Major dietary patterns and their associations with socio-demographic characteristics and obesity among adolescents in Petaling District, Malaysia

Dietary pattern analysis has emerged as important instruments to identify modifiable dietary risk factors for non-communicable diseases. The aim of this study was to determine the major dietary patterns among adolescents in Petaling District, Selangor and their associations with socio-demographic characteristics and obesity. An analytic cross- sectional study design was conducted in selected secondary schools in Petaling District. Sampling with probability proportionate to size was used and five schools were selected. Self-administered semi-quantitative food frequency questionnaire was used for data collection. Weight was measured with a digital bathroom scale (TANITA model) and height was measured using SECA body meter. Principal component factor analysis using varimax orthogonal transformation was used to identify the dietary patterns. Chi square was used to test for associations of dietary patterns with socio-demographic characteristics and obesity. Three major dietary patterns were identified: firstly, fruits and vegetables; secondly, sugar and fat and finally, meat and chicken which explained for 12.7%, 11.6% and 10.7% variation in food intake, respectively. There were significant associations between ethnicity, religion, family income, educational level of parents and the dietary patterns. However, there was no significant association between obesity and the dietary patterns. It may be more effective to describe a healthy diet using results of dietary pattern analysis in public health intervention, rather than describing single food items or nutrients. It is recommended that nutrition education programmes should be implemented in schools so as to prevent the development of obesity in the non-obese

Barriers to modern contraceptive practices among selected married women in a Public University in Malaysia.

In Malaysia, only 30% of the married women use modern contraceptive methods. Low usage of contraceptive methods, results in high rates of unwanted pregnancies and its consequence which includes; psychological problems physical health and unsafe abortion. The main purpose of this study is to understand the barriers of modern contraceptive practices among women in University Putra Malaysia. This study was carried out through two main research questions: 1.What is the women’s perceptions of modern contraceptive methods? 2. Why women do not use modern contraceptive methods? A qualitative research method was used for exploring misconceptions and barriers to contraceptive use among married female staff in University Putra Malaysia (UPM). The data was collected using the non probability, purposive sampling method, from 6 women by face to face interviews, which was also audio-recorded. The records were then transcribed verbatim and analyzed consecutively. This study finding showed there were personal, cultural, and health system barriers to modern contraceptive use. The women have been surrounded by fears, and misconceptions which serve as obstacles to initiation and continuation of contraceptive use. Strong socio-cultural norms and health services barriers including negative response of service providers, and low male family planning activities influence contraceptive use negatively. This study suggests that the promotion of modern contraceptive methods should be considered in women and men educational programs. Further studies should examine health providers’ views and quality of family planning services

Predictors of cardiovascular disease in patients with type 2 diabetes mellitus

Aims: Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in patients with type 2 diabetes mellitus (T2DM). Although patients with T2DM and CVD share common risk factors, the link between these diseases remains unclear. This study intends to identify the predicting risk factors of CVD in Malaysian T2DM patients. Methods: We conducted an analytical cross-sectional study on 313 patients diagnosed withT2DM at selected tertiary hospitals upon prior ethical approvals. Systematic random sampling method was applied in patient selection. Socio-demographic data was assessed using a pre-tested interviewer-administered structured questionnaire. Diet (by 24-hour dietary recall), physical activity level [via International Physical Activity Questionnaire (IPAQ)], smoking andalcohol consumption status were ascertained. Anthropometric and blood pressure measurements were performed according to standard procedures. Clinical and laboratory characteristics on cardiovascular risk factors (medical history, treatments, glycaemic control,and lipid profile) were collected from medical records, clinical examination and face-to-face interview. All statistical analyses were performed by using SPSS Statistics Version 21.0. Results: The mean age of study subjects was 55.7±9.2 years, with a mean diabetes duration of 10.1±8.1 years (CVD patients 11.5±8.7 years, non-CVD patients 9.2±7.6 years); 52.1%subjects were females; and 47.0% were Malays. Approximately one third (36.1%) of thesubjects were suffering from CVD. Multivariate logistic regression analysis showed age(B=0.056, adjusted OR 95% CI=1.058, p=0.004), lower HDL-C level (B=-1.466, adjusted OR 95% CI =0.231, p=0.003), working status of self-employment (B=1.381, adjusted OR 95% CI=3.978, p=0.002) in comparison to retirement, low (B=1.164, adjusted OR 95% CI=3.203, p<0.001) andmoderate physical activity levels (B=1.172, adjusted OR 95% CI=3.227, p<0.001) compared tohigh physical activity level were significantly associated with higher CVD risk, uponadjustment for potential covariates. Conclusion: Increased age, lower HDL-C, low and moderate physical activity levels, andworking status appeared to be significant predictive factors of CVD among the T2DM patients studied

Further evidence of psychological factors underlying choice of elective cesarean delivery (ECD) by primigravidae

Requests for elective cesarean delivery (ECD) have increased in Iran. While some sociodemographic and fear-related factors have been linked with this choice, psychological factors such as self-esteem, stress, and health beliefs are under-researched.; A total of 342 primigravidae (mean age = 25 years) completed questionnaires covering psychological dimensions such as self-esteem, perceived stress, marital relationship quality, perceived social support, and relevant health-related beliefs.; Of the sample, 214 (62.6%) chose to undergo ECD rather than vaginal delivery (VD). This choice was associated with lower self-esteem, greater perceived stress, belief in higher susceptibility to problematic birth and barriers to an easy birth, along with lower perceived severity of ECD, fewer perceived benefits from VD, lower self-efficacy and a lower feeling of preparedness. No differences were found for marital relationship quality or perceived social support.; The pattern suggests that various psychological factors such as self-esteem, self-efficacy, and perceived stress underpin the decision by primigravidae to have an ECD

A survey of schoolchildren's exposure to secondhand smoke in Malaysia

BACKGROUND: There is a lack of data describing the exposure of Malaysian schoolchildren to Secondhand Smoke (SHS). The aim of this study is to identify factors influencing schoolchildren's exposures to SHS in Malaysia. METHOD: This cross-sectional study was carried out to measure salivary cotinine concentrations among 1064 schoolchildren (10-11 years) attending 24 schools in Malaysia following recent partial smoke-free restrictions. Parents completed questionnaires and schoolchildren provided saliva samples for cotinine assay. RESULTS: The geometric mean (GM) salivary cotinine concentrations for 947 non-smoking schoolchildren stratified by household residents' smoking behaviour were: for children living with non-smoking parents 0.32 ng/ml (95% CI 0.28-0.37) (n = 446); for children living with a smoker father 0.65 ng/ml (95% CI 0.57-0.72) (n = 432); for children living with two smoking parents 1.12 ng/ml (95% CI 0.29-4.40) (n = 3); for children who live with an extended family member who smokes 0.62 ng/ml (95% CI 0.42-0.89) (n = 33) and for children living with two smokers (father and extended family member) 0.71 ng/ml (95% CI 0.40-0.97) (n = 44). Parental-reported SHS exposures showed poor agreement with children's self-reported SHS exposures. Multiple linear regression demonstrated that cotinine levels were positively associated with living with one or more smokers, urban residence, occupation of father (Armed forces), parental-reported exposure to SHS and education of the father (Diploma/Technical certificate). CONCLUSIONS: This is the first study to characterise exposures to SHS using salivary cotinine concentrations among schoolchildren in Malaysia and also the first study documenting SHS exposure using salivary cotinine as a biomarker in a South-East Asian population of schoolchildren. Compared to other populations of similarly aged schoolchildren, Malaysian children have higher salivary cotinine concentrations. The partial nature of smoke-free restrictions in Malaysia is likely to contribute to these findings. Enforcement of existing legislation to reduce exposure in public place settings and interventions to reduce exposure at home, especially to implement effective home smoking restriction practices are required