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  1. Cheah, Whye Lian, Tay, Siow Phing, Chai, Shiun Chat, Bong, Cheong Shin, Luqmanul Hakim Baharuddin, Zhuleikha Bainun Jalil Che' Jalil
    MyJurnal
    Dental caries is a major health problem affecting an estimated 90% of school children worldwide. This cross-sectional study aimed to evaluate oral health knowledge, attitude, and practices among secondary school students in Kuching, Sarawak. Data was collected using a pretested questionnaire on 209 randomly selected students from four schools. Results showed no significant differences between the gender and age groups in terms of knowledge level, but significant differences were observed between the schools. The students had positive attitude towards the dental services, but their dental visits were still low due to fear of dental needle and handpieces. Toothbrush and toothpaste were still the most commonly used oral hygiene aids. As compared to parents and friends, dentist was perceived to have more influence on oral hygiene practices among the students. Girls consumed more sweets, snacks and soft drinks than boys. However, girls spent longer time to brush their teeth and brush more frequently. Oral health education should be a life-long practice and incorporated into the school environment with the support of teachers and parents.
    Matched MeSH terms: Fear
  2. Zhang Y, Shang S, Tian L, Zhu L, Zhang W
    BMC Psychol, 2023 Oct 17;11(1):338.
    PMID: 37848985 DOI: 10.1186/s40359-023-01376-z
    BACKGROUND: Numerous studies have explored the association between fear of missing out and mobile phone addiction, but there are different viewpoints and the results are inconsistent. This study intends to estimate the strength of the correlation between fear of missing out and mobile phone addiction in general through a meta-analysis, and to analyze the influencing factors of the inconsistent results of previous studies.

    METHODS: We Searched China National Knowledge Infrastructure Database, Wan fang Database, CQVIP Journal Database、Web of Science Core Collection, Elsevier SD, Springer Online Journals, Medline, EBSCO-ERIC, SAGE Online Journals, PsycINFO, PsycArticles and ProQuest Dissertations and Theses。85 studies (90 independent effect size) were included from 2016 to 2023。The pooled correlation coefficient of the association between fear of missing out and mobile phone addiction was calculated by a random effects model using Comprehensive Meta-Analysis(Version 3.3).

    RESULTS: The main effect analysis revealed a high positive correlation between fear of missing out and mobile phone addiction (r = 0.47, 95%CI [0.44, 0.50]). Furthermore, the measurements of mobile phone addiction moderated the strength of the association between fear of missing out and mobile phone addiction, with the highest correlation measured using MPATS and the lowest correlation measured using MPDQ. The age, gender, year of publication, cultural background, and the measurements of fear of missing out had no significant effect on the correlation between fear of missing out and mobile phone addiction.

    CONCLUSION: The results indicated that fear of missing out was closely related to mobile phone addiction, which complied with the I-PACE model. Psychological services and mental health services should be developed to reduce the emergence of fear of missing out in the digital age and thus alleviate dependence on devices.

    Matched MeSH terms: Fear
  3. Meimandipour A, Hair-Bejo M, Shuhaimi M, Azhar K, Soleimani AF, Rasti B, et al.
    Br Poult Sci, 2010 Feb;51(1):52-9.
    PMID: 20390569 DOI: 10.1080/00071660903394455
    1. An experiment was conducted to determine the effects of supposedly unpleasant physical treatment on broiler performance, small intestinal development and ameliorating role of probiotics. 2. The following treatments were applied from day one: (1) chicks exposed to normal human contact fed basal diet (control); (2) chicks were exposed to unpleasant physical treatment and fed basal diet (UPT-BD); and (3) chicks were exposed to unpleasant physical treatment and fed basal diet supplemented with Lactobacillus (UPT-BDL). Chicks were exposed to UPT from days 1 to 21. Different segments of gastrointestinal tract were sampled at 14, 28, 35 and 42 d of age. 3. Broilers of UPT-BD had lower feed consumption compared with control group at 7 d of age. Overall, UPT-BDL birds showed higher body weight gain (BWG) and better feed conversion ratio (FCR) over the course of the experiment. 4. Birds of UPT-BD had lower concentrations of lactic, propionic and butyric acids in the caecum as compared with other groups at 14 d of age. Acetic acid concentration was profoundly decreased in both UPT groups compared to the control. 5. Duodenal villus height of UPT-BD broilers showed a slight reduction compared to the control and UPT-BDL birds at 14 d of age. Afterwards until day 42, UPT-BDL birds showed the highest villus height among treatments in different parts of the small intestine. 6. The results suggested that, even though UPT did not have significant inhibitory effects on the development of the small intestine and broiler performance, it negatively affected bacterial metabolic end products in the caecum, which could be ameliorated by the addition of Lactobacillus.
    Matched MeSH terms: Fear/physiology*
  4. Aishairma Aris, Ling Ming Jing, Aida Kalok, Yang Wai Wai
    MyJurnal
    Introduction: Severe labour pain and dissatisfaction towards supports received from midwives during labour are common experiencesamong parturient mothers. Thesenegative emotional experiences need to be given attention as they are associated with higher acute stress reactions and postpartum depressive symptoms. Therefore, this study examinedthe labour pain and satisfaction toward labour support and their influential factors. Methods: A total of 136 parturient mothersregistered for a labour in the UniversitiKebangsaan Malaysia Medical Centre were included in this studyusing simple random sampling. The mothers had met the eligibility criteria; live and singleton pregnancy, able to communicate in English, Malay or Mandarin. Visual anologue scale and Bryanton Adaptation of the Nursing Support in Labor Questionnaire (BASILIQ) which contained both quantitative and qualitative questions were used to measure the pain and satisfaction level respectively. Descriptive statistics, Spearman correlation, Mann-Whitney and Kruskal-Wallis tests and also content analysis wereutilised to analyse the data. Results: Labour pain was low (Mean=2.24, SD=2.20) and satisfaction toward the labour support was high (Mean=76.9, SD=8.75). Both the pain and satisfaction were not significantly related to each other and also to any of the mothers’ demographic (p > 0.05) and obstetrical data (p > 0.05). However, 32.9% (n=25) out of 76 subjectswho responded to the qualitative questions had highlighted the need of havingfriendly and helpful nurses during their labour.In addition, 56% (n=14) out of 25 subjects who provided additional comments had suggested to include theemotional support to reduce their labour pain, fear and anxiety. Conclusion: Friendly and helpful nurses are part of the emotional support for labour. There- fore, it is recommended that a structured emotional laboursupport should be made availableto parturient mothers. Further research examining the effectiveness of the emotional support on the pain and satisfaction, nevertheless, is warranted.
    Matched MeSH terms: Fear
  5. Hamed SK, Ab Aziz MJ, Yaakub MR
    Sensors (Basel), 2023 Feb 04;23(4).
    PMID: 36850346 DOI: 10.3390/s23041748
    Nowadays, social media has become the main source of news around the world. The spread of fake news on social networks has become a serious global issue, damaging many aspects, such as political, economic, and social aspects, and negatively affecting the lives of citizens. Fake news often carries negative sentiments, and the public's response to it carries the emotions of surprise, fear, and disgust. In this article, we extracted features based on sentiment analysis of news articles and emotion analysis of users' comments regarding this news. These features were fed, along with the content feature of the news, to the proposed bidirectional long short-term memory model to detect fake news. We used the standard Fakeddit dataset that contains news titles and comments posted regarding them to train and test the proposed model. The suggested model, using extracted features, provided a high detection accuracy of 96.77% of the Area under the ROC Curve measure, which is higher than what other state-of-the-art studies offer. The results prove that the features extracted based on sentiment analysis of news, which represents the publisher's stance, and emotion analysis of comments, which represent the crowd's stance, contribute to raising the efficiency of the detection model.
    Matched MeSH terms: Fear
  6. Khan TM, Khan AU, Ali I, Wu DB
    Vaccine, 2016 Mar 8;34(11):1393-8.
    PMID: 26845740 DOI: 10.1016/j.vaccine.2016.01.045
    A cross-sectional study was carried out among HCPs in Northwest General Hospital & Research Centre, Hayatabad Peshawar, Pakistan. The purpose of this study was to investigate knowledge, awareness and attitude of HCPs towards influenza vaccination. A total of N=170 questionnaires were distributed among the staff. There was a 97% response rate to this survey (n=165). The median age of the respondents was 30 years and most of them, 98 (59.0%), were from age group of 24-30 years. The majority of the HCPs that participated in this study were male 106 (64.2%), and by profession, the majority were physicians 77 (46.7%), followed by pharmacists and nurses. A majority 114 (69.1%) believed that it was not compulsory for HCPs to get vaccinated for influenza. Top three identified barriers to vaccination were: not everyone is familiar with the availability of the influenza vaccination at their institution (Relative importance weight factors (RIWF)=0.71), due to needle fear I do not like to get vaccinated (RIWF=0.70) and it is not compulsory for healthcare professionals to get vaccinated for influenza (RIWF=0.64). The logistic regression analysis has revealed association for job experience and profession with the most of the eleven knowledge item. However, when overall sum of eleven items were tested to identify the factors affecting the knowledge score, along with profession (-0.215 [-0.389 to 0.040]; p=0.016) and job experience (0.823 [0.521-1.125]; p<0.001) HCPs age (-0.409 [-0.755 to -0.064]; p=0.020) was found to be another significant factor affecting the total knowledge score of HCPs. Overall, scoring of the correct responses revealed that nurses have better knowledge and understanding about influenza and the influenza vaccination (6.5±0.8, p<0.001*), followed by pharmacists (6.3±1.14) and physicians. In spite of the published guidelines and recommendations, a very low percentage of the healthcare professionals in our hospital were vaccinated against influenza, and the barriers to vaccination were prevalent. Various strategies, including arranging seminars regarding awareness about vaccinations, are required to improve the knowledge and overall outcomes.
    Matched MeSH terms: Fear
  7. Lim SH, Alias H, Kien JKW, Akbar M, Kamarulzaman A, Wong LP
    AIDS Educ Prev, 2019 06;31(3):193-205.
    PMID: 31145000 DOI: 10.1521/aeap.2019.31.3.193
    This study aimed to examine the barriers and facilitators to HIV testing and treatment among Malaysian MSM. Between June 2014 and December 2015, in-depth interviews were conducted in 20 HIV-positive MSM recruited from a teaching hospital and NGO in Kuala Lumpur. Thematic analysis was used to identify, analyze, and report themes. Most participants investigated their HIV status after long period of sickness. Others sought testing upon partner's diagnosis and some were diagnosed via blood donation. Barriers to testing include personal (perceived good health, fear of positive result, denial); social and structural factors (stigmatization by health providers and family, lack of information about free HIV testing and long wait time). Barriers to treatment comprise personal factors (perceived HIV as incurable and treatment as complicated), social factors (HIV and homosexual stigma), and cost. Promoting benefits of regular testing and early treatment is needed to improve HIV care continuum among MSM in Malaysia.
    Matched MeSH terms: Fear
  8. Tee YC, Earnshaw VA, Altice FL, Jin H, Kamarulzaman A, Wickersham JA
    AIDS Behav, 2019 Apr;23(4):1039-1047.
    PMID: 30560483 DOI: 10.1007/s10461-018-2362-4
    People with HIV (PWH) in Malaysia experience high levels of stigma, which may act as a barrier to accessing healthcare. Stigma against PWH in medical settings is understudied in Malaysia. In the present study, we examine factors associated with physicians' intention to discriminate against PWH in Malaysia. A cross-sectional online survey was emailed to all 1431 physicians at two major university hospitals in Malaysia; 568 (39.6%) participants completed the survey and were included in this analysis. Measures included intention to discriminate against PWH, stigma-related constructs, and socio-demographic characteristics. Multivariate linear regression was used to identify factors associated with intention to discriminate against PWH. Participants were comprised of women (53.5%), Malays (43.1%), and Chinese (35.0%) with nearly 10 years of clinical experience. Most participants were from non-surgical specialties (77.6%). The final multivariate linear regression showed that physicians who expressed greater discriminatory intent against PWH also expressed more negative feelings toward PWH, more HIV-related shame, were more fearful of HIV, and believed that PWH do not deserve good care. Physicians from surgical-based specialties were also significantly more likely to endorse discriminatory intent toward PWH. Stigma and intentions to discriminate against a class of patients, including PWH, can undermine engagement in care, which is central to international HIV prevention and treatment strategies. Interventions that reduce stigma toward PWH among physicians are crucial to ensuring equitable and stigma-free healthcare.
    Matched MeSH terms: Fear
  9. Ahmad P, Chaudhary FA, Asif JA, AlSagob EI, Alkahtany MF, Almadi KH, et al.
    Work, 2022;71(1):177-186.
    PMID: 34924411 DOI: 10.3233/WOR-205093
    BACKGROUND: When anxiety is persistent among dental students, the consequence could be poor academic performance, ill health, lack of empathy, and exhaustion.

    OBJECTIVE: This study aimed to determine the level of anxiety along with anxiety-provoking factors among clinical dental students.

    METHODS: This study included dental undergraduate and postgraduate clinical students from a public university. A modified version of the self-administered Moss and McManus questionnaire, which consisted of 50 items, was utilized to evaluate the levels of anxiety. The results were analyzed using SPSS® version 24. The significance level was set at p fear of accidental pulp exposure, dealing with a child or non-cooperative patient, and fear of taking an incorrect impression. Postgraduate students showed lower anxiety scores in various clinical tasks as compared to undergraduate students.

    CONCLUSIONS: Postgraduate dental students share largely the same perspectives with undergraduate dental students on the clinical anxiety-provoking situations with slight variations. Being the future healthcare providers, dental students must learn techniques to help them manage their dental anxiety and fear as well as deal with anxiety related to treating patients.

    Matched MeSH terms: Fear
  10. Vijayan R, Afshan G, Bashir K, Cardosa M, Chadha M, Chaudakshetrin P, et al.
    J Pain Res, 2018;11:2567-2575.
    PMID: 30425567 DOI: 10.2147/JPR.S162296
    Background: The supply of controlled drugs is limited in the Far East, despite the prevalence of health disorders that warrant their prescription. Reasons for this include strict regulatory frameworks, limited financial resources, lack of appropriate training amongst the medical profession and fear of addiction in both general practitioners and the wider population. Consequently, the weak opioid tramadol has become the analgesic most frequently used in the region to treat moderate to severe pain.

    Methods: To obtain a clearer picture of the current role and clinical use of tramadol in Southeast Asia, pain specialists from 7 countries in the region were invited to participate in a survey, using a questionnaire to gather information about their individual use and experience of this analgesic.

    Results: Fifteen completed questionnaires were returned and the responses analyzed. Tramadol is used to manage acute and chronic pain caused by a wide range of conditions. Almost all the specialists treat moderate cancer pain with tramadol, and every one considers it to be significant or highly significant in the treatment of moderate to severe non-cancer pain. The reasons for choosing tramadol include efficacy, safety and tolerability, ready availability, reasonable cost, multiple formulations and patient compliance. Its safety profile makes tramadol particularly appropriate for use in elderly patients, outpatients, and for long-term treatment. The respondents strongly agreed that tighter regulation of tramadol would reduce its medical availability and adversely affect the quality of pain management. In some countries, there would no longer be any appropriate medication for cancer pain or the long-term treatment of chronic pain.

    Conclusions: In Southeast Asia, tramadol plays an important part in the pharmacological management of moderate to severe pain, and may be the only available treatment option. If it were to become a controlled substance, the standard of pain management in the region would decline.
    Matched MeSH terms: Fear
  11. Singh D, Narayanan S, Shanmugam T, Vicknasingam B
    J Psychoactive Drugs, 2021 Mar 22.
    PMID: 33749541 DOI: 10.1080/02791072.2021.1900627
    People who use amphetamine-type stimulant (ATS) are known to face barriers in seeking treatment. We sought to identify these barriers and gender differences in barriers (if any) faced by them. A convenience sample of 386 respondents who use ATS was recruited from five formal drug rehabilitation centers for this cross-sectional study. The majority were male (83%), with 17% being female. The barriers most frequently cited by both men and women were: the perception that ATS use needed no treatment, fears of community discrimination, peer influence, and long waiting time to get into a treatment programme. One-third of the sample held that the mandated treatment programmes were ineffective, based on past experience. In terms of male-female differences, long waiting time discouraged significantly more women than men, whereas more men than women asserted that formal treatment programmes were ineffective. We also found no significant differences in barriers faced by ATS users and those using ATS with other illicit substances. Outreach initiatives to minimize the impact of treatment barriers, coupled with offering separate treatment protocols and facilities, will encourage people who use ATS to seek treatment voluntarily.
    Matched MeSH terms: Fear
  12. Ng CJ, Lai PS, Lee YK, Azmi SA, Teo CH
    Int J Clin Pract, 2015 Oct;69(10):1050-70.
    PMID: 26147376 DOI: 10.1111/ijcp.12691
    AIM: To identify the barriers and facilitators to start insulin in patients with type 2 diabetes.
    METHOD: This was a systematic review. We conducted a systematic search using PubMed, EMBASE, CINAHL and Web of Science (up to 5 June 2014) for original English articles using the terms 'type 2 diabetes', 'insulin', and free texts: 'barrier' or 'facilitate' and 'initiate'. Two pairs of reviewers independently assessed and extracted the data. Study quality was assessed with Qualsyst.
    RESULTS: A total of 9740 references were identified: 41 full-text articles were assessed for eligibility. Twenty-five articles (15 qualitative, 10 quantitative) were included in the review. Good inter-rater reliability was observed for the Qualsyst score (weighted kappa 0.7). Three main themes identified were as follows: patient-related, healthcare professional and system factors. The main patient-related barriers were fear of pain and injection (n = 18), concerns about side effects of insulin (n = 12), perception that insulin indicated end stage of diabetes (n = 11), inconvenience (n = 10), difficulty in insulin administration (n = 7), punishment (n = 7) and stigma and discrimination (n = 7). Healthcare professionals' barriers were as follows: poor knowledge and skills (n = 9), physician inertia (n = 5) and language barriers (n = 4). System barriers included lack of time (n = 5). The most common facilitators were understanding the benefits of insulin (n = 7), not being afraid of injections (n = 5), and patient education and information (n = 5).
    CONCLUSION: Major barriers to insulin initiation persist despite availability of newer and safer insulin. Healthcare professionals should explore and address these barriers. Targeted interventions should be developed to overcome these barriers.
    Matched MeSH terms: Fear
  13. Sugawara D, Gu Y, Masuyama A, Ng SL, Phoo EYM, Raja Reza Shah RIAB, et al.
    BMC Res Notes, 2021 Nov 04;14(1):409.
    PMID: 34736522 DOI: 10.1186/s13104-021-05819-x
    OBJECTIVES: The COVID-19 pandemic has impacted the mental health of people worldwide. Psychological resilience has been shown to buffer against the threat of the pandemic (i.e., COVID-19 fear) and sustain mental health. The extent to which psychological resilience factors impact mental health maintenance, however, is unclear, given broad differences in infection rates, prevention approaches, government interventions across different cultures and contexts. Our study examines resilience factors and how they protect individuals from COVID-19-related fear and sustain their mental health.

    DATA DESCRIPTION: Data were collected from 1583 (Mage = 32.22, SD = 12.90, Range = 19-82) respondents from Japan, China, the United States, and Malaysia between October to November 2020. We collected data across age and sex, marital status, number of children, and occupations. We also accounted for stay-at-home measures, change in income, COVID-19 infection status, place of residence, and subjective social status in the study. Our variables included mental health-related and resilience constructs, namely (i) fear of COVID-19, (ii) depression, anxiety, and stress; (iii) present, past, and future life satisfaction, (iv) sense of control, (v) positive emotions, (vi) ego-resilience, (vii) grit, (viii) self-compassion, (ix) passion, and (x) relational mobility. All questionnaires were assessed for their suitability across the four countries with the necessary translation checks. Results from this study can be instrumental in examining the impact of multiple resilience factors and their interaction with demographic variables in shaping mental health outcomes.

    Matched MeSH terms: Fear
  14. Chen S, Lin Z, Tan KL, Chen R, Su W, Zhao H, et al.
    Front Psychiatry, 2020;11:564843.
    PMID: 33061920 DOI: 10.3389/fpsyt.2020.564843
    Butyrylcholinesterase (BChE) efficiently hydrolyzes acetylcholine (ACh) at high concentrations when acetylcholinesterase (AChE) is substrate-inhibited. Recent studies have shown that BChE also has a function that is independent of ACh, but it has not been fully explored. Low BChE expression is accompanied with higher stress-induced aggression and ghrelin levels in stress models, and BChE knockout mice exhibit cognitive and memory impairments. However, the role of BChE in posttraumatic stress disorder (PTSD) remains unclear. In the present study, we investigated the role of BChE in contextual fear memory and its regulatory effect on the expression of factors related to the glutamate (Glu)-glutamine (Gln) cycle via knockdown studies. We used AAVs and lentiviruses to knockdown BChE expression in the mouse hippocampal CA1 region and C8D1A astrocytes. Our behavioral data from those mice injected with AAV-shBChE in the hippocampal CA1 region showed strengthened fear memory and increased dendritic spine density. Elevated Glu levels and glutamine synthetase (GS) enzyme activity were detected in contextual fear conditioned-BChE knockdown animals and astrocytes. We observed that an AAV-shBChE induced lowering of BChE expression in the hippocampus CA1 region enhanced contextual fear memory expression and promoted the astrocytic Glu-Gln cycle but did not elevate ACh-hydrolyzing activity. This study provides new insight into the regulatory role of BChE in cognition and suggests potential target for stress-related psychiatric disorder such as PTSD where patients experience fear after exposure to severe life-threatening traumatic events.
    Matched MeSH terms: Fear
  15. Goh HT, Nadarajah M, Hamzah NB, Varadan P, Tan MP
    PM R, 2016 12;8(12):1173-1180.
    PMID: 27268565 DOI: 10.1016/j.pmrj.2016.05.012
    BACKGROUND: Falls are common after stroke, with potentially serious consequences. Few investigations have included age-matched control participants to directly compare fall characteristics between older adults with and without stroke. Further, fear of falling, a significant psychological consequence of falls, has only been examined to a limited degree as a risk factor for future falls in a stroke population.

    OBJECTIVE: To compare the fall history between older adults with and without a previous stroke and to identify the determinants of falls and fear of falling in older stroke survivors.

    DESIGN: Case-control observational study.

    SETTING: Primary teaching hospital.

    PARTICIPANTS: Seventy-five patients with stroke (mean age ± standard deviation, 66 ± 7 years) and 50 age-matched control participants with no previous stroke were tested.

    METHODS: Fall history, fear of falling, and physical, cognitive, and psychological function were assessed. A χ2 test was performed to compare characteristics between groups, and logistic regression was performed to determine the risk factors for falls and fear of falling.

    MAIN OUTCOME MEASURES: Fall events in the past 12 months, Fall Efficacy Scale-International, Berg Balance Scale, Functional Ambulation Category, Fatigue Severity Scale, Montreal Cognitive Assessment, and Patient Healthy Questionnaire-9 were measured for all participants. Fugl-Meyer Motor Assessment was used to quantify severity of stroke motor impairments.

    RESULTS: Twenty-three patients and 13 control participants reported at least one fall in the past 12 months (P = .58). Nine participants with stroke had recurrent falls (≥2 falls) compared with none of the control participants (P < .01). Participants with stroke reported greater concern for falling than did nonstroke control participants (P < .01). Female gender was associated with falls in the nonstroke group, whereas falls in the stroke group were not significantly associated with any measured outcomes. Fear of falling in the stroke group was associated with functional ambulation level and balance. Functional ambulation level alone explained 22% of variance in fear of falling in the stroke group.

    CONCLUSIONS: Compared with persons without a stroke, patients with stroke were significantly more likely to experience recurrent falls and fear of falling. Falls in patients with stroke were not explained by any of the outcome measures used, whereas fear of falling was predicted by functional ambulation level. This study has identified potentially modifiable risk factors with which to devise future prevention strategies for falls in patients with stroke.

    LEVEL OF EVIDENCE: III.

    Matched MeSH terms: Fear*
  16. Romli MH, Mackenzie L, Lovarini M, Clemson L, Tan MP
    Front Public Health, 2020;8:612599.
    PMID: 33511098 DOI: 10.3389/fpubh.2020.612599
    Background: Fear of falling (FoF) is a common issue among older people, impacting on psychological health, functional performance and mortality. Many factors associated with fear of falling have been investigated but little is known about the role of home hazards. Home hazards can be due to unsafe environmental and functional features. This study is aims to evaluate the association between home hazards with fear of falling among community-dwelling individuals aged 55 years and over. Methods: Baseline data with 1,489 older individuals from the Malaysian Elders Longitudinal Research (MELoR) study were analyzed. Home visits for interview and observations in the home were conducted with the participants. FoF was established with a single-item question and home hazards with the Home Falls and Accidents Screening Tool (HOME FAST). Results: The majority (76.4%) of older participants experienced FoF. The history of falls was not associated with FoF (p = 0.868), but FoF was associated with participants limiting their daily activities (p < 0.001). Home hazards were less likely (p = 0.023) and functional issues were more likely (p < 0.001) to be associated with a high degree of FoF. However, both home hazards domains were not associated with activity restriction due to FoF. Conclusions: Education about home hazards from the perspective of person-environment interaction may encourage home hazards management and reduce FoF which should be evaluated in future studies.
    Matched MeSH terms: Fear
  17. Mat S, Kamaruzzaman SB, Chin AV, Tan MP
    Front Public Health, 2020;8:571196.
    PMID: 33163471 DOI: 10.3389/fpubh.2020.571196
    Objectives: To determine the temporal relationship between the presence of knee pain and knee pain severity identified at baseline with fall risk, fear of falling and changes in instrumental activity of daily living at 12-months follow-up. Methods: This was a prospective study from the Malaysian Elders Longitudinal Research (MELoR) study involving community dwelling older persons aged 55 years and older. The presence of one fall in the preceding 12 months, knee pain, and functional capacity were determined at baseline (2013-2015) and follow-up (2015-2016). Function was determined as loss of at least one of seven instrumental activities of daily living (IADL). Physical performance was evaluated at baseline using the timed-up-and-go (TUG) test. Fear of falling (FoF) was determined using the single question "Are you afraid of falling?" Results: Data were available for 605 participants, mean (SD) age = 69.10 (7.24) years. Knee pain was present in 30.2% at baseline. Neither the presence of knee pain nor knee pain severity at baseline were associated with falls at 1-year follow-up. Knee pain was significantly associated with FoF at follow-up [aRR (95%CI) = 1.76 (1.02-3.04)] but not changes in IADL. Among individuals with no falls at baseline, the presence of knee pain was protective of falls at follow-up after adjustment for baseline physical performance [adjusted rate ratio, aRR (95% confidence interval, CI) = 0.35 (0.13-0.97)]. Conclusion: Knee pain is associated with increased FoF at 1.5 years' follow-up within a multi-ethnic population aged 55 years, residing in an urban location in a middle-income South East Asian nation. Interestingly, after differences in muscle strength was accounted for, knee pain was protective against falls at follow-up. Our findings challenge previous assumptions on joint pain and falls and highlights the importance of large prospective studies and further mechanistic research incorporating psychological factors in this area of increasing prominence.
    Matched MeSH terms: Fear
  18. Alex D, Khor HM, Chin AV, Hairi NN, Cumming RG, Othman S, et al.
    Front Public Health, 2020;8:506238.
    PMID: 33304870 DOI: 10.3389/fpubh.2020.506238
    Falls are major issues affecting the older population with potentially serious complications, including fractures, head injury, institutionalization, fear of falling and depression. While risk factors for falls have been established across Western Europe and North America, geographical differences in falls risk have not been well researched. We aim to examine the clinical and physical risk factors for falls in a middle-income South East Asian country. Cross-sectional data from the Malaysian Elders Longitudinal Research (MELoR) study involving 1,362 community dwelling individuals aged 55 years and above was utilized. Information on sociodemographic and medical history was obtained by computer-assisted questionnaires completed during home visits and hospital-based detailed health checks. Univariate and multivariate analyses compared non-fallers and fallers in the previous 12 months. Urinary incontinence, hearing impairment, depression, arthritis and cognitive impairment were risk factors for falls in the past 12 months after adjustment for age in our study population. Awareness about the risk factors in a population helps the design of fall prevention strategies that target specific or multiple risk factors.
    Matched MeSH terms: Fear*
  19. Mat S, Ng CT, Tan PJ, Ramli N, Fadzli F, Rozalli FI, et al.
    PM R, 2018 03;10(3):254-262.
    PMID: 28827207 DOI: 10.1016/j.pmrj.2017.08.405
    BACKGROUND: Osteoarthritis (OA) is considered an established risk factor for falls. Published studies evaluating secondary falls prevention strategies among individuals with OA are limited.
    OBJECTIVE: To evaluate the effect of a personalized home-based exercise program to improve postural balance, fear of falling, and falls risk in older fallers with knee OA and gait and balance problems.
    DESIGN: Randomized controlled trial.
    SETTING: University of Malaya Medical Centre.
    PARTICIPANTS: Fallers who had both radiological OA and a Timed Up and Go (TUG) score of over 13.5 seconds.
    MAIN OUTCOME MEASURE: Postural sway (composite sway) was quantified with the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) under 4 different sensory conditions: eyes open on firm surface, eyes closed on firm surface, eyes open on unstable foam surface, and eyes closed on unstable foam surface. Participants were asked to stand upright and to attempt to hold their position for 10 seconds for each test condition. The average reading for all conditions were calculated.
    METHODS: Participants randomized to the intervention arm received a home-based modified Otago Exercise Program (OEP) as part of a multifactorial intervention, whereas control participants received general health advice and conventional treatment. This was a secondary subgroup analysis from an original randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT) (trial registration number: ISRCTN11674947). Posturography using a long force plate balance platform (Balancemaster, NeuroCom, USA), the Knee injury and Osteoarthritis Outcome Score (KOOS) and the short-form Falls Efficacy Scale-International (short FES-I) were assessed at baseline and 6 months.
    RESULTS: Results of 41 fallers with radiological evidence of OA and impaired TUG (intervention, 17; control, 24) were available for the final analysis. Between-group analysis revealed significant improvements in the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Limits of Stability (LOS), and short FES-I scores by the intervention group compared to the control group at 6 months. No significant difference in time to first fall or in fall-free survival between the intervention and control groups was found.

    CONCLUSION: Home-based balance and strength exercises benefited older fallers with OA and gait and balance disorders by improving postural control, with no observable trend in reduction of fall recurrence. Our findings will now inform a future, adequately powered, randomized controlled study using fall events as definitive outcomes.

    LEVEL OF EVIDENCE: I.
    Matched MeSH terms: Fear
  20. Mat S, Ng CT, Fadzil F, Rozalli FI, Tan MP
    Clin Interv Aging, 2017;12:2025-2032.
    PMID: 29238177 DOI: 10.2147/CIA.S149991
    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.
    Matched MeSH terms: Fear/psychology*
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