(1) Background: The assessment of vaccine effectiveness against the Omicron variant is vital in the fight against COVID-19, but research on booster vaccine efficacy using nationwide data was lacking at the time of writing. This study investigates the effectiveness of booster doses on the Omicron wave in Malaysia against COVID-19 infections and deaths; (2) Methods: This study uses nationally representative data on COVID-19 from 1 January to 31 March 2022, when the Omicron variant was predominant in Malaysia. Daily new infections, deaths, ICU utilization and Rt values were compared. A screening method was used to predict the vaccine effectiveness against COVID-19 infections, whereas logistic regression was used to estimate vaccine effectiveness against COVID-19-related deaths, with efficacy comparison between AZD1222, BNT162b2 and CoronaVac; (3) Results: Malaysia's Omicron wave started at the end of January 2022, peaking on 5 March 2022. At the time of writing, statistics for daily new deaths, ICU utilization, and effective reproductive values (Rt) were showing a downtrend. Boosted vaccination is 95.4% (95% CI: 95.4, 95.4) effective in curbing COVID-19 infection, compared to non-boosted vaccination, which is 87.2% (95% CI: 87.2, 87.2). For symptomatic infection, boosted vaccination is 97.4% (95% CI: 97.4, 97.4) effective, and a non-boosted vaccination is 90.9% (95% CI: 90.9, 90.9). Against COVID-19-related death, boosted vaccination yields a vaccine effectiveness (VE) of 91.7 (95% CI: 90.6, 92.7) and full vaccination yields a VE of 65.7% (95% CI: 61.9, 69.1). Looking into the different vaccines as boosters, AZD1222 is 95.2% (CI 95%: 92.7, 96.8) effective, BNT162b2 is 91.8% (CI 95%: 90.7, 92.8) effective and CoronaVac is 88.8% (CI 95%: 84.9, 91.7) effective against COVID-19 deaths. (4) Conclusions: Boosters are effective in increasing protection against COVID-19, including the Omicron variant. Given that the VE observed was lower, CoronaVac recipients are encouraged to take boosters due to its lower VE.
Employee turnover could affect the organisation's performance. Job dissatisfaction and burnout have been identified as factors influencing the intention to leave. Thus, this study aimed to determine the level of intent to leave, and predictors associated with intention to leave among medical researchers in Malaysia. A cross-sectional, stratified random sampling study was conducted among researchers in a research organisation under the Ministry of Health. Respondents answered an online questionnaire that included sociodemographic information, job dissatisfaction, burnout, and intention to leave. A total of 133 researchers participated. More than one-third (41.4%) of the researchers had a moderate and high level of intention to leave. Burnout and job dissatisfaction were identified as significant predictors. Burnout was noted to have a positive relationship with the intent to leave (β = 0.289, 95% CI (B): 0.287, 1.096). Meanwhile, job satisfaction was found to have a negative relationship with the intention to leave (β = -0.348, 95% CI (B): -0.768, -0.273). Burnout among researchers is quite worrisome as more than two-thirds of the researchers experienced moderate to high burnout. Reducing burnout and job dissatisfaction would increase work performance and produce high-quality research output, hence decreasing the turnover rate.
Many stroke survivors suffer with varying degrees of disability and require assistance. Family members commonly act as informal caregivers, caring for these stroke survivors and ensuring care adherence. However, many caregivers reported a poor quality of life and physical and psychological distress. Due to these issues, multiple studies have been conducted to understand the experience of caregivers, the outcomes of caregiving, and interventional studies among caregivers. This study aims to explore the intellectual landscape of studies on stroke caregivers using bibliometric analysis. Studies with "stroke" and "caregiver" terms in the title were extracted from the Web of Sciences (WOS) database. The resulting publications were analysed using the 'bibliometrix' package in R. There were 678 publications analysed, dating from 1989 to 2022. The USA has the highest number of publications (28.6%), followed by China (12.1%) and Canada (6.1%). The most productive institution, journal and author were The University of Toronto (9.5%), 'Topics in Stroke Rehabilitation' journal (5.8%) and Tamilyn Bakas (3.1%), respectively. Co-occurrences keywords analysis revealed mainstream research on stroke survivors, burden, quality of life, depression, care, and rehabilitation, reflecting the timeless hotspot in the field. This bibliometric analysis helps us understand the current state of stroke caregiver research and its recent developments. This study can be used to evaluate research policies and promote international cooperation.
An important preventive measure in the fight against the HIV epidemic is the adoption of HIV testing. The government of the Republic of Trinidad and Tobago conducted a registration exercise in 2019 for undocumented migrants and refugees from Venezuela residing in the country. These migrants were allowed access to the public health system. In this study, we observed the correlates of HIV testing in Venezuelan migrants residing in Trinidad. A convenience sample of n = 250 migrants was collected via telephone survey from September through December 2020. Variables of interest included social factors, health needs, and uptake of HIV testing. Pearson χ2 tests examined the associations between study variables, and multivariable logistic regression with backward elimination produced the odds of taking an HIV test. In our study, 40.8% of migrants reported having received an HIV test since arriving in Trinidad. Persons who migrated with family or friends had greater odds of getting an HIV test relative to persons who arrived alone (OR = 2.912, 95% CI: 1.002-8.466), and migrants who knew where to get an HIV test also greater odds of getting a test relative to person who did not know where to get a test (OR = 3.173, 95% CI: 1.683-5.982). Migrants with known physical health problems had greater odds of getting an HIV test relative to migrants without these health problems (OR = 1.856, 95% CI: 1.032-3.337). Persons who arrived with family or friends had greater odds of experiencing difficulties accessing public health care relative to persons who arrived alone (OR = 3.572, 95% CI: 1.352-9.442). Migrants earning between $1000 and $2999 TT per month had greater odds of experiencing trouble accessing public health services relative to persons who had monthly earnings of less than $1000 TT (OR = 2.567, 95% CI: 1.252-5.264). This was the first quantitative study on HIV testing among Venezuelan migrants in Trinidad. Migrants still experience difficulties accessing healthcare, which, in turn influences national HIV prevention and control efforts. The results gathered may help in developing HIV prevention plans that are led by a national health policy that takes migrant communities' needs into account.
TikTok use and overuse have grown rapidly in recent years among adolescents. However, risk factors for problematic TikTok use are still largely unknown. In addition, drawing on the flow theory and parental mediation theory, this study aims to examine how adolescents' perceptions of enjoyment, concentration, and time distortion affect their problematic TikTok use behavior. Further, we examined the moderating effect of active parental mediation. An online survey in China received responses from a sample of 633 adolescents between the ages of 10 and 19 (males: 51.2%; Mage = 15.00; DS = 0.975). Our findings showed that enjoyment was positively associated with concentration and, in turn, with time distortion. We also found significant positive effects of concentration and time distortion on problematic TikTok use. The effect of enjoyment, however, was non-significant, indicating that hedonic mood was not associated with problematic TikTok use. Out of the three moderated relationships examined in this study, only active parental control was found to be a significant moderator for the relationship between concentration and problematic TikTok use. The significant negative moderation result showed that as active parental mediation grows, the impact of adolescents' concentration on problematic TikTok use is reduced. Future research directions and implications are discussed.
Background: Chemsex is the use of illicit drugs—particularly methamphetamine, gamma hydroxybutyrate (GHB), and gamma-butyrolactone (GBL)—to enhance sexual activity. Chemsex, which occurs primarily among communities of men who have sex with men (MSM), is associated with greater HIV risk behaviors, including multiple sex partners, group sex, condomless sex, and injection drug use. Despite evidence showing chemsex engagement among Malaysian MSM, there is a paucity of research on chemsex among MSM in Malaysia. Methods: This cross-sectional study was conducted through an online survey (August to September 2021) among 870 Malaysian MSM. Participants were recruited through targeted advertisements on social networks. We collected information regarding participants’ recent (<6 months) engagement in chemsex, demographic characteristics, psychosocial factors, pre-exposure prophylaxis (PrEP) knowledge and history, and recent sexual- and drug-related behavior. Multivariable logistic regression was used to identify factors associated with recent (<6 months) chemsex engagement. Results: Just under 1 in 10 (9.0%) of participants reported having engaged in chemsex in the previous six months. More than two-thirds of participants (69.1%) had not disclosed their sexual orientation to anyone in their family and 35.2% reported moderate to severe depressive symptoms. Multivariable analysis found that recent injection drug use (adjusted odds ratio: aOR = 6.61; 95% confidence interval: CI, 2.30−19.03), having shared pre-exposure prophylaxis (PrEP) with someone else (aOR = 5.60; 95% CI, 1.76−17.77), higher perceived HIV risk (aOR = 3.15; 95% CI, 1.25−7.93), knowing someone using PrEP (aOR = 2.93; 95% CI, 1.62−5.31), recent engagement in transactional sex (aOR = 2.38; 95% CI, 1.06−5.39), having a recent STI diagnosis (aOR = 2.36; 95% CI, 1.25−4.44), recent engagement in anal sex (aOR = 2.21; 95% CI, 1.07−4.57), and recent sexual intercourse with an HIV-positive partner (aOR = 2.09; 95% CI, 1.07−4.08) were associated with recent engagement in chemsex. Conclusions: Malaysian MSM who practice chemsex are vulnerable to several HIV risk factors, such as transactional sex, HIV-positive sexual partners, and injection drug use. There is an urgent need for programs that integrate drug, sexual health, and mental health services, with a focus on harm reduction (e.g., condoms, access to and utilization of HIV testing and PrEP services, drug knowledge, and safer drug use) tailored for MSM who practice chemsex.
Respiratory syncytial virus (RSV) is the most common pathogen causing viral respiratory tract infections among younger children worldwide. The influence of meteorological factors on RSV seasonal activity is well-established for temperate countries; however, in subtropical countries such as Malaysia, relatively stable temperate climates do not clearly support this trend, and the available data are contradictory. Better understanding of meteorological factors and seasonality of RSV will allow effective strategic health management relating to RSV infection, particularly immunoprophylaxis of high-risk infants with palivizumab. Retrospectively, from 2017 to 2021, we examined the association between various meteorological factors (rainfall, rainy days, temperature, and relative humidity) and the incidence of RSV in children aged less than 12 years in Kuala Lumpur, Malaysia. RSV activity peaked in two periods (July to August and October to December), which was significantly correlated with the lowest rainfall (p < 0.007) and number of rainy days (p < 0.005). RSV prevalence was also positively associated with temperature (p < 0.006) and inversely associated with relative humidity (p < 0.006). Based on our findings, we recommend that immunoprophylaxis with palivizumab be administered in children aged less than 2 years where transmission of RSV is postulated to be the highest after the end of two monsoon seasons.
The use of social media has increased during the COVID-19 pandemic because people are isolated and working from home. The use of social media enhances information exchange in society and may influence public protective behavior against the COVID-19 pandemic. The purpose of this study is to identify the factors affecting public protective behavior when relying on COVID-19 pandemic-related content shared on social media. A model based on Protection Motivation Theory (PMT) was proposed and validated using a quantitative survey approach. A questionnaire was distributed to random respondents, and 488 responses were received and analyzed using Smart-PLS software. The findings showed that perceived risk, e-health literacy, public awareness, and health experts' participation influence public protective behavior when using social media to share COVID-19-relevant content. The outcomes of this study can enhance government agencies' and public health care authorities' understanding of how to use social media to raise awareness and reduce panic among the public.
Depression, anxiety, and stress (DAS) among adolescents have become a public health concern. The aim of this study was to develop, implement, and measure an IMB-based health education intervention module for reducing DAS among adolescents in boarding schools in the state of Negeri Sembilan, Malaysia. A single-blinded cluster randomised control trial (RCT) was conducted among students with abnormal DASS-21 scores. They were divided into an intervention group (three schools, 62 participants) and a control group (three schools, 57 participants). Participants in the intervention group received IMB-based health education, while participants in the control group underwent the standard care session. To determine the effectiveness of the intervention, the Generalised Linear Mixed Model (GLMM) analysis was conducted. A total of 119 students participated in this study, and no loss to follow-up was reported. Both intervention and control groups showed significantly reduced DAS scores (p < 0.005). However, the reduction of these scores was greater in the intervention group. The GLMM analysis revealed that the intervention was effective in reducing depression (ß = -2.400, t = -3.102, SE = 0.7735, p = 0.002, 95% CI = -3.921, -0.878), anxiety (ß = -2.129, t = -2.824, SE = 0.7541, p = 0.005, 95% CI = -3.612, -0.646), and stress (ß = -1.335, t = -2.457, SE = 0.536, p = 0.015, 95% CI = -2.045, -0.266) among adolescents. The IMB-based health education module was effective in reducing DAS among adolescents in boarding schools.
The aim of this review is to highlight the spectrum on which human behavior has been affected by blanket restriction measures and on a wider scale, the COVID-19 pandemic. Some of the human behaviors that have been impacted by the COVID-19 lockdown are dietary behavior and nutrition, food options and food delivery usage, physical activity and sedentary behaviors. This is important in planning effective public health strategies with minimal detriment to all subsets of society as well as improving the distribution of government aid to populations that are more severely affected. Our main purpose is to present the literature from a rapidly growing pool of scientific research to hopefully enable a better and more comprehensive understanding of the effects of this pandemic and the lessons learnt from the accompanying restrictions, as well as policy recommendations that can be made in national pandemic responses in the future.
Chemical-based coagulants and flocculants are commonly used in the coagulation-flocculation process. However, the drawbacks of using these chemical materials have triggered researchers to find natural materials to substitute or reduce the number of chemical-based coagulants and flocculants. This study examines the potential application of Nephelium lappaceum seeds as a natural coagulant-coagulant aid with Tin (IV) chloride (SnCl4) in eliminating suspended solids (SS), colour, and chemical oxygen demand (COD) from landfill leachate. Results showed that the efficiency of Nephelium lappaceum was low when used as the main coagulant in the standard jar test. When SnCl4 was applied as a single coagulant, as much as 98.4% of SS, 96.8% of colour and 82.0% of COD was eliminated at an optimal dose of 10.5 g/L and pH 7. The higher removal efficiency of colour (88.8%) was obtained when 8.40 g/L of SnCl4 was applied with a support of 3 g/L of Nephelium lappaceum. When SnCl4 was utilised as a coagulant, and Nephelium lappaceum seed was used as a flocculant, the removal of pollutants generally improved. Overall, this research showed that Nephelium lappaceum seed is a viable natural alternative for treating landfill leachate as a coagulant aid.
Research shows that nature exposure is directly and indirectly associated with more positive body image, which is an important facet of well-being more generally. In this study, we tested the mediating roles of physical activity in nature, perceived restoration in nature, autonomous motivation, and connectedness to nature in explaining the association between nature exposure and positive body image. An online sample of 924 Lithuanian adults (age M = 40.0 years, 73.6% women) completed a survey that included the Nature Exposure (NE) Scale, the Body Appreciation Scale-2, a measure of frequency of physical activity in nature (PAN), the Behavioral Regulation in Exercise Questionnaire-2, the Restoration Outcome Scale, and the Connectedness to Nature Scale. Path analysis was conducted to examine hypothesized direct and indirect effects. Results showed that both greater NE (B = 0.564, SE = 0.057, p < 0.001) and autonomy in exercise motivation (B = 0.039, SE = 0.006, p < 0.001) were associated with more frequent PAN. Direct effects from exercise autonomy to nature restorativeness (B = 0.017, SE = 0.006, p = 0.004) and body appreciation (B = 0.041, SE = 0.004, p < 0.001) were observed. Associations were also found between connectedness to nature and body appreciation (B = 0.166, SE = 0.040, p < 0.001), nature restorativeness and body appreciation (B = 0.075, SE = 0.019, p < 0.001), and frequency of PAN and body appreciation (B = 0.064, SE = 0.019, p < 0.001). PAN mediated the relationship between NE and body appreciation. The final model was invariant across place of residence (urban vs. rural) and gender. Including self-determined physical activity in nature may increase the effectiveness of intervention programs aimed at promoting more positive body image.
Oxidative stress and inflammation are two common risk factors of various life-threatening disease pathogenesis. In recent years, medicinal plants that possess antioxidant and anti-inflammatory activities were extensively studied for their potential role in treating and preventing diseases. Spilanthes acmella (S. acmella), which has been traditionally used to treat toothache in Malaysia, contains various active metabolites responsible for its anti-inflammatory, antiseptic, and anesthetic bioactivities. These bioactivities were attributed to bioactive compounds, such as phenolic, flavonoids, and alkamides. The review focused on the summarization of in vitro and in vivo experimental reports on the antioxidant and anti-inflammatory actions of S. acmella, as well as how they contributed to potential health benefits in lowering the risk of diseases that were related to oxidative stress. The molecular mechanism of S. acmella in reducing oxidative stress and inflammatory targets, such as inducible nitric oxide synthase (iNOS), transcription factors of the nuclear factor-κB family (NF-κB), cyclooxygenase-2 (COX-2), and mitogen-activated protein kinase (MAPK) signaling pathways were discussed. Besides, the antioxidant potential of S. acmella was measured by total phenolic content (TPC), total flavonid content (TFC), 2,2-diphenyl-1-picrylhydrazyl (DPPH), and superoxide anion radical scavenging (SOD) and thiobarbituric acid reactive substance (TBARS) assays. This review revealed that S. acmella might have a potential role as a reservoir of bioactive agents contributing to the observed antioxidant, anti-inflammatory, and health beneficial effects.
Anthropogenic activities are largely responsible for the vast amounts of pollutants such as polycyclic aromatic hydrocarbons, cyanides, phenols, metal derivatives, sulphides, and other chemicals in wastewater. The excess benzene, toluene and xylene (BTX) can cause severe toxicity to living organisms in wastewater. A novel approach to mitigate this problem is the benthic microbial fuel cell (BMFC) setup to produce renewable energy and bio-remediate wastewater aromatic hydrocarbons. Several mechanisms of electrogens have been utilized for the bioremediation of BTX through BMFCs. In the future, BMFCs may be significant for chemical and petrochemical industry wastewater treatment. The distinct factors are considered to evaluate the performance of BMFCs, such as pollutant removal efficiency, power density, and current density, which are discussed by using operating parameters such as, pH, temperature and internal resistance. To further upgrade the BMFC technology, this review summarizes prototype electrode materials, the bioremediation of BTX, and their applications.
High consumption of sugar-sweetened beverages (SSBs) among adolescents has turned into a global concern due to its negative impact on health. This cross-sectional study determined the amount of SSB consumption among adolescents and its associated factors. A total of 421 adolescents aged 13.3 ± 1.3 years (41.8% males, 58.2% females) completed a self-administered questionnaire on sociodemographic characteristics, physical activity, screen-viewing behavior, sleep quality, frequency of eating at fast food restaurants, home food availability, peer social pressure, parenting practice, and SSB consumption. Weight and height were measured. Results showed that the mean daily consumption of SSBs among adolescents was 1038.15 ± 725.55 mL. The most commonly consumed SSB was malted drink, while the least commonly consumed SSB was instant coffee. The multiple linear regression results revealed that younger age (β = -0.204, p < 0.001), higher physical activity (β = 0.125, p = 0.022), higher screen time (β = 0.147, p = 0.007), poorer sleep quality (β = 0.228, p < 0.001), and unhealthy home food availability (β = 0.118, p = 0.032) were associated with a higher SSB intake. Therefore, promoting a healthy lifestyle may help to reduce the excessive consumption of SSBs among adolescents.
The presence of toxic polonium-210 (Po-210) in the environment is due to the decay of primordial uranium-238. Meanwhile, several studies have reported elevated Po-210 radioactivity in the rivers around the world due to both natural and anthropogenic factors. However, the primary source of Po-210 in Langat River, Malaysia might be the natural weathering of granite rock along with mining, agriculture and industrial activities. Hence, this is the first study to determine the Po-210 activity in the drinking water supply chain in the Langat River Basin to simultaneously predict the human health risks of Po-210 ingestion. Therefore, water samples were collected in 2015⁻2016 from the four stages of the water supply chain to analyze by Alpha Spectrometry. Determined Po-210 activity, along with the influence of environmental parameters such as time-series rainfall, flood incidents and water flow data (2005⁻2015), was well within the maximum limit for drinking water quality standard proposed by the Ministry of Health Malaysia and World Health Organization. Moreover, the annual effective dose of Po-210 ingestion via drinking water supply chain indicates an acceptable carcinogenic risk for the populations in the Langat Basin at 95% confidence level; however, the estimated annual effective dose at the basin is higher than in many countries. Although several studies assume the carcinogenic risk of Po-210 ingestion to humans for a long time even at low activity, however, there is no significant causal study which links Po-210 ingestion via drinking water and cancer risk of the human. Since the conventional coagulation method is unable to remove Po-210 entirely from the treated water, introducing a two-layer water filtration system at the basin can be useful to achieve SDG target 6.1 of achieving safe drinking water supplies well before 2030, which might also be significant for other countries.
Medical students are vulnerable to depression and anxiety due to the nature of their academic life. This study aimed to determine the prevalence of depressive and anxiety symptoms among medical students and the association between religious coping, religiosity and socio-demographic factors with anxiety and depressive symptoms. A cross sectional design was used for this study. Scales used were the Malay version of the Duke Religious Index (DUREL-M), the Malay version of the Brief Religious Coping Scale (Brief RCOPE) and the Malay version Hospital and Anxiety Depression Scale (HADS-M). 622 students participated in this study. They scored moderately on the organized (mean: 3.51) and non-organized religious (mean: 3.85) subscales of the DUREL, but had high intrinsic religiosity (mean: 12.18). The prevalence of anxiety and depressive symptoms were 4.7% and 17.4% respectively, which is lower than local as well as international data. Islam, negative religious coping and the presence of depressive symptoms were significantly associated with anxiety symptoms. Only the presence of anxiety symptoms was significantly associated with depressive symptoms. Negative religious coping, rather than positive religious coping, has significant association with depressive and anxiety symptoms. Redirecting focus towards negative religious coping is imperative to boost mental health outcomes among medical students.
The prevalence of type 2 diabetes is escalating rapidly in Asian countries, with the rapid increase likely attributable to a combination of genetic and lifestyle factors. Recent research suggests that common genetic risk variants contribute minimally to the rapidly rising prevalence. Rather, recent changes in dietary patterns and physical activity may be more important. This nested case-control study assessed the association and predictive utility of type 2 diabetes lifestyle risk factors in participants from Malaysia, an understudied Asian population with comparatively high disease prevalence. The study sample comprised 4077 participants from The Malaysian Cohort project and included sub-samples from the three major ancestral groups: Malay (n = 1323), Chinese (n = 1344) and Indian (n = 1410). Association of lifestyle factors with type 2 diabetes was assessed within and across ancestral groups using logistic regression. Predictive utility was quantified and compared between groups using the Area Under the Receiver-Operating Characteristic Curve (AUC). In predictive models including age, gender, waist-to-hip ratio, physical activity, location, family history of diabetes and average sleep duration, the AUC ranged from 0.76 to 0.85 across groups and was significantly higher in Chinese than Malays or Indians, likely reflecting anthropometric differences. This study suggests that obesity, advancing age, a family history of diabetes and living in a rural area are important drivers of the escalating prevalence of type 2 diabetes in Malaysia.
This study determined the potential risk factors that may contribute to seropositivity among dogs and dog handlers from working dog and dog shelter institutions. Data was collected from dogs (n = 266) and dog handlers (n = 161) using a standardised guided questionnaire. Serum obtained from the dogs and dog handlers was tested using the microscopic agglutination test (MAT). A logistic regression analysis was used to predict leptospiral seropositivity of dogs and dog handlers based on potential risk factors. A total of 22.2% of dogs and 21.7% of dog handlers were seropositive. The significant predictors for the dogs' seropositivity were presence of rats (OR = 4.61 (95% CI: 1.05, 20.33), p = 0.043) and shared common area (OR = 5.12 (95% CI: 1.94, 13.46), p = 0.001) within the organisation. Significant predictor for dog handler seropositivity was contact time with the dogs of more than six hours/day (OR = 3.28 (95% CI: 1.28, 8.40), p = 0.013) after controlling for the effect of other risk factors such as small mammal contact, rat infestation at home, flooding at housing area (within three months) and urban locality. The exposure to various disease sources identified poses risk to dogs and dog handlers. Risk could be reduced with adequate application of protection at work while handling dogs and thus limiting contact with these sources and reducing exposure to infection.