Effectiveness of a Theory-Based Digital Animated Video Intervention to Reduce Intention and Willingness to Sext Among Diploma Students: Cluster Randomized Controlled Trial.

BACKGROUND: Sexting refers to the exchange of sexually explicit digital content in the form of texts, photos, or videos. In recent years, sexting has become a public health concern. Surveys in Malaysia show a high prevalence of young adults engaged in sexting. Given that sexting is associated with sexual risk behavior, cyberbullying, and mental health issues, this behavior needs intervention to alleviate the resulting public health burden. However, there is a scarcity of theory-based intervention programs on the prevention of intention and willingness to sext among young adults. OBJECTIVE: This study aimed to develop and implement a sexting intervention module guided by the prototype willingness model (PWM), delivered using web-based animated video, and evaluate its effectiveness among diploma students from a public higher educational institution. The primary outcomes were intention and willingness to sext, while the secondary outcomes were knowledge, attitude, perceived norms, and prototype perceptions of sexting. METHODS: This 2-armed, parallel, single-blinded cluster randomized controlled trial was conducted in a public higher educational institution in the state of Melaka, Malaysia. Diploma students from 12 programs were randomly allocated into intervention and control groups. Both groups answered a self-administered web-based questionnaire assessing the outcomes at the baseline. The intervention group received a newly developed intervention module based on the PWM in the form of 5 animated videos posted on a private YouTube platform, while the control group was put on the waitlist. The intervention group was encouraged to discuss any issues raised with the researchers via WhatsApp private chat after viewing the videos. All participants were observed immediately and 3 months postintervention. Data analysis was performed with SPSS (version 26; IBM Corp). A generalized linear mixed model was used to determine the effectiveness of the intervention. RESULTS: There were a total of 300 participants with an attrition rate of 8.3% (n=25). After adjusting for age, sex, relationship status, and the amount of time spent on the web, there were significant differences in the intention to sext (ß=-.12; P=.002; Cohen d=0.23), willingness to sext (ß=-.16; P<.001; Cohen d=0.40), knowledge (ß=.12; P<.001; Cohen d=0.39), attitude (ß=-.11; P=.001; Cohen d=0.31), perceived norms (ß=-.06; P=.04; Cohen d=0.18), and prototype perceptions (ß=-.11; P<.001; Cohen d=0.35) between the intervention and control groups over 3 months. CONCLUSIONS: In this study, the sexting intervention module using the PWM that was delivered via web-based animated videos was effective in reducing intention and willingness to sext as well as in improving knowledge of sexting, attitudes, perceived norms, and prototype perceptions. Therefore, relevant agencies involved in the promotion of sexual and reproductive health among young adults in Malaysia can consider the implementation of this module. TRIAL REGISTRATION: Thai Clinical Trial Registry TCTR20201010002; https://www.thaiclinicaltrials.org/show/TCTR20201002001.

The Effectiveness of Early Food Introduction in Preventing Childhood Allergic Diseases: Protocol for a Systematic Review and Meta-Analysis.

BACKGROUND: Allergic diseases affect around 40% of the pediatric population worldwide. The coexistence of asthma, allergic rhinitis, eczema, and food allergy renders allergy treatment and prevention challenging. Infant feeding strategies recommend avoiding allergenic foods to prevent allergy development and anaphylaxis. However, recent evidence suggests that early consumption of food allergens during weaning in infants aged 4-6 months could result in food tolerance, thus reducing the risk of developing allergies. OBJECTIVE: The aim of this study is to systematically review and carry out a meta-analysis of evidence on the outcome of early food introduction for preventing childhood allergic diseases. METHODS: We will conduct a systematic review of interventions through a comprehensive search of various databases including PubMed, Embase, Scopus, CENTRAL, PsycINFO, CINAHL, and Google Scholar to identify potential studies. The search will be performed for any eligible articles from the earliest published articles up to the latest available studies in 2023. We will include randomized controlled trials (RCTs), cluster RCTs, non-RCTs, and other observational studies that assess the effect of early food introduction to prevent childhood allergic diseases. RESULTS: Primary outcomes will include measures related to the effect of childhood allergic diseases (ie, asthma, allergic rhinitis, eczema, and food allergy). PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines will be followed for study selection. All data will be extracted using a standardized data extraction form and the quality of the studies will be assessed using the Cochrane Risk of Bias tool. A summary of findings table will be generated for the following outcomes: (1) total number of allergic diseases, (2) rate of sensitization, (3) total number of adverse events, (4) improvement of health-related quality of life, and (5) all-cause mortality. Descriptive and meta-analyses will be performed using a random-effects model in Review Manager (Cochrane). Heterogeneity among selected studies will be assessed using the I2 statistic and explored through meta-regression and subgroup analyses. Data collection is expected to start in June 2023. CONCLUSIONS: The results acquired from this study will contribute to the existing literature and harmonize recommendations for infant feeding with regard to the prevention of childhood allergic diseases. TRIAL REGISTRATION: PROSPERO CRD42021256776; https://tinyurl.com/4j272y8a. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/46816.

Effects of an educational intervention on Nigerian midwives' intention to provide planned home birth care.

BACKGROUND: The majority of women in Sokoto, Nigeria prefer homebirths, but midwives are reluctant to provide care in the home setting. As such, many women continue to give birth at home alone or assisted by untrained attendants, which is associated with an increased risk for maternal and neonatal morbidity and mortality. METHODS: A randomized controlled trial was conducted among 226 midwives from 10 health care facilities. The intervention group received an educational program on home birth. A validated questionnaire that evaluated knowledge, attitudes, norms, perceived control, and intention to provide planned home birth care was given at baseline, immediately after the intervention, and at three-months follow-up. Data were analyzed using linear mixed-effect model statistics. RESULTS: Following the intervention, the intervention group demonstrated higher knowledge and more positive attitudes, norms, perceived control, and intention to provide planned home birth care compared with the control group (P < 0.05). No significant changes in the scores of the control group were observed during the study duration (P > 0.05). DISCUSSION: Educating midwives on planned home birth increases their willingness to provide planned home birth care. Health system administrators, policymakers, and researchers may use similar interventions to promote skilled home birth attendance by midwives. Increasing the number of midwives who are willing to attend planned home births provides women at low risk for medical complications with safer options for labor, delivery, and postpartum care.

Facing flood disaster: A cluster randomized trial assessing communities' knowledge, skills and preparedness utilizing a health model intervention.

Floods occur when a body of water overflows and submerges normally dry terrain. Tropical cyclones or tsunamis cause flooding. Health and safety are jeopardized during a flood. As a result, proactive flood mitigation measures are required. This study aimed to increase flood disaster preparedness among Selangor communities in Malaysia by implementing a Health Belief Model-Based Intervention (HEBI). Selangor's six districts were involved in a single-blinded cluster randomized controlled trial Community-wide implementation of a Health Belief Model-Based Intervention (HEBI). A self-administered questionnaire was used. The intervention group received a HEBI module, while the control group received a health talk on non-communicable disease. The baseline variables were compared. Immediate and six-month post-intervention impacts on outcome indicators were assessed. 284 responses with a 100% response rate. At the baseline, there were no significant differences in ethnicity, monthly household income, or past disaster experience between groups (p>0.05). There were significant differences between-group for intervention on knowledge, skills, preparedness (p<0.001), Perceived Benefit Score (p = 0.02), Perceived Barrier Score (p = 0.03), and Cues to Action (p = 0.04). GEE analysis showed receiving the HEBI module had effectively improved knowledge, skills, preparedness, Perceived Benefit Score, Perceived Barrier Score, and Cues to Action in the intervention group after controlling the covariate. Finally, community flood preparedness ensured that every crisis decision had the least impact on humans. The HEBI module improved community flood preparedness by increasing knowledge, skill, preparedness, perceived benefit, perceived barrier, and action cues. As a result, the community should be aware of this module. Clinical trial registration: The trial registry name is Thai Clinical Trials Registry, trial number TCTR20200202002.

COVID-19 Inpatient Deaths and Brought-in-Dead Cases in Malaysia.

Coronavirus disease 2019 (COVID-19) deaths can occur in hospitals or otherwise. In Malaysia, COVID-19 deaths occurring outside of the hospital and subsequently brought to the hospital are known as brought-in-dead (BID) cases. To date, the characteristics of BID COVID-19 cases in Malaysia are not clear. The objectives of this study are 2-fold: to explore the characteristics of 29,155 mortality cases in Malaysia and determine the factors associated with the high probability of BID, using the multilevel logistic regression model. Data on COVID-19 mortality cases from the entire country between March 17, 2020 and November 3, 2021 were retrieved from a national open data source. Of the 29,155 COVID-19 mortality cases, 5,903 (20.2%) were BID. A higher probability of BID (p < 0.05) was seen among individuals aged between 18 and 59 years, non-Malaysians, had no comorbidities, did not receive COVID-19 vaccination, and the interval between the date of death and diagnosis. A high prevalence of BID is an alarming public health issue, as this may signal health system failure at one or several levels and, hence, need urgent attention from relevant stakeholders. Based on the findings of this study, increasing the intensity of the vaccination campaign, addressing any issues faced by noncitizens about to COVID-19 management in- and out-of-hospital, increasing the awareness of signs and symptoms of worsening COVID-19 and, hence, the significance of self-monitoring, and determining the potential gaps in the health system may contribute to their increased risk of deaths.

Non-pharmacological interventions for bone health after stroke: A systematic review.

OBJECTIVE: To examine the effectiveness and safety of non-pharmacological interventions to reduce bone loss among post-stroke adult patients. DATA SOURCES: Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database for Systematic Reviews, MEDLINE, CINAHL, ScienceDirect, Scopus, PubMed and PeDRO databases were searched from inception up to 31st August 2021. METHODS: A systematic review of randomized controlled trials, experimental studies without randomization and prospective cohort studies with concurrent control of non-pharmacological interventions for adult stroke patients compared with placebo or other stroke care. The review outcomes were bone loss, fall and fracture. The Cochrane Risk of Bias Tools were used to assess methodological quality, and Grading of Recommendations, Assessment, Development and Evaluations Framework to assess outcome quality. Synthesis Without Meta-Analysis (SWiM) was used for result synthesis. RESULTS: Seven studies (n = 453) were included. The methodological and outcome qualities varied from low to moderate. There were statistically significant changes between the intervention and parallel/placebo group in bone mineral density, bone mineral content, cortical thickness and bone turnover markers with specific physical and vibration therapies (p<0.05). Falls were higher in the intervention group, but no fracture was reported. CONCLUSION: There was low to moderate evidence that physical and vibration therapies significantly reduced bone loss in post-stroke patients at the expense of a higher falls rate. The sample size was small, and the interventions were highly heterogeneous with different duration, intensities and frequencies. Despite osteoporosis occurring with ageing and accelerated by stroke, there were no studies on vitamin D or protein supplementation to curb the ongoing loss. Effective, high-quality non-pharmacological intervention to improve post-stroke bone health is required.

Risk factors for early TB treatment interruption among newly diagnosed patients in Malaysia.

TB treatment interruption has resulted in delayed sputum conversion, drug resistance, and a high mortality rate and a prolonged treatment course, hence leading to economic and psychosocial affliction. To date, there are limited studies investigating the physico-social risk factors for early treatment interruptions. This prospective multicenter cohort study aimed to investigate the risk factors for early treatment interruption among new pulmonary tuberculosis (TB) smear-positive patients in Selangor, Malaysia. A total of 439 participants were recruited from 39 public treatment centres, 2018-2019. Multivariate Cox proportional hazard analyses were performed to analyse the risk factors for early treatment interruption. Of 439 participants, 104 (23.7%) had early treatment interruption, with 67.3% of early treatment interruption occurring in the first month of treatment. Being a current smoker and having a history of hospitalization, internalized stigma, low TB symptoms score, and waiting time spent at Directly Observed Treatment, Short-course centre were risk factors for early treatment interruption. An appropriate treatment adherence strategy is suggested to prioritize the high-risk group with high early treatment interruption. Efforts to quit smoking cessation programs and to promote stigma reduction interventions are crucial to reduce the probability of early treatment interruption.

Asymptomatic morphometric vertebral fractures and its associated factors: A cross-sectional study among adults in a selected urban area in Selangor, Malaysia.

OBJECTIVE: This study aimed to determine the prevalence of vertebral fractures (VF) in a selected urban population in Malaysia and to explore possible variables associated with VF in the study population. METHODS: A cross-sectional study involving community-living, healthy subjects aged between 45-90 years from the state of Selangor, Malaysia, were invited to attend a bone health check-up. Subjects with diseases known to affect bone metabolism or were on treatment for osteoporosis (OP) were excluded. Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry (DXA). Lateral and antero-posterior view lumbar spine x-rays were performed and VF was determined by the semi-quantitative Genant method. RESULTS: A total of 386 subjects were studied. Asymptomatic morphometric VF were found in 44 (11.4%) subjects. T12 was the most common vertebrae to be fractured. The prevalence of VF was significantly higher in menopausal women (12.4%) compared to non-menopausal women, in those above the age of 60 (18.5%), in those of Chinese ethnicity (16.5%), in those with a low body fat percentage (17.1%) and among those with OP (27.0%). The mean (standard deviation) 25-hydroxyvitamin D [25(OH)D] levels were significantly higher in those with VF compared to those without VF, 67.64 (23.50) and 57.47 (21.71) nmol/L, respectively. However, after multiple regression analysis, age over 60 years and OP on DXA BMD measurement were the only significant associated factors for VF. CONCLUSION: Overall, 11.4% of a selected Malaysian urban population had asymptomatic morphometric VF. Age over 60 years and OP on DXA BMD measurement, but not 25(OH)D levels, were associated with VF.

Determinants of uptake of first dose of intermittent preventive treatment among pregnant women in a secondary health Centre in Maiduguri, Nigeria.

BACKGROUND: Studies on uptake of first dose of intermittent preventive treatment in pregnancy (IPTp) are lacking, despite it being a predictor of subsequent doses. This study aimed at assessing the determinants of uptake of first dose of IPTp among pregnant women at the State Specialist Hospital, Maiduguri. METHODS: A cross-sectional study was conducted, in which respondents were selected using a systematic random sampling method, and structured questionnaires were used to obtain information from them. Chi-squared test was used to determine factors associated with uptake of first IPTp dose, while a further multivariate logistic regression was performed to determine its predictors. RESULTS: Three hundred and eighty respondents answered the survey, whose ages ranged from 15 to 45 years, and 86.8% were multigravid. Sixty five percent of them were aware of IPTp, and 34.7% believed that IPTp could be harmful to their pregnancies. Over a half of the respondents (52.9%) believed that taking all their IPTp medicines was very good for their pregnancies, while 45.0% felt that taking their IPTp medicines was very pleasant. Only two respondents (0.5%) stated that it was very untrue that their significant others thought that they should take all their IPTp medicines. Half of the respondents said it was very easy for them to take all their IPTp medicines even if they were experiencing mild discomforts while taking them. Less than a half (42.37%) had received their first dose of IPTp. In bivariate as well as multivariate analysis, only higher level of knowledge was significantly associated with uptake of first IPTp dose. Those with better knowledge of IPTp were about twice more likely to have taken their first dose of IPTp, compared to those with lower knowledge of IPTp (AOR = 1.85; 95% CI: 1.17-2.92). CONCLUSIONS: Knowledge of IPTp as well as its uptake, were sub-optimal in this study. Since knowledge of IPTp significantly predicts uptake of the first dose of IPTp, there is the need to implement health education campaigns to raise the awareness of pregnant women and their families on the need to receive and comply with it.

Different reference ranges affect the prevalence of osteoporosis and osteopenia in an urban adult Malaysian population.

OBJECTIVES: To determine the prevalence of osteopenia (OPe) and osteoporosis (OP) in an urban adult population in Malaysia, and to compare the change in the prevalence when using a Caucasian compared to an Asian reference range. METHODS: A cross-sectional random sample of the population aged between 45 and 90 years from the state of Selangor, Malaysia, was invited to attend a bone health check-up. Participants with diseases known to affect bone metabolism or who were on treatment for OP were excluded. Bone mineral density was measured using dual energy X-ray absorptiometry. Based on the World Health Organization definitions, the prevalence of OPe and OP was calculated using the Asian and Caucasian T-scores. RESULTS: A total of 342 subjects (222 females, 120 males), with a mean age of 59.68 (standard deviation: 8.89) years, who fulfilled the study criteria were assessed. Based on the Asian reference range, there were 140 (40.9%) subjects with OPe and 48 (14.0%) with OP. On applying the Caucasian reference range, there were 152 (44.4%) subjects with OPe and 79 (23.1%) with OP, with significant increases in males, females, and Chinese ethnic groups. Overall, 75 (21.9%) of subjects had a change in their diagnostic status. T-scores were consistently lower when the Caucasian reference range was used. CONCLUSIONS: In a healthy urban Malaysian population, the prevalence of OP is 14.0% and OPe is 40.9%. Application of a Caucasian reference range significantly increased the number of subjects with OP and may potentially lead to over-treatment.

Sociodemographic and health care factors in determining immunization defaulters among preschool children in Petaling District, Selangor: a cross-sectional study in Malaysia.

BACKGROUND: Immunization is an effective public health intervention to reduce morbidity and mortality among children and it will become more effective if the child can receive the full course of recommended immunization doses. The objective of this study was to determine the prevalence of childhood immunization defaulters and its associated factors among children below 5 years attending registered child care centers in Petaling District, Selangor. METHODS: This was a cross-sectional survey among mothers with children below 5 years from 60 registered child care centers in District of Petaling, Selangor. Data was collected by a self-administered questionnaire from a total of 1015 mothers. Simple Logistic Regression, Chi-square or Fisher's exact test were performed to determine the association between individual categorical variables and childhood immunization defaulters. Multivariate logistic regression was used to determine the predictors of childhood immunization defaulters. RESULTS: The study showed that the prevalence rate for defaulting immunization was 20.7%. After adjusting all confounders, six statistically significant predictors of childhood immunization defaulters were determined. They were non-Muslims (aOR = 1.669, 95% CI = 1.173, 2.377, p = 0.004), mothers with diploma and below educational background (aOR = 2.296, 95% CI = 1.460, 3.610, p < 0.0001), multiple children of 5 and above in a family (aOR = 2.656, 95% CI = 1.004, 7.029, p = 0.040), mothers with younger children aged 2 years and below (aOR = 1.700, 95% CI = 1.163, 2.486, p = 0.006), long travelling time of more than 30 min to the immunization health facility (aOR = 2.303, 95% CI = 1.474, 3.599, p < 0.0001) and had delayed at least one of the immunization schedule (aOR = 2.747, 95% CI = 1.918, 3.933, p < 0.0001). CONCLUSION: This study highlights the need of implementation of intervention programs should be intensified to improve the childhood immunization status, focusing on the Non-Muslim community, mothers with low educational level, mothers with multiple children and mothers with children aged 2 years and below. In light of the growing problem of immunization defaulters in Malaysian children, identifying mothers at risk of not completing their children immunization schedule and educating them is an important strategy to recurrent outbreaks of infectious disease in the country.

Fractional exhaled nitric oxide (FeNO) among office workers in an academic institution, Malaysia--associations with asthma, allergies and office environment.

OBJECTIVE: There are few studies on fractional exhaled nitric oxide (FeNO) and respiratory symptoms among adults in tropical areas. The aim was to study associations between FeNO and selected personal factors, respiratory symptoms, allergies, office characteristics and indoor office exposures among office workers (n = 460) from a university in Malaysia. METHODS: Information on health was collected by a questionnaire, skin prick test and FeNO measurement. Temperature, relative air humidity, carbon monoxide and carbon dioxide were measured in the offices. Settled dust was vacuumed in the offices and analyzed for endotoxin, (1,3)-ß-glucan and house dust mites allergens, namely Dermatophagoides pteronyssinus (Der p 1) and Dermatophagoides farinae (Der f 1). Two-level linear mixed models and multiple logistic regression were used to analyze the associations. RESULTS: One-fourth (25.9%) of the office workers had elevated FeNO level (≥ 25 ppb) and 61.5% had HDM, cat, seafood or pollen allergy. Male gender (p < 0.001), current smoking (p = 0.037), height (p < 0.001) and atopy (p < 0.001) were associated with FeNO. The amount of vacuumed dust was associated with FeNO among atopic subjects (p = 0.009). Asthma and rhinitis symptoms were associated with FeNO (p < 0.05), especially among atopic subjects. In particular, a combination of atopy and elevated FeNO were associated with doctor-diagnosed asthma (p < 0.001), rhinitis (p < 0.001) and airway symptoms last 12 months (p < 0.001). CONCLUSION: Gender, smoking, height and atopy are important risk factors for elevated FeNO levels. A combination of allergy testing and FeNO measurement could be useful in respiratory illness epidemiology studies and patient investigations in tropical areas.

Predictors affecting breast self-examination practice among undergraduate female students in Klang Valley, Malaysia.

AIM: Breast cancer is the most common cancer among women worldwide, including Malaysia. In developing countries, predictors affecting breast self-examination (BSE) practice are different. This cross-sectional study was conducted to determine the prevalence of BSE practice and the predictors affecting BSE practice among undergraduate female students in Klang Valley, Malaysia. MATERIAL AND METHODS: A cross-sectional study was conducted among 820 female undergraduate students to assess the BSE performance and related determinants of BSE practice in Klang Valley, Malaysia. Data were collected via a self-administered structured questionnaire that was developed for this study. RESULTS: The mean age of the respondents was 21.7 ± 1.2 years old. Most of them were single (96.8%), Malay (91.9%) and 19.6% of the participants performed BSE regularly. Multivariate logistic regression modeling revealed that BSE performance was more likely among women who have checked their breast with a doctor (odds ratio = 2.04, P = 0.00), and women who have personal history of breast disease (odds ratio = 4.43, P = 0.03). CONCLUSION: The findings showed a low BSE practice rate among young Malaysian women. Hence, the community's breast health awareness is needed to improve breast cancer prevention among young Malaysian women.

Sick building syndrome (SBS) among office workers in a Malaysian university--Associations with atopy, fractional exhaled nitric oxide (FeNO) and the office environment.

There are few studies on sick building syndrome (SBS) including clinical measurements for atopy and fractional exhaled nitric oxide (FeNO). Our aim was to study associations between SBS symptoms, selected personal factors, office characteristics and indoor office exposures among office workers from a university in Malaysia. Health data were collected by a questionnaire (n=695), skin prick test (SPT) (n=463) and FeNO test (n=460). Office settled dust was vacuumed and analyzed for endotoxin, (1,3)-ß-glucan and house dust mites (HDM) allergens group 1 namely Dermatophagoides pteronyssinus (Der p 1) and Dermatophagoides farinae (Der f 1). Office indoor temperature, relative air humidity (RH), carbon monoxide (CO) and carbon dioxide (CO2) were measured by a direct reading instrument. Associations were studied by two-levels multiple logistic regression with mutual adjustment and stratified analysis. The prevalence of weekly dermal, mucosal and general symptoms was 11.9%, 16.0% and 23.0% respectively. A combination of SPT positivity (allergy to HDM or cat) and high FeNO level (≥25 ppb) was associated with dermal (p=0.002), mucosal (p<0.001) and general symptoms (p=0.05). Der f1 level in dust was associated with dermal (p<0.001), mucosal (p<0.001) and general (p=0.02) symptoms. Among those with allergy to D. farinae, associations were found between Der f 1 levels in dust and dermal (p=0.003), mucosal (p=0.001) and general symptoms (p=0.007). Office-related symptoms were associated with Der f 1 levels in dust (p=0.02), low relative air humidity (p=0.04) and high office temperature (p=0.05). In conclusion, a combination of allergy to cat or HDM and high FeNO is a risk factor for SBS symptoms. Der f 1 allergen in dust can be a risk factor for SBS in the office environment, particularly among those sensitized to Der f 1 allergen.

Asthma, Airway Symptoms and Rhinitis in Office Workers in Malaysia: Associations with House Dust Mite (HDM) Allergy, Cat Allergy and Levels of House Dust Mite Allergens in Office Dust.

A prevalence study was conducted among office workers in Malaysia (N= 695). The aim of this study was to examine associations between asthma, airway symptoms, rhinitis and house dust mites (HDM) and cat allergy and HDM levels in office dust. Medical data was collected by a questionnaire. Skin prick tests were performed for HDM allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae) and cat allergen Felis domesticus. Indoor temperature and relative air humidity (RH) were measured in the offices and vacuumed dust samples were analyzed for HDM allergens. The prevalence of D. pteronyssinus, D. farinae and cat allergy were 50.3%, 49.0% and 25.5% respectively. Totally 9.6% had doctor-diagnosed asthma, 15.5% had current wheeze and 53.0% had current rhinitis. The Der p 1 (from D. pteronyssinus) and Der f 1 (from D. farinae) allergens levels in dust were 556 ng/g and 658 ng/g respectively. Statistical analysis was conducted by multilevel logistic regression, adjusting for age, gender, current smoking, HDM or cat allergy, home dampness and recent indoor painting at home. Office workers with HDM allergy had more wheeze (p= 0.035), any airway symptoms (p= 0.032), doctor-diagnosed asthma (p= 0.005), current asthma (p= 0.007), current rhinitis (p= 0.021) and rhinoconjuctivitis (p< 0.001). Cat allergy was associated with wheeze (p= 0.021), wheeze when not having a cold (p= 0.033), any airway symptoms (p= 0.034), doctor-diagnosed asthma (p= 0.010), current asthma (p= 0.020) and nasal allergy medication (p= 0.042). Der f 1 level in dust was associated with daytime breathlessness (p= 0.033) especially among those with HDM allergy. Der f 1 levels were correlated with indoor temperature (p< 0.001) and inversely correlated with RH (p< 0.001). In conclusion, HDM and cat allergies were common and independently associated with asthma, airway symptoms and rhinitis. Der f 1 allergen can be a risk factor for daytime breathlessness.

Exploring cancer development in adulthood: cholinesterase depression and genotoxic effect from chronic exposure to organophosphate pesticides among rural farm children.

Children are the vulnerable group in the agricultural community due to their early exposure to pesticides through the dynamic interplay between genetic predisposition, environment, and host-related factors. This study aims to identify the possible association between the depression in blood cholinesterase level and genotoxic effect among farm children. The results of micronuclei assay and comet assay showed that the reduced blood cholinesterase level from organophosphate pesticide exposure is significantly associated with an increase in chromosome breakage and DNA strand breaks. These genotoxicity end points suggest that farm children's cells experience early DNA damage that may lead to uncontrolled cell proliferation during their adulthood. Thus, farm children who grow up near pesticide-treated farmland have a higher probability of developing cancer than children with minimal or zero exposure to pesticides.

The Socio-Demographic and Clinical Factors Associated with Quality of Life among Patients with Haematological Cancer in a Large Government Hospital in Malaysia

Background: The paper examined the quality of life of haematological cancer patients according to their socio-demographic profiles and clinical diagnoses. Methods: This cross-sectional study was conducted at the tertiary referral centre of Ampang Hospital, Kuala Lumpur, involving 105 patients. The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) questionnaire was used to measure their quality of life. Results: The study involved patients diagnosed with all types of haematological cancer, including non-Hodgkin lymphoma (NHL), acute myelogenous leukaemia (AML), acute lymphoblastic leukaemia (ALL), Hodgkin lymphoma (HL), and multiple myeloma (MM), with a response rate of 83.3%. The patients with ALL, HL, without NHL, and without MM were younger than other patients. There were significant differences in quality of life scores in different socio-demographic groups and types of cancer diagnosis. The global quality of life of the female patients was much better than that of the male patients. Patients who were 40 years old or younger had a better global quality of life and physical functioning, as well as fewer symptoms of constipation, nausea, and vomiting. Employed patients were in less pain but showed greater impairments of cognitive function than did unemployed patients. Patients who earned a monthly wage of RM1000 or less had reduced physical function, more symptoms of pain, and more financial difficulties compared with patients who earned more. Patients with AML tended to have better physical functioning than did patients with MM, whose physical functioning was impaired. Comparatively, more symptoms of dyspnoea were found in ALL and HL patients than in other types of lymphoma. Compared with other patients, those with ALL had a greater loss of appetite, and other lymphoma patients had fewer symptoms of pain. Patients with NHL had impaired role functioning and more constipation compared with other patients. The results were all statistically significant (P < 0.05). Conclusion: The quality of life of haematological cancer patients is affected by sociodemographic factors and clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients.