Developing criteria for a profession to be considered as profession of allied health in Malaysia: a qualitative study from the Malaysian perspective.

BACKGROUND: The Malaysian Allied Health Profession Act (Act 774) regulates the practice of allied health practitioners in Malaysia, with two described professions viz. allied health profession (AHP) and profession of allied health (PAH). While AHPs have been clearly identified by the law, comprehensive implementation of the act requires development of specific criteria in defining any profession as PAH in the Malaysian context. Hence, the research aims to explore and identify the criteria for defining such professions for healthcare policy direction in Malaysia. METHODS: This research utilised two methods of qualitative research (document review and focus group discussions (FGDs) involving 25 participants from four stakeholders (higher education providers, employers, associations and regulatory bodies). Both deductive and inductive thematic content analysis were used to explore, develop and define emergent codes, examined along with existing knowledge on the subject matter. RESULTS: Sixteen codes emerged from the FGDs, with risk of harm, set of competency and skills, formal qualification, defined scope of practice, relevant training and professional working within the healthcare team being the six most frequent codes. The frequencies for these six codes were 62, 46, 40, 37, 36 and 18, correspondingly. The risk of harm towards patients was directly or indirectly involved with patient handling and also relates to the potential harms that may implicate the practitioners themselves in performing their responsibilities as the important criterion highlighted in the present research, followed by set of competency and skills. CONCLUSIONS: For defining the PAH in Malaysia, the emerged criteria appear interrelated and co-exist in milieu, especially for the risk of harm and set of competency and skills, with no single criterion that can define PAH fully. Hence, the integration of all the empirically identified criteria must be considered to adequately define the PAH. As such, the findings must be duly considered by policymakers in performing suitable consolidation of healthcare governance to formulate the appropriate regulations and policies for promoting the enhanced framework of allied health practitioners in Malaysia.

Quantification of Pubic Symphysis Metamorphosis Based on the Analysis of Clinical MDCT Scans in a Contemporary Malaysian Population.

Forensic age estimation methods are biased to sex and population; in general, accuracy is reduced when applied to foreign populations. This study assessed the accuracy of the Suchey-Brooks method in contemporary Malaysian individuals and aimed to formulate population-specific standards. Multi-detector computed tomography scans of 355 individuals (165 male; 190 female) of 15-83 years of age were reconstructed using 3D-volumetric rendering in RadiAnt. Pubic symphyseal phase, bias, inaccuracy, and percentage correct age classifications are examined. Transition analysis was used to develop age estimation standards. High observer agreement (κ = 0.763-0.832) and a positive relationship between age and pubic symphyseal phase (r = 0.884-0.90) were demonstrated. Mean inaccuracies were 8.62 and 8.95 years for males and females, respectively; overall correct classification was 97.8%. Transition ages between phases in males were 18.79, 23.29, 28.85, 43.64, and 61.15 years; in females, the corresponding data were 19.77, 22.53, 32.62, 41.85, and 57.39 years.

Quantification of spheno-occipital synchondrosis fusion in a contemporary Malaysian population.

Timing of fusion of the spheno-occipital synchondrosis (SOS) is correlated with age. Previous research, however, has demonstrated variation in the timing of closure among different global populations. The present study aims to quantify the timing of SOS fusion in Malaysian individuals as visualised in multi-detector computed tomography (CT) scans and to thereafter formulate age estimation models based on fusion status. Anonymised cranial CT scans of 336 males and 164 females, aged 5-25 years, were acquired from the National Institute of Forensic Medicine, Hospital Kuala Lumpur and Department of Diagnostic Imaging, Hospital Sultanah Aminah. The scans were received in DICOM format and reconstructed into three-dimensional images using OsiriX. The SOS is scored as open, fusing endocranially, fusing ectocranially or completely fused. Statistical analyses are performed using IBM SPSS Statistics version 24. Transition analysis (Nphases2) is then utilised to calculate age ranges for each stage. To assess the reliability of an observation, intra- and inter-observer agreement is quantified using Fleiss Kappa and was found to be excellent (κ=0.785-0.907 and 0.812). The mean (SD) age for complete fusion is 20.84 (2.84) years in males and 19.78 (3.35) years in females. Transition ages between Stages 0 and 1, 1 and 2, and 2 and 3 in males are 12.52, 13.98 and 15.52 years, respectively (SD 1.37); in females, the corresponding data are 10.47, 12.26 and 13.80 years (SD 1.72). Complete fusion of the SOS was observed in all individuals above the age of 18 years. SOS fusion status provides upper and lower age boundaries for forensic age estimation in the Malaysian sample.

Estimation of stature from hand and handprint measurements in Iban population in Sarawak, Malaysia and its applications in forensic investigation.

Handprints and dismembered hands are commonly found during crime scene investigations and disaster victim identifications, respectively. It has been indicated that the accuracy of handprint and hand measurements for estimating stature maybe population specific. Since Iban is the largest ethnic population in Sarawak, Malaysia and because the application of anthropometry of hand and handprint within this population as well as other populations within the Southeast Asian countries remain unreported, this present study that investigated the reliability and accuracy of these two anthropometric aspects acquires forensic significance. Upon measuring the height, 21 measurements were recorded on each hand and the corresponding handprint of 50 male and 52 female consented adult Iban subjects. Using univariate statistics as well as simple and multiple regression analyses, interpretation of the measurements examined here was attempted. Results revealed that lengths of hand and handprint are the more reliable traits for estimating stature in both the male and female Iban subjects (p < 0.05) with correlation strength ranging from 0.60 to 0.76. Comparable to the established skeletal standards for hand, the stature prediction accuracy using hand and handprint measurements investigated in this research ranged between 4.29 and 5.78 cm. Hence, this research provided the first forensic standard for estimation of stature among the Iban population in Sarawak that may prove useful for crime scene investigations and disaster victim identifications in Malaysia.