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Fulltext Understanding COVID-19 Halal Vaccination Discourse on Facebook and Twitter Using Aspect-Based Sentiment Analysis and Text Emotion Analysis

Feizollah A, Anuar NB, Mehdi R, Firdaus A, Sulaiman A

Int J Environ Res Public Health, 2022 May 21;19(10).
PMID: 35627806 DOI: 10.3390/ijerph19106269

The COVID-19 pandemic introduced unprecedented challenges for people and governments. Vaccines are an available solution to this pandemic. Recipients of the vaccines are of different ages, gender, and religion. Muslims follow specific Islamic guidelines that prohibit them from taking a vaccine with certain ingredients. This study aims at analyzing Facebook and Twitter data to understand the discourse related to halal vaccines using aspect-based sentiment analysis and text emotion analysis. We searched for the term "halal vaccine" and limited the timeline to the period between 1 January 2020, and 30 April 2021, and collected 6037 tweets and 3918 Facebook posts. We performed data preprocessing on tweets and Facebook posts and built the Latent Dirichlet Allocation (LDA) model to identify topics. Calculating the sentiment analysis for each topic was the next step. Finally, this study further investigates emotions in the data using the National Research Council of Canada Emotion Lexicon. Our analysis identified four topics in each of the Twitter dataset and Facebook dataset. Two topics of "COVID-19 vaccine" and "halal vaccine" are shared between the two datasets. The other two topics in tweets are "halal certificate" and "must halal", while "sinovac vaccine" and "ulema council" are two other topics in the Facebook dataset. The sentiment analysis shows that the sentiment toward halal vaccine is mostly neutral in Twitter data, whereas it is positive in Facebook data. The emotion analysis indicates that trust is the most present emotion among the top three emotions in both datasets, followed by anticipation and fear.
Fulltext Ultrasonographic Evaluation of Skin Toxicity Following Radiotherapy of Breast Cancer: A Systematic Review

Hussein FA, Manan HA, Mustapha AWMM, Sidek K, Yahya N

Int J Environ Res Public Health, 2022 Oct 18;19(20).
PMID: 36294025 DOI: 10.3390/ijerph192013439

The present review aimed to systematically review skin toxicity changes following breast cancer radiotherapy (RT) using ultrasound (US). PubMed and Scopus databases were searched according to PRISMA guidelines. The characteristics of the selected studies, measured parameters, US skin findings, and their association with clinical assessments were extracted. Seventeen studies were included with a median sample size of 29 (range 11-166). There were significant US skin changes in the irradiated skin compared to the nonirradiated skin or baseline measurements. The most observed change is skin thickening secondary to radiation-induced oedema, except one study found skin thinning after pure postmastectomy RT. However, eight studies reported skin thickening predated RT attributed to axillary surgery. Four studies used US radiofrequency (RF) signals and found a decrease in the hypodermis's Pearson correlation coefficient (PCC). Three studies reported decreased dermal echogenicity and poor visibility of the dermis-subcutaneous fat boundary (statistically analysed by one report). The present review revealed significant ultrasonographic skin toxicity changes in the irradiated skin most commonly skin thickening. However, further studies with large cohorts, appropriate US protocol, and baseline evaluation are needed. Measuring other US skin parameters and statistically evaluating the degree of the association with clinical assessments are also encouraged.
Fulltext Tuberculosis Death Epidemiology and Its Associated Risk Factors in Sabah, Malaysia

Avoi R, Liaw YC

Int J Environ Res Public Health, 2021 Sep 16;18(18).
PMID: 34574665 DOI: 10.3390/ijerph18189740

Tuberculosis (TB) is a leading killer from a single infectious agent globally. In 2019, Malaysia's TB incidence rate was 92 per 100,000 population, and the TB mortality rate was estimated at 4 cases per 100,000 population per year. However, the state of Sabah had a higher burden of TB with a notification rate of 128 per 100,000 population and a TB case fatality rate of 8% compared to the national figure. This study aims to provide a comprehensive report on TB deaths epidemiology and its associated factors at a sub-national level. This nested case-control study used Sabah State Health Department TB surveillance data from the Malaysia national case-based TB registry (MyTB) between 2014 and 2018. Cases were defined as all-cause TB deaths that occurred before anti-TB treatment completion from the time of TB diagnosis. Controls were randomly selected from TB patients who completed anti-TB treatment. The TB mortality rate had increased significantly from 9.0/100,000 population in 2014 to 11.4/100,000 population in 2018. The majority of TB deaths occurred in the first two months of treatment. TB-related deaths were primarily due to advanced disease or disseminated TB, whereas non-TB-related deaths were primarily due to existing comorbidities. Many important independent risk factors for TB deaths were identified which are useful to address the increasing TB mortality rate.
Fulltext Treatment-seeking behavior among male civil servants in northeastern Malaysia: A mixed-methods study

Arumugam P, Tengku Ismail TA, Daud A, Musa KI, A Hamid NA, Ismail SB, et al.

Int J Environ Res Public Health, 2020 04 15;17(8).
PMID: 32326447 DOI: 10.3390/ijerph17082713

Background: Men's health in Malaysia is slowly gaining more attention, but minimal research has examined how Malaysian men behave and seek treatment. While few studies have investigated men's treatment-seeking behavior (TSB), those that have been conducted seem to be inconclusive and tend to yield contradictory findings.
Objectives: This paper aims to determine the proportion of inappropriate TSB and to explore in-depth treatment-seeking behavior among male civil servants in northeastern Malaysia.
Methods: This paper adopted a mixed-methods approach, specifically a concurrent parallel study design. A quantitative study using a self-administered questionnaire was performed to identify the proportion of appropriate and inappropriate TSB among male civil servants in northeastern Malaysia. Concurrently, a qualitative study was conducted involving six focus group discussion sessions, and the results of both parts were integrated to provide a detailed explanation of TSB among the participants.
Results: A total of 381 participants were involved in the quantitative study, yielding a response rate of 94.8%; 246 (64.6%) engaged in inappropriate TSB. Some of the reported morbidities among the participants were hypertension (26.5%) and diabetes mellitus (26.2%). From the qualitative study, a main theme related to TSB emerged with several sub-themes, which were health literacy, stage of seeking treatment, preference for alternative treatment, perceived threat of illness, self-treatment, and the influence of family members and others.
Conclusions: TSB among male civil servants in northeastern Malaysia is poor, and the factors contributing to it are multidimensional. This study has provided new valuable evidence on men's TSB in northeastern Malaysia. The findings can be used to facilitate and improve current policies and the implementation of men's health services throughout the country.
Fulltext Treatment of clinical solid waste using a steam autoclave as a possible alternative technology to incineration

Hossain MS, Balakrishnan V, Rahman NN, Sarker MZ, Kadir MO

Int J Environ Res Public Health, 2012 Mar;9(3):855-67.
PMID: 22690168 DOI: 10.3390/ijerph9030855

A steam autoclave was used to sterilize bacteria in clinical solid waste in order to determine an alternative to incineration technology in clinical solid waste management. The influence of contact time (0, 5, 15, 30 and 60 min) and temperature (111 °C, 121 °C and 131 °C) at automated saturated steam pressure was investigated. Results showed that with increasing contact time and temperature, the number of surviving bacteria decreased. The optimum experimental conditions as measured by degree of inactivation of bacteria were 121 °C for 15 minutes (min) for Gram negative bacteria, 121 °C and 131 °C for 60 and 30 min for Gram positive bacteria, respectively. The re-growth of bacteria in sterilized waste was also evaluated in the present study. It was found that bacterial re-growth started two days after the inactivation. The present study recommends that the steam autoclave cannot be considered as an alternative technology to incineration in clinical solid waste management.
Fulltext Treatment of Wastewater Using Seaweed: A Review

Arumugam N, Chelliapan S, Kamyab H, Thirugnana S, Othman N, Nasri NS

Int J Environ Res Public Health, 2018 12 13;15(12).
PMID: 30551682 DOI: 10.3390/ijerph15122851

Inadequately treated or untreated wastewater greatly contribute to the release of unwanted toxic contaminants into water bodies. Some of these contaminants are persistent and bioaccumulative, becoming a great concern as they are released into the environment. Despite the abundance of wastewater treatment technologies, the adsorption method overall has proven to be an excellent way to treat wastewater from multiple industry sources. Because of its significant benefits, i.e., easy availability, handling, and higher efficiency with a low cost relative to other treatments, adsorption is opted as the best method to be used. However, biosorption using naturally found seaweeds has been proven to have promising results in removing pollutants, such as dyes from textile, paper, and the printing industry, nitrogen, and phosphorous and phenolic compounds, as well as heavy metals from various sources. Due to its ecofriendly nature together with the availability and inexpensiveness of raw materials, biosorption via seaweed has become an alternative to the existing technologies in removing these pollutants from wastewater effectively. In this article, the use of low-cost adsorbent (seaweed) for the removal of pollutants from wastewater has been reviewed. An extensive table summarises the applicability of seaweed in treating wastewater. Literature reported that the majority of research used simulated wastewater and minor attention has been given to biosorption using seaweed in the treatment of real wastewater.
Fulltext Transport, Mobility and the Wellbeing of Older Adults: An Exploration of Private Chauffeuring and Companionship Services in Malaysia

Abdul Latiff AR, Mohd S

Int J Environ Res Public Health, 2023 Feb 03;20(3).
PMID: 36768086 DOI: 10.3390/ijerph20032720

As physical abilities and health decline with age, older adults tend to lose their driving abilities, which affects their mobility. As mobility is important to older adults' wellbeing, there is a need to explore alternative modes of transportation to increase their ability to actively participate in society. Hence, this paper aims to understand the characteristics of private chauffeuring and companionship services for older adults, and to assess their possible effects on older adults' wellbeing. We gathered the views of transport operators, government agencies, and city councils that offer private chauffeuring and companionship services for older adults. We frame the model of private chauffeuring and companionship services as alternative mobility for older adults and outline a conceptual framework for its possible effects on their wellbeing. The underlying mobility characteristics were availability, accessibility, safety, and affordability-all of which influence wellbeing. The study found that the private chauffeuring and companionship model for older adults includes an additional model of government-to-consumer services in addition to the existing peer-to-peer and business-to-consumer services. While the services are available, the services provided are not standardized, with different operators offering different services and prices, and limiting certain geographical areas. Transport operators perceived that the services they offer promote older adults' physical and mental health, improve their social participation in the community, and empower them in making their travel decisions. The findings of the paper provide insights for policy makers for future planning of alternative transportation for older adults to enhance their mobility.
Fulltext Translation, Cross-Cultural Adaptation, and Validation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) into the Malay Language

Zun AB, Ibrahim MI, Mokhtar AM, Halim AS, Wan Mansor WNA

Int J Environ Res Public Health, 2019 06 10;16(11).
PMID: 31185665 DOI: 10.3390/ijerph16112054

BACKGROUND: Patient feedback is an important tool in assessing health system quality. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) was developed in 2006 as a standardized instrument to assess patient perceptions in the United States of America. This study aimed to translate and validate the HCAHPS questionnaire into the Malay language in order to assess patient perceptions of health services in Malaysia.
METHODS: The original HCAPHS in English was translated into Malay based on the established guideline. The content validation involved an expert panel of 10 members, including patients. The face validation pilot testing of the HCAHPS-Malay version was conducted among 10 discharged patients. The exploratory factor analysis (EFA) used principal axis factor, and varimax rotation was established based on a cross-sectional study conducted among 200 discharged patients from Hospital Universiti Sains Malaysia (Hospital USM).
RESULTS: The overall content validity index was 0.87, and the universal face validity index was 0.82. From the EFA, the factor loading value ranged from 0.652 to 0.961 within nine domains. The internal consistency reliability with Cronbach's alpha was 0.844.
CONCLUSION: The HCAHPS-Malay is a reliable and valid tool to determine patients' perception of healthcare services among inpatients in Hospital USM based on the content and face validation result together with a good construct validity and excellent absolute reliability. Further testing on HCAHPS-Malay version in other settings in Malaysia needs to be done for cross-validation.
Fulltext Translation and Validation of the Malay Version of the Parents' Satisfaction Scale (PSS-M) for Assessment of Caregivers' Satisfaction with Health Care Services for Children with Autism Spectrum Disorder

Nik Adib NA, Ibrahim MI, Ab Rahman A, Bakar RS, Yahaya NA, Hussin S, et al.

Int J Environ Res Public Health, 2018 11 04;15(11).
PMID: 30400357 DOI: 10.3390/ijerph15112455

BACKGROUND: A Malay version of Parent Satisfaction Scale (PSS-M) is needed to investigate the factors contributing to the Malay caregivers' satisfaction with health care management for children with autism spectrum disorder (ASD). The aim of the study is to translate and validate the questionnaire to assess the caregivers' satisfaction on health care services.
METHODS: A cross-sectional study was conducted among 110 caregivers of children with ASD aged between 2 and 17 years old that received treatment at two tertiary care centres in Kelantan. Permission to use the original version of the PSS questionnaire was obtained. The original English version of the PSS was translated into a Malay version following the 10 steps proposed by an established guideline. Pre-testing of the PSS was carried out with 30 caregivers before confirmatory factor analysis (CFA) was established using 110 caregivers. They were asked to assess their understanding of the questionnaire. The one-dimensional questionnaire consists of 11 items, including staff attitudes, availability of staff, supportiveness, and helpfulness. The 5-point Likert scale provided ratings from 1 (strongly disagree) to 5 (strongly agree). Confirmatory factor analysis was performed using a robust maximum likelihood estimator.
RESULTS: The analysis showed model fit data with good reliability.
CONCLUSION: The PSS-M shows overall model fitness based on specific indices, with good construct validity and excellent absolute reliability to determine the satisfaction level of caregivers of children with ASD with respect to health care services.
Fulltext Translation and Validation of the Malay Version of the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA)

Mohd Ali M, Mohd Hoesni S, Rosharudin NA, Yusoff SR, Razman MOI, Khairuddin KF, et al.

Int J Environ Res Public Health, 2022 Sep 10;19(18).
PMID: 36141671 DOI: 10.3390/ijerph191811399

The Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) has been translated and adapted globally. This study aimed to examine the psychometric properties of the Malay version of the ERQ-CA. The ERQ-CA underwent forward and back translation twice and was tested in two separate studies, Study 1 and Study 2, with 296 and 359 students aged between 13 and 14 years old, respectively. Cronbach's alpha values were calculated, and confirmatory factor analysis was conducted. The results from Study 1 demonstrate good internal consistency for cognitive reappraisal and expressive suppression. The results indicate a good factor loading for most of the items, but only one value of the goodness-of-fit met the criteria for a good fit. The results from Study 2 show improvements in the values of the goodness-of-fit that are comparable to previous studies, but there was a decrease in the factor loading scores. Overall, the Malay version of the ERQ-CA possesses acceptable reliability and validity. Further studies are required in the near future to develop a Malay version of the ERQ-CA that reasonably represents Malaysian adolescents.
Fulltext Transformation of Children's Paintings into Public Art to Improve Public Spaces and Enhance People's Happiness

Luo N, Ibrahim R, Abidin SZ

Int J Environ Res Public Health, 2022 Dec 14;19(24).
PMID: 36554658 DOI: 10.3390/ijerph192416780

Characteristics of children's paintings have been suggested considered for application in public art since they are known to positively evoke a sense of well-being when people see them. This study aims to understand the impact of artistic features from children's drawings on people's well-being; then analyzing the adaptive design principles of 3D public art featuring children's paintings on people's happiness; and finally, exploring the influence of 3D public art featuring children's paintings on improving public spaces and enhancing people's well-being. The results lead to proposing a conceptual framework for public artworks in public spaces for improving people's happiness. The proposed conceptual framework recommends that, by applying the visual and thinking features of children's paintings to public art, artists can design high-quality artworks suitable for a city, which could improve people's happiness in public spaces. This study recommends further research into how public art can promote public spaces and shape the urban culture. It contributes to enhancing the quality of public art and public spaces, and inspiring a sense of well-being among citizens through the use of appropriate public art. The results are significant because they will help artists to create more high-quality public artworks for urban public spaces in order to evoke people's happiness.
Fulltext Trait Emotional Intelligence and Happiness of Young Adults: The Mediating Role of Perfectionism

Badri SKZ, Kong MY, Wan Mohd Yunus WMA, Nordin NA, Yap WM

Int J Environ Res Public Health, 2021 10 14;18(20).
PMID: 34682544 DOI: 10.3390/ijerph182010800

Perfectionism or a tendency to aim for an unrealistic standard can impair happiness. However, the potential mechanisms of perfectionism to explain the association between trait emotional intelligence (EI) and happiness are still understudied. This study explores the mediating role of perfectionism in the relationship between trait emotional intelligence (EI) and happiness among young adults. A cross-sectional sample of 259 young adults aged between 18 to 35 years old was recruited. All analyses were conducted using SPSS and AMOS Structural Equation Modeling. High trait EI was linked to low perfectionism and high happiness levels. Furthermore, perfectionism mediated the relationship between trait EI and happiness. Although high trait EI lowered maladaptive perfectionism, the negative impact of maladaptive perfectionism remained and subsequently led to decreasing happiness levels of young adults. This study offers an enhanced understanding of the role of perfectionism in explaining the happiness state of young adults. Moreover, it provides practical implications for using trait EI and managing perfectionism tendency to manage the happiness and wellbeing of the young adult population.
Fulltext Traditional Chinese Medicine Body Constitutions and Psychological Determinants of Depression among University Students in Malaysia: A Pilot Study

Yap SY, Foo CN, Lim YM, Ng FL, Mohd-Sidik S, Tang PY, et al.

Int J Environ Res Public Health, 2021 May 18;18(10).
PMID: 34069915 DOI: 10.3390/ijerph18105366

Depression is commonly observed in university students, who are a high risk group for developing psychiatric disorders during adulthood. This study aimed to determine the prevalence of depression and its traditional Chinese medicine body constitutions and psychological determinants among university students in Malaysia. A cross-sectional pilot study was conducted between 9 and 28 September 2020 among 80 university students in Malaysia. Participants completed online survey questionnaires, including the validated Patient Health Questionnaire (PHQ-9), Constitution in Chinese Medicine Questionnaire (CMCQ), Dysfunctional Attitude Scale (DAS), Depression Anxiety Stress Scale (DASS-21) stress subscale, Perceived Stress Scale (PSS-10), and Rosenberg Self-Esteem Scale (RSES), which assess depression, body constitution, dysfunctional attitude, stress, perceived stress, and self-esteem. Multiple linear regression analyses were performed to determine the associated risk factors for depression. The overall prevalence of depression among university students was 33.8%. The multiple regression analysis showed a significant relationship between depression and qi-stagnation constitution (B = 0.089, p = 0.011), balanced constitution (B = -0.077, p = 0.049), and self-esteem (B = -0.325, p = 0.001). Our findings suggest that some traditional Chinese medicine body constitutions and self-esteem are significant risk factors affecting depression among university students. Identifying risk factors of depression is vital to aid in the early detection of depression among university students.
Fulltext Towards Wearable Augmented Reality in Healthcare: A Comparative Survey and Analysis of Head-Mounted Displays

Baashar Y, Alkawsi G, Wan Ahmad WN, Alomari MA, Alhussian H, Tiong SK

Int J Environ Res Public Health, 2023 Feb 22;20(5).
PMID: 36900951 DOI: 10.3390/ijerph20053940

Head-mounted displays (HMDs) have the potential to greatly impact the surgical field by maintaining sterile conditions in healthcare environments. Google Glass (GG) and Microsoft HoloLens (MH) are examples of optical HMDs. In this comparative survey related to wearable augmented reality (AR) technology in the medical field, we examine the current developments in wearable AR technology, as well as the medical aspects, with a specific emphasis on smart glasses and HoloLens. The authors searched recent articles (between 2017 and 2022) in the PubMed, Web of Science, Scopus, and ScienceDirect databases and a total of 37 relevant studies were considered for this analysis. The selected studies were divided into two main groups; 15 of the studies (around 41%) focused on smart glasses (e.g., Google Glass) and 22 (59%) focused on Microsoft HoloLens. Google Glass was used in various surgical specialities and preoperative settings, namely dermatology visits and nursing skill training. Moreover, Microsoft HoloLens was used in telepresence applications and holographic navigation of shoulder and gait impairment rehabilitation, among others. However, some limitations were associated with their use, such as low battery life, limited memory size, and possible ocular pain. Promising results were obtained by different studies regarding the feasibility, usability, and acceptability of using both Google Glass and Microsoft HoloLens in patient-centric settings as well as medical education and training. Further work and development of rigorous research designs are required to evaluate the efficacy and cost-effectiveness of wearable AR devices in the future.
Fulltext Tobacco Denormalization Indicator in the Prevalence of Positive Smoker Identity and Its Associated Factors

Ahmad MH, Ibrahim MI, Ab Rahman A, Musa KI, Mohd Zain F, Mohd Zain R, et al.

Int J Environ Res Public Health, 2020 Mar 31;17(7).
PMID: 32244417 DOI: 10.3390/ijerph17072363

Positive smoker identity (PSI) is a construct that evaluates the degree of smokers' positive thoughts, images and feeling about smoking behavior and culture. PSI encompasses the indicators related to tobacco denormalization strategy, which is one of the four WHO tobacco endgame strategies. PSmoQi is a newly validated instrument which could reliably assess PSI. This study's objectives were to determine the prevalence of positive smoker identity and its associated factors using PSmoQi. A sample of 253 smokers from government agencies in Kota Bharu City, Malaysia were recruited using invitation letters sent to their head of agencies. Data collection was done in a briefing session voluntary attended by the smokers. Factors associated with PSI were analyzed using Multiple Logistic Regression. The prevalence of smokers with positive smoker identity was 72.3%. Factors associated with positive smoker identity were older age (Adjusted Odds ratio; AOR: 1.042; 95% confident interval; CI: 1.004, 1.081); p = 0.028), higher smoking self-concept scale Malay version (SSCS-M) score (AOR: 1.216; 95% CI: 1.112, 1.329; p < 0.001), higher heaviness index (AOR: 1.002; 95% CI: 1.001, 1.004; p = 0.011) and lower educational attainment (AOR: 0.458; 95% CI: 0.233, 0.900; p = 0.024). This study shows a high prevalence of PSI among smokers from government agencies in Kota Bharu City. Factors such as age, SSCS-M score, heaviness index and educational attainment influenced the level of positive smoker identity in a smoker. The finding would contribute an evidentiary guideline in screening smokers for smoking cessation clinic enrollment to achieve the best interventional outcome, as well as it would provide an objective indicator for tobacco denormalization status in a population.
Fulltext Time-Use and Mental Health in Older Adults: A Scoping Review

Foong HF, Lim SY, Koris R, Haron SA

Int J Environ Res Public Health, 2021 Apr 22;18(9).
PMID: 33922295 DOI: 10.3390/ijerph18094459

Time-use of older adults can be different than in earlier life, especially during the transition from pre- to post-retirement or after experiencing major life events, and the changes could affect their mental health. However, the extent and nature of such research in gerontology have not been examined to date. Therefore, this scoping review sought to map the literature on time-use and mental health in the older population to examine the extent and nature of those research activities. A scoping review was conducted using four databases-PubMed, Scopus, CINAHL, and EMBASE according to PRISMA guidelines. Data were extracted using a pretested tool to develop a descriptive analysis and thematic summary. A total of 11 articles met the eligibility criteria. Seven out of 11 studies involved cross-sectional design, while the remainder were longitudinal studies. The longitudinal studies mainly were secondary data analysis. Time-use data were mainly collected using daily diaries, and the most common mental health outcome included was depression. Only two studies did not evaluate the direct relationship between time-use and mental health. Our review has revealed studies evaluating time-use and mental health in older adults. Limitations of review and recommendations for future studies are discussed.
Fulltext The effects of targeted deliveries of lovastatin and tocotrienol on ossification-related gene expressions in fracture healing in an osteoporosis rat model

Ibrahim N', Mohamed N, Soelaiman IN, Shuid AN

Int J Environ Res Public Health, 2015 Oct;12(10):12958-76.
PMID: 26501302 DOI: 10.3390/ijerph121012958

Osteoporotic drugs are used to prevent fragility fractures, but their role in fracture healing still remains unknown. Thus, alternative agents with suitable mode of delivery are needed to promote fracture healing. This study was performed to investigate the effects of direct deliveries of lovastatin and tocotrienol to fracture sites on ossification-related gene expression in fracture healing in a postmenopausal osteoporosis model. Forty-eight Sprague Dawley female rats were divided into six groups. Group I comprised the sham-operated rats, while Groups II-VI were ovariectomized rats. After 8 weeks, the right tibiae of all rats were fractured and stabilized. Group I and Group II were given two single injections of lovastatin and tocotrienol carriers. Group III was given an estrogen preparation at 64.5 µg/kg daily via oral gavages. Group IV was injected with lovastatin particles (750 µg/kg), while Group V was injected with tocotrienol particles (60 mg/kg). Group VI received two single injections of 750 µg/kg lovastatin particles and 60 mg/kg tocotrienol particles. After 4 weeks, the gene expressions were measured. Group VI showed significantly higher gene expressions of osteocalcin, BMP-2, VEGF-α, and RUNX-2 compared to Group II. In conclusion, combined treatment of lovastatin and tocotrienol upregulated the expression of genes related to fracture healing.
Fulltext The Validity and Reliability of the Malay Version of the Cyberbullying Scale among Secondary School Adolescents in Malaysia

Saman ZM, Siti-Azrin AH, Othman A, Kueh YC

Int J Environ Res Public Health, 2021 11 06;18(21).
PMID: 34770183 DOI: 10.3390/ijerph182111669

The effect of cyberbullying among adolescents in Malaysia is not much studied. The Cyberbullying Scale (CBS) has been validated to be used among English speaking adolescents to measure cyberbullying but not in Malay language. Therefore, its validity should be established before use in the Malaysian context. Thus, the study aimed to evaluate the validity and reliability of the Malay version of the CBS (CBS-M) among secondary school students. The study was cross-sectional and involved a self-administered questionnaire with 16 items from CBS-M, and 21 items from the Depression, Anxiety, and Stress Scale (DASS-21). Participants were recruited using a multi-stage sampling method. The validity of the CBS-M was tested in two phases, namely, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Spearman's correlation was used to examine the strength of the relationship between the CBS and subscales from DASS-21 to further support the validity of CBS-M. A total of 401 respondents from Muar, Johor, participated. The mean age was 14.6 years (SD = 1.25). EFA results indicated a one-factor model of CBS-M with a total variance extracted of 33.9%. Internal consistency measured by Cronbach's alpha reached 0.87. The model was then tested using CFA. The initial model did not fit the data well. Thus, several model re-specifications were conducted on the initial model. The final measurement model of CBS-M fit the data well with acceptable fit indices (CFI = 0.946, TLI = 0.932, SRMR = 0.055, RMSEA = 0.049). The composite reliability for CBS-M was satisfactory with a value of 0.832. The CBS-M questionnaire is a valid and reliable tool for measuring cyberbullying among young adolescents in Malaysia.
Fulltext The Validation and Improvement of a Food Literacy Behavior Checklist for Food Literacy Programs

Paynter E, Begley A, Butcher LM, Dhaliwal SS

Int J Environ Res Public Health, 2021 12 16;18(24).
PMID: 34948890 DOI: 10.3390/ijerph182413282

Food literacy is a multidimensional construct required to achieve diet quality. The Food Sensations® for Adults (FSA) program aims to improve the food literacy of low to middle-income adults living in Western Australia and is funded by the Western Australian Department of Health. The original published behavior checklist used to measure change in food literacy has been revised based on experience of the facilitators and the iterative development of the program. This research sought to assess the validity and reliability of the improved food literacy behavior checklist. A total of 1,359 participants completed the checklist over an 18-month period. Content, face, and construct validity were considered in the re-development of the checklist. An exploratory factor analysis of the checklist identified three factors: (1) Plan and Manage, (2) Selection, and (3) Preparation. Cronbach's alpha coefficients of 0.883, 0.760, and 0.868 were found for each of the three factors respectively. These coefficients indicated good internal consistency and were higher than those found in the original checklist analysis. An external validation was undertaken with the original food literacy behavior checklist, and a strong positive relationship between the two tools was found. In addition to being used to evaluate FSA, this revised and extensively validated tool could provide guidance to others evaluating similar food literacy programs and contribute to international measurement research.
Fulltext The Use of Stents in Children with Nasolacrimal Duct Obstruction Requiring Surgical Intervention: A Systematic Review

Tai ELM, Kueh YC, Abdullah B

Int J Environ Res Public Health, 2020 02 07;17(3).
PMID: 32046207 DOI: 10.3390/ijerph17031067

Nasolacrimal duct obstruction (NLDO) is the most common cause of childhood epiphora. It is managed conservatively in the first year of life, after which surgical treatment is classically based on a stepwise paradigm of probing, intubation, and dacryocystorhinostomy. This systematic review aims to present the current role of intubation in the management of children with NLDO requiring surgical intervention. A search for English-language articles from the electronic databases PubMed, SCOPUS, and the COCHRANE library was conducted over a period of five months in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook. The following keywords were used to aid retrieval: stents, children, lacrimal intubation, endoscopic dacryocystorhinostomy, external dacryocystorhinostomy, NLDO, dacryocystitis, congenital, acquired. The primary outcome was defined as the success of the intervention, determined by resolution of symptoms and patency of the lacrimal anatomy confirmed by the fluorescein dye disappearance test or syringing. Secondary outcomes included the presence of complications. A total of 144 articles were identified; of these, 35 fulfilled the study criteria. The majority of the included studies involved lacrimal intubation alone, followed by intubation as an adjunctive procedure to balloon dacryoplasty and dacryocystorhinostomy. The overall success rate of these procedures ranged from 41.1% to 100%. Post-operative complications were reported in 65.7% of the included studies. Lacrimal intubation was most commonly performed as a primary procedure in children with NLDO, with high success rates. The main complication was stent dislodgement. There is lack of evidence regarding the benefit of intubation over probing as primary treatment of congenital NLDO. In the absence of high-quality evidence, the decision of whether to perform lacrimal intubation in children with NLDO requiring surgical intervention depends on clinical judgement and other low-level evidence, such as observational non-randomised trials.

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