Formation and utilisation of acid sulfate soils in Southeast Asia for sustainable rice cultivation

Large parts of lowland areas in Southeast Asia were submerged in seawater some 4300 years ago due to a rise in sea level. During this period, the coastal plains in the region were pyritised. Agricultural development led to oxidisation of the pyrite (FeS2) which in turn allowed weathered mineral silicates to be present in the sediments. High levels of Al and/or Fe are thus present in the soils/water that affect plants and aquatic life. Rice grown on the so-called acid sulfate soils suffer from low pH and Al 3+ and/or Fe2+ toxicity, with yields below the national average. The critical pH and Al concentration for rice growth is 6 and 15-30 uM respectively. The soil become infertile due to high concentrations of acid sulfate. Application of ground magnesium limestone (GML) or basalt in combination with bio-fertiliser fortified with phosphate-solubilising bacteria (PSB) can help reduce the acid sulfate. The PSB not only excrete organic acids that inactivate Al and Fe via chelation, but also increase soil pH to the level that precipitates Al as inert Al-hydroxides. Additionally, rice roots are able to excrete organic acids under the presence of high concentration of Al and/or Fe, which further reduces the availability of Al and Fe in the water

Knowledge, attitudes and practices on sunscreen usage in preventing skin cancer among university students

Solar ultraviolet radiation is one of predisposing risk factors for skin cancer. The use of sunscreen plays a vital role in the prevention of skin cancer. A cross-sectional study was conducted to evaluate the knowledge, attitudes and practices related to sunscreen use in the prevention of skin cancer among undergraduate students of Universiti Kebangsaan Malaysia (n=78) in the Faculty of Health Sciences (FSK), Faculty of Engineering and Built Environment (FKAB) and Faculty of Social Sciences & Humanity (FSSK). Majority of the students used sunscreen. The mean level of knowledge for FSSK students was the highest compared to FSK and FKAB students. Next, the mean level of attitude for FSSK students was higher than the FSK and FKAB students. Meanwhile, there was a significant difference (p<0.05) in attitude between FSSK and FKAB students. FSSK students demonstrated highest mean level of practice compared to FSK and FKAB students. Finally, FKAB recorded the lowest number of students with high knowledge and the usage of sunscreen with statistical significance (p<0.05) between the level of knowledge and the use of sunscreen. This indicates that there was a linear association between level of knowledge and the use of sunscreen among FKAB students. In conclusion, knowledge, attitudes and practice were generally satisfactory among UKM students. However, periodic awareness could be applied to instill a healthy habit of using sunscreen in future

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Validation and reliability of the translated Malay version of the psychosocial impact of dental aesthetics questionnaire for adolescents

Background: This paper describes the cross-cultural adaptation of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) into Malay version (Malay PIDAQ), an oral health-related quality of life (OHRQoL) instrument specific for orthodontics for Malaysian adolescents between 12 and 17 years old. Methods: The PIDAQ was cross-culturally adapted into Malay version by forward- and backward-translation processes, followed by psychometric validations. After initial investigation of the conceptual suitability of the measure for the Malaysian population, the PIDAQ was translated into Malay, pilot tested and back translated into English. Psychometric properties were examined across two age groups (319 subjects aged 12-14 and 217 subjects aged 15-17 years old) for factor structure, internal consistency, reproducibility, discriminant and construct validity, criterion validity, and assessment of floor and ceiling effects. Results: Fit indices by confirmatory factor analysis showed good fit statistics (comparative fit index = 0.936, root-mean-square error of approximation = 0.064) and invariance across age groups. Internal consistency and reproducibility tests were satisfactory (Cronbach's α = 0.71-0.91; intra-class correlations = 0.72-0.89). Significant differences in Malay PIDAQ mean scores were observed between subjects with severe malocclusion and those with slight malocclusion based on a self-rated and an investigator-rated malocclusion index, for all subscales and all age groups (p < 0.05). Construct validity of the Malay PIDAQ subscales with those who rated themselves with excellent to poor dental appearance and those who felt they needed or did not need braces, showed significant associations for all age groups (p < 0.05). Criterion validity also showed significant association between the Malay PIDAQ scores with those with and without impact on daily activities attributed to malocclusion. There were no ceiling effects detected but floor effects were detected for the Aesthetic Concern subscale. Conclusion: The study has provided initial evidence for the validity and reliability of the Malay PIDAQ to assess the impact of malocclusion on the OHRQoL of 12-17 year old Malaysian adolescents

Inculcating Heart Intelligence in English Communication Workshop for Day-care Educators

Teaching is a noble job that not everyone aspires to do. Many join the teaching force as a last resort. For early childhood education, this can be detrimental as literature shows that early learning requires special attention because it lays the foundations for lifelong learning. Heart Intelligence is a module which introduces Spiritual, Emotional and Social Intelligence, enhanced by the notion of `Man as Caliph (i.e. leader)’ and his role to harmonise and protect the world. This Heart Intelligence module enhances the beliefs and understanding of spiritual, emotional and social skills of the educators. The purpose of this study is to examine how this module gives impact to the educators and how it helps the educators to have more control on their job engagement. A qualitative research design was employed to collect data through an open-ended questionnaire from 26 educators who voluntarily participated in this study. Participants were required to apply the elements of Islamic teaching during English Communication Module and apply them to their students when they get back to their workplace. They provided positive feedback especially after they have implemented the Heart Intelligence Module (Anita, 2016). From the responses, there were positive changes in the educators especially when dealing with their students at school. The module helps them to decrease stress at workplace, work better with the students and feel satisfied with their job. They also suggested some new ideas for the module throughout the teaching and learning session as to introduce the concept of human and `caliph’

Inculcating Heart Intelligence in English Communication Workshop for Day-care Educators

Teaching is a noble job. However, not everyone aspires to become a teacher. Many join the teaching force as a last resort for want of a job. For early childhood education, this can be detrimental as literature shows that early learning requires special attention because it lays the foundations for lifelong learning. Heart Intelligence is a module which introduces Spiritual and Emotional Intelligence, enhanced by the notion of `Man as Caliph (i.e. leader)’ and his role to harmonise and protect the world. This Heart Intelligence module enhances the beliefs and understanding of spiritual, emotional and social skills of the educators. The purpose of this study is to examine how this module gives impact to the educators and how it helps the educators to have more control on their job engagement. A qualitative research design was employed to collect data through interviews and reflection from 29 educators who voluntarily participated in this study. Participants were required to apply the elements of Islamic teaching during English Communication Module and apply them to their students when they get back to their workplace. They provided positive feedback especially after they have implemented the Heart Intelligence module inside the classrooms. From the responses, there were positive changes in the educators especially when dealing with their students at school. The module helps them to decrease stress at workplace, work better with the students and feel satisfied with their job. They also suggested some new ideas for the module throughout the teaching and learning session as to introduce the concept of human and `caliph’

Therapeutic Potential of <i>Hibiscus sabdariffa</i> Linn. in Attenuating Cardiovascular Risk Factors

Cardiovascular diseases (CVDs) represent a broad spectrum of diseases afflicting the heart and blood vessels and remain a major cause of death and disability worldwide. CVD progression is strongly associated with risk factors, including hypertension, hyperglycemia, dyslipidemia, oxidative stress, inflammation, fibrosis, and apoptosis. These risk factors lead to oxidative damage that results in various cardiovascular complications including endothelial dysfunctions, alterations in vascular integrity, the formation of atherosclerosis, as well as incorrigible cardiac remodeling. The use of conventional pharmacological therapy is one of the current preventive measures to control the development of CVDs. However, as undesirable side effects from drug use have become a recent issue, alternative treatment from natural products is being sought in medicinal plants and is gaining interest. Roselle (Hibiscus sabdariffa Linn.) has been reported to contain various bioactive compounds that exert anti-hyperlipidemia, anti-hyperglycemia, anti-hypertension, antioxidative, anti-inflammation, and anti-fibrosis effects. These properties of roselle, especially from its calyx, have relevance to its therapeutic and cardiovascular protection effects in humans. This review summarizes the findings of recent preclinical and clinical studies on roselle as a prophylactic and therapeutic agent in attenuating cardiovascular risk factors and associated mechanisms