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Drinking water, sanitation, and hygiene (WASH) situation in primary schools of Pakistan: the impact of WASH-related interventions and policy on children school performance

Ahmed J, Wong LP, Chua YP, Hydrie MZI, Channa N

Environ Sci Pollut Res Int, 2022 Jan;29(1):1259-1277.
PMID: 34355319 DOI: 10.1007/s11356-021-15681-w

The United Nation's Sustainable Development Goals include the target of ensuring access to water and sanitation and hygiene (WASH) for all; however, very few studies have assessed comprehensive school WASH service in Pakistan. The purpose of this study was to identify WASH services in primary schools of Pakistan, and to assess how recent WASH interventions and policies are associated with the school's academic performance. A representative cross-sectional study was conducted in primary schools in the Sindh province of Pakistan. Structured observations and interviews were done to ascertain the schools' WASH conditions. The primary exposures of interest were the implementation of previous WASH interventions and National WASH policy in the school and the WASH coverage. Outcomes of interest included WASH conditions and school performance. The structural equation modeling (SEM) using a bootstrap resampling procedure was employed to characterize how WASH exposures were associated with WASH conditions and school performance. Data were collected from 425 schools. The Basic WASH facilities coverage in the primary schools of Sindh remains overall low according to WHO WASH service ladder criteria. Also, inconsistency in all three inclusive domains of WASH (availability, accessibility, and functionality) facilities were found. The school performance was significantly associated (P<0.001) with the presence of WASH interventions and/or WASH policy, while WASH policy and/or recent WASH intervention at the school were not associated with overall water quality. Our assessment unveiled several WASH gaps that exist, including high heavy metal and fecal contamination. Adoption of national WASH policy and financing of evidence-based WASH interventions are recommended in primary schools to improve educational outcomes.

Matched MeSH terms: Drinking Water*
Fulltext Arsenic in drinking water, hair, and prevalence of arsenicosis in Perak, Malaysia

Ramly N, Ahmad Mahir HM, Wan Azmi WNF, Hashim Z, Hashim JH, Shaharudin R

Front Public Health, 2023;11:998511.
PMID: 36875418 DOI: 10.3389/fpubh.2023.998511

Arsenic is a carcinogen element that occurs naturally in our environment. Humans can be exposed to arsenic through ingestion, inhalation, and dermal absorption. However, the most significant exposure pathway is via oral ingestion. Therefore, a comparative cross-sectional study was conducted to determine the local arsenic concentration in drinking water and hair. Then, the prevalence of arsenicosis was evaluated to assess the presence of the disease in the community. The study was conducted in two villages, namely Village AG and Village P, in Perak, Malaysia. Socio-demographic data, water consumption patterns, medical history, and signs and symptoms of arsenic poisoning were obtained using questionnaires. In addition, physical examinations by medical doctors were performed to confirm the signs reported by the respondents. A total of 395 drinking water samples and 639 hair samples were collected from both villages. The samples were analyzed using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) to determine arsenic concentration. The results showed that 41% of water samples from Village AG contained arsenic concentrations of more than 0.01 mg/L. In contrast, none of the water samples from Village P exceeded this level. Whilst, for hair samples, 85 (13.5%) of total respondents had arsenic levels above 1 μg/g. A total of 18 respondents in Village AG had at least one sign of arsenicosis and hair arsenic levels of more than 1 μg/g. Factors significantly associated with increased arsenic levels in hair were female, increasing age, living in Village AG and smoking. The prevalence of arsenicosis in the exposed village indicates chronic arsenic exposure, and immediate mitigation action needs to be taken to ensure the wellbeing of the residents in the exposed village.

Matched MeSH terms: Drinking Water*
From tap to table: An assessment of drinking water quality in Perak, Malaysia

Ibrahim TNBT, Feisal NAS, Azmi NM, Nazli SN, Salehuddin ASM, Nasir NICM, et al.

Med J Malaysia, 2024 Mar;79(Suppl 1):14-22.
PMID: 38555880

INTRODUCTION: A study on the quality of drinking water was conducted at Air Kuning Treatment Plant In Perak, Malaysia, based on a sanitary survey in 14 sampling points stations from the intake area to the auxiliary points. This was to ensure the continuous supply of clean and safe drinking water to the consumers for public health protection. The objective was to examine the physical, microbiological, and chemical parameters of the water, classification at each site based on National Drinking Water Standards (NDWQS) and to understand the spatial variation using environmetric technique; principal component analysis (PCA).
MATERIALS AND METHODS: Water samples were subjected to in situ and laboratory water quality analyses and focused on pH, turbidity, chlorine, Escherichia coli, total coliform, total hardness, iron (Fe), aluminium (Al), zinc (Zn), magnesium (Mg) and sodium (Na). All procedures followed the American Public Health Association (APHA) testing procedures.
RESULTS: Based on the results obtained, the values of each parameter were found to be within the safe limits set by the NDWQS except for total coliform and iron (Fe). PCA has indicated that turbidity, total coliform, E. coli, Na, and Al were the major factors that contributed to the drinking water contamination in river water intake.
CONCLUSION: Overall, the water from all sampling point stations after undergoing water treatment process was found to be safe as drinking water. It is important to evaluate the drinking water quality of the treatment plant to ensure that consumers have access to safe and clean drinking water as well as community awareness on drinking water quality is essential to promote public health and environmental protection.

Matched MeSH terms: Drinking Water*
Sex-specific pleiotropic changes in emotional behavior and alcohol consumption in human α-synuclein A53T transgenic mice during early adulthood

Kalinichenko LS, Kohl Z, Mühle C, Hassan Z, Hahn A, Schmitt EM, et al.

J Neurochem, 2024 Mar;168(3):269-287.
PMID: 38284431 DOI: 10.1111/jnc.16051

Point mutations in the α-synuclein coding gene may lead to the development of Parkinson's disease (PD). PD is often accompanied by other psychiatric conditions, such as anxiety, depression, and drug use disorders, which typically emerge in adulthood. Some of these point mutations, such as SNCA and A30T, have been linked to behavioral effects that are not commonly associated with PD, especially regarding alcohol consumption patterns. In this study, we investigated whether the familial PD point mutation A53T is associated with changes in alcohol consumption behavior and emotional states at ages not yet characterized by α-synuclein accumulation. The affective and alcohol-drinking phenotypes remained unaltered in female PDGF-hA53T-synuclein-transgenic (A53T) mice during both early and late adulthood. Brain region-specific activation of ceramide-producing enzymes, acid sphingomyelinase (ASM), and neutral sphingomyelinase (NSM), known for their neuroprotective properties, was observed during early adulthood but not in late adulthood. In males, the A53T mutation was linked to a reduction in alcohol consumption in both early and late adulthood. However, male A53T mice displayed increased anxiety- and depression-like behaviors during both early and late adulthood. Enhanced ASM activity in the dorsal mesencephalon and ventral hippocampus may potentially contribute to these adverse behavioral effects of the mutation in males during late adulthood. In summary, the A53T gene mutation was associated with diverse changes in emotional states and alcohol consumption behavior long before the onset of PD, and these effects varied by sex. These alterations in behavior may be linked to changes in brain ceramide metabolism.

Matched MeSH terms: Alcohol Drinking/genetics
Fulltext Sanitation, water, energy use, and traffic volume affect environmental quality: Go-for-green developmental policies

Khalil L, Abbas S, Hussain K, Zaman K, Iswan, Salamun H, et al.

PLoS One, 2022;17(8):e0271017.
PMID: 36026488 DOI: 10.1371/journal.pone.0271017

Carbon emissions are primarily the result of human activity in urban areas. Inadequate sanitary facilities, contaminated drinking water, nonrenewable energy, and high traffic congestion have all impacted the natural ecosystem. Using data from 1975 to 2019, the study assessed the impact of the aforementioned variables on Pakistan's carbon emissions in light of this crucial fact. The ARDL cointegration method was used to estimate the short- and long-run parameter estimates. Urban sanitation challenges and energy consumption increase carbon emissions, which affects the natural environment by raising a country's carbon intensity. Economic expansion confirmed the inverted U-shaped relationship between carbon emissions and economic growth to verify the Environmental Kuznets Curve (EKC) hypothesis in the long run. In contrast, the monotonically rising function of carbon emissions provides evidence of the nation's economic development in the short run. Access to clean drinking water improves population health and encourages the purchase of eco-friendly products. The government must improve sanitation services and use renewable energy sources to enhance air quality.

Matched MeSH terms: Drinking Water*
Fulltext Factors associated with alcohol use before or during sex among men who have sex with men in a large internet sample from Asia

Yang C, Guadamuz TE, Lim SH, Koe S, Wei C

LGBT Health, 2016 Apr;3(2):168-74.
PMID: 26789393 DOI: 10.1089/lgbt.2014.0041

We explored factors associated with alcohol use before or during sex among a sample of 10,861 men who have sex with men (MSM) in Asia who were recruited online for the study. Multinomial logistic regression analysis indicated that having sex under the influence of alcohol was associated with having multiple male partners, seeking partners primarily through gay bar/gym/dance party/friends, selling sex and using multiple drugs during the past 6 months, and unprotected anal sex. More efforts are needed to better assess alcohol use and misuse among MSM in Asia and understand contextual influences on alcohol use and HIV-related behaviors in order to implement culturally-specific interventions.

Matched MeSH terms: Alcohol Drinking
Fulltext Evaluation of selected metal elements in commercial drinking water and tap water in Peninsular Malaysia

Khoo, Hock-Eng, Azrina Azlan, Mohd Aizat Idris, Amin Ismail, Muhammad Rizal Razman

Jurnal Sains Kesihatan Malaysia, 2011;9(1):5-11.
MyJurnal

The present study was carried out to determine the concentrations of selected metal elements (lead, copper, manganese, zinc and iron) in 51 samples of commercial drinking water and tap water available in Malaysia. The results indicated that low metal elements were found in the studied water samples. Lead, manganese, zinc and iron were not detected in some of the studied samples, except copper. The concentrations of the metal elements in the studied samples were well below the maximum permitted concentrations as recommended. Therefore these drinking water are safe for consumption and do not pose adverse effect to the health of consumers due to metal toxicity.

Matched MeSH terms: Drinking Water
Preliminary assessment on the hydrogeochemistry of Kapas Island, Terengganu

Noorain Mohd Isa, Ahmad Zaharin Aris

Sains Malaysiana, 2012;41:23-32.

Classified as a small island, Kapas Island experiences major problems especially in supplying freshwater where groundwater abstraction is the only way to meet the demand of drinking water and domestic use. Groundwater samples were collected from seven constructed boreholes to examine the hydrochemistry properties of major ions and in-situ parameters as these could provide a basis for future reference. The chemical composition showed strong and significant correlation for each studied parameter; an indication of the effect of environmental variables to the groundwater composition. The composition changed from Ca-rich to Na-rich are explained mostly by mixing and cation exchange processes. This study provided an input for water management at Kapas Island where groundwater is a crucial resource to maintain the hydrogeological balance of the island.

Matched MeSH terms: Drinking Water
Developmental programing of thirst and sodium appetite

Mecawi AS, Macchione AF, Nuñez P, Perillan C, Reis LC, Vivas L, et al.

Neurosci Biobehav Rev, 2015 Apr;51:1-14.
PMID: 25528684 DOI: 10.1016/j.neubiorev.2014.12.012

Thirst and sodium appetite are the sensations responsible for the motivated behaviors of water and salt intake, respectively, and both are essential responses for the maintenance of hydromineral homeostasis in animals. These sensations and their related behaviors develop very early in the postnatal period in animals. Many studies have demonstrated several pre- and postnatal stimuli that are responsible for the developmental programing of thirst and sodium appetite and, consequently, the pattern of water and salt intake in adulthood in need-free or need-induced conditions. The literature systematically reports the involvement of dietary changes, hydromineral and cardiovascular challenges, renin-angiotensin system and steroid hormone disturbances, and lifestyle in these developmental factors. Therefore, this review will address how pre- and postnatal challenges can program lifelong thirst and sodium appetite in animals and humans, as well as which neuroendocrine substrates are involved. In addition, the possible epigenetic molecular mechanisms responsible for the developmental programing of drinking behavior, the clinical implications of hydromineral disturbances during pre- and postnatal periods, and the developmental origins of adult hydromineral behavior will be discussed.

Matched MeSH terms: Drinking/physiology
Fulltext A comparison of responses to alcohol expectancy questionnaire (CEOA) of Indian and Malaysian medical students

Ganaraja B, Ramesh BM, Kotian MS

Indian J. Physiol. Pharmacol., 2010;54(3):265-70.
PMID: 21409864

Alcohol addiction is a social problem faced by every country worldwide. Young people are more at risk of this menace. In spite of a clear knowledge and message about the effects of alcohol on individual health and social fabric, it is hard to curb the overuse of this beverage. In the present study, we compared the outcome of a survey using Comprehensive effects of Alcohol (CEOA) in two private Medical institutions in two Asian countries, viz. KMC, Mangalore, India (n=180) and AIMST, Kedah, Malaysia (n=170). The study included both males and female students. The result suggested that the negative reinforcement responses were rated higher in both the study groups. But those who have tasted alcohol before had a higher rating that alcohol may cause positive reinforcement. Both groups of respondents showed similar trend suggesting that the alcohol expectancies are similar in Indian students and Malaysian students. From the results we could conclude that the responses of the two sample groups were comparable to each other. While the male respondents were inclined show higher affinity towards acceptance of alcohol females are very much less so. However, the respondents of both groups appeared to be well aware of the negative aspects of alcohol. Importantly previous exposure to alcohol intake dramatically changed the perception and showed increased inclination towards alcoholism. This study thus provides an important clue to the clinician, counselors and parents regarding the importance of guiding the young people about the alcoholism.

Matched MeSH terms: Alcohol Drinking/psychology*
Acute ingestion of hydrogen-rich water does not improve incremental treadmill running performance in endurance-trained athletes

Ooi CH, Ng SK, Omar EA

Appl Physiol Nutr Metab, 2020 May;45(5):513-519.
PMID: 31675478 DOI: 10.1139/apnm-2019-0553

There is emerging evidence that hydrogen-rich water (H2-water) has beneficial effects on the physiological responses to exercise. However, few studies investigate its ergogenic potential. This randomized controlled trial examined the effects of H2-water ingestion on physiological responses and exercise performance during incremental treadmill running. In a double-blind crossover design, 14 endurance-trained male runners (age, 34 ± 4 years; body mass, 63.1 ± 7.2 kg; height, 1.72 ± 0.05 m) were randomly assigned to ingest 2 doses of 290-mL H2-water or placebo on each occasion. The first bolus was given before six 4-min submaximal running bouts, and the second bolus was consumed before the maximal incremental running test. Expired gas, heart rate (HR), and ratings of perceived exertion (RPE) were recorded; blood samples were collected at the end of each submaximal stage and post maximal running test. Cardiorespiratory responses, RPE, and blood gas indices were not significantly different at each submaximal running intensity (range: 34%-91% maximal oxygen uptake) between H2-water and placebo trials. No statistical difference was observed in running time to exhaustion (618 ± 126 vs. 619 ± 113 s), maximal oxygen uptake (56.9 ± 4.4 vs. 57.1 ± 4.7 mL·kg-1·min-1), maximal HR (184 ± 7 vs. 184 ± 7 beat·min-1), and RPE (19 ± 1 vs. 19 ± 1) in the runners between the trials. The results suggest that the ingestion of 290 mL of H2-water before submaximal treadmill running and an additional dose before the subsequent incremental running to exhaustion were not sufficiently ergogenic in endurance-trained athletes. Novelty Acute ingestion of H2-water does not seem to be ergogenic for endurance performance. A small dose of H2-water does not modulate buffering capacity during intense endurance exercise in athletes.

Matched MeSH terms: Drinking Water/chemistry*
Fulltext Factors related to alcohol drinking among the adolescents in federal territory, Kuala Lumpur

Wan Rozita WM, Kaur H, Amal NM, Lim KH

Malaysian Journal of Public Health Medicine, 2005;5(1):23-26.
MyJurnal

Misuse of alcohol among adolescents, particularly schoolchildren has become one of the public health concerns in Malaysia due to its serious effects and an increased risk of alcohol related injuries, especially motor vehicle injuries. This is the most common type of youthful fatal injury in Malaysia. However the availability of data on the extent of alcohol abuse particularly among school children in this country is limited. Therefore, we conducted this study with the objectives of identifying the prevalence of alcohol drinking among school children in Kuala Lumpur, factors rekited to alcohol drinking among the adolescents and to assess health status of their parents through the presence of any related alcohol diseases and the habits of alcohol drinking among their parents.
In this baseline study a two stage stratified sampling design was used to recruit 8532 eligible students from the selected secondary schools in Kuala Lumpur. The prevalence of alcohol drinking was 9.0% (771 / 8532) . Significant factors identihed related to alcohol consumption were akoholic father (OR=1.29), akoholic mother (1 .55) ; elder siblings consume alcohol (2 .49) and the Chinese ethnic group (1 .55) . The study revealed that factors which signihcantly contributed to the habit of alcohol drinking were related to whether their parents consumed alcohol or not or either their eMer siblings were ako taking alcohol. Therefore, the, results from this study could be used as a baseline data to describe the level of alcohol consumption among adolescents particularly school children. Ehfective public health interventions that focus on the familial context of adolescents' drinking habits may be developed.

Matched MeSH terms: Alcohol Drinking*
Fulltext Psychometric properties of the Malay version of alcohol, smoking and substance involvement screening test (ASSIST-M)

Salina, M., Rusdi, A.R., Zahari, M.M., Sharmilla, K., Yee, A.

Malaysian Journal of Psychiatry, 2016;25(2):0-0.
MyJurnal

Background: The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) developed by the World Health Organization is designed to identify individuals at risk for alcohol use problems and provide brief intervention.
Objectives: To evaluate the validity and reliability of the ASSIST in Malaysia’s official language, the Bahasa Malay, among a group of alcohol users. The study also aimed to assess the impact of alcohol on the quality of life of patients.
Methods: The final version of ASSIST-M was administered to 51 patients who were identified as alcohol users and attended the outpatient psychiatric clinic during a three-month period from September to November of 2012. Patients completed ASSIST, ASSIST-M, Mini-International Neuropsychiatric Interview (M.I.N.I.), Malay version of The Alcohol Use Disorders Identification Test (AUDIT-M), CAGE Assessment for Alcohol Abuse (CAGE), and the World Health Organization Quality of Life Scale-Brief-Malay version (WHOQoL-Brief-M). Statistical procedures were performed to assess the reliability and validity of the ASSIST-M.
Results: Factor analysis of ASSIST-M yielded one factor similar to the factor structure of the English version. The Cronbach’s α coefficient of ASSIST-M was 0.80. The parallel reliability of the ASSIST-M was high with the intra-class correlation (ICC) of 0.96 (P< 0.01). The test–retest reliability of the ASSIST-M after the 1-week interval was high with the ICC of 0.94(P< 0.01). The ASSIST-M was positively correlated with the AUDIT-M (r =0.67, p <0 .01) and the CAGE (r=0. 57, p < 0.01). ASSIST-M score showed a negative and statistically significant relationships with the physical (r= -0 .28, p < 0.01) and social relationship (r= -0.37, p<0.01) subscales of the WHOQoL-Brief-M. The optimal cutoff point for ASSIST-M for alcohol use disorder was more than 14 with the with a sensitivity of 84.21 %, specificity of 84.38 %, positive predictive value (PPV) of 76.19% and negative predictive value (NPV) of 90%.
Conclusions/Importance: The ASSIST-M displayed a fair psychometric performance in assessing alcohol use disorder in Malaysia.
Keywords: Alcohol Dependence, ASSIST, ASSIST-M, M.I.N.I., CAGE, WHOQoL
Study site: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Alcohol Drinking*
Fulltext Quantitative Microbial Risk Assessment of Drinking Water Quality to Predict the Risk of Waterborne Diseases in Primary-School Children

Ahmed J, Wong LP, Chua YP, Channa N, Mahar RB, Yasmin A, et al.

Int J Environ Res Public Health, 2020 04 17;17(8).
PMID: 32316585 DOI: 10.3390/ijerph17082774

Primary-school children in low- and middle-income countries are often deprived of microbiologically safe water and sanitation, often resulting in a high prevalence of gastrointestinal diseases and poor school performance. We used Quantitative Microbial Risk Assessment (QMRA) to predict the probability of infection in schoolchildren due to consumption of unsafe school water. A multistage random-sampling technique was used to randomly select 425 primary schools from ten districts of Sindh, Pakistan, to produce a representative sample of the province. We characterized water supplies in selected schools. Microbiological testing of water resulted in inputs for the QMRA model, to estimate the risks of infections to schoolchildren. Groundwater (62%) and surface water (38%) were identified as two major sources of drinking water in the selected schools, presenting varying degrees of health risks. Around half of the drinking-water samples were contaminated with Escherichia coli (49%), Shigella spp. (63%), Salmonella spp. (53%), and Vibrio cholerae (49%). Southern Sindh was found to have the highest risk of infection and illness from Campylobacter and Rotavirus. Central and Northern Sindh had a comparatively lower risk of waterborne diseases. Schoolchildren of Karachi were estimated to have the highest probability of illness per year, due to Campylobacter (70%) and Rotavirus (22.6%). Pearson correlation was run to assess the relationship between selected pathogens. V. cholerae was correlated with Salmonella spp., Campylobacter, Rotavirus, and Salmonella spp. Overall, the risk of illness due to the bacterial infection (E. coli, Salmonella spp., V. cholerae, Shigella, and Campylobacter) was high. There is a dire need for management plans in the schools of Sindh, to halt the progression of waterborne diseases in school-going children.

Matched MeSH terms: Drinking Water*
Fulltext Green Tea and Pomegranate Extract Administered During Critical Moments of the Production Cycle Improves Blood Antiradical Activity and Alters Cecal Microbial Ecology of Broiler Chickens

Perricone V, Comi M, Giromini C, Rebucci R, Agazzi A, Savoini G, et al.

Animals (Basel), 2020 Apr 30;10(5).
PMID: 32366030 DOI: 10.3390/ani10050785

Phytobiotics are usually tested in feed and throughout the production cycle. However, it could be beneficial to evaluate their effects when administered only during critical moments, such as changes in feeding phases. The aim of the trial was to investigate the effect of a commercial plant extract (PE; IQV-10-P01, InQpharm Animal Health, Kuala Lumpur, Malaysia) on growth performance, blood antiradical activity and cecal microbiome when administered in drinking water to broiler chickens during the post-hatching phase and at each change of diet. In the experiment, 480 1-day-old male broiler chicks were assigned to two groups in a 50-day trial. Broilers received drinking water (C) or drinking water plus PE (T) at a rate of 2 mL/L on days 0 to 4, 10-11 and 20-21. PE did not affect performance and water intake, while total antiradical activity was improved (p < 0.05). A greater abundance of lactic acid bacteria (false discovery rate (FDR) < 0.05) was found in the T group and the result was confirmed at a lower taxonomic level with higher Lactobacillaceae abundance (FDR < 0.05). Our findings suggest that PE administration during critical moments of the production cycle of broiler chickens may exert beneficial effects at a systemic level and on gut microbial ecology.

Matched MeSH terms: Drinking; Drinking Water
Pharmaceuticals, hormones, plasticizers, and pesticides in drinking water

Wee SY, Ismail NAH, Haron DEM, Yusoff FM, Praveena SM, Aris AZ

J Hazard Mater, 2022 02 15;424(Pt A):127327.
PMID: 34600377 DOI: 10.1016/j.jhazmat.2021.127327

Humans are exposed to endocrine disrupting compounds (EDCs) in tap water via drinking water. Currently, most of the analytical methods used to assess a long list of EDCs in drinking water have been made available only for a single group of EDCs and their metabolites, in contrast with other environmental matrices (e.g., surface water, sediments, and biota) for which more robust methods have been developed that allow detection of multiple groups. This study reveals an analytical method of one-step solid phase extraction, incorporated together with liquid chromatography-tandem mass spectrometry for the quantification of multiclass EDCs (i.e., pharmaceuticals, hormones, plasticizers, and pesticides) in drinking water. Fifteen multiclass EDCs significantly varied in amount between field samples (p

Matched MeSH terms: Drinking Water*
Gadolinium based contrast agents (GBCAs): Uniqueness, aquatic toxicity concerns, and prospective remediation

Oluwasola IE, Ahmad AL, Shoparwe NF, Ismail S

J Contam Hydrol, 2022 Oct;250:104057.
PMID: 36130428 DOI: 10.1016/j.jconhyd.2022.104057

The current toxicity concerns of gadolinium-based contrast agents (GBCAs) have birthed the need to regulate and, sometimes restrict its clinical administration. However, tolerable concentration levels of Gd in the water sector have not been set. Therefore, the detection and speedy increase of the anthropogenic Gd-GBCAs in the various water bodies, including those serving as the primary source of drinking water for adults and children, is perturbing. Nevertheless, the strongly canvassed risk-benefit considerations and superior uniqueness of GBCAs compared to the other ferromagnetic metals guarantees its continuous administration for Magnetic resonance imaging (MRI) investigations regardless of the toxicity concerns. Unfortunately, findings have shown that both the advanced and conventional wastewater treatment processes do not satisfactorily remove GBCAs but rather risk transforming the chelated GBCAs to their free ionic metal (Gd 3+) through inadvertent degradation processes. This unintentional water processing-induced GBCA dechelation leads to the intricate pathway for unintentional human intake of Gd ion. Hence exposure to its probable ecotoxicity and several reported inimical effects on human health such as; digestive symptoms, twitching or weakness, cognitive flu, persistent skin diseases, body pains, acute renal and non-renal adverse reactions, chronic skin, and eyes changes. This work proposed an economical and manageable remediation technique for the potential remediation of Gd-GBCAs in wastewater, while a precautionary limit for Gd in public water and commercial drinks is advocated.

Matched MeSH terms: Drinking Water*
Fulltext Dietary practices of adolescents in Singapore and Malaysia

Lew K, Barlow PJ

Singapore Med J, 2005 Jun;46(6):282-8.
PMID: 15902356

INTRODUCTION: This study sets out to investigate any differences in dietary practices between adolescents in Singapore and Malaysia.
METHODS: An adolescent dietary practices survey was conducted in Singapore and Malaysia involving 200 adolescents (100 from each country) aged 11 to 21 years in order to have a better understanding of the adolescents' dietary practices. Dietary practices were assessed by a self-administered dietary practices questionnaire (DPQ).
RESULTS: The major differences identified between adolescents' dietary practices in Singapore and Malaysia are related to alcohol consumption and venue for taking of lunch. More Malaysian adolescents have their lunch prepared at home (32.9 percent), compared with 7.2 percent of Singaporean adolescents. More adolescents in Malaysia drink alcohol (49.4 percent), compared with only 21.7 percent of Singaporean adolescents.
CONCLUSION: From the dietary practices survey of adolescents from Singapore and Malaysia, it may be concluded that while general dietary practices are similar, the major differences identified were significantly (p-value is less than 0.05) higher alcohol consumption by Malaysian adolescents and significantly (p-value is less than 0.05) more Malaysians took their lunch at home compared with Singaporeans. The reasons for the differences are discussed in the paper.

Matched MeSH terms: Alcohol Drinking/epidemiology
Removal of chloride ion from drinking water using Ag NPs-Modified bentonite: Characterization and optimization of effective parameters by response surface methodology-central composite design

Moradi H, Sabbaghi S, Mirbagheri NS, Chen P, Rasouli K, Kamyab H, et al.

Environ Res, 2023 Apr 15;223:115484.
PMID: 36775091 DOI: 10.1016/j.envres.2023.115484

The presence of chloride ion as an environmental pollutant is having a devastating and irreversible effect on aquatic and terrestrial ecosystems. To ensure safe and clean drinking water, it is vital to remove this substance using non-toxic and eco-friendly methods. This study presents a novel and highly efficient Ag NPs-modified bentonite adsorbent for removing chloride ion, a common environmental pollutant, from drinking water using a facile approach. The surface chemical properties and morphology of the pristine Na-bentonite and Ag NPs-Modified bentonite were characterized by field emission scanning electron microscopy (FESEM) and X-ray spectroscopy (EDX), X-Ray diffraction (XRD), Fourier transform infrared (FTIR), and zeta potential (ζ). To achieve maximum chloride ion removal, the effects of experimental parameters, including adsorbent dosage (1-9 g/L), chloride ion concentration (100-900 mg/L), and reaction time (5-25 h), were examined using the Response Surface Methodology (RSM). The chloride ion removal of 90% was obtained at optimum conditions (adsorbent dosage: 7 g/L, chloride ion concentration: 500 mg/L, and reaction time: 20 h). The adsorption isotherm and kinetics results indicated that the Langmuir isotherm model and pseudo-second-order kinetics were found suitable to chloride ion removal. Additionally, the regeneration and reusability of the Ag NPs-modified bentonite were further studied. In the regeneration and reusability study, the Ag NPs-modified bentonite has shown consistently ≥90% and ≥87% chloride ion removal even up to 2 repeated cycles, separately. Thus, the findings in this study provided convincing evidence for using Ag-NPs modified bentonite as a high-efficiency and promising adsorbent to remove chloride ion from drinking water.

Matched MeSH terms: Drinking Water*
Fulltext AUDIT-C as a possible source of referral during the COVID-19 pandemic for participants presenting patterns of high-risk alcohol consumption in a South African township

Goldschmidt L, Mncina B, Langa M, Rebello S, Budaza T, Tshabalala J, et al.

BMC Public Health, 2023 Sep 30;23(1):1890.
PMID: 37775803 DOI: 10.1186/s12889-023-16775-5

BACKGROUND: Unhealthy alcohol use is a leading contributor to premature death and disability worldwide. The World Health Organization's Global Status Report on Alcohol and Health ranked South Africa as having one of the riskiest patterns of alcohol consumption, which calls for intervention. Recognising the need for effective primary care interventions, particularly in the absence of appropriate alcohol-related harm reduction policies at national and local levels, this paper highlights the opportunities and challenges associated with a two-pronged, community-centred approach to the identification of unhealthy alcohol use and interventions.
METHODS: This approach included the use of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) as a means of screening to identify individuals at moderate (score of 5-7) to high risk (score of 8 +) alcohol use, raising awareness, and investigating the potential utility of brief advice and referrals as a means of reducing risk.
RESULTS: Of the 54,187 participants, 43.0% reported engaging in moderate-risk alcohol consumption, with 22.1% reporting high-risk alcohol consumption. Resistance to brief advice was observed to increase with higher AUDIT-C scores. Similarly, participants engaging in high-risk alcohol consumption were resistant to accepting treatment referrals, with fewer than 10% open to receiving a referral.
CONCLUSIONS: While men were most likely to report patterns of high-risk alcohol consumption, they were more resistant to accepting referrals. Additionally, participants who were willing to receive brief advice were often resistant to taking active steps to alter their alcohol use. This study highlights the need to consider how to prevent harmful patterns of alcohol use effectively and holistically, especially in low socioeconomic settings through primary health care and community services.

Matched MeSH terms: Alcohol Drinking/prevention & control

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