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Fulltext Shisha smoking and associated factors among medical students in Malaysia

Al-Naggar RA, Bobryshev YV

Asian Pac J Cancer Prev, 2012;13(11):5627-32.
PMID: 23317228

BACKGROUND: The aim of the study was to determine the prevalence of shisha smoking and associated factors among medical students in Malaysia.

MATERIALS AND METHODS: A cross-sectional study was conducted at the Management and Science University from December 2011 until March 2012. The questionnaire consisted of five sections including socio-demographic, social environment, knowledge about shisha, psychosocial factors, and personal shisha smoking behavior. Obtained data were analyzed using Statistical Package for the Social Sciences (SPSS 13). T-test was used to determine the relationships between shisha smoking and socio-demographic characteristic.

RESULTS: A total number of 300 medical students participated in this study. Mean age was 22.5±2.5 years. The majority were female, Malay, single, from urban areas (67%, 54%, 97%, 73%; respectively). The prevalence of shisha smoking among medical students was found to be 20%. The study revealed that many students believed that shisha does not contains nicotine, carbon monoxide, does not lead to lung cancer, dental problems and does not lead to cardiovascular diseases (25%, 20.7%, 22.3%, 29%, 26.7%; respectively). Age and sex were found to be significantly associated with smoking shisha status among medical students (p=0.029, p<0.001; respectively). Furthermore, having parents, siblings and friends smokers of shisha were found to be significantly associated with shisha smoking status (p<0.001, p<0.001, p<0.001; respectively). Furthermore, family problems, problems with friends, financial problems and university life were found to significantly associated with shisha smoking status among medical students (p<0.001, p=0.002, p<0.001, p=0.002; respectively).

CONCLUSIONS: There is a high prevalence of shisha smoking and a poor knowledge about its impact on health among medical students. More attention is needed to focus on medical education in this regard. The policies that are currently employed in order to reduce the cigarettes smoking should be applied to shisha smoking and shisha products.

Matched MeSH terms: Social Environment
Self-specific environments associated with nasopharyngeal carcinoma in Selangor, Malaysia

Armstrong RW, Kutty MK, Armstrong MJ

Soc Sci Med, 1978 Dec;12(3D-4D):149-56.
PMID: 734454 DOI: 10.1016/0160-8002(78)90029-1
Matched MeSH terms: Social Environment*
Rarity of cancer of the cervix in the Malaysian Orang Asli despite the presence of known risk factors

Sumithran E

Cancer, 1977 Apr;39(4):1570-2.
PMID: 856445

Cancer of the cervix is exceedingly uncommon in the Malaysian Orang Asli (aborigine), despite the presence of factors associated with an increased risk of developing this malignancy. In only three patients was the diagnosis of carcinoma of the cervix established, out of a total of nearly 18,000 female inpatients, admitted to the Gombak Orang Asli Hospital over a 13-year period. Over this same period, 81 female patients were diagnosed as having cancer. Interviews with female Orang Asli patients show the presence of alleged risk factors for cervical cancer, including early age of first intercourse, multiparity and non-circumcision of husbands. The low incidence of cancer of the cervix in this aborigine community may be due to the strict moral code of the Orang Asli, limiting extramarital sexual activity and associated venereal infection.

Matched MeSH terms: Social Environment
Fulltext Range Measurement and a Habitat Suitability Map for the Norway Rat in a Highly Developed Urban Environment

Oyedele DT, Sah SA, Kairuddinand L, Wan Ibrahim WM

Trop Life Sci Res, 2015 Dec;26(2):27-44.
PMID: 26868708 MyJurnal

Studies of habitat suitability (HS) are essential when animals' habitats have been altered or when animals migrate to a habitat different from their natural habitat. This study assessed HS and used an integrated geographic information system in the assessment of Rattus norvegicus in a highly developed urban environment. Using data from the Campbell market and the police quarters of George Town, Malaysia, home range (through the use of 100% Minimum Convex Polygon [MCP], 95% MCP and 95% Harmonic Mean [HM]) was estimated. Home range for male rats at Campbell market reached an asymptote, with a slight increase, at 96 radio fixes (home range = 133.52 m(2); core area = 29.39 m(2)). Female rats reached an asymptote at 62 radio fixes (home range = 13.38 m(2); core area = 9.17 m(2)). At Campbell market, male rats emerged at 1900 hours every day, whereas females emerged at 2000 hours; at police quarters, the most common time of emergence for males was 2000 hours and for females was 2200. Raster charts of R. norvegicus showed that rat hot spots can be grouped into 4 zones (market, shop houses, settlement and general places). The standardised raster chart isolated the market as the major rallying points of the rats (hot spots) by producing the highest rats frequencies of 255. All of the habitat suitability thresholds, including the built-up points, skip bins, water source and nature of the site explored in this study, produced a structural pattern (monotonic increase or decrease) of habitat suitability.

Matched MeSH terms: Social Environment
Quality of life in dementia patients: nursing home versus home care

Nikmat AW, Hawthorne G, Al-Mashoor SH

Int Psychogeriatr, 2011 Dec;23(10):1692-700.
PMID: 21729416 DOI: 10.1017/S1041610211001050

Care management providing a high quality of life (QoL) is a crucial issue in dealing with increasing numbers of dementia patients. Although the transition from informal (home-based) care to formal (institutional) care is often a function of dementia stage, for those with early dementia there is currently no definitive evidence showing that informal or formal care provides a higher QoL, particularly where informal care is favored for local cultural reasons. This paper outlines the research protocol for a study comparing formal and informal care in Malaysia. It seeks to provide evidence regarding which is more appropriate and results in higher QoL in early dementia.

Matched MeSH terms: Social Environment
Psychological distress as a mediator in the relationships between biopsychosocial factors and disordered eating among Malaysian university students

Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS

Appetite, 2012 Dec;59(3):679-87.
PMID: 22885453 DOI: 10.1016/j.appet.2012.08.002

The mechanism linking biopsychosocial factors to disordered eating among university students is not well understood especially among Malaysians. This study aimed to examine the mediating role of psychological distress in the relationships between biopsychosocial factors and disordered eating among Malaysian university students. A self-administered questionnaire measured self-esteem, body image, social pressures to be thin, weight-related teasing, psychological distress, and disordered eating in 584 university students (59.4% females and 40.6% males). Body weight and height were measured. Structural equation modeling analysis revealed that the partial mediation model provided good fit to the data. Specifically, the relationships between self-esteem and weight-related teasing with disordered eating were mediated by psychological distress. In contrast, only direct relationships between body weight status, body image, and social pressures to be thin with disordered eating were found and were not mediated by psychological distress. Furthermore, multigroup analyses indicated that the model was equivalent for both genders but not for ethnic groups. There was a negative relationship between body weight status and psychological distress for Chinese students, whereas this was not the case among Malay students. Intervention and prevention programs on psychological distress may be beneficial in reducing disordered eating among Malaysian university students.

Matched MeSH terms: Social Environment*
Fulltext Prevalence and of smoking and associated factors among Malaysian University students

Al-Naggar RA, Al-Dubai SA, Al-Naggar TH, Chen R, Al-Jashamy K

Asian Pac J Cancer Prev, 2011;12(3):619-24.
PMID: 21627354

OBJECTIVE: The objectives were to determine the prevalence and associated factors for smoking among university students in Malaysia.
METHODOLOGY: A cross-sectional study was conducted among 199 students in the period from December of academic year 2009 until April of academic year 2010 in Management and Science University (MSU), Shah Alam, Selangor, Malaysia. The questionnaire was distributed randomly to all faculties of MSU by choosing one of every 3 lecture rooms, as well as the library and cafeterias of the campus randomly by choosing one from every 3 tables. Questions concerned socio-demographic variables, knowledge, attitudes and practice toward smoking. Participant's consent was obtained and ethical approval was provided by the ethics committee of the University. Data entry and analysis were performed using descriptive statistics, chi square test, Student t- test and logistic multiple regression with the SPSS version 13.0, statistical significance being concluded at p < 0.05.
RESULTS: About one third of students were smokers (29%). The most important reason of smoking was stress (20%) followed by 'influenced by friends' (16 %). Prevalence of smoking was significantly higher among male and those in advanced semesters (p = >0.001, p = 0.047). Smokers had low level of knowledge (p < 0.05), had wrong beliefs on smoking (p < 0.05), and negative attitude toward tobacco control policies compared to non smokers (p < 0.05). On multiple logistic regression, significant predictors of smoking in the model were gender (p = 0.025), age (p = 0.037), semester of study (p = 0.025) and attitude toward smoking (p < 0.001).
CONCLUSION: This study found that 29% of university students were smokers. Males and students in advanced semesters were more likely to smoke. The results provide baseline data to develop an anti-smoking program to limit smoking in the university by implementing policies against smoking.

Matched MeSH terms: Social Environment
Fulltext Physical inactivity among health staff: what influences the behaviour?

Nurhaliza Zakariah, Ragunath, Priya, Feisul Idzwan Mustapha, Huda Zainuddin

Malaysian Journal of Medicine and Health Sciences, 2018;14(3):16-23.
MyJurnal

Introduction: Physical inactivity has been recognised as the fourth leading risk factor for mortality worldwide. Individuals who are physically inactive have an increased risk of 20% to 30% of dying prematurely. Individuals who fulfil the minimum recommendations of physical activity can reduce the development of Non-Communicable Diseases. In 2015, 33.5% of Malaysian adults were reported to be physically inactive. Various factors were found to be associated with physical activity participation and these factors need to be explored. Methods: A cross-sectional study using proportionate simple random sampling was conducted. A total of 310 health staff were sampled according to the proportion from five divisions and data were collected using a self-administered questionnaire. IBM SPSS version 22.0 were used to analyse the data. Predictors for physical activity were also determined. Results: The response rate was 97.7% (303 out of 310). The prevalence of physical inactivity among respondents was 37.6%. The predictors for physical inactivity were smoker/ex-smoker (aOR=2.308, p=0.027), certificate/diploma education (aOR=2.135, p=0.008), personal barrier (aOR=1.055, p=0.017) and social environment barrier (aOR=1.106, p =0.025). Conclusion: People that have a higher possibility of being physically inactive were those with certificate or diploma education and smokers or ex-smokers. Those with personal barriers and social environment barriers likewise have higher probability of being physically inactive. Thus, appropriate health interventions should be developed by taking these factors into consideration to promote physical activity among the health staff.

Matched MeSH terms: Social Environment
Fulltext Perceived unmet needs of an age-friendly environment: A qualitative exploration of older adults' perspectives in a Malaysian city

Lim XJ, Chew CC, Chang CT, Supramaniam P, Ding LM, Devesahayam PR, et al.

PLoS One, 2023;18(6):e0286638.
PMID: 37279237 DOI: 10.1371/journal.pone.0286638

This exploratory qualitative study investigates older adults' unmet needs in the age-friendly city of Ipoh, Malaysia. Seventeen participants were interviewed, including ten older adults residing in Ipoh City for at least six months, four carers, and three professional key informants. Interviews were conducted using semi-structured questions based on the WHO Age-Friendly Cities Framework. A 5P framework for active ageing based on the ecological ageing model was adapted for data analysis. The 5P framework consists of domains of person (micro), process (meso), place (macro), policymaking (macro), and prime, which allows for the dissection of older adults' unmet needs in planning for multilevel approaches, which were employed for analysis. Person: the personal needs requiring improvement included digital divide disparity, inadequate family support, and restricted sports activities attributed to physical limitations. Process: There were fewer social activities and a lack of low-cost and easily accessible venues for seniors. Economic challenges include expensive private healthcare services, variation in the quality of care in older residential care facilities, and limited savings for retirement. Place issues include unequal distribution of exercise equipment, public open spaces, the need for more conducive parking for seniors, and a place for social activities. Difficulties assessing public transportation, digitalized services, and unaffordable e-hailing services are common among seniors. Housing issues for seniors include a lack of barrier-free housing design and unaffordable housing. Policymaking: Insufficient private sector commitment to improving services to older adults, lack of policy governance on the quality of nursing homes, and insufficient multidisciplinary governance collaboration. Prime: Health promotion for preventing age-related illness is required to preserve health in old age, and full-time family caregivers' psychological well-being is often overlooked.

Matched MeSH terms: Social Environment*
Fulltext Perceived physical activity barriers related to body weight status and sociodemographic factors among Malaysian men in Klang Valley

Ibrahim S, Karim NA, Oon NL, Ngah WZ

BMC Public Health, 2013;13:275.
PMID: 23530696 DOI: 10.1186/1471-2458-13-275

Physical inactivity has been acknowledged as a public health issue and has received increasing attention in recent years. This cross-sectional study was conducted to determine the barriers to physical activity among Malaysian men. These barriers were analyzed with regards to sociodemographic factors, physical activity level, BMI and waist circumference.

Matched MeSH terms: Social Environment*
One world is not enough: the structured phenomenology of lifestyle migrants in East Asia

Stones R, Botterill K, Lee M, O'Reilly K

Br J Sociol, 2019 Jan;70(1):44-69.
PMID: 29479667 DOI: 10.1111/1468-4446.12357

The paper is based on original empirical research into the lifestyle migration of European migrants, primarily British, to Thailand and Malaysia, and of Hong Kong Chinese migrants to Mainland China. We combine strong structuration theory (SST) with Heideggerian phenomenology to develop a distinctive approach to the interplay between social structures and the lived experience of migrants. The approach enables a rich engagement with the subjectivities of migrants, an engagement that is powerfully enhanced by close attention to how these inner lives are deeply interwoven with relevant structural contexts. The approach is presented as one that could be fruitfully adopted to explore parallel issues within all types of migration. As is intrinsic to lifestyle migration, commitment to a better quality of life is central to the East Asian migrants, but they seek an uncomplicated, physically enhanced texture of life, framed more by a phenomenology of prosaic well-being than of self-realization or transcendence. In spite of possessing economic and status privileges due to their relatively elite position within global structures the reality for a good number of the lifestyle migrants falls short of their prior expectations. They are subject to particular kinds of socio-structural marginaliszation as a consequence of the character of their migration, and they find themselves relatively isolated and facing a distinct range of challenges. A comparison with research into various groups of migrants to the USA brings into relief the specificities of the socio-structural positioning of the lifestyle migrants of the study. Those East Asian migrants who express the greatest sense of ease and contentment seem to be those who have responded creatively to the specific challenges of their socio-structural situation. Often, this appears to have been achieved through understated but active involvements with their new settings and through sustaining focused transnational connections and relationships.

Matched MeSH terms: Social Environment*
Normative beliefs about aggression as a mediator of narcissistic exploitativeness and cyberbullying

Ang RP, Tan KA, Talib Mansor A

J Interpers Violence, 2011 Sep;26(13):2619-34.
PMID: 21156699 DOI: 10.1177/0886260510388286

The current study examined normative beliefs about aggression as a mediator between narcissistic exploitativeness and cyberbullying using two Asian adolescent samples from Singapore and Malaysia. Narcissistic exploitativeness was significantly and positively associated with cyberbullying and normative beliefs about aggression and normative beliefs about aggression were significantly and positively associated with cyberbullying. Normative beliefs about aggression were a significant partial mediator in both samples; these beliefs about aggression served as one possible mechanism of action by which narcissistic exploitativeness could exert its influence on cyberbullying. Findings extended previous empirical research by showing that such beliefs can be the mechanism of action not only in offline but also in online contexts and across cultures. Cyberbullying prevention and intervention efforts should include modification of norms and beliefs supportive of the legitimacy and acceptability of cyberbullying.

Matched MeSH terms: Social Environment
Need for developing a security robot-based risk management for emerging practices in the workplace using the Advanced Human-Robot Collaboration Model

Zheyuan C, Rahman MA, Tao H, Liu Y, Pengxuan D, Yaseen ZM

Work, 2021;68(3):825-834.
PMID: 33612525 DOI: 10.3233/WOR-203416

BACKGROUND: The increasing use of robotics in the work of co-workers poses some new problems in terms of occupational safety and health. In the workplace, industrial robots are being used increasingly. During operations such as repairs, unmanageable, adjustment, and set-up, robots can cause serious and fatal injuries to workers. Collaborative robotics recently plays a rising role in the manufacturing filed, warehouses, mining agriculture, and much more in modern industrial environments. This development advances with many benefits, like higher efficiency, increased productivity, and new challenges like new hazards and risks from the elimination of human and robotic barriers.
OBJECTIVES: In this paper, the Advanced Human-Robot Collaboration Model (AHRCM) approach is to enhance the risk assessment and to make the workplace involving security robots. The robots use perception cameras and generate scene diagrams for semantic depictions of their environment. Furthermore, Artificial Intelligence (AI) and Information and Communication Technology (ICT) have utilized to develop a highly protected security robot based risk management system in the workplace.
RESULTS: The experimental results show that the proposed AHRCM method achieves high performance in human-robot mutual adaption and reduce the risk.
CONCLUSION: Through an experiment in the field of human subjects, demonstrated that policies based on the proposed model improved the efficiency of the human-robot team significantly compared with policies assuming complete human-robot adaptation.

Matched MeSH terms: Social Environment
Methods of qualitative research in dentistry: a review

Masood M, Masood Y, Newton TJ

Dent Update, 2010 Jun;37(5):326-8, 331-2, 334-6.
PMID: 20669712 DOI: 10.12968/denu.2010.37.5.326

Over the last decade, researchers in health services research started using qualitative research methods. This has led to a corresponding rise in the reporting of the qualitative research studies in medical and related journals, including dental journals. Qualitative research is often contrasted with quantitative research as a set of 'non quantitative methods', since it does not deal with numbers and enumerate phenomena. It interprets the information people bring to research, which helps us to understand social phenomena in natural settings like their own territory, in their own language and on their own terms, giving emphasis to the meaning, experience and view of all the participants.

CLINICAL RELEVANCE: This article will help the clinician to understand the importance of in-depth knowledge of behaviour and social phenomena around the patient.

Matched MeSH terms: Social Environment
Fulltext Measuring and mapping urban growth patterns using remote sensing and GIS techniques

Aburas, Maher Milad, Sabrina Ho Abdullah, Mohammad Firuz Ramli, Zulfa Hanan Ash'aari

The Pertanika Journal of Scholarly Research Reviews, 2017;3(1):55-69.
MyJurnal

Remote sensing and geographic information system techniques are significant and popular approaches that have been used in recent years to measure and map urban growth patterns. This paper primarily aims to provide a basis for a literature review of urban growth measurement and mapping by using different methods. For this purpose, the general characteristics of measuring and mapping urban growth patterns are described and classified. The strengths and weaknesses of the various methods have been identified from an analysis and discussion of the characteristics of the techniques. Results of reviews confirm that combining quantitative and qualitative techniques, such as Shannon approach and change detection, to measure and map urban growth patterns will improve understanding of the phenomenon of urban growth. Moreover, using social and economic data such as population and income data will improve understanding of the relationships between causes and effects. The integration of social and economic factors with quantitative and qualitative techniques will contribute to a perfect evaluation of urban growth patterns and land use changes, taking technical, social, economic, spatial, and temporal factors into account.

Matched MeSH terms: Social Environment
Fulltext Managing obesity in Malaysian schools: are we doing the right strategies?

Vikneswaran A/L Sabramani, Idayu Badila Idris, Rosnah Sutan, Zaleha Md. Isa, Saidatul Norbaya Buang, Hasanain Faisal Ghazi

Malaysian Journal of Public Health Medicine, 2015;15(2):75-83.
MyJurnal

The evolution in lifestyle and dietary habits of the Malaysian people that have taken place over the last few decades can be largely attributed to both family and social environment. These factors are known to affect the nutritional status of the community, in both children and adults. Reduced physical activity and changes in their diet have been one of the contributing factors to the rising prevalence of overweight and obesity. However, in Malaysia, in which nutrition transition has been a norm, it is worrying when the trends of overweight and obesity have been rising steadily over the years especially among children. Although numerous strategies to control obesity in Malaysia have been taking place, many had shown little effect. Analysing strategies implemented at national level is thus crucial in order to ascertain reasons for the shortfalls of these strategies especially among children. Obesity most commonly begins as early as the ages of 5 and 6 years, or during adolescence. Obesity is indeed a major public health concern due to its huge negative impact on the society at large which is well supported by evidence-based literatures. Managing this issue is complex and holistic approach is thus crucial in reducing its incidence and prevalence.

Matched MeSH terms: Social Environment
Longhouse dwelling, social contact and the prevalence of leprosy and tuberculosis among native tribes of Sarawak

Chen PCY

Soc Sci Med, 1988;26(10):1073-7.
PMID: 3393924 DOI: 10.1016/0277-9536(88)90225-0

In Sarawak, some tribes stay in communal longhouses whilst others live in villages of single dwellings. The present study looks into the question of whether there is an association between the prevalence of leprosy and tuberculosis with the quantum of social contact that occurs in these two types of settlement patterns. It was found that the prevalence of leprosy and tuberculosis is significantly higher among longhouse dwellers compared with single house dwellers. It was also noted that social groups tended to be larger and to persist for much longer among longhouse dwellers than among those in single dwellings. This lends support to the evidence that social contact in longhouses is more extensive and contributes towards a higher prevalence of leprosy and tuberculosis.

Matched MeSH terms: Social Environment*
Fulltext Learning environment assessments of a single curriculum being taught at two medical schools 10,000 miles apart

Tackett S, Shochet R, Shilkofski NA, Colbert-Getz J, Rampal K, Abu Bakar H, et al.

BMC Med Educ, 2015;15:105.
PMID: 26081751 DOI: 10.1186/s12909-015-0388-0

Perdana University Graduate School of Medicine (PUGSOM), the first graduate-entry medical school in Malaysia, was established in 2011 in collaboration with Johns Hopkins University School of Medicine (JHUSOM), an American medical school. This study compared learning environments (LE) at these two schools, which shared the same overarching curriculum, along with a comparator Malaysian medical school, Cyberjaya University College of Medical Sciences (CUCMS). As a secondary aim, we compared 2 LE assessment tools - the widely-used Dundee Ready Educational Environment Measure (DREEM) and the newer Johns Hopkins Learning Environment Scale (JHLES).

Matched MeSH terms: Social Environment*
Latah: the symbolism of a putative mental disorder

Kenny MG

Cult Med Psychiatry, 1978 Sep;2(3):209-31.
PMID: 710172

This paper examines the symbolic properties and cultural relevance of latah, a behavioral state noted in Malay and Indonesia since the 19th Century. Most interpretations of latah have been psychological, latah being perceived as a 'mental disorder.' In the following, it is concluded that latah is intimately related to other aspects of Malayo-Indonesian culture and that it is a well-known cultural pattern and not a mental disorder as such, though it may occur among persons, largely women, in a socially and psychologically marginal situation. Latah is a symbolic representation of marginality, and it is as appropriate to certain mythological and religious figures to the socially marginal.

Matched MeSH terms: Social Environment
International study of medical school learning environments and their relationship with student well-being and empathy

Tackett S, Wright S, Lubin R, Li J, Pan H

Med Educ, 2017 Mar;51(3):280-289.
PMID: 27896846 DOI: 10.1111/medu.13120

OBJECTIVE: To assess whether favourable perceptions of the learning environment (LE) were associated with better quality of life, less burnout and more empathy across three undergraduate medical education programmes in Israel, Malaysia and China.

METHODS: Cross-sectional surveys were administered at the end of the 2013-2014 academic year at three medical schools: Technion American Medical Students Program (TAMS) in Israel, Perdana University-Royal College of Surgeons in Ireland School of Medicine (PURCSI) in Malaysia and Peking Union Medical College (PUMC) in China. LE perceptions were assessed using the Johns Hopkins Learning Environment Scale (JHLES). Well-being was assessed using validated items for quality of life and the depersonalisation and emotional exhaustion domains of burnout. The 20-item Jefferson Empathy Scale assessed empathy. Statistical analyses included bivariate regressions and multivariate regressions that adjusted for gender, school, class year and perceived academic rank.

RESULTS: Overall, 400/622 (64.3%) students responded, with the following rates by site: TAMS 92/121 (76.0%), PURCSI 160/198 (80.1%) and PUMC 148/303 (48.8%). In multivariate models, favourable overall LE perceptions were associated with higher odds of good quality of life (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.8-5.8; p < 0.001) and lower odds of emotional exhaustion (OR, 0.34; 95% CI, 0.24-0.50; p < 0.001) and depersonaliation (OR, 0.30; 95% CI, 0.24-0.37; p = 0.001). 'Community of Peers', one of seven factors in the JHLES, was the only one to be independently associated with better quality of life and less emotional exhaustion and depersonalisation. After adjusting for covariates, there was not a statistically significant association between overall LE and empathy (OR, 1.4; 95% CI, 0.91-2.2; p = 0.12).

CONCLUSIONS: Students' LE perceptions are closely associated with their well-being, and fostering peer community may hold promise for enhancing quality of life and protecting against burnout. Across these three settings, LE and empathy were not closely related, suggesting that any influence of learning environment on empathy would be modest.

Matched MeSH terms: Social Environment*

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