Introduction: Childhood obesity becomes a global epidemic with the majority are living in developing countries. Obese children are at risk of becoming obese adults with non-communicable diseases, which may further lead to huge economic burden for the affected countries. The study objectives were to determine the biosocial background contributing overweight and obesity among preschoolers in Putrajaya (2017) - sociodemographic, pre-and perinatal factors, feeding and weaning practices. Methods: Cross-sectional study was performed using cluster random sampling among 897 preschoolers, whose anthropometric body weights and heights were measured. The calculated BMI was used to determine their obese status based on WHO Growth Standards 2006 and Reference 2007. Their mothers were distributed with self-administered, validated, and pre-tested questionnaires regarding their children’s first two-years-of-life experience. Chi Square test was used for bivariate categorical analysis, Independent T-test and Mann Whitney U test for continuous data analysis. Multivariate binary logistic regression was executed to determine predictors of child obesity. Results: The prevalence of obese children was 7.4%, which can be predicted by the increase in child’s age (Adjusted Odd Ratio: 2.619; 95%CI: 1.435 – 4.780), mothers with higher level of education (AOR: 3.896; 95%CI: 1.127 – 13.470), and higher maternal BMI (AOR: 1.132; 95%CI: 1.057 – 1.213). Conclusion: Three predictors of child obesity can be derived from sociodemographic and pre-and perinatal factors. Further application on these predictors in more targeted interventions and policies need to be considered to reduce the prevalence of obesity and related non-communicable diseases in the country.
Introduction: Adolescent aggression has become a serious public health problem with the escalating juvenile cases and violence among secondary school students by inflicting harm to others. The objective of this study was to deter-mine the biopsychosocial predictors of adolescent aggression among Form Four students in Hulu Langat. Methods: Cross-sectional study was conducted by proportionate population sampling method among Form Four students from all public secondary schools in Hulu Langat. Pre-tested questionnaires distributed to measure students’ ag-gression, demographic (ethnicity, family income), biological (sex, head injury, nutritional deficiency, breakfast skip-ping), psychological (attitude towards aggression, normative beliefs to aggression, personality trait, and emotional intelligence), and social factors (family environment, single parent status, domestic violence, peer deviant affiliation, alcohol, smoking, and substance abuse). Data was analysed using multivariate analysis to determine the significant predictors. Results: 480 students from four randomly selected schools participated in the study with response rate of 96.5%. The median aggression score was low, which was 23.00 (IQR=12.00). From simple linear regression, 15 factors had significant relationship with adolescent aggression. The predictors of adolescent aggression were lower family income, Malay ethnicity, nutritional deficiency, attitude towards aggression, and peer deviant affiliation (F [8, 244] =15.980, p-value
Introduction: Adolescent aggression is an important public health concern with escalating prevalence of juvenile cases and violence among these age groups including robbery, homicide, and gang fights. The objectives of this study protocol are to determine the biopsychosocial predictors and explore the contextual factors of adolescent ag- gression among secondary school students in Hulu Langat. Methods: Explanatory mixed method study design will be used, consist of quantitative cross-sectional study followed by basic qualitative study. Proportionate population sampling among Form 4 secondary school students from selected public secondary schools in Hulu Langat will be executed. Questionnaires will be distributed to 481 students on aggression as the dependent variable, and several independent variables: demographic (ethnicity, family income), biological (sex, head injury, nutritional deficiency, breakfast skipping), psychological (attitude and normative beliefs, personality trait, emotional intelligence), and so- cial factors (family environment, single parent status, domestic violence, peer deviant affiliation, alcohol, smoking, substance abuse). Subsequently, participants with moderate to high aggression scores will be further explored on the contextual factors of adolescent aggression by in-depth interview. Multiple linear regression will be executed using SPSS to determine significant predictors whereas thematic analysis will be applied for qualitative data analysis on the context of adolescent aggression. Both findings will be further integrated and discussed to give comprehensive description on the phenomena. Conclusion: Better knowledge and understanding on adolescent aggression may generate new framework to drive more effective preventive strategies and unravel adolescent aggressive related Pub- lic Health problems.
Introduction: Family plays an important role in the development of an adolescent. Several theories postulate in-fluences of bully behaviours within family context. Persistent act of school bullying may lead to violence and eventually disruption of a normal adolescence mental health. This study was done to address whether family factors were associated with school bully perpetrator. Methods: This was a cross sectional study conducted among Form One students from twenty-five schools in Selangor. Parental and respondents’ consents were obtained prior to this research. Data was collected using a self-administered questionnaire comprising of sociodemographic data of the respondents, their family characteristics and parenting style. Cronbach alpha ranged from 0.70- 0.89. Data was analysed using SPSS v25. Ethical approval was obtained from the Ethics Committee for Research Involving Human Subject of Universiti Putra Malaysia (UPM). Results: Response rate was 92.7% with 1221 respondents. Majority of the respondents were females (62%), Malays (82.8%) and lived with married parents (91.2%). Prevalence of bully perpetrator was 12.8%. Parental marital status (p < 0.05), presence of substance abuse among family member (p < 0.05), presence of violence act among family member (p < 0.05), witnessing violence at home (p < 0.05), sibling violence (p < 0.05), presence of family hostility (p < 0.05) and permissive maternal parenting style ( p < 0.05) were associated with school bully perpetrators. Conclusion: This study showed the association between family factors and the development of school bully perpetrators. It is a strong message for parents, educators, policy makers and health providers to collaborate and redesign prevention programmes in an effort to contracept the birth of a school bully.
Introduction: Even though exclusive breastfeeding prevalence has increased from 19.3% in 2006 to 47.1% in 2016, this practice was slightly higher in urban areas (48.3%) compared to rural area (45.1%) in Malaysia. National Plan of Action for Nutrition of Malaysia III has set an indicator to achieve at least 70% exclusive breastfeeding by 2025. Therefore this study is to identify predictors that influenced exclusive breastfeeding practice in rural areas. Methods: This cross-sectional study was conducted in six rural health clinics in Hulu Langat District, Selangor among moth- ers with youngest child aged 6-48 months old. Respondents were selected through systematic random sampling. Validated self-administered questionnaire was used to assess sociodemographic factors, maternal factors, external factors and child’s factors. Mother’s height and weight was measured and body mass index was calculated. Data were analyzed using SPSS version 23. Multivariate logistic regression was used to determine the predictors for ex- clusive breastfeeding practice. Results: Response rate was 96% with a total of 311 mothers participated in this study. More than half of the mothers exclusively breastfed (52.4%). The predictors for exclusive breastfeeding were Malay ethnicity (AOR=3.951, 95% CI: 1.374-11.358), having tertiary education (AOR=2.401, 95% CI: 1.100-5.241) and positive attitude toward breastfeeding (AOR=7.755, 95% CI: 1.382-43.502). Conclusion: Prevalence of exclusive breastfeeding was higher in this study than the national level. Programme planners should pay special attention to Chinese and Indian ethnicities, mothers with lower level of education and negative attitude in order to improve breastfeeding practice among rural mothers.
Knowledge on under-five childhood immunization has been identified as a key factor in determining understanding and compliance to the schedule. Understanding the current levels of knowledge and introducing a health intervention to improve the level will benefit the population to be healthier and reduce morbidity. Materials and Method: A quasi-experimental study was conducted in nurseries in Putrajaya and Cyberjaya, Malaysia from January 2016 to January 2018. 98 respondents from Putrajaya were given the technology based intervention and 98 from Cyberjaya were the wait-listed control group. Respondents answered a validated, self-administered questionnaire at baseline, immediate post-intervention and 3 months post-intervention that were specifically targeted to examine their levels of knowledge on under five childhood intervention. Results: Data was analysed using Statistical Package for Social Science (SPSS) Version 23. The level of knowledge at baseline was 58.9% for the intervention group and 61.7% for the control group with no significant difference between both groups (p=0.651). Immediate post intervention showed a significant difference (p
Introduction: During which HFMD epidemic has kept on recurring worldwide, effective vaccine and specific treatment for HFMD are still not available, calling attention to on preventive practices as the mainstay of the management. Therefore, it is timely to renew the assessment on maternal preventive practices and its predictors in Klang District, Selangor wherein the endemicity and upsurge of HFMD cases has been demonstrated. Methods: A cross-sectional study was conducted from 1st April 2017 until 15th May 2015 among mothers of Community Development Department (KEMAS) preschool children in Klang District. Respondents were selected based on probability proportional to size sampling, whereas data collection was facilitated by validated, and reliable self-administered questionnaire, that examine on the preventive practices towards HFMD. Results: A total of 353 mothers responded to questionnaire, resulting response rate of 80.2%. Most of the respondent were housewife, married and obtained educational level up to secondary school. Insufficient knowledge score (13.61 ± 4.04) was demonstrated, with health belief highlighted on low mean score for perceived severity and perceived barrier, which was 8.30(SD=1.36) and 7.80(SD=2.14) respectively. Simple linear regression revealed significant linear relationship between preventive practices with knowledge and all health belief subscales. Hierarchical multiple linear regression reported predictors of preventive practices towards HFMD, which include knowledge, (perceived susceptibility)2, perceived severity, and perceived barrier, with the group of variables was significantly predicting the (preventive practice)3 and accounted for 13.1% variance in the (preventive practices)3 (F[5,347]=11.588, p value=
Introduction: Antenatal period is the best time to promote physical activity among women. However, this oppor-tunity is usually missed due to various factors such perceived harm to the baby, tiredness, difficulty to perform the activities, pelvic and back pain, lack of information, as well as low social support. This study determined the associ-ation of social support with the level of physical activity among pregnant women in the district of Seremban, Negeri Sembilan. Methods: A total of 936 antenatal women met the eligibility criteria and were enrolled in a cross-sectional study using proportionate stratified random sampling. Data on social support from the spouse, family and friend were obtained using a 5-point Likert scale while physical activity was assessed using a short version of the Interna-tional Physical Activity Questionnaire (IPAQ). Statistical analysis was conducted using chi-square test to evaluate the association between the study variables. Results: A total of 880 respondents completed the questionnaire. Out of that, 64.2% were physically inactive. Significant associations were found between social support from the spouse (p < 0.001), family (p = 0.001) and friends (p = 0.004) with the level of physical activity among the respondents. Conclusion: Social support plays a pivotal role in motivating antenatal women to perform physical activity. Thus, health intervention on physical activity among these women should involve the spouse, family members and friends to ensure the success of the program.
Introduction: Despite advancement of treatment modalities, Tuberculosis (TB) treatment interruption rate has glob- ally accelerating, calling for greater framework shifting towards psychosocial intervention. Similarly, Selangor state had reported the perturbing TB treatment interruption rate, which was figured persistently above 10% in the interval year of 2014 to 2018, thus signifies an empirical assessment on Information-Motivation-Behavioural skills (IMB) determinants of TB intensive phase treatment. This study aims to determine the time to intensive phase TB treatment interruption and its prognostic factors among newly diagnosed pulmonary Tuberculosis (PTB) smear positive patients in urban district Selangor. Methods: A multi-centric prospective cohort study will recruit 695 newly diagnosed PTB smear positive patients at treatment centres in urban districts, Selangor. This study will utilize validated self-admin- istered questionnaire and standardised data collection form (PROFORMA). At baseline, we will elicit information on IMB models constructs, additionally on socio-demographics, health service factors and clinical characteristics. Meanwhile, four points follow up will be executed to retrieve information on treatment status and time varying effects of body weight, treatment side effects, symptoms improvement and internalised stigma. Finally, survival analysis will be computed to identify the time to intensive phase treatment interruption and its prognostic factors. Conclusion: This study will enlighten IMB model determinants of intensive phase treatment interruption, hence to endeavour psychosocial elements in designing time relevant public health strategies in TB case management.
Women with gestational diabetes mellitus (GDM) during their pregnancy have a greater risk of developing overt diabetes mellitus and dysglycemia (prediabetes, impaired glucose tolerance or impaired fasting glucose) later in future, compared to mothers with normal pregnancy. Postpartum screening is crucial for early identification of type 2 diabetes (T2DM) in women with GDM. Nevertheless, despite various strategies, its rate remains low. A systematic review using databases of PubMed/Medline, Science Direct and CINAHL from 2008 to 2018, was conducted to iden- tify the factors influencing the attendance of postpartum diabetes screening. Open access English articles, focusing on observational studies were reviewed. Primary screening of titles and abstracts of 91 articles were done, secondary screening of 31 articles resulted in 6 articles, included in this manuscript. Various factors identified to be associated with the attendance to postpartum diabetes screening, which are age, education, ethnicity, some obstetric factors like multiparty, and history of insulin usage previously. Many women fail to be screened for diabetes during the postpar- tum period, and this delays T2DM diagnosis, which in turn gives rise to various complications. Further research that considers these factors is necessary for developing interventions to improve postpartum T2DM screening for mothers with GDM during their pregnancy.
Introduction: Ovarian cancer is the fourth most common cancer among Malaysian women. Despite being a malig-nancy with low incidence, ovarian cancer has a high mortality rate with just about 35.2% of 5-year survival. There is a limited published study on the risk factors for this cancer in Malaysia. This study aimed at identifying the repro-ductive risk factors of ovarian cancer among women at selected hospitals in Klang Valley. Methods: A hospital-based case-control study was conducted from April 2017 to November 2019. Subjects were Malaysian citizens and aged 18 years and above. The case referred to a known case ovarian based on histopathological examination (HPE) and had been diagnosed not more than 2 years during the recruitment into the study. Controls were selected based on a negative result of HPE or intra-operative visual inspection and examination or normal findings from the ultrasound. Data was collected using a self-administered questionnaire. Results: A total of 111 cases and 134 controls who ful-filled the inclusion criteria participated in this study. Binary multiple logistic regression analysis showed that age at first pregnancy and infertility experience were significantly associated with risk of ovarian cancer. The odds of first pregnancy after the age of 25 years among cases was higher compared to the odds among controls (AOR=2.997, 95%CI: 1.295, 6.932, p=0.010). On the other hand, the odds of infertility experience among cases was lower com-pared to the controls (AOR=0.289, 95%CI: 0.099, 0.846, p=0.024). The lower odds of infertility experience among cases shown in this study must be interpreted with care because of wide interval and as infertility was reported to be a risk factor of ovarian cancer elsewhere. Conclusion: Reproductive risk factor for ovarian cancer were aged at first pregnancy of 25 years and above. Prevention of ovarian cancer should be targeted to his group.
Introduction: Hypertension treatment aims to reduce morbidity and mortality from cardiovascular and renal com- plications. In Malaysia, there is a high prevalence of uncontrolled hypertension among patients on treatment. This study aimed to identify the predictors of uncontrolled hypertension among patients receiving treatment from public primary care clinics in Pulau Pinang, Malaysia. Methods: An unmatched case-control study with 1:1 ratio was con- ducted among 334 hypertensive patients receiving treatment from selected public primary care clinics. Mean blood pressure measurements from the last two clinical visits were used to determine the hypertension status, and uncon- trolled hypertension was defined as 140/90 mm Hg or higher. The cases were those with uncontrolled hypertension, while the controls were those with controlled hypertension. Participants were recruited by simple random sampling. Independent variables were sociodemographic factors, clinical and psychosocial factors, medication adherence, lifestyle modification, and clinical inertia. Data were collected using validated questionnaires and review of medi- cal records. Multiple logistic regression analysis was performed by using IBM SPSS Statistics 25. Results: The mean age of respondents was 59 years (SD=11). Patients with medication non-adherence had 11.36 times higher odds of uncontrolled hypertension (aOR=11.36, 95% CI=6.59, 19.56, p
The American College of Obstetricians and Gynaecologists (ACOG), US Department of Health and Human Services (HHS), and American College of Sports Medicine (ACSM) recommend that all pregnancies with medical clearance should engage in moderate-intensity physical activity (PA) at least 150 minutes per week. However, most of them are physically inactive. Thus, this article aims to identify predictors of physical inactivity among antenatal women. Four databases were used to search relevant articles using PICO strategy systematically. The screening began with examining titles, abstracts, and keywords, followed by scrutinizing and assessing full articles. Finally, a total of five studies were included for the data extraction, and the predictors are sociodemographic (trimesters, parity, marital status, and pre-pregnancy PA status), socioeconomic (household income), lifestyle (smoking and eating unhealthy diet) and health-related factors (multiple pregnancies, received fertility treatment, being unwell, musculoskeletal pain, symptom of early pregnancy and uterine contraction). All these predictors provide crucial information for the success of future physical activity intervention.
Aggression is one of the most common Paediatric Psychiatric emergency problems presented in healthcare services with major public health impacts. The aim of this review is to determine the psychosocial predictors of adolescent aggression. Systematic review on observational study designs were conducted. Recent five years English published journal articles (2014-2018) were searched in three databases (Science Direct, PubMed and EBSCO) from April 2018 until May 2018. The final 15 articles (seven prospective cohort, eight cross-sectional studies) were included in the systematic review. Psychological predictors were mainly on the personality traits and emotional problems experienced by the adolescents including callous-unemotional traits, hostility, anger, and low empathy. Self-control was found to be protective against adolescent aggression. Social predictors that contribute to the aggression among adolescents according to the highest reported number of articles were peer influence, followed by school climate, substance use, neighbourhood influence, family, and parent factors. In conclusion, psychosocial predictors of adolescent aggression include both Psychological Factors; mainly personality traits and emotional problems, and Social Factors; mainly peer influence and substance use. This warrants for more holistic approach in dealing with aggressive adolescents that can be applied in more targeted and focused intervention strategy deliveries.
Background: Lack of awareness, poor knowledge and attitude regarding cancer have been identified as possible reasons accounting for the late presentation which lead to the poor survival of cancer patients in Malaysia. Method: A cross sectional study was conducted in three traditional Malay villages in Negeri Sembilan among adult males. Those who were already diagnosed with prostate cancer or Non malaysians were excluded from the study. Data was collected using self-administered questionnaires which consist of several sections namely socio-demographic, awareness about prostate cancer, sources of information, family history of prostate cancer, lifestyle associated with risk of cancer, knowledge and attitude towards prostate cancer. Data was analysed using SPSS version 22.0. Chisquare test was used to determine associations. Level of significance was set at p