International Journal of Public Health Research <p>International Journal of Public Health Research (IJPHR) is a free and open access, published by Department of Community Health, Universiti Kebangsaan Malaysia Medical Center. Articles published in this journal are being peer-reviewed, referred and cited by international authors. This journal is indexed in :</p> <ul> <li class="show">My Jurnal (Malaysian Citation Centre)</li> <li class="show">Western Pacific Region Index Medicus</li> <li class="show">Scientific Indexing Services</li> <li class="show">Google Scholar</li> <li class="show">Asean Citation Index</li> <li class="show">DOI (Digital Object Identifier)</li> </ul> Universiti Kebangsaan Malaysia en-US International Journal of Public Health Research 2232-0245 <span>IJPHR applies the </span><a href="">Creative Commons Attribution (CC BY) license</a><span> to articles and other works we publish. If you submit your paper for publication byIJPHR, you agree to have the CC BY license applied to your work. Under this Open Access license, you as the author agree that anyone can reuse your article in whole or part for any purpose, for free, even for commercial purposes. Anyone may copy, distribute, or reuse the content as long as the author and original source are properly cited. This facilitates freedom in re-use and also ensures that IJPHR content can be mined without barriers for the needs of research.</span> Support of smoking restriction in public areas among adolescents in Malaysia-The findings from Tobacco and E-Cigarette Survey among adolescents in Malaysia (TECMA) <p><strong>Introduction: </strong>Adolescents are the future generation, and their support for smoke-free policies might create momentum for future stringent smoke-free initiatives. This study aimed to determine the levels and factors associated with support for smoking in public areas among Malaysian school-going adolescents aged 10-19 years.</p> <p><strong>&nbsp;</strong></p> <p><strong>Methods: </strong>The data were derived from the Tobacco and E-cigarettes among adolescents in Malaysia (TECMA), which employed the cross-sectional study design and multistage sampling to select the representative samples of school-going adolescents. Data was obtained through self-administered of pre-validated questionnaire. Descriptive study, cross-tabulation and multivariable analysis were used for analysis</p> <p><strong>&nbsp;</strong></p> <p><strong>Result: </strong>Majority of respondents supported smoking restriction in public areas (86.3%, 95 CI 85.4-87.1). The proportion and likelihood of support of smoke-free initiative were higher among respondents with better knowledge of the harmful effects of second-hand smoke (SHS), been taught in school about the health effects of smoking, older age group (16-19 years), female, those students schooling in urban areas, Malay and other Bumiputras from Sabah and Sarawak. However, current smokers and ECV users were less likely to support smoke-free initiatives in public areas.&nbsp;</p> <p>&nbsp;</p> <p><strong>Conclusion: </strong>The level of support for smoke-free initiative in public areas was high among youths in Malaysia, and this might offer promising prospects to expand the non-smoking areas to more public areas in the future. &nbsp;</p> <p>.</p> <p>&nbsp;</p> <p><strong>Keywords: </strong>smoke-free public area, level of support, school-going adolescent,smoking status, TECMA</p> Kuang Hock Lim Pei Pei Heng Hui Li Lim Yoon Ling Cheong Chee Cheong Kee Sumarni Mohd Ghazali Jia Hui Lim ##submission.copyrightStatement## 2021-10-07 2021-10-07 12 1 Construct validity and reliability of Malay Language-perception towards smoking questionnaire (BM-PTSQ) among secondary school adolescents <p><strong>Introduction</strong>: Multitude studies have shown perception is an integral factor associated with smoking, However, no such tool was available in Malay language. In this study, we established a Bahasa Malaysia version of PTSQ (BM-PTSQ) and tested the validity and reliability among secondary school adolescents.&nbsp;</p> <p><strong>Methods</strong>: The English version of PTSQ originally consists of 12 items. It was translated into Bahasa Malaysia and back-translated again into English to check for consistency. After face validity (face-to-face query) was determined among 20 secondary school adolescents, only 10 items were included in the survey.&nbsp;Construct validity &nbsp;was established from 407 school adolescents through random selection in the same locality. More than 60% of the respondents were female, a majority (67.3%) were schooling in rural areas. Then, the reliability of the questionnaire was determined with Cronbach’s alpha.</p> <p><strong>Results</strong>: &nbsp;EFA&nbsp;has grouped PTSQ into two components, they are associated with either knowledge or attitude towards smoking. The variance and Cronbach’s alpha for the first and second component were 38.24% and 0.861 (7 items) and 21.62% and 0.661 (3 items) respectively.&nbsp;</p> <p><strong>Conclusion</strong>:&nbsp;&nbsp;The PTSQ showed good validity and reliability for measurement of perception in smoking among school adolescents in Malaysia, thus this is a viable measurement tool. More importantly this study shows an urgent need to improve the smoking education among adolescents in Malaysia.&nbsp;&nbsp;</p> Jia Hui Lim Kuang Hock Lim LIM KUANG HOCK Sumarni Mohd Ghazali Pei Pei Heng Yoon Ling Cheong Hui Li Hock Lim Chee Cheong Kee Yee Lin Goh Khuen Yen Ng ##submission.copyrightStatement## 2022-02-09 2022-02-09 12 1 Aetiologies of Liver Cirrhosis among Adult Patients attending a Hepatology Clinic at Selangor, Malaysia <p><strong>Introduction:</strong> Liver cirrhosis is an important cause of morbidity and mortality.</p> <p><strong>Methods: </strong>Our study aimed to describe the clinical pattern of cirrhosis and its associated factors among adult patients attending Hepatology Clinic, Serdang Hospital, Malaysia from 1<sup>st</sup>&nbsp;January 2010 to 30<sup>th </sup>June 2017. Aetiology was further determined by history, biochemistry and/or histology. The severity of the cirrhosis, together with the presence of complications and incidence of hepatocellular carcinoma were documented.</p> <p><strong>Results: </strong>A total of 357 adult patients were diagnosed with cirrhosis including 199 male patients (55.7%) and 158 female patients (44.3%), with a mean age of 54-year-old (range: 28–84 –year-old). The causes of cirrhosis were chronic hepatitis B (N=145, 40.6%), chronic hepatitis C (N= 67, 18.8%), cryptogenic liver disorder (N= 63, 17.6%), alcohol (N=42, 11.8%), non-alcoholic fatty liver disease (N=25, 7.0%), and others (N=15, 4.2%). Chronic hepatitis B was the predominant aetiology among Chinese whereas alcohol was the main aetiology among Indians, and Hepatitis C cirrhosis was highest among Malays. Majority of the patients had compensated cirrhosis with Child-Pugh A (N=221, 61.9%) at the time of diagnosis. 80.4% (N=287) of the cirrhotic patients had performed at least one endoscopy surveillance, with 28.6% (82/287) of them had endoscopic evidence of portal hypertension. 32.2% of patients had at least one hospitalization due to complication of cirrhosis. 41 patients (11.5%) had concurrent hepatocellular carcinoma during the follow up.</p> <p><strong>Conclusions: </strong>Despite universal hepatitis B vaccination, Hepatitis B viral infection remains the most common cause of cirrhosis among patients attending Hepatology Clinic, Serdang Hospital. </p> <p><strong>Keywords: Aetiology - Liver cirrhosis - Malaysia</strong></p> Chieng Jin Yu Pan Yan Liew Chiat Fong Mazawawi Muhammad Syed Anas Tamamulqomar Said Abu Hass ##submission.copyrightStatement## 2022-02-14 2022-02-14 12 1 Physical Inactivity and Its Associated Factors among Adults in Malaysia: Findings from National Health and Morbidity Survey (NHMS) 2019 <p><strong>Introduction:</strong> Physical inactivity has been identified as the fourth leading risk factor for worldwide mortality with major implications towards general health. Monitoring the level of physical inactivity may reduce the burden of non-communicable diseases (NCDs) and their risk factors. This study aims to determine the prevalence of physical inactivity and its associated factors among adults aged 18 years and above in Malaysia.</p> <p><strong>Methodology:</strong> Data was obtained from the National Health and Morbidity Survey (NHMS) 2019. It was a cross-sectional, population-based survey which employed two- stage stratified random sampling design. A total of 10,356 out of 10,472 respondents were interviewed using a short version of International Physical Activity Questionnaire (IPAQ).</p> <p><strong>Results:</strong> Overall, the prevalence of physical inactivity among adults aged 18 years and above in Malaysia was 24.6% (95% CI: 23.2, 26.1). Results from multivariable logistic model showed that Chinese ethnicity (aOR 1.32; 95% CI: 1.04, 1.67), urban dwellers (aOR 1.30; 95% CI: 1.07, 1.57), those who were single (including widow, widower and divorcee) (aOR 1.36; 95% CI: 1.14, 1.61), students (aOR 2.10; 95% CI: 1.30, 3.40), higher household income earners (aOR 1.34; 95% CI: 1.07, 1.68) and those with hypercholesterolaemia (aOR 1.25; 95% CI: 1.03, 1.51) were significantly more likely to be physically inactive.</p> <p><strong>Conclusion:</strong> Specific and appropriate intervention towards targeted group is in crucial need to increase the level of physical activity and to promote an active living towards an active and healthy Malaysia.</p> Nazirah Alias Chan Ying Ying Lim Kuang Kuay Ahzairin Ahmad Halizah Mat Rifin Nik Adilah Shahein Azli Baharudin ##submission.copyrightStatement## 2022-02-17 2022-02-17 12 1 Aduan Di Hospital Sultan Ismail Johor Bahru Dan Faktor Yang Mempengaruhi Tuntutan Pampasan <p><strong>ABSTRACT</strong></p> <table> <tbody> <tr> <td width="113"> <p><strong>Introduction:</strong></p> </td> <td width="470"> <p>Complaints in the health care system are complaints made by patients or patient’s relatives due to various reasons such as poor quality of service or unmeet expectations. There are few studies done measuring the prevalence of hospital’s complaints but none being done in Hospital Sultan Ismail Johor Bahru and very limited study looking at factors associated with it and with compensation claims. This study aims to identify complaints at Hospital Sultan Ismail Johor Bahru and factors associated with complaints and with compensated claims.</p> </td> </tr> <tr> <td width="113"> <p><strong>Methods</strong></p> </td> <td width="470"> <p>A cross sectional study was done at Hospital Sultan Ismail Johor Bahru using a data from 1<sup>st</sup> January 2009 until 31<sup>st</sup> December 2016. All relevant data was taken from the complaint data collected by the hospital Complaints Management Committee.</p> </td> </tr> <tr> <td width="113"> <p><strong>Results</strong></p> </td> <td width="470"> <p>The study found a total of 304 complaints data with a prevalence of 0.13 per 1000 patient arrivals. Out of these complaints, 16.7% were compensation claims. 51.5% of complainants were male and 67.4% were Malays. 46.2% of complaints were related to clinical management, 61.4% were made against the doctor. Only 12.1% complaints were related to mortality and 11.4% related to morbidity. This study also found that there was significant relationship between race, type of complaint and disease factor with complaints.</p> </td> </tr> <tr> <td width="113"> <p><strong>Conclusions</strong></p> </td> <td width="470"> <p>Compensation claims were highly related to clinical management and disease factors. These complaints should investigate thoroughly to see what can be done or to be improved in the future.</p> </td> </tr> <tr> <td width="113"> <p><strong>Keywords</strong></p> </td> <td width="470"> <p>Complaints, patient’s complaint, compensation claims</p> </td> </tr> </tbody> </table> <p><strong>&nbsp;</strong></p> <p><strong>&nbsp;</strong></p> <p><strong>ABSTRAK</strong></p> <p><strong>&nbsp;</strong></p> <table> <tbody> <tr> <td width="113"> <p><strong>Pengenalan:</strong></p> </td> <td width="470"> <p>Aduan dalam sistem rawatan kesihatan adalah aduan yang dibuat oleh pesakit atau saudara-mara pesakit kerana pelbagai alasan seperti kualiti perkhidmatan yang buruk atau harapan yang tidak dipenuhi. Terdapat beberapa kajian yang dilakukan untuk mengukur berlakunya aduan hospital tetapi tidak ada yang dilakukan di Hospital Sultan Ismail Johor Bahru dan kajian yang sangat terhad melihat faktor-faktor yang berkaitan dengannya dan dengan tuntutan pampasan. Kajian ini bertujuan untuk mengenal pasti aduan di Hospital Sultan Ismail Johor Bahru dan faktor-faktor yang berkaitan dengannya dan dengan tuntutan pampasan<strong>.</strong></p> </td> </tr> <tr> <td width="113"> <p><strong>Metodologi</strong><strong>:</strong></p> </td> <td width="470"> <p>Kajian ini menggunakan kaedah keratan lintang <em>(cross sectional study).</em> Data diambil dari jumlah aduan terkumpul oleh Jawatankuasa Pengurusan Aduan Hospital Sultan Ismail Johor Bahru bermula dari 1 Januari 2009 sehingga 31 Disember 2016.</p> </td> </tr> <tr> <td width="113"> <p><strong>Hasil Kajian:</strong></p> </td> <td width="470"> <p>Hasil kajian mendapati terdapat 304 data aduan dengan prevalens 0.13 per 1000 kedatangan pesakit. Seramai 16.7% pengadu telah membuat tuntutan pampasan. Kebanyakan pengadu adalah terdiri daripada lelaki (51.5%) dengan (67.4%) adalah berbangsa Melayu.&nbsp; Sejumlah (46.2%) aduan adalah berkaitan pengurusan klinikal, (61.4 %) aduan dibuat terhadap perkhidmatan doktor manakala (12.1%) aduan adalah berkaitan mortaliti dan (11.4%) berkaitan morbiditi. Kajian ini juga mendapati terdapat hubungan di antara bangsa, jenis aduan dan faktor penyakit dengan tuntutan pampasan.</p> </td> </tr> <tr> <td width="113"> <p><strong>Kesimpulan</strong></p> </td> <td width="470"> <p>Aduan berkaitan pengurusan klinikal dan faktor penyakit mempunyai hubungan signifikan dengan pengadu yang menuntut pampasan. Oleh itu, aduan ini harus disiasat secara menyeluruh untuk mengetahui apa yang perlu dilakukan atau diperbaiki supaya kejadian tidak berulang pada masa akan dating.</p> </td> </tr> <tr> <td width="113"> <p><strong>Kata Kunci &nbsp;&nbsp; </strong></p> </td> <td width="470"> <p>Aduan, aduan pesakit, tuntutan pampasan</p> </td> </tr> </tbody> </table> <p><strong>&nbsp;</strong></p> <p><strong>&nbsp;</strong></p> Marsom Surya Azimatun Noor Aizuddin Hanuzah Omar ##submission.copyrightStatement## 2022-02-18 2022-02-18 12 1 Analisis Kualiti Hidup Pesakit Kanser Prostat di Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur <p><strong>Abstrak</strong></p> <p>Kanser prostat merupakan ketiga tertinggi bagi golongan lelaki di Malaysia.&nbsp; Data 2018 melaporkan kanser prostat mencatatkan insiden 1,807 kes berbanding 1,186 kes pada tahun 2014 (Globocan 2018). &nbsp;Kanser prostat ini turut memberi kesan terhadap beban penyakit serta beban ekonomi kepada negara dan memberi kesan terhadap kualiti hidup pesakit terutamanya pesakit berumur melebihi 65 tahun. Kajian ini dilakukan bagi mengukur tahap kualiti hidup pesakit kanser prostat dan menentukan faktor-faktor yang mempengaruhi kualiti hidup pesakit tersebut. Reka bentuk kajian adalah tirisan melintang yang dilakukan dari Januari sehingga Disember 2018. Sampel kajian terdiri daripada pesakit kanser prostat yang didiagnos dan mendapatkan rawatan di Klinik Urologi, Jabatan Pembedahan dan Jabatan Onkologi dari tahun 2008 hingga 2017. Kajian menggunapakai set soal selidik EORTC QLQ-C30 dan EORTC QLQ-PR25 yang telah diterjemahkan ke Bahasa Melayu. Seramai 193 pesakit telah mengambil bahagian. Analisis mendapati tahap kanser memberi perbezaan yang signifikan kepada status kesihatan serta fungsi dan simptom kanser prostat (p &lt; 0.001). Analisis faktor penentu mendapati umur , skor Gleason dan juga tahap lewat kanser merupakan faktor penentu kepada kualiti hidup pesakit kanser prostat (p &lt; 0.05). Langkah kesedaran, saringan serta rawatan awal dilihat perlu dipertingkatkan bagi meningkatkan tahap kualiti hidup pesakit kanser prostat di hospital ini.</p> <p><strong>Kata-Kunci</strong>: kualiti hidup – kanser prostat – faktor penentu</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p><strong>Abstract</strong></p> <p>Prostate cancer is the third commonest type of cancer among males in Malaysia that reported prostate cancer recorded 1,807 cases in 2018 compared to 1,186 cases in 2014 (Globocan 2018). Prostate cancer also is known to cause burden of disease and economic burden of the country and affects the quality of life of patients. &nbsp;This study conducted to assess the quality of life of prostate cancer patients and to determine the predictor factors that affect the quality of life of the patient. The study design was a cross-sectional conducted from January to December 2018. The study sample consists of prostate cancer patients diagnosed and sought treatment at the Urology Clinic, Department of Surgery and Oncology Department from 2008 to 2017. The study adopted the set of EORTC QLQ-C30 and EORTC QLQ-PR25 which has been translated into Malay. A total of 193 patients participated. The analysis found that cancer levels had a significant difference in health status and the function and symptoms of prostate cancer (p &lt;0.001) in different stage of cancer. Multivariable analysis found that age, Gleason scores and advance-stage of cancer were predictor factors for the quality of life of prostate cancer patients. Awareness, early detection and treatment measures need to be enhanced to improve the quality of life of prostate cancer patients in the hospital.</p> <p>&nbsp;</p> <p><strong>Keywords</strong>: Predictor factor – prostate cancer – quality of life</p> <p>&nbsp;</p> Norzaher Ismail Syafiq Taib Siti Nor Mat Shamsul Azhar Shah ##submission.copyrightStatement## 2022-02-18 2022-02-18 12 1 Six Sigma Practices Integrated with IR 4.0 for Sustainability in Malaysian Healthcare Industry <p>Provision of safe, reliable, and affordable care while improving performance and efficiency remains a challenge in the healthcare sector. This study, therefore, reviews the previous researches on the effect of six sigma and industrial revolution 4.0 technologies (IR 4.0) on sustainability as there is still a paucity of literature on the implementation of the practices in the healthcare sector. Notably, the growing challenges within service organizations have motivated healthcare organizations to upgrade their conventional delivery system to a smart sophisticated systems. Thus, this present study makes an attempt to model these practices as integrated with IR 4.0 technologies into achieving sustainability in the healthcare industry. In order to fill the void of this gap, this study intends to investigate the joint effects of six sigma and IR 4.0 technologies on sustainable performance of healthcare delivery services. The study confirms the future direction of the public health sector that is recently employing new technologies in its service systems. The data shall be collected from the top management employees, the health practitioners who are working and familiar with the services and operations of the organization and are familiar with the smart tools to expedite services for healthcare. This study extends the current literature on IR 4.0 technologies and six-sigma as enablers of economic, environmental and social sustainability. This study shall unfold the significant contribution of operations management practices and how sustainable performance can be enhanced through performance variation and strategic implementation of modern technologies in the healthcare sector.</p> Diekola Muslim Akanmu Norshahrizan Nordin ##submission.copyrightStatement## 2022-02-25 2022-02-25 12 1 Perception about E-Cigarettes in Malaysia: Sociodemographic Correlates <p>Introduction: The prevalence of e-cigarette smoking is increasing. Many people still have a poor understanding of the risks of e-cigarettes. The purpose of this study is to examine sociodemographic factors associated with knowledge about e-cigarettes with a focus on the perception that e-cigarettes are less dangerous than regular cigarettes. <br>Methods: Multivariable logistic regressions are utilised to estimate the effects of sociodemographic factors on the likelihood of having the perception that e-cigarettes are less dangerous than regular cigarettes. These regressions are stratified by ethnic groups. A Malaysian nationwide survey that consists of a large sample size (n = 4176) is used for secondary analysis. <br>Results: Age, gender and educational level are associated with the perception about e-cigarettes. Older individuals are less likely to think that e-cigarettes are less dangerous than regular cigarettes compared with younger individuals. Males are more likely to have the perception that e-cigarettes are less dangerous than regular cigarettes relative to females. Having primary or secondary educational level rather than tertiary educational level is associated with a reduced likelihood of having the perception that e-cigarettes are less dangerous than regular cigarettes. <br>Conclusions: Sociodemographic factors play an important role in determining the perception about e-cigarettes. Nationwide policies directed toward improving knowledge about e-cigarettes among individuals who think that e-cigarettes are less dangerous than regular cigarettes may be effective in lowering the risk of suffering from the currently unknown long-term negative effect of e-cigarettes.</p> Yong Kang Cheah Chien Huey Teh Kuang Hock Lim Chee Cheong Kee ##submission.copyrightStatement## 2022-03-03 2022-03-03 12 1 Cessation of E-Cigarette Use Among Adults in Malaysia: Findings from a Nationwide Survey <p><strong>Introduction</strong></p> <p>The use of e-cigarettes has increased rapidly around the world including in Malaysia. However, a significant proportion of people who started using e-cigarettes later discontinued using them. The aim of this study is to identify prevalence of former e-cigarette use and factors associated with quitting, among Malaysian adults.</p> <p><strong>Methods</strong></p> <p>This study is a part of a national household survey examining the use of e-cigarettes among Malaysian adults aged 18 years and above in 2016. A multistage stratified cluster sampling method was used in the survey. A bilingual (Malay and English) structured questionnaire was used and data was collected via face-to-face interview. Prevalence of current e-cigarette use and former e-cigarette use were determined. A multiple logistic regression model was used to identify factors associated with quitting e-cigarettes.</p> <p><strong>Results</strong></p> <p>A total of 4,288 adults participated in the survey, where 110 (3.2%) and 289 (8.6%) were identified as current and former e-cigarette users respectively. The following factors were significantly associated with quitting e-cigarette use: e-cigarette users who had no exposure to e-cigarettes at the workplace (aOR = 2.70; 95% CI: 1.39, 5.24); the perception that e-cigarette is more harmful to others compared to tobacco smoke (aOR = 2.46; 95% CI: 1.22, 4.97); and the perception that e-cigarettes do not help people to maintain cigarette abstinence (aOR = 2.19; 95% CI: 1.23, 3.92).</p> <p><strong>Conclusions</strong></p> <p>This study contributes to a better understanding of the factors associated with cessation of e-cigarettes. Findings from this study can assist any e-cigarette cessation intervention measures.</p> Muhammad Fadhli Mohd Yusoff Jane Ling Miaw Yn Thamil Arasu Saminathan Jamaluddin Ab Rahman Wan Shakira Rodzlan Hasani Tania Gayle Robert Lourdes Kuang Hock Lim Sumarni Mohd Ghazali Mohamad Haniki Nik Mohamed ##submission.copyrightStatement## 2022-03-04 2022-03-04 12 1 Knowledge and Attitude of Universiti Kebangsaan Malaysia (UKM) Medical Students on Forest Bathing <p><strong>ABSTRACT</strong></p> <p><strong>Background and aims</strong>: Forest bathing or Shinrin-Yoku is a practice of being mindful of nature and it offers multiple health benefits in both physiological and psychological factors. This study aimed to determine the knowledge and attitude of Universiti Kebangsaan Malaysia (UKM) medical students towards forest bathing and its relationship with the sociodemographic factors.</p> <p><strong>Materials and methods</strong>: A total of 165 UKM medical students were recruited using proportionate random sampling. The subjects were then categorized based on the academic year (Year 1 - Year 5). Exclusion criteria includes those who deferred their academic year and/or who were hospitalized. A questionnaire was given via a google form consisting of sociodemographic data details and 15 questions for each knowledge and attitude on forest bathing.&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</p> <p><strong>Results</strong>: The prevalence of good knowledge and good attitude of UKM medical students towards forest bathing were 64.2% (n=106) and 50.9% (n=84) respectively. Female medical students had a good knowledge (n=63, 73.3%) and good attitude (n=52, 60.5%) compared to male medical students’ knowledge (n=43, 54.4%) and attitude (n=32, 10.5%) leading to a p-value of 0.012 and p-value of 0.010. Otherwise, other sociodemographic factors including race, level of medical year and level of lifestyle did not affect participants’ knowledge and attitude on forest bathing.</p> <p><strong>Conclusion</strong>: Majority of UKM medical students have a higher prevalence of good knowledge compared to good attitude on forest bathing. Therefore, intervention is recommended especially towards male medical students as forest bathing has enough evidence as preventive medicine.</p> <p><strong>Keywords</strong>: Shinrin-yoku, Preventive medicine, Nature therapy, Malaysia.</p> Aaron Ignatius Sze Lynn Teo Wan Muhammad Aiman Hazimin Fahninazirah Ahmad Aeinaa Shida Rafidah Hod Hanizah Mohd Yusoff Ahmad Fariz Mohamed Rozita Hod ##submission.copyrightStatement## 2022-03-04 2022-03-04 12 1 Plain packaging and Pictorial Warning in Asia Countries: Where are we? <p>Worldwide, around 8 million people die yearly due to tobacco usage. Cigarette smoking is the most popular form of tobacco usage. Smoking has linked to many detrimental health effects among adults and adolescents. Recognising the burden of smoking, World Health Organization have implemented various tobacco control strategies under the Framework Convention of Tobacco Control and mPOWER. This includes implementation of plain packaging and pictorial warning. In Asia, only Thailand, Singapore, Turkey, Saudi Arabia, and Israel have implemented plain cigarette pack.&nbsp; However, some countries have made progress to implement plain cigarette pack. Although some countries have not implemented plain pack, implementation of larger pictorial warning serve as a pathway for implementation of plain packaging. Countries with pictorial warning on cigarette pack should ensure it covers at least 50% of pack.&nbsp; Timor Leste has the largest pictorial warning on cigarette pack in the world. In conclusion, only 5 countries in Asia have implemented plain pack and some countries in this region are yet to implement size of pictorial warning according to requirement of World Health Organization. All countries should target to implement standardized pack to denormalise tobacco usage.</p> Kavita Jetly Azmawati Mohammed Nawi Qistina Mohd Ghazali Mohd Rizal Abd Manaf ##submission.copyrightStatement## 2022-02-25 2022-02-25 12 1 Heatwave Impact on Mortality and Morbidity and Associated Vulnerable Factors: A Systematic Review Protocol <p><strong>Introduction:&nbsp;</strong>Heatwave can increase the risk for heat-related illnesses and mortality. Many studies showed certain population are vulnerable to heatwave such as elderly, children and low-income households. However, the findings were inconsistent. Therefore, this systematic review provides a comprehensive review on heatwave impact and vulnerability factors on the mortality and morbidity impacts.</p> <p><strong>Methodology:&nbsp;</strong>Five electronic databases (Pubmed, Ebsco Host, WOS, OVID Medline and Scopus) were primary searching tools to retrieve relevant literatures. This systematic review used the Medical Subject Heading (MESH) terms and keywords. An additional searching tool (Google Scholar) was used to seek further information and minimize missed evidence. We selected the literature based on the inclusion criteria (empirical full-text article, English language and published between 2010-2021). Two authors were assigned in each step of the process, starting from screening of the title, abstract and full text based on the inclusion criteria, data extraction and quality appraisal. Mixed-Method Appraisal Tool (MMAT) was utilized to assess the quality of selected articles. Thematic analysis and narrative approach were used to describe the findings.</p> <p><strong>Conclusion:</strong> This review presents the comprehensive evidence-based regarding heatwave impact and associated vulnerable groups for better understanding and effective preventive measure planning to reduce the impact of heatwave on population health.</p> <p><strong>Prospero registration number: </strong>CRD42021232847</p> Fadly Syah Arsad Rozita Hod Norfazilah Ahmad Mazni Baharom ##submission.copyrightStatement## 2022-03-08 2022-03-08 12 1 Occupational Sharps Injury Management <p>Introduction: Occupational sharps injury remains a never-ending issue faced by healthcare workers (HCWs). There were several types of post-exposure management available. Thus, it was hoped that a narrative overview could further illuminate this. Methodology: A search was conducted to review published and unpublished studies through searches of online databases (i.e., PubMed/MEDLINE, Google Scholar, Google search and Science Direct) on occupational sharps injury management, including bloodborne diseases, post-exposure management and rationale of the follow-up interval. Results: Working in a healthcare setting, sharps appeared to be an inevitable hazard faced every day by individual HCWs. While PEP was available for HIV and Hepatitis B, none was available for Hepatitis C, albeit the latter seemed to have curative treatment for it. Conclusion: We hoped that this narrative overview could provide an impetus towards the understanding of post-exposure management in our local healthcare setting.</p> Abdullah Aliff Abdul Wahab Rosnah Ismail Halim Ismail ##submission.copyrightStatement## 2022-03-09 2022-03-09 12 1