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Unhygienic disposal of children's stools affects children's health in terms of their susceptibility to many diseases. However, there are no existing studies into the impact of unhygienic stool disposal in Cambodia. Therefore, this study aimed to identify factors associated with the unhygienic disposal of children's stools among children under the age of five in Cambodia. An analytical cross-sectional study was conducted using data from the Cambodia Demographic and Health Survey (CDHS) 2014. A multivariable binary logistic regression was conducted using Stata to analyze factors associated with the unhygienic disposal of children's stools. Overall, the prevalence of practicing unhygienic disposal of children's stools was 29.27% (95%CI: 27.51%- 31.09%). Factors statistically associated with this practice were: living in the Central Plain, Plateau and Mountains, Coastal and Sea regions (AOR = 1.65; 95% CI: 1.33-2.04), (AOR = 2.53; 95% CI: 1.98-3.24) and (AOR = 4.16; 95% CI: 3.15-5.48) respectively, poor household wealth (AOR = 1.58; 95% CI: 1.31-1.91), the mother having no education (AOR = 1.45; 95% CI: 1.14-1.85), a high number of children aged under five (AOR = 1.11; 95% CI: 1.03-1.20), being in the \"other\" religious category (AOR = 1.77; 95% CI: 1.25-2.51), living in a household with unimproved toilet facilities (AOR = 1.22; 95% CI: 1.11-1.34), living in a household with inadequate hygiene (AOR = 1.33; 95% CI: 1.12-1.59), and the household not being visited by a family planning worker in the last year (AOR = 1.45; 95% CI: 1.19-1.77). However, an increase in the child's age by even a month had significant negative associations with unhygienic practice (AOR = 0.65; 95% CI: 0.60-0.70), even when controlling for other covariates. Almost one third of the mothers do not practice hygienic disposal of children's stools in Cambodia. Unhygienic practices were more prevalent in certain regions, and were also associated with low wealth, lack of education, an increase in the number of children under five in the household, religion, lack of sanitation and access to healthcare professionals. Conversely, the child's age was found to be positively associated with the hygienic disposal of children's stools.

In animal models, exposure to high noise levels can cause permanent damage to hair-cell synapses (cochlear synaptopathy) for high-threshold auditory nerve fibers without affecting sensitivity to quiet sounds. This has been confirmed in several mammalian species, but the hypothesis that lifetime noise exposure affects auditory function in humans with normal audiometric thresholds remains unconfirmed and current evidence from human electrophysiology is contradictory. Here we report the auditory brainstem response (ABR), and both transient (stimulus onset and offset) and sustained functional magnetic resonance imaging (fMRI) responses throughout the human central auditory pathway across lifetime noise exposure. Healthy young individuals aged 25–40 years were recruited into high (n = 32) and low (n = 30) lifetime noise exposure groups, stratified for age, and balanced for audiometric threshold up to 16 kHz fMRI demonstrated robust broadband noise-related activity throughout the auditory pathway (cochlear nucleus, superior olivary complex, nucleus of the lateral lemniscus, inferior colliculus, medial geniculate body and auditory cortex). fMRI responses in the auditory pathway to broadband noise onset were significantly enhanced in the high noise exposure group relative to the low exposure group, differences in sustained fMRI responses did not reach significance, and no significant group differences were found in the click-evoked ABR. Exploratory analyses found no significant relationships between the neural responses and self-reported tinnitus or reduced sound-level tolerance (symptoms associated with synaptopathy). In summary, although a small effect, these fMRI results suggest that lifetime noise exposure may be associated with central hyperactivity in young adults with normal hearing thresholds. •Neural correlates of lifetime noise exposure using fMRI.•Auditory brainstem response (ABR) measured in the same listeners.•Tinnitus and reduced sound-level tolerance measured in the same listeners.•Enhanced fMRI response to sound onset is associated with high noise exposure.

Context Magnetic resonance imaging (MRI) is an invaluable diagnostic and research tool. Having an MRI scan is not always comfortable and may deter people from taking part in MRI research. Maximizing comfort during scanning will improve participants’ experiences and image quality. Objective To define which factors improve comfort during an MRI scan for research by asking people who have participated in MRI research. Setting and participants People who had participated in MRI research during the past two years were invited, as ‘public advisors’ to discuss their experiences together and agree on which factors are most important in ensuring comfort while participating in MRI research. Results Public advisors ranked researcher‐participant communication as the most important factor. In response, an example script to guide MRI researchers in communicating with participants was developed through close consultation between research staff, public advisors and the public. This outlines the often‐missing information necessary to convey to participants, including explaining the reasons behind instructions, managing expectations, providing reassurance, encouragement and progress updates during scanning. Conclusions Drawing upon personal experiences as MRI research participants, public advisors highlighted the importance of effective and on‐going researcher communication throughout. The example script may be used as a training tool for researchers to help ensure participants’ comfort during scanning. Patient and public contribution All contributors had previously taken part in MRI research. The project was co‐designed, co‐delivered and co‐authored with a public research partner. Public advisors agreed key factors of importance. External public reviewers and public advisors reviewed example script drafts.

Lifetime noise exposure is generally quantified by self-report. The accuracy of retrospective self-report is limited by respondent recall but is also bound to be influenced by reporting procedures. Such procedures are of variable quality in current measures of lifetime noise exposure, and off-the-shelf instruments are not readily available. The Noise Exposure Structured Interview (NESI) represents an attempt to draw together some of the stronger elements of existing procedures and to provide solutions to their outstanding limitations. Reporting is not restricted to prespecified exposure activities and instead encompasses all activities that the respondent has experienced as noisy (defined based on sound level estimated from vocal effort). Changing exposure habits over time are reported by dividing the lifespan into discrete periods in which exposure habits were approximately stable, with life milestones used to aid recall. Exposure duration, sound level, and use of hearing protection are reported for each life period separately. Simple-to-follow methods are provided for the estimation of free-field sound level, the sound level emitted by personal listening devices, and the attenuation provided by hearing protective equipment. An energy-based means of combining the resulting data is supplied, along with a primarily energy-based method for incorporating firearm-noise exposure. Finally, the NESI acknowledges the need of some users to tailor the procedures; this flexibility is afforded, and reasonable modifications are described. Competency needs of new users are addressed through detailed interview instructions (including troubleshooting tips) and a demonstration video. Limited evaluation data are available, and future efforts at evaluation are proposed.

Globally, adolescent mental health problems reportedly manifest more severely in individuals with lower mental health literacy. Mental health curriculum interventions using social media have been associated with positive implementation outcomes. This study aimed to investigate whether such an intervention significantly improves adolescent mental health literacy and is associated with positive implementation outcome measures. This study employed a quasi-experimental design, comparing the before-and-after difference between the intervention group (n =77) and the control group (n =76). A mental health literacy module was delivered using social media. Data were collected using validated questionnaires. Effect size and difference-in-differences model calculations (and associated 95% confidence intervals, CI) were conducted alongside other descriptive analyses. The estimated intervention effect size and difference-in-differences estimates were greater than zero. The effect was greater in the intervention than in the control group (p<0.05) despite sex and age differences. The effect size estimate provided by Cohen's d and Hedges' g values was medium-to-large (d/g=0.429-0.767, p<0.05). The difference-in-differences reflected a significant effect (DID=0.348, CI: 0.154-0.542, p<0.001) in increasing mental health literacy despite differences associated with sex, age, and school grade. The intervention program was acceptable, appropriate, feasible, and satisfactory, and more than 80% of participants said they agree to completely agree with these implementation outcomes. Resources and personal and family-related factors were among the perceived influencing factors determining the effectiveness and implementation outcome measures. The intervention program effectively improved the mental health literacy of adolescents. It has been highlighted that social media interventions for mental health promotion could be practical and scalable; however, there is a need to take into account socio-demographic differences and barriers to inclusion/compliance.

Background: Soft drinks are an attractive and popular drink, consumed by many people to fulfill their energy. However, soft drink consumption is an important risk factor for non-communicable diseases. This study aimed to investigate the association between socioeconomic factors and soft drink consumption among adults in Cambodia.  Methods: A cross-sectional analytical study with multi-stage random sampling was used to select 749 respondents from 12 communes across 5 districts in Phnom Penh, the capital city of Cambodia. A structured questionnaire was used to assess socioeconomic factors and soft drink consumption. Data were analyzed using bivariate and multivariable logistic regression. Crude odds ratios and adjusted odds ratios (AORs) with 95% confident intervals (CI) were calculated to show the strength of associations. Results: The overall prevalence of soft drink consumption was 44.73% (95%CI: 41.16-48.30%) across the sample population. The final model of multiple logistic regression showed only four factors to be significantly associated with soft drink consumption: gender, age, family size and income. Respondents most likely to consume soft drinks were men (AOR: 1.49, 95%CI: 1.10-2.00; p=0.009), those aged 31-59 years (AOR: 1.93, 95%CI: 1.98-4.62; p<0.001), those in a household of less than 5 individuals (AOR: 1.38, 95%CI: 1.44-3.19; p=0.036), and those earning <300$/month (AOR: 1.59, 95%CI: 1.10-2.31; p=0.003). Conclusion: The prevalence of soft drink consumption in Cambodia is a major concern for public health. The predictive factors significantly associated with soft drink consumption identified by this study were gender, age, household size and income. Therefore, all stakeholders should contribute to social marketing and intervention focusing on reducing the consumption of soft drinks through advertising on social media, television and other popular media platforms. Furthermore, additional taxation of soft drinks should be considered.

Advanced methodical learning and optimised learning leads to better-trained doctors. Such teaching typically comprises the illustration of features and access to facilities. This article explores the role of \"Special clinics\" in medical education. The role of sophisticated \"Special clinics\" is to provide vigour and vibrancy in treating and teaching as well as advancing the art and science of medicine. All this contributes towards the current evidence indicating benefits of reducing hospitalization. This article comprises an analysis of the guidance produced by leading medical education institutions. Findings are presented in the perspective of a relevant theoretical framework around \"Special clinics\", in light of the available evidence and personal experience. The implementation and potential impacts of \"Special clinics\" are presented within the context of the \"4SAs\", a favoured teaching mnemonic: 1) Scientific Approach: medical education rules and regulations reflecting scientific reasoning in support of \"Special clinics\", 2) Setting Advantages: the mechanisms by which \"Special clinics\" are conducive to and contribute towards increasing the capacity to comprehensively treat complex disorders in the outpatient setting, avoiding hospitalization and its associated risks, as well as expenditure, 3) Sophistication Advantages: tools and techniques to ensure advanced clinical skills teaching including novel outpatient technologies, understanding the need for focussed study and practice, and exploiting the advantages of internationalization of medical education, and 4) Successes and Advancements: opportunities to observe experts providing specialist care of the highest standard. The use of a focussed approach aims to explore and advance frontiers of medical education. \"Special clinics\" will soon form a major component of the hospital workload and play a crucial role in medical education. They provide the advantage of condition-specific patient-centered care, the motivation for excellence. Clinical skills learnt by medical students in \"Special clinics\" will undoubtedly contribute to long-term improvements in the medical care.

Background: Soft drinks are an attractive and popular drink, consumed by many people to fulfill their energy. However, soft drink consumption is an important risk factor for non-communicable diseases. This study aimed to investigate the association between socioeconomic factors and soft drink consumption among adults in Cambodia.  Methods: A cross-sectional analytical study with multi-stage random sampling was used to select 749 respondents from 12 communes across 5 districts in Phnom Penh, the capital city of Cambodia. A structured questionnaire was used to assess socioeconomic factors and soft drink consumption. Data were analyzed using bivariate and multivariable logistic regression. Crude odds ratios and adjusted odds ratios (AORs) with 95% confident intervals (CI) were calculated to show the strength of associations. Results: The overall prevalence of soft drink consumption was 44.73% (95%CI: 41.16-48.30%) across the sample population. The final model of multiple logistic regression showed only four factors to be significantly associated with soft drink consumption: gender, age, family size and income. Respondents most likely to consume soft drinks were men (AOR: 1.49, 95%CI: 1.10-2.00; p=0.009), those aged 31-59 years (AOR: 1.93, 95%CI: 1.98-4.62; p<0.001), those in a household of less than 5 individuals (AOR: 1.38, 95%CI: 1.44-3.19; p=0.036), and those earning <300$/month (AOR: 1.59, 95%CI: 1.10-2.31; p=0.003). Conclusion: The prevalence of soft drink consumption in Cambodia is a major concern for public health. The predictive factors significantly associated with soft drink consumption identified by this study were gender, age, household size and income. Therefore, all stakeholders should contribute to social marketing and intervention focusing on reducing the consumption of soft drinks through advertising on social media, television and other popular media platforms. Furthermore, additional taxation of soft drinks should be considered.

Background: Soft drinks are an attractive and popular drink, consumed by many people to fulfill their energy. However, soft drink consumption is an important risk factor for non-communicable diseases. This study aimed to investigate the association between socioeconomic factors and soft drink consumption among adults in Cambodia.  Methods: A cross-sectional analytical study with multi-stage random sampling was used to select 749 respondents from 12 communes across 5 districts in Phnom Penh, the capital city of Cambodia. A structured questionnaire was used to assess socioeconomic factors and soft drink consumption. Data were analyzed using bivariate and multivariable logistic regression. Crude odds ratios and adjusted odds ratios (AORs) with 95% confident intervals (CI) were calculated to show the strength of associations. Results: The overall prevalence of soft drink consumption was 44.73% (95%CI: 41.16-48.30%) across the sample population. The final model of multiple logistic regression showed only four factors to be significantly associated with soft drink consumption: gender, age, family size and income. Respondents most likely to consume soft drinks were men (AOR: 1.49, 95%CI: 1.10-2.00; p=0.009), those aged 31-59 years (AOR: 1.93, 95%CI: 1.98-4.62; p<0.001), those in a household of less than 5 individuals (AOR: 1.38, 95%CI: 1.44-3.19; p=0.036), and those earning <300$/month (AOR: 1.59, 95%CI: 1.10-2.31; p=0.003). Conclusion: The prevalence of soft drink consumption in Cambodia is a major concern for public health. The predictive factors significantly associated with soft drink consumption identified by this study were gender, age, household size and income. Therefore, all stakeholders should contribute to social marketing and intervention focusing on reducing the consumption of soft drinks through advertising on social media, television and other popular media platforms. Furthermore, additional taxation of soft drinks should be considered.

Background: Over the past decades, fast food has been rapidly gaining popularity and availability worldwide. Its consequential impact on human health is among the highest in terms of non-communicable diseases. Therefore, this study aimed to investigate the level of understanding of fast food consumption among adults in Phnom Penh, the capital city of Cambodia. Methods: A cross-sectional analytical study aimed to investigate the level of understanding of factors associated with fast food consumption, among adults in Phnom Penh. Multi-stage random sampling was used to select 749 respondents from 12 communes of five districts in Phnom Penh. A structured questionnaire was used to assess the level of understanding of fast food consumption, and associated factors. Data were analyzed using descriptive statistics, together with bivariate and multivariable logistic regression. Crude odds ratios (CORs) and adjusted odds ratios (AORs) with 95% confident intervals (CI) were calculated to show the strength of associations. Results: The understanding of factors associated with fast food consumption was poor in 52.07% (95% CI: 48.48-55.66), fair in 22.70% (95% CI: 19.69-25.70) and good in 25.23% (95% CI: 22.12-28.35) of those surveyed. After adjusting for other covariates, unsatisfactory levels of knowledge around fast food consumption were found to be significantly associated with not taking regular exercise (AOR = 1.53; 95% CI: 1.15-2.25; p<0.001) and sleeping less than eight hours per night (AOR = 1.64; 95% CI: 1.09-2.12; p=0.014). Conclusion: Health promotion and disease prevention should be conducted among at-risk populations in order to raise the level of understanding of factors around fast food consumption.