Breast cancer is the leading cancer affecting women in Singapore. Its survivors commonly experience decline in physical function and quality of life post-mastectomy, due to their upper limb morbidity ...and wound issues. Rehabilitation can address the aforementioned issues. When rehabilitation is accessible and easy to adhere, it can optimize recovery. Home-based tele-rehabilitation guided by healthcare professionals and self-managed by patients can potentially optimize the patients' adherence to rehabilitation and recovery. With that in mind, a team of breast cancer specialists (oncologists, nurses, and therapists) in Singapore has developed one of the first tele-rehabilitation systems for local women undergoing a unilateral mastectomy. To our knowledge, no such systems have been evaluated or proven effective as a treatment option among local breast cancer patients with acute disabilities.
This is a pilot quasi-experimental trial that aims to evaluate the feasibility of tele-rehabilitation and tele-drain care compared to usual care. Up to 40 patients (20 per group) will be recruited for this trial. They will be assigned to an intervention group that receives rehabilitation via a tele-rehabilitation system or a control group that receives rehabilitation in person at their clinic. The primary outcome of this trial is rehabilitation participation (i.e., the time spent on rehabilitation). The secondary outcomes are upper extremity functioning, perceived health, and quality of life.
As part of this pilot trial, patients who opt in for the tele-rehabilitation will be asked to share their experience with and thoughts on the tele-rehabilitation system. With the evidence obtained from the tele-rehabilitation patients of this trial, we will be able to improve the current system for our future trial. Further, our additional data on rehabilitation participation, physical function, and quality of life will help us design a sufficiently powered future main trial.
The trial was approved by the National Healthcare Group's Domain Specific Review Board (#2019/00283) and registered with www.ClinicalTrials.gov (# NCT04269967 ) in February 2020.
Familial hypercholesterolaemia (FH) is a condition that should be familiar to all health professionals involved in preventive medicine. FH is the most common and serious monogenic disorder of lipid ...metabolism that leads to premature coronary heart disease. However, most cases remain undetected or inadequately treated in our community. We provide an overview of FH, with emphasis on evidence for treatment, new models of care (MoCs) and health economic evaluations. Evidence for treatment is based on cohort studies; while this is a low level class of evidence, MoCs concur in recommending early intervention and lowering of plasma low‐density lipoprotein‐cholesterol levels by at least 40% with statins. Preliminary health economic evaluations suggest that detecting and treating FH is cost‐effective, but further studies based on high‐quality international data and standardised costing methods are needed. If the recommendations in the published MoCs are followed, there is likely to be significant improvement in the health and quality of life of patients with FH and their families, as well as major cost savings in healthcare for end‐organ damage, including myocardial infarction, acute coronary syndromes and possibly stroke, but this requires to be verified.
Drawing upon the computers-are-social-actors (CASA) paradigm, this study examined the effects of designing conversational commerce chatbots with expertise cues. Accordingly, these cues were ...operationalized through designation of chatbots as product-specific advisers, dialogues containing expertise-cued labels and social descriptors (e.g., "I am your personal expert adviser for sportswear!"), gender of chatbots, and appearance styles of chatbots. A within-subject laboratory experiment was conducted in which university undergraduates (n=71) viewed two videos displaying mock user-chatbot interactions - one featured the experimental condition (chatbots with expertise cues) while the other featured the control condition (chatbot without expertise cues). Compared against the control, the experimental condition elevated perceived source expertise of chatbots, platform trust ability and trust integrity, and purchase intention through the conversational commerce platform. The expertise cues effects on purchase intention was mediated by platform trust ability. Theoretical and practical implications are discussed through the lens of CASA and source credibility model in this paper.
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