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Fulltext Spatial and Temporal Analysis of Plasmodium knowlesi Infection in Peninsular Malaysia, 2011 to 2018

Phang WK, Hamid MHA, Jelip J, Mudin RN, Chuang TW, Lau YL, et al.

Int J Environ Res Public Health, 2020 12 11;17(24).
PMID: 33322414 DOI: 10.3390/ijerph17249271

The life-threatening zoonotic malaria cases caused by Plasmodium knowlesi in Malaysia has recently been reported to be the highest among all malaria cases; however, previous studies have mainly focused on the transmission of P. knowlesi in Malaysian Borneo (East Malaysia). This study aimed to describe the transmission patterns of P. knowlesi infection in Peninsular Malaysia (West Malaysia). The spatial distribution of P. knowlesi was mapped across Peninsular Malaysia using Geographic Information System techniques. Local indicators of spatial associations were used to evaluate spatial patterns of P. knowlesi incidence. Seasonal autoregressive integrated moving average models were utilized to analyze the monthly incidence of knowlesi malaria in the hotspot region from 2012 to 2017 and to forecast subsequent incidence in 2018. Spatial analysis revealed that hotspots were clustered in the central-northern region of Peninsular Malaysia. Time series analysis revealed the strong seasonality of transmission from January to March. This study provides fundamental information on the spatial distribution and temporal dynamic of P. knowlesi in Peninsular Malaysia from 2011 to 2018. Current control policy should consider different strategies to prevent the transmission of both human and zoonotic malaria, particularly in the hotspot region, to ensure a successful elimination of malaria in the future.
Fulltext Public Awareness of and Action towards Heart Attack Symptoms: An Exploratory Study

Abdo Ahmed AA, Mohammed Al-Shami A, Jamshed S, Fata Nahas AR, Mohamed Ibrahim MI

Int J Environ Res Public Health, 2020 12 02;17(23).
PMID: 33276636 DOI: 10.3390/ijerph17238982

BACKGROUND: Cardiovascular disease (CVD) is still the leading cause of mortality worldwide, and Malaysia is not an exception in this regard. The current research is an attempt to explore symptom awareness of and necessary actions in response to heart attack (HA) among lay public.
METHODS: This is a cross-sectional study design, and a survey was conducted from May to July 2018 among general public in Kuantan, Pahang state, Malaysia.
RESULTS: A total of 393 respondents recruited. Slightly more than one-fourth of the respondents (26.35%) were aware of HA symptoms like pain and/or discomfort in the jaw, neck, or back, while 71.65% showed awareness only of chest pain or discomfort as symptoms. Only 35.6% reported to call an ambulance if they experience someone suffering from HA symptoms, while 82% recognized ≥1 symptom, and only 11.5% recognized all five HA symptoms. Very few respondents, i.e., 1.3% reported awareness about correct recognition of all five HA symptoms. Respondents who had diabetes and hypercholesteremia were more likely to recognize all five HA symptoms. For those who had excellent awareness of all five HA symptoms, the odds ratio (OR) were significantly higher among single respondents (OR 0.023; 95% CI 0.001-0.594), Malay (OR 0.376; 95% CI 0.193-0.733), and those who received information associated with HA (OR 7.540; 95% CI 2.037-27.914). However, those who were aware that HA requires quick treatment had significantly low odds ratio (OR 0.176; 95% CI 0.044-0.710).
CONCLUSIONS: The awareness of and action towards the signs and symptoms of HA among the public were poor.
Fulltext The Effects of Pro-Inflammatory and Anti-Inflammatory Agents for the Suppression of Intimal Hyperplasia: An Evidence-Based Review

Che Man R, Sulaiman N, Ishak MF, Bt Hj Idrus R, Abdul Rahman MR, Yazid MD

Int J Environ Res Public Health, 2020 10 26;17(21).
PMID: 33114632 DOI: 10.3390/ijerph17217825

Anti-atherogenic therapy is crucial in halting the progression of inflammation-induced intimal hyperplasia. The aim of this concise review was to methodically assess the recent findings of the different approaches, mainly on the recruitment of chemokines and/or cytokine and its effects in combating the intimal hyperplasia caused by various risk factors. Pubmed and Scopus databases were searched, followed by article selection based on pre-set inclusion and exclusion criteria. The combination of keywords used were monocyte chemoattractant protein-1 OR MCP-1 OR TNF-alpha OR TNF-α AND hyperplasia OR intimal hyperplasia OR neointimal hyperplasia AND in vitro. These keywords combination was incorporated in the study and had successfully identified 77 articles, with 22 articles were acquired from Pubmed, whereas 55 articles were obtained from Scopus. However, after title screening, only twelve articles meet the requirements of defined inclusion criteria. We classified the data into 4 different approaches, i.e., utilisation of natural product, genetic manipulation and protein inhibition, targeted drugs in clinical setting, and chemokine and cytokines induction. Most of the articles are working on genetic manipulation targeted on specific pathway to inhibit the pro-inflammatory factors expression. We also found that the utilisation of chemokine- and cytokine-related treatments are emerging throughout the years. However, there is no study utilising the combination of approaches that might give a better outcome in combating intimal hyperplasia. Hopefully, this concise review will provide an insight regarding the usage of different novel approaches in halting the progression of intimal hyperplasia, which serves as a key factor for the development of atherosclerosis in cardiovascular disease.
Fulltext The Effectiveness of Educational Interventions on Breast Cancer Screening Uptake, Knowledge, and Beliefs among Women: A Systematic Review

Noman S, Shahar HK, Abdul Rahman H, Ismail S, Abdulwahid Al-Jaberi M, Azzani M

Int J Environ Res Public Health, 2020 12 31;18(1).
PMID: 33396424 DOI: 10.3390/ijerph18010263

There have been various systematic reviews on the significance of educational interventions as necessary components to encourage breast cancer screening (BCS) and reduce the burden of breast cancer (BC). However, only a few studies have attempted to examine these educational interventions comprehensively. This review paper aimed to systematically evaluate the effectiveness of various educational interventions in improving BCS uptake, knowledge, and beliefs among women in different parts of the world. Following the PRISMA guidelines, a comprehensive literature search on four electronic databases, specifically PubMed, Scopus, Web of Science, and ScienceDirect, was performed in May 2019. A total of 22 interventional studies were reviewed. Theory- and language-based multiple intervention strategies, which were mainly performed in community and healthcare settings, were the commonly shared characteristics of the educational interventions. Most of these studies on the effectiveness of interventions showed favorable outcomes in terms of the BCS uptake, knowledge, and beliefs among women. Educational interventions potentially increase BCS among women. The interpretation of the reported findings should be treated with caution due to the heterogeneity of the studies in terms of the characteristics of the participants, research designs, intervention strategies, and outcome measures.
Fulltext Human Health Risk Assessments of Trace Metals on the Clam Corbicula javanica in a Tropical River in Peninsular Malaysia

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

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

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

Ying Ying C, Awaluddin SM, Kuang Kuay L, Siew Man C, Baharudin A, Miaw Yn L, et al.

Int J Environ Res Public Health, 2020 12 29;18(1).
PMID: 33383635 DOI: 10.3390/ijerph18010168

Internet addiction (IA) among adolescents is an issue of growing concern with adverse effects on adolescents' health and social functioning. This study aims to determine the prevalence of IA among school-going adolescents in Malaysia and its associated factors-specifically, lifestyle factors. A nationwide cross-sectional school-based health survey was conducted in 2017 among 27,497 students from 212 randomly selected secondary schools. Information regarding sociodemography, lifestyle, and internet use was obtained using a self-administered questionnaire. IA was measured using the Malay Version of Internet Addiction Test (MVIAT). The prevalence of internet addiction was 29.0%. A multivariable logistic analysis revealed that inadequate fruit and vegetable intakes, consumed carbonated soft drinks at least once a day, consumed fast food at least three days/week, sedentary behavior, current E-cigarette users, and ever/current alcohol drinkers were lifestyle factors significantly associated with IA. Adolescents from urban schools, of higher school grade, and those whose parents are married but living apart were also found to have a greater risk for internet addiction. A positive association was found between IA with unhealthy dietary and lifestyle behaviors among adolescents. The modification of lifestyle factors needs to be considered while developing strategies and interventions for awareness-raising and prevention of IA among adolescents.
Fulltext Obesity among Health-Care Workers: Which Occupations Are at Higher Risk of Being Obese?

Kunyahamu MS, Daud A, Jusoh N

Int J Environ Res Public Health, 2021 04 20;18(8).
PMID: 33924182 DOI: 10.3390/ijerph18084381

Obesity among health-care workers (HCWs) is an important issue as it can affect both their health condition and their professional capability. Although adult obesity is attributable to occupational factors, few reports are available on Malaysian health-care workers' obesity and whether different health-care job categories are related to workers' obesity. This study aimed to determine the prevalence of obesity among HCWs and the association between various HCW job categories and obesity. A cross-sectional study was conducted by analyzing secondary data from the 2019 annual cardiovascular health screening program, which included information regarding all government health-care workers in the east coast region of Peninsular Malaysia. The subject's body mass index (BMI) was categorized according to WHO criteria. Only 43% of the subjects had a normal BMI, while 33.1% were categorized as overweight, and 21.1% were obese. Different HCWs' job categories were shown to be significantly associated with their obesity status, with nurses apparently having a higher risk of being obese (Adj OR = 1.91, 95% CI 1.45, 2.53, p-value < 0.001). This study's results require further exploration of HCWs' working condition factors and for different job categories that contribute to obesity. Public health intervention programs to combat obesity should be implemented that primarily target HCW groups at the highest risk of obesity.
Fulltext Protocol of a Single-Blind Two-Arm (Waitlist Control) Parallel-Group Randomised Controlled Pilot Feasibility Study for mHealth App among Incontinent Pregnant Women

Jaffar A, Mohd Sidik S, Foo CN, Muhammad NA, Abdul Manaf R, Fadhilah Ismail SI, et al.

Int J Environ Res Public Health, 2021 04 30;18(9).
PMID: 33946203 DOI: 10.3390/ijerph18094792

BACKGROUND: The delivery of pelvic floor muscle training (PFMT) through mHealth apps has been shown to produce promising results in improving pelvic floor muscle strength and urinary incontinence (UI). However, there is limited evidence on mHealth apps designed for pregnant women who are at high risk of developing UI. This pilot study aims to evaluate the feasibility of conducting an effectiveness trial for a newly developed PFMT app among pregnant women in Malaysia.
METHODS: This is a prospective, single-centre, single-blind, randomised controlled pilot feasibility study: The Kegel Exercise Pregnancy Training app (KEPT-app) Trial. Sixty-four incontinent pregnant women who attended one primary care clinic for the antenatal follow-up will be recruited and randomly assigned to either intervention or waitlist control group. The intervention group will receive the intervention, the KEPT-app developed from the Capability, Opportunity, Motivation-Behaviour (COM-B) theory with Persuasive Technology and Technology Acceptance Model.
DISCUSSION: This study will provide a fine-tuning for our future randomised control study on the recruitment feasibility methods, acceptability, feasibility, and usability of the KEPT-app, and the methods to reduce the retention rates among pregnant women with UI.
TRIAL REGISTRATION: This study was registered on ClinicalTrials.gov on 19 February 2021 (NCT04762433) and is not yet recruiting.
Fulltext Physicochemical Properties and Biocompatibility of Electrospun Polycaprolactone/Gelatin Nanofibers

Lim WL, Chowdhury SR, Ng MH, Law JX

Int J Environ Res Public Health, 2021 04 29;18(9).
PMID: 33947053 DOI: 10.3390/ijerph18094764

Tissue-engineered substitutes have shown great promise as a potential replacement for current tissue grafts to treat tendon/ligament injury. Herein, we have fabricated aligned polycaprolactone (PCL) and gelatin (GT) nanofibers and further evaluated their physicochemical properties and biocompatibility. PCL and GT were mixed at a ratio of 100:0, 70:30, 50:50, 30:70, 0:100, and electrospun to generate aligned nanofibers. The PCL/GT nanofibers were assessed to determine the diameter, alignment, water contact angle, degradation, and surface chemical analysis. The effects on cells were evaluated through Wharton's jelly-derived mesenchymal stem cell (WJ-MSC) viability, alignment and tenogenic differentiation. The PCL/GT nanofibers were aligned and had a mean fiber diameter within 200-800 nm. Increasing the GT concentration reduced the water contact angle of the nanofibers. GT nanofibers alone degraded fastest, observed only within 2 days. Chemical composition analysis confirmed the presence of PCL and GT in the nanofibers. The WJ-MSCs were aligned and remained viable after 7 days with the PCL/GT nanofibers. Additionally, the PCL/GT nanofibers supported tenogenic differentiation of WJ-MSCs. The fabricated PCL/GT nanofibers have a diameter that closely resembles the native tissue's collagen fibrils and have good biocompatibility. Thus, our study demonstrated the suitability of PCL/GT nanofibers for tendon/ligament tissue engineering applications.
Fulltext Cross-Cultural Adaptation and Psychometric Properties of the Malay Version of the Communication Skills Attitude Scale (CSAS) among Medical Students in Malaysia

Mohamad-Isa MZ, Mohamed-Yassin MS, Badlishah-Sham SF, Baharudin N, Ramli AS

Int J Environ Res Public Health, 2021 04 05;18(7).
PMID: 33916335 DOI: 10.3390/ijerph18073778

Communication is one of the fundamental skills in the medical profession. The Communication Skills Attitude Scale (CSAS) is a widely used questionnaire to measure the attitudes of medical students toward learning communication skills. It has been adapted and translated into many languages. The objective of this study was to adapt and translate the CSAS into the Malay language and determine its psychometric properties in medical students. This is a cross-sectional study involving 218 first-year Universiti Teknologi MARA students. Content validation, cross-cultural adaptation, translation, and face validation of the 26-item CSAS were performed according to established guidelines. Principal component analysis with direct oblimin rotation was used to determine the underlying structure of the CSAS-Malay. The reliability was assessed using Cronbach's α coefficient for internal consistency and using the intraclass correlation coefficient for the test-retest reliability. Although the contents of the CSAS-Malay and the original version were conceptually equivalent, item 11 was removed during the content validation stage due to a low item content validity index (I-CVI < 1.00). Two subscales were derived from the remaining 25 items, which were the Positive Attitude Scale and the Negative Attitude Scale. Items 1 and 15 were removed due to poor factor loadings. The total variance explained by the final two-factor solution with three items removed was 30.8%. Cronbach's α coefficients for both the Positive and Negative Attitude Scales in the final questionnaire were 0.815 and 0.614, respectively. It also showed a good reproducibility with intraclass correlation coefficient (ICC) values of 0.725-0.950 for all the items. This study provided preliminary information about the psychometric properties of the CSAS-Malay. The final 23-item questionnaire had a good construct validity, an acceptable internal consistency, and at least a moderate test-retest reproducibility. It can be used to assess the attitudes of medical students toward learning communication skills. Future research to improve the generalizability of the questionnaire should include medical students from other universities with diverse backgrounds.
Fulltext Factors Associated with Happiness among Malaysian Elderly

Shah SA, Safian N, Ahmad S, Wan Ibadullah WAH, Mohammad ZB, Nurumal SR, et al.

Int J Environ Res Public Health, 2021 04 06;18(7).
PMID: 33917528 DOI: 10.3390/ijerph18073831

Happiness is an essential component to experience healthy ageing. Hence, understanding the factors that contribute to happiness is important. This study aimed to determine the factors associated with happiness among the elderly population in Malaysia. In this study, 1204 respondents were recruited from urban and rural areas in Selangor. A face-to-face interview was conducted using the Bahasa Malaysia version of the Japan Gerontological Evaluation Study questionnaire. The inclusion criteria include Malaysians who are 60-years old and above and can converse in the Malaysian language. Those who encounter less than seven scores for the Abbreviated Mental Test were excluded from the study. Among the 1204 respondents, 953 (79.2%) were happy. Sociodemographic characteristics showed that being a men, age of 60 to 74 years, and living in urban areas were significantly associated with happiness. A logistic regression model showed that locality (aOR 1.61), income category (Bottom 40% aOR 0.49; Middle-class group 40% aOR 1.40), social engagement (active aOR 1.77; less active aOR 1.25), receiving emotional support (aOR 2.11) and handgrip strength (aOR 1.02) were significantly associated with happiness. Thus, ensuring the elderly population in receiving emotional support and active social engagement among them can enhance their happiness level.
Fulltext Healthcare Utilization and Knee Osteoarthritis Symptoms among Urban Older Malaysian

Kamsan SS, Singh DKA, Tan MP, Kumar S

Int J Environ Res Public Health, 2021 04 04;18(7).
PMID: 33916628 DOI: 10.3390/ijerph18073777

Knee osteoarthritis (OA) is a prevalent chronic disorder in the older population. While timely management is important to minimize the consequences of knee OA, information on the utilization of healthcare services among this population remains limited. Therefore, the objectives of this study were to determine the healthcare utilization and its associated factors in older persons with knee OA. Cross-sectional data from 1073 participants aged 60 years and above from the Malaysian Elders Longitudinal Research (MELoR) study were included. The utilization rate of healthcare services was quantified. Factors related to the utilization of healthcare services were determined using logistic regression analysis. Healthcare utilization among participants with knee OA was significantly higher than those without knee OA (p < 0.01). Outpatient usage was higher (p < 0.01) in comparison to inpatient and pharmacotherapy. Being married and having an income were significantly associated with seeking outpatient care (OR: 11.136, 95% CI: 1.73-52.82, p < 0.01) and pharmacotherapy (OR: 10.439, 95% CI: 1.187-91.812, p < 0.05), while females were less likely to utilize inpatient care services (OR: 0.126, 95% CI: 0.021-0.746, p < 0.05). The higher rate of healthcare utilization among older persons with knee OA indicates the increased healthcare needs of this population, who are commonly assumed to suffer from a benign disease.
Fulltext Invasive Weed Asystasia gangetica as a Potential Biomonitor and a Phytoremediator of Potentially Toxic Metals: A Case Study in Peninsular Malaysia

Yap CK, Chew W, Al-Mutairi KA, Al-Shami SA, Nulit R, Ibrahim MH, et al.

Int J Environ Res Public Health, 2021 04 28;18(9).
PMID: 33924835 DOI: 10.3390/ijerph18094682

The invasive weed Asystasia gangetica was investigated for its potential as a biomonitor and as a phytoremediator of potentially toxic metals (PTMs) (Cd, Cu, Ni, Pb, and Zn) in Peninsular Malaysia owing to its ecological resistance towards unfavourable environments. The biomonitoring potential of PTMs was determined based on the correlation analysis of the metals in the different parts of the plant (leaves, stems, and roots) and its habitat topsoils. In the roots, the concentrations (mg/kg dry weight) of Cd, Cu, Ni, Pb, and Zn ranged from 0.03 to 2.18, 9.22 to 139, 0.63 to 5.47, 2.43 to 10.5, and 50.7 to 300, respectively. In the leaves, the concentrations (mg/kg dry weight) of Cd, Cu, Ni, Pb, and Zn ranged from 0.03 to 1.16, 7.94 to 20.2, 0.03 to 6.13, 2.10 to 21.8, and 18.8 to 160, respectively. In the stems, the concentrations (mg/kg dry weight) of Cd, Cu, Ni, Pb, and Zn ranged from 0.03 to 1.25, 5.57 to 11.8, 0.23 to 3.69, 0.01 to 7.79, and 26.4 to 246, respectively. On the other hand, the phytoremediation potential of the five metals was estimated based on the bioconcentration factor (BCF) and the translocation factor (TF) values. Correlation analysis revealed that the roots and stems could be used as biomonitors of Cu, the stems as biomonitors of Ni, the roots and leaves as biomonitors of Pb, and all three parts of the plant as biomonitors of Zn. According to the BCF values, in the topsoil, the "easily, freely, leachable, or exchangeable" geochemical fractions of the five metals could be more easily transferred to the roots, leaves, and stems when compared with total concentrations. Based on the TF values of Cd, Ni, and Pb, the metal transfer to the stems (or leaves) from the roots was efficient (>1.0) at most sampling sites. The results of BCF and TF showed that A. gangetica was a good phytoextractor for Cd and Ni, and a good phytostabilizer for Cu, Pb, and Zn. Therefore, A. gangetica is a good candidate as a biomonitor and a phytoremediator of Ni, Pb, and Zn for sustainable contaminant remediation subject to suitable field management strategies.
Fulltext The Inter-Relation of Corporate Social Responsibility at Employee Level, Servant Leadership, and Innovative Work Behavior in the Time of Crisis from the Healthcare Sector of Pakistan

Ahmad N, Scholz M, Arshad MZ, Jafri SKA, Sabir RI, Khan WA, et al.

Int J Environ Res Public Health, 2021 04 27;18(9).
PMID: 33925322 DOI: 10.3390/ijerph18094608

Organizational crisis can serve as a base to provide an opportunity to an organization for enhancing individuals, organizations, and communities. The healthcare sector is one of those sectors that remains under continuous pressure to provide high-quality service delivery to the patients. Hence, the requirement of innovation for this sector is huge when compared to other sectors. The majority of the previous studies have investigated the phenomenon of CSR at the employee's level (CSR-E) to influence employee behavior positively. However, the importance of CSR-E to enhance the innovative capability of the employees at the workplace is not well-explored in extant literature. Moreover, it is not clear from previous studies how the concept of servant leadership can explain the employee's engagement towards innovative work behavior (EIB). Thus, the current survey aims to test the relationship of CSR-E and EIB in the healthcare sector of Pakistan with the mediating effect of servant leadership. The data of the current study were obtained through a self-administered (paper-pencil) survey and they were analyzed through the structural equation modeling (SEM) technique. The empirical results of SEM analysis revealed that CSR-E and EIB are positively related and servant leadership partially mediates this relationship. The findings of the current study will be helpful for policymakers to improve their understanding towards CSR-E to induce EIB in the time of crisis. At the same time, the current study also highlights the importance of servant leadership to the policymakers in encouraging the employees to display their innovative capability at the workplace to serve their organization during the time of crisis.
Fulltext Association of Physicochemical Characteristics, Aggregate Indices, Major Ions, and Trace Elements in Developing Groundwater Quality Index (GWQI) in Agricultural Area

Harun HH, Kasim MRM, Nurhidayu S, Ash'aari ZH, Kusin FM, Karim MKA

Int J Environ Res Public Health, 2021 04 25;18(9).
PMID: 33923119 DOI: 10.3390/ijerph18094562

The aim of this study was to propose a groundwater quality index (GWQI) that presents water quality data as a single number and represents the water quality level. The development of the GWQI in agricultural areas is vital as the groundwater considered as an alternative water source for domestic purposes. The insufficiency of the groundwater quality standard in Malaysia revealed the importance of the GWQI development in determining the quality of groundwater. Groundwater samples were collected from thirteen groundwater wells in the Northern Kuala Langat and the Southern Kuala Langat regions from February 2018 to January 2019. Thirty-four parameters that embodied physicochemical characteristics, aggregate indicator, major ions, and trace elements were considered in the development of the GWQI. Multivariate analysis has been used to finalize the important parameters by using principal component analysis (PCA). Notably, seven parameters-electrical conductivity, chemical oxygen demand (COD), magnesium, calcium, potassium, sodium, and chloride were chosen to evaluate the quality of groundwater. The GWQI was then verified by comparing the groundwater quality in Kota Bharu, Kelantan. A sensitivity analysis was performed on this index to verify its reliability. The sensitivity GWQI has been analyzed and showed high sensitivity to any changes of the pollutant parameters. The development of GWQI should be beneficial to the public, practitioners, and industries. From another angle, this index can help to detect any form of pollution which ultimately could be minimized by controlling the sources of pollutants.
Fulltext Association between Compliance with Movement Behavior Guidelines and Obesity among Malaysian Preschoolers

Lee ST, Wong JE, Chan GKL, Poh BK

Int J Environ Res Public Health, 2021 04 27;18(9).
PMID: 33925298 DOI: 10.3390/ijerph18094611

A daily balance of physical activities, sedentary behaviors and sleep are important for maintaining the health of young children. The aim of this study is to explore the association between 24-h movement behavior of Malaysian children aged 4 to 6 years with weight status. A total of 230 preschoolers were recruited from 22 kindergartens in Kuala Lumpur. Physical activity was assessed by Actical accelerometer while screen time and sleep duration were proxy-reported by parents. Children spent on average 5.5 ± 1.3 h on total physical activity (including 1.0 ± 0.4 h of moderate- vigorous physical activity), 3.0 ± 1.6 h on screen activities and 9.5 ± 1.3 h sleeping daily. The proportion of children who complied with physical activity and sleep guidelines were 48.7% and 55.2%, respectively. About 25.2% of children met screen time recommendation. Only 6.5% of children met all three age-specific physical activity, screen time and sleep guidelines. Children who met any two guidelines were less likely to be overweight or obesity compared to those who did not meet any of the guidelines (OR: 0.276; 95% CI: 0.080-0.950). In conclusion, Malaysian preschoolers have low compliance to movement behavior guidelines, especially in meeting screen time recommendations. Compliance to movement behavior guidelines was associated with lower odds of overweight and obesity.
Fulltext The Interplay of Socioecological Determinants of Work-Life Balance, Subjective Wellbeing and Employee Wellbeing

Wong KP, Lee FCH, Teh PL, Chan AHS

Int J Environ Res Public Health, 2021 04 24;18(9).
PMID: 33923234 DOI: 10.3390/ijerph18094525

Today's workers are struggling to achieve a balance between their work and personal life roles because of both specific needs and limited resources. This study explored the socioecological factors that influence work-life balance (WLB) and how they operate. The relationships between WLB, subjective wellbeing, employee wellbeing and quality time allocation were examined. A total of 1063 responses were received, using an online survey. The results show that relational, community and societal factors directly influenced the individual factors and were indirectly associated with perceived WLB. Individual factors (i.e., personal feelings, behaviours and health) were found to be the crucial determinants of an individual's perceived WLB. It was found that WLB positively correlated with employee wellbeing and quality and quantity of personal life-time. Subjective wellbeing was found to be a significant moderator in the relationship between WLB and its outcomes. This study demonstrated the process of how workers determine their own WLB by applying the socioecological framework for categorising the determinants and suggested new avenues that improve the whole wellbeing of workers and also foster long-term development of organisations.
Fulltext Economic Burden of Stroke Disease: A Systematic Review

Rochmah TN, Rahmawati IT, Dahlui M, Budiarto W, Bilqis N

Int J Environ Res Public Health, 2021 07 15;18(14).
PMID: 34299999 DOI: 10.3390/ijerph18147552

Globally, one of the main causes of non-communicable disease as a cause of death every year is stroke. The objective of this study was to analyze the burden in consequence of stroke. This research used a systematic review method. Furthermore, a search for articles was carried out in June-July 2020. Four databases were used to search articles from 2015 to 2020. Eligible studies were identified, analyzed, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The inclusion criteria were prospective cost studies, retrospective cost studies, database analysis, mathematical models, surveys, and COI studies that assess burden of stroke in primary and referral healthcare (hospital-based). The results showed that from four databases, 9270 articles were obtained, and 13 articles were qualified. A total of 9270 articles had the identified search keywords, but only 13 articles met the set criteria for inclusion. The criteria for inclusion were stroke patients, the economic burden of stroke disease based on cost of illness method, which is approximately equal to USD 1809.51-325,108.84 (direct costs 86.2%, and indirect costs 13.8%). Those that used the health expenditure method did not present the total cost; instead, only either direct or indirect cost of health expenditure were reported. For most hospital admissions due to stroke, LOS (length of stay) was the dominant cost. The high economic burden to manage stroke justifies the promotion and preventive efforts by the policymakers and motivates the practice of healthy lifestyles by the people.
Fulltext Automatic COVID-19 Detection Using Exemplar Hybrid Deep Features with X-ray Images

Barua PD, Muhammad Gowdh NF, Rahmat K, Ramli N, Ng WL, Chan WY, et al.

Int J Environ Res Public Health, 2021 07 29;18(15).
PMID: 34360343 DOI: 10.3390/ijerph18158052

COVID-19 and pneumonia detection using medical images is a topic of immense interest in medical and healthcare research. Various advanced medical imaging and machine learning techniques have been presented to detect these respiratory disorders accurately. In this work, we have proposed a novel COVID-19 detection system using an exemplar and hybrid fused deep feature generator with X-ray images. The proposed Exemplar COVID-19FclNet9 comprises three basic steps: exemplar deep feature generation, iterative feature selection and classification. The novelty of this work is the feature extraction using three pre-trained convolutional neural networks (CNNs) in the presented feature extraction phase. The common aspects of these pre-trained CNNs are that they have three fully connected layers, and these networks are AlexNet, VGG16 and VGG19. The fully connected layer of these networks is used to generate deep features using an exemplar structure, and a nine-feature generation method is obtained. The loss values of these feature extractors are computed, and the best three extractors are selected. The features of the top three fully connected features are merged. An iterative selector is used to select the most informative features. The chosen features are classified using a support vector machine (SVM) classifier. The proposed COVID-19FclNet9 applied nine deep feature extraction methods by using three deep networks together. The most appropriate deep feature generation model selection and iterative feature selection have been employed to utilise their advantages together. By using these techniques, the image classification ability of the used three deep networks has been improved. The presented model is developed using four X-ray image corpora (DB1, DB2, DB3 and DB4) with two, three and four classes. The proposed Exemplar COVID-19FclNet9 achieved a classification accuracy of 97.60%, 89.96%, 98.84% and 99.64% using the SVM classifier with 10-fold cross-validation for four datasets, respectively. Our developed Exemplar COVID-19FclNet9 model has achieved high classification accuracy for all four databases and may be deployed for clinical application.
Fulltext Candida Chorioamnionitis in Mothers with Gestational Diabetes Mellitus: A Report of Two Cases

Shazniza Shaaya E, Halim SAA, Leong KW, Ku KBP, Lim PS, Tan GC, et al.

Int J Environ Res Public Health, 2021 07 13;18(14).
PMID: 34299901 DOI: 10.3390/ijerph18147450

Background:Candida chorioamnionitis is rarely encountered, even though vulvovaginal candidiasis incidence is about 15%. Interestingly, it has characteristic gross and histological findings on the umbilical cord that are not to be missed. Case Report: We report two cases of Candida chorioamnionitis with presence of multiple yellowish and red spots of the surface of the umbilical cord. Microscopically, these consist of microabscesses with evidence of fungal yeasts and pseudohyphae. The yeasts and pseudohyphae were highlighted by periodic acid- Schiff and Grocott methenamine silver histochemical stains. Both cases were associated with a history of gestational diabetes mellitus. Discussion: Peripheral funisitis is a characteristic feature of Candida chorioamnionitis. It is associated with high risk of adverse perinatal and neonatal outcomes, such as preterm delivery, stillbirth and neonatal death. We recommend careful examination of the umbilical cord of mothers with gestational diabetes mellitus.

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