Mother’s Knowledge, Attitude and Practices and its Influence toward Nutritional Status of Children in Terengganu

This cross-sectional study aimed to identify the nutritional status, Knowledge, Attitude and Practice (KAP) regarding stunting among mothers and its relationship with stunting among children below two years old in Terengganu. A total of 330 mother-child pairs from Terengganu were recruited through purposive sampling. Anthropometric measurement comprised weight and height. Information on socio–demographic, and a validated questionnaire on knowledge, attitude and practice of stunting were selfreported. Chi-square test was applied in this study with p<0.05 considered significant outcome. The majority (61.2%) of the mothers aged 30−39 years old, with tertiary educational level (51.5%) and in the low income group (86.4%). The prevalence of stunting, wasting and underweight was 25.2%, 9.4% and 14.2% respectively for the children below two years old in Terengganu. KAP analysis revealed that 44.5% of mothers had moderate level of knowledge, while 68.8% and 92.7% had good level of attitude and practice, respectively. A significant association (p<0.05) was found between knowledge of mothers with stunting among the children, while no significant association between attitudes and practice with stunting. The present study found that mothers’ knowledge significantly impacted their child’s growth status in relation to stunting. Future intervention programmes should incorporate nutrition education focusing on mothers’ knowledge to prevent stunting among children

Breakfast Intake and its Association with Body Mass Index among Pre-schoolers in Taska Permata Keluarga Kuala Nerus, Terengganu

In Malaysia, breakfast is the most frequently skipped meal. Skipping breakfast has been associated with an increased risk of childhood obesity. However, this relationship has not been investigated widely among preschoolers in Malaysia. Hence, this cross-sectional study aimed to determine the association between breakfast intake and Body Mass Index (BMI) among preschoolers in Taska Permata Keluarga (TPK), Kuala Nerus. A total of 131 Malays preschoolers aged four to six years old were recruited from nine TPK using convenience sampling method. Information on sociodemographic, breakfast intake pattern and anthropometric measurements (weight and height) were obtained. Respondents consisted of 74 (56.5%) boys and 57 (43.5%) girls. Anthropometric results showed that 8.4% preschoolers were overweight and obese. Among the preschoolers, 22.1% of them were breakfast skippers. In terms of gender breakdown, 20.3% boys and 24.6% girls skipped breakfast. There was a significant association between breakfast intake and BMI status among preschoolers (p = 0.003). This indicated that preschoolers that skipped breakfast were associated with overweight or obese compared to those who consumed breakfast daily. Breakfast consumption is a marker of a healthy lifestyle which can reduce the risk of childhood obesity. This habit should be inculcated during this critical period of life in which parents play a vital role in promoting breakfast consumption among preschoolers

Engaging gen Y through social network sites / Vincent Wee Eng Kim and Vivien Wee Mui Eik @ Bee Jade

Social networking sites are able to build on the interactive power of the Internet. This study attempts to discover the influence of social media on the present generation Y as consumers, their buying behaviour and to determine the roles that the social media plays as a popular medium to communicate a message. The findings of this research will provide clear and useful information to facilitate further research in similar fields of study. A set of questionnaire was administered to 200 students from ten selected institutions of higher learning in the Klang Valley. The respondents were asked about their current perceptions regarding their interaction with the social media websites and how these websites have influenced their purchasing behaviour which would enable further understanding about the social media. The respondents, responses show that, generally social media was used to seek useful information. They prefer to purchase in groups and the social media acts as a community platform to post and share their views. The respondents agreed that social media was more effective in finding information as compared to the use of the traditional mass media. Viral advertising in the form ofvideos are very appealing to them. Furthermore, social media also improves customers service and business networking

The Effect of Advance Care Planning on Heart Failure: a Systematic Review and Meta-analysis.

BACKGROUND: Advance care planning is widely advocated to improve outcomes in end-of-life care for patients suffering from heart failure. But until now, there has been no systematic evaluation of the impact of advance care planning (ACP) on clinical outcomes. Our aim was to determine the effect of ACP in heart failure through a meta-analysis of randomized controlled trials (RCTs). METHODS: We searched CINAHL, Cochrane Central Register of Controlled Trials, Database of Systematic Reviews, Embase, ERIC, Ovid MEDLINE, Science Citation Index and PsycINFO (inception to July 2018). We selected RCTs including adult patients with heart failure treated in a hospital, hospice or community setting. Three reviewers independently screened studies, extracted data, assessed the risk of bias (Cochrane risk of bias tool) and evaluated the quality of evidence (GRADE tool) and analysed interventions according to the Template for Intervention Description and Replication (TIDieR). We calculated standardized mean differences (SMD) in random effects models for pooled effects using the generic inverse variance method. RESULTS: Fourteen RCTs including 2924 participants met all of the inclusion criteria. There was a moderate effect in favour of ACP for quality of life (SMD, 0.38; 95% CI [0.09 to 0.68]), patients' satisfaction with end-of-life care (SMD, 0.39; 95% CI [0.14 to 0.64]) and the quality of end-of-life communication (SMD, 0.29; 95% CI [0.17 to 0.42]) for patients suffering from heart failure. ACP seemed most effective if it was introduced at significant milestones in a patient's disease trajectory, included family members, involved follow-up appointments and considered ethnic preferences. Several sensitivity analyses confirmed the statistically significant direction of effect. Heterogeneity was mainly due to different study settings, length of follow-up periods and compositions of ACP. CONCLUSIONS: ACP improved quality of life, patient satisfaction with end-of-life care and the quality of end-of-life communication for patients suffering from heart failure and could be most effective when the right timing, follow-up and involvement of important others was considered.This research did not receive any funding

Progress and divergence in palliative care education for medical students: A comparative survey of UK course structure, content, delivery, contact with patients and assessment of learning.

BACKGROUND: Effective undergraduate education is required to enable newly qualified doctors to safely care for patients with palliative care and end-of-life needs. The status of palliative care teaching for UK medical students is unknown. AIM: To investigate palliative care training at UK medical schools and compare with data collected in 2000. DESIGN: An anonymised, web-based multifactorial questionnaire. SETTINGS/PARTICIPANTS: Results were obtained from palliative care course organisers at all 30 medical schools in 2013 and compared with 23 medical schools (24 programmes) in 2000. RESULTS: All continue to deliver mandatory teaching on 'last days of life, death and bereavement'. Time devoted to palliative care teaching time varied (2000: 6-100 h, mean 20 h; 2013: 7-98 h, mean 36 h, median 25 h). Current palliative care teaching is more integrated. There was little change in core topics and teaching methods. New features include 'involvement in clinical areas', participation of patient and carers and attendance at multidisciplinary team meetings. Hospice visits are offered (22/24 (92%) vs 27/30 (90%)) although they do not always involve patient contact. There has been an increase in students' assessments (2000: 6/24, 25% vs 2013: 25/30, 83%) using a mixture of formative and summative methods. Some course organisers lack an overview of what is delivered locally. CONCLUSION: Undergraduate palliative care training continues to evolve with greater integration, increased teaching, new delivery methods and wider assessment. There is a trend towards increased patient contact and clinical involvement. A minority of medical schools offer limited teaching and patient contact which could impact on the delivery of safe palliative care by newly qualified doctors.This is the author accepted manuscript. The final version is available from Sage Publications via http://dx.doi.org/10.1177/026921631562712

Implementing advance care planning in heart failure : a qualitative study of primary healthcare professionals

Background: Advance care planning (ACP) can improve the quality of life of patients suffering from heart failure (HF). However, primary care healthcare professionals (HCPs) find ACP difficult to engage with and patient care remains suboptimal. Aim: To explore the views of primary care HCPs on how to improve their engagement with ACP in heart failure. Design and Setting: A qualitative interview study with GPs and primary care nurses in England. Method: Semi-structured interviews were conducted with a purposive sample of 24 primary HCPs. Data were analysed using reflexive thematic analysis. Results: Three main themes were constructed from the data: ACP as integral to holistic care in HF; potentially limiting factors to the doctor-patient relationship; approaches to improve professional performance. Many HCPs saw the benefits of ACP as synonymous with providing holistic care and improving patients’ quality of life. However, some feared that initiating ACP could irrevocably damage their doctor-patient relationship. Their own fear of death and dying, a lack of disease specific communication skills and uncertainty about the right timing were significant barriers to ACP. To optimise their engagement with ACP in HF, HCPs recommended better clinician-patient dialogue through question prompts, enhanced shared decision-making approaches, synchronising ACP across medical specialities, and disease specific training. Conclusion: GPs and primary care nurses are vital to deliver ACP for patients suffering from HF. HCPs highlighted important areas to improve their practice and the urgent need for investigations into better clinician-patient engagement with ACP

WRIDY: MULTISENSORY WRITING APPROACH IN MOBILE APPLICATION FOR KIDS WITH LEARNING DISABILITIES INCLUDING DYSLEXIA

Handwriting development begins as early as infancy when children are first able to grasp a writing object and leave a mark on the paper. Handwriting is linked with brain functioning; experts suggest that handwriting skill lightens a student’s cognitive load. With consistent handwriting practice, it becomes less demanding and more automatic, enabling students critical thinking and thought organization. The lack of writing skill decreases kids’ capacity to carry out higher-order skills. Most of the writing intervention approaches are not multisensory and some are using substances that may be dangerous for kids such as sand or shaving cream or pipe cleaners or play-doh etc. These issues become more challenging for kids with a learning disability such as dyslexia. This empirical gap in the multisensory writing system is the target of this research. A multisensory mobile application (Wridy) is designed and developed to support kids with learning disabilities. Wridy is an early-stage multisensory writing intervention tool. It uses a dyslexia-friendly user interface, fonts and colour. Wridy is demonstrated to the teachers of the Dyslexia Association Kuching, Malaysia. The results of the survey show that Wridy is helpful and useful in learning writing alphabets especially for kids with learning disabilities such as dyslexia

Faktor-faktor yang mempengaruhi kemapanan intervensi obesiti juara sihat daripada perspektif kanak-kanak: satu kajian kualitatif

Prevalens berlebihan berat badan dan obesiti kanak-kanak secara global telah meningkat secara mendadak dalam beberapa tahun ini, termasuk di Malaysia. Intervensi obesiti yang dijalankan di sekolah penting untuk menggalakkan gaya hidup sihat dan perubahan tingkah laku. Terdapat banyak intervensi yang telah dijalankan bagi menangani masalah obesiti kanak-kanak; namun, kemapanan intervensi obesiti kanak-kanak sering kali diabaikan. Tujuan kajian ini adalah untuk meneroka persepsi kanak-kanak tentang faktor-faktor yang mempengaruhi kemapanan intervensi Juara Sihat di sekolah rendah di Kuala Lumpur. Temu bual bersemuka mendalam dijalankan dengan 26 responden berumur 12 hingga 14 tahun yang dipilih melalui persampelan bertujuan daripada kanak-kanak yang terlibat di dalam program Juara Sihat tersebut. Transkripsi data verbatim dilakukan dan analisis tema dijalankan. Kajian ini mendapati tema utama yang dikenalpasti sebagai faktor penggalak adalah (1) sokongan keluarga, fasilitator, guru sekolah, dan kawan-kawan; (2) amalan aktiviti fizikal dan pemakanan sihat selepas intervensi; (3) kesedaran kendiri; (4) pengetahuan terhadap piramid makanan dan pemakanan sihat; dan (5) persekitaran rumah, manakala faktor penghalang adalah (1) tidak konsisten dalam pengetahuan; (2) keselamatan diri; (3) rakan sebaya; (4) sikap peribadi; dan (5) bosan terhadap program. Hasil kajian menunjukkan faktor penggalak kemapanan intervensi Juara Sihat yang utama adalah amalan aktiviti fizikal dan pemakanan sihat, manakala faktor penghalang utama adalah tidak konsisten dalam pengetahuan. Oleh itu, intervensi obesiti kanak-kanak berasaskan sekolah perlu mempertimbangkan faktor-faktor ini yang mempengaruhi kemapanan intervensi. Kajian masa depan dicadangkan untuk mempertimbangkan faktor-faktor tersebut ketika perancangan program intervensi obesiti kanak-kanak untuk meningkatkan keberkesanan intervensi obesiti untuk jangka masa yang lebih panjang