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Fulltext Physical Frailty among Urban-Living Community-Dwelling Older Adults in Malaysia

Norazman CW, Adznam SN, Jamaluddin R

Int J Environ Res Public Health, 2020 09 09;17(18).
PMID: 32916809 DOI: 10.3390/ijerph17186549

Frailty is a multidimensional syndrome, which is a worldwide concern within the field of geriatrics due to the aggravating effect on the physical and mental functions of the elderly. This study aimed to determine the prevalence and risk factors of the frailty syndrome among urban-living community-dwelling elderly in Malaysia. A cross-sectional study was conducted among 301 community-dwelling elders. Frailty status was assessed using the Fried phenotype criteria. Depressive symptoms were assessed using the Geriatric Depression Scale (M-GDS-14), whereas the functional abilities and cognitive status were measured using the Lawton Instrumental Activities of Daily Living (Lawton IADL) scale and the Mini-Mental State Examination (MMSE-M), respectively. Malnutrition risk was observed through the abridged version (Short Form) of the Mini Nutritional Assessment (MNA-SF). Multinomial logistic regression analysis was employed to determine the significant predictors of the frailty syndrome. Three hundred and one elderly persons engaged in this study, with a mean age of 67.08 ± 5.536 ranging between 60 to 84 years old. The prevalence values of frailty and pre-frail were 15.9% and 72.8%, respectively, in which women appeared to be at a higher risk of frailty. The multivariate model revealed that frailty could be predicted from an increase in age, lower household income, being at risk of malnutrition, wasting (low skeletal muscle mass), and high serum C-reactive protein (CRP) level. A holistic approach is suggested for managing the frailty syndrome as it involves a decline in the multiple components of the geriatric syndrome.
Fulltext Hedonic and Utilitarian Performances as Determinants of Mental Health and Pro-Social Behaviors among Volunteer Tourists

Han H, Meng B, Chua BL, Ryu HB

Int J Environ Res Public Health, 2020 09 10;17(18).
PMID: 32927834 DOI: 10.3390/ijerph17186594

International volunteer tourism is an emerging and sustainable trend of the global tourism industry. In this study, we attempted to provide a clear comprehension of volunteer tourists' mental health increase and pro-social intention formation. A survey method and quantitative approach were used. Our result from the structural analysis showed that hedonic and utilitarian performances, mental health, and volunteer tourism engagement had significant associations and that these relationships contributed to improving pro-social intention. In addition, results from the metric invariance assessment revealed that the volunteer tourism engagement and pro-social intention relation was under the significant influence of problem awareness and ascribed responsibility. Mental health and engagement acted as significant mediators. The comparative importance of volunteer tourism engagement was uncovered. Overall, our results provided a sufficient understanding of volunteer tourists' pro-social decision-making process and behaviors.
Fulltext Perceived Severity and Susceptibility towards Leptospirosis Infection in Malaysia

Sukeri S, Zahiruddin WM, Shafei MN, Hamat RA, Osman M, Jamaluddin TZMT, et al.

Int J Environ Res Public Health, 2020 09 01;17(17).
PMID: 32882876 DOI: 10.3390/ijerph17176362

BACKGROUND: Perceived severity and susceptibility refers to one's belief of the seriousness and the risk of contracting a specific disease. It is an essential study in public health as it assists in the understanding of the motivating factors towards disease prevention. This qualitative study aimed to explore perceived severity and susceptibility towards leptospirosis infection among respondents in two states of Malaysia.
METHODS: Focus group discussions using the phenomenology approach was conducted involving 72 respondents in Selangor and Kelantan. Data were examined using content analysis.
RESULTS: Respondents perceived leptospirosis infection as severe due to its poor disease prognosis and complications. However, some rated it less severe when compared with other chronic diseases such as cancer and AIDS. Their perceptions were influenced by their knowledge about the disease, media portrayal and frequency of health campaigns by the government. All respondents believed they were not susceptible to the disease.
CONCLUSION: The low perceived susceptibility of leptospirosis infection is a matter of concern as it may contribute to respondents' lack of motivation towards preventing the disease. The study findings may provide the basis for health promotional activities designed to heighten public perceived threat towards leptospirosis infection and thereby improving preventive health behaviors for avoiding leptospirosis.
Fulltext Supporting Role of Society and Firms to COVID-19 Management among Medical Practitioners

Zandi G, Shahzad I, Farrukh M, Kot S

Int J Environ Res Public Health, 2020 10 29;17(21).
PMID: 33138254 DOI: 10.3390/ijerph17217961

Measurement of job stress and employees' commitment are few of the admired topics in the corporate world amongst business writers. With a principal aim to trial the blow of exposure to COVID-19 patients on doctors' job stress and commitment, in Pakistan; data have been collected through 7-10 min telephonic interview from voluntary participants and a sample of 129 responses were analyzed by Structure Equation Modeling-Partial Least Square (SEM-PLS) path modeling through Smart PLS 3.2. The results of the study indicated; direct positive & significant impact of Extent of Exposure on Job Stress while direct negative, significant association with Commitment. Job Stress also observed having direct negative impact on commitment. The Extent of Exposure-Job Stress relationship was also found stronger among group of doctors having Low level of Perceived Organizational Support and weaker among group of doctors having High level of Perceive Organizational support. Perceived Organizational Support showed a moderating effect on the Extent of Exposure-Job Stress relationship; while, Social Support showed no moderation. Researchers are required to investigate more and management of the medical services providers (both hospitals and government) needs to focus on doctors' perception about Organizational Support, as doctors show no concern about the support from society as long as their well-being is cared for by respective hospitals. This study is an effort to stimulate more empirical evidence towards the treating and handling of COVID-19 patients and the psychological well-being of doctors.
Fulltext Socio-Economic Factors Related to Drinking Water Source and Sanitation in Malaysia

Kong YL, Anis-Syakira J, Fun WH, Balqis-Ali NZ, Shakirah MS, Sararaks S

Int J Environ Res Public Health, 2020 10 29;17(21).
PMID: 33137998 DOI: 10.3390/ijerph17217933

Access to improved water and sanitation is essential. We describe these practices in Malaysia using data from a nationwide community survey and used logistic regression to assess the determinants. Of the 7978 living quarters (LQs), 58.3% were in urban areas. About 2.4%, 0.5% and 27.4% of LQs had non-improved water sources, non-improved toilet types and improper domestic waste disposal, respectively. Open burning was practiced by 26.1%. Water source was a problem for long houses (10.5%), squatters (8.5%) and shared houses (4.0%). Non-improved toilet types were 11.9% for squatters and 4.8% for shared houses. Improper domestic waste disposal practices were higher for occupants of village houses (64.2%), long houses (54.4%), single houses (45.8%) and squatters (35.6%). An increase in education or income level was associated with a decrease in improper domestic waste disposal methods. House type significantly affected water and sanitation after adjusting for the effects of other variables. Lower household income was associated with non-improved toilet types and improper domestic waste disposal. Lower education and rural location influenced domestic waste disposal. The water and toilet facilities in Malaysia were generally good, while domestic waste management practices could be improved. There remain pockets of communities with environmental challenges for the nation.
Fulltext Validity and Reliability of a Food Frequency Questionnaire (FFQ) to Assess Dietary Intake of Preschool Children

Noor Hafizah Y, Ang LC, Yap F, Nurul Najwa W, Cheah WL, Ruzita AT, et al.

Int J Environ Res Public Health, 2019 11 27;16(23).
PMID: 31783477 DOI: 10.3390/ijerph16234722

As there are few food frequency questionnaires (FFQ) to assess the dietary intake of preschool children, this study examined the validity and reliability of an FFQ for this purpose. A total of 210 preschoolers aged 4 to 6 years participated in the validation study, while a subsample of 66 participants joined the reliability study. The FFQ is modified from the ToyBox-study and South East Asian Nutrition Surveys (SEANUTS), and comprised 108 food items from 13 food groups. A three-day estimated dietary record (3DR) was used as reference and reliability was assessed through a second administration of the FFQ (FFQ2), four weeks after the first administration (FFQ1). For the validation study, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ and 3DR. Cross-classification of quartile analysis showed moderate agreement between the two methods. As for reliability, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ1 and FFQ2. Cronbach's alpha values (0.708 to 0.824) and intraclass correlation coefficients (0.710 to 0.826) showed good agreement between repeated FFQs. The results suggest that the FFQ has acceptable validity and good reliability. Hence, the FFQ can be used to assess preschool children's food intake.
Fulltext The Effects of Circadian Rhythm Disruption on Mental Health and Physiological Responses among Shift Workers and General Population

Ahmad M, Md Din NSB, Tharumalay RD, Che Din N, Ibrahim N, Amit N, et al.

Int J Environ Res Public Health, 2020 09 30;17(19).
PMID: 33007836 DOI: 10.3390/ijerph17197156

Background: The effect of circadian disruption on the bio-psychological clock system has been widely studied. However, the mechanism and the association of circadian rhythm disruption with mental health and physiological responses are still unclear. Therefore, this study was conducted to investigate the effects of circadian rhythm disruption on mental health and physiological responses among shift workers and the general population. Methods: A total of 42 subjects participated in this quasi-experimental study. Participants were divided into a group of shift workers (n = 20) and a general population group (n = 22). Polysomnography tests, blood tests (cortisol, triglycerides and glucose), and psychological tests (Abbreviated Profile of Mood States, General Health Questionnaire-28, Working Memory and Processing Speed Indexes of the Wechsler Adult Intelligent Scale (WAIS-IV) were used to examine the effects of circadian rhythm disruption. Results: The results showed a significant relationship between circadian rhythm disruption and mood (r = 0.305, p < 0.05). The findings of this study also indicated that there was a significant effect of circadian rhythm disruption on mood (F(2,40) = 8.89, p < 0.001, η2 =0.182), processing speed (F(2,40) = 9.17, p < 0.001, η2 = 0.186) and working memory (F(2,40) = 4.963, p < 0.01, η2 = 0.11) in shift workers and the general population. Conclusions: Our findings showed that circadian rhythm disruption affects mood and cognitive performance, but it does not significantly affect psychological wellbeing and physiological responses. Future studies are warranted to examine moderator and mediator variables that could influence the circadian rhythm disruption.
Fulltext Partnership Status and Living Situation in Persons Experiencing Physical Disability in 22 Countries: Are There Patterns According to Individual and Country-Level Characteristics?

Fekete C, Arora M, Reinhardt JD, Gross-Hemmi M, Kyriakides A, Le Fort M, et al.

Int J Environ Res Public Health, 2020 09 24;17(19).
PMID: 32987936 DOI: 10.3390/ijerph17197002

Persons experiencing disabilities often face difficulties to establish and maintain intimate partnerships and the decision whether to live alone or with others is often not their own to make. This study investigates whether individual and country-level characteristics predict the partnership status and the living situation of persons with spinal cord injury (SCI) from 22 countries. We used data from 12,591 participants of the International SCI Community Survey (InSCI) and regressed partnership status and living situation on individual (sociodemographic and injury characteristics) and country-level characteristics (Human Development Index, HDI) using multilevel models. Females, younger persons, those with lower income, without paid work, more severe injuries, and longer time since injury were more often single. Males, older persons, those with higher income, paid work, less severe injuries, and those from countries with higher HDI more often lived alone. This study provides initial evidence for the claim that the partnership status and the living situation of people with SCI are influenced by sociodemographic and socioeconomic factors and are not merely a matter of choice, in particular for those with severe injuries.
Fulltext Correlation between Oral Glucose Tolerance Test Abnormalities and Adverse Pregnancy Outcomes in Gestational Diabetes: A Cross-Sectional Study

Kalok A, Ong MY, Hasrori A, Chiang KS, Yazim F, Baharuddin S, et al.

Int J Environ Res Public Health, 2020 09 24;17(19).
PMID: 32987806 DOI: 10.3390/ijerph17196990

Gestational diabetes mellitus (GDM) is associated with maternal and neonatal complications. We aimed to evaluate the relationship between the abnormalities of the oral glucose tolerance test (OGTT) and adverse pregnancy outcomes. This was a retrospective study of GDM patients over a five-year period in a Malaysian tertiary center. The diagnosis of GDM was based on the National Institute for Health and Care Excellence (NICE) guideline. The data on patients' demographics, OGTT results, GDM treatment, and pregnancy outcomes were analyzed. A total of 1105 women were included in the final analysis. The percentage of women with isolated abnormal fasting glucose, isolated two-hour abnormality, and both abnormal values were 4.8%, 87.1%, and 8.1%, respectively. Women with both OGTT abnormalities had a higher risk of preeclampsia (odds ratio (OR) 4.73; 95% confidence interval (CI) 1.45-15.41) and neonatal hypoglycemia (OR 8.78; 95% CI 1.93-39.88). Isolated postprandial abnormality was associated with an 80% lesser risk of neonatal hypoglycemia (OR 0.19; 95% CI 0.04-0.87). Both isolated fasting and multiple OGTT abnormalities were associated with insulin therapy. Multiple OGTT abnormalities were a positive predictor of adverse pregnancy outcomes, while isolated postprandial abnormality was associated with a lesser risk of neonatal complication. Further prospective study is essential to validate these findings.
Fulltext Understanding How Nutrition Literacy Links to Dietary Adherence in Patients Undergoing Maintenance Hemodialysis: A Theoretical Exploration Using Partial Least Squares Structural Equation Modeling

Lim JH, Chinna K, Khosla P, Karupaiah T, Daud ZAM

Int J Environ Res Public Health, 2020 10 14;17(20).
PMID: 33066603 DOI: 10.3390/ijerph17207479

Dietary non-adherence is pervasive in the hemodialysis (HD) population. Health literacy is a plausible predictor of dietary adherence in HD patients, but its putative mechanism is scarcely studied. Thus, this study aimed to establish the causal model linking nutrition literacy to dietary adherence in the HD population. This was a multi-centre, cross-sectional study, involving 218 randomly selected multi-ethnic HD patients from nine dialysis centres in Klang Valley, Malaysia. Dietary adherence and self-management skills were assessed using validated End-Stage Renal Disease Adherence Questionnaire and Perceived Kidney/Dialysis Self-Management Scale, respectively. Validated self-developed scales were used to gauge nutrition literacy, dietary knowledge and Health Belief Model constructs. Relationships between variables were examined by multiple linear regressions and partial least squares structural equation modeling. Limited nutrition literacy was evident in 46.3% of the HD patients, associated with older age, lower education level, and shorter dialysis vintage. Dietary adherence rate was at 34.9%. Nutrition literacy (β= 0.390, p < 0.001) was an independent predictor of dietary adherence, mediated by self-efficacy (SIE = 0.186, BC 95% CI 0.110-0.280) and self-management skills (SIE = 0.192, BC 95% CI 0.103-0.304). Thus, nutrition literacy-enhancing strategies targeting self-efficacy and self-management skills should be considered to enhance dietary adherence in the HD population.
Fulltext Translation, Cross-Cultural Adaptation, and Validation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) into the Malay Language

Zun AB, Ibrahim MI, Mokhtar AM, Halim AS, Wan Mansor WNA

Int J Environ Res Public Health, 2019 06 10;16(11).
PMID: 31185665 DOI: 10.3390/ijerph16112054

BACKGROUND: Patient feedback is an important tool in assessing health system quality. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) was developed in 2006 as a standardized instrument to assess patient perceptions in the United States of America. This study aimed to translate and validate the HCAHPS questionnaire into the Malay language in order to assess patient perceptions of health services in Malaysia.
METHODS: The original HCAPHS in English was translated into Malay based on the established guideline. The content validation involved an expert panel of 10 members, including patients. The face validation pilot testing of the HCAHPS-Malay version was conducted among 10 discharged patients. The exploratory factor analysis (EFA) used principal axis factor, and varimax rotation was established based on a cross-sectional study conducted among 200 discharged patients from Hospital Universiti Sains Malaysia (Hospital USM).
RESULTS: The overall content validity index was 0.87, and the universal face validity index was 0.82. From the EFA, the factor loading value ranged from 0.652 to 0.961 within nine domains. The internal consistency reliability with Cronbach's alpha was 0.844.
CONCLUSION: The HCAHPS-Malay is a reliable and valid tool to determine patients' perception of healthcare services among inpatients in Hospital USM based on the content and face validation result together with a good construct validity and excellent absolute reliability. Further testing on HCAHPS-Malay version in other settings in Malaysia needs to be done for cross-validation.
Fulltext Factors Contributing to Sharp Waste Disposal at Health Care Facility Among Diabetic Patients in North-East Peninsular Malaysia

Hasan UA, Mohd Hairon S, Yaacob NM, Daud A, Abdul Hamid A, Hassan N, et al.

Int J Environ Res Public Health, 2019 06 26;16(13).
PMID: 31247892 DOI: 10.3390/ijerph16132251

BACKGROUND: Type 2 diabetic patients are major users of medical sharps in the community. Proper sharp disposal practice among them, however, was reported to be low. The current study was aimed to determine the factors contributing to sharp waste disposal at a health care facility among Type 2 diabetic patients.
METHODS: In this cross-sectional study, Type 2 diabetic patients who were on insulin therapy attending health clinics were randomly selected and interviewed using a validated questionnaire. Binary logistic regression analysis was applied.
RESULTS: Out of 304 respondents, only 11.5% of them brought their used sharps to be disposed at health care facilities. Previous advice on sharp disposal from health care providers, knowledge score, and duration of diabetes were significant contributing factors for sharp waste disposal at health care facilities: (Adj. OR 6.31; 95% CI: 2.63, 15.12; p < 0.001), (Adj. OR 1.05; 95% CI: 1.03, 1.08; p < 0.001), and (Adj. OR 2.51; 95% CI: 1.06, 5.93; p = 0.036), respectively.
CONCLUSION: Continuous education and a locally adapted safe sharp disposal option must be available to increase awareness and facilitate diabetic patients adopting proper sharp disposal behavior.
Fulltext Effectiveness of Diabetes Community Sharp Disposal Education Module in Primary Care: An Experimental Study in North-East Peninsular Malaysia

Hasan UA, Mohd Hairon S, Yaacob NM, Daud A, Abdul Hamid A, Hassan N, et al.

Int J Environ Res Public Health, 2019 09 11;16(18).
PMID: 31514391 DOI: 10.3390/ijerph16183356

Background: Structured education is needed to cultivate safe sharp disposal behavior among diabetic patients. Thus, this study aimed to assess the effectiveness of the Diabetes Community Sharp Disposal Education Module in improving knowledge and sharp disposal practice among Malaysian Type 2 diabetic patients. Methods: This quasi-experimental study was conducted at primary health clinics in two districts in Kelantan, a state in the North-East Region of Peninsular Malaysia. A total of 132 Type 2 diabetic patients on insulin therapy were involved, with 68 participants in each control and intervention group. The health education intervention was based on the validated Diabetes Community Sharp Disposal Education Module. The knowledge and practices were measured using a validated questionnaire at baseline, one month, and three months after the intervention. Results: There was a significant increment in the mean knowledge score for intervention group; from baseline to one month follow up and from baseline to three months follow up [Greenhouse-Geisser; F(1.5, 199.7) = 62.38, p < 0.001; effect size (η2) = 0.318]. Intervention group had significantly higher mean knowledge score as compared to control group; at one month and three months follow up [F(1, 134) = 17.38, p < 0.001; effect size (η2) = 0.115]. There was a statistically significant increment in the proportion of participants in the intervention group who practiced the proper community sharp disposal method over time, X2(2) = 52.061, p < 0.001. Conclusions: The Diabetes Community Sharp Disposal Education Module was an effective health education tool to improve knowledge and encourage Malaysian diabetic patients to engage with proper sharp disposal practices.
Fulltext Prospective Application of Palm Oil Mill Boiler Ash as a Biosorbent: Effect of Microwave Irradiation and Palm Oil Mill Effluent Decolorization by Adsorption

Hamzah MH, Ahmad Asri MF, Che Man H, Mohammed A

Int J Environ Res Public Health, 2019 09 17;16(18).
PMID: 31533308 DOI: 10.3390/ijerph16183453

Common conventional biological treatment methods fail to decolorize palm oil mill effluent (POME). The present study focused on using the abundant palm oil mill boiler (POMB) ashes for POME decolorization. The POMB ashes were subjected to microwave irradiation and chemical treatment using H2SO4. The resultant adsorbents were characterized using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and Brunauer-Emmett-Teller (BET) analyses. The adsorption efficiency was evaluated at various pH levels (2-8.5), adsorption dosages (3-15 g) in 200 mL, and contact times (1-5 h). The microwave-irradiated POMB-retained ash recorded the highest color removal of 92.31%, for which the best conditions were pH 2, 15 g adsorbent dosage in 200 mL, and 5 h of contact time. At these best treatment conditions, the color concentration of the treated effluent was analyzed using the method proposed by the American Dye Manufacturers Institute (ADMI). The color concentration was 19.20 ADMI, which complies with the Malaysia discharge standard class A. The Freundlich isotherm model better fit the experimental data and had a high R2 of 0.9740. Based on these results, it can be deduced that microwave-irradiated POMB-retained ash has potential applications for POME decolorization via a biosorption process.
Fulltext Antibiotic Susceptibility Patterns, Biofilm Formation and esp Gene among Clinical Enterococci: Is There Any Association?

Weng PL, Ramli R, Hamat RA

Int J Environ Res Public Health, 2019 09 17;16(18).
PMID: 31533204 DOI: 10.3390/ijerph16183439

Enterococci are commonly found in humans, animals and environments. Their highly adaptive mechanisms are related to several virulent determinants and their ability to resist antibiotics. Data on the relationship between the esp gene, biofilm formation and antibiotic susceptibility profiles may differ between countries. This cross-sectional study was conducted to determine the proportion of esp gene and biofilm formation among Enterococcus faecalis and Enterococcus faecium clinical isolates. We also investigated the possible association between the esp gene with antibiotic susceptibility patterns and biofilm formation. The isolates were collected from clinical samples and identified using biochemical tests and 16SRNA. Antibiotic susceptibility patterns and a biofilm assay were conducted according to the established guidelines. Molecular detection by PCR was used to identify the esp gene using established primers. In total, 52 and 28 of E. faecalis and E. faecium were identified, respectively. E. faecium exhibited higher resistance rates compared to E. faecalis as follows: piperacillin/tazobactam (100% versus 1.9%), ampicillin (92.8% versus 1.9%), high-level gentamicin resistance (HLGR) (89.3% versus 25.0%) and penicillin (82.1% versus 7.7%). E. faecium produced more biofilms than E. faecalis (59.3% versus 49.0%). E. faecium acquired the esp gene more frequently than E. faecalis (78.6% versus 46.2%). Interestingly, the associations between ampicillin and tazobactam/piperacillin resistance with the esp gene were statistically significant (X2 = 4.581, p = 0.027; and X2 = 6.276, p = 0.012, respectively). Our results demonstrate that E. faecium exhibits high rates of antimicrobial resistance, esp gene acquisition and biofilm formation. These peculiar traits of E. faecium may have implications for the management of enterococcal infections in hospitals. Thus, concerted efforts by all parties in establishing appropriate treatment and effective control measures are warranted in future.
Fulltext Treatment of Wastewater Using Seaweed: A Review

Arumugam N, Chelliapan S, Kamyab H, Thirugnana S, Othman N, Nasri NS

Int J Environ Res Public Health, 2018 12 13;15(12).
PMID: 30551682 DOI: 10.3390/ijerph15122851

Inadequately treated or untreated wastewater greatly contribute to the release of unwanted toxic contaminants into water bodies. Some of these contaminants are persistent and bioaccumulative, becoming a great concern as they are released into the environment. Despite the abundance of wastewater treatment technologies, the adsorption method overall has proven to be an excellent way to treat wastewater from multiple industry sources. Because of its significant benefits, i.e., easy availability, handling, and higher efficiency with a low cost relative to other treatments, adsorption is opted as the best method to be used. However, biosorption using naturally found seaweeds has been proven to have promising results in removing pollutants, such as dyes from textile, paper, and the printing industry, nitrogen, and phosphorous and phenolic compounds, as well as heavy metals from various sources. Due to its ecofriendly nature together with the availability and inexpensiveness of raw materials, biosorption via seaweed has become an alternative to the existing technologies in removing these pollutants from wastewater effectively. In this article, the use of low-cost adsorbent (seaweed) for the removal of pollutants from wastewater has been reviewed. An extensive table summarises the applicability of seaweed in treating wastewater. Literature reported that the majority of research used simulated wastewater and minor attention has been given to biosorption using seaweed in the treatment of real wastewater.
Fulltext Suicide Precipitants Differ Across the Lifespan but Are Not Significant in Predicting Medically Severe Attempts

Choo CC, Chew PKH, Ho RC

Int J Environ Res Public Health, 2018 04 05;15(4).
PMID: 29621197 DOI: 10.3390/ijerph15040691

An important risk factor for suicide assessment is the suicide precipitant. This study explores suicide attempt precipitants across the lifespan. Three years of medical records related to suicide attempters who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to analysis. These cases were divided into three age groups: Adolescence, Early Adulthood, and Middle Adulthood. A total of 540 cases were examined (70.9% females; 63.7% Chinese, 13.7% Malays, 15.9% Indians), whose ages ranged from 12 to 62. There were eight cases above the age of 65 years which were excluded from the analysis. Significant differences were found in precipitants for suicide attempts across the lifespan. Middle adults had relatively fewer relationship problems, and adolescents had comparatively fewer financial and medical problems. The models to predict medically severe attempts across the age groups using suicide precipitants were not significant. The findings were discussed in regards to implications in suicide assessment and primary prevention in Singapore, as well as limitations and recommendations for future research.
Fulltext The Effects of Annatto Tocotrienol Supplementation on Cartilage and Subchondral Bone in an Animal Model of Osteoarthritis Induced by Monosodium Iodoacetate

Chin KY, Wong SK, Japar Sidik FZ, Abdul Hamid J, Abas NH, Mohd Ramli ES, et al.

Int J Environ Res Public Health, 2019 08 13;16(16).
PMID: 31412648 DOI: 10.3390/ijerph16162897

Osteoarthritis is a degenerative joint disease which primarily affects the articular cartilage and subchondral bones. Since there is an underlying localized inflammatory component in the pathogenesis of osteoarthritis, compounds like tocotrienol with anti-inflammatory properties may be able to retard its progression. This study aimed to determine the effects of oral tocotrienol supplementation on the articular cartilage and subchondral bone in a rat model of osteoarthritis induced by monosodium iodoacetate (MIA). Thirty male Sprague-Dawley rats (three-month-old) were randomized into five groups. Four groups were induced with osteoarthritis (single injection of MIA at week 0) and another served as the sham group. Three of the four groups with osteoarthritis were supplemented with annatto tocotrienol at 50, 100 and 150 mg/kg/day orally for five weeks. At week 5, all rats were sacrificed, and their tibial-femoral joints were harvested for analysis. The results indicated that the groups which received annatto tocotrienol at 100 and 150 mg/kg/day had lower histological scores and cartilage remodeling markers. Annatto tocotrienol at 150 mg/kg/day significantly lowered the osteocalcin levels and osteoclast surface of subchondral bone. In conclusion, annatto tocotrienol may potentially retard the progression of osteoarthritis. Future studies to confirm its mechanism of joint protection should be performed.
Fulltext Recent Incidence of Human Malaria Caused by Plasmodium knowlesi in the Villages in Kudat Peninsula, Sabah, Malaysia: Mapping of The Infection Risk Using Remote Sensing Data

Sato S, Tojo B, Hoshi T, Minsong LIF, Kugan OK, Giloi N, et al.

Int J Environ Res Public Health, 2019 08 16;16(16).
PMID: 31426380 DOI: 10.3390/ijerph16162954

Plasmodium knowlesi (Pk) is a malaria parasite that naturally infects macaque monkeys in Southeast Asia. Pk malaria, the zoonosis transmitted from the infected monkeys to the humans by Anopheles mosquito vectors, is now a serious health problem in Malaysian Borneo. To create a strategic plan to control Pk malaria, it is important to estimate the occurrence of the disease correctly. The rise of Pk malaria has been explained as being due to ecological changes, especially deforestation. In this research, we analysed the time-series satellite images of MODIS (MODerate-resolution Imaging Spectroradiometer) of the Kudat Peninsula in Sabah and created the "Pk risk map" on which the Land-Use and Land-Cover (LULC) information was visualised. The case number of Pk malaria of a village appeared to have a correlation with the quantity of two specific LULC classes, the mosaic landscape of oil palm groves and the nearby land-use patches of dense forest, surrounding the village. Applying a Poisson multivariate regression with a generalised linear mixture model (GLMM), the occurrence of Pk malaria cases was estimated from the population and the quantified LULC distribution on the map. The obtained estimations explained the real case numbers well, when the contribution of another risk factor, possibly the occupation of the villagers, is considered. This implies that the occurrence of the Pk malaria cases of a village can be predictable from the population of the village and the LULC distribution shown around it on the map. The Pk risk map will help to assess the Pk malaria risk distributions quantitatively and to discover the hidden key factors behind the spread of this zoonosis.
Fulltext Do Differences in Social Environments Explain Gender Differences in Recreational Walking across Neighbourhoods?

Ghani F, Rachele JN, Loh VH, Washington S, Turrell G

Int J Environ Res Public Health, 2019 06 04;16(11).
PMID: 31167430 DOI: 10.3390/ijerph16111980

Within a city, gender differences in walking for recreation (WfR) vary significantly across neighbourhoods, although the reasons remain unknown. This cross-sectional study investigated the contribution of the social environment (SE) to explaining such variation, using 2009 data from the How Areas in Brisbane Influence healTh and AcTivity (HABITAT) study, including 7866 residents aged 42-67 years within 200 neighbourhoods in Brisbane, Australia (72.6% response rate). The analytical sample comprised 200 neighbourhoods and 6643 participants (mean 33 per neighbourhood, range 8-99, 95% CI 30.6-35.8). Self-reported weekly minutes of WfR were categorised into 0 and 1-840 mins. The SE was conceptualised through neighbourhood-level perceptions of social cohesion, incivilities and safety from crime. Analyses included multilevel binomial logistic regression with gender as main predictor, adjusting for age, socioeconomic position, residential self-selection and neighbourhood disadvantage. On average, women walked more for recreation than men prior to adjustment for covariates. Gender differences in WfR varied significantly across neighbourhoods, and the magnitude of the variation for women was twice that of men. The SE did not explain neighbourhood differences in the gender-WfR relationship, nor the between-neighbourhood variation in WfR for men or women. Neighbourhood-level factors seem to influence the WfR of men and women differently, with women being more sensitive to their environment, although Brisbane's SE did not seem such a factor.

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