INTRODUCTION: Haze is a recurrent problem in Southeast Asia. Exposure to haze is linked to ophthalmic, respiratory and cardiovascular diseases, and mortality. In this study, we investigated the role of demographic factors, knowledge and perceived risk in influencing protective behaviours during the 2013 haze in Singapore. METHODS: We evaluated 696 adults in a cross-sectional study. Participants were sampled via a 2-stage simple random sampling without replacement from a large residential district in Singapore in 2015. The questionnaire measured the participant's knowledge, perceived risk and behaviours during the Southeast Asian haze crisis in 2013. Reliability and validity of the questionnaire were assessed using comparative fit index (≥0.96) and root mean square error of approximation (≤0.05). We performed structural equation modelling to examine the relationship between the hypothesised factors and protective behaviours. RESULTS: More than 95% of the individuals engaged in at least 1 form of protective behaviour. Knowledge was strongly associated with protective behaviours via direct effect (β=0.45, 95% CI 0.19-0.69, CONCLUSION Knowledge was associated with protective behaviours, suggesting the importance of public education. Efforts should target those of lower education level and smokers. The wearing of N95 masks correlates with uptake of other protective behaviours.
Adult ; Asia, Southeastern ; Cross-Sectional Studies ; Ethnic Groups ; Humans ; Minority Groups ; Reproducibility of Results ; Singapore/epidemiology*

Background/Aims: Depression and anxiety are associated with poorer outcomes in patients with hepatocellular carcinoma (HCC). However, the prevalence of depression and anxiety in HCC are unclear. We aimed to establish the prevalence of depression and anxiety in patients with HCC. Methods: MEDLINE and Embase were searched and original articles reporting prevalence of anxiety or depression in patients with HCC were included. A generalized linear mixed model with Clopper-Pearson intervals was used to obtain the pooled prevalence of depression and anxiety in patients with HCC. Risk factors were analyzed via a fractional-logistic regression model. Results: Seventeen articles involving 64,247 patients with HCC were included. The pooled prevalence of depression and anxiety in patients with HCC was 24.04% (95% confidence interval [CI], 13.99–38.11%) and 22.20% (95% CI, 10.07–42.09%) respectively. Subgroup analysis determined that the prevalence of depression was lowest in studies where depression was diagnosed via clinician-administered scales (16.07%;95% CI, 4.42–44.20%) and highest in self-reported scales (30.03%; 95% CI, 17.19–47.01%). Depression in patients with HCC was lowest in the Americas (16.44%; 95% CI, 6.37–36.27%) and highest in South-East Asia (66.67%; 95% CI, 56.68–75.35%). Alcohol consumption, cirrhosis, and college education significantly increased risk of depression in patients with HCC. Conclusions One in four patients with HCC have depression, while one in five have anxiety. Further studies are required to validate these findings, as seen from the wide CIs in certain subgroup analyses. Screening strategies for depression and anxiety should also be developed for patients with HCC.

Objective:Escalator signage could be playing a vital role to alert users for safe use of escalators.This study aimed to evaluate the availability,standardization,and content of safety information on escalator signage in the shopping malls.Methods:An observational study was conducted from November 2017 to February 2018 to assess the availability,standardization of safety information among the signage inside the shopping mall,and the content of safety information for public safety in Malaysia.A checklist was developed by adapting escalator safety guidelines from seven countries and regions including Malaysia.Data collectors identified from the selected states were required to capture three photographs at different angles of the escalator signage for each ascending and descending directions at each entrance of the mall.Descriptive analysis was performed;each criterion was presented in frequency and percentage.Results:A total of 268 escalators from 84 shopping malls in 9 states of Malaysia were assessed.Two operating escalators were not equipped with signage.More than one-fifth (23.0％) of the signage was not standardized within the mall.The majority of safety information was displayed in the form of a pictogram,a minority of signage displayed information in both pictogram and text format:"children must hold hand" (12.7％) and "be careful of long clothing" (10.8％),respectively.Nevertheless,"toddlers should be carried" (8.6％) and "take extra care with rubber shoes/tied shoes/laces" (30.2％) were found absent in most of the signage.Conclusion:Escalator signage was present in almost all of the escalators observed.However,non-standardization of the signage of escalators should warrant the attention of relevant authorities to revise the safety guidelines and improve the quality of escalator.