Intervention Group Group Research Articles

THE EFFECTS OF TELEREHABILITATION IN RHEUMATIC DISEASES DURING COVID-19 PANDEMIC

Purpose: This study was designed to investigate the effects of telerehabilitation on fatigue, depression, anxiety, disease activity, sleep quality and quality of life in patients with rheumatic diseases. Methods: This study included 28 patients with rheumatic diseases. Patients were divided into two groups as intervention group (IG) (n=16) and control group (CG) (n=12). Both groups kept on their regular medical care and an IG group additionally had exercise program. An exercise program including strengthening, stretching, breathing, posture and relaxation exercises was practiced to the IG via video-conference method while no additional therapy was applied to the CG. Assessments were performed using SurveyMonkey to avoid face to face connection. Anxiety and depression were assessed with Hospital Anxiety and Depression Scale (HADS), fatigue was assessed with Fatigue Severity Scale (FSS), sleep quality was assessed with Pittsburg Sleep Quality Index (PSQI) and quality of life was assessed with Health Assessment Questionnaire (HAQ). Additionally, disease activity was evaluated with disease-specific measurements. Results: Significant differences were found in anxiety (p=0.009), fatigue (p=0.003) and sleep quality (p=0.011) in group-by-time assessments in IG while no significant group-by-time difference were observed in any assessments in CG (p>0.05). No significant differences was observed in delta measurements of fatigue, quality of life, depression, anxiety and sleep quality within groups although patients in IG had better outcomes for all parameters compared to CG (p>0.05). Conclusion: Telerehabilitation was found to be a safe and effective method for patients with rheumatic diseases.

Effect of a fluid consumption education intervention on the hydration status of care home residents aged over 65 years

ABSTRACT Dehydration is a typical problem among the elderly people who live in nursing homes. It is a condition that is costly in terms of health care costs and length of treatment due to the illnesses it causes. It is a condition that can be prevented, and elderly people can benefit from initiatives to increase their fluid intake. This study aimed to find out how the hydration status of elderly people is affected by hydration education. It was also an assessment of the participants’ hydration status and water intake from sources. Forty-three elderly people from two nursing homes participated in this quasi-experimental study. There were 25 elderly in the intervention group (IG) and 18 in the control group (CG). For one month, 40-minute sessions per week (20 minutes of education and 20 minutes of activity) were devoted to teaching about fluid consumption. To evaluate the effectiveness of the education, the water balance questionnaire, urine USG and pH measurement, and the Physical Activity Scale for the Elderly were assessed before, at the end of the intervention, and three months after. The results showed that the IG group’s hydration improved, and their short-term water consumption increased. Education needs to be carefully implemented and the results followed up to ensure that elderly people develop a habit of drinking water.

Partners' experiences of breastfeeding: a qualitative evaluation of a breastfeeding support intervention in Sweden.

The World Health Organization states that women and their families need breastfeeding support from the healthcare system. However, knowledge about the most effective way to involve the partner in breastfeeding is lacking. A qualitative evaluation can provide insight and knowledge about the partner's experiences towards a breastfeeding support intervention and thus contribute to how forthcoming breastfeeding support policies are designed. The aim of this study was to explore partners' experiences regarding breastfeeding while participating in The Breastfeeding Study. An exploratory, longitudinal and qualitative design was used. This study was part of The Breastfeeding Study, which took place in Sweden. The intervention was performed in line with the Ten Steps to Successful Breastfeeding. Partners in the in the intervention group (IG) were part of a structured breastfeeding support programme. An individual breastfeeding plan was established in cooperation with the parents-to-be during pregnancy, and the plan was followed up at the child healthcare centre. A purposive sample was recruited from March to December 2021. Interviews and diary entries from IG (n = 8) and control group (CG) (n = 8) during pregnancy and 2 months after birth were analysed by content analysis, in accordance with the COREQ guidelines. Partners' experiences can be summarised under the main category of 'Striving to be part of the family and important that the family's everyday life was well-functioning'. IG partners experienced that both parents were involved and cooperated in the breastfeeding process and that guidance from healthcare professionals (HCPs) helped them to feel secure. CG partners experienced feeling excluded and not receiving support from HCPs. Both parents need to be targeted in breastfeeding support policies to meet the support needs. Midwives at antenatal care and child healthcare nurses at the child healthcare centre have important roles to play in providing structured breastfeeding support and a breastfeeding plan. Both IG and CG partners strived to become a part of the infant's life and to make family life work. Midwives should involve both parents in a reflective dialogue on how the partner can be involved, apart from just feeding the infant. Retrospectively registered in ACTRN12623000648628.

Video Education Program for Proper use of Inhalation Devices in Elderly COPD Patients.

This research investigated the utility of a QR code-based video pharmaceutical education program to guide the proper use of the inhalation device in elderly chronic obstructive pulmonary disease (COPD) patients. The patients were recruited for this prospective study during a COPD hospitalization, with 96 patients in the control group (CG) receiving conventional hospital care and 93 patients in the intervention group (IG) receiving QR code-based video pharmaceutical education from hospitalization to six months after discharge to improve proper utilization of inhalation technology The outcome measures used to assess the effectiveness of the education program were the COPD Assessment Test (CAT), inhaler use accuracy, inhaler technique score, Beliefs about Medicines Questionnaire (BMQ) score and patient satisfaction. Compared with CG, inhaler use accuracy and inhaler use scores improved in the IG group, while BMQ-Concern and CAT scores were significantly lower (P<0.05). Improvements in patient quality-of-life and satisfaction were reported. This study revealed that the QR code-based video pharmaceutical education program can improve the quality of life and satisfaction of elderly COPD patients.

Integrating High-Intensity Interval Training into a School Setting Improve Body Composition, Cardiorespiratory Fitness and Physical Activity in Children with Obesity: A Randomized Controlled Trial.

The aim of this study was to examine the effects of school-based high-intensity interval training (HIIT) on cardiorespiratory fitness and visceral adipose tissue (VAT) in children with obesity. A total of 40 students (11.0 ± 0.6 years; 20 boys) were randomized into an intervention group (IG) and control group (CG). The IG group performed a 12-week HIIT intervention with three sessions per week. Each session included 18 min of training (three sets of eight bouts of 15 s run at 100% maximal aerobic speed (MAS) separated by eight bouts of 15 s recovery run at 50% MAS) in PE class; the CG group were instructed to continue their normal behaviors. All subjects had indices of body mass index (BMI), fat mass (FM), body fat percentage (%BF), fat free mass (FFM), VAT, and maximal oxygen uptake (VO2max) measured at baseline and post-intervention. The cooperation of students was high, and all 40 students were included in the final analysis. A significant group–time interaction was determined in body composition (p < 0.05), with a significant decrease in BM (−3.4 ± 1.4 kg, p = 0.001; η2 = 0.63), BMI (−1.7 ± 0.5, p = 0.001; η2 = 0.58), %BF (−3.3 ± 1.4, p = 0.001; η2 = 0.54), and FM (−3.2 ± 1.4 kg, p = 0.001; η2 = 0.69), and VAT (−22.4 ± 9.8 cm2; p = 0.001; η2 = 0.61) in the IG. Furthermore, VO2max exhibited a significant increase in the IG (4.5 ± 1.6 mL/kg/min, p = 0.001; η2 = 0.84) and CG groups (1.7 ± 1.1 mL/kg/min, p = 0.001; η2 = 0.44). Integrating regular school-based HIIT sessions is a suitable method to improve body composition, cardiorespiratory fitness, and physical activity in students with obesity. Trial Registration: ChiCTR2100048737.

Impact of feed supplement with alfa-amylase and beta-glucanase on ingestive-related biomarkers registered with real-time sensors.

The aim of this study was to investigate the impact of feed supplements with alfa-amylase and beta-glucanase (Optipartum C+ 200) on ingestive-related behaviour biomarkers registered with real-time sensors: rumination behaviours and reticulorumen parameters (pH and temperature). Cows (n=20) in the treatment group (TG) were fed with Optipartum C+ 200 (Enzymes feed supplement: Alfa-Amylase 57 Units; Beta-Glucanase 107 Units) from 21 days before calving until 30 days after calving with a feeding rate of 200 g/cow/day. Cows (n=22) in the control group (CG) were fed a feed ration without feed supplement. Measurements started from 6 days before calving and continued until 21 days after calving. The following indicators were registered: with the RumiWatch System: Rumination time; Eating time; Drinking time; Rumination chews; Eating chews; Drinking gulps; Bolus; Chews per minute; Chews per bolus. With the SmaXtec system: the temperature, pH of the contents of the cows' reticulorumens, and cows' walking activity. According to our results, feed supplementation with alfa-amylase and beta-glucanase (Optipartum C+ 200) in the TG group resulted in increases in the following parameters: 9% rumination time and eating time, 19% drinking time, 11% rumination chews, 16% eating chews, 13% number of boluses per rumination, 5% chews per minute and 16% chews per bolus. The rumination time showed a strong, positive relation with rumination chews and bolus indicators in both groups (TG and CG) (p⟨0.001); while the rumination time in both groups of cows showed an opposite direction and was negatively related to eating time and eating chews (p⟨0.05). We found a 1.28 % lower reticulorumen pH and a 0.64 % lower reticulorumen temperature in cows fed with the supplement compared with cows in the control group. Cows in TG were 8.80% more active than those in the CG group. For improvement of ingestive-related behaviour we suggest adding a feed supplement with alfa-amylase and beta-glucanase (Optipartum C+ 200).

Exercise throughout Pregnancy Prevents Excessive Maternal Weight Gain during the COVID-19 Pandemic: A Randomized Clinical Trial.

The purpose of this study was to examine the effects of a virtual exercise program throughout pregnancy during the COVID-19 pandemic on maternal weight gain. A randomized clinical trial (NCT NCT04563065) was performed. In total, 300 pregnant individuals were assessed for eligibility, and a total of 157 were randomized, of which 79 were in the control group (CG), and 78 were in the intervention group (IG). Those in the intervention group participated in a virtual supervised exercise program throughout pregnancy, 3 days per week. Fewer pregnant participants exceeded the weight gain recommendations in the IG group than in the CG (n = 4/5.9% vs. n = 31/43.1%, p = 0.001). Weight gain during pregnancy was lower in the IG than in the CG (9.96 ± 3.27 kg vs. 12.48 ± 4.87 kg, p = 0.001). Analysis of subgroups based on pre-pregnancy body mass index, showed significant differences in excessive maternal weight gain between study groups in normal-weight (IG, n = 0/0% vs. CG, n = 10/25%, p = 0.001) and those with overweight (IG, n = 2/18% vs. CG, n = 12/60%, p = 0.025). A virtual supervised exercise program throughout pregnancy could be a clinical tool to manage maternal weight gain during the COVID-19 pandemic by controlling excessive gain.

Effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS in improving the physical function recovery for patients following minimally invasive esophagectomy: a prospective randomized controlled trial

BackgroundPerioperative rehabilitation management is essential to enhanced recovery after surgery (ERAS). Limited reports, however, have focused on quantitative, detailed early activity plans for patients receiving minimally invasive esophagectomy (MIE). The purpose of this research was to estimate the effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS in the recovery of bowel and physical functions for patients undergoing MIE.MethodsIn this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients admitted to the Affiliated Cancer Hospital of Zhengzhou University from June 2019 to February 2020 were selected and randomly assigned to an intervention group (IG) or a control group (CG). The participants in the IG received medical care based on the t-ECRP strategy during perioperative period, and participants in the CG received routine care. The recovery of bowel and physical functions, readiness for hospital discharge (RHD), and postoperative hospital stay were evaluated on the day of discharge.ResultsTwo hundred and fifteen cases with esophageal cancer (EC) were enrolled and randomized to the IG (n = 107) or CG (n = 108). The mean age was 62.58 years (SD 9.07) and 71.16% were male. For EC, 53.49% were mid-location cancers and 79.07% were classified as pathological stage II and III cancers. There were no significant differences between the two groups in terms of demographic and clinical characteristics and baseline physical functions. Participants in the IG group presented significantly shorter lengths of time to first flatus (P < 0.001), first postoperative bowel movement (P = 0.024), and for up and go test (P < 0.001), and lower scores of frailty (P < 0.001). The analysis also showed that participants in the IG had higher scores of RHD and shorter lengths of postoperative stay than in the CG (P < 0.05).ConclusionsThe t-ECRP appears to improve bowel and physical function recovery, ameliorate RHD, and shorten postoperative hospital stay for patients undergoing MIE. Clinicians should consider prescribing quantitative, detailed, and individualized early activity plans for these patients.Trial registrationClinicalTrials.gov (Identifier: NCT01998230)

The Modified Hospital Elder Life Program (HELP) in geriatric hospitalized patients in internal wards: A double-blind randomized control trial

BackgroundHospital Elder Life Program (HELP) provides protocols based on factors for reducing delirium. Due to the lack of geriatric wards and aged care teams in Iran, it seems that some of the original HELP interventions need to be modified through a trial study. Hence, this study was conducted to determine whether the Iranian modified HELP could reduce delirium in geriatric hospitalized patients.MethodsThis double-blind randomized controlled trial was designed and conducted in a hospital at Kashan University of Medical Sciences in Iran. A total of 195 hospitalized patients aged ≥70 years, were 84 in the Intervention Group (IG) and 111 in the Control Group (CG). After assessing delirium risk factors, participants in the IG group received interventions based on the cognitive, vision/hearing, sleep, mobility, feeding, and hydration protocols by nursing students and the CG group received routine care.Delirium incidence was assessed by the Confusion Assessment Method. Delirium incidence, cognitive and functional abilities, frailty, fall, and length of stay were outcomes.ResultsThe mean age of the patients was 78.53(Standard Deviation = 5.87) years. Delirium incidence was higher in the CG comparing to IG (14.71% vs 3.66%).Significant reduction observed in risk incidence of delirium because of interventions [Odds Ratio:0.124, Confidence Interval: 0.03–0.48].ConclusionThe modified HELP effectively reduced delirium rates in geriatric hospitalized patients.Trial registrationThis study was registered at the Iranian Registry of Clinical Trials IRCT20180910040995N1.

Evaluation of a Post-Operative Rehabilitation Program in Patients Undergoing Laparoscopic Colorectal Cancer Surgery: A Pilot Study.

This pilot study explores the effects of a post-operative physical exercise program on the quality of life (QoL) and functional and nutritional parameters of patients that underwent laparoscopic colorectal cancer surgery, compared to usual care alone. The intervention group (IG) attended a 2-month-long supervised and combined exercise–training program during the post-operative period. Both IG and control group (CG) participated in the QoL, functional, and nutritional assessments before exercise training (T0), 2 months after the beginning of the exercise (end of treatment) (T1), and 2 (T2) and 4 (T3) months from the end of treatment. Eleven patients with colorectal cancer that underwent laparoscopic surgery were enrolled (six intervention; five control). The IG showed significant improvements compared to the CG in “Physical functioning” (PF2) (p = 0.030), “Cognitive functioning” (CF) (p = 0.018), and “Fatigue” (FA) (p = 0.017) of the European Organization for Research and Treatment of Cancer Quality of Life-C30 Questionnaire (EORTC QLQ-C30) at T1; in SMWT (p = 0.022) at T1; in PF2 (p = 0.018) and FA (p = 0.045) of EORTC QLQ-C30 at T2, in phase angle (PhA) of bioelectrical impedance analysis (p = 0.022) at T3. This pilot study shows that a post-operative, combined, and supervised physical exercise program may have positive effects in improving the QoL, functional capacity, and nutritional status in patients that undergo laparoscopic colorectal cancer surgery.

Efficacy of Single-Dose Ivermectin on Virologic and Clinical Recovery in COVID-19

Background: Coronavirus disease 2019 (COVID-19) pandemic mounts an ever increasing challenge on healthcare resources. Ivermectin shows promise in in vitro studies on coronavirus, but there are few prospective trials on currently approved dosage recommendation for the treatment of COVID-19. Aims: To study the virologic and clinical recovery after single-dose ivermectin, given within first 5 days of symptom onset. Settings and design: Prospective, open-labeled, randomized controlled trial. Patients were recruited in between August 30, 2020, and November 6, 2020, at a single referral center for patients with COVID. Materials and methods: The study participants included patients presenting with severe acute respiratory syndrome coronavirus 2 infection. The patients were randomized to receive a single-dose ivermectin, 0.2 mg/kg in the treatment group (TG). Both groups [TG and control group (CG)], continued to receive standard treatment. Results: The recruited cohort was comparable in the two arms of the study, except age and height. There was no statistically significant difference in virologic clearance between the two arms (percentage COVID positive day 7: TG: 34.2% vs. CG: 52.6%, P = 0.165). Conclusion: Our study shows that after administration of single dose of currently approved doses of ivermectin (0.2 mg/kg), there does not exist a significant virologic or clinical recovery in COVID-19 disease.

A Novel Substrate-Inspired Fluorescence-Based Albumin Detection Improves Assessment of Clinical Outcomes in Hemodialysis Patients Receiving a Nursing Nutrition Intervention.

BackgroundAlbumin level does not precisely reflect nutritional status. We aimed to investigate the impact of a nutrition intervention on hemodialysis patients by use of fluorescence-based plasma albumin (FPA) detection.Material/MethodsEighty patients underwent maintenance hemodialysis for more than half a year and had a mean albumin <3.5 g/dL for over 3 months. The subjects were randomly divided into either a Control Group (CG) or an Intervention Group (IG). The IG received nutritional supplementation, and the CG group received routine nutritional support for 12 months. FPA and plasma albumin (PA) concentrations were measured. The fluorescence probe 1,3-Dichloro-7-hydroxy-9,9-dimethyl-2(9H)-acridone methyl biphenyl benzoate was used in FPA detection. Quality of life was estimated using WHOQOL-BREF (Quality of Life Scale developed through the World Health Organization), the 36-Item Short-Form Survey (SF-36), and the 6-minute walking test (6MWT).ResultsAfter a 6-month and a 12-month intervention, PA and FPA concentrations increased, and the increase in FPA concentration was higher than that of PA in the IG group (P<0.05). Comparatively, the parameters of quality of life and 6MWT were improved in the IG group (P<0.05) but there were only minor changes in the CG group (P>0.05). There is an obvious association between the changes in FPA concentration and the parameters of quality of life and 6MWT but not PA.ConclusionsUse of the fluorescence probe improves the detection sensitivity of plasma albumin and provides a potential method to assess clinical outcomes in hemodialysis patients.

Promoting social capital, self-management and health literacy in older adults through a group-based intervention delivered in low-income urban areas: results of the randomized trial AEQUALIS

BackgroundEvidence is scarce on how to promote health and decrease cumulative inequalities for disadvantaged older people. Downstream complex interventions focusing on intermediate factors (self-management, health literacy and social capital) may have the potential to mitigate the inequitable impacts of social determinants in health. The aim of the AEQUALIS study was to assess the effectiveness of a group-based intervention to improve self-perceived health as indicator of health inequality.MethodsPragmatic randomised clinical trial addressed to older adults (≥ 60 years) living in urban disadvantaged areas with low self-perceived health. The intervention was delivered in primary care settings and community assets between 2015 and 2017 and consisted in 12 weekly sessions. The primary outcome was self-perceived health assessed in two ways: with the first item of the SF-12 questionnaire, and with the EQ-5D visual analog scale. Secondary outcomes were health-related quality of life, social capital, self-management, mental health and use of health services. Outcomes were assessed at baseline, post intervention and follow-up at 9 months after the end of the intervention.Results390 people were allocated to the intervention group (IG) or the control group (CG) and 194 participants and 164 were included in the data analysis, respectively. Self perceived health as primary outcome assessed with SF-12-1 was not specifically affected by the intervention, but with the EQ-5D visual analog scale showed a significant increase at one-year follow-up only in the IG (MD=4.80, 95%CI [1.09, 8.52]). IG group improved health literacy in terms of a better understanding of medical information (− 0.62 [− 1.10, − 0.13]). The mental component of SF-12 improved (3.77 [1.82, 5.73]), and depressive symptoms decreased at post-intervention (− 1.26 [− 1.90, − 0.63]), and at follow-up (− 0.95 [− 1.62, − 0.27]). The use of antidepressants increased in CG at the follow-up (1.59 [0.33, 2.86]), while it remained stable in the IG.ConclusionsThis study indicates that a group intervention with a strong social component, conducted in primary health care and community assets, shows promising effects on mental health and can be used as a strategy for health promotion among older adults in urban disadvantaged areas.Trial registrationClinicalTrials.gov, NCT02733523. Registered 11 April 2016 - Retrospectively registered

The Physiological Effects of a Walking to Music Intervention in Adults with Intermediate Hyperglycemia

Purpose: Overweight individuals are at risk of intermediate hyperglycemia (IHG) [1]. Increasing physical activity (PA) in IHG is one method to reduce the risk of glucometabolic and cardiovascular (CV) complications [2]. This study investigates walking to music as a modality to increase moderate intensity PA and regulate glucometabolic disturbances. Patients and Methods: Participants were randomized to usual care (UC) or intervention group (IG) who completed a 6 month walking to music program. Physiological assessments for a range of variables (DEXA, flow mediated dilatation (FMD) and glucometabolic biomarkers) were completed at baseline, 4, 6 and 9 months (follow-up). Results: For IG group, walking compliance decreased with time however 71.4%, 79.5% and 73% of walking completed was moderate intensity at 4, 6 and 9 months. At 6 months IG FMD was significantly lower than UC and HbA1Cwas 5% lower. Other physiological markers were not altered. Conclusion: Walking to music may be a novel method to encourage moderate intensity PA. However, the majority of results demonstrate that this intervention was not more effective than UC in managing glucometabolic and CV biomarkers in IHG. Future interventions should include additional support for the entire study duration however this has cost implications.

Remote but Together: Live-video Group Exercise Via Zoom for Heart Failure Patients Has High Adherence and Satisfaction

Introduction Palliative care can improve heart failure (HF) symptoms, however many HF patients lack access. Likewise, standard exercise programs can improve symptoms in HF patients, however participation rates are low due to poor access and patient-specific barriers, such as high symptom burden. Further, measurement of physical function at home is uncommon. It is unknown whether gentle exercise via remote live-video conferencing is feasible in patients with HF. Aims The purpose of this study, PALL-HEART was to pilot test a live, gentle exercise intervention delivered via group video-conference, compared to an education/control group, on: 1) feasibility/adherence; 2) participant satisfaction; and, 3) utility of home-based measurement of physical function. Methods This 8-week randomized controlled trial included participants (N=20) recruited from an academic health system HF clinic. Both the intervention group (IG) and the health education (HE) group received a tablet computer preloaded with HF education topics, while the IG group participated in live 60-minute gentle exercise classes via video-conference twice weekly. The HE group was instructed to explore the education resources and called weekly to ascertain office visits or hospitalizations. Outcomes measured: 1) intervention feasibility using adherence (number of attended sessions, number of minutes attended), technological issues (ease of tablet use; number of technological disruptions; 2) satisfaction with intervention; and, 3) utility of home-based physical function measures (strength [arm curls, chair stands], balance [1 leg stand], hip flexibility [sit and reach], endurance [2 minute step test], agility [timed get up and go]). Effect sizes were calculated using Cohen's d by group. Results Twenty (IG=10, HE=10) participated, with a mean age of 68.7 years (SD = 12.7), 17 (85%) male gender, 16 (80%) white, and mean BMI of 29.4 (SD = 5.1). The trial design was feasible with 100% participation in classes, 100% of minutes attended, zero technological disruptions, and 100% participant satisfaction ratings. Further, some participants joined classes more often than we instructed (>100% adherence). Physical function measures were conveniently assessed at home (within 15 minutes) with small to moderate preliminary effect sizes in the intervention group at 8 weeks on: hip flexibility (sit to reach; d = 0.25), leg strength (chair stands; d = 0.16), endurance (two-minute-step test; d = 0.13), and balance (get up and go; d = 0.31). Conclusion Our novel approach to home exercise is highly feasible with very high adherence rates, satisfaction, and easily adapted home-based physical function measures. Testing for improvements in physical function and psychological measures is now needed. These findings are especially critical now as we seek suitable platforms for remote access to health care.

The sophrology as adjuvant therapy may improve the functionality of patients with fibromyalgia. A pilot randomized controlled trial

Introduction: Sophrology is the science of the serene spirit applied to human consciousness. Body relaxation exercises are not yet a consensus in the treatment of fibromyalgia. Objective: To investigate the effectiveness of a relaxation exercise program based on sophrology in patients with fibromyalgia. Method: This is a pilot study, controlled, randomized and with blinded evaluator and eighteen patients with medical diagnosis of fibromyalgia were randomized into two groups: the intervention group (IG) who participated in sophrology sessions (n= 8) and control group (CG) who participated of a resistance training program (n= 10). Both groups underwent treatments 2 times per week for 12 weeks and reevaluations every 4 weeks. The assessment instruments used were the visual analogic scale of pain (VAS), the satisfaction with the treatment by the Likert scale, the 6-minute walk test (6MWT), the Timed Up and Go test (TUG) and the Fibromyalgia Impact Questionnaire (FIQ). Results: We did not find statistical differences in any of the variables between the groups. The intragroup evaluation, there was a significant difference in CG for TC6 (p= 0.01) and TUG (p= 0.04). In IG there was a statistically significant difference (p = 0.02) for the FIQ. Conclusion: Thus, the improvement in 6MWT and TUG in the CG and the improvement in the FIQ in the IG group showed promising results, although studies with larger sample is needed for more accurate results.

Herbst appliance anchored to miniscrews in the upper and lower arches vs standard Herbst: A pilot study

The aim of this pilot study was to present the preliminary results of Class II malocclusion treatment using a skeletally anchored Herbst appliance with miniscrews inserted in the maxillary and mandibular arches to improve anchorage control and skeletal effects. The treatment group (TG) consisted of 13 patients (10 males [M], 3 females [F]; mean age of 12.8years) with Class II Division 1 malocclusion who were treated with the Herbst appliance and miniscrews inserted in the maxillary and mandibular arches. They were compared with a control group (CG) of 13 patients (10F, 3M, mean age of 12.2years) with Class II Division 1 malocclusion treated with the standard Herbst appliance without miniscrews. Lateral cephalograms were taken before and after Herbst treatment, and cephalometric analysis was performed. In the TG group SNB (°) increased by 2.9°, whereas in CG group SNB (°) increased by 1.1° (P=0.017). ANB (°) decreased in both groups: -3.3° in the TG group vs -1.3° in the CG group (P=0.014). Pg-OLp distance increased in both groups: 5.70mm in the TG group and 0.8mm in the CG group (P=0.022). Mandibular incisors proclined 1.6° in the TG group and 3.7° in theCG group. Herbst treatment reinforced with 4 miniscrews (2 in each arch) increased the orthopedic effect of treatment in growing patients with Class II malocclusion.

Effects of a Laxation and Probiotic Bowel Preparation Regimen: A Randomized Controlled Trial in Patients Undergoing Prostate Radiation Therapy

Aim: To determine the effect of bulking and osmotic laxation regimens on reducing rectal gas in patients receiving external beam radiation therapy for prostate cancer.Methods: A single blinded randomized controlled trial was conducted. Participants assigned to the intervention group (IG) were instructed to consume a bulking laxative and probiotic and the standard care group (SC) instructed to consume an osmotic laxative. Both groups followed a standard low gas diet. Rectal gas ratings were determined from cone-beam computed tomography (CBCT) scans. Dietary and laxative compliance, bowel habits, fiber and fluid intakes were determined from food diaries.Results: Demographic characteristics were not significantly different between the two treatment arms. The mean age was 74 years. Participants were randomized into the IG (n = 8) and SC group (n = 9). Analysis of 433 CBCT scans indicate the odds of a higher rectal gas rating were significantly increased for the IG compared with the SC group (OR 3.2, 95% CI 1.77–5.78, P < 0.001).Conclusions: The osmotic laxative was more effective at achieving lower rectal gas levels than a bulking laxative with probiotic in this study. Larger studies of commonly used laxatives are required to develop recommendations for bowel preparation during radiotherapy to the prostate.

A Survey on Knowledge of Registered Drugs amongst Patients from the Specialist Clinic, Malaysia

Introduction: One of the solutions to reduce unregistered drugs usage is via awareness and educational programmes. The aim of this study is to determine the significance difference of patients’ level of knowledge between control and intervention groups towards registered drugs. Method: The study used a pre- and post-test by answering the validated survey during October-November 2018 at a tertiary hospital in Malaysia. It has two groups as an intervention group (IG) receiving counseling and control group (CG) which did not receive any counseling. This study used systematic random sampling. The data analysis was performed using SPSS version 23. Descriptive data was reported, including the answers each question, score, level of knowledge based on the percentages and the socio-demographic data. The pre and post differences of the score between control and intervention groups were assessed using ANCOVA. Result: A total of 657 respondents were obtained which overall response rate of 93%). Majority of the participants are aged between 18-28 years old (47%), female (58.3), Malay (47.4%), Degree holder (69.1%) and in the government sector (38.3%). However, the majority of participants are in the category of the acceptable level of knowledge towards registered drugs (40.8%) and only 3.5% of the participants are in the category of excellent. However, about 66.1% of the participants have scored above 50%. It can be considered that the majority of the participants have knowledge about registered drugs. IG group displayed significantly higher post-test results compared with CG group (p<0.001). Conclusion: The used of the validated survey during the awareness programmes might give benefit to the public who attends the awareness and educational programmes and finally can improve the effectiveness of the programmes in the future. In the future, the improvement of the design of the campaign might include the use of a survey in order to give more understanding to the public towards registered drugs.

3. DEVELOPMENT AND EVALUATION OF A COMPREHENSIVE VACCINE HESITANCY CURRICULUM

Background Vaccine hesitancy may lead to delayed or incomplete vaccination, increased risk of vaccine-preventable disease and distrust between pediatricians and families. Studies have shown many pediatric providers are uncomfortable addressing parental concerns and educating hesitant parents on vaccine safety, necessity and misconceptions, yet few curricula to fill this need have been published. We developed and implemented a comprehensive longitudinal curriculum for pediatric residents on vaccine hesitancy and evaluated its efficacy via randomized controlled trial, hypothesizing that residents undergoing the curriculum would demonstrate improved knowledge, comfort and communication skills with vaccine hesitant families compared to a control group. Methods Using Kern's curriculum design framework, we designed and implemented didactic sessions for each pediatric vaccine and interactive role-playing sessions on communication skills. Half the pediatric residents were randomized to the intervention group (IG) and received the curriculum over 1 year; the control group (CG) received standard education only. Residents completed written pre and posttests and a standardized patient (SP) assessment at the end of the study period; group differences were evaluated using independent t-tests. Results 35 residents were randomized to IG and 35 to CG. Pre-test scores did not differ significantly between the 2 groups.The CG did not show a significant difference between pre and posttest scores for didactic knowledge or reported comfort level. The IG showed a significant increase in both knowledge and comfort level post curriculum. IG pretest knowledge score increased from 47% to 66%,p=0.00. IG pretest comfort level increased from 2.9/5 to 3.76/5,p=0.00. IG group SP score was significantly higher than the CG: 78% vs. 52%,p=0.00. Conclusion Implementation of a comprehensive curriculum on vaccine hesitancy resulted in improvements in vaccine knowledge base, communication skills and comfort level with vaccine hesitancy discussions in pediatric residents. Studies should be done to assess the impact of such a curriculum on patients and vaccination rates.