Introduction: Premarital sexual is a sexual and reproductive health concern among adolescents in Malaysia. Guided by the constructs of the Social Cognitive Theory (SCT), this study aimed to determine the moderating role of gender on premarital sexual practices among the late adolescents in Kuantan, Pahang. Methods: Probability sampling was utilized to sample the late adolescents from tertiary educational centres. Confirmatory factor analysis (CFA) was conducted to verify the factor structure of the observed variables, with the interrelationship between variables were studied using structural equation modelling (SEM). Moderation analysis was completed via multigroup analysis (MGA). Results: A response rate of 72.2% was obtained, with 390 adolescents aged 18 to 19 years old participated in the study. The total mean for premarital sexual practices was 1.14 ± 0.47, with highest mean observed for masturbation (1.33 ± 0.83). Attitude (β = -0.111, p = 0.021), religiosity (β = -0.014, p = 0.032) and high-risk activities (β = 0.999, p < 0.001) illustrated significant relationships with premarital sexual practices. A moderated regression analysis showed significant interactive effects between gender and premarital sexual practices, with negative association between attitude and religiosity with premarital sexual practices were found among male respondents. Conclusion: This empirical study demonstrated significant moderation effect of gender between attitude and religiosity with premarital sexual practices among targeted late adolescents’ population in Pahang, Malaysia. Any efforts to tackle issue related to premarital sexual practices among similar population should be directed towards male adolescents with lower religiosity score.

Introduction: Khat chewing has been a common habit throughout the Horn of Africa and the Arabian Peninsula for thousands of years. It is estimated that more than 20 million people in Africa and the Arabian Peninsula are adolescents. This study aimed to assess the knowledge, attitude, and self-efficacy of khat chewing among adolescents in Mogadishu, Somalia. Method: A cross-sectional study with a sample of 284 adolescents was used. A self-administered pretested questionnaire was used after obtaining an ethical approval from Universiti Putr Malaysia. Data were coded, entered, and statistically analyzed. Results: The prevalence of khat chewing among respondents was 10.2%. Almost more than half of the participants had poor knowledge (184, 64.8%) and self-efficacy (154, 54.2%), while 140 (49.3%) respondents had positive attitudes. Significant predictors of the students’ knowledge of khat chewing included monthly income of more than 500$ (AOR: 2.145), family history such as cousin (AOR=0.347), fathers with a high school (AOR=1.75) and a college degree (AOR=2.21). Significant predictors of the students’ attitude towards khat chewing included family income of 100-299 USD (AOR=0.5), fathers’ with a high school (AOR=2.5) and college (AOR=2.4). Significant predictors of the students’ self-efficacy to resist khat chewing included family income of 100- 300$ (AOR=2.25), fathers with a high school (AOR=2.6), and khat accessibility that is fairly difficult (AOR=0.63) and fairly easy (AOR=0.55). Conclusion: The study highlights the need for increased awareness and education about the adverse effects of khat chewing and the importance of addressing social norms and peer pressure in shaping adolescent attitudes toward Khat.

Introduction: Despite the importance of postpartum type-2 diabetes mellitus (T2DM) screening to ensure early detection and effective management of T2DM among women previously diagnosed with gestational diabetes mellitus, low uptake has been reported. In view of the proven effectiveness of theory-based interventions, this study aimed to evaluate the effectiveness of Information Motivation Behavioural Skills (IMB)-based intervention to improve postpartum T2DM screening uptake among pregnant women with GDM in Negeri Sembilan, Malaysia. Methods: A prospective quasi-experimental study was carried out among comparable respondents in the intervention and control groups, involving 61 and 55 respondents respectively. Validated and reliable self-administered questionnaire was used to measure pre- and post-intervention of knowledge, attitude and self-efficacy, based on the constructs of the IMB model, with postpartum T2DM screening uptake measured at 6-week postpartum. Results: The IMB-based intervention was effectively improved knowledge on gestational diabetes mellitus (GDM), and attitude as well as self-efficacy related to the screening, with significant difference in the 6-week postpartum T2DM screening uptake between the intervention and control groups. Between groups comparison revealed significantly higher mean scores for knowledge (ηp 2 =0.11), attitude (ηp 2 =0.031) and self-efficacy (ηp 2 =0.52) in the intervention group compared to the control group, with self-efficacy is showing the largest size effect. Conclusion: The IMB-based health intervention had effectively improved the 6-week postpartum T2DM screening among women with GDM in the intervention group, through the significant improvement of knowledge on GDM and attitude as well as self-efficacy related to the screening.

Introduction: Ageing is commonly linked with physical inactivity. This review was performed to identify the factors associated with participation in physical activity among older adults in Malaysia. Methods: A systematic review was conducted using five databases; Pubmed, Sagepub, Scopus, Cochrane Library and Science Direct. Observational and intervention studies published between January 2010 and December 2020 were included, with Malaysian older adults aged 55 years and older being the main subject. Results: A total of 9 articles were included in the review. Analysis was guided by the Social Ecological Model for Health Promotion. The review had successfully identified gender, age, education level, health reasons, ethnicity and attitude as intrapersonal factors, social support (friend) and marital status as interpersonal factors, and locality as well as availability of facilities as environmental factors. Conclusions: Physical activity participation among Malaysian older adults were mainly determined by intrapersonal factors, particularly gender, health condition and educational level.

Introduction: The unprecedented COVID-19 pandemic has led to unavoidable new norms, including increasing demands for online learning. In view of the potential constraints to virtually learn anatomy among medical students, this study was conducted to identify the level of exposure towards online anatomy learning as well as the perceived constraints among medical students in a public university in Malaysia. Methods: A cross sectional study utilizing online survey was conducted during the movement control order (MCO) enforcement in Malaysia between March and October 2020 among all consented medical students at a public university in the Klang Valley area. The data was collected using a validated self-administered questionnaire which was distributed using Google Form application. Results: A total of 281 medical students consented and completed the online survey, with 94.3% students had low level of exposure towards online anatomy learning. Year of study and accessibility towards computing facilities and internet connection were significantly associated with online anatomy learning, with the non-clinical students are 19.9 (aOR= 19.888, B=2.990, 95%CI: 2.484-159.220) times more likely to have higher exposure towards online anatomy learning respectively. Conclusion: A very high proportion of medical students having low exposure towards online anatomy learning was observed in this study, which was predicted among the clinical students. Strengthening the utilization of online learning should be seriously considered in parallel with the new norms and the many uncertainties with COVID-19 pandemic, to ensure continuity of effective and quality learning.

Introduction: Population ageing brings along various crucial implications, with working beyond retirement age is one of the economics implications of ageing. Realizing the increasing demand and concern to accommodate older adults into the workforce, this review was conducted to develop better understanding on the factors associated with post-retirement employment among older adults aged 50 years and older. Methods: Using Scopus, ScienceDirect and PubMed databases, related articles between January 2017 and June 2021 were thoroughly searched using combination of keywords and screened according to the predetermined eligibility criteria. Post-retirement employment was defined as employment of older adults aged 50 years old and above beyond retirement age or re-employment of retired older adults, either from compulsory or voluntary retirement. All observational, qualitative, mixed methods and experimental studies were included in the screening process. The Crowe Critical Appraisal Tool (CCAT) was used to assess the quality of included articles. Results: A total of 12 articles included for review, with seven articles rated as high-quality. The review had successfully identified 10 factors associated with working beyond retirement age among older adults. Having good health status and being male gender were the commonest factors influencing the decision to work beyond retirement age, followed by level of education, financial commitment/ reasons, and work characteristics. Conclusion: The findings of this review provide a crucial insight and foundation towards addressing the unique needs of older workers in the employment policy.

Introduction: Premarital sexual behaviour remains an important sexual and reproductive health issue among adolescents in Malaysia. It is also a prohibited act and considered sinful among the Muslims community. This study aimed to identify the determinants of premarital sexual behaviour among the late adolescents age group in Pahang, Malaysia. Methods: An observational study was conducted among eligible late adolescents, which were recruited using probability sampling method. Only those aged 18 to19 years old, and previously attended the public secondary schools in Malaysia were included, with non-Malaysian, married and those who were absent during the data collection day were excluded. Data was collected using a valid and reliable set of questionnaires measuring the personal (demographic profile, knowledge and attitude), behavioural (premarital sexual behaviour and high-risk activities) and environmental (subjective norms and perceived parental communication) factors. Multiple logistic regression analysis was conducted to identify the determinants of premarital sexual behaviour. Results: A total of 390 adolescents aged 18 and 19 years old participated in this study, with 82.3% of respondents reported never had premarital sexual behaviour. Multiple logistic regression showed that the male and engagement in high-risk activities had higher odds in premarital sexual behaviour respectively (AOR =11.649, 95% CI: 3.615,37.536, p <0.001; AOR=19.224, 95% CI: 7.820,47.262, p <0.001). Conclusion: Male gender and engagement in high-risk activities remained important risk factors towards the ongoing concern related to premarital sexual behaviour among adolescents in Malaysia. Failure to address this issue should be explored and improve accordingly.

Introduction: Diabetes health literacy and numeracy are health indicators of increasing attention to empower diabetic self-management. This study aimed to explore the predictors of diabetes health literacy and numeracy among urbanized older adults. Methods: A total of 408 older adults with type 2 diabetes mellitus, aged 50 years and older were recruited using stratified random sampling from eight health clinics in Petaling district. A pre-tested questionnaire was used to measure knowledge, attitude, self-efficacy, self-care behavioral skills, diabetes health literacy and numeracy related to diabetes mellitus, as well as the sociodemographic background. Multivariable linear regression was used to understand and rank the predictors of diabetes health literacy and numeracy among the respondents. Results: The total mean score for diabetes health literacy was 53.74 ± 0.60, which was significantly predicted by age (β = -0.21, p=0.01), secondary (β =12.21, p<0.001) and tertiary (β = 16.37, p<0.001) education levels, non-Malays (β = -5.83, p<0.001), being employed (β = -2.77,p=0.02), have other comorbidities (β = -3.02, p=0.003), diabetes related self-efficacy (β = -0.37, p=0.02) and self-care behavioral skills (β =0.36, p<0.001). Meanwhile, the total mean score for diabetes health numeracy was 1.50 ± 0.13 and was significantly predicted by age (β=-0.15, p<0.001), secondary (β=1.09, p=0.002) and tertiary (β=2.24, p<0.001) education levels, and attitude towards diabetes (β=0.16, p<0.001). Conclusion: Very low diabetic numeracy was observed, which was predicted by increased age, low education and low attitude score towards managing diabetes. Hence promoting diabetic numeracy should be targeted among older adults with identified risks.

Aim: Depression symptoms in older persons are overlooked and untreated because they coincide with other conditions that older persons face. This review aimed to determine the prevalence and factors associated with depression among community dwelling older persons in Thailand according to the Social Cognitive Theory constructs. Design: Systematic review. Data sources: Four electronic databases: PubMed, PsychINFO, ScienceDirect and Scopus, with only articles published between January 2000 and December 2021 were included. Methods: The Preferred Reporting Systems for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to conduct this systematic review. All included articles were appraised using the Crowe Critical Appraisal Tool (CCAT), with all 13 studies were assessed to be of high quality, with score of more than 75. Results: A total of 13 full-texts articles were included in this review, of which 12 were cross-sectional study design, and only one was a cohort study. The prevalence of depression among older persons in Thailand were between 5.7% to 68%, with the most commonly reported factors that significantly associated with depression were gender, social support, marital status, employment status or income, and education level. Conclusion: Depression among older persons is a mental Health challenging issue in Thailand. Studying the factors that contribute to depression in older persons is more important in order to have a better understanding of the underlying causes as well as for early detection and effective management of depression among older persons in Thailand.

Introduction: Increasing prevalence of dementia and the associated caregiving burden are expected due to longer life expectancy. This review aimed to critically assess dementia-driven caregiving burden and the associated factors in Malaysia. Methods: A systematic search using several combinations of keywords was conducted in Ovid Medline, PubMed, Science Direct, ProQuest, and Ebscohost databases. The primary outcome was the score or level of caregiver burden, while the secondary outcome was the factors associated with such burden. The quality of the individual articles was assessed using the Newcastle–Ottawa Scale and the Joanna Briggs Institute checklist. Results: The systematic search resulted in seven studies being reviewed, consisting of six cross-sectional studies and one quasi-experimental study. Using the Zarit Burden Interview, two studies reported moderate caregiver burden with mean scores of 35.4 (15.08) and 46.0 (17.0). High levels of burden or strain were reported using the Caregiver Strain Index in other studies. The three main associated factors with burden identified in these studies were the presence of behavioural and psychological symptoms of dementia (BPSD), higher education level, and lack of social support. Conclusion: Moderate to severe caregiving burden level were found to be experienced by dementia caregivers in this country. High education, lack of support, as well as taking care of patient with BPSD being the most prominent factors associated with burden. Therefore, burden should be regularly assessed among the dementia caregivers especially among those with lack of social support and manage family members with BPSD, as to prevent adverse outcome from dementia caregiving.