150 Falls in Malaysia: Magnitude, Risk, Disparities, and Solutions

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv34-iv39
Author(s):  
Maw Pin Tan ◽  
Sumaiyah Mat ◽  
Deepa Alex ◽  
Shahrul Bahyah Kamaruzzaman
Keyword(s):  
Ethnic Differences ◽  
Cultural Practices ◽  
Longitudinal Research ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychological Status ◽  
Control Group ◽  
Cross Sectional ◽  
One Year ◽  
Risk Factors For Falls

Abstract The Malaysian Elders Longitudinal Research (MELoR) study found 1 in 4 residents aged 65 years and over living in the Klang Valley of Malaysia fall at least once a year in their survey conducted between 2013 and 2015. Recent figures obtained from the First Older Persons’ National Health and Morbidity Survey conducted in 2018 revealed that 15% of Malaysians aged 60 years and over fall at least once a year. In a 10-year follow-up study involving 200 individuals who presented to the emergency department over a six-month period in 2002, 22% were no longer alive at one year, and 80% had died at 10 years. Older age, indoor falls, subsequent hospital admission and functional impairment predicted death at one year. Cross-sectional data from MELoR revealed ethnic differences in fall prevalence, with the ethnic Indians more likely to report falls in the past 12 months compared to the ethnic Malays. Independent risk factors for falls identified from MELoR were urinary incontinence, reduced grip strength, hearing impairment, comorbidities and reducing walking speed. The ethnic differences in falls in our population remain unexplained. Lifestyle and cultural practices may well be the underlying rationale, but genetic influences cannot currently be ruled out. The results of a randomized controlled trial on multifactorial interventions, the Malaysian Falls Assessment and Intervention Trial (MyFAIT), was published last year. Mo differences in falls outcomes with an individualized multifactorial intervention were observed, despite improvements in physical performance and psychological status in the intervention group compared to the control group. The research group has now secured two-year funding to evaluate post-fall behavior in our setting in the Life After Falls (LiAF) study. In addition, dissemination and upskilling efforts are underway through training workshops, formation of the Malaysian Falls Network (MyFalls) and collaborations with the private sector to increase awareness on falls and increase fall prevention efforts throughout the country.

Abstract TP168: Efficacy of a Pictogram to Promote Stroke Knowledge Among Illiterate Korean Elderly

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Cha-Nam Shin ◽  
Jeongha Sim ◽  
Dongchoon Ahn
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Longitudinal Research ◽  
Controlled Trial ◽  
Intervention Group ◽  
Warning Signs ◽  
Repeated Measure ◽  
Control Group ◽  
Control Group Design ◽  
Stroke Knowledge

Background and Purpose: Extensive research supports the importance of knowledge in stroke prevention and reducing prehospital delay time. However, the level of stroke knowledge among Korean older adults remains low. In particular, older adults who are illiterate lack of stroke information despite being at high risk. The purpose of this study was to develop and examine the efficacy of a pictogram to enhance stroke knowledge in the high-risk and illiterate older adults. Methods: We conducted a pretest-posttest nonequivalent control group design study and compared differences in stroke knowledge before and after the intervention. A total of 117 older adults (82 in the intervention group and 35 in the control group) who were 60 years and older residing in community participated in the study. Participants in the intervention group received a pictogram-based education, while participants in the control group received a powerpoint-based education. Stroke knowledge was measured by structured survey questionnaires. Descriptive statistics for sample characteristics, repeated measure ANOVA for the efficacy, and independent t-test for satisfaction comparison between groups were used. Results: The intervention group showed a higher increase in stroke knowledge (F=16.45), awareness of risk factors (F=15.71), stroke warning signs and symptoms (F=17.29), and action at stroke (F=19.36) compared to the control group at p <.001. Also, the intervention group reported that they would recommend the education program to others (t=2.64, p<.05) and the program was applicable to real situation (t=4.47, p <.001), which were scored higher than the control group. Conclusions: The data revealed that a pictogram-based education is more effective than a powerpoint-based education among illiterate older adults. Replicated studies with this pictogram in a larger randomized controlled trial is warranted, which may give greater validity to our findings. Future longitudinal research is recommended to examine retention of stroke knowledge over the long term.

Training in Nonviolent Resistance for Foster Parents

2016 ◽  
Vol 28 (8) ◽  
pp. 931-942 ◽  
Author(s):  
Frank Van Holen ◽  
Johan Vanderfaeillie ◽  
Haim Omer ◽  
Femke Vanschoonlandt
Keyword(s):  
Parenting Stress ◽  
Behavioral Problems ◽  
Parenting Practices ◽  
Foster Parents ◽  
Longitudinal Research ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Treatment As Usual ◽  
Externalizing Problem

Objective: The aim of this study is to evaluate a training in non-violent resistance (NVR) for foster parents who take care of a foster child (ages 6-18) with externalizing problem behavior. Methods: A randomized controlled trial was used to compare an intervention group (NVR, n = 31) with a treatment as usual control group (TAU, n = 31). The NVR-intervention consists of ten weekly home sessions. Measures regarding behavioral problems in foster children, parenting stress and parenting practices in foster mothers, and the size of the supportive network were assessed before, after treatment, and at three months follow-up. Results: NVR showed to be an acceptable approach that lead to an increase in experienced support and some promising changes in parenting stress and parenting practices. Conclusion: Implementation of this intervention might increase the effectiveness of foster care. More longitudinal research using a Multitrait-multimethod-approach is however needed.

scholarly journals Evaluation of Mothers’ Perceptions of a Technology-Based Supportive Educational Parenting Program (Part 2): Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Shefaly Shorey ◽  
Esperanza Debby Ng
Keyword(s):  
Cultural Practices ◽  
Controlled Trial ◽  
Perinatal Care ◽  
Intervention Group ◽  
Well Being ◽  
Educational Programs ◽  
Parenting Program ◽  
Future Research ◽  
Control Group ◽  
Semistructured Interview

BACKGROUND Transitioning into parenthood can be stressful as parents struggle to cope with new parenting responsibilities. Although perinatal care in hospitals aims to improve parental outcomes, there is a general consensus that it is suboptimal and insufficient. Therefore, many studies have designed intervention methods to supplement support for parents during this stressful period. However, studies often focus on parental outcomes as indicators of their interventions’ success and effectiveness. Studies evaluating participants’ experiences and feedback are limited. OBJECTIVE This study aimed to examine the experiences and perceptions of participants who participated in a supportive education parenting program intervention study. METHODS A qualitative semistructured interview was conducted with 16 mothers (6 control and 10 intervention) from a randomized controlled trial. The supportive education parenting program received by the intervention group included 2 phone-based perinatal educational sessions, a phone-based educational session after childbirth, and a 1-month postpartum access to a mobile health app. The interviews were approximately 30- to 60-min long, audiotaped and transcribed verbatim, and analyzed using thematic analysis. Study findings were reported according to the Consolidated Criteria for Reporting Qualitative Research checklist. RESULTS The 3 main themes evaluating mothers’ experiences and perceptions were generated: (1) changed perspective toward parenthood, (2) journey from pregnancy to after birth, and (3) a way forward. Mothers from the intervention group mostly had good perinatal experiences with sufficient support received, which elevated their emotional well-being and increased parenting involvement. Mothers in the control group, although satisfied with the hospital care received, were more stressed and shared a need for professional advice and extra support. Apart from technical enhancements, mothers also requested extended social support during early pregnancy up to 1 year postpartum, taking into consideration Asian cultural practices. CONCLUSIONS Mothers who received the intervention were overall satisfied with the support provided by the technology-based supportive educational parenting program. The success of the educational program in this study highlights the need to supplement standard care in hospitals with technology-based educational programs. Future research should include fathers’ perceptions to attain an in-depth understanding of overall participants’ experiences and needs in the future development of supportive and educational programs.

scholarly journals Reinforcing Adherence to Lipid-lowering Therapy after an Acute Coronary Syndrome: A Pragmatic Randomized Controlled Trial

2020 ◽  
Author(s):  
Stefanos Zafeiropoulos ◽  
Ioannis Farmakis ◽  
Anastasios Kartas ◽  
Alexandra Arvanitaki ◽  
Konstantinos Arvanitakis ◽  
...  
Keyword(s):  
Goal Attainment ◽  
Controlled Trial ◽  
Intervention Group ◽  
Lipid Lowering ◽  
Control Group ◽  
Lipid Lowering Therapy ◽  
Good Adherence ◽  
Coronary Syndrome ◽  
Randomized Controlled ◽  
One Year

Abstract Aims: Achieving the low-density lipoprotein cholesterol (LDL-C) goal following an acute coronary syndrome (ACS) is a milestone often missed due to suboptimal adherence to secondary prevention treatments. Whether improved adherence could result in reduced LDL-C levels is unclear. We aimed to evaluate an educational-motivational intervention to increase long-term lipid-lowering therapy (LLT) adherence and LDL-C goal attainment rate among post-ACS patients.Methods: IDEAL-LDL was a parallel, two-arm, single-center, pragmatic, investigator-initiated randomized controlled trial. Hospitalized patients for ACS were randomized to a physician-led integrated intervention consisting of an educational session at baseline, followed by regular motivational interviewing phone sessions or usual care. Co-primary outcomes were the LLT adherence (measured by Proportion of Days Covered (PDC); good adherence defined as PDC>80%), and LDL-C goal (<70 mg/dl or 50% reduction from baseline) achievement rate at one year.Results: In total, 360 patients (mean age 62 years, 81% male) were randomized. Overall, good adherence was positively associated with LDL-C goal achievement rate at one year. Median PDC was higher in the intervention group than the control group [0.92 (IQR, 0.82–1.00) vs. 0.86 (0.62–0.98); p=0.03] while the intervention group had increased odds of good adherence (adjusted odds ratio: 1.76 (95% confidence interval 1.02 to 2.62; p=0.04). However, neither the rate of LDL-C goal achievement (49.6% in the intervention vs. 44.9% in the control group; p=0.49) nor clinical outcomes differed significantly between the two groups.Conclusion: Α multifaceted intervention improved LLT adherence in post-ACS patients without a significant difference in LDL-C goal attainment. (IDEAL-LDL, ClinicalTrials.gov: NCT02927808)

Apathy in Nursing Home Residents with Dementia: Results From A Cluster-Randomized Controlled Trial

2015 ◽  
Vol 30 (2) ◽  
pp. 251-257 ◽  
Author(s):  
Y. Treusch ◽  
T. Majic ◽  
J. Page ◽  
H. Gutzmann ◽  
A. Heinz ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Nursing Home Residents ◽  
Cluster Randomized Trial ◽  
Control Group ◽  
Intervention Period ◽  
Significant Group ◽  
Dementia Patients ◽  
Cluster Randomized ◽  
One Year

AbstractPurpose:Here we evaluate an interdisciplinary occupational and sport therapy intervention for dementia patients suffering from apathy.Subjects and methods:A prospective, controlled, rater-blinded, clinical trial with two follow-ups was conducted as part of a larger cluster-randomized trial in 18 nursing homes in Berlin. n = 117 dementia patients with apathy, defined as a score of 40 or more on the apathy evaluation scale (AES) or presence of apathy on the Neuropsychiatric Inventory (NPI), were randomly assigned to intervention or control group. The intervention included 10 months of brief activities, provided once a week. The primary outcome measure was the total score on the AES scale measured directly after the intervention period and again after 12 months.Results:We found significant group differences with respect to apathy during the 10 month intervention period (F2,82 = 7.79, P < 0.01), which reflected an increase in apathy in the control group, but not in the intervention group. Within one year after the intervention was ceased, the treatment group worsened and no longer differed significantly from the control group (P = 0.55).Conclusions:Our intervention was effective for the therapy of apathy in dementia, when applied, but not one year after cessation of therapy.

scholarly journals The Impact of an Early Eclectic Rehabilitative Intervention on Symptoms in First Episode Depression among Employed People

2013 ◽  
Vol 2013 ◽  
pp. 1-8
Author(s):  
Tero Raiskila ◽  
Sanna Blanco Sequeiros ◽  
Jorma Kiuttu ◽  
Marja-Liisa Kauhanen ◽  
Kristian Läksy ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
First Episode ◽  
Control Group ◽  
Treatment As Usual ◽  
Intervention Treatment ◽  
Working Age ◽  
Rehabilitative Intervention ◽  
One Year ◽  
The Impact

Objective. To evaluate the effect of an early vocational-orientated eclectic intervention on beck depression inventory (BDI) scores compared to treatment as usual in first ever depressive episode among employed people.Design. A randomized controlled trial comparing the rehabilitative intervention and the conventional treatment.Subjects. The subjects came from occupational health care units.Methods. Employees were sent to a rehabilitation center after being screened for depression using the BDI. They were diagnosed using the structured clinical interview for DSM-IV. The participating subjects (N=283) were randomized into intervention and control groups. The intervention group received eclectic early depression intervention treatment (N=134) and the control group was treated in the conventional way (N=100). They were followed for one year.Results. The mean decrease in BDI scores within the intervention group was from 20.8 to 11.6 and within the control group from 19.3 to 10.8. BDI score decreased by 10 or more points in 64% of the participants in the intervention group and in 53% of the control group (P=0.013).Conclusions. There was some evidence that early eclectic intervention in first ever episode depression may be more effective than conventional treatments among working age people in employment.

scholarly journals Effects of a One-Year Home-Based Case Management Intervention on Falls in Older People: A Randomized Controlled Trial

2014 ◽  
Vol 22 (4) ◽  
pp. 457-464 ◽  
Author(s):  
Ulrika Olsson Möller ◽  
Jimmie Kristensson ◽  
Patrik Midlöv ◽  
Charlotte Ekdahl ◽  
Ulf Jakobsson
Keyword(s):  
Case Management ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Management Intervention ◽  
Randomized Controlled ◽  
Case Management Intervention ◽  
Injurious Falls ◽  
Home Based ◽  
One Year

Objectives:To investigate the effects of a home-based one-year case management intervention in older people with functional dependency and repeated contact with the health care services on self-reported falls and self-reported injurious falls.Methods:The study was a randomized controlled trial with repeated follow-ups. The sample (n = 153) was consecutively and randomly assigned to the intervention group (n = 80, mean age = 81.4 [SD 5.9]) or control group (n = 73, mean age = 81.6 [SD 6.8]). The intervention group received a case management intervention which comprised monthly home visits during 12 months by nurses and physiotherapists employing a multifactorial preventive approach.Results:In the intervention group, 96 falls occurred during the intervention period compared with 85 falls in the control group (p = .900). There were 40 and 38 injurious falls (p = .669) in the intervention and control groups, respectively.Conclusions:This home-based case management intervention was not able to prevent falls or injurious falls.

Effect of Individual Psychological Intervention in Chinese Women With Gynecologic Malignancy: A Randomized Controlled Trial

2005 ◽  
Vol 23 (22) ◽  
pp. 4913-4924 ◽  
Author(s):  
Y.M. Chan ◽  
Peter W.H. Lee ◽  
Daniel Y.T. Fong ◽  
Amy S.M. Fung ◽  
Lina Y.F. Wu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Intervention ◽  
Chinese Women ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Report ◽  
Psychological Status ◽  
Control Group ◽  
Psychological Therapies

Purpose To evaluate the effectiveness of psychological intervention in the care of cancer patients and to determine whether routine use of individual psychological therapies is indicated. Patients and Methods Patients with newly diagnosed gynecologic malignancies from August 1999 to November 2000 were recruited and randomly assigned to either a control group receiving routine medical care or to an intervention group receiving individual psychotherapy. A set of fixed-choice, self-report questionnaires assessing the patients' psychological status, quality of life, and their perceptions related to the medical consultations was completed at recruitment and then every 3 months for 18 months. Data analysis was performed according to the intention-to-treat principle by fitting the data into a linear mixed-effects model. Multivariable analyses were performed to examine the effects of confounding factors. Results One hundred fifty-five patients participated in the trial. There were no statistically significant differences between the two groups at baseline. There was a trend toward better quality of life and functional status and also improvement of the symptoms over time for both groups. No differences were found between the groups in the scores measured by any of the instruments at baseline and at any time points after the cancer diagnosis. Psychological intervention had no significant effects on the psychosocial parameters. Conclusion Routine use of psychological therapies as given in our format has no significant effect on the patients' quality of life and psychological status.

scholarly journals Combination treatment of autologous bone marrow stem cell transplantation and hyperbaric oxygen therapy for type 2 diabetes mellitus: A randomized controlled trial

2019 ◽  
Vol 28 (12) ◽  
pp. 1632-1640
Author(s):  
Esteban J. Estrada ◽  
José Luis Decima ◽  
Guillermo Bortman ◽  
Javier Roberti ◽  
Elida Beatriz Romero ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
C Peptide ◽  
Randomized Controlled ◽  
Insulin Requirements ◽  
One Year

The objective of this study was to compare standard treatment versus the combination of intrapancreatic autologous stem cell (ASC) infusion and hyperbaric oxygen treatment (HBOT) before and after ASC in the metabolic control of patients with type 2 diabetes mellitus (T2DM). This study was a prospective, randomized controlled trial. The combined intervention consisted of 10 sessions of HBOT before the intrapancreatic infusion of ASC and 10 sessions afterwards. ASCs were infused into the main arterial supply of the pancreas to maximize the presence of the stem cells where the therapeutic effect is most desired. A total of 23 patients were included (control group = 10, intervention group = 13). Age, gender, diabetes duration, number of medications taken, body weight and height, and insulin requirements were recorded at baseline and every three months. Also, body mass index, fasting plasma glucose, C-peptide, and HbA1c, C-peptide/glucose ratio (CPGR) were measured every three months for one year. HbA1c was significantly lower in the intervention group compared with control throughout follow-up. Overall, 77% of patients in the intervention group and 30% of patients in the control group demonstrated a decrease of HbA1c at 180 days (compared with baseline) of at least 1 unit. Glucose levels were significantly lower in the intervention group at all timepoints during follow-up. C-peptide levels were significantly higher in the intervention group during follow-up and at one year: 1.9 ± 1.0 ng/mL versus 0.7 ± 0.4 ng/mL in intervention versus control groups, respectively, p = 0.0021. CPGR was higher in the intervention group at all controls during follow-up. The requirement for insulin was significantly lower in the intervention group at 90, 180, 270, and 365 days. Combined therapy of intrapancreatic ASC infusion and HBOT showed increased metabolic control and reduced insulin requirements in patients with T2DM compared with standard treatment.

Comparing audiometric parameters between crushed and intact cartilage tympanoplasty: a double-blinded, randomised, controlled trial study

2020 ◽  
pp. 1-5
Author(s):  
A Tajdini ◽  
N Hatami ◽  
B Rahmaty ◽  
A Kouhi ◽  
S Dabiri ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Hearing Results ◽  
Cartilage Tympanoplasty ◽  
One Year ◽  
Randomised Controlled ◽  
Double Blinded

Abstract Objective To investigate hearing and the take rate of crushed cartilage grafts in tympanoplasty. Methods In this double-blinded, randomised, controlled trial, 46 patients with tympanic membrane perforation were enrolled. A conchal cartilage graft was used for reconstruction in both intervention and control groups. In the intervention group, crushed cartilage was used. The success rate and hearing results were ascertained every four months over a one-year follow-up period. Results A total of 36 patients – 20 in the intervention group and 16 in the control group – completed one year of follow up. There were no statistically significant differences between the two groups in mean air–bone gap, bone conduction threshold, speech discrimination score or speech reception threshold. Conclusion The reduction in living cells after crushed cartilage tympanoplasty may decrease the rigidity and the volume of the graft, but may not necessarily improve the hearing results.

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