Pusat Pengajian Sains Perubatan - Tesis
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- PublicationThe proportion and associated factors of prematurity among neonatal death in Kelantan 2020-2023(2025-06)Ghazali, Mohd Faiz MohdBackground: Neonatal deaths accounted for nearly 47% of all under-five child deaths globally in 2022, with prematurity being a major contributor. Although the neonatal mortality rate in Kelantan has remained below the Sustainable Development Goal (SDG) target, the trend in Kelantan has shown a progressive increase since years 2020 that warrants attention. The neonatal mortality rate in Kelantan increased from 2.79 to 4.88 per 1,000 live births between 2020 and 2023. This study aims to determine the proportion of prematurity and its associated factors among neonatal death cases in Kelantan, from 2020 to 2023. Methodology: This cross-sectional study was conducted from December 2024 to May 2025 based on a retrospective review of neonatal death data reported to the Kelantan State Health Department from 2020 to 2023. Secondary data for this study were obtained from Under-5 Mortality Notification System and the Neonatal Death Investigation Form. A total of 475 neonatal death cases were selected using simple random sampling with SPSS. Sociodemographic, maternal, fetal and intrapartum factors were extracted from the records and analysed using descriptive analysis, simple logistic regression, and multiple logistic regression to identify factors associated with prematurity. Results: among 475 neonatal deaths reviewed, the proportion of prematurity was 32.0%. Prematurity was significantly associated with several maternal and fetal risk factors, including hypertension (aOR = 4.72, 95% CI: 1.08, 20.53), prolonged rupture of membranes (aOR = 3.89, 95% CI: 1.86, 8.11), and fetal congenital anomaly (aOR = 2.66, 95% CI: 1.58, 4.47). The odds of premature birth increased markedly with decreasing birth weight, with extremely low birth weight (<1000g) showing the highest association (aOR = 20.54, 95% CI: 10.08, 41.83). Conclusion: Prematurity accounted for a significant proportion of neonatal deaths in Kelantan. Maternal and neonatal factors such as hypertension, prolonged rupture of membranes, birth weight and fetal congenital anomaly were significantly associated with prematurity among neonatal death. Identification of these contributing factors may support the improvement of future strategies and interventions, including enhancing antenatal care, optimising intrapartum management, and strengthening the capacity of neonatal and maternal healthcare services. This could improve the quality of services and contribute to the reduction of neonatal deaths due to prematurity birth in the Kelantan.
- PublicationHealth-related quality of life and its association among medical officers in Selangor(2025-06)Ariffin, KhairunnisaIntroduction: Health is a fundamental human right and a vital resource for societal productivity and well-being. For health professionals, particularly medical officers (MOs), maintaining optimal physical, mental, and social well-being is crucial, as it affects both their quality of life (QoL) and the quality of patient care. Despite their essential role, MOs are increasingly affected by occupational stressors, including extended working hours, administrative burdens, job insecurity, and system inefficiencies, which negatively impact their QoL. Objectives: This study aims to assess the QoL of medical officers in Selangor and examine the underlying factors influencing their well-being. The findings are expected to contribute to policy recommendations that enhance work-life balance, reduce psychological distress, and improve healthcare delivery. Methods and Results: 165 MOs were selected through simple random sampling from hospitals and health clinics. Data were collected using an online questionnaire with sociodemographic information and the WHOQOL-BREF to measure QoL. The analysis involved descriptive statistics and linear regression. The mean score for the psychological health domain was 55.45, lower than the general population norm, indicating considerable psychological challenges among MOs. Multiple linear regression analysis identified two significant factors associated with better psychological health: normal body mass index (BMI) and permanent employment status. MOs with a normal BMI scored 3.61 points higher in psychological well-being than those who were overweight (p = 0.030). Additionally, MOs in permanent positions had psychological scores 9.55 points higher than those employed on a contract basis (p = 0.003). These results suggest that physical health and employment stability are important determinants of psychological well-being among MOs. Conclusion: The results highlight the impact of lifestyle and job security on mental health. Holistic interventions addressing work conditions and personal health are essential to improve the quality of life and performance of MOs.
- PublicationTrend and associated factors of food poisoning outbreaks in secondary schools in Kelantan, from 2022 to 2024(2025-06)Sha’ari, Ahmad ZulfahmiBackground: Food poisoning is a recurring challenge in Malaysia’s public health system, consistently ranking among the nation’s top five communicable diseases. In Kelantan, the concern over the increasing trend of food poisoning involving school settings has been growing. Objective: This study aimed to describe the trend of food poisoning outbreak cases, to describe the proportion of food poisoning outbreak cases and to determine the factors associated with food poisoning cases during outbreaks among secondary school students in Kelantan within the same period. Methodology: This study conducted a cross-sectional design to describe the trend and proportion of food poisoning outbreaks reported among secondary school students in Kelantan from 2022 to 2024. For the analysis of associated risk factors, a case-control design with a 1:3 ratio was applied, where student cases from selected outbreaks were compared with matched controls. Data were extracted from the final outbreak reports using the “Borang Siasatan Keracunan Makanan (FWBD/KRM/BG 001), Revision 2008”. Result: The findings showed an upward trend in food poisoning outbreaks from 2022 to 2023, followed by a plateau in 2024. The proportion of outbreaks involving secondary schools was 90.9% in 2022, 44.4% in 2023, and 33.3% in 2024, with an overall combined proportion of 45.9% across the three years. The mean age of affected students was 14.77 years (SD = 1.38), with 62.5% in the lower secondary age group (13-15 years). Schools under the Ministry of Education (MOE) accounted for 73.5% of the cases, and 55.9% of outbreaks occurred in rural areas. Notably, 85.3% of incidents were linked to hostel canteens. Poultry was identified as the leading food vehicle (50.0%), while Salmonella spp. emerged as the most common microbial agent (64.7%). Inadequate cooking and reheating and improper storage were the most frequent critical control point (CCP) failures (64.7%). Male students were found to have a lower likelihood of being affected (AOR = 0.76; 95% CI: 0.60,0.96; p = 0.023). Conversely, consumption of red meat significantly increased the risk of food poisoning (AOR = 4.45; 95% CI: 3.25,6.08; p < 0.001), as did exposure to inadequate cooking and reheating (AOR = 1.50; 95% CI: 1.20,1.89; p < 0.001). Conclusion This study revealed a clear link between food poisoning outbreaks in Kelantan’s secondary schools and specific operational practices within school. While non-modifiable factors like student’s sex influenced susceptibility, the more concerning aspects were preventable factors particularly in cooking, reheating, and storage of high-risk foods such as red meat. These findings highlighted the need for strengthening food safety training for canteen personnel, enforcing strict CCP monitoring, and integrating targeted health literacy for students in preventing future outbreaks.
- PublicationOccupational safety and health knowledge and its predictors among medical officers in government primary healthcare facilities in Kedah(2025-06)Saad, Ahmad Shahril HafifiBackground : Occupational safety and health (OSH) knowledge is essential in promoting a safe healthcare work environment, especially in primary healthcare settings where medical officers face multifaceted occupational hazards. Despite Malaysia's commitment to OSH through legislative reforms, knowledge gaps remain evident, particularly in primary care. Objectives: This study aimed to assess the level of OSH knowledge among medical officers in Kedah’s primary healthcare and to identify the predictors associated with higher knowledge scores. Methodology: A cross-sectional study involving 173 randomly selected medical officers from government primary healthcare facilities across Kedah was conducted between January and March 2025. A validated self-administered questionnaire was used to measure sociodemographic data, occupational characteristics, and OSH knowledge. Descriptive analysis, one-way ANOVA, simple linear regression (SLR), and multiple linear regression (MLR) were employed to determine predictors. Results: The mean OSH knowledge score was 71.66 (SD=14.16), with only 36.4% of respondents achieving satisfactory knowledge (≥75%). Age, gender, ethnicity, job grade, unit of service, duration of service, and prior OSH training were significantly associated with knowledge levels in univariate analysis. MLR revealed two significant predictors: prior OSH training (Adj. β = -19.37; p < 0.001) and 10–20 years of service (Adj. β = 7.09; p < 0.001). The final model explained 52.5% of the variance in knowledge scores (R² = 0.525). Respondents who had received OSH training scored significantly higher, In contrast, younger officers and those without training showed notable knowledge gaps. Conclusion: This study highlights critical gaps in OSH knowledge among primary healthcare medical officers in Kedah. Structured OSH training and accumulated service experience are associated with adequacy of OSH knowledge. The findings underscore the need for mandatory training, mentoring programs, and curriculum integration to ensure uniform OSH competency among all healthcare personnel.
- PublicationA structural equation model of physical activity, psychological factors, and life satisfaction among health sciences students in health campus, Universiti Sains Malaysia(2025-07)Xie, YushuIntroduction: With the acceleration of globalization and the continuous increase of social stress, mental health issues are becoming increasingly prominent worldwide, especially among young people. Physical activity is broadly acknowledged as a crucial element for supporting both physical and mental health, proven effective in reducing depression, anxiety, and improving well-being. However, the participation rate in physical activity among university students remains low, and their mental health status is deteriorating. This study focuses on life satisfaction as the primary outcome variable, aiming to explore the mechanisms by which physical activity and psychological factors (self-compassion, body compassion, perceived stress) influence life satisfaction. Objective: This study aims to examine the structural relationships among physical activity, self-compassion, body compassion, perceived stress, and life satisfaction among undergraduate health sciences students at the Health Campus of Universiti Sains Malaysia. Methods：This cross-sectional study utilized self-administered questionnaires to gather data, with undergraduate students recruited through convenience sampling. A total of 300 participants were included. Confirmatory Factor Analysis (CFA) was initially performed to confirm the validity and reliability of the measurement instruments. Due to some participants selecting "Not Sure" in the physical activity questionnaire, it was not possible to calculate the metabolic equivalent (MET) for those cases. As a result, only 240 complete datasets were retained for further analysis. Subsequently, Structural Equation Modeling (SEM) was applied to examine the interrelationships among the study variables. The self-administered questionnaire served as the data collection tool throughout the study. CFA was employed to assess and confirm the psychometric properties of the measurement tools, verifying their reliability and validity before advancing to the modeling stage. The "Not Sure" responses to items in the physical activity questionnaire resulted in missing MET scores, leading to the exclusion of incomplete data. Ultimately, 240 complete datasets were used for SEM analysis to model the associations among the variables, focusing on both direct and indirect effects. This combined approach of initial CFA for validation, followed by SEM for modeling, ensured a thorough and methodical analysis of the study data. Results： The CFA results showed that all instruments had good validity and reliability. All factor loadings exceeded 0.30, and model fit indices for each scale met recommended thresholds (CFI > 0.90, TLI > 0.90, RMSEA < 0.08, SRMR < 0.08). The final SEM model demonstrated a good fit (Comparative Fit Index=0.989, Tucker-Lewis Index=0.979, Standardized Root Mean Square Residual=0.032, Root Mean Square Error of Approximation=0.033). Analysis showed that physical activity did not directly predict life satisfaction (β = 0.081, p = 0.161), but had a positive indirect effect through reducing feelings of helplessness. In the dimensions of body compassion, “acceptance” directly improved life satisfaction, while “defusion” had an indirect effect through stress reduction; “common humanity” did not show a significant effect. Self-compassion positively influenced life satisfaction indirectly through enhanced body acceptance, while self-criticism affected life satisfaction by reducing helplessness and increasing body acceptance. The overall stress level showed a significant negative impact on life satisfaction. Conclusion：This study indicates that the effect of physical activity on life satisfaction is achieved indirectly through the reduction of perceived stress rather than a direct effect. Additionally, improving body acceptance and fostering positive self-compassion play a crucial role in enhancing life satisfaction. Future intervention strategies should consider integrating physical activity with psychological adjustment, focusing on stress reduction and the development of self-acceptance, to more effectively promote the overall well-being of university students.