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Fulltext Cost-Effectiveness and Cost-Utility of Palbociclib versus Ribociclib in Women with Stage IV Breast Cancer: A Real-World Data Evaluation

Al-Ziftawi NH, Alam MF, Elazzazy S, Shafie AA, Hamad A, Mohamed Ibrahim MI

Int J Environ Res Public Health, 2022 Dec 28;20(1).
PMID: 36612831 DOI: 10.3390/ijerph20010512

Palbociclib and ribociclib are indicated in the first-line treatment of hormonal-receptor-positive HER-2 negative (HR+/HER-2 negative) advanced breast cancer. Despite their clinical benefit, they can increase healthcare expenditure. Yet, there are no comparative pharmacoeconomic evaluations for them in developing countries, the Middle East, or Gulf countries. This study compared the cost-effectiveness of palbociclib and ribociclib in Qatar. A 10-year within-cycle-corrected Markov's model was developed using TreeAge Pro® software. The model consisted of three main health states: progression-free (PFS), progressed-disease (PD), and death. Costs were obtained from the actual hospital settings, transition probabilities were calculated from individual-patient data, and utilities were summarized from the published literature. The incremental cost-effectiveness ratio (ICER) and the incremental cost-utility ratio (ICUR) were calculated and compared to three gross-domestic-products per capita. Deterministic and probabilistic sensitivity analyses were performed. Ribociclib dominated palbociclib in terms of costs, life-years gained, and quality-adjusted life-years gained. The conclusions remained robust in the different cases of the deterministic sensitivity analyses. Taking all combined uncertainties into account, the confidence in the base-case conclusion was approximately 60%. Therefore, in HR+/HER-2 negative stage IV breast cancer patients, the use of ribociclib is considered cost-saving compared to palbociclib.
Fulltext Effects of Combined Upper and Lower Limb Plyometric Training Interventions on Physical Fitness in Athletes: A Systematic Review with Meta-Analysis

Deng N, Soh KG, Zaremohzzabieh Z, Abdullah B, Salleh KM, Huang D

Int J Environ Res Public Health, 2022 Dec 28;20(1).
PMID: 36612806 DOI: 10.3390/ijerph20010482

Objective: We aimed to meta-analyze the effects of combined upper and lower limb plyometric training (ULLPT) on physical fitness attributes in athletes. Methods: A systematic literature search was conducted in Web of Science, SPORTDiscus, PubMed, and SCOPUS, for up to 13 August 2022. Controlled studies with baseline and follow-up measures were included if they examined the effects of ULLPT on at least one measure of physical fitness indices in athletes. A random effects meta-analysis was performed using the Comprehensive Meta-Analysis software. Results: Fifteen moderate-to-high-quality studies with 523 participants aged 12−22.4 years were included in the analyses. Small to large (ES = 0.42−1.66; p = 0.004 to <0.001) effects were noted for upper and lower body muscle power, linear sprint speed, upper and lower body muscle strength, agility, and flexibility, while no significant effects on static and dynamic balance were noted (ES = 0.44−0.10; all p > 0.05). Athletes’ sex, age, and training program variables had no modulator role on the effects of ULLPT in available data sets. Conclusions: ULLPT induces distinct neuro-muscular adaptations in the upper and lower body musculature and is an efficient method for enhancing athletes’ physical fitness.
Fulltext The Effectiveness of E-Health Interventions Promoting Physical Activity and Reducing Sedentary Behavior in College Students: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Peng S, Yuan F, Othman AT, Zhou X, Shen G, Liang J

Int J Environ Res Public Health, 2022 Dec 25;20(1).
PMID: 36612643 DOI: 10.3390/ijerph20010318

Insufficient physical activity (PA) and excessive sedentary behavior (SB) are detrimental to physical and mental health. This systematic review and meta-analysis aimed to identify whether e-health interventions are effective for improving PA and SB in college students. Five electronic databases, including Medline, Web of Science, Embase, Cochrane Library, and ProQuest, were searched to collect relevant randomized controlled trials up to 22 June 2022. In total, 22 trials (including 31 effects) with 8333 samples were included in this meta-analysis. The results showed that e-health interventions significantly improved PA at post-intervention (SMD = 0.32, 95% CI: 0.19, 0.45, p < 0.001) compared with the control group, especially for total PA (SMD = 0.34, 95% CI: 0.10, 0.58, p = 0.005), moderate to vigorous PA (SMD = 0.17, 95% CI: 0.01, 0.32, p = 0.036), and steps (SMD = 0.75, 95% CI: 0.23, 1.28, p < 0.001. There were no significant effects for both PA at follow-up (SMD = 0.24, 95% CI: − 0.01, 0.49, p = 0.057) and SB (MD = −29.11, 95% CI: −70.55, 12.32, p = 0.17). The findings of subgroup analyses indicated that compared to the control group, interventions in the group of general participants (SMD = 0.45, 95% CI: 0.27, 0.63, p < 0.001), smartphone apps (SMD = 0.46, 95% CI: 0.19, 0.73, p = 0.001), and online (SMD = 0.23, 95% CI: 0.04, 0.43, p < 0.001) can significantly improve PA at post-intervention. Moreover, the intervention effects were significant across all groups of theory, region, instrument, duration, and female ratio. At follow-up, interventions in groups of developing region (SMD = 1.17, 95% CI: 0.73, 1.62, p < 0.001), objective instrument (SMD = 0.83, 95% CI: 0.23, 1.42, p = 0.007), duration ≤ 3-month (SMD = 1.06, 95% CI: 0.72, 1.39, p < 0.001), and all female (SMD = 0.79, 95% CI: 0.02, 1.56, p = 0.044) can significantly improve PA. The evidence of this meta-analysis shows that e-health interventions can be taken as promising strategies for promoting PA. The maintenance of PA improvement and the effect of interventions in reducing SB remain to be further studied. Educators and health practitioners should focus on creating multiple e-health interventions with individualized components.
Fulltext Engagement in Chemsex among Men Who Have Sex with Men (MSM) in Malaysia: Prevalence and Associated Factors from an Online National Survey

Maviglia F, Wickersham JA, Azwa I, Copenhaver N, Kennedy O, Kern M, et al.

Int J Environ Res Public Health, 2022 Dec 24;20(1).
PMID: 36612617 DOI: 10.3390/ijerph20010294

Background: Chemsex is the use of illicit drugs—particularly methamphetamine, gamma hydroxybutyrate (GHB), and gamma-butyrolactone (GBL)—to enhance sexual activity. Chemsex, which occurs primarily among communities of men who have sex with men (MSM), is associated with greater HIV risk behaviors, including multiple sex partners, group sex, condomless sex, and injection drug use. Despite evidence showing chemsex engagement among Malaysian MSM, there is a paucity of research on chemsex among MSM in Malaysia. Methods: This cross-sectional study was conducted through an online survey (August to September 2021) among 870 Malaysian MSM. Participants were recruited through targeted advertisements on social networks. We collected information regarding participants’ recent (<6 months) engagement in chemsex, demographic characteristics, psychosocial factors, pre-exposure prophylaxis (PrEP) knowledge and history, and recent sexual- and drug-related behavior. Multivariable logistic regression was used to identify factors associated with recent (<6 months) chemsex engagement. Results: Just under 1 in 10 (9.0%) of participants reported having engaged in chemsex in the previous six months. More than two-thirds of participants (69.1%) had not disclosed their sexual orientation to anyone in their family and 35.2% reported moderate to severe depressive symptoms. Multivariable analysis found that recent injection drug use (adjusted odds ratio: aOR = 6.61; 95% confidence interval: CI, 2.30−19.03), having shared pre-exposure prophylaxis (PrEP) with someone else (aOR = 5.60; 95% CI, 1.76−17.77), higher perceived HIV risk (aOR = 3.15; 95% CI, 1.25−7.93), knowing someone using PrEP (aOR = 2.93; 95% CI, 1.62−5.31), recent engagement in transactional sex (aOR = 2.38; 95% CI, 1.06−5.39), having a recent STI diagnosis (aOR = 2.36; 95% CI, 1.25−4.44), recent engagement in anal sex (aOR = 2.21; 95% CI, 1.07−4.57), and recent sexual intercourse with an HIV-positive partner (aOR = 2.09; 95% CI, 1.07−4.08) were associated with recent engagement in chemsex. Conclusions: Malaysian MSM who practice chemsex are vulnerable to several HIV risk factors, such as transactional sex, HIV-positive sexual partners, and injection drug use. There is an urgent need for programs that integrate drug, sexual health, and mental health services, with a focus on harm reduction (e.g., condoms, access to and utilization of HIV testing and PrEP services, drug knowledge, and safer drug use) tailored for MSM who practice chemsex.
Fulltext Ecological Study of Sick Building Syndrome among Healthcare Workers at Johor Primary Care Facilities

Salvaraji L, Shamsudin SB, Avoi R, Saupin S, Kim Sai L, Asan SB, et al.

Int J Environ Res Public Health, 2022 Dec 19;19(24).
PMID: 36554980 DOI: 10.3390/ijerph192417099

INTRODUCTION: Persistent exposure to indoor hazards in a healthcare setting poses a risk of SBS. This study determines the prevalence of and risk factors for SBS among healthcare workers in health clinics.
METHODS: A cross-sectional study was conducted across four health clinics from February 2022 to May 2022. As part of the study, self-administered questionnaires were completed to determine symptoms related to SBS. An indoor air quality (IAQ) assessment was conducted four times daily for fifteen minutes at five areas in each clinic (laboratory, lobby, emergency room, pharmacy, and examination room).
RESULT: Most of the areas illustrated poor air movement (<0.15 m/s), except for the laboratory. The total bacterial count (TBC) was above the standard limit in both the lobby and emergency room (>500 CFU/m3). The prevalence of SBS was 24.84% (77) among the healthcare workers at the health clinics. A significant association with SBS was noted for those working in the examination room (COR = 2.86; 95% CI = 1.31; 6.27) and those experiencing high temperature sometimes (COR = 0.25; 95% CI = 0.11; 0.55), varying temperature sometimes (COR = 0.31; 95% CI = 0.003), stuffy air sometimes (COR = 0.17; 95% CI = 0.005; 0.64), dry air sometimes (COR = 0.20; 95% CI = 0.007; 0.64), and dust sometimes (COR = 0.25; 95% CI = 0.11; 0.60) and everyday (COR = 0.34; 95% CI = 0.14; 0.81). Only healthcare workers in the examination room (AOR = 3.17; 95% CI = 1.35; 7.41) were found to have a significant risk of SBS when controlling for other variables.
CONCLUSION: SBS is prevalent among healthcare workers at health clinics.
Fulltext Motivations Influencing Alipay Users to Participate in the Ant Forest Campaign: An Empirical Study

Wang S, Ibrahiem MH, Li M

Int J Environ Res Public Health, 2022 Dec 18;19(24).
PMID: 36554915 DOI: 10.3390/ijerph192417034

As one of the largest payment platforms in China, Alipay, launched a green behavior project called Ant Forest. The purpose of taking this initiative by Alipay is to make the world greener. This mobile application has motivated many users to plant millions of trees. However, minimal studies have been conducted to empirically disclose the factors that motivate Alipay users to participate in Ant Forest. A mixed-method approach is used to examine the factors influencing Alipay users to participate in Ant Forest and the level of satisfaction they got from it. The qualitative method was carried out through a structured questionnaire from 400 Alipay users and qualitative data from 20 users who have applied to Ant Forest and successfully planted trees. Additionally, alongside the mixed method employed to rationalize the relationship highlighted, a multiple regression model was employed to predict the value of a dependent variable (level of satisfaction) based on the value of several independent variables (namely, number of years engaged with Ant Forest activities, age, gender, profession, and education). The empirical results show that intrinsic motivations (enjoyment, social interaction, fulfilment, altruism) and extrinsic motivations (external rewards, competition) influence Alipay users to participate in the Ant Forest project. Further insights are presented in the concluding section for all stakeholders for environmental sustainability among the users of Alipay.
Fulltext The Impact of Social Media on Employee Mental Health and Behavior Based on the Context of Intelligence-Driven Digital Data

Zhou R, Luo Z, Zhong S, Zhang X, Liu Y

Int J Environ Res Public Health, 2022 Dec 17;19(24).
PMID: 36554845 DOI: 10.3390/ijerph192416965

With the rapid development and widespread popularity of the Internet, employee social media use at work has become an increasingly common phenomenon in organizations. This paper analyzes 105 related papers from the Social Science Citation Index in Web of Science through Scoping Review to clarify the definition and characteristics of employee social media use and the types of social media and summarizes the current research methods. Then, the reasons for employees' willingness and refusal to use social media and the positive and negative effects of employee social media use on employees' work attitudes, behaviors, and performance are discussed. Then, the mediating variables, moderating variables, and theoretical frameworks used in the relevant studies are described, and a comprehensive model of employee social media use is constructed. Finally, this paper indicates future research directions based on the latest research results in 2020-2022, i.e., improving research methods, increasing antecedent studies, expanding consequence research, and expanding mediating variables, moderating variables, and theoretical perspectives.
Fulltext Validation of the Malay Oral Impacts on Daily Performances and Evaluation of Oral Health-Related Quality of Life in a Multi-Ethnic Urban Malaysian Population: A Cross-Sectional Study

Lim FY, Goo CL, Leung WK, Goh V

Int J Environ Res Public Health, 2022 Dec 16;19(24).
PMID: 36554823 DOI: 10.3390/ijerph192416944

Oral Impacts on Daily Performances (OIDP) can be used as a generic or condition-specific oral health-related quality of life (OHRQoL) instrument. It offers different contexts on how dental conditions affect OHRQoL. This cross-sectional study aimed to validate a newly translated Malay OIDP (OIDP-M), compare OHRQoL, decayed, missing, or filled teeth (DMFT) in Malaysians, and investigate factors associated with OHRQoL. A total of 368 Malaysians were surveyed and examined for DMFT. Short-form oral health impact profile-Malaysia [S-OHIP(M)] and OIDP-M were used to measure OHRQoL. The OIDP-M was tested for reliability and validity. DMFT, S-OHIP(M), and OIDP-M between ethnicities were compared. Associations between ethnicity, DMFT, S-OHIP(M), and OIDP-M of Malays and Chinese were evaluated through partial correlation. Malays and Chinese had more filled teeth and DMFT compared with Indians. Malays reported worse OHRQoL through S-OHIP(M). Decayed teeth were positively associated with S-OHIP(M), physical, psychological, social disabilities, and handicap. For OIDP-M, decayed teeth were positively associated with OIDP-M, working, and sleeping. Missing teeth and ethnicity were positively associated with eating and speaking. Filled teeth were negatively associated with cleaning teeth. The OIDP-M was reliable and valid for evaluating OHRQoL. There were differences in DMFT and OHRQoL between ethnicities. Ethnicity affects OHRQoL, where Malays experienced worse OHRQoL due to dental problems.
Fulltext Development and Validation of a New Gadget Addiction Scale (Screen Dependency Scale) among Pre-School Children in Malaysia

Abdul Hadi A, Roslan SR, Mohammad Aidid E, Abdullah N, Musa R

Int J Environ Res Public Health, 2022 Dec 16;19(24).
PMID: 36554796 DOI: 10.3390/ijerph192416916

BACKGROUND: Excessive screen time in young children is associated with many harmful consequences including screen dependency. Research has shown a worrying prevalence of media-related dependency among adolescents and pre-school children. There are a few available questionnaires among adolescents but none for pre-school children. This study aimed to design and validate a questionnaire to assess screen dependency among pre-school children aged 4 to 6 years old.
METHODOLOGY: A cross-sectional two-phase study was carried out to develop the scale. In phase 1, a preliminary parent-report measure questionnaire was developed in Bahasa Malaysia. Later, it was sent to four experts for content validity followed by face validity. In Phase 2, a total of 386 parents of pre-school children aged 4 to 6 years old, split into two samples, were involved in the field study for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).
RESULT: Sample 1 was used to perform EFA to determine the factorial structure of the SDS. All items with a factor loading of >0.4 were included. Sample 2 was used to perform the CFA. RMSEA and CFI analysis showed that the SDS has a good fit and confirms the dimensional structure found via EFA. The final questionnaire consists of 15 items with a 4 factors' structure and has excellent internal consistency reliability.
CONCLUSIONS: The Screen Dependency Scale (SDS) is a reliable and valid questionnaire to detect screen dependency among pre-school children aged 4 to 6 years old in Malaysia.
Fulltext Physical Activity in Malaysia: Are We Doing Enough? Findings from the REDISCOVER Study

Nik-Nasir NM, Md-Yasin M, Ariffin F, Mat-Nasir N, Miskan M, Abu-Bakar N, et al.

Int J Environ Res Public Health, 2022 Dec 15;19(24).
PMID: 36554769 DOI: 10.3390/ijerph192416888

Physical activity (PA) in the form of structured or unstructured exercise is beneficial for health. This paper aims to study PA levels across four domains according to the International Physical Activity Questionnaire (IPAQ) and its associated factors. A total of 7479 Malaysian adult participants between 18 to 90 years old from the REDISCOVER study who completed the IPAQ were analyzed. PA was calculated as MET-min per week and were categorized according to insufficiently active, sufficiently active and very active. Multinomial regression was used to determine the association between sociodemographic, clinical factors and the level of PA. The mean age of the participants was 51.68 (±9.5 SD). The total reported physical activity in median (IQR) was 1584.0 (0-5637.3) MET-min per week. The highest total for PA was in the domestic domain which is 490 (0-2400) MET-min per week. Factors associated with sufficiently active or very active PA include Malay ethnicity, no formal education, elementary occupation, current smokers and high HDL. Whereas low income, male and normal BMI are less likely to participate in sufficiently active or very active PA. Intervention to encourage higher PA levels in all domains is important to achieve recommended PA targets.
Fulltext Forecasting HFMD Cases Using Weather Variables and Google Search Queries in Sabah, Malaysia

Jayaraj VJ, Hoe VCW

Int J Environ Res Public Health, 2022 Dec 15;19(24).
PMID: 36554768 DOI: 10.3390/ijerph192416880

HFMD is a viral-mediated infectious illness of increasing public health importance. This study aimed to develop a forecasting tool utilizing climatic predictors and internet search queries for informing preventive strategies in Sabah, Malaysia. HFMD case data from the Sabah State Health Department, climatic predictors from the Malaysia Meteorological Department, and Google search trends from the Google trends platform between the years 2010-2018 were utilized. Cross-correlations were estimated in building a seasonal auto-regressive moving average (SARIMA) model with external regressors, directed by measuring the model fit. The selected variables were then validated using test data utilizing validation metrics such as the mean average percentage error (MAPE). Google search trends evinced moderate positive correlations to the HFMD cases (r0-6weeks: 0.47-0.56), with temperature revealing weaker positive correlations (r0-3weeks: 0.17-0.22), with the association being most intense at 0-1 weeks. The SARIMA model, with regressors of mean temperature at lag 0 and Google search trends at lag 1, was the best-performing model. It provided the most stable predictions across the four-week period and produced the most accurate predictions two weeks in advance (RMSE = 18.77, MAPE = 0.242). Trajectorial forecasting oscillations of the model are stable up to four weeks in advance, with accuracy being the highest two weeks prior, suggesting its possible usefulness in outbreak preparedness.
Fulltext Maternal and Dietary Factors Are Associated with Metabolic Syndrome in Women with a Previous History of Gestational Diabetes Mellitus

Hasbullah FY, Mohd Yusof BN, Abdul Ghani R, Mat Daud Z', Appannah G, Abas F, et al.

Int J Environ Res Public Health, 2022 Dec 14;19(24).
PMID: 36554678 DOI: 10.3390/ijerph192416797

While it is known that women with a previous history of gestational diabetes mellitus (post-GDM) have a higher risk of metabolic syndrome (MetS), evidence of lifestyle practices from low- and middle-income countries (LMICs) is still scarce. This study aimed to determine the factors associated with MetS in women post-GDM. This cross-sectional study involved 157 women post-GDM (mean age 34.8 ± 5.6 years) sampled from Selangor, Malaysia. We collected data on sociodemographic characteristics and obstetric history. Food intake was assessed using a food frequency questionnaire, and dietary patterns were derived from principal component analysis. MetS was diagnosed according to the 2009 Harmonized criteria. The prevalence of MetS in this study was 22.3%. Western dietary pattern consumption was correlated with MetS, body mass index (BMI), waist circumference, and triglyceride levels. Independent factors associated with MetS were lower education level (odds ratio, OR 4.017, p = 0.007), pre-pregnancy BMI (OR 1.192, p = 0.002), and Caesarean delivery (OR 3.798, p = 0.009). The study identified the maternal and dietary factors associated with MetS in women post-GDM in Malaysia. Community-based interventions that include dietary modification are warranted to prevent MetS and its complications, thus helping to reduce the overall disease burden.
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 Social Identity, Core Self-Evaluation, School Adaptation, and Mental Health Problems in Migrant Children in China: A Chain Mediation Model

Chen Y, Yu X, Ma'rof AA, Zaremohzzabieh Z, Abdullah H, Halimatusaadiah Hamsan H, et al.

Int J Environ Res Public Health, 2022 Dec 11;19(24).
PMID: 36554527 DOI: 10.3390/ijerph192416645

(1) Background: The present study investigated the relationships between social identity, core self-evaluation, school adaptation, and mental health problems in migrant children, and the mechanism underlying these relationships; (2) Methods: The participants were migrant middle school students in China. Data analysis was conducted using SPSS version 26. A survey comprising the social identity scale, core self-evaluation scale, school adaptation scale, and mental health scale MMHI-60 was deployed; (3) Results: Findings indicated a significant and negative association between social identity and mental health problems, and such an association was sequentially mediated by core self-evaluation and school adaptation. Furthermore, core self-evaluation and school adaptation played a chain mediation role between social identity and migrant children's mental health problems; (4) Conclusions: It is crucial to improve social identity, core self-evaluation, and school adaptation to reduce mental health problems among this population. Therefore, the research results provide a new direction for promoting the development of mental health education for migrant workers and their children in China.
Fulltext Medical Experts' Agreement on Risk Assessment Based on All Possible Combinations of the COVID-19 Predictors-A Novel Approach for Public Health Screening and Surveillance

Ibrahim MS, Naing NN, Abd Aziz A, Makhtar M, Mohamed Yusoff H, Esa NK, et al.

Int J Environ Res Public Health, 2022 Dec 10;19(24).
PMID: 36554487 DOI: 10.3390/ijerph192416601

During the initial phase of the coronavirus disease 2019 (COVID-19) pandemic, there was a critical need to create a valid and reliable screening and surveillance for university staff and students. Consequently, 11 medical experts participated in this cross-sectional study to judge three risk categories of either low, medium, or high, for all 1536 possible combinations of 11 key COVID-19 predictors. The independent experts' judgement on each combination was recorded via a novel dashboard-based rating method which presented combinations of these predictors in a dynamic display within Microsoft Excel. The validated instrument also incorporated an innovative algorithm-derived deduction for efficient rating tasks. The results of the study revealed an ordinal-weighted agreement coefficient of 0.81 (0.79 to 0.82, p-value < 0.001) that reached a substantial class of inferential benchmarking. Meanwhile, on average, the novel algorithm eliminated 76.0% of rating tasks by deducing risk categories based on experts' ratings for prior combinations. As a result, this study reported a valid, complete, practical, and efficient method for COVID-19 health screening via a reliable combinatorial-based experts' judgement. The new method to risk assessment may also prove applicable for wider fields of practice whenever a high-stakes decision-making relies on experts' agreement on combinations of important criteria.
Fulltext Hydrological Analysis of Batu Dam, Malaysia in the Urban Area: Flood and Failure Analysis Preparing for Climate Change

Allias Omar SM, Wan Ariffin WNH, Mohd Sidek L, Basri H, Moh Khambali MH, Ahmed AN

Int J Environ Res Public Health, 2022 Dec 09;19(24).
PMID: 36554413 DOI: 10.3390/ijerph192416530

Extensive hydrological analysis is carried out to estimate floods for the Batu Dam, a hydropower dam located in the urban area upstream of Kuala Lumpur, Malaysia. The study demonstrates the operational state and reliability of the dam structure based on hydrologic assessment of the dam. The surrounding area is affected by heavy rainfall and climate change every year, which increases the probability of flooding and threatens a dense population downstream of the dam. This study evaluates the adequacy of dam spillways by considering the latest Probable Maximum Precipitation (PMP) and Probable Maximum Flood (PMF) values of the concerned dams. In this study, the PMP estimations are applied using comparison of both statistical method by Hershfield and National Hydraulic Research Institute of Malaysia (NAHRIM) Envelope Curve as input for PMF establishments. Since the PMF is derived from the PMP values, the highest design flood standard can be applied to any dam, ensuring inflow into the reservoirs and limiting the risk of dam structural failure. Hydrologic modeling using HEC-HMS provides PMF values for the Batu dam. Based on the results, Batu Dam is found to have 200.6 m3/s spillway discharge capacities. Under PMF conditions, the Batu dam will not face overtopping since the peak outflow of the reservoir level is still below the crest level of the dam.
Fulltext The Impact of Heatwaves on Mortality and Morbidity and the Associated Vulnerability Factors: A Systematic Review

Arsad FS, Hod R, Ahmad N, Ismail R, Mohamed N, Baharom M, et al.

Int J Environ Res Public Health, 2022 Dec 06;19(23).
PMID: 36498428 DOI: 10.3390/ijerph192316356

BACKGROUND: This study aims to investigate the current impacts of extreme temperature and heatwaves on human health in terms of both mortality and morbidity. This systematic review analyzed the impact of heatwaves on mortality, morbidity, and the associated vulnerability factors, focusing on the sensitivity component.
METHODS: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow checklist. Four databases (Scopus, Web of Science, EBSCOhost, PubMed) were searched for articles published from 2012 to 2022. Those eligible were evaluated using the Navigation Guide Systematic Review framework.
RESULTS: A total of 32 articles were included in the systematic review. Heatwave events increased mortality and morbidity incidence. Sociodemographic (elderly, children, male, female, low socioeconomic, low education), medical conditions (cardiopulmonary diseases, renal disease, diabetes, mental disease), and rural areas were crucial vulnerability factors.
CONCLUSIONS: While mortality and morbidity are critical aspects for measuring the impact of heatwaves on human health, the sensitivity in the context of sociodemographic, medical conditions, and locality posed a higher vulnerability to certain groups. Therefore, further research on climate change and health impacts on vulnerability may help stakeholders strategize effective plans to reduce the effect of heatwaves.
Fulltext Experience of Pharmacists with Anti-Cancer Medicine Shortages in Pakistan: Results of a Qualitative Study

Shukar S, Zahoor F, Omer S, Awan SE, Yang C, Fang Y

Int J Environ Res Public Health, 2022 Dec 06;19(23).
PMID: 36498446 DOI: 10.3390/ijerph192316373

This study aimed to examine the current situation of anti-cancer drug shortages in Pakistan, namely its determinants, impacts, adopted mitigation strategies, and proposed solutions. Qualitative semi-structured, in-depth interviews were conducted with 25 pharmacists in oncology hospitals in Pakistan from August to October 2021. Data were collected in person and online, recorded, and subjected to inductive thematic analysis after being transcribed verbatim. Most participants experienced anti-cancer drug shortages that increased during the pandemic. Etoposide, paclitaxel, vincristine, dacarbazine, and methotrexate were frequently short. Important causes included the compromised role of regulatory authorities, lack of local production, and inventory mismanagement. The impacts were delayed/suboptimal treatment and out-of-pocket costs for patients, patients' prioritization, increased workload, negative work environment, and patients' trust issues for pharmacists. The participants proposed that a cautious regulator's role is needed to revise policies for all stakeholders and support all stakeholders financially at their level to increase access to these medicines. Based on the outcomes, it is clear that anti-cancer medicine shortages are a current issue in Pakistan. Governmental authorities need to play a role in revising policies for all levels of the drug supply chain and promoting local production of these drugs. Stakeholders should also collaborate and manage inventory.
Fulltext Health Complaints, Mental Status and Quality of Life among the Aquaculture Workers: A Cross-Sectional Study in Northern Region of Peninsular Malaysia

Mat Zain NS, Lee LK

Int J Environ Res Public Health, 2022 Dec 06;19(23).
PMID: 36498443 DOI: 10.3390/ijerph192316371

Aquaculture is seen as an essential food-producing sector for improving global food security and nutrition indices. This cross-sectional study examined the health complaints and mental health status of aquaculture workers, as well as their relationship with quality of life, with respect to the brackish water and freshwater aquaculture cultivation system in Penang, Malaysia. The workers’ health complaints were collected, and mental health status was evaluated as means of depression, anxiety, stress and self-esteem. Self-perceived quality of life was assessed using a structured questionnaire. This study involved the participation of 88 brackish water (84.6%) and 16 freshwater (15.4%) aquaculture workers. A total of 72.7% of the brackish water aquaculture workers were aged beyond 50 years old and had worked within five years (77.3%) in the aquaculture industry. Both brackish water and freshwater cultivation workers were confronted with fatigue, pain and insomnia. Up to 48%, 40.4%, 26% and 24% of them were facing depression, anxiety, stress and low self-esteem, respectively. A total of 3.4% of the brackish water aquaculture workers were having bad quality of life. The complaints of neck/shoulder/arm pain (F = 13.963; p < 0.001), back pain (F = 10.974; p < 0.01), hand/wrist pain (F = 8.041; p < 0.01), knee/hip pain (F = 12.910; p < 0.01) and insomnia (F = 10.936; p < 0.01) were correlated with bad quality of life among the workers. For mental health status, self-esteem (F = 4.157; p < 0.05) was found to be negatively correlated with quality of life scores. The results outlined the concerning level of health complaints and psychological distress among the aquaculture workers. The study emphasized the importance of developing an appropriate occupational health strategy in the aquaculture industry. Longitudinal investigations aimed to explore the effects of psychological distress on employment productivity among the high-risk workers are warranted.
Fulltext Perception of Current Educational Environment, Clinical Competency, and Depression among Malaysian Medical Students in Clinical Clerkship: A Cross-Sectional Study

Sudi R, Chang WL, Arshad NH, Zainal Abidin SN, Suderman U, Woon LS

Int J Environ Res Public Health, 2022 Dec 05;19(23).
PMID: 36498345 DOI: 10.3390/ijerph192316274

The COVID-19 pandemic has altered the educational environment of medical students in clinical clerkship, with potential impacts on clinical competency and reported increased prevalence of depression. This study aimed to determine the relationship between the perception of the educational environment, self-perceived clinical competency, and depression among them. Subjects (N = 196) at the National University of Malaysia participated through convenience sampling in an online survey including sociodemographic data, COVID-19-related stressors, Dundee Ready Education Environment Measure (DREEM), self-perceived clinical competency, and Patient Health Questionnaire (PHQ-9). The cut-off point for depression was a PHQ-9 score ≥ 15. Multiple logistic regression followed bivariate analyses to identify factors for depression. The participants (mean age: 23.2 years, SD ± 0.98 years) were mainly female (71.9%) and Malay (59.2%). The prevalence of depression was 17.4% (95% CI: 12.3-23.4%). Most participants perceived the educational environment positively. In logistic regression, ethnicity (Adjusted OR = 3.1, 95% CI: 1.2-8.1) and DREEM score were significantly associated with depression, whereas self-perceived clinical competency was not. A higher DREEM score indicating a better perception of the educational environment was linked to a lower likelihood of depression (p = 0.046). Besides ethnicity, perception of the educational environment emerged as a factor associated with depression. This relationship between the educational environment and mental well-being warrants further exploration.

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