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Fulltext Proton Pump Inhibitors and Fracture Risk: A Review of Current Evidence and Mechanisms Involved

Thong BKS, Ima-Nirwana S, Chin KY

Int J Environ Res Public Health, 2019 May 05;16(9).
PMID: 31060319 DOI: 10.3390/ijerph16091571

The number of patients with gastroesophageal problems taking proton pump inhibitors (PPIs) is increasing. Several studies suggested a possible association between PPIs and fracture risk, especially hip fractures, but the relationship remains contentious. This review aimed to investigate the longitudinal studies published in the last five years on the relationship between PPIs and fracture risk. The mechanism underlying this relationship was also explored. Overall, PPIs were positively associated with elevated fracture risk in multiple studies (n = 14), although some studies reported no significant relationship (n = 4). Increased gastrin production and hypochlorhydria are the two main mechanisms that affect bone remodeling, mineral absorption, and muscle strength, contributing to increased fracture risk among PPI users. As a conclusion, there is a potential relationship between PPIs and fracture risks. Therefore, patients on long-term PPI treatment should pay attention to bone health status and consider prophylaxis to decrease fracture risk.
Fulltext Validation of Infant and Young Child Feeding Questionnaire for the Assessment of Knowledge, Attitudes and Practices among Child Care Providers: The IYCF-CCPQ

Zakria NM, Tengku Ismail TA, Wan Mansor WNA, Sulaiman Z

Int J Environ Res Public Health, 2019 06 17;16(12).
PMID: 31213022 DOI: 10.3390/ijerph16122147

The validation of a new questionnaire is essential to improving its credibility in the assessment and collection of evidence. This study aimed to validate a newly developed infant and young child feeding questionnaire for child care providers (IYCF-CCPQ) to measure the knowledge, attitudes, and practices regarding infant and young child feeding among them. A cross-sectional study was conducted with 200 child care providers who were involved in handling children less than two years old in child care centers in the northeastern part of Peninsular Malaysia. The IYCF-CCPQ was self-administered and consists of three domains: Knowledge (104 items), attitude (90 items), and practice (42 items). The dichotomous-scale items in the knowledge domain were analyzed using a two-parameter logistic model of item response theory (2-PL IRT). The Likert-type-scale items in the attitude section were assessed using exploratory factor analysis (EFA). The items in the practice section were assessed descriptively. Internal consistency by marginal reliability was assessed in the knowledge domain, and Cronbach's alpha coefficient was used for the attitude domain. The marginal reliability values were 0.91 and 0.74 for the knowledge domains related to breastfeeding/formula feeding and complementary feeding, respectively, and the Cronbach's alpha values were 0.89 and 0.90 for the attitude domains related to breastfeeding/formula feeding and complementary feeding, respectively. The analysis showed good psychometric properties (discrimination, difficulty index, factor loading, and communalities) and good reliability. The IYCF-CCPQ is valid for use assessing the knowledge, attitudes, and practices among Malaysian child care providers regarding infant and young child feeding.
Fulltext Application of the Theory of Planned Behavior in Environmental Science: A Comprehensive Bibliometric Analysis

Si H, Shi JG, Tang D, Wen S, Miao W, Duan K

Int J Environ Res Public Health, 2019 08 04;16(15).
PMID: 31382712 DOI: 10.3390/ijerph16152788

Since the theory of planned behavior (TPB) was proposed by Ajzen in 1985, it has attracted extensive interest and been widely applied worldwide. Although an increasing number of studies have employed the TPB in the domain of environmental science, there have been no attempts to retrospectively analyze existing articles. The current study aimed to holistically understand the application status of the TPB in environmental science from a knowledge domain visualization perspective. A total of 531 journal articles were obtained through the Scopus database to perform a bibliometric analysis and content analysis. The results showed that waste management, green consumption, climate and environment, saving and conservation, and sustainable transportation are the primary research topics; the United States (U.S.), Mainland China, the United Kingdom (UK), and Malaysia are the most productive countries/regions. Moreover, the cross-disciplinary situations, main source journals, and key articles were revealed. Furthermore, the extended factors, integrated theories, major methods, specific groups, and control variables of environmental science research using the TPB were elaborated and integrated into a comprehensive application framework. Constructive criticisms were ultimately discussed. The findings contribute in several ways to help relevant researchers learn about the application of TPB to environmental science and provide new insights and holistic references for further research on environment-related behavior.
Fulltext A Comparative Study of Biogas Production from Cattle Slaughterhouse Wastewater Using Conventional and Modified Upflow Anaerobic Sludge Blanket (UASB) Reactors

Musa MA, Idrus S, Harun MR, Tuan Mohd Marzuki TF, Abdul Wahab AM

Int J Environ Res Public Health, 2019 12 31;17(1).
PMID: 31906118 DOI: 10.3390/ijerph17010283

Cattle slaughterhouses generate wastewater that is rich in organic contaminant and nutrients, which is considered as high strength wastewater with a high potential for energy recovery. Work was undertaken to evaluate the efficiency of the 12 L laboratory scale conventional and a modified upflow anaerobic sludge blanket (UASB) reactors (conventional, R1 and modified, R2), for treatment of cattle slaughterhouse wastewater (CSWW) under mesophilic condition (35 ± 1 °C). Both reactors were acclimated with synthetic wastewater for 30 days, then continuous study with real CSWW proceeds. The reactors were subjected to the same loading condition of OLR, starting from 1.75, 3, 5 10, 14, and 16 g L-1d-1, corresponding to 3.5, 6, 10, 20, 28, and 32 g COD/L at constant hydraulic retention time (HRT) of 24 h. The performance of the R1 reactor drastically dropped at OLR 10 g L-1d-1, and this significantly affected the subsequent stages. The steady-state performance of the R2 reactor under the same loading condition as the R1 reactor revealed a high COD removal efficiency of 94% and biogas and methane productions were 27 L/d and 89%. The SMP was 0.21 LCH4/gCOD added, whereas the NH3-N alkalinity ratio stood at 651 mg/L and 0.2. SEM showed that the R2 reactor was dominated by Methanosarcina bacterial species, while the R1 reactor revealed a disturb sludge with insufficient microbial biomass.
Fulltext Assessment of Health-Related Quality of Life, Medication Adherence, and Prevalence of Depression in Kidney Failure Patients

Butt MD, Ong SC, Butt FZ, Sajjad A, Rasool MF, Imran I, et al.

Int J Environ Res Public Health, 2022 Nov 18;19(22).
PMID: 36429988 DOI: 10.3390/ijerph192215266

BACKGROUND: Kidney failure is a global health problem with a worldwide mean prevalence rate of 13.4%. Kidney failure remains symptomless during most of the early stages until symptoms appear in the advanced stages. Kidney failure is associated with a decrease in health-related quality of life (HRQOL), deterioration in physical and mental health, and an increased risk of cardiovascular morbidity and mortality. This study aimed to evaluate the factors associated with decreased HRQOL and other factors affecting the overall health of patients. Another objective was to measure how medication adherence and depression could affect the overall HRQOL in patients with kidney failure.
METHODOLOGY: The study used a prospective follow-up mix methodology approach with six-month follow-ups of patients. The participants included in the study population were those with chronic kidney disease grade 4 and kidney failure. Pre-validated and translated questionnaires (Kidney Disease Quality of Life-Short Form, Hamilton Depression Rating Scale Urdu Version, and Morisky Lewis Greens Adherence Scale) and assessment tools were used to collect data.
RESULTS: This study recruited 314 patients after an initial assessment based on inclusion criteria. The mean age of the study population was 54.64 ± 15.33 years. There was a 47.6% male and a 52.4% female population. Hypertension and diabetes mellitus remained the most predominant comorbid condition, affecting 64.2% and 74.6% of the population, respectively. The study suggested a significant (p < 0.05) deterioration in the mental health composite score with worsening laboratory variables, particularly hematological and iron studies. Demographic variables significantly impact medication adherence. HRQOL was found to be deteriorating with a significant impact on mental health compared to physical health.
CONCLUSIONS: Patients on maintenance dialysis for kidney failure have a significant burden of physical and mental symptoms, depression, and low HRQOL. Given the substantial and well-known declines in physical and psychological well-being among kidney failure patients receiving hemodialysis, the findings of this research imply that these areas related to health should receive special attention in the growing and expanding population of kidney failure patients.
Fulltext Development of Osteoporosis Screening Algorithm for Population Aged 50 Years and above in Klang Valley, Malaysia

Subramaniam S, Chan CY, Soelaiman IN, Mohamed N, Muhammad N, Ahmad F, et al.

Int J Environ Res Public Health, 2020 04 07;17(7).
PMID: 32272697 DOI: 10.3390/ijerph17072526

Background: The current osteoporosis screening instruments are not optimized to be used among the Malaysian population. This study aimed to develop an osteoporosis screening algorithm based on risk factors for Malaysians. Methods: Malaysians aged ≥50 years (n = 607) from Klang Valley, Malaysia were interviewed and their bone health status was assessed using a dual-energy X-ray absorptiometry device. The algorithm was constructed based on osteoporosis risk factors using multivariate logistic regression and its performance was assessed using receiver operating characteristics analysis. Results: Increased age, reduced body weight and being less physically active significantly predicted osteoporosis in men, while in women, increased age, lower body weight and low-income status significantly predicted osteoporosis. These factors were included in the final algorithm and the optimal cut-offs to identify subjects with osteoporosis was 0.00120 for men [sensitivity 73.3% (95% confidence interval (CI) = 54.1%-87.7%), specificity 67.8% (95% CI = 62.7%-85.5%), area under curve (AUC) 0.705 (95% CI = 0.608-0.803), p < 0.001] and 0.161 for women [sensitivity 75.4% (95% CI = 61.9%-73.3%), specificity 74.5% (95% CI = 68.5%-79.8%), AUC 0.749 (95% CI = 0.679-0.820), p < 0.001]. Conclusion: The new algorithm performed satisfactorily in identifying the risk of osteoporosis among the Malaysian population ≥50 years. Further validation studies are required before applying this algorithm for screening of osteoporosis in public.
Fulltext Modelling Well-Being with Mindfulness Intervention on Bottom- and Middle-40% Income Earners in Malaysia

Zaidi FZ, Lai MM, Jumaat A, Lee Y

Int J Environ Res Public Health, 2023 Feb 16;20(4).
PMID: 36834173 DOI: 10.3390/ijerph20043480

This paper examines mindfulness as a costless cognitive asset in reducing stress and improving subjective well-being and psychological well-being among Malaysian bottom-forty-percent and middle-forty-percent income earners, known as B40 and M40, respectively. The participants recruited for this experimental study were divided into intervention and control groups and completed pre- and post-assessment questionnaires. The leveraging on digital technologies during pandemic times from May to June 2021 enabled participants in the intervention group (n = 95) to undergo four weekly online mindfulness intervention sessions through Google Meet and completed daily home mindfulness practices using the mobile application for mindfulness: the MindFi version 3.8.0 mobile app. Based on the Wilcoxon signed-rank test, the intervention group's mindfulness and well-being levels increased significantly after four weeks. This outcome contrasted to those in the control group (n = 31), who exhibited lower mindfulness and well-being levels. The PLS-SEM structural model consists of mindfulness as an independent variable, subjective and psychological well-being as dependent variables, and perceived stress and financial desire discrepancies as the mediators. This model has a goodness-of-fit of 0.076, proving that it is a fit and strong model. There is a positive relationship between mindfulness and subjective well-being (β = 0.162, p-value < 0.01). This model supports the mediation effect of perceived stress between mindfulness and subjective well-being variables (β = 0.152, p-value < 0.05). The overall structural model implies that the effectiveness of mindfulness intervention training not only enhanced bottom- and middle-income earners' well-being but also lowered the perceived stress level that, henceforth, brought the mind and body together in the present moment.
Fulltext Connectedness among Urban Parks from the Users' Perspective: A Systematic Literature Review

Li J, Md Dali M, Nordin NA

Int J Environ Res Public Health, 2023 Feb 18;20(4).
PMID: 36834348 DOI: 10.3390/ijerph20043652

Although many benefits of urban green space networks have been consistently demonstrated, most of the discussion on space connectivity has concentrated on ecological aspects, such as patch-corridor-matrix connectivity. There are limited systematic studies that have investigated the connectedness between urban parks and people. This study aimed to explore the connectedness among urban parks from the users' perspective by using a systematic literature review. By following the PRISMA protocol and analyzing 54 studies from Scopus and Web of Science between 2017 and 2022, we proposed the concepts of physical connectedness and perceived connectedness. The "physical connectedness" contained the dimensions of road attributes and park attributes, as well as six categories including physical accessibility, street connectivity, the street environment, spatial scale, facilities and amenities, and natural elements. The "perceived connectedness" mainly referred to people's perception of the physical environment. The four categories were perceived accessibility, perceived safety, aesthetics, and Kaplan's perceptual model. Finally, in terms of individual attributes, the impact of sociodemographic factors (age, gender, income, education, and occupation) and the motivation for activity on park connectedness were also taken into account. On the basis of our findings, this study suggested that park connectedness should not only focus on physical connectedness but also perceived connectedness.
Fulltext A Novel Social Distancing Approach for Limiting the Number of Vehicles in Smart Buildings Using LiFi Hybrid-Network

Murad SS, Yussof S, Badeel R, Hashim W

Int J Environ Res Public Health, 2023 Feb 15;20(4).
PMID: 36834127 DOI: 10.3390/ijerph20043438

The coronavirus (COVID-19) has arisen as one of the most severe problems due to its ongoing mutations as well as the absence of a suitable cure for this virus. The virus primarily spreads and replicates itself throughout huge groups of individuals through daily touch, which regretfully can happen in several unanticipated way. As a result, the sole viable attempts to constrain the spread of this new virus are to preserve social distance, perform contact tracing, utilize suitable safety gear, and enforce quarantine measures. In order to control the virus's proliferation, scientists and officials are considering using several social distancing models to detect possible diseased individuals as well as extremely risky areas to sustain separation and lockdown procedures. However, models and systems in the existing studies heavily depend on the human factor only and reveal serious privacy vulnerabilities. In addition, no social distancing model/technique was found for monitoring, tracking, and scheduling vehicles for smart buildings as a social distancing approach so far. In this study, a new system design that performs real-time monitoring, tracking, and scheduling of vehicles for smart buildings is proposed for the first time named the social distancing approach for limiting the number of vehicles (SDA-LNV). The proposed model employs LiFi technology as a wireless transmission medium for the first time in the social distance (SD) approach. The proposed work is considered as Vehicle-to-infrastructure (V2I) communication. It might aid authorities in counting the volume of likely affected people. In addition, the proposed system design is expected to help reduce the infection rate inside buildings in areas where traditional social distancing techniques are not used or applicable.
Fulltext Stigmatizing Monkeypox and COVID-19: A Comparative Framing Study of The Washington Post's Online News

Ju W, Sannusi SN, Mohamad E

Int J Environ Res Public Health, 2023 Feb 14;20(4).
PMID: 36834039 DOI: 10.3390/ijerph20043347

BACKGROUND: Stigma relating to health can result in a broad range of vulnerabilities and risks for patients and healthcare providers. The media play a role in people's understanding of health, and stigma is socially constructed through many communication channels, including media framing. Recent health issues affected by stigma include monkeypox and COVID-19.
OBJECTIVES: This research aimed to examine how The Washington Post (WP) framed the stigma around monkeypox and COVID-19. Guided by framing theory and stigma theory, online news coverage of monkeypox and COVID-19 was analyzed to understand the construction of social stigma through media frames.
METHODS: This research used qualitative content analysis to compare news framings in The Washington Post's online news coverage of monkeypox and COVID-19.
RESULTS: Using endemic, reassurance, and sexual-transmission frames, The Washington Post predominantly defined Africa as the source of monkeypox outbreaks, indirectly labeled gays as a specific group more likely to be infected with monkeypox, and emphasized that there was no need to worry about the spread of the monkeypox virus. In its COVID-19 coverage, The Washington Post adopted endemic and panic frames to describe China as the source of the coronavirus and to construct an image of panic regarding the spread of the virus.
CONCLUSIONS: These stigma discourses are essentially manifestations of racism, xenophobia, and sexism in public health issues. This research confirms that the media reinforces the stigma phenomenon in relation to health through framing and provides suggestions for the media to mitigate this issue from a framing perspective.
Fulltext The United Nations (UN) Card, Identity, and Negotiations of Health among Rohingya Refugees

Rahman MM, Dutta MJ

Int J Environ Res Public Health, 2023 Feb 15;20(4).
PMID: 36834082 DOI: 10.3390/ijerph20043385

Being persecuted and expelled from Myanmar, Rohingya refugees are now distributed throughout the world. The Southeast Asian nation of Malaysia has been a preferred destination for Rohingyas fleeing Myanmar's state-sponsored genocide and more recently in a bid to change their fates from the refugee camps in Bangladesh. Refugees are one of the most vulnerable groups in Malaysia and often face dire circumstances, in which their health and wellbeing are compromised. Amidst a plethora of structural challenges, Rohingya refugees try to claim some of their rights with the aid of the UN card (UNHCR ID cards) in Malaysia. Guided by the culture-centered approach (CCA), this study examined the perspectives and experiences of healthcare among Rohingya refugees while living in Malaysia, now resettled in Aotearoa, New Zealand. The participants' narratives showed that the UN card not only materialized their refugee status in Malaysia but also offered them a way of living in a world where documents anchor the materiality of health.
Fulltext Obesity and Its Association with Undiagnosed Diabetes Mellitus, High Blood Pressure and Hypercholesterolemia in the Malaysian Adult Population: A National Cross-Sectional Study Using NHMS Data

Koo HC, Tan LK, Lim GP, Kee CC, Omar MA

Int J Environ Res Public Health, 2023 Feb 09;20(4).
PMID: 36833764 DOI: 10.3390/ijerph20043058

This study aimed to report the prevalence of obesity, classified using Asian cut-off, and its relationships with undiagnosed diabetes mellitus, high blood pressure, and hypercholesteremia. We analyzed the nationally representative data from 14,025 Malaysian adults who participated in the NHMS 2015. The relationship between obesity and undiagnosed diabetes mellitus, high blood pressure, and hypercholesteremia was determined using multivariable logistic regressions, and lifestyle risk factors and sociodemographic characteristics were adjusted. The undiagnosed high blood pressure group showed the highest proportionate of overweight/obese (80.0%, 95% CI: 78.1-81.8) and central obesity (61.8%, 95% CI: 59.3-64.2). Inverse association was observed between underweight with undiagnosed high blood pressure (aOR: 0.40, 95% CI: 0.26-0.61) and hypercholesterolemia (aOR: 0.75, 95% CI: 0.59-0.95) groups. In contrast, positive relationships were shown between overweight/obese and risk of undiagnosed diabetes mellitus (aOR: 1.65, 95% CI: 1.31-2.07), high blood pressure (aOR: 3.08, 95% CI: 2.60-3.63), and hypercholesterolemia (aOR: 1.37, 95% CI: 1.22-1.53). Likewise, central obesity was positively associated with a risk of undiagnosed diabetes mellitus (aOR: 1.40, 95% CI: 1.17-1.67), high blood pressure (aOR: 2.83, 95% CI: 2.45-3.26), and hypercholesterolemia (aOR: 1.26, 95% CI: 1.12-1.42). Our findings indicated the importance of periodical health examinations to assess the risk of non-communicable diseases among the general and abdominal obese Malaysian adults.
Fulltext Cyberbullying, Social Media Addiction and Associations with Depression, Anxiety, and Stress among Medical Students in Malaysia

Lee MHL, Kaur M, Shaker V, Yee A, Sham R, Siau CS

Int J Environ Res Public Health, 2023 Feb 10;20(4).
PMID: 36833827 DOI: 10.3390/ijerph20043136

This study aims to determine the prevalence and factors associated with cyberbullying and social media addiction. This cross-sectional study was conducted among 270 medical students from a public university in Kuching, Malaysia. The instruments used in this study included the cyberbullying questionnaire survey, Bergen Social Media Addiction Scale (BSMAS), and the Depression Anxiety Stress Scale 21-item (DASS-21). The prevalence of cyberbullying victimization was 24.4%, whilst 13.0% reported cyberbullying perpetration over the past six months. Male gender was positively associated with both cyberbullying perpetration and cybervictimization, whilst social media addiction was positively associated with cybervictimization. Psychological motives such as positive attitudes toward cyberbullying and gaining power were associated with cyberbullying perpetration. Cybervictimization doubled the tendency to depression (aOR 2.50, 95% CI [1.23, 5.08], p = 0.012), anxiety (aOR 2.38, 95% CI [1.29, 4.40], p = 0.006), and stress (aOR 2.85, 95% CI [1.41, 5.77], p = 0.004), whilst social media addiction was associated with a higher tendency to depression (aOR 1.18, 95% CI [1.10, 1.26], p < 0.001), anxiety (aOR 1.15, 95% CI [1.08, 1.22], p < 0.001), and stress (aOR 1.21, 95% CI [1.12, 1.32], p < 0.001). Medical schools in Malaysia need policies and guidelines against cyberbullying.
Fulltext Spatial Accessibility of Primary Care in the Dual Public-Private Health System in Rural Areas, Malaysia

Ab Hamid J, Juni MH, Abdul Manaf R, Syed Ismail SN, Lim PY

Int J Environ Res Public Health, 2023 Feb 10;20(4).
PMID: 36833838 DOI: 10.3390/ijerph20043147

Disparities in access to health services in rural areas represent a global health issue. Various external factors contribute to these disparities and each root requires specific remedial action to alleviate the issue. This study elucidates an approach to assessing the spatial accessibility of primary care, considering Malaysia's dual public-private system specifically in rural areas, and identifies its associated ecological factors. Spatial accessibility was calculated using the Enhance 2-Step Floating Catchment Area (E2SFCA) method, modified as per local context. Data were secondary sourced from Population and Housing Census data and administrative datasets pertaining to health facilities and road network. The spatial pattern of the E2SFCA scores were depicted using Hot spot Analysis. Hierarchical multiple linear regression and geographical weight regression were performed to identify factors that affect E2SFCA scores. Hot spot areas revolved near the urban agglomeration, largely contributed by the private sector. Distance to urban areas, road density, population density dependency ratios and ethnic composition were among the associated factors. Accurate conceptualization and comprehensive assessment of accessibility are crucial for evidence-based decision making by the policymakers and health authorities in identifying areas that need attention for a more specific and localized planning and development.
Fulltext The Connection between Absorptive Capacity and Green Innovation: The Function of Board Capital and Environmental Regulation

Javeed SA, Teh BH, Ong TS, Lan NTP, Muthaiyah S, Latief R

Int J Environ Res Public Health, 2023 Feb 10;20(4).
PMID: 36833812 DOI: 10.3390/ijerph20043119

The stress of environmental regulations, sustainable development objectives, and global warming is becoming more prominent now. Most studies conclude that the industrial sector is largely at fault and under tremendous pressure to address these climate change issues. This study highlights the significance of green innovation to Chinese firms in mitigating these conservational challenges, and the study probes the association between green innovation and absorptive capacity. Additionally, board capital (the social and human capital of directors) and environmental regulation-both drivers of green innovation-are explored as moderators between green innovation and absorptive capacity. With appropriate econometric methods and theoretical support from the natural resource-based review, the resource dependency theory, and the Porter hypothesis, the results indicate the positive relationship between green innovation and absorptive capacity. They also reveal board capital and environmental regulation as positive moderators, emphasizing their significance to green innovation. This study offers several suggestions and directives for stakeholders, such as businesses, policymakers, and governments, to foster green innovation for greater profitability, minimizing negative industrial consequences.
Fulltext myBeST-A Web-Based Survival Prognostic Tool for Women with Breast Cancer in Malaysia: Development Process and Preliminary Validation Study

Nik Ab Kadir MN, Mohd Hairon S, Yaacob NM, Yusof SN, Musa KI, Yahya MM, et al.

Int J Environ Res Public Health, 2023 Feb 08;20(4).
PMID: 36833678 DOI: 10.3390/ijerph20042985

Women with breast cancer are keen to know their predicted survival. We developed a new prognostic model for women with breast cancer in Malaysia. Using the model, this study aimed to design the user interface and develop the contents of a web-based prognostic tool for the care provider to convey survival estimates. We employed an iterative website development process which includes: (1) an initial development stage informed by reviewing existing tools and deliberation among breast surgeons and epidemiologists, (2) content validation and feedback by medical specialists, and (3) face validation and end-user feedback among medical officers. Several iterative prototypes were produced and improved based on the feedback. The experts (n = 8) highly agreed on the website content and predictors for survival with content validity indices ≥ 0.88. Users (n = 20) scored face validity indices of more than 0.90. They expressed favourable responses. The tool, named Malaysian Breast cancer Survival prognostic Tool (myBeST), is accessible online. The tool estimates an individualised five-year survival prediction probability. Accompanying contents were included to explain the tool's aim, target user, and development process. The tool could act as an additional tool to provide evidence-based and personalised breast cancer outcomes.
Fulltext Validating an Instrument for Measuring Newly Graduated Nurses' Adaptation

Baharum H, Ismail A, Awang Z, McKenna L, Ibrahim R, Mohamed Z, et al.

Int J Environ Res Public Health, 2023 Feb 06;20(4).
PMID: 36833559 DOI: 10.3390/ijerph20042860

A long-established approach, Confirmatory Factor Analysis (CFA) is used to validate measurement models of latent constructs. Employing CFA can be useful for assessing the validity and reliability of such models. The study adapted previous instruments and modified them to suit the current setting. The new measurement model is termed NENA-q. Exploratory factor analysis (EFA) revealed the instruments of the NENA-q model formed a construct of the second order with four dimensions, namely organizational contribution (OC), academic institution contribution (AIC), personality traits (PT), and newly employed nurses' adaptation (NENA). Researchers administered the questionnaires to a sample of 496 newly employed nurses working in hospitals under the Ministry of Health (MOH) for the confirmation of the extracted dimensions. The study performed a two-step CFA procedure to validate NENA-q since the model involves higher-order constructs. The first step was individual CFA, while the second step was pooled CFA. The validation procedure through confirmatory factor analysis (CFA) found the model achieved the threshold of construct validity through fitness index assessment. The model also achieved convergent validity when all average variance extracted (AVE) exceeded the threshold value of greater than 0.5. The assessment of the composite reliability (CR) value indicates all CR values exceeded the threshold value of 0.6, which indicates the construct achieved composite reliability. Overall, the NENA-q model consisting of the OC construct, AIC construct, PT construct, and NENA construct for CFA has met the fitness indexes and passed the measurements of the AVE, CR, and normality test. Once the measurement models have been validated through CFA procedure, the researcher can assemble these constructs into structural model and estimate the required parameter through structural equation modelling (SEM) procedure.
Fulltext The Residential Environment and Health and Well-Being of Chinese Migrant Populations: A Systematic Review

Huang L, Said R, Goh HC, Cao Y

Int J Environ Res Public Health, 2023 Feb 08;20(4).
PMID: 36833663 DOI: 10.3390/ijerph20042968

China's internal migrants suffer from marginalised housing conditions, poor neighbourhood environments and residential segregation, which may have significant implications on health and well-being. Echoing recent calls for interdisciplinary research on migrant health and well-being, this study examines the associations and mechanisms of the impact of the residential environment on the health and well-being of Chinese migrants. We found that most of the relevant studies supported the "healthy migration effect", but the phenomenon was only applicable to migrants' self-reported physical health rather than mental health. The subjective well-being of migrants is lower than that of urban migrants. There is a debate between the effectiveness of residential environmental improvements and the ineffectiveness of residential environmental improvements in terms of the impact of the neighbourhood environment on migrants' health and well-being. Housing conditions and the neighbourhood's physical and social environment can enhance migrants' health and well-being by strengthening place attachment and social cohesion, building localised social capital and gaining neighbourhood social support. Residential segregation on the neighbourhood scale affects the health outcomes of migrant populations through the mechanism of relative deprivation. Our studies build a vivid and comprehensive picture of research to understand migration, urban life and health and well-being.
Fulltext Enhancing Food Security through Digital Inclusive Finance: Evidence from Agricultural Enterprises in China

Huang S, Nik Azman NH

Int J Environ Res Public Health, 2023 Feb 08;20(4).
PMID: 36833648 DOI: 10.3390/ijerph20042956

As a means of enhancing food security, efficient agricultural processing and the maintenance of a smooth supply chain are essential for ensuring food quality and reducing food wastage. Agricultural enterprises play a crucial role in the processing and transportation of food from farms to dinner tables. Operating income growth plays the vital role of ensuring that agricultural enterprises function in a stable manner while also indicating the quantity and quality of market food supply. Therefore, the objective of this study is to explore the impact of digital inclusive finance on food security by analyzing the effect of digital inclusive finance on the operating income of agricultural enterprises in China. By applying pooled OLS analysis to Chinese agricultural enterprises that are listed in the National Equities Exchange and Quotations, this study finds that digital inclusive finance can help improve agricultural operating income. The results reveal that digital inclusive finance can facilitate the promotion of agricultural operating income by increasing the supply of financing, accelerating inventory liquidity, and supporting investment in research and development. In addition, this study concludes that digital inclusive finance is more effective for increasing agricultural operating income as a result of its wider coverage and deeper utilization. Furthermore, the development of traditional finance is still necessary for the digitization of digital inclusive finance to be effective.
Fulltext Systematic Review of Brain-Eating Amoeba: A Decade Update

Ahmad Zamzuri M'I, Abd Majid FN, Mihat M, Ibrahim SS, Ismail M, Abd Aziz S, et al.

Int J Environ Res Public Health, 2023 Feb 09;20(4).
PMID: 36833715 DOI: 10.3390/ijerph20043021

INTRODUCTION: Primary amoebic meningoencephalitis (PAM) is a rare but lethal infection of the brain caused by a eukaryote called Naegleria fowleri (N. fowleri). The aim of this review is to consolidate the recently published case reports of N. fowleri infection by describing its epidemiology and clinical features with the goal of ultimately disseminating this information to healthcare personnel.
METHODS: A comprehensive literature search was carried out using PubMed, Web of Science, Scopus, and OVID databases until 31 December 2022 by two independent reviewers. All studies from the year 2013 were extracted, and quality assessments were carried out meticulously prior to their inclusion in the final analysis.
RESULTS: A total of 21 studies were selected for qualitative analyses out of the 461 studies extracted. The cases were distributed globally, and 72.7% of the cases succumbed to mortality. The youngest case was an 11-day-old boy, while the eldest was a 75-year-old. Significant exposure to freshwater either from recreational activities or from a habit of irrigating the nostrils preceded onset. The symptoms at early presentation included fever, headache, and vomiting, while late sequalae showed neurological manifestation. An accurate diagnosis remains a challenge, as the symptoms mimic bacterial meningitis. Confirmatory tests include the direct visualisation of the amoeba or the use of the polymerase chain reaction method.
CONCLUSIONS: N. fowleri infection is rare but leads to PAM. Its occurrence is worldwide with a significant risk of fatality. The suggested probable case definition based on the findings is the acute onset of fever, headache, and vomiting with meningeal symptoms following exposure to freshwater within the previous 14 days. Continuous health promotion and health education activities for the public can help to improve knowledge and awareness prior to engagement in freshwater activities.

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