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  1. Praveena SM, Cheema MS, Guo HR
    Ecotoxicol Environ Saf, 2019 Apr 15;170:699-707.
    PMID: 30580164 DOI: 10.1016/j.ecoenv.2018.12.048
    Generally, non-nutritive artificial sweeteners are widely utilized as sugar substitute in various applications. With various applications, non-nutritive artificial sweeteners are now being recognized as emerging contaminants with high water persistence and are chemically stable in environment. Although non-nutritive artificial sweeteners were documented on their occurrence in environment, yet their potential impacts to environment and human health remain ambiguous. Therefore, this review was prepared to provide a more comprehensive insight of non-nutritive artificial sweeteners in environment matrixes by highlighting special concerns on human health and environmental risks. Precisely, this review monitors the exploration of non-nutritive artificial sweeteners occurrences as an emerging contaminants in environment worldwide and their associated risks to human as well as environment. At present, there are a total of 24 non-nutritive artificial sweeteners' studies with regards to their occurrence in the environment from 38 locations globally, spanning across Europe including United Kingdoms, Canada, United States and Asia. Overall, the quantitative findings suggested that the occurrence of non-nutritive artificial sweeteners is present in surface water, tap water, groundwater, seawater, lakes and atmosphere. Among these environmental matrixes, surface water was found as the most studied matrix involving non-nutritive artificial sweeteners. However, findings on non-nutritive artificial sweeteners impacts on human health and environment are limited to understanding its overall potential impacts and risks. Additionally, this review also serves as a framework for future monitoring plans and environmental legislative to better control these emerging contaminants in environment.
  2. How V, Singh S, Dang T, Fang Lee L, Guo HR
    Int J Environ Health Res, 2023 Apr;33(4):413-429.
    PMID: 35157533 DOI: 10.1080/09603123.2022.2033706
    Farmers in tropical countries have been impacted by slow-onset heat stress. By comparing the nature of farming activities performed by conventional farmworkers and agroecological farmers, this study examined the changes in physiological health in responses to heat exposure through a six-month longitudinal study. Throughout the six-month follow-up period, the heat stress index (HSI), physiological strain indices (PSI), and physiological health parameters (BMI, blood glucose level, blood cholesterol level, uric acid level) were measured and repeated every two-month. Physiological parameters were recorded twice daily, before and during their first lunch break. This study found that slow-onset heat stress affects farmers differently. The health of agroecological farmers is more resistant to slow-onset extreme temperatures. Pre-existing metabolic health effects from pesticide exposure make conventional farmers more susceptible to extreme temperatures, delaying their bodies' adaptation to rising temperatures.
  3. Dhamanti I, Juliasih NN, Semita IN, Zakaria N, Guo HR, Sholikhah V
    J Multidiscip Healthc, 2023;16:1337-1348.
    PMID: 37204999 DOI: 10.2147/JMDH.S412327
    PURPOSE: This study examined how health staff in Indonesian hospitals perceived open disclosure of patient safety incidents (PSIs).

    PATIENTS AND METHODS: This study employed a mixed method explanatory sequential approach. We surveyed 262 health workers and interviewed 12 health workers. Descriptive statistical (frequency distributions and summary measures) analysis was performed to assess the distributions of variables using SPSS. We used thematic analysis for the qualitative data analysis.

    RESULTS: We discovered a good level of open disclosure practice, open disclosure system, attitude toward open disclosure and process, open disclosure according to the level of harm resulting from PSIs in the quantitative phase. The qualitative phase revealed that most participants were confused about the difference between incident reporting and incident disclosure. Furthermore, the quantitative and qualitative analyses revealed that major errors or adverse events should be disclosed. The contradictory findings may be due to a lack of awareness of incident disclosure. The important factors in disclosing the incident are effective communication, type of incident, and patient and family characteristics.

    CONCLUSION: Open disclosure is novel for Indonesian health professionals. A good open disclosure system in hospitals could address several issues such as lack of knowledge, lack of policy support, lack of training, and lack of policy. To limit the negative implications of disclosing situations, the government should develop supportive policies at the national level and organize many initiatives at the hospital level.

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