METHODS: This study is a pragmatic, cluster-randomised, parallel-group, matched pair, controlled trial with blinded outcome assessment. Randomisation is performed using a computer-generated table with a 1:1 allocation comparing the SIMSP and the POHP involving 28 preschools in the Kampar district, Perak, Malaysia. The intervention consists of preschool visits by a group of dental therapists, in-class oral health lessons and daily toothbrushing conducted by class teacher, child home toothbrushing supervised by parents, and infographic oral health messages to parents. The control consists of the existing POHP that involves preschool visits by a group of dental therapists only. The trial lasts for 6 months. Primary outcome variable is the mean plaque score change after 6 months. To determine the feasibility of the SIMSP, a process evaluation will be conducted using the perspectives of dental therapists, teachers, and parents on the appropriateness, effectiveness, facilitators, and barriers to the SIMSP implementation as well as an audit trail to assess the trial intervention.
DISCUSSION: Cluster randomisation may lead to a random effect and cluster selection bias. These factors will be accounted for when analysing the data and interpreting the outcomes. The effectiveness of the SIMSP will be evaluated by comparing the results with those of the POHP.
TRIAL REGISTRATION: ClinicalTrials.gov NCT04339647 . Registered on 5 April 2020 - Retrospectively registered.
Materials and Methods: This is a single-center quasi-experimental study involving 100 patients seen in the outpatient department with knee osteoarthritis. They were randomly (computer generated) allocated into two arms (high frequency [H-F] or low frequency [L-F]). H-F is set at 100 Hz and L-F is set at 4 Hz. A baseline assessment is taken with the visual analog score (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score, and Lequesne index. They were instructed to self-administer the TENS therapy as per protocol and followed up at the 4th and 12th week to be reevaluated on the above scores.
Results: The final results show that both H-F and L-F groups showed improvement in all parameters of the VAS, WOMAC index, Oxford Knee Score, and Lequesne index (73%). Only the pain component of Lequesne index, activities of daily living component of Lequesne index, total Lequesne index, and pain component of WOMAC index shows a statistically significant difference, favoring the H-F group. The H-F group yields a faster result; however, with time the overall effect remains the same in both groups.
Conclusion: Both H-F and L-F groups show improvement in all the component of Lequesne index, Oxford Knee Score, WOMAC index, and VAS with no statistical difference between the two groups. Although H-F yields a faster result, not everyone is able to tolerate the intensity. Therefore, the selection of H-F or L-F should be done on case basis depending on the severity of symptoms, patient's expectation, and patient's ability to withstand the treatment therapy. Based on this 12th week follow-up, both groups will continue to improve with time. A longer study should be conducted to see it this improvement will eventually plateau off or continue to improve until the patient is symptom free.
METHODS: This is a cross-sectional study with two-stage stratified random sampling. In total, 3977 older persons participated in this study. Face-to-face interviews were conducted using a mobile device to obtain information about socio-demographic background, food insecurity, non-communicable diseases, social support and living arrangements. Descriptive and multiple complex sample logistic regression analyses were performed for data analysis.
RESULTS: The overall prevalence of food insecurity among older persons was 10.4%. Older persons from rural areas with no or only primary and secondary education, income less than RM 2000 (USD 477.57), at risk of malnutrition and not receiving very high social support were more likely to be food-insecure.
CONCLUSION: Approximately, one-tenth of Malaysian older adults were classified as food-insecure; particularly those living in rural areas from lower socio-economic status, not receiving very high social support and malnourished were more likely to be at risk. A specific nutrition program, such as meals on wheels and food vouchers, should be targeted toward older persons who are at risk to improve their malnutrition status. Geriatr Gerontol Int 2020; 20: 73-78.
DESIGN: In-depth and focus group interviews were conducted with participants who have engaged in telemedicine. Questions included were participants' perception on the programme being used, satisfaction as well as engagement with the telemedicine programme. All interviews and focus groups were audio-recorded and transcribed verbatim. Data were analysed using a thematic approach.
PARTICIPANTS AND SETTING: People with type 2 diabetes (n=48) who participated in a randomised controlled study which examined the use of telemedicine for diabetes management were recruited from 11 primary care clinics located within the Klang Valley.
RESULTS: Twelve focus groups and two in-depth interviews were conducted. Four themes emerged from the analysis: (1) generational difference; (2) independence and convenience, (3) sharing of health data and privacy and (4) concerns and challenges. The main obstacles found in patients using the telemedicine systems were related to internet connectivity and difficulties experienced with system interface. Cost was also another significant concern raised by participants. Participants in this study were primarily positive about the benefits of telemedicine, including its ability to provide real-time data and disease monitoring and the reduction in clinic visits.
CONCLUSION: Despite the potential benefits of telemedicine in the long-term care of diabetes, there are several perceived barriers that may limit the effectiveness of this technology. As such, collaboration between educators, healthcare providers, telecommunication service providers and patients are required to stimulate the adoption and the use of telemedicine.NCT0246680.
Methods: This open label comparative design study randomized health professional clinicians to receive "practice points" on tendinopathy management via Twitter or Facebook. Evaluated outcomes included knowledge change and self-reported changes to clinical practice.
Results: Four hundred and ninety-four participants were randomized to 1 of 2 groups and 317 responders analyzed. Both groups demonstrated improvements in knowledge and reported changes to clinical practice. There was no statistical difference between groups for the outcomes of knowledge change (P = .728), changes to clinical practice (P = .11) or the increased use of research information (P = .89). Practice points were shared more by the Twitter group (P