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Effect of peanut butter supplementation on physical and cognitive functions in community-dwelling older adults: Study protocol for a 6-month randomised controlled trial
No full textIntroduction: Ageing is associated with physical and cognitive declines, which may be further exacerbated by poor nutrition. Nuts are energy and nutrient dense, and their consumption is associated with better physical and cognitive functions in older adults, but data from interventional studies are limited. This 6-month randomised controlled trial is designed to investigate the effects of consuming 43 g/day of peanut butter (equivalent to 1.5 servings of nuts) on physical function, including walking speed (primary outcome), standing and dynamic balance, upper and lower body strength, lower body power and endurance, and associated factors including muscle mass, cognitive function and DNA telomere length in community-dwelling older adults.
Method and analysis: A total of 120 participants aged ≥65 years will be recruited and randomly allocated (1:1 ratio) to either the intervention group (n=60) that will receive individually packaged sealed containers containing 43 g of peanut butter to be consumed once daily for 6 months alongside habitual diet, or the control group (n=60) that will maintain their habitual diet. Primary and secondary outcomes will be assessed at baseline and at 6 months. The primary outcome is walking speed assessed using the 4 m usual gait speed test. Secondary outcomes include other physical function assessments: standing balance, chair stand time, timed-up-and-go test and four-square step test; and hand grip and knee extensor muscle strength; cognitive function assessed using the Montreal Cognitive Assessment and trail making tests; body composition; nutritional status; and DNA telomere length from participants’ buccal cell samples. Linear mixed models will be used to compare changes in outcomes between intervention and control groups.
Ethics and dissemination: The study protocol is approved by the Deakin University Human Research Ethics Committee. The trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12622001291774. The results will be disseminated through peer-reviewed journals, conference presentations and media
Exploring risk perception, mental health, mental fatigue, stigma, and the quality of life among UAE healthcare workers during the COVID-19 pandemic: A national multicentric cross-sectional study
No full textGlobally, the COVID-19 pandemic has presented serious mental health challenges for healthcare professionals. This study investigated the mental health, mental fatigue, quality of life, and stigma of social discrimination among healthcare workers in the United Arab Emirates (UAE) during the COVID-19 pandemic. A correlational, cross-sectional, multi-centric design was employed to collect data from 1383 healthcare workers across various healthcare settings. Participants were recruited using combined cluster and purposive sampling techniques. Standardized questionnaires, including the COVID-19 Pandemic Mental Health Questionnaire (CoPaQ), the Mental Fatigue Scale (MFS), the Social Discrimination Scale-Stigma Subscale (SDS), and the WHO Quality of Life QuestionnaireBrief (WHOQOL-BREF), were administered to assess the study variables. The results indicated significant mental health impacts, with high average scores for post-traumatic stress disorder (PTSD) (9.37 ± 6.74) and positive coping by inner strengths (17.63 ± 5.72). Mental fatigue was prevalent (8.15 ± 8.62), and stigma of social discrimination scored notably (23.83 ± 7.46). Quality of life was the highest in the social domain (65.38 ± 24.58). Significant correlations were observed between mental health subscales, mental fatigue, and quality of life domains. These findings highlight the critical need for targeted mental health support programs, improved social support networks, and personalized interventions to mitigate the mental health challenges faced by healthcare workers. Healthcare organizations can guarantee a resilient workforce that can handle future health crises by giving mental health resources and support systems top priority
Urgent care for injuries: Consumer perspective from Rockingham community conversation – June 2024
Get PDFMany people seeking urgent care have injuries (a new condition involving pain, sprain, strain or fracture of nerve, muscle, tendon, joint or bones). They make up 8-9% of the people going to the Rockingham General Hospital emergency department. In 2022, a new model of care started at the hospital diverting patients with injuries from the emergency department to physiotherapy outpatients. A community conversation was held in June 2024 in Rockingham to explore the issues associated with seeking urgent and follow up care with an injury. Consumers attended and their perspectives were workshopped with researchers from the University of Notre Dame Australia and the consumer engagement team from the WA Health Translation Network. A number of key themes for consumers seeking urgent care with an injury in Rockingham were identified and explored in this report.https://researchonline.nd.edu.au/health_reports/1001/thumbnail.jp
Screening, investigation and follow-up of neonates with small for gestational age in a metropolitan hospital in Australia-observational retrospective study
No full textBackground: Infants with small for gestational age (SGA) have an increased risk of short and long-term health outcomes, with potentially modifiable risk factors. This study aims to determine the prenatal risk factors associated SGA and evaluate the clinical management of affected infants.
Methods: An observational retrospective study of medical records of infants born at Nepean Hospital and discharged with a diagnosis of SGA over 5 years (1st January 2015 to 31st December 2019). Data included demographic details, antenatal care, maternal risk factors and clinical management of the infants.
Results: Six hundred and seven infants had a discharge diagnosis of SGA, from 20,392 infants born. Of the 607 infants identified, 487 (80%) had SGA, 97 (16%) had asymmetrical SGA, 175 (29%) had symmetrical SGA, and 50 (8%) were incorrectly diagnosed with SGA based on growth measurements taken at birth. The most prevalent maternal risk factors were the presence of chronic disease (n=402, 66.23%), current smoking (n=159, 26.19%), social work input (n=108, 17.79%), gestational diabetes mellitus (n=96, 15.82%) and Aboriginal background (n=73, 12.03%). Prenatal genetic testing was conducted in 89.62% (n=544); 58.81% (n=357) had placental abnormalities; 36.57% (n=222) were recommended follow-up with a general practitioner (GP) and paediatrician, and 21.09% (n=128) were recommended a combination of midwifery in the home (MITH), GP, and paediatric follow-up. Two infants were recorded with no follow-up.
Conclusions: Diagnostic inaccuracies were found in infants with SGA. More intensive antenatal care for women with risk factors for SGA might improve the health of those with chronic disease; support for smoking cessation could also be offered
Sex-differential testosterone response to long-term weight loss
No full textObjectives: Obesity-associated gonadal dysfunction is a common comorbidity in patients seeking weight loss interventions. We examined the incremental effect of weight loss on gonadal axes in men and women over 3 years. Changes in sex hormones were compared between dietary intervention (Diet) and bariatric procedures: Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG) and laparoscopic adjustable gastric banding (LAGB). Additional analysis assessed changes in corticotropic, somatotropic and thyroid axes after weight loss interventions.
Methods: This prospective, observational study included 61 adults with Body Mass Index \u3e30 kg/m2 , mean age 51 (SD = 11) years. Endocrine parameters were measured at baseline and at 6 timepoints over 36-months.
Results: For each 1 kg of weight lost, between baseline and 36 months, total testosterone increased by 0.6% (95% CI: 0.2%, 1.0%, p = 0.002) in males and decreased by 0.8% (95% CI: −1.4%, −0.3%, p = 0.003) in females. These changes remained statistically significant when controlled for age and for menopausal status in females. At 36 months, in comparison with Diet, RYGB women had lower total testosterone by 54% (95% CI: −90%, −17%, p = 0.004), reduced free androgen index (FAI) by 65% (95% CI; −114%, −17%, p = 0.009) while SG had reduced FAI by 39% (95% CI; −77%, 0%, p = 0.05). No such differences between groups were noted for male subjects. Adrenocorticotropic hormone declined by 0.3% (95% CI: 0.0, −0.5%, p = 0.05), insulin-like growth factor-1 increased by 0.4% (95% CI; 0.2%, 0.7%, p = 0.005), without such thyrotrophin change for each 1 kg of weight loss, for entire cohort, over 36 months.
Conclusions: The testosterone changes observed in this study were proportional to the amount of weight loss. In females, reduction in androgens was independent of age and menopausal status and more pronounced after bariatric procedures. This study finding warrants further clinical research to explore an impact of androgen reduction on functional and cognitive status in postmenopausal women. The observed changes in pituitary hormones may contribute to the metabolic benefits of bariatric surgery
Supply of nirmatrelvir/ritonavir and molnupiravir for patients with COVID-19 in the first eight months since listing on the Australian Pharmaceutical Benefits Scheme: A retrospective observational study
Get PDFObjectives: To compare the supply of molnupiravir and nirmatrelvir/ritonavir in relation to patient characteristics and other co-prescribed medicines and to estimate the number of patients without contraindications to nirmatrelvir/ritonavir who were treated with molnupiravir.
Study design, setting: Retrospective observational study of patients identified in the Pharmaceutical Benefits Scheme (PBS) 10 % sample dataset who were supplied with either molnupiravir or nirmatrelvir/ritonavir between May and December 2022. We supplemented the PBS dataset with aggregated counts from published literature to determine prevalence of clinical contraindications to nirmatrelvir/ritonavir. Main outcome measures: We used multivariable Poisson regression to estimate risk ratios (RR) of receiving nirmatrelvir/ritonavir over molnupiravir.
Results: We identified 54,550 patients who received either nirmatrelvir/ritonavir (26.8 %) or molnupiravir (73.2 %). Their average age was 71.6 (SD = 13.4) years and 57.1 % were female. Patients were less likely to receive nirmatrelvir/ritonavir with increasing age (RR = 0.50; 95 % CI: 0.48–0.53; for ages 85 + compared to \u3c 65 years) or who had received medicines contraindicated for use with nirmatrelvir/ritonavir (RR = 0.66; 95 % CI: 0.64–0.68). During the study period, we estimated that between 28.4 % and 45.4 % of patients aged ≥ 65 years had received molnupiravir in the absence of pharmacological and clinical contraindications to nirmatrelvir/ ritonavir.
Conclusion: Many prescriptions were written for molnupiravir where there were no contraindications to nirmatrelvir/ritonavir. The benefits that followed from prompt government action in approving and obtaining nirmatrelvir/ritonavir were therefore likely to be less than they could potentially have been. Governments should consider investing in quality improvement systems to ensure the best outcomes in terms of efficacy and safety
Factors associated with satisfaction of the australian rural resident medical officer cadetship program: results from a cross-sectional study
No full textBackground: Australian Rural Resident Medical Officer Cadetships are awarded to medical students interested in a rural medical career. The Rural Residential Medical Ofcer Cadetship Program (Cadetship Program) is administered by the Rural Doctors Network on behalf of the NSW Ministry of Health. This study aimed to assess the overall experience of medical students and key factors that contributed to their satisfaction with the Cadetship Program.
Methods: A quantitative cross-sectional study was conducted among 107 former cadets who had completed the Cadetship Program. Data on medical students’ experience with the Cadetship Program (outcome variable) and potential explanatory variables were collected using a structured self-administered questionnaire. Explanatory variables included gender, geographical location, rural health club membership, rural clinical school attendance, fnancial support, mentorship benefts, networking opportunities, infuence on career decisions, opportunity for preferential placements, and relocation. Both bivariate (Pearson’s chi-squared test) and multiple logistic regression analysis were employed to identify the factors associated with medical students’ overall experience with the Cadetship Program. The non-linear analysis was weighted to represent the rural/remote health workforce, in Stata/SE 14.1.
Results: Our results indicate that 91% of medical students were satisfied with the Cadetship Program. The logistic regression model identified two significant predictors of a positive experience with the Cadetship Program. Medical students who perceived financial support as beneficial were significantly more likely to report a satisfactory program experience (aOR=6.22, 95% CI: 1.36–28.44, p=0.019) than those who perceived financial support as not beneficial. Similarly, those who valued networking opportunities were more likely to have a positive view of their cadetship experience (aOR=10.06, 95% CI: 1.11–91.06, p=0.040) than their counterparts.
Conclusion: Our study found that students who valued fnancial support and networking opportunities had the most positive views of the Cadetship Program. These fndings demonstrate that the Cadetship Program may be most helpful for those who need fnancial support and for students who seek networking opportunities. These fndings increase our knowledge about the characteristics of medical students who have the most positive experience