A comparison of periodic health examinations and workplace health screening for workers in Singapore and Japan.

This article aims to provide a historical overview of how workplace safety and health legislations in Singapore and Japan have evolved, and perform a comparative analysis of the occupational health systems where work-related medical examinations and health screening are concerned. The discourse is centered on three key themes - coverage, comprehensiveness, and continuity of care. The comparative analysis was performed based on secondary data obtained from open-source platforms. Singapore and Japan have robust workplace safety and health legislative frameworks and laws. However, their approaches diverge because of differing socioeconomic and political contexts. Japan's regulations are generally more comprehensive, require more frequent monitoring of workers' health status, and encompass both physical and mental health components. Singaporean companies focus primarily on the physical component of health, and statutory examinations are required only for exposure to specific occupational hazards. With increasing prominence of mental health issues and shift towards preventive care in Singapore, there will be greater emphasis on a holistic approach to each employee's overall health in future. For Japan, the challenge would be to strike a balance between long-term sustainability of current policies against the need for state and corporations to still retain an adequate stake in ensuring workers' overall health.

TRPM2 Channels: A Potential Therapeutic Target in Melanoma?

The transient receptor potential, the melastatin (TRPM) subfamily, which consists of eight known members, appears to have significant importance in melanoma progression, treatment, and prognosis. As several members were originally cloned from cancerous tissue, initial studies aimed towards identifying TRPM involvement in cancer progression and tumorigenesis. For relevance in skin cancer, previous research has shown roles for several TRPM members in skin cancer progression, growth, and patient prognosis. One unique member, TRPM2, appears to have notable therapeutic potential in the treatment of melanoma. Previous and recent studies have demonstrated increased TRPM2 expression levels in melanoma, as well as important roles for TRPM2 in melanoma growth, proliferation, and survival. TRPM2 is thus an emerging target in the treatment of melanoma, where TRPM2 antagonism may offer an additional treatment option for melanoma patients in the future.

Long COVID-Challenges in diagnosis and managing return-to-work.

OBJECTIVES: Long COVID may be a public health concern resulting in a hidden toll of the pandemic years later, on workers and their work ability in the workforce. We illustrate the challenges in diagnosing long COVID in a patient, its associated psychological impact on work and how return-to-work can be better managed and supported from an occupational health perspective. METHODS: An Occupational Health trainee working as a government public health officer experienced persistent fatigue, decreased effort tolerance, and difficulties in concentration after contracting COVID-19. There were unintended psychological effects arising from the functional limitations that were not explained with a proper diagnosis. This was further complicated with a lack of access to occupational health services for return-to-work. RESULTS: He developed his own rehabilitation plan to improve his physical tolerance. Progressive efforts to build up his physical fitness complemented with workplace adjustments helped to overcome his functional limitations and allowed him to effectively return-to-work. CONCLUSION: Diagnosing long COVID continues to remain challenging due to a lack of consensus on a definitive diagnostic criterion. This may give rise to unintended mental and psychological impact. Workers with long COVID symptoms can return-to-work, involving a complex individualized approach to the symptoms' impact on work, and workplace adjustments and job modifications available. The psychological toll on the worker must also be addressed. Occupational health professionals are best placed to facilitate these workers in their journey to return-to-work, with multi-disciplinary delivery models providing return to work services.

Methods for Investigating Transient Receptor Potential Melastatin-2 (TRPM2): A Cation Channel Activated by ADP-Ribose and Involved in Cell Death.

Transient receptor potential melastatin-2 (TRPM2) is an emerging chemotherapeutic target due to its involvement in poly(ADP-ribose) metabolism and the ability to induce anticancer effects after antagonism of its functions. Normally functioning as a nonspecific cation channel that is activated by free ADP-ribose, TRPM2 is involved with many cellular processes, including the induction of cell death after oxidative stress. What is becoming clear is that antagonism of TRPM2 selectively induces anticancer effects in several types of cancer. We previously demonstrated decreased growth and proliferation, increased levels of DNA damage, and the selective induction of cell death in breast cancer and melanoma cells. Due to these effects, it appears that TRPM2 has a novel role in cancer cells. Further, this novel role appears to involve nuclear function, because our studies, as well as those from other independent groups, demonstrate a nuclear localization of TRPM2 in various types of cancers. Thus, as an emerging therapeutic target, it is important to describe research techniques that can be utilized to analyze TRPM2 function, determine its effects in cancerous and noncancerous cells, and provide molecular biological methods to inhibit or downregulate its function.

Nonpharmaceutical interventions reduce the incidence and mortality of COVID-19: A study based on the survey from the International COVID-19 Research Network (ICRN).

The recently emerged novel coronavirus, "severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)," caused a highly contagious disease called coronavirus disease 2019 (COVID-19). It has severely damaged the world's most developed countries and has turned into a major threat for low- and middle-income countries. Since its emergence in late 2019, medical interventions have been substantial, and most countries relied on public health measures collectively known as nonpharmaceutical interventions (NPIs). We aimed to centralize the accumulative knowledge of NPIs against COVID-19 for each country under one worldwide consortium. International COVID-19 Research Network collaborators developed a cross-sectional online survey to assess the implications of NPIs and sanitary supply on the incidence and mortality of COVID-19. The survey was conducted between January 1 and February 1, 2021, and participants from 92 countries/territories completed it. The association between NPIs, sanitation supplies, and incidence and mortality were examined by multivariate regression, with the log-transformed value of population as an offset value. The majority of countries/territories applied several preventive strategies, including social distancing (100.0%), quarantine (100.0%), isolation (98.9%), and school closure (97.8%). Individual-level preventive measures such as personal hygiene (100.0%) and wearing facial masks (94.6% at hospitals; 93.5% at mass transportation; 91.3% in mass gathering facilities) were also frequently applied. Quarantine at a designated place was negatively associated with incidence and mortality compared to home quarantine. Isolation at a designated place was also associated with reduced mortality compared to home isolation. Recommendations to use sanitizer for personal hygiene reduced incidence compared to the recommendation to use soap. Deprivation of masks was associated with increased incidence. Higher incidence and mortality were found in countries/territories with higher economic levels. Mask deprivation was pervasive regardless of economic level. NPIs against COVID-19 such as using sanitizer, quarantine, and isolation can decrease the incidence and mortality of COVID-19.

Factors influencing healthcare-seeking behaviour among Muslims from Southeast Asian countries (Indonesia and Malaysia) living in Japan: an exploratory qualitative study.

OBJECTIVES: To identify factors influencing healthcare-seeking behaviours and to explore issues with healthcare experiences of Muslims from Southeast Asian countries (Indonesia and Malaysia) living in Japan. DESIGN: Qualitative study. SETTING: Kansai area of Japan (Kyoto, Osaka, Hyogo and Nara prefectures). PARTICIPANTS: Forty-five Muslims in Japan from Southeast Asian countries (Indonesia and Malaysia). METHODS: Semistructured interviews were conducted by trained interviewers who are Muslims living in Japan. Interviews were conducted in Indonesian and Malaysian languages and transcribed and translated into English. The data were thematically analysed. RESULTS: Four themes were identified: (1) trying to comply with the recommendations of Islam, (2) confusion about healthcare system, (3) improvising an informal support system and (4) language barrier problems. CONCLUSION: Muslims in Japan have some issues when obtaining healthcare services mainly because of communication issues besides the conflicts to meet their religious obligations. Education and awareness building for the Muslim patients in Japan as well as Japanese healthcare providers are needed to allow smooth communication between Japanese healthcare providers and Muslim patients in Japan.

Development and Evaluation of Statistical Models Based on Machine Learning Techniques for Estimating Particulate Matter (PM2.5 and PM10) Concentrations.

Despite extensive research on air pollution estimation/prediction, inter-country models for estimating air pollutant concentrations in Southeast Asia have not yet been fully developed and validated owing to the lack of air quality (AQ), emission inventory and meteorological data from different countries in the region. The purpose of this study is to develop and evaluate two machine learning (ML)-based models (i.e., analysis of covariance (ANCOVA) and random forest regression (RFR)) for estimating daily PM2.5 and PM10 concentrations in Brunei Darussalam. These models were first derived from past AQ and meteorological measurements in Singapore and then tested with AQ and meteorological data from Brunei Darussalam. The results show that the ANCOVA model (R2 = 0.94 and RMSE = 0.05 µg/m3 for PM2.5, and R2 = 0.72 and RMSE = 0.09 µg/m3 for PM10) could describe daily PM concentrations over 18 µg/m3 in Brunei Darussalam much better than the RFR model (R2 = 0.92 and RMSE = 0.04 µg/m3 for PM2.5, and R2 = 0.86 and RMSE = 0.08 µg/m3 for PM10). In conclusion, the derived models provide a satisfactory estimation of PM concentrations for both countries despite some limitations. This study shows the potential of the models for inter-country PM estimations in Southeast Asia.

Clinical outcomes and performance indicators of patients with kidney failure and acute kidney injuries in ASEAN countries.

INTRODUCTION: This review article reports clinical outcomes and performance indicators of patients with kidney failure (KF) and acute kidney injuries (AKI) in Association of South East Asian Nations (ASEAN) countries. METHODOLOGY: Association of South East Asian Nations data, segregated by income status, from national registries and literature were collated, compared and benchmarked against international references. RESULTS: The national incidence and prevalence of treated KF ranged from 172 to 479 per million population (pmp) and 36-2255 pmp, respectively. Brunei (79%), Malaysia (66%) and Singapore (66%) had world-leading proportions of diabetes-related KF. Hemodialysis (HD), Peritoneal Dialysis (PD) and transplant accounted for 68-100%, 0-27% and 0-18% of all KF replacement therapy, respectively. Transplant patient survival was superior with 90%-93% at 5 years and 71%-90% at 10 years, compared to PD (44%-54%) and HD (53-64%) at 5 years. Higher-income countries were able to achieve good anemia control, HD and PD adequacy targets, while usage of arteriovenous fistula in HD varied from 70% to 85%. Acute Kidney Injury rates ranged from 24.2% to 49.2% of high-dependency admissions. Lower incidences of PD peritonitis and HD catheter-related Bloodstream Infections; and PD-favouring quality-of-life were evident in higher-income countries. CONCLUSION: Association of South East Asian Nations has a challenging burden of kidney disease, with extremely high incidence, prevalence, DM-related KF and AKI rates. The magnitude of the prevailing problem calls for the creation of a regional society under the auspices of ASEAN with a shared perspective of universal, equitable and charitable access to quality renal care; consistent with the founding premises and healthcare initiatives of ASEAN.

Antagonism of the transient receptor potential melastatin­2 channel leads to targeted antitumor effects in primary human malignant melanoma cells.

Melanoma continues to be the most aggressive and devastating form of skin cancer for which the development of novel therapies is required. The present study aimed to determine the effects of antagonism of the transient receptor potential melastatin­2 (TRPM2) ion channel in primary human malignant melanoma cells. TRPM2 antagonism via use of the antifungal agent, clotrimazole, led to decreases in cell proliferation, as well as dose­dependent increases in cell death in all melanoma cell lines investigated. The targeting of TRPM2 channels was verified using TRPM2 knockdown, where treatment with TRPM2 small­interfering RNA led to similar levels of cell death in all melanoma cell lines when compared with clotrimazole treatment. Minimal effects on proliferation and cell death were observed following antagonism or knockdown of TRPM2 in non­cancerous human keratinocytes. Moreover, characteristics of TRPM2 were explored in these melanoma cells and the results demonstrated that TRPM2, localized to the plasma membrane as a non­specific ion channel in non­cancerous cells, displayed a nuclear localization in all human melanoma cell lines analyzed. Additional characterization of these melanoma cell lines confirmed that each expressed one or more established multidrug resistance genes. Results of the present study therefore indicated that antagonism of the TRPM2 channel led to antitumor effects in human melanoma cells, including those that are potentially unresponsive to current treatments due to the expression of drug resistance genes. The unique cellular localization of TRPM2 and the specificity of the antitumor effects elicited by TRPM2 antagonism suggested that TRPM2 possesses a unique role in melanoma cells. Collectively, the targeting of TRPM2 represents a potentially novel, efficacious and readily accessible treatment option for patients with melanoma.

Over-the-Counter Medicine Attitudes and Knowledge among University and College Students in Brunei Darussalam: Findings from the First National Survey.

Over-the-counter (OTC) medicine is defined as safe and effective for the general public to use, without seeking therapy from a health professional. As primary social media and internet users, university and college students are more likely to be exposed to unverified sources of health information. This study aims to assess the knowledge, attitudes, and behaviour of students at institutions of higher learning in Brunei with regard to the safe use of OTC medicines. A cross-sectional study was performed using a self-administered online questionnaire, adapted from the literature with additional information from the United States Food and Drug Administration (FDA) on the educational resources in understanding OTC medicine for consumers. The questionnaire consisted of 4 sections: demographic information, knowledge of OTC medicines, attitudes, and practice. Descriptive and inferential statistics were used for data analysis. A total of 335 students returned a completed questionnaire. The students had a mean knowledge score of 7.1 out of 9, with more than half (53.4%) having good knowledge (knowledge score > 7), and only a small percentage (5.7%) with poor knowledge. Almost all of the students (99.7%) had a positive attitude toward OTC medicine use. Few of the students practiced improper habits in terms of OTC medicine use, such as not reading the instructions or taking more than the recommended dose. Awareness of proper OTC medicine use among students in institutions of higher learning is necessary to prevent the rise of inappropriate user practices.

Hospital factors that predict intention of health care workers to leave their job during the COVID-19 pandemic.

PURPOSE: To identify factors responsible for hospital health care workers' intention to leave their job during the COVID-19 pandemic. DESIGN: A cross-sectional study was performed. METHODS: A self-administered questionnaire was delivered to solicit hospital health care workers' demographics, intention to leave, workplace environment, and changes related to COVID-19 from July to November 2020 in Taiwan. Principal component analysis was performed to compare group-related factors. Multiple logistic regression was used to determine the risk factors for the intention of health care workers to leave their job. FINDINGS: Among the 1209 health care workers (mean age, 36.3 years) who participated in the study, intention to leave the job was found to be related to factors relating to COVID-19, including perceived risk, affected social relationships, and increased workload and job stress, after adjustment for demographic and work factors. Supportive administration/management were protective factors against leaving the job. These results were supported by sensitivity analyses. CONCLUSIONS: Our findings suggest that the intention of health care workers to leave their job during a pandemic is related to potentially modifiable factors relating to the infection itself and work environment. CLINICAL RELEVANCE: High perceived risk of COVID-19, affected social relationaops, and increased workload and job stress were positively associated with the intention of health care workers to leave their job, whereas supportive administration and management were protective factors against leaving the job. Development of workplace strategies is important to help mitigate these above factors, improve psychological wellbeing, and promote workforce stability.

The global case fatality rate of coronavirus disease 2019 by continents and national income: A meta-analysis.

The aim of this study is to provide a more accurate representation of COVID-19's case fatality rate (CFR) by performing meta-analyses by continents and income, and by comparing the result with pooled estimates. We used multiple worldwide data sources on COVID-19 for every country reporting COVID-19 cases. On the basis of data, we performed random and fixed meta-analyses for CFR of COVID-19 by continents and income according to each individual calendar date. CFR was estimated based on the different geographical regions and levels of income using three models: pooled estimates, fixed- and random-model. In Asia, all three types of CFR initially remained approximately between 2.0% and 3.0%. In the case of pooled estimates and the fixed model results, CFR increased to 4.0%, by then gradually decreasing, while in the case of random-model, CFR remained under 2.0%. Similarly, in Europe, initially, the two types of CFR peaked at 9.0% and 10.0%, respectively. The random-model results showed an increase near 5.0%. In high-income countries, pooled estimates and fixed-model showed gradually increasing trends with a final pooled estimates and random-model reached about 8.0% and 4.0%, respectively. In middle-income, the pooled estimates and fixed-model have gradually increased reaching up to 4.5%. in low-income countries, CFRs remained similar between 1.5% and 3.0%. Our study emphasizes that COVID-19 CFR is not a fixed or static value. Rather, it is a dynamic estimate that changes with time, population, socioeconomic factors, and the mitigatory efforts of individual countries.

Proposed Data-Driven Approach for Occupational Risk Management of Aircrew Fatigue.

BACKGROUND: Fatigue is pervasive, under-reported, and potentially deadly where flight operations are concerned. The aviation industry appears to lack a standardized, practical, and easily replicable protocol for fatigue risk assessment which can be consistently applied across operators. AIM: Our paper sought to present a framework, supported by real-world data with subjective and objective parameters, to monitor aircrew fatigue and performance, and to determine the safe crew configuration for commercial airline operations. METHODS: Our protocol identified risk factors for fatigue-induced performance degradation as triggers for fatigue risk and performance assessment. Using both subjective and objective measurements of sleep, fatigue, and performance in the form of instruments such as the Karolinska Sleepiness Scale, Samn-Perelli Crew Status Check, Psychomotor Vigilance Task, sleep logs, and a wearable actigraph for sleep log correlation and sleep duration and quality charting, a workflow flagging fatigue-prone flight operations for risk mitigation was developed and trialed. RESULTS: In an operational study aimed at occupational assessment of fatigue and performance in airline pilots on a three-men crew versus a four-men crew for a long-haul flight, we affirmed the technical feasibility of our proposed framework and approach, the validity of the battery of assessment instruments, and the meaningful interpretation of fatigue and work performance indicators to enable the formulation of safe work recommendations. CONCLUSION: A standardized occupational assessment protocol like ours is useful to achieve consistency and objectivity in the occupational assessment of fatigue and work performance.

Knowledge and Self-Protective Practices Against COVID-19 Among Healthcare Workers in Vietnam.

Background: In middle-income countries such as Vietnam, where healthcare resources are already constrained, protecting healthcare workers (HCWs) is essential for ensuring the sustainability of COVID-19 response in Vietnam. This study was conducted to assess the knowledge and practices regarding the prevention of the COVID-19 among the HCWs in Vietnam to identify the ways of disseminating information to maximize the safety of these essential workers. Methods: An online cross-sectional study, using respondent-driven sampling, was conducted in Vietnam with 742 participants within 2 weeks. The validity of the questionnaire was examined by exploratory factor analysis. Descriptive statistics were used to identify the level of knowledge and practices among the HCWs to prevent the COVID-19. Inferential statistics and regression modeling were used to identify the associated factors with results. Results: Vietnamese HCWs had a high level of knowledge with more than 75% of the participants demonstrating awareness of all the modes of transmission aside from air. The mean knowledge score was 3.7 ± 0.8 (range 1-5). Nearly all the participants relied on the Ministry of Health (98.3%) and the internet (95.5%) for information regarding the COVID-19. The participants endorsed a moderately high level of self-protective practices with mean scores of 4.2 and 3.6 (band score 1-5) for the precautionary and psychological measures, respectively. Nurses were more likely to practice the precautionary measures than doctors and the HCWs at the central level were more likely to practice the psychological measures than those at the district level. Conclusion: Future education initiatives should consolidate the latest literature in an accessible format, focusing initially on the gaps of knowledge regarding aerosol transmission. These initiatives should primarily focus on the doctors, especially those in emergency and intensive care departments.

Impacts of COVID-19 on the Life and Work of Healthcare Workers During the Nationwide Partial Lockdown in Vietnam.

Background: Healthcare workers are frontline responders facing a disproportionate increase in occupational responsibilities during the COVID-19 pandemic. Added work-related stress among healthcare personnel may lead to personal and work-related repercussions, such as burnout or decreased quality of care for patients; however, little is known about how the COVID-19 pandemic affects the daily work and life of these workers. This study aimed to evaluate the personal and occupational impacts of the COVID-19 induced partial lockdown in Vietnam among hospital staff. Methods: A cross-sectional web-based study was carried out to collect demographic data and the personal and job impacts of respondents during the second week of national lockdown in April 2020. Snowball sampling technique was applied to recruit 742 hospital staff. The exploratory factor analysis (EFA) was used to examine the validity of the instrument. Results: Of the 742 respondents, 21.2% agreed that "working attitude well-maintained," followed by 16.1% of respondents who reported that there were "enough employees at work." Only 3.2% of respondents agreed that "their work was appreciated by society." Furthermore, healthcare workers in the central region were less likely to have experienced "Avoidance of disclosure and discrimination related to COVID-19" than other areas (Coef. = - 0.25, CI: -0.42 to -0.07). Being women also had a negative association with scores in "Avoidance of disclosure and discrimination related to COVID 19" domain (Coef. = -0.27, CI: -0.43 to -0.12) while having a positive association with "negative attitude towards working conditions" domain (Coef. = 0.19, CI: 0.09 to 0.3). In addition, working in administrative offices (Coef. = 0.20; 95% CI = 0.05 to 0.36) and infectious departments (Coef. = 0.36; 95% CI = 0.09 to 0.63) had a positive association with "Increased work pressure due to COVID 19" domain. Conclusion: These findings revealed marginal impacts of the COVID-19 pandemic on the work and life of hospital staff in Vietnam. Furthermore, this study highlighted the importance of implementing preventive strategies during the nationwide partial lockdown to manage hospital admissions and the burden on healthcare workers. Finally, this study characterizes targeted demographics that may benefit from appreciation by employers and society during a national pandemic.

Psychosocial Impacts of COVID-19 on Healthcare Workers During the Nationwide Partial Lockdown in Vietnam in April 2020.

Background: The psychosocial impact of COVID-19 is greater among healthcare workers (HCWs) than the general population. This study aims to identify psychosocial problems faced by HCWs in Vietnam during the national partial lockdown between 1 and 22 April 2020 and to identify risk factors associated with psychosocial issues among this population. Methods: A cross-sectional study was conducted in the second week of April 2020 during the national lockdown in Vietnam. Snowball sampling technique was used to recruit participants through web-based surveys. The Impact of Events Scale-Revised (IES-R) was used to assess the impact of COVID-19 on HCWs through online surveys. Results: Of the 349 HCWs, we found 22.6% reported psychosocial problems. Most of participants reported having exposure to COVID-19 daily (48.7%). The majority of them also felt that their job put them at risk of SARS-CoV-2 infections (90.3%) and expressed fear of potential infection (85.7%). Despite COVID-19 risks, 95.4% of participants, however, expressed their willingness to continue working at their current health facility. In addition, 94.8% of participants believed if they or their family members had been infected, their agency leaders would have provided them with appropriate medical care. Lastly, HCWs who worked in the internal medicine department who did not take care of COVID-19 patients or expressed fear of becoming infected were more likely to have higher total IES-R scores. Conclusion: Our findings suggest that the support of healthcare leaders and assurance of care might be helpful in mitigating the psychological effects of COVID-19 among HCWs in Vietnam. These resources should be tailored to HCWs who are working in different areas of health services, including staff who are not working directly with COVID-19 patients. In addition, psychosocial health resources should be provided for not only physicians but also nursing staff.

COVID-19 and Return-To-Work for the Construction Sector: Lessons From Singapore.

Singapore's construction sector employs more than 450,000 workers. During the height of the COVID-19 pandemic in Singapore from April to June 2020, migrant workers were disproportionately affected, including many working in the construction sector. Shared accommodation and construction worksites emerged as nexuses for COVID-19 transmission. Official government resources, including COVID-19 epidemiological data, 43 advisories and 19 circulars by Singapore's Ministries of Health and Manpower, were reviewed over 8 month period from March to October 2020. From a peak COVID-19 incidence of 1,424.6/100,000 workers in May 2020, the incidence declined to 3.7/100,000 workers by October 2020. Multilevel safe management measures were implemented to enable the phased reopening of construction worksites from July 2020. Using the Swiss cheese risk management model, the authors described the various governmental, industry, supervisory and worker-specific interventions to prevent, detect and contain COVID-19 for safe resumption of work for the construction sector.