HEARTA biannual publication of the SarawakTALK Heart Foundation (383498-P)

Volume 20 December 2019 KDN No.: PPK434/04/2013 (032273)

Heart toHeart from pg. 6 - 7

Electricity for Life 2019 @ , , Limbang & | pg. 4 - 5 Health Awareness @ Long Virtual Run @ Limbang Lawas | pg. 7 Kevok, Telang Usan | pg. 4 - 5 Day 2019 @Lundu| pg. 8 HEARTTALK Volume 20 December 2019 From the Editor 2019 is best remembered for the Foundation’s CHAIRMAN successful outreach to the rural communities of Miri, in particular, the Kayan and Penan folks. Thanks to TYT Tun Pehin Sri Haji the invaluable support and assistance from the district office of Telang Usan in coordinating the events in Long Bedian and Long Kevok and Sarawak Breast Cancer DEPUTY CHAIRMAN Support Group, the Foundation was able to carry its YB Tan Sri Datuk Amar Dr. James Jemut heart awareness programmes there smoothly. Masing Elsewhere, the Foundation celebrated Sarawak Day on BOARD OF TRUSTEES 22 July with a similar awareness event in Lundu, in collaboration with Lundu District Office, Lundu District Council, Nurses Club and N3 Tanjong Datu YB Datin Patinggi Datuk Amar Hajah Jamilah Service Centre. Binti Haji Anu YB Dato Sri Prof Dr Sim Kui Hian World Heart Day 2019, originally scheduled for 22 September, was postponed to 13 October due to the haze. We are thankful and heartened YB Dr Annuar Rapa’ee by the enthusiasm of the participants who were not deterred by the rain YBhg Tan Sri Dato Sri Empiang Jabu on that day in finishing the Walk-A-Mile across the iconic Jambatan Darul Hana and actively taking part in the various activities. And for the first time, YBhg Dato Anne Teng World Heart Day was boosted by virtual runs in Limbang and Lawas where YBhg Dato Sri Fong Joo Chung ardent supporters of our cause organised the event at their own cost and celebrated in full fanfare. The centrespread of photographs on Pages 6 and YBhg Datuk Prof Dr Chew Peng Hong 7 says it all. YBhg Datuk Haji Abdillah Haji Abdul Rahim Electricity for Life 2019, the Foundation’s initiative in partnership with Dr Mohd Hirman Ritom the Sarawak Health Department, Sarawak Heart Centre and Medtronic Ms Pauline Kon Suk Khim International () covered the northern part of Sarawak namely Bario, Lawas, Limbang and Miri in October. Read all about it on Pages 4 and 5. Mr Eric Lim Swee Khoon It is with much pleasure that we share the accolades of Dr Melvin Chung MEDICAL ADVISOR Hsien Liang whose research on childhood obesity was funded by the Foundation. Dr Chung was awarded the First Prize in the Young Investigator’s Symposium, Malaysian Association for the Study of Obesity (MASO) 2019 Dr. Yii Kie Sing Scientific Conference on Obesity in Kuala Lumpur and the Suaidi Award for the best performing postgraduate student in UNIMAS in , both in October 2019. His research on Childhood Obesity: Effects of Physical Activity on Nutritional Status and Motor Skills Performance among children EDITORIAL aged 4-6 years old in Peri-Urban Kuching, Sarawak has been featured in a few issues of our HeartTalk. Editor Mr. Eric Lim Swee Khoon The Foundation welcomes applications from hospitals, institutions of higher Member Ms Lee Siew Hoon learning and professionals in the medical field for sponsorships to carry out research on heart-related diseases.

We will continue in our outreach to the far-flung parts of the State – Bario and ContentS Ba Kelalan are in the cards for 2020 - to increase awareness of heart health in the rural communities, apart from the urban towns. Editor’s Message 2 Health Awareness @Long Kevok 3 As we enter the New Year, we would like to take this opportunity to thank all our benefactors and volunteers for their support and contribution to our Electricity for Life 2019 4-5 cause and their trust in the Foundation as an advocate for better heart health World Heart Day 2019 6-7 in Sarawak. Sarawak Day in Lundu 8 Research wins awards 9 With best wishes for a happy and heart-healthy 2020, A Visual Guide to Heart Disease 10-11

Eric Lim Swee Khoon

Sarawak Heart Foundation • Member of World Heart Federation No.11, 1st Floor, Lot 2343, Block 10 KCLD Bormill Estate Commercial Centre, Jalan Tun Ahmad Zaidi Adruce 93150 Kuching Tel: 082-233 784 / 258 212 / 012-886 8491 Fax: 082-258 303 Email: [email protected] Facebook: SarawakHeart Website: sarawakheartfoundation.org.my Health Awareness @Long Kevok, Telang Usan, Miri 3 Aug 19

HEARTTALK December 2019 • 3 Electricity 30 Sep – 2 Oct 2019 For Life 2019 Introduction A Sarawak Heart Foundation Initiative It has been the tradition of the Sarawak Heart Foundation and in collaboration with: Sarawak Heart Centre to organize this yearly event Electricity For • Sarawak State Health Department Life (EFL) in conjunction with the World Heart Day. As we know, • Sarawak Heart Centre Sarawak is the largest state in Malaysia (land area of 124,451km2 or • Medtronic International (Malaysia) 37.5% of the total area in Malaysia) and it is impossible to travel the whole state in two to three days. This year, we plan to cover Northern Sarawak which consists of the divisions of Miri and Limbang. As the only government tertiary referral centre for cardiology services in Sarawak, we know that it is imperative for us to create awareness for the public and healthcare providers on the updates of heart diseases and introduce new services available in Sarawak Heart Centre. When Sarawak Heart Centre is advancing to more challenging and sophisticated treatments for heart diseases, we do not forget the need of the healthcare services in district hospitals as well as the rural area. This is the depth and breadth of our service. Therefore, one of the themes of Electricity for Life is always on closing the gaps: we want to strengthen the connection from everyone in the Land of the Hornbills to Sarawak Heart Centre. The tour for Electricity for Life is not just to provide continuous medical education to the public and healthcare providers but also to listen and understand the healthcare need of the rural area with our heart, with the aim of improving the accessibility of cardiology services in the districts.

Before we embark on the journey of Electricity for Life 2019, we would like to express our sincere gratitude to Dr Ong Ting Kiam, Head of Department of Cardiology, Sarawak Heart Centre, Professor Dr Alan Fong Yean Yip, senior consultant cardiologist from Sarawak Heart Centre, Dr Yong Bee Kui from Sarawak Heath Department, and Mr. Eldon Chuo from Medtronic International (Malaysia) in organizing this event.

the clinic. In recent years, Bario Community Clinic has upgraded from fully solar powered to electricity supply by SESCO. There were also upgrades on new laboratory facilities as well and new ward. We also met with Dr Nadia, medical officer in-charge of KK Bario, who has been in Bario for the past one year. We were discussing about how to improve the cardiology services in Bario. To my surprise, they have started thrombolytic service for ST-elevation myocardial infarction in Bario. They even have two ultrasound machines which were able to do simple bedside echocardiogram (even though they do not have x-ray facilities). We gave continuous medical education to the staff in the clinic on the recent updates of cardiology services. Our visit ended with a tour of Bario town. We took photographs in front of a wrecked plane in 1960s before we took off in the Twin Our first day of EFL was a half-day Otter to Miri in stormy weather. Bariovisit to Bario Highlands, 178km east of Miri city and 1000m above sea level. Our journey started with the flight in the 19-seater Twin Otter from Miri to Bario, famous for the Bario rice, Bario salt, Bario pineapple as well as the stunning countryside scenery. We received a warm welcome from Mr. Davies and the staff of Bario Community Clinic (KK Bario). Mr. Davies is the senior Assistant Medical Officer in KK Bario, who has been working there for almost 10 years. Originally from , he decided to move to Bario with his wife (who is also a staff nurse) after falling in love with Bario at first sight. We were brought around the community clinic and were briefed on the recent development of

4 • HEARTTALK December 2019 Lawas On the second day, Limbang The journey to Limbang hospital was a we travelled 250km to the north of Miri in cross-border drive in a Toyota Hilux. We crossed the Lawas-Mengkalap a 19-seater win Otter to Lawas. This place immigration to Brunei and exit to Limbang at the Pandaruan-Limbang is not new to me as I used to do visiting immigration. Thanks to the new bridge across the river, the journey specialist clinic in the hospital. Lawas took only about an hour. Five years ago, it used to be a three-hour Hospital is still the same except that it journey because the only way to cross the river was by ferry. When is surrounded by corrugated zinc wall we reached Limbang around 1pm, we were welcomed by Dr Hazwani, and behind it is where the new hospital the deputy director of Limbang Hospital and Dr Priya, senior medical is supposed to be. We were led to the officer. Limbang Hospital is the second largest district hospital in the office of Dr Syahir, the deputy director of northern region of Sarawak. It has two General Wards, a Pediatric Lawas Hospital where we were honoured Ward and a Maternity Ward. In the centre of the hospital are the new to see the drawing of the new 76-bedded 64-slice CT scan machine and the sophisticated ultrasound machine hospital (scheduled for completion in (echocardiogram capable) located in the new Radiology Unit building. 2011) hanging on the wall of his office. Apparently, Limbang Hospital has two resident radiologists, a resident Even though Lawas Hospital is structurally pediatrician, a resident obstetrics and gynaecology specialist and 22 the same, the manpower has increased medical officers now. Soon there will be one resident physician posted tremendously - 172 medical staff with to Limbang Hospital. For cardiology service, we were discussing 9 medical officers. We then headed to about doing CT coronary angiogram in Limbang, as well as training the meeting room where the nurses the physician or medical assistant in echocardiogram. Sarawak Heart were having the ‘pain free’ workshop. In Centre has always been the training ground for echocardiogram and conjunction with World Heart Day, we CT coronary angiogram in Sarawak. We then headed to the meeting continued the workshop with the CME on room where we had two hours of continuous medical education on approaches to chest pain and introduced almost all the topics in cardiology. However, we had to end the CME the electrophysiology services available early due to heavy rain. We were all drowned in the noise of the heavy in Sarawak Heart Centre. As time was downpour bombarding the roof. Fortunately, the last flight to Miri was running out, we had to leave the place not cancelled and we took off in the ATR72 to Miri. and head southward to Limbang Hospital.

Miri Hospital is the main secondary referral hospital in the northern region of Sarawak. serves as a medical hub for a population of more than 1.5 million people. MiriBefore the CME session on cardiology updates, we met with Dr Jack Wong, the director of Miri Hospital. We had a great discussion about cardiology services in Miri Hospital, especially on the usage of biomarkers, for example, high sensitive troponin test. We then met up with senior physician Dr Desmond and the medical department in the Clinical Research Centre meeting room. Continuous medical education was touched on the electrophysiology services, left atrial appendage occluder devices for stroke prevention as well as management of patients with pacemaker devices. The meeting ended at 12pm before we took our flight back to Kuching.

For this three-day initiative, we have strengthened the relationship among the district hospitals and Sarawak Heart Centre. We listened to each other and ideas were exchanged on how to improve cardiology services in Sarawak. Among more realistic ideas to be realized including the provision of echocardiogram training to the physicians and paramedics in district hospitals and improving on the referral for arrhythmia-related heart diseases. We are also grateful to Medtronic International (Malaysia) for providing free medical magnets to all the district hospitals with operation theatres to help in managing patients with pacemakers going for surgery.

In summary, Electricity for Life 2019 was a fruitful journey. We hope to meet everyone again on World Heart Day 2020.

Reported by Dr Koh Keng Tat, Clinical Cardiologist, Sarawak Heart Centre on behalf of the travel team for Electricity for Life Initiative

HEARTTALK December 2019 • 5 A Heartwarming ‘Walk-A-Mile’ across Jambatan Darul Hana

World Heart Day 2019 was celebrated at Kuching Waterfront on 13 October with about 3,000 participants and Walk-A-Mile across the iconic Jambatan Darul Hana.

The early morning rain did not deter the participants from finishing the Walk-A-Mile across Jambatan Darul Hana and taking part in the various activities.

Response to the Walk-A-Mile was overwhelming including a 337-strong contingent who participated in a Virtual Run in Limbang and Lawas to celebrate World Heart Day for the first time.

Three iconic landmarks, Jambatan Darul Hana, Masjid India Kuching (the Floating Mosque) and Fort Margherita had lit up from 21 September to 29 September, the official date for World Heart Day throughout the world. They were among 80 illuminations, including the Kuala Lumpur Tower, around the world supporting the Light Up Red initiated by World Heart Foundation to raise awareness of the world’s number one killer – cardiovascular disease.

The theme for this year’s World Heart Day is “My Heart, Your Heart”. It is about celebrating and connecting like-minded people. Everyone is to make a promise – a promise as an individual to get more active, say no to smoking and eat more healthily.

World Heart Day is the world’s biggest platform for raising awareness about cardiovascular disease, including heart disease and stroke. It is a global event that sees individuals, families, communities, organisations and governments around the world take part in activities to take charge of their heart health and that of others. It has the power to unite people from all countries and backgrounds in the fight against cardiovascular disease and inspires and drives international action to encourage heart- healthy living across the world.

6 • HEARTTALK December 2019 A Heartwarming ‘Walk-A-Mile’ across Jambatan Darul Hana13 October 2019

ThankVIRTUAL you RUN IN LIMBANG AND LAWAS

MASJID INDIA KUCHING JOINS LIGHT UP RED

World Heart Day 2019 saw another Sarawak Heart Foundation thanks landmark in Kuching light up as a Department of Islamic Religious show of support for healthy hearts. Affairs Sarawak, Kuching Waterfront Masjid India Kuching or better known and The Commission of the City of as the Floating Mosque joined Kuching North for their support in the Jambatan Darul Hana and Fort light up of their respective properties. Margherita in lighting up for a week from 21- 29 September 2019.

HEARTTALK December 2019 • 7 Health Awareness on Sarawak Day 2019, Lundu

Health Awareness @Kuching Sentral 14 July 2019

8 • HEARTTALK December 2019 wins

FOUNDATION-FUNDED RESEARCH ON CHILDHOOD OBESITY winsACCOLADES

Our heartiest congratulations go to Dr Melvin Chung Hsien Liang, whose research on childhood obesity was funded by the Foundation. Dr Melvin was awarded the First Prize in the Young Investigator’s Symposium, Malaysian Association for the Study of Obesity (MASO) 2019 Scientific Conference on Obesity in Kuala Lumpur on 16 October 2019. Later that month, he received the Suaidi Award for the best performing postgraduate student throughout the MPH and DrPH programme in UNIMAS in Kuching.

His research on Childhood Obesity: Effects of Physical Activity on Nutritional Status and Motor Skills Performance among children aged 4-6 years old in Peri-Urban Kuching, Sarawak has been featured in a few issues of HeartTalk and it was also published in a UK-based international journal Early Child Development and Care. PArT of F InDInGS EffEcts of Physical a FIRST PART of and Motor s FINAL REPORT ctivity on n agEd 4-6 y kills PE utritional Ears old in PrforE M obesity : obesity : UNDERSTANDING OUR CHILDREN’S PHYSICAL ACTIVITY ancE status Childhood Childhood ri-u aMong childrE FIRST PART of Dr. Melvin Chung Hsien Liang RESEARCH Intervention through MD(VSMU), Physical MPH(UNIMAS) Activity STATUS AND ITS RELATIONSHIP TO MOTOR SKILLSFINAL REPORT rban Dr. Melvin Chung Hsien Liang,BSc(Hons), MSc(PH), PgDip(Ed), PhD kuching, n Asso. Prof. Dr. Cheah Whye Lian, MComMed(Epid & Biostats)(USM) PROGRESS Dr. Helmy Hazmi, MD(UNIMAS), Intervention through MD(VSMU), Physical MPH(UNIMAS) Activity UNDERSTANDING sarawak Dr. Melvin Chung Hsien Liang, STATUS OUR CHILDR recently in view of the rising trend of childhood obesity. Dr. Melvin Chung Hsien Liang,BSc(Hons), MSc(PH), PgDip(Ed), PhD AND ITS EN’S P Introduction Asso. Prof. Dr. Cheah Whye Lian, MD(VSMU), MPH(UNIMAS) RELATIONSHI HYSICAL ACTIVITY Dr. Melvin Chung Hsien Liang, P According to Collins and Peebles (2011), in the past Asso. Prof. Dr. Cheah Whye Lian, MComMed(Epid & Biostats)(USM) Asso. Prof. Dr. Cheah Whye Lian, TO MOTOR Childhood obesity has been growing at an alarming rate BSc(Hons), MSc(PH), PgDip(Ed), PhD MD(VSMU), SKILLS EFFECTIVENESS OF Dr. Helmy Hazmi, MD(UNIMAS), Dr. Helmy Hazmi, MD(UNIMAS), MPH(UNIMAS) BSc(Hons), MSc(PH), PgDip(Ed), PhD Dr. Helmy Hazmi, MD(UNIMAS), and is the most common nutritional problem among 1Department of Community Medicine and Public Health,Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, MComMed(Epid & Biostats)(USM) 30 years, the percentage of obese children ages 2 to children (WHO, 2000). Several reports already showed 1Department of Community Medicine and Public Health,Faculty of Medicine MComMed(Epid and Health & Biostats)(USM)Sciences, Universiti Malaysia Sarawak, Correspondence to94300 be addressed Kota Samarahan, to Melvin Sarawak, Chung Hsien Malaysia. Liang Tel [email protected]; : +6082 581000, Fax : +6082 [email protected] 665152 ACTIVITY high and increasing rates of overweight and obesity PHYSICAL among preschool children living in developing countries 5 years old had been doubled up. This can be due 94300 Kota Samarahan, Sarawak, Malaysia. Tel : +6082 581000, Fax : +6082 665152 RESEARCH (de Onis & Blössner, 2000). The most common causes Correspondence to be addressed to Melvin Chung Hsien Liang [email protected]; [email protected] PROGRESS Ch Ildhood ob They were about equal numbers, 83 (54.2%) to 70 Inter eSIty : vention thr to two main factor: “eating too much and moving too eFFe ough Ph are lack of physical activity, unhealthy eating patterns, C Dr. M ysical Act tIV elvin Ch e ung Hsien ivi N Lian ty e As g, MD(VSMU) SS so. Prof , MPH( o . Dr. Cheah Wh UNIMAS) F ye Lian BS Dr. He , c(Hons), MSc(PH) (45.8%), of males and females respondents. Most of lmy Hazmi, MD , PgDip(Ed), PhD (UNIMAS), MCo Health talk on Childhood Obesity in Dewan Suarah Bau mMed(Epid & Bio P s hySICA tats)(USM) l AC Introd high level of inactivity or sedentary behaviour, genetic tIVIty uction Ch ildhood obesity INTERVENTION FOR IN has been growin te an g at RV d is the most an alarming rate the male respondents had a mean of height of 105.3 eN common n tIo childre utritional pro N F n (WHO blem a mon oR , 2000). Several g high an reports already s d increasing rat howed RURA am es o f o verweig l ong preschool ch ht and obesity factors, or a combination of these factors. PR ildren living in de e-SC (de Onis veloping little” (Everitt, 2016). Besides, with the advanced of hoole & Blössner, 2000 countries ). The most RS are lack of phys common caus cm ±6.85 while the female respondents with the mean ical activity, u es high nhealthy eatin IN KUC level of in activity or sede g patterns, h fac ntary be ha Introduction ING, SARAWAK tors, or a comb viour, genetic ination of these factors. Health talk o Melvin Chung Traditionally, it is n Childhood Obesi H. known that e arl ty in Dewan Suarah Bau L., Cheah Whye Lian, Helmy Hazmi has th e hig y c hildhood p erio of height of 104.4cm ±6.50. The overall weight for hest leve d ch ls of physical RESEARCH ildren are natu activity. Y oung -SCHOOLERS rally p hysically a known as “su ctive or us percharged d ually has th ynamos”. Societ e pe rception t h y usually Traditionally, it is known that early childhood period h at children at t PRE abitually “a ctive his pe riod a re 1.0 enou gh” Executive Summary healthy. H and t herefore, these respondents was 19.1kg ±6.28 with male and owever, quite technology and social media, it is worrying that the parents, educat healthcare pro PROGRESS ional pro fessiona viders, and They were about equal numbers, 83 (54.2%) to 70 ls could ha ve o their level of phys verestimated ical activity. Bes RURAL of technol ides, with the ad Childhood obesity has been growing at an alarmi ogy and social vance has the highest levels of physical activity. Young “dig media, it is worryin ital childhoo g that d” begins earl the behaviou y, and levels of s female respondents respectively 19.5kg ±6.37 and Ch r, pa eden I rticularly, tary ldhood sc and is th reen time or o e mo ng r used exceeded electronic med Pre-schoolers queui be ate rec ia SI st commo ommend ng up f ty : ed leve or heal n nutri Acco ls. th screeni tional problem among rding to Nationa ng children l Associat (MVPA Physical Educ ion fo r Sport ) daily, 60 minu (WHO, 2000). ation (NASPE and tes of which is children are naturally physically active or usually recom , 2006) professiona minutes unstruct structured and 60 m ur Intervention through Physical Activity Several reports al end that youn Heartl groups Talk V ed or in free play. g ch i Ho hi 120 minu ldren sh ould p art attention that the wever, it came to 18.6kg ±6.19. With that, it gave them an overall Body Childhood obesity has been growing at an alarming rate gh and ready showed tes of icipate olu current

increasin moderate-to-vig in act me t15rends in- thJunee leve orous p hysica ivity of children a ls of p2017hysical g r ates o The incl l activity ppeared to be h “digital childhood” started early, and levels of physical f overwe usion criteria for direc eaded Dr. Melv among presc ight and obesity thi tion. in the wrong in Chung Hsien Liang, MD(VSMU) (45.8%), of males and females respondents. Most ofhoo s study are k , MPH(UNIMAS) l children living in devel haveThe accimportancee indergartens which known as “supercharged dynamos”. Society usually Asso. Prof. Dr. Cheah Whye Lian, (de On oping co ss to anof Pohysicautdoorl A pcti BSc(Hons), MSc(PH), PgDip(E is & Blössner, 2000). untries lavityy ar ea and equipm Mass Index (BMI) of 17.0 ±4.05. From this study, e d), PhD supported the curricu Physic FF al ac e The most common cau tivity is v ita ent that C Dr. H l fo r a ch t elmy Hazmi are lac ild’s de IV l lays vel e , MD(U k um; the foun opment N NIMAS) MComMed of pre dation and e , (Epid physical acti s school chifor a SS & Biostats es health o )(USM) of age; and children attendancecomprise ats th ldreny and active F vity all mo 3- life. It , unhealthy eating patterns, des of movement c 5 years has the perception that children at this period are high activity resultin aused by musc level of inactivity or sedentary behaviour, gene g in le IN KUCHING, SARAWAK increased energ & Tybo y expen about 52.9% of the respondents had normal BMI, required at least three d r, 2005) e diture (M . The healtchildcareh be ust and is the most common nutritional problem among extend w nefits of physica centre factors, or ell beyo l activit a nd physical h y Introduction a combi t ysimp ac pt oner ealth, having a ic po nation o com the week.dom sitive f the orbi ains o f motorChild sk inactivity or sedentary behaviour particularly screen se factors d or disease that couldwell-be in interg, cog ills, prensycholo g with P . nitive developm ical hy ent, s SICA and emotiona ocial compet habitually “active enough” and therefore, quite l m ence the male respondents had a mean of height of 105.3 aturity. L l of ph fereack wiof p AC in hysica ysical activity and th c 19.6% underweight and 27.5% overweight. Besides, rea th l practice tIVI se the risk for man ac tivity ca n ty Childhood obesity has been growing at an alarmi Trad y health issu itional cardiovas es such as ob os cular esit ly, it is known that e who di saeases, bo ne h y, any other clinical tri respiratory difficu re pa reticipatinalth pro blems, ng rate early chil lties. T he p agnd i and is the mo the highes dhood peri al young hysical ac tivity l n st t od o r o ther c hhildren has re evel o f common nutritional problem among levels of physi has nat ealth-orientedceived in creasin project healthy. However, parents, healthcare providers, and are excluded from the study. Thereionally becau werese o a total ofg at 158tention f cal activity. Young children the rapid rise in ch the results reported that the gross MS mean score was children (WHO, 2000). Several are naturally physica ildhood obesity. IN According to Fleg te reports already lly active o children (82 boys an al et al. (2002) children (WHO, 2000). Several reports already showed sh , in th RV ow e p e ed r us percentage o ast 30 years, N “supercharged dynamos”. Society usually h f obese ch the t ually k d 76 girls) from 22 centres.ildr Informed I high and increasin en ag o es 2 N F nown as doubled. T to 5 ye o g rates of o his can be ars old had R ver consen due t o t weight and obesit t and too muc wo main factors: time or electronic media used exceeded recommended educational professionals could have overestimated y enrolment h and mo ving “eating perception too l ittle” (So 104.4 ±16.75. Majority of the respondents had gross Melvin Chung H.L., Cheah Whye Lian, Helmy Hazmi 2006) rt among preschool children living in developing countries f e that chi ave the orms will. Ther efobere, p hysobtained from& Daesch theel, cm ±6.85 while the female respondents with the meanldren at this period are habitually parPre-schoo s ical activities in e entsl erors fr etting arly o mg Tabuarika KEMAS s a re critically im childhood “ac dian, Bau t portant in hel (de Onis & Blössner, 2000). The tive e s. Verbal hassente increased h ealwill be alsopin gob t o re duce nough” and therefore, quite health th risks associa mos from each ch overweight c ted with obese RURA t common cau 4 • HEARTTALK hildren. and ses June 2017 ild by asking the child taine their level of physical activity. Besides, with the advance l PRe are lack of ph parents, hea y. Howeve d MS score more than 90. For their PA level using step -SChoole ysical activity, unhealthy lthcare provid r, like to if he or she RS eating patterns, professionals ers, and educational participate in a “exer would high and increasing rates of overweight and obesity high level of inactivity or sedentary behaviour, genetic could have overestimated theirHeart level Talkrespo Volume 17cise-t -ime June c 2018 nded in lass”. Child Pre-schoolers queuing up for health screening factors, or a combina of physical activity. a positive manner ren of technology and social media, it is worrying that the tion of these factors. Besides, wi or saying “yes” indicating by nodding thei counts, it is found that the average step counts are levels. Health Introductiontechnology and social media, i th the adva their r head IN KUChING, SARAWAK talk on Childhood Obesity in Dewan Suarah Bau of height of 104.4cm ±6.50. The overall weight for nced of with the c assent to the researcher, “digital t is worrying that the lassroom teachers Traditionally, it is known that early childhood period childhood” begins ear to c as witne ss. “digital childhood” begins early, and levels of sedentary Traditionally,behaviour parti it is ly,known and leve that earlyarry outchildhood this study period Permissi hason 10110.7 ±1439.65. More than half of the respondents has the highest levels of physical activity. Yo cularly scree ls of sedentary was o btained from the Medical n ti me or and Eth ics Rese among preschool children living in developing countries (MVPA) daily, 60 minutes of which is structured andMelvin 60 Chung H.L., Cheah Whye Lian, Helmy Hazmi children are naturally physically active or ung used exceeded recommended levels. electronic media arch Com mittee of Sarawak Univ ersiti Malaysia behaviour, particularly, screen time or electronic media us ually the highest levels of physical activity. and Ministry Young of Health children had more than 7500 steps count, only 3.3% of the known as “supercharged dynamos”. Society usually also obta ine Malaysia. Approval was According to d from Sarawa k Co minutes unstructured or in free play. However, it came to has t he perc eption that children at this period are these respondents was 19.1kg ±6.28 with male andN ational Asso Department (Jabatan Kemajuan Masyarakatmmunity D eve Physical Education (NASPE, 2006),ciati onp fo r Sport and lopment respondents had step count of less than 7500. Executive Summary used exceeded recommended levels. habitually “act ive e nough” and therefore, quite are naturally physically active orSara usuallywak known as recommend that youn rofessional grou ). Negeri 1.0 healthy. However, parents, h g children shou ps (de Onis & Blössner, 2000). The most common causes attention that the current trends in the levels of physical ealthcare prov iders, an d 120 m inutes of moderate-to-vigorous physicalld participate activity in According to National Association for Sport and educational pr “supercharged dynamos”. SocietyThe usually has the Heart Talk Volume 15 - June 20171.0 ofessionals cou ld have overestimated (MVPA intervention programme was developed b Executive Summary ) daily, 60 min of Heart Talk Volume 18 - December 2018 their level of physical activity. Besides, with the a which is str researcher ta y activity of children appeared to be headed in the wrong dvance minutes unstructured or uctured and 60 rgeted mainly the the T a b el 1 : of technology and social media, it is worrying that the female respondents respectively 19.5kg ±6.37 and in free play. However, it came themselves. I preschool children Physical Education (NASPE, 2006) professional groups perception that children at this periodn are habitually “active The recent increase trend in childhood obesity to ou r a ttention that the the intervention group, all the N u oit r n a pl ro fil ,e M S s c “digital childhood” begins early, and levels of sedentary current trends in th received the same curriculum and training instructions. c hildren direction. physical activity of children appear to be headede levels in the of respondents (N=153). are lack of physical activity, unhealthy eating patterns, Childhood obesity has been growing at an alarming rate behaviour, particularly, screen time or electronic media Pre-schoole The k indergarten recommend that young children should participate in rs queuing up for health screening enough”wrong direction. and therefore, quite healthy. However,teachers we parents, o re s a n d P A el v e ol f used exceeded recomm interventi re tr ained prior to the ended levels. on. The children i n the contr According to National Associati (MVPA) daily, 60 minutes their usual routine with one physical activityol group lesson continue per among younger children has been a major public and is the most common nutritional problem among on f or Sport a of which is structured and 60 PhysicalIn order to address the research problem, activity a quasi- (PA) is d an important component for Health talk on Childhood Obesity in Dewan Suarah Bau 120 minutes of moderate-to-vigorous physical activity nd healthcare providers and educationalwee professionals Physical Education minutes unstructured or in 18.6kg ±6.19. With that, it gave them an overall Body k lasti ng 30 mi (NASPE, 2006) profe free play. How experimental study of motor skills perf nutes. Kinde Childhood obesity has been growing at an alarming rate ssional groups ever, it came to parent rgarten recommend that young children should participateHeart in Talkattention Volume that the current 15 - June 2017 s i n the c teachers and trends in the levels of phys physical act ivity among rural pr ormance ontrol g roup were informed about the high level of inactivity or sedentary behaviour, genetic children (WHO, 2000). Several reports already showed 120 minutes activity of c ical could have overestimated theirand study level desig of physical activity. Characteristic of moderate-t o-vigorou hildren appeared to be headed in the wrong carried out early 201 eschool children were n, the testing a s physical a ctivity 7. The not know any further detaind the intervention arm but did The inclusion criteria for this study are kindergartens which direction. were all sampling frame for t The inclusion criteria for this study are kindergartens which a child’s t growthhi development and it is the starting point he 22 government kindergartens in Bau sDistrict. study ls reg high and increasing rates of overweight and obesity Besides, with the advancementmodules. of technology aandrding the intesocialrve n (%) Overall Mass Index (BMI) of 17.0 ±4.05. From this study, ntion health concern, particularly in the rural areas. As early and is the most common nutritional problem among Physical activity is vital for a child’s developmentamong and preschool children living in developing countries haveThe accessimportance to an of Physicaloutdoor Activity play area and equipment that media,2.0 itResearch is worrying Progress that the “digital childhood” begins Respondent Mean (SD) factors, or a combination of these factors. The importance of Physical Activity Phase Progress Physical activity is vital for a child’s development and Remark I (a) s have access to an outdoor play area and equipment that supported the curriculum; preschoollays the found children 3-5 years vProposal lays the foundation for a healthy and active life. It ation for a healthy and for early an and active levels ofPermission sedentary to lifestyle. carry o behaviour particularly It incorporated screen different types of (de Onis & Blössner, 2000). The most common causes activ u e life. It writing and t this study was o Male childhood represents an important phase in cultivating comprises all mod Universiti btained fro es of movement ca used by muscle approval Malaysia Sarawa m the Medical and Ethics about 52.9% of the respondents had normal BMI, Develo k on 11/1/2017. Ap Researc of age; and children attendanceactivity resulting at the in inc childcare centre pment (Jabata proval was a h Committee of children (WHO, 2000). Several reports already showed comprises all modes of movement caused by aremuscle lack of physical activity, unhealthy eating patterns, reased energy expenditure (M time or electronicapplication media usedn Kemajuan Maexceededl sorecommended obtained Depa 83(54.2) ust syarakat rtm & Tybor, 2005). The health benefits from Ministry of Rural and Regional DevelopmentNeg oneri Sara ent of Commu Female of physical activity wak) on 24/1/2017, followed by approvalnity extend well beyond physical health, having a positive Approval from NMRR was obtained on 17/3/2017. 6/2/2017. required at least three days per week. Children with levels.I (b) vStage I supported the curriculum; preschoolactivity resulting in increasedchildren energy expenditure 3-5 highyears (Must level of inactivity or sedentary behaviour, genetic impact on the domains of motor skills Objective Age (years) 70 (45.8) movements s and which involved muscle methodolo , psychological Recruitment kindergartens in B gy of the research were explained to the office healthy lifestyle, promoting physical activity at a well-being, cognitive deve comorbid or disease that could interfere lopment, with soci practice au District were & Tybor, 2005). The health benefits of physical activity al competence 19.6% underweight and 27.5% overweight. Besides, Only 15 kindergartens that fu assessed for eligibi rs and teachers. All the factors, or a combination of these factors. and e motional mat lity to participate 4 high and increasing rates of overweight and obesity urity. Lack o f p hysical ac lfilled the criteria were selected after in the interven Traditionally, it is known that early childhood period incre tivity c an 4 • H tion study. ase the risk for many heal EARTTALK June 2018 consulting the admini of physical activity and those who are participatingth issues such as obe insity, strator extend well beyond physical health, having a positive cardiovascu Several researchers have suggested that this can be of 75 (49.0) of age; and children attendance at the childcare centre lar disea ses, bone h ealth problems, and 5 respiratory di activities that required energy effort fficulties. The ph ysical activity level of 4.5 (0.50) younger age not only give long term health benefit but any other clinical trial or otheryo u health-orientedng child project related to the children’s MS performance (Okely et al., impact on the domains of motor skills, psychological ren has received increasing attention Heart 78 (51.0) Traditionally, it is known that early childhood period has Talk the results reported that the gross MS mean score Issue17.indd 4 was among preschool children living in developing countries nationally because of the rapid rise in childh Height (cm) has the highest levels of physical activity. Young well-being, cognitive development, social competence are excluded from the study. There were a total ofood obe158sity. 2001; Wrotniak et al., 2006; Raudsepp and Päll, 2006). the highest levels of physical activity. Young children According to Flegal et al. (2002 ), in the past 30 y 11/7/2018 3:08:37 required at least three days per week. Children with ears, the (WHO, 2018). The health benefitsPM < 100 of PA percentage of obese children children (82 boys and 76 girls) from 22 centres.ages 2 to 5 years Informed old had Graf et al.(2004) had reported that children with higher also help in developing good motor skills. Hence, a and emotional maturity. Lack of physical activityare naturally can physically active or usually known as doubled. This can be du e to two main factors: “eating 104.4 ±16.75. Majority of the respondents had gross 100 – 119 31 (20.3) children are naturally physically active or usually (de Onis & Blössner, 2000). The most common causes too m uch and moving too little” (Sorte & Da levels of MS performance tend to be more physically consent and enrolment forms will be obtained fromes chtheel, increase the risk for many health issues such“supercharged as obesity, dynamos”. Society usually have the 2006). Therefore, ph ysical activities in ea rly c setting hildhood 116 (75.8) 104.9 (6.68) s are critic ally importan t in >=120 comorbid or disease that could interfere with practice parentsPre-schooler ors from guardians. Tabika K Verbal assent will be also helping obtained to re duce active than children with less well-developed MS. EM not only reflected in physical health, it AS, Bau the incre ased h cardiovascular diseases, bone health problems,perception and that children at this period are habitually ealth risks associated wit h obese overweight chil and 4 (2.6) known as “supercharged dynamos”. Society usually from each child by asking the child dren.if he or she would MS score more than 90. For their PA level using step Weight (kg) are lack of physical activity, unhealthy eating patterns, respiratory difficulties. The physical activity“active level enough” of and therefore, quite healthy. However, 4 • HEARTTALK June 2017 of physical activity and thoseyoung who children are has received participating increasing attentionparents, in healthcare providers, and educational like to participate in a “exercise-time class”. Children alsoA cross-sectionalpositively study whichinfluenced involved 153 children frommotor < 16skills school-based intervention programme government kindergartens in Bau District was carried has the perception that children at this period are nationally because of the rapid rise in childhoodprofessionals obesity. could have overestimated their Heart level Talkresponded Volume in a positive manner 17 by - nodding June their 2018head counts, it is found that the average step counts are 16 – 30 54 (35.3) high level of inactivity or sedentary behaviour, genetic out early 2017. The Test of Gross Motor Development of physical activity. Besides, with the advanced of or saying “yes” indicating their assent to the researcher, >30 79 (51.6) 19.1 (6.28) any other clinical trial or other health-oriented project of a(TGMD) person, version 2 (Ulrich, psychological 2000) was used to assess well being, has been adopted and adapted habitually “active enough” and therefore, quite According to Flegal et al. (2002), in the pasttechnology 30 years, the and social media, it is worrying that the with the classroom teachers as witness. Permission 10110.7 ±1439.65. More than half of the respondents BMI – age 14 (9.2) factors, or a combination of these factors. Introduction six locomotor and six object control standard scores percentage of obese children ages 2 to 5 years“digital old childhood” had begins early, and levels of sedentary to carry out this study was obtained from the Medical are excluded from the study. There were a total of 158 cognitiveas well as determine development, a gross motor quotient (GMQ). PAemotional Underweight among the pre-schoolers in rural of doubled. This can be due to two main factors:behaviour “eating particularly screen time or electronic media and Ethics Research Committee of Universiti Malaysia healthy. However, parents, healthcare providers, and Traditionally, it is known that early childhood period has had more than 7500 steps count, only 3.3% of levels the were assessed using a Yamax Digi-Walker CW-70 Normal 30 (19.6) too much and moving too little” (Sorte & Daeschel, Sarawak and Ministry of Health Malaysia. Approval was used exceeded recommended levels. (Tokyo, Japan) pedometer during all waking hours of six Overweight / Obese 81 (52.9) 17.0 (4.05) children (82 boys and 76 girls)2006). from Therefore, 22 physical centres. activities in early Informed childhood also obtained from Sarawak Community Development and social competence (Zeng et al., Kuching to determine the PA and FMS educational professionals could have overestimated the highest levels of physical activity. Young children respondents had step count of less than 7500.consecutive days, including two weekend days, and only Gross MS Score 42 (27.5) Traditionally, it is known that early childhood period has settings are critically important in helpingAccording to reduce to National Association for Sport and Department (Jabatan Kemajuan Masyarakat Negeri to remove the device during water-based activities and < 90 consent and enrolment formsthe will increased be health obtained risks associated with fromPhysical obese andEducation the (NASPE, 2006), professional groups Sarawak). 2017). Besides, fundamental motor level as baseline and its outcome post their level of physical activity. Besides, with the advance are naturally physically active or usually known as during sleeping. This study objective is to determine PA 90 – 110 40 (26.1) the highest levels of physical activity. Young children overweight children. recommend that young children should participate in 104.4 Pre-schoolers from Tabika KEMAS, Bau and MS among the preschool children in rural Sarawak. >111 56 (36.6) Pre-schoolers queuing up for health screening parents or guardians. Verbal assent will be also120 obtained minutes of moderate-to-vigorous physical activity The intervention programme was developed by the skills (FMS) also play a vital role in (16.75) intervention. The aim of this study is to of technology and social media, it is worrying that the “supercharged dynamos”. Societyresearcher targeted usually mainly the preschool has children the Table 1 : Nutritional profile, MS scores and PA level of 57 (37.3) are naturally physically active or usually known as (MVPA) daily, 60 min of which is structured and 60 A total of 153 respondents participated in this study with Physical Activity Level themselves. In the intervention group, all the children (Step counts) “digital childhood” begins early, and levels of sedentary from4 • HEART eachTALK June 2017child by asking the child if he or sheminutes would unstructured or in free play. However, it came respondents (N=153). childhoodthe mean age development.of 4.5 years ±0.50 as depicted in Wick Table 1. et determine FMS and PA outcome from a “supercharged dynamos”. Society usually have the perceptionto our attention that the current children trends in the at levels this of periodreceived the sameare curriculum habitually and training instructions.“active < 7500 The kindergarten teachers were trained prior to the 7500 – 9999 5 (3.3) (MVPA) daily, 60 minutes of which is structured and 60 physical activity of children appear to be headed in the al.(2017),4 • HEARTTALK reported December 2018 that motor skills 10110.7 school based intervention programme behaviour, particularly, screen time or electronic media like to participate in a “exercise-time class”. Children intervention. The children in the control group continued >= 10000 70 (45.8) perception that children at this period are habitually enough”wrong direction. and therefore, quite healthy. However, parents, (1439.65) minutes unstructured or in free play. However, it came to their usual routine with one physical activity lesson per 78(51.0) among rural preschool children in used exceeded recommended levels. responded in a positive manner by nodding theirIn order head to address the research problem, a quasi- week lasting 30 minutes. Kindergarten teachers and activities are able to stimulate the healthcare providers and educational professionals HeartTalk attention that the current trends in the levels of physical “active enough” and therefore, quite healthy. However, experimental study of motor skills performance and parents in the control group were informed about the Characteristic Issue18.indd 4 According to National Association for Sport and study design, the testing and the intervention arm but did neuromuscular system and allows Kuching. The specific objectives are to or saying “yes” indicating their assent to thecould researcher,physical have activity amongoverestimated rural preschool children were their level of physical activity. n (%) Overall activity of children appeared to be headed in the wrong parents, healthcare providers, and educational carried out early 2017. The sampling frame for this study not know any further details regarding the intervention Physical Education (NASPE, 2006) professional groups with the classroom teachers as witness. Permission were all the 22 government kindergartens in Bau District. modules. Meanthe child (SD) to build a strong foundation determine the socio-demographic and Besides, with the advancement of technology and social Respondent 18/1/2019 3:40: recommend that young children should participate in direction. professionals could have overestimated their level 41 PM to carry out this study was obtained frommedia, the 2.0 Medical itResearch is worrying Progress that the “digital childhood” begins and more competent in PA so that nutritional characteristic of the rural 120 minutes of moderate-to-vigorous physical activity of physical activity. Besides, with the advanced of Phase Progress Remarks Male and Ethics Research Committee of Universiti I Malaysia(a) vProposal they can adapt easily to the new preschool children and their PA and early and levels ofPermission sedentary to carry out this study behaviour was obtained from the particularly Medical and Ethics Research screen Committee of 83(54.2) technology and social media, it is worrying that the writing and Universiti Malaysia Sarawak on 11/1/2017. Approval was also obtained Department of Community Female Sarawak and Ministry of Health Malaysia. Approvalapproval was Development (Jabatan Kemajuan Masyarakat Negeri Sarawak) on 24/1/2017, followed by approval situation. FMS also contributes FMS level. “digital childhood” begins early, and levels of sedentary time or electronicapplication from Ministrymedia of Rural andused Regional Developmentexceeded on 6/2/2017. recommended 70 (45.8) also obtained from Sarawak Community Development Approval from NMRR was obtained on 17/3/2017. Age (years) to cognitive development too, for Physical activity is vital for a child’s development and behaviour particularly screen time or electronic media levels.I (b) vStage I Objectives and methodology of the research were explained to the officers and teachers. All the The importance of Physical Activity Department (Jabatan Kemajuan Masyarakat NegeriRecruitment kindergartens in Bau District were assessed for eligibility to participate in the intervention study. 4 example, when an infant started to crawl, they were Only 15 kindergartens that fulfilled the criteria were selected after 75 (49.0) This study was a cross- lays the foundation for a healthy and active life. It used exceeded recommended levels. consulting the administrator of 5 4.5 (0.50) Sarawak). 4 • HEARTTALK June 2018 actually practicing a physical skills which allows them to sectional study carried out in 9 comprises all modes of movement caused by muscle Several researchers have suggested that this can be 78 (51.0) explore their surrounding environment, and when they government kindergartens, involving activity resulting in increased energy expenditure (Must related to the children’s MS performance (Okely et al., Height (cm) According to National Association for Sport and HeartTalk Issue17.indd 4 The intervention programme was developed by the started to walk, this will usually involved other movement district because of153 its children. homogenous It was socio-demography carried out in Bau & Tybor, 2005). The health benefits of physical activity Physical Education (NASPE, 2006), professional groups 2001; Wrotniak et al., 2006; Raudsepp and Päll, 2006).11/7/2018 3:08:37 PM < 100 researcher targeted mainly the preschool children 31 (20.3) such as touching and along the way, they will build their characteristic in terms of ethnicity, household income, extend well beyond physical health, having a positive recommend that young children should participate in Graf et al.(2004) had reported that children with higher 100 – 119 themselves. In the intervention group, all the children 116 (75.8) confidence104.9 (6.68) in handling the objects around them. A child and public facilities. Besides, Chang et al.(2012) impact on the domains of motor skills, psychological 120 minutes of moderate-to-vigorous physical activity levels of MS performance tend to be more physically >=120 received the same curriculum and training instructions. 4 (2.6) with poorly developed FMS will felt clumsy and lack of reported the prevalence of overweight and obesity well-being, cognitive development, social competence (MVPA) daily, 60 min of which is structured and 60 active than children with less well-developed MS. Weight (kg) and emotional maturity. Lack of physical activity can The kindergarten teachers were trained prior to the confidence in sports, and this will discourage them from among the young and middle-aged group adults in minutes unstructured or in free play. However, it came < 16 engaging in future activity. A well developed FMS will increase the risk for many health issues such as obesity, intervention. The children in the controlA cross-sectional group continued study which involved 153 children from 54 (35.3) the rural of Sarawak were high, as well as the level to our attention that the current trends in the levels of 16 – 30 usually result in active leisure behaviour, while poorer cardiovascular diseases, bone health problems, and their usual routine with one physicalgovernment activity lesson kindergartens per in Bau District was carried 79 (51.6) 19.1 (6.28) of physical inactivity (Cheah et al.,2014). Apart from physical activity of children appear to be headed in the >30 FMS development will ended up with sedentary lifestyle respiratory difficulties. The physical activity level of week lasting 30 minutes. Kindergartenout teachersearly 2017. and The Test of Gross Motor Development 14 (9.2) that, with the rapid urbanization and influence of urban wrong direction. such as television viewing (Webster et al., 2018) young children has received increasing attention parents in the control group were informed(TGMD) aboutversion the 2 (Ulrich, 2000) was used to assess BMI – age lifestyle, mushrooming of supermarket and various fast nationally because of the rapid rise in childhood obesity. study design, the testing and the interventionsix locomotor arm andbut didsix object control standard scores Underweight food centers, plus studies regarding issues among In order to address the research problem, a quasi- 30 (19.6) not know any further details regardingas well the asintervention determine a gross motor quotient (GMQ). PA Normal Society usually have the perception that children preschool children in rural community are rather According to Flegal et al. (2002), in the past 30 years, the experimental study of motor skills performance and 81 (52.9) at this17.0 period (4.05) are usually known as “supercharged modules. levels were assessed using a Yamax Digi-Walker CW-70 Overweight / Obese limited despite there is an indication that low PA trend percentage of obese children ages 2 to 5 years old had physical activity among rural preschool children were 42 (27.5)dynamos” and “active enough” and assumed that they (Tokyo, Japan) pedometer during all waking hours of six are slowly seen in the rural communities, particularly doubled. This can be due to two main factors: “eating carried out early 2017. The sampling frame for this study Gross MS Score should be fairly healthy (Prioreschi et al., 2017). However, consecutive days, including two weekend days, and only areas closer to towns. Therefore, Bau district was a too much and moving too little” (Sorte & Daeschel, were all the 22 government kindergartens in Bau District. < 90 the PA pattern in children have a tendency to be poor and to remove the device during water-based activities and 40 (26.1) suitable study area for this research. 2006). Therefore, physical activities in early childhood 90 – 110 this had104.4 become a great topic for healthcare providers settings are critically important in helping to reduce Research Progress during sleeping. This study objective is to determine PA 56 (36.6) 2.0 >111 4 • (16.75) the increased health risks associated with obese and Remarks and MS among the preschool children in rural Sarawak. 57 (37.3) HEART The prevalence of overweight and obese was Phase Progress TALK June 2019 27.5%. About 74% of the children had gross motor Permission to carry out this study was obtained from the Medical and Ethics Research Committee of Physical Activity Level overweight children. vProposal Pre-schoolers from Tabika KEMAS, Bau I (a) Universiti Malaysia Sarawak on 11/1/2017. Approval was also obtained Department of Community (Step counts) skills score more than 90, and majority of the children writing and A total of 153 respondents participated in this study with Development (Jabatan Kemajuan Masyarakat Negeri Sarawak) on 24/1/2017, followed by approval approval the mean age of 4.5 years ±0.50 as depicted in Table 1. < 7500 from Ministry of Rural and Regional Development on 6/2/2017. 5 (3.3) TALK June 2017 application 7500 – 9999 10110.7 4 • HEART Approval from NMRR was obtained on 17/3/2017. 70 (45.8) 4 • HEARTTALK December 2018 >= 10000 (1439.65) Objectives and methodology of the research were explained to the officers and teachers. All the 78(51.0) vStage I consulting the administrator of I (b) kindergartens in Bau District were assessed for eligibility to participate in the intervention study. Recruitment Only 15 kindergartens that fulfilled the criteria were selected after HeartTalk Issue18.indd 4

4 • HEARTTALK June 2018

11/7/2018 3:08:37 PM 18/1/2019 3:40:41 PM

HeartTalk Issue17.indd 4

Health Awareness @ Farley Supermarket, Kota Samarahan • 30 November 2019

HEARTTALK December 2019 • 9 Mention heart disease, and most people picture a heart attack. But the term covers several conditions that can hurt your ticker and keep it from doing its job. These include coronary artery disease, arrhythmia, cardiomyopathy, and heart failure. Learn the warning signs of each and how to react.

- P Clogged Arteries a A buildup of sticky plaque (fat and r t 1 cholesterol) can narrow your heart’s o f 2 arteries, making it harder for blood to - pass through. Many people don’t even know there’s a problem until an artery is clogged by a blood clot and they have a heart attack. But there may be warning signs of coronary artery disease, like frequent chest pain called angina.

What Does a Heart Attack Feel Like?

Inside a Heart Attack You might have: Plaque is hard on the outside and mushy on the inside. • Pain or pressure in the chest Sometimes that hard outer shell cracks. When this • Discomfort spreading to the back, jaw, throat, or arm happens, a blood clot forms. If it completely blocks • Nausea, indigestion, or heartburn your artery, it cuts off the blood supply to part of your • Weakness, anxiety, or shortness of breath heart. Blood carries oxygen, and a shortage of that can • Fast or irregular heartbeats quickly damage the organ and possibly kill you. The • It’s an emergency even when your symptoms are mild. attack is sudden, and it’s important to get medical help right away.

Symptoms in

Women Act Fast Women don’t always feel chest pain. Compared to If you think you’re having a heart attack, call 911 right men, they’re more likely to have heartburn or heart away, even if you’re not sure. Don’t wait to see if you feel flutters, lose their appetite, cough, or feel tired or weak. better. And don’t drive yourself to the hospital. The EMS Don’t ignore these symptoms. The longer you wait to team will come to you and start work right away. A fast get treatment, the more damage can be done. response can save your life.

10 • HEARTTALK December 2019 Irregular Heart Beat: Heart Failure Arrhythmia

Heart Muscle Disease:

This doesn’t mean your heart stops Cardiomyopathy working. It means the organ can’t Abnormal heart muscle, or pump enough blood to meet your Your heart beats because of electrical cardiomyopathy, makes it hard to body’s needs. So over time, it gets impulses, and they can get off rhythm. pump and carry blood to the rest bigger and pumps faster. This weakens Arrhythmias can make your heart of your body. Over time, health the muscle and lowers the amount of race, slow down, or quiver. They’re problems such as high blood blood flowing out even more, which often harmless and pass quickly, but pressure, obesity, and diabetes can adds to the problem. some types can affect your blood flow cause this serious condition, which and take a serious toll on your body. can lead to heart failure. Most cases of heart failure are the Tell your doctor if you notice anything result of coronary artery disease and unusual. heart attacks.

FromCongenital birth, you can have aHeart leaky valve Defector a damaged wall separating your heart chambers. Sometimes, the defects aren’t found until you’re an adult.

They don’t all need treatment, but some require medicine or surgery. If you have one, you’re more likely to have arrhythmias, heart failure, and infected valves, but there are ways to lower these chances.

ThisSudden isn’t the same Cardiac as a heart attack. DeathSudden cardiac death happens when the heart’s electrical system goes haywire, making it beat irregularly and dangerously fast. Instead of pumping out blood to your body, your chambers quiver.

A defibrillator can help bring back a regular heart beat, but without it, the person can die within minutes. Start CPR while waiting for a defibrillator, and have someone call 911 immediately.

Electrocardiogram (EKG) An EKG records your heart’s electrical activity. During this painless test, your doctor will stick electrodes on your skin for a few minutes. The results tell him if you have a regular heartbeat or not. It can confirm you’re having a heart attack, or if you’ve had one in the past. Your doctor can also compare these graphs over time to track how your ticker is doing.

ThisStress measures howTest well your heart works when it’s pushed hard. You walk on a treadmill or ride a stationary bike, and the workout gets tougher. Meanwhile, your doctor watches your EKG, heart rate, and blood pressure to see if the organ gets enough blood.

Part 2 will be in the next issue of HeartTalk

An extract from https://www.webmd.com/heart-disease/ss/slideshow-visual-guide-to-heart-disease HEARTTALK December 2019 • 11 “FriendS of the Sarawak Heart Foundation foundation” Form (383498-P) wE neED yOUR hELP? Join our team to promote a heart-healthy community in Sarawak. We need people who are keen to share their skills and interests.

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