BACKGROUND/OBJECTIVES: The purpose of this study is to utilize an extended Theory of Planned Behavior in identifying predictors of exclusive breastfeeding intention and behavior among women in Kelantan, Malaysia. SUBJECTS/METHODS: A prospective cohort study was conducted, recruiting pregnant womenthrough two-stage cluster sampling. Their exclusive breastfeeding intention, attitude, perceived norm, perceived behavioral control and past behavior were obtained at baseline through interviewer-guided questionnaire. At one month after delivery, another interview was conducted to determine the two additional variables in the extended theory, which were their postpartum support and breastfeeding difficulty. The behavior, which was the actual duration of exclusive breastfeeding, was obtained from the second follow-up at six months. Pearson correlation and two hierarchical regression analyses were conducted. RESULTS: A total of 200 women completed the study follow-up. Their median intended exclusive breastfeeding duration was 4.0 (IQR 5) months, and the median actual duration was 1.0 (IQR 4) month. The Theory of Planned Behavior explained 51.0% of the variance in intention, with perceived behavioral control and attitude were the significant predictors. It also explained 10.0% of the variance in behavior, but the addition of postpartum support and breastfeeding difficulty increased the amount of explained variance in behavior by 6.0%. The significant predictors of exclusive breastfeeding behavior were intention, postpartum support and breastfeeding difficulty. CONCLUSION: The extended Theory of Planned Behaviorhad a good predictive ability in explaining exclusive breastfeedingintention and behavior. The women's intention to practice exclusive breastfeeding may be improved by improving their perceived behavioral control and attitude. Providing correct postpartum support and skills to handle breastfeeding difficulties after delivery will improve their exclusive breastfeeding behavior.
Breast Feeding* ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Intention* ; Malaysia* ; Postpartum Period ; Prospective Studies

Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) is increasingly reported worldwide causing serious threats to healthcare. This study aimed to identify the common organisms associated with CRE, the clinical characteristics and risk factors for acquiring CRE infection and colonisation among hospitalised patients. Methods: This is a matched, case-control study. Patients aged 18 years and above whom were hospitalised from January 2019 to December 2019 and had CRE isolated from clinical specimens were matched with carbapenem-susceptible controls (CSE), based on gender and age. Univariate and multivariate statistical analysis was performed. Results: Among 184 patients, Klebsiella pneumoniae was the most common organism causing CRE infection and colonisation. Chronic kidney disease (p=0.025, OR:3.12, 95% CI:1.15-8.41), urinary catheterisation (p=0.005, OR:3.67, 95% CI:1.49- 9.00), prior use of cephalosporin (p<0.001, OR:4.69, 95% CI:1.96–11.22) and beta-lactam combination agent (p<0.001, OR:7.18, 95% CI:2.98-17.26) were identified as the independent risk factors. Conclusion: Chronic kidney disease, urinary catheterisation, prior use of cephalosporin and beta-lactam combination agents were independently associated with CRE infection and colonisation. These findings enable targeting potential CRE cohorts, hence, necessitate early undertaking of prevention measures to delay the onset of CRE. A rigorous effort by antibiotic stewardship an infection control team are pivotal.