Displaying publications 561 - 580 of 760 in total

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  1. Sani NA, Yusoff SSM, Norhayati MN, Zainudin AM
    PMID: 36833525 DOI: 10.3390/ijerph20042828
    Tai Chi is a mindfulness-body practice that has physiological and psychosocial benefits and can be integrated into the prevention and rehabilitation of various medical conditions; however, the effectiveness of Tai Chi in the treatment of depression remains unclear. This review aimed to determine the effects of Tai Chi exercise on mental and physical well-being in patients with depressive symptoms. We searched databases for English language publications that appeared during January 2000-2022. The included trials were RCTs that involved people with depression with no other medical conditions, and included both adolescent and adult samples. A meta-analysis was performed using a random effects model and the heterogeneity was estimated using I2 statistics. The quality of each trial was assessed according to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology. The eight trials were divided into two comparisons: (1) a combination of Tai Chi and antidepressants versus standard antidepressants; (2) Tai Chi versus no intervention. The Tai Chi intervention showed improvements in mental and physical well-being as evidenced by the reductions in depression and anxiety and improved quality of life (QOL) of the patients with depressive symptoms. Further well-controlled RCTs are recommended with a precision trial design and larger sample sizes.
  2. Ali SNM, Cioca LI, Kayati RS, Saputra J, Adam M, Plesa R, et al.
    PMID: 36833563 DOI: 10.3390/ijerph20042866
    Due to unpredictable and demanding working circumstances and the significant potential for dangers and accidents, seafaring has been characterised as one of the world's riskiest and stressful vocations that lead to physical and mental health problems. However, very few instruments measure work-related stress, particularly in a seafaring context. None of the instruments are psychometrically sound. Therefore, a valid and reliable instrument to measure seafaring work-related stress is indispensable. This study aims to review work-related stress instruments and to explore the work-related stress construct among seafarers in Malaysia. This study uses a systematic review and semi-structured interviews across two phases. In Phase 1, we conducted a systematic review of several databases: Academic Search Ultimate, Emerald Journal Premier, Journal Storage (JSTOR), ScienceDirect, Springer Link, Taylor and Francis Online, and Wiley Online Library based on Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). In 8975 articles, only 4 (four) studies used psychological instruments and 5 (five) studies used survey questionnaires to measure work-related stress. In Phase 2, we conducted a semi-structured interview with 25 (twenty-five) seafarers, online due to COVID-19 restrictions. The semi-structured interview indicated 6 (six) themes, namely, physical stress, personal issues, social living onboard, technostress, work factors, and the effect of the COVID-19 pandemic. In conclusion, the present study has identified three psychometric instruments for measuring work-related stress among seafarers: The Psychological General Well-Being Index, Perceived Stress Scale, and Job Content Questionnaire. We also found psychometric elements in some of the instruments are questionable, such as theoretical basis, construct development, and inadequate internal consistency value. In addition, this study also found that work-related stress is a multidimensional construct that needs to be studied based on work contexts. The findings of this study can contribute to the body of knowledge of a work-related stress construct in a seafaring context and could help to inform policy makers in the maritime industry. This study suggests a psychological instrument to measure work-related stress among seafarers in future studies.
  3. Fauzan NS, Sukadarin EH, Widia M, Irianto I, Ghazali I
    PMID: 36833630 DOI: 10.3390/ijerph20042934
    This systematic literature review (SLR) aims to determine the factors influencing the use of hearing protection devices (HPDs) among industrial workers. This study was guided by the PRISMA Statement (Preferred Reporting Items for Systematic reviews and Meta-Analyses) review method, and four databases comprising Scopus, Science Direct, PubMed, Wiley Online Library, and Google Scholar were employed. A total of 196 articles were identified, and 28 studies on the factors associated with HPD use among industrial workers from 2006 to 2021 met the inclusion criteria. Resultantly, five main themes emerged from this review: sociodemographic (29%), interpersonal influences (18%), situational influences (18%), cognitive-perceptual (29%), and health-promoting behavior (6%) associated with HPD use among industrial workers. A total of 17 sub-themes were identified, including age, gender, educational level, noise level, working experience, social models, interpersonal support, social norms, safety climate, training, organizational support, perceived barrier, perceived susceptibility, perceived severity, perceived benefit, self-efficacy, and cues to action. The significant factors influencing workers to use HPDs are sociodemographic, interpersonal influences, situational influences, and health-promoting behavior. Future studies should focus on the cues to action toward human behavior influencing the use of HPDs, workers' health status, and comorbidities of hearing loss. Therefore, this systematic study gives valuable reference resources for up-and-coming researchers as well as new knowledge to expert professionals and academics in various industries.
  4. Yong KH, Teo YN, Azadbakht M, Phung H, Chu C
    Int J Environ Res Public Health, 2023 May 22;20(10).
    PMID: 37239636 DOI: 10.3390/ijerph20105910
    Global climate change has contributed to the intensity, frequency, and duration of heatwave events. The association between heatwaves and elderly mortality is highly researched in developed countries. In contrast, heatwave impact on hospital admissions has been insufficiently studied worldwide due to data availability and sensitivity. In our opinion, the relationship between heatwaves and hospital admissions is worthwhile to explore as it could have a profound impact on healthcare systems. Therefore, we aimed to investigate the associations between heatwaves and hospitalisations for the elderly by age group in Selangor, Malaysia, from 2010 to 2020. We further explored the impact of heatwaves on the risks of cause-specific hospital admissions across age groups within the elderly. This study applied generalized additive models (GAMs) with the Poisson family and distributed lag models (DLMs) to estimate the effect of heatwaves on hospitalisations. According to the findings, there was no significant increase in hospitalisations for those aged 60 and older during heatwaves; however, a rise in mean apparent temperature (ATmean) by 1 °C significantly increased the risk of hospital admission by 12.9%. Heatwaves had no immediate effects on hospital admissions among elderly patients, but significant delay effects were identified for ATmean with a lag of 0-3 days. The hospital admission rates of the elderly groups started declining after a 5-day average following the heatwave event. Females were found to be relatively more vulnerable than males during heatwave periods. Consequently, these results can provide a reference to improve public health strategies to target elderly people who are at the greatest risk of hospitalisations due to heatwaves. Development of early heatwave and health warning systems for the elderly would assist with preventing and reducing health risks while also minimising the burden on the whole hospital system in Selangor, Malaysia.
  5. Sahril N, Chan YM, Chan YY, Ahmad NA, Kassim MSA, Shahein NA, et al.
    PMID: 36901351 DOI: 10.3390/ijerph20054342
    OBJECTIVE: This study aims to determine the prevalence of poor self-rated health (SRH) in Malaysia and its association with sociodemographic characteristics, lifestyle behavior, chronic diseases, depression, and functional limitations in activities of daily living (ADLs) among older persons.

    DESIGN: Cross-sectional. Setting, participants, and outcome measures: We used data from the National Health and Morbidity Survey 2018, a nationwide community-based study. This study was conducted using a two-stage stratified cluster sampling design. Older persons were defined as persons aged 60 years and above. SRH was assessed using the question "How do you rate your general health?" and the answers were "very good", "good", "moderate", "not good", and "very bad". SRH was then grouped into two categories; "Good" (very good and good) and "Poor" (moderate, not good, and very bad). Descriptive and logistic regression analyses were conducted using SPSS version 25.0.

    RESULTS: The prevalence of poor SRH among older persons was 32.6%. Poor SRH was significantly related to physical inactivity, depression, and limitations in activities of daily living (ADLs). Multiple logistic regression revealed that poor SRH was positively associated with those who had depression (aOR 2.92, 95% CI:2.01,4.24), limitations in ADLs (aOR 1.82, 95% CI: 1.31, 2.54), low individual income (aOR 1.66, 95% CI:1.22, 2.26), physical inactivity (aOR 1.40, 95% CI:1.08, 1.82), and hypertension (aOR 1.23, 95% CI:1.02, 1.49).

    CONCLUSIONS: Older persons with depression, limitations in ADLs, low income, physical inactivity, and hypertension were significantly associated with poor SRH. These findings provide information to aid health personnel and policymakers in the development and implementation of health promotion and disease prevention programs, as well as adequate evidence in planning different levels of care for the older population.

  6. Abdul Rashid MR, Syed Mohamad SN, Tajjudin AIA, Roslan N, Jaffar A, Mohideen FBS, et al.
    PMID: 36901486 DOI: 10.3390/ijerph20054476
    This study aimed to explore the socio-demographic characteristics, mental health status, and perceived causes of pandemic fatigue with COVID-19 pandemic fatigue among the general population of Malaysia. The data was collected online during the transition from the COVID-19 pandemic phase to the endemic phase in Malaysia from 1 to 30 April 2022. Sociodemographic data, Depression Anxiety Stress Scale-21 (DASS-21), perceived causes of pandemic fatigue, and the Fatigue Assessment Scale (FAS) were included in the survey. The chi-square test and a simple logistic regression analysis were used to identify predictors of pandemic fatigue. The completed survey (N = 775) included individuals aged 18 years or above [mean 31.98 (SD = 12.16)] from all states in Malaysia. Pandemic fatigue prevalence was 54.2%. Severe to extremely severe depression, anxiety, and stress symptoms were detected in 11.2%, 14.9%, and 9.1% of the participants, respectively. Younger age, non-Malay ethnicity, living alone, and higher income categories were significantly higher in the fatigued group. Higher DASS-21 scores on all domains were associated with higher FAS scores. Meanwhile, high scores for perceived tiredness from complying with the COVID-19 Standard Operating Procedure (SOP), perceived risk of infection from COVID-19, perceived hardship due to the pandemic, perceived public complacency during the pandemic, and perceived changes due to the pandemic were associated with a higher FAS score. This study provides valuable information for policymakers and mental health professionals worldwide on pandemic fatigue and its associated factors, including mental health status in Malaysia.
  7. Ao X, Ong TS, Teh BH
    PMID: 36901536 DOI: 10.3390/ijerph20054528
    Environmental degradation and ecological devastation have become widespread global concerns in recent years as a result of the expansion of the international economy. China's rapid economic development has been accompanied by a sloppy economic growth model that has damaged the local ecological environment. The Chinese government intends to improve the ecological environment by the end of 2020 in an effort to direct and improve these environmental issues. The strictest environmental laws became effective in 2015. In light of this, this research uses panel data analysis to examine the environmental strategy and environmental governance of Chinese corporations. This article analyses 14,512 samples of listed mainland Chinese enterprises from 2015 to 2020. This research investigates the connection between Corporate Sustainability Development Strategy and Corporate Environmental Governance, as well as the moderating effect of Corporate Environmental Investments.
  8. Kandayah T, Safian N, Azhar Shah S, Abdul Manaf MR
    PMID: 36982085 DOI: 10.3390/ijerph20065179
    BACKGROUND: Sarcopenia is a disease associated with the loss of muscle mass, strength, and function. It affects the elderly in various ways, such as reduced mobility, compromising their daily activities, and even deteriorating metabolic health. Primary care serves as the first point of contact for patients and plays an important role in health promotion and disease prevention. Hence, this review is conducted to identify the challenges in the management of sarcopenia in the primary care setting.

    METHOD: In December 2022, a scoping review was conducted using PubMed, SCOPUS, Web of Science, and a manual search, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We used articles that have been written in English, and relevant articles were then screened, duplicates were removed, eligibility criteria were applied, and studies that met the criteria were reviewed. The keywords challenges, management, sarcopenia, and primary care were included.

    RESULT: The initial search generated 280 publications, and 11 articles were included after inclusion and exclusion criteria for this review. In this review, challenges in the management of sarcopenia in a primary care setting are reviewed based on the screening and diagnosis.

    CONCLUSIONS: With an increasing aging population, it is important to understand the challenges in the management of sarcopenia in a primary care setting. Identification of elderly at risk of sarcopenia, followed by referring the affected elderly for confirmation of the diagnosis, is essential to preventing the adverse health effects. The initiation of treatment that comprises resistance exercise training and nutrition should not be delayed, as they are salient in the management of sarcopenia.

  9. Tan KP, Ang JK, Koh EBY, Pang NTP, Mat Saher Z
    PMID: 36901243 DOI: 10.3390/ijerph20054232
    Caregivers of People with dementia (PwD) commonly experience burdens and other mental health issues, e.g., depression and anxiety. At present, there are limited studies that examine the relationships between caregiver psychological factors and caregiver burden, and depressive and anxiety symptoms. Therefore, this study's objectives were to examine the relationships between psychological flexibility and mindfulness in caregivers of PwD, and to determine the predictors of these three outcomes. This was a cross-sectional study conducted in the geriatric psychiatry clinic of Kuala Lumpur Hospital, Malaysia, and the sample (n = 82) was recruited via a universal sampling method over three months. The participants completed a questionnaire that consisted of the sociodemographics of the PwD and caregivers, illness characteristics of the PwD, Acceptance and Action Questionnaire-II (AAQ-II), Mindful Attention Awareness Scale (MAAS), Zarit Burden Interview Scale (ZBI), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7). The results show that despite significant relationships between psychological flexibility and mindfulness and lower levels of caregiver burden, and depressive and anxiety symptoms (p < 0.01), only psychological inflexibility (p < 0.01) remained as a significant predictor of the three outcomes. Therefore, in conclusion, intervention programs that target the awareness of the caregiver's psychological inflexibility should be implemented to alleviate these adverse outcomes in dementia caregivers.
  10. Che Had NH, Alavi K, Md Akhir N, Muhammad Nur IR, Shuhaimi MSZ, Foong HF
    PMID: 36901256 DOI: 10.3390/ijerph20054243
    The phenomenon of ageing may contribute to the rise of the dependent population. Due to the obstacles and difficulties they confront, the elderly's mobility decreases significantly. The aim of this article is to identify factors associated with mobility barriers in older adults. The method employed is an examination of articles published between 2011 and 2022 to identify common themes in previous studies. Four search engines were being used, and 32 articles have been included. This study demonstrated that health is a major factor associated with decreased mobility. This review identified four types of barriers which are health, built environment, socio-economic background and social relation change. This review could help policy makers and gerontologist in identifying solutions to resolve the mobility issues in older people.
  11. Nik Ab Kadir MN, Yaacob NM, Yusof SN, Ab Hadi IS, Musa KI, Mohd Isa SA, et al.
    Int J Environ Res Public Health, 2022 Nov 20;19(22).
    PMID: 36430052 DOI: 10.3390/ijerph192215335
    Prediction of survival probabilities based on models developed by other countries has shown inconsistent findings among Malaysian patients. This study aimed to develop predictive models for survival among women with breast cancer in Malaysia. A retrospective cohort study was conducted involving patients who were diagnosed between 2012 and 2016 in seven breast cancer centres, where their survival status was followed until 31 December 2021. A total of 13 predictors were selected to model five-year survival probabilities by applying Cox proportional hazards (PH), artificial neural networks (ANN), and decision tree (DT) classification analysis. The random-split dataset strategy was used to develop and measure the models' performance. Among 1006 patients, the majority were Malay, with ductal carcinoma, hormone-sensitive, HER2-negative, at T2-, N1-stage, without metastasis, received surgery and chemotherapy. The estimated five-year survival rate was 60.5% (95% CI: 57.6, 63.6). For Cox PH, the c-index was 0.82 for model derivation and 0.81 for validation. The model was well-calibrated. The Cox PH model outperformed the DT and ANN models in most performance indices, with the Cox PH model having the highest accuracy of 0.841. The accuracies of the DT and ANN models were 0.811 and 0.821, respectively. The Cox PH model is more useful for survival prediction in this study's setting.
  12. Omar R, Mahjom M, Haron NH, Mat Lazim R, Kamal FSQ
    Int J Environ Res Public Health, 2022 Nov 24;19(23).
    PMID: 36497673 DOI: 10.3390/ijerph192315601
    This study aimed to examine the characteristics of HCWs infected with COVID-19 and factors associated with healthcare-associated infection. A cross-sectional study, using secondary data of COVID-19 HCW cases from a registry developed by the Occupational and Environmental Health Unit (OEHU) in Kedah State Health Department, Malaysia, was analysed using Excel and STATA version 14.0. Descriptive analysis and multiple logistic regression were conducted to identify the factors for healthcare-associated COVID-19 infection. A total of 1679 HCWs tested positive for COVID-19 between 1 January 2021 and 19 September 2021. The infection was mainly non-healthcare-associated (67.0%), with healthcare-associated cases contributing to only 33% of the cases. The significant factors associated with healthcare-associated transmission were the following: doctor (aOR = 1.433; 95% CI = 1.044, 1.968), hospital setting (aOR = 1.439; 95% CI = 1.080, 1.917), asymptomatic (aOR = 1.848; 95% CI = 1.604, 2.130), incompletely or not vaccinated (aOR = 1.400; 95% CI = 1.050, 1.866) and CT-value ≥ 30 (aOR = 2.494; 95% CI = 1.927, 3.226). Identifying factors of healthcare-associated infection would help in planning control measures preventing healthcare-associated transmission in the workplace. However, more than half of COVID-19 cases among HCWs involved non-healthcare-associated COVID-19 infection, and, thus, requires further study to identify high-risk behaviours.
  13. Subsittipong N, Choi J, Kim TH, Han E
    PMID: 35409470 DOI: 10.3390/ijerph19073786
    Background: The introduction of new vaccines has been delayed in some countries in the Asia-Pacific region, which has led to delays in accessing vaccines for target patients. However, the approval lag of vaccines in the Asia-Pacific region has not been assessed. The objective of this study is to assess the availability and approval lag of vaccines in Asia-Pacific countries and compare them among Asia-Pacific countries, the United States (US), and Europe (EU). Methods: The information on vaccines prequalified by the World Health Organization (WHO) between 2010 and 2019 was obtained primarily from the WHO website. The date of approval of the WHO prequalified vaccine in Australia, India, South Korea, Thailand, Singapore, Malaysia, the US, and EU was retrieved from the official website of national regulatory agencies. The vaccines were divided into two groups based on their first approval pathway, that is, vaccines that were first approved by SRA (Stringent Regulatory Authority including the US, EU, and WHO) and those that were first approved by non-SRA. The absolute approval lag represented the availability of the vaccine. Relative approval lag represented the lag time between the approval date of the country of interest and the first global approval date and was measured as the median approval lag. A Mann−Whitney U test was used to examine statistical differences between relative approval lag between the SRA first and the non-SRA first groups. Results: A total of 92 vaccines were prequalified by the WHO between 2010 and 2019, but only 61 vaccines were included in the analysis. Over 50% of vaccines were first licensed by non-SRAs. Of all the WHO-prequalified vaccines, the median approval lag in the ASEAN countries in this study was longer than those in the US and EU, with a median of 30 months in Australia, 15 months in South Korea, 52 months in Thailand, and 23 months in Singapore, compared to 0 months in the US and EU. The differences in approval lags between SRA first vaccines and non-SRA first vaccines were statistically significant in South Korea and Thailand (p < 0.05). Conclusions: The approval lag of vaccines was observed in the Asia-Pacific region, indicating a gap between the Asia-pacific region and the US and EU in regard to access to new vaccines. Future studies need to analyze the background factors related to the gap in availability and vaccine approval lag in the Asia-Pacific region and assess the impact of vaccine approval lag in the region.
  14. Zulkafflee NS, Mohd Redzuan NA, Hanafi Z, Selamat J, Ismail MR, Praveena SM, et al.
    PMID: 31795132 DOI: 10.3390/ijerph16234769
    Rice ingestion is one of the major pathways for heavy metal bioaccumulation in human. This study aimed to measure the heavy metal content of paddy soils and its bioavailability in paddy grain in order to assess the health risk. In total, 10 rice samples (50 g each) of paddy plants were harvested from the Selangor and Terengganu areas of Malaysia to assess the bioavailability of heavy metal (As, Cd, Cu, Cr, and Pb) using the in vitro digestion model of Rijksinstituut voor Volksgezondheid en Milieu. The bioavailability of heavy metal concentrations in rice samples were analyzed using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The findings showed the bioavailability of heavy metal concentrations was decreased in the order Cr > Cu > Pb > As > Cd. Chromium was found to be the most abundant bioavailable heavy metal in cooked rice, which was the result of its high content in paddy soil. Hazard Quotient values for the bioavailability of the heavy metal studied were less than one indicating no non-carcinogenic health risks for adults and children. Meanwhile, the total Lifetime Cancer Risk exceeded the acceptable value showing a potential of carcinogenic health risk for both adults and children. The application of in vitro digestion model in assessing bioavailability of heavy metal produces a more realistic estimation of human health risks exposure. However, a regular monitoring of pollution in Selangor and Terengganu areas is crucial since the exposure of heavy metals through rice consumption poses the potential non-carcinogenic and carcinogenic health risk to the local residents.
  15. Mohd Nordin NA, Yusoff NAH, Ajit Singh DK
    PMID: 31783575 DOI: 10.3390/ijerph16234746
    Although exercise is proven as an effective strategy to combat post-stroke complications and the risk of stroke recurrence, many stroke survivors fail to engage in this activity following rehabilitation. In this study, we assessed the feasibility and usefulness of a low-frequency group exercise to determine its suitability as an approach to facilitate exercise engagement among stroke survivors. Forty-one stroke survivors, mean (SD) age 59.34 (10.02) years, mean time post-stroke 17.13 (17.58) months, completed a 90 minute, once per week, group exercise supervised by therapists for 12 weeks. The exercise outcomes were measured using standardized clinical tests. We observed improvement in the group's physical performance; balance score by 3 units (Z = -3.88, p < 0.001), speed of repetitive sit to stand by 3.4 s (Z = -4.69, p < 0.001), and walking speed by 8.22 m/min (Z = -3.25, p < 0.001). Scores of seven out of 14 Berg's balance scale items increased significantly, indicating better balance ability among the survivors. In conclusion, a 12-week, once per week group exercise session seems feasible and sufficient to improve the physical performance of community dwelling stroke survivors. This exercise arrangement may be offered to stroke survivors to facilitate exercise practice following rehabilitation.
  16. Gill BS, Jayaraj VJ, Singh S, Mohd Ghazali S, Cheong YL, Md Iderus NH, et al.
    Int J Environ Res Public Health, 2020 Jul 30;17(15).
    PMID: 32751669 DOI: 10.3390/ijerph17155509
    Malaysia is currently facing an outbreak of COVID-19. We aim to present the first study in Malaysia to report the reproduction numbers and develop a mathematical model forecasting COVID-19 transmission by including isolation, quarantine, and movement control measures. We utilized a susceptible, exposed, infectious, and recovered (SEIR) model by incorporating isolation, quarantine, and movement control order (MCO) taken in Malaysia. The simulations were fitted into the Malaysian COVID-19 active case numbers, allowing approximation of parameters consisting of probability of transmission per contact (β), average number of contacts per day per case (ζ), and proportion of close-contact traced per day (q). The effective reproduction number (Rt) was also determined through this model. Our model calibration estimated that (β), (ζ), and (q) were 0.052, 25 persons, and 0.23, respectively. The (Rt) was estimated to be 1.68. MCO measures reduce the peak number of active COVID-19 cases by 99.1% and reduce (ζ) from 25 (pre-MCO) to 7 (during MCO). The flattening of the epidemic curve was also observed with the implementation of these control measures. We conclude that isolation, quarantine, and MCO measures are essential to break the transmission of COVID-19 in Malaysia.
  17. Leong FW, Mohd Yasin MA, Muhd Ramli ER, Fadzil NA, Kueh YC
    Int J Environ Res Public Health, 2019 Nov 12;16(22).
    PMID: 31726715 DOI: 10.3390/ijerph16224434
    There has been an increasing interest in personality study over the years. This has led to the necessity for personality measures with good psychometric properties. However, good personality measures are usually too cumbersome to apply in real practical settings due to their length. This study aims to validate a commonly used short personality measure of the Big Five model, i.e., Mini-IPIP (Mini International Personality Item Pool), which has never been validated and used in the substance abuse population in the local setting. The participants were 239 individuals attending one of the six methadone clinics in Malaysia. Structural analysis was conducted using confirmatory factor analysis. Results showed a good model fit for Mini-IPIP when item-parcelling and adding-in correlated uniqueness items were applied (fit indices: Comparative Fit Index = 0.949, Standardised Root Mean Residual = 0.044). Our study supported the five-factor solution for the Mini-IPIP. It is valid and reliable to be used among individuals with drug abuse in Malaysia.
  18. Chan CY, Subramaniam S, Chin KY, Ima-Nirwana S, Muhammad N, Fairus A, et al.
    Int J Environ Res Public Health, 2019 Oct 25;16(21).
    PMID: 31731507 DOI: 10.3390/ijerph16214115
    Osteoporosis is a skeletal disorder commonly found among the elderly, in which the bones become weak, brittle, and more susceptible to fracture. Adequate knowledge and positive attitude towards the disease and osteoprotective activities may prevent osteoporosis, but comprehensive studies to verify this hypothesis are limited in Malaysia. This study aims to bridge the research gap by determining the levels of knowledge, beliefs, and practices regarding osteoporosis and their associations with bone mineral density (BMD) among men and women ≥ 40 years in Klang Valley, Malaysia. In this cross-sectional study, 786 Malaysians (382 men, 404 women) completed a questionnaire on knowledge, beliefs, and osteoprotective practices, and underwent BMD scan using a dual-energy X-ray absorptiometry device. The current study found moderate levels of knowledge and beliefs regarding osteoporosis but poor osteoprotective practices. Osteoporosis knowledge, beliefs, and practices were significantly different based on subjects' demographic characteristics (p < 0.05). Osteoporosis knowledge and beliefs were correlated significantly with osteoprotective practices (p < 0.05). Bone health status of the subjects was associated positively with calcium supplement intake, and negatively with exercise barriers and smoking status of the subjects (p < 0.05). However, no significant correlation was noted between osteoporosis knowledge and bone health (p > 0.05). Conclusively, despite some correlations between individual components, the detachment between bone health knowledge and beliefs, and osteoprotective practices among Malaysians is apparent. Integrating all three components into a comprehensive osteoporosis prevention program is warranted.
  19. Cheung ML, Chau KY, Lam MHS, Tse G, Ho KY, Flint SW, et al.
    Int J Environ Res Public Health, 2019 Jun 26;16(13).
    PMID: 31247962 DOI: 10.3390/ijerph16132257
    With the advancement of information technology, wearable healthcare technology has emerged as one of the promising technologies to improve the wellbeing of individuals. However, the adoption of wearable healthcare technology has lagged when compared to other well-established durable technology products, such as smartphones and tablets, because of the inadequate knowledge of the antecedents of adoption intention. The aim of this paper is to address an identified gap in the literature by empirically testing a theoretical model for examining the impact of consumers' health beliefs, health information accuracy, and the privacy protection of wearable healthcare technology on perceived usefulness. Importantly, this study also examines the influences of perceived usefulness, consumer innovativeness, and reference group influence on the adoption intention of wearable healthcare technology. The model seeks to enhance understanding of the influential factors in adopting wearable healthcare technology. Finally, suggestions for future research for the empirical investigation of the model are provided.
  20. Wong SK, Chin KY, Ima-Nirwana S
    PMID: 31505801 DOI: 10.3390/ijerph16183313
    A positive association between metabolic syndrome (MetS) and osteoporosis has been demonstrated in previous animal studies. The mechanisms of MetS in orchestrating the bone remodelling process have traditionally focused on the interactions between mature osteoblasts and osteoclasts, while the role of osteocytes is unexplored. Our earlier studies demonstrated the bone-promoting effects of tocotrienol using a rat model of osteoporosis induced by MetS. This study aimed to investigate the expression of osteocyte-derived peptides in the bone of rats with MetS-induced osteoporosis treated with tocotrienol. Age-matched male Wistar rats (12-week-old; n = 42) were divided into seven experimental groups. Two groups served as the baseline and normal group, respectively. The other five groups were fed with a high-carbohydrate high-fat (HCHF) diet to induce MetS. The five groups of HCHF animals were treated with tocopherol-stripped corn oil (vehicle), annatto tocotrienol (60 and 100 mg/kg), and palm tocotrienol (60 and 100 mg/kg) starting from week 8. At the end of the study, the rats were sacrificed and their right tibias were harvested. Protein was extracted from the metaphyseal region of the proximal right tibia and levels of bone peptides, including osteoprotegerin (OPG), soluble receptor activator of nuclear factor-kappa B ligand (sRANKL), sclerostin (SOST), Dickkopf-related protein 1 (DKK-1), fibroblast growth factor-23 (FGF-23), and parathyroid hormone (PTH), were measured. The vehicle-treated animals displayed higher levels of sRANKL, SOST, DKK-1, FGF-23, and PTH as compared to the normal animals. Oral supplementation of annatto and palm tocotrienol (60 and 100 mg/kg) reduced the levels of sRANKL and FGF-23 in the HCHF animals. Only 100 mg/kg annatto and palm tocotrienol lowered SOST and DKK-1 levels in the HCHF animals. In conclusion, tocotrienol exerts potential skeletal-promoting benefit by modulating the levels of osteocytes-derived bone-related peptides.
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