Out-of-pocket (OOP) payments are the principal means of financing health care throughout much of Asia. We estimate the magnitude and distribution of OOP payments for health care in fourteen countries and territories accounting for 81% of the Asian population. We focus on payments that are catastrophic, in the sense of severely disrupting household living standards, and approximate such payments by those absorbing a large fraction of household resources. Bangladesh, China, India, Nepal and Vietnam rely most heavily on OOP financing and have the highest incidence of catastrophic payments. Sri Lanka, Thailand and Malaysia stand out as low to middle income countries that have constrained both the OOP share of health financing and the catastrophic impact of direct payments. In most low/middle-income countries, the better-off are more likely to spend a large fraction of total household resources on health care. This may reflect the inability of the poorest of the poor to divert resources from other basic needs and possibly the protection of the poor from user charges offered in some countries. But in China, Kyrgyz and Vietnam, where there are no exemptions of the poor from charges, they are as, or even more, likely to incur catastrophic payments.
The lower percentage of water, sanitation and hygiene are the root causes of diarrhoea and cholera. Cholera is a sudden onset of acute watery diarrhoea which can progress to severe dehydration and death if untreated. The current pandemic, Vibrio Cholera O1 started in 1961. This study explores water, sanitation, hygiene and cholera and diarrhoea in three affected villages of Beluran District, Sabah Malaysia to support effective and timely public health intervention. This cross sectional study uses purposive sampling. All (114) households were interviewed and household water samples collected. The study reported lower coverage improved sanitation facilities (35.3% to 52.3%), no latrine at home (37% to 63%), improved water supply (52% to 60%), and prevalence of hand washing after toilet (57% - 74%). For water quality, Ecoli was present in household water (32% to 37%) but Vibrio cholerae was not isolated in any of the water samples tested. Statistically significant associations were found for; 1) occupation−nonagriculture and unimproved sanitation facility and 2) house ownership and correct knowledge of ORS preparation. Predictors for household water quality were: latrine at home, and improved household toilet. Aggressive strategies to improve water supply, sanitation and hygiene−hand washing after toilet−were recommended for future prevention of cholera and diarrhoea in the affected area.
Although handwashing is an effective way to prevent infections, there is scarce evidence on predictors of handwashing during a pandemic. This paper aims to identify behavioural and demographic predictors of handwashing. The study surveyed 674 adults in Malaysia in May 2020 regarding whether the time spent on social media predicted handwashing contingent on gender and number of children. More time spent on social media was positively associated with handwashing for males with three or more children. However, for males without children, social media use was negatively associated with handwashing. The association was not significant for males with one or two children. For females, more time spent on social media was significantly linked to more handwashing only for females with one child. Gender, a traditional predictor of handwashing, was a useful predictor only for those who spent more than three hours per day on social media and had at most one child. Number of children was a novel negative predictor for males who did not use social media and who averaged one hour per day on social media, a positive predictor for males who spent lots of time on social media, but not a predictor for females. In sum, social media use predicts handwashing, and is thus a helpful variable for use in targeted health communication during a pandemic - particularly through social media. Further, more conventional predictors like gender and number of children exhibit contingency effects with social media use.
The magnetic and electronic properties of boron-doped SrTiO3 have been studied by first-principles calculations. We found that the magnetic ground states of B-doped SrTiO3 strongly depended on the dopant-dopant separation distance. As the dopant-dopant distance varied, the magnetic ground states of B-doped SrTiO3 can have nonmagnetic, ferromagnetic or antiferromagnetic alignment. The structure with the smallest dopant-dopant separation exhibited the lowest total energy among all configurations considered and was characterized by dimer pairs due to strong attraction. Ferromagnetic coupling was observed to be stronger when the two adjacent B atoms aligned linearly along the B-Ti-B axis, which could be associated with their local bonding structures. Therefore, the symmetry of the local structure made an important contribution to the generation of a magnetic moment. Our study also demonstrated that the O-Ti-O unit was easier than the Ti-B-Ti unit to deform. The electronic properties of boron-doped SrTiO3 tended to show semiconducting or insulating features when the dopant-dopant distance was less than 5 Å, which changed to metallic properties when the dopant-dopant distance was beyond 5 Å. Our calculated results indicated that it is possible to manipulate the magnetism and band gap via different dopant-dopant separations.
This study was conducted to determine the prevalence of household food insecurity and its potential risk factors and outcomes among the Orang Asli (Temuan) households. Socioeconomic, demographic and food security information of the households and anthropometric measurements and dietary intakes of preschoolers (n = 64) were obtained using a structured questionnaire. Food security was assessed using the Radimer/Cornell hunger and food insecurity instrument. Diet quality was based on 24 hour recall and analyzed according to the Malaysian RDA and Food Guide Pyramid. Majority of the households (82%) reported some kind of household food insecurity. The prevalence of significant underweight, stunting and wasting were 45.3%, 51.6% and 7.8%, respectively. Dietary intakes were less than 2/3 RDA levels for calories, calcium and iron. However, the intakes of protein, vitamin A, vitamin C and niacin exceeded the RDA and the sources for these nutrients were mainly rice, fish and green leafy vegetables. Among the five food groups, only the number of servings from cereals/cereal products/tubers group was achieved while that of the milk/diary products was the worst. Majority of the children (68.7%) had poor, 31.3% had fair and none with excellent diet quality. In general, diet quality and nutritional status of the children decreased as household food insecurity worsened. It is recommended that the nutritional problems of Orang Asli children be addressed through health, nutrition and economic programs and further studies should be carried out on determinants and consequences of household food insecurity.
Matched MeSH terms: Family Characteristics/ethnology*
Food variety scores (FVS) and dietary diversity scores (DDS) were estimated based on foods consumed weekly by 285 Malaysian households using a food frequency questionnaire. The scoring system of FVS and DDS was based on a scale of 0-7 and 0-6 respectively. The mean household FVS and DDS was 164.1 ± 93 and 6 ± 0.4. The age of respondents (husbands or wives; p < .01), sex (p < .05), and household food expenditure (p < .01) had a significant influence on both FVS and DDS. The food-intake pattern of Malaysian households showed that their typical diets had high protein and energy-based foods.
In the current protocol, the arene diazonium saccharin derivatives were initially produced from various substituted aromatic amines; subsequently, these intermediates were treated with a greener organic iodide for the preparation of the aryl iodide. We tried to choose low-cost, commercially available, biodegradable, recoverable, ecofriendly, and safe reagents and solvents. The arene diazonium saccharin intermediates could be stored in the liquid phase into a refrigerator for a long time with no significant loss activity. The outstanding merits of the current protocol (a) included the partial recovering of saccharin and tetraethylammonium salt, (b) reduce the use of solvents and the reaction steps due to eliminating separation and purification of intermediates, (c) good yield of the sterically hindered substrates, and (d) avoid the generation of heavy metal or corrosive waste.
Dengue virus infection is a common tropical disease which often occurs without being detected. These asymptomatic cases provide information in relation to the manifestation of immunological aspects. In this study, we developed an ELISA method to compare neutralizing effects of dengue prM and E antibodies between dengue patients and their asymptomatic household members. Recombinant D2 premembrane (prM) was constructed, cloned, and tested for antigenicity. The recombinant protein was purified and tested with controls by using an indirect ELISA method. Positive dengue serum samples with their asymptomatic pair were then carried out onto the developed ELISA. In addition, commercially available recombinant envelope (E) protein was used to develop an ELISA which was tested with the same set of serum samples in the prM ELISA. Asymptomatic individuals showed preexisting heterotypic neutralizing antibodies. The recombinant prM was antigenically reactive in the developed ELISA. Dengue patients had higher prM and E antibodies compared to their household members. Our study highlights the neutralizing antibodies levels with respect to dengue prM and E between dengue patients and asymptomatic individuals.
Laser-assisted high speed milling is a subtractive machining method that employs a laser to thermally soften a difficult-to-cut material's surface in order to enhance machinability at a high material removal rate with improved surface finish and tool life. However, this machining with high speed leads to high friction between workpiece and tool, and can result in high temperatures, impairing the surface quality. Use of conventional cutting fluid may not effectively control the heat generation. Besides, vegetable-based cutting fluids are invariably a major source of food insecurity of edible oils which is traditionally used as a staple food in many countries. Thus, the primary objective of this study is to experimentally investigate the effects of water-soluble sago starch-based cutting fluid on surface roughness and tool's flank wear using response surface methodology (RSM) while machining of 316 stainless steel. In order to observe the comparison, the experiments with same machining parameters are conducted with conventional cutting fluid. The prepared water-soluble sago starch based cutting fluid showed excellent cooling and lubricating performance. Therefore, in comparison to the machining using conventional cutting fluid, a decrease of 48.23% in surface roughness and 38.41% in flank wear were noted using presented approach. Furthermore, using the extreme learning machine (ELM), the obtained data is modeled to predict surface roughness and flank wear and showed good agreement between observations and predictions.
CONCLUSIONS: The comparison of different selection indices is justified only if the indices are constrated to achieve the same profit function, even when each index is not optimized with respect to that profit function.When a profit function is known and is non-linear, the desired gains index may be more efficient than the economic index. The optimum desired gains index should be determined by iterative techniques over several generations to compare the genetic progress with the economic index, because gains by the economic index are not linear and the changes observed in the initial generations of selection are not the same rates in future generations, although those changes are linear in the case of the desired gains index.
Discharge of household greywater into water bodies can lead to an increase in contamination levels in terms of the reduction in dissolved oxygen resources and rapid bacterial growth. Therefore, the quality of greywater has to be improved before the disposal process. The present review aimed to present a hybrid treatment system for the greywater generated from households. The hybrid system comprised a primary stage (a natural filtration unit) with a bioreactor system as the secondary treatment combined with microalgae for greywater treatment, as well as the natural flocculation process. The review discussed the efficiency of each stage in the removal of elements and nutrients. The hybrid system reviewed here represented an effective solution for the remediation of household greywater.
Hereditary or developmental neurological disorders (HNDs or DNDs) affect the quality of life and contribute to the high mortality rates among neonates. Most HNDs are incurable, and the search for new and effective treatments is hampered by challenges peculiar to the human brain, which is guarded by the near-impervious blood-brain barrier. Clustered Regularly Interspaced Short Palindromic Repeat (CRISPR), a gene-editing tool repurposed from bacterial defense systems against viruses, has been touted by some as a panacea for genetic diseases. CRISPR has expedited the research into HNDs, enabling the generation of in vitro and in vivo models to simulate the changes in human physiology caused by genetic variation. In this review, we describe the basic principles and workings of CRISPR and the modifications that have been made to broaden its applications. Then, we review important CRISPR-based studies that have opened new doors to the treatment of HNDs such as fragile X syndrome and Down syndrome. We also discuss how CRISPR can be used to generate research models to examine the effects of genetic variation and caffeine therapy on the developing brain. Several drawbacks of CRISPR may preclude its use at the clinics, particularly the vulnerability of neuronal cells to the adverse effect of gene editing, and the inefficiency of CRISPR delivery into the brain. In concluding the review, we offer some suggestions for enhancing the gene-editing efficacy of CRISPR and how it may be morphed into safe and effective therapy for HNDs and other brain disorders.
Demographic, economic and behavioural factors are central features underpinning the successful management and biological control of dengue. This study aimed to examine these factors and their association with the seroprevalence of this disease.
Childhood malnutrition is a multi-dimensional problem. An increase in household income is not sufficient to reduce childhood malnutrition if children are deprived of food security, education, access to water, sanitation and health services. The aim of this study is to identify the characteristics of malnourished children below five years of age and to ascertain the risk factors of childhood malnutrition in a state in Malaysia.
PIP: The population explosion has been abating since the 2nd half of the 1960s. The birth rate of the 3rd World dropped from 45/1000 during 1950-55 to 31/1000 during 1985-90. From the 1st half of the 1960s to the 1st half of the 1980s the total fertility of such countries dropped from 6.1 to 4.2 children/woman. In Taiwan, Singapore, Hong Kong, South Korea, and Malaysia living standards improved as a result of industrialization, and fertility decreased significantly. In Sri Lanka, China, North Vietnam, and Thailand the drop of fertility is explained by cultural and religious factors. In 1982 about 78% of the population of developing countries lived in 39 states that followed an official policy aimed at reducing the population. Another 16% lived in countries supporting the concept of a desired family size. However, World Bank data showed that in the mid-1980s in 27 developing countries no state family planning (FP) programs existed. India adopted an official FP program in 1952, Pakistan followed suit in 1960, South Korea in 1961, and China in 1962. In Latin America a split policy manifested itself: in Brazil birth control was rejected, only Colombia had a FP policy. In 1986 the governments of 68 of 131 developing countries representing 3.1 billion people considered the number of children per woman too high. 31 of these countries followed concrete population control policies. On the other hand, in 1986 24 countries of Africa with 40% of the continent's population took no measures to influence population growth. In Latin America and the Caribbean 18 of 33 countries were idle, except for Mexico that had a massive state FP program. These programs also improve maternal and child health with birth spacing of at least 2 years, and the prevention of pregnancies of too young women or those over 40. The evaluation of rapidly spreading FP programs in the 1970s was carried out by the World Fertility Survey in 41 countries. The impact of FP programs was more substantial than socioeconomic factors. Contraceptive use increased in Mexico from 13% in 1973 to 41% in 1978 among women of fertile age. According to 1984 and 1988 UN data modern methods of contraception were used by 70% of women in China, 60-65% in Southeast Asia, Costa Rica, and Puerto Rico. In contrast, less than 5% used them in most countries of Africa, 15-20% in West Asia, 25-30% in South Asia, and 40% in Latin America. The pill was the most popular method. From the early 1980s in South and East Asia 1/5 of women got sterilized after attaining the desired family size. Less than 10% of women used IUDs in developing countries. FP programs have benefited from higher education levels and economic incentives and sanctions and exemplified in Singapore, China, South Korea, Thailand, and Taiwan.
A cross sectional survey was conducted in Kampung Datuk Kerarnat, an urbanized residential area in Kuala Lumpur from August to November ZOO5 to assess knowledge, attitude and preventive practices on dengue among its residents. A two stage sampling strategy was used to select survey household. An adult aged at least 21 years old was identified from each selected household and interviewed using a standardized questionnaire. Data was collected on demographics, dengue related KAP and house-types. Knowledge, attitude and practice were assessed using a scoring system. Each appropriate answer was given a point and the points for each section of the questionnaire were totalled. Knowledge was assessed as ‘good' or ‘moderate to poor’ based on arbitrary cut-off point. Out of 133 respondents interviewed, 78.2% were able to identify at least one clinical sign of dengue, 73% knew that dengue fever was caused by the bite of dengue infected Aedes mosquitoes, 71 % correctly identified breeding sites, 69.2% correctly identified the Aedes mosquito and 42% correctly reported biting times ofthe mosquito vector. Overall, knowledge
was categorized as poor, attitude was good and dengue control and prevention practices was moderately poor. There was a weak but significant positive correlation between knowledge and practice (r=0.271, p=0.002) but there was no significant correlation between attitude with practice and between attitude with knowledge (p>0.05) . The results suggested that inspite of good attitude l
on dengue fever, it did not correlate with good practices and good knowledge in dengue prevention. We conclude that there is a need to increase health promotion activities to increase knowledge which forms the basis for preventive practices as part of the strategy to control dengue. Preventive strategies are the only means of controlling the disease.
Constantly changing electricity demand has made variability and uncertainty inherent characteristics of both electric generation and cellular communication systems. This paper develops an online learning algorithm as a prescheduling mechanism to manage the variability and uncertainty to maintain cost-aware and reliable operation in cloud radio access networks (Cloud-RANs). The proposed algorithm employs a combinatorial multi-armed bandit model and minimizes the long-term energy cost at remote radio heads. The algorithm preschedules a set of cost-efficient energy packages to be purchased from an ancillary energy market for the future time slots by learning both from cooperative energy trading at previous time slots and by exploring new energy scheduling strategies at the current time slot. The simulation results confirm a significant performance gain of the proposed scheme in controlling the available power budgets and minimizing the overall energy cost compared with recently proposed approaches for real-time energy resources and energy trading in Cloud-RANs.