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Fulltext Adolescent Connectedness: Testing Confirmatory Factor Analysis of the Hemingway: Measure of Adolescent Connectedness-Bahasa Melayu Version (HMAC-BM)

Mohd Khatib NA, Roseliza-Murni A, Mohd Hoesni S, Manap J

Int J Environ Res Public Health, 2022 Sep 26;19(19).
PMID: 36231492 DOI: 10.3390/ijerph191912189

Measuring the factors that underlie adolescent connectedness has become a prominent focused issue in past studies across many disciplines. Thus far, the Hemingway: Measure of Adolescent Connectedness (HMAC) is the first research-based measure of adolescent's relationship and sense of belonging with other people and their surroundings. The current study aimed to examine the measurement model of the Hemingway: Measure of Adolescent Connectedness which has been translated into Bahasa Melayu (HMAC-BM) in order to check for its feasibility among Malaysian adolescents. A total of 377 adolescents aged 16 years old were recruited from the Federal Territory of Kuala Lumpur. Three factors, namely connectedness to family, school, and neighbors with seven sub-factors of the HMAC-BM, were analyzed by Confirmatory Factor Analysis (CFA) using the IBM SPSS Amos 23.0 (23.0, IBM Technology, Armonk, NY, USA). Results of the CFA supported the second-order factor of the HMAC-BM structures. The overall HMAC-BM scale and its subscales have higher factor loadings ranging from 0.60 to 0.79. Cronbach's alpha coefficients ranged from 0.78 to 0.95 for the three subscales and 0.84 for the total scale. Results also revealed seven sub-factors with forty-one factors-solution that accounted for 0.89% of total variance explained for adolescent connectedness. Findings provide empirical support for the feasibility of HMAC-BM in explaining Malaysian adolescents' social connectedness. Hence, the HMAC-BM is a promising measure that can be used on Malaysian adolescents. The findings have important implications which provide a clear picture of HMAC-BM as an accurate instrument to measure adolescent's social connectedness toward enhancing prosocial attitudes and well-being.
Fulltext Prevalence of Good Condom Usage and Its Association with Condom Use Self-Efficacy among Youth Attending HIV/STDs Clinics in Primary-Care Settings in Malaysia

Hamid NC, Malek KA, Mat-Nasir N, Mohamad M, Nasir NM

Int J Environ Res Public Health, 2022 Sep 26;19(19).
PMID: 36231478 DOI: 10.3390/ijerph191912179

The low prevalence of condom usage among youth with Human Immunodeficiency Virus/Sexually Transmitted Diseases (HIV/STDs) is a concern. Condom use self-efficacy has been identified as a significant predictor of condom usage. This cross-sectional study examines the prevalence of good condom usage and its association with condom use self-efficacy among Malaysian urban youth, aged between 18 to 24 years old attending HIV/STDs clinics in primary-care settings, Selangor. Utilising the Harmonised Malay version of Condom Use Self-Efficacy Scale (CUSES M-H) questionnaire, the data from 218 responders were analysed using univariate and multiple logistic regression. The prevalence of good condom usage was 61% (95% CI: 54%, 68%). The average mean score of condom use self-efficacy was 3.07. Condom use self-efficacy was divided into four subscales of mechanics, perceived barriers, assertiveness and intoxicants. The assertiveness subscale had the highest average mean score of 3.42, while the intoxicant subscale score had the lowest average mean score of 2.24. Good condom usage was significantly associated with condom use during first sexual intercourse (aOR = 5.81, 95% CI: 1.97, 17.14), duration diagnosis of HIV/STDs of more than 12 months (aOR = 6.40, 95% CI: 2.30, 17.86) and the high assertiveness subscale score (aOR = 1.19, 95% CI: 1.03, 1.36). A behavioural change campaign that targets high-risk youth in primary care settings could promote condom use self-efficacy particularly assertiveness to increase condom usage among the youth.
Fulltext Acceptance of COVID-19 Vaccine Booster Doses Using the Health Belief Model: A Cross-Sectional Study in Low-Middle- and High-Income Countries of the East Mediterranean Region

Ghazy RM, Abdou MS, Awaidy S, Sallam M, Elbarazi I, Youssef N, et al.

Int J Environ Res Public Health, 2022 Sep 25;19(19).
PMID: 36231447 DOI: 10.3390/ijerph191912136

Coronavirus disease (COVID-19) booster doses decrease infection transmission and disease severity. This study aimed to assess the acceptance of COVID-19 vaccine booster doses in low, middle, and high-income countries of the East Mediterranean Region (EMR) and its determinants using the health belief model (HBM). In addition, we aimed to identify the causes of booster dose rejection and the main source of information about vaccination. Using the snowball and convince sampling technique, a bilingual, self-administered, anonymous questionnaire was used to collect the data from 14 EMR countries through different social media platforms. Logistic regression analysis was used to estimate the key determinants that predict vaccination acceptance among respondents. Overall, 2327 participants responded to the questionnaire. In total, 1468 received compulsory doses of vaccination. Of them, 739 (50.3%) received booster doses and 387 (26.4%) were willing to get the COVID-19 vaccine booster doses. Vaccine booster dose acceptance rates in low, middle, and high-income countries were 73.4%, 67.9%, and 83.0%, respectively (p < 0.001). Participants who reported reliance on information about the COVID-19 vaccination from the Ministry of Health websites were more willing to accept booster doses (79.3% vs. 66.6%, p < 0.001). The leading causes behind booster dose rejection were the beliefs that booster doses have no benefit (48.35%) and have severe side effects (25.6%). Determinants of booster dose acceptance were age (odds ratio (OR) = 1.02, 95% confidence interval (CI): 1.01-1.03, p = 0.002), information provided by the Ministry of Health (OR = 3.40, 95% CI: 1.79-6.49, p = 0.015), perceived susceptibility to COVID-19 infection (OR = 1.88, 95% CI: 1.21-2.93, p = 0.005), perceived severity of COVID-19 (OR = 2.08, 95% CI: 137-3.16, p = 0.001), and perceived risk of side effects (OR = 0.25, 95% CI: 0.19-0.34, p < 0.001). Booster dose acceptance in EMR is relatively high. Interventions based on HBM may provide useful directions for policymakers to enhance the population's acceptance of booster vaccination.
Fulltext Associations of Problematic Internet Use, Weight-Related Self-Stigma, and Nomophobia with Physical Activity: Findings from Mainland China, Taiwan, and Malaysia

Liu W, Chen JS, Gan WY, Poon WC, Tung SEH, Lee LJ, et al.

Int J Environ Res Public Health, 2022 Sep 25;19(19).
PMID: 36231435 DOI: 10.3390/ijerph191912135

Insufficient physical activity is a common problem for university students because they may engage in sedentary lifestyle owing to excessive time spent on their smartphones and social media use. This may result in problematic internet use (PIU) and nomophobia (fear of not having a mobile phone). Moreover, prior evidence shows that weight-related self-stigma is an important factor contributing to low physical activity. Therefore, the present study examined the associations between PIU, nomophobia, and physical activity among university students across mainland China, Taiwan, and Malaysia. Participants (3135 mainland Chinese, 600 Taiwanese, and 622 Malaysian) completed the Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), Nomophobia Questionnaire (NMPQ), Weight Self-Stigma Questionnaire (WSSQ), and International Physical Activity Questionnaire Short Form (IPAQ-SF). The measurement invariance of the assessed questionnaires was supported across the three regions. The present findings analyzed using partial least squares structural equation modeling showed that (i) greater nomophobia was associated with higher levels of physical activity, (ii) greater weight-related self-stigma was associated with higher levels of physical activity, and (iii) greater nomophobia was associated with greater weight-related self-stigma. Although the present findings suggest the possibility that experiencing some level of nomophobia or weight-related self-stigma appears to help improve physical activity, it is not recommended that these be encouraged, but reducing PIU should be targeted as a means to improve physical activity.
Fulltext Small/Kiddie Cigarette Packaging Size and Its Impact on Smoking: A Systematic Review

Mat Rifin H, Jane Ling MY, Robert Lourdes TG, Saminathan TA, Rodzlan Hasani WS, Ab Majid NL, et al.

Int J Environ Res Public Health, 2022 Sep 23;19(19).
PMID: 36231349 DOI: 10.3390/ijerph191912051

Background: Small cigarette pack sizes contain less than 20 cigarette sticks in a pack. Smaller packs may suggest lower costs, increasing affordability among lower-income users, especially the younger generation, which could lead to tobacco-related diseases and economic costs, including human capital lost results from tobacco-attributable morbidity and mortality. This concern has caused many countries to ban the sale of single cigarette sticks or kiddie packs. However, small cigarette pack sizes were proposed recently to be reintroduced by the tobacco industry with an excuse to prevent consumers from buying illicit cigarettes. This would demean efforts in combating tobacco consumption based on the existing tobacco control policies to prevent minors from purchasing cigarettes. Given the competing influences of affordability and availability of tobacco on consumption and the dearth of evidence-based review on the impact of pack size on smoking, this systematic review was conducted to identify the link between kiddie packs and smoking specifically on the initiation of smoking, urge/tendency to buy cigarettes among the general population and attempt to reduce cigarette consumption and prevalence of smoking using kiddie packs among current smokers. Methods: We include all studies except for reviews, guidelines, conference papers, commentaries, editorials, or opinion pieces. A database search was conducted in PubMed, EMBASE, CENTRAL, Web of Science and Scopus on 27 November 2021. The results were presented in the form of narrative synthesis under four groups: initiation of smoking; urge/tendency to buy cigarettes; the prevalence of smoking, and attempt to reduce cigarette consumption. The literature search identified 1601 articles, of which 21 articles had met the inclusion criteria. The methodological quality of all included articles was determined using a validated 16-item quality assessment tool (QATSDD). The average quality score for all papers was 34.8%. Discussion: Given the diverse study settings of the articles and despite the challenges of the methodological quality of some articles, this review provides some evidence that kiddie packs may increase the urge/tendency to buy cigarettes and mixed evidence on the attempt to reduce cigarette consumption. This review also found some evidence that kiddie pack purchasing among teenage smokers was higher compared to adults. However, we are uncertain about the link between kiddie packs and smoking initiation. Nevertheless, since most studies were of low quality, further high-quality studies are needed to conclude about the impact of kiddie packs on smoking to assist the policymakers and stakeholders in formulating new policies and strengthening existing strategies related to the kiddie packs.
Fulltext The Alchemy of Coaching: Psychological Capital as HERO within Coaches' Selves

Burhanuddin NAN, Ahmad NA, Said RR, Asimiran S

Int J Environ Res Public Health, 2022 Sep 23;19(19).
PMID: 36231322 DOI: 10.3390/ijerph191912020

The complex nature of coaching challenges instructional coaches (ICs) professionally as it requires them to deal with not only teachers' resistance, acceptance and expectation but also adhere to the complex and multifaceted roles that they are bearing. Psychological capital (PsyCap) has been upheld as an effective construct for defending against stress, negative emotions and burnout among educators. This phenomenological study explores ways in which PsyCap was experienced by Malaysian instructional coaches (ICs). Data were gathered from face-to-face interviews with seven instructional coaches purposefully selected from six different District Education Offices (DEOs) throughout Malaysia. Extracted from participants' own words and through the exploration performed, PsyCap was experienced by the participants through a sense of responsibility, positive resources and work commitment. This study highlights the importance of PsyCap as inner positive psychological resources that aided instructional coaches in their practice of coaching. In addition, this study suggests future research recommendations towards implementing PsyCap developmental training with another group of instructional coaches.
Fulltext Assessment of Mental Health and Quality of Life Status of Undergraduate Students in Indonesia during COVID-19 Outbreak: A Cross-Sectional Study

Karuniawati H, Sari N, Hossain MS, Ismail WI, Haq AHB, Yulianti T, et al.

Int J Environ Res Public Health, 2022 Sep 22;19(19).
PMID: 36231312 DOI: 10.3390/ijerph191912011

The COVID-19 pandemic globally impacted physical, spiritual, and mental health (MH). The consequences significantly affected students' quality of life (QoL) too. This cross-sectional study assessed MH status and its relationship to the QoL of college students in Indonesia. This study collected data (September 2021-April 2022) online using the depression, anxiety, and stress scale-21 (DASS-21) to measure MH and the world health organization quality-of-life scale (WHOQoL-BREF) to measure the QoL. The data were analysed using SPSS with a bivariate and multivariate linear regression test. A total of 606 respondents participated in this study, with the majority being women (81.0%), aged 21-27 years (44.3%), and unmarried (98.5%) respondents. We observed 24.4% (n = 148) moderate depression, 18.3% (n = 111) very severe anxiety, and 21.1% (n = 128) moderate stress status. The QoL measurement determined that a moderate QoL in the physical and environmental health domains (>70%) and poor QoL in the psychological health domain (58.3%) were found. Gender, age, family support, history of COVID-19 diagnosis, family with COVID-19 diagnosis, vaccination status, and physical symptoms are significantly associated with MH status and QoL (p-value < 0.05). This study demonstrated that COVID-19 was negatively related to college students' MH and QoL. Targeted interventions may be needed to ameliorate both MH and QoL.
Fulltext Antibiotic Resistance during COVID-19: A Systematic Review

Sulayyim HJA, Ismail R, Hamid AA, Ghafar NA

Int J Environ Res Public Health, 2022 Sep 21;19(19).
PMID: 36231256 DOI: 10.3390/ijerph191911931

One of the public health issues faced worldwide is antibiotic resistance (AR). During the novel coronavirus (COVID-19) pandemic, AR has increased. Since some studies have stated AR has increased during the COVID-19 pandemic, and others have stated otherwise, this study aimed to explore this impact. Seven databases-PubMed, MEDLINE, EMBASE, Scopus, Cochrane, Web of Science, and CINAHL-were searched using related keywords to identify studies relevant to AR during COVID-19 published from December 2019 to May 2022, according to PRISMA guidelines. Twenty-three studies were included in this review, and the evidence showed that AR has increased during the COVID-19 pandemic. The most commonly reported resistant Gram-negative bacteria was Acinetobacterbaumannii, followed by Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. A. baumannii and K. pneumonia were highly resistant to tested antibiotics compared with E. coli and P. aeruginosa. Moreover, K. pneumonia showed high resistance to colistin. Commonly reported Gram-positive bacteria were Staphylococcus aureus and Enterococcus faecium. The resistance of E. faecium to ampicillin, erythromycin, and Ciprofloxacin was high. Self-antibiotic medication, empirical antibiotic administration, and antibiotics prescribed by general practitioners were the risk factors of high levels of AR during COVID-19. Antibiotics' prescription should be strictly implemented, relying on the Antimicrobial Stewardship Program (ASP) and guidelines from the World Health Organization (WHO) or Ministry of Health (MOH).
Fulltext Development and Usability Assessment of a Mobile App (Demensia KITA) to Support Dementia Caregivers in Malaysia: A Study Protocol

Rashid NSA, Chen XW, Mohamad Marzuki MF, Takshe AA, Okasha A, Maarof F, et al.

Int J Environ Res Public Health, 2022 Sep 20;19(19).
PMID: 36231181 DOI: 10.3390/ijerph191911880

The impact of dementia on caregivers is complex and multi-dimensional. In low- and middle-income settings, caregivers are often left without adequate support, despite their multiple needs. These include health information, caregiving skills, social and emotional support, and access to local resources-all of which can be partially fulfilled by technology. In recent years, mobile apps have emerged and proven useful for caregivers. We found a few existing apps suitable for Malaysian users in terms of affordability and cultural and linguistic compatibility. Our study aims to design a mobile app that suits dementia caregivers in Malaysia and consists of three phases. Phase I is content development that employs Focus Group Discussion (FGD) and Nominal Group Technique (NGT) involving field experts. Phase II comprises a mobile app (Demensia KITA) designed in collaboration with a software developer specializing in mobile health apps. Phase III entails testing the usability of the app using the Malay version of the mHealth App Usability Questionnaire (M-MAUQ). This study protocol elaborates on the rigorous steps of designing a mobile app and testing its usability, along with anticipated challenges. Our protocol will provide insight for future researchers, healthcare providers, and policymakers and pave the way for better use of digital technology in the field of aging and caregiving.
Fulltext How Internet Websites Portray Herbal Vitality Products Containing Eurycoma longifolia Jack: An Evaluation of the Quality and Risks of Online Information

Wahab MSA, Abd Hamid NN, Yassen AO, Naim MJ, Ahamad J, Zulkifli NW, et al.

Int J Environ Res Public Health, 2022 Sep 20;19(19).
PMID: 36231154 DOI: 10.3390/ijerph191911853

BACKGROUND: Tongkat Ali (TA) or Eurycoma longifolia is a herbal medicine (HM) plant traditionally used to treat sexual dysfunction and enhance libido in men. Websites containing information about HM are abundant. However, studies have shown that in general the quality of websites containing information on HM is low. The present study aims to assess the quality and risks of websites containing information about TA supplements and to identify the health claims for TA.
METHODOLOGY: A cross-sectional study to evaluate the quality and risks of websites discussing TA supplements was conducted. Online marketing websites, research articles, news articles, personal opinions, and those restricted by password were excluded. The quality and risks of websites were assessed using a modified DISCERN tool and a set of risk assessment criteria, respectively. The health claims for TA were identified and analyzed using content analysis.
RESULTS: Overall, 321 websites met the inclusion criteria and were further evaluated. The overall rating of the quality of the websites was low, with a mean score ± standard deviation of 1.07 ± 0.51. Most websites lacked information that there may be more than one possible treatment choice and did not discuss areas of uncertainty. However, 67.9% (218/321) of the websites received a risk score of zero. A minority of websites (5/321, 1.6%) discouraged the use of conventional medicines. The most common health claims for TA included in the websites related to the enhancement of testosterone level (121/321, 37.7%), treatment of malaria (112/321, 34.9%), and improvement in libido (108/321, 33.6%).
CONCLUSIONS: Websites containing information about TA supplements generally have a low-quality rating based on a modified DISCERN tool despite having a low-risk score. Government agencies and healthcare professionals (HCPs) must be more proactive in the critique and dissemination of information relating to HM, and in ensuring the safe use of HM among the public and patients.
Fulltext Perceived Social Support Increases Creativity: Experimental Evidence

Tan CS, Chin XY, Chng ST, Lee J, Ooi CS

Int J Environ Res Public Health, 2022 Sep 19;19(18).
PMID: 36142114 DOI: 10.3390/ijerph191811841

The literature has consistently shown that social support has a positive relationship with creativity. However, further investigation is needed to clarify the causal relationship between the two constructs. The present study addressed this need by exploring the impact of experimentally induced perceived social support on creativity among young adults. A total of 135 undergraduate students in Malaysia participated in an online experiment. All participants first answered the creative self-efficacy scale and were then randomly allocated to the experimental and control groups. Perceived social support was primed by a writing test and measured by the Multidimensional Scales of Perceived Social Support. Both groups also answered a divergent thinking test (measured for fluency, flexibility, and originality) and a self-rated creativity scale. Multivariate analysis of covariance showed that, after statistically controlling for the effect of creative self-efficacy, participants in the experimental group reported higher scores in perceived social support and all creativity measures than their counterparts in the control group. The results demonstrated that the manipulation is effective and the induced perceived social support leads to higher creativity. Our findings not only offer empirical evidence of the causality of social support and creativity but also has practical value for creativity development.
Fulltext The Malaysian HEalth and WellBeing AssessmenT (MyHEBAT) Study Protocol: An Initiation of a National Registry for Extended Cardiovascular Risk Evaluation in the Community

Firus Khan AY, Ramli AS, Abdul Razak S, Mohd Kasim NA, Chua YA, Ul-Saufie AZ, et al.

Int J Environ Res Public Health, 2022 Sep 19;19(18).
PMID: 36142062 DOI: 10.3390/ijerph191811789

Cardiovascular disease (CVD) has been a burden to many developing countries for decades, including Malaysia. Although various steps have been taken to prevent and manage CVD, it remains the leading cause of morbidity and mortality. The rising prevalence of CVD risk factors such as hypertension, hypercholesterolaemia, diabetes, overweight and obesity is the main driving force behind the CVD epidemic. Therefore, a nationwide health study coined as the Malaysian Health and Wellbeing Assessment (MyHEBAT) was designed. It aimed to investigate the prevalence of CVD and the associated risk factors in the community across Malaysia. The MyHEBAT study recruited participants (18-75 years old) through community health screening programmes from 11 states in Malaysia. The MyHEBAT study was further divided into two sub-studies, namely, the Cardiovascular Risk Epidemiological Study (MyHEBAT-CRES) and the MyHEBAT Familial Hypercholesterolaemia Study (MyHEBAT-FH). These studies assessed the prevalence of CVD risk factors and the prevalence of FH in the community, respectively. The data garnered from the MyHEBAT study will provide information for healthcare providers to devise better prevention and clinical practice guidelines for managing CVD in Malaysia.
Fulltext Factors Associated with Musculoskeletal Disorders among Regular and Special Education Teachers: A Narrative Review

Abdul Rahim AA, Jeffree MS, Ag Daud DM, Pang N, Sazali MF

Int J Environ Res Public Health, 2022 Sep 16;19(18).
PMID: 36141974 DOI: 10.3390/ijerph191811704

Musculoskeletal disorder (MSD) is a major health problem, which can lead to an enormous burden to the institution as well as chronic disability to the individual. Teachers are at risk of developing MSD due to the exposure to various ergonomic risk factors. Teachers of special education, for example, are expected to perform extra duty such as lifting and moving students, feeding food, changing diapers, and helping them in ambulation. Although there is an adequate amount of scientific research on MSD's prevalence and its risk factors among regular teachers, only few studies have focused on special education teachers. This review aimed to address these gaps by describing the evidence from various papers on the prevalence of MSD among regular and special education teachers and the related risk factors. The papers have been gathered using electronic databases, including PubMed, Science Direct, Google Scholar, and Springer. The prevalence of MSD among regular teachers ranges from 48.7% to 73.7%, while the prevalence ranges from 38.7% to 94% in special education teachers. Risk factors, such as individual (age, duration of teaching, working hours, and work burden), physical (teaching activities, affected body areas), and psychological factors (stress, anxiety, fear), were identified. From the review, it is recommended to implement ergonomically designed workplaces, comprehensive ergonomic training, psychological approaches, and functional training among teachers at risk.
Fulltext Mediating Role of Intra-Team Conflict between Paternalistic Leadership and Decision-Making Quality among China University's CMT during COVID-19

Cheah KSL, Abdullah Z, Xiao M

Int J Environ Res Public Health, 2022 Sep 16;19(18).
PMID: 36141967 DOI: 10.3390/ijerph191811697

Universities across China have set up crisis management teams (CMTS) to deal with the crisis brought on by the COVID-19 pandemic. This study focuses on how the paternalistic leadership practices of a Chinese university CMT influence crisis strategic decisions by managing conflict. These relationships were verified using hierarchical regression analysis on 312 samples from the surveyed university during the pandemic and found the following: benevolent leadership and moral leadership have positive effects on decision quality. However, unlike most studies on paternalistic leadership, in crisis situations, the negative effects of authoritarian leadership disappear under the mediating effect of affective conflict. This means that affective conflict within CMT fully mediates the relationship between authoritarian leadership and decision quality, and partially mediates the relationship between moral leadership and decision quality, while cognitive conflict partially mediates the relationship between benevolent leadership and crisis decision quality. It indicates that a CMT must stimulate and maintain a certain level of cognitive conflict while suppressing affective conflict to achieve high-quality crisis decision-making. This state can be achieved by practicing lower levels of authoritarian leadership and maintaining high levels of moral and benevolent leadership practices.
Fulltext Crocus Sativus for Insomnia: A Systematic Review and Meta-Analysis

Munirah MP, Norhayati MN, Noraini M

Int J Environ Res Public Health, 2022 Sep 16;19(18).
PMID: 36141931 DOI: 10.3390/ijerph191811658

Insomnia is a common complaint affecting human performance in daily life activities. This study aimed to analyze the effects of Crocus sativus on insomnia. Methods: PRISMA guidelines were used according to the PICOS model. A systematic search of PubMed/Medline and the Cochrane Library was undertaken for literature until December 2021. A random effects model was used with I2 statistic to assess heterogeneity and a GRADE assessment was used to assess the quality of the outcomes. Eight articles were included, involving 431 participants. Crocus sativus reduced insomnia severity (SMD: 0.53; 95%CI: -0.05 to 1.11; I2 statistic = 59%; p = 0.08) and increased sleep quality (SMD 0.89, 95% CI 0.10 to 1.68; I2 statistic = 90%; p = 0.03; 6 studies, 308 participants, very low-quality evidence) and duration (SMD: 0.57; 95%CI: 0.21 to 0.93; I2 statistic = 40%; p = 0.002; 5 studies; 220 participants, moderate-quality evidence) compared with the placebos. Although there is limited evidence of a very low- to moderate-quality, Crocus sativus may benefit people with insomnia. This non-pharmacological intervention may reduce the chance of adults with insomnia taking sedative-hypnotic medication, thus reducing dependency and withdrawal symptoms.
Fulltext Quality of Life and Its Associated Factors among Patients with Psoriasis in a Semi-Urban Northeast Malaysia

Ahmad Fuat MS, Mat Yudin Z, Muhammad J, Mohd Zin F

Int J Environ Res Public Health, 2022 Sep 14;19(18).
PMID: 36141851 DOI: 10.3390/ijerph191811578

Psoriasis is a chronic relapsing dermatological disorder that significantly affects the patients' psychosocial well-being and quality of life (QOL). This study aimed to determine the proportion of severely impaired QOL, the factors associated with severely impaired QOL, and its correlation with depression among semi-urban populations on the Northeast Coast of the Peninsular Malaysia. A cross-sectional study was conducted among 257 patients with psoriasis at the Dermatology Clinic of Hospital Sultanah Bahiyah via a self-administered questionnaire that included sociodemographic profiles, the validated Malay version of the Dermatology Life Quality Index (DLQI), and the Malay version of the Beck depression scale. The data were analysed using logistic and linear regression models. About 20.5% of the patients had severely impaired QOL quality of life, while 79.5% of the patients had non-impaired QOL. Multiple logistic regression analysis showed that the psoriatic severity [Adjusted OR = 1.91, 95% CI: 1.76, 9.93; p < 0.001] and exposed area [Adjusted OR 2.93, 95% CI: 0.38, 2.29; p = 0.050] had a significant association with severely impaired QOL. Among the patients, 18.7% had a positive result in the screening for depression, which revealed a significant association between QOL and depression scores [r = 0.47, 95% CI: 0.35, 0.56, p < 0.001]. Psoriasis can impair QOL and have a relation with mental health. Regular screening for depression among patients with psoriasis is a beneficial strategy for the early detection of depression, especially in semi-urban areas.
Fulltext Factors Influencing Visual Improvement after Phacoemulsification Surgery among Malaysian Cataract Patients

Sa'at N, Ghazali AK, Yaacob NM, Salowi MA

Int J Environ Res Public Health, 2022 Sep 13;19(18).
PMID: 36141761 DOI: 10.3390/ijerph191811485

Blindness and visual impairment are part of the global burden of eye disease, with cataract being one of the leading causes of blindness. This study aimed to determine the factors affecting visual acuity (VA) improvement among cataract patients after phacoemulsification surgery in Malaysia. Cataract patients aged over 18 who underwent phacoemulsification surgery between January 2014 and December 2018 were included in this retrospective cohort study. Patients' sociodemographic, comorbidities, surgical, and related complication factors were extracted from the National Eye Database. The outcome was measured by the difference in visual acuity before and after the operation and was categorized as "improved", "no change", and "worse". A total of 180,776 patients were included in the final analysis. Multinomial logistic regression analysis showed "no changes in VA" was significantly higher in patients aged less than 40 years old (OR: 1.66; 95% CI: 1.22, 2.26), patients with ocular comorbidities (OR: 1.65; 95% CI: 1.53, 1.77), patients who had undergone surgery lasting more than 60 min (OR: 1.39; 95% CI: 1.14, 1.69), patients who had surgery without an intraocular lens (IOL) (OR: 1.64; 95% CI: 1.20, 2.26), and patients with postoperative complications (OR: 8.76; 95% CI: 8.13, 9.45). Worsening VA was significantly higher among male patients (OR: 1.11; 95% CI: 1.01, 1.22), patients who had ocular comorbidities (OR: 1.76; 95% CI: 1.59, 1.96), patients who had undergone surgery lasting more than 60 min (OR: 1.94; 95% CI: 1.57, 2.41), patients who had surgery without an IOL (OR: 2.03; 95% CI: 1.48, 2.80), and patients with postoperative complications (OR: 21.46; 95% CI: 19.35, 23.80). The factors impacting "no changes" in and "worsening" of VA after cataract surgery were the following: older age, male gender, ethnicity, ocular comorbidities, surgeon grade, absence of IOL, intraoperative complication, and postoperative problems.
Fulltext The Effect of Persistence of Physical Exercise on the Positive Psychological Emotions of Primary School Students under the STEAM Education Concept

Yuan Y, Ji X, Yang X, Wang C, Samsudin S, Omar Dev RD

Int J Environ Res Public Health, 2022 Sep 12;19(18).
PMID: 36141724 DOI: 10.3390/ijerph191811451

The effect of persistence of physical exercise on the psychological and emotional aspects of primary school students is studied to improve the comprehensive quality of current Chinese primary school students and explore the effect of physical exercise on students' emotions under the science, technology, engineering, art, mathematics (STEAM) education concept. First, students in a primary school in Nanchang are taken as the survey participants. Second, by formulating a physical exercise scale and a psychological and emotional scale, the current situation of physical exercise of primary school students is investigated by means of mathematical statistics. Finally, the current situation of physical exercise and the overall situation of positive psychological emotions of primary school students are analyzed, and the effect of physical exercise on the positive psychological emotions of primary school students is studied. The data show that there are significant differences in the amount of exercise and its three dimensions of intensity, time, and frequency, as well as the scores of positive emotions in the gender dimension, with the boys scoring higher than the girls. In terms of grades, students in grades 1, 2, and 6 are higher than students in grades 3, 4, and 5 on the level of a small amount of exercise, while students in grades 3, 4, and 5 are higher than the other three grades in terms of a moderate amount of exercise. Moreover, in the aspect of positive psychological emotions, the lower-grade students are obviously higher than the upper-grade students, and the second- and third-grade students present marginal significance, p = 0.058. The correlation and regression between physical exercise and positive psychological emotions are calculated and analyzed, and it is found that there is a significant positive correlation between physical exercise indicators and positive psychological emotions, with a correlation coefficient of 0.297. Physical exercise explains 8.8% of positive emotions. This research also makes relevant recommendations for students and schools and has played a role in strengthening the physical exercise and mental health of primary and secondary school students. Greater attention to the physical exercise of primary school students is recommended.
Fulltext Translation and Validation of the Malay Version of the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA)

Mohd Ali M, Mohd Hoesni S, Rosharudin NA, Yusoff SR, Razman MOI, Khairuddin KF, et al.

Int J Environ Res Public Health, 2022 Sep 10;19(18).
PMID: 36141671 DOI: 10.3390/ijerph191811399

The Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) has been translated and adapted globally. This study aimed to examine the psychometric properties of the Malay version of the ERQ-CA. The ERQ-CA underwent forward and back translation twice and was tested in two separate studies, Study 1 and Study 2, with 296 and 359 students aged between 13 and 14 years old, respectively. Cronbach's alpha values were calculated, and confirmatory factor analysis was conducted. The results from Study 1 demonstrate good internal consistency for cognitive reappraisal and expressive suppression. The results indicate a good factor loading for most of the items, but only one value of the goodness-of-fit met the criteria for a good fit. The results from Study 2 show improvements in the values of the goodness-of-fit that are comparable to previous studies, but there was a decrease in the factor loading scores. Overall, the Malay version of the ERQ-CA possesses acceptable reliability and validity. Further studies are required in the near future to develop a Malay version of the ERQ-CA that reasonably represents Malaysian adolescents.
Fulltext Economic Analysis of Patient's Own Medication, Unit-Use and Ward Stock Utilization: Results of the First Pilot Study

Abdul Nasir HH, Goh HP, Wee DVT, Goh KW, Lee KS, Hermansyah A, et al.

Int J Environ Res Public Health, 2022 Sep 09;19(18).
PMID: 36141623 DOI: 10.3390/ijerph191811350

BACKGROUND: Medication wastage is causing a cost burden to the healthcare system that is worth millions of dollars. An economic and ecological friendly intervention such as using a patient's own medications (POM) has proven to reduce wastage and save the cost spent by the hospital. The potential benefits of using POM in inpatient settings have yet to be explored in a country with universal health coverage. This study aimed to pilot test the POM intervention in an adult ward setting and to perform the economic analysis of using POM and ward stock during hospitalization.
METHODS: A prospective cross-sectional observational study was conducted among the patients admitted to the medical and surgical wards in a public hospital located in Brunei Darussalam between February 2022 and April 2022. Hospitalized adults above 18 years old with regular medications with a minimum length of stay of 48 h and a maximum length of stay of 21 days were included in the study. These eligible patients were divided into a POM group and a non-POM group. The economic analysis of using POM was performed by calculating the direct cost per unit of medication used during admission (from unit-use, ward stock and POM) and comparing the cost spent for both groups. Expired ward stock deemed as medication wastage was determined. Medical research ethics were approved, and all participating patients had given their written informed consent before enrolling in this study.
RESULTS: A total of 112 patients aged 63.2 ± 15.8 years participated in this study. The average cost of medication supplied by the inpatient pharmacy for the non-POM group was USD 21.60 ± 34.20 per patient, whereas, for the POM group, it was approximately USD 13.00 ± 18.30 per patient, with a mean difference of USD 8.60 ± 5.17 per patient (95% CI: -3.95, 27.47, p ≥ 0.05). The use of POM minimized 54.03% (USD 625.04) of the total cost spent by the hospital for the POM group within the period of the study.
CONCLUSION: The pilot study showed that the supplied medication cost per patient was not significantly different between the POM and non-POM groups. Nevertheless, the utilization of POM during hospitalization is capable of reducing at least 50% of the total cost spent on inpatient medications by the hospital. The use of POM during hospitalization also helped in reducing the total time spent on the medication process per patient.

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