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Fulltext Screw osteosynthesis in the treatment of fracture lateral humeral condyle in children

Baharuddin M, Sharaf I

Med J Malaysia, 2001 Dec;56 Suppl D:45-7.
PMID: 14569766

We reviewed the results of screw osteosynthesis for the treatment of fracture lateral condylar physis in twenty children whose average age was six years old (range, two to ten years) at the time of operation from January 1998 till December 2000. The average interval between the injury and the operation was three and half days (range, one day to two weeks). The average duration of follow up was one year (range, one year to two years). Osteosynthesis was revised in two patients due to anterior placement of screw and rotated distal fracture fragment. Osseous union was achieved in all twenty patients. The result was rated excellent in nineteen patients and good in one patient.
Improving coping mechanisms of Malaysian adolescents living in orphanages through a life skills education program: A multicentre randomized controlled trial

Mohammadzadeh M, Awang H, Ismail S, Shahr HK

Asian J Psychiatr, 2020 Feb;48:101892.
PMID: 31864126 DOI: 10.1016/j.ajp.2019.101892

The current study amid to determine whether a life skills-based education could improve coping skills among adolescents in Malaysian orphanages. It was a randomized controlled trial comprising intervention and control groups which were randomly selected to receive the life skills, or the Placebo education programmes. The DASS21 and Brief COPE were used as the study instruments. Results showed the mean scores of self-distraction, active coping, use of emotional support, use of instrumental support, positive reinterpretation, planning and acceptance, at post-test, were significantly increased compared to the pre-test values. Denial, substance abuse, behavioural disengagement and self-blame significantly decreased. The findings provide an opportunity to assess the effects of participation in a life skills education programme on behavioural health in Malaysia orphanages.

Matched MeSH terms: Outcome Assessment (Health Care)*
Sodium pentosan polysulfate efficacy as thromboprophylaxis agent in high-risk women following gynecological surgery

Indirayani I, Kalok A, Nik Ismail NA, Shah SA, Lim PS, Mohamed Ismail NA, et al.

J Obstet Gynaecol Res, 2018 Aug;44(8):1458-1465.
PMID: 29845672 DOI: 10.1111/jog.13686

AIM: Sodium pentosan polysulfate (Na-PPS) is a plant-based agent that has similar action with low-molecular-weight heparin. It inhibits factor Xa, preventing blood clot formation. To date, its use in clinical practice as thromboprophylaxis agent is still limited. In addition, the efficacy and safety profile of this agent was not robustly reported globally, especially for countries with major Muslim population. We hypothesized that Na-PPS was equally effective as the standard thromboprophylaxis. We aim to compare the efficacy and safety of Na-PPS against standard agent (fondaparinux or enoxaparin).
METHODS: This was a randomized control, open-label trial. Women underwent major gynecological surgery were randomized to receive either subcutaneous 50 mg of Na-PPS twice daily or subcutaneous enoxaparin 40 mg once daily. Fondaparinux 2.5 mg once daily was given to Muslim women as an alternative to enoxaparin. The treatment was started 6 h postoperatively, for at least 3 days. All the patients received thromboembolic deterrent stockings. The primary efficacy outcome was venous thromboembolism up to 3 days postsurgery. The main safety outcomes were minor and major bleeding.
RESULTS: Among 109 participants, there was no incidence of venous thromboembolism. None of the women developed major bleeding. Minor bleeding was observed in 28.3% (15/53) and 5.4% (3/56) of Na-PPS and standard thromboprophylaxis group, respectively (P = 0.001).
CONCLUSION: Na-PPS was associated with increased risk of minor bleeding. There was insufficient data to conclude its efficacy as thromboprophylaxis. Further research is needed to evaluate Na-PPS safety as a standard thromboprophylactic agent.

Matched MeSH terms: Outcome Assessment (Health Care)*
A qualitative exploration of the reasons for the discontinuation of smoking cessation treatment among Quit Smoking Clinics' defaulters and health care providers in Malaysia

Lee ML, Hassali MA, Shafie AA

Res Social Adm Pharm, 2013 Jul-Aug;9(4):405-18.
PMID: 22835711 DOI: 10.1016/j.sapharm.2012.05.010

BACKGROUND: Treatment default among the smokers hinders the effectiveness of the delivery of cessation services. While many studies have predicted the defaulters' characteristics, the reasons why these smokers dropped out and continued smoking are seldom explored.
OBJECTIVES: This study examined the barriers encountered by such smokers and their respective health care providers (HCPs) in relation to the discontinuation of cessation treatment.
METHODS: From May 2010 to March 2011, 15 current adult smokers and 9 HCPs from 2 Quit Smoking Clinics (QSCs) in the Melaka Tengah District, Malacca, Malaysia were interviewed on smoking, cessation, and the QSC. Interviews were audio recorded and transcribed verbatim. The transcripts were subsequently translated into English and analyzed using thematic analysis.
RESULTS: The barriers encountered were categorized as Individual- and Clinic-level. Both smokers and HCPs acknowledged that the smokers' low intrinsic motivation was the individual-level barrier. The clinic-level barriers were the mismatched perceptions of smokers and HCPs regarding the HCPs' roles, skills, and attitudes, as well as the availability and efficacy of smoking cessation aids (SCAs). While the smokers viewed the program as not helpful, the HCPs cited the lack of organizational support as their main barrier.
CONCLUSIONS: The reasons for treatment default centered on the overall dissatisfaction with the treatment (due to the program, HCP, and SCA factors) combined with the smokers' low intrinsic motivation. Optimizing the interplay of the extrinsic motivational cues, such as the HCP and SCA factors, would complement the smoker's low intrinsic motivation and thus encourage treatment retention. However, it is necessary to strike a balance between the individual smoker's needs and the availability of organizational support.
KEYWORDS: Qualitative; Smoking cessation; Treatment discontinuation
Study site: Quite smoking clinics, Klinik Kesihatan Ayer Keroh, Hospital Melaka, Melaka, Malaysia
Fulltext How to use the International Classification of Functioning, Disability and Health as a reference system for comparative evaluation and standardized reporting of rehabilitation interventions

Stucki G, Pollock A, Engkasan JP, Selb M

Eur J Phys Rehabil Med, 2019 Jun;55(3):384-394.
PMID: 30990004 DOI: 10.23736/S1973-9087.19.05808-8

Rehabilitation aims to optimize functioning of persons experiencing functioning limitations. As such the comparative evaluation of rehabilitation interventions relies on the analysis of the differences between the change in patient functioning after a specific rehabilitation intervention versus the change following another intervention. A robust health information reference system that can facilitate the comparative evaluation of changes in functioning in rehabilitation studies and the standardized reporting of rehabilitation interventions is the International Classification of Functioning, Disability and Health (ICF). The objective of this paper is to present recommendations that Cochrane Rehabilitation could adopt for using the ICF in rehabilitation studies by: 1) defining the functioning categories to be included in a rehabilitation study; 2) specifying selected functioning categories and selecting suitable data collection instruments; 3) examining aspects of functioning that have been documented in a study; 4) reporting functioning data collected with various data collection instruments; and 5) communicating results in an accessible, meaningful and easily understandable way. The authors provide examples of concrete studies that underscore these recommendations, whereby also emphasizing the need for future research on the implementation of specific recommendations, e.g. in meta-analysis in systematic literature reviews. Furthermore, the paper outlines how the ICF can complement or be integrated in established Cochrane and rehabilitation research structures and methods, e.g. use of standard mean difference to compare cross-study data collected using different measures, in developing core outcome sets for rehabilitation, and the use of the PICO model.

Matched MeSH terms: Outcome Assessment (Health Care)*
Step-down units are cost-effective alternatives to coronary care units with non-inferior outcomes in the management of ST-elevation myocardial infarction patients after successful primary percutaneous coronary intervention

Chou YS, Lin HY, Weng YM, Goh ZNL, Chien CY, Fan HJ, et al.

Intern Emerg Med, 2020 01;15(1):59-66.
PMID: 30706252 DOI: 10.1007/s11739-019-02037-z

Percutaneous coronary interventions (PCIs) within a door-to-balloon timing of 90 min have greatly decreased mortality and morbidity of ST-elevation myocardial infarction (STEMI) patients. Post-PCI, they are routinely transferred into the coronary care unit (CCU) regardless of the severity of their condition, resulting in frequent CCU overcrowding. This study assesses the feasibility of step-down units (SDUs) as an alternative to CCUs in the management of STEMI patients after successful PCI, to alleviate CCU overcrowding. Criteria of assessment include in-hospital complications, length of stay, cost-effectiveness, and patient outcomes up to a year after discharge from hospital. A retrospective case-control study was done using data of 294 adult STEMI patients admitted to the emergency departments of two training and research hospitals and successfully underwent primary PCI from 1 January 2014 to 31 December 2015. Patients were followed up for a year post-discharge. Student t test and χ2 test were done as univariate analysis to check for statistical significance of p
Measuring quality of life in different cultures: translation of the Functional Living Index for Cancer (FLIC) into Chinese and Malay in Singapore

Goh CR, Lee KS, Tan TC, Wang TL, Tan CH, Wong J, et al.

Ann Acad Med Singap, 1996 May;25(3):323-34.
PMID: 8876896

Quality-of-life assessment has become an accepted method of evaluation in clinical medicine. The technique is based on a patient's self-assessment of physical, psychological, and social function, as well as the effects of distressing physical symptoms. The most important aspect of quality-of-life assessment is that it brings into focus a patient-centred view of health outcome, which is broader than the physiologic measures which predominate in Western medicine. Strategies for the development and use of assessment questionnaires have evolved over the past 15 years, and numerous questionnaires have been created. Most originate in Western societies, with English as the most common language of development. Adapting such questionnaires for use in other language and cultural settings is an imprecise practice. Language translation and equivalent cultural meaning must both be addressed. This paper reports on the language translation process and results for the Functional Living Index for Cancer (FLIC) as translated into Chinese and Malay in Singapore. We employed a step-wise process beginning with translation/back translation, followed by structured pilot field trials and population sampling. Taped versions of the questionnaire were devised to meet illiteracy problems in the sample population. Paired comparisons of the Chinese and Malay versions of individual questions with their English counterparts show good correlations and similar means most of the time. Factor analysis on a population sample of 246 (112 Chinese, 35 Malay and 98 English speaking) with cancers of minimal, extensive or palliative extent is convergent with that obtained on a North American population. However, a separate analysis of the Chinese questionnaires showed some differences in factor pattern. Specific language and cultural translation difficulties are discussed. Of note is the predicted significant decrease in total FLIC scores with extent of disease within each of the language preference populations, which provides some evidence for the validity for each language version in the Singapore culture(s). Thus, the FLIC translations into Malay and Chinese in Singapore can be considered for use in local trials, subject to ongoing evaluation.
Genderwise clinical response of antipsychotics among schizophrenic patients: a prospective observational study from Lahore, Pakistan

Asif U, Saleem Z, Yousaf M, Saeed H, Hashmi FK, Islam M, et al.

Int J Psychiatry Clin Pract, 2018 Sep;22(3):177-183.
PMID: 29082784 DOI: 10.1080/13651501.2017.1395055

OBJECTIVE: The study was aimed to evaluate the gender specific response to adherence and occurrence of side effects among schizophrenic patients in Lahore, Pakistan.
METHODS: A prospective study was performed for a period of 1 year among 180 newly diagnosed schizophrenics, aged 20-60 years to observe the symptoms, medication adherence and side effects. Morisky-Green-Levine Scale was used to evaluate medication adherence, LUNSER for side effects and PANSS to measure positive and negative symptoms. Data were analyzed using SPSS.
RESULTS: Positive symptoms (Male: Baseline 36.14 vs. endpoint 23.58, Female: 35.29 vs. 23.74) and negative symptoms (Males 27.9 vs. 20.05, Females 28.41 vs. 20.2) of schizophrenia were equally reduced after a follow up of 1 year in both the genders. Male population suffered more accumulative side effects (11.4 in males vs. 6.40 in females), extrapyramidal symptoms such as tardive dyskinesia and tremors (1.21 in males vs. 0.57 in females) and other side effects as compared to women (p ≤ .005). Males were found poorly adherent to antipsychotic treatment than females (93.3% in males vs. 6.7% in females (p ≤ .005).
CONCLUSIONS: Prescribing practices should not overlook sex specific factors like hormonal changes, altered brain morphology and socioeconomic factors that may be responsible for the difference in the response to the course of schizophrenia.
Fulltext Knowledge and attitudes of adult HIV positive patients to HIV/AIDS in Selected ART Clinics in Yola, Nigeria

Martins, Olutayo Folashade, Rampal, Lekhraj, Lye, Munn-Sann, Sherina Mohd Sidik, Norlijah Othman, Iliyasu, Zubairu, et al.

Malaysian Journal of Medicine and Health Sciences, 2015;11(2):35-44.
MyJurnal

Though cases of AIDS are visible in Nigeria and awareness of HIV is high, correct knowledge on HIV transmission and prevention has remained low with significant numbers of people living with HIV/AIDS having low attitudes towards life and the disease itself. This study determined the baseline knowledge on HIV transmission and prevention, and attitudes towards HIV/AIDS of adult HIV positive patient enrolled into care at all four comprehensive antiretroviral therapy (ART) sites in Yola, Nigeria. Baseline reports on the knowledge and attitudes of adult HIV positive patients were obtained from a three arm randomized single blind clinical trial involving 386 randomly selected adult HIV patients who were enrolled into ART care at all four comprehensive ART sites in Yola. An administered, validated structured questionnaire was used for data collection. Outcome measures were sound knowledge on HIV transmission and prevention, and attitudes towards HIV/AIDS. Data was analyzed using SPSS version 22. Test of significance was at α level 0.05. Overall 237 (61.4%) had sound knowledge on HIV transmission and prevention, while 346 (89.6%) of respondents had high attitudes towards HIV/AIDS. Though majority of respondents had sound knowledge on HIV transmission and prevention as well as high attitudes towards HIV/AIDS, interventions to improve knowledge and attitudes among this group of individuals would improve positive preventive strategies.
Report of the Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) Consensus Workshop on Establishing a Core Outcome Measure for Hemodialysis Vascular Access

Viecelli AK, Tong A, O'Lone E, Ju A, Hanson CS, Sautenet B, et al.

Am J Kidney Dis, 2018 05;71(5):690-700.
PMID: 29478866 DOI: 10.1053/j.ajkd.2017.12.003

Vascular access outcomes in hemodialysis are critically important for patients and clinicians, but frequently are neither patient relevant nor measured consistently in randomized trials. A Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) consensus workshop was convened to discuss the development of a core outcome measure for vascular access. 13 patients/caregivers and 46 professionals (clinicians, policy makers, industry representatives, and researchers) attended. Participants advocated for vascular access function to be a core outcome based on the broad applicability of function regardless of access type, involvement of a multidisciplinary team in achieving a functioning access, and the impact of access function on quality of life, survival, and other access-related outcomes. A core outcome measure for vascular access required demonstrable feasibility for implementation across different clinical and trial settings. Participants advocated for a practical and flexible outcome measure with a simple actionable definition. Integrating patients' values and preferences was warranted to enhance the relevance of the measure. Proposed outcome measures for function included "uninterrupted use of the access without the need for interventions" and "ability to receive prescribed dialysis," but not "access blood flow," which was deemed too expensive and unreliable. These recommendations will inform the definition and implementation of a core outcome measure for vascular access function in hemodialysis trials.
Fulltext Cognitive-behavioural social skills training in primary school children with behavioural problems: lessons learnt from a pilot study

Azizah Othman, Kok, Wei Wee, Rohani Mohd Shahidi

Malaysian Journal of Paediatrics and Child Health, 2011;17(1):0-0.
MyJurnal

The report describes a pilot study of cognitive-behavioural social skills program conducted on primary school children in Kelantan, Malaysia. Designs: Uncontrolled pre- and post- single design study. Methods: Children aged 9 - 11 referred by school teachers for behavioural problems were put into Petersen’s Stop-Think-Do cognitive-behavioural social skills program for 6 sessions delivered by a clinical psychologist. Main outcome measure was Goodman’s Strengths and Difficulties Questionnaires; to assess child’s emotional and behavioural functioning rated by parents and children themselves. Results: The results showed positive short-term effects of the program at improving some aspects of children’s psychological functioning, however they are not significant. Findings are limited to several issues including subjects’ drop-out, problems in generalizing learnt behaviour, and the use of single outcome measure. Conclusion: Whilst the program could possibly improve children behavioural functioning more dramatically, the implementation of such program in school setting must be organized in full collaboration and assistance from the parents and school administrators.
Fulltext Prolonged administration of β-lactam antibiotics - a comprehensive review and critical appraisal

Osthoff M, Siegemund M, Balestra G, Abdul-Aziz MH, Roberts JA

Swiss Med Wkly, 2016;146:w14368.
PMID: 27731492 DOI: 10.4414/smw.2016.14368

Prolonged infusion of β-lactam antibiotics as either extended (over at least 2 hours) or continuous infusion is increasingly applied in intensive care units around the world in an attempt to optimise treatment with this most commonly used class of antibiotics, whose effectiveness is challenged by increasing resistance rates. The pharmacokinetics of β-lactam antibiotics in critically ill patients is profoundly altered secondary to an increased volume of distribution and the presence of altered renal function, including augmented renal clearance. This may lead to a significant decrease in plasma concentrations of β-lactam antibiotics. As a consequence, low pharmacokinetic/pharmacodynamic (PK/PD) target attainment, which is described as the percentage of time that the free drug concentration is maintained above the minimal inhibitory concentration (MIC) of the causative organism (fT>MIC), has been documented for β-lactam treatment in these patients when using standard intermittent bolus dosing, even for the most conservative target (50% fT>MIC). Prolonged infusion of β-lactams has consistently been shown to improve PK/PD target attainment, particularly in patients with severe infections. However, evidence regarding relevant patient outcomes is still limited. Whereas previous observational studies have suggested a clinical benefit of prolonged infusion, results from two recent randomised controlled trials of continuous infusion versus intermittent bolus administration of β-lactams are conflicting. In particular, the larger, double-blind placebo-controlled randomised controlled trial including 443 patients did not demonstrate any difference in clinical outcomes. We believe that a personalised approach is required to truly optimise β-lactam treatment in critically ill patients. This may include therapeutic drug monitoring with real-time adaptive feedback, rapid MIC determination and the use of antibiotic dosing software tools that incorporate patient parameters, dosing history, drug concentration and site of infection. Universal administration of β-lactam antibiotics as prolonged infusion, even if supported by therapeutic drug monitoring, is not yet ready for "prime time", as evidence for its clinical benefit is modest. There is a need for prospective randomised controlled trials that assess patient-centred outcomes (e.g. mortality) of a personalised approach in selected critically ill patients including prolonged infusion of β-lactams compared with the current standard of care.
International consensus on patient-centred outcomes in eating disorders

Austin A, De Silva U, Ilesanmi C, Likitabhorn T, Miller I, Sousa Fialho MDL, et al.

Lancet Psychiatry, 2023 Dec;10(12):966-973.
PMID: 37769672 DOI: 10.1016/S2215-0366(23)00265-1

The effectiveness of mental health care can be improved through coordinated and wide-scale outcome measurement. The International Consortium for Health Outcomes Measurement has produced collaborative sets of outcome measures for various mental health conditions, but no universal guideline exists for eating disorders. This Position Paper presents a set of outcomes and measures for eating disorders as determined by 24 international experts from professional and lived experience backgrounds. An adapted Delphi technique was used, and results were assessed through an open review survey. Final recommendations suggest outcomes should be tracked across four domains: eating disorder behaviours and cognitions, physical health, co-occurring mental health conditions, and quality of life and social functioning. Outcomes are collected using three to five patient-reported measures. For children aged between 6 years and 12 years, the measures include the Children's Eating Attitude Test (or, for those with avoidant restrictive food intake disorder, the Eating Disorder in Youth Questionnaire), the KIDSCREEN-10, and the Revised Children's Anxiety and Depression Screener-25. For adolescents aged between 13 years and 17 years, the measures include the Eating Disorder Examination Questionnaire (EDE-Q; or, for avoidant restrictive food intake disorder, the Nine-Item Avoidant Restrictive Food Intake Disorder Screener [NIAS]), the two-item Patient Health Questionnaire (PHQ-2), the nine-item Patient Health Questionnaire (PHQ-9), the two-item Generalised Anxiety Disorder (GAD-2), the seven-item Generalised Anxiety Disorder (GAD-7), and the KIDSCREEN-10. For adults older than 18 years, measures include the EDE-Q (or, for avoidant restrictive food intake disorder, the NIAS), the PHQ-2, the PHQ-9, the GAD-2, the GAD-7, the Clinical Impairment Assessment, and the 12-item WHO Disability Assessment Schedule 2.0. These questionnaires should be supplemented by information on patient characteristics and circumstances (ie, demographic, historical, and clinical factors). International adoption of these guidelines will allow comparison of research and clinical interventions to determine which settings and interventions work best, and for whom.
Comparison of the effectiveness of trauma services provided by secondary and tertiary hospitals in Malaysia

Sethi D, Aljunid S, Saperi SB, Clemens F, Hardy P, Elbourne D, et al.

Ann Emerg Med, 2007 Jan;49(1):52-61, 61.e1.
PMID: 17084938

STUDY OBJECTIVE: The trauma services provided by 6 hospitals operating at 2 levels of care (4 secondary or district general hospitals and 2 tertiary care hospitals) in Malaysia are compared in terms of mortality and disability for direct admissions to emergency departments to test the hypothesis that care at a tertiary care hospital is better than at a district general hospital.
METHODS: All cases were recruited prospectively for 1 year. The hospitals were purposefully selected as typical for Malaysia. There are 3 primary outcome measures: death, musculoskeletal impairment, and disability at discharge. Adjustment was made for potential covariates and within-hospital clustering by using multivariable random-effects logistic regression analysis.
RESULTS: For direct admissions, logistic-regression-identified odds of dying were associated with older age (>55 years), odds ratio (OR) 1.9 (95% confidence interval [CI] 1.3 to 2.8); head injury, OR 2.7 (95% CI 1.9 to 3.9); arrival by means other than ambulance, OR 0.6 (95% CI 0.4 to 0.8); severe injuries (Injury Severity Score >15) at a district general hospital, OR 45.2 (95% CI 27.0 to 75.7); severe injuries at a tertiary care hospital, OR 11.2 (95% CI 7.3 to 17.3); and admission to a tertiary care hospital compared to a district general hospital if severely injured (Injury Severity Score >15), OR 0.2 (95% CI 0.1 to 0.4). Admission to a tertiary care hospital was associated with increased odds of disability (OR 1.9; 95% CI 1.5 to 2.3) and musculoskeletal impairment (OR 3.5; 95% CI 2.7 to 4.4) at discharge.
CONCLUSION: Care at a tertiary care hospital was associated with reduced mortality (by 83% in severe injuries), but with a higher likelihood of disability and impairment, which has implications for improving access to trauma services for the severely injured in Malaysia and other low- and middle-income settings.

Matched MeSH terms: Outcome Assessment (Health Care)*
Fulltext Lipophilic versus hydrophilic statin therapy for heart failure: a protocol for an adjusted indirect comparison meta-analysis

Bonsu KO, Kadirvelu A, Reidpath DD

Syst Rev, 2013;2:22.
PMID: 23618535 DOI: 10.1186/2046-4053-2-22

Statins are known to reduce cardiovascular morbidity and mortality in primary and secondary prevention studies. Subsequently, a number of nonrandomised studies have shown statins improve clinical outcomes in patients with heart failure (HF). Small randomised controlled trials (RCT) also show improved cardiac function, reduced inflammation and mortality with statins in HF. However, the findings of two large RCTs do not support the evidence provided by previous studies and suggest statins lack beneficial effects in HF. Two meta-analyses have shown statins do not improve survival, whereas two others showed improved cardiac function and reduced inflammation in HF. It appears lipophilic statins produce better survival and other outcome benefits compared to hydrophilic statins. But the two types have not been compared in direct comparison trials in HF.
The effect of food safety education on handwashing practices in school canteens’ food handlers

Nik Rosmawati N, Wan Manan W, Noor Izani N, Nik Nurain N, Razlina A

Sains Malaysiana, 2018;47:2119-2128.

This study aims to assess the effectiveness of a newly developed food safety education to improve the handwashing
practices of food handlers in school canteens. A community-based intervention study was carried out over a 2-year period.
Sixteen out of 98 primary schools were randomly selected and assigned into intervention and control groups using a
simple random sampling method. The study population included food handlers who worked in the canteens of the school
selected. The Food Safety Education Programme (FSEP) for the intervention group was developed based on the theory of
planned behaviour. The main outcome measures used were handwashing practices from the observations carried out at
baseline, 6-weeks (Post1) and 12-weeks (Post2) after the intervention. Out of 79 food handlers who participated in this
study, 33 (41.8%) were in the intervention group and 46 (58.2%) were in the control group. Prior to FSEP, handwashing
was not commonly practiced following critical events and the majority did not perform correctly. The time-effect of the
mixed design analysis of variance showed a significant increase (p=0.004) in the mean percentage of the total observed
handwashing practices from 29% at the baseline to 50.8% at Post1 (p=0.004). However, the intervention-effect of mixed
design ANOVA did not show any significant difference in the handwashing practices (p=0.210). The FSEP was effective in
improving the handwashing practices of the food handlers in the selected primary school canteens.
Fulltext The use of nerve conduction studies in determining the short-term outcome of Bell's palsy

Prakash KM, Raymond AA

Med J Malaysia, 2003 Mar;58(1):69-78.
PMID: 14556328

Bell's palsy is a common neurological problem causing considerable loss of self-esteem among patients. A prospective observational study was conducted to determine the short-term outcome of Bell's palsy at 1 month and 2 months after the onset and the relationship between these outcomes with facial nerve degeneration. We also determined if gender, age, diabetes, systolic and diastolic blood pressure influence the severity of facial nerve degeneration and the clinical outcome at 2 months after the onset. After clinically grading the newly diagnosed unilateral Bell's palsy patients using the House-Brackmann facial nerve grading system, nerve conduction studies of the facial nerve were done to determine the severity of facial nerve degeneration. The recovery of the facial paralysis was clinically graded again at the end of 1 month and 2 months from the onset. A total of 37 patients were recruited. There was a strong positive correlation between facial nerve degeneration and the clinical outcome of Bell's palsy at 1 month (r = 0.794; p < 0.0005) and 2 months (r = 0.732; p < 0.0005) after the onset. There was no significant correlation between either the facial nerve degeneration or the clinical outcome at 2 months with the patients' age (p = 0.288 and p = 0.799 respectively), systolic blood pressure (p = 0.425 and p = 0.933 respectively) or diastolic blood pressure (p = 0.243 and p = 0.579 respectively). Neither the severity of facial nerve degeneration nor the clinical outcome at 2 months were significantly different between male and female patients (p = 0.460 and p = 0.725 respectively) or diabetic and non-diabetic patients (p = 0.655 and p = 0.655 respectively).

Matched MeSH terms: Outcome Assessment (Health Care)*
Fulltext A randomised controlled trial of peer-adult-led intervention on improvement of knowledge, attitudes and behaviour of university students regarding HIV/AIDS in Malaysia

Jahanfar S, Lye MS, Rampal L

Singapore Med J, 2009 Feb;50(2):173-80.
PMID: 19296033

INTRODUCTION: The aim of this study was to investigate the knowledge, attitudes and behaviour of university students regarding acquired immunodeficiency syndrome (AIDS) and the human immunodeficiency virus (HIV).
METHODS: A randomised controlled trial of 530 university students was done using peer-adult facilitators. Participants completed a questionnaire before and after the intervention, which was a four-hour group session. A prevention programme was developed by local experts, health educators and peer facilitators. The peer-adult-led programme was designed to provide a conceptual model of HIV risk reduction through information, motivational and behavioural skills, a harm reduction module and health promotion theme.
RESULTS: The main outcome measured was the level of knowledge, attitudes and behaviour scores. The results suggest that relative to the control group, participants in the intervention group had higher levels of knowledge (30.37 vs. 25.40; p-value is 0.001) and a better attitude (12.27 vs. 10.84; p-value is 0.001). However, there was no difference in the behavioural score (9.47 vs. 9.41; p-value is 0.530). The correlation between the level of knowledge and age and the level of education was found in the intervention group, but not in the control group (p-value is 0.01). Attitude and gender were found to be correlated in the intervention group only (p-value is 0.01).
CONCLUSION: Our programme was successful in increasing knowledge and improving attitudes towards AIDS and HIV. However, it did not improve risk-taking behaviour. Peer-adult-led educational programmes for youth using various interactional activities, such as small group discussions, poster activity and empathy exercises, can be successful in changing the prevailing youth perceptions of AIDS and HIV.
Fulltext Schwartz rounds for healthcare personnel in coping with COVID-19 pandemic

Saniasiaya J, Ramasamy K

Postgrad Med J, 2020 Jul;96(1137):425.
PMID: 32345755 DOI: 10.1136/postgradmedj-2020-137806
Fulltext Hospital Food Service Strategies to Improve Food Intakes among Inpatients: A Systematic Review

Osman NS, Md Nor N, Md Sharif MS, Hamid SBA, Rahamat S

Nutrients, 2021 Oct 18;13(10).
PMID: 34684649 DOI: 10.3390/nu13103649

This review aims to identify hospital food service strategies to improve food consumption among hospitalized patients. A systematic search that met the inclusion and exclusion criteria was manually conducted through Web of Science and Scopus by an author, and the ambiguities were clarified by two senior authors. The quality assessment was separately conducted by two authors, and the ambiguities were clarified with all the involved authors. Qualitative synthesis was used to analyze and summarized the findings. A total of 2432 articles were identified by searching the databases, and 36 studies were included. The majority of the studies applied menu modifications and meal composition interventions (n = 12, 33.3%), or included the implementation of the new food service system (n = 8, 22.2%), protected mealtimes, mealtime assistance and environmental intervention (n = 7, 19.4%), and attractive meal presentation (n = 3, 8.3%). Previous studies that used multidisciplinary approaches reported a significant improvement in food intake, nutritional status, patient satisfaction and quality of life (n = 6, 16.7%). In conclusion, it is suggested that healthcare institutions consider applying one or more of the listed intervention strategies to enhance their foodservice operation in the future.

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