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Fulltext Kimura's Disease with Atypical Musculoskeletal Presentation

Hafiz A., Yusuf, A., Rosmaliza, I., Premchandran, N., Kalavathy, R.

Malays Orthop J, 2010;4(2):44-47.
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We would like to highlight an unusual clinical presentation of Kimura's disease, a rare, benign, idiopathic condition, usually seen as swelling and lesions of the head and neck region and commonly affecting young men of Asian descent. It is rare for this disorder to present with lesions on other parts of the body, especially the lower limbs. We report a 27-year-old man who presented with a large mass located at the inguinal region and extending down to the upper thigh. Due to the large size of the mass (28 x 18 cm), our provisional diagnosis was a soft tissue sarcoma. Open biopsy showed that the lesion was benign.
Fulltext Nonlinear effects of public debt on economic growth in Nigeria

Yusuf A, Mohd S

SN Bus Econ, 2023;3(4):88.
PMID: 36919014 DOI: 10.1007/s43546-023-00468-7

The COVID-19 pandemic induced governments all over the world to momentarily accumulate higher levels of public debt in order to invest in deficit spending and social protection programs to tackle the anticipated economic slump. The Nigerian government has borrowed heavily from domestic and foreign sources in order to resolve the growing budget deficits and return the economy to a sustainable growth trajectory. Previous studies frequently made the incorrect assumption that the relationship between public debt and growth is linear and symmetric, leading to empirical results that is frequently disputed and imprecise. This study's main objective is to examine the asymmetric impact of public debt on economic growth in Nigeria from 1980 to 2020 using the Nonlinear Autoregressive Distributed Lag method. Empirical evidence indicated that external debt have a significant positive and symmetric impact on economic growth in the long and short run, while debt service payment supporting the debt overhang hypothesis activated a symmetric effect that stifle growth. Domestic debt retarded growth asymmetrically in the short term and linearly over the long term. Foreign reserve holding, on the other hand, had an asymmetric long-run influence and a symmetric short-run impact on growth motivation. To mitigate the negative effects of unsustainable public debt, the study advocated for fiscal reforms that effectively reduce deficit financing to keep the level of government debt low and be able to respond robustly to an economic shock, improve domestic revenue generation and infrastructure spending, and strengthen governance practices and institutions.
Fulltext Growth and Fiscal Effects of Insecurity on the Nigerian Economy

Yusuf A, Mohd S

Eur J Dev Res, 2022 Apr 19.
PMID: 35464616 DOI: 10.1057/s41287-022-00531-3

In spite of government counter-terrorism expenditure and efforts, the prevalence of insecurity in Nigeria appears to be rising and fast evolving into an existential crisis that is shaking the foundation of its nationhood. The current study used annual time-series data from 1980 to 2019 and the ARDL methodology to analyse the fiscal and socio-economic consequences of insecurity on economic growth in Nigeria. The empirical findings demonstrated that high unemployment rate, domestic capital formation, foreign direct investment, government spending on education and security are negatively affected by the growing level of insecurity and consequently retarded growth in the long and short run. Conversely, improved health services, equitable income distribution and productive use of public borrowing were positively correlated with security and, therefore, stimulated growth in the long and short run. Government revenue and inflation rate accelerated growth in the long run whereas their short-run effect was deleterious. The findings suggest that good governance, provision of a safe and secured environment for human capital development and businesses, improved access to social and economic services will curb violent tendencies, create jobs, reduce poverty, increase government revenue and engender long-term inclusive growth.
Quality of life in Malay and Chinese women newly diagnosed with breast cancer in Kelantan, Malaysia

Yusuf A, Ahmad Z, Keng SL

Asian Pac J Cancer Prev, 2013;14(1):435-40.
PMID: 23534769

BACKGROUND: Breast cancer is the leading cause of cancer-related death among women in Malaysia. A diagnosis is very stressful for women, affecting all aspects of their being and quality of life. As such, there is little information on quality of life of women with breast cancer across the different ethnic groups in Malaysia. The purpose of this study was to examine the quality of life in Malay and Chinese women newly diagnosed with breast cancer in Kelantan.
MATERIALS AND METHODS: A descriptive study involved 58 Malays and 15 Chinese women newly diagnosed with breast cancer prior to treatment. Quality of life was measured using the Malay version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast-specific module (QLQ-BR23). Socio-demographic and clinical data were also collected. All the data were analyzed using SPSS version 20.0.
RESULTS: Most of the women were married with at least a secondary education and were in late stages of breast cancer. The Malay women had lower incomes (p=0.046) and more children (p=0.001) when compared to the Chinese women. Generally, both the Malay and Chinese women had good functioning quality-of-life scores [mean score range: 60.3-84.8 (Malays); 65.0-91.1 (Chinese)] and global quality of life [mean score 60.3, SD 22.2 (Malays); mean score 65.0, SD 26.6 (Chinese)]. The Malay women experienced more symptoms such as nausea and vomiting (p=0.002), dyspnoea (p=0.004), constipation (p<0.001) and breast-specific symptoms (p=0.041) when compared to the Chinese.
CONCLUSIONS: Quality of life was satisfactory in both Malays and Chinese women newly diagnosed with breast cancer in Kelantan. However, Malay women had a lower quality of life due to high general as well as breast-specific symptoms. This study finding underlined the importance of measuring quality of life in the newly diagnosed breast cancer patient, as it will provide a broader picture on how a cancer diagnosis impacts multi-ethnic patients. Once health care professionals understand this, they might then be able to determine how to best support and improve the quality of life of these women during the difficult times of their disease and on-going cancer treatments.
Perceptions of risk factors for phlebitis among Malaysian nurses

Ying CX, Yusuf A, Keng SL

Br J Nurs, 2020 Jan 23;29(2):S18-S23.
PMID: 31972104 DOI: 10.12968/bjon.2020.29.2.S18

BACKGROUND: Intravenous therapy is an integral part of professional nursing practice. Nurses have a responsibility to recognise risk factors for phlebitis.
AIMS: To investigate nurses' perceptions of risk factors for phlebitis in a tertiary teaching hospital in north-east Peninsular Malaysia.
METHODS: A cross-sectional study of 199 randomly selected nurses were surveyed for their perceptions of risk factors for phlebitis using a self-administered questionnaire.
FINDINGS: More than half of the nurses (56.8%) had a good perception levels of risk factors for phlebitis. There was a significant association between the clinical area and nurses' perceptions of risk factors for phlebitis (p=0.04). Nurses working in medical, orthopaedic, and surgical areas had slightly better perceptions than nurses working in multidisciplinary and oncology areas.
CONCLUSION: These findings suggest that nurses need to continually improve their knowledge about risk factors for phlebitis to ensure safer nursing practice.
Climate change: Why higher education matters?

Leal Filho W, Aina YA, Dinis MAP, Purcell W, Nagy GJ

Sci Total Environ, 2023 Sep 20;892:164819.
PMID: 37315612 DOI: 10.1016/j.scitotenv.2023.164819

Higher education (HE) matters to the global struggle to combat climate change. Research builds knowledge and informs climate solutions. Educational programmes and courses upskill current and future leaders and professionals to tackle the systems change and the transformation needed to improve society. Through their outreach and civic engagement work, HE helps people understand and address the climate change impacts, notably on under-resourced or marginalised people. By raising awareness of the problem and supporting capacity and capability building, HE encourages changes in attitudes and behaviours, focusing on adaptive change in preparing people to face the challenges of a changing climate. However, HE has yet to fully articulate its contribution towards climate change challenges, which means that organisational structures, curricula and research programmes do not reflect the interdisciplinary nature of the climate crisis. This paper describes the role of HE in supporting education and research efforts on climate change and outlines areas where further action is urgently needed. The study adds to the empirical research on HE's role in combating climate change and the role of cooperation in maximising the global effort to cope with a changing climate.
A case of lupus nephritis flare-up in severe COVID-19 infection

Yusuf AS, Cheong XK, Rozita M, Periyasamy P, Ruslinda M

Med J Malaysia, 2021 09;76(5):757-761.
PMID: 34508391

The novel Coronavirus disease 2019 (COVID-19) had rapidly spread and became a worldwide pandemic since its detection in Wuhan, China. The disease has caused significant morbidity and mortality, particularly among patients with comorbidities. The current treatment involves supportive management alongside antiviral therapy and immunosuppressant therapy in severely affected patients. We describe a case of a patient with underlying lupus nephritis (LN) who presented with severe COVID-19 infection and concomitant LN flare with acute kidney injury (AKI). The patient was treated with antiviral therapy, Favipiravir, considering his risk of developing severe COVID-19 infection. As the patients would usually have AKI alongside LN flare, we administered initial steroid therapy at a lower dose (Methylprednisolone 50mg daily) and oral hydroxychloroquine despite the initial concerns on immunosuppressant usage in COVID-19 infections. Although our patient recovered relatively well from COVID- 19 infection, he continued to have positive reverse transcriptase-polymerase chain reaction (RT-PCR) nasopharyngeal swab for COVID-19 up to 29 days of illness. His kidney function stabilised despite having persistent nephrotic range proteinuria. Hence, the attending team decided to pulse the patient with a high dose steroid (IV Methylprednisolone 250mg OD for three days) after two weeks of illness despite the persistent positive swab. The patient's condition continued to improve, and this case illustrates an approach in treating COVID-19 with concomitant active immune-mediated glomerulonephritis. We find that it is safe to institute high dose immunosuppressant in recovered COVID-19 patients two weeks after the illness.
Fulltext Awareness of ovarian cancer risk factors among women in Malaysia: a preliminary study

Keng SL, Abdul Wahab SB, Chiu LB, Yusuf A

Asian Pac J Cancer Prev, 2015;16(2):537-40.
PMID: 25684484

BACKGROUND: Ovarian cancer is recognized as the fourth leading cancer in Malaysia. However, women do not always seek help in a timely manner and gaps in awareness may influence screening uptake and presentation. The purpose of this study was to determine levels of awareness of ovarian cancer risk factors in female population in Penang, Malaysia.

MATERIALS AND METHODS: A cross-sectional study was conducted in Penang, Malaysia from January until February 2014. Eighty-seven women were selected by convenient sampling. Awareness of risk factors of ovarian cancer was assessed using a self-administered questionnaire. Data were analyzed using statistical package for the social sciences (SPSS) version 20.0 for descriptive statistics and Pearson chi-square test for the association between socio-demographic data and awareness. A p value ≤0.05 was considered statistically significant.

RESULTS: In all, 74.7% of participants answered correctly for the risk factor of increasing age, although 94.3% were unaware of increased risk of tall women. A majority, 71.3%, had a low level of awareness of ovarian cancer risk factors. There was a significant association between age and knowledge (p=0.047). Additionally, there was a significant association between higher education level and level of awareness of ovarian cancer risk factors (p=0.039).

CONCLUSIONS: This study revealed that awareness of ovarian cancer risk factors among Malaysian women is low. The results show a need for improved public understanding about ovarian cancer risks and provision of important information for health professionals about initiatives needed for future awareness, prevention and screening programs.
Malaysian nurses' knowledge and attitudes regarding BRCA genetic testing

Liu KT, Wan Rosli WR, Yusuf A, Lean Keng S

Belitung Nurs J, 2021;7(6):493-499.
PMID: 37497287 DOI: 10.33546/bnj.1802

BACKGROUND: Breast cancer genetic (BRCA) testing for cancer susceptibility is an emerging technology in medicine.
OBJECTIVE: This study assessed the knowledge and attitude of nurses regarding BRCA genetic testing in a tertiary teaching hospital in Malaysia.
METHODS: A descriptive cross-sectional study was conducted among 150 nurses using a simple random sampling technique in a tertiary teaching hospital in northeast peninsular Malaysia. Data were collected using a self-administered questionnaire consisting of socio-demographic data, assessing nurses' knowledge and attitude regarding BRCA genetic testing. Fisher exact test analysis was used to determine the association between socio-demographic characteristics with knowledge and attitude level. In addition, the overall knowledge and attitude were analysed using the sum score of each outcome based on Bloom's cut-off point.
RESULTS: Of the 150 nurses, 66.7% had high knowledge level about BRCA genetic testing, and 58% were positive towards genetic testing. The participants' mean age was 28.9 years (SD = 6.70). Years of working experience (p = 0.014) significantly influenced knowledge level on BRCA genetic testing, whereas speciality working experience (p <0.001) significantly influenced BRCA genetic testing attitudes.
CONCLUSIONS: The results show that most nurses have adequate knowledge of BRCA genetic testing. However, their attitude could be termed negative. Therefore, targeted education programs on BRCA genetic testing and risk are needed to improve the knowledge and attitude of nurses and, ultimately, can educate the women and increase health-seeking behaviour among eligible women.
Fulltext Growth Performance, Carcass Characteristics and Meat Yield of Boer Goats Fed Diets Containing Leaves or Whole Parts of Andrographis paniculata

Yusuf AL, Goh YM, Samsudin AA, Alimon AR, Sazili AQ

Asian-Australas J Anim Sci, 2014 Apr;27(4):503-10.
PMID: 25049980 DOI: 10.5713/ajas.2013.13533

The study was conducted to determine the effect of feeding diets containing Andrographis paniculata leaves (APL), whole Andrographis paniculata plant (APWP) and a control without Andrographis paniculata (AP0), on growth performance, carcass characteristics and meat yield of 24 intact Boer bucks. The results obtained indicated that inclusion of Andrographis paniculata significantly improved feed intake, weight gain, feed efficiency and live weight. The ratios of carcass to fat, lean to bone, lean to fat, and composition of meat were also improved. In addition, there were significant differences (p<0.05) between the dietary treatments in dressing percentage and chilling loss. Goats fed on AP0 (control) had significantly higher proportions of fat and bone, as well as thicker back fat than the supplemented animals (APL and APWP). Higher gut fill in animals fed Andrographis paniculata suggested slow rate of digestion, which could have improved utilization and absorption of nutrients by the animals. Goats fed Andrographis paniculata also produced higher meat yield and relatively lower fat contents (p<0.05).
Understanding the breast cancer experience: a qualitative study of Malaysian women

Yusuf A, Ab Hadi IS, Mahamood Z, Ahmad Z, Keng SL

Asian Pac J Cancer Prev, 2013;14(6):3689-98.
PMID: 23886167

Breast cancer is the most common and leading cause of cancer mortality among Malaysian women. Despite good survival rates, the diagnosis of cancer still invokes the feeling of stress, fear and uncertainty. Because very little is known about the experiences of Malaysian women with breast cancer, a qualitative study using semi- structured interviews to explore the lived experience of newly diagnosed breast cancer. Using a purposive sampling method, 20 Malaysian women newly diagnosed with breast cancer, including Malays (n=10) and Chinese (n=10) were recruited in two main public hospitals in Kelantan. Similarities and divergence in women's experience were identified through thematic analysis of interview transcripts. Three themes emerged from the data: uncertainty experience of the illness, transition process and fatalistic view of breast cancer. In many ways, these findings were parallel with previous studies, suggesting that the experience of breast cancer is to a certain extent similar among women newly diagnosed with breast cancer. This study adds to the sparse literature concerning the experience of illness following breast cancer diagnosis among the Malays and Chinese. More importantly, this study addressed areas that were previously lacking, specifically in depth information on breast cancer experience from a developing country with a multi-ethnic population. The results of this investigation provide preliminary information to healthcare professionals on the impact of illness and cultural influence on survivorship to plan for appropriate education and supportive programme in order to meet the needs of breast cancer women more effectively.
Fulltext Stability analysis and optimal control of covid-19 with convex incidence rate in Khyber Pakhtunkhawa (Pakistan)

Khan A, Zarin R, Hussain G, Ahmad NA, Mohd MH, Yusuf A

Results Phys, 2021 Jan;20:103703.
PMID: 33520623 DOI: 10.1016/j.rinp.2020.103703

The dynamic of covid-19 epidemic model with a convex incidence rate is studied in this article. First, we formulate the model without control and study all the basic properties and results including local and global stability. We show the global stability of disease free equilibrium using the method of Lyapunov function theory while for disease endemic, we use the method of geometrical approach. Furthermore, we develop a model with suitable optimal control strategies. Our aim is to minimize the infection in the host population. In order to do this, we use two control variables. Moreover, sensitivity analysis complemented by simulations are performed to determine how changes in parameters affect the dynamical behavior of the system. Taking into account the central manifold theory the bifurcation analysis is also incorporated. The numerical simulations are performed in order to show the feasibility of the control strategy and effectiveness of the theoretical results.
Potential biomarkers in NASH-induced liver cirrhosis with hepatocellular carcinoma: A preliminary work on roles of exosomal miR-182, miR-301a, and miR-373

Muhammad Yusuf AN, Raja Ali RA, Muhammad Nawawi KN, Mokhtar NM

Malays J Pathol, 2020 Dec;42(3):377-384.
PMID: 33361718

INTRODUCTION: Recent studies have published the roles of exosomal miRNAs in the pathogenesis of various type of malignancies and can be developed as potential biomarkers for diagnostic, prognostic and therapeutic purposes. The aim of this study was to identify the expression level of selected miRNAs (miR-182, miR-301a, and miR-373) in exosomes of the serum and ascitic fluid in patients with non-alcoholic steatohepatitis (NASH)-related liver cirrhosis with or without hepatocellular carcinoma (HCC).
MATERIALS AND METHODS: A literature search was performed to identify potential miRNAs involved in the pathogenesis of HCC. Unpaired serum and ascitic fluid were obtained from 52 patients with NASH related liver cirrhosis (n=26 for each group of with and without HCC). Exosomal miRNA was isolated from all samples. Expression levels of miR-182, miR-301a and miR- 373 were determined using quantitative real-time PCR.
RESULTS: Serum-derived exosomal mir-182, miR-301a and miR-373 were significantly up-regulated with fold change of 1.77, 2.52, and 1.67 (p< 0.05) respectively in NASH-induced liver cirrhosis with HCC as compared to NASH-induced liver cirrhosis without HCC. We identified the expression levels of ascitic fluid-derived exosomal mir-182, miR-301a, and miR-373 were significantly up-regulated with fold change of 1.6, 1.94 and 2.13 respectively in NASH-induced liver cirrhosis with HCC as compared to NASH-induced liver cirrhosis without HCC (p <0.05). There was poor correlation expression of all the selected exosomal miRNA between serum- and ascitic fluid-derived in HCC group.
CONCLUSIONS: This preliminary data showed significant increase in the expression levels of exosomal miR-182, miR-301a and miR- 373 in both serum and ascetic fluid suggesting the possible roles of these miRNAs as circulating biomarkers for NASH-induced liver cirrhosis with hepatocellular carcinoma.
Fulltext Development of Mobile App for Breast Examination Awareness Using Health Belief Model: A Qualitative Study

Nasution A, Yusuf A, Lean Keng S, Rasudin NS, P Iskandar YH, Ab Hadi IS

Asian Pac J Cancer Prev, 2021 Oct 01;22(10):3151-3163.
PMID: 34710991 DOI: 10.31557/APJCP.2021.22.10.3151

BACKGROUND: Mobile health technologies are widely being used for delivering health behaviour interventions. However, there is insufficient evidence that they are integrating theory and only a few researchers utilized a qualitative approach in their study.
OBJECTIVES: This paper aims to identify requirements in developing a breast examination awareness mobile app based on the component of the Health Belief Model (HBM) for integration in health promotion strategy.
METHODS: A qualitative approach using semi-structured in-depth interview was utilized in this study. A purposive sampling method was conducted among public women attending hospital services, software and content experts in a tertiary teaching hospital in the East coast of Peninsular Malaysia. These interviews were recorded, transcribed and organized using NVIVO 11. The main themes were identified through thematic analysis of the interview transcripts. Results: A total of 37 participants recruited in this study. The themes that emerged from the analysis are vulnerability, forecasting, reactive, influence, outcome and obstacles. The sub-themes findings supported the HBM's component in terms of the requirement for are an infographic risk factor, video (symptoms, self-examination), info (metastasis, survival, screening, triple assessment, treatment, myth and facts, benefit of early treatment, support groups), features (screening reminder, sharing button, prompt) and mobile app's design.
CONCLUSION: The research findings could provide a guide for future app development from public women, content and software experts. The information will be used to develop a breast examination awareness mobile app integrated with health theories.
Fulltext Breast awareness mobile apps for health education and promotion for breast cancer

Yusuf A, P Iskandar YH, Ab Hadi IS, Nasution A, Lean Keng S

Front Public Health, 2022;10:951641.
PMID: 36324460 DOI: 10.3389/fpubh.2022.951641

BACKGROUND: Lack of knowledge, poor awareness, and attitude are barriers to breast cancer (BC) screening participation. The ubiquitous usage of mobile phones makes it a perfect platform for delivering interventions to increase knowledge and awareness in screening, a strategy for early identification of BC. However, although numerous applications for BC prevention are available on major mobile phone platforms, relatively few have been tested in scientific studies to determine their efficacy.
OBJECTIVE: This study aimed to assess the efficacy of BrAware Apps in increasing the knowledge of BC risk factors, awareness of warning signs and confidence in breast self-examination (BSE) among women in northeast peninsular Malaysia.
METHODS: A quasi-experimental pre and post-test research design were conducted with 41 women participants in Kelantan, Malaysia, before and after using the BrAware apps. Participants were given an online, adapted Breast Cancer Awareness Measure questionnaire. Post-test was 2 months after using the BrAware apps. Comparison using paired T-tests were conducted to evaluate the change in knowledge of risk factors, warning signs awareness and confidence level for BSE.
RESULTS: The mean age of women was 39.71(SD = 8.80). The participants' mean knowledge score of BC warning signs differs before using BrAware (mean 70.62, SD 11.74) and after using the BrAware app (mean 79.83, SD 10.15) at the <0.001 level of significance.
CONCLUSIONS: The BrAware mobile app had a positive effect in increasing the women's knowledge of risk factors of BC, warning signs awareness and confidence level for BSE. It can be concluded that the mobile app may be an adjunct in educating women on BC.
Depression, anxiety and stress among metastatic breast cancer patients on chemotherapy in China

Guo YQ, Ju QM, You M, Liu Y, Yusuf A, Soon LK

BMC Nurs, 2023 Feb 06;22(1):33.
PMID: 36747213 DOI: 10.1186/s12912-023-01184-1

OBJECTIVE: This study aimed to assess the level of depression, anxiety and stress among metastatic breast cancer (MBC) patients undergoing chemotherapy (CT) in Beijing, China.
METHODS: A cross-sectional study was conducted on 176 MBC women receiving CT, selected by purposive sampling. Data were collected using self-administered questionnaires that included participants' socio-demographic status, DASS-21 and Brief COPE. Data were analyzed using descriptive statistics and general linear regression analysis.
RESULTS: The incidence of depression, anxiety and stress among MBC women were 52.3%, 60.2% and 36.9%, respectively. General linear regression showed that age, marital status, monthly income, physical functioning, emotional functioning, pain, dyspnea, and appetite loss were associated with depression. All variance determined the depression (R2) was 35.6%. Marital status, self-blame and behavioral disengagement were the predictors of stress and accounted for a 35.4% stress variance in MBC women.
CONCLUSION: Our study demonstrated depression, anxiety, and stress prevalence are high in MBC women. Assessment of psychological distress (depression, anxiety, and stress) is important to recognise MBC patients who need help and further medical and mental help support. This study's findings can increasingly highlight that depression, anxiety, and stress are substantial problems in MBC patients. Therefore, psychological interventions are needed to reduce depression, anxiety, and stress for MBC patients.
Fulltext Spiritual Needs and Influencing Factors of Postoperative Breast Cancer Women Undergoing Chemotherapy: A Cross-Sectional Study

Cheng SL, Yusuf A, He YY, Tang WZ, Sulaiman NABS

Risk Manag Healthc Policy, 2024;17:843-853.
PMID: 38617594 DOI: 10.2147/RMHP.S453184

PURPOSE: The purpose of the study was to determine the status of spiritual needs and influencing factors of postoperative breast cancer (BC) women undergoing chemotherapy.
PARTICIPANTS AND METHODS: This study is a cross-sectional study. A total of 173 participants completed a general information questionnaire and a Chinese version of the Spiritual Needs Scale at the Guangxi Medical University Cancer Hospital. Data were collected by purposive sampling from December 2022 to April 2023. Data were analyzed by descriptive statistics, independent t-test, ANOVA, non-parametric test, and logistic regression analysis.
RESULTS: The spiritual needs of postoperative BC women undergoing chemotherapy were at a high level (84.20 ± 12.86). The need for "hope and peace" was considered paramount and the need for a "relationship with transcendence" was considered the least important. Significant differences were found in the following: spiritual needs total score (P=0.040) and "hope and peace" (P=0.021) in education level; "love and connection" in disease stage (P=0.021); "meaning and purpose" in education level (P=0.013), household income (P=0.012), and payment method (P=0.015); "relationship with transcendence" in religion (P<0.001); and "acceptance of dying" in marital status (P=0.023). The level of education was the influencing factor of spiritual needs (OR=1.50, P=0.005), especially for "hope and peace" (OR=1.50, P=0.012).
CONCLUSION: The spiritual need of postoperative BC Chinese women undergoing chemotherapy is at a high level and should receive more attention. In clinical work, nurses should fully assess the spiritual needs of patients and meet their specific needs. Results may help nurses to develop targeted and comprehensive spiritual intervention strategies according to the characteristics of patients.
Fulltext Barriers to institutional social sustainability

Leal Filho W, Salvia AL, Vasconcelos CRP, Anholon R, Rampasso IS, Eustachio JHPP, et al.

Sustain Sci, 2022;17(6):2615-2630.
PMID: 36032314 DOI: 10.1007/s11625-022-01204-0

Social sustainability is a work field characterised by an emphasis on social aspects, e.g. equity, ethics, health, gender balance, or empowerment, within a broader sustainability context. Although the concept seems to be reasonably well established and deemed worthy of pursuing, some obstacles prevent its wide dissemination. Through a bibliometric analysis focusing on the literature on social sustainability at institutions, with a focus on companies, this paper aims to investigate and describe some of the barriers associated with social sustainability implementation. Apart from identifying that sustainability reporting, environmental disclosure and financial performance play a central role in successfully achieving social sustainability, in the context of which gender-related issues seem more tangential, the results indicated some solutions commonly reported for overcoming barriers and obstacles to a company's social sustainability implementation within different sectors. These solutions have to do, among many other factors addressed in this study, with strengthening communication transparency and trust, contributing to awareness, using technology to document and promote social sustainability. Thus, empowering organizations and citizens, recognized as essential factors to social development, and addressing the challenges in a multi-dimensional way.
Fulltext Correction to: Factors influencing childhood anaemia in Bangladesh: a two level logistic regression analysis

Yusuf A, Mamun ASMA, Kamruzzaman M, Saw A, Abo El-Fetoh NM, Lestrel PE, et al.

BMC Pediatr, 2019 Jul 26;19(1):258.
PMID: 31349810 DOI: 10.1186/s12887-019-1607-3

Following publication of the original article [1], the authors reported that name that appeared in published online version is incorrect.
Fulltext Factors influencing childhood anaemia in Bangladesh: a two level logistic regression analysis

Yusuf A, Mamun ASMA, Kamruzzaman M, Saw A, Abo El-Fetoh NM, Lestrel PE, et al.

BMC Pediatr, 2019 06 29;19(1):213.
PMID: 31255172 DOI: 10.1186/s12887-019-1581-9

BACKGROUND: Anemia is not only a major public health problem among children in developing countries, it is also an important predictor for their future growth and development. The objective of this study was to identify possible factors associated with anemia among pre-school children in Bangladesh after removing a cluster effect of the population, and to determine the prevalence of this condition.
METHODS: Data for this study was extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS-2011). In this survey, data was collected using a two-stage stratified cluster sampling approach. The chi-square test and a two-level logistic regression model were used for further analysis.
RESULTS: Data from 2231 children aged 6-59 months were included for analysis. The prevalence of child anemia was noted to be 52.10%. Among these anemic children, 48.40% where from urban environment and 53.90% were from rural areas. The prevalence of mild, moderate and severe anemia among children was 57.10, 41.40 and 1.50% respectively. The two-level logistic regression model revealed that the following factors were associated with childhood anemia: children of anemic mothers (p

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