Introduction  Tuberculosis (TB) has been reported among young foreign-born students enrolled in Japanese-language schools, who developed the disease after arriving in Japan. However, their experiences with TB from the onset of symptoms to the diagnosis remain unclear. This study aimed to clarify the experiences of young foreign-born students from China and Vietnam regarding healthcare support for TB diagnoses in Japan. Methods  Semi-structured interviews were conducted with interpreters and Chinese and Vietnamese students in their 20s who were primarily enrolled in Japanese-language schools. Verbatim transcripts were prepared by a translation company, and data were analysed qualitatively to describe their experiences from the onset of symptoms to the diagnosis of TB.Results  The study included 10 Japanese-language students aged 20-27 years (five each from China and Vietnam). At the onset of TB, participants faced language and cultural barriers and financial strain related to tuition and living expenses. They became aware of physical symptoms shortly after arriving in Japan. Despite recognising the seriousness of their symptoms, which did not improve with self-medication, they hesitated to seek immediate medical care because of uncertainty about navigating the Japanese healthcare system. This ‘uncertainty about navigating the Japanese healthcare system’ was the turning point for the three processes: the decision to consult a physician due to the exacerbation of symptoms, the decision to consult a physician in one’s home country, and the decision to consult a specialist because the patient had not been cured by a local physician.Conclusions  This study highlights significant challenges, including language and cultural barriers, financial issues, and prioritising economic activities over health, impacting the access to health care for TB diagnosis among foreign-born students. These findings indicate the need for support to reduce the risk of TB and delays in medical examination and diagnosis.

Objective  We investigated lifestyle changes and disease risk factors in Vietnamese workers after migrating to Japan.Methods  From January to March 2022, semi-structured interviews were conducted with 15 Vietnamese workers in Japan regarding their daily habits, focusing on diet and environmental changes. Data were analyzed qualitatively. Results  Six men and nine women (average age: 25.5 years) participated. Their residence status included Technical Intern Training (nine individuals), Designated Activities (two), and Engineer/Specialist in Humanities/International Services (four). Their periods of stay ranged from six months to eight years. We extracted 31 main categories (and 100 subcategories) from the interviews that indicated lifestyle changes from Vietnam to Japan. These changes included switching to an imbalanced diet, less fruit intake, greater snack intake, lower alcohol intake, and decreased physical activity after moving to Japan. Participants cited busy schedules (and therefore less time) as the primary reason for dietary changes and reduced physical activity in Japan. Additionally, stress levels rose significantly after migration, with some participants attributing that increase to lifestyle changes. Furthermore, despite reporting no major illnesses in Vietnam, health checkups after living in Japan identified disease risk factors, such as weight changes and negative health conditions (e.g., dyslipidemia, hypertension, liver dysfunction, and anemia). Conclusions  Our findings suggest that lifestyle changes are related to post-migration abnormalities in health screening outcomes, including weight gain and dyslipidemia. Recognizing and providing early support for these changes are important in preventing the onset or worsening of noncommunicable diseases among migrant workers.

  Positive Deviance (PD) is based on the observation that in every community there are certain individuals or groups whose uncommon behaviors and strategies enable them to find better solutions to problems than their peers, while having access to the same resources and facing similar or worse challenges. Developed in 1990 by Save the Children to improve child nutrition in Vietnam, the PD approach has gained traction among development partners for various international development projects. This paper discusses how the PD approach and the Logical Framework Approach can be integrated in global health projects.  The PD approach is effective for projects targeting behavior change, such as those aiming to improve nutrition, reduce infant mortality, promote reproductive health, and prevent non-communicable diseases. To integrate PD with the Logical Framework Approach, projects should create a logic model outlining inputs, activities, outputs, outcomes, and impacts. The PD approach should then be incorporated into each stage of this model. An objective that should be achieved through behavior change is defined as Outcome (Project Purpose), and Outputs need to be considered with the governance and the structure of the target societies and organizations as determinant factors for the dissemination of PD practices. Five steps of the PD implementation process, i.e., defining problems, identifying positive deviants, specifying and extracting PD practices, planning and implementing activities, and monitoring and evaluating, can be incorporated in the project as activities. Inputs should emphasize local initiatives, with experts playing supportive roles.  While an increasing number of development partners for low- and middle-income countries have adopted the PD approach, such initiatives are still rare among Japanese organizations. The case presented demonstrates that even small-scale projects can yield significant results, encouraging Japanese colleagues to learn from this experience and consider how to initiate the challenge of applying the PD approach in future projects.

The Coronavirus Disease 2019 (COVID-19) pandemic has increased the demand for personal protective equipment (PPE), prompting a need to assess its usage among healthcare workers following established guidelines and ensure its rational use. This study aimed to assess the knowledge, attitude, and practice (KAP) of PPE use among healthcare workers (HCWs) in Ministry of Health (MOH) facilities during the COVID-19 pandemic and to determine the predictors associated with good KAP.MethodsThis cross-sectional study was conducted from February to March 2021. The study utilized an online, anonymous, self-administered questionnaire which was pretested and content-validated. The final questionnaire consisted of 28 items and was distributed among HCWs working directly with patients/specimens/close contacts in the MOH facilities. Descriptive and inferential analyses were performed using Statistical Package for Social Sciences 26.0.ResultsA total of 3132 respondents were included in the analysis after the exclusion criteria. 87.7% of HCWs possessed a good knowledge of PPE, 71.1% had a positive attitude, and 10.2% showed good practice. Formal training and having a good attitude and knowledge were significant predictors for good knowledge and positive attitude, respectively, while age, gender, state region and HCWs’ designation were the significant predictors of good practice.ConclusionsMost HCWs possessed good knowledge and positive attitude on PPE use but low magnitude on practice in terms of following guidelines, suggesting a gap between the level of knowledge and attitude and the actual practice. This necessitates additional education and training approaches to promote compliance with guidelines and ensure the rational use of PPE.

Tobacco uses and obesity are major global public health concerns, with adolescence being a critical period for the onset of these risk factors. In Malaysia, rising trends in adolescent smoking and obesity necessitate further investigation. This study examined gender-specific associations between different types of tobacco use and body mass index (BMI) among school-going adolescents. Data were derived from the NHMS 2017, a nationwide cross-sectional survey using a two-stage stratified random sampling design (N=27,497). Complex sample logistic regression was employed to assess the odds of past 30-day tobacco use by BMI category (underweight/normal weight, overweight, obese) stratified by gender. Confounders, including age, ethnicity, physical activity, fast food consumption, and mental health, were controlled for in the analysis. Adolescents classified as obese had a significant association with tobacco use, but this was not observed in overweight individuals. Male smokers were significantly less likely to be obese, whereas female smokers had a higher likelihood of obesity (AOR = 1.59, 95% CI: 1.25–2.02). Specifically, female users of e-cigarettes (AOR = 1.86, 95% CI: 1.36–2.56), smokeless tobacco (AOR = 1.66, 95% CI: 1.14–2.43), and other tobacco products (AOR = 1.62, 95% CI: 1.05–2.52) exhibited a higher risk of obesity. No significant association was found among male smokers. Female adolescent smokers showed a greater likelihood of obesity, emphasizing the need for gender-specific interventions. To mitigate these risks, public health efforts should incorporate education, policy measures, and lifestyle promotion. Further research is warranted to explore underlying biological mechanisms

Falls during pregnancy are a typical reason for minor injuries, and they can occasionally be dangerous for both the mother and the unborn child. This study is designed to identify the knowledge and practice in preventing falls among obstetrics patients in Hospital Sultanah Nur Zahirah. This cross-sectional study used a self-reported questionnaire involving women admitted and delivered at a state hospital between October to December 2022. The Pearson Chi-Square test in SPSS software was used to examine associations between sociodemographic characteristics and variables of interest. Overall, 350 postnatal women were selected as the subjects. The mean age of the women was 30.41 ± 5.4 (range: 19-44) years old. Most of the respondents were in parity 2 to 4 (56.3%). Fifty-seven women (16.3%) reported falling at least once during the index pregnancy. The mean score for knowledge was 12.30 ± 3.72, with 16.6% having good knowledge and the mean score for practice was 7.24 ± 4.23, 25.4% of them were having good practice. The women’s knowledge of preventing falls during pregnancy was predicted by their age (χ2 = 19.73, p = <0.05), education (χ2 = 21.582, p = <0.05) and parity (χ2 = 15.208, p = <0.05). The practice of the women about preventing falls was significantly poorer amongst the women who were younger (χ2 = 23.434, p = <0.05), less family income (χ2 = 17.95, p = <0.05), and had no more than a secondary education (χ2 = 14.88, p = <0.05). The findings of the study revealed that age, level of education and parity is associated with knowledge of women in preventing falls. While age, level of education and family income are associated with practice in preventing falls. Hence, awareness campaigns using effective risk communication models are advised to increase knowledge and good practice among pregnant women

This study investigates indoor environmental factors in several offices from one of the university at Malaysia's East Coast, focusing on enhancing occupational health and well-being among university staff by examining lighting quality and thermal comfort. Monitoring sampling were done based on hazard reports logged and data from three main offices or location were collected in this study. Utilizing Extech HD450 Heavy Duty Data Logging Light Meter to measure illuminance, the study found that most sampled points fell below the Occupational Safety and Health Guidelines' recommended range of 300-500 lux, indicating insufficient lighting that can cause visual discomfort and reduce productivity. Thermal comfort assessments, conducted with EVM-7 Indoor Air Quality 3M QUEST and AirPro Solution Models AP500, revealed acceptable temperature and humidity levels but often inadequate air velocity, particularly in the Science Officer's Office, leading to poor air circulation and potential health issues. The study highlights the necessity of improving lighting solutions by installing additional fixtures or upgrading existing ones for sufficient and evenly distributed illumination and enhancing ventilation systems to ensure adequate air movement. Addressing these deficiencies is crucial for creating a conducive working environment, promoting employee satisfaction and productivity. This research focuses solely on monitoring and analyzing the collected data. No qualitative evaluation has been conducted as part of this study. This research advocates for a holistic approach to Indoor Environmental Quality (IEQ), involving regular assessment and targeted interventions to enhance the overall quality of university office environments, ultimately fostering a healthier and more productive workplace.

Malaria is a life-threatening, preventable, and curable vector borne disease caused by parasites that are transmitted to people through the bites of infected female Anopheles. The WHO Global Report 2010-2016 reported insecticide resistance in malaria. The main objective of this study is to determine the effectiveness of new generation Long-Lasting Insecticidal Nets (LLIN) compared to standard LLIN and untreated nets in terms of the mortality rate of adult female Anopheles gambiae. A comprehensive review of the literature was published in three databases (PubMed, Ovid, EBSCO Host) since 2010. Publications were searched with keywords including malaria, long-lasting treated bed net, long lasting insecticide-treated bed net, LLIN, and experimental hut. The search has identified 60 articles. Based on the PRISMA flowchart, 10 articles are qualified for data collection and analysis. The gathered data was analysed using Review Manager. Following meta-analysis between subgroups, a risk difference of 0.31 between standard LLINs versus untreated net (p<0.001, I²=100% 95% CI:0.01,0.60). A comparison of upgraded LLINs with the untreated net has shown a significant difference with a pooled risk difference of 0.54 favours upgraded LLINs (p<0.001, I²=100% 95% CI: 0.54,0.84). Comparison between upgraded LLINs versus standard gave an overall risk difference of 0.24 (p < 0.001, I² = 100%, 95% CI: 0.10–0.39). Upgraded LLINs significantly increase Anophelesmortality compared to standard LLINs and untreated nets, suggesting their potential for improved malaria control. Thus, using upgraded nets in the field and translating them into malaria preventive programs would help achieve the target and improve healthoutcomes for those living in endemic areas.

A series of comprehensive focus group discussions with active firefighters revealed that inconsistencies in incorporating a rigorous physical training program during work hours contributed significantly to the challenges of maintaining functional fitness, particularly strength. This article outlines a process for identifying the specific exercises required to enhance strength, drawing on the expertise and experience of physical trainers. Modified nominal group technique (mNGT) sessions were conducted to identify and rank exercises for five functional strengths (i.e., pushing, pulling, lifting, carrying, and dragging). A total of six physical trainers from the firefighter academy were interviewed to 1) identify the skeletal muscles involved in the functional movements using a visual aid; 2) generate ideas for exercises via brainstorming; 3) privately rank the displayed list of exercises for each muscle group involved in each functional movement; and 4) design a physical training programme for beginner, intermediate and advanced levels by manipulating loads. Males dominated the expert group (66.7%) and had a mean of 11.50 (SD 5.20) years of experience in physical training. The mNGTs yielded three top-ranking exercises for each functional strength: 1) Pushing: the push-up, sit-up, and jumping jack; 2) pulling: the push-up, jumping jack, and sit-up; 3) lifting: the jumping jack, push-up, and jumping squat; 4) carrying: the push-up, plank, and sit -up; and 5) dragging: the jumping jack, sit-up, and jumping squat. Then each exercise was designed for the beginner, intermediate, and advanced levels by manipulating loads (i.e. additional weight or number of repetitions). This study demonstrated that mNGT is an effective tool for identifying the three top-ranking exercises that address firefighter recruits’ functional strength. The experts chose multi-joint exercises targeting agonist and antagonist skeletal muscle groups and mimicking movements of daily work life. The exercises, corroborated by previous empirical evidence, provide opportunities for common skeletal muscle groupings to be targeted simultaneously to increase cardiovascular adaptations over a shorter period. The physical exercise is now ready to be implemented for piloting purposes among firefighter recruits.