In 2006 a report on the analysis for lead in 80 new residential paints from four countries in Asia revealed high levels in three of the countries (China, India and Malaysia) and low levels in a fourth country (Singapore) where a lead in paint regulation was enforced. The authors warned of the possible export of lead-painted consumer products to the United States and other countries and the dangers the lead paint represented to children in the countries where it was available for purchase. The need for a worldwide ban on the use of lead in paints was emphasized to prevent an increase in exposure and disease from this very preventable environmental source. Since the earlier paper almost 300 additional new paint samples have been collected from the four initial countries plus 8 additional countries, three from Asia, three from Africa and two from South America. During the intervening time period two million toys and other items imported into the United States were recalled because the lead content exceeded the United States standard. High lead paints were detected in all 12 countries. The average lead concentration by country ranged from 6988 (Singapore) to 31,960ppm (Ecuador). One multinational company sold high lead paint in one country through January 2007 but sold low lead paint later in 2007 indicating that a major change to cease adding lead to their paints had occurred. However, the finding that almost one-third of the samples would meet the new United States standard for new paint of 90ppm, suggests that the technology is already available in at least 11 of the 12 countries to produce low lead enamel paints for domestic use. The need remains urgent to establish effective worldwide controls to prevent the needless poisoning of millions of children from this preventable exposure.
Matched MeSH terms: Lead Poisoning/prevention & control
The rapid advances in technology and improved living standard of the society necessitate abundant use of fossil fuels which poses two major challenges to any nation. One is fast depletion of fossil fuel resources; the other is environmental pollution. The porous medium combustion (PMC) has proved to be one of the technically and economically feasible options to tackle the aforesaid problems to a remarkable extent. PMC has interesting advantages compared with free flame combustion due to the higher burning rates, the increased power dynamic range, the extension of the lean flammability limits, and the low emissions of pollutants. This article provides a comprehensive picture of the global scenario of research and developments in PMC and its applications that enable a researcher to decide the direction of further investigation. The works published so far in this area are reviewed, classified according to their objectives and presented in an organized manner with general conclusions. A separate section is devoted for the numerical modeling of PMC.
Matched MeSH terms: Air Pollution/prevention & control
Postpartum depression has been described as a thief that steals motherhood. It can result in tragedy and sometimes in headline-gripping maternal suicide or infanticide. Because one of the highest priorities for nursing is to continually advance the knowledge that underlies nursing practice, it is essential that we understand what nurse researchers have done to advance the knowledge base of postpartum depression. This integrative review is a two-part series for MCN that summarizes 141 postpartum depression studies conducted by nurse researchers from around the globe, including United States, Australia, Canada, China (Hong Kong, Taiwan), Finland, Iceland, Sweden, Turkey, and Malaysia. Specific areas of postpartum depression to which nurse researchers have devoted their primary attention include epidemiology, risk factors, transcultural perspectives, instrument development, screening, interventions, and mother-infant interactions.
Neonatal Tetanus is a severe disease with high fatality. It should no longer be present in a country with the development status of Malaysia. However, sporadic cases still occur and the disease has not been eradicated. This editorial summarises the disease pattern, incidence and suggests reasons for the continued persistence of the condition locally.
This study aims to study the demographics, clinical presentation, treatment and outcome of neonatal tetanus patients managed at Hospital Duchess of Kent from January 1st 2006 to December 31st 2006. Five neonates were studied. All presented with fever, poor sucking and limb stiffness, with a history of unsterile delivery and uncertain maternal tetanus immunity status. All were nursed in a minimal-stimuli environment and were given IV penicillin G, IM tetanus immunoglobulin and sedatives to control spasms. Nutrition and chest physiotherapy were rendered. Three patients required artificial ventilation. Duration of treatment ranged from 25 to 44 days. All survived. Inadequate maternal immunization, unsterile delivery and inappropriate umbilical cord care are major contributing factors of neonatal tetanus in our study. Supportive measures are the mainstay of treatment in our setting with very limited resources.
Cervical cancer is the second most common female cancer after breast cancer both in Malaysia and worldwide although it can be mostly prevented. The objective of this study was to assess the knowledge level and attitude of University Kebangsaan Malaysia female students in the Faculties of Pharmacy and Allied Health Sciences on the prevention of cervical cancer. A total of 675 respondents were recruited for this cross-sectional study involving pre-tested questionnaires. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 15.0. There was significant association between grade and mean score of knowledge with different faculties and year of education (p<0.05). However, significant association was shown only between grade of knowledge with different programs in the Faculty of Allied Health Sciences. For mean score of knowledge, significant difference only existed among different races (p<0.05). Mass media was the most common source of information. In conclusion, the knowledge level of respondents on cervical cancer and its prevention was not satisfactory despite their positive attitude on prevention. Thus, more awareness programs should be conducted in University campuses to provide students with knowledge on prevention of cervical cancer.
Formation of compost from oil palm empty fruit bunches (EFB) and decanter cake slurry by adding palm oil mill effluent (POME) with regular turning operation was investigated. The experiment was conducted in a commercial composting plant under the normal production process. The addition of decanter cake slurry has hastened the composting process of the EFB. The C/N ratio after 51 days for the mature compost with the decanter cake slurry was 18.65 while that of the matured compost without the decanter cake slurry remained high at 28.96. The compost formed from the addition of decanter cake to EFB and POME had 46.4% nitrogen, 17.9% phosphorus, 17.7% potassium and 23.1% calcium more than that without decanter cake. The use of compost produced from EFB, POME and decanter cake slurry could solve more environmental problems and enhance economic benefits in the oil palm industry.
Malaysia, Brunei, Singapore, Indonesia, East Timor and the Philippines constitute peninsular and island South-East Asia. For reasons of largely shared ethnicity, with Chinese elements added to the basic Austromalaysian populations, as well as geographical contiguity, they can be usefully grouped together for studies of chronic disease prevalence and underlying risk factors. The fact of problems are shared in common, particularly regarding increasing cancer rates, underlines the necessity for a coordinated approach to research and development of control measures. To provide a knowledge base, the present review of available data for cancer registration, epidemiology and control was conducted. The most prevalent cancer site in males is the lung, followed by the liver, colon or the prostate in the majority of cases, while breast and cervical cancers predominate in most female populations. However, there are interesting differences among the racial groups, particularly regarding the stomach. General tendencies for increase in adenocarcinomas but decrease in squamous cell carcinomas and gastric cancer, point to change in environmental influence over time. Variation in risk factors depends to some extent on the level of economic development but overall the countries of the region face similar challenges in achieving effective cancer control. A major task is persuading the general populace of the efficacy of early detection and clinical treatment.
Matched MeSH terms: Neoplasms/prevention & control
Palm oil production is one of the major industries in Malaysia and this country ranks one of the largest productions in the world. In Malaysia, the total production of crude palm oil in 2008 was 17,734,441 tonnes. However, the production of this amount of crude palm oil results in even larger amounts of palm oil mill effluent (POME). In the year 2008 alone, at least 44 million tonnes of POME was generated in Malaysia. Currently, the ponding system is the most common treatment method for POME but other processes such as aerobic and anaerobic digestion, physicochemical treatment and membrane filtration may also provide the palm oil industries with possible insights into the improvement of POME treatment processes. Generally, open ponding offers low capital and operating costs but this conventional method is becoming less attractive because the methane produced is wasted to the atmosphere and the system can not be certified for Carbon Emission Reduction trading. On the other hand, anaerobic digestion of POME provides the fastest payback of investment because the treatment enables biogas recovery for heat generation and treated effluent for land application. Lastly, it is proposed herewith that wastewater management based on the promotion of cleaner production and environmentally sound biotechnologies should be prioritized and included as a part of the POME management in Malaysia for attaining sustainable development. This paper thus discusses and compares state-of-the-art POME treatment methods as well as their individual performances.
Matched MeSH terms: Water Pollution, Chemical/prevention & control*
The role of alcohol in the causation of Fetal Alcohol Syndrome (FAS) has been firmly established. In most cases events leading to its occurrence have been set into motion prior to conception. Alcohol consumption during pregnancy, the sole causative agent of FAS, can therefore be prevented even prior to conception by implementation of preconception counseling (PCC). The present review examines the important issues involved in the implementation of PCC for the prevention of FAS which can be of immense help to the affected population.
Dengue is the most important arthropod borne viral disease of public health significance. Compared to nine reporting countries in the 1950's, today the geographical distribution includes more than 100 countries world wide. The WHO estimates that more than 2.5 billion people are at risk of dengue infections, with 50 million cases occurring annually with 22,000 deaths'. The dengue virus is an enveloped single stranded RNA of the family Flaviridae. There are four serotypes which share genetic and antigenic features but infection with the one serotype does not provide long-term protection against other serotypes. The principal vector is the day biting Aedes aegypti which typically breeds in clean stagnant water in a wide variety of sites including man made containers in the domestic and peridomestic urban environment
VectoBac DT, a tablet formulation of Bacillus thuringiensis israelensis (Bti) was evaluated for the potential control of dengue vectors in various types of potable water containers. On introduction to containers, the tablet sinks to the bottom and the Bti toxins are found concentrated at the sides and the base, while the treated water column is free of Bti toxins within 24 hours after tablet introduction. In a simulated study, earthen, HDPE and plastic containers were kept covered and laboratory-bred larvae were introduced to determine the control by the tablet. The efficacy and persistence of the tablet, with a control of > 90%, was significantly longer in earthen containers in comparison to the HDPE and plastic containers. Efficacy and persistence were observed in earthen containers for a minimum period of 5.5 months (166 days) both without water replenishment and with weekly, 50% water volume, replenishment, and for a maximum period of 2.2 months (66 days) with daily, 50% water volume, replenishment. In plastic and HDPE containers, the tablet activity had a persistence of 2.1 months (63 days) without water replenishment and 1.8 months (54 days) with weekly water replenishment. The efficacy and persistence of the VectoBac DT was significantly longer in the earthen containers, with or without regularly treated water exchange, due to the Bti toxins being embedded in the porous earthen container surfaces, which protects them from rapid degradation. Lesser toxin amounts are removed from the water column during water exchange. The efficacy of VectoBac DT was also evaluated for the control of natural infestation of Aedes larvae which were resistant to temephos at the WHO diagnostic dosage of 0.012 mg/l. The tablet significantly reduced the pupal density by 8 fold in earthen containers for 67 days and 5 fold in HDPE containers for 55 days in comparison to untreated containers (p < 0.05). However, the tablet was effective for a shorter period of 25 days post-tablet-introduction due to fungal infestation in the treated plastic containers. There is a need to determine the capacity of the VectoBac DT to reduce the dengue vector population to a threshold which will prevent dengue outbreaks in dengue endemic areas.
Introduction: The Internet has emerged as a potentially effective medium for information exchange. The Internet's potential has been recognised and web-based education programmes have been steadily adopted in recent years in preventing and managing chronic diseases such as diabetes mellitus. This review provides a descriptive discussion of web-based behavioural interventions for the management of type 2 diabetes mellitus.
Method: Systematic literature searches were performed using MEDLINE, EMBASE, PUBMED, PsycINFO, Web of Science and Cochrane Library to retrieve articles published between 2000 and June 2010 which fulfilled all inclusion criteria. Methodological quality assessment and data synthesis were then performed.
Results: Twenty articles representing 13 different studies were reviewed. None of the studies were ranked as low in the methodological quality. Goal-setting, personalised coaching, interactive feedback and online peer support groups were some of the successful approaches which were applied in e-interventions to manage type 2 diabetes mellitus. Strong theoretical background, use of other technologies and longer duration of intervention were proven to be successful strategies as well.
Conclusion: The web-based interventions have demonstrated some level of favourable outcomes, provided they are further enhanced with proper e-research strategies.
Matched MeSH terms: Diabetes Mellitus, Type 2/prevention & control*
In Malaysia, most municipal wastes currently are disposed into poorly managed 'controlled tipping' systems with little or no pollution protection measures. This study was undertaken to assist the relevant governmental bodies and service providers to identify an improved waste disposal management strategy. The study applied the choice experiment technique to estimate the nonmarket values for a number of waste disposal technologies. Implicit prices for environmental attributes such as psychological fear, land use, air pollution, and river water quality were estimated. Compensating surplus estimates incorporating distance from the residences of the respondents to the proposed disposal facility were calculated for a number of generic and technology-specific choice sets. The resulting estimates were higher for technology-specific options, and the distance factor was a significant determinant in setting an equitable solid waste management fee.
Matched MeSH terms: Water Pollution/prevention & control
Cancer incidences as well as the most prevalent cancer types vary greatly across Asian countries since people have differing health behaviors as well as lifestyle factors related to cancer risk. Countries have varying systems of government organization, laws, resources, facilities, and management strategies for addressing the cancer burden. Examples such as Korea and Japan with existing national cancer control programs need to focus on early screening and detection and quality of screening methods. If screening and detection increase to cover more than 50% of the target population, survival rate increases and thus the number of cancer patients detected increases resulting in higher medical cost. Thus, expansion of cancer screening, in addition to smoking prevention, immunization increase, and diet control awareness, are needed for cancer prevention strategies. Countries such as Thailand, China, Malaysia, and Turkey need to begin organized efforts to reduce cancer deaths through state-wide cancer screening programs. Strategies focused on increasing survival among cancer patients are also needed. In addition, government organizations and law regulations need to be in place as the first step towards cancer prevention. For the countries such as Nepal, Pakistan, Mongolia, and Iraq which do not have any cancer-related organizations in place, the first step that is needed is to raise public awareness about cancer; a public awareness campaign is the number one priority and should begin immediately. The easiest and most feasible step at this point is dissemination of cancer education materials during school health education and physical health screening. This must be started immediately because we need to avoid the development of existing cancers where patients will need to seek specialized cancer treatment facilities that are non-existent in these regions. In addition, hospitals need to take a step further and start undergoing registration of cancer prevalence and incidence cases beginning at the regional level. Through the hospital census, countries will be able to determine the magnitude of the cancer burden. Moreover, countries with professionals and researchers with advanced cancer research, education, and training also need to contribute through international cooperation.
Renal replacement therapy in Malaysia has shown exponential growth since 1990. The dialysis acceptance rate for 2003 was 80 per million population, prevalence 391 per million population. There are now more than 10,000 patients on dialysis. This growth is proportional to the growth in gross domestic product (GDP). Improvement in nephrology and urology services with widespread availability of ultrasonography and renal pathology has improved care of renal patients. Proper management of renal stone disease, lupus nephritis, and acute renal failure has decreased these as causes of end-stage renal disease (ESRD) in younger age groups. Older patients are being accepted for dialysis, and 51% of new patients on dialysis were diabetic in 2003. The prevalence of diabetes is rising in the country (presently 7%); glycemic control of such patients is suboptimal. Thirty-three percent of adult Malaysians are hypertensive and blood pressure control is poor (6%). There is a national coordinating committee to oversee the control of diabetes and hypertension in the country. Primary care clinics have been provided with kits to detect microalbuminuria, and ACE inhibitors for the treatment of hypertension and diabetic nephropathy. Prevention of renal failure workshops targeted at primary care doctors have been launched, opportunistic screening at health clinics is being carried out, and public education targeting high-risk groups is ongoing. The challenge in Malaysia is to stem the rising tide of diabetic ESRD.