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Intensive Lifestyle Counselling Intervention: Preventing Maternal Risk for Gestational Diabetes Mellitus  [PDF]
Noraliza Radzali, Rosnah Sutan
Open Journal of Obstetrics and Gynecology (OJOG) , 2016, DOI: 10.4236/ojog.2016.65034
Abstract: This study is aimed to evaluate the effectiveness of an intensive lifestyle counselling (ILC) designed to prevent gestational diabetes mellitus (GDM) among high risk mothers. A quasi-experimental trial was conducted in four selected health clinics (two clinics for intervention and two clinics for control) in Negeri Sembilan, Malaysia. Of the 320 subjects recruited, 148 respondents in the intervention group and 150 respondents in the control group had completed the study (response rate 93.1%). The intervention group was given a routine antenatal care (RC) and a package of structured ILC sessions on diet, physical activity (PA) and information on appropriate gestational weight gain (GWG) in five routine antenatal care visits until 39 weeks’ gestation. The controls received only the RC. Both groups are comparable for sociodemographic characteristics (p < 0.05). GDM incidence is higher in control group (16.7%) compared to intervention group (6.1%), p = 0.046. After controlling the covariates, the intervention group consistently showed protective for developing GDM, (aOR: 0.25, CI: 0.18 - 0.23, p = 0.003). The intervention group had significantly increased in PA (moderate intensity) mean score (660.3 ± 289.4 Met/min) compared to control group (571.36 ± 230.38 Met/min), F(1, 296) = 10.418, p < 0.001 and comply to dietary recommendation (50.7% in intervention versus 16.7% in control), p < 0.001. Total GWG significantly lesser in intervention (11.4 ± 2.5 Kg) than the control group (12.7 ± 2.9 Kg), p < 001. An ILC can reduce GDM incidence, by increasing PA, increase compliance to the dietary intake recommendation and lesser total GWG among high risk mothers.
Post-Traumatic Stress Disorder among the Adolescents Reside in Padang’s Prone Earthquake Area in West Sumatera, Indonesia  [PDF]
? Firdawati, Rosnah Sutan
Health (Health) , 2017, DOI: 10.4236/health.2017.99094
Abstract: The prevalence of post-traumatic stress disorder (PTSD) among the adolescents after earthquakes is not commonly reported in Indonesia. However, symptoms of PTSD such as loss of concentration, re-experiencing, avoidance and numbing commonly presented to the medical staffs even two years after 30th September of 2009 which was the worst earthquakes in Indonesia. The present study aimed to assess the relationship between individual characteristics, family status and cognitive factors (coping strategies and self-efficacy) with PTSD among adolescents in earthquake prone areas. Padang, West Sumatera was chosen after the occurrence of the earthquake on 30th September 2009. A cross sectional study was conducted on randomly selected 600 adolescents using revised University of California, Los Angeles Reaction Index (UCLA-RI) questionnaire to measure PTSD, levels of trauma and coping strategies. The result showed that the prevalence of PTSD among adolescents aged 12 - 18-year-old at 32 months after the earthquake was 36%. The adolescents’ age (p < 0.01), gender (p < 0.01), coping strategies (p = 0.04) and self-efficacy (p = 0.02) were significantly associated with the PTSD. Parental status, family income and parents’ education status were found not related to PTSD. Parents and school teachers must be alerted on the important of adolescents’ physical and mental health screening post traumatic disaster such as earthquake even though adolescents are well known of fit and healthy group. Good coping strategies and having strong self-efficacy were found useful tool to buffer and reduce the occurrence of PTSD.
The Effects of Short Health Messages Intervention in Improving Knowledge and Attitude on Sexual and Reproductive Health among Late Adolescents at Colleges in Malaysia  [PDF]
Firdaus Ujang, Rosnah Sutan
Open Journal of Preventive Medicine (OJPM) , 2018, DOI: 10.4236/ojpm.2018.88019
Abstract: Sexual and reproductive health problems among adolescents are increasing in trend. Inadequate knowledge of sexual and reproductive health is the main cause of problems in sexual and reproductive health. Short messages service (SMS) intervention has been implemented widely in health education and the outcomes are positive. Hence, this study was conducted to evaluate the effects of mobile phone messaging in improving sexual and reproductive health among late adolescents (age 18 - 19 years old). A quasi-experimental study was conducted in two Professional Vocasional Colleges in Malaysia. A total of 116 respondents in the intervention group and 130 respondents in the control group had completed the study. There was a series of 24 messages (SMS) sent to the respondents biweekly for 12 weeks. The adolescent girls (mean knowledge score 15.90, sd ± 3.321) in the intervention group had a significantly (P = 0.007) higher mean score in knowledge of sexual and reproductive health than boys (mean knowledge score 13.87, sd ± 4.003) at post intervention. The adolescent boys (mean knowledge scores 15.35, sd ± 4.748) in the control group had a significantly (P = 0.009) higher mean score for knowledge on HIV/AIDS than girls (mean scores 13.08, sd ± 4.325) at post intervention. In the intervention group, the number of respondents with good knowledge and good attitude on HIV/AIDS increased at 3 months post intervention. SMS intervention on knowledge of sexual and reproductive health for adolescents was accepted and effectively improved the knowledge scores and sustained even after 3 months post intervention. Therefore, the SMS intervention should be implemented as an intervention package to improve knowledge and reduce risk in developing sexual and health related problems among adolescents.
Expanding the Role of Pre-Marital HIV Screening: Way Forward for Zero New Infection  [PDF]
Sujith Kumar Manakandan, Rosnah Sutan
Open Journal of Obstetrics and Gynecology (OJOG) , 2017, DOI: 10.4236/ojog.2017.71008
Abstract: Pre-marital HIV screening is one of many initiatives taken by various worldwide countries to combat the fast spreading of HIV infections. In Malaysia, it was initially started in the year 2001 in Johor state the southern zone of Malaysia and subsequently with the collaboration of the Department of the Islamic Religious Affairs; it was made mandatory for all prospective Muslim couples. The main objective of this mandatory pre-marital HIV screening test was an early detection and appropriate management. Although the aim was beneficial, but there are still certain limitations, such as lack of confidentiality, stigmatization and termination of proposed marriage. Furthermore, there is obvious under-reporting of HIV cases among non-Muslims due to poor attendance at voluntary HIV screening. A small change in the existing policies may benefit this current program.
Parenting Skills Determinant in Preventing Adolescents’ Sexual Health Risk Behavior  [PDF]
Rosnah Sutan, Aimi Nazri Mahat
Open Journal of Preventive Medicine (OJPM) , 2017, DOI: 10.4236/ojpm.2017.71001
Abstract: Parenting skill is one of the crucial needs that parents must have in caring adolescents’ sexual health risk behavior. Present study aims to determine predictors of parenting skills in preventing adolescents’ sexual health risk behavior. A cross sectional study was conducted among adolescents’ parents who attended government health clinics in a semi-urban district, West Malaysia. Data were collected by systematic random sampling using validated questionnaire from eight government health clinics based on routine daily out-patient services. There were 386 respondents participated with 98.9% of response rate. Parental skill is categorized as appropriate or inappropriate based on Trans-Theoretical Model (TTM) staging. Eighteen independent variables were used: parental socioeconomic status, adolescent characteristic, parenting style, parent-adolescent communication, parental stress, perception on adolescent sexual risk, comfortable in discussing sexual issues, knowledge in sexual reproductive health (SRH) and knowledge in HIV/AIDS. Assessment of parenting skills using the TTM stage showed 139 respondents (36%) had inappropriate parenting skills, in which they were in pre contemplation, contemplation or preparedness stages, while 247 respondents (64%) showed appropriate parenting skills when they were in action and maintenance stages of TTM. Older parent, late adolescent, low parental education level, extended family living arrangement, comfortable in discussing sexual issues, good parent-adolescent communication and higher knowledge in HIV/AIDS were found significant in bivariate analysis. Multivariate logistic regression analysis identified older parent (AOR = 1.927, 95% CI = 1.889 - 1.966, p < 0.001), lower parental education (AOR = 2.394, 95% CI = 1.348 - 4.254, p = 0.003), comfortable in discussing sexual issues (AOR = 3.810, 95% CI = 1.622 - 8.948, p = 0.002), good parent-adolescent communication (AOR = 4.741, 95% CI = 2.478 - 9.071, p ≤ 0.001) and having higher knowledge on HIV/AIDS (AOR = 2.804, 95% CI = 1.528 - 5.147, p = 0.001) as significant predictors for appropriate parenting skills in preventing adolescent sexual health risk behavior. In conclusion, more than one third of parents were still not ready in preventing adolescent sexual risk behavior. Targeting the young parents and those having difficulty in communicating sexual issues with theirs adolescents should be emphasized in early intervention program for parents. Self-assessment using TTM stage questionnaire will help parents to identify their parenting skills in preventing adolescent
Psychosocial impact of perinatal loss among Muslim women
Rosnah Sutan, Hazlina Miskam
BMC Women's Health , 2012, DOI: 10.1186/1472-6874-12-15
Abstract: A qualitative study was conducted in a specialist centre among Muslim mothers who had experienced perinatal loss. Purposive sampling to achieve maximum variation among Muslims in relation to age, parity and previous perinatal death was used. Data was collected by focus group discussion and in-depth unstructured interview until the saturation point met. Sixteen mothers who had recent perinatal loss of wanted pregnancy, had received antenatal follow up from public or private health clinics, and had delivery in our centre participated for the study. All of them had experienced psychological difficulties including feelings of confusion, emptiness and anxiety over facing another pregnancy.Two out of sixteen showed anger and one felt guilt. They reported experiencing a lack of communication and privacy in the hospital during the period of grief. Family members and friends play an important role in providing support. The majority agreed that the decision makers were husbands and families instead of themselves. The respondents felt that repetitive reminder of whatever happened was a test from God improved their sense of self-worth. They appreciated this reminder especially when it came from husband, family or friends closed to them.Muslim mothers who had experienced perinatal loss showed some level of adverse psychosocial impact which affected their feelings. Husbands and family members were the main decision makers for Muslim women. Health care providers should provide psychosocial support during antenatal, delivery and postnatal care. On-going support involving husband should be available where needed.The loss of a baby either during pregnancy or after delivery holds great significance for parents and their close family members. This loss may be perceived as a loss of the parent’s future hopes and of their potential for fulfilling their dreams. Evidence-based showed that perinatal loss significantly increases anxiety in a subsequent pregnancy and often produces feelings o
The Effect of Early Initiation of Breastfeeding on Neonatal Mortality among Low Birth Weight in Aceh Province, Indonesia: An Unmatched Case Control Study
Satrinawati Berkat,Rosnah Sutan
Advances in Epidemiology , 2014, DOI: 10.1155/2014/358692
Abstract: Background. Early initiation of breastfeeding is the breastfeed that is received by the baby within the first hour of birth. It is recommended to reduce infant mortality and illness. Objective. To assess the effect of early initiation of breastfeeding on neonatal mortality for low birth weight in Aceh province, Indonesia. Method. In this qualitative study unmatched case controls were used as the design. Data was collected in 8 districts in Aceh province, Indonesia, between January and December 2012. The total sample for this study was 500?LBW who were born between 2010 and 2012, subdivided into 250?LBW who died in neonatal period and 250?LBW who survived during neonatal period. Result. Thermal care and hygienic practice were not significantly associated with neonatal mortality among LBW. Feeding and early initiation of breastfeeding were associated. Discussion. Early initiation of breastfeeding had an effect on neonatal mortality for the low birth weight in Aceh province, Indonesia. The risk of mortality was decreased for those neonates who accepted breast milk within the first hour after birth. Therefore it is concluded that a new strategy to promote and improve the coverage of the initiation of breastfeeding is needed. 1. Introduction Breastfeeding has many health benefits for both the mother and infant. To reduce infant mortality and ill health, the mother first provides breast milk to her infant within one hour of birth—referred to as “early initiation of breastfeeding” [1]. This ensures that the infant receives the colostrum (“first milk”) [1]. Colostrums: there are ninety known components of the colostrum and two primary benefits. The two primary benefits are immune factors and growth factors. Colostrum also contains vitamins, minerals, and amino acids needed by the neonates [2]. There is growing evidence of the significant impact of early initiation of breastfeeding, preferably within the first hour after birth, on reducing overall neonatal mortality [3]. It ensures that skin-to-skin contact is made early on, an important factor in preventing hypothermia and establishing the bond between mother and child. Early initiation of breastfeeding also reduces a mother’s risk of postpartum hemorrhage, one of the leading causes of maternal mortality [3]. Colostrum, the mother’s milk during the first postpartum days, provides protective antibodies and indispensable nutrients, essentially acting as a first immunization for newborns, strengthening their immune system and reducing the chances of death in the neonatal period [3]. Optimally, the baby should
Socio-maternal risk factors of ADHD among Iraqi children: A case-control study  [PDF]
Hussain R. Saadi, Khadijah Shamsuddin, Rosnah Sutan, Serene A. Alshaham
Open Journal of Preventive Medicine (OJPM) , 2013, DOI: 10.4236/ojpm.2013.32034

Background: Attention-deficit hyperactivity disorder (ADHD) is a chronic disorder that appears first in childhood at preschool age (4 - 5) years, and is manifested by a symptomatic pattern of difficulties with attention, motor activity and impulsivity. Maternal factors like stress, socio-demographic and maternal life style factors are potential risk factors for ADHD. Methodology: A retrospective case-control study was conducted in Baghdad-Iraq. Cases have been taken from 5 private paediatric clinics. Controls were chosen from kindergartens within the same residential area of the paediatric private clinics. Mothers of cases and controls were investigated for the risk factors of ADHD using a self-administered questionnaire. The total sample size was 260. Number of cases was 130 and number of controls was 130. Results: Five variables were significantly associated with development of ADHD after using a multivariate logistic regression model, maternal war stress (Adjusted OR 9.08, 95% CI 4.70 - 17.52 and P value < 0.001), maternal smoking (Adjusted OR 3.27 95% CI 1.40 - 7.63, P < 0.001), father lost job (Adjusted OR 2.81, 95% CI 1.51 - 5.24, P value < 0.001), and house damaged (Adjusted OR 2.55, 95% CI 1.04 - 6.24, P < 0.05). Family income was also associated with risk of ADHD (OR 1.02 95% CI 1.00 - 3.12, P value < 0.05). Conclusion and suggestion: Maternal exposure to war stress has 9 times higher risk of developing ADHD among offspring. This study aimed to offer to the policy makers a good benchmark to plan more programmes related to women and child health with respect to the fourth and fifth Millennium Development Goals (MDGs) in reduction of child mortality and morbidity and improvement of maternal health. There is a real necessity to address the need of vulnerable pregnant mothers at war and disaster’s time for programmes which will be able to control the stress that those pregnant mothers would encounter during those hard times.

Determinant of Low Birth Weight Infants: A Matched Case Control Study  [PDF]
Rosnah Sutan, Mazlina Mohtar, Aimi Nazri Mahat, Azmi Mohd Tamil
Open Journal of Preventive Medicine (OJPM) , 2014, DOI: 10.4236/ojpm.2014.43013

Background: Low birth weight (LBW) is a well-known factor associated with neonatal mortality and has contributed to a range of poor health outcomes. Thus, the objective of this study was to determine factors associated with LBW infants. Methods: A matched case control study was conducted in Universiti Kebangsaan Malaysia. Data of deliveries were obtained from Total Hospital Information System and medical records. All registered deliveries from January to June 2012 were used as sample populations. There were 180 pairs of cases and controls matched on babies’ gender. Fourteen variables were analyzed: maternal age, ethnicity, gravida, parity, gestational age, maternal booking weight, height and body mass index (BMI), history of low birth weight infants, birth interval, booking hemoglobin levels, hypertension, diabetes mellitus and mode of delivery. Results: Younger mother (t = 6.947, p < 0.001), lower booking BMI (t = 3.067, p = 0.002), prematurity (t = 12.324, p < 0.001), history of LBW infants (OR = 3.0, p = 0.001), LSCS (OR = 0.06, p = 0.001) and current hypertension (OR = 3.1, p = 0.008) were found significant in bivariate analysis. Multivariable conditional logistic regression identified younger maternal age (AOR = 2.9, 95% CI = 1.86 -4.51, p < 0.001), previous history of LBW infants (AOR = 3.7, 95% CI = 1.03 -13.58, p = 0.045), prematurity (AOR = 2.4, 95% CI = 1.79 -3.26, p < 0.001), and current hypertension (AOR = 4.5, 95% CI = 1.06 -19.22, p = 0.041) as significant factors associated with LBW infants. Conclusion: Younger maternal age, history of LBW infants, prematurity and hypertension have been recognized as predictors of LBW infants. The importance of pre-pregnancy screening, early antenatal booking and proper identification of high risk-mother needs to be strengthened and enforced in effort to reduce incidence of LBW infants.

Measuring Factors Influencing Progression across the Stages of Readiness to Lose Weight among Overweight and Obese Adolescents  [PDF]
Rosnah Sutan, Asmah Johari, Rozita Hod, M. T. Azmi
Health (Health) , 2017, DOI: 10.4236/health.2017.91011
Abstract: Epidemic incidence of obesity has become one of the public health priorities in disease control prevention. The study aims to determine the prevalence of readiness stages to lose weight among the overweight and obese adolescents and its influencing factors. A cross-sectional study was conducted on 631 adolescents of body mass index for age with z-score > 1 SD based on World Health Organization growth reference chart. The stages of readiness to lose weight were assessed using Trans-Theoretical Model. Intrinsic and extrinsic factors were collected using self-administered questionnaire. Majority of the respondents were in the action stage (40.3%) followed by contemplation (26.5%), preparation (15.5%), maintenance (11.4%) and pre-contemplation (6.3%). Ordinal regression analysis identified significant factors influencing progression across the stages of readiness to lose weight: no junk foods sold in school canteens (p = 0.005), TV viewing time ≤2 hours (p = 0.001), high physical activity means score (p < 0.001) and family encouragement on healthy eating (p = 0.010). Majority of adolescents who were overweight and obese were at the action stage of weight reduction. Focusing on extrinsic factors help to improve the effectiveness of weight management intervention.
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