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Introduction/Purpose: Diabetic foot complications and subsequent lower limb amputations commonly occur in diabetic patients due to poor foot care. We aimed to understand the extent of proper footcare practices and to identify the factors which influence these among diabetic patients in a multi-ethnic Asian population. Methods: A cross-sectional multi-centre quantitative study was performed. Inclusion criteria was all patients attending hospital outpatients clinics for diabetes. Patients were only excluded if they were unable to understand basic English. Demographic information, medical history (including formal assessment for peripheral neuropathy) and Nottingham Assessment of Functional Footcare (NAFF) scoreswere collected. All data was analysed using SPSS Version 21. Results: 350 valid responses were obtained. The mean NAFF score was 49.6±7.19. Univariate analysis revealed that ethnically non-Chinese patients had significantly better scores than did Chinese patients. After linear regression analysis, a statistically significant correlation with better foot care practices was found for patients with higher education levels, active employment and the presence of previous diabetic foot complications. Conclusion: The mean NAFF scores in our study were lower than those published in other populations which may in part account for the huge burden of diabetic foot disease in Singapore. Patients appear to start to look after their feet better only after suffering a complication.Cultural and financial factors probably account for the differences in our risk factor findings and those published in other populations. Future studies should i evaluate the effectiveness of targeted interventions for the specific groups that we have identified who have poorer NAFF scores.

Introduction: Community Health Education (CHE) is a development strategy which aims to address the needs of communities in developing countries through an emphasis on moral values and civic education. The syllabus of the CHE program guides a trainer to find the needs of a developing community and take a moral values-based approach to health issues such as alcoholism, smoking, injuries to accidents, and sexually-transmitted illnesses. The fundamental philosophy is that of development as opposed to aid. Methods: In November 2010 and February 2011, this training was conducted for leaders and volunteers from two Cambodian Non-Governmental Organizations (NGOs) involved in HIV prevention education and training in Cambodia. In order to investigate long-term impact, participants who underwent training sessions in November 2010 and February 2011 also underwent Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs). Results: A total of 28 participants partook in the 3 FGDs and 5 participants took part in the KIIs. Participants were able to recall a number of moral values and concepts from the training. These included forgiveness, love, altruism, unity, respect, empathy, teamwork, optimism, and hopefulness. The organizations were then able to use the CHE model to change the way their organization worked together to achieve the goals in their communities. The participants were also able to use the teaching modalities employed by CHE sessions in their own work with their target communities. Conclusion: The CHE training system has had a number of positive effects. They have influenced the personal lives of the participants, the way their organizations are run and the way they reach out to their target communities. In light of the themes identified in our results, we propose further research to compare the relative magnitude of all of these effects on these organizations in the long run compared to the short run.

Lower-back pain (LBP) is a major cause of occupational disability and morbidity. This study investigates the effectiveness of a fabric-based pneumatic exosuit in reducing discomfort and lumbar muscle activation in healthy individuals who are performing manual-handling tasks. The suit combines the comfort of soft exosuits and the support of rigid exoskeletons. Ten healthy subjects performed a circuit of lifting tasks, simulating manual-handling work, with and without AireLevate support. We assessed the comfort levels and ease of task completion via a questionnaire after each manual-handling task. There was no difference in spinal range of motion, local discomfort, or general discomfort of activities with or without the AireLevate. There was a statistically significant reduction in muscle activation of the erector spinae at the L-5 level with AireLevate support (p < 0.02). This study demonstrates the exosuit’s ability in reducing lower-back muscle activation during manual-handling tasks, while maintaining comfort and mobility. Practitioner summary: We developed a soft exosuit which was shown to significantly reduce the muscle action of the erector muscles of the lumbar spine. In addition, participants perceived that the suit was easy to use and did not limit manual-handling tasks.