OBJECTIVE: To determine the effectiveness of a brief intervention for smoking cessation using the '5A' model with self-help materials compared to using self-help materials alone.
METHODS: This randomised controlled trial was conducted at the Primary Care Clinic at the University Malaya Medical Centre (UMMC) between June and October 2009. Subjects were all current smokers aged 18 years and above. A total of 208 subjects were recruited and randomised into two groups. Subjects in the intervention group were given a brief intervention based on the '5A' model with selfhelp materials, while the control group received self-help materials alone. Subjects were later followed up at one and four months via telephone calls. The outcome measure was a self-reported attempt to quit smoking.
RESULTS: At one-month follow-up, 15/77 (19.5%) of the participants in the intervention group had attempted to quit smoking compared to 8/80 (10.0%) in the control group. There was no significant difference between the two groups (p=0.09). At the four-month follow-up, 13/58 (22.4%) participants in the intervention group had attempted to quit smoking compared to 9/57 (15.8%) in the control group. Once more, there was no significant difference between the two groups (p=0.37).
CONCLUSION: This study showed that there was no significant difference between a brief intervention using the '5A' model with self-help materials and using self-help materials alone for smoking cessation in a Malaysian primary care setting. However, these results do need to be treated with caution when taking into consideration the high dropout rate and bias in the study design.
Method: A cross-sectional study was conducted among 198 caregivers in Kuching from January till July 2014. The respondents were recruited using systematic sampling and were required to provide information on sociodemographic and environmental factors as well as complete the Hospital Anxiety and Depression Scale (HADS) questionnaire. The data was analysed using the IBM SPSS Statistical Software Version 20.0.
Results: The prevalence rates of anxiety and depression among caregivers were 32.8% and 27.8%, respectively. The caregiver's age (OR=0.97, 95% CI = 0.953 - 0.996), the perception of caregiving as an economic burden (OR= 2.70, 95% CI= 1.256 - 5.803) and the dependence of the patient (OR= 2.27, 95% CI= 1.087 - 4.719) were associated with anxiety. A caregiver who was male (OR= 2.21, 95% CI= 1.143 - 4.262), a caretaker who held the perception that a patient was dependent on them (OR=2.53, 95% CI= 1.203 - 5.337), and a caretaker who lacked stress-coping skills (OR=2.48, 95% CI= 1.030 - 5.973) were found to be significant factors in depression.
Conclusion: A high prevalence of probable anxiety and depression among caregivers points to the need to screen caregivers. There is a vital need to train healthcare workers to be able to detect early anxiety and depression. Culturally sensitive research should be carried out for different ethnicity, and improving the support system for caregivers is necessary.
METHODS: From 2015 and 2017, nulliparas, ≥ 39 weeks' gestation with prolonged latent phase of labor (persistent contractions after overnight hospitalization > 8 h), cervical dilation ≤3 cm, intact membranes and reassuring cardiotocogram were recruited. Participants were randomized to immediate induction of labor (with vaginal dinoprostone or amniotomy or oxytocin as appropriate) or expectant management (await labor for at least 24 h unless indicated intervention as directed by care provider). Primary outcome measure was Cesarean delivery.
RESULTS: Three hundred eighteen women were randomized (159 to each arm). Data from 308 participants were analyzed. Cesarean delivery rate was 24.2% (36/149) vs. 23.3%, (37/159) RR 1.0 95% CI 0.7-1.6; P = 0.96 in induction of labor vs. expectant arms. Interval from intervention to delivery was 17.1 ± 9.9 vs. 40.1 ± 19.8 h; P
METHOD: M. oleifera leaves, seeds and pods were extracted with 80% of ethanol. Individual compounds were isolated using a column chromatographic technique and elucidated based on the nuclear magnetic resonance (NMR) and electrospray ionisation mass spectrometry (ESIMS) spectral data. The anti-allergic activity of the extracts, isolated compounds and ketotifen fumarate as a positive control was evaluated using rat basophilic leukaemia (RBL-2H3) cells for early and late phases of allergic reactions. The early phase was determined based on the inhibition of beta-hexosaminidase and histamine release; while the late phase was based on the inhibition of interleukin (IL-4) and tumour necrosis factor (TNF-α) release.
RESULTS: Two new compounds; ethyl-(E)-undec-6-enoate (1) and 3,5,6-trihydroxy-2-(2,3,4,5,6-pentahydroxyphenyl)-4H-chromen-4-one (2) together with six known compounds; quercetin (3), kaempferol (4), β-sitosterol-3-O-glucoside (5), oleic acid (6), glucomoringin (7), 2,3,4-trihydroxybenzaldehyde (8) and stigmasterol (9) were isolated from M. oleifera extracts. All extracts and the isolated compounds inhibited mast cell degranulation by inhibiting beta-hexosaminidase and histamine release, as well as the release of IL-4 and TNF-α at varying levels compared with ketotifen fumarate.
CONCLUSION: The study suggested that M. oleifera and its isolated compounds potentially have an anti-allergic activity by inhibiting both early and late phases of allergic reactions.
AIMS: To better understand collaboration between and within these systems and create a theoretical framework for system development.
METHOD: A total of 26 focus groups and 27 individual interviews were undertaken with patients, carers, psychiatric hospital staff, primary care and district hospital staff, religious and traditional healers, community leaders, non-governmental organisation workers, and school and college counsellors. Grounded theory methods were used to analyse the data and create a theory of collaboration.
RESULTS: Three themes both defined and enabled collaboration: (a) collaborative behaviours; (b) motivation towards a common goal or value; and (c) autonomy. Three other enablers of collaboration were identified: (d) relatedness (for example trusting, understanding and caring about the other); (e) resources (competence, time, physical resources and opportunities); and (f) motivation for collaboration (weighing up the personal costs versus benefits of acting collaboratively).
CONCLUSIONS: The first three themes provided a definition of collaboration in this context: 'two or more parties working together towards a common goal or value, while maintaining autonomy'. The main barriers to collaboration were lack of autonomy, relatedness, motivation and resources, together with the potential cost of acting collaboratively without reciprocation. Finding ways to change these structural, cultural and organisational features is likely to improve collaboration in this system and improve access to care and outcomes for patients.