OBJECTIVE: We aim to evaluate the cognitive function of obstructive sleep apnea patients by using the 'Mini Mental State Examination'.
METHODOLOGY: This was a cross sectional study to evaluate the cognitive function of moderate and severe obstructive sleep apnea patients with age ranged from 18 to 60 old who attended our sleep clinic. These patients were confirmed to have moderate and severe obstructive sleep apnea by Type 1 polysomnography (attended full overnight study). The age, gender and ethnicity were noted and other relevant data such as weight, height, body mass index and apnea and hypopnoea index were recorded accordingly. The cognitive function was evaluated using validated Malay version of Mini Mental State Examination which measured 5 areas of cognitive functions comprising orientation, registration, attention and calculation, word recall and language abilities, and visuospatial.
RESULTS: A total of 38 patients participated in this study. All 19 patients of moderate group and 14 patients of severe group had normal cognitive function while only 5 patients in severe group had mild cognitive function impairment. There was a statistically significant difference between the moderate group and severe group on cognitive performance (p value = 0.042).
CONCLUSIONS: Severe obstructive sleep apnea patients may have impaired cognitive function. Mini Mental State Examination is useful in the screening of cognitive function of obstructive sleep apnea patients but in normal score, more sophisticated test batteries are required as it is unable to identify in 'very minimal' or 'extremely severe' cognitive dysfunction.
MATERIALS AND METHODS: A cross-sectional study was done among 253 children of 5-, 12-, and 15-year-olds living in various orphanage houses of Selangor, Kuala Lumpur, Malaysia. Demographic data, and dietary and oral hygiene practices were collected through a structured questionnaire. Clinical examinations of children were conducted to assess oral health status and recorded in the World Health Organization oral health assessment form (1997). Stimulated saliva was collected for S. mutans and Lactobacilli levels. The statistical software, namely, Statistical Package for the Social Sciences version 19.0 was used for the analysis of the data.
RESULTS: The final data analysis included 253 children of which 116 (45.8%) were boys and 137 (54.2%) were girls. Overall, 140 (55.33%) children were caries-free and 113 (44.66%) children presented with caries (decayed/missing/filled surface >0). High levels of salivary microbiological counts (S. mutans and Lactobacilli), i.e., ≥105, stress the importance of necessary preventive oral health services. Treatment needs among orphan children showed that most of the children, i.e., 58 (22.9%), need preventive or caries-arresting care followed by 49 (19.4%) who require two-surface filling as an immediate measure.
CONCLUSION: From the results of our study, orphan children have low utilization of preventive and therapeutic oral health services. Urgent attention is required to plan a comprehensive dental health-care program to improve their oral health status.
CLINICAL SIGNIFICANCE: Parents are the primary caretakers of children, but woefully some of them have to lead their lives without parents, the latter either being dead or incapable of bringing up their children. Such a group of children is known as orphans. As oral health is an integral part of general health, it is essential for health-care policy makers to address oral health needs of this underprivileged group of society. This article highlights the risk factors and treatment needs among orphan schoolchildren.
METHODS: A qualitative study with four focus-group discussions was conducted with 20 registered nurses from general wards in a Malaysian public hospital. Semi-structured interviews were used to elicit participants' opinions. NVivo 10 software was used for data management and content analysis was used to analyze the data.
RESULTS: Several participants used inconsistent methods to involve patients in bedside handovers and others did not involve the patients at all. The participants' interpretations of the concept of patient-centered care were ambiguous; they claimed that patient involvement during bedside handovers was impractical and, therefore, not reflective of patient-centered care. Some nurses' subjective views of patient involvement as impractical during bedside handovers were manifested in their deliberate exclusion of patients from the handover process.
CONCLUSIONS: Changes in patient involvement and nursing practices congruent with patient-centered care require that nurse educators in hospital settings reform nursing education to focus on fostering of communication skills needed to function in nurse-patient partnerships. Guidelines for patient involvement consistent with patient-centered values should be developed using ward nurses' subjective views and introduced to all registered nurses in practice.