Hasni Embong

Clinical nursing education is essential for facilitating students’ successful transition into professional practice. The Rain Classroom-based Flipped

Maternal anemia during pregnancy may adversely affect fetal growth, including neonatal head circumference (HC). This retrospective cohort study aimed to identify predictors of small HC among infants born to women with third-trimester anemia. Secondary data were obtained from the HosXP electronic medical database and delivery records of pregnant women who delivered between October 2020 and September 2023. A total of 934 women met the eligibility criteria and were included in the analysis. Maternal characteristics were summarized using descriptive statistics. Associations between maternal factors and neonatal HC were examined using the Chi-square test, Fisher’s exact test or Mann–Whitney U test, and independent predictors were identified using binary logistic regression analysis. The mean neonatal HC was 32.76 ± 1.50 cm, and 43.90% of infants were classified as having a small HC. Gravidity, pre-pregnancy body mass index (BMI), and gestational weight gain (GWG) were significantly associated with neonatal HC. Multivariable analysis revealed that women with two pregnancies (aOR = 0.51, 95% CI: 0.352–0.734) and those with three or more pregnancies (aOR = 0.54, 95% CI: 0.373–0.773) had lower odds of delivering infants with small HC than primigravida women. Pre-pregnancy overweight or obesity was associated with lower odds of small HC (aOR = 0.59, 95% CI: 0.426–0.805), whereas inadequate GWG increased the likelihood of this outcome (aOR = 1.38, 95% CI: 1.010–1.894). Maternal gravidity, pre-pregnancy BMI, and GWG may influence neonatal HC. These findings may support nurses in identifying women at risk, monitoring GWG, and providing targeted nutritional counseling during antenatal care.

This retrospective study examined the associations between pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and perinatal outcomes among women with singleton pregnancies delivering at a general hospital in Nakhon Si Thammarat Province, Thailand. Secondary data were retrieved from the HosXP electronic medical database and delivery records. Of 4659 eligible delivery records, 4051 women met the study criteria and were included in the analysis. Multivariable binary logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). The incidences of preterm birth, small-for-gestational-age (SGA) infants, and below-optimal head circumference (HC) were 6.99%, 18.22%, and 42.85%, respectively. Maternal underweight before pregnancy was significantly associated with increased odds of preterm birth (aOR = 1.60, 95% CI: 1.21–2.12), SGA (aOR = 1.79, 95% CI: 1.44–2.24), and below-optimal HC (aOR = 1.44, 95% CI: 1.18–1.76). Inadequate GWG was also associated with higher odds of SGA (aOR = 1.66, 95% CI: 1.38–2.00) and below-optimal HC (aOR = 1.29, 95% CI: 1.11–1.49). Conversely, maternal overweight/obesity and excessive GWG were associated with lower odds of SGA and below-optimal HC. These findings indicate that pre-pregnancy BMI and GWG were independently associated with adverse perinatal outcomes among Thai women with singleton pregnancies and may provide context-specific evidence to support maternal nutritional assessment and gestational weight monitoring during antenatal care.

Background Clinical Virtual Simulation (CVS) is a relatively new teaching approach in nursing education. However, in-depth longitudinal research on learning ability and knowledge retention is lacking. This study aims to identify the effect of CVS on self-directed learning ability and knowledge retention among nursing students in China. This work is a quasi-experimental study that was conducted in two months. Sophomore nursing students from Xi’an Fanyi University were divided into two groups: The control group (n = 43), in which the traditional teaching method was used and the experimental group (n = 41), in which a combination of traditional teaching and CVS was employed. The students in the control group attended a theoretical course, followed by clinical practice courses, and received practice guidance in a laboratory. The students in the experimental group attended a theoretical course, learned and practised the simulation project on a virtual simulation platform, then, attended clinical practice courses and received practice guidance in a laboratory. The research duration was one month. The knowledge retention of the students was assessed immediately, two weeks and one month after the intervention using a multiple-choice test. The self-rating scale of self-directed learning ability was used to determine the self-directed learning ability of the students. Statistically significant improvements were observed in the knowledge retention and self-directed learning ability (p < 0.05) of the students in the experimental group compared with those in the control group. It is concluded that the application of CVS can enhance the memory and retention of theoretical knowledge and improve the self-directed learning ability of nursing students

This scoping review explores the use of Rain Classroom, an interactive platform integrated with WeChat, within nursing education by analyzing its uses, benefits, and challenges. Out of 1,726 studies screened between 2016 and 2025, 27 empirical studies highlighted key strengths such as increased interactivity, real-time feedback, and adaptability. Nonetheless, notable obstacles persist, including technological demands on faculty, challenges with student self-discipline, and infrastructure limitations. While Rain Classroom presents significant potential, its effective implementation requires addressing both technical and educational hurdles, indicating a need for further research into its long-term effects and best practices for integration.

This study examines the knowledge and practices of exclusive breastfeeding (EBF) and their relationship with work-related factors among 152 working mothers at Hospital Pakar Universiti Sains Malaysia (HPUSM). Conducted in September 2023 using a self-administered questionnaire, findings showed 75.7% had excellent EBF knowledge and 59.9% had excellent practice. No significant associations were found between EBF practice and work hours, maternity leave, or the use of private rooms. However, refrigerator availability was significantly linked to better EBF practice. The study highlights the need for improved workplace support, including lactation facilities and education on milk handling, to enhance breastfeeding among working mothers.

This study examined the level of self-perceived clinical competence among 275 final-year nursing students from seven public universities in Peninsular Malaysia. Data were collected via online questionnaires using a cross-sectional design and purposive sampling. Results showed that most students perceived themselves as highly competent, particularly in domains related to nursing professional behavior and general performance. This finding revealed that final-year nursing students generally feel confident and competent in their clinical abilities as they transition into professional practice. This study emphasizes the importance of enhancing clinical education to ensure that graduates are well-prepared for the demands of the workforce.

HRMARS is well established journal publisher based in Pakistan. It is publishing prominent journals in social sciences since 2011.

Many reports recently showed the worried outcomes such as neonatal pneumonia, preterm birth, postpartum infections to the mother, and COVID-19 vertical transmission to the foetus happened in pregnancy ^[1,5-6]. COVID-19 vaccination is an effective and safe approach to controlling the pandemic and decreasing associated morbidity and mortality ^[2]. Pregnant women are more likely develop more severe symptoms of COVID-19 than their non-pregnant peers ^[3]. Also, there is still less study conducted in Malaysia to assess COVID-19 vaccine acceptance among pregnant women. This cross-sectional study aimed to determine the COVID-19 vaccine acceptance rate among pregnant women in Hospital USM. Initially, 367 respondents estimated using Raosoft Software but only 254 were recruited using simple random sampling method. The link of the questionnaire was given through a WhatsApp platform. The questionnaire used were adapted from Goncu Ayhan ^[4] consists of three parts: sociodemographic data, acceptance rates of COVID-19 vaccine and the reasons for refusing the COVID-19 vaccine. The questionnaire was translated to Bahasa Malaysia, checked by the Language Unit USM, and validated by the experts, three nursing lecturers. The Cronbach Alpha result from the pilot test was 0.744. The data were analysed using IBM SPSS system version 26.0 and the significant level (α value) was set at 5% for all statistical analyses. All null hypotheses will be rejected if (p<0.05). The Descriptive Analysis test and the Pearson Chi-Square test were used to analyse the data. Both Human Research Ethics Committee USM and Obstetrics & Gynaecology Department in Hospital USM have approved this study. No conflict of interest in the study. A total of 254 pregnant women, most of them being 198 were aged 20 to 35, 246 were Malays, 180 respondents with college/university education, and 110 housewives. The 68 prevalence of participants' household incomes ranged from RM1000 to RM1999 and RM4000-RM4999, and their gravida and parity are primarily at 2-3 times, with the majority occurring between 20 and 30 weeks of gestation (Table 1). This study included only 58 pregnant women who had comorbidities during their pregnancy. The results revealed pregnant women in Hospital USM had moderate acceptance of COVID-19 (M=70.00, SD=14.629) with a minimal percentage of 55% and a maximal percentage of 82%. It was revealed that 174 (68.5%) showed moderate acceptance while 42 (16.5%) showed high acceptance. Meanwhile, only 38 (15%) indicate low acceptance of the COVID-19 vaccine. The main reasons for them to refuse the vaccine were lack of data on the safety of the COVID-19 vaccination in pregnant women, they believed that if they are sick, both mother and baby will not encounter any negative effects, and some of the family members were hesitant to be vaccinated. This study also examined the correlation between the COVID-19 vaccine acceptance rate and sociodemographic factors using Pearson's Chi- Square test. There was a significant correlation between age, educational level, career, household income, gravida, and parity with the COVID-19 vaccine acceptance rates (p<0.05). Yet, there was no significant correlation between ethnicity, gestational age, or comorbidities with the acceptance rate of the COVID-19 vaccine. In conclusion, the acceptance rate of the COVID-19 vaccine among pregnant women needs to be increased to reduce the risk of worse complications if contracting the COVID-19 disease. Health education regarding the importance of the COVID-19 vaccine can be delivered during every antenatal visit. Since this study was conducted in hospital settings which include clinics, the pregnant women shall be familiar with the updated regulations of the health systems. This benefits the nurses to increase their efforts for pregnant women to accept those two doses followed by taking the booster willingly. If this succeeds, the risk of them contracting the coronavirus disease and getting complications from it will be eliminated.

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