Displaying publications 321 - 340 of 4568 in total

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  1. Alslaibi TM, Abunada Z, Abu Amr SS, Abustan I
    Environ Technol, 2018 Nov;39(21):2691-2702.
    PMID: 28789588 DOI: 10.1080/09593330.2017.1365936
    Landfills are one of the main point sources of groundwater pollution. This research mainly aims to assess the risk of nitrate [Formula: see text] transport from the unlined landfill to subsurface layers and groundwater using experimental results and the SESOIL model. Samples from 12 groundwater wells downstream of the landfill were collected and analyzed in 2008, 21 years after the landfill construction. The average [Formula: see text] concentration in the wells was 54 mg/L, slightly higher than the World Health Organization ([Formula: see text] 50 mg/L) standards. SESOIL model was used to predict the [Formula: see text] concentration at the bottom of the unsaturated zone. Results indicated that the current mean [Formula: see text] concentration at the bottom of the unsaturated zone is 75 mg/L. the model predicted that the level of NO3 will increased up to 325 mg/L within 30 years. Accordingly, the [Formula: see text] concentration in groundwater wells near the landfill area is expected to gradually increase with time. Although the current risk associated with the [Formula: see text] level might not be harm to adults, however, it might pose severe risks to both adults and infants in the near future due to [Formula: see text] leaching. Urgent mitigation measures such as final cell cover (cap), lining system and vertical expansion should be considered at the landfill to protect the public health in the area.
    Matched MeSH terms: Risk Assessment
  2. Normaliza AM, Sa'ari MY, Leonard LS, Colman MG
    Med J Malaysia, 2018 02;73(1):62-64.
    PMID: 29531209
    No abstract provided.
    Matched MeSH terms: Risk Factors
  3. Omar K, Baha Raja D, Abdul Taib NA, Rajaram N, Ahmed J, Arvinder-Singh HS, et al.
    Travel Med Infect Dis, 2022;47:102318.
    PMID: 35342008 DOI: 10.1016/j.tmaid.2022.102318
    BACKGROUND: Guided by the best practices adapted from national and international bodies including the World Health Organization (WHO), the Centers for Disease Control (CDC), and the UK Joint Biosecurity Centre (JBC), this paper aims to develop and provide an empirical risk stratification and assessment framework for advancing the safe resumption of global travel during the COVID-19 pandemic.

    METHOD: Variables included in our model are categorized into four pillars: (i) incidence of cases, (ii) reliability of case data, (iii) vaccination, and (iv) variant surveillance. These measures are combined based on weights that reflect their corresponding importance in risk assessment within the context of the pandemic to calculate the risk score for each country. As a validation step, the outcome of the risk stratification from our model is compared against four countries.

    RESULTS: Our model is found to have good agreement with these benchmarked risk designations for 27 out of the top 30 countries with the strongest travel ties to Malaysia (90%). Each factor within this model signifies its importance and can be adapted by governing bodies to address the changing needs of border control policies for the recommencement of international travel.

    CONCLUSION: In practice, the proposed model provides a turnkey solution for nations to manage transmission risk by enabling stakeholders to make informed, evidence-based decisions to minimize fluctuations of imported cases and serves as a structure to support the improvement, planning, and activation of public health control measures.

    Matched MeSH terms: Risk Assessment
  4. Razak MR, Aris AZ, Zainuddin AH, Yusoff FM, Balia Yusof ZN, Kim SD, et al.
    Chemosphere, 2023 Feb;313:137377.
    PMID: 36457264 DOI: 10.1016/j.chemosphere.2022.137377
    Per- and polyfluoroalkyl substances (PFAS) are gaining worldwide attention because of their toxicity, bioaccumulative and resistance to biological degradation in the environment. PFAS can be categorised into endocrine disrupting chemicals (EDCs) and identified as possible carcinogenic agents for the aquatic ecosystem and humans. Despite this, only a few studies have been conducted on the aquatic toxicity of PFAS, particularly in invertebrate species such as zooplankton. This study evaluated the acute toxicity of two main PFAS, perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS), by using freshwater cladocerans (Moina micrura) as bioindicators. This study aimed to assess the adverse effects at different levels of organisations such as organ (heart size and heart rate), individual (individual size and mortality) and population (lethal concentration, LC50). PFOA was shown to be more hazardous than PFOS, with the LC50 values (confidence interval) of 474.7 (350.4-644.5) μg L-1 and 549.6 (407.2-743.9) μg L-1, respectively. As the concentrations of PFOS and PFOA increased, there were declines in individual size and heart rate as compared to the control group. The values of PNECs acquired by using the AF method (PNECAF) for PFOA and PFOS were 0.4747 and 0.5496 μg L-1, respectively. Meanwhile, the PNEC values obtained using the SSD method (PNECSSD) were 1077.0 μg L-1 (PFOA) and 172.5 μg L-1 (PFOS). PNECAF is more protective and conservative compared to PNECSSD. The findings of this study have significant implications for PFOS and PFOA risk assessment in aquatic environments. Thus, it will aid freshwater sustainability and safeguard the human dependency on water resources.
    Matched MeSH terms: Risk Assessment
  5. Kim YE
    Child Abuse Negl, 2022 Aug;130(Pt 1):105474.
    PMID: 34996620 DOI: 10.1016/j.chiabu.2021.105474
    BACKGROUND: Risk factors for child maltreatment have been exacerbated during the COVID-19 pandemic, especially due to economic downfalls leading to parental job losses and poor mental health.

    OBJECTIVE: This study aimed to examine the association between child maltreatment and unemployment rate in the Republic of Korea.

    PARTICIPANTS AND SETTING: Nationally representative data at the province level were used.

    METHODS: The monthly excess number of hotline calls related to child maltreatment during the COVID-19 pandemic was estimated for each province. Fixed effects regressions was used to examine the relationship between the excess number of hotline calls and unemployment rate.

    RESULTS: The average excess number of hotline calls was significantly negative in the early stage of the pandemic, but became significantly positive afterwards except for some months with averages not statistically different from zero. The regression results showed that an increase of male unemployment rate by 1% was significantly associated with an increase in the excess number of hotline calls by 0.15-0.17 per 10,000 children for most dependent variables for the first year of the COVID-19 pandemic. The statistical significance of female unemployment rate was mixed with the opposite sign of the coefficient to that of male unemployment. Overall unemployment rate was not significant.

    CONCLUSIONS: This study suggests that disruptions in child welfare services should be avoided to prevent underreporting of or delayed responses to suspected cases. Also, policies need to be designed considering potential pathways from economic downfalls, especially male unemployment, to child maltreatment.

    Matched MeSH terms: Risk Factors
  6. Zulkiply SH, Rosliza AM
    Med J Malaysia, 2022 Nov;77(6):755-763.
    PMID: 36448396
    INTRODUCTION: Suicide is recognized as an important public health concern, as it is the second leading cause of death among young people. About 80% of all suicide cases occur in low- and middle-income countries (LMICs). Understanding the risk factors for suicidal behaviours among young people in LMIC is important in developing preventive strategies; however, evidence on this is still lacking. Socio-ecological model (SEM) is a suitable framework in explaining the factors of suicidal behaviour. The aim of this review is to identify the factors associated with suicidal ideation and suicidal attempt among young people in LMIC, guided by the SEM model, and eventually develop its preventive strategies.

    MATERIALS AND METHODS: This review has two parts. The first part is a scoping review of the factors associated with suicidal ideation and attempt among young people. The search was conducted in Pubmed, Scopus, and PsycInfo. The second part is the development of preventive strategies according to the identified factors. Both parts will be guided by the SEM model.

    RESULTS: A total of ten studies with 45,278 participants that matched the criteria are included in this review. The review found that the risk factors for suicidal ideation among young people in LMIC are being female, psychiatric illness, psychology problem, smoking, alcohol intake, victim of abuse, bullied, and food insecurity. The preventive strategies include policy, mental healthcare services, awareness programme, and coping strategies.

    CONCLUSION: More epidemiological studies are needed to evaluate the risk factors of suicide that are unique in LMIC, such as help-seeking behaviour and available mental healthcare services. Suicide prevention requires concerted effort of policymakers, healthcare services, community and individual; thus, SEM framework is suitable as a guidance for suicide prevention.

    Matched MeSH terms: Risk Factors
  7. Ibrahim MS, Naing NN, Abd Aziz A, Makhtar M, Mohamed Yusoff H, Esa NK, et al.
    Int J Environ Res Public Health, 2022 Dec 10;19(24).
    PMID: 36554487 DOI: 10.3390/ijerph192416601
    During the initial phase of the coronavirus disease 2019 (COVID-19) pandemic, there was a critical need to create a valid and reliable screening and surveillance for university staff and students. Consequently, 11 medical experts participated in this cross-sectional study to judge three risk categories of either low, medium, or high, for all 1536 possible combinations of 11 key COVID-19 predictors. The independent experts' judgement on each combination was recorded via a novel dashboard-based rating method which presented combinations of these predictors in a dynamic display within Microsoft Excel. The validated instrument also incorporated an innovative algorithm-derived deduction for efficient rating tasks. The results of the study revealed an ordinal-weighted agreement coefficient of 0.81 (0.79 to 0.82, p-value < 0.001) that reached a substantial class of inferential benchmarking. Meanwhile, on average, the novel algorithm eliminated 76.0% of rating tasks by deducing risk categories based on experts' ratings for prior combinations. As a result, this study reported a valid, complete, practical, and efficient method for COVID-19 health screening via a reliable combinatorial-based experts' judgement. The new method to risk assessment may also prove applicable for wider fields of practice whenever a high-stakes decision-making relies on experts' agreement on combinations of important criteria.
    Matched MeSH terms: Risk Assessment
  8. Selvam K, Ganapathy T, Najib MA, Khalid MF, Abdullah NA, Harun A, et al.
    Int J Environ Res Public Health, 2022 Nov 22;19(23).
    PMID: 36497549 DOI: 10.3390/ijerph192315475
    This scoping review aims to provide a comprehensive overview of human melioidosis in Southeast Asia as well as to highlight knowledge gaps in the prevalence and risk factors of this life-threatening disease using available evidence-based data for better diagnosis and treatment. Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) was used as the guideline for this review. The literature search was conducted on 23 March 2022 through two electronic databases (PubMed and Scopus) using lists of keywords referring to the Medical Subject Headings (MeSH) thesaurus. A total of 38 articles related to human melioidosis were included from 645 screened articles. These studies were carried out between 1986 and 2019 in six Southeast Asian countries: Thailand, Cambodia, Malaysia, Myanmar, Singapore, and Vietnam. Melioidosis has been reported with a high disease prevalence among high-risk populations. Studies in Thailand (48.0%) and Cambodia (74.4%) revealed disease prevalence in patients with septic arthritis and children with suppurative parotitis, respectively. Other studies in Thailand (63.5%) and Malaysia (54.4% and 65.7%) showed a high seroprevalence of melioidosis among Tsunami survivors and military personnel, respectively. Additionally, this review documented soil and water exposure, diabetes mellitus, chronic renal failure, thalassemia, and children under the age of 15 as the main risk factors for melioidosis. Human melioidosis is currently under-reported in Southeast Asia and its true prevalence is unknown.
    Matched MeSH terms: Risk Factors
  9. Bahari NI, Ahmad N, Mahmud MH, Baharom M, Amir SM, Peng CS, et al.
    J Prev (2022), 2023 Feb;44(1):105-125.
    PMID: 36129587 DOI: 10.1007/s10935-022-00707-x
    BACKGROUND: Primary prevention of type 2 diabetes mellitus (T2DM) is possible in at-risk populations, and prevention programmes have been shown to be effective in real-world scenarios. Despite this evidence, diabetes prevalence has tripled in recent decades and is expected to reach 700 million patients by 2045, making it one of the leading causes of death globally. This review is aimed at identifying the issues and challenges in the primary prevention of T2DM.

    METHODS: Scopus, Web of Science, PubMed and Ovid MEDLINE were systematically searched for published articles. Articles were screened based of inclusion and exclusion criteria. The inclusion criteria were: (1) published in 2010-2020, (2) full original article, (3) written in English, (4) qualitative, mixed-methods article, observational or interventional study. The exclusion criteria were: (1) animal study, (2) in vivo/in vitro study, (3) type 1 diabetes or gestational DM and (4) conference abstract, book chapter, report, and systematic review. Eligible articles were assessed using Mixed Methods Appraisal Tool (MMAT) by three assessors.

    RESULTS: A total of 11 articles were selected for qualitative synthesis from the initial 620 articles. The issues and challenges seen in T2DM primary prevention followed three themes: healthcare program (sub-themes: lack of resources, community partnership, participation, health literacy), health provider (sub-themes: lack of implementation, health care staff, collaboration, availability), individual (sub-themes: awareness, communication, misbehaviour, family conflict).

    CONCLUSION: Factors relating to healthcare programmes, health providers, and individual issues are the main challenges in T2DM primary prevention. By establishing sustainable preventative initiatives that address these issues and challenges in the primary prevention of T2DM, a reduction in T2DM prevalence could be achievable.

    Matched MeSH terms: Risk Factors
  10. Jacob MA, Ekker MS, Allach Y, Cai M, Aarnio K, Arauz A, et al.
    Neurology, 2022 Feb 08;98(6):e573-e588.
    PMID: 34906974 DOI: 10.1212/WNL.0000000000013195
    BACKGROUND AND OBJECTIVES: There is a worldwide increase in the incidence of stroke in young adults, with major regional and ethnic differences. Advancing knowledge of ethnic and regional variation in causes and outcomes will be beneficial in implementation of regional health care services. We studied the global distribution of risk factors, causes, and 3-month mortality of young patients with ischemic stroke, by performing a patient data meta-analysis from different cohorts worldwide.

    METHODS: We performed a pooled analysis of individual patient data from cohort studies that included consecutive patients with ischemic stroke aged 18-50 years. We studied differences in prevalence of risk factors and causes of ischemic stroke between different ethnic and racial groups, geographic regions, and countries with different income levels. We investigated differences in 3-month mortality by mixed-effects multivariable logistic regression.

    RESULTS: We included 17,663 patients from 32 cohorts in 29 countries. Hypertension and diabetes were most prevalent in Black (hypertension, 52.1%; diabetes, 20.7%) and Asian patients (hypertension 46.1%, diabetes, 20.9%). Large vessel atherosclerosis and small vessel disease were more often the cause of stroke in high-income countries (HICs; both p < 0.001), whereas "other determined stroke" and "undetermined stroke" were higher in low and middle-income countries (LMICs; both p < 0.001). Patients in LMICs were younger, had less vascular risk factors, and despite this, more often died within 3 months than those from HICs (odds ratio 2.49; 95% confidence interval 1.42-4.36).

    DISCUSSION: Ethnoracial and regional differences in risk factors and causes of stroke at young age provide an understanding of ethnic and racial and regional differences in incidence of ischemic stroke. Our results also highlight the dissimilarities in outcome after stroke in young adults that exist between LMICs and HICs, which should serve as call to action to improve health care facilities in LMICs.

    Matched MeSH terms: Risk Factors
  11. Oginawati K, Susetyo SH, Rosalyn FA, Kurniawan SB, Abdullah SRS
    Environ Sci Pollut Res Int, 2021 Mar;28(11):14000-14008.
    PMID: 33201502 DOI: 10.1007/s11356-020-11590-6
    Chromium (Cr) is used as a mixture to improve strength and corrosion resistance. Milling and welding processes can expose workers to Cr through dermal exposure and inhalation. Cr exposure can be determined by urine testing. The purpose of this study was to analyze the concentration of Cr in urine (UCr) of workers. This study was carried out using a cross-sectional method. Sampling was conducted in the village of Mekarmaju, Bandung, Indonesia. The number of respondents included 30 blacksmiths, and the control group comprised 10 people who were not blacksmiths. Cr6+ exposure was measured using a personal sampling pump placed on the collar of the worker's shirt as a breathing zone and then analyzed using a UV-visible spectrophotometer. UCr was measured with a graphite furnace atomic absorption spectrophotometer. The measured Cr6+ concentration in the exposed working area ranged from 0.03 to 0.63 mg/m3, whereas that in non-exposed area ranged from 0.02 to 0.04 mg/m3. Results showed that 16 out of 30 blacksmiths had a UCr concentration above the biological exposure index (BEI) value, 21 had a higher value than the threshold limit value (TLV), and 22 had hazard index (HI) values > 1, which indicated that Cr has a hazardous potential in the body. The analysis of the exposed and control groups showed a significant difference with a p value of 0.000 for TLV, chronic daily intake, and UCr. These results clearly showed that Cr6+ exposure may harm the health of these workers in the future. The results obtained in this study can be used to promote workers' awareness on the potential health risk caused by Cr6+ exposure in the working environment.
    Matched MeSH terms: Risk Assessment
  12. Abjani F, Madhavan P, Chong PP, Chinna K, Rhodes CA, Lim YAL
    Ann Hum Biol, 2023 Feb;50(1):137-147.
    PMID: 36650931 DOI: 10.1080/03014460.2023.2170464
    CONTEXT: The continuous rise in urbanisation and its associated factors has been reflected in the structure of the human gut ecosystem.

    OBJECTIVE: The main focus of this review is to discuss and summarise the major risk factors associated with urbanisation that affect human gut microbiota thus affecting human health.

    METHODS: Multiple medical literature databases, namely PubMed, Google, Google Scholar, and Web of Science were used to find relevant materials for urbanisation and its major factors affecting human gut microbiota/microbiome. Both layman and Medical Subject Headings (MeSH) terms were used in the search. Due to the scarcity of the data, no limitation was set on the publication date. Relevant materials in the English language which include case reports, chapters of books, journal articles, online news reports and medical records were included in this review.

    RESULTS: Based on the data discussed in the review, it is quite clear that urbanisation and its associated factors have long-standing effects on the human gut microbiota that result in alterations of gut microbial diversity and composition. This is a matter of serious concern as chronic inflammatory diseases are on the rise in urbanised societies.

    CONCLUSION: A better understanding of the factors associated with urbanisation will help us to identify and implement new biological and social approaches to prevent and treat diseases and improve health globally by deepening our understanding of these relationships and increasing studies across urbanisation gradients.HIGHLIGHTSHuman gut microbiota have been linked to almost every important function, including metabolism, intestinal homeostasis, immune system, biosynthesis of vitamins, brain processes, and behaviour.However, dysbiosis i.e., alteration in the composition and diversity of gut microbiota is associated with the pathogenesis of many chronic conditions.In the 21st century, urbanisation represents a major demographic shift in developed and developing countries.During this period of urbanisation, humans have been exposed to many environmental exposures, all of which have led to the dysbiosis of human gut microbiota.The main focus of the review is to discuss and summarise the major risk factors associated with urbanisation and how it affects the diversity and composition of gut microbiota which ultimately affects human health.

    Matched MeSH terms: Risk Factors
  13. Shastry S, Mohan G, Pa P, Mundkur S, Kurien A, Ahammad J
    Transfus Apher Sci, 2023 Apr;62(2):103583.
    PMID: 36344327 DOI: 10.1016/j.transci.2022.103583
    BACKGROUND: Thromboembolic events are rare but one of the fatal complications in thalassemia. Assessment of the hypercoagulable state is not done regularly, and we have assessed the utility of Thromboelastography (TEG) for monitoring the activation of the coagulation pathway in patients with thalassemia.

    METHODOLOGY: A prospective single-center cohort study was conducted in a tertiary care set-up. Transfusion Dependent Thalassemia patients registered with the pediatric unit were screened for hypercoagulability using TEG during six months of the study period and followed up for three years for the development of thromboembolic events. Patient demographics, history of splenectomy, Serum ferritin levels and annual red cell transfusion requirement (mL/kg/year) were assessed. TEG parameters used were R time, K time, alpha angle, Maximum amplitude, Clot index, and Lysis 30. The thrombin generation test (V Curve) obtained from the first-degree derivate of the TEG velocity curve was also used for analysis.

    RESULTS: A total of 34 patients were recruited during the six months study period with an average age of 10.6 years ( ± 5.47). The average pre-transfusion hemoglobin level and the volume of packed red cells received were 7.24 g/dL and 152.82 mL/kg/year respectively. The TEG tracing was suggestive of a hypercoagulable state in 58.82% of patients. The mean values of angle (70.74), MA (64.16), CI (2.65) and TG (774.43) in TDT patients compared to age matched reference range (62.81, 57.99, 0.8, 577.83 respectively) was suggestive of prothrombotic changes. Annual blood transfusion requirement was negatively correlated with hypercoagulable status (-0.344, CI= -0.68 to 0.08). One out of 34 patients developed corona radiata infarct (with annual blood requirement; 112.7 mL/kg/Year). The risk to develop a hypercoagulable state appeared to be higher when the volume of RBCs transfused was less than 154 mL/kg/Year.

    CONCLUSION: TDT patients are at risk of developing thromboembolism, and screening with TEG may be useful to identify those at high risk.

    Matched MeSH terms: Risk Factors
  14. Khalil MKN, Abd Razak MA, Tahir FA, Sahril N, Shahein NA, Rezali MS, et al.
    Nutrients, 2023 Mar 20;15(6).
    PMID: 36986223 DOI: 10.3390/nu15061493
    BACKGROUND: Anaemia continues to be a global public health burden affecting all age groups, particularly children. Indigenous people, including the Orang Asli (OA) population in Malaysia, are at risk of anaemia due to the vast disparities in social determinants of health in their population compared to the non-indigenous population.

    OBJECTIVES: This review aimed to identify the prevalence and risk factors of anaemia among OA children in Malaysia and analyse the knowledge gaps.

    METHODS: A systematic search was conducted in PubMed, Cochrane Library, Scopus and Google Scholar databases. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines.

    RESULTS: This review identified six studies involving the participation of OA children from eight subtribes residing in Peninsular Malaysia. The overall prevalence of anaemia among OA children ranged from 21.6 to 80.0%, with iron deficiency anaemia prevalence at 34.0%. The risk factors of anaemia among OA children reported from one study in this review were being younger than ten years old children (AOR 2.11 (95% CI 1.23, 3.63)) and moderate to heavy Ascaris infections (AOR 2.05 (95% CI 1.12, 3.76)). There was no data from OA children from certain age groups and subtribes. Additionally, there is a paucity of data on risk factors for anaemia among OA children from the currently available evidence.

    CONCLUSION: The prevalence of anaemia among OA children poses a moderate to severe public health concern. Therefore, more comprehensive studies in the future are needed to address the gaps identified in this review, primarily regarding anaemia risk factors. This data would encourage policymakers in devising effective national prevention strategies to improve morbidity and mortality among OA children in the future.

    Matched MeSH terms: Risk Factors
  15. Swarna Nantha Y, Vijayasingham S, Adam NL, Vengadasalam P, Ismail M, Ali N, et al.
    Diabetes Obes Metab, 2023 Nov;25(11):3298-3306.
    PMID: 37551550 DOI: 10.1111/dom.15229
    AIM: Evidence from the literature points towards a viable choice of utilizing Labisia pumila to improve the metabolic profile in animal studies. To that end, this prospective study was designed to assess the health impact of the consumption of L. pumila standardized extract (SKF7®) on key parameters of obesity in humans such as body weight (BW), body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR).

    MATERIALS AND METHODS: A dose-ranging analysis using SKF7® was conducted through a randomized, double-blind, multicentre, placebo-controlled, phase 2 clinical trial involving individuals with obesity (N = 133) between January 2020 and April 2021. The potential percentage of change was assessed in relation to BW, BMI, WC and WHtR.

    RESULTS: Average treatment effect estimates (treatment group vs. placebo) show a statistically significant reduction in the percentage of change for BW (mean = -2.915; CI: -4.546, -1.285), BMI (-2.921; CI: -4.551, -1.291), WC (mean = -2.187; CI: -3.784, -0.589) and WHtR (mean = -2.294, CI: -3.908, -0.681) in the group with a total of 750 mg of SKF7® (p 

    Matched MeSH terms: Risk Factors
  16. Lim HM, Ng CJ, Abdullah A, Dunn AG
    BMC Prim Care, 2023 Nov 15;24(1):240.
    PMID: 37964208 DOI: 10.1186/s12875-023-02182-7
    BACKGROUND: People are exposed to variable health information from the Internet, potentially influencing their health decision-making and behaviour. It remains a challenge for people to discern between good- and poor-quality online health information (OHI). This study explored how patients evaluate and determine trust in statin-related OHI in patients with high cardiovascular risk.

    METHODS: This qualitative study used vignettes and think-aloud methods. We recruited patients from a primary care clinic who were at least 18 years old, had high cardiovascular risk and had previously sought OHI. Participants were given two statin-related vignettes: Vignette 1 (low-quality information) and Vignette 2 (high-quality information). Participants voiced their thoughts aloud when reading the vignettes and determined the trust level for each vignette using a 5-point Likert scale. This was followed by a semi-structured interview which was audio-recorded and transcribed verbatim. The transcripts were coded and analysed using thematic analysis.

    RESULTS: A total of 20 participants were recruited, with age ranging from 38-74 years. Among all the high cardiovascular-risk participants, eight had pre-existing cardiovascular diseases. For Vignette 1 (low-quality information), five participants trusted it while nine participants were unsure of their trust. 17 participants (85%) trusted Vignette 2 (high-quality information). Five themes emerged from the analysis of how patients evaluated OHI: (1) logical content, (2) neutral stance and tone of OHI content, (3) credibility of the information source, (4) consistent with prior knowledge and experience, and (5) corroboration with information from other sources.

    CONCLUSION: Patients with high cardiovascular risks focused on the content, source credibility and information consistency when evaluating and determining their trust in statin-related OHI. Doctors should adopt a more personalised approach when discussing statin-related online misinformation with patients by considering their prior knowledge, beliefs and experience of statin use.

    Matched MeSH terms: Risk Factors
  17. Siau CS, Chan CMH, Wee LH, Wahab S, Visvalingam U, Chen WS, et al.
    Omega (Westport), 2023 Jun;87(2):469-484.
    PMID: 34096373 DOI: 10.1177/00302228211021746
    We examined whether burnout, depression, anxiety, stress, lifetime suicidal ideation, self-efficacy in preventing suicide and demographic factors predicted the understanding of and willingness to help suicidal patients among hospital healthcare workers. A total of 368 healthcare workers from the major surgical and medical departments in a general hospital setting were recruited. Participants responded to the Depression Anxiety and Stress Scale-21, Self-efficacy in Suicide Prevention, and Understanding Suicide Attempt Patient Scale. Those from the psychiatric department, with higher suicide prevention self-efficacy, and lower personal accomplishment indicated more understanding and helpful attitudes; doctors, depressed and anxious healthcare workers reported less understanding and helpful attitudes. Suicide prevention efforts must be conducted in tandem with equipping and supporting the healthcare workers who manage suicidal patients.
    Matched MeSH terms: Risk Factors
  18. Lim HM, Ng CJ, Abdullah A, Dalmazzo J, Lim WX, Lee KH, et al.
    Front Public Health, 2023;11:1132397.
    PMID: 37228723 DOI: 10.3389/fpubh.2023.1132397
    BACKGROUND: Online health misinformation about statins potentially affects health decision-making on statin use and adherence. We developed an information diary platform (IDP) to measure topic-specific health information exposure where participants record what information they encounter. We evaluated the utility and usability of the smartphone diary from the participants' perspective.

    METHODS: We used a mixed-method design to evaluate how participants used the smartphone diary tool and their perspectives on usability. Participants were high cardiovascular-risk patients recruited from a primary care clinic and used the tool for a week. We measured usability with the System Usability Scale (SUS) questionnaire and interviewed participants to explore utility and usability issues.

    RESULTS: The information diary was available in three languages and tested with 24 participants. The mean SUS score was 69.8 ± 12.9. Five themes related to utility were: IDP functions as a health information diary; supporting discussion of health information with doctors; wanting a feedback function about credible information; increasing awareness of the need to appraise information; and wanting to compare levels of trust with other participants or experts. Four themes related to usability were: ease of learning and use; confusion about selecting the category of information source; capturing offline information by uploading photos; and recording their level of trust.

    CONCLUSION: We found that the smartphone diary can be used as a research instrument to record relevant examples of information exposure. It potentially modifies how people seek and appraise topic-specific health information.

    Matched MeSH terms: Risk Factors
  19. Ng DC, Liew CH, Tan KK, Chin L, Ting GSS, Fadzilah NF, et al.
    BMC Infect Dis, 2023 Jun 12;23(1):398.
    PMID: 37308825 DOI: 10.1186/s12879-023-08357-y
    BACKGROUND: Children account for a significant proportion of COVID-19 hospitalizations, but data on the predictors of disease severity in children are limited. We aimed to identify risk factors associated with moderate/severe COVID-19 and develop a nomogram for predicting children with moderate/severe COVID-19.

    METHODS: We identified children ≤ 12 years old hospitalized for COVID-19 across five hospitals in Negeri Sembilan, Malaysia, from 1 January 2021 to 31 December 2021 from the state's pediatric COVID-19 case registration system. The primary outcome was the development of moderate/severe COVID-19 during hospitalization. Multivariate logistic regression was performed to identify independent risk factors for moderate/severe COVID-19. A nomogram was constructed to predict moderate/severe disease. The model performance was evaluated using the area under the curve (AUC), sensitivity, specificity, and accuracy.

    RESULTS: A total of 1,717 patients were included. After excluding the asymptomatic cases, 1,234 patients (1,023 mild cases and 211 moderate/severe cases) were used to develop the prediction model. Nine independent risk factors were identified, including the presence of at least one comorbidity, shortness of breath, vomiting, diarrhea, rash, seizures, temperature on arrival, chest recessions, and abnormal breath sounds. The nomogram's sensitivity, specificity, accuracy, and AUC for predicting moderate/severe COVID-19 were 58·1%, 80·5%, 76·8%, and 0·86 (95% CI, 0·79 - 0·92) respectively.

    CONCLUSION: Our nomogram, which incorporated readily available clinical parameters, would be useful to facilitate individualized clinical decisions.

    Matched MeSH terms: Risk Factors
  20. Pedamallu H, Zmora R, Perak AM, Allen NB
    Circ Res, 2023 Jun 09;132(12):1570-1583.
    PMID: 37289908 DOI: 10.1161/CIRCRESAHA.123.321998
    Since it was first defined by the American Heart Association in 2010, cardiovascular health (CVH) has been extensively studied across the life course. In this review, we present the current literature examining early life predictors of CVH, the later life outcomes of child CVH, and the relatively few interventions which have specifically addressed how to preserve and promote CVH across populations. We find that research on CVH has demonstrated that prenatal and childhood exposures are consistently associated with CVH trajectories from childhood through adulthood. CVH measured at any point in life is strongly predictive of future cardiovascular disease, dementia, cancer, and mortality as well as a variety of other health outcomes. This speaks to the importance of intervening early to prevent the loss of optimal CVH and the accumulation of cardiovascular risk. Interventions to improve CVH are not common but those that have been published most often address multiple modifiable risk factors among individuals within the community. Relatively few interventions have been focused on improving the construct of CVH in children. Future research is needed that will be both effective, scalable, and sustainable. Technology including digital platforms as well as implementation science will play key roles in achieving this vision. In addition, community engagement at all stages of this research is critical. Lastly, prevention strategies that are tailored to the individual and their context may help us achieve the promise of personalized prevention and help promote ideal CVH in childhood and across the life course.
    Matched MeSH terms: Risk Factors
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