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  1. Fulltext Influence of communication determinants on safety commitment in a high-risk workplace: a systematic literature review of four communication dimensions
    Zara J, Nordin SM, Isha ASN
    Front Public Health, 2023;11:1225995.
    PMID: 37614453 DOI: 10.3389/fpubh.2023.1225995
    Health, safety, and environment (HSE) are critical aspects of any industry, particularly in high-risk environments, such as the oil and gas industry. Continuous accident reports indicate the requirement for the effective implementation of safety rules, regulations, and practices. This systematic literature review examines the relationship between safety communication and safety commitment in high-risk workplaces, specifically focusing on the oil and gas industry. The review comprises 1,439 articles from 2004 to 2023, retrieved from the Scopus and Web of Science databases following the PRISMA comprehensive guidelines. This study considers safety communication, communication climate, and communication satisfaction to evaluate their influence on safety commitment under occupational health and safety. This study identifies safety commitment issues and their underlying factors, discussing measures for preventing and reducing accidents and incidents and highlighting preventive measures for future research. It also signifies the variables influencing accident and incident rates. The research underscores the importance of communication dimensions and the need for workers to possess adequate skills, knowledge, and attitudes regarding occupational safety and health procedures. Moreover, the study contributes to the industrial and academic domains by improving organizational safety commitment, promoting a safety culture, and developing effective communication strategies. Furthermore, practitioners may benefit from this comprehensive overview in developing, evaluating, and enhancing occupational safety.
  2. Fulltext Measuring patients' satisfaction toward health tourism in Malaysia through hospital environment, nutritional advice, and perceived value: A study on Chinese exchange students
    Li L, Ragavan NA, Patwary AK, Baijun W
    Front Public Health, 2022;10:893439.
    PMID: 36016897 DOI: 10.3389/fpubh.2022.893439
    Malaysia is a reputed destination for health tourism in the Asia Pacific region for its hospitable nature and good quality of service. Patients' satisfaction has been a key concern in health tourism to maintain the flow of tourists' arrival for medical purposes. By considering the importance of health tourism and patients' satisfaction in Malaysia, this study aimed to examine the influence of hospital environment, nutritional advice, perceived value on patients' satisfaction. This study is cross-sectional in nature and follows a quantitative approach. The researchers used questionnaires as a survey tool to obtain information from the respondents. The sample of this is chosen from Chinese exchange students in Malaysia. Using a systematic random sampling technique, 205 usable responses were selected from the respondents and proceeded with further analysis. The study conducted structural equation modeling using Smart PLS version 3. The results found that hospital environment, nutritional advice, and perceived value significantly influence patients' satisfaction in Malaysia.
  3. Fulltext The impact of perceived value and affection on Chinese residents' continuous use intention of mobile health science information: An empirical study
    Tian K, Hao L, Xuan W, Phongsatha T, Hao R, Wei W
    Front Public Health, 2023;11:1034231.
    PMID: 36844825 DOI: 10.3389/fpubh.2023.1034231
    INTRODUCTION: Disseminating health science information via the internet has become an essential means for improving Chinese residents' health literacy, which has received constant attention from the Chinese government. Therefore, it is important to explore Chinese residents' perceived value and emotional response to mobile health science information for determining Chinese residents' satisfaction and use intention.

    METHODS: This study applied the cognition-affect-conation model to evaluate the perceived value, arousal, pleasure, trust, satisfaction, and continuous use intention. A mobile device was used to obtain health science information from 236 Chinese residents via an online survey and the data were analyzed using partial least squares (PLS)-structural equation modeling.

    RESULTS: The results showed that Chinese residents' perceived value of health science information obtained using the mobile device directly affect the degree of arousal (β = 0.412, P < 0.001), pleasure (β = 0.215, P < 0.01), and trust (β = 0.339, P < 0.001). The degree of arousal (β = 0.121, P < 0.01), pleasure (β = 0.188, P < 0.01), and trust (β = 0.619, P < 0.001) directly affected Chinese residents' satisfaction, which further affected their continuous use intention (β = 0.513, P < 0.001). Similarly, trust directly affected Chinese residents' continuous use intention (β = 0.323, P < 0.001). The degree of arousal directly affected their degree of pleasure (β = 0.304, P < 0.001), and pleasure also imposed a direct effect on trust (β = 0.293, P < 0.001).

    DISCUSSION: The result of this study provided an academic and practical reference to improve mobile health science popularization information. Affective changes have imposed an important effect on Chinese residents' continuous use intention. High-quality, diversified and frequent use of health science information can significantly increase residents' continuous use intention, improving their health literacy as a consequence.

  4. Fulltext A longitudinal analysis of injury characteristics among elite and amateur tennis players at different tournaments from electronic newspaper reports
    Musa RM, Hassan I, Abdullah MR, Latiff Azmi MN, Abdul Majeed APP, Abu Osman NA
    Front Public Health, 2022;10:835119.
    PMID: 36033746 DOI: 10.3389/fpubh.2022.835119
    The non-complexity of tennis, coupled with its health benefits, renders it appealing and encourages varying competitions at different levels of age, gender, and expertise. However, the rapid increase in the participation rates witnesses a surge in injury occurrences, prompting the need for in-depth analysis to facilitate immediate intervention. We employed a media content analysis technique in which tennis-associated articles published in the last 5 years were examined. A total of 207 news reports were gathered and screened for analysis. Subsequently, 71 articles were excluded from the study due to content duplications or summary updates of existing news articles, while 23 news articles were also excluded from the study due to inappropriateness. Finally, 113 news reports directly related to injury in tennis were coded and analyzed. We examined various types of injuries reported from the screened articles with respect to their status (fresh, recurrent, and recovery) across expertise levels i.e., elite, or amateur. Similarly, the incidence of injury occurrences based on the types of tournaments the players engage in was also investigated. A chi-square analysis was employed to achieve the objectives of the study. Occurrences of tennis-associated injuries are disseminated across expertise levels [ χ ( 18 ) 2 = 16.542; p = 0.555], with knee, hip, elbow, and shoulder injuries being highly prevalent in both elite and amateur players. Nevertheless, it was noted that elite players suffered a staggering 72.60% of injury-related problems, while amateur players sustained 27.40% of injuries. Moreover, the status of injury spreads based on types of tournaments [ χ ( 4 ) 2 = 3.374; p = 0.497], with higher occurrences of fresh and recurrent injuries, while low recovery rates were observed. The findings further demonstrated that injuries are sustained regardless of tournament types [ χ ( 36 ) 2 = 39.393; p = 0.321]. However, most of the injuries occurred at international tournaments (85%). Whereas, only 5.30% of the injuries occurred at national/regional tournaments while 9.70% were unidentified. It could be deduced from the findings of this investigation that elite players are more prone to injuries compared with amateur players. Furthermore, the most common tennis-related injuries affect the lower, trunk, and upper regions of the body, respectively. A large number of the reported tennis injuries are fresh and recurrent, with a few recoveries. The international tennis tournaments are highly attributed to injury occurrences as opposed to the national/regional tournaments. The application of the media-based data mining technique is non-trivial in projecting injury-related problems that could be used to facilitate the development of an injury index peculiar to the tennis sport for prompt intervention.
  5. Fulltext COVID-19 Isolation Control Proposal via UAV and UGV for Crowded Indoor Environments: Assistive Robots in the Shopping Malls
    Aslan MF, Hasikin K, Yusefi A, Durdu A, Sabanci K, Azizan MM
    Front Public Health, 2022;10:855994.
    PMID: 35734764 DOI: 10.3389/fpubh.2022.855994
    Artificial intelligence researchers conducted different studies to reduce the spread of COVID-19. Unlike other studies, this paper isn't for early infection diagnosis, but for preventing the transmission of COVID-19 in social environments. Among the studies on this is regarding social distancing, as this method is proven to prevent COVID-19 to be transmitted from one to another. In the study, Robot Operating System (ROS) simulates a shopping mall using Gazebo, and customers are monitored by Turtlebot and Unmanned Aerial Vehicle (UAV, DJI Tello). Through frames analysis captured by Turtlebot, a particular person is identified and followed at the shopping mall. Turtlebot is a wheeled robot that follows people without contact and is used as a shopping cart. Therefore, a customer doesn't touch the shopping cart that someone else comes into contact with, and also makes his/her shopping easier. The UAV detects people from above and determines the distance between people. In this way, a warning system can be created by detecting places where social distance is neglected. Histogram of Oriented-Gradients (HOG)-Support Vector Machine (SVM) is applied by Turtlebot to detect humans, and Kalman-Filter is used for human tracking. SegNet is performed for semantically detecting people and measuring distance via UAV. This paper proposes a new robotic study to prevent the infection and proved that this system is feasible.
  6. Fulltext Facial Mask Detection Using Depthwise Separable Convolutional Neural Network Model During COVID-19 Pandemic
    Asghar MZ, Albogamy FR, Al-Rakhami MS, Asghar J, Rahmat MK, Alam MM, et al.
    Front Public Health, 2022;10:855254.
    PMID: 35321193 DOI: 10.3389/fpubh.2022.855254
    Deep neural networks have made tremendous strides in the categorization of facial photos in the last several years. Due to the complexity of features, the enormous size of the picture/frame, and the severe inhomogeneity of image data, efficient face image classification using deep convolutional neural networks remains a challenge. Therefore, as data volumes continue to grow, the effective categorization of face photos in a mobile context utilizing advanced deep learning techniques is becoming increasingly important. In the recent past, some Deep Learning (DL) approaches for learning to identify face images have been designed; many of them use convolutional neural networks (CNNs). To address the problem of face mask recognition in facial images, we propose to use a Depthwise Separable Convolution Neural Network based on MobileNet (DWS-based MobileNet). The proposed network utilizes depth-wise separable convolution layers instead of 2D convolution layers. With limited datasets, the DWS-based MobileNet performs exceptionally well. DWS-based MobileNet decreases the number of trainable parameters while enhancing learning performance by adopting a lightweight network. Our technique outperformed the existing state of the art when tested on benchmark datasets. When compared to Full Convolution MobileNet and baseline methods, the results of this study reveal that adopting Depthwise Separable Convolution-based MobileNet significantly improves performance (Acc. = 93.14, Pre. = 92, recall = 92, F-score = 92).
  7. Fulltext Interventions to promote physical activity in older people with type 2 diabetes mellitus: a systematic review
    Sazlina SG, Browning C, Yasin S
    Front Public Health, 2013;1:71.
    PMID: 24392445 DOI: 10.3389/fpubh.2013.00071
    Type 2 diabetes mellitus (T2DM) among people aged 60 years and above is a growing public health problem. Regular physical activity is one of the key elements in the management of T2DM. Recommendations suggest that older people with T2DM will benefit from regular physical activity for better disease control and delaying complications. Despite the known benefits, many remain sedentary. Hence, this review assessed interventions for promoting physical activity in persons aged 65 years and older with T2DM.
  8. Fulltext An Exploratory Qualitative Study With Older Malaysian Stroke Survivors, Caregivers, and Healthcare Practitioners About Falls and Rehabilitation for Falls After Stroke
    Ahmad Ainuddin H, Romli MH, Hamid TA, Sf Salim M, Mackenzie L
    Front Public Health, 2021;9:611814.
    PMID: 33987161 DOI: 10.3389/fpubh.2021.611814
    Background: Studies on rehabilitation for falls after a stroke remain limited despite its impact being profound. This scenario justifies a deeper understanding of why falls in stroke rehabilitation received less attention. Current investigations on the perception of falls and stroke also proved inadequate. Therefore, this study aims to explore the perceptions and experiences of older Malaysian stroke survivors, spousal caregivers, and healthcare practitioners on falls in stroke rehabilitation. Method: A qualitative study of three focus groups with 18 individuals from one community-based stroke rehabilitation center was conducted. The discussions were audio-recorded, video-recorded, transcribed, summarized, and analyzed using thematic analysis. Results: Three themes emerged from the analysis: (i) perceived factors and consequences of falls after stroke, (ii) physical-based interventions predominate in rehabilitation for falls after stroke, and (iii) the role of home hazards in fall prevention is taken for granted. Although, awareness of falls is high, they are regarded as a peripheral issue in stroke. Rehabilitation interventions such as improved functionality are believed to be adequate and can indirectly prevent falls. Other interventions for fall prevention such as home hazards management are relatively less known. Conclusion: There is a need for more attention regarding home environment risk assessment and intervention among healthcare professionals, and more education for clients and caregivers is required. Although, other stroke interventions may also benefit stroke survivors, falls prevention should be a central component in stroke rehabilitation. As this study focused on a specific population, the findings should be validated with larger populations, and in diverse settings.
  9. Fulltext Stroke Rehabilitation for Falls and Risk of Falls in Southeast Asia: A Scoping Review With Stakeholders' Consultation
    Ahmad Ainuddin H, Romli MH, Hamid TA, Salim MSF, Mackenzie L
    Front Public Health, 2021;9:611793.
    PMID: 33748063 DOI: 10.3389/fpubh.2021.611793
    Background: Research on rehabilitation for falls after stroke is warranted. However, published evidence on fall interventions with stroke survivors is limited and these are mainly international studies that may be less relevant for Southeast Asia. Objective: This review aims to systematically identify literature related to stroke rehabilitation for falls and risk of falls in Southeast Asia. Methods: A scoping review with stakeholders' consultation was implemented. An electronic search was conducted up to December 2020 on 4 databases (Medline, CINAHL, Scopus, ASEAN Citation Index). Only original studies conducted in Southeast Asia were selected. Results: The initial search yielded 3,112 articles, however, only 26 were selected in the final analysis. Most of the articles focused on physical rehabilitation and implemented conventional therapies. While the literature may reflect practice in Southeast Asia, stakeholders perceived that the literature was inadequate to show true practice, was not informative and missed several aspects such as functional, cognitive, and psychological interventions in managing falls. Individual-centric interventions dominated the review while community-based and environmental-focused studies were limited. Majority of the articles were written by physiotherapists while others were from physicians, occupational therapists, and an engineer but few from other healthcare practitioners (i.e., speech therapists, psychologists) or disciplines interested in falls. Conclusions: Falls prevention among stroke survivors has received a lack of attention and is perceived as an indirect goal in stroke rehabilitation in Southeast Asia. More innovative research adopted from falls research with older people is needed to advance falls prevention and intervention practice with stroke survivors.
  10. Fulltext Determinants of active aging and quality of life among older adults: systematic review
    Marzo RR, Khanal P, Shrestha S, Mohan D, Myint PK, Su TT
    Front Public Health, 2023;11:1193789.
    PMID: 37435519 DOI: 10.3389/fpubh.2023.1193789
    INTRODUCTION: Population demography across the globe shows an increasing trend in the aging population due to better healthcare, improved nutrition, advanced health-related technology, and decreased fertility rate. Despite these advancements, there remains a knowledge gap in understanding the association between active aging determinants and quality of life (QoL) among older adults, particularly within diverse cultural contexts, which has not been adequately explored in previous research. Therefore, understanding the association between active aging determinants and QoL can help policymakers plan early interventions or programs to assist future older adults in both aging actively and optimizing their quality of life (QoL), as these two factors have a bidirectional relationship.

    OBJECTIVE: This study aimed to review evidence regarding the association between active aging and quality of life (QoL) among older adults and to determine the most widely used study designs and measurement instruments in studies conducted between 2000 and 2020.

    METHODS: Relevant studies were identified by a systematic search of four electronic databases and cross-reference lists. Original studies examining the association between active aging and QoL in individuals aged 60 years or older were considered. The quality of the included studies and the direction and consistency of the association between active aging and QoL were assessed.

    RESULTS: A total of 26 studies met the inclusion criteria and were included in this systematic review. Most studies reported a positive association between active aging and QoL among older adults. Active aging had a consistent association with various QoL domains including physical environment, health and social services, social environment, economic, personal, and behavioral determinants.

    CONCLUSION: Active aging had a positive and consistent association with several QoL domains among older adults, backing the notion that the better the active aging determinants, the better the QoL among older adults. Considering the broader literature, it is necessary to facilitate and encourage the active participation of older adults in physical, social, and economic activities for the maintenance and/or improvement of QoL. Identifying other possible determinants and enhancing the methods to improve those determinants may help improve the QoL among older adults.

  11. Fulltext Knowledge, attitudes, and practices of the general population of Pakistan regarding typhoid conjugate vaccine: findings of a cross-sectional study
    Tahir MJ, Zaman M, Saffi J, Asghar MS, Tariq W, Ahmed F, et al.
    Front Public Health, 2023;11:1151936.
    PMID: 37333546 DOI: 10.3389/fpubh.2023.1151936
    Typhoid fever, a common enteric disease in Pakistan, caused by Salmonella typhi, is becoming an extended drug-resistant organism and is preventable through the typhoid conjugate vaccine (TCV). Public adherence to preventive measures is influenced by knowledge and attitude toward the vaccine. This study investigates the knowledge, attitudes, and practices of the general population of Pakistan toward TCV. The differences in mean scores and factors associated with typhoid conjugate vaccine knowledge, attitudes, and practices were investigated. A total of 918 responses were received with a mean age of 25.9 ± 9.6, 51% were women, and 59.6% had graduation-level education. The majority of them responded that vaccines prevent illness (85.3%) and decrease mortality and disability (92.6%), and typhoid could be prevented by vaccination (86.7%). In total, 77.7 and 80.8% considered TCV safe and effective, respectively. Of 389 participants with children, 53.47% had vaccinated children, according to the extended program on immunization (EPI). Higher family income has a higher odds ratio (OR) for willingness toward booster dose of TCV [crude odds ratio (COR) = 4.920, p-value <0.01; adjusted odds ratio (aOR) = 2.853, value of p <0.001], and negative attitude regarding the protective effect of TCV has less willingness toward the booster dose with statistical significance (COR = 0.388, value of p = 0.017; aOR = 0.198, value of p = 0.011). The general population of Pakistan had a good level of knowledge about the benefits of TCV, and attitude and practices are in favor of the usage of TCV. However, a few religious misconceptions are prevalent in public requiring the efforts to overcome them to promote the usage of vaccines to prevent the disease and antibiotic resistance.
  12. Fulltext Editorial: Health literacy and disease prevention
    Shikha D, Kushwaha P, Gokdemir O, Marzo RR, Bhattacharya S
    Front Public Health, 2023;11:1128257.
    PMID: 37056654 DOI: 10.3389/fpubh.2023.1128257
  13. Fulltext A narrative action on the battle against hunger using mushroom, peanut, and soybean-based wastes
    Mohd Zaini NA, Azizan NAZ, Abd Rahim MH, Jamaludin AA, Raposo A, Raseetha S, et al.
    Front Public Health, 2023;11:1175509.
    PMID: 37250070 DOI: 10.3389/fpubh.2023.1175509
    Numerous generations have been affected by hunger, which still affects hundreds of millions of people worldwide. The hunger crisis is worsening although many efforts have been made to minimize it. Besides that, food waste is one of the critical problems faced by most countries worldwide. It has disrupted the food chain system due to inefficient waste management, while negatively impacting the environment. The majority of the waste is from the food production process, resulting in a net zero production for food manufacturers while also harnessing its potential. Most food production wastes are high in nutritional and functional values, yet most of them end up as low-cost animal feed and plant fertilizers. This review identified key emerging wastes from the production line of mushroom, peanut, and soybean (MPS). These wastes (MPS) provide a new source for food conversion due to their high nutritional content, which contributes to a circular economy in the post-pandemic era and ensures food security. In order to achieve carbon neutrality and effective waste management for the production of alternative foods, biotechnological processes such as digestive, fermentative, and enzymatic conversions are essential. The article provides a narrative action on the critical potential application and challenges of MPS as future foods in the battle against hunger.
  14. Fulltext Factors influencing parents' hesitancy to vaccinate their children aged 5-11 years old against COVID-19: results from a cross-sectional study in Malaysia
    Marzo RR, Chakraborty R, Soh SY, Thew HZ, Chong C, Siau CS, et al.
    Front Public Health, 2023;11:1091015.
    PMID: 37261237 DOI: 10.3389/fpubh.2023.1091015
    INTRODUCTION: Vaccination programs have been rolled out across the globe to contain and mitigate the spread of the COVID-19 infection. Until recently, such programs were limited to adults and the older population, thereby limiting children from getting vaccinated. Recently, the Malaysian government rolled out vaccination for children aged 5-11 years. However, there are certain factors that might affect vaccination uptake among children. This study explores factors influencing parents' hesitancy to vaccinate children in Malaysia.

    METHOD: A nationwide online cross-sectional convenience sampling survey from April 21, 2022 to June 3, 2022 was conducted. The study used descriptive statistics to inform about vaccine hesitancy among parents. Cross-tabulation was performed to calculate the frequency and percentage of vaccine hesitancy, quality of life, e-health literacy, and the 5C psychological antecedents of vaccination among parents with children 5-11 years in Malaysia. Graphical methods were used to portray the levels of e-health literacy and levels of 5C psychological antecedents of vaccination. The study used both bi-variate and multivariate analysis to understand the relationship between vaccine hesitancy and the socio-demo-economic factors, quality of life, e-health literacy and 5C psychological antecedents.

    RESULTS: Of 382 participants, almost one-third (33%) of participants reported vaccine hesitancy for their children. For 5C's psychological antecedents of vaccination, around one quarter (26.96%) reported disagreement for confidence in vaccination, almost half (52.36%) reported disagreement for vaccination complacency, three-fifths (60.99%) reported vaccination constraint, one quarter (25.92%) reported calculation antecedent, and almost one-third reported disagreement over collective responsibility antecedent (25.92%). Chi-square test revealed that gender, employment status, and parents' COVID-19 vaccination status were significantly associated (p<0.05) with vaccine hesitancy among parents. Assessing the influence of transactional e-health literacy, only the communication component contained a significant association (p<0.05). Among the 5C psychological antecedents, confidence, calculation, and collective responsibility were significantly associated (p<0.05) with vaccine hesitancy. Parents with secondary [OR: 8.80; CI: 2.44-31.79, (p<0.05)], post-secondary [OR: 5.21; CI: 2.10-13.41, (p<0.05)], and tertiary education [OR: 6.77; CI: 2.25-20.35, (p<0.05)] had significantly higher likelihood of vaccine hesitancy than those with primary education.

    CONCLUSION: Highly educated parents are more skeptical and are more likely to perceive the vaccine as unsafe and ineffective for their children. It is critical to disseminate the required information about the vaccine safety to the educated group.

  15. Fulltext Associations between biopsychosocial factors and transportation patterns of older adults residing in Klang Valley, Malaysia
    Mohd Rosnu NS, Ishak WS, Abd Rahman MH, Shahar S, Musselwhite C, Mat Ludin AF, et al.
    Front Public Health, 2023;11:1153822.
    PMID: 37275505 DOI: 10.3389/fpubh.2023.1153822
    INTRODUCTION: Aging is associated with physiological changes in multiple systems in the body and may impact the transportation choices of older adults. In this study, we examine the associations between biopsychosocial factors and the transportation choices of Malaysian older adults.

    METHODS: One hundred and nineteen (119) older adults, aged 60 and above, living in Klang Valley, Malaysia were recruited for this cross-sectional study. Participants were interviewed face-to-face to obtain sociodemographic data, health status (whether there were and, if yes, the number of comorbidities), outdoor mobility and transportation patterns, Instrumental Activity Daily Living (IADL) status and cognitive function. Participants' physical performance (dominant handgrip strength, 10-m walk, and timed up and go tests), hearing threshold (pure tone audiometry), and vision function (visual acuity, contrast sensitivity) were measured. Transportation patterns of older adults were categorized into three groups, that is, flexible (using public transport and/or private vehicles), using only private vehicles and restricted (relying on others or walking).

    RESULTS: Further information is needed to enable such older adults as older women, those with comorbidities and poorer functional status to access transportation, especially to meet their health care needs.

    DISCUSSION: The majority (51%) of participants were in the 'using only private vehicles' group, followed by the 'flexibles' (25%) and the 'restricted' (24%). Factors significantly associated with the restricted transportation group were: (a) being female (AdjOR 15.39, 95% CI 0.86-23.39, p 

  16. Fulltext Cardiometabolic risk factors among children who are affected by overweight, obesity and severe obesity
    Nur Zati Iwani AK, Jalaludin MY, Roslan FA, Mansor F, Md Zain F, Hong JYH, et al.
    Front Public Health, 2023;11:1097675.
    PMID: 37181686 DOI: 10.3389/fpubh.2023.1097675
    BACKGROUND: The increasing severity of obesity is expected to lead to more serious health effects. However, there is limited information on the prevalence and clinical characteristics of cardiometabolic risk factors in severely children affected by obesity in Malaysia. This baseline study aimed to investigate the prevalence of these factors and their association with obesity status among young children.

    METHODS: In this study, a cross-sectional design was employed using the baseline data obtained from the My Body Is Fit and Fabulous at school (MyBFF@school) intervention program involving obese school children. Obesity status was defined using the body mass index (BMI) z-score from the World Health Organization (WHO) growth chart. Cardiometabolic risk factors presented in this study included fasting plasma glucose (FPG), triglycerides (TGs), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), blood pressure, acanthosis nigricans, insulin resistance (IR), and MetS. MetS was defined using the International Diabetes Federation (IDF) 2007 criteria. Descriptive data were presented accordingly. The association between cardiometabolic risk factors, such as obesity status, and acanthosis nigricans with MetS was measured using multivariate logistic regression, which was adjusted for gender, ethnicity, and strata.

    RESULTS: Out of 924 children, 38.4% (n = 355) were overweight, 43.6% (n = 403) were obese, and 18% (n = 166) were severely obese. The overall mean age was 9.9 ± 0.8 years. The prevalence of hypertension, high FPG, hypertriglyceridemia, low HDL-C, and the presence of acanthosis nigricans among severely children affected by obesity was 1.8%, 5.4%, 10.2%, 42.8%, and 83.7%, respectively. The prevalence of children affected by obesity who were at risk of MetS in <10-year-old and MetS >10-year-old was observed to be similar at 4.8%. Severely children affected by obesity had higher odds of high FPG [odds ratio (OR) = 3.27; 95% confdence interval (CI) 1.12, 9.55], hypertriglyceridemia (OR = 3.50; 95%CI 1.61, 7.64), low HDL-C (OR = 2.65; 95%CI 1.77, 3.98), acanthosis nigricans (OR = 13.49; 95%CI 8.26, 22.04), IR (OR = 14.35; 95%CI 8.84, 23.30), and MetS (OR = 14.03; 95%CI 3.97, 49.54) compared to overweight and children affected by obesity. The BMI z-score, waist circumference (WC), and percentage body fat showed a significant correlation with triglycerides, HDL-C, the TG: HDL-C ratio, and the homeostatic model assessment for IR (HOMA-IR) index.

    CONCLUSIONS: Severely children affected by obesity exhibit a higher prevalence of and are more likely to develop cardiometabolic risk factors compared to overweight and children affected by obesity. This group of children should be monitored closely and screened periodically for obesity-related health problems to institute early and comprehensive intervention.

  17. Fulltext The role of the university in recovering from COVID-19 and preparing for future crises-perspectives and experiences from Sunway University, Malaysia
    Renganathan E, Guinto R, Mahmood J, Lacey-Hall O, Veerakumarasivam A, Poppema S
    Front Public Health, 2023;11:1072823.
    PMID: 37168072 DOI: 10.3389/fpubh.2023.1072823
    This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. Universities, as engines of knowledge creation and dissemination and as incubators of disciplined yet original thinking, have a key role to play in tackling the most complex challenges that societies and our planet face, from infectious diseases to the climate emergency. This commentary presents the perspectives from Sunway University, a young private university in Malaysia that made a strong commitment to the sustainable development goals (SDGs) prior to the pandemic, and its experiences in promoting research, innovation, and learning as part of COVID-19 recovery and in preparation for future crises such as the climate emergency. Some of the university's initiatives include embracing the planetary health approach, reviving essential public health functions, exploring pandemic resilience, addressing 'infodemics' and promoting science diplomacy. The example of Sunway University provides some insights on the opportunities and challenges that academic institutions face as they seek to reorient the paradigm of education, research, and service away from disciplinary siloes and towards a more integrated, preventive, accessible and translational approach.
  18. Fulltext Editorial: Women in science: Public Health Education and Promotion 2022
    Caron RM, Jamshed SQ, Goodman MS, Kang S
    Front Public Health, 2023;11:1204113.
    PMID: 37213627 DOI: 10.3389/fpubh.2023.1204113
  19. Fulltext Eighteen months into the COVID-19 pandemic: The prevalence of depression, anxiety, and stress symptoms in Southeast Asia and the associated demographic factors
    Tay WWY, Jesuthasan J, Wan KS, Ong T, Mustapha F
    Front Public Health, 2022;10:863323.
    PMID: 35991032 DOI: 10.3389/fpubh.2022.863323
    Mental health has become a growing concern in the wake of the COVID-19 pandemic. We sought to determine the prevalence of mental health symptoms 18 months after the pandemic's declaration. Our cross-sectional study conducted among 18- to 65-year-old adults (N = 33,454) in October 2021 using the Depression, Anxiety and Stress Scales (DASS-21) found a high prevalence of severe to extremely severe anxiety (49%), depression (47%) and stress (36%) symptoms in Malaysia, Indonesia, Thailand, and Singapore. Multiple logistic regression showed that female and non-binary genders were associated with increased odds of severe/extremely severe symptoms of anxiety (female: aOR 1.44 [95% CI 1.37-1.52]; non-binary aOR 1.46 [1.16-1.84]), depression (female: aOR 1.39 [1.32-1.47]; non-binary aOR 1.42 [1.13-1.79]), and stress (female: aOR 1.48 [CI 1.40-1.57]; non-binary aOR 1.42 [1.12-1.78]). In all three symptom domains, the odds of severe/extremely severe symptoms decreased across age groups. Middle- and high-income respondents had lower odds of reporting severe/extremely severe anxiety (middle-income: aOR 0.79 [0.75-0.84]; high-income aOR 0.77 [0.69-0.86]) and depression (middle-income: aOR 0.85 [0.80-0.90]; high-income aOR 0.84 [0.76-0.94]) symptoms compared to low-income respondents, while only middle-income respondents had lower odds of experiencing severe/extremely severe stress symptoms (aOR 0.89 [0.84-0.95]). Compared to residents of Malaysia, residents of Indonesia were more likely to experience severe/extremely severe anxiety symptoms (aOR 1.08 [1.03-1.15]) but less likely to experience depression (aOR 0.69 [0.65-0.73]) or stress symptoms (aOR 0.92 [0.87-0.97]). Respondents living in Singapore had increased odds of reporting severe/extremely severe depression symptoms (aOR 1.33 [1.16-1.52]), while respondents residing in Thailand were more likely to experience severe/extremely severe stress symptoms (aOR 1.46 [1.37-1.55]). This study provides insights into the impacts of the COVID-19 pandemic on the point prevalence of psychological distress in Southeast Asia one and a half years after the beginning of the pandemic.
  20. Fulltext Knowledge, Perceptions and Behaviors Related to COVID-19 in a University Setting in Malaysia
    Lee KW, Yap SF, Ong HT, Leong PP, Mohamad Hatta N, Lye MS
    Front Public Health, 2022;10:873022.
    PMID: 35480574 DOI: 10.3389/fpubh.2022.873022
    BACKGROUND: In Malaysia the COVID-19 disease (COVID-19) has continued to escalate since its first detection in late January 2020, despite widespread implementation of control measures. This study aims to determine the knowledge, perception and behaviors with respect to COVID-19 in the midst of the third wave of the infection.

    METHODS: A cross-sectional study was carried out among staffs and students of Universiti Tunku Abdul Rahman (UTAR). The survey consists of basic sociodemographic information, 22 items on knowledge on COVID-19, 3 items on perceived self-risk, 2 items on preparedness & perceived self-efficacy, 10 items on preventive (own) measures, 9 items assessing unwanted and desirable behaviors during the pandemic. Simple and multiple linear regression were performed to determine the factors associated with knowledge, preventive measures adopted, self-risk perception, preparedness & perceived self-efficacy, and behaviors.

    RESULTS: A total of 434 responded to the survey of whom the majority (85.1%) had high scores for knowledge (mean score of 18.72 out of 22). A significant positive association was found between knowledge and older age (adjusted B coefficient (SE) = 0.046 (0.022), p = 0.039), those from medical faculty (adjusted B coefficient (SE) = 0.870 (0.420), p = 0.039) and residence in high-risk areas (adjusted B coefficient (SE) = 0.831 (0.295), p = 0.005). Predictors for higher perception of COVID-19 risk included presence of COVID-19 cases among social contacts (adjusted B coefficient (SE) = 0.751 (0.308), p = 0.015) and living with elderly (adjusted B coefficient (SE) = 1.137 (0.296), p < 0.001), while that for perception of preparedness and self-efficacy were living with children (adjusted Beta coefficient (SE) = 0.440 (0.173), p = 0.011) and absence of positive cases among social contacts (adjusted B coefficient (SE) = 0.418 (0.183), p = 0.023). Good preventive measures among the respondents were positively associated with knowledge (adjusted B coefficient (SE) = 0.116 (0.025), p < 0.001), as well as with female gender (adjusted B coefficient (SE) = 0.348 (0.142), p = 0.014). Unwanted behavior was significantly associated with male gender (adjusted B coefficient (SE) = 0.664 (0.321), p = 0.039) and COVID-19 positive status (adjusted B coefficient (SE) = 9.736 (3.297), p = 0.003). Knowledge of COVID-19 (adjusted B coefficient (SE) = 0.069 (0.035), p = 0.048) and being married (adjusted B coefficient (SE) = 0.917 (0.462), p = 0.048) were the predictors of desirable behavior.

    CONCLUSION: Overall, the UTAR community had demonstrated a good level of knowledge and preventive behaviors, albeit with some areas for improvement.

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