A study on awareness level on occupational safety and health on employees of Jabatan Air Negeri Sabah and Sabah Electricity Sdn Bhd / Anis Ismail and Ain Azreen Azahr

Occupational safety and health is one of the issues that has begin to reach people’s attention. A report by Social Security Organization (SOCSO) stated that the number of accidents in year 2012 has risen to 61,552 accidents, compare to 59,897 accidents in the year 2011. Both Jabatan Air Negeri Sabah and Sabah Electricity Sdn Bhd are in the same utilities sector. Utilities sector employees are more exposed to hazard at work place such as machinery usage, current exposure, and chemical substances. Thus, this study was done to study the employees awareness level on occupational safety and health. The study has been conducted at Jabatan Air Negeri Sabah and Sabah Electricity Sdn Bhd, involving 80 respondents in different departments. Result of the study shows that the most influential factors of employee awareness level on occupational safety and health is employee commitment. Recommendations for future research were also discussed by the researchers in this report

Association of mechanical bowel preparation with oral antibiotics and anastomotic leak following left sided colorectal resection:an international, multi-centre, prospective audit

Introduction: The optimal bowel preparation strategy to minimise the risk of anastomotic leak is yet to be determined. This study aimed to determine whether oral antibiotics combined with mechanical bowel preparation (MBP+Abx) was associated with a reduced risk of anastomotic leak when compared to mechanical bowel preparation alone (MBP) or no bowel preparation (NBP). Methods: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 Left Sided Colorectal Resection audit was performed. Patients undergoing elective left sided colonic or rectal resection with primary anastomosis between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak. Results: Of 3676 patients across 343 centres in 47 countries, 618 (16.8%) received MBP+ABx, 1945 MBP (52.9%) and 1099 patients NBP (29.9%). Patients undergoing MBP+ABx had the lowest overall rate of anastomotic leak (6.1%, 9.2%, 8.7% respectively) in unadjusted analysis. After case-mix adjustment using a mixed-effects multivariable regression model, MBP+Abx was associated with a lower risk of anastomotic leak (OR 0.52, 0.30–0.92, P = 0.02) but MBP was not (OR 0.92, 0.63–1.36, P = 0.69) compared to NBP. Conclusion: This non-randomised study adds ‘real-world’, contemporaneous, and prospective evidence of the beneficial effects of combined mechanical bowel preparation and oral antibiotics in the prevention of anastomotic leak following left sided colorectal resection across diverse settings. We have also demonstrated limited uptake of this strategy in current international colorectal practice

Evaluating the incidence of pathological complete response in current international rectal cancer practice

The mainstay of management for locally advanced rectal cancer is chemoradiotherapy followed by surgical resection. Following chemoradiotherapy, a complete response may be detected clinically and radiologically (cCR) prior to surgery or pathologically after surgery (pCR). We aim to report the overall complete pathological response (pCR) rate and the reliability of detecting a cCR by conventional pre-operative imaging.A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients treated by elective rectal resection were included. A pCR was defined as a ypT0 N0 EMVI negative primary tumour; a partial response represented any regression from baseline staging following chemoradiotherapy. The primary endpoint was the pCR rate. The secondary endpoint was agreement between post-treatment MRI restaging (yMRI) and final pathological staging.Of 2572 patients undergoing rectal cancer surgery in 277 participating centres across 44 countries, 673 (26.2%) underwent chemoradiotherapy and surgery. The pCR rate was 10.3% (67/649), with a partial response in 35.9% (233/649) patients. Comparison of AJCC stage determined by post-treatment yMRI with final pathology showed understaging in 13% (55/429) and overstaging in 34% (148/429). Agreement between yMRI and final pathology for T-stage, N-stage, or AJCC status were each graded as 'fair' only (n = 429, Kappa 0.25, 0.26 and 0.35 respectively).The reported pCR rate of 10% highlights the potential for non-operative management in selected cases. The limited strength of agreement between basic conventional post-chemoradiotherapy imaging assessment techniques and pathology suggest alternative markers of response should be considered, in the context of controlled clinical trials

Evaluation of Diagnostic Accuracy and its Standard Error using Constant Shape Weibull Mixture ROC Curve

Receiver Operating Characteristic (ROC) Curve is a widely used classification technique in Medical Diagnosis which classifies the healthy and diseased individuals on the basis of optimal cut off value of the biomarker. In this article, we have proposed Constant Shape Weibull Mixture ROC (CSWMROC) model. The properties of CSWMROC Curve are discussed and expressions for AUC, its variance and confidence interval are derived. The estimates of AUC of CSWMROC curve are obtained using Method of Moments (MOM). Numerical example is considered to support the proposed theory

Study of the Electric Quadrupole Transitions in 50-51Mn Isotopes by Using F742pn and F7cdpn Interactions

The nuclear shell-model has been used to compute excitation levels of ground band and electric quadrupole transitions for 50-51Mn isotopes in f-shell. In the present study, f742pn and f7cdpn effective interactions have been carried out in full f-shell by using Oxbash Code. The radial wave functions of the single-particle matrix elements have been calculated in terms of the harmonic oscillator (Ho) and Skyrme20 potentials. The predicted theoretical results have been compared with the available experimental data; it has been seen that the predicted results are in agreement with the experimental data. From the current results of the calculations, many predictions of angular momentum and parities of experimental states have been made, and the energy spectra predictions of the ground band and B(E2; ↓) electric quadrupole transitions in 50-51Mn isotopes of the experimental data are not known yet. In the nuclear shell-model calculations framework, energy levels have been determined for 50-51Mn isotopes; new values of electric quadrupole transitions have been predicted in the studied results. This investigation increases the theoretical knowledge of all isotopes with respect to the energy levels and reduced transition probabilities.</jats:p

Evaluation of knowledge regarding gestational diabetes mellitus and its association with glycaemic level:A Malaysian study

Aims The aim of this study was to evaluate the knowledge about GDM and its corresponding relation with glycaemic level in GDM patients. Method A cross-sectional study was conducted in antenatal clinic of Hospital Pulau Pinang, Malaysia from June 2013 to December 2013 using Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) on the sample of 175 GDM patients. Three most recent fasting plasma glucose (FPG) values (mmol/l) were taken from patients profiles and mean was calculated. Results A total of 166 patients were included in final analysis. A total mean knowledge score of 166 patients was 10.01 ± 3.63 and total mean FPG value was 5.50 ± 1.13. Knowledge had a significant negative association with FPG (r = - 0.306, P &lt; 0.01). Among different knowledge domains, highest mean score was seen for diet/food values domain and lowest for management of GDM. Educational level seems to be the most significant predictor of GDM knowledge and glycaemic control. Highest mean knowledge score and lowest mean glycaemic levels were recorded for patients aged 25-29 years, Malay ethnicity, working women and family history of DM. Conclusion Higher Knowledge about GDM is related to better glycaemic control. New educational strategies should be developed to improve the lower health literacy.</p

Improving Clinical Care in Tobacco and Smoking-Related Problems: A Report of Clinical Audit and Quality Improvement Project

AimsAround 40% of people with serious mental health problems smoke, which is significantly higher compared to the general population of the United Kingdom. The Welsh Government has set the target to reduce the overall prevalence of smoking in Wales to 16% from 19. In order to reduce the impact of smoking on the population, the first step is to identify the problem. Hence, a comprehensive history of smoking will help to identify the addiction-related problems. Hence, this combined clinical audit and quality improvement project (QIP) is aimed at the evaluation of the admission clerking around the assessment and management of smoking-related problems in an inpatient mental health unit.MethodsThis clinical audit was carried out at the local inpatient general adult mental health units in Wrexham. It was based on NICE smoking guidelines “Smoking: acute, maternity and mental health services”. Clinically relevant information without personal identification information was collected based on a proforma. The first re-audit was repeated without a specific intervention to see any change in pattern and the need for intervention. This was followed by the first intervention, i.e., the sharing of a PowerPointTM presentation discussing commonly utilised measurement tools in the assessment of smoking-related behaviours and the second re-audit.ResultsThe first round of clinical audit involves 32 admissions, the first re-audit was 19 admissions, and the second re-audit was 37 admissions. The baseline showed 71.88% of inpatient admissions were asked about their smoking history, but only less than 10% of them were assessed in detail around the types and quantity of tobacco products, features of dependence and withdrawal, the motivation of the clients to quit smoking, and any help offered to the patients. The number of inpatient admissions which was assessed for their smoking-related behaviour dropped to 36.84% during the first re-audit, and less than 16% of them were assessed in detail. The number improved slightly to 57.14% after the first intervention, although less than 40% of the inpatient admissions were assessed in detail.ConclusionThere is an inconsistent pattern of change in the percentage, and it seems that the intervention leads to minimal improvement of the assessment of smoking-related problems during admission clerking. The minimal change may be attributable to the change in posting around the intervention period. The future plan includes a more regular intervention arranged around the beginning of new postings for doctors to ensure they have adequate exposure to the assessment of smoking-related addiction problems.</jats:sec

Integrating Religion and Spirituality into Mental Health Care, Psychiatry and Psychotherapy

Integrating spirituality into mental health care, psychiatry and psychotherapy is still controversial, albeit a growing body of evidence is showing beneficial effects and a real need for such integration. In this review, past and recent research as well as evidence from the integrative concept of a Swiss clinic is summarized. Religious coping is highly prevalent among patients with psychiatric disorders. Surveys indicate that 70–80% use religious or spiritual beliefs and activities to cope with daily difficulties and frustrations. Religion may help patients to enhance emotional adjustment and to maintain hope, purpose and meaning. Patients emphasize that serving a purpose beyond one’s self can make it possible to live with what might otherwise be unbearable. Programs successfully incorporating spirituality into clinical practice are described and discussed. Studies indicate that the outcome of psychotherapy in religious patients can be enhanced by integrating religious elements into the therapy protocol and that this can be successfully done by religious and non-religious therapists alike