Displaying publications 21 - 40 of 99 in total

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  1. Meau YP, Ibrahim F, Narainasamy SA, Omar R
    Comput Methods Programs Biomed, 2006 May;82(2):157-68.
    PMID: 16638620
    This study presents the development of a hybrid system consisting of an ensemble of Extended Kalman Filter (EKF) based Multi Layer Perceptron Network (MLPN) and a one-pass learning Fuzzy Inference System using Look-up Table Scheme for the recognition of electrocardiogram (ECG) signals. This system can distinguish various types of abnormal ECG signals such as Ventricular Premature Cycle (VPC), T wave inversion (TINV), ST segment depression (STDP), and Supraventricular Tachycardia (SVT) from normal sinus rhythm (NSR) ECG signal.
  2. Yafouz B, Kadri NA, Rothan HA, Yusof R, Ibrahim F
    Electrophoresis, 2016 Feb;37(3):511-8.
    PMID: 26530354 DOI: 10.1002/elps.201500282
    Dielectrophoresis (DEP), the induced movement of dielectric particles placed in a nonuniform electric field, has been used as a potential technique for manipulation and separation of many biological samples without destructive consequences to the cell. Cells of the same genotype in different physiological and pathological states have unique morphological and structural features, therefore, it is possible to differentiate between them using their DEP responses. This paper reports the experimental discrimination of normal and dengue-infected human hepatic fetal epithelial cells (WRL-68 cells) based on their DEP crossover frequency, at which no resultant movement occurs in the cells in response to the DEP force. A microarray dot electrode was used to conduct the DEP experiments. The DEP forces applied to the cells were quantified by analyzing the light intensity shift within the electrode's dot region based on the Cumulative Modal Intensity Shift image analysis technique. The differences in dielectric properties between infected and uninfected cells were exploited by plotting a unique DEP spectrum for each set of cells. We observed that the crossover frequency decreased from 220 kHz for the normal WRL-68 cells to 140 kHz after infection with the dengue virus in a medium conductivity of 100 μS/cm. We conclude that the change in the DEP crossover frequency between dengue-infected cells and their healthy counterparts should allow direct characterization of these cell types by exploiting their electrophysiological properties.
  3. Motlagh FE, Ibrahim F, Rashid RA, Seghatoleslam T, Habil H
    Chin Med, 2016;11:16.
    PMID: 27053944 DOI: 10.1186/s13020-016-0088-7
    Acupuncture therapy has been used to treat substance abuse. This study aims to review experimental studies examining the effects of acupuncture on addiction. Research and review articles on acupuncture treatment of substance abuse published between January 2000 and September 2014 were searched using the databases ISI Web of Science Core Collection and EBSCO's MEDLINE Complete. Clinical trial studies on the efficacy of acupuncture therapy for substance abuse were classified according to substance (cocaine, opioid, nicotine, and alcohol), and their treatment protocols, assessments, and findings were examined. A total of 119 studies were identified, of which 85 research articles addressed the efficacy of acupuncture for treating addiction. There were substantial variations in study protocols, particularly regarding treatment duration, frequency of electroacupuncture, duration of stimulation, and choice of acupoints. Contradictory results, intergroup differences, variation in sample sizes, and acupuncture placebo effects made it difficult to evaluate acupuncture effectiveness in drug addiction treatment. This review also identified a lack of rigorous study design, such as control of confounding variables by incorporating sham controls, sufficient sample sizes, reliable assessments, and adequately replicated experiments.
  4. Ibrahim F, Ismail NA, Taib MN, Wan Abas WA
    Physiol Meas, 2004 Jun;25(3):607-15.
    PMID: 15253113 DOI: 10.1088/0967-3334/25/3/002
    This paper describes a model for predicting hemoglobin (Hb) by using bioelectrical impedance analysis (BIA) in dengue patients in the Hospital Universiti Kebangsaan Malaysia (HUKM). Bioelectrical impedance measurements were conducted on 83 (47 males and 36 females) serologically confirmed dengue fever (DF) and dengue hemorrhagic fever (DHF) patients during their hospitalization. The predictive equation for Hb was derived using multivariate analysis. We investigated all the parameters in BIA, patients' symptom and demographic data. In this developed model, four predictors (reactance (XC), sex, weight and vomiting) were found to be the best predictive factors for modeling Hb in dengue patients. However, the model can only explain approximately 42% of the variation in Hb status, thus single frequency bio-impedance stand-alone technique is insufficient to monitor Hb for the DF and DHF patients. Further investigation using multi-frequency BIA is recommended in modeling Hb to achieve the most parsimonious model.
  5. Ibrahim F, Mohan D, Sajab MS, Bakarudin SB, Kaco H
    Polymers (Basel), 2019 Sep 23;11(10).
    PMID: 31547544 DOI: 10.3390/polym11101544
    In this study, lignin has been extracted from oil palm empty fruit bunch (EFB) fibers via an organosolv process. The organosolv lignin obtained was defined by the presence of hydroxyl-containing molecules, such as guaiacyl and syringyl, and by the presence of phenolic molecules in lignin. Subsequently, the extracted organosolv lignin and graphene nanoplatelets (GNP) were utilized as filler and reinforcement in photo-curable polyurethane (PU), which is used in stereolithography 3D printing. The compatibility as well as the characteristic and structural changes of the composite were identified through the mechanical properties of the 3D-printed composites. Furthermore, the tensile strength of the composited lignin and graphene shows significant improvement as high as 27%. The hardness of the photo-curable PU composites measured by nanoindentation exhibited an enormous improvement for 0.6% of lignin-graphene at 92.49 MPa with 238% increment when compared with unmodified PU.
  6. Lim YY, Wahab S, Kumar J, Ibrahim F, Kamaluddin MR
    Children (Basel), 2021 Apr 25;8(5).
    PMID: 33922985 DOI: 10.3390/children8050333
    Child sexual abuse is a public health issue that has been associated with a variety of negative health outcomes. Child sexual abusers constitute a heterogeneous population of individuals. This review lays out an overview of the current understanding of typologies and psychological profiles of child sexual abusers. Typologies of child sexual abusers in general and online child sexual abusers are reviewed to summarise the existing knowledge. Psychological traits including personality traits, cognitive distortion, empathy, and impulsivity are examined to provide a wider perspective of the psycho-criminogenic factors of child sexual abuse. Although past research on child sexual abusers has provided insights into the organisation and classification of different types of child sexual abusers, the classification of these typologies has drawn widespread criticisms. In this review, we discuss the challenges and limitations pertaining to the existing typologies and studies related to the psychological profile of child sexual abusers.
  7. Motlagh F, Ibrahim F, Rashid R, Seghatoleslam T, Habil H
    J Neurosci Res, 2017 08;95(8):1633-1646.
    PMID: 27862172 DOI: 10.1002/jnr.23988
    This study aims to introduce a new approach of a comprehensive paradigm to evaluate brain electrophysiological properties among addicts. Electroencephalographic spectral power as well as amplitudes and latencies of mismatch negativity (MMN), P300, and P600 components were evaluated among 19 male heroin addicts and 19 healthy nonsmoker subjects using a paradigm consisting of three subparadigms, namely (1) digit span Wechsler test, (2) auditory oddball, and (3) visual cue-reactivity oddball paradigms. Task 1 provided auditory P300 and P600 in association with working memory. Task 2 provided auditory P300 as well as small and large deviant MMN event-related potential (ERPs). Finally, task 3 provided visual cue-reactivity P300. Results show that beta power was higher among heroin addicts while delta, theta, and alpha powers were decreased compared with healthy subjects. ERP analysis confirmed the decline of brain-evoked potential amplitudes when compared with healthy subjects, thus indicating a broad neurobiological vulnerability of preattentive and attentional processing including attentional deficits and compromise of discrimination abilities. The prolonged latency of ERPs reflects poor cognitive capacity in the engagement of attention and memory resources. On the other hand, an increase of attention towards the heroin-related stimuli could be concluded from the increase of P300 in the cue-reactivity condition among heroin addicts. Findings suggest that applying this paradigm in addiction studies benefits comprehensive evaluation of neuroelectrophysiological activity among addicts, which can promote a better understanding of drugs' effects on the brain as well as define new neuroelectrophysiological characteristics of addiction properties. © 2016 Wiley Periodicals, Inc.
  8. Vitus V, Ibrahim F, Wan Kamarul Zaman WS
    Tissue Eng Part C Methods, 2022 10;28(10):529-544.
    PMID: 35350873 DOI: 10.1089/ten.TEC.2021.022333
    Human hair is a potential biomaterial for biomedical applications. Improper disposal of human hair may pose various adverse effects on the environment and human health. Therefore, proper management of human hair waste is pivotal. Human hair fiber and its derivatives offer various advantages as biomaterials such as biocompatibility, biodegradability, low toxicity, radical scavenging, electroconductivity, and intrinsic biological activity. Therefore, the favorable characteristics of human hair have rendered its usage in tissue engineering (TE) applications including skin, cardiac, nerve, bone, ocular, and periodontal. Moreover, the strategies by utilizing human hair as a biomaterial for TE applications may reduce the accumulation of human hair. Thus, it also improves human hair waste management while promoting natural, environmental-friendly, and nontoxic materials. Furthermore, promoting sustainable materials production will benefit human health and well-being. Hence, this article reviews and discusses human hair characteristics as sustainable biomaterials and their recent application in TE applications. Impact Statement This review article highlights the sustainability aspects of human hair as raw biomaterials and various elements of human hair that could potentially be used in tissue engineering (TE) applications. Furthermore, this article discusses numerous benefits of human hair, highlighting its value as biomaterials in bioscaffold development for TE applications. Moreover, this article reviews the role and effect of human hair in various TE applications, including skin, cardiac, nerve, bone, ocular, and periodontal.
  9. Ibrahim F, Thio TH, Faisal T, Neuman M
    Sensors (Basel), 2015 Mar 23;15(3):6947-95.
    PMID: 25806872 DOI: 10.3390/s150306947
    This paper reviews a number of biomedical engineering approaches to help aid in the detection and treatment of tropical diseases such as dengue, malaria, cholera, schistosomiasis, lymphatic filariasis, ebola, leprosy, leishmaniasis, and American trypanosomiasis (Chagas). Many different forms of non-invasive approaches such as ultrasound, echocardiography and electrocardiography, bioelectrical impedance, optical detection, simplified and rapid serological tests such as lab-on-chip and micro-/nano-fluidic platforms and medical support systems such as artificial intelligence clinical support systems are discussed. The paper also reviewed the novel clinical diagnosis and management systems using artificial intelligence and bioelectrical impedance techniques for dengue clinical applications.
  10. Syed Ibrahim SA, Ibrahim F, Taib NAM, Cho J
    Lymphat Res Biol, 2023 Oct;21(5):463-468.
    PMID: 37093011 DOI: 10.1089/lrb.2022.0102
    Background: Breast cancer-related lymphedema (BCRL) is a debilitating chronic illness. Early management and prevention of disease progression rely on lymphedema monitoring and assessment. At present, lymphedema monitoring systems are costly and do not promote remote monitoring. Thus, a low-cost, portable, mobile-based bioimpedance lymphedema monitoring system (Mobilymph) was developed to ensure continuous lymphedema surveillance. Method and Results: Forty-five healthy and 100 BCRL participants were recruited in this study. Mobilymph bioimpedance measurement was validated with a Quadscan 4000 on healthy participants' arms. The interarm bioimpedance ratio was determined to evaluate the discriminatory capability of Mobilymph to detect BCRL. Mobilymph's bioimpedance results show no significant difference compared to Quadscan 4000. The interarm bioimpedance ratios were significantly different (p 
  11. Thiha A, Ibrahim F, Muniandy S, Madou MJ
    Microsyst Nanoeng, 2019;5:62.
    PMID: 31754454 DOI: 10.1038/s41378-019-0103-0
    Carbon micro- and nanoelectrodes fabricated by carbon microelectromechanical systems (carbon MEMS) are increasingly used in various biosensors and supercapacitor applications. Surface modification of as-produced carbon electrodes with oxygen functional groups is sometimes necessary for biofunctionalization or to improve electrochemical properties. However, conventional surface treatment methods have a limited ability for selective targeting of parts of a surface area for surface modification without using complex photoresist masks. Here, we report microplasma direct writing as a simple, low-cost, and low-power technique for site-selective plasma patterning of carbon MEMS electrodes with oxygen functionalities. In microplasma direct writing, a high-voltage source generates a microplasma discharge between a microelectrode tip and a target surface held at atmospheric pressure. In our setup, water vapor acts as an ionic precursor for the carboxylation and hydroxylation of carbon surface atoms. Plasma direct writing increases the oxygen content of an SU-8-derived pyrolytic carbon surface from ~3 to 27% while reducing the carbon-to-oxygen ratio from 35 to 2.75. Specifically, a microplasma treatment increases the number of carbonyl, carboxylic, and hydroxyl functional groups with the largest increase observed for carboxylic functionalities. Furthermore, water microplasma direct writing improves the hydrophilicity and the electrochemical performance of carbon electrodes with a contact-angle change from ~90° to ~20°, a reduction in the anodic peak to cathodic peak separation from 0.5 V to 0.17 V, and a 5-fold increase in specific capacitance from 8.82 mF∙cm-2 to 46.64 mF∙cm-2. The plasma direct-writing technology provides an efficient and easy-to-implement method for the selective surface functionalization of carbon MEMS electrodes for electrochemical and biosensor applications.
  12. Abdul Manaf R, Dickson N, Lovell S, Ibrahim F
    BMC Public Health, 2019 Nov 07;19(1):1473.
    PMID: 31699061 DOI: 10.1186/s12889-019-7855-1
    BACKGROUND: Men who inject drugs (MWIDs) comprise the highest percentage of diagnosed HIV cases in Malaysia. Their female partners risk being infected through unprotected sexual contact. This paper reports the prevalence of consistent condom use and its predictors among the wives and regular sexual partners of MWIDs in Klang Valley, Malaysia.

    METHODS: A cross-sectional study using a self-administered questionnaire was conducted among the wives and regular sexual partners of MWIDs in the study location; 221 women were recruited through respondent-driven sampling. Data were analysed descriptively for the prevalence of consistent condom use, HIV status and HIV risk-related behaviour. Subsequently, simple and multiple logistic regressions were undertaken to identify the predictors of consistent condom use.

    RESULTS: The prevalence of consistent condom use among respondents was 19.5%. Slightly more than half (52.5%) of respondents had never used condoms with their partner. Fourteen women (6.3%) reported being HIV positive. While 7.7% had HIV-positive partners, 45.7% were unaware of their partner's HIV status. Consistent condom use was significantly higher among single women (AOR = 4.95; 95% CI: 2.45, 9.99), women who lived in urban areas (AOR = 2.97; 95% CI: 1.30, 6.78), HIV-positive women (AOR = 3.45; 95% CI: 1.13, 10.5) and women involved in sex work (AOR = 3.55, 95% CI: 1.45, 8.67).

    CONCLUSIONS: Inconsistent condom use among the majority of female sexual partners of MWIDs underscores the heightened risk faced by these women and calls for alternative prevention methods that women are able to control.

  13. Ibrahim F, Samsudin EZ, Ishak AR, Sathasivam J
    Front Public Health, 2022;10:1067764.
    PMID: 36424957 DOI: 10.3389/fpubh.2022.1067764
    Indoor air quality (IAQ) has recently gained substantial traction as the airborne transmission of infectious respiratory disease becomes an increasing public health concern. Hospital indoor environments are complex ecosystems and strategies to improve hospital IAQ require greater appreciation of its potentially modifiable determinants, evidence of which are currently limited. This mini-review updates and integrates findings of previous literature to outline the current scientific evidence on the relationship between hospital IAQ and building design, building operation, and occupant-related factors. Emerging evidence has linked aspects of building design (dimensional, ventilation, and building envelope designs, construction and finishing materials, furnishing), building operation (ventilation operation and maintenance, hygiene maintenance, access control for hospital users), and occupants' characteristics (occupant activities, medical activities, adaptive behavior) to hospital IAQ. Despite the growing pool of IAQ literature, some important areas within hospitals (outpatient departments) and several key IAQ elements (dimensional aspects, room configurations, building materials, ventilation practices, adaptive behavior) remain understudied. Ventilation for hospitals continues to be challenging, as elevated levels of carbon monoxide, bioaerosols, and chemical compounds persist in indoor air despite having mechanical ventilation systems in place. To curb this public health issue, policy makers should champion implementing hospital IAQ surveillance system for all areas of the hospital building, applying interdisciplinary knowledge during the hospital design, construction and operation phase, and training of hospital staff with regards to operation, maintenance, and building control manipulation. Multipronged strategies targeting these important determinants are believed to be a viable strategy for the future control and improvement of hospital IAQ.
  14. Ibrahim F, Samsudin EZ, Chen XW, Toha HR
    J Occup Environ Med, 2022 Jan 01;64(1):e20-e27.
    PMID: 34789681 DOI: 10.1097/JOM.0000000000002428
    OBJECTIVE: To examine the prevalence of burnout and its work-related factors among public health providers (PHP) during the COVID-19 pandemic.

    METHODS: We surveyed 366 PHP in May 2021 on their burnout, demographic, and work-related characteristics. Logistic regression analyses were conducted to identify associated factors.

    RESULTS: 45% PHP reported burnout. Higher PHP burnout was associated with younger age (AOR 0.96, 95% CI 0.93-0.99), prolonged COVID-19 involvement (AOR 2.35, 95% CI 1.16-4.72), as well as perceiving medium (AOR 2.10, 95% CI 1.27-3.48) and high emotional demand (AOR 4.45, 95% CI 1.67-11.77), low (AOR 2.10, 95% CI 1.27-3.48) and medium (AOR 4.18, 95% CI 1.64-10.59) role clarity, medium job satisfaction (AOR 3.21, 95% CI: 1.11-9.29), and low organisational justice (AOR 3.32, 95% CI 1.51-7.27).

    CONCLUSIONS: Improving job content and organisational characteristics may be key to reducing PHP burnout.

  15. Ghozali G, Azuhairi A A, Mohd Zulkefli NA, Ibrahim F
    F1000Res, 2019;8:115.
    PMID: 37767456 DOI: 10.12688/f1000research.17628.2
    Background: Drug abuse is a serious global health problem. Globally, 269 million people or 5.3 percent of the population aged 15‒64 years used drugs in 2018. Evidence shows that most drug addicts start using drugs in adolescence (<15-years-old). Adolescents need role models who are able to guide them; teachers have important roles as they are primary role models for students. Therefore, teachers should have positive beliefs to guide students effectively, i.e. they should have good awareness about the threat of drug abuse and high confidence to implement required prevention. This research developed an alternative electronic delivery method of learning material to empower teachers in preventing drug abuse. This study aimed to compare the effect of the electronic and a printed teaching module on teachers' beliefs about drug abuse prevention. Methods: 260 junior high school teachers were selected randomly. These teachers were split into two groups. Before intervention, a questionnaire was completed by both groups. The teachers then completed the learning material: electronic module in the first group and printed module in the second group. One month later, data was collected from both groups using the same questionnaire to assess the beliefs of the teachers Results: There was significant positive effect on teachers' beliefs, both in electronic module and printed module groups. All categories of beliefs at one month after intervention were significantly higher than those at baseline (P<0.001). Based on between group comparison analysis of mean changes, perceived susceptibility in electronic module group was significantly higher than printed module group (P<0.001), while perceived severity, benefits, barriers and efficacy were not significantly different (P>0.05). Conclusions: Electronic and printed module intervention significantly increased teachers' beliefs in drug abuse prevention. The printed module was still effective to be used as learning media, while the electronic module was an alternative with some advantages.
  16. Vitus V, Ibrahim F, Wan Kamarul Zaman WS
    Polymers (Basel), 2021 Nov 23;13(23).
    PMID: 34883564 DOI: 10.3390/polym13234058
    A scaffold is a crucial biological substitute designed to aid the treatment of damaged tissue caused by trauma and disease. Various scaffolds are developed with different materials, known as biomaterials, and have shown to be a potential tool to facilitate in vitro cell growth, proliferation, and differentiation. Among the materials studied, carbon materials are potential biomaterials that can be used to develop scaffolds for cell growth. Recently, many researchers have attempted to build a scaffold following the origin of the tissue cell by mimicking the pattern of their extracellular matrix (ECM). In addition, extensive studies were performed on the various parameters that could influence cell behaviour. Previous studies have shown that various factors should be considered in scaffold production, including the porosity, pore size, topography, mechanical properties, wettability, and electroconductivity, which are essential in facilitating cellular response on the scaffold. These interferential factors will help determine the appropriate architecture of the carbon-based scaffold, influencing stem cell (SC) response. Hence, this paper reviews the potential of carbon as a biomaterial for scaffold development. This paper also discusses several crucial factors that can influence the feasibility of the carbon-based scaffold architecture in supporting the efficacy and viability of SCs.
  17. Basar MR, Ahmad MY, Cho J, Ibrahim F
    Sensors (Basel), 2014 Jun 19;14(6):10929-51.
    PMID: 24949645 DOI: 10.3390/s140610929
    Wireless capsule endoscopy (WCE) is a promising technology for direct diagnosis of the entire small bowel to detect lethal diseases, including cancer and obscure gastrointestinal bleeding (OGIB). To improve the quality of diagnosis, some vital specifications of WCE such as image resolution, frame rate and working time need to be improved. Additionally, future multi-functioning robotic capsule endoscopy (RCE) units may utilize advanced features such as active system control over capsule motion, drug delivery systems, semi-surgical tools and biopsy. However, the inclusion of the above advanced features demands additional power that make conventional power source methods impractical. In this regards, wireless power transmission (WPT) system has received attention among researchers to overcome this problem. Systematic reviews on techniques of using WPT for WCE are limited, especially when involving the recent technological advancements. This paper aims to fill that gap by providing a systematic review with emphasis on the aspects related to the amount of transmitted power, the power transmission efficiency, the system stability and patient safety. It is noted that, thus far the development of WPT system for this WCE application is still in initial stage and there is room for improvements, especially involving system efficiency, stability, and the patient safety aspects.
  18. Ibrahim F, Sian TC, Shanggar K, Razack AH
    J Phys Ther Sci, 2013 Sep;25(9):1087-91.
    PMID: 24259921 DOI: 10.1589/jpts.25.1087
    [Purpose] Our objective was to assess the effect of salat and mimicking salat movements and postures on subjects with erectile dysfunction. [Methods] Ten volunteers were recruited in this study. Subjects who were Muslims (Group I) were asked to perform their daily salat and a new intervention of an additional 12 movement cycles of salat for three sessions a week. Non-Muslim subjects (Group II) were taught to mimic salat movements, and were asked to perform a total of 12 movement cycles without reading the recitation for three sessions a week. An International Index for Erectile Function 5 (IIEF-5) questionnaire was given to the subjects before and after the intervention of performing salat or mimicking salat movements and postures. A nocturnal electrobioimpedance volume assessment (NEVA) device was used to measure the nocturnal penile tumescence (NPT) parameters over two consecutive nights. A nonparametric test was conducted to find the significant NPT parameters. [Results] The results showed that all measured parameters improved significantly, with the largest change observed in the maximum percent volumetric change over the baseline (from 138 to 222%). [Conclusion] This preliminary study suggests that the alternative approach of salat and mimicking salat movements and postures, may have beneficial effects for ED patients.
  19. Sosroseno W, Sugiatno E, Samsudin AR, Ibrahim F
    J Oral Implantol, 2008;34(4):196-202.
    PMID: 18780564 DOI: 10.1563/0.910.1
    The aim of the present study was to test the hypothesis that the proliferation of a human osteoblast cell line (HOS cells) stimulated with hydroxyapatite (HA) may be regulated by nitric oxide (NO). The cells were cultured on the surface of HA. Medium or cells alone were used as controls. L-arginine, D-arginine, 7-NI (an nNOS inhibitor), L-NIL (an iNOS inhibitor), L-NIO (an eNOS inhibitor) or carboxy PTIO, a NO scavenger, was added in the HA-exposed cell cultures. The cells were also precoated with anti-human integrin alphaV antibody. The levels of nitrite were determined spectrophotometrically. Cell proliferation was assessed by colorimetric assay. The results showed increased nitrite production and cell proliferation by HA-stimulated HOS cells up to day 3 of cultures. Anti-integrin alphaV antibody, L-NIO, or carboxy PTIO suppressed, but L-arginine enhanced, nitrite production and cell proliferation of HA-stimulated HOS cells. The results of the present study suggest, therefore, that interaction between HA and HOS cell surface integrin alphaV molecule may activate eNOS to catalyze NO production which, in turn, may regulate the cell proliferation in an autocrine fashion.
  20. Ibrahim F, Samsudin EZ, Ishak AR, Sathasivam J
    Heliyon, 2024 Jul 30;10(14):e34454.
    PMID: 39082032 DOI: 10.1016/j.heliyon.2024.e34454
    INTRODUCTION: Poor indoor air quality (IAQ) in healthcare settings may adversely impact occupants' well-being and promote transmission of infectious respiratory disease. However, evidence on its potentially modifiable determinants, including occupant behaviour, remains scarce. This study aims to determine the relationship between occupant behaviour and IAQ in Malaysian hospital outpatient departments (OPDs).

    METHODS: A multistage cross-sectional study of six randomly selected Malaysian public hospital OPDs was conducted. In stage one, IAQ parameters, including temperature, relative humidity (RH), air velocity (AV), carbon dioxide (CO2), total bacterial count (TBC), and total fungal count (TFC) were measured. In stage two, an observation form based on the Korsavi and Montazami tool for measuring adaptive behaviour was used to examine occupant density, activities, and operation of building envelopes and appliances. Simple correlation, partial correlation, and linear regression analyses were performed to examine the relationship between occupant behaviour and IAQ parameters.

    RESULTS: The IAQ of selected hospital OPDs complied with established standards, except for temperature and AV. Occupant density was positively correlated with temperature and CO2. Meanwhile, occupants' activities including slow walking and brisk walking were positively correlated with temperature, AV, CO2, TBC and TFC. Conversely, occupants' opening of windows and doors were positively correlated with temperature and AV but negatively correlated with CO2, TBC and TFC. Finally, turning on fans was positively correlated with AV but negatively correlated with TBC, whereas turning on air conditioner was positively correlated with CO2. Among occupants' behaviour, opening of windows and doors contributed the most to variation in IAQ parameters.

    CONCLUSIONS: The study findings suggest that IAQ in hospital OPDs are influenced by occupant density, activities, and operation of doors, windows, and appliances. Prospective hospital IAQ guidelines should incorporate policies and measures targeting these factors to ensure occupants' best practices in maintaining healthy hospital indoor air environments.

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