Displaying publications 1 - 20 of 51 in total

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  1. Hasan SS, Kow CS, Verma RK, Ahmed SI, Mittal P, Chong DWK
    Medicine (Baltimore), 2017 Sep;96(35):e7929.
    PMID: 28858118 DOI: 10.1097/MD.0000000000007929
    Aging is significantly associated with the development of comorbid chronic conditions. These conditions indicate the use of multiple medications, and are often warranted by clinical guidelines. The aim of the present study was to evaluate medication appropriateness and frailty among Malaysian aged care home residents with chronic disease. The participants were 202 elderly (≥65 years) individuals, a cross-sectional sample from 17 aged care homes. After ethics approval, each participant was interviewed to collect data on sociodemographics, frailty status (Groningen Frailty Indicator [GFI]), medication appropriateness (Medication Appropriateness Index (MAI), the 2015 Beers' criteria (Potentially Inappropriate Medication [PIM]), and 2014 STOPP criteria (Potentially Inappropriate Prescribing [PIP]). The findings show that 81% (n = 164) and 42% (n = 85) were taking medications for cardiovascular and central nervous system-related conditions, respectively, and 34% were using medications for diabetes (n = 69). Each participant had a mean of 2.9 ± 1.5 chronic diseases, with an average GFI score of 6.4 ± 3.6. More than three-quarters of the participants (76%) were frail and polypharmacy was a factor in nearly half (48%); 41% and 36% were prescribed at least one PIP and PIM, respectively, whereas the average MAI score was 0.6 (range: 0-6). The number of medications used per participant correlated significantly and positively (0.21, P = .002) with GFI score. These findings reinforce the need for participants of aged care homes to receive periodic medication review aimed at minimizing morbidity associated with inappropriate pharmacotherapy.
    Matched MeSH terms: Nursing Homes*
  2. Camilloni B, Neri M, Lepri E, Basileo M, Sigismondi N, Puzelli S, et al.
    Vaccine, 2010 Nov 3;28(47):7536-41.
    PMID: 20846530 DOI: 10.1016/j.vaccine.2010.08.064
    The study evaluated the immunogenicity and efficacy of a trivalent subunit MF59-adjuvanted influenza vaccine (A/Wisconsin/67/05 (H3N2), A/Solomon Islands/3/06 (H1N1) and B/Malaysia/2506/04) in preventing serologically diagnosed infections in a group of 67 institutionalized elderly volunteers during 2007/2008 winter, characterized by co-circulation of drifted A/H3N2, A/H1N1 and B influenza viruses. Influenza vaccination induced a significant increase in the amounts of hemagglutination inhibiting antibodies, both against the vaccine and the epidemic drifted strains. However, vaccination did not prevent the circulation of the new drifted influenza B virus (B/Florida/4/06-like), belonging to the B/Yamagata/16/88-lineage, antigenically and genetically distinct from B/Victoria/2/87-lineage viruses from which the vaccine B strain was derived.
    Matched MeSH terms: Nursing Homes*
  3. Jeon YH, Chien WT, Ha JY, Ibrahim R, Kirley B, Tan LL, et al.
    Aging Ment Health, 2018 10;22(10):1279-1286.
    PMID: 28714742 DOI: 10.1080/13607863.2017.1351521
    OBJECTIVES: An Asia-Pacific regional collaboration group conducted its first multi-country research project to determine whether or not European quality indicators (QIs) for psychosocial care in dementia could be implemented as a valid tool in residential aged care across seven Asia-Pacific sites (Australia, Hong Kong Special Administrative Region, Mainland China, Malaysia, Singapore, South Korea, and Thailand).

    METHOD: Following the European QI protocol, auditing and data extraction of medical records of consenting residents with dementia were conducted by trained auditors with relevant health care backgrounds. Detailed field notes by the auditors were also obtained to describe the characteristics of the participating care facilities, as well as key issues and challenges encountered, for each of the 12 QIs.

    RESULTS: Sixteen residential care facilities in the seven Asia-Pacific sites participated in this study. Data from 275 residents' records revealed each of the 12 Qis' endorsement varied widely within and between the study sites (0%-100%). Quality of the medical records, family and cultural differences, definitions and scoring of certain indicators, and time-consuming nature of the QI administration were main concerns for implementation.

    CONCLUSION: Several items in the European QIs in the current format were deemed problematic when used to measure the quality of psychosocial care in the residential aged care settings in participating Asia-Pacific countries. We propose refinements of the European QIs for the Asian-Pacific context, taking into account multiple factors identified in this study. Our findings provide crucial insights for future research and implementation of psychosocial dementia care QIs in this region.

    Matched MeSH terms: Nursing Homes/standards*
  4. Loganathan A, Ng CJ, Tan MP, Low WY
    BMJ Open, 2015 Nov 05;5(11):e008460.
    PMID: 26546140 DOI: 10.1136/bmjopen-2015-008460
    OBJECTIVE: To explore the barriers faced by healthcare professionals (HCPs) in managing falls among older people (aged above 60 years) who have a high risk of falling.
    RESEARCH DESIGN: The study used a qualitative methodology, comprising 10 in-depth interviews and two focus group discussions. A semistructured topic guide was used to facilitate the interviews, which were audio recorded, transcribed verbatim and checked for accuracy. Data were analysed thematically using WeftQDA software.
    PARTICIPANTS: 20 HCPs who managed falls in older people.
    SETTING: This study was conducted at the Primary Care Clinic in the University Malaya Medical Centre (UMMC), Malaysia.
    RESULTS: Four categories of barriers emerged-these were related to perceived barriers for older people, HCPs' barriers, lack of caregiver support and healthcare system barriers. HCPs perceived that older people normalised falls, felt stigmatised, were fatalistic, as well as in denial regarding falls-related advice. HCPs themselves trivialised falls and lacked the skills to manage falls. Rehabilitation was impeded by premature decisions to admit older people to nursing homes. Lastly, there was a lack of healthcare providers as well as a dearth of fall education and training on fall prevention for HCPs.
    CONCLUSIONS: This study identified barriers that explain poor fall management in older people with a high risk of falls. The lack of structured fall prevention guidelines and insufficient training in fall management made HCPs unable to advise patients on how to prevent falls. The findings of this study warrant evidence-based structured fall prevention intervention targeted to patients as well as to HCPs.
    Study site: Primary Care Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia.
    Matched MeSH terms: Nursing Homes
  5. Ciminelli G, Garcia-Mandicó S
    J Public Health (Oxf), 2020 11 23;42(4):723-730.
    PMID: 32935849 DOI: 10.1093/pubmed/fdaa165
    BACKGROUND: There are still many unknowns about COVID-19. We do not know its exact mortality rate nor the speed through which it spreads across communities. This lack of evidence complicates the design of appropriate response policies.

    METHODS: We source daily death registry data for 4100 municipalities in Italy's north and match them to Census data. We augment the dataset with municipality-level data on a host of co-factors of COVID-19 mortality, which we exploit in a differences-in-differences regression model to analyze COVID-19-induced mortality.

    RESULTS: We find that COVID-19 killed more than 0.15% of the local population during the first wave of the epidemic. We also show that official statistics vastly underreport this death toll, by about 60%. Next, we uncover the dramatic effects of the epidemic on nursing home residents in the outbreak epicenter: in municipalities with a high share of the elderly living in nursing homes, COVID-19 mortality was about twice as high as in those with no nursing home intown.

    CONCLUSIONS: A pro-active approach in managing the epidemic is key to reduce COVID-19 mortality. Authorities should ramp-up testing capacity and increase contact-tracing abilities. Adequate protective equipment should be provided to nursing home residents and staff.

    Matched MeSH terms: Nursing Homes
  6. Letchumanan D, Mohamad Norpi N, Yusof ZYM, Razak IA, Abu Kasim NH, Abdullah NA, et al.
    Gerodontology, 2020 Dec;37(4):332-341.
    PMID: 32115787 DOI: 10.1111/ger.12466
    OBJECTIVE: To assess the perceptions of caregivers towards oral healthcare services received by elders in Malaysian nursing homes and to identify challenges and suggestions for improvement.

    BACKGROUND: Caregivers play an important role in the oral health care of elders in nursing homes.

    METHODS: This study employed a qualitative approach using the nominal group technique (NGT) to obtain caregivers' feedback in nursing homes in Malaysia. Data were manually transcribed, summarised into keywords/key phrases, and ranked using weighted scores.

    RESULTS: In total, 36 caregivers (21 from government and 15 from private nursing homes) participated in the NGT sessions. Overall, caregivers were satisfied with the low treatment cost, the quality of treatment, and the availability of dental visits to nursing homes. Caregivers were dissatisfied with the frequency of dental visits, long waiting times at government dental clinics, and inadequate denture hygiene education for elders in nursing homes. The challenges faced by caregivers were elders' poor oral health knowledge and attitude and lack of elders' trust of caregivers to look after their oral health. Suggestions for improvement were to increase the frequency of dental visits to nursing homes, provide oral health education to elders and caregivers, and give treatment priority to elders at dental clinics.

    CONCLUSION: Despite being satisfied with the basic oral healthcare services received by elders in Malaysian nursing homes, caregivers raised some issues that required further attention. Suggestions for improvement include policy changes in nursing home dental visits and treatment priority for elders at government dental clinics.

    Matched MeSH terms: Nursing Homes
  7. Zhao Y, Rokhani FZ, Shariff Ghazali S, Chew BH
    BMJ Open, 2021 02 18;11(2):e041452.
    PMID: 33602703 DOI: 10.1136/bmjopen-2020-041452
    INTRODUCTION: Smart technologies, digital health and eHealth have been shown to enhance institutional elderly care. Because of the rapidly ageing societies, information technologies in geriatric healthcare are urgently needed. A lot of innovation in smart healthcare has occurred in the past decade, and its use in nursing care assessment, daily living activities and service management is yet to be defined. More fundamentally, the concepts, definitions and scopes of a smart nursing home are still vague. Thus, this scoping review aims to examine the extent, range (variety) and nature (characteristics) of evidence on the existing smart concepts and feasible healthcare technologies, types of medical services in nursing home settings and acceptability of a smart nursing home by the elderly people ≥60 years old, their caregivers, nursing home operators and government agencies.

    METHODS AND ANALYSIS: This scoping review will be guided by the smart technology adoption behaviours of elder consumers theoretical model (Elderadopt) by Golant and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. First, we will conduct an internet search for nursing homes and websites and databases related to the stakeholders to retrieve the definitions, concepts and criteria of a smart nursing home (phase 1). Second, we will conduct an additional systematic electronic database search for published articles on any measures of technological feasibility and integration of medical services in nursing home settings and their acceptability by nursing home residents and caregivers (phase 2). The electronic database search will be carried out from 1999 to 30 September 2020 and limited to works published in English and Chinese languages. For phase 2, the selection of literature is further limited to residents of nursing homes aged ≥60 years old with or without medical needs but are not terminally ill or bed-bound. Qualitative data analysis will follow the Framework Methods and thematic analysis using combined inductive and deductive approaches, conducted by at least two reviewers.

    ETHICS AND DISSEMINATION: This protocol is registered on osf.io (URL: https://osf.io/qtwz2/). Ethical approval is not necessary as the scoping review is not a primary study, and the information is collected from selected articles that are publicly available sources. All findings will be disseminated at conferences and published in peer-reviewed journals.

    Matched MeSH terms: Nursing Homes*
  8. Azlina Wati Nikmat, Nurul Azreen Hashim, Siti Aminah Omar, Salmi Razali
    ASEAN Journal of Psychiatry, 2015;16(2):222-231.
    MyJurnal
    The evaluation of mental health among older adults has become increasingly important in health and social science. Although this has been studied in developed countries, there are also issues for emerging countries, which have aging populations. The aims of this study were to determine the prevalence of loneliness/social isolation and late-life depression among older adults with cognitive impairment living in institutional care. Methods: A cross sectional survey involving residents of four government nursing homes in West Malaysia was carried out. All residents aged 60 years old and above with cognitive impairment were included in the study. Participants were assessed by the Short Mini Mental State Examination (SMMSE), Friendship Scale (FS) and Geriatric Depression Scale (GDS). Results: The prevalence of depression and loneliness/social isolation were 85.5% and 95.5% respectively. Depression was strongly associated with age, education attainment, financial conditions, health, cognitive impairment and loneliness/social isolation. Loneliness/social isolation was strongly associated to depression and relationship satisfaction with children. Conclusion: There was high prevalence of depression and loneliness/social isolation among older adults with cognitive impairment living in institutional care. Depression and loneliness/social isolation are interrelated and influence each other and these problems need to be addressed to improve their quality of life.
    Device, Questionnaire & Scale: Mini Mental State Examination (MMSE-12); Friendship Scale (FS); Geriatric Depression Scale (GDS-15)
    Matched MeSH terms: Nursing Homes
  9. Subramaniam P, Woods B
    Clin Interv Aging, 2016;11:1263-1276.
    PMID: 27698556
    There is increasing interest in using information and communication technology to help older adults with dementia to engage in reminiscence work. Now, the feasibility of such approaches is beginning to be established. The purpose of this study was to establish an evidence-base for the acceptability and efficacy of using multimedia digital life storybooks with people with dementia in care homes, in comparison with conventional life storybooks, taking into account the perspectives of people with dementia, their relatives, and care staff.
    Matched MeSH terms: Nursing Homes
  10. Martineau AR, Hanifa Y, Witt KD, Barnes NC, Hooper RL, Patel M, et al.
    Thorax, 2015 Oct;70(10):953-60.
    PMID: 26063508 DOI: 10.1136/thoraxjnl-2015-206996
    RATIONALE: Low-dose vitamin D supplementation is already recommended in older adults for prevention of fractures and falls, but clinical trials investigating whether higher doses could provide additional protection against acute respiratory infection (ARI) are lacking.

    OBJECTIVE: To conduct a clinical trial of high-dose versus low-dose vitamin D3 supplementation for ARI prevention in residents of sheltered-accommodation housing blocks ('schemes') and their carers in London, UK.

    MEASUREMENTS AND METHODS: Fifty-four schemes (137 individual participants) were allocated to the active intervention (vitamin D3 2.4 mg once every 2 months +10 μg daily for residents, 3 mg once every 2 months for carers), and 54 schemes with 103 participants were allocated to control (placebo once every 2 months +vitamin D3 10 μg daily for residents, placebo once every 2 months for carers) for 1 year. Primary outcome was time to first ARI; secondary outcomes included time to first upper/lower respiratory infection (URI/LRI, analysed separately), and symptom duration.

    MAIN RESULTS: Inadequate vitamin D status was common at baseline: 220/240 (92%) participants had serum 25(OH)D concentration <75 nmol/L. The active intervention did not influence time to first ARI (adjusted HR (aHR) 1.18, 95% CI 0.80 to 1.74, p=0.42). When URI and LRI were analysed separately, allocation to the active intervention was associated with increased risk of URI (aHR 1.48, 95% CI 1.02 to 2.16, p=0.039) and increased duration of URI symptoms (median 7.0 vs 5.0 days for active vs control, adjusted ratio of geometric means 1.34, 95% CI 1.09 to 1.65, p=0.005), but not with altered risk or duration of LRI.

    CONCLUSIONS: Addition of intermittent bolus-dose vitamin D3 supplementation to a daily low-dose regimen did not influence risk of ARI in older adults and their carers, but was associated with increased risk and duration of URI.

    TRIAL REGISTRATION NUMBER: clinicaltrials.gov NCT01069874.

    Matched MeSH terms: Nursing Homes
  11. Hasan SS, Thiruchelvam K, Kow CS, Ghori MU, Babar ZU
    Expert Rev Pharmacoecon Outcomes Res, 2017 Oct;17(5):431-439.
    PMID: 28825502 DOI: 10.1080/14737167.2017.1370376
    INTRODUCTION: Medication reviews is a widely accepted approach known to have a substantial impact on patients' pharmacotherapy and safety. Numerous options to optimise pharmacotherapy in older people have been reported in literature and they include medication reviews, computerised decision support systems, management teams, and educational approaches. Pharmacist-led medication reviews are increasingly being conducted, aimed at attaining patient safety and medication optimisation. Cost effectiveness is an essential aspect of a medication review evaluation. Areas covered: A systematic searching of articles that examined the cost-effectiveness of medication reviews conducted in aged care facilities was performed using the relevant databases. Pharmacist-led medication reviews confer many benefits such as attainment of biomarker targets for improved clinical outcomes, and other clinical parameters, as well as depict concrete financial advantages in terms of decrement in total medication costs and associated cost savings. Expert commentary: The cost-effectiveness of medication reviews are more consequential than ever before. A critical evaluation of pharmacist-led medication reviews in residential aged care facilities from an economical aspect is crucial in determining if the time, effort, and direct and indirect costs involved in the review rationalise the significance of conducting medication reviews for older people in aged care facilities.
    Matched MeSH terms: Nursing Homes/economics; Nursing Homes/organization & administration
  12. Heidari M, Ghodusi Borujeni M, Rezaei P, Kabirian Abyaneh S, Heidari K
    Malays J Med Sci, 2020 Jul;27(4):119-129.
    PMID: 32863751 DOI: 10.21315/mjms2020.27.4.11
    Background: Mental disorders are common among the elderly with serious symptoms of depression and social isolation. This study was conducted to investigate the effect of laughter therapy (LT) on depression and quality of life (QOL) of the elderly living in Abadeh nursing homes.

    Methods: This is a controlled semi-experimental study with a pre-test, post-test design. Ninety eligible ones of the elderly living in the Abadeh nursing homes and from July to September 2017, entered the study. Some of the criteria for entering the study include being over 60 years old, orientation, not having blindness and deafness, lack of physical and mental problems. After determining the intervention and control groups, the scale of depression and QOL was administered to the subjects and their scores were collected in the pre-test.

    Results: Most of the study samples were in the intervention (35.55%) and control (37.77%) group in the age range of 60-69 years. In both intervention and control groups, respectively, 31.11% and 68.88% elderly were males and females. The mean scores of depression in the intervention group after LT (M = 2.57) were lower than those before the intervention (M = 6.87) [CI = -5.58-(-3.02)] and also the results of independent t-test showed a statistically significant difference before and after the intervention between the two groups (P < 0.001). The mean score of dimensions of QOL after LT was higher than that before in the intervention and there was a statistically significant difference in all dimensions with paired t-test (P < 0.001).

    Conclusion: Since the implementation of this programme could improve the mental status and QOL of the elderly, this method of therapy can be used as an alternative or complementary model to enhance the health of the elderly.

    Matched MeSH terms: Nursing Homes
  13. Badrasawi MM, Shahar S, Abd Manaf Z, Haron H
    Clin Interv Aging, 2013;8:279-85.
    PMID: 23493965 DOI: 10.2147/CIA.S37586
    Talbinah is a barley syrup cooked with milk and sweetened by honey. In his famous Hadith on Talbinah, the Prophet Mohammad (SAW) recommended it when sad events happen for its effect on soothing hearts and relieving sadness. This 3-week crossover designed, randomized clinical trial was conducted to determine the effect of Talbinah on mood and depression among institutionalized elderly people in Seremban. A sample of 30 depressed elderly subjects (21 men and 9 women) was selected from the long term care facility. Three different interview-based validated scales (Geriatric Depression Scale, Depression Anxiety Stress Scales, and Profile of Mood States) were used to determine mood, depression, stress, and anxiety at week 0, 3, 4, and 7. The nutritional value of Talbinah was examined using proximate food analysis, minerals content analysis, and differential amino acid analysis. The results indicated that Talbinah is a high carbohydrate food (86.4%) and has a high tryptophan: branch chain amino acids ratio (1:2). A Wilcoxon nonparametric test showed that there was a statistically significant decrease on depression, stress, and mood disturbances scores among the intervention group (P < 0.05) for all parameters. In conclusion, Talbinah has the potential to reduce depression and enhance mood among the subjects. Ingestion of functional foods such as Talbinah may provide a mental health benefit to elderly people.
    Device, Questionnaire & Scale: Geriatric Depression Scale (GDS-12R), Depression Anxiety Stress Scales (DASS-21); Profile of Mood States (POMS-65)
    Matched MeSH terms: Nursing Homes*
  14. Isahak I, Mahayiddin AA, Ismail R
    PMID: 18041300
    The aims of the study were to determine the attack rate of influenza-like illness among inhabitants of five old folk homes nationwide using influenza vaccine as a probe and the effectiveness of influenza vaccination in prevention of influenza-like illness. We conducted a nonrandomized, single-blind placebo control study from June 2003 to February 2004. VAXIGRIP(R) 2003 Southern hemisphere formulation was used. Among 527 subjects, the attack rates of influenza-like illness in the influenza vaccine group were 6.4, 4.6 and 2.4% during the first, second and third 2-month periods, respectively. The attack rates of influenza-like illness in the placebo group were 17.7, 13.8 and 10.1%. Influenza vaccination reduced the risk of contracting influenza-like illness by between 14, and 45%. The vaccine effectiveness in reducing the occurrence of influenza-like illness ranged from 55 to 76%, during the 6-month study followup. The presence of cerebrovascular diseases significantly increased the risk of influenza-like illness (p < 0.005). Vaccine recipients had fewer episodes of fever, cough, muscle aches, runny nose (p < 0.001) and experience fewer sick days due to respiratory illness. Subjects who received influenza vaccination had clinically and statistically significant reductions in the attack rate of influenza-like illness. Our data support influenza vaccination of persons with chronic diseases and >50 year olds living in institutions.
    Matched MeSH terms: Nursing Homes/statistics & numerical data*
  15. Chen LL, Tangiisuran B, Shafie AA, Hassali MA
    Int J Clin Pharm, 2012 Aug;34(4):596-603.
    PMID: 22622593 DOI: 10.1007/s11096-012-9651-1
    BACKGROUND: There is an increasing evidence of medicines related issues such as inappropriate prescribing among older people. Inappropriate prescribing is an important risk factor for adverse drug reactions and hospitalizations in the older people.

    OBJECTIVE: To assess and characterize the prevalence of Potentially Inappropriate Medications (PIMs) in nursing home care in Malaysia as defined by Screening Tool of Older Peoples Prescriptions (STOPP) and Beers criteria.

    SETTING: Four Nursing Homes situated in Penang, Malaysia.

    METHODS: A multicenter and cross-sectional study was conducted over 2 months period at four large non-governmental organizations nursing homes in Penang, Malaysia. The study population included older residents (≥65 years old) taking at least one medication. Residents who had been diagnosed with dementia or taking anti dementia drugs, delirium, too frail or refused to give consent were excluded. Demographic, clinical data and concurrent medications were collected through direct interview and also by reviewing medical records. STOPP and Beers criteria were applied in the medical review to screen for PIMs.

    MAIN OUTCOME MEASURE: Potentially Inappropriate Medication using STOPP and Beers criteria.

    RESULTS: Two hundred eleven residents were included in the study with the median age of 77 (inter quartile range (IQR) 72-82) years. Median number of prescription medicines was 4 (IQR 1-14). STOPP identified less residents (50 residents, 23.7 %) being prescribed on PIMs compared with Beers criteria (69 residents, 32.7 %) (p < 0.001). There was a significant difference in the number of residents with PIMs detected by STOPP (23.7 %) and by Beers criteria (32.7 %), p < 0.001. The common identified PIMs by Beers criteria included nifedipine short acting, chlorpheniramine and diphenhydramine. The STOPP identified first generation antihistamines, duplication of drug classes, glibenclamide and anticholinergic agents. Higher number of medications (OR = 1.405 [1.193-1.654]; OR = 1.447 [1.215-1.723]) and longer stay at nursing home (OR = 1.132 [1.045-1.226]; OR = 1.133 [1.034-1.241]) were identified as predictors for both Beers and STOPP PIMs.

    CONCLUSION: Potentially inappropriate medications are highly prevalent among older residents living in the nursing homes and are associated with number of medications and longer nursing home stay. Further research is warranted to study the impact of PIMs towards health related outcomes in these elderly.

    Matched MeSH terms: Nursing Homes/statistics & numerical data*
  16. Suzana Shahar, Yow, Bee Charn
    MyJurnal
    Poor appetite and inadequate food intake together with depression are associated with malnutrition, that will increase risk of morbidity and mortality among elderly people. Identifying factors associated with these conditions are essential for formulation of preventive strategies. Therefore, a study was conducted to identify factors associated with poor appetite and depression among institutionalised Chinese elderly people in Butterworth, Penang. A total of 100 Chinese elderly (49 men and 51 women) aged 60 years and above, (mean age ± SD of 74.7 ± 9.2 years), with no known terminal and mental illnesses from two nursing homes participated in this study. Subjects were interviewed to gather information on appetite using Council of Nutrition Appetite Questionnaire (CNAQ), depression using Geriatric Depression Scale (GDS) and also socio demographic and health status. Food intake was assessed using a combination of one-day food weighing and 24 hour diet recall. Body weight and height were measured. Results showed that the mean energy and nutrients intake did not achieve the Recommended Nutrient Intake of Malaysia (RNI), with the exception for vitamin C. Only 4% of the subjects were underweight and obese, 65% normal and 31% overweight. A total of 70% and 73% of subjects had poor appetite and depression, respectively. Subjects who had depression (adjusted OR = 2.78, 95% CI = 0.95-8.03), energy intake below RNI (adjusted OR = 2.34, 95% CI = 0.68-6.95) and difficulty to fall asleep at night (insomnia) (adjusted OR = 2.22, 95% CI = 0.72-6.82) were more likely to have poor appetite. Subjects who had poor appetite (adjusted OR = 3.36, 95% CI = 1.19-9.47) and insomnia (adjusted OR = 2.58, 95% CI = 0.83-7.98) were more likely to have depression. In conclusion, although the majority of subjects had normal body weight but the nutrient intake was inadequate. Poor appetite and depression were prevalent and interrelated and also strongly associated with insomnia.
    Device, Scales & Questionnaire: Council of Nutrition Appetite Questionnaire (CNAQ-8); Geriatric Depression Scale (GDS-15)
    Matched MeSH terms: Nursing Homes
  17. Nurul Atifah MA, Loo HK, Subramaniam G, Wong EH, Selvi P, Ho SE, et al.
    Malays J Pathol, 2005 Dec;27(2):75-81.
    PMID: 17191389
    Antimicrobial resistance to the extended-spectrum cephalosporins is increasingly reported worldwide. In the local setting, nosocomial infections with multi-resistant Gram-negative bacilli are not uncommon and are a growing concern. However, there is limited data on the carriage rates of such organisms in the local setting. In May 2001, a prospective study was carried out to determine the enteric carriage rates of ceftazidime-resistant Gram negative bacilli (CAZ-R GNB) among residents of nursing homes and from in-patients of the geriatric and adult haematology wards of University Malaya Medical Centre. Ceftazidime-resistant Gram-negative bacilli (CAZ-R GNB) were detected in 25 samples (30%), out of which 6 were from nursing home residents, 5 from geriatric in-patients and 14 from the haematology unit. A total of 28 CAZ-R GNB were isolated and Escherichia coli (10) and Klebsiella pneumoniae (7) were the predominant organisms. Resistance to ceftazidime in E. coli and Klebsiella was mediated by extended-spectrum beta-lactamases (ESBLs). Although the majority of the CAZ-R GNB were from patients in the haematology ward, the six nursing home residents with CAZ-R GNB were enteric carriers of ESBL-producing coliforms. Prior exposure to antibiotics was associated with carriage of ESBL organisms and to a lesser extent, the presence of urinary catheters.
    Matched MeSH terms: Nursing Homes/statistics & numerical data
  18. Balakrishnan S, Aamar A, Rhee S, Zakaria S, Khaliq W
    Med J Malaysia, 2016 Jun;71(3):152-3.
    PMID: 27495894
    Gram-negative endocarditis is rare and it has high mortality if there is a delay in diagnosis and treatment. Gram-negative organisms should be considered in the differential diagnosis of IE in hemodialysis patients. Central lineassociated bloodstream infections (CLABSIs) can be prevented by following sterile measures during catheter insertion and proper management of catheter site.
    Matched MeSH terms: Nursing Homes
  19. Mohd Said MR, Mohd Firdaus MAB
    Med J Malaysia, 2021 03;76(2):258-260.
    PMID: 33742641
    Acute ischaemic stroke is a debilitating disease and may lead to haemorrhagic transformation associated with few factors such as high National Institute of Health Stroke Scale (NIHSS), low Modified Rankin Score (MRS), cardio-embolic clot and others.1 We report herein a 61 years old man whom presented with left sided weakness and diagnosed with acute right middle cerebral artery (MCA) infarction. Thrombolytic therapy was not offered due to low Alberta Stroke Program Early CT (ASPECT) score and hence managed conservatively. However, within 24 hours, his Glasgow Coma Scale (GCS) reduced by 4 points and urgent Computed Tomography (CT) brain confirmed haemorrhagic transformation with midline shift. He underwent emergency surgical decompression and subsequently had prolonged hospital stay complicated by ventilated acquired pneumonia. He recovered after a course of antibiotic and discharged to a nursing home with MRS of 5.
    Matched MeSH terms: Nursing Homes
  20. Kua CH, Mak VSL, Huey Lee SW
    J Am Med Dir Assoc, 2019 03;20(3):362-372.e11.
    PMID: 30581126 DOI: 10.1016/j.jamda.2018.10.026
    OBJECTIVES: Deprescribing is effective in addressing concerns relating to polypharmacy in residents of nursing homes. However, the clinical outcomes of deprescribing interventions among residents in nursing homes are not well understood. We evaluated the impact of deprescribing interventions by health care professionals on clinical outcomes among the older residents in nursing homes.

    DESIGN: Systematic review and meta-analysis of randomized controlled trials. CINAHL, International Pharmaceutical Abstracts, MEDLINE, EMBASE, and Cochrane Library were searched from inception until September 2017; manual searches of reference lists of systematic reviews identified in the electronic search; and online trial registries for unpublished, ongoing, or planned trials. (PROSPERO CRD42016050028).

    SETTING AND PARTICIPANTS: Randomized controlled trials in a nursing home setting that included participants of at least 60 years of age.

    MEASURES: Falls, all-cause mortality, hospitalization, and potentially inappropriate medication were assessed in the meta-analysis.

    RESULTS: A total of 41 randomized clinical studies (18,408 residents) that examined deprescribing (defined as either medication discontinuation, substitution, or reduction) in nursing were identified. Deprescribing interventions significantly reduced the number of residents with potentially inappropriate medications by 59% (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.19-0.89). In subgroup analysis, medication review-directed deprescribing interventions reduced all-cause mortality by 26% (OR 0.74, 95% CI 0.65-0.84), as well as the number of fallers by 24% (OR 0.76, 95% CI 0.62-0.93).

    CONCLUSIONS: Compared to other deprescribing interventions, medication review-directed deprescribing had significant benefits on older residents in nursing homes. Further research is required to elicit other clinical benefits of medication review-directed deprescribing practice.

    Matched MeSH terms: Nursing Homes*
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