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The Influence of Teachers' Self-Efficacy and School Leaders' Transformational Leadership Practices on Teachers' Innovative Behaviour

Zainal MA, Mohd Matore MEE

Int J Environ Res Public Health, 2021 Jun 14;18(12).
PMID: 34198506 DOI: 10.3390/ijerph18126423

BACKGROUND: The current rapid development demands educators to possess innovative behaviour. Presently, in the environment of rapid technological growth and borderless global communication, teachers with innovative behaviour are capable of facing each painful challenge that confronts the education system; therefore, it is essential to understand the factors influencing the innovative behaviour of teachers.
PURPOSE: To identify the influence of teachers' self-efficacy and school administrators' transformational leadership practices on teachers' innovative behaviour.
METHOD: A quantitative approach using a cross-sectional survey design with a sample of 1415 teachers from four states in Malaysia, and the data were statistically analysed using SPSS® version 26.0 for Windows™ (IBM Corporation, New York, NY, USA).
RESULT: Multiple Regression Analysis found that teachers' self-efficacy and school administrators' transformational leadership practices both had a significant influence on teachers' innovative behaviour by contributing 47.0% of the variance in teachers' innovative behaviour.
CONCLUSION: The findings suggested that teachers' self-efficacy and school administrators' transformational leadership practices both play a role in influencing teachers' innovative behaviour. Therefore, the stakeholders need to consider the aspects of self-efficacy and transformational leadership practices of school administrators in drafting policies and related programmes to improve teachers' innovative behaviour.
Fulltext Modelling Well-Being with Mindfulness Intervention on Bottom- and Middle-40% Income Earners in Malaysia

Zaidi FZ, Lai MM, Jumaat A, Lee Y

Int J Environ Res Public Health, 2023 Feb 16;20(4).
PMID: 36834173 DOI: 10.3390/ijerph20043480

This paper examines mindfulness as a costless cognitive asset in reducing stress and improving subjective well-being and psychological well-being among Malaysian bottom-forty-percent and middle-forty-percent income earners, known as B40 and M40, respectively. The participants recruited for this experimental study were divided into intervention and control groups and completed pre- and post-assessment questionnaires. The leveraging on digital technologies during pandemic times from May to June 2021 enabled participants in the intervention group (n = 95) to undergo four weekly online mindfulness intervention sessions through Google Meet and completed daily home mindfulness practices using the mobile application for mindfulness: the MindFi version 3.8.0 mobile app. Based on the Wilcoxon signed-rank test, the intervention group's mindfulness and well-being levels increased significantly after four weeks. This outcome contrasted to those in the control group (n = 31), who exhibited lower mindfulness and well-being levels. The PLS-SEM structural model consists of mindfulness as an independent variable, subjective and psychological well-being as dependent variables, and perceived stress and financial desire discrepancies as the mediators. This model has a goodness-of-fit of 0.076, proving that it is a fit and strong model. There is a positive relationship between mindfulness and subjective well-being (β = 0.162, p-value < 0.01). This model supports the mediation effect of perceived stress between mindfulness and subjective well-being variables (β = 0.152, p-value < 0.05). The overall structural model implies that the effectiveness of mindfulness intervention training not only enhanced bottom- and middle-income earners' well-being but also lowered the perceived stress level that, henceforth, brought the mind and body together in the present moment.
Fulltext Research Trends of Biodegradation of Cooking Oil in Antarctica from 2001 to 2021: A Bibliometric Analysis Based on the Scopus Database

Zahri KNM, Zulkharnain A, Sabri S, Gomez-Fuentes C, Ahmad SA

Int J Environ Res Public Health, 2021 02 19;18(4).
PMID: 33669826 DOI: 10.3390/ijerph18042050

In the present age, environmental pollution is multiplying due to various anthropogenic activities. Pollution from waste cooking oil is one of the main issues facing the current human population. Scientists and researchers are seriously concerned about the oils released from various activities, including the blockage of the urban drainage system and odor issues. In addition, cooking oil is known to be harmful and may have a carcinogenic effect. It was found that current research studies and publications are growing on these topics due to environmental problems. A bibliometric analysis of studies published from 2001 to 2021 on cooking oil degradation was carried out using the Scopus database. Primarily, this analysis identified the reliability of the topic for the present-day and explored the past and present progresses of publications on various aspects, including the contributing countries, journals and keywords co-occurrence. The links and interactions between the selected subjects (journals and keywords) were further visualised using the VOSviewer software. The analysis showed that the productivity of the publications is still developing, with the most contributing country being the United States, followed by China and India with 635, 359 and 320 publications, respectively. From a total of 1915 publications, 85 publications were published in the Journal of Agricultural and Food Chemistry. Meanwhile, the second and third of the most influential journals were Bioresource Technology and Industrial Crops and Products with 76 and 70 total publications, respectively. Most importantly, the co-occurrence of the author's keywords revealed "biodegradation", "bioremediation", "vegetable oil" and "Antarctic" as the popular topics in this study area, especially from 2011 to 2015. In conclusion, this bibliometric analysis on the degradation of cooking oil may serve as guide for future avenues of research in this area of research.
Fulltext Management of Traumatic and Non-Traumatic Cerebrospinal Fluid Rhinorrhea-Experience from Three Southeast Asian Countries

Zahedi FD, Subramaniam S, Kasemsiri P, Periasamy C, Abdullah B

Int J Environ Res Public Health, 2022 Oct 25;19(21).
PMID: 36360727 DOI: 10.3390/ijerph192113847

BACKGROUND: Cerebrospinal fluid (CSF) rhinorrhea requires proper management to avoid disastrous consequences. The objectives of this study were to ascertain the patient characteristics, etiologies, sites of defect, skull base configurations, methods of investigation, and management outcomes of CSF rhinorrhea.
METHODS: A retrospective study was performed over 4 years involving three surgeons from Malaysia, Singapore, and Thailand. Hospital records were reviewed to determine the patients' characteristics, the causes and sites of leaks, methods of investigation, skull base configurations, choices of treatment, and outcomes.
RESULTS: A total of 15 cases (7 traumatic and 8 non-traumatic) were included. Imaging was performed in all cases. The most common site of leakage was the cribriform plate (9/15 cases). The mean ± SD of the Keros heights were 4.43 ± 1.66 (right) and 4.21 ± 1.76 mm (left). Type II Keros was the most common (60%). The mean ± SD angles of the cribriform plate slope were 51.91 ± 13.43 degrees (right) and 63.54 ± 12.64 degrees (left). A class II Gera configuration was the most common (80%). All except two patients were treated with endonasal endoscopic surgical repair, with a success rate of 92.3%. A multilayered repair technique was used in all patients except one. The mean ± SD postoperative hospital stay was 9.07 ± 6.17 days.
CONCLUSIONS: Non-traumatic CSF rhinorrhea outnumbered traumatic CSF rhinorrhea, with the most common site of leak at the cribriform plate. Imaging plays an important role in investigation, and Gera classification appears to be better than Keros classification for evaluating risk. Both conservative and surgical repairs are practiced with successful outcomes. Endonasal endoscopic CSF leak repair is the mainstay treatment.
Fulltext LSTM Networks to Improve the Prediction of Harmful Algal Blooms in the West Coast of Sabah

Yussof FN, Maan N, Md Reba MN

Int J Environ Res Public Health, 2021 07 19;18(14).
PMID: 34300100 DOI: 10.3390/ijerph18147650

Harmful algal bloom (HAB) events have alarmed authorities of human health that have caused severe illness and fatalities, death of marine organisms, and massive fish killings. This work aimed to perform the long short-term memory (LSTM) method and convolution neural network (CNN) method to predict the HAB events in the West Coast of Sabah. The results showed that this method could be used to predict satellite time series data in which previous studies only used vector data. This paper also could identify and predict whether there is HAB occurrence in the region. A chlorophyll a concentration (Chl-a; mg/L) variable was used as an HAB indicator, where the data were obtained from MODIS and GEBCO bathymetry. The eight-day dataset interval was from January 2003 to December 2018. The results obtained showed that the LSTM model outperformed the CNN model in terms of accuracy using RMSE and the correlation coefficient r as the statistical criteria.
Fulltext Implementation of Kinetic and Kinematic Variables in Ergonomic Risk Assessment Using Motion Capture Simulation: A Review

Yunus MNH, Jaafar MH, Mohamed ASA, Azraai NZ, Hossain MS

Int J Environ Res Public Health, 2021 08 06;18(16).
PMID: 34444087 DOI: 10.3390/ijerph18168342

Work-related musculoskeletal disorders (WMSDs) are among the most common disorders in any work sector and industry. Ergonomic risk assessment can reduce the risk of WMSDs. Motion capture that can provide accurate and real-time quantitative data has been widely used as a tool for ergonomic risk assessment. However, most ergonomic risk assessments that use motion capture still depend on the traditional ergonomic risk assessment method, focusing on qualitative data. Therefore, this article aims to provide a view on the ergonomic risk assessment and apply current motion capture technology to understand classical mechanics of physics that include velocity, acceleration, force, and momentum in ergonomic risk assessment. This review suggests that using motion capture technologies with kinetic and kinematic variables, such as velocity, acceleration, and force, can help avoid inconsistency and develop more reliable results in ergonomic risk assessment. Most studies related to the physical measurement conducted with motion capture prefer to use non-optical motion capture because it is a low-cost system and simple experimental setup. However, the present review reveals that optical motion capture can provide more accurate data.
Fulltext Biomechanics Analysis of the Firefighters' Thorax Movement on Personal Protective Equipment during Lifting Task Using Inertial Measurement Unit Motion Capture

Yunus MNH, Jaafar MH, Mohamed ASA, Azraai NZ, Amil N, Zein RM

Int J Environ Res Public Health, 2022 Oct 31;19(21).
PMID: 36361112 DOI: 10.3390/ijerph192114232

Back injury is a common musculoskeletal injury reported among firefighters (FFs) due to their nature of work and personal protective equipment (PPE). The nature of the work associated with heavy lifting tasks increases FFs' risk of back injury. This study aimed to assess the biomechanics movement of FFs on personal protective equipment during a lifting task. A set of questionnaires was used to identify the prevalence of musculoskeletal pain experienced by FFs. Inertial measurement unit (IMU) motion capture was used in this study to record the body angle deviation and angular acceleration of FFs' thorax extension. The descriptive analysis was used to analyze the relationship between the FFs' age and body mass index with the FFs' thorax movement during the lifting task with PPE and without PPE. Sixty-three percent of FFs reported lower back pain during work, based on the musculoskeletal pain questionnaire. The biomechanics analysis of thorax angle deviation and angular acceleration has shown that using FFs PPE significantly causes restricted movement and limited mobility for the FFs. As regards human factors, the FFs' age influences the angle deviation while wearing PPE and FFs' BMI influences the angular acceleration without wearing PPE during the lifting activity.
Fulltext Association between Perceived Oral Symptoms and Presence of Clinically Diagnosed Oral Diseases in a Sample of Pregnant Women in Malaysia

Yunita Sari E, Saddki N, Yusoff A

Int J Environ Res Public Health, 2020 10 08;17(19).
PMID: 33049972 DOI: 10.3390/ijerph17197337

The integration of oral health into primary health care denotes the important role of medical counterparts as the front liners in antenatal care to help screen mothers for oral symptoms and refer them to dentists accordingly. However, the validity of self-perceived oral health status is inconclusive. This study determined the association between self-perceived oral symptoms and the presence of clinically diagnosed oral diseases in a sample of pregnant women. A total of 192 pregnant women participated in this cross-sectional study. Clinical oral examinations were performed to record dental caries experience, gingival health and periodontal health. The women were also asked about their oral symptoms. Most women had at least one oral symptom (84.9%): cavitated tooth (62.0%), bad breath (38.5%), bleeding gums (28.6%), and toothache (22.9%). About half of the women had untreated dental caries (58.9%), and the odds were significantly higher in women who complained of having cavitated tooth. About half of the women had moderate to severe gingivitis (53.7%), and the odds were significantly higher in women who complained of bleeding gums. About half had periodontal pockets (46.3%), and the odds were higher in women who complained of bleeding gums and bad breath although lower in women who complained of swollen gums. In conclusion, the prevalence of dental caries and periodontal disease among pregnant women in this study were relatively high. The presence of untreated dental caries, moderate and severe gingivitis, and periodontal pockets were significantly associated with their corresponding oral symptoms.
Fulltext The Double-Edged Sword of Urbanization and Its Nexus with Eco-Efficiency in China

Yue L, Xue D, Draz MU, Ahmad F, Li J, Shahzad F, et al.

Int J Environ Res Public Health, 2020 01 09;17(2).
PMID: 31936543 DOI: 10.3390/ijerph17020446

Urbanization has made tremendous contributions to China's economic development since its economic reforms and opening up. At the same time, population agglomeration has aggravated environmental pollution and posed serious challenges to China's environment. This article empirically investigates the impacts of China's urbanization on eco-efficiency, comprehensively reflecting economic growth, resource input, and waste discharge. We first measured the provincial eco-efficiency in China from 2005 to 2015 using the Super Slack-Based model (Super-SBM). We then constructed a spatial model to empirically analyze the effects of urbanization on eco-efficiency at the national level, and at four regional levels. The results indicated that the regional eco-efficiency in China has fluctuated, but is generally improving, and that a gap between regions was evident, with a trend toward further gap expansion. We observed an effect of spatial spillover in eco-efficiency, which was significant and positive for the whole country, except for the western region. The influence of urbanization on China's eco-efficiency exhibited a U-curve relationship. The changing trend in the eastern, central, and western regions was the same as that in the whole country; however, the trend exhibited an inverted U-curve relationship in the northeastern region. To the best of our knowledge, covering a time period of 2005-2015, this article is the first of its kind to study the impact of urbanization on eco-efficiency in China at both the national and regional levels. This study may help policy-makers to create sustainable policies that could be helpful in balancing urbanization and the ecological environment.
Fulltext The Effect of Persistence of Physical Exercise on the Positive Psychological Emotions of Primary School Students under the STEAM Education Concept

Yuan Y, Ji X, Yang X, Wang C, Samsudin S, Omar Dev RD

Int J Environ Res Public Health, 2022 Sep 12;19(18).
PMID: 36141724 DOI: 10.3390/ijerph191811451

The effect of persistence of physical exercise on the psychological and emotional aspects of primary school students is studied to improve the comprehensive quality of current Chinese primary school students and explore the effect of physical exercise on students' emotions under the science, technology, engineering, art, mathematics (STEAM) education concept. First, students in a primary school in Nanchang are taken as the survey participants. Second, by formulating a physical exercise scale and a psychological and emotional scale, the current situation of physical exercise of primary school students is investigated by means of mathematical statistics. Finally, the current situation of physical exercise and the overall situation of positive psychological emotions of primary school students are analyzed, and the effect of physical exercise on the positive psychological emotions of primary school students is studied. The data show that there are significant differences in the amount of exercise and its three dimensions of intensity, time, and frequency, as well as the scores of positive emotions in the gender dimension, with the boys scoring higher than the girls. In terms of grades, students in grades 1, 2, and 6 are higher than students in grades 3, 4, and 5 on the level of a small amount of exercise, while students in grades 3, 4, and 5 are higher than the other three grades in terms of a moderate amount of exercise. Moreover, in the aspect of positive psychological emotions, the lower-grade students are obviously higher than the upper-grade students, and the second- and third-grade students present marginal significance, p = 0.058. The correlation and regression between physical exercise and positive psychological emotions are calculated and analyzed, and it is found that there is a significant positive correlation between physical exercise indicators and positive psychological emotions, with a correlation coefficient of 0.297. Physical exercise explains 8.8% of positive emotions. This research also makes relevant recommendations for students and schools and has played a role in strengthening the physical exercise and mental health of primary and secondary school students. Greater attention to the physical exercise of primary school students is recommended.
Fulltext Modelling Analysis on Dietary Patterns and Oral Health Status among Adolescents

You HW

Int J Environ Res Public Health, 2022 Nov 18;19(22).
PMID: 36429979 DOI: 10.3390/ijerph192215255

Adolescence is a crucial stage between childhood and adulthood during which an individual learns new behaviours and practices including dietary patterns. This study aimed to examine the diet and oral health status among adolescents, and employed a structured questionnaire with three sections, namely, demographic, Adolescents' Food Habits Checklist (AFHC) and the Kayser-Jones Brief Oral Health Status Examination (BOHSE). The AFHC was formulated consisting of 23 items to collect information about dietary patterns with respect to food purchase, preparation and consumption habits. Meanwhile, the BOHSE contained nine items to evaluate the oral conditions of adolescents. The relationship between dietary pattern and oral health in adolescents was investigated. A total of 160 adolescents were randomly selected in this study. The data analysis was presented in the form of tables. This study adhered to the STROBE checklist's Guidelines for Systematic Reporting of Examination. According to the findings, food consumption dietary patterns among adolescents had the highest mean score (4.475). This demonstrates that adolescents practiced healthy food consumption. A significant positive correlation was found between food purchase, food preparation, food consumption and dietary patterns. Moreover, females had a slightly higher mean score than males, showing that females have a healthier diet status than males. This study can serve as points of reflection and recommendations on dietary patterns and oral health status.
Fulltext Characterisation of Bacterial Isolates from Infected Post-Operative Patients in a Malaysian Tertiary Heart Care Centre

Yong YK, Wen NCM, Yeo GEC, Chew ZX, Chan LL, Md Zain NZ, et al.

Int J Environ Res Public Health, 2021 09 17;18(18).
PMID: 34574752 DOI: 10.3390/ijerph18189828

Several bacterial species cause post-operative infections, which has been a critical health concern among hospital patients. Our study in this direction is a much-needed exploratory study that was carried out at the National Heart Institute (IJN) of Malaysia to examine the virulence properties of causative bacteria obtained from postoperative patients. The bacterial isolates and data were provided by the IJN. Antibiotic resistance gene patterns, and the ability to form biofilm were investigated for 127 isolates. Klebsiella pneumoniae (36.2%) was the most common isolate collected, which was followed by Pseudomonas aeruginosa (26%), Staphylococcus aureus (23.6%), Streptococcus spp. (8.7%) and Acinetobacter baumannii (5.5%). There were 49 isolates that showed the presence of multidrug resistance genes. The mecA gene was surprisingly found in methicillin-susceptible S. aureus (MSSA), which also carried the ermA gene from those erythromycin-susceptible strains. The phenotypic antibiotic resistance profiles varied greatly between isolates. Findings from the biofilm assay revealed that 44 of the 127 isolates demonstrated the ability to produce biofilms. Our findings provide insights into the possibility of some of these bacteria surviving under antibiotic stress, and some antibiotic resistance genes being silenced.
Fulltext Double Eyelid Tape Wear Affects Anterior Ocular Health among Young Adult Women with Single Eyelids

Yong PT, Arif N, Sharanjeet-Kaur S, Hairol MI

Int J Environ Res Public Health, 2020 10 22;17(21).
PMID: 33105550 DOI: 10.3390/ijerph17217701

Many East Asians apply double eyelid tape to create the double eyelid effect temporarily as a means of increasing their beauty. This study evaluated the effects of four-week wear of double eyelid tape on anterior ocular health in young adult women with single eyelids. Twenty-nine participants who met the inclusion criteria were recruited. The participants' anterior ocular health was examined including blinking characteristics (blink pattern and blink rate), ocular surface health (presence of corneal abrasion, corneal staining, conjunctival staining, corneal curvatures, meibomian gland dysfunction), tear break up time, intraocular pressure, and subjective comfort level. Participants were required to apply the double eyelid tape for at least eight hours a day and five days a week for four weeks. The parameters were re-measured at the end of each week. There was a significant increase in conjunctival staining, corneal staining, and meibomian gland dysfunction, with a significant reduction in tear break-up time and intraocular pressure. By week 3, all participants had incomplete blinks. There was no significant change in symptoms and subjective comfort level reported. Therefore, patients and eye care practitioners should be aware of the potential implications of double eyelid tape wear on ocular health, with no significant change in subjective comfort.
Fulltext The Scorching Truth: Investigating the Impact of Heatwaves on Selangor's Elderly Hospitalisations

Yong KH, Teo YN, Azadbakht M, Phung H, Chu C

Int J Environ Res Public Health, 2023 May 22;20(10).
PMID: 37239636 DOI: 10.3390/ijerph20105910

Global climate change has contributed to the intensity, frequency, and duration of heatwave events. The association between heatwaves and elderly mortality is highly researched in developed countries. In contrast, heatwave impact on hospital admissions has been insufficiently studied worldwide due to data availability and sensitivity. In our opinion, the relationship between heatwaves and hospital admissions is worthwhile to explore as it could have a profound impact on healthcare systems. Therefore, we aimed to investigate the associations between heatwaves and hospitalisations for the elderly by age group in Selangor, Malaysia, from 2010 to 2020. We further explored the impact of heatwaves on the risks of cause-specific hospital admissions across age groups within the elderly. This study applied generalized additive models (GAMs) with the Poisson family and distributed lag models (DLMs) to estimate the effect of heatwaves on hospitalisations. According to the findings, there was no significant increase in hospitalisations for those aged 60 and older during heatwaves; however, a rise in mean apparent temperature (ATmean) by 1 °C significantly increased the risk of hospital admission by 12.9%. Heatwaves had no immediate effects on hospital admissions among elderly patients, but significant delay effects were identified for ATmean with a lag of 0-3 days. The hospital admission rates of the elderly groups started declining after a 5-day average following the heatwave event. Females were found to be relatively more vulnerable than males during heatwave periods. Consequently, these results can provide a reference to improve public health strategies to target elderly people who are at the greatest risk of hospitalisations due to heatwaves. Development of early heatwave and health warning systems for the elderly would assist with preventing and reducing health risks while also minimising the burden on the whole hospital system in Selangor, Malaysia.
Fulltext Pre-Pregnancy BMI Influences the Association of Dietary Quality and Gestational Weight Gain: The SECOST Study

Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Tee YYS, Bindels J, et al.

Int J Environ Res Public Health, 2019 10 04;16(19).
PMID: 31590213 DOI: 10.3390/ijerph16193735

Poor diet quality in pregnancy could impact gestational weight gain (GWG) and consequently fetal growth and development. But today there is limited data available on gestational diet quality. This study investigated the association between diet quality in each pregnancy trimester and GWG in Malaysian women. Diet quality was assessed using the modified Healthy Eating Index for Malaysians (HEI). Total GWG was defined as the difference between measured weight at last prenatal visit and pre-pregnancy weight. About one-fourth of women (23.3%) had excessive total GWG. There were significant differences in the HEI component score across trimesters, except for fruits. Overall, overweight/obese women had lower total HEI score (51.49-55.40) during pregnancy compared to non-overweight/obese women (53.38-56.50). For non-overweight/obese women, higher total HEI scores in the second and third trimesters were significantly associated with lower risk of inadequate GWG (aOR = 0.97, 95% CI = 0.95-0.99, p = 0.01) and higher risk of excessive GWG (aOR = 1.04, 95% CI = 1.01-1.07, p = 0.03), respectively. Overweight/obese women with higher total HEI scores in the second (aOR = 1.04, 95% CI = 1.01-1.07, p = 0.02) and third trimester (aOR = 1.04, 95% CI = 1.01-1.08, p = 0.02) were significantly at higher risk for excessive GWG. Pregnant women had relatively low diet quality throughout pregnancy. Diet quality and GWG association differed according to pre-pregnancy BMI with excessive GWG more likely to be associated with higher total HEI scores in the third trimester.
Fulltext Higher Parity, Pre-Pregnancy BMI and Rate of Gestational Weight Gain Are Associated with Gestational Diabetes Mellitus in Food Insecure Women

Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Tee YYS, Bindels J, et al.

Int J Environ Res Public Health, 2021 03 07;18(5).
PMID: 33800084 DOI: 10.3390/ijerph18052694

Food insecurity may exacerbate adverse maternal health outcomes during pregnancy, however, this association has not been well established, particularly in the context of developing countries. This study aimed to identify the associations between household food insecurity and gestational diabetes mellitus (GDM) risk among urban pregnant women. Household food insecurity was assessed using the translated 10-item Radimer/Cornell hunger scale. Logistic regression models were used to estimate the associations between food insecurity status and GDM risk. About 35.6% of women experienced food insecurity, with 25.2% reported household food insecurity, 8.0% individual food insecurity, and 2.4% child hunger. Food insecure women were at significantly higher risk of developing GDM compared to food secure women (AOR = 16.65, 95% CI = 6.17-24.98). The significant association between food insecurity and GDM risk was influenced by pre-pregnancy BMI, parity and rate of GWG at second trimester. Food insecure women with parity ≥ 2 (AOR = 4.21, 95% CI = 1.98-8.92), overweight/obese BMI prior to pregnancy (AOR = 12.11, 95% CI = 6.09-24.10) and excessive rate of GWG in the second trimester (AOR = 9.66, 95% CI = 4.27-21.83) were significantly more likely to develop GDM compared to food secure women. Food insecurity showed strong association with GDM risk in that the association was influenced by maternal biological and physical characteristics. Multipronged interventions may be necessary for food insecure pregnant women who are not only at risk of overweight/obesity prior to pregnancy but also may have excessive gestational weight gain, in order to effectively reduce GDM risk.
Fulltext Association of Internet Addiction with Adolescents' Lifestyle: A National School-Based Survey

Ying Ying C, Awaluddin SM, Kuang Kuay L, Siew Man C, Baharudin A, Miaw Yn L, et al.

Int J Environ Res Public Health, 2020 12 29;18(1).
PMID: 33383635 DOI: 10.3390/ijerph18010168

Internet addiction (IA) among adolescents is an issue of growing concern with adverse effects on adolescents' health and social functioning. This study aims to determine the prevalence of IA among school-going adolescents in Malaysia and its associated factors-specifically, lifestyle factors. A nationwide cross-sectional school-based health survey was conducted in 2017 among 27,497 students from 212 randomly selected secondary schools. Information regarding sociodemography, lifestyle, and internet use was obtained using a self-administered questionnaire. IA was measured using the Malay Version of Internet Addiction Test (MVIAT). The prevalence of internet addiction was 29.0%. A multivariable logistic analysis revealed that inadequate fruit and vegetable intakes, consumed carbonated soft drinks at least once a day, consumed fast food at least three days/week, sedentary behavior, current E-cigarette users, and ever/current alcohol drinkers were lifestyle factors significantly associated with IA. Adolescents from urban schools, of higher school grade, and those whose parents are married but living apart were also found to have a greater risk for internet addiction. A positive association was found between IA with unhealthy dietary and lifestyle behaviors among adolescents. The modification of lifestyle factors needs to be considered while developing strategies and interventions for awareness-raising and prevention of IA among adolescents.
Fulltext Health-Related Quality of Life and Family Functioning of Primary Caregivers of Children with Cerebral Palsy in Malaysia

Ying K, Rostenberghe HV, Kuan G, Mohd Yusoff MHA, Ali SH, Yaacob NS

Int J Environ Res Public Health, 2021 02 28;18(5).
PMID: 33670850 DOI: 10.3390/ijerph18052351

Caregiving for children with cerebral palsy (CP) has proved to negatively impact on the physical and psychological well-being of their primary caregivers. The aim of the current study was to examine the overall impact of caregiving for children with CP on the primary caregivers' health-related quality of life (HRQOL) and family functioning, and to identify potential factors associated with primary caregivers' HRQOL and family functioning. The cross-sectional study involved a total of 159 primary caregivers of children with CP with a mean age of 42.8 ± 8.4 years. Demographic data and information on the physical and leisure activities of the primary caregivers were collected, and their quality of life (QOL) was measured based on the self-reported Pediatric Quality of Life Inventory Family Impact Module (PedsQL FIM). Primary caregivers in the current study have shown good HRQOL and family functioning, with scores of 82.4 and 85.3 out of 100, respectively. Through multiple linear regression analyses, the mother's level of education, family monthly income, sleeping problems in children with CP, and the existence of children with other types of disability have been identified as factors contributing to HRQOL and family functioning. The findings help set out the course for stakeholders to establish action to enhance the QOL of primary caregivers.
Fulltext A Deep Learning Model for Automated Sleep Stages Classification Using PSG Signals

Yildirim O, Baloglu UB, Acharya UR

Int J Environ Res Public Health, 2019 02 19;16(4).
PMID: 30791379 DOI: 10.3390/ijerph16040599

Sleep disorder is a symptom of many neurological diseases that may significantly affect the quality of daily life. Traditional methods are time-consuming and involve the manual scoring of polysomnogram (PSG) signals obtained in a laboratory environment. However, the automated monitoring of sleep stages can help detect neurological disorders accurately as well. In this study, a flexible deep learning model is proposed using raw PSG signals. A one-dimensional convolutional neural network (1D-CNN) is developed using electroencephalogram (EEG) and electrooculogram (EOG) signals for the classification of sleep stages. The performance of the system is evaluated using two public databases (sleep-edf and sleep-edfx). The developed model yielded the highest accuracies of 98.06%, 94.64%, 92.36%, 91.22%, and 91.00% for two to six sleep classes, respectively, using the sleep-edf database. Further, the proposed model obtained the highest accuracies of 97.62%, 94.34%, 92.33%, 90.98%, and 89.54%, respectively for the same two to six sleep classes using the sleep-edfx dataset. The developed deep learning model is ready for clinical usage, and can be tested with big PSG data.
Fulltext Microarray Profiling of Differentially Expressed Genes in Coronary Artery Bypass Grafts of High-Risk Patients with Postoperative Cognitive Dysfunctions

Yazit NAA, Juliana N, Kadiman S, Hafidz KM, Mohd Fahmi Teng NI, Abdul Hamid N, et al.

Int J Environ Res Public Health, 2023 Jan 13;20(2).
PMID: 36674212 DOI: 10.3390/ijerph20021457

Postoperative cognitive dysfunction (POCD) is cognitive decline after surgery. The authors hypothesized that gene-level changes could be involved in the pathogenesis of POCD. The present study evaluated the incidence of POCD and its associated differentially expressed genes. This was a prospective cohort study conducted on high-risk coronary artery bypass graft patients aged 40 to 75 years. POCD classification was based on a one standard deviation decline in the postoperative scores compared to the preoperative scores. The differentially expressed genes were identified using microarray analysis and validated using quantitative RT-PCR. Forty-six patients were recruited and completed the study. The incidence of POCD was identified using a set of neurocognitive assessments and found to be at 17% in these high-risk CABG patients. Six samples were selected for the gene expression analyses (3 non-POCD and 3 POCD samples). The findings showed five differentially expressed genes in the POCD group compared to the non-POCD group. The upregulated gene was ERFE, whereas the downregulated genes were KIR2DS2, KIR2DS3, KIR3DL2, and LIM2. According to the results, the gene expression profiles of POCD can be used to find potential proteins for POCD diagnostic and predictive biomarkers. Understanding the molecular mechanism of POCD development will further lead to early detection and intervention to reduce the severity of POCD, and hence, reduce the mortality and morbidity rate due to the condition.

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