J, Darus A, Hoe VC, Miyai N, Isahak M, et al.

J Occup Health, 2013;55(6):468-78.
PMID: 24162147

OBJECTIVES: The aim of this study was to investigate the clinical characteristics of HAVS in a tropical environment in comparison with a temperate environment.
METHODS: We conducted a series medical examinations among the forestry, construction and automobile industry workers in Malaysia adopting the compulsory medical examination procedure used by Wakayama Medical University for Japanese vibratory tools workers. We matched the duration of vibration exposure and compared our results against the Japanese workers. We also compared the results of the Malaysian tree fellers against a group of symptomatic Japanese tree fellers diagnosed with HAVS.
RESULTS: Malaysian subjects reported a similar prevalence of finger tingling, numbness and dullness (Malaysian=25.0%, Japanese=21.5%, p=0.444) but had a lower finger skin temperature (FST) and higher vibrotactile perception threshold (VPT) values as compared with the Japanese workers. No white finger was reported in Malaysian subjects. The FST and VPT of the Malaysian tree fellers were at least as bad as the Japanese tree fellers despite a shorter duration (mean difference=20.12 years, 95%CI=14.50, 25.40) of vibration exposure.
CONCLUSIONS: Although the vascular disorder does not manifest clinically in the tropical environment, the severity of HAVS can be as bad as in the temperate environment with predominantly neurological disorder. Hence, it is essential to formulate national legislation for the control of the occupational vibration exposure.
Dose-response relationship between hand-transmitted vibration and hand-arm vibration syndrome in a tropical environment

Su AT, Maeda S, Fukumoto J, Darus A, Hoe VC, Miyai N, et al.

Occup Environ Med, 2013 Jul;70(7):498-504.
PMID: 23645621 DOI: 10.1136/oemed-2012-101321

The dose-response relationship for hand-transmitted vibration has been investigated extensively in temperate environments. Since the clinical features of hand-arm vibration syndrome (HAVS) differ between the temperate and tropical environment, we conducted this study to investigate the dose-response relationship of HAVS in a tropical environment.
Fulltext COVID-19 handling report for pre-case, case (pre-hospital and hospital), and post-case phases in the elderly as vulnerable populations in 6 Asia Pacific countries

Susilowati IH, Nakatani H, Nugraha S, Pengpid S, Keawpan W, Hasiholan BP, et al.

Glob Health Med, 2020 Dec 31;2(6):350-359.
PMID: 33409414 DOI: 10.35772/ghm.2020.01061

In this current COVID-19 pandemic, the elderly (60 years and over) are more vulnerable populations to be infected and become victims. In a disaster cycle, the various parts are usually divided into three stages, consisting of the pre-impact stage, the trans-impact stage, and the post-impact stage. It is necessary to explain how to handle the COVID-19 disaster for the elderly at each step (explain the meaning of pre-case, case (pre-hospital and hospital), and post-case phases, respectively). This paper presents the handling of COVID-19 for elderly in pre-case, case, and post-case phases in six Asia-Pacific countries (Indonesia, Thailand, Singapore, Malaysia, Vietnam, and Japan). The data and information come from COVID-19 official websites of each country, including information from World Health Organization (WHO), United States Centers for Disease Control and Prevention (CDC), mass media, and professional associations. The handling of COVID-19 in the pre-case phase has been done correctly for the elderly, especially in Indonesia, Japan, Thailand, and Singapore. In the case phase (pre-hospital and hospital), only Indonesia, Japan, and Thailand have followed special handling protocols for the elderly, particularly for those who have comorbidities and respiratory diseases. For the post-case phase, all countries have the same treatment protocol for all age groups, with none specific for the elderly.

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