Displaying publications 81 - 100 of 239 in total

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  1. Kotirum S, Muangchana C, Techathawat S, Dilokthornsakul P, Wu DB, Chaiyakunapruk N
    Front Public Health, 2017;5:289.
    PMID: 29209602 DOI: 10.3389/fpubh.2017.00289
    Current study aimed to estimate clinical and economic outcomes of providing the Haemophilus influenzae type b (Hib) vaccination as a national vaccine immunization program in Thailand. A decision tree combined with Markov model was developed to simulate relevant costs and health outcomes covering lifetime horizon in societal and health care payer perspectives. This analysis considered children aged under 5 years old whom preventive vaccine of Hib infection are indicated. Two combined Hib vaccination schedules were considered: three-dose series (3 + 0) and three-dose series plus a booster does (3 + 1) compared with no vaccination. Budget impact analysis was also performed under Thai government perspective. The outcomes were reported as Hib-infected cases averted and incremental cost-effectiveness ratios (ICERs) in 2014 Thai baht (THB) ($) per quality-adjusted life year (QALY) gained. In base-case scenario, the model estimates that 3,960 infected cases, 59 disability cases, and 97 deaths can be prevented by national Hib vaccination program. The ICER for 3 + 0 schedule was THB 1,099 ($34) per QALY gained under societal perspective. The model was sensitive to pneumonia incidence among aged under 5 years old and direct non-medical care cost per episode of Hib pneumonia. Hib vaccination is very cost-effective in the Thai context. The budget impact analysis showed that Thai government needed to invest an additional budget of 110 ($3.4) million to implement Hib vaccination program. Policy makers should consider our findings for adopting this vaccine into national immunization program.
  2. Luo S, Soh KG, Zhang L, Zhai X, Sunardi J, Gao Y, et al.
    Front Public Health, 2022;10:1046456.
    PMID: 36684974 DOI: 10.3389/fpubh.2022.1046456
    AIMS: This study aims to present an in-depth review of the available literature on the effect of core training on skill-related physical fitness performance among soccer players, as well as to offer suggestions for researchers and coaches.

    METHODS: The data in this study were presented based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Using scientific databases and web search engines including Scopus, Ebscohost, Web of Science, PubMed, and Google Scholar, researchers collected studies from the published literature. Only 26 of the 84 articles satisfied all the inclusion criteria and were thus included in the systematic review. The quality of each study was determined using the PEDro scale. The scores for 26 studies range between three and six.

    RESULTS: Core training can improve soccer players' skill-related physical fitness, including their power, speed, balance, and agility.

    CONCLUSION: The core is the anatomic and functional center of the body as well as its "engine." All movements emanate from the center of the body and are transmitted to the extremities. The core muscles differ from the limb muscles because they frequently cocontract, thus making the torso hard to the point whereby all the muscles work together to become synergists. Theoretically, a strong core permits the passage of force from the lower body to the upper body with minimal energy loss in the torso. Based on the 26 studies, this review suggests that core training should be incorporated into the daily training sessions of soccer players, with a minimum frequency and length of 15 min per training session, twice per week, for 4 weeks.

    SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com, identifier INPLASY202290045.

  3. Muthu P, Tan Y, Latha S, Dhanalakshmi S, Lai KW, Wu X
    Front Public Health, 2022;10:1030656.
    PMID: 36699937 DOI: 10.3389/fpubh.2022.1030656
    Assistive technology for the differently abled and older adults has made remarkable achievements in providing rehabilitative, adaptive, and assistive devices. It provides huge assistance for people with physical impairments to lead a better self-reliant daily life, in terms of mobility, education, rehabilitation, etc. This technology ranges from simple hand-held devices to complex robotic accessories which promote the individual's independence. This study aimed at identifying the assistance required by differently-abled individuals, and the solutions proposed by different researchers, and reviewed their merits and demerits. It provides a detailed discussion on the state of art assistive technologies, their applications, challenges, types, and their usage for rehabilitation. The study also identifies different unexplored research areas related to assistive technology that can improve the daily life of individuals and advance the field. Despite their high usage, assistive technologies have some limitations which have been briefly described in the study. This review, therefore, can help understand the utilization, and pros and cons of assistive devices in rehabilitation engineering and assistive technologies.
  4. Ahmmed F, Hossain MJ, Sutopa TS, Al-Mamun M, Alam M, Islam MR, et al.
    Front Public Health, 2022;10:988016.
    PMID: 36504941 DOI: 10.3389/fpubh.2022.988016
    Exclusive breastfeeding (EBF) is essential for infant and child health. This study aimed to explore the trend in the EBF over the last decade in Bangladesh and investigated if there was a significant association with maternal employment by analyzing the data extracted from three consecutive nationally representative surveys: Bangladesh Demographic and Health Surveys (BDHS) of 2011, 2014, and 2017-2018. Prevalence of EBF (95% confidence interval) with the Cochran-Armitage test was reported to see the trend in EBF. A chi-square (χ2) test was applied to find the potential factors associated with EBF. Finally, a three-level logistic regression was utilized to find the significant association between maternal employment and EBF while adjusting other covariates. We observed no increase in the practice of EBF over the last decade (P = 0.632). The prevalence of EBF was 64.9% (95% CI: 61.41, 68.18) in 2011, followed by 60.1% (95% CI: 56.25, 64) in 2014, and 64.9% (95% CI: 61.82, 67.91) in 2017. Regression results showed that employed mothers had 24% (p < 0.05) lower odds of EBF than unemployed mothers. Early initiation of breastfeeding was also found to be significantly associated [Adjusted odds ratio (AOR): 1.22, P < 0.05] with EBF. Government and policymakers must come forward with new interventions to increase the practice of EBF, providing basic education and campaigns on the topic of EBF. Maternity leave should be extended up to 6 months of the child's age to achieve an optimal level of EBF.
  5. Sutan R, Aminuddin NA, Mahdy ZA
    Front Public Health, 2022;10:973271.
    PMID: 36324467 DOI: 10.3389/fpubh.2022.973271
    BACKGROUND: Preeclampsia is associated with an increased risk of adverse maternal and perinatal outcomes. This study aimed to assess preeclampsia prevalence in a Malaysian referral maternity hospital and the association between preeclampsia and maternal characteristics and outcomes.

    METHODS: A cross-sectional study was conducted between January 2010 and December 2020 using secondary data from a single tertiary healthcare center in Greater Kuala Lumpur, Malaysia. A total of 40,212 deliveries were included for analysis to investigate the association between conditions (maternal characteristics and adverse birth outcomes) and preeclampsia. Multivariable logistic regression was conducted to assess the association between multiple independent variables and the outcome variable (preeclampsia).

    RESULTS: The reported prevalence of preeclampsia was 1.6%. Pregnant women with preeclampsia had a higher risk of preterm delivery (67.7%), instrumental and cesarean delivery (74.7%), neonatal low birth weight (48.5%), neonatal 5-min Apgar score <7 (18.1%), and neonatal intensive care unit (NICU) admission (19.8%). There were significantly higher odds of developing preeclampsia among nullipara [adjusted odd ratio (adjOR) 1.792, 95% CI: 1.518-2.115], women with a previous history of preeclampsia (adjOR 5.345, 95% CI: 2.670-10.698) and women with multiple pregnancies (adjOR 1.658, 95% CI: 1.071-2.566). However, there is a significant association between maternal characteristic variables. There was a significant association when a combination of variables for risk assessment: the presence of anemia and gestational hypertension effect on preeclampsia (OR 26.344, 95% CI: 9.775-70.993, p < 0.002) and gestational hypertension without anemia on preeclampsia (OR 3.084, 95% CI: 2.240-4.245, p < 0.001). Similarly, an association was seen between chronic hypertension and younger age (<35 years old) on preeclampsia (OR 14.490, 95% CI: 9.988-21.021, p < 0.001), and having chronic hypertension with advanced maternal age (≥35 years old) on preeclampsia (OR 5.174, 95% CI: 3.267-8.195, p < 0.001). Both conditions had increased odds of preeclampsia, in varying magnitudes. Overall, the significant interaction effects suggest that a history of chronic or gestational hypertension has a different relationship to the incidence of preeclampsia depending on the maternal age and anemia status. Pregnant women with preeclampsia had significantly higher odds for preterm delivery (adjOR 6.214, 95% CI: 5.244-7.364), instrumental and cesarean delivery (adjOR 4.320, 95% CI: 3.587-5.202), neonatal low birth weight (adjOR 7.873, 95% CI: 6.687-9.271), 5-min Apgar score <7 (adjOR 3.158, 95% CI: 2.130-4.683), and NICU admission (adjOR 8.778, 95% CI: 7.115-10.830).

    CONCLUSIONS: Nulliparity, previous history of preeclampsia, and multiple pregnancies were associated with an increased risk of preeclampsia. The presence of different underlying conditions, such as chronic hypertension, anemia, and extremes of maternal age played an important role in increasing preeclampsia risk in the considered study. Larger samples are needed to validate such findings.

  6. Nadeem MA, Surienty L, Haque MM
    Front Public Health, 2022;10:1004767.
    PMID: 36452948 DOI: 10.3389/fpubh.2022.1004767
    The agriculture sector is a traditional economic pillar of many emerging economies. However, it is facing greater occupational health and safety (OHS) challenges in Pakistan, and its performance is continuously decreasing. An effective OHS implementation provides better control over OHS challenges and may help to restore its former glory. Therefore, this study aims to explore different organizational decision-making styles and safety accountability to put OHS into practice in this sector. Based on institutional theory, a theoretical framework was developed. Two hundred and eighty-seven agriculture farms in Punjab, Pakistan were surveyed and analyzed using SmartPLS 3.3.7. The findings revealed that implementation styles (rational and incremental) and safety accountability positively impact OHS implementation. Similarly, the moderating role of mimetic motives was found positively significant in the relationship between rational style and OHS implementation, and negatively significant in the relationship between incremental style and OHS implementation. While no moderating effect of mimetic motive was found between safety accountability and OHS implementation. This study suggested that OHS implementation should not be viewed as a social or technical issue alone. Strategic arrangements should be made at the organizational level to gain better control over OHS challenges by considering the institutional environment in which the organization operates.
  7. Al-Rahmi AM, Shamsuddin A, Wahab E, Al-Rahmi WM, Alyoussef IY, Crawford J
    Front Public Health, 2022;10:1003007.
    PMID: 36203665 DOI: 10.3389/fpubh.2022.1003007
    Social media utilization at the student-level has become more prevalent contemporary higher education. Hence, this study is aimed at developing a specific model, along with the behavioral intention to use, to explore educational quality, actual social media use, and task-technology fit that affects student satisfaction and performance impact through examining the synergies of constructivism, user acceptance and usage of information technology, and technology acceptance. To test, a survey was administered to 430 students across five Malaysian universities. Through structural equation modeling, findings indicate that to improve student satisfaction and student performance through embedded social media, students need to have opportunities to collaborate on learning, have easy access to social media, perceive such use to be easy, and have aligned expectation on performance and effort. Interestingly, the actual social media use, was the only variable in the model that did not predict student satisfaction, despite its role in predicting student performance. The study highlights that constructivist learning, as well as task-technology fit over social media, enhances the students' learning experience and enables knowledge sharing and dissemination. The effect of using social media on student satisfaction and academic performance highlights that all students think that it is adequate for their instructors to improve their usage of social media tools. Therefore, we advocate learners and students employing social media for academic purposes with the help of lecturers at higher teaching organizations and institutions.
  8. Marzo RR, ElSherif M, Abdullah MSAMB, Thew HZ, Chong C, Soh SY, et al.
    Front Public Health, 2022;10:1021495.
    PMID: 36589987 DOI: 10.3389/fpubh.2022.1021495
    INTRODUCTION: The healthcare setting is a stressful and demanding work environment, and healthcare workers face a continuous expansion of their job roles and responsibilities. Past studies have shown that factors affecting burnout, resilience, and quality of life among healthcare workers merit further research, as there were inconsistent findings, especially with regards to the influence of demographic and work-related factors. Therefore, this study aims to determine whether demographic and work-related factors are associated with burnout, resilience, and quality of life among healthcare workers.

    METHOD: This cross-sectional study was conducted between February 15, 2022 and March 15, 2022, among 394 healthcare workers from Putrajaya and Selangor hospitals, Malaysia. Maslach Burnout Inventory, World Health Organization Quality of Life-BREF 26 inventory, and Brief Resilience Scale were utilized to capture information on burnout, quality of life, and resilience, respectively.

    RESULTS: The mean score of physical health of participants who work more than 10 h (11.38) is lower than participants who work from 8 to 10 h (13.00) and participants who work 7 h daily (13.03), p-value < 0.001. Similarly, the mean score of psychological health of participants who work more than 10 h (12.35) is lower than participants who work from 8 to 10 h (13.72) and participants who work 7 h daily (13.68), p-value = 0.001. Higher income levels were associated with high resilience and quality of life.

    CONCLUSION: It is imperative that healthcare practitioners and policy makers adopt and implement interventions to promote a healthy workplace environment, address ethical concerns, and prevent burnout among healthcare workers during the COVID-19 pandemic. Managing the issue of long working hours could possibly result in improved resilience, burnout, and quality of life among healthcare workers. Despite this study able to tickle out some policy specific areas where interventions are needed, identifying effective solutions and evaluating their efficiency will require larger and interventional studies.

  9. Marzo RR, Khaled Y, ElSherif M, Abdullah MSAMB, Zhu Thew H, Chong C, et al.
    Front Public Health, 2022;10:1021497.
    PMID: 36530707 DOI: 10.3389/fpubh.2022.1021497
    BACKGROUND: Healthcare workers have to deal with highly demanding work situations, making healthcare as one of the most challenging professions. Up to now, far too little attention has been paid to burnout, resilience and the quality of life among Malaysian healthcare workers. Therefore, this paper explores the correlation between burnout, resilience and quality of life among Malaysian healthcare workers during the COVID-19 pandemic.

    METHOD: A total of 394 healthcare workers reported their responses on Maslach Burnout Inventory questionnaire, World Health Organization Quality of Life (WHOQOL)-BREF, and Brief Resilience Scale. Respondents were contacted through convenience sampling method and targeted population constituted Malaysian healthcare workers aged 18 years and above.

    RESULTS: For occupational exhaustion, about 50.5% of participants have moderate degree, 40.6% have high degree, and 8.9% have low degree of burnout. Health workers from age 25 to 35 years have lower physical health compared to health workers aged <25 years (coefficient = -0.77, p = 0.021). Similarly, healthcare workers who were working more than 10 h every day were more likely to report poor psychological health (coefficient = -2.49, p = 0.06). Positive correlation between physical and psychological health was observed. Further, a negative correlation was found between occupational exhaustion and the quality of life.

    CONCLUSION: It is important to target physical as well as psychological wellbeing of the healthcare workers. Also, it is important to understand the contribution of long working hours in declining the quality of life of the healthcare workers. Thus, allocating fixed working hours for healthcare workers would bring a much-required change.

  10. Xinyan Z, Mamun AA, Ali MH, Siyu L, Yang Q, Hayat N
    Front Public Health, 2022;10:1016065.
    PMID: 36388276 DOI: 10.3389/fpubh.2022.1016065
    The world is witnessing an increasing number of senior adult residents who experience health issues. Healthcare innovation facilitates monitoring the health conditions of senior adults and reducing the burden on healthcare institutions. The study explored the effect of health improvement expectancy, effort expectancy, price value, perceived vulnerability, health consciousness, and perceived reliability on the intention and adoption of medical wearable devices (MWD) among senior adults in China. Furthermore, a cross-sectional design was adopted, while quantitative data was collected from 304 senior adults through an online survey. A hybrid approach of partial least square structural equational modeling and artificial neural network-based analysis technique was adopted. The findings demonstrated that health improvement expectancy, perceived vulnerability, price value, and perceived reliability significantly affected the intention to adopt MWDs. Moreover, the intention to adopt MWDs significantly positively affected the actual adoption of MWDs among senior adults. Although the moderating effect of the pre-existing conditions and income between the intention to use MWDs and actual adoption of MWDs was positive, it was not statistically significant. The artificial neural network analysis has proven that perceived reliability, price value, and vulnerability are the most critical factors contributing to the intention to use MWDs. The current study offered valuable insights into the factors affecting the intention and adoption of MWDs among senior adults. Following that, theoretical and practical contributions were documented to improve the ease of use and price value for the prospective users of MWDs. The correct healthcare policies could curtail the influx of senior adults into the hospital and empower these adults to track and manage their health issues at home.
  11. Elnaem MH, Mubarak N, K T MS, Barakat M, Abdelaziz DH, Mansour NO, et al.
    Front Public Health, 2022;10:1011376.
    PMID: 36388263 DOI: 10.3389/fpubh.2022.1011376
    BACKGROUND: Pharmacy students will assume future roles as frontline healthcare providers. Therefore, evaluating their current state of mental wellbeing and its associated factors is essential for better planning students' support initiatives. This study aimed to assess mental wellbeing and its associated factors among undergraduate pharmacy students from 14 countries during the pandemic.

    METHODS: A cross-sectional study was conducted among undergraduate pharmacy students in 14 countries in Asia and the Middle East. The validated Warwick-Edinburgh Mental Wellbeing Scale (the 14-item WEMWBS) was adopted to assess mental wellbeing. Data collection was performed online between February and April 2022. Descriptive and inferential statistics were used as appropriate.

    RESULTS: A total of 2,665 responses were received, mainly from females (68.7%) with a higher presence of private universities (59.1%). About 34.9% had low mental wellbeing levels, while 57 and 8.1% had medium, and high levels, respectively. Binary logistic regression showed that males (AOR: 1.34; CI 95%: 1.11-1.61; p < 0.01) and students with no chronic illnesses (AOR: 2.01; CI 95%: 1.45-2.80; p < 0.001) were more likely to have higher mental wellbeing. Also, participants who did not engage in any exercise (AOR: 0.71; CI 95%: 0.52-0.98; p = 0.04) and those in public universities (AOR: 0.82; CI 95%: 0.69-0.97; p = 0.02) were less likely to have higher mental wellbeing. Additionally, students who had interest/passion for pharmacy (AOR: 1.69; CI 95%: 1.07-2.68; p = 0.02), and those who known pharmacists inspired (AOR: 1.81; CI 95%: 1.06-3.12; p = 0.03), were more likely to have higher mental wellbeing compared with those who had no specific reason for their choice to study pharmacy. The participants with excellent (AOR: 1.87; CI 95%: 1.29-2.70; p = 0.001) or very good self-reported academic performance (AOR: 1.57; CI 95%: 1.12-2.22; p = 0.01) were more likely to have higher mental wellbeing compared to those with fair academic performance.

    CONCLUSION: More than a third of the participants had low mental wellbeing. Various demographic, lifestyle, medical and academic factors appeared to affect students' mental wellbeing. Careful consideration of these factors and their integration into the pharmacy schools' plans for student support services and academic advising would be essential to improve students' mental wellbeing.

  12. Eltewacy NK, Nabil S, Sweedy R, Marzo RR, Hamza N, EARG Group
    Front Public Health, 2022;10:1018757.
    PMID: 36324469 DOI: 10.3389/fpubh.2022.1018757
    INTRODUCTION: During the COVID-19 lockdown, people's lifestyles have changed including their habits and physical activities. There has been an increase in anabolic hormones and nutritional supplement use among people who regularly do exercise in the MENA region. This study aims to assess knowledge, practice, and attitude toward the use of anabolic hormones and nutritional supplements among people who regularly exercise in the Middle East and North Africa (MENA) region and to compare their exercise habits and hormones and supplements usage between before and during COVID-19 lockdown.

    METHODS: A self-administrated online Google form survey was carried out between February 2021 and April 2021. Five thousand eight hundred forty-five participants who regularly exercise and aged ≥18 years responded to the questionnaire. The questionnaire was distributed through social media platforms and included five sections: demographic, training characters, knowledge, practice, and attitude.

    RESULTS: The participants mean age was 27.4 ± 8.6 years. Males represented 58.2 % of participants. 75.3% of the study participants had not used either hormones or supplements, and about 19% used supplements only. The mean percent score for knowledge, practice, and attitude were 39.3 ± 30.5, 1.1 ± 9.5, and 21.3 ± 23.8, respectively. Level of knowledge was higher among participants who worked in the medical field or as sports coaches. The practice was higher among male participants. The most commonly used anabolic hormones and nutritional supplements were steroids and proteins with bodybuilding being the most common purpose. Internet was the main source of information and pharmacy was the main source for procuring these substances. There was a significant decrease in proteins, carbohydrates, and sports drinks used during the COVID-19 lockdown compared to before the COVID-19 lockdown, while a statistically significant increase in vitamins used during the COVID-19 lockdown compared to before COVID-19 lockdown.

    DISCUSSION: In the MENA region, there has been an increase in the use of anabolic hormones and nutritional supplements. Most of the population has low knowledge of the harmful effect of uncontrolled, uninformed and unmonitored use of these substances Therefore, increasing the awareness level of participants and sports coaches should be a priority to limit the unsupervised use of hormones and supplements.

  13. Saleem MS, Isha ASNB, Benson C, Awan MI, Naji GMA, Yusop YB
    Front Public Health, 2022;10:1086843.
    PMID: 36620270 DOI: 10.3389/fpubh.2022.1086843
    INTRODUCTION: Buildings and infrastructure are the primary focus of the construction industry, which also includes related activities such as design, planning, demolition, renovation, maintenance, and repair. Safety performance is crucial to the industry's ability to work effectively in spite of hazardous conditions on the job site during any given project. Improving construction workers' safety performance in Malaysia requires an in-depth examination of the interplay between workers' psychological capital, work pressure, employee engagement, and safety participation.

    METHODS: Administrative and field workers from different divisions across Malaysia's six regions were randomly sampled to collect data for this study. The workers were given a total of 500 questionnaires, of which 345 were returned to the team of researchers. Based on the data analysis, there is an effective interaction between the factors tested toward safety performance.

    RESULTS: According to findings, psychological capital positively and significantly affected workers' work engagement. Also, work engagement greatly impacted both workers' safety performance outcomes. Also, as expected, worker pressure significantly and negatively affected workers' safety performance.

    DISCUSSION: Insights gained from this research have helped us better organize work and involve employees in safety activities/policies to boost workplace safety performance. The study also suggested that firms should reduce their employees' workloads because doing so would not lower their Psychological Capital but would instead fortify them to better carry out their duties in a risk-free manner.

  14. Nik Abdull Halim NMH, Che Dom N, Dapari R, Salim H, Precha N
    Front Public Health, 2022;10:1074028.
    PMID: 36600940 DOI: 10.3389/fpubh.2022.1074028
    INTRODUCTION: The Aedes mosquito species, which are the vectors for the transmission of the dengue virus (DENV) to humans, are becoming increasingly susceptible to the formidable effects of influential factors, especially temperature. However, there are still very few studies that have systematically reviewed the existing literature. Hence, in the present study, a systematic literature review and meta-analysis was conducted into the effects of temperature on dengue vectors.

    METHOD: Several research methodologies were incorporated into the current study, and a review was carried out using PRISMA as a guide. The publications for this study were chosen from two prominent databases, Scopus and Web of Science. All of the studies were assessed, reviewed, and evaluated independently by two reviewers. The meta-analysis tool, Review Manager (RevMan Copenhagen Version 5.4.1), was used to record the extracted data for the meta-analysis. Moran's I 2 and a funnel plot were utilized to measure heterogeneity, and publication bias was investigated. A 95% confidence interval (CI) and overall risk difference (RD) were estimated using a random-effects model.

    RESULT AND DISCUSSION: As a consequence of the search efforts, a total of 46 articles were selected for inclusion in the systematic review and meta-analysis. This review was divided into five major themes, based on a thematic analysis: (i) hatching rate, (ii) development time, (iii) longevity, (iv) survival rate, and (v) wing morphology. In addition, the development time, survival rate, and wing morphology revealed significantly higher risk differences between the maximum and minimum temperatures (RD: 0.26, 95% CI: 0.16, 0.36; p = < 0.00001; RD: 0.10, 95% CI: 0.05, 0.14; p < 0.0001; and RD: 0.07, 95% CI: 0.02, 0.12; p = 0.006, respectively). This study makes several substantial contributions to the body of knowledge and to practical applications. Finally, a number of recommendations are made at the conclusion of this research for the future reference of researchers.

  15. Sohail MT, Yang M, Maresova P, Mustafa S
    Front Public Health, 2022;10:1046780.
    PMID: 36339186 DOI: 10.3389/fpubh.2022.1046780
    This study was conducted to evaluate public awareness about COVID with aimed to check public strategies against COVID-19. A semi structured questionnaire was collected and the data was analyzed using some statistical tools (PLS-SEM) and artificial neural networks (ANN). We started by looking at the known causal linkages between the different variables to see if they matched up with the hypotheses that had been proposed. Next, for this reason, we ran a 5,000-sample bootstrapping test to assess how strongly our findings corroborated the null hypothesis. PLS-SEM direct path analysis revealed HRP -> PA-COVID, HI -> PA-COVID, MU -> PA-COVID, PM -> PA-COVID, SD -> PA-COVID. These findings provide credence to the acceptance of hypotheses H1, H3, and H5, but reject hypothesis H2. We have also examined control factors such as respondents' age, gender, and level of education. Age was found to have a positive correlation with PA-COVID, while mean gender and education level were found to not correlate at all with PA-COVID. However, age can be a useful control variable, as a more seasoned individual is likely to have a better understanding of COVID and its effects on independent variables. Study results revealed a small moderation effect in the relationships between understudy independent and dependent variables. Education significantly moderates the relationship of PA-COVID associated with MU, PH, SD, RP, PM, PA-COVID, depicts the moderation role of education on the relationship between MU*Education->PA-COVID, HI*Education->PA.COVID, SD*Education->PA.COVID, HRP*Education->PA.COVID, PM*Education -> PA.COVID. The artificial neural network (ANN) model we've developed for spreading information about COVID-19 (PA-COVID) follows in the footsteps of previous studies. The root means the square of the errors (RMSE). Validity measures how well a model can predict a certain result. With RMSE values of 0.424 for training and 0.394 for testing, we observed that our ANN model for public awareness of COVID-19 (PA-COVID) had a strong predictive ability. Based on the sensitivity analysis results, we determined that PA. COVID had the highest relative normalized relevance for our sample (100%). These factors were then followed by MU (54.6%), HI (11.1%), SD (100.0%), HRP (28.5%), and PM (64.6%) were likewise shown to be the least important factors for consumers in developing countries struggling with diseases caused by contaminated water. In addition, a specific approach was used to construct a goodness-of-fit coefficient to evaluate the performance of the ANN models. The study will aid in the implementation of effective monitoring and public policies to promote the health of local people.
  16. Ge P, Li Q, Dong M, Niu Y, Han X, Xiong P, et al.
    Front Public Health, 2022;10:1074559.
    PMID: 36620260 DOI: 10.3389/fpubh.2022.1074559
    OBJECTIVE: To investigate the status of Chinese residents' self-medication behavior and the important factors to consider when purchasing OTC drugs, and to explore the related factors of the possibility that Chinese residents take medical staff's suggestions as important factors to consider when purchasing OTC drugs.

    STUDY DESIGN: A cross-sectional survey.

    METHODS: A questionnaire was developed for exploring the sociodemographic characteristics of the respondents, their self-medication status, and important considerations. The questionnaire includes several scales including Health Literacy Scale-Short Form (HLS-SF), EQ-5D Visual Analog Scale (EQ-5D-VAS), Big Five Inventary-10 Items (BFI-10), and New General Self Efficacy Scale (NGSES). After carrying out a multi-stage sampling method, the questionnaire was conducted nationwide from July 10 to September 15, 2021. Next, descriptive statistics were conducted to analyze the general features. Logistic regression was then used to analyze the related factors of the possibility that the respondents took the suggestions of medical staff as an important consideration when purchasing OTC drugs.

    RESULTS: Nine thousand two hundred fifty-six qualified questionnaires were received. 99.06% of Chinese adults had self-medication behaviors. The types of OTC drugs purchased most by the respondents were NSAIDs (5,421/9,256 people, 58.57%) and vitamins/minerals (4,851/9,256 people, 52.41%). 86.2% of the respondents took the suggestions of medical staff as an important consideration when purchasing OTC drugs. The results of multi-factor logistic regression showed that women, those living in the central and western regions of China, those suffering from chronic diseases, those with high agreeableness, high conscientiousness, high neuroticism and openness, high health literacy, high EQ-5D-VAS, and those with high self-efficacy are more likely to take medical staff's suggestions as important factors to consider.

    CONCLUSION: The vast majority of Chinese adults have self-medication behavior. Important considerations when purchasing OTC drugs include medical staff's suggestions, drug safety and drug efficacy. Whether residents take the suggestions of medical staff as an important consideration is related to their sociological characteristics, agreeableness, conscientiousness, neuroticism, openness, health literacy, self-assessment health status, and self-efficacy. When purchasing and using OTC drugs, residents should carefully listen to the suggestions from medical staff. They should also carefully consider their own conditions before buying OTC drugs.

  17. Kalok A, Razak Dali W, Sharip S, Abdullah B, Kamarudin M, Dasrilsyah RA, et al.
    Front Public Health, 2023;11:1092724.
    PMID: 36908400 DOI: 10.3389/fpubh.2023.1092724
    INTRODUCTION: The coronavirus disease 2019 (COVID-19) caused a global pandemic that resulted in devastating health, economic and social disruption. Pregnant mothers are susceptible to COVID-19 complications due to physiological and immunity changes in pregnancy. We aimed to assess the maternal vaccine acceptance of the COVID-19 vaccine.

    METHODS: A multi-center study across four teaching hospitals in the Klang Valley, Malaysia was conducted between September 2021 and May 2022. A survey was conducted using a self-administered electronic questionnaire. The survey instruments included; (1) maternal perception and attitude toward COVID-19 vaccination, (2) COVID-19 pregnancy-related anxiety, and 3) generalized anxiety disorder.

    RESULTS: The response rate was 96.6%, with a final number for analysis of 1,272. The majority of our women were Malays (89.5%), with a mean age (standard deviation, SD) of 32.2 (4.6). The maternal vaccine acceptance in our study was 77.1%. Household income (p < 0.001), employment status (p = 0.011), and health sector worker (p = 0.001) were independent predictors of maternal willingness to be vaccinated. COVID-19 infection to self or among social contact and greater COVID-19 pregnancy-related anxiety were associated with increased odds of accepting the SARS-CoV-2 vaccine. Women who rely on the internet and social media as a source of vaccine information were more likely to be receptive to vaccination (adjusted odd ratio, AOR 1.63; 95% CI 1.14-2.33). Strong correlations were observed between maternal vaccine acceptance and the positive perception of (1) vaccine information (p < 0.001), (2) protective effects of vaccine (p < 0.001), and (3) getting vaccinated as a societal responsibility (p < 0.001).

    DISCUSSION: The high maternal vaccine acceptance rate among urban pregnant women in Malaysia is most likely related to their high socio-economic status. Responsible use of the internet and social media, alongside appropriate counseling by health professionals, is essential in reducing vaccine hesitancy among pregnant women.

  18. Sharif Nia H, Allen KA, Arslan G, Kaur H, She L, Khoshnavay Fomani F, et al.
    Front Public Health, 2023;11:1085197.
    PMID: 36875362 DOI: 10.3389/fpubh.2023.1085197
    BACKGROUND AND PURPOSE: Recent new mutations and increases in transmission of COVID-19 among adolescents and children highlight the importance of identifying which factors influence parental decisions regarding vaccinating their children. The current study aims to explore whether child vulnerability and parents' attitudes toward vaccines mediate the association between perceived financial well-being and vaccine hesitancy among parents.

    METHOD: A predictive, cross-sectional, multi-country online questionnaire was administered with a convenience sample of 6,073 parents (Australia, 2,734; Iran, 2,447; China, 523; Turkey, 369). Participants completed the Parent Attitude About Child Vaccines (PACV), the Child Vulnerability Scale (CVS), a Financial Well-being (FWB) measure, and Parental Vaccine Hesitancy (PVH) questionnaire.

    RESULTS: The current study revealed that perceived financial well-being had significant and negative associations with parents' attitudes toward COVID-19 vaccines and child vulnerability among the Australian sample. Contrary to the Australian findings, results from Chinese participants indicated that financial well-being had significant and positive predictive effects on parent attitudes toward vaccines, child vulnerability, and parental vaccine hesitancy. The results of the Iranian sample revealed that parents' attitudes toward vaccines and child vulnerability significantly and negatively predicted parental vaccine hesitancy.

    CONCLUSION: The current study revealed that a parents' perceived financial well-being had a significant and negative relationship with parental attitudes about vaccines and child vulnerability; however, it did not significantly predict parental vaccine hesitancy among Turkish parents as it did for parents in Australia, Iran, and China. Findings of the study have policy implications for how certain countries may tailor their vaccine-related health messages to parents with low financial wellbeing and parents with vulnerable children.

  19. Yusuf A, P Iskandar YH, Ab Hadi IS, Nasution A, Lean Keng S
    Front Public Health, 2022;10:951641.
    PMID: 36324460 DOI: 10.3389/fpubh.2022.951641
    BACKGROUND: Lack of knowledge, poor awareness, and attitude are barriers to breast cancer (BC) screening participation. The ubiquitous usage of mobile phones makes it a perfect platform for delivering interventions to increase knowledge and awareness in screening, a strategy for early identification of BC. However, although numerous applications for BC prevention are available on major mobile phone platforms, relatively few have been tested in scientific studies to determine their efficacy.

    OBJECTIVE: This study aimed to assess the efficacy of BrAware Apps in increasing the knowledge of BC risk factors, awareness of warning signs and confidence in breast self-examination (BSE) among women in northeast peninsular Malaysia.

    METHODS: A quasi-experimental pre and post-test research design were conducted with 41 women participants in Kelantan, Malaysia, before and after using the BrAware apps. Participants were given an online, adapted Breast Cancer Awareness Measure questionnaire. Post-test was 2 months after using the BrAware apps. Comparison using paired T-tests were conducted to evaluate the change in knowledge of risk factors, warning signs awareness and confidence level for BSE.

    RESULTS: The mean age of women was 39.71(SD = 8.80). The participants' mean knowledge score of BC warning signs differs before using BrAware (mean 70.62, SD 11.74) and after using the BrAware app (mean 79.83, SD 10.15) at the <0.001 level of significance.

    CONCLUSIONS: The BrAware mobile app had a positive effect in increasing the women's knowledge of risk factors of BC, warning signs awareness and confidence level for BSE. It can be concluded that the mobile app may be an adjunct in educating women on BC.

  20. Lee KW, Yap SF, Ong HT, Pheh KS, Lye MS
    Front Public Health, 2022;10:936486.
    PMID: 36276401 DOI: 10.3389/fpubh.2022.936486
    AIM: We examined the anxiety levels and coping strategies among staff and students of a tertiary educational institution during the COVID-19 pandemic and determined the association between anxiety level and coping strategies.

    METHOD: Through an online survey, we used Coronavirus Anxiety Scale (CAS) to measure the level of anxiety associated with the COVID-19 crisis and Brief Coping Orientation to Problems Experienced (COPE) to assess the coping responses adopted to handle stressful life events. Coping strategies were classified as adaptive and maladaptive, for which the aggregate sores were calculated. Multiple linear regression was used to determine the predictors of anxiety adjusted for potentially confounding variables. Results from 434 participants were available for analysis.

    RESULTS: The mean score (SD) of the CAS was 1.1 (1.8). The mean scores of adaptive and maladaptive coping strategies were 35.69 and 19.28, respectively. Multiple linear regression revealed that maladaptive coping [Adjusted B coefficient = 4.106, p-value < 0.001] and presence of comorbidities [Adjusted B coefficient = 1.376, p-value = 0.025] significantly predicted anxiety.

    CONCLUSION: Maladaptive coping and presence of comorbidities were the predictors of coronavirus anxiety. The apparent lack of anxiety in relation to COVID-19 and movement restriction is reflective of the reported high level of satisfaction with the support and services provided during the COVID-19 outbreak in Malaysia. Adaptive coping strategies were adopted more frequently than maladaptive. Nevertheless, public education on positive coping strategies and anxiety management may be still be relevant to provide mental health support to address the needs of the general population.

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