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Fulltext Effectiveness of An Educational Intervention of Breast Cancer Screening Practices Uptake, Knowledge, and Beliefs among Yemeni Female School Teachers in Klang Valley, Malaysia: A Study Protocol for a Cluster-Randomized Controlled Trial

Noman S, Shahar HK, Abdul Rahman H, Ismail S

Int J Environ Res Public Health, 2020 02 12;17(4).
PMID: 32059587 DOI: 10.3390/ijerph17041167

Breast cancer is the most common cancer spread among women worldwide. Whereas many studies have discussed the significance of breast cancer screening among women in various countries, few have attempted to discuss this topic among female school teachers. As teachers educate and communicate with students, this may play an essential role in health education and in promoting healthy behavior, such as breast cancer screening. The primary goal of this study is to develop and implement an educational intervention of breast cancer screening and evaluate its effectiveness among Yemeni female school teachers in Malaysia. This was carried out as per the health belief model. A cluster-randomized controlled trial was conducted among 183 Yemeni female school teachers in twelve schools in Klang Valley, Malaysia. A random assignment of the target schools was made to include them within the intervention or control group. Participants in the intervention group were offered a 90-minute session for one-day educational intervention on breast cancer screening. On the other hand, participants in the control group were offered the same educational materials at the end of the study. Relevant data was collected at baseline, one month following the intervention, and then three- and six-months follow-up assessments. Analysis of such data was done via IBM SPSS software 25.0 by generalized estimating equations (GEE) to assess the differential changes over time. A primary outcome embodied in breast cancer screening practice uptake was expected. Secondary outcomes include the target group's knowledge on and beliefs of breast cancer screening. This study intends to contribute to the credibility and effectiveness of utilizing a theory-based breast cancer screening intervention in order to raise the awareness of women on conducting breast cancer screening.
Fulltext Grey System Theory in the Study of Medical Tourism Industry and Its Economic Impact

Dang HS, Nguyen TM, Wang CN, Day JD, Dang TMH

Int J Environ Res Public Health, 2020 02 04;17(3).
PMID: 32033177 DOI: 10.3390/ijerph17030961

The Asia-Pacific region is known as a favorite destination for global medical travelers due to its medical expertise, innovative technology, safety, attractive tourism destination and cost advantage in the recent decade. This study contributes to propose an approach which effectively assesses performance of medical tourism industry based on considering the economic impact factors as well as provides a conceptual framework for the industry analysis. Grey system theory is utilized as a major analyzing approach. According to that, factors impact on the sustainable development of medical tourism in Asia-Pacific region could be identified. The performance of each destination in this region was simultaneously revealed. The results presented an overall perspective of the medical tourism industry in the scope of the Asia-Pacific region, and in Taiwan particularly. Data was collected on six major destinations including Singapore, Thailand, India, South Korea, Malaysia and Taiwan. The results proved that tourism sources and healthcare medical infrastructures play a crucial role in promoting the healthcare travel industry, while cost advantage and marketing effectiveness were less considered. In addition, performance analyse indicated that Thailand has a good performance and stands in the top ranking, followed by Malaysia, India, Singapore, South Korea and Taiwan, respectively. The revenue of Taiwan has increased slowly in the last six years, with a market worth approximately NT$20.5 billion, and the number of medical travelers is expected to increase to 777,523 by 2025. The findings of this study are expected to provide useful information for the medical tourism industry and related key players in strategic planning.
Fulltext Diabetes in Pregnancy and Risk of Antepartum Depression: A Systematic Review and Meta-Analysis of Cohort Studies

Lee KW, Ching SM, Devaraj NK, Chong SC, Lim SY, Loh HC, et al.

Int J Environ Res Public Health, 2020 05 26;17(11).
PMID: 32466479 DOI: 10.3390/ijerph17113767

Previous literature has reported that patients with diabetes in pregnancy (DIP) are at risk of developing antepartum depression but the results have been inconsistent in cohort studies. We conducted a systematic review and performed a meta-analysis to quantify the association between DIP and risk of antepartum depression in cohort studies. Medline, Cinahl, and PubMed databases were searched for studies investigating DIP involving pregnant women with pre-existing diabetes and gestational diabetes mellitus and their risk of antepartum depression that were published in journals from inception to 27 December 2019. We derived the summary estimates using a random-effects model and reported the findings as pooled relative risks (RR) and confidence interval (CI). Publication bias was assessed using a funnel plot and was quantified by Egger and Begg's tests. Ten studies, involving 71,036 pregnant women were included in this meta-analysis. The pooled RR to develop antepartum depression was (RR = 1.430, 95% CI: 1.251-1.636) among women with gestational diabetes mellitus. Combining pregnant women with pre-existing diabetes mellitus and gestational diabetes mellitus, they had a significant increased risk of developing antepartum depression (RR = 1.431, 95% CI: 1.205-1.699) compared with those without it. In comparison, we found no association between pre-existing diabetes mellitus in pregnancy (RR = 1.300, 95% CI: 0.736-2.297) and the risk of developing antepartum depression. This study has a few limitations: first, different questionnaire and cut-off points were used in evaluation of depression across the studies. Second, there was a lack of data on history of depression prior to pregnancy, which lead to confounding bias that could not be solved by this meta-analysis. Third, data were dominated by studies in Western countries; this is due to the studies from Eastern countries failing to meet our inclusion criteria for statistical analysis. Women with gestational diabetes mellitus have an increased risk of developing antepartum depression compared to those without the disease. Therefore, more attention on the mental health status should be given on pregnant women diagnosed with pre-existing diabetes mellitus and gestational diabetes mellitus.
Fulltext The Correlation between Hemoglobin A1c (HbA1c) and Hyperreflective Dots (HRD) in Diabetic Patients

Wong BS, Sharanjeet-Kaur S, Ngah NF, Sawri RR

Int J Environ Res Public Health, 2020 05 01;17(9).
PMID: 32369922 DOI: 10.3390/ijerph17093154

Hyperreflective dots (HRD) are activated retinal microglial cells induced by retinal inflammation in diabetic patients. This study was conducted to compare the HRD count of normal and diabetic subjects; to determine the correlation between hemoglobin A1c (HbA1c) levels and HRD count; to determine HbA1c cut-off levels for the appearance of HRD in diabetic patients. A cross-sectional study was conducted among normal and diabetic patients. Fundus photos, SD-OCT images and HbA1c levels were taken. A total of 25 normal subjects, 32 diabetics without retinopathy and 26 mild-to-moderate nonproliferative diabetic retinopathy (NPDR) diabetics were recruited. There was a statistically significant difference between the mean count of HRD among the normal group, the diabetic without retinopathy group and the mild-to-moderate NPRD group. The mean HRD count in the inner retina layer was significantly higher compared to the outer retina layer. There was a significant linear relationship between the HbA1c levels and HRD count. Using the receiver operating curve, the HbA1c level of 5.4% was chosen as the cut-off point for the appearance of HRD. The positive linear correlation between the HbA1c levels and the appearance of HRD may indicate that hyperglycemia could activate retina microglial cells in diabetic patients.
Fulltext Effect of Kelulut Honey on the Cellular Dynamics of TGFβ-Induced Epithelial to Mesenchymal Transition in Primary Human Keratinocytes

Nordin A, Chowdhury SR, Saim AB, Bt Hj Idrus R

Int J Environ Res Public Health, 2020 05 06;17(9).
PMID: 32384749 DOI: 10.3390/ijerph17093229

Over-induction of epithelial to mesenchymal transition (EMT) by tumor growth factor beta (TGFβ) in keratinocytes is a key feature in keloid scar. The present work seeks to investigate the effect of Kelulut honey (KH) on TGFβ-induced EMT in human primary keratinocytes. Image analysis of the real time observation of TGFβ-induced keratinocytes revealed a faster wound closure and individual migration velocity compared to the untreated control. TGFβ-induced keratinocytes also have reduced circularity and display a classic EMT protein expression. Treatment of 0.0015% (v/v) KH reverses these effects. In untreated keratinocytes, KH resulted in slower initial wound closure and individual migration velocity, which sped up later on, resulting in greater wound closure at the final time point. KH treatment also led to greater directional migration compared to the control. KH treatment caused reduced circularity in keratinocytes but displayed a partial EMT protein expression. Taken together, the findings suggest the therapeutic potential of KH in preventing keloid scar by attenuating TGFβ-induced EMT.
Fulltext Hypocholesterolaemic and Anti-Atherogenic Effects of Palm-Based Oils (NoveLin I and NoveLin II) in Cholesterol-Fed Rabbits

Che Idris CA, Wai Lin S, Abdull Razis AF

Int J Environ Res Public Health, 2020 05 06;17(9).
PMID: 32384714 DOI: 10.3390/ijerph17093226

NoveLin I and NoveLin II are palm-based oils. NoveLin I has an equal distribution of saturated, monounsaturated and polyunsaturated fatty acids, whereas NoveLin II has a moderate level of monounsaturated fatty acids, and a lower content of saturated and polyunsaturated fatty acids. However, their hypocholesterolaemic and anti-atherogenic effects have not been studied. Therefore, this study aimed to assess the hypocholesterolaemic and anti-atherogenic effects of these oils. Forty male New Zealand White rabbits were divided into four groups and fed with diets containing 35% energy fat with added 0.15% (w/w) dietary cholesterol. Group 1, as the control group (CNO) was fed with a diet containing coconut oil, group 2 and 3 were fed with diets containing either NoveLin I or NoveLin II, and group 4, was fed with diet containing olive oil (OLV) for 100 days. Our results demonstrated that both NoveLin groups have significantly lower total cholesterol and low-density lipoprotein-cholesterol (LDL-C) compared to CNO group and are comparable to the OLV group. Low density lipoprotein-cholesterol/high density lipoprotein-cholesterol (LDL/HDL-C) ratio was significantly lower after the NoveLin II diet but attained significance only in comparison to NoveLin I and CNO groups. Aortic fibrous plaque score was significantly lower in both NoveLin groups compared to CNO group. Our findings suggest that despite the high-fat cholesterol diet, NoveLin II oil resulted in atherogenic effects comparable to olive oil.
Fulltext View of Pakistani Residents toward Coronavirus Disease (COVID-19) during a Rapid Outbreak: A Rapid Online Survey

Hayat K, Rosenthal M, Xu S, Arshed M, Li P, Zhai P, et al.

Int J Environ Res Public Health, 2020 05 12;17(10).
PMID: 32408528 DOI: 10.3390/ijerph17103347

BACKGROUND: Coronavirus disease (COVID-19) is a deadly disease that is affecting most of the countries worldwide. Public understanding, including knowledge about signs and symptoms, mode of transmission, and hygiene of COVID-19, is vital for designing effective control strategies during a public health crisis. The current study is aimed at investigating the public's perspective about COVID-19, including their knowledge, attitude, and practices.
METHODS: A rapid online survey comprising 22 items was administered during the rapid outbreak of COVID-19 in Pakistan. Questions were focused on the prevention, transmission, clinical features, and control of COVID-19. In addition, the attitudes and practices of the participants were explored. Descriptive statistics, Mann-Whitney tests, Kruskal-Wallis tests, and regression analysis were carried out during data analysis.
RESULTS: A total of 1257 respondents participated in this study. Most of the respondents had good knowledge (good = 64.8%, average = 30.5%, poor = 4.7%) of COVID-19. Gender, marital status, education, and residence were observed to have a significant association with the knowledge score. A vast majority of the survey respondents (77.0%) believed that COVID-19 would be controlled successfully in Pakistan. The practices of wearing a mask (85.8%) and handwashing (88.1%) were common among the participants.
CONCLUSION: The participants demonstrated good knowledge and reasonable attitudes and practices toward most aspects of the COVID-19 outbreak. Improvements in certain areas could be made by mass-level education.
Fulltext Assessing Cadmium and Chromium Concentrations in Drinking Water to Predict Health Risk in Malaysia

Ahmed MF, Mokhtar MB

Int J Environ Res Public Health, 2020 04 24;17(8).
PMID: 32344678 DOI: 10.3390/ijerph17082966

Although toxic Cd (cadmium) and Cr (chromium) in the aquatic environment are mainly from natural sources, human activities have increased their concentrations. Several studies have reported higher concentrations of Cd and Cr in the aquatic environment of Malaysia; however, the association between metal ingestion via drinking water and human health risk has not been established. This study collected water samples from four stages of the drinking water supply chain at Langat River Basin, Malaysia in 2015 to analyze the samples by inductivity coupled plasma mass spectrometry. Mean concentrations of Cd and Cr and the time-series river data (2004-2014) of these metals were significantly within the safe limit of drinking water quality standard proposed by the Ministry of Health Malaysia and the World Health Organization. Hazard quotient (HQ) and lifetime cancer risk (LCR) values of Cd and Cr in 2015 and 2020 also indicate no significant human health risk of its ingestion via drinking water. Additionally, management of pollution sources in the Langat Basin from 2004 to 2015 decreased Cr concentration in 2020 on the basis of autoregression moving average. Although Cd and Cr concentrations were found to be within the safe limits at Langat Basin, high concentrations of these metals have been found in household tap water, especially due to the contamination in the water distribution pipeline. Therefore, a two-layer water filtration system should be introduced in the basin to achieve the United Nations Sustainable Development Goals (SDGs) 2030 agenda of a better and more sustainable future for all, especially via SDG 6 of supplying safe drinking water at the household level.
Fulltext Dietary Patterns and Associated Factors Among Adolescents in Malaysia: Findings from Adolescent Nutrition Survey 2017

Man CS, Salleh R, Ahmad MH, Baharudin A, Koon PB, Aris T

Int J Environ Res Public Health, 2020 05 14;17(10).
PMID: 32423077 DOI: 10.3390/ijerph17103431

Balanced diet in the early stages of life plays a role in optimum growth and maintains good health status of adolescents. Dietary habits that are established during adolescence will sustain till adulthood. Therefore, this present study aims to identify the dietary patterns and to determine factors associated with dietary patterns in terms of socio-demographic characteristics, locality of schools, ethnicity, eating habits, self-perceived weight status, and food label reading habit among adolescents in Malaysia. Data from the Adolescent Nutrition Survey (ANS) 2017 was used for the present study. ANS is a population representative school-based cross-sectional study among school-going adolescents from primary four to secondary five from schools in 13 states and three federal territories registered under the Ministry of Education Malaysia. A self-administrated questionnaire was used to collect information on socio-demographic characteristics, locality of schools, ethnicity, eating habits, self-perceived weight status, and food label reading habit. A pre-tested face-to-face food frequency questionnaire (FFQ) was used to collect information on food group intake frequency. Dietary patterns were identified by using exploratory factor analysis and associated factors, using complex sample general linear model (GLM) analysis. All statistical analyses were carried out at 95% confidence interval or p-value < 0.05. The dietary patterns identified are healthy, unhealthy, and alternative proteins. The healthy dietary pattern was significantly associated with the types of school and ethnicity. The unhealthy dietary pattern was significantly associated with the locality of schools, ethnicity, frequency of snacks intake per week, frequency of eating out per week, self-perceived weight status, and food label reading habit. Significant associations were found between alternative proteins dietary pattern and locality of schools, ethnicity, and types of school. This study found that there is a disparity of dietary patterns between different ethnicity, locality of schools, and types of school. We recommend strategies of specifying ethnicity and geographical area to improve dietary patterns of adolescents in Malaysia.
Fulltext Associations of Serum 25-Hydroxyvitamin D with Adiposity and At-Risk Lipid Profile Differ for Indigenous (Orang Asli) Male and Female Adults of Peninsular Malaysia

Chua EY, Mohd Shariff Z, Sulaiman N, Appannah G, Yong HY

Int J Environ Res Public Health, 2020 04 21;17(8).
PMID: 32326217 DOI: 10.3390/ijerph17082855

BACKGROUND: Low vitamin D status, adiposity, and at-risk lipid profile are associated with adverse health consequences. This study aimed to assess serum 25(OH)D concentration of Indigenous (Orang Asli) adults and to determine the associations between serum 25(OH)D with adiposity and lipid profile, respectively.
METHODS: This cross-sectional study was conducted among 555 (164 men, 391 women) Orang Asli adults aged 18-65 years of Jah Hut sub-tribe in Krau Wildlife Reserve (KWR), Peninsular Malaysia. Demographic and socio-economic information were obtained using interviewer-administered questionnaire. Participants were also assessed for serum 25-hydroxyvitamin D (25(OH)D) concentration, adiposity indices (BMI, WC, WHtR, WHR, %BF) and lipid parameters (TC, LDL-C, HDL-C, TG). Data were analyzed using binary logistic regression via SPSS.
RESULTS: The prevalence of suboptimal 25(OH)D concentration was 26.3%, comprising 24.9% insufficiency (50 to <75 nmol/L) and 1.4% deficiency (<50 nmol/L). While men (14-30.5%) were associated with a more proatherogenic lipid profile than women (6.1-14.3%), more women were with central obesity (M: 19.5-46.3%; F: 34.5-49.1%) and suboptimal (<75 nmol/L) vitamin D status (M: 11.6%; F: 32.4%). While suboptimal 25(OH)D concentration was significantly associated with higher odds of at-risk LDL-C (p < 0.01) and obesity (WC, WHtR) (p < 0.05) in men, no significant association was observed for women. Nonetheless, it should be noted that there were only 19 men with suboptimal (<75 nmol/L) vitamin D status.
CONCLUSIONS: While suboptimal vitamin D status was relatively low in Orang Asli adults, the prevalence of obesity and undesirable serum lipids were relatively high. The sex-specific associations between vitamin D status with adiposity indices and serum lipids warrant further investigation.
Fulltext A Qualitative Evaluation of Adverse Drug Reaction Reporting System in Pakistan: Findings from the Nurses' Perspective

Hussain R, Hassali MA, Ur Rehman A, Muneswarao J, Atif M, Babar ZU

Int J Environ Res Public Health, 2020 04 27;17(9).
PMID: 32349339 DOI: 10.3390/ijerph17093039

The contribution of all key healthcare professionals is vital to promote an efficient adverse drug reaction (ADR) reporting system. In this context, nurses are important as they are in a better position to observe a patient's response regarding the drug therapy and to report an ADR. The aim of the study was to explore the perspectives of nurses about ADR reporting system in Lahore, Pakistan. A total of 21 nurses were interviewed. The thematic content analysis of the qualitative interviews yielded six major themes and eight subthemes. Major themes included: (1) Knowledge about the concept of the medication safety & the ADR; (2) Knowledge regarding pharmacovigilance activities; (3) Willingness to report; (4) Practices related to the ADR reporting; (5) Barriers to the ADR reporting; (6) Facilitators to the ADR reporting. The majority of the nurses were aware of medicine safety and ADRs, but in many cases, they were unable to report these ADRs. The study pointed out considerable concerns regarding the knowledge and practices of nurses about pharmacovigilance activities in their workplace, mainly due to increased workload, due to the absence of a reporting system and legal liability. The main challenges turned out to be the lack of knowledge and training, as well as the implementation of guidelines. Based on the findings, it is suggested that outcome of this study can serve as a guide to design policies that support ADR reporting by nurses in Pakistan.
Fulltext Does Food Insecurity Contribute towards Depression? A Cross-Sectional Study among the Urban Elderly in Malaysia

Mesbah SF, Sulaiman N, Shariff ZM, Ibrahim Z

Int J Environ Res Public Health, 2020 04 30;17(9).
PMID: 32365772 DOI: 10.3390/ijerph17093118

With the aging of the population worldwide, there is an increasing concern for the mental health status as well as physical health. Depression is a common mental health problem among the elderly populations. Since the elderly are susceptible to food insecurity, this cross-sectional study is aimed to determine an association between food insecurity and depression among elderly people. A total of 220 elderly people- aged 60 years and above, residing in the Petaling district of Selangor, were included in this study. Face-to-face interviews were conducted to obtain the pertinent information on demographic background, food security status (six items USDA FSSM), functional status (IADL, EMS), psychosocial status (LSNS-6), and depression status (GDS-15). Binary logistic regression was used to assess the factors that were associated with depression. The median age of the elderly sample was 65.5 years. The prevalence of depression and food insecurity that was recorded were 13.2% and 19.5%, respectively. Social isolation (AOR = 5.882, 95% CI: 2.221, 15.576), food insecurity (AOR = 3.539, 95% CI: 1.350, 9.279), and unsafe mobility (AOR= 3.729, 95% CI: 1.302, 10.683) increased the odds of depression. In conclusion, social isolation, food insecurity, and unsafe mobility are factors associated with depression among the elderly people. Plans such as health interventions as well as grocery and financial aid among the qualifying elderly are suggested to improve this depression and food insecurity.
Fulltext Reply to "Comment on: Effects of Nigella Sativa on Type-2 Diabetes Mellitus: A Systematic Review"

Hamdan A, Idrus RH, Mokhtar MH

Int J Environ Res Public Health, 2020 04 29;17(9).
PMID: 32365740 DOI: 10.3390/ijerph17093111

Thank you for your interest and the comments [1] on our review article "Effects of Nigella Sativa on Type-2 Diabetes Mellitus: A Systematic Review" [2]; we believe research into natural products needs to be supported, as they are at the forefront of drug discovery [...].
Fulltext Is First Trimester Maternal 25-Hydroxyvitamin D Level Related to Adverse Maternal and Neonatal Pregnancy Outcomes? A Prospective Cohort Study among Malaysian Women

Abd Aziz NH, Yazid NA, Abd Rahman R, Abd Rashid N, Wong SK, Mohamad NV, et al.

Int J Environ Res Public Health, 2020 05 08;17(9).
PMID: 32397276 DOI: 10.3390/ijerph17093291

Information on the role of 25-hydroxyvitamin D (25(OH)D) in preventing adverse pregnancy/neonatal outcomes is limited in Malaysia. This study aims to determine the relationship between the level of maternal 25(OH)D in the first trimester of pregnant women and their pregnancy/neonatal outcomes. A total of 60 pregnant women in the first trimester were recruited and followed until the end of their pregnancy. The occurrence of any antenatal, delivery, and neonatal complications was recorded. Their blood was collected in the first trimester for total serum 25(OH)D determination using enzyme-linked immunosorbent assay. Overall, 10% of the women had vitamin D deficiency, while 57% had vitamin D insufficiency in their first trimester. No statistically significant difference in 25(OH)D level/status was observed between women with or without antenatal and delivery complications (p > 0.05). No difference in maternal serum 25(OH)D level and vitamin D status was observed between neonates with or without complications (p > 0.05). In conclusion, there is a high prevalence of vitamin D insufficiency among Malaysian pregnant women, but it is not associated with adverse maternal and neonatal outcomes. More comprehensive studies should be planned to verify this relationship.
Fulltext Statistical Modelling of the Effects of Weather Factors on Malaria Occurrence in Abuja, Nigeria

Segun OE, Shohaimi S, Nallapan M, Lamidi-Sarumoh AA, Salari N

Int J Environ Res Public Health, 2020 05 16;17(10).
PMID: 32429373 DOI: 10.3390/ijerph17103474

Background: despite the increase in malaria control and elimination efforts, weather patterns and ecological factors continue to serve as important drivers of malaria transmission dynamics. This study examined the statistical relationship between weather variables and malaria incidence in Abuja, Nigeria. Methodology/Principal Findings: monthly data on malaria incidence and weather variables were collected in Abuja from the year 2000 to 2013. The analysis of count outcomes was based on generalized linear models, while Pearson correlation analysis was undertaken at the bivariate level. The results showed more malaria incidence in the months with the highest rainfall recorded (June-August). Based on the negative binomial model, every unit increase in humidity corresponds to about 1.010 (95% confidence interval (CI), 1.005-1.015) times increase in malaria cases while the odds of having malaria decreases by 5.8% for every extra unit increase in temperature: 0.942 (95% CI, 0.928-0.956). At lag 1 month, there was a significant positive effect of rainfall on malaria incidence while at lag 4, temperature and humidity had significant influences. Conclusions: malaria remains a widespread infectious disease among the local subjects in the study area. Relative humidity was identified as one of the factors that influence a malaria epidemic at lag 0 while the biggest significant influence of temperature was observed at lag 4. Therefore, emphasis should be given to vector control activities and to create public health awareness on the proper usage of intervention measures such as indoor residual sprays to reduce the epidemic especially during peak periods with suitable weather conditions.
Fulltext Relationship between Alcohol Consumption and Drinking Refusal Self-Efficacy among University Students: The Roles of Sports Type and Gender

Kim Y, Kuan G

Int J Environ Res Public Health, 2020 06 14;17(12).
PMID: 32545921 DOI: 10.3390/ijerph17124251

The present study examines the relationship between drinking behaviour and drinking refusal self-efficacy among university students, with a focus on the influential roles of sports type and gender. A total of 354 students from Seoul National University of Science and Technology volunteered and participated in this study. The Korean Alcohol Use Disorders Identification Test (AUDIT-K), the Korean Drinking Refusal Self-Efficacy (DRSE) Questionnaire-Revised, and a questionnaire measuring participation in sports activities were administered to measure students' alcohol drinking behaviours, refusal self-efficacy and sport-related activities, respectively. The data were analysed using descriptive statistics, two-way ANOVAs, correlation analysis, and regression analysis. The subdomains of DRSE had significant influences on binge drinking. Specifically, low DRSE in situations involving social pressure played a key role in predicting increased binge drinking. There was also a significant relationship between sports type and drinking behaviour, but only for male students. Those who participated in individual sports binge drank less than those who participated in team sports. Finally, gender differences were also revealed in drinking behaviour. Male students were more likely to binge drink compared to their female counterparts. This study offers a foundation for practical interventions to help control problematic drinking behaviour among university students.
Fulltext Monitoring and Assessment of Water Level Fluctuations of the Lake Urmia and Its Environmental Consequences Using Multitemporal Landsat 7 ETM+ Images

Nhu VH, Mohammadi A, Shahabi H, Shirzadi A, Al-Ansari N, Ahmad BB, et al.

Int J Environ Res Public Health, 2020 06 12;17(12).
PMID: 32545634 DOI: 10.3390/ijerph17124210

The declining water level in Lake Urmia has become a significant issue for Iranian policy and decision makers. This lake has been experiencing an abrupt decrease in water level and is at real risk of becoming a complete saline land. Because of its position, assessment of changes in the Lake Urmia is essential. This study aims to evaluate changes in the water level of Lake Urmia using the space-borne remote sensing and GIS techniques. Therefore, multispectral Landsat 7 ETM+ images for the years 2000, 2010, and 2017 were acquired. In addition, precipitation and temperature data for 31 years between 1986 and 2017 were collected for further analysis. Results indicate that the increased temperature (by 19%), decreased rainfall of about 62%, and excessive damming in the Urmia Basin along with mismanagement of water resources are the key factors in the declining water level of Lake Urmia. Furthermore, the current research predicts the potential environmental crisis as the result of the lake shrinking and suggests a few possible alternatives. The insights provided by this study can be beneficial for environmentalists and related organizations working on this and similar topics.
Fulltext Mainstream Preschool Teachers' Skills at Identifying and Referring Children with Autism Spectrum Disorder (ASD)

Mohammed Taresh S, Aniza Ahmad N, Roslan S, Ma'rof AM, Mohammed Zaid S

Int J Environ Res Public Health, 2020 06 16;17(12).
PMID: 32560042 DOI: 10.3390/ijerph17124284

Background: Early intervention will help children with autism spectrum disorder (ASD) to attain early learning reinforcement. This study focuses on exploring the ability of preschool teachers to identify children with ASD and their referral decision-making process. Method: This is a mixed-method study (qualitative and quantitative methods) involving 20 respondents. The qualitative study is based on an open question case study, while the quantitative study consists of questionnaire with demographic variables to identify the effect of the demographic variables on the preschool teachers' ability to identify children with ASD. Sample: The sample was selected via convenience sampling among mainstream preschool teachers. The data was analyzed using SPSS software and thematic analysis. Results: The findings show that preschool teachers did not have skills at identifying children with ASD, and the majority of them labelled children with ASD as spoilt or hyperactive children. They also viewed children with ASD as having other disorders such as attention deficit hyperactivity disorder (ADHD) or communication disorders such as introversion. Moreover, preschool teachers expressed that the reason for the child's behaviour could be due to the parents' inability to properly educate their child. Additionally, the demographic variables of the preschool teachers, such as age, education level and teaching experience, were found not to affect their ASD identification skills. Conclusion: Preschool teachers need to improve their skills in identifying ASD among children via training.
Fulltext I Teach Nursing as a Male Nursing Educator: The East Asian Perspective, Context, and Social Cognitive Career Experiences

Dos Santos LM

Int J Environ Res Public Health, 2020 06 17;17(12).
PMID: 32560396 DOI: 10.3390/ijerph17124327

Social and cultural backgrounds, as well as understanding, play key roles in workforce development and human resource shortages, which are associated with the transition to nursing education and teaching from frontline nursing practices. A qualitative method, with the direction of the general inductive approach, was employed in this study. The researcher collected information from 18 male nursing educators who switched their senior roles (from the frontline and practicing fields to nursing education) at nursing schools in South Korea, Japan, Taiwan, China, and Malaysia. Three interview sessions were used to collect information. Three themes were merged from the information: (i) gender-oriented knowledge, teaching and learning; (ii) respect; and (iii) health promotion. More importantly, participants advocated that their male roles and identities provided uniqueness to patients, students, parents, and the general public concerning Asian customs and practices. Based on the social cognitive career theory, personal goals and achievements of career satisfaction took important roles. Although the general public may not agree with these career decisions, due to gender and social biases, participants continued to contribute their energy and knowledge in the health and social caring professions.
Fulltext How Is Work-Life Balance Arrangement Associated with Organisational Performance? A Meta-Analysis

Wong K, Chan AHS, Teh PL

Int J Environ Res Public Health, 2020 06 21;17(12).
PMID: 32575807 DOI: 10.3390/ijerph17124446

The impacts of the work-life balance arrangement on organisational performance is a growing concern amongst researchers and practitioners. This study synthesised 202 records from 58 published papers to evaluate the relationship between the work-life balance arrangement and organisational performance by means of a meta-analysis. The organisational performance was measured based on six perspectives, including career motivation, employee attendance, employee recruitment, employee retention, organisational commitment, and productivity. The results showed a positive relationship between the work-life balance arrangement and organisational performance (OR: 1.181, 95% CI: 1.125-1.240, p < 0.001). Of the six perspectives, only career motivation, employee attendance, employee recruitment, and employee retention were significantly associated with the work-life balance arrangement. The moderators affecting the relationship between the work-life balance arrangement and organisational performance were gender, sector, and employee hierarchy. The results provide theoretical suggestions on the effectiveness of the work-life balance arrangement in terms of the six perspectives related to organisational performance.

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