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Background: Caring for stroke survivors can affect the caregiver's life, especially with the increment of patients' dependency level. This led to depression, anxiety, and stress in the caregiver, impacting their quality of life (QoL). This study aims to model relationships between caregivers' factors and stroke survivors' factors with caregivers' QoL and to estimate the mediation effects of caregivers' depression, anxiety, and stress in the relationships between stroke survivors' dependency level and caregivers' QoL.  Methods: Data from a cross-sectional study with a sample size of 250 subjects was analyzed. Linear regression was done to model the relationship between stroke survivors' factors and caregivers' factors with caregivers' QoL. Hayes's PROCESS macro model 4 for bootstrapping indirect effects was used to estimate the mediation effects of depression, anxiety, and stress in the relationship between stroke survivors' dependency level and caregivers' QoL., Results: Stroke survivors' dependency levels that were measured by the Modified Barthel Index score (b=0.14; 95% CI: 0.07, 0.20), caregivers' depression score (b=-0.81; 95% CI: -1.44, -0.20), and caregivers' anxiety score (b=-0.73; 95% CI: -1.34, -0.12) were found to be associated with caregivers' QoL. Caregivers' depression score (effect=0.02; 95% CI for bootstrapping: 0.01, 0.04) and caregivers' anxiety score (effect=0.01; 95% CI for bootstrapping: 0.01, 0.04) were found as partial mediators in the relationship between stroke survivors' dependency level and caregivers' QoL., Conclusion:  Stroke survivors' dependency level and caregivers' depression and anxiety significantly impact caregivers' QoL, with the latter factors partially mediating this relationship. Interventions such as providing caregivers with psychological support, stress management programs, and training in caregiving skills could help mitigate these impacts and improve caregivers' QoL., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Human Research Ethics Committee of University Sains Malaysia and Malaysia Medical Research and Ethics Committee (MREC) issued approval USM/JEPeM/KK/23010124 and NMRR ID-23-00426-JE4 (IIR). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors declare(s) a grant from Tabung Insentif Pembangunan Pengajian Siswazah (TIPPS), Universiti Sains Malaysia. This study was funded by the Tabung Insentif Pembangunan Pengajian Siswazah (TIPPS), Universiti Sains Malaysia. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ershad Ahmad Khan et al.)

Background Spontaneous preterm birth (SPB) is a global public health concern with devastating health effects on SPB survivors. This study aimed to determine modifiable antenatal risk factors associated with SPB among women attending government healthcare facilities in Malaysia. Methodology A retrospective record review of 49,416 national obstetrics registry data from 2015 was conducted and analyzed using binary logistic regression based on six antenatal factor divisions. Results Mothers with pre-existing diabetes had higher odds (adjusted odds ratio (aOR) = 3.09) of delivering prematurely than mothers without diabetes. Mothers with chronic hypertension with superimposed pre-eclampsia (aOR = 2.51) and gestational hypertension (aOR = 1.44) had higher odds of experiencing preterm birth than mothers with no hypertension. Underweight mothers had higher odds (aOR = 1.27) of delivering prematurely than mothers with an ideal body mass index (18.5 to <25.0 kg/m 2 ). Mothers with moderate anemia (hemoglobin level: 7 to <9 g/dL) had higher odds (aOR = 1.18) of preterm birth than mothers with normal hemoglobin levels (≥11 g/dL). Conclusions Maternal biomarkers, such as glucose level, blood pressure, BMI, and hemoglobin level, play an important role in reducing the rate of SPB in Malaysia. This study recommends strengthening pre-pregnancy, antenatal, and postpartum care through multidisciplinary and multi-agency team collaboration, addressing both modifiable and non-modifiable risk factors and adopting a dual approach that combines preventive and curative care., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Damanhuri et al.)

Introduction: Job stress is an important occupational health problem globally. Hence, identification of workers at risk of developing job stress is paramount to the decision-makers. This study aims to estimate the proportion of job stress and its relationship with different categories of healthcare workers (HCWs) in the primary care and public health settings in northeastern Malaysia., Methodology: A cross-sectional study involving 520 HCWs across all categories was conducted in Kelantan State, Malaysia. A proforma and validated Malay version of the Job Content Questionnaires were administered to obtain the data. The participants were then classified into four categories of workers according to Karasek's job demands-control model classification which were active, passive, high strain, and low strain., Results: We found that a total of 145 (28.5%) HCWs in the study have job stress (high-strain job type). HCWs with a degree or higher qualification had the highest proportion of job stress (41.2%), while the diploma group has the lowest proportion of job stress among the four academic qualification groups (22.9%). Pearson chi-square shows a significant association between Karasek's job types and the level of social support from their supervisors (p < 0.05) but no association between job strain and the level of supervisor's social support (p > 0.05)., Conclusion: Job stress among HCWs is prevalent, and the professional group had the highest percentage of risk job stress as compared to other groups. There is a significant association between the supervisor's social support and Karasek's job strain categories., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ab Aziz et al.)