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Fulltext The Validity and Reliability of the Malay Version of the Cyberbullying Scale among Secondary School Adolescents in Malaysia

Saman ZM, Siti-Azrin AH, Othman A, Kueh YC

Int J Environ Res Public Health, 2021 11 06;18(21).
PMID: 34770183 DOI: 10.3390/ijerph182111669

The effect of cyberbullying among adolescents in Malaysia is not much studied. The Cyberbullying Scale (CBS) has been validated to be used among English speaking adolescents to measure cyberbullying but not in Malay language. Therefore, its validity should be established before use in the Malaysian context. Thus, the study aimed to evaluate the validity and reliability of the Malay version of the CBS (CBS-M) among secondary school students. The study was cross-sectional and involved a self-administered questionnaire with 16 items from CBS-M, and 21 items from the Depression, Anxiety, and Stress Scale (DASS-21). Participants were recruited using a multi-stage sampling method. The validity of the CBS-M was tested in two phases, namely, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Spearman's correlation was used to examine the strength of the relationship between the CBS and subscales from DASS-21 to further support the validity of CBS-M. A total of 401 respondents from Muar, Johor, participated. The mean age was 14.6 years (SD = 1.25). EFA results indicated a one-factor model of CBS-M with a total variance extracted of 33.9%. Internal consistency measured by Cronbach's alpha reached 0.87. The model was then tested using CFA. The initial model did not fit the data well. Thus, several model re-specifications were conducted on the initial model. The final measurement model of CBS-M fit the data well with acceptable fit indices (CFI = 0.946, TLI = 0.932, SRMR = 0.055, RMSEA = 0.049). The composite reliability for CBS-M was satisfactory with a value of 0.832. The CBS-M questionnaire is a valid and reliable tool for measuring cyberbullying among young adolescents in Malaysia.
Fulltext Development and Testing of a Community-Based Intervention to Address Intimate Partner Violence among Rohingya and Syrian Refugees: A Social Norms-Based Mental Health-Integrated Approach

James LE, Welton-Mitchell C, Michael S, Santoadi F, Shakirah S, Hussin H, et al.

Int J Environ Res Public Health, 2021 11 07;18(21).
PMID: 34770188 DOI: 10.3390/ijerph182111674

Intimate partner violence (IPV) is the leading form of gender-based violence globally and increases during times of conflict and displacement. To reduce IPV and encourage help-seeking, a two-phase community-based intervention was co-designed with Rohingya in Malaysia and Syrians in Lebanon. Three day workshops, utilizing a social norms-based mental health-integrated approach, were implemented for women and men in each country (n = 148). Pre- to post-measures indicated reductions in beliefs about acceptability of violence and rigid gender norms, and improvements in mental health, functioning, coping, and self-efficacy for women and men following workshop participation. Workshop participation was also associated with increased help-seeking intent, for both mental health and IPV (victims and perpetrators). Workshops included community design of poster campaigns to address IPV, which were then tested in each setting using a randomized controlled trial in Malaysia (n = 240) and a matched cluster comparison in Lebanon (n = 260). Women in both settings found IPV less acceptable in the poster condition. Help-seeking preferences were also influenced by the poster for women and men in both countries. This participatory intervention research can provide a roadmap for use in other settings, emphasizing the value of community-generated solutions to IPV among displaced populations.
Fulltext Cross-Cultural Adaptation and Validation of the Malay Version of Sports Motivation Scale-II

Chin NS, Liew GC, Kueh YC, Hashim HA, Tee V, Kuan G

Int J Environ Res Public Health, 2021 11 07;18(21).
PMID: 34770207 DOI: 10.3390/ijerph182111694

The 18-item Sport Motivation Scale (SMS-II) is one of the most-utilised scales measuring athletes' motivation and its psychometric properties. However, we found no Malay version used to examine the Malaysian multi-ethnic population. Thus, the study aimed to translate and validate the SMS-II into the Malay version using confirmatory factor analysis. A total of 436 (16.44 ± 1.22) state athletes were asked to complete the SMS-II Malay version, which utilised the forward-backwards translation method. The results showed an acceptable fit with the data (CFI = 0.906, SRMR = 0.064; RMSEA = 0.056) and internal consistency, with a Cronbach's alpha value that exceeded 0.50, which supported its usage for the assessment of motivation among the multi-ethnic Malaysian athletes. The Cronbach's alpha values of all the factors were satisfactory, except for introjected regulation. Thus, further studies are needed to improve the reliability of such factors. Nonetheless, the Malay version of SMS-II was found to be valid and reliable for assessing the level of motivation of the multi-ethnic Malaysian athletes.
Fulltext Forecasting COVID-19 Case Trends Using SARIMA Models during the Third Wave of COVID-19 in Malaysia

Tan CV, Singh S, Lai CH, Zamri ASSM, Dass SC, Aris TB, et al.

Int J Environ Res Public Health, 2022 Jan 28;19(3).
PMID: 35162523 DOI: 10.3390/ijerph19031504

With many countries experiencing a resurgence in COVID-19 cases, it is important to forecast disease trends to enable effective planning and implementation of control measures. This study aims to develop Seasonal Autoregressive Integrated Moving Average (SARIMA) models using 593 data points and smoothened case and covariate time-series data to generate a 28-day forecast of COVID-19 case trends during the third wave in Malaysia. SARIMA models were developed using COVID-19 case data sourced from the Ministry of Health Malaysia's official website. Model training and validation was conducted from 22 January 2020 to 5 September 2021 using daily COVID-19 case data. The SARIMA model with the lowest root mean square error (RMSE), mean absolute percentage error (MAE) and Bayesian information criterion (BIC) was selected to generate forecasts from 6 September to 3 October 2021. The best SARIMA model with a RMSE = 73.374, MAE = 39.716 and BIC = 8.656 showed a downward trend of COVID-19 cases during the forecast period, wherein the observed daily cases were within the forecast range. The majority (89%) of the difference between the forecasted and observed values was well within a deviation range of 25%. Based on this work, we conclude that SARIMA models developed in this paper using 593 data points and smoothened data and sensitive covariates can generate accurate forecast of COVID-19 case trends.
Fulltext Self-reported sleep quality using the Malay version of the Pittsburgh Sleep Quality Index (PSQI-M) in Malaysian adults

Farah NM, Saw Yee T, Mohd Rasdi HF

Int J Environ Res Public Health, 2019 Nov 27;16(23):4750.
PMID: 31783607 DOI: 10.3390/ijerph16234750

(1) Background: The Pittsburgh Sleep Quality Index (PSQI) is a useful tool for the assessment of subjective sleep quality in non-clinical and clinical settings. This study aimed to determine sleep quality in a general Malaysian adult population using a validated Malay version of the Pittsburgh sleep quality index (PSQI-M); (2) Methods: The original PSQI was translated into Malay following forward and backward translation guidelines. The final Malay version was administered to a sample of healthy working adults (n = 106; mean age: 35.3 ± 7.6 years) without history of sleep disorders. Reliability and agreement were assessed using Cronbach's alpha, intra-class correlations coefficient (ICC), standard error of measurement (SEM), and Bland-Altman plot. Convergent validity of PSQI-M was examined with the Malay version of Epworth sleepiness scale (ESS-M) using Pearson's correlation coefficient; (3) Results: Overall mean PSQI global score was 5.25 ± 1.85. About 45% of the sample had PSQI global score >5, indicating poor sleep quality. Total sleep duration per night was 5.95 ± 1.05 h, below the recommended amount. Sleep quality seems to be affected by age but not gender. Internal consistency as measured by Cronbach's alpha in the whole sample was 0.74, with test-retest reliability (ICC) of 0.58 and SEM of 1.34. The PSQI test-retest scores indicated that most of the respondents (90%) lay within the 95% limits of agreement. The PSQI-M also showed significant correlation with ESS-M scores (r = 0.37, p < 0.01); (4) Conclusion: The PSQI-M showed acceptable reliability and is valid to be used in a general Malaysian adult population. Findings also indicate that a majority of the adults in our sample were experiencing inadequate sleep, thus further research is needed to identify the factors associated with poor sleep quality.
Study site and participants: adults working in a university satellite campus in Kuala Lumpur, Malaysia
Fulltext Treatment-seeking behavior among male civil servants in northeastern Malaysia: A mixed-methods study

Arumugam P, Tengku Ismail TA, Daud A, Musa KI, A Hamid NA, Ismail SB, et al.

Int J Environ Res Public Health, 2020 04 15;17(8).
PMID: 32326447 DOI: 10.3390/ijerph17082713

Background: Men's health in Malaysia is slowly gaining more attention, but minimal research has examined how Malaysian men behave and seek treatment. While few studies have investigated men's treatment-seeking behavior (TSB), those that have been conducted seem to be inconclusive and tend to yield contradictory findings.
Objectives: This paper aims to determine the proportion of inappropriate TSB and to explore in-depth treatment-seeking behavior among male civil servants in northeastern Malaysia.
Methods: This paper adopted a mixed-methods approach, specifically a concurrent parallel study design. A quantitative study using a self-administered questionnaire was performed to identify the proportion of appropriate and inappropriate TSB among male civil servants in northeastern Malaysia. Concurrently, a qualitative study was conducted involving six focus group discussion sessions, and the results of both parts were integrated to provide a detailed explanation of TSB among the participants.
Results: A total of 381 participants were involved in the quantitative study, yielding a response rate of 94.8%; 246 (64.6%) engaged in inappropriate TSB. Some of the reported morbidities among the participants were hypertension (26.5%) and diabetes mellitus (26.2%). From the qualitative study, a main theme related to TSB emerged with several sub-themes, which were health literacy, stage of seeking treatment, preference for alternative treatment, perceived threat of illness, self-treatment, and the influence of family members and others.
Conclusions: TSB among male civil servants in northeastern Malaysia is poor, and the factors contributing to it are multidimensional. This study has provided new valuable evidence on men's TSB in northeastern Malaysia. The findings can be used to facilitate and improve current policies and the implementation of men's health services throughout the country.
Fulltext Mental Health Status of University Healthcare Workers during the COVID-19 Pandemic: A Post-Movement Lockdown Assessment

Woon LS, Sidi H, Nik Jaafar NR, Leong Bin Abdullah MFI

Int J Environ Res Public Health, 2020 12 08;17(24).
PMID: 33302410 DOI: 10.3390/ijerph17249155

This study investigated the prevalence and severity of depression, anxiety, and stress and determined the association between various factors, social support, and depression, anxiety, and stress among university healthcare workers in Malaysia after the government lifted the movement control order (MCO) put in place to curb the coronavirus disease 2019 (COVID-19) pandemic. This online, cross-sectional survey recruited 399 participants from two university hospitals, and they were administered a self-reported questionnaire on demographic, personal, and clinical characteristics, as well as COVID-19-related stressors and coping. In addition, they completed the Multidimensional Scale of Perceived Social Support (MSPSS) to measure perceived social support, as well as the 21-item Depression, Anxiety, and Stress Scale (DASS-21) to assess depression, anxiety, and stress. We found that the prevalence rates of depression, anxiety, and stress were 21.8%, 31.6%, and 29.1%, respectively. Participants with moderate to extremely severe depression, anxiety, and stress made up 13.3%, 25.8%, and 8.1% of the sample, respectively. Being single or divorced, fear of frequent exposure to COVID-19 patients, agreeing that the area of living had a high prevalence of COVID-19 cases, uncertainty regarding the prevalence of COVID-19 cases in the area of living, and a history of pre-existing psychiatric illnesses were associated with higher odds of depression, anxiety, and stress. Conversely, having more than three children and greater perceived friend support were associated with lower odds of depression, anxiety, and stress. The prevalence of depression, anxiety, and stress remained elevated even after the MCO was lifted.
Study site: Hospital Universiti Sains Malaysia (HUSM); Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Fulltext Temporal and Spatial Dynamics of EEG Features in Female College Students with Subclinical Depression

Zhao S, Ng SC, Khoo S, Chi A

Int J Environ Res Public Health, 2022 Feb 04;19(3).
PMID: 35162800 DOI: 10.3390/ijerph19031778

Synchronization of the dynamic processes in structural networks connect the brain across a wide range of temporal and spatial scales, creating a dynamic and complex functional network. Microstate and omega complexity are two reference-free electroencephalography (EEG) measures that can represent the temporal and spatial complexities of EEG data. Few studies have focused on potential brain spatiotemporal dynamics in the early stages of depression to use as an early screening feature for depression. Thus, this study aimed to explore large-scale brain network dynamics of individuals both with and without subclinical depression, from the perspective of temporal and spatial dimensions and to input them as features into a machine learning framework for the automatic diagnosis of early-stage depression. To achieve this, spatio-temporal dynamics of rest-state EEG signals in female college students (n = 40) with and without (n = 38) subclinical depression were analyzed using EEG microstate and omega complexity analysis. Then, based on differential features of EEGs between the two groups, a support vector machine was utilized to compare performances of spatio-temporal features and single features in the classification of early depression. Microstate results showed that the occurrence rate of microstate class B was significantly higher in the group with subclinical depression when compared with the group without. Moreover, the duration and contribution of microstate class C in the subclinical group were both significantly lower than in the group without subclinical depression. Omega complexity results showed that the global omega complexity of β-2 and γ band was significantly lower for the subclinical depression group compared with the other group (p < 0.05). In addition, the anterior and posterior regional omega complexities were lower for the subclinical depression group compared to the comparison group in α-1, β-2 and γ bands. It was found that AUC of 81% for the differential indicators of EEG microstates and omega complexity was deemed better than a single index for predicting subclinical depression. Thus, since temporal and spatial complexity of EEG signals were manifestly altered in female college students with subclinical depression, it is possible that this characteristic could be adopted as an early auxiliary diagnostic indicator of depression.
Fulltext Perceived Stress, Social Support, Emotional Intelligence, and Post-Stress Growth among Chinese Left-Behind Children: A Moderated Mediation Model

Zhang L, Roslan S, Zaremohzzabieh Z, Jiang Y, Wu S, Chen Y

Int J Environ Res Public Health, 2022 Feb 07;19(3).
PMID: 35162873 DOI: 10.3390/ijerph19031851

BACKGROUND: Several previous studies have revealed a negative impact of perceived stress on post-stress growth. Nevertheless, the potential mediating and moderating mechanisms are unclear, particularly for left-behind children in China. Therefore, this study aims to investigate the negative relationship between perceived stress and post-stress growth, the mediating effect of social support, as well as the moderating effect of emotional intelligence in a sample of Chinese left-behind children.
METHODS: A sample of 837 Chinese students in elementary and middle school was collected for this study. The Perceived Stress Scale, the Social Support Scale, the Emotional Intelligence Scale, and the Post-Stress Growth Scale were employed to examine them. The data were analyzed using SPSS 25.0 software.
RESULTS: The results indicate a significant negative association between perceived stress and post-stress growth. Among perceived stress and social support, the former acted as a mediator, while the latter as a moderator. This study sheds light on the post-stress growth of Chinese left-behind children. The findings validated a model of moderated mediation that shows the relationship between perceived stress, emotional intelligence, social support, and post-stress growth.
CONCLUSION: This study confirmed that social support is one of the most important factors among left-behind children, from perceived stress to post-stress growth. Furthermore, the study reveals that emotional intelligence can adjust the relationship between perceived stress and social support to post-stress growth. Therefore, for both family education and school education, the result provides a new direction.
Fulltext Driver Behavior Profiling and Recognition Using Deep-Learning Methods: In Accordance with Traffic Regulations and Experts Guidelines

Al-Hussein WA, Por LY, Kiah MLM, Zaidan BB

Int J Environ Res Public Health, 2022 Jan 27;19(3).
PMID: 35162493 DOI: 10.3390/ijerph19031470

The process of collecting driving data and using a computational model to generate a safety score for the driver is known as driver behavior profiling. Existing driver profiles attempt to categorize drivers as either safe or aggressive, which some experts say is not practical. This is due to the "safe/aggressive" categorization being a state that describes a driver's conduct at a specific point in time rather than a continuous state or a human trait. Furthermore, due to the disparity in traffic laws and regulations between countries, what is considered aggressive behavior in one place may differ from what is considered aggressive behavior in another. As a result, adopting existing profiles is not ideal. The authors provide a unique approach to driver behavior profiling based on timeframe data segmentation. The profiling procedure consists of two main parts: row labeling and segment labeling. Row labeling assigns a safety score to each second of driving data based on criteria developed with the help of Malaysian traffic safety experts. Then, rows are accumulated to form timeframe segments. In segment labeling, generated timeframe segments are assigned a safety score using a set of criteria. The score assigned to the generated timeframe segment reflects the driver's behavior during that time period. Following that, the study adopts three deep-learning-based algorithms, namely, Deep Neural Network (DNN), Recurrent Neural Network (RNN), and Convolutional Neural Network (CNN), to classify recorded driving data according to the established profiling procedure, and selects the most suitable one for a proposed recognition system. Various techniques were used to prevent the classification algorithms from overfitting. Using gathered naturalistic data, the validity of the modulated algorithms was assessed on various timeframe segments ranging from 1 to 10 s. Results showed that the CNN, which achieved an accuracy of 96.1%, outperformed the other two classification algorithms and was therefore recommended for the recognition system. In addition, recommendations were outlined on how the recognition system would assist in improving traffic safety.
Fulltext The Relationship between Internet Addiction, Internet Gaming and Anxiety among Medical Students in a Malaysian Public University during COVID-19 Pandemic

Ismail N, Tajjudin AI, Jaafar H, Nik Jaafar NR, Baharudin A, Ibrahim N

Int J Environ Res Public Health, 2021 11 12;18(22).
PMID: 34831627 DOI: 10.3390/ijerph182211870

The internet has become an important medium for learning and communication during the COVID-19 pandemic, particularly for university students. Nevertheless, an increase in internet usage could predispose people to internet addiction (IA) and internet gaming (IG). Equally, there is concern that anxiety levels have increased during the pandemic. The aim of this study is to determine the prevalence of IA and IG, and their associations with anxiety among medical students during the pandemic. Data were collected during the second wave of the "Conditional Movement Control Order" (CMCO) in Malaysia between 12 November and 10 December 2020. A total of 237 students participated through proportionate stratified random sampling in this cross-sectional study. They completed a set of online questionnaires which consisted of a sociodemographic profile, the Malay version of the internet addiction test (MVIAT), the Malay version of the internet gaming disorder-short form (IGDS9-SF) and the Malay version of the depression, anxiety and stress scale (DASS-21). The prevalence of IA and internet gaming disorder (IGD) were 83.5% and 2.5%, respectively. A multiple logistic regression showed that those in pre-clinical years had a greater risk of anxiety than those in clinical years [(AOR) = 2.49, p-value 0.01, 95% CI = 1.22-5.07]. In contrast, those who scored high on IA were protected against anxiety [AOR = 0.100, p-value 0.03, 95% CI = 0.01-0.76)]. In conclusion, IA was highly prevalent during the COVID-19 pandemic and its high usage might serve as a protective factor against anxiety among the medical students in this study sample.
Investigating the Effect of Social and Cultural Factors on Drivers in Malaysia: A Naturalistic Driving Study

Al-Hussein WA, Kiah MLM, Por LY, Zaidan BB

Int J Environ Res Public Health, 2021 Nov 09;18(22).
PMID: 34831495 DOI: 10.3390/ijerph182211740

Road accidents are increasing every year in Malaysia, and it is always challenging to collect reliable pre-crash data in the transportation community. Existing studies relied on simulators, police crash reports, questionnaires, and surveys to study Malaysia's drivers' behavior. Researchers previously criticized such methods for being biased and unreliable. To fill in the literature gap, this study presents the first naturalistic driving study in Malaysia. Thirty drivers were recruited to drive an instrumented vehicle for 750 km while collecting continuous driving data. The data acquisition system consists of various sensors such as OBDII, lidar, ultrasonic sensors, IMU, and GPS. Irrelevant data were filtered, and experts helped identify safety criteria regarding multiple driving metrics such as maximum acceptable speed limits, safe accelerations, safe decelerations, acceptable distances to vehicles ahead, and safe steering behavior. These thresholds were used to investigate the influence of social and cultural factors on driving in Malaysia. The findings show statistically significant differences between drivers based on gender, age, and cultural background. There are also significant differences in the results for those who drove on weekends rather than weekdays. The study presents several recommendations to various public and governmental sectors to help prevent future accidents and improve traffic safety.
Fulltext Staying Active under Restrictions: Changes in Type of Physical Exercise during the Initial COVID-19 Lockdown

Benzing V, Nosrat S, Aghababa A, Barkoukis V, Bondarev D, Chang YK, et al.

Int J Environ Res Public Health, 2021 11 16;18(22).
PMID: 34831770 DOI: 10.3390/ijerph182212015

The COVID-19 pandemic and the associated governmental restrictions suddenly changed everyday life and potentially affected exercise behavior. The aim of this study was to explore whether individuals changed their preference for certain types of physical exercise during the pandemic and to identify risk factors for inactivity. An international online survey with 13,881 adult participants from 18 countries/regions was conducted during the initial COVID-19 related lockdown (between April and May 2020). Data on types of exercise performed during and before the initial COVID-19 lockdown were collected, translated, and categorized (free-text input). Sankey charts were used to investigate these changes, and a mixed-effects logistic regression model was used to analyze risks for inactivity. Many participants managed to continue exercising but switched from playing games (e.g., football, tennis) to running, for example. In our sample, the most popular exercise types during the initial COVID-19 lockdown included endurance, muscular strength, and multimodal exercise. Regarding risk factors, higher education, living in rural areas, and physical activity before the COVID-19 lockdown reduced the risk for inactivity during the lockdown. In this relatively active multinational sample of adults, most participants were able to continue their preferred type of exercise despite restrictions, or changed to endurance type activities. Very few became physically inactive. It seems people can adapt quickly and that the constraints imposed by social distancing may even turn into an opportunity to start exercising for some. These findings may be helpful to identify individuals at risk and optimize interventions following a major context change that can disrupt the exercise routine.
Fulltext Perceived Symptoms of Depression, Anxiety and Stress amongst Staff in a Malaysian Public University: A Workers Survey

Manaf MRA, Shaharuddin MA, Nawi AM, Tauhid NM, Othman H, Rahman MRA, et al.

Int J Environ Res Public Health, 2021 Nov 12;18(22).
PMID: 34831628 DOI: 10.3390/ijerph182211874

Mental health conditions are a major part of workers' health that predisposes to poor self-motivation for sustaining productivity. This study was aimed to determine the prevalence of depression, anxiety, and stress among staff in a Malaysian public university and its associated factors. A cross-sectional study was conducted among 459 staff from the Universiti Kebangsaan Malaysia (UKM) between April and June 2019. A questionnaire that consisted of items on socio-demographic and socioeconomic characteristics, employment description, lifestyle risk behaviors, personal medical history, and symptoms of depression, anxiety, and stress was administered to participants. Descriptive and inferential statistics were conducted using SPSS version 22.0. The prevalence of perceived symptoms of depression, anxiety, and stress among the respondents was 28.7%, 50.1%, and 14.8%, respectively. Over one-quarter (26.5%) of the participants presented symptoms of two or more mental disorders. Women, those aged less than 40 years old, and non-academic professionals were more likely to exhibit depressive symptoms, while those with medical conditions that required hospitalizations sustained anxiety symptoms. Perceived stress was more likely to be prevalent among staff with secondary education or less and smokers. Proactive support for staff needs to be offered in sustaining their emotional well-being.
Fulltext Eco-Friendly Coagulant versus Industrially Used Coagulants: Identification of Their Coagulation Performance, Mechanism and Optimization in Water Treatment Process

Khairul Zaman N, Rohani R, Izni Yusoff I, Kamsol MA, Basiron SA, Abd Rashid AI

Int J Environ Res Public Health, 2021 08 31;18(17).
PMID: 34501755 DOI: 10.3390/ijerph18179164

The evaluation of complex organic and inorganic coagulant's performances and their relationships could compromise the surface water treatment process time and its efficiency. In this work, process optimization was investigated by comparing an eco-friendly chitosan with the industrially used coagulants namely aluminum sulfate (alum), polyaluminum chloride (PAC), and aluminum chlorohydrate (ACH) in compliance with national drinking water standards. To treat various water samples from different treatment plants with turbidity and pH ranges from 20-826.3 NTU and 5.21-6.80, respectively, 5-20 mg/L coagulant dosages were varied in the presence of aluminum, ferum, and manganese. Among all, 10 mg/L of the respective ACH and chitosan demonstrated 97% and 99% turbidity removal in addition to the removal of the metals that complies with the referred standard. However, chitosan owes fewer sensitive responses (turbidity and residual metal) with the change in its input factors (dosage and pH), especially in acidic conditions. This finding suggested its beneficial role to be used under the non-critical dosage monitoring. Meanwhile, ACH was found to perform better than chitosan only at pH > 7.4 with half dosage required. In summary, chitosan and ACH could perform equally at a different set of optimum conditions. This optimization study offers precise selections of coagulants for a practical water treatment operation.
Fulltext Surveillance of Injury Types, Locations, and Intensities in Male and Female Tennis Players: A Content Analysis of Online Newspaper Reports

Musa RM, Hassan I, Abdullah MR, Azmi MNL, P P Abdul Majeed A, Abu Osman NA

Int J Environ Res Public Health, 2021 12 01;18(23).
PMID: 34886410 DOI: 10.3390/ijerph182312686

The popularity of modern tennis has contributed to the increasing number of participants at both recreational and competitive levels. The influx of numerous tennis participants has resulted in a wave of injury occurrences of different types and magnitudes across both male and female players. Since tennis injury harms both players' economic and career development, a better understanding of its epidemiology could potentially curtail its prevalence and occurrences. We used online-based tennis-related injury reports to study the prevalence, location types, and injury intensities in both male and female tennis players for the past five years. It is demonstrated from the chi-square analysis that injury occurrences are significantly associated with a specific gender (χ2(18) = 50.773; p = 0.001), with male players having a higher risk of injury manifestation (68.10%) as compared with female players (31.90%). Nonetheless, knee, hip, ankle, and shoulder injuries are highly prevalent in both male and female players. Moreover, the injury intensities are distributed across gender (χ2(2) = 0.398; p = 0.820), with major injuries being dominant, followed by minor injuries, whilst a few cases of career-threatening injuries were also reported. It was similarly observed that male players recorded a higher degree of both major, minor, and career-threatening injuries than female players. In addition, male players sustained more elbow, hip, knee, shoulder, and thigh injuries than female players. Whereas, female players mostly suffered from Achilles and back injuries, ankle and hamstring injuries affected both genders. The usage of online newspaper reports is pivotal in characterizing the epidemiology of tennis-related injuries based on locations and gender to better understand the pattern and localization of injuries, which could be used to address the problem of modern tennis-related injuries.
Fulltext Speak like a Native English Speaker or Be Judged: A Scoping Review

Tan KH, Jospa MEAW, Mohd-Said NE, Awang MM

Int J Environ Res Public Health, 2021 12 03;18(23).
PMID: 34886478 DOI: 10.3390/ijerph182312754

This review aims to examine the discrimination and prejudices toward the accent of non-native English speakers and cyberbullying as the ripple effect of these negative consequences. Following Arksey and O'Malley's framework of conducting a scoping review, 60 studies from 2012 to 2021 were retrieved from the ERIC and Google Scholar databases. The studies were reviewed from two aspects: (1) psychological impact on speakers with a non-native English accent, (2) attitudes toward non-native English accents from the victim's and perpetrator's perspectives. The findings suggested that speaking with a non-native English accent drew negative cognitive, affective, and behavioral experiences. Biases toward non-native English accents were due to the general derogatory perception of an accent and the comprehensibility of speakers' accent and pronunciation. "Accent acceptability" can be inculcated at all levels of education, not only through multicultural education but also through the concerted effort of policy makers and practitioners to seriously address this social issue. Accent awareness can dispel unwarranted and undesirable judgements of non-native English accent speakers. Future studies should be conducted on the effects of social and mental health experiences, particularly of non-native ESL and EFL teachers, given that this may be the only profession required to teach "live" during the pandemic and thus be subjected to public praise or ridicule.
Fulltext Reply to Ivy et al. Comment on "Khairul Zaman et al. Eco-Friendly Coagulant versus Industrially Used Coagulants: Identification of Their Coagulation Performance, Mechanism and Optimization in Water Treatment Process. Int. J. Environ. Res. Public Health 2021, 18, 9164"

Khairul Zaman N, Rohani R, Izni Yusoff I, Kamsol MA, Basiron SA, Abd Rashid AI

Int J Environ Res Public Health, 2021 12 02;18(23).
PMID: 34886441 DOI: 10.3390/ijerph182312716

We appreciate very much the interest of Ivy et al. in our work [...].
Fulltext LMDI Decomposition Analysis of E-Waste Generation in the ASEAN

Choi G, Kim T, Kim M

Int J Environ Res Public Health, 2021 12 06;18(23).
PMID: 34886589 DOI: 10.3390/ijerph182312863

The economies of ASEAN member states are growing rapidly, and electrical and electronic waste (E-waste) generated from them are also showing a rapid increase. In this context, this study conducted an LMDI decomposition analysis on the amount of E-waste generated in ASEAN member countries from 2015 to 2019 and decomposed it into E-waste intensity, economic growth, and population effects. Then, based on analysis results, policy implications are suggested to improve their E-waste management. According to the analysis results, ASEAN countries can be classified into three groups. The first group includes Indonesia, the Philippines, Singapore, Thailand; economic growth was the main driving factor of E-waste increase in these countries. However, E-waste had also decreased due to the effect of E-waste intensity. The second group includes countries where economic growth was not the only driving factor for E-waste increase, but also where E-waste had increased due to the effect of E-waste intensity. These countries include Cambodia, Malaysia, and Viet Nam. Finally, the third group consists of countries where the effect of E-waste intensity is the main driving factor, including Brunei Darussalam, Lao PDR, and Myanmar. This research shows that ASEAN countries need policies that can effectively deal with the threat of E-waste as a result of high economic growth and policies that can improve intensity by reducing the generation of E-waste.
Fulltext Eating Behaviors among Online Learning Undergraduates during the COVID-19 Pandemic

Pung CYY, Tan ST, Tan SS, Tan CX

Int J Environ Res Public Health, 2021 12 05;18(23).
PMID: 34886546 DOI: 10.3390/ijerph182312820

The outbreak of Coronavirus Disease-2019 (COVID-19) has upended education systems. The pandemic switched traditional face-to-face classes to online classes. Poor eating behaviors in undergraduate students' lives may affect the well-being of their later stages of life. This study aimed to investigate the eating behaviors among online learning undergraduates during the COVID-19 pandemic. A total of 122 students were recruited. The results revealed more than half of the respondents (52.46%) skipped meals. Breakfast (46.72%) was the most skipped meal. The majority of the respondents (94.26%) snacked between meals. Biscuits (88.52%), bread (84.43%), and fruits (80.33%) were the most common snacked foods. Meal skipping was found to be associated with gender (χ2 = 6.83, p < 0.05). In the future, more health interventions program aimed to promote healthy eating behaviors among undergraduates are highly warranted.

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