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Patient Reporting of Adverse Drug Reactions (ADRs): Survey of Public Awareness and Predictors of Confidence to Report

Hariraj V, Aziz Z

Ther Innov Regul Sci, 2018 11;52(6):757-763.
PMID: 29714567 DOI: 10.1177/2168479017745025

BACKGROUND: Many countries incorporate direct patient reporting of adverse drug reactions (ADRs) into their pharmacovigilance systems as patients provide a different insight into drug safety compared to health care professionals. This study aimed to examine public awareness about ADR reporting in Malaysia and patients' confidence in reporting ADRs.
METHODS: Using a cross-sectional design and convenient sampling, data were collected in public areas within Kuala Lumpur, Malaysia, via face-to-face interview with a structured questionnaire. Multivariate logistic regression analysis was used to identify the significant predictors of patients' confidence in ADR reporting.
RESULTS: Out of 860 consented respondents achieving a response rate of 73.5%, only 69 (8%) were aware of the Malaysian ADR monitoring system. The majority (60%) of the respondents indicated they had the confidence to report ADRs. Multivariate logistic regression analysis revealed that ease in completing the ADR reporting form was the strongest variable predictive of confidence to report ADRs (odds ratio [OR], 18.45; 95% confidence interval [CI], 10.55-32.25). Increased confidence in ADR reporting was also associated with education level. Respondents with a higher education level were more likely to be confident to report ADRs compared to those with primary or no formal education (OR, 2.49; 95% CI, 0.77-8.1).
CONCLUSIONS: Lack of awareness of the ADR monitoring system is still prevalent among Malaysian patients. The ease of completing the ADR form and education level are predictive of patient confidence to report ADRs. These factors should be considered in designing public promotional activities to encourage patient contributions to pharmacovigilance.

Matched MeSH terms: Logistic Models
Physical, psychological and sexual effects in multi-ethnic Malaysian women who have undergone hysterectomy

Wong LP, Arumugam K

J Obstet Gynaecol Res, 2012 Aug;38(8):1095-105.
PMID: 22540215 DOI: 10.1111/j.1447-0756.2011.01836.x

The postoperative effects on Asian women after hysterectomy have not been fully explored. This study was undertaken to investigate the physical, psychological and sexual functioning effects in multi-ethnic Malaysian women who have undergone hysterectomy.

Matched MeSH terms: Logistic Models
DNA Damage, Copper and Lead Associates with Cognitive Function among Older Adults

Meramat A, Rajab NF, Shahar S, Sharif RA

J Nutr Health Aging, 2017;21(5):539-545.
PMID: 28448084 DOI: 10.1007/s12603-016-0759-1

BACKGROUND: A cross sectional study was conducted in a group of 317 subjects older than 60 in Malaysia, aimed to determine risk factors associated with cognitive impairment in older adults, focusing on trace elements and DNA damage.
METHOD: Cognitive decline was determined by Montreal Cognitive Assessment (MoCA). Oxidative stress markers (malondialdehyde-MDA and superoxide dismutase-SOD) were determined and DNA damage was assayed using Alkaline Comet Assay. Toenail samples were taken and analyzed using ICP-MS to determine trace element levels.
RESULTS: A total of 62.1 % of subjects had cognitive impairment. Subjects with cognitive impairment had significantly higher levels of MDA and DNA damage as compared to the group with normal cognitive function; MDA (2.07 ± 0.05 nmol/L vs 1.85 ± 0.06 nmol/L) (p<0.05) and DNA damage (% Tail Density, 14.52 ± 0.32 vs 10.31 ± 0.42; Tail Moment, 1.79 ± 0.06 vs 1.28 ± 0.06) (p<0.05 for all parameters). However, the level of SOD among subjects with cognitive impairment (6.67 ± 0.33 u.e/min/mg protein) was lower than the level among those with normal cognitive functions (11.36 ± 0.65 u.e/min/mg protein) (p<0.05). Multiple logistic regression revealed the predictors for cognitive impairment among the subjects were DNA damage (Adjusted odd ratio [OR], 1.37; 95% confidence interval [CI], 1.18-1.59), level of trace elements in toenails namely, lead (OR, 2.471; CI, 1.535-3.980) and copper (OR, 1.275; CI, 1.047-1.552) (p<0.05).
CONCLUSION: High levels of lead and copper can lead to increase in oxidative stress levels and are associated with DNA damage that eventually could be associated with cognitive decline.

Matched MeSH terms: Logistic Models
Factors Related to Urinary Incontinence among the Malaysian Elderly

Eshkoor SA, Hamid TA, Shahar S, Mun CY

J Nutr Health Aging, 2017;21(2):220-226.
PMID: 28112780 DOI: 10.1007/s12603-016-0779-x

BACKGROUND: Urinary incontinence is a prevalent condition in the elderly that is the spontaneous leakage of urine. It is an age-related problem and increases especially in people aged above 65 years. It can cause many psychological, behavioral, biological, economic and social effects. The treatment of urinary incontinence can reduce morbidity and mortality. Thus, this study aimed to determine the effects of variables including age, ethnicity, gender, education, marital status, body weight, blood elements and nutritional parameters on urinary incontinence among the Malaysian elderly.
METHODS: The study was on 2322 non-institutionalized Malaysian elderly. The hierarchy logistic regression analysis was applied to estimate the risk of independent variables for urinary incontinence among respondents.
RESULTS: The findings indicated that approximately 3.80% of subjects had urinary incontinence. In addition, constipation was found a significant factor that increased the risk of urinary incontinence in samples (p=0.006; OR=3.77). The increase in dietary monounsaturated fat (p=0.038; OR=0.59) and plasma triglyceride levels (p=0.029; OR=0.56) significantly reduced the risk of incontinence in subjects. Many of suspected variables including socio-demographic factors, diseases, nutritional minerals, blood components and body weight were non-relevant factors to urinary incontinence in respondents.
CONCLUSIONS: Constipation increased the risk of urinary incontinence in subjects, and increase in dietary monounsaturated fat and plasma triglyceride levels decreased the risk.

Matched MeSH terms: Logistic Models
Fulltext Knowledge, attitude and perception of second-hand smoke and factors promoting smoking in Malaysian adolescents

Abidin NZ, Zulkifli A, Abidin EZ, Rasdi I, Ismail SN, Rahman AA, et al.

Int J Tuberc Lung Dis, 2014 Jul;18(7):856-61.
PMID: 24902566 DOI: 10.5588/ijtld.13.0906

OBJECTIVE: To identify the relationship between knowledge, attitude and perception regarding environmental tobacco smoke (ETS) and smoking among Malaysian adolescents living in states with complete or partial smoke-free legislation (SFL).
METHODS: A total of 898 respondents aged 13-14 years were randomly selected from 21 secondary schools. The Malay version of the modified Global Youth Tobacco Survey questionnaire was used. Hierarchical logistic regression was performed in examining predictors of smoking attempt among adolescents.
RESULTS: Participants exposed to ETS >5 h/day were more likely to have smoked compared to those exposed to ETS <1 h/day (OR 4.1, 95%CI 1.03-16.0). Living in a state with partial SFL was associated with a two-fold increase in self-reported smoking attempts (OR 1.95, 95%CI 1.10-3.43) compared to living in a state with complete SFL. Negative attitudes and perceptions towards smoking and ETS exposure were linked to lower smoking attempts in states with complete SFL.
CONCLUSIONS: Adolescents with limited ETS exposure who lived in a state with complete SFL were less likely to attempt smoking compared to those exposed more regularly to ETS and living in a state with partial SFL. Preventing adolescents from becoming smokers is the key to reducing national prevalence rates in smoking. There is a need to implement comprehensive smoke-free legislation nationally across Malaysia.

Matched MeSH terms: Logistic Models
Fulltext Prevalence of tuberculosis symptoms and latent tuberculous infection among prisoners in northeastern Malaysia

Margolis B, Al-Darraji HA, Wickersham JA, Kamarulzaman A, Altice FL

Int J Tuberc Lung Dis, 2013 Dec;17(12):1538-44.
PMID: 24200265 DOI: 10.5588/ijtld.13.0193

There are currently no routine screening procedures for active tuberculosis (TB) or latent tuberculous infection (LTBI) in Malaysian prisons.

Matched MeSH terms: Logistic Models
Respiratory health among office workers in Malaysia and endotoxin and (1,3)-β-glucan in office dust

Lim FL, Hashim Z, Than LTL, Md Said S, Hashim JH, Norbäck D

Int J Tuberc Lung Dis, 2019 11 01;23(11):1171-1177.
PMID: 31718753 DOI: 10.5588/ijtld.18.0668

OBJECTIVE: To examine the associations between endotoxin and (1,3)-β-glucan concentrations in office dust and respiratory symptoms and airway inflammation among 695 office workers in Malaysia.METHODS: Health data were collected using a questionnaire, sensitisation testing and measurement of fractional exhaled nitric oxide (FeNO). Indoor temperature, relative air humidity (RH) and carbon dioxide (CO₂) were measured in the offices and settled dust was vacuumed and analysed for endotoxin and (1,3)-β-glucan concentrations. Associations were analysed by two level multiple logistic regression.RESULTS: Overall, 9.6% of the workers had doctor-diagnosed asthma, 15.5% had wheeze, 18.4% had daytime attacks of breathlessness and 25.8% had elevated FeNO (≥25 ppb). The median levels in office dust were 11.3 EU/mg endotoxin and 62.9 ng/g (1,3)-β-glucan. After adjusting for personal and home environment factors, endotoxin concentration in dust was associated with wheeze (P = 0.02) and rhinoconjunctivitis (P = 0.007). The amount of surface dust (P = 0.04) and (1,3)-β-glucan concentration dust (P = 0.03) were associated with elevated FeNO.CONCLUSION: Endotoxin in office dust could be a risk factor for wheeze and rhinoconjunctivitis among office workers in mechanically ventilated offices in a tropical country. The amount of dust and (1,3)-β-glucan (a marker of indoor mould exposure) were associated with Th2 driven airway inflammation.

Matched MeSH terms: Logistic Models
Fulltext Low-density lipoprotein cholesterol goal attainment among Malaysian dyslipidemic patients

Al-Khateeb A, Mohamed MS, Imran K, Ibrahim S, Zilfalill BA, Yusof Z

Southeast Asian J. Trop. Med. Public Health, 2011 Mar;42(2):388-94.
PMID: 21710862

The aim of the present study was to evaluate Malaysian dyslipidemic patient treatment practices and outcomes. Factors contributing to success in reaching treatment goal were determined. A retrospective review of the records of dyslipidemic patients who attended the Universiti Sains Malaysia Hospital in 2007 was conducted. All the patients were receiving standard recommended doses of statins. Records were analysed for 890 patients. Patients were divided into three categories: 384 patients (43.1%) had coronary heart disease or coronary heart disease risk equivalents, 216 patients (24.3%) had moderate risk for coronary heart disease and 290 patients (32.6%) had low risk. Statins were the most commonly prescribed drug group (92%), of which atorvastatin was the most commonly prescribed drug (50.6%). The overall success rate for reaching goal was 64.2%. The percentages of patients achieving low-density lipoprotein cholesterol targets in the coronary heart disease and coronary heart disease risk equivalents, moderate, and low-risk groups were 50.5, 66.7, and 80.3%, respectively (p < 0.001). Multiple logistic regression showed achievement of therapeutic goal declined with increasing risk group. The baseline low-density lipoprotein cholesterol value was inversely related to therapeutic goal attainment. An inadequate proportion of dyslipidemic patients achieved the National Cholesterol Education Program therapeutic goals for low-density lipoprotein cholesterol, especially those in the coronary heart disease and coronary heart disease risk equivalent group. The achievement of this goal was dependent on baseline low-density lipoprotein cholesterol levels.

Matched MeSH terms: Logistic Models
Outcomes and appropriateness of management of nosocomial Acinetobacter bloodstream infections at a teaching hospital in northeastern Malaysia

Deris ZZ, Harun A, Shafei MN, Rahman RA, Johari MR

Southeast Asian J. Trop. Med. Public Health, 2009 Jan;40(1):140-7.
PMID: 19323046

Acinetobacter spp is a known nosocomial pathogen causing a wide range of clinical diseases such as pneumonia, wound infection and bloodstream infections (BSI). The clinical outcomes of acinetobacter BSI were determined by a 1:1 case control study involving 58 confirmed cases of acinetobacter BSI who were compared to other gram-negative infections. The crude mortality of acinetobacter BSI was 47.2%, which was significantly greater than other gram-negative BSI (OR 1.89, 95% CI 1.10-3.24) but there were no significant differences in attributed mortality between the two groups. We found that patients treated in intensive care units (ICU), who had longer ICU stays, who presented with shock or coagulopathy, had prior exposure to carbapenems, had mechanical ventilation, were on a ventilator for longer periods, had a nasogastric tube, had an arterial catheter or had parenteral nutrition at a significantly greater risk of mortality due to acinetobacter BSI. Patients presenting with septic shock (OR 17.95, 95% CI 3.36-95.84) or having a central venous catheter (OR 12.48, 95% CI 1.09-142.68) were independently at higher risk for mortality. Appropriateness of therapy reduced the mortality attributes of acinetobacter BSI (OR 0.197, 95% CI 0.040-0.967) but did not significantly reduce crude mortality in acinetobacter BSI patients. This study shows the importance of preventing acinetobacter BSI and the appropriate use of antimicrobial agents to reduce mortality.

Matched MeSH terms: Logistic Models
Women's attitude and sociodemographic characteristics influencing usage of herbal medicines during pregnancy in Tumpat District, Kelantan

Rahman AA, Sulaiman SA, Ahmad Z, Salleh H, Daud WN, Hamid AM

Southeast Asian J. Trop. Med. Public Health, 2009 Mar;40(2):330-7.
PMID: 19323019

The objective of this cross-sectional study was to determine whether the use of herbal medicines during pregnancy is associated with women's attitudes towards herbal medicines and their sociodemographic features, such as age, education level, and income. Two-hundred ten women (110 "users," 100 "non-users") were studied. The probability of using herbal medicines among women who had negative attitudes towards the use of herbal medicines was 50.0% less compared to those who had positive attitudes (OR = 0.51, 95% CI = 0.29 - 0.92). Women who had a positive attitude towards the safety of herbal medicines were less likely to use herbal medicines during pregnancy. There were no significant associations between usage and sociodemographic features, such as age, income, race, and education.

Matched MeSH terms: Logistic Models
The use of an In House Scoring System Scale versus Glasgow Coma Scale in non-traumatic altered states of consciousness patients: can it be used for triaging patients in Southeast Asian developing countries?

Maheswaran M, Adnan WA, Ahmad R, Ab Rahman NH, Naing NN, Abdullah J

Southeast Asian J. Trop. Med. Public Health, 2007 Nov;38(6):1126-40.
PMID: 18613557

Non-traumatic Altered States of Consciousness (ASC) are a non-specific consequence of various etiologies, and are normally monitored by Glasgow Coma Scale (GCS). The GCS gives varriable results among untrained emergency medicine personel in developing countries where English is not the first language. An In House Scoring System (IHSS) scale was made by the first author for the purpose of triaging so as to quickly asses patients when seen by medical personel. This IHSS scale was compared to the GCS to determine it's specificity and sensitivity in the accident and emergency department (ED) of Hospital University Sains Malaysia (HUSM). All patients with non-traumatic ASC were selected by purposive sampling according to pre-determined criteria. Patients were evaluated by the two systems, IHSS and GCS, by emergency physicians who were on call. Patient demographics, clinical features, investigations, treatment given and outcomes were collected and followed for a period of 14 days. A total of 221 patients with non-traumatic ASC were studied, 54.3% were males. The mean age of the patients was 56 years old. The mean overall GCS score on presentation to the ED was 10.3. The mean duration of ASC was 11.6 hours. One hundred thirty patients (58.8%) experienced ASC secondary to general or focal cerebral disorders. The mortality rate was 40.3% 2 weeks after the ED visit. Fifty-four point three percent of the patients were awake and considered to have good outcomes while 45.7% of the patients had poor outcomes (comatose or dead) 2 weeks after the ED visit. The mean overall GCS score, verbal and motor subscores as well as the IHSS had significantly decreased (worsened) after treatment in the ED. A poor IHSS scale, hypertension, current smoking, abnormal pupillary reflexes and acidosis were associated with a worse 2-week outcome. The mean age and WBC count was lower and the mean overall GCS score and eye, verbal and motor subscores were higher as well as those having a lower IHSS scale for the good outcome category. Multivariate analysis revealed that smokers and hypertensives were at higher risk for a poor outcome. Higher eye scores on the GCS were associated fewer poor outcomes. There was significant agreement between the IHSS scale and GCS scores in the assessment of non-traumatic ASC. The sensitivity and specificity of the IHSS score versus GCS were 71.9% and 100.0%, respectively.

Matched MeSH terms: Logistic Models
Fulltext Helicobacter pylori infection in peptic ulcer disease: the importance of smoking and ethnicity

Pillay KV, Htun M, Naing NN, Norsa'adah B

Southeast Asian J. Trop. Med. Public Health, 2007 Nov;38(6):1102-10.
PMID: 18613553

This study was conducted to determine the prevalence of Helicobacter pylori (H. pylori) and its associated factors among patients with peptic ulcer disease in Taiping Hospital. Consecutive peptic ulcer disease patients who had undergone esophagogastro-duodenoscopy were included. The H. pylori status was assessed by the rapid urease test. We excluded those who had active bleeding, a perforated peptic ulcer, severe vomiting, a history of gastric surgery, peptic ulcer disease or renal or liver diseases, carcinoma of the stomach, and recent use of antibiotics or proton pump inhibitors. Socio-demography, H. pylori status, medication history and other relevant clinical data were collected from case notes. A total of 416 subjects were selected, 49.7% were positive and 50.3% were negative for H. pylori infection. There were significant associations between H. pylori and age, ethnicity, smoking status and NSAID usage. However, there were no significant relationships between H. pylori status and gender or type of peptic ulcer. Multiple logistic regression showed that other ethnicities than Malays and smokers had a higher risk of H. pylori. Our prevalence rate was low and the identified risk factors were consistent with previous studies. Ethnic differences may be related to genetic and sociocultural behaviors. Quitting smoking may benefit peptic ulcer patients with H. pylori infection.

Matched MeSH terms: Logistic Models
Prevalence and associated factors of head lice infestation among primary schoolchildren in Kelantan, Malaysia

Bachok N, Nordin RB, Awang CW, Ibrahim NA, Naing L

Southeast Asian J. Trop. Med. Public Health, 2006 May;37(3):536-43.
PMID: 17120976

Head lice infestation contributes a significant morbidity among schoolchildren in Malaysia. A cross-sectional study was designed to determine the prevalence and associated factors of head lice infestation among primary schoolchildren in Kelantan, Malaysia. Six schools were randomly selected from three sub-districts of Kuala Krai, Kelantan. A total of 463 eleven-year-old pupils were screened by visual scalp examination and fine-toothed combing. Self-administered questionnaire was used to collect data on socio-demography and associated factors of head lice infestation. The prevalence of head lice infestation was 35.0% (95% Cl: 30.6, 39.3) with 11.9% inactive, 23.1% active, 18.2% light and 16.8% heavy infestations. The associated factors were girls; family income of RM247 or less; head lice infestation of family member and having four or more siblings. The high prevalence of head lice infestation in this study indicates the need for regular school health program that emphasis on the eradication of head lice. The significant associated factors identified in this study reconfirm the importance of controlling the transmissibility of head lice. Pupils and parents should be informed regarding factors that may facilitate the transmission of head lice.

Matched MeSH terms: Logistic Models
Risk factors for hypoxemia and respiratory failure in respiratory syncytial virus bronchiolitis

Chan PW, Lok FY, Khatijah SB

Southeast Asian J. Trop. Med. Public Health, 2002 Dec;33(4):806-10.
PMID: 12757230

Respiratory syncytial virus (RSV) bronchiolitis is a common infection in young children and may result in hospitalization. We examined the incidence of, and risk factors associated with, hypoxemia and respiratory failure in 216 children aged < 24 months admitted consecutively for proven RSV bronchiolitis. Hypoxemia was defined as SpO2 < 90% in room air and severe RSV bronchiolitis requiring intubation and ventilation was categorized as respiratory failure. Corrected age at admission was used for premature children (gestation < 37 weeks). Hypoxemia was suffered by 31 (14.3%) children. It was more likely to occur in children who were Malay (OR 2.56, 95%CI 1.05-6.23, p=0.03) or premature (OR 6.72, 95%CI 2.69-16.78, p<0.01). Hypoxemia was also more likely to develop in children with failure to thrive (OR 2.96, 95%CI 1.28-6.82, p<0.01). The seven (3.2%) children who were both premature (OR 11.94, 95%CI 2.50-56.99, p<0.01) and failure to thrive (OR 6.41, 95%CI 1.37-29.87, p=0.02) were more likely to develop respiratory failure. Prematurity was the only significant risk factor for hypoxemia and respiratory failure by logistic regression analysis (OR 1.17, 95%CI 1.06-1.55, p<0.01 and OR 1.14 95%CI 1.02-2.07, p=0.02 respectively). Prematurity was the single most important risk factor for both hypoxemia and respiratory failure in RSV bronchiolitis.

Matched MeSH terms: Logistic Models
Fulltext Factors contributing to poor compliance with anti-TB treatment among tuberculosis patients

Naing NN, D'Este C, Isa AR, Salleh R, Bakar N, Mahmod MR

Southeast Asian J. Trop. Med. Public Health, 2001 Jun;32(2):369-82.
PMID: 11556591

Tuberculosis (TB) has made a comeback. It has become a resurgent public health problem in developing countries in the tropics and is the leading cause of death from any single infectious agent. Non-compliance to anti-tuberculosis treatment is the most serious problem in TB control. A cross-sectional study was conducted to investigate the determinants of poor compliance with anti-tuberculosis treatment among tuberculosis patients in Kota Bharu, Kelantan, Malaysia in 1999. A total of 390 patients were included in the study of which 130 were tuberculosis patients who defaulted treatment and 260 were those compliant to treatment. Data collection was done by interviewing the patients and collecting clinical and laboratory data from their medical records. Using multiple logistic regression analysis, patients who were not on direct observed therapy (DOT) lived distant to the health facility, were non-intravenous drug users (IVDU) and were HIV positive had statistically significant higher odds of being non-compliant. Patients should be given treatment under direct supervision with special attention to IVDU and HIV positive groups. Anti-TB treatment should be accessible to patients at the nearest health center from their residence. Interventions with health education programs emphasizing the benefits of treatment compliance should be implemented by further large-scale multicentered studies.
Study site: Chest clinic, Hospital Kota Bharu, Kelantan, Malaysia

Matched MeSH terms: Logistic Models
Fulltext Prevalence and some risk factors of Giardia duodenalis infection in a rural community in Malaysia

Norhayati M, Penggabean M, Oothuman P, Fatmah MS

Southeast Asian J. Trop. Med. Public Health, 1998 Dec;29(4):735-8.
PMID: 10772555

A study on prevalence and risk factors of Giardia duodenalis infection was conducted in rural communities of Malaysia. A total of 917 individuals between 2-70 years old (431 males and 486 females), participated in this study. The overall prevalence of G. duodenalis infection was 19.2%. The prevalence was significantly different between different age groups, but not genders. Our study indicated that age < or = 12 years old and the presence of family members infected with G. duodenalis were the risk factors of infection. Person-to-person contact within the family members was the possible mode of transmission. Health education on personal hygiene, together with the treatment of the infected people, may help in reducing and controlling this infection in these communities.

Matched MeSH terms: Logistic Models
Fulltext Laboratory evaluation of propoxur and fenvalerate against infected and noninfected Leptotrombidium fletcheri (Acari: Trombiculidae)

Ho TM, Fauziah MK

Southeast Asian J. Trop. Med. Public Health, 1993 Sep;24(3):570-2.
PMID: 8160070
Matched MeSH terms: Logistic Models
Endotoxin, ergosterol, muramic acid and fungal DNA in dust from schools in Johor Bahru, Malaysia--Associations with rhinitis and sick building syndrome (SBS) in junior high school students

Norbäck D, Hashim JH, Markowicz P, Cai GH, Hashim Z, Ali F, et al.

Sci Total Environ, 2016 Mar 1;545-546:95-103.
PMID: 26745297 DOI: 10.1016/j.scitotenv.2015.12.072

This paper studied associations between ocular symptoms, rhinitis, throat and dermal symptoms, headache and fatigue in students by ethnicity and in relation to exposure to chemical microbial markers and fungal DNA in vacuumed dust in schools in Malaysia. A total of 462 students from 8 randomly selected secondary schools in Johor Bahru, Malaysia, participated (96% response rate). Dust was vacuumed from 32 classrooms and analysed for levels of five types of endotoxin as 3-hydroxy fatty acids (C10, C12, C14, C16 and C18 3-OH), muramic acid, ergosterol and five sequences of fungal DNA. Multiple logistic regression was applied. Totally 11.9% reported weekly ocular symptoms, 18.8% rhinitis, 15.6% throat and 11.1% dermal symptoms, 20.6% headache and 22.1% tiredness. Totally 21.1% reported pollen or furry pet allergy (atopy) and 22.0% parental asthma or allergy. Chinese students had less headache than Malay and Indian had less rhinitis and less tiredness than Malay. Parental asthma/allergy was a risk factor for ocular (odds ratio=3.79) and rhinitis symptoms (OR=3.48). Atopy was a risk factor for throat symptoms (OR=2.66), headache (OR=2.13) and tiredness (OR=2.02). There were positive associations between amount of fine dust in the dust samples and ocular symptoms (p<0.001) and rhinitis (p=0.006). There were positive associations between C14 3-OH and rhinitis (p<0.001) and between C18 3-OH and dermal symptoms (p=0.007). There were negative (protective) associations between levels of total endotoxin (LPS) (p=0.004) and levels of ergosterol (p=0.03) and rhinitis and between C12 3-OH and throat symptoms (p=0.004). In conclusion, the amount of fine dust in the classroom was associated with rhinitis and other SBS symptoms and improved cleaning of the schools is important. Endotoxin in the school dust seems to be mainly protective for rhinitis and throat symptoms but different types of endotoxin could have different effects. The ethnic differences in symptoms among the students deserve further attention.

Matched MeSH terms: Logistic Models
Motivations and built environment factors associated with campus walkability in the tropical settings

Ramakreshnan L, Fong CS, Sulaiman NM, Aghamohammadi N

Sci Total Environ, 2020 Dec 20;749:141457.
PMID: 33370890 DOI: 10.1016/j.scitotenv.2020.141457

Recognizing and mainstreaming pertinent walkability elements into the university campus planning is crucial to materialise green mandates of the campus, while enhancing social and economic sustainability. In one of such attempts, this transverse study investigated the walking motivations, built environment factors associated with campus walkability and the relative importance of the studied built environment factors in reference to the sociodemographic attributes from the viewpoint of the campus community in a tropical university campus in Kuala Lumpur, Malaysia. An online survey using a structured questionnaire was conducted between May and September 2019. The built environment factors associated with campus walkability were expressed and ranked as adjusted scores (AS). Meanwhile, multivariable logistic regression was deployed to examine the relative importance of the studied built environment factors in reference to the sociodemographic attributes of the campus community. Among 504 total responses acquired, proximity between complementary land uses (90.7%) was reported as the main motivation for walking. On the other hand, street connectivity and accessibility (AS: 97.62%) was described as the most opted built environment factor, followed by land use (AS: 96.76%), pedestrian infrastructure (AS: 94.25%), walking experience (AS: 87.07%), traffic safety (AS: 85.28%) and campus neighbourhood (AS: 59.62%), respectively. Among the sociodemographic attributes, no regular monthly income (OR = 3.162; 95% CI = 1.165-8.379; p

Matched MeSH terms: Logistic Models
GIS-based groundwater potential analysis using novel ensemble weights-of-evidence with logistic regression and functional tree models

Chen W, Li H, Hou E, Wang S, Wang G, Panahi M, et al.

Sci Total Environ, 2018 Sep 01;634:853-867.
PMID: 29653429 DOI: 10.1016/j.scitotenv.2018.04.055

The aim of the current study was to produce groundwater spring potential maps using novel ensemble weights-of-evidence (WoE) with logistic regression (LR) and functional tree (FT) models. First, a total of 66 springs were identified by field surveys, out of which 70% of the spring locations were used for training the models and 30% of the spring locations were employed for the validation process. Second, a total of 14 affecting factors including aspect, altitude, slope, plan curvature, profile curvature, stream power index (SPI), topographic wetness index (TWI), sediment transport index (STI), lithology, normalized difference vegetation index (NDVI), land use, soil, distance to roads, and distance to streams was used to analyze the spatial relationship between these affecting factors and spring occurrences. Multicollinearity analysis and feature selection of the correlation attribute evaluation (CAE) method were employed to optimize the affecting factors. Subsequently, the novel ensembles of the WoE, LR, and FT models were constructed using the training dataset. Finally, the receiver operating characteristic (ROC) curves, standard error, confidence interval (CI) at 95%, and significance level P were employed to validate and compare the performance of three models. Overall, all three models performed well for groundwater spring potential evaluation. The prediction capability of the FT model, with the highest AUC values, the smallest standard errors, the narrowest CIs, and the smallest P values for the training and validation datasets, is better compared to those of other models. The groundwater spring potential maps can be adopted for the management of water resources and land use by planners and engineers.

Matched MeSH terms: Logistic Models

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