Factors Influencing Excessive Gestational Weight Gain Among Pregnant Women in Urban Malaysia Introduction Excessive gestational weight gain (GWG) is a growing public health concern due to its association with higher risk of adverse maternal and perinatal outcomes. Recognising the key factors of underlying GWG incidence is thus crucial for developing targeted interventions. This study aims to determine the prevalence of excessive GWG and its associated factors among pregnant women in an urban district of Klang Valley, Malaysia. Methods A retrospective cross-sectional study was conducted (betweenNovember 2017 and October 2018) among 472 pregnant women who gave birth between January 2015 and December 2016. Data on sociodemographic characteristics, medical illnesses, and pre-pregnancy body mass index (BMI) were retrieved from the birth registry and maternal health records. The classification of GWG is based on the Institute of Medicine's recommendation Results The classification of GWG is based on the Institute of Medicine's recommendation. A total of 113 (23.9%) pregnant women had excessive GWG. Multiple logistic regression showed the odds of getting excessive GWG were higher among those with lower education levels (Adj. OR = 1.85; 95% CI = 1.084, 3.147), being employed (Adj. OR = 2.30; 95% CI = 1.342, 3.928), nulliparous (Adj. OR = 2.46; 95% CI = 1.450, 4.164), and having pre-pregnancy BMI of ≥25kg/m2(Adj. OR = 6.47; 95% CI = 3.909, 10.721). Conclusions Lifestyle interventions, such as weight reduction programs and health education, should focus on women with high pre-pregnancy BMI, nulliparous women, working women and women with low education levels. Pre-pregnancy clinics and workplaces can serve as platforms to promote healthy dietary choices and encourage regular physical exercise.

Parenting Factors and Child Obesity: A Study Among Preschoolers in Selangor, Malaysia Introduction Child obesity is a pressing global concern. In Malaysia, the rates of child obesity have risen significantly over recent decades, with 5.6% of children under the age of five being categorized as overweight or obese. Children's behavior is influenced by their home environment, which includes both physical and social aspects such as parental behavioral models, parenting styles, practices, beliefs, and societal norms. However, there is a scarcity of data on the prevalence of child obesity and its relationship with parental factors. This research set out to explore the link between parenting styles, parental physical activity, dietary habits, body image perception, screen time, and child obesity. Methods A survey using a quantitative approach was conducted among preschoolers in Selangor to test the proposed relationships between these factors. Data were gathered from 354 preschool students in Selangor. This study used a multi-stage sampling technique. In the multi-stage sampling technique, the researcher used a series of sampling frames by developing population strata and then selected using purposive sampling method. Results The analysis was carried out using SPSS version 26 and Smart PLS version 4.0. The direct effect analysis revealed that parenting styles (p = 0.000), along with parental dietary habits and body image perception (p=0.001), were significantly associated with child obesity. In contrast, parental physical activity (p = 0.167) and screen time (p = 0.739) did not show a significant relationship with childhood obesity. Conclusions The study's outcomes can assist healthcare practitioners in understanding and providing substantial evidence of the significant relationship between parenting styles, dietary practices, body image perception, and child obesity.

Environmental Factors Contributing to Stunting among Under Six Years Old Children: A Scoping Review IntroductionStunting among young children is a serious public health issue worldwide. Stunting is also one of the major risk factors for poor physical and mental development of these children. It is known that children’s health and wellbeing are a result of exposure to unhealthy environment and a lack of stimulating activities especially in the low- and middle-income countries ultimately leading to the increase in the number of stunted children. This scoping review aims to identify environmental factors that contribute to stunting less than six years old children.MethodsIn this review, PRISMA-ScR checklist to search Scopus, PubMed, and Web of Science databases. We included all original articles published between 2018 and 2022 and written in the English Language using combination of primary keyword (child*) and its MeSH and synonyms for population, and two secondary keywords (environ*) for exposure and (stunt*) for outcome as searching strategy. By using PRISMA extension for scoping reviews, 65 articles were reviewed and finally 25 eligible studies were included.ResultsThe included studies showed that lack of cleanwater access, poor sanitation, and poor hygiene practice were associated with higher risk of stunting among these children. Improper solid waste management, area of residence and type of housing, poor quality of cooking fuels and poor air quality, presence of intestinal parasitic infection and increased blood lead levels, were also noted as potential environmental factors that affect stunting.ConclusionsInvestment in infrastructure to provide safe and clean water and adequate sanitation facilities in communities with expanded health promotion activities focusing on hygiene practices and waste management may thus stunting and improve children’s health outcome.

Breastfeeding Under Siege: A Scoping Review of Flood Impacts on Lactating Mothers Introduction Floods, as one of the most frequent and devastating natural disasters, create unique challenges for breastfeeding mothers. However, there is limited understanding of the multifaceted impacts of floods on breastfeeding practices. This review aims to examine the impact of floods on breastfeeding mothers and aims to guide disaster response strategies to support maternal and infant health. Methods A scoping review was conducted using the Arksey and O'Malley framework and the PRISMA-ScR methodology. A systematic search of PubMed, Web of Science, and Scopus databases identified eight studies that met predefined inclusion criteria. Eligibility criteria encompassed peer-reviewed articles with quantitative, qualitative, or mixed methods designs. Studies were included if they focused on breastfeeding mothers affected by floods. Results Eight studies from diverse geographic regions reported significant impacts on breastfeeding practices, including environmental hazard, sociocultural, malnutrition and psychosocial impacts dimensions. Displacement and lack of privacy (e.g., overcrowded shelters, absence of breastfeeding-friendly spaces) disrupted feeding routines. Additionally, maternal malnutrition, stress, and unregulated distribution of formula milk further undermined breastfeeding efforts. Conclusions Flood disasters pose significant challenges in terms of environmental hazard, sociocultural, malnutrition and psychosocial impacts on breastfeeding mothers, jeopardizing maternal and infant well-being. Addressing these issues requires integrated disaster response strategies, including breastfeeding-friendly facilities, nutritional aid, and mental health support. These findings underscore the importance of prioritizing breastfeeding in disaster preparedness and response plans to enhance resilience and reduceinfant mortality during crises.

Pregnant adolescents have been shown to have a higher incidence of health and non-health-related complications that affect both mothers and infants. These include increased risk of pregnancy-related diseases such as anemia and pre-eclampsia, preterm and low-birth-weight babies, as well as other social consequences such as educational and financial difficulties. This mini review evaluates selected articles which explain the attitudes, knowledge, behavior and other risk factors associated with pregnancy among adolescents in developing countries. It also revealed that inadequate knowledge among adolescents about reproductive and sexual health, other social, cultural and peer influences, parenting values, and poor financial and educational status were factors that contribute to adolescent pregnancy. Likewise, a lack of support from parents, educators and healthcare workers had negative impacts on healthy sexual behavior among adolescents, which may ultimately lead to adolescent pregnancy. We conclude that the factors discussed in this review need to be evaluated and taken into consideration by policymakers and healthcare workers when formulating strategies to prevent pregnancies among adolescents.

Introduction: Caring for gastrointestinal cancer patients can be demanding and to some, caregivers, burdensome; resulting in them having low quality of life (QOL) and thus they may become the next potential patients. Hence, true heartfelt experiences need to be captured to highlight issues and preventive measures that are not voiced out as most often caregiving is done in silence and out of responsibility. Therefore, this study aimed to explore on the caregivers’ insights on how caregiving experience has resulted in their low QOL. Methods: Seven family caregivers were purposively selected from two oncology centres in the Klang Valley, Malaysia for this qualitative case study. The selection was based on the low scores obtained from Malay Caregiver Quality of Life Cancer (MCQOL) questionnaire during an initial cross-sectional study. Following that, in-depth interviews were performed on those selected caregivers. Interview data were triangulated with the questionnaire and observations for validity. Member and expert checking were conducted to ensure credibility and trustworthiness. A thematic content analysis was later performed. Results: Thematic analysis revealed four distinct contributors to the caregivers’ QOL; namely, patients’ financial and stress management; impact towards physical, psychological, social (including relationship) wellbeing, communication; and support from families, organisation and community. Conclusion: The qualitative study discovered evidence for collaborative support needed to ensure better QOL for the caregivers.

Background: The patient’s intention to engage in diabetes care is the hallmark of role acceptance as a health manager and implies one’s readiness to change. The study aimed to understand the process of having the intention to engage in diabetes care. Methods: A qualitative study using narrative inquiry was conducted at a public primary care clinic. Ten participants with type 2 diabetes of more than a 1-year duration were selected through purposive sampling. In-depth interviews were conducted using a semi-structured protocol guide and were audio-taped. The interviews were transcribed and the texts were analyzed using a thematic approach with the Atlas.ti ver. 8.0 software (Scientific Software Development GmbH, Berlin, Germany). Results: Three themes emerged from the analysis. The first theme, “Initial reactions toward diabetes,” described the early impression of diabetes encompassing negative emotions, feeling of acceptance, a lack of concern, and low level of perceived efficacy. “Process of discovery” was the second overarching theme marking the journey of participants in finding the exact truth about diabetes and learning the consequences of ignoring their responsibility in diabetes care. The third theme, “Making the right decision,” highlighted that fear initiated a decision-making process and together with goal-setting paved the way for participants to reach a turning point, moving toward engagement in their care. Conclusion Our findings indicated that fear could be a motivator for change, but a correct cognitive appraisal of diabetes and perceived efficacy of the treatment as well as one’s ability are essentially the pre-requisites for patients to reach the stage of having the intention to engage.

Background: The patient’s intention to engage in diabetes care is the hallmark of role acceptance as a health manager and implies one’s readiness to change. The study aimed to understand the process of having the intention to engage in diabetes care. Methods: A qualitative study using narrative inquiry was conducted at a public primary care clinic. Ten participants with type 2 diabetes of more than a 1-year duration were selected through purposive sampling. In-depth interviews were conducted using a semi-structured protocol guide and were audio-taped. The interviews were transcribed and the texts were analyzed using a thematic approach with the Atlas.ti ver. 8.0 software (Scientific Software Development GmbH, Berlin, Germany). Results: Three themes emerged from the analysis. The first theme, “Initial reactions toward diabetes,” described the early impression of diabetes encompassing negative emotions, feeling of acceptance, a lack of concern, and low level of perceived efficacy. “Process of discovery” was the second overarching theme marking the journey of participants in finding the exact truth about diabetes and learning the consequences of ignoring their responsibility in diabetes care. The third theme, “Making the right decision,” highlighted that fear initiated a decision-making process and together with goal-setting paved the way for participants to reach a turning point, moving toward engagement in their care. Conclusion Our findings indicated that fear could be a motivator for change, but a correct cognitive appraisal of diabetes and perceived efficacy of the treatment as well as one’s ability are essentially the pre-requisites for patients to reach the stage of having the intention to engage.

Pakistan has one of the highest unmet needs for family planning among low and middle-income countries. Postpartum family planning (PPFP) is considered to have the potential of significantly improving the contraceptive prevalence rate and reducing the unmet need for family planning. Jhpiego (John Hopkins Affiliate) implemented a PPFP pilot project in the district headquarter hospital of Mandi Bahauddin. The key interventions of the Jhpiego pilot were to improve services pertinent to PPFP. Based on the successes of the pilot, the interventions were scaled up to other health facilities. The present study aims to identify the factors associated with the utilization of the postpartum family planning health project implemented in the health facilities once the scale-up activities ended and comparing it with the pilot facility. A cross-sectional survey with a sample of 410 women using postpartum care services in the facilities was conducted using a structured questionnaire. The findings indicated that the complete set of interventions were not present in the facilities. Postpartum family planning method uptake was low (26%) along with the shortage of contraceptives supplies. Multivariate logistic regression was conducted to identify the predictors for the current use of postpartum family planning. The predictors identified that women with the age of 25 years and above with 3 or more children, who attended antenatal care visits and were counselled on PPFP were more likely to adopt/use PPFP in the postpartum period. The findings indicated scale-up was limited and the interventions were not sustained once the donor support ended.

Introduction: Mental health problem is an important public health issue which causes deterioration in quality of life, function and financial capabilities. According to the National Health and Morbidity Survey (NHMS) 1996, the prevalence of mental problem among adults in Malaysia was 10.7% and this has increased to 29.2% in NHMS 2015. The aim of this study was to evaluate the burden of depression, anxiety and stress among adults in a city in Klang Valley, Malaysia including its associated factors. Methods: A cross-sectional study was conducted by analysing secondary data obtained from screening program performed in six primary health clinics in the city throughout 2016. There were 576 adults participated in the screening program which consisted of mental health screening using Depression, Anxiety, Stress 21 (DASS-21) questionnaire and health status screening using Health Status Screening Form. Results: The prevalence of depression was 20.5%, anxiety was 44.5%, while stress was 10.1%. By using logistic regression, history of being abused was the only significant protective factor associated with depression, anxiety and stress with OR of 0.062 (95% CI 0.007; 0.563, p=0.004), OR of 0.001 (95% CI 0.000; -, p=0.001) and OR of 0.026 (95% CI 0.003; 0.238, p<0.001) respectively. Other independent variables were not statistically significant. Conclusions: As conclusions, surprisingly the risk of depression, anxiety and stress were not increased among participants who reported history of being abused. This was probably due to good coping mechanism among them. Nevertheless, early intervention needs to be emphasized to prevent mental disorders among this group of people in community.