Objective: To study the barriers toward the utilization of primary care services for mental health problems among adolescents in a secondary school in Hulu Langat, Selangor, Malaysia. Methods: This was a cross-sectional study conducted in July 2008 at a secondary school in Hulu Langat, Selangor. The respondents were selected using randomised cluster sampling among Form Four and Form Five students. Students were given self-administered questionnaire, consisting socio-demographic data and questions on their help-seeking barrier and behaviour. Help-seeking behaviour questions assess the use of medical facility and help-seeking sources. The formal helpseeking sources include from teachers, counsellors and doctors. The informal help-seeking sources include from friends, parents and siblings. Results: A total of 175 students were included in the study. None of the students admitted of using the primary health care services for their mental health problems. Majority of the students were not aware of the services availability in the primary health care (97.1%). More than half of them thought the problems were due to their own mistakes (55.4%) and the problems were not that serious (49.1%). With regard to perception of the primary health care services, (43.2%) of the students were worried about confidentiality, half of them were concerned about other people�s perception especially from their family members (44.6%) and friends (48.6%). Minority of them (10.8%) thought that nobody can help them. Few of them thought smoking (3.4%), alcohol (3.4%) and recreational drugs (1.1%) can solve their emotional problems. Conclusion: One of the major barriers identified in the students� failure to use the health care facilities was their unawareness of the availability of the service for them in the community. Thus there is a need to promote and increase their awareness on this issue.

Introduction Obstructive sleep apnea (OSA) is associated with multiple medical and psychosocial impacts. Current evidence on individuals at risk of developing OSA in Malaysia particularly at primary care setting is scarce. This study aimed to determine the magnitude of patients at risk of developing OSA attended an suburban primary care clinic and associated factors in southern Malaysia. Methodology: This was a cross sectional study of adults≥ 18-year old using systematic random sampling. Berlin Questionnaire was used to determine the risk of developing OSA. Respondent’s socio-demographic characteristics and clinical parameters including body mass index, weight, blood pressure, neck and waist circumference were obtained. Data was analyzed using SPSS version 20.0. Results: Out of 160 participants, 65.6% were females with the median (IQR) age of 55.6 (27.75) years and 81.9% were obese. Self-reported hypertension and diabetes was 55.6% and 35.60% respectively. One-fifths (19.4%) had high risk of developing OSA. Regarding symptoms described in the Berlin questionnaire, 37.5% reported snoring and 10.6% had excessive daytime sleepiness. The risk of developing OSA is associated with gender (p= 0.008), neck circumference (p= 0.010) and diastolic blood pressure (p= 0.015). Multivariate logistic regression found the only factor significantly associated with at high risk of developing OSA is diastolic blood pressure (p= 0.031).

To date, specific questionnaire assessing knowledge on calcium supplement is unavailable. Thus, we aimed to develop and validate this questionnaire. Four areas of knowledge (calcium in general, dietary calcium, benefits and risk of calcium supplement, and practices that reduce its benefits) were identified through literature review and interviews with ten doctors. Twelve items were created in English and reviewed by two family medicine specialists, an orthopaedic surgeon, and a pharmacist. A bilingual (English-Malay) questionnaire was produced via back-to-back translation and face validity was tested on seven patients. Discriminative validation was done by comparing knowledge scores between patients, medical students and doctors. Test-retest reliability was tested with a two weeks interval. Subsequently, the questionnaire was piloted on 100 patients. The KnowCaS-12 scores of doctors were significantly higher than those of patients (p<0.001) and students (p<0.001), indicating good discriminative validity. Although the Cronbach’s alpha was 0.68, it had good test-retest reliability [Spearman’s rho correlation: 0.40, p=0.02; pre- and post-test score median (IQR): 8.00 (3.00) and 9.00 (2.00) respectively, p-value of Wilcoxon Signed Ranks test: 0.08). The pilot study showed 52.5% of the participants took calcium supplement. Their median (IQR) for KnowCaS-12 was 7.00 (6.00), which was not significantly different from those who did not take calcium supplement. In conclusion, the bilingual KnowCaS-12 questionnaire appears to have good content validity, face validity, discriminative validity and test-retest reliability, thus it can be used for future studies. Practice of consuming calcium supplement seems to be common and users’ knowledge regarding calcium supplement was only moderate. Keywords: questionnaire design, validation studies, knowledge, calcium, dietary supplements