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Fulltext An individually-tailored multifactorial intervention program for older fallers in a middle-income developing country: Malaysian Falls Assessment and Intervention Trial (MyFAIT)

Tan PJ, Khoo EM, Chinna K, Hill KD, Poi PJ, Tan MP

BMC Geriatr, 2014;14:78.
PMID: 24951180 DOI: 10.1186/1471-2318-14-78

Background: In line with a rapidly ageing global population, the rise in the frequency of falls will lead to increased healthcare and social care costs. This study will be one of the few randomized controlled trials evaluating a multifaceted falls intervention in a low-middle income, culturally-diverse older Asian community. The primary objective of our paper is to evaluate whether individually tailored multifactorial interventions will successfully reduce the number of falls among older adults.
Methods: Three hundred community-dwelling older Malaysian adults with a history of (i) two or more falls, or (ii) one injurious fall in the past 12 months will be recruited. Baseline assessment will include cardiovascular, frailty, fracture risk, psychological factors, gait and balance, activities of daily living and visual assessments. Fallers will be randomized into 2 groups: to receive tailored multifactorial interventions (intervention group); or given lifestyle advice with continued conventional care (control group). Multifactorial interventions will target 6 specific risk factors. All participants will be re-assessed after 12 months. The primary outcome measure will be fall recurrence, measured with monthly falls diaries. Secondary outcomes include falls risk factors; and psychological measures including fear of falling, and quality of life.
Discussion: Previous studies evaluating multifactorial interventions in falls have reported variable outcomes.
Given likely cultural, personal, lifestyle and health service differences in Asian countries, it is vital that
individually-tailored multifaceted interventions are evaluated in an Asian population to determine applicability of these interventions in our setting. If successful, these approaches have the potential for widespread application in geriatric healthcare services, will reduce the projected escalation of falls and fall-related injuries, and improve the quality of life of our older community.
Trial registration: ISRCTN11674947
Study: Malaysian Falls Assessment and Intervention Trial; MyFAIT

Matched MeSH terms: Early Medical Intervention/economics*; Early Medical Intervention/methods
Fulltext Systematic review and meta-analysis of clinical outcomes of early caffeine therapy in preterm neonates

Kua KP, Lee SW

Br J Clin Pharmacol, 2017 01;83(1):180-191.
PMID: 27526255 DOI: 10.1111/bcp.13089

AIMS: This study evaluated the therapeutic outcomes of early versus late caffeine therapy in preterm neonates.
METHODS: We performed a systematic literature search in PubMed, Embase, CINAHL and CENTRAL from inception to 30 June 2016 to identify studies investigating the use of early caffeine therapy (initiated at less than 3 days of life) in preterm infants. Effect estimates were combined using random-effects meta-analysis. The primary outcomes for this study were bronchopulmonary dysplasia and mortality.
RESULTS: The initial search found 4066 citations, of which 14 studies enrolling a total of 64 438 participants were included. The time of initiation of early caffeine therapy varied from the first 2 h to 3 days postnatal. Early caffeine therapy reduced the risk of bronchopulmonary dysplasia in both cohort studies (RR: 0.80, 95% CI: 0.66 to 0.96) and randomized controlled trials (RR: 0.67, 95% CI: 0.56 to 0.81). In cohort studies, neonates treated early with caffeine also showed decreased risks of patent ductus arteriosus, brain injury, retinopathy of prematurity and postnatal steroid use. However, the mortality rate was increased.
CONCLUSIONS: The findings suggest that early caffeine therapy is associated with reduced incidence of bronchopulmonary dysplasia and may help decrease the burden of morbidities in preterm infants.

Matched MeSH terms: Early Medical Intervention*
Fulltext Cost analysis of an early intervention programme for children with autism spectrum disorder and its contributing factors in Klang Valley, 2019

Mohammad Najib Baharuddin, Muhamad Hanafiah Juni

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):90-90.
MyJurnal

Introduction: Autism spectrum disorder (ASD) is a public health concern globally, characterized by impairments in cognitive process, social functioning, communication skills, behaviours and interests. These problems require mul-tidisciplinary approach through an early intervention programme (EIP) which is remarkably expensive. To date, the knowledge of EIP costs for ASD children in Malaysia remains unknown. The objective of this study was to determine the annual average EIP costs for ASD children from the societal perspective (total average costs, education costs, treatment costs, and living costs), and its contributing factors. Methods: A cross-sectional cost analysis study using simple random sampling according to proportion was conducted among 280 parents of ASD children receiving EIP services in Klang Valley. The data was collected using interview-based questionnaire and proforma. The Ac-tivity-based Costing Technique and Microsoft Excel 2016 were used to estimate the total annual average EIP costs, education costs, treatment costs, and living costs per ASD child. The association between the total annual average EIP costs and its contributing factors were carried out using Statistical Package for Social Sciences version 25. Results: The total annual average EIP costs, education costs, treatment costs, and living costs per ASD child were estimated at RM15,158; RM3,896; RM1,948; and RM4,409 respectively. There was a significant association (p

Matched MeSH terms: Early Medical Intervention
Incidence and management of cleft lip and palate in Pakistan

Sharif F, Mahmood F, Azhar MJ, Asif A, Zahid M, Muhammad N, et al.

J Pak Med Assoc, 2019 May;69(5):632-639.
PMID: 31105281

OBJECTIVE: To compare the occurrence, distribution and management of clefts of lip and palate in local patients with the available data from India and China.
METHODS: The retrospective study was conducted at the Interdisciplinary Research Centre in Biomedical Materials, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan, and comprised data related to a three-month period from January to March 2015 at two medical centres in Lahore. Data from Pakistani centres was analysed based on province, gender, age and clefts of lip and palate conditions and Spearman's correlation matrix.
RESULTS: Of the 1574 cases, 1061(67.4%) were from Punjab, 361(23%) Khyber Pakhtunkhwa, 85(5%) Sindh and 67(4.2%) were from Azad Jammu and Kashmir. The incidence of clefts of lip and palate was higher in males than females. There was higher awareness of the need for timely management in new borns with clefts of lip and palate. Some patients seeking secondary treatment were also being surgically corrected. There is no national registry of children born with cleft defect, making it difficult to assess the full scale of the problem..
CONCLUSIONS: Based on available data, it is likely that there are many adults who have not been treated when younger..

Matched MeSH terms: Early Medical Intervention