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Fulltext Risk Perception of SARS-CoV-2 Infection and Implementation of Various Protective Measures by Dentists Across Various Countries

Marya A, Karobari MI, Selvaraj S, Adil AH, Assiry AA, Rabaan AA, et al.

Int J Environ Res Public Health, 2021 May 29;18(11).
PMID: 34072456 DOI: 10.3390/ijerph18115848

OBJECTIVE: Healthcare workers in general are at a high risk of potential infections with COVID-19, especially those who work with aerosol generating procedures. Dentists fall in this category, as not only do they operate with aerosol generating procedures but also operate within a face-to-face contact area.
METHODS: A structured self-administered questionnaire was developed at Najran University and provided to the participants for data collection. The data collected included information on risk perception and incorporation of measures for protection against COVID-19 to gauge the attitude of dentists during this period. Also, clinical implementation of various protective measures was reviewed.
RESULTS: Of the n = 322 dentists that answered the questions, 50% were general dentists and 28.9% were dentists working at specialist clinics, while the remaining 21.1% of dentists were employed in academic institutions. Among the newer additions to the clinic, 36.3% of dentists answered that they had added atomizers to their practices, followed by 26.4% of dentists that had incorporated the use of UV lamps for sterilization. We found that 18.9% dentists were using HEPA filters in their clinics, while 9.9% of dentists were making use of fumigation devices to control the risk of infection. One-way ANOVA was also carried out to demonstrate that there was a statistically significant difference (p = 0.049) between groups of dentists utilizing HEPA filters, UV lamps, atomizers, and fumigation devices to prevent the spread of SARS-CoV2 across their workplaces.
CONCLUSION: Dentists are aware of recently updated knowledge about the modes of transmission of COVID-19 and the recommended infection control measures in dental settings. A better understanding of the situation and methods to prevent it will ensure that the dental community is able to provide healthcare services to patients during the pandemic.
Fulltext Pregnancy and COVID-19 Pandemic Perception in Malaysia: A Cross-Sectional Study

Syed Anwar Aly SA, Abdul Rahman R, Sharip S, Shah SA, Abdullah Mahdy Z, Kalok A

Int J Environ Res Public Health, 2021 May 27;18(11).
PMID: 34072017 DOI: 10.3390/ijerph18115762

Pregnant women are susceptible to COVID-19 complications due to gestation-related physiological changes. We aimed to evaluate the level of maternal knowledge, perception, and practice during the pandemic. A cross-sectional study was conducted during the Malaysian Movement Control Order (MCO) between April and June 2020. A self-administered electronic questionnaire that included the knowledge and practice domains was distributed. A newly designed set of questions was used to evaluate (1) women's perception of MCO and (2) maternal experience, which was subdivided into clinical care provision and maternal anxiety. The survey response rate was 93% with the final number for analysis of 415. The majority of women (95%) demonstrated an adequate level of knowledge on COVID-19, whilst 99% had a good practice. We found that tertiary education (p < 0.001), employment status (p = 0.03), higher household income (p < 0.001), and multiple sources of information (p < 0.001) were independent predictors of adequate maternal knowledge on COVID-19. Women with adequate knowledge also reported a more positive perception of MCO (p < 0.001) and better obstetric care experience (p = 0.037), as did those of Malay ethnicity. Younger (p < 0.001) and nulliparous (p = 0.01) women demonstrated greater anxiety levels. The majority of our women reported good practice and adequate knowledge, which contributed to a positive perception of MCO and better maternal obstetric experience. First-time mothers may benefit from extra support and reassurance during the pandemic to alleviate maternal anxiety.
Fulltext Survival and Characteristics of Bladder Cancer: Analysis of the Malaysian National Cancer Registry

Nik Ab Kadir MN, Mohd Hairon S, Yaacob NM, Ab Manan A, Ali N

Int J Environ Res Public Health, 2021 05 14;18(10).
PMID: 34069096 DOI: 10.3390/ijerph18105237

BACKGROUND: Bladder cancer ranked ninth of principal male cancer in Malaysia. This study aimed to evaluate the clinical characteristics and survival of bladder cancer patients in Malaysia.
METHODS: A retrospective cohort study was conducted by obtaining records in the Malaysian National Cancer Registry. Patients aged 15 years old and above with diagnosis date between 2007 and 2011 were included. Death was updated until 31 December 2016. Five-year observed survival and median survival time were determined by the life table method and Kaplan-Meier estimate method.
RESULTS: Among 1828 cases, the mean (SD) age of diagnosis was 64.9 (12.5) years. The patients were predominantly men (78.7%), Malay ethnicity (49.4%) and transitional cell carcinoma (78.2%). Only 14.8% of patients were at stage I. The overall five-year observed survival and median survival time was 36.9% (95% CI: 34.6, 39.1) and 27.3 months (95% CI: 23.6, 31.0). The highest five-year observed survival recorded at stage I (67.6%, 95% CI: 62.0, 73.3) and markedly worsen at stage II (34.3%, 95% CI: 27.9, 40.8), III (25.7%, 95% CI: 18.7, 32.6) and IV (12.2%, 95% CI: 8.1, 16.3).
CONCLUSIONS: Survival of bladder cancer patients in Malaysia was lower with advancing stage. The cancer control programme should be enhanced to improve survival.
Fulltext Baseline Optical Coherence Tomography Parameters That May Influence 6 Months Treatment Outcome of Polypoidal Choroidal Vasculopathy Eyes with Combination Therapy: A Short-Term Pilot Study

Ghoshal R, Sharanjeet-Kaur S, Fadzil NM, Ghosh S, Ngah N, Aziz RAA

Int J Environ Res Public Health, 2021 05 18;18(10).
PMID: 34070071 DOI: 10.3390/ijerph18105378

Although optical coherence tomography (OCT) parameters have assisted in the diagnosis of polypoidal choroidal vasculopathy (PCV), its potential to evaluate treatment outcomes has not been established. The purpose of this pilot study was to evaluate baseline OCT parameters that may influence treatment outcome in PCV eyes with combination therapy. In this single-centered, prospective study, patients were recruited with at least one treatment-naïve PCV eye and treated with combination therapy of intravitreal anti-vascular endothelial growth factor and photodynamic therapy. Best-corrected distance and near visual acuity (DVA and NVA), and contrast sensitivity (CS) were recorded at baseline and six months after treatment. OCT parameters were determined. Twenty-six eyes of 26 patients aged between 51 to 83 years were evaluated. In eyes that had disrupted external limiting membrane (ELM), photoreceptors inner and outer segment (IS-OS) junction at 1000 micron of fovea at baseline showed low mean visual functions after 6 months of treatment. Eyes with foveal sub-retinal fluid (SRF) and polyp at central 1000 micron of fovea at baseline showed significantly worse DVA and CS after six months. Thus, the presence of foveal SRF, foveal polyp, disrupted ELM, and IS-OS junction at baseline significantly influenced the six months' visual outcome in PCV eyes treated with combination therapy.
Fulltext Comparison of Joint Effect of Acute and Chronic Toxicity for Combined Assessment of Heavy Metals on Photobacterium sp.NAA-MIE

Adnan NA, Halmi MIE, Abd Gani SS, Zaidan UH, Abd Shukor MY

Int J Environ Res Public Health, 2021 06 21;18(12).
PMID: 34205553 DOI: 10.3390/ijerph18126644

Predicting the crucial effect of single metal pollutants against the aquatic ecosystem has been highly debatable for decades. However, dealing with complex metal mixtures management in toxicological studies creates a challenge, as heavy metals may evoke greater toxicity on interactions with other constituents rather than individually low acting concentrations. Moreover, the toxicity mechanisms are different between short term and long term exposure of the metal toxicant. In this study, acute and chronic toxicity based on luminescence inhibition assay using newly isolated Photobacterium sp.NAA-MIE as the indicator are presented. Photobacterium sp.NAA-MIE was exposed to the mixture at a predetermined ratio of 1:1. TU (Toxicity Unit) and MTI (Mixture Toxic Index) approach presented the mixture toxicity of Hg2+ + Ag+, Hg2+ + Cu2+, Ag+ + Cu2+, Hg2+ + Ag+ + Cu2+, and Cd2+ + Cu2+ showed antagonistic effect over acute and chronic test. Binary mixture of Cu2+ + Zn2+ was observed to show additive effect at acute test and antagonistic effect at chronic test while mixture of Ni2+ + Zn2+ showing antagonistic effect during acute test and synergistic effect during chronic test. Thus, the strain is suitable and their use as bioassay to predict the risk assessment of heavy metal under acute toxicity without abandoning the advantage of chronic toxicity extrapolation.
Fulltext Physical Activity, Sedentary Behavior, and Weight Status of University Students during the COVID-19 Lockdown: A Cross-National Comparative Study

Tan ST, Tan CX, Tan SS

Int J Environ Res Public Health, 2021 07 03;18(13).
PMID: 34281062 DOI: 10.3390/ijerph18137125

The temporary closure of learning institutions during the COVID-19 pandemic has dramatically reduced the physical activity of students across all ages. Therefore, this study aimed to investigate the prevalence of physical inactivity and the patterns of physical activity among university students in confinement. This cross-sectional study involved 147 Malaysian students and 107 Indonesian students. Body weight before the pandemic and during the pandemic was self-reported by the respondents, and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to assess the physical activity and sedentary behavior of the respondents. The findings revealed that 79.6% of Malaysians and 77.6% of Indonesians were physically active during the confinement. There was no significant difference (p < 0.05) in the duration devoted to vigorous-intensity activity (MMalaysian = 0.00 MET minutes/week and MIndonesian = 480.00 MET minutes/week) and moderate-intensity activity (MMalaysian = 0.00 MET minutes/week and MIndonesian = 0.00 MET minutes/week) among the studied population. During the pandemic, Malaysian students (M = 1386.00 MET minutes/week) devoted a significantly higher duration to walking (M = 1386.00 MET minutes/week) and sedentary behavior (9.16 ± 4.47 h/day) than Indonesian students (M = 990.00 MET minutes/week and sedentary behavior = 7.85 ± 4.27 h/day). Overall, no significant difference was noted in the total physical activity of Malaysian and Indonesian students during the pandemic (MMalaysian = 2826.00 MET minutes/week and MIndonesian = 1782.00 MET minutes/week). Findings from Spearman's rank correlation test suggested that there was a weak inverse correlation between the duration engaged in vigorous-intensity activity and weight change among the Malaysian students (rs = -0.199, p = 0.016), after adjusting for gender and age. Overall, the closure of learning institutions and exercise facilities has further prevented individuals from complying with the WHO recommendation of moderate-to-vigorous physical activity during the period of home confinement.
Fulltext Physical Activity among Adults Residing in 11 Countries during the COVID-19 Pandemic Lockdown

Ding K, Yang J, Chin MK, Sullivan L, Durstine JL, Violant-Holz V, et al.

Int J Environ Res Public Health, 2021 Jul 01;18(13).
PMID: 34280992 DOI: 10.3390/ijerph18137056

During the novel coronavirus (COVID-19) pandemic, physical activity (PA) behaviors were altered worldwide due to public health measures such as "lockdown." This study described PA among adults residing in 11 countries during COVID-19 lockdown and examined factors associated with PA engagement. We conducted a cross-sectional anonymous survey among adults (≥18 years old) in 11 countries (Brazil, Bulgaria, China, India, Ireland, Malaysia, North Macedonia, Singapore, Spain, Turkey, United States). Of 11,775 participants, 63.7% were female and 52.8% were 18-34 years old. More than 40% of participants were insufficiently active (43.9%) and reported a decrease in their PA during lockdown (44.8%). Statistically significant differences were observed in (1) proportions of participants being insufficiently active, (2) level of PA, and (3) decrease in PA across the 11 countries. More stringent governmental policy responses were associated with greater likelihood of being insufficiently active during lockdown (adjusted odds ratio = 1.22, 95% confidence interval = 1.03, 1.45). Higher depression or anxiety scores were associated with greater likelihood of decreased level of PA during lockdown.We found substantial reductions in PA levels during COVID-19 lockdown across countries. Country-specific PA promotion interventions are needed during this and similar global emergencies.
Fulltext Relationship between Mindfulness, Psychological Skills, and Mental Toughness in College Athletes

Wu CH, Nien JT, Lin CY, Nien YH, Kuan G, Wu TY, et al.

Int J Environ Res Public Health, 2021 06 24;18(13).
PMID: 34202770 DOI: 10.3390/ijerph18136802

Numerous studies have shown that dispositional mindfulness is positively associated with many mental abilities related to sports performance, including psychological skills and mental toughness. The purpose of this study was to explore the relationship between dispositional mindfulness, psychological skills, and mental toughness among different types of athletes. For this cross-sectional study, 101 college athletes were recruited. Their dispositional mindfulness, psychological skills, and mental toughness were measured by the Mindfulness Attention Awareness Scale (MAAS), Athletic Psychological Skills Inventory (APSI), and Traits of Mental Toughness Inventory for Sports Scale (TMTIS). Pearson's correlation was used to calculate how dispositional mindfulness is associated with psychological skills and mental toughness. The results revealed that dispositional mindfulness is positively associated with comprehensive APSI (r = 0.21-0.36, p < 0.05), TMTIS overall (r = 0.27, p < 0.01), positive effort (r = 0.26, p = 0.01), and pressure (r = 0.30, p < 0.01). These findings suggest a positive linkage between mindfulness and the two examined psychological characteristics related to sports performance. Other approaches to increase mindfulness may be considered in the future.
Fulltext Mixed POT-BM Approach for Modeling Unhealthy Air Pollution Events

Masseran N, Safari MAM

Int J Environ Res Public Health, 2021 06 23;18(13).
PMID: 34201763 DOI: 10.3390/ijerph18136754

This article proposes a novel data selection technique called the mixed peak-over-threshold-block-maxima (POT-BM) approach for modeling unhealthy air pollution events. The POT technique is employed to obtain a group of blocks containing data points satisfying extreme-event criteria that are greater than a particular threshold u. The selected groups are defined as POT blocks. In parallel with that, a declustering technique is used to overcome the problem of dependency behaviors that occurs among adjacent POT blocks. Finally, the BM concept is integrated to determine the maximum data points for each POT block. Results show that the extreme data points determined by the mixed POT-BM approach satisfy the independent properties of extreme events, with satisfactory fitted model precision results. Overall, this study concludes that the mixed POT-BM approach provides a balanced tradeoff between bias and variance in the statistical modeling of extreme-value events. A case study was conducted by modeling an extreme event based on unhealthy air pollution events with a threshold u > 100 in Klang, Malaysia.
Fulltext Effects of Group and Individual Culturally Adapted Cognitive Behavioral Therapy on Depression and Sexual Satisfaction among Perimenopausal Women

Khoshbooii R, Hassan SA, Deylami N, Muhamad R, Engku Kamarudin EM, Alareqe NA

Int J Environ Res Public Health, 2021 07 20;18(14).
PMID: 34300161 DOI: 10.3390/ijerph18147711

AIMS: Previous research has shown the efficacy of culturally adapted Cognitive Behavioral Therapy (CA-CBT) in reducing depression, yet its effect on increasing sexual satisfaction is not well documented. In this study, an embedded randomized controlled trial design was used to examine the effect of group and individual CA-CBT on depression and sexual satisfaction among perimenopausal women.
METHOD: A total of 64 depressed Iranian perimenopausal women were randomly assigned to two formats of treatments; sixteen sessions of group CA-CBT and eight sessions of individual CA-CBT, as well as a waitlist control group. Depression and sexual satisfaction were measured using BDI-II and ENRICH, respectively, at T1 (pre-treatment), T2 (post-treatment) and T3 (follow-up).
RESULTS: Repeated measures ANOVA indicated that the women who underwent both group and individual CA-CBT had effectively reduced depression and increased sexual satisfaction between pre-treatment and post-treatment, and it was sustained after six months of follow-ups with large effect sizes of significant differences (p < 0.001), but the control group did not.
CONCLUSION: The results showed promising evidence for the efficacy of both treatment groups of CA-CBT for depression and sexual satisfaction among perimenopausal women. The population mental health burden among perimenopausal women may likely be reduced by propagating this effective treatment.
Fulltext LSTM Networks to Improve the Prediction of Harmful Algal Blooms in the West Coast of Sabah

Yussof FN, Maan N, Md Reba MN

Int J Environ Res Public Health, 2021 07 19;18(14).
PMID: 34300100 DOI: 10.3390/ijerph18147650

Harmful algal bloom (HAB) events have alarmed authorities of human health that have caused severe illness and fatalities, death of marine organisms, and massive fish killings. This work aimed to perform the long short-term memory (LSTM) method and convolution neural network (CNN) method to predict the HAB events in the West Coast of Sabah. The results showed that this method could be used to predict satellite time series data in which previous studies only used vector data. This paper also could identify and predict whether there is HAB occurrence in the region. A chlorophyll a concentration (Chl-a; mg/L) variable was used as an HAB indicator, where the data were obtained from MODIS and GEBCO bathymetry. The eight-day dataset interval was from January 2003 to December 2018. The results obtained showed that the LSTM model outperformed the CNN model in terms of accuracy using RMSE and the correlation coefficient r as the statistical criteria.
Fulltext Investigating the Antioxidant and Cytocompatibility of Mimusops elengi Linn Extract over Human Gingival Fibroblast Cells

Bhavikatti SK, Karobari MI, Zainuddin SLA, Marya A, Nadaf SJ, Sawant VJ, et al.

Int J Environ Res Public Health, 2021 07 04;18(13).
PMID: 34281099 DOI: 10.3390/ijerph18137162

Background-chlorhexidine (CHX) is most commonly used as a chemical plaque control agent. Nevertheless, its adverse effects, including teeth discoloration, taste alteration and calculus build-up, limit its use and divert us to medicinal herbs. The purpose of the study was to evaluate the phytochemical composition, antioxidant potential, and cytotoxic effects of Mimusops elengi Linn extract (ME) over normal human cultured adult gingival fibroblasts (HGFs). Methods-in vitro phytochemical screening, total flavonoid content, antioxidant potential by DPPH and Nitric Oxide (NO) radical scavenging activity, and cytotoxic effects of ME extracts over HGF were explored. The viability of HGF cells was determined using 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT), neutral red uptake, and trypan blue assay after treatment with different concentrations of CHX and ME (0.3125 to 10 µg/mL). Results-ME showed some alkaloids, glycosides, saponins and flavonoids exhibited relatively moderate-to-good antioxidant potential. Increasing the concentration of CHX and ME from 0.3125 to 10 µg/mL reduced cell viability from 29.71% to 1.07% and 96.12% to 56.02%, respectively. At higher concentrations, CHX reduced the viability of cells by 52.36-fold compared to ME, revealed by MTT assay. At 10 µg/mL concentration, the mean cell viability of CHX and ME-treated cells was 2.24% and 57.45%, respectively, revealed by a neutral red assay. The viability of CHX- and ME-treated HGF cells estimated at higher concentrations (10 µg/mL) using trypan blue assay was found to be 2.18% and 47.36%, respectively. A paired t-test showed significance (p < 0.05), and one-way ANOVA difference between the mean cell viability of CHX- and ME-treated cells at different concentrations. One-way ANOVA confirmed the significant difference between the viability of CHX- and ME-treated cells. Conclusions-The cytoprotective and antioxidant effects of ME emphasize its potential benefits. Therefore, it could emerge as a herbal alternative and adjunct to conventional oral hygiene methods, that can diminish periodontal tissue destruction.
Fulltext Haemoglobin Levels in Early Life among Infants with and without Retinopathy of Prematurity

Pheng E, Lim ZD, Tai Li Min E, Rostenberghe HV, Shatriah I

Int J Environ Res Public Health, 2021 07 01;18(13).
PMID: 34280989 DOI: 10.3390/ijerph18137054

Retinopathy of prematurity (ROP) is a proliferative retinal vascular disorder attributed to an ischaemic stimulus in preterm infants. Haemoglobin, the main component for oxygen transportation, may be implicated in ROP development. This retrospective study compared the mean weekly haemoglobin levels between infants with and without ROP over the first six weeks of life. Premature infants of less than 32 weeks gestational age and less than 1.5 kg birth weight were grouped into age and birth weight-matched ROP cases and controls. Weekly mean haemoglobin levels were documented. An independent t-test was used to analyze the difference in mean haemoglobin levels between infants with ROP and infants without ROP. Adjustment for confounders was performed using one-way analysis of covariance. There was a statistically significant difference in adjusted mean haemoglobin levels between the ROP and non-ROP group during the first week of life (p = 0.038). No significant intergroup differences were observed at the other weeks. Haemoglobin monitoring during the first week of postnatal life may be useful to guide ROP screening in premature infants.
Fulltext The Challenges of Partnering to Promote Health through Sport

Donaldson A, Staley K, Cameron M, Dowling S, Randle E, O'Halloran P, et al.

Int J Environ Res Public Health, 2021 07 05;18(13).
PMID: 34281130 DOI: 10.3390/ijerph18137193

Interagency partnerships and collaborations underpin a settings-based approach to health promotion in all settings, including sport. This study used an online concept mapping approach to explore the challenges that Regional Sports Assemblies (RSAs) in Victoria, Australia experienced when working in partnerships to develop and deliver physical activity programs in a community sport context. Participants from nine RSAs brainstormed 46 unique partnership-related challenges that they then sorted into groups based on similarity of meaning and rated for importance and capacity to manage (6-point scale; 0 = least, 5 = most). A six cluster map (number of statements in cluster, mean cluster importance and capacity ratings)-Co-design for regional areas (4, 4.22, 2.51); Financial resources (3, 4.00, 2.32); Localised delivery challenges (4, 3.72, 2.33); Challenges implementing existing State Sporting Association (SSA) products (9, 3.58, 2.23); Working with clubs (8, 3.43, 2.99); and Partnership engagement (18, 3.23, 2.95)-was considered the most appropriate interpretation of the sorted data. The most important challenge was Lack of volunteer time (4.56). Partnerships to implement health promotion initiatives in sports settings involve multiple challenges, particularly for regional sport organisations working in partnership with community sport clubs with limited human and financial resources, to implement programs developed by national or state-based organisations.
Fulltext Factors Affecting the Manufacturing Industry Transformation and Upgrading: A Case Study of Guangdong-Hong Kong-Macao Greater Bay Area

Yang F, Sun Y, Zhang Y, Wang T

Int J Environ Res Public Health, 2021 07 04;18(13).
PMID: 34281094 DOI: 10.3390/ijerph18137157

This study aims to analyze the development trend of the manufacturing industry transformation and upgrading in the Guangdong-Hong Kong-Macao Greater Bay Area (2008-2018). On the basis of synergetics, the order parameter method of factor analysis is used to study these factors. The results show that: (1) There are five slow variable factors, such as intelligent manufacturing industry, technological innovation, scale agglomeration, market demand, and fixed asset investment, which are important power sources of the transformation and upgrading of the manufacturing industry in Greater Bay Area. The development of these factors is relatively mature, and they cooperate with each other. (2) Similar to a fast variable of manufacturing development ecology, green development is an important coordinating factor in removing bottlenecks. Finally, suggestions for the development of the transformation and upgrading of the manufacturing industry are put forward.
Fulltext Oncogenic Role of miR-200c-3p in High-Grade Serous Ovarian Cancer Progression via Targeting the 3'-Untranslated Region of DLC1

Ankasha SJ, Shafiee MN, Abdul Wahab N, Raja Ali RA, Mokhtar NM

Int J Environ Res Public Health, 2021 05 27;18(11).
PMID: 34071861 DOI: 10.3390/ijerph18115741

High-grade serous ovarian cancer (HGSC) is the most common ovarian cancer with highly metastatic properties. A small non-coding RNA, microRNA (miRNA) was discovered to be a major regulator in many types of cancers through binding at the 3'-untranslated region (3'UTR), leading to degradation of the mRNA. In this study, we sought to investigate the underlying mechanisms involved in the dysregulation of miR-200c-3p in HGSC progression and metastasis. We identified the upregulation of miR-200c-3p expression in different stages of HGSC clinical samples and the downregulation of the tumor suppressor gene, Deleted in Liver Cancer 1 (DLC1), expression. Over expression of miR-200c-3p in HGSC cell lines downregulated DLC1 but upregulated the epithelial marker, E-cadherin (CDH1). Based on in silico analysis, two putative binding sites were found within the 3'UTR of DLC1, and we confirmed the direct binding of miR-200c-3p to the target binding motif at position 1488-1495 bp of 3'UTR of DLC1 by luciferase reporter assay in a SKOV3 cell line co-transfected with vectors and miR-200c-3p mimic. These data showed that miR-200c-3p regulated the progression of HGSC by regulating DLC1 expression post-transcription and can be considered as a promising target for therapeutic purposes.
Fulltext A Qualitative Study to Explore the Barriers for Nonadherence to Referral to Hospital Births by Women with High-Risk Pregnancies in Nepal

Rajbanshi S, Norhayati MN, Nik Hazlina NH

Int J Environ Res Public Health, 2021 05 28;18(11).
PMID: 34071394 DOI: 10.3390/ijerph18115801

Maternal and neonatal morbidity and mortality tend to decrease if referral advice during pregnancy is utilized appropriately. This study explores the reasons for nonadherence to referral advice among high-risk pregnant women. A qualitative study was conducted in Morang District, Nepal. A phenomenological inquiry was used. Fourteen participants were interviewed in-depth. High-risk women who did not comply with the referral to have a hospital birth were the study participants. Participants were chosen purposively until data saturation was achieved. The data were generated using thematic analysis. Preference of homebirth, women's diminished autonomy and financial dependence, conditional factors, and sociocultural factors were the four major themes that hindered hospital births. Women used antenatal check-ups to reaffirm normalcy in their current pregnancies to practice homebirth. For newly-wed young women, information barriers such as not knowing where to seek healthcare existed. The poorest segments and marginalized women did not adhere to referral hospital birth advice even when present with high-risk factors in pregnancy. Multiple factors, including socioeconomic and sociocultural factors, affect women's decision to give birth in the referral hospital. Targeted interventions for underprivileged communities and policies to increase facility-based birth rates are recommended.
Fulltext Spatial Analysis of Groundwater Hydrochemistry through Integrated Multivariate Analysis: A Case Study in the Urbanized Langat Basin, Malaysia

Zainol NFM, Zainuddin AH, Looi LJ, Aris AZ, Isa NM, Sefie A, et al.

Int J Environ Res Public Health, 2021 05 27;18(11).
PMID: 34071804 DOI: 10.3390/ijerph18115733

Rapid urbanization and industrial development in the Langat Basin has disturbed the groundwater quality. The populations' reliance on groundwater sources may induce possible risks to human health such as cancer and endocrine dysfunction. This study aims to determine the groundwater quality of an urbanized basin through 24 studied hydrochemical parameters from 45 groundwater samples obtained from 15 different sampling stations by employing integrated multivariate analysis. The abundance of the major ions was in the following order: bicarbonate (HCO3-) > chloride (Cl-) > sodium (Na+) > sulphate (SO42-) > calcium (Ca2+) > potassium (K+) > magnesium (Mg2+). Heavy metal dominance was in the following order: Fe > Mn > Zn > As > Hg > Pb > Ni > Cu > Cd > Se > Sr. Classification of the groundwater facies indicated that the studied groundwater belongs to the Na-Cl with saline water type and Na-HCO3 with mix water type characteristics. The saline water type characteristics are derived from agricultural activities, while the mixed water types occur from water-rock interaction. Multivariate analysis performance suggests that industrial, agricultural, and weathering activities have contributed to groundwater contamination. The study will help in the understanding of the groundwater quality issue and serve as a reference for other basins with similar characteristics.
Fulltext The Moderating Role of Corporate Social Responsibility in the Association of Internal Corporate Governance and Profitability; Evidence from Pakistan

Lu J, Javeed SA, Latief R, Jiang T, Ong TS

Int J Environ Res Public Health, 2021 05 28;18(11).
PMID: 34071620 DOI: 10.3390/ijerph18115830

At present, climate and other environmental problems are arising because of the development of the industrial sector at a large level. The industrial sector is supposed to be a major cause of climate change problems that lead to global warming. Therefore, corporate social responsibility (CSR) with the help of corporate governance is an imperative approach to control these social problems. Consequently, in the context of the organizational and management theory, agency theory, and the stakeholder theory, this study focuses on important factors of internal corporate governance such as chief executive officer (CEO) power, the board size, independence, ownership concentration, managerial ownership, and audit quality for improving the profitability of firms. Moreover, this study considers corporate social responsibility as a controlling and moderating factor for firm performance and internal corporate governance. We employed ordinary least square (OLS) for endogeneity testing, fixed effect (FE), generalized method of moments (GMM), and feasible generalized least square (FGLS) on data of Pakistani firms for the period of 2010-2019. The results of this study demonstrate the following outcomes: firstly, all internal corporate governance factors are positively linked with firm performance; secondly, corporate social responsibility (CSR) is the most valuable tool for improving profitability. Importantly, this study suggests that all internal corporate governance factors are positively linked with firm performance because of the interactive role of corporate social responsibility (CSR). This study practically contributes to the literature by suggesting the imperative role of corporate social responsibility (CSR) for internal corporate governance, which may help to reduce climate and social problems.
Fulltext mHealth Interventions to Address Physical Activity and Sedentary Behavior in Cancer Survivors: A Systematic Review

Khoo S, Mohbin N, Ansari P, Al-Kitani M, Müller AM

Int J Environ Res Public Health, 2021 05 28;18(11).
PMID: 34071342 DOI: 10.3390/ijerph18115798

This review aimed to identify, evaluate, and synthesize the scientific literature on mobile health (mHealth) interventions to promote physical activity (PA) or reduce sedentary behavior (SB) in cancer survivors. We searched six databases from 2000 to 13 April 2020 for controlled and non-controlled trials published in any language. We conducted best evidence syntheses on controlled trials to assess the strength of the evidence. All 31 interventions included in this review measured PA outcomes, with 10 of them also evaluating SB outcomes. Most study participants were adults/older adults with various cancer types. The majority (n = 25) of studies implemented multicomponent interventions, with activity trackers being the most commonly used mHealth technology. There is strong evidence for mHealth interventions, including personal contact components, in increasing moderate-to-vigorous intensity PA among cancer survivors. However, there is inconclusive evidence to support mHealth interventions in increasing total activity and step counts. There is inconclusive evidence on SB potentially due to the limited number of studies. mHealth interventions that include personal contact components are likely more effective in increasing PA than mHealth interventions without such components. Future research should address social factors in mHealth interventions for PA and SB in cancer survivors.

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