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Fulltext Facilitating Exercise Engagement among Community Dwelling Stroke Survivors: Is a once Per Week Group Session Sufficient?

Mohd Nordin NA, Yusoff NAH, Ajit Singh DK

Int J Environ Res Public Health, 2019 11 27;16(23).
PMID: 31783575 DOI: 10.3390/ijerph16234746

Although exercise is proven as an effective strategy to combat post-stroke complications and the risk of stroke recurrence, many stroke survivors fail to engage in this activity following rehabilitation. In this study, we assessed the feasibility and usefulness of a low-frequency group exercise to determine its suitability as an approach to facilitate exercise engagement among stroke survivors. Forty-one stroke survivors, mean (SD) age 59.34 (10.02) years, mean time post-stroke 17.13 (17.58) months, completed a 90 minute, once per week, group exercise supervised by therapists for 12 weeks. The exercise outcomes were measured using standardized clinical tests. We observed improvement in the group's physical performance; balance score by 3 units (Z = -3.88, p < 0.001), speed of repetitive sit to stand by 3.4 s (Z = -4.69, p < 0.001), and walking speed by 8.22 m/min (Z = -3.25, p < 0.001). Scores of seven out of 14 Berg's balance scale items increased significantly, indicating better balance ability among the survivors. In conclusion, a 12-week, once per week group exercise session seems feasible and sufficient to improve the physical performance of community dwelling stroke survivors. This exercise arrangement may be offered to stroke survivors to facilitate exercise practice following rehabilitation.
Fulltext Factors Influencing Asia-Pacific Countries' Success Level in Curbing COVID-19: A Review Using a Social-Ecological System (SES) Framework

Ling GHT, Md Suhud NAB, Leng PC, Yeo LB, Cheng CT, Ahmad MHH, et al.

Int J Environ Res Public Health, 2021 Feb 10;18(4).
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.
Fulltext Distribution of Refractive Errors among Healthy Infants and Young Children between the Age of 6 to 36 Months in Kuala Lumpur, Malaysia-A Pilot Study

Yahya AN, Sharanjeet-Kaur S, Akhir SM

Int J Environ Res Public Health, 2019 11 27;16(23).
PMID: 31783494 DOI: 10.3390/ijerph16234730

Uncorrected refractive error, especially myopia, in young children can cause permanent visual impairment in later life. However, data on the normative development of refractive error in this age group is limited, especially in Malaysia. The aim of this study was to determine the distribution of refractive error in a sample of infants and young children between the ages of 6 to 36 months in a prospective, cross-sectional study. Cycloplegic retinoscopy was conducted on both eyes of 151 children of mean age 18.09 ± 7.95 months. Mean spherical equivalent refractive error for the right and left eyes was +0.85 ± 0.97D and +0.86 ± 0.98D, respectively. The highest prevalence of refractive error was astigmatism (26%), followed by hyperopia (12.7%), myopia (1.3%) and anisometropia (0.7%). There was a reduction of hyperopic refractive error with increasing age. Myopia was seen to emerge at age 24 months. In conclusion, the prevalence of astigmatism and hyperopia in infants and young children was high, but that of myopia and anisometropia was low. There was a significant reduction in hyperopic refractive error towards emmetropia with increasing age. It is recommended that vision screening be conducted early to correct significant refractive error that may cause disruption to clear vision.
Fulltext Ride or Not to Ride: Does the Customer Deviate toward Ridesharing?

Shamim A, Khan AA, Qureshi MA, Rafique H, Akhunzada A

Int J Environ Res Public Health, 2021 10 01;18(19).
PMID: 34639652 DOI: 10.3390/ijerph181910352

Traditional taxi services have now been transformed into e-hailing applications (EHA) such as Uber, Careem, Hailo, and Grab Car globally due to the proliferation of smartphone technology. On the one hand, these applications provide transport facilities. On the other hand, users are facing multiple issues in the adoption of EHAs. Despite problems, EHAs are still widely adopted globally. However, a sparse amount of research has been conducted related to EHAs, particular in regards to exploring the significant factors of intention behind using EHAs Therefore, there is a need to identify influencing factors that have a great impact on the adoption and acceptance of these applications. Hence, this research aims to present an empirical study on the factors influencing customers' intentions towards EHAs. The Technology Acceptance Model (TAM) was extended with four external factors: perceived mobility value, effort expectancy, perceived locational accuracy, and perceived price. A questionnaire was developed for the measurement of these factors. A survey was conducted with 211 users of EHAs to collect data. Structural equation modeling (SEM) was used to analyze the collected data. The results of this study exposed that perceived usefulness, perceived price, and perceived ease of use affect behavior intention to use EHAs. Furthermore, perceived ease of use was impacted by effort expectancy, perceived locational accuracy, and perceived mobility. The findings of the study provide a foundation to develop new guidelines for such applications that will be beneficial for developers and designers of these applications.
Fulltext Human Health Risk Assessments of Trace Metals on the Clam Corbicula javanica in a Tropical River in Peninsular Malaysia

Yap CK, Wong KW, Al-Shami SA, Nulit R, Cheng WH, Aris AZ, et al.

Int J Environ Res Public Health, 2020 12 29;18(1).
PMID: 33383875 DOI: 10.3390/ijerph18010195

This study aimed to analyse ten trace metal concentrations in the edible part of the freshwater clam Corbicula javanica and to provide a critical assessment of the potential risks to human health through consumption of this clam as food based on well-established indices and food safety guidelines. The clams were captured from a pristine original site and transplanted to other sites with different environmental qualities. The trace metal levels in the edible total soft tissue (TST) of the clam were below those of the food safety guidelines referred to except for Pb, which exceeded the permissible limit set by the European Commission (2006) and the US Food and Drug Administration/ Center for Food Safety and Applied Nutrition); Interstate Shellfish Sanitation Conference. (USFDA/CFSAN; ISSC) (2007). The estimated daily intake (EDI) values of the clam were found to be lower than the oral reference dose and the calculated target hazard quotient (THQ) and total THQ were found to be less than 1. Therefore, in conclusion, the human health risk for consumption of TST of C. javanica at both average and high-level were insignificant regardless of the environment it was exposed to.
Fulltext A Commentary on the Use of Bivalve Mollusks in Monitoring Metal Pollution Levels

Yap CK, Sharifinia M, Cheng WH, Al-Shami SA, Wong KW, Al-Mutairi KA

Int J Environ Res Public Health, 2021 Mar 25;18(7).
PMID: 33805997 DOI: 10.3390/ijerph18073386

The objective of this commentary is to promote the use of bivalves as biomonitors, which is a part of the continual efforts of the International Mussel Watch. This commentary is an additional discussion on "Bivalve mollusks in metal pollution studies: From bioaccumulation to biomonitoring" by Zuykov et al., published in Chemosphere 93, 201-208. The present discussion can serve as a platform for further insights to provide new thoughts and novel ideas on how to make better use of bivalves in biomonitoring studies. The certainty of better and more extensive applications of mollusks in environmental monitoring in the future is almost confirmed but more studies are urgently needed. With all the reported studies using bivalves as biomonitors of heavy metal pollution, the effectiveness of using Mussel Watch is beyond any reasonable doubts. The challenge is the development of more accurate methodologies for of heavy metal data interpretation, and the precision of the biomonitoring studies using bivalves as biomonitors, whether in coastal or freshwater ecosystems. Lastly, inclusion of human health risk assessment of heavy metals in commercial bivalves would make the research papers of high public interest.
Fulltext The Role of Personality and Top Management Support in Continuance Intention to Use Electronic Health Record Systems among Nurses

Alsyouf A, Ishak AK, Lutfi A, Alhazmi FN, Al-Okaily M

Int J Environ Res Public Health, 2022 Sep 05;19(17).
PMID: 36078837 DOI: 10.3390/ijerph191711125

This study examines nurses' Continuance Intention (CI) to use electronic health records (EHRs) through a combination of three conceptual frameworks: the Unified Theory of Acceptance and Use of Technology (UTAUT), the theory of expectation-confirmation (ECT), and the Five-Factor Model (FFM). A model is developed to examine and predict the determinants of nurses' CI to use EHRs, including top management support (TMS) and the FFM's five personality domains. Data were collected from a survey of 497 nurses, which were analyzed using partial least squares. No significant relationship was found between TMS and CI. The study revealed that performance expectancy significantly mediated the influences of two different hypotheses of two predictors: agreeableness and openness to testing CI. A significant moderating impact of conscientiousness was found on the relationship between performance expectancy and CI and the relationship between social influence and CI. The findings of this study indicated that rigorous attention to the personality of individual nurses and substantial TMS could improve nurses' CI to use EHRs. A literature gap was filled concerning the mediating effects of performance expectancy on the FFM-CI relationship, and the moderation effects of Conscientiousness on UTAUT constructs and CI are another addition to the literature. The results are expected to assist government agencies, health policymakers, and health institutions all over the globe in their attempts to understand the post-adoption use of EHRs.
Fulltext Sugar-Sweetened Beverages Consumption in a Multi-Ethnic Population of Young Men and Association with Sociodemographic Characteristics and Obesity

AlTamimi JZ, Alshwaiyat NM, Alkhalidy H, AlKehayez NM, Alagal RI, Alsaikan RA, et al.

Int J Environ Res Public Health, 2023 Mar 09;20(6).
PMID: 36981770 DOI: 10.3390/ijerph20064861

Sugar-sweetened beverages are frequently consumed among adults and are linked with the incidence of obesity. We aimed to determine rates of weekly and daily sugar-sweetened beverage intake in a multi-ethnic population of young men and their association with sociodemographic characteristics and obesity. This cross-sectional study included 3600 young men who lived in Riyadh, KSA. Participants' sociodemographic characteristics and frequency of sugar-sweetened beverage consumption were gathered through personal interviews. The outcome variables in this study are based on the weekly and daily consumption of sugar-sweetened beverages. Weight and height were measured following standard protocols. The rates of weekly and daily sugar-sweetened beverage intake by participants were 93.6% and 40.8%, respectively. Nationality was a predictor of weekly and daily consumption of sugar-sweetened beverages. The highest rates of weekly (99.5%) and daily (63.9%) consumption were observed in subjects from the Philippines and Yemen, respectively, while Bangladeshi subjects had the lowest rates of weekly (76.9%) and daily (6.9%) consumption. Obesity was another predictor of sugar-sweetened beverage consumption. Obese participants had a significantly higher odds ratio of weekly sugar-sweetened beverage consumption than non-obese subjects (OR = 4.53, p = 0.037). In conclusion, sugar-sweetened beverage consumption was relatively high and our results support an association between the consumption of sugar-sweetened beverages and certain sociodemographic variables and obesity.
Fulltext Prevalence of Fast Food Intake among a Multi-Ethnic Population of Young Men and Its Connection with Sociodemographic Determinants and Obesity

AlTamimi JZ, Alshwaiyat NM, Alkhalidy H, AlFaris NA, AlKehayez NM, Alsemari MA, et al.

Int J Environ Res Public Health, 2022 Nov 13;19(22).
PMID: 36429650 DOI: 10.3390/ijerph192214933

Fast food is commonly consumed by young adults. Eating fast food is connected with the risk of obesity and other related diseases. The present study examines the prevalence of fast food intake in a diverse sample of young men. This cross-sectional study included 3600 young men (20-35 years) who resided in Riyadh, KSA. The frequency of fast food intake was assessed using a valid and reliable questionnaire. Weekly and daily intake of fast food were the two outcome variables adopted to assess the intake frequency. Weight and height were measured. Fast food was eaten by 88.8% and 50.1% of participants weekly and daily, respectively. Fast food intake was predicted by the nationality of participants. The highest prevalence of weekly fast food intake (99.7%) was observed among Saudi, Egyptian, and Indian participants, while the lowest rate was observed among Sudanese participants (48.6%). The highest and lowest rates of daily intake were seen among Filipino (83.4%) and Bangladeshi (6.3%) participants. Obesity was another predictor of fast food intake. Obese participants had a significantly higher odds ratio of weekly (OR = 2.89, p = 0.006) and daily (OR = 1.39, p = 0.021) fast food intake than non-overweight/non-obese participants. In conclusion, fast food is frequently consumed by young men in KSA. Our findings link the likelihood of fast food intake to sociodemographic determinants and obesity.
Fulltext Comparative Evaluation of Dental Implant Failure among Healthy and Well-Controlled Diabetic Patients-A 3-Year Retrospective Study

Sghaireen MG, Alduraywish AA, Srivastava KC, Shrivastava D, Patil SR, Al Habib S, et al.

Int J Environ Res Public Health, 2020 07 21;17(14).
PMID: 32708165 DOI: 10.3390/ijerph17145253

Diabetes mellitus is known to compromise the various aspects of homeostasis, including the immune response and the composition of oral microflora. One of the oral manifestations of diabetes mellitus is tooth loss and the survival rate of dental implants chosen as a treatment modality for its rehabilitation is controversial. The current study aims to evaluate and compare the failure rate of dental implants between well-controlled diabetic and healthy patients. A retrospective study of case-control design was conceptualized with 121 well-controlled diabetic and 136 healthy individuals. Records of subjects who had undergone oral rehabilitation with dental implants between the periods of January 2013 to January 2016 were retrieved. Post-operative evaluation was carried out for all patients for about three years to assess the immediate and long-term success of the procedure. From a total of 742 dental implants, 377 were placed in well-controlled diabetic patients (case group) and 365 in healthy subjects (control group). A comparable (9.81%), but non-significant (p = 0.422) failure rate was found in the case group in comparison to the control group (9.04%). A non-significant (p = 0.392) raised number (4.98%) of failure cases were reported among females in comparison to males (4.44%). In respect to arch, the mandibular posterior region was reported as the highest failure cases (3.09%; p = 0.411), with 2.29% of cases reported in the mandibular anterior (p = 0.430) and maxillary posterior (p = 0.983) each. The maxillary anterior region was found to have the least number (1.75%; p = 0.999) of failure cases. More (4.98%; p = 0.361) cases were reported to fail during the functional loading stage in contrast to osseointegration (4.44%; p = 0.365). A well-controlled diabetic status does not impose any additional risk for individuals undergoing dental implant therapy.
Fulltext Assessing the Prevalence and Association of Pulp Stones with Cardiovascular Diseases and Diabetes Mellitus in the Saudi Arabian Population-A CBCT Based Study

Srivastava KC, Shrivastava D, Nagarajappa AK, Khan ZA, Alzoubi IA, Mousa MA, et al.

Int J Environ Res Public Health, 2020 12 11;17(24).
PMID: 33322604 DOI: 10.3390/ijerph17249293

The detection of pulp stone in a patient suffering from undiagnosed systemic diseases can be an early diagnostic indicator. Thus, the aim of the study was to assess the prevalence of pulp stones in the Saudi Arabian population with cardiovascular diseases and diabetes mellitus. In a retrospective study, we included cone-beam computed tomography (CBCT) scans of 73 patients with cardiovascular disease and 76 patients with diabetes mellitus as group I and II, respectively. Group III comprised of CBCT scan of 80 healthy controls. From a total of 229 scans, 4807 teeth were screened for pulp stones throughout the arches. A chi-square test was used for comparing the prevalence of pulp stones among the groups. Univariable and multivariable analysis was done to evaluate the independent risk indicators for pulp stones. The tooth-wise prevalence of pulp stones in group I, II, and III was found to be 16.65%, 9.01%, and 3.86%, respectively. Patient-wise (p < 0.01) and tooth-wise (p < 0.01) prevalence was recorded significantly highest in the cardiovascular group followed by the diabetic group. The control group had the least prevalence. Significantly (p < 0.01) higher number of pulp stones were found in cardiovascular patients with age > 50 years compared to other groups. Similarly, a significantly increased number of pulp stones were seen in the 1st molar (p < 0.05) and the maxillary jaw (p < 0.05) of patients with cardiovascular diseases. Subjects with cardiovascular disease and diabetes were found to have 2.94 times (p < 0.001; CI 1.54-3.10) and 1.81 times (p < 0.01; CI 0.48-2.06) higher risk of having pulp stones in comparison to healthy subjects. The first molar has 2.20 times (p < 0.001; CI 0.84-2.45) increased the risk of having pulp stones compared to other tooth types. Systemic disease such as cardiovascular disease and diabetes mellitus poses a higher risk for the development of pulp stones. Among the systemic disease group, patients in the cardiovascular group showed a higher risk for pulp stones and also reported the maximum number of pulp stones compared to the diabetic and healthy subjects.
Fulltext Effects of Group and Individual Culturally Adapted Cognitive Behavioral Therapy on Depression and Sexual Satisfaction among Perimenopausal Women

Khoshbooii R, Hassan SA, Deylami N, Muhamad R, Engku Kamarudin EM, Alareqe NA

Int J Environ Res Public Health, 2021 07 20;18(14).
PMID: 34300161 DOI: 10.3390/ijerph18147711

AIMS: Previous research has shown the efficacy of culturally adapted Cognitive Behavioral Therapy (CA-CBT) in reducing depression, yet its effect on increasing sexual satisfaction is not well documented. In this study, an embedded randomized controlled trial design was used to examine the effect of group and individual CA-CBT on depression and sexual satisfaction among perimenopausal women.
METHOD: A total of 64 depressed Iranian perimenopausal women were randomly assigned to two formats of treatments; sixteen sessions of group CA-CBT and eight sessions of individual CA-CBT, as well as a waitlist control group. Depression and sexual satisfaction were measured using BDI-II and ENRICH, respectively, at T1 (pre-treatment), T2 (post-treatment) and T3 (follow-up).
RESULTS: Repeated measures ANOVA indicated that the women who underwent both group and individual CA-CBT had effectively reduced depression and increased sexual satisfaction between pre-treatment and post-treatment, and it was sustained after six months of follow-ups with large effect sizes of significant differences (p < 0.001), but the control group did not.
CONCLUSION: The results showed promising evidence for the efficacy of both treatment groups of CA-CBT for depression and sexual satisfaction among perimenopausal women. The population mental health burden among perimenopausal women may likely be reduced by propagating this effective treatment.
Fulltext Eldercare's Turnover Intention and Human Resource Approach: A Systematic Review

Jurij R, Ismail IR, Alavi K, Alavi R

Int J Environ Res Public Health, 2023 Feb 22;20(5).
PMID: 36900943 DOI: 10.3390/ijerph20053932

Eldercare workers' turnover intentions have caused serious concern given their high demand and pivotal role in ensuring elderly individuals' well-being. This systematic review examined the main factors of eldercare employees' turnover intentions with the purpose of identifying gaps and structure a novel human resource (HR) approach framework for eldercare social enterprises through a global literature review and realistic conclusions. A total of 29 publications appeared between 2015 and 2021 were digitally extracted from six databases and are extensively discussed in this review. Resultantly, eldercare workers' turnover intentions were positively impacted by job burnout, low job motivation, and restricted job autonomy. The findings of this study correspond to those of past literature, which highlighted the necessity of thoroughly examining eldercare worker retention practices from an organisational (HR) perspective. Furthermore, the current study outlines the factors influencing eldercare workers' turnover intentions as well as determine proper HR approaches to mitigate employee turnover issues among eldercare workers for organisational sustainability.
Fulltext The Potential Use of Nephelium lappaceum Seed as Coagulant-Coagulant Aid in the Treatment of Semi-Aerobic Landfill Leachate

Aziz HA, Rahmat NS, Alazaiza MYD

Int J Environ Res Public Health, 2021 Dec 31;19(1).
PMID: 35010685 DOI: 10.3390/ijerph19010420

Chemical-based coagulants and flocculants are commonly used in the coagulation-flocculation process. However, the drawbacks of using these chemical materials have triggered researchers to find natural materials to substitute or reduce the number of chemical-based coagulants and flocculants. This study examines the potential application of Nephelium lappaceum seeds as a natural coagulant-coagulant aid with Tin (IV) chloride (SnCl4) in eliminating suspended solids (SS), colour, and chemical oxygen demand (COD) from landfill leachate. Results showed that the efficiency of Nephelium lappaceum was low when used as the main coagulant in the standard jar test. When SnCl4 was applied as a single coagulant, as much as 98.4% of SS, 96.8% of colour and 82.0% of COD was eliminated at an optimal dose of 10.5 g/L and pH 7. The higher removal efficiency of colour (88.8%) was obtained when 8.40 g/L of SnCl4 was applied with a support of 3 g/L of Nephelium lappaceum. When SnCl4 was utilised as a coagulant, and Nephelium lappaceum seed was used as a flocculant, the removal of pollutants generally improved. Overall, this research showed that Nephelium lappaceum seed is a viable natural alternative for treating landfill leachate as a coagulant aid.
Fulltext A New Pedestrian Crossing Level of Service (PCLOS) Method for Promoting Safe Pedestrian Crossing in Urban Areas

Ahmed T, Moeinaddini M, Almoshaogeh M, Jamal A, Nawaz I, Alharbi F

Int J Environ Res Public Health, 2021 08 20;18(16).
PMID: 34444563 DOI: 10.3390/ijerph18168813

Crosswalks are critical locations in the urban transport network that need to be designed carefully as pedestrians are directly exposed to vehicular traffic. Although various methods are available to evaluate the level of service (LOS) at pedestrian crossings, pedestrian crossing facilities are frequently ignored in assessing crosswalk conditions. This study attempts to provide a comprehensive framework for evaluating crosswalks based on several essential indicators adopted from different guidelines. A new pedestrian crossing level of service (PCLOS) method is introduced in this research, with an aimto promote safe and sustainable operations at such locations. The new PCLOS employs an analytical point system to compare existing street crossing conditions to the guidelines' standards, taking into account the scores and coefficients of the indicators. The quantitative scores and coefficients of indicators are assigned based on field observations and respondent opinions. The method was tested to evaluate four pedestrian crosswalks in the city of Putrajaya, Malaysia. A total of 17 indicators were selected for the study after a comprehensive literature review. Survey results show that the provision of a zebra crossing was the most critical indicator at the pedestrian crossings, while drainage near crosswalks was regarded as the least important. Four indicators had a coefficient value above 4, indicating that these are very critical pedestrian crossing facilities and significantly impact the calculation of LOS for pedestrian crossings. Four crosswalks were evaluated using the proposed method in Putrajaya, Malaysia. The crosswalk at the Ministry of Domestic Trade Putrajaya got the "PCLOS A". In contrast, the midblock crossing in front of the Putrajaya Corporation was graded "PCLOS C". While the remaining two crosswalks were graded as "PCLOS B" crosswalks. Based on the assigned PCLOS grade, the proposed method could also assist in identifying current design and operation issues in existing pedestrian crossings and providing sound policy recommendations for improvements to ensure pedestrian safety.
Fulltext Determining the Relationship of Meteorological Factors and Severe Pediatric Respiratory Syncytial Virus (RSV) Infection in Central Peninsular Malaysia

Chan CM, Wahab AA, Ali A

Int J Environ Res Public Health, 2023 Jan 19;20(3).
PMID: 36767211 DOI: 10.3390/ijerph20031848

Respiratory syncytial virus (RSV) is the most common pathogen causing viral respiratory tract infections among younger children worldwide. The influence of meteorological factors on RSV seasonal activity is well-established for temperate countries; however, in subtropical countries such as Malaysia, relatively stable temperate climates do not clearly support this trend, and the available data are contradictory. Better understanding of meteorological factors and seasonality of RSV will allow effective strategic health management relating to RSV infection, particularly immunoprophylaxis of high-risk infants with palivizumab. Retrospectively, from 2017 to 2021, we examined the association between various meteorological factors (rainfall, rainy days, temperature, and relative humidity) and the incidence of RSV in children aged less than 12 years in Kuala Lumpur, Malaysia. RSV activity peaked in two periods (July to August and October to December), which was significantly correlated with the lowest rainfall (p < 0.007) and number of rainy days (p < 0.005). RSV prevalence was also positively associated with temperature (p < 0.006) and inversely associated with relative humidity (p < 0.006). Based on our findings, we recommend that immunoprophylaxis with palivizumab be administered in children aged less than 2 years where transmission of RSV is postulated to be the highest after the end of two monsoon seasons.
Fulltext Survival and Characteristics of Bladder Cancer: Analysis of the Malaysian National Cancer Registry

Nik Ab Kadir MN, Mohd Hairon S, Yaacob NM, Ab Manan A, Ali N

Int J Environ Res Public Health, 2021 05 14;18(10).
PMID: 34069096 DOI: 10.3390/ijerph18105237

BACKGROUND: Bladder cancer ranked ninth of principal male cancer in Malaysia. This study aimed to evaluate the clinical characteristics and survival of bladder cancer patients in Malaysia.
METHODS: A retrospective cohort study was conducted by obtaining records in the Malaysian National Cancer Registry. Patients aged 15 years old and above with diagnosis date between 2007 and 2011 were included. Death was updated until 31 December 2016. Five-year observed survival and median survival time were determined by the life table method and Kaplan-Meier estimate method.
RESULTS: Among 1828 cases, the mean (SD) age of diagnosis was 64.9 (12.5) years. The patients were predominantly men (78.7%), Malay ethnicity (49.4%) and transitional cell carcinoma (78.2%). Only 14.8% of patients were at stage I. The overall five-year observed survival and median survival time was 36.9% (95% CI: 34.6, 39.1) and 27.3 months (95% CI: 23.6, 31.0). The highest five-year observed survival recorded at stage I (67.6%, 95% CI: 62.0, 73.3) and markedly worsen at stage II (34.3%, 95% CI: 27.9, 40.8), III (25.7%, 95% CI: 18.7, 32.6) and IV (12.2%, 95% CI: 8.1, 16.3).
CONCLUSIONS: Survival of bladder cancer patients in Malaysia was lower with advancing stage. The cancer control programme should be enhanced to improve survival.
Fulltext Patulin Contamination of Citrus Fruits from Punjab and Northern Pakistan and Estimation of Associated Dietary Intake

Aslam K, Iqbal SZ, Razis AFA, Usman S, Ali NB

Int J Environ Res Public Health, 2021 Feb 25;18(5).
PMID: 33668973 DOI: 10.3390/ijerph18052270

This research aims to assess the natural occurrence of patulin (PAT) in selected citrus fruits from central cities of Punjab and Pakistan's northern cities. A total of 2970 fruit samples from 12 citrus cultivars were examined using liquid chromatography fitted with a UV detector. The detection limit (LOD) and quantification limit were 0.04 and 0.12 µg/kg, respectively. About 56% of samples of citrus fruits from Punjab's central cities, Pakistan, were found to be contaminated with PAT, with values ranging from 0.12 to 1150 µg/kg in samples from central Punjab cities. Furthermore, 31.7% of samples of citrus fruits from northern cities of Pakistan were contaminated with PAT, with values ranging from 0.12 to 320 µg/kg. About 22.1% of citrus fruit samples had PAT levels greater than the suggested limits established by the European Union (EU). The dietary intake levels of PAT ranged from 0.10 to 1.11 µg/kg bw/day in the central cities of Punjab, Pakistan, and 0.13 to 1.93 µg/kg bw/day in the northern cities of Pakistan.
Fulltext The Double-Edged Sword of Urbanization and Its Nexus with Eco-Efficiency in China

Yue L, Xue D, Draz MU, Ahmad F, Li J, Shahzad F, et al.

Int J Environ Res Public Health, 2020 01 09;17(2).
PMID: 31936543 DOI: 10.3390/ijerph17020446

Urbanization has made tremendous contributions to China's economic development since its economic reforms and opening up. At the same time, population agglomeration has aggravated environmental pollution and posed serious challenges to China's environment. This article empirically investigates the impacts of China's urbanization on eco-efficiency, comprehensively reflecting economic growth, resource input, and waste discharge. We first measured the provincial eco-efficiency in China from 2005 to 2015 using the Super Slack-Based model (Super-SBM). We then constructed a spatial model to empirically analyze the effects of urbanization on eco-efficiency at the national level, and at four regional levels. The results indicated that the regional eco-efficiency in China has fluctuated, but is generally improving, and that a gap between regions was evident, with a trend toward further gap expansion. We observed an effect of spatial spillover in eco-efficiency, which was significant and positive for the whole country, except for the western region. The influence of urbanization on China's eco-efficiency exhibited a U-curve relationship. The changing trend in the eastern, central, and western regions was the same as that in the whole country; however, the trend exhibited an inverted U-curve relationship in the northeastern region. To the best of our knowledge, covering a time period of 2005-2015, this article is the first of its kind to study the impact of urbanization on eco-efficiency in China at both the national and regional levels. This study may help policy-makers to create sustainable policies that could be helpful in balancing urbanization and the ecological environment.
Fulltext Psychosocial Work Environment and Teachers' Psychological Well-Being: The Moderating Role of Job Control and Social Support

Ibrahim RZAR, Zalam WZM, Foster B, Afrizal T, Johansyah MD, Saputra J, et al.

Int J Environ Res Public Health, 2021 07 08;18(14).
PMID: 34299757 DOI: 10.3390/ijerph18147308

Nowadays, the issue of teachers' psychological well-being causes serious concern, especially in Malaysia. Many studies related to psychological well-being have focused on students rather than on the health and well-being of teachers. Thus, the current study investigated the determinants of psychological well-being (depression, anxiety and stress) from the psychosocial work environment (job control, job demands and social support), and examined the moderating role of job control and social support in the relationship between job demands and psychological well-being among teachers. The design of this study was quantitative research through a survey questionnaire. The sample consisted of 335 high school teachers (23.3%-male; 76.7%-female) who responded to measuring scales of job demands, job control, social support, depression, anxiety and stress, and socio-demographic profile. The data were analyzed using two statistical methods, namely descriptive and inferential statistics. The hierarchical linear regression model was used to analyze the data by assisting the statistical software, i.e., SPSS-23. The results showed that job demands, job control and social support significantly predicted teachers' psychological well-being. Furthermore, the effect of job demands on teachers' depression and anxiety was partially moderated by job control and social support. In conclusion, this study has successfully identified the significant predictors of teachers' psychological well-being and the role of job control and social support as a moderating variable to teachers' psychological well-being in Malaysia. The result provides insights and contributes to the literature of teachers' psychological well-being determinants and involves Malaysian respondents with a collectivistic eastern culture.

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