Displaying publications 41 - 60 of 747 in total

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  1. Sato S, Tojo B, Hoshi T, Minsong LIF, Kugan OK, Giloi N, et al.
    PMID: 31426380 DOI: 10.3390/ijerph16162954
    Plasmodium knowlesi (Pk) is a malaria parasite that naturally infects macaque monkeys in Southeast Asia. Pk malaria, the zoonosis transmitted from the infected monkeys to the humans by Anopheles mosquito vectors, is now a serious health problem in Malaysian Borneo. To create a strategic plan to control Pk malaria, it is important to estimate the occurrence of the disease correctly. The rise of Pk malaria has been explained as being due to ecological changes, especially deforestation. In this research, we analysed the time-series satellite images of MODIS (MODerate-resolution Imaging Spectroradiometer) of the Kudat Peninsula in Sabah and created the "Pk risk map" on which the Land-Use and Land-Cover (LULC) information was visualised. The case number of Pk malaria of a village appeared to have a correlation with the quantity of two specific LULC classes, the mosaic landscape of oil palm groves and the nearby land-use patches of dense forest, surrounding the village. Applying a Poisson multivariate regression with a generalised linear mixture model (GLMM), the occurrence of Pk malaria cases was estimated from the population and the quantified LULC distribution on the map. The obtained estimations explained the real case numbers well, when the contribution of another risk factor, possibly the occupation of the villagers, is considered. This implies that the occurrence of the Pk malaria cases of a village can be predictable from the population of the village and the LULC distribution shown around it on the map. The Pk risk map will help to assess the Pk malaria risk distributions quantitatively and to discover the hidden key factors behind the spread of this zoonosis.
  2. Ghani F, Rachele JN, Loh VH, Washington S, Turrell G
    PMID: 31167430 DOI: 10.3390/ijerph16111980
    Within a city, gender differences in walking for recreation (WfR) vary significantly across neighbourhoods, although the reasons remain unknown. This cross-sectional study investigated the contribution of the social environment (SE) to explaining such variation, using 2009 data from the How Areas in Brisbane Influence healTh and AcTivity (HABITAT) study, including 7866 residents aged 42-67 years within 200 neighbourhoods in Brisbane, Australia (72.6% response rate). The analytical sample comprised 200 neighbourhoods and 6643 participants (mean 33 per neighbourhood, range 8-99, 95% CI 30.6-35.8). Self-reported weekly minutes of WfR were categorised into 0 and 1-840 mins. The SE was conceptualised through neighbourhood-level perceptions of social cohesion, incivilities and safety from crime. Analyses included multilevel binomial logistic regression with gender as main predictor, adjusting for age, socioeconomic position, residential self-selection and neighbourhood disadvantage. On average, women walked more for recreation than men prior to adjustment for covariates. Gender differences in WfR varied significantly across neighbourhoods, and the magnitude of the variation for women was twice that of men. The SE did not explain neighbourhood differences in the gender-WfR relationship, nor the between-neighbourhood variation in WfR for men or women. Neighbourhood-level factors seem to influence the WfR of men and women differently, with women being more sensitive to their environment, although Brisbane's SE did not seem such a factor.
  3. Deng J, Zhang N, Ahmad F, Draz MU
    PMID: 31208141 DOI: 10.3390/ijerph16122130
    :The aim of this paper is to examine the impact of local government competition and environmental regulation intensity on regional innovation performance and its regional heterogeneity. Based on the theoretical mechanism of the aforementioned variables, this study uses the Chinese provincial panel data from 2001 to 2016. We use the super-efficiency data envelopment analysis (SE-DEA) to evaluate regional innovation performance. To systematically examine the impact of local government competition and environmental regulation intensity on regional innovation performance, we build a panel date model using the feasible generalized least squares (FGLS) method. The results indicate that: the regional innovation performance can be significantly improved through technological spillover; local governments compete for foreign direct investment (FDI) to participate in regional innovative production. Moreover, improvements in environmental regulation intensity enhance regional innovation performance through the innovation compensation effect. Our results show that the local governments tend to choose lower environmental regulation intensity to compete for more FDI, which has an inhibitory effect on regional innovation performance. Furthermore, due to regional differences in factor endowments, economic reforms and economic development levels in Chinese provinces, there exists a significant regional consistency in the impact of local government competition and environmental regulation intensity on regional innovation performance. Therefore, institutional arrangements and incentive constraints must be adopted to enhance regional innovation performance as well as to guide and foster the mechanism of green innovation competition among local governments. At the same time, considering the regional heterogeneity of local government competition and environmental regulation intensity affecting regional innovation performance, policy makers should avoid the "one-size-fits-all" strategy of institutional arrangements.
  4. Hamzah FH, Mohd Hairon S, Yaacob NM, Musa KI
    PMID: 31295907 DOI: 10.3390/ijerph16142453
    Prompt investigation of food poisoning outbreak are essential, as it usually involves a short incubation period. Utilizing the advancement in mobile technology, a mobile application named MyMAFI (My Mobile Apps for Field Investigation) was developed with the aim to be an alternative and better tool for current practices of field investigation of food poisoning outbreak. A randomized cross-over trial with two arms and two treatment periods was conducted to assess the effectiveness of the newly developed mobile application as compared to the standard paper-based format approach. Thirty-six public health inspectors from all districts in Kelantan participated in this study and they were randomized into two equal sized groups. Group A started the trial as control group using the paper-format investigation form via simulated outbreaks and group B used the mobile application. After a one-month 'washout period', the group was crossed over. The primary outcome measured was the time taken to complete the outbreak investigation. The treatment effects, the period effects and the period-by-treatment interaction were analyzed using Pkcross command in Stata software. There was a significant treatment effect with mean square 21840.5 and its corresponding F statistic 4.47 (p-value = 0.038), which indicated that the mobile application had significantly improve the reporting timeliness. The results also showed that there was a significant period effect (p-value = 0.025); however, the treatment by period interaction was not significant (p-value = 0.830). The newly developed mobile application-MyMAFI-can improve the timeliness in reporting for investigation of food poisoning outbreak.
  5. Cao X, Rajarshi A, Tong J
    PMID: 30126241 DOI: 10.3390/ijerph15081782
    With the increasing scarcity of traditional energy sources, global warming and environmental degradation, the increased use of renewable energy (RE) has become an effective path for sustainable development. Therefore, countries are paying more and more attention to the development of the RE industry, and the world trade in renewable energy products (REPs) is developing rapidly. First of all, this paper defines REPs, refines the scope of REPs, and proposes the "Equalization Technology Classification" method for the technology classification of REPs. Second, based on the United Nations Comtrade (COMTRADE) data, the export technology structure of China's REPs from 2007 to 2016 was empirically measured. Finally, a comparative study was conducted on the renewable energy product (REP) export technologies of major REP exporting countries (or regions) in the world. We found that (1) China's exports of REPs are mainly medium-high and medium technical complexity products, and that there are few high technical complexity products; (2) the export technology structure of China's REPs is deteriorating, and its overall technical level is in the middle of the global industrial value chain. The export technology of China's REPs has a gap compared with that of Denmark, Hong Kong China, and Singapore; (3) the technological competition of the world's REPs is becoming increasingly fierce. The growth rates of REP technologies in South Korea, Japan, and Malaysia's REPs are significantly higher than that of China.
  6. Dhillon H, Nordin RB, Ramadas A
    PMID: 31547629 DOI: 10.3390/ijerph16193561
    Diabetes complications, medication adherence, and psychosocial well-being have been associated with quality of life (QOL) among several Western and Asian populations with diabetes, however, there is little evidence substantiating these relationships among Malaysia's unique and diverse population. Therefore, a cross-sectional study was conducted in a Malaysian public primary care clinic among 150 patients diagnosed with type 2 diabetes mellitus (T2DM). Structured and validated questionnaires were used to investigate the associations between demographic, clinical, and psychological factors with QOL of the study participants. Approximately three-quarters of patients had a good-excellent QOL. Diabetes-related variables that were significantly associated with poor QOL scores included insulin containing treatment regimens, poor glycemic control, inactive lifestyle, retinopathy, neuropathy, abnormal psychosocial well-being, higher diabetes complication severity, and nonadherence (p < 0.05). The main predictors of a good-excellent QOL were HbA1c ≤ 6.5% (aOR = 20.78, 95% CI = 2.5175.9, p = 0.005), normal anxiety levels (aOR = 5.73, 95% CI = 1.8-18.5, p = 0.004), medication adherence (aOR = 3.35, 95% CI = 1.3-8.7, p = 0.012), and an aDCSI score of one and two as compared to those greater than or equal to four (aOR = 7.78, 95% CI = 1.5-39.2, p = 0.013 and aOR = 8.23, 95% CI = 2.1-32.8, p = 0.003), respectively. Medication adherence has also been found to be an effect modifier of relationships between HbA1c, depression, anxiety, disease severity, and QOL. These predictors of QOL are important factors to consider when managing patients with T2DM.
  7. Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Tee YYS, Bindels J, et al.
    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.
  8. Oluchi SE, Manaf RA, Ismail S, Udeani TK
    PMID: 31590340 DOI: 10.3390/ijerph16193752
    Fever is one of the most common symptoms of pediatric illnesses; it is an important early symptom of malaria. Fever had served as the entry point for presumptive treatment of malaria among children in Nigerian. Appropriate HSB is important when seeking treatment for fever among under-five children; this will help for better prognosis because treatment will be initiated early. This study attempted to identify caregiver's HSB for under-five children with fever. A cross-sectional study was conducted in Imo-State, Nigeria. Appropriate HSB was operationally defined as seeking treatment from health facility within 24 h of fever. Data were obtained using pretested self-administered questionnaire. Data were analyzed using SPSS version 22. Simple and multiple logistic regression were used to determine predictors of appropriate HSB. A total of 559 eligible respondents were recruited; 103 (18.6%) caregivers had appropriate HSB. The predictors of HSB are being male child (aOR = 2.760; 95% CI:1.536-4.958), the age of child younger than 27 months (aOR = 2.804; 95% CI:1.485-5.295), employed caregivers (aOR = 1.882; 95% CI:1.014-3.493), number of household members (aOR = 2.504; 95% CI:1.464-4.283), and caregivers who decided to seek treatment at early stage (aOR = 7.060; 95% CI:1.616-30.852). Only 18.6% caregivers practiced appropriate HSB for fever cases among under-five children. It is essential to educate caregivers and emphasise on early treatment of fever and appropriate use of health facilities for fever. The findings will be used to improve intervention at the community level and will be compared with follow-up data to evaluate their effectiveness.
  9. Baloch GM, Kamaludin K, Chinna K, Sundarasen S, Nurunnabi M, Khoshaim HB, et al.
    PMID: 33673237 DOI: 10.3390/ijerph18041799
    COVID-19 has speedily immersed the globe with 72+ million cases and 1.64 million deaths, in a span of around one year, disturbing and deteriorating almost every sphere of life. This study investigates how students in Pakistan have coped with the COVID-19. Zung's self-rating anxiety scale (SAS) was used for measuring anxiety and the coping strategies were measured on four strategies i.e., seeking social support, humanitarian, acceptance, and mental disengagement. Among 494 respondents, 61% were females and 77.3% of the students were in the age group of 19-25 years. The study findings indicate that approximately 41 percent of students are experiencing some level of anxiety, including 16% with severe to extreme levels. Seeking social support seemed to be the least preferred coping strategy and that female students seek social support, humanitarian, and acceptance coping strategies more than males. Students used both emotion-based and problem-based coping strategies. The variables of gender, age, ethnicity, level and type of study, and living arrangement of the students were associated with usage of coping strategies. Findings showing that students do not prefer to seek social support. The study outcomes will provide basic data for university policies in Pakistan and the other countries with same cultural contexts to design and place better mental health provisions for students.
  10. Ling GHT, Md Suhud NAB, Leng PC, Yeo LB, Cheng CT, Ahmad MHH, et al.
    PMID: 33578829 DOI: 10.3390/ijerph18041704
    Little attention has been paid to the impacts of institutional-human-environment dimensions on the outcome of Coronavirus disease 2019 (COVID-19) abatement. Through the diagnostic social-ecological system (SES) framework, this review paper aimed to investigate what and how the multifaceted social, physical, and governance factors affected the success level of seven selected Asia-Pacific countries (namely, South Korea, Japan, Malaysia, Singapore, Vietnam, Indonesia, and New Zealand) in combatting COVID-19. Drawing on statistical data from the Our World In Data website, we measured the COVID-19 severity or abatement success level of the countries on the basis of cumulative positive cases, average daily cases, and mortality rates for the period of 1 February 2020 to 30 June 2020. A qualitative content analysis using three codes, i.e., present (P), partially present (PP), and absent (A) for each SES attribute, as well as score calculation and rank ordering for government response effectiveness and the abatement success level across the countries, was undertaken. Not only did the standard coding process ensure data comparability but the data were deemed substantially reliable with Cohen's kappa of 0.76. Among 13 attributes of the SES factors, high facility adequacy, comprehensive COVID-19 testing policies, strict lockdown measures, imposition of penalty, and the high trust level towards the government seemed to be significant in determining the COVID-19 severity in a country. The results show that Vietnam (ranked first) and New Zealand (ranked second), with a high presence of attributes/design principles contributing to high-level government stringency and health and containment indices, successfully controlled the virus, while Indonesia (ranked seventh) and Japan (ranked sixth), associated with the low presence of design principles, were deemed least successful. Two lessons can be drawn: (i) having high number of P for SES attributes does not always mean a panacea for the pandemic; however, it would be detrimental to a country if it lacked them severely, and (ii) some attributes (mostly from the governance factor) may carry higher weightage towards explaining the success level. This comparative study providing an overview of critical SES attributes in relation to COVID-19 offers novel policy insights, thus helping policymakers devise more strategic, coordinated measures, particularly for effective country preparedness and response in addressing the current and the future health crisis.
  11. Mohd Noor N, Che Yusof R, Yacob MA
    PMID: 33498397 DOI: 10.3390/ijerph18030861
    In response to the coronavirus disease 2019 (COVID-19) pandemic, healthcare providers are exposed to psychological and mental health implications, including vicarious traumatization, anxiety, and depression. Gradual increases in the number of COVID-19 cases meant they were inadequately protected from contamination due to a shortage of protective equipment, excessive workloads, emotional exhaustion and frustration. These circumstances affect their work performance in delivering health services. This study aims to compare the levels of anxiety in frontline and non-frontline healthcare providers during the COVID-19 pandemic. This study applied a comparative cross-sectional design between May and July 2020 at the Hospital Raja Perempuan Zainab II. Convenient sampling was applied in the selection of eligible participants. The case report form contained two self-administered questionnaires, namely, The Hospital Anxiety and Depression Scale and Medical Outcome Study Social Support Survey. Descriptive analysis, analysis of variance, and analysis of covariance were conducted using SPSS version 26. The number of participants recruited was 306, including 160 healthcare providers in the frontline group and 146 in the non-frontline group. The non-frontline healthcare providers reported a significantly higher anxiety mean score of 1.7 than the frontline providers after adjusting for gender, duration of employment, and social support. It indicates that non-frontline healthcare providers require psychological support similar to that of frontline healthcare providers during the COVID-19 pandemic.
  12. Toumpakari Z, Jago R, Howe LD, Majid HA, Papadaki A, Mohammadi S, et al.
    PMID: 31766777 DOI: 10.3390/ijerph16234662
    Patterns of physical activity (PA) that optimize both fitness and fatness may better predict cardiometabolic health. Reduced rank regression (RRR) was applied to identify combinations of the type (e.g., football vs. skipping), location and timing of activity, explaining variation in cardiorespiratory fitness (CRF) and Body Mass Index (BMI). Multivariable regressions estimated longitudinal associations of PA pattern scores with cardiometabolic health in n = 579 adolescents aged 13-17 years from the Malaysian Health and Adolescent Longitudinal Research Team study. PA pattern scores in boys were associated with higher fitness (r = 0.3) and lower fatness (r = -0.3); however, in girls, pattern scores were only associated with higher fitness (r = 0.4) (fatness, r = -0.1). Pattern scores changed by β = -0.01 (95% confidence interval (CI) -0.04, 0.03) and β = -0.08 (95% CI -0.1, -0.06) per year from 13 to 17 years in boys and girls respectively. Higher CRF and lower BMI were associated with better cardiometabolic health at 17 years, but PA pattern scores were not in either cross-sectional or longitudinal models. RRR identified sex-specific PA patterns associated with fitness and fatness but the total variation they explained was small. PA pattern scores changed little through adolescence, which may explain the limited evidence on health associations. Objective PA measurement may improve RRR for identifying optimal PA patterns for cardiometabolic health.
  13. Rahim MHA, Ibrahim MI, Noor SSM, Fadzil NM
    PMID: 33430195 DOI: 10.3390/ijerph18020409
    BACKGROUND: Hand hygiene (HH) is the simplest and most effective way to reduce the incidence of healthcare-associated infections (HCAIs).

    METHODS: This cross-sectional study aimed to determine factors associated with self-reported HH performance among nurses at Kelantan tertiary care hospitals. A sample of 438 registered nurses was selected through a stratified random sampling method. Self-reported HH performance was assessed using a validated WHO self-administered HH knowledge and perception questionnaire for healthcare workers.

    RESULTS: A multiple linear regression analysis was performed to identify the predictors. The factors that significantly predicted self-reported HH performance among nurses included perception score (beta coefficient (β) = 0.260; 95% CI: 0.200, 0.417; p < 0.001), pediatric department (β = -0.104; 95% CI: -9.335, -2.467; p < 0.001), and orthopedic department (β = -5.957; 95% CI: -9.539, -0.720; p < 0.023), adjusted R2 = 0.102; p < 0.001. Nurses with a strong perception and belief in HH were more likely to have better HH performance. Compared to pediatric and orthopedic, surgical departments were associated with better self-reported HH performance.

    CONCLUSIONS: This study showed the importance of factors that could improve the intervention's performance in HH strategy. Lack of perception and HH program intervention in departments engaged in patient care could lead to poor HH practices, thus increasing HCAIs and antimicrobial resistance (AMR).

  14. Lim SY, Chan YM, Ramachandran V, Shariff ZM, Chin YS, Arumugam M
    PMID: 33478001 DOI: 10.3390/ijerph18020827
    BACKGROUND: Evidence is growing that a high-acid diet might accelerate the rate of bone loss, and gene polymorphisms such as Interleukin 6 (IL6) -174G/C and -572G/C are related to bone deterioration. However, no study of the interaction between diet and IL6 polymorphisms has been conducted among Asians. Thus, the objective of this study was to determine whether IL6 gene polymorphisms modified the association between dietary acidity and the rate of bone resorption.

    METHODS: This cross-sectional study recruited 203 postmenopausal women (age ranged from 51 to 85 years old) in community settings. The dietary intakes of the participants were assessed using a validated interviewer-administered semi-quantitative food frequency questionnaire (FFQ), while dietary acid load (DAL) was estimated using net endogenous acid production (NEAP). Agena® MassARRAY genotyping analysis and serum collagen type 1 cross-linked C-telopeptide (CTX1) were used to identify the IL6 genotype and as a bone resorption marker, respectively. The interactions between diet and single-nucleotide polymorphisms (SNPs) were assessed using linear regressions.

    RESULTS: A total of 203 healthy postmenopausal women aged between 51 and 85 years participated in this study. The mean BMI of the participants was 24.3 kg/m2. In IL6 -174 G/C, all the participants carried the GG genotype, while the C allele was absent. Approximately 40% of the participants had a high dietary acid load. Dietary acid load (B = 0.15, p = 0.031) and the IL6 -572 CC genotype group (B = 0.14, p = 0.044) were positively associated with a higher bone resorption. However, there was no moderating effect of the IL6 genetic polymorphism on the relationship between and acid ash diet and bone resorption markers among the postmenopausal women (p = 0.79).

    CONCLUSION: High consumption of an acid ash diet and the IL6 -572 C allele seem to attribute to high bone resorption among postmenopausal women. However, our finding does not support the interaction effect of dietary acidity and IL6 (-174G/C and -572G/C) polymorphisms on the rate of bone resorption. Taken together, these results have given scientific research other candidate genes to focus on which may interact with DAL on bone resorption, to enhance planning for preventing or delaying the onset of osteoporosis among postmenopausal women.

  15. Ibrahim MF, Kuan G, Hashim HA, Hamzah NA, Kueh YC
    PMID: 33450935 DOI: 10.3390/ijerph18020622
    The objective of this study was to validate the translated Malay version of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-M) scale among Malaysian primary school children using the confirmatory factor analysis (CFA). The Q-LES-Q-M measures the level of enjoyment and satisfaction experienced with relation to physical health, feelings, homework, and leisure. The participants were 607 Malay students, 240 (39.5%) boys and 367 (60.5%) girls, with an age range from 10 to 11 years old. The original version of the Q-LES-Q was translated into the Malay language by forward to backward translation procedures with consideration for the local culture and suitable vocabulary for primary school students. The participants then completed the Q-LES-Q-M. CFA was performed using Mplus 8 software. Using CFA, the initial model did not result in a good data fit. Further analysis of the CFA suggested some changes to the model to improve the fit indices. Model modification included the deletion of three problematic items and co-varying some error items. This resulted in improved fit indices and 40 items remained in the final model. The final model showed good reliability based on two indicators of composite reliability (CR) and Cronbach's alpha (CA). The factors with their CR and CA were physical activity (CR = 0.857, CA = 0.854), feelings (CR = 0.808, CA = 0.813), homework (CR = 0.837, CA = 0.837) and leisure (CR = 0.742, CA = 0.737). The final measurement consists of 40 items. The retained items were deemed suitable for Malay primary school children. The revised Q-LES-Q-M with 40 items is suitable for measuring the levels of children's involvement in determining the enjoyment and satisfaction of learning and physical activity.
  16. Mohd Azmi NAS, Juliana N, Azmani S, Mohd Effendy N, Abu IF, Mohd Fahmi Teng NI, et al.
    PMID: 33466883 DOI: 10.3390/ijerph18020676
    The synthesis and secretion of cortisol are controlled by the hypothalamic-pituitary-adrenal axis. Cortisol exhibits a proper 24-h circadian rhythm that affects the brain, the autonomic nervous system, the heart, and the vasculature that prepares the cardiovascular system for optimal function during these anticipated behavioral cycles. A literature search was conducted using databases such as Google Scholar, PubMed, and Scopus. Relevant search terms included "circadian rhythm and cardiovascular", "cortisol", "cortisol and acute coronary syndrome", "cortisol and arrhythmias", "cortisol and sudden cardiac death", "cortisol and stroke", and "cardioprotective agents". A total of 120 articles were obtained on the basis of the above search. Lower levels of cortisol were seen at the beginning of sleep, while there was a rise towards the end of sleep, with the highest level reached at the moment the individual wakes up. In the present review, we discuss the role of 11β-hydroxysteroid dehydrogenase (11β-HSD1), which is a novel molecular target of interest for treating metabolic syndrome and type-2 diabetes mellitus. 11β-HSD1 is the major determinant of cortisol excess, and its inhibition alleviates metabolic abnormalities. The present review highlights the role of cortisol, which controls the circadian rhythm, and describes its effect on the cardiovascular system. The review provides a platform for future potential cardioprotective therapeutic agents.
  17. Pheh KS, Tan KA, Ibrahim N, Sidik SM
    PMID: 33573341 DOI: 10.3390/ijerph18031257
    Attention-deficit/hyperactivity disorder (ADHD), a common neurodevelopmental disorder, often persists into adulthood. In Malaysia, the prevalence rate of hyperactivity symptoms is highest among Chinese Malaysians. There are limited evidence-based treatment options targeting the core symptoms of ADHD, as well as executive functioning. In addition, conventional psychotherapeutic approaches for adults with ADHD have been found to be highly labor-intensive. The present study will evaluate the effectiveness of an online mindfulness-based intervention to reduce inattention and hyperactivity-impulsivity and improve executive functioning among Chinese Malaysian college emerging adults with ADHD. Informed by established literature, we will design an 8-week online mindfulness-based intervention (i.e., iMBI). We will conduct a two-arm randomized controlled trial comparing an iMBI plus treatment-as-usual group (n = 54) and an enhanced treatment-as-usual control group (n = 54). Outcome measures of inattention, hyperactivity-impulsivity, and executive functioning will be collected at baseline, immediately post-intervention, and 1-month post-intervention. The findings of the present study will not only demonstrate the implementation of iMBI as a new treatment modality but also inform practitioners on the effectiveness of iMBI in reducing the burden of adults living with ADHD.
  18. Kunasegaran T, Balasubramaniam VRMT, Arasoo VJT, Palanisamy UD, Ramadas A
    PMID: 33572656 DOI: 10.3390/ijerph18031272
    A rapid increase in the prevalence of gestational diabetes mellitus (GDM) has been associated with various factors such as urbanization, lifestyle changes, adverse hyperglycemic intrauterine environment, and the resulting epigenetic changes. Despite this, the burden of GDM has not been well-assessed in Southeast Asia. We comprehensively reviewed published Southeast Asian studies to identify the current research trend in GDM in this region. Joanna Briggs Institute's methodology was used to guide the scoping review. The synthesis of literature findings demonstrates almost comparable clinical evidence in terms of risk factors and complications, challenges presented in diagnosing GDM, and its disease management, given the similarities of the underlying population characteristics in Southeast Asia. Evidence suggests that a large proportion of GDM risk in women may be preventable by lifestyle modifications. However, the GDM burden across countries is expected to rise, given the heterogeneity in screening approaches and diagnostic criteria, mainly influenced by economic status. There is an urgent need for concerted efforts by government and nongovernmental sectors to implement national programs to prevent, manage, and monitor the disease.
  19. Edi M, Chin YS, Woon FC, Appannah G, Lim PY, On Behalf Of The Micos Research Group
    PMID: 33530307 DOI: 10.3390/ijerph18031068
    Despite the advancement of the healthcare system, low birth weight (LBW) remains as one of the leading causes of under-five mortality. This cross-sectional study aimed to determine the prevalence of LBW and its associated factors among 483 third trimester pregnant women recruited from six selected public health clinics in the Federal Territory of Kuala Lumpur and the state of Selangor, Malaysia. Pregnant women were interviewed for information on socio-demographic characteristics, smoking behaviour, and second-hand smoke (SHS) exposure at home and in the workplace. Information on the obstetrical history and prenatal care visits history were retrieved from the maternal medical records, while infant's birth outcomes were retrieved from infant medical records. The prevalence of LBW (<2.5 kg) in infants was 10.4%, with a mean birth weight of 3.0 [standard deviation (SD) 0.4] kg. Results from the multivariable logistic regression model showed that inadequate weight gained during pregnancy [odds ratio (OR) = 2.41, 95% confidence interval (CI) = 1.18-4.90] and exposure to SHS at home (OR = 1.92, 95% CI = 1.03-3.55) were significantly associated with LBW. In conclusion, pregnant women should monitor their rate of weight gain throughout pregnancy and avoid SHS exposure at home to reduce the risk of delivering LBW infants.
  20. Tan TW, Tan HL, Chang MN, Lin WS, Chang CM
    PMID: 33810438 DOI: 10.3390/ijerph18073456
    (1) Background: The implementation of effective control measures in a timely fashion is crucial to control the epidemic outbreak of COVID-19. In this study, we aimed to analyze the control measures implemented during the COVID-19 outbreak, as well as evaluating the responses and outcomes at different phases for epidemic control in Taiwan. (2) Methods: This case study reviewed responses to COVID-19 and the effectiveness of a range of control measures implemented for epidemic control in Taiwan and assessed all laboratory-confirmed cases between 11 January until 20 December 2020, inclusive of these dates. The confirmation of COVID-19 infection was defined as the positive result of a reverse-transcriptase-polymerase-chain-reaction test taken from a nasopharyngeal swab. Test results were reported by the Taiwan Centers for Disease Control. The incidence rate, mortality rate, and testing rate were compiled, and the risk ratio was provided to gain insights into the effectiveness of prevention measures. (3) Results and Discussion: This study presents retrospective data on the COVID-19 incidence rate in Taiwan, combined with the vital preventive control measures, in a timeline of the early stage of the epidemic that occurred in Taiwan. The implementation of multiple strategy control measures and the assistance of technologies to control the COVID-19 epidemic in Taiwan led to a relatively slower trend in the outbreak compared to the neighboring countries. In Taiwan, 766 confirmed patients were included, comprised of 88.1% imported cases and 7.2% local transmission cases, within the studied period. The incidence rate of COVID-19 in Taiwan during the studied period was 32 per million people, with a mortality rate of 0.3 per million people. Our analysis showed a significantly raised incidence risk ratio in the countries of interest in comparison to Taiwan during the study period; in the range of 1.9 to 947.5. The outbreak was brought under control through epidemic policies and hospital strategies implemented by the Taiwan Government. (4) Conclusion: Taiwan's preventive strategies resulted in a drastically lower risk for Taiwan nationals of contracting COVID-19 when new pharmaceutical drug or vaccines were not yet available. The preventive strategies employed by Taiwan could serve as a guide and reference for future epidemic control strategies.
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