Development of an online animated sexting prevention module based on the prototype willingness model to reduce intention and willingness to sexting among diploma students.

INTRODUCTION: Sexting refers to the act of sending and receiving sexually explicit content in the form of in the form of texts, photos, or videos via the Internet and mobile phones. This behaviour is associated with many negative health consequences among young people. However, there is a lack of intervention studies to curb this behaviour. We have developed a new sexting prevention module and tested it using a randomised controlled field trial. This paper reported the phase one of the study i.e., the development of an animated sexting prevention module using the prototype willingness model (PWM) to reduce the intention and willingness to sext amongst diploma students in Malaysia. MATERIALS AND METHOD: The initial phase involved a review of previous interventions, validation from field experts, and the process of developing video. Then the module pilot was tested among 30 diploma students from a public university. They were given access to the newly developed videos posted on a private YouTube channel and asked to evaluate the videos quantitatively and qualitatively by using the acceptability of the intervention module (AIM), intervention appropriateness measure (IAM) and feasibility of the intervention measure (FIM). The minimum and maximum scores of each measure were 12 and 24 respectively whereby a higher score indicated greater acceptability, appropriateness and feasibility. RESULTS: The intervention consisted of five sections addressing the constructs of PWM, namely attitude, perceived norm, prototype perception, as well as intention and willingness of sexting. The contents were then converted into five videos with a total duration of 23 minutes. Based on the pilot test, the scores of AIM, IAM and FIM were not normally distributed and their median and the interquartile range values were 20 (4), 21 (4) and 22 (4) respectively. Most of the respondents gave favourable opinions on the intervention besides providing some input for improvement. CONCLUSION: This animated sexting intervention module based on PWM to reduce the intention and willingness was novel. The module was acceptable, appropriate and feasible to be implemented among undergraduate students. Further evaluation of this intervention module can be performed to provide more comprehensive evidence of its effectiveness.

Preventable stillbirths and neonatal deaths in Malaysia: An analysis of the under-five mortality surveillance data 2015-2017.

INTRODUCTION: The under-five mortality (U5M) trend in Malaysia significantly declined from 30.0 per 1000 live births (1980) to 8.0 per 1000 live births (2004), and the trend plateaued over the next two decades. Stillbirths and neonatal deaths were the major contributors to U5M. Scarce literature addressing factors associated with preventable U5M in Malaysia. The objective of this study was to describe preventable stillbirths and neonatal mortality, the associated factors and recommendation for improvement. MATERIALS AND METHODS: The U5M surveillance data from 2015 to 2017 was retrieved for Malaysian cases of stillbirths and neonatal deaths with multiple pregnancies as exclusion. Stillbirth and neonatal death cases were analysed descriptively for socio-demographic and clinical characteristics. Logistic regressions were performed to identify the associated factors. RESULTS: There were 15,444 cases selected for analysis, of which 55% of stillbirths and 45% of neonatal deaths. There were 21% of preventable deaths (U5M) and the major contributing causes of preventable stillbirths and neonatal deaths were classified as perinatal death (82.5%), infectious and parasitic diseases (4.1%) and congenital malformations (3.5%). The birth weight (aOR 6.03, 95% CI: 4.14-8.79), hypertensive mother (aOR 1.88, 95% CI: 1.66-2.12) and instrumental delivery (aOR 1.64, 95% CI: 1.16-2.31) were significantly associated with preventable stillbirths and neonatal deaths. Higher household income (>RM3000 per month) was noted as a protective factor (aOR 0.79, 95% CI:0.69,0.89). Mothers with ethnicities other thanBumiputera, single mothers and housewives were identified as the group of mothers with higher odds of poor perinatal services. Among the 3242 cases of preventable stillbirths and neonatal deaths with a complete documented level of adequacy and quality of healthcare, the most frequently identified factors were due to insufficient antenatal care (ANC) (20.4%), non-compliance with medical advice (12.3%) and unsuitable place of delivery (8.6%). CONCLUSION: Increasing trend of preventable stillbirths and neonatal deaths was noted over 3 years (2015-2017), and one-fifth was related to insufficient ANC service-related factors. Remedial measures in improving the quality of ANC services with an emphasis on the targeted high-risk maternal socio-demographic group (other Bumiputera, older antenatal mothers, nonmarried, poor family income neglected family) and enhancing ANC competency skills among the healthcare provider through adequate training are required to decrease preventable stillbirths and neonatal deaths in Malaysia.

Assessment of Implementation of Pre-pregnancy care services in Negeri Sembilan, Malaysia.

INTRODUCTION: Pre-pregnancy care (PPC) is an established health care program for women of reproductive age that has been widely implemented globally. The implementation of these services varies between countries based on the guidelines advocated. Thus, a standard level of assessment on measuring the performance of the service was difficult. This study aimed to measure the status of implementation PPC services among health workers using the transtheoretical model framework. METHODS: A cross-sectional study was conducted among 445 healthcare workers using a validated questionnaire based on local PPC guideline published by the Ministry of Health Malaysia (MOH). RESULTS: The results showed that many respondents were in the implementation action stage (57%), followed by the maintenance stage (20%), preparation stage (19%), contemplation stage (4%) and pre-contemplation stage (<1%). Further categorisation showed that only 43% of the respondents are successfully implementing PPC according to the standard of MOH. Clinics lead by the Family Medicine Specialist (Adjusted Odds Ratio, AOR 2.845; 95% Confidence Interval, 95%CI: 1.839, 4.40), daily usage of teleprimary care system (TPC) in the clinic (AOR 1.563; 95%CI: 1.019, 2.397), and attended TPC training (AOR 3.358; 95%CI: 2.221, 5.075) were significantly determining the success of PPC implementation. CONCLUSION: The emphasis on motivation and rewards among the healthcare workers, provision of good internet connection at health clinics and developing a comprehensive model of PPC training targeting the specific healthcare workers are mandatory to enhance the PPC services implementation.

Usage Of Home-Based Maternal Health Record In Antenatal Monitoring Among Malaysian Women Attended University Kebangsaan Malaysia Medical Centre

Maternal Home-based Record (MHR) is a concise medical record that can be kept by the pregnant women for regular documentation throughout pregnancy stages. This study was done to assess the usage of the MHR among the pregnant women and its associated factors. A good MHR usage was assigned using mean value as cut-off point that has been agreed by an expert group from scoring system which incorporates usage elements in term of follow-up, information documentation, knowledge seeking, continuity of care and self-monitoring of pregnancy. A cross-sectional survey was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) and a total of 79 pregnant women who attended the antenatal clinic were recruited. A validated self-administered questionnaire was used. The questionnaire was newly developed in Bahasa Malaysia. Content validity and reliability test for internal consistency for the knowledge, satisfaction and usage scale was performed. The Cronbach’s Alpha value for each domain was 0.764, 0.716 and 0.877 respectively. The results showed that the prevalence of good MHR usage was 51.3%. There were significant association found between level of education (Adj OR=0.32, 95% CI 0.12, 0.85, p=0.023) and doctor as birth attendant in previous pregnancies (Adj OR= 2.54, 95% CI 1.97, 6.59, p=0.045) with good usage of MHR. There was a positive significant relationship between satisfaction level among the respondent and the level of the usage (p=0.01, r=0.377), whereby with every increase in 1 score in satisfaction level will increase the usage score by 0.4 (95% CI 0.2 to 0.7) units, p<0.01. Therefore, MHR is still relevant as antenatal care monitoring instruments and it is important to make an effort to improve patient satisfaction in using MHR. Health care providers can use this validated self-administered questionnaire to assess function of MHR to remain relevant to the pregnant women population in their locality.

Proportion And Factors Related To Periodontal Disease Among Young Adult Attended Al-Fatah Dental Faculty, Libya

This study was conducted to determine the proportion and factors associated with periodontal disease among younger adult attended Al Fatah Dental Faculty in Libya. A cross sectional study with universal sampling methods was carried out from July 2010 until September 2010 among 70 Libyan subjects aged between 20-35 years. The data in this study was collected using self administrated questionnaire, followed by oral examination done by trained dentists. The results of this study showed that, the prevalence of periodontal disease in Libyan subjects was 75.7%. Gender, oral care habits, smoking were found significantly associated with presence of periodontal disease. Gingivitis has been found the most common types of periodontal disease (94%). High percentage of periodontal disease in this study was among men (87.9%) compared to women (69.9%). In conclusion, modifiable factors like changing lifestyle such as avoiding smoking and practicing oral care can be promoted to prevent periodontitis

The risk factors for unexplained antepartum stillbirths in Scotland, 1994 to 2003.

OBJECTIVE: To determine the factors contributing to unexplained antepartum stillbirth in Scotland. STUDY DESIGN: A 10-year birth database in Scotland was used to compare the unexplained antepartum stillbirth with other birth outcomes. The sample unit was a pregnant mother with a gestational age of 20 weeks and above and with a fetal birth weight of 200 g and above. RESULT: Maternal age of 35 years and above, lower deprivation category, inaccessible area of residence, maternal smoking, maternal height of <160 cm and gestational age of above 39 weeks were significantly associated with unexplained antepartum stillbirth. In multivariable analysis only maternal age (adjusted odds ratio (OR): 1.8, confidence interval (CI): 1.1 to 3.0, P=0.02), smoking during pregnancy (adjusted OR: 2.0, CI: 1.1 to 3.5, P=0.02), and maternal height (adjusted OR: 1.4, CI: 1.1 to 1.8, P=0.01), remain significant. Screening of pregnancies based on these three risk factors had 4.2% sensitivity and 99.4% specificity. The prevalence of stillbirth for this population was 0.2%. A positive predictive value of only 1.2% implies that only 1 in 83 women with these three risk factors will have antepartum stillbirth. The remaining 82 will suffer needless anxiety and potentially diagnostic procedures. CONCLUSION: Advanced maternal age, maternal smoking, and shorter maternal height were associated risk for unexplained antepartum stillbirth but screening based on these factors would be of limited value.