Global climate change and rapid urbanization, mainly driven by anthropogenic activities, lead to urban flood vulnerability and uncertainty in sustainable stormwater management. This study projected the temporal and spatial variation in urban flood susceptibility during the period 2020-2050 on the basis of shared socioeconomic pathways (SSPs). A case study in Guangdong-Hong Kong-Macao Greater Bay Area (GBA) was conducted for verifying the feasibility and applicability of this approach. GBA is predicted to encounter the increase in extreme precipitation with high intensity and frequency, along with rapid expansion of constructed areas, resulting in exacerbating of urban flood susceptibility. The areas with medium and high flood susceptibility will be expected to increase continuously from 2020 to 2050, by 9.5 %, 12.0 %, and 14.4 % under SSP1-2.6, SSP2-4.5, and SSP5-8.5 scenarios, respectively. In terms of the assessment of spatial-temporal flooding pattern, the areas with high flood susceptibility are overlapped with that in the populated urban center in GBA, surrounding the existing risk areas, which is consistent with the tendency of construction land expansion. The approach in the present study will provide comprehensive insights into the reliable and accurate assessment of urban flooding susceptibility in response to climate change and urbanization.
Air pollution has massive impacts on human life and poor air quality results in three million deaths annually. Air pollution can result from natural causes, including volcanic eruptions and extreme droughts, or human activities, including motor vehicle emissions, industry, and the burning of farmland and forests. Emission sources emit multiple pollutant types with diverse characteristics and impacts. However, there has been little research on the risk of multiple air pollutants; thus, it is difficult to identify multi-pollutant mitigation processes, particularly in Southeast Asia, where air pollution moves dynamically across national borders. In this study, the main objective was to develop a multi-air pollution risk index product for CO, NO2, and SO2 based on Sentinel-5P remote sensing data from 2019 to 2020. The risk index was developed by integrating hazard, vulnerability, and exposure analyses. Hazard analysis considers air pollution data from remote sensing, vulnerability analysis considers the air pollution sources, and exposure analysis considers the population density. The novelty of this study lies in its development of a multi-risk model that considers the weights obtained from the relationship between the hazard and vulnerability parameters. The highest air pollution risk index values were observed in urban areas, with a high exposure index that originates from pollution caused by human activity. Multi-risk analysis of the three air pollutants revealed that Singapore, Vietnam, and the Philippines had the largest percentages of high-risk areas, while Indonesia had the largest total high-risk area (4361 km2). Using the findings of this study, the patterns and characteristics of the risk distribution of multiple air pollutants in Southeast Asia can be identified, which can be used to mitigate multi-pollutant sources, particularly with respect to supporting the clean air targets in the Sustainable Development Goals.
While most Third World countries, particularly in Africa and Latin America, have experienced a deterioration in child welfare as a result of the severe economic downturn in the 1980s, Southeast Asia in general managed to sustain improvements in the situation of its children because it has maintained satisfactory rates of economic growth. However, there were exceptions within Southeast Asia. The Philippines, Vietnam, Dem. Kampuchea and Laos had unsatisfactory growth rates and, consequently, unsustained nutritional gains from the 1970s through the 1980s. Economic factors exerted a big impact on the Philippine nutrition situation, particularly on the dietary status of the households and the nutritional status of children. As a result of the economic dislocation occurring in the country, the nutritional gains of 1978-82 were not maintained in succeeding years. Unlike the case of Thailand, it has been estimated that the solution to nutritional problems in the Philippines is far from being achieved in the immediate future (Villavieja et al. 1989). On the other hand, the nutrition improvements in Thailand have been as remarkable as the economic growth over the last decade. Long-term investments in health, nutrition and other social services in Thailand (as well as in Indonesia) have paid off according to the assessment by the United Nations (1990). It appears, therefore, that the nutrition situation in developing countries is highly dependent on the economic situation, globally and nationally (Cornia et al. 1987), as well as on investment in social services. Adjustment policies should, therefore, consider their implications on distribution and poverty in order that they could positively contribute to the improvement of the nutrition of the people.
Facility Layout Problem (FLP) is a NP-hard problem concerned with the arrangement of facilities as to minimize the distance travelled between all pairs of facilities. Many exact and approximate approaches have been proposed with an extensive applicability to deal with this problem. This paper studies the fundamentals of some well-known heuristics and metaheuristics used in solving the FLPs. It is hoped that this paper will trigger researchers for in-depth studies in FLPs looking into more specific interest such as equal or unequal FLPs.
Knowledge of the characteristics of older adults with type 2 diabetes mellitus (T2DM) is indispensible for improvement of their care. A cross-sectional study in two rural public primary healthcare centres in Malaysia identified 170 actively engaged older patients with T2DM, with suboptimal glycaemic control and frequent hypoglycaemia. The prevalence of multiple co-morbidities, complications of T2DM, high cardiovascular risk, neurological, musculoskeletal and visual deficits suggested high risk of disabilities and dependency but not yet disabled. This short window for interventions presents as an opportunity for development of a more comprehensive approach extending beyond glycaemia control to risk management, preventing functional loss and continuity of social participation.
Study site: Klinik Kesihatan, Selangor, Malaysia
A cross-sectional survey was conducted with the objective to explore a community's knowledge and practices towards prevention of Influenza A (H1N1) in three residential areas in Tampin. Respondents were randomly selected from a list of residences and interviewed face-to-face using a structured questionnaire. A total of 221 respondents (80.9%) were involved with the majority (64.7%) comprising female and who had attained secondary level of education (86.0%). The main source of information was from television/radio. The total score for knowledge questions was 15 and practice questions were 25. A total of 60.2% attained "adequate knowledge" and 52.0% "good practice". Mean (SD) for knowledge score was 11.6 (2.3) and practice was 18.1 (4.1). Ethnicity, education, income and practice score were identified as predictors for knowledge score. Income and knowledge scores were predictors for practice score. There was positive correlation between knowledge and practice scores.
Chronic venous disorders range from telangiactasia or spider veins to varicose veins, venous swellings, skin changes and venous ulcerations. The aim of this study is to assess outcome of varicose vein surgery in the ethnically diverse population of Penang, Malaysia. This study is a retrospective analysis of patients seen from 1999 to 2004. All patients who presented to the outpatient clinic of our surgical department with saphenofemoral junction (SFJ) and/or saphenopopliteal junction (SPJ) reflux associated with incompetence of the great saphenous vein (GSV) or small saphenous vein (SSV) respectively underwent classical varicose varicose vein surgery. A single surgeon at a single institution performed the surgeries. Data from pre-operative, post-operative and follow-up procedures were recorded in case report forms. A total of 202 cases were treated. Of these, 200 were qualified by the inclusion criteria and follow-ups, with 23 who were treated bilaterally. Of those treated, Chinese comprised 47.5%, Indians 27.0%, Malays 12.5% and foreigners 13.0% (largely Indonesian Chinese, British and Americans). The average age was 52.1 years. Indians had the highest average BMI of 29.2, compared to the Chinese who had the lowest of 24.6. Based on occupation, housewives (43.0%), blue collar workers (19.0%), salespersons (12.0%) and factory workers (9.5%) were among those afflicted with varicose veins. While local Chinese predominated in the business groups (salespersons and food-related workers), the Indians and Malays in this study were mainly factory workers and/or blue collar workers. Symptomatology in descending order of severity included pain in 80.0% of cases, swelling in 65.5%, heaviness in 53.5%, cramps in 53.0%, lipodermatosclerosis in 39.0%, superficial thrombophlebitis in 33.5%, venous ulceration in 32.0%, eczema 22.0% and cellulitis in 12.5% of patients. Post surgery pains dropped to 9.9%, cramps 6.4%, heaviness 5.5% and swelling 5.3% (p<0.0001 in all groups). Indians had the highest rate of venous ulcers (35.2% of all Indians treated) possibly due to their high BMI and low socioeconomic background. In cases of venous ulcers, gram negative infections (49.8%) were more common than gram positive infections at 18.8%. Operative procedures performed included great saphenous vein high ligation in 96.5% of cases, stripping 93.5% and multiple avulsions in 98.5%, saphenous popliteal junction ligation with multiple avulsions in 13.0% and subfascial ligation in 10.5%. Operative complications included induration (40.0% of cases), bruising in 49.5%, pains in 15.0%, paraesthesia in 3.5%, wound infection in 4.0%, deep venous thrombosis in 3.0% and ulcer recurrence in 7.5%. A total of 96.2% of patients treated expressed satisfaction with varicose vein surgery. Late presentations of chronic venous insufficiency, possibly as a result of poor understanding and inadequate education on diet, weight control, use of stockings and change in lifestyle by patients, employers and general practitioners are probably the cause of high rates of severe chronic venous disease especially venous ulcerations in the local community. However, classical varicose vein surgery is widely applicable across diverse ethnicities with a high rate of success.
Study site: Surgical clinic, Penang Adventist Hospital, Pulau Pinang, Malaysia
This is a cross sectional study to determine the relationship of postnatal depression (PND) and socio-cultural practices post-delivery among women in Kota Bharu, Kelantan. Four hundred and twenty one pregnant women were screened for depression between 36 - 42 weeks of pregnancy, 1 week and 4 - 6 weeks postpartum using Edinburgh Postnatal Depression Scale (EPDS). The women also completed questionnaires on socio-demography, psychosocial support and traditional postnatal care. The prevalence of PND at 4-6 weeks postpartum was 20.7%. Depressive symptoms at the end of pregnancy (p<0.05) and one week postpartum (p<0.05), worry about the baby (p<0.05), use of traditional medication (p<0.05) and traditional massage (p<0.05) were significantly associated with PND.
Study site: Maternal and Child Health Clinics (Klinik Kesihatan), Kota Bharu, Kelantan, Malaysia
To determine the immunisation status of hospitalised infants and to examine the potential risk factors associated with incomplete immunisation. Prospective study of infants admitted to a paediatric hospital in Kuala Lumpur, conducted by interviewing carers. Twenty-two percent of infants had incomplete immunisation. The most significant factor that was associated with incomplete immunisation was the carer's lack of knowledge on the timing of the next immunisation (p = 0.005). Other factors that had significant association were the presence of a previous admission to hospital (p = 0.03) and the infant's age of more than 6 months (p = 0.025). The rate of incomplete immunisation in the study population was 22%. An admission to hospital of an infant should be taken as an opportunity to update their immunisation in order to improve the rate of uptake.
Chronic disability in children imposes great strains on a family. The responsibility of mothering disabled children may be detrimental to the well-being of mothers. This study aims to assess the different types of coping styles of mothers with disabled children and its influencing factors. It is a cross-sectional study using Coping Inventory Stressful Situation (CISS) scale to determine the mothers' coping styles. A sample of 81 mothers with disabled children attending two rural Community Rehabilitation Centres, were included in the study. Overall, the mothers were using a mixture of coping strategies. However, they scored more in the task-oriented (mean T score = 52.88) and emotion-oriented (mean T score = 50.52) coping styles, while the other subscales of coping styles, namely avoidance, distraction and social diversion were below average (mean T score < 50). Divorced mothers (p=0.04) and those with low educational level (p=0.00) were more inclined to use emotion-oriented coping strategies while mothers with younger children (< 5 years old) used more avoidance coping strategies (p=0.01). There were no significant difference of coping styles in association with the mothers' age, ethnicity, duration of marriage, number of siblings, child's birth order or gender. By understanding the mothers' coping styles, health care workers would be able to educate the mothers with effective coping strategies and consequently reduce their psychological distress.
A case control study was conducted in 1996 among primary school student in Terengganu. The objective of the study is to determine the relationship between road traffic accidents and factors such as socio-economic status, distance from school, number of siblings, behavioural problems, knowledge and attitudes of pupil and their parents towards road safety and parents' educational status. A total of 140 cases was obtained from 3 urban schools and 3 from rural schools. Cases were matched with control according to age sex and locality of residence. There were significant associations between road traffic accidents and pupils' knowledge regarding road crossing (OR = 0.40, 95% CI = 0.19-0.85), parental supervision (OR = 0.43, 95% CI = 0.19, 0.64) and parents having driving licences (OR = 0.99, 95% CI = 0.856-0.999). Road safety education for pupils and parental supervision are key measures in preventing road traffic accidents among primary school children.
Objectives: i) To determine the prevalence of smoking among the community aged 15 and above in Kg. Jenderam Hilir in Sepang District, Selangor state. ii) To determine the relationship between smoking and age, sex, household income and education. iii) To determine the parental and peer influence on smoking in Kg Jenderam Hilir.
Materials and Methods: A study was conducted to Kg Jenderam Hilir, Sepang. All residents aged 15 years and above from all the 381 households of Kg Jenderam Hilir were included in this study. A standardized pre-tested structured questionnaire was used in this study.
Results: Out of 894 respondents interviewed 69% were males compared to 3.9% of the females (overall 33.6%) reported to have smoked at least once in his/her lifetime. The difference was statistically significant. The mean duration of smoking was 17.7 years. The age at which smoking was first attempted ranged from 4 years to 51 years with a mean of 18.7 years. The mean initiation age for the males was significantly lower as compared to the mean initiation age for the females. The prevalence of current smokers was significantly higher amongst males (52.8%) as compared to the females (1.4%). The prevalence of smoking among current smokers increased with age (p<0.01). there was no significant difference in the prevalence of smoking by household income and educational level. The mean number of cigarettes smoked by current smokers per day was 14.9 cigarettes and ranged from 1 to 60 cigarettes. The mean number of cigarettes smoked by the males was significantly higher than the females (p<0.05). the mean duration of smoking among current smokers was 20 years. There was a significant difference in the level of addiction to smoking and the duration of smoking (p<0.05). sixty five percent of the current smokers reported to have tried to quit smoking while 26% of ever smokers had reported to quit smoking and remained non-smokers. The quit ratio was calculated to be 26.0%. the quit ratio was 52.6% among those with college or university education. There was a significant difference in the quit ratio by education level (p<0.01). There was no significant difference in smokers whose parents were smokers as compared to non-smokers whose parents were smokers. However, there was a significant association between smoking and peer influence (p<0.01).
Hospital records of children admitted to the department of Paediatrics, University Hospital, Kuala Lumpur, from January 1981 to December 1990, who were diagnosed to have acute rheumatic fever (ARF) were studied. 134 children satisfied the Jones' modified criteria, thus giving a hospital incidence of 21.2/100,000 paediatric admission per year, of which incidence of first attack was 15.8/100,000 per year and recurrent attack was 5.38/100,000 per year. The M:F ratio is 1.39:1. Majority of cases occur in the 6-11 years age group with 6 cases encountered below the age of 5. The Indians had a higher relative risk to develop both the first acute attack as well as recurrences with a relative risk of 2.4 and 4.10 respectively as compared to the Malays. Majority of the patients, irrespective of the ethnic group, came from families with low income.
A total of 209 randomly selected Malaysian university students (128 from Universiti Kebangsaan Malaysia, 81 from the University of New South Wales) completed a self-filled questionnaire enquiring about their smoking behaviour and psychosocial characteristics. The prevalence of smoking was 26.6 per cent among students in Malaysia and 18.8 per cent among students in Australia (average 23.4%). Both samples have similar patterns in terms of age of starting smoking, time of the day when they smoked, family and peer history of smoking, and whether or not they inhaled deeply during smoking. The smokers tend to be male, studying beyond the first year, staying with peers outside the hostel, having financial sources other than a scholarship, and abnormal mental health score. However, the smokers from the Australian samples were noted to smoke less and made fewer attempts at quitting the habit.
A dietary survey was carried out in 216 children (109 males, 107 females) aged 1-7 years, living in rural villages in Selangor, Malaysia to assess their nutrient intake and to determine the association between nutrient consumption and socio-economic background. All the children studied had inadequate intakes of energy, iron and niacin according to Recommended Daily Intake (RDI). Children aged of 4-9 years showed inadequate intake of calcium, thiamine and riboflavin. However, the intake of protein, vitamin A and ascorbic acid were above the recommended value. The mean percentage requirements of protein, iron and niacin were significantly higher in children from small families compared with children from large families. However the employment status of mothers had a significantly effect on the mean percentage requirements of niacin. The results indicate that education level of the mothers, is strongly associated with the mean percentage nutrient requirements of children and we strongly feel that this is a strategy to be adopted for improvement in nutrition of children.
In view of controversial reports about the role of prelabour rupture of foetal membranes (PROM) in neonatal morbidity and to study the association of PROM with infections and meconium aspiration syndrome (MAS), a prospective case control study was conducted in a level II nursery of Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan. Of the 111 neonates with PROM studied, 18 developed clinical problems (septicaemia and other specific problems such as pneumonia, omphalitis, skin infection and MAS) while 5/56 of the control group developed similar problems. The difference between the two groups was not significant (p < 0.30). There was no neonatal death. It is concluded that PROM is not associated with neonatal morbidity. Neonates with this problem alone do not need to be admitted to the neonatal nursery.
This is a study of infant feeding practices of 126 mothers. Seventy-seven mothers or 61.1% practised breast feeding. The typical breast feeding mother was more likely to be a Malay, with lower family income and residing in the rural area. The educational status of the mother was not an important factor in influencing her to breast feed. Health education on breast feeding should be intensified in schools to reinforce the implementation of the Malaysian Code of Ethics for Infant Formula Products.
The socioeconomic, social behaviour and dietary pattern of 100 Aborigines and Malays, aged 7 years and above from Kuala Pangsoon, Selangor Malaysia were studied by using pretested questionnaires. The individual's dietary intake was estimated using 24 hour recall for 3 days within one week which was chosen at random. The household's food consumption pattern was evaluated using food frequency questionnaires. There was no difference in the total income per month for both communities, as well as the educational attainment of the head of household and property ownership. The proportion of smokers among the Aborigines and the Malays was almost similar (33%) but the percentage of heavy smokers was higher among Aborigines compared to Malays. One third of the Aborigines regularly consume alcohol. The main energy source for both communities was rice, sugar and cooking oil whilst fish and eggs were the main sources of protein. More than 50% of the Aborigines take tapioca or tapioca leaves at least once a week compared to less than 20% among the Malays. There was no significant different in the intake of energy, protein and carbohydrate between the groups. However, the Aborigines take less fats and iron compared to the Malays. The difference in terms of smoking, drinking habit and dietary intake may determine the distribution of disease in both communities.