82 research outputs found
Osteoarthritis and falls among older adults / Sumaiyah Mat
No full textFalls are major public health problem in older adults. Fall-related injuries have been reported as the leading causes of years lived with disability globally. While osteoarthritis, a common degenerative joint disorder, has been considered an established risk factor for falls. Our literature review has found limited evidence and conflicting results to support this assumption. This study was performed and analysed in a two-staged design: 1) a case-control comparison of characteristics related to OA among fallers and non-faller controls, 2) a pre-planned subgroup analysis of individuals with OA within a randomized controlled trial of multifaceted interventions in the secondary prevention of falls in older people. Cases consisted of 229 fallers; individuals aged 65 years and above with a history of two falls or one injurious fall in the past 12 months. 160 control participants were non-fallers, aged 65 and above without no history of falls. Regardless of the definition used, OA was not associated with falls. However, different degrees of severity of OA symptoms in varying OA definitions showed an interesting relationship with falls. In individuals with radiological OA, mild symptoms appear protective of falls which was probably due to increase of anxiety while those with clinical OA and severe symptoms are at increased risk of falls compared to those with mild symptoms mediated by fear of falling. Thus, OA was not directly associated with falls, however, psychological problems secondary to OA might have a different impact on the risk of falls. In a separate study of postural control (n=102), impaired postural balance found among fallers was not influenced by presence of OA. The poorer EPE observed in individuals with symptomatic OA appeared to have a protective effect against falls. An evaluation of the features of OA detected on MRI revealed that that presence of sub-chondral cysts and menisceal tears mediates in increase in postural sway among fallers.
iv
Among our older participants with OA, fallers had higher serum TIMP2 level, indicating that falls among older adults with OA was associated with a higher degree of degeneration. In the subgroup analysis of individuals with OA from the RCT on multifactorial intervention for falls, the modified Otago exercise improved postural control and reduced fear of falling in those with pre-existing impairments in gait and balance. In essence, this study has contributed to existing knowledge on falls by contradicting previously unsubstantiated assumptions of the association between OA and falls. Instead, a sinusoidal relationship appears to exist between OA and falls, with mild OA being protective of falls and severe OA predisposing to falls. Falls risk appears to be influenced by psychological status, while impaired dynamic postural control associated with increased falls risk is not influenced by the presence of OA. However, the presence of sub-chondral cyst and menisceal tear detected by MRI did mediate the impaired postural control observed in our fallers. In our serological analysis, falls among older adults with OA were associated with a more active degenerative state. The improvement in postural control and falls efficacy observed among our OA fallers, suggest that the modified Otago is potentially benefical, and will serve as a pilot study for a larger randomized-controlled study for secondary falls prevention for individuals with OA
A cross-sectional study on factors influencing attendance to eye screening
No full textThis study aimed to survey the factors influencing attendance to eye screening among Diabetes mellitus (DM) patients. This cross-sectional survey was carried out among 170 DM patients using self-administered questionnaires. Majority of participants, 45.9% (n = 78) highlighted that lack of information regarding diabetes and not understanding the significance of eye screening are the barriers to eye screening. Whereas, 10.6% (n = 18) reported lack of access to healthcare facilities, 6.5% (n = 11) experienced time limitation and 2.9% (n = 5) suffered financial issues. However, more than half of the participants (58.2%) have good knowledge related to diabetic eye complications. There was a significant difference between educational level with patients’ attendance in yearly eye screening. Lack of information received by the patients on the importance of eye screening and communication issues seems to be prominent and becomes the reason for patients not attending eye screening
Erratum: Reducing the Duration of Untreated Psychosis (DUP) in a US Community
No full textCorrigendum to "Reducing the Duration of Untreated Psychosis (DUP) in a US Community: A Quasi-Experimental Trial" by Srihari et al. Schizophrenia Bulletin Open, Volume 3, Issue 1, January 2022, sgab057, doi:10.1093/schizbullopen/sgab057. In the originally published version of this manuscript, some of the author affiliations were incorrectly listed but that is now corrected. Larry J. Seidman is deceased, and this is now indicated in the online version. NIH funding information and an acknowledgment to the contributions of Philip Markovich, Nina Levine, Sumaiyah Syed, and Shadie Burke have been added
The mediating role of psychological symptoms on falls risk among older adults with osteoarthritis
No full textSumaiyah Mat,1 Chin Teck Ng,1–3 Farhana Fadzil,4 Faizatul Izza Rozalli,4 Maw Pin Tan1,5 1Ageing and Age-Associated Disorders Research Group, University of Malaya, Kuala Lumpur, Malaysia; 2Department of Rheumatology and Immunology, Singapore General Hospital, 3Duke-NUS Medical School, National University Singapore, Singapore; 4Department of Radiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 5Geriatric Division, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Abstract: The purpose of this study was to investigate the role of fear of falling (FoF) and psychological symptoms in explaining the relationship between osteoarthritis (OA) symptom severity and falls. Individuals aged ≥65 years with ≥2 falls or ≥1 injurious fall over the past 12 months were included in the falls group, while volunteers aged ≥65 years with no history of falls over 12 months were recruited as controls. The presence of lower extremity OA was determined radiologically and clinically. Severity of symptoms was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. FoF and psychological status were measured with the shortened version of the Falls Efficacy Scale-International and the 21-item Depression, Anxiety and Stress Scale (DASS-21), respectively. Of 389 (229 fallers, 160 non-fallers) potential participants, mean (SD) age: 73.74 (6.60) years, 141 had clinical OA and 171 had radiological OA. Fallers with both radiological OA and clinical OA had significantly higher FoF and DASS-21 scores than non-fallers. FoF was significantly positively correlated with symptom severity in fallers and non-fallers with radiological and clinical OA. Depression, anxiety, and stress scores were only significantly correlated with symptom severity among fallers but not non-fallers in both clinical and radiological OA. The relationship between mild symptoms and reduced risk of falls compared to no symptoms in those with radiological OA was attenuated by increased anxiety. The increased falls risk associated with severe symptoms compared to mild symptoms in clinical OA was attenuated by FoF. FoF may, therefore, be a potentially modifiable risk factor for OA-associated falls which could be considered in future intervention studies. Keywords: falls, fear of falling, osteoarthritis, psychological status, age
Mobile health information technology for physical activity education during cardiac rehabilitation: a scoping review
No full textIntroduction: In healthcare delivery system, mobile health is a modern information and communication technology system that facilitates the delivery of nursing care and services to remote locations. Research indicates that mobile health education can enhance physical activity in chronic diseases patients like cardiovacular disease overall. Nonetheless, the effects of mobile health on cardiac disease patients during cardica rehabilitation have yet to be assessed. Objective: To assess the impact of mobile health education on the physical activity levels of cardiac patients during cardica rehabilitation from previous studies. Method: This study used a scoping review method approach. The inclusion criteria encompassed papers published in English from 2019 to 2024. Participants with adult cardiac disease underwent therapies utilising information technology, with outcomes measured in terms of physical activity, the studies employed a randomised controlled trial methodology. Exclusion criteria included psychiatric diseases, literature reviews, systematic reviews, and overviews. This review was performed across four databases: PubMed, Scopus, Wiley, and Emerald Insight. A critical appraisal was performed utilising the Joanna Briggs Institute's Critical Appraisal Checklist. Findings: There are a total of 16 articles included in this review. Three themes emerged in this study. The results indicated that mobile health technology can effectively assist cardiac patients during cardiac rehabilitation by providing tools for real-time monitoring, patient education, and behavioural adjustment. These therapies markedly enhanced physical activity levels and overall quality of life in cardiac patients Conclusion: The educational interventions utilising mobile health, including mobile health, applications, and websites, can enhance the physical activity levels of cardiac patients during cardiac rehabilitation. Thus, mobile health can be utilised in hospitals to deliver nursing care, facilitate education, and remotely monitor the physical activity of cardiac patients during cardiac rehabilitatio
A study of factors influencing eye screening: Descriptive findings
No full textIntroduction: Individuals with Diabetes Mellitus (DM) are at increased risk for developing diabetic ocular complications. This study was carried out to determine factors influencing eye screening among Diabetes Mellitus patients. The descriptive findings of participants’ sociodemographic data will be discussed.
Materials and Method: A cross-sectional survey was conducted at the few selective Primary Health Centers and endocrine clinics, Hospital Tengku Ampuan Afzan (HTAA) in Kuantan, Pahang. A total number of 170 diabetic patients were recruited for the purpose of this study. Questionnaire for this survey was adapted and modified from Knowledge, Attitude and Practice (KAP 2008) with the overall Cronbach Alpha score was 0.5. Descriptive statistics was referred to evaluate the data.
Results: Participants’ mean age was 55.5 years old (SD ± 11.22), with age range between 20 years and 79 years old. From 170 participants, 51 male (30%) and 119 female (70%) were involved in this study. Majority of 139 participants (81.8%) were Malay. For educational level, 74 participants (43.5%) have the secondary education, only 12 participants (7.1%) have tertiary education and the rest of 43 participants (25.3%) have no formal education. The majority of participants (71.2%) have the monthly income less than RM 1000 and only 7 (4.1%) have monthly income of RM 4000 and above. Almost all patients (168 participants or 98.8%) have type 2 Diabetes Mellitus (DM). The majority of 65 patients (38.2%) were first diagnosed to have diabetes between 1 to 5 years duration, and only 10 patients (5.9%) diagnosed to have diabetes of 15 years and above. Most of the participants (109 or 64.1%) have a family history of DM. As for current treatment, the majority of them are taking oral medication 136 (80.0%).
Conclusion: The main background characteristics of DM patients in current study were female, Malay, low household income and family trait with DM
FACTORS ASSOCIATED WITH ANXIETY LEVEL OF TRIMESTER III PRIMIGRAVIDA PREGNANT WOMEN IN MENUR HEALTH CENTER SURABAYA
No full textPregnancy and childbirth are normal things experienced by women, but this still has a high risk and burden women. The purpose of this study is to determine the associated factors of anxiety level among pregnant women in the early third trimester in the Surabaya City Health Service Center Menu. This research is an observational study, which means that it is carried out by conducting field observations with a cross-sectional design and taking samples with a convenient sampling technique of 44 people. Our findings show that the anxiety level in pregnant women with mild levels of primigravida in the first 3 months was reported among 19 people (43.2%) and an average high anxiety level of up to 25 people (56.8%). The analysis was carried out in two dimensions using the Chi-Square test which showed a p value of 0.002. Thus the relationship between the husband's support and anxiety in the third trimester of pregnancy at the Surabaya City Health Service Center is closely related. Therefore, it is suggested that a husband to provide full support to his wife in the third-trimester primigravida because this can reduce anxiety
Effectiveness of herbs taken concurrently with antihypertensive drugs in managing hypertension and lipid outcomes. A systematic review and meta-analysis.
No full textPurpose: Hypertension is the primary cause of mortality. Hence globally, there is a growing interest in complementing antihypertensive drugs with herbs to alleviate blood pressure among hypertensive patients. Thus, this review aimed to evaluate the effectiveness of complementing drugs with herbs on blood pressure and lipid profile outcomes, the associated factors and the types of complementary herbs alongside their consumption regimes. Methods: This review is registered in PROSPERO on the National Institute of Health Database with an ID: CRD42021270481. Using the PICOS (population, intervention, comparison, outcome, study type) mnemonic formula and search strategy, we searched (January 2010 to February 2024) five electronic databases including Pubmed, Scopus, Web of Science, CINAHL (Cumulative Index for Nursing and Allied Health Literature) and Psychology & Behavioral Sciences Collection (PBSC). The inclusion criteria of the review were that all included papers had to be randomised control trials in English among hypertensive adults who complemented antihypertensive drugs with herbs. A Cochrane risk of bias assessment as well as a meta-analysis and narrative synthesis were conducted to answer the objectives. Results: Twenty-five randomised controlled trials involving 1996 participants from 14 countries were included. The risk of bias among included articles was assessed and presented using the Cochrane risk of bias tool and the graphs were generated. The effects of complementing antihypertensive drugs with different herb regimes on blood pressure and lipid profile outcomes were compared to those solely on antihypertensive drugs and placebo via a random model effects meta-analysis using the Revman manager. Systolic blood pressure (SBP) and triglycerides gave a significant reduction in favour of the intervention group which complemented herbs. The overall pooled systolic blood pressure showed a reduction of (SMD=0.81, 95 % CI 0.14–1.47, p < 0.02, p for heterogeneity=0.00001, I2 =97 %) while triglycerides were (SMD=0.73, 95 % CI 0.17–1.28, p < 0.01, p for heterogeneity=0.00001, I2 =85 %). However, diastolic blood pressure, total cholesterol, HDL and LDL did not exert significant outcomes. Conclusion: The complemented herbs with antihypertensive drugs did show improvement in overall blood pressure management in the majority of the studies compared to the placebo group. Blood pressure and lipid profiles are the health outcomes that enable access to complementing herbs in controlling high blood pressure. Some limitations of this review are attributed to performance, detection and attrition bias in a few included articles alongside the presence of a high heterogeneity overall
Nutritional status and dietary intake among Nigerian adolescent: a systematic review
No full textAbstract Introduction The prevailing nutritional conditions and the triple challenge of malnutrition faced by adolescents have adverse consequences for both the present and future generations’ health and nutrition. Summarizing the available research on the nutritional status and dietary habits of adolescents in Nigeria is crucial. Objective This study aims to systematically evaluate available literature on the nutritional status of adolescent aged 10 to 19years in Nigeria. Methodology A systematic search using PRISMA guideline was conducted. Three electronic databases were searched i.e., PubMed, Web of Science and Scopus using specific terms and keywords for online articles published between 2013 and 2023. After applying specified inclusion and exclusion criteria, 51 articles were selected for data extraction, synthesis and quality assessment. Results Of the 51 included studies, 78.4% were conducted in the Southern Nigeria, 11.8% in the Northern Nigeria and 9.8% included both regions. The prevalence of overweight ranged between 0.8 and 31% and obesity ranged between 0.1 and 14%. The prevalence of thinness, stunting and underweight ranged between 3 and 31%, 0.4 to 41.6%, 0.3 to 73.3% respectively. The review also identified an inadequate intake of essential nutrients including iron, zinc, calcium, vitamin A, C, D, niacin, thiamin, riboflavin, cobalamin, and folate, with vitamin A deficiency prevalence ranges from 44 to 96%. The dietary patterns were characterized by a high consumption of cereals grains and starchy foods, low animal proteins, fast-food with soft drinks, and limited consumption of fruits and vegetables along with meal skipping. Conclusion These findings portray a complex picture of the nutritional challenges faced by this demographic group, highlighting both undernutrition and overnutrition, poor eating behaviour and micronutrient deficiency as significant concerns. The review revealed regional disparities in research representation, with a concentration of studies in Southern Nigeria. This highlights the importance of directing research efforts toward the northern regions, where the prevalence of nutritional issues is equally severe, but less studied. Systematic review registration number PROSPERO CRD42023481095
- …
