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Background: The escalating trend of obesity in Malaysia is surmounting, and the lack of evidence on the environmental influence on obesity is untenable. Obesogenic environmental factors often emerge as a result of shared environmental, demographic, or cultural effects among neighbouring regions that impact lifestyle. Employing spatial clustering can effectively elucidate the geographical distribution of obesity and pinpoint regions with potential obesogenic environments, thereby informing public health interventions and further exploration on the local environments. This study aimed to determine the spatial clustering of body mass index (BMI) among adults in Malaysia. Method: This study utilized information of respondents aged 18 to 59 years old from the National Health and Morbidity Survey (NHMS) 2014 and 2015 at Peninsular Malaysia and East Malaysia. Fast food restaurant proximity, district population density, and district median household income were determined from other sources. The analysis was conducted for total respondents and stratified by sex. Multilevel regression was used to produce the BMI estimates on a set of variables, adjusted for data clustering at enumeration blocks. Global Moran's I and Local Indicator of Spatial Association statistics were applied to assess the general clustering and location of spatial clusters of BMI, respectively using point locations of respondents and spatial weights of 8 km Euclidean radius or 5 nearest neighbours. Results: Spatial clustering of BMI independent of individual sociodemographic was significant (p < 0.001) in Peninsular and East Malaysia with Global Moran's index of 0.12 and 0.15, respectively. High-BMI clusters (hotspots) were in suburban districts, whilst the urban districts were low-BMI clusters (cold spots). Spatial clustering was greater among males with hotspots located closer to urban areas, whereas hotspots for females were in less urbanized areas. Conclusion: Obesogenic environment was identified in suburban districts, where spatial clusters differ between males and females in certain districts. Future studies and interventions on creating a healthier environment should be geographically targeted and consider gender differences. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is a significant health concern and imposes a substantial burden on society. Although leading a healthy lifestyle is an effective means of reducing the risk of T2DM, the complex interplay of diverse lifestyle factors necessitates a comprehensive assessment.This study aims to develop and investigate the association between a healthy lifestyle index (HLI) and T2DM among teachers.A total of 11412 teachers from schools in Peninsular Malaysia were recruited. The HLI score was constructed using both unweighted and regression-weighted methods. A comparison was conducted and the index with the lowest AIC was considered the best. The final model with an index and other covariates was then optimised, followed by model validations.All teachers (n = 11412) who completed the baseline survey were included in the analysis. Majority were females, Malays, married, and had at least a bachelor’s degree. Among the developed indexes comprised of waist circumference, physical activity, sleep duration, and mental health status (e.g. stress, anxiety, and depression). The B HLI index is the best proxy for teachers’ lifestyles associated with T2DM. The optimised regression showed that an increase of an HLI score reduced the odds of T2DM by 59%. The model had an adjusted R2 of 26.8% and an area under the curve of 0.837. The model was externally validated with the validation dataset by achieving an adequate C-statistic value of 0.798.A higher HLI score was associated with a reduced odd of T2DM. This finding highlights the importance of integrating multidimensional lifestyle modification rather than singular ones when developing health promotion strategies.Objective: Type 2 diabetes mellitus (T2DM) is a significant health concern and imposes a substantial burden on society. Although leading a healthy lifestyle is an effective means of reducing the risk of T2DM, the complex interplay of diverse lifestyle factors necessitates a comprehensive assessment.This study aims to develop and investigate the association between a healthy lifestyle index (HLI) and T2DM among teachers.A total of 11412 teachers from schools in Peninsular Malaysia were recruited. The HLI score was constructed using both unweighted and regression-weighted methods. A comparison was conducted and the index with the lowest AIC was considered the best. The final model with an index and other covariates was then optimised, followed by model validations.All teachers (n = 11412) who completed the baseline survey were included in the analysis. Majority were females, Malays, married, and had at least a bachelor’s degree. Among the developed indexes comprised of waist circumference, physical activity, sleep duration, and mental health status (e.g. stress, anxiety, and depression). The B HLI index is the best proxy for teachers’ lifestyles associated with T2DM. The optimised regression showed that an increase of an HLI score reduced the odds of T2DM by 59%. The model had an adjusted R2 of 26.8% and an area under the curve of 0.837. The model was externally validated with the validation dataset by achieving an adequate C-statistic value of 0.798.A higher HLI score was associated with a reduced odd of T2DM. This finding highlights the importance of integrating multidimensional lifestyle modification rather than singular ones when developing health promotion strategies.Methods: Type 2 diabetes mellitus (T2DM) is a significant health concern and imposes a substantial burden on society. Although leading a healthy lifestyle is an effective means of reducing the risk of T2DM, the complex interplay of diverse lifestyle factors necessitates a comprehensive assessment.This study aims to develop and investigate the association between a healthy lifestyle index (HLI) and T2DM among teachers.A total of 11412 teachers from schools in Peninsular Malaysia were recruited. The HLI score was constructed using both unweighted and regression-weighted methods. A comparison was conducted and the index with the lowest AIC was considered the best. The final model with an index and other covariates was then optimised, followed by model validations.All teachers (n = 11412) who completed the baseline survey were included in the analysis. Majority were females, Malays, married, and had at least a bachelor’s degree. Among the developed indexes comprised of waist circumference, physical activity, sleep duration, and mental health status (e.g. stress, anxiety, and depression). The B HLI index is the best proxy for teachers’ lifestyles associated with T2DM. The optimised regression showed that an increase of an HLI score reduced the odds of T2DM by 59%. The model had an adjusted R2 of 26.8% and an area under the curve of 0.837. The model was externally validated with the validation dataset by achieving an adequate C-statistic value of 0.798.A higher HLI score was associated with a reduced odd of T2DM. This finding highlights the importance of integrating multidimensional lifestyle modification rather than singular ones when developing health promotion strategies.Results: Type 2 diabetes mellitus (T2DM) is a significant health concern and imposes a substantial burden on society. Although leading a healthy lifestyle is an effective means of reducing the risk of T2DM, the complex interplay of diverse lifestyle factors necessitates a comprehensive assessment.This study aims to develop and investigate the association between a healthy lifestyle index (HLI) and T2DM among teachers.A total of 11412 teachers from schools in Peninsular Malaysia were recruited. The HLI score was constructed using both unweighted and regression-weighted methods. A comparison was conducted and the index with the lowest AIC was considered the best. The final model with an index and other covariates was then optimised, followed by model validations.All teachers (n = 11412) who completed the baseline survey were included in the analysis. Majority were females, Malays, married, and had at least a bachelor’s degree. Among the developed indexes comprised of waist circumference, physical activity, sleep duration, and mental health status (e.g. stress, anxiety, and depression). The B HLI index is the best proxy for teachers’ lifestyles associated with T2DM. The optimised regression showed that an increase of an HLI score reduced the odds of T2DM by 59%. The model had an adjusted R2 of 26.8% and an area under the curve of 0.837. The model was externally validated with the validation dataset by achieving an adequate C-statistic value of 0.798.A higher HLI score was associated with a reduced odd of T2DM. This finding highlights the importance of integrating multidimensional lifestyle modification rather than singular ones when developing health promotion strategies.Conclusion: Type 2 diabetes mellitus (T2DM) is a significant health concern and imposes a substantial burden on society. Although leading a healthy lifestyle is an effective means of reducing the risk of T2DM, the complex interplay of diverse lifestyle factors necessitates a comprehensive assessment.This study aims to develop and investigate the association between a healthy lifestyle index (HLI) and T2DM among teachers.A total of 11412 teachers from schools in Peninsular Malaysia were recruited. The HLI score was constructed using both unweighted and regression-weighted methods. A comparison was conducted and the index with the lowest AIC was considered the best. The final model with an index and other covariates was then optimised, followed by model validations.All teachers (n = 11412) who completed the baseline survey were included in the analysis. Majority were females, Malays, married, and had at least a bachelor’s degree. Among the developed indexes comprised of waist circumference, physical activity, sleep duration, and mental health status (e.g. stress, anxiety, and depression). The B HLI index is the best proxy for teachers’ lifestyles associated with T2DM. The optimised regression showed that an increase of an HLI score reduced the odds of T2DM by 59%. The model had an adjusted R2 of 26.8% and an area under the curve of 0.837. The model was externally validated with the validation dataset by achieving an adequate C-statistic value of 0.798.A higher HLI score was associated with a reduced odd of T2DM. This finding highlights the importance of integrating multidimensional lifestyle modification rather than singular ones when developing health promotion strategies. [ABSTRACT FROM AUTHOR]

Purpose: The multidimensional scale of perceived social support (MSPSS) was developed to measure perceived social support. It has been translated and culturally adapted among natives literate in the Malay language. However, its psychometric properties for teachers who are majority females and married have not been assessed.Methods: This was a cross-sectional study conducted among the public secondary school teachers in the central region of Peninsular Malaysia from May to July 2013. A total of 150 and 203 teachers were recruited to perform exploratory factor analysis and confirmatory factor analysis (CFA), respectively. Reliability testing was evaluated on 141 teachers via internal consistency and two-week interval test-retest.Results: The 12-item three-factor structure of MSPSS-M was revised to 8-item two-factor structure. The revised MSPSS-M demonstrated excellent fit in CFA with adequate divergent and convergent validity and good factor loadings (0.80-0.90). The revised MSPSS-M also displayed good internal consistency with Cronbach's alpha of 0.91, 0.93 and 0.92 and good test-retest reliability with intraclass correlation of 0.89, 0.88 and 0.88 in the total scale, family and friends factors, respectively.Conclusion: The revised 8-item MSPSS-M is a reliable and valid tool for assessment of perceived social support among teachers. [ABSTRACT FROM AUTHOR]

Objectives: To establish the prevalence of voice disorder using the Malay-Voice Handicap Index 10 (Malay-VHI-10) and to study the determinants, quality of life, depression, anxiety and stress associated with voice disorder among secondary school teachers in Peninsular Malaysia. Methods: This study was divided into two phases. Phase I tested the reliability of the Malay-VHI-10 while Phase II was a cross-sectional study with two-stage sampling. In Phase II, a self-administered questionnaire was used to collect socio-demographic and teaching characteristics, depression, anxiety and stress scale (Malay version of DASS-21); and health-related quality of life (Malay version of SF12-v2). Complex sample analysis was conducted using multivariate Poisson regression with robust variance. Results: In Phase I, the Spearman correlation coefficient and Cronbach alpha for total VHI-10 score was 0.72 (p < 0.001) and 0.77 respectively; showing good correlation and internal consistency. The ICCs ranged from 0.65 to 0.78 showing fair to good reliability and demonstrating the subscales to be reliable and stable. A total of 6039 teachers participated in Phase II. They were primarily Malays, females, married, had completed tertiary education and aged between 30 to 50 years. A total of 10.4% (95% CI 7.1, 14.9) of the teachers had voice disorder (VHI-10 score > 11). Compared to Malays, a greater proportion of ethnic Chinese teachers reported voice disorder while ethnic Indian teachers were less likely to report this problem. There was a higher prevalence ratio (PR) of voice disorder among single or divorced/widowed teachers. Teachers with voice disorder were more likely to report higher rates of absenteeism (PR: 1.70, 95% CI 1.33, 2.19), lower quality of life with lower SF12-v2 physical (0.98, 95% CI 0.96, 0.99) and mental (0.97, 95% CI 0.96, 0.98) component summary scales; and higher anxiety levels (1.04, 95% CI 1.02, 1.06). Conclusions: The Malay-VHI-10 is valid and reliable. Voice disorder was associated with increased absenteeism, marginally associated with reduced health-related quality of life as well as increased anxiety among teachers. [ABSTRACT FROM AUTHOR]