Introduction: Diabetic foot ulcers (DFUs) remain one of the greatest significant problems of diabetes mellitus. It is a cause of main suffering and expenses for patient, and financial problem on health facilities and public. One of the strategies to overcome DFU is through health education to prevent foot ulcer, which focused in promoting foot self-care. To reach this aim, researchers had applied different educational approaches. This systematic review is to evaluate various types of educational programs in terms of its method of delivery and effectiveness. Methods: The search involved various databases; EBSCOHOST, MEDLINE, CINAHL, Cochrane library, ScienceDirect, PubMed, SAGE SringerLink, Web of Science and Wiley Online Library. It was limited to full text research articles that report intervention studies, and the writte up in English Language, the publication was from 2005 to 2021. The key words were “diabetes”, “diabetes foot”, “foot self-care”, health education and “interventions”. Results: Twenty studies were involved in this review. Nine studies were randomized controlled trials (RCTs), while eleven reported non-randomized controlled trials (NRCTs). Conclusion: There are evidences that foot care education improves foot care and diabetic foot problems. Various health education approaches, for instance foot assessment, discussion, counseling, homebased visitation and telephone calls have been shown to be effective in improving educational programs. Studies in the future should focus on RCTs in different sites and apply follow-up of long duration to provide better recommendations to healthcare practitioners on effective educational interventions to prevent DFUs.

Cervical cancer is a worldwide health issue. Each year, it kills hundreds of thousands of women worldwide. Despite the availability of screening tests, the incidence of cervical cancer remains high in low and middle-income countries. In this review, we survey the current literature on factors affecting cervical cancer screening uptake among women in low and middle-income countries. It also highlights potential strategies for improving screening uptake and suggests directions for future research. Knowledge about cervical cancer and its screening, socio-demographic factors, personal and behavioural factors, cultural factors and beliefs, and health service factors are considered the main barriers and facilitators to cervical cancer screening uptake among women in low and middle-income countries. Understanding the facilitators and barriers to cervical cancer screening encountered by women in low and middle-income countries can improve screening uptake by overcoming inequalities in resource and information access. Culturally sensitive screening programs, improvement of the health system, and health education interventions to raise awareness of screening and its benefits can be effective strategies to improve screening uptake among women in low and middle-income countries.

Introduction: Diabetes is a chronic illness and it has a significant impact on health. Behavioral interventions theory could improve self-care practices of the foot among patients with diabetic. Behavioral interventions could prevent the risk of foot problems. This trial aims at determining the effect of patient education intervention on foot self-care behavior and clinical outcomes among diabetes patients. Methods: The study is a two-arm single-blinded randomized controlled trial which will be conducted in the Federal Medical Centre (FMC) Owerri, Imo state, Nigeria involving 160 diabetic patients. A central computer-generated randomization list will be generated. Sequentially numbered sealed opaque envelopes will be used to determine concealment. The sample size is 160; therefore 80 participants will receive three sessions of patient education in addition to usual care (intervention group) for three and six months while another 80 participants (control group) will receive only usual care and will receive health education after the study is completed. The outcome of the intervention effectiveness is measured by modified version of Diabetes foot Self-Care Behavior Scale (DFSBS). Discussion: Our hypothesis is that based on the Health Belief Model, patient education intervention can improve foot self-care behavior in the intervention group. Data collection will be done at baseline, and at three- and six-months post intervention. Trial Registration: The Clinical Trials Registry- India (CTRI), Reference no CTRI/2021/06/034311.

Introduction: Increase in the number of opioids seized in the recent year may indicate increased opioid use in Malaysia. In counteracting opioid abuse, Methadone Maintenance Therapy (MMT) was introduced in Malaysia but relapse following MMT has become an important issue. This study aimed to determine the prevalence and patient factors that served as predictors of opioid relapse among MMT patients. Method: A cross-sectional study involving 159 MMT patients who have reached dose stabilization (eight weeks at a constant dose of methadone) was conducted in Johor Bahru Health District. The dependent variable was opioid relapse, while the independent variables include socio-demographic characteristics, MMT history, crime history, cognitive and interpersonal factors, and social-environment influence. Face-to-face interviews using structured questionnaires and secondary data collection using data collection sheets were done. Multiple logistic regression was used to determine the predictors. Significant level set at alpha less than 5%. Result: The response rate was 86.9% with majority of them were Malay, male, and Muslim. The prevalence of opioid relapse was 11.9%. Those who were non-polydrug users (AOR=3.701, 95%CI=1.182, 11.587, p=0.025), classified as having moderate (AOR=5.869, 95%CI=1.524, 22.595, p=0.010) and high (AOR=5.952, 95%CI=1.000, 35.445, p=0.050) relapse risk response after given hypothetical situation whether respondent been offered drug or not, were more likely to have relapsed. Respondents with higher cognitive and behavioral problem-solving response scores were less likely to have relapsed (AOR=0.949, 95%CI=0.909, 0.991, p=0.008). Conclusion: About 1 in 5 MMT clients had relapsed after they reach dose stabilization. The predictors of opioid relapse were non-polydrug users, having moderate to high relapse risk, and cognitive and behavioral problem-solving responses.

Introduction: Screening of cervical cancer had decreased its morbidity and mortality in developed countries. Health education interventions are expected to enhance knowledge, attitude and practice of screening. Their success rely on designs and methods. Thus, this systematic review aims to identify the methods used and the effectiveness of health education interventions in improving knowledge, beliefs, and practices of cervical cancer screening among women of reproductive age. Methods: A systematic review of all published eligible studies in (PubMed, Science Direct and MEDLINE) databases from 1st of January 2016 to 31st of October 2020 was run using different keywords. A total of 14 research articles were included. The quality and risk of bias of studies was assessed by using EPHPP and the average score was given accordingly. This study was registered in PROSPERO (record #CRD42020188462). Results: The review combined 14 studies. Five studies were conducted in the USA, two in Hong Kong, one in Korea, one in England, one in Denmark, one in Norway, one in Turkey, one in Malaysia and one in Tanzania. Almost all interventions boosted the knowledge, attitude or screening uptake. Conclusion: This review showed that the most popular methods of delivering health intervention were health talk, Group discussion and pamphlet. Health education interventions was effective in improving the knowledge, attitude and screening uptake. Although, this effect differs according to methods of delivery, study background and populations. Therefore, it is better to understand the existing situation to develop the best intervention and more studies are needed to recognise barriers to screening.

Early childhood caries (ECC) is a serious public health problem in both developing and developed countries. Given that children mainly depend on their parents for their day-to-day activities, it is important to investigate the extent of parental influence on the oral health of their children. The objective of this study is to review the association of parental knowledge, attitude, and practice of oral health with ECC among preschool children. PubMed, Medline, and Google scholar were used to search for related articles published within the past 10 years. All of the studies that investigated parental oral health practice have shown association with the development of dental caries. However, there were discrepancies in the outcome of studies that examined the association of parental knowledge and attitude with ECC. More investigations on parental knowledge and attitude are needed to clarify their association with ECC.

The role of caregivers is very important in the management of person with dementia, where it is not uncommon for them to experience psychological distress. However, the level of distress can be managed and reduced through strategic educational intervention. A systematic review has been conducted through searching Medline, Science direct, Cochrane library and EMBASE databases to provide a narrative synthesis that elaborate on methods and outcomes of the educational intervention among informal caregiver of person with dementia. From a total of 5125 records, eight studies were selected and included in this review, where the results show that educational intervention can be implemented either as individual or group intervention. Group intervention methods mainly focus on training programs such as workshops and lectures, and also group-based discussions. While for individual intervention, most of the activities were implemented through self-learning using technology or computer-based systems. In conclusion, based on the outcome of the studies, both methods of implementations are found to be useful in reducing psychological distress of the informal caregiver.

Abstract Introduction: Family planning allows couples to have their desired number of children and optimum birth spacing. While the contraceptive prevalence rate (CPR) in Malaysia was reported as 52.2% in 2014, little is known regarding the practice of family planning among marginalised groups such as the Orang Asli women. This study aims to determine family planning practice among married Orang Asli women in Sepang district and its associated factors. Methods: A cross sectional study using a pretested questionnaire was conducted in five Orang Asli settlements in Sepang using cluster sampling. Chi-square test and simple logistic regression were used in bivariate analysis, whereas binary logistic regression was used to determine the predictors of family planning practice. Results: 212 (58.4%) participants were current users of family planning, with 68.3% of the users reported using oral contraceptive pills. In the logistic regression models, family planning practice was significantly more common among women who had children (AOR= 43.659, 95% CI: 5.788, 329.323), being housewives (AOR=1.973, 95% CI: 1.205, 3.230) and had higher attitude score (AOR=1.113, 95% CI: 1.006, 1.232). Conclusion: The CPR of current study was about the same as the national CPR in 2014. The predictors of family planning practice among Orang Asli women were having children, being a housewife and having a better attitude towards family planning. Future intervention to increase the CPR should focus on improving women’s attitude regarding family planning.

Introduction: This article aims to describe the effect of an intervention to promote the practice of voluntary Islamic fasting and its barriers among a group of overweight and obese Muslim women working in the public sector in Malaysia. Materials and methods: In this quasi-experimental study, an intervention to encourage voluntary fasting was delivered in a half day seminar, supported by relevant booklets prepared. A self-administered questionnaire was used to capture data on voluntary fasting practices and its perceived barriers before and four months after the intervention. Data was analysed using Mc Nemar test to compare the proportion before and after the intervention. Significant level was set at p<0.05. Results: A total of 56 women were recruited. Their mean age was 36.65 years, most were married, had formal education up to secondary level and median income of RM 3000 per month. At baseline, 60.7% of them have practiced voluntary fasting. After intervention, the number of participants who practices voluntary fasting increased with a significant increase in three types of voluntary fasting (i.e. Mondays only, Thursdays only and 6 days in Shawal). The highest barrier to practice voluntary fasting was having no motivation to do so, followed by work commitment, health problems and family commitment. Discussion and Conclusion: Most of the respondents could practice voluntary fasting regularly if motivated to do so and backed by social support both at work and at home.

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. Chi-square test was used to determine associations. Level of significance was set at p<0.05. The knowledge and attitude scores were then categorized into 2 levels (50% or more of total score equals to ‘good’ and less than 50 % equals to ‘poor’). Results: A total of 168 respondents participated in this study and 62.1% of them had heard about prostate cancer and it is associated with level of education, monthly income and age (p= 0.023, 0.007 and 0.022). Most common sources of information are television, newspaper and friends (52.8%, 43.4% and 39.6% respectively). Among those who had heard about prostate cancer, 58.5% had good knowledge and this was significantly associated with smoking status (p =0.022). Conclusion: The percentage of awareness, knowledge and attitude regarding prostate cancer among the study population are still low. More effort should be carried out especially among men in rural communities to improve the situation.