bluuebunny/crossref_metadata_2025_split huggingface dataset:
116 Knowing what Older Adults Want: A Soft Service Robot in Object Retrieval Tasks
Authors: Lee Loong Yi , Hossen Ismaiil S , Syadiqeen Omar Ali , Teh Pei-Lee , Tan Chee Pin , Nurzaman Surya G 
Published: December 2019

Abstract

Introduction
An ageing society in this period of technological development may benefit from having service robots assist them in daily tasks. To that end, service robots that are equipped with soft grippers have the potential to handle the unstructured nature of objects such as eye-glasses and cutlery at homes. Drawing from Technology Acceptance Model, this paper aims to analyse technology adoption of a “soft service robot” for object retrieval tasks among older adults.

Method
A video demonstrating the operational functions of an in-house developed soft service robot was shown to 30 participants aged 60 and above. The video shows that the soft service robot can be remotely controlled through the internet to move around and pick up various household objects delicately. The soft service robot also enables users to interact with another individual through an integrated tablet. Thirty participants completed a survey measuring perceived ease of use, perceived usefulness, attitude towards the soft service robot and behavioural intention using seven-point Likert scales. Multiple regression analysis was performed to test the hypothesized model.

Results
Our study showed that the behavioral intention of older adults was jointly determined by the perceived usefulness (β=0.401; p-value&lt; 0.01) and the attitude of the older adults towards the soft service robot (β=0.530; p-value&lt;0.01). Interestingly, this study found a non-significant perceived ease of use-intention relationship (β=-0.167; p-value&gt;0.05) in the model.

Conclusion
Our findings indicated that making a soft service robot easier-to-use has little or no impact on the formation of intentions. Essentially, a soft service robot that is perceived to be useful will be accepted by older adults. From a practical standpoint, it is of significant importance for service robotics designer and developers to build soft service robot with useful functions to enhance greater adoption of such technology among older adults.
120 Communicating Medication-Related Fall Risk via a Patient Portal: What is Important According to Older Fallers in Europe?
Authors: Ploegmakers Kim , Linn Annemiek , Medlock Stephanie , Van der Velde Nathalie , Van Weert Julia 
Published: December 2019

Abstract

Background
Falls are the leading cause of injury and functional decline in older adults. Medication is a leading cause of falls, second only to mobility impairments. Older adults with Fall Risk Increasing Drug (FRID) use are not aware of having a risk of falling and most of them don’t relate fall risk to their drug use. With this European survey we explored if: 1) older adults want to know their personal fall risk, 2) if they want this to be shown via a patient portal, 3) what other elements a patient portal should contain and 4) what potential barriers and facilitators exist for usage of a patient portal.

Methods
We distributed a questionnaire in 10 European countries that was filled in by 58 older fallers (mean age 75,5 years) who visited a geriatric outpatient clinic.

Results
Most participants wanted to know their fall risk (82,8%). The most important elements for the Portal, besides fall risk, were information on FRIDs and patient’s illnesses (62%) and access to the medical record (57%). Paying for the system (63%) and privacy issues (53%) were the most important barriers for using the Portal. A user-friendly Portal (57%), the ability to share information with the doctor (47%) and recommendation by doctors (47%) were the most important facilitators.

Conclusion
More knowledge dissemination is needed to make older fallers aware of medications that can cause falls. This can be done via a Patient Portal. For a successful implementation, the barriers and facilitators should be taken into account.
128 Getting Healthcare Students to be More Empathatic for Geriatric Patients: The Impact of Simulation Suit on Pharmacy Students
Authors: Lee Shaun , Teh Pei-Lee 
Published: December 2019

Abstract

Introduction
The world’s population worldwide is greying, and it is important that health care professionals such as pharmacists are able to gain proficiency in working with older adults who may be suffering from both physical and mental illnesses. One of the challenges for many schools that offer healthcare related courses is the need to support continued empathy towards this ageing population so that they can offer better healthcare services. Recently, ageing suits which are an immersive simulation suit designed to simulate the effects of ageing have been introduced to enable nursing students to experience what older adults face in health care situation.

Method
In this randomised controlled study, all year 1 students enrolled in the Bachelor of Pharmacy course (n=120) at our institution were assigned to either a polypharmacy only workshop or use an ageing suit together with polypharmacy workshop (intervention). The intervention group was tasked to perform a series of exercises, including walking a flight of stairs, picking up a coin as well as filling up a form. All participants completed the Jefferson Empathy Scale and semi-structured questionnaire.

Results
At the end of exercise, intervention group participants had a marginal improvement in their self-reported empathy levels, with an improvement of 1.7 +14.5 points compared to 1.2 + 9.4 points in control (p=0.81). Participants in the intervention reported changes in physical performance consistent with the expected changes associated with ageing. They also reported a change in attitude and were able to empathize better with older adults especially on issues related to patient communication.

Conclusion
As such, future research should also include and involve a wider range of students to ensure that they become health advocates for the health care needs of older adults. This will enable them to deliver better healthcare services to meet the needs of the older adults.
13 Characteristics, Circumstances, and Clinical Outcomes of Inpatient Falls in the Medical Department, Hospital Kuala Lumpur (HKL)
Authors: Karthigayan Aruna , Tarmizi Noor Azleen Ahmad , Chong Elizabeth Gar Mit , Mazzuin Rizah , Yau Weng Keong , Lee Fatt Soon 
Published: December 2019

Abstract

Introduction
Falls among hospital inpatients are common, generally ranging from 2.3 to 7 falls per 1000 patient bed days1. Around 30% of falls as inpatient are injurious2. Falls are associated with a longer length of stay in hospital and greater utilization of healthcare facilities3.

Objective
The goal of this study is to describe patient characteristics, circumstances of fall and clinical outcomes after inpatient fall

Methodology
This is a retrospective, descriptive study of all patients admitted to the Medical Department in year 2017 who sustained an inpatient fall. The data was obtained from the database of the Falls Team HKL.

Results
162 patients, with an average age of (61.82±15.50) years were included in this study. Of these, 103(63.58%) were male and 74(45.68%) were ≥65 years. 120(74.1%) were walking unaided prior to admission. 146(90.1%) patients were admitted with an acute medical illness and 13(8.0%) with an acute fall.
Median time to first fall was 5(IQR 3-8) days after admission. 160(98.77%) falls occurred in the ward. 79(48.77%) falls occurred between 9:00pm to 6:59am. 75(46.3%) patients fell near their bed and 56(34.6%) fell in the toilet. 47(29.01%) had an injurious fall; 32(19.7%) had minor injury, 9(5.6%) had moderate injury and 6(3.7%) had severe injury. Patients with injurious falls were more likely to have “Direct Impact to Head” during fall [OR; 12.73 (95%CI 5.62 – 28.82)]. They were also more likely to have a Head CT after fall [(OR; 6.41 (95%CI 3.02 – 13.62)]. 18(11.1%) patients died during hospitalisation. Median time to death was 9(IQR 4-16.25) days after fall. 144(88.9%) patients were discharged alive at median 6(IQR 3.75 – 9.25) days after fall. Upon discharge, only 49(30.2%) patients were walking unaided.

Conclusion
Inpatient falls affects patients of all age groups, regardless of gender. Our data shows that Inpatient falls can cause increased morbidity due to falls related injuries; however, there is no difference in age, gender, length of stay or death as inpatient between patients with injurious and non-injurious falls.
130 Impact of Balance Training in Virtual Reality on Body Balance in Patients after Total HIP Replacement
Authors: Hadamus Anna , Białoszewski Dariusz , Kowalska Aleksandra Justyna , Urbaniak Edyta , Boratyński Rafał , Marczyński Wojciech 
Published: December 2019

Abstract

Introduction
Virtual Reality (VR) training is becoming an increasingly popular form of exercise aiding in re-education of body balance. Many reports have demonstrated its effectiveness, greater patient involvement in exercise and better outcomes compared to traditional rehabilitation [1]. The aim of this study was to assess the impact of the additional training in VR on body balance in patients after total hip replacement.

Material and Methods
56 patients randomly assigned to an experimental group (30 people) and a control group (26 people) was included in the study. All patients had undergone THR within 2 to 12 weeks before the beginning of the study. The control group underwent standard post-operative rehabilitation, while a VR training programme was used in the experimental group as an additional rehabilitation tool. Balance was assessed with the VBC system and the AMTi AccuSway plate. The results were considered significant for p &lt;0.05.

Results
CoP displacement in the frontal plane was reduced in both groups in tests with eyes closed (p&lt;0.05). Other parameters in standing tests remain the same. The maximum forward deflection test has shown a significant increase in the range of forward movement in the experimental group (p &lt;0.05). In the control group, the duration of the forward movement phase was reduced, but the range remained the same. The rhythmic sway test showed an increase in the average speed of movements in the experimental group (p &lt;0.05). There were no changes in the control group.

Conclusions
1. Postural stability training in VR primarily involves dynamic aspects of the maintenance of balance.
2. Improvement in functional tests may indicate a better clinical outcome of rehabilitation in patients who have additionally trained in VR.
3. The improvement obtained in static tests most probably results from improvement in muscle strength and static stability resulting from the rehabilitation.
131 Impact of Virtual Reality Training in Patients After HIP Arthroplasty on Pressure Distribution in Standing and Walking
Authors: Hadamus Anna , Białoszewski Dariusz , Urbaniak Edyta , Kowalska Aleksandra Justyna , Wydra Kamil , Marczyński Wojciech 
Published: December 2019

Abstract

Introduction
Patients after hip arthroplasty (THR) load the feet asymmetrically during standing or walking. Many reports indicate effectiveness of the Virtual Reality (VR) training in reeducation of postural stability, gait parameters and symmetry. The aim of this study was to assess if VR training programme based on non-walking exercises improve gait parameters or change foot pressure distribution.

Materials and methods
56 patients after THR were randomly assigned to an experimental group (30 people) and a control group (26 people). The control group (CG) attended a standard post-operative rehabilitation programme, while 12 sessions of VR training were added to the standard programme in the experimental group (EG). Each patient performed standing with eyes opened and gait test on Zebris FDM-T treadmill. We calculated spatio-temporal parameters, foot pressure distribution and CoP displacement. The results were considered significant for p &lt;0.05.

Results
In the static tests, the force on the forefoot and the rearfoot of the operated limb increased in EG (p&lt;0.05). The force on the non-operated-side foot decreased and the force of the foot on the operated side increased in CG (p &lt;0.05). No differences were found in the CoP movement in both groups.
Most of the gait parameters improved significantly in both groups (p&lt;0.05). However, EG obtained superior results in comparison to CG (p &lt;0.05) after rehabilitation with regard to step time in the operated limb, stride time, cadence and maximum force in the midfoot area in the operated limb.

Conclusions
1. The significantly better gait performance parameters obtained in the experimental group indicate a better movement capacity in these patients. This suggests that using VR in motor re-education in patients after THR may enhance the effects of rehabilitation.
2. Further studies are necessary to assess the influence of VR training on pressure distribution both in static and dynamic tests.
137 Fall-Risk Increasing Drugs
Authors: Van Der Velde Nathalie 
Published: December 2019

Abstract
Use of certain drugs (psychotropic and cardiovascular) has been indicated as one of the major risk factors for falls. However, in clinical practice, physicians struggle with withdrawal of fall-risk-increasing drugs. At the heart of this struggle lies the inadequacy of our knowledge pertaining to the effectiveness of drug withdrawal for individual patients. Complex interactions between risk factors for falls can be expected, especially for drug-related fall incidents, as both drug-drug interactions as well as drug-disease interactions are known to be of clinical relevance. Also, specific biomarkers may be of importance, such as genetic variations as was recently shown by our group. By lowering drug-related fall risk, loss of quality of life, institutionalization and death can be prevented. For optimal drug withdrawal in clinical practice, better understanding and prediction of drug-related fall risk is essential. The presentation will address identification of fall-risk increasing drugs and specifically predictive factors that may be of clinical relevance such as the effect of genetic variation on medication-related falls.
144 Polypharmacy and Anticholinergic Burden in Older People in Brunei Darussalam
Authors: Yeo Su Ying , Choo Sanny Zi Lung , Rosli Nadzirah , Koh Eng Chong , Teo Shyh Poh 
Published: December 2019

Abstract

Introduction
Polypharmacy and anticholinergic burden are associated with falls in older people. A longitudinal study found patients with five or more drugs had 21% increased falls over 2 years. [Dhalwani, Fahami, Sathanapally et al, BMJ Open, 2017,7(10), e016358]. A cohort study identified a 1.51 odds of recurrent falls with anticholinergic medication, while taking multiple anticholinergics resulted in 100% likelihood of recurrent falls. [Marcum, Wirtz, Pettinger, et al, BMC Geriatrics, 2016,16,76].

Methods
Retrospective study of polypharmacy in older people in Brunei based on data from Bru-HIMS, the Brunei public healthcare sector electronic prescribing and pharmacy management system. In this national study, stratified sampling was done by district, with patients randomly selected within each district. Active medications were identified from Bru-HIMS. The Anticholinergic Cognitive Burden (ACB) Scale was used to calculate anticholinergic burden. Findings for two districts (Tutong and Temburong) are described.

Results
For the 327 patients, 142 (43%) were male and 185 (57%) female. Median age was 72 years (Range 65 to 103 years). 234 (72%) had 5 drugs or more prescribed. Of the 2332 prescriptions, 268 (11.5%) had anticholinergic activity on the ACB scale. Median ACB score was 1. The most commonly prescribed were Orphenadrine, Chlorpheniramine, Diphenhydramine, Cinnarizine and Amitriptyline. There was a positive correlation between polypharmacy and anticholinergic burden (r = 0.4593).

Conclusion
There was a high rate of polypharmacy in older people, with anticholinergic drug burden identified. It may be useful to educate clinicians and patients regarding risks of polypharmacy and anticholinergic burden, including falls.
145 Antihypertensive Medications and Falls in the Older Person
Authors: Quah Jing Yao , Nadarajah Reena , Chong Elizabeth Gar Mit , Razali Rizah Mazzuin , Lee Fatt Soon , Yau Weng Keong 
Published: December 2019

Abstract

Background
There have always been concerns about the increased risk of falls in the older person taking antihypertensive medications. This retrospective study is aimed to determine whether different classes and number of antihypertensive medication used were associated with increased risk of falls in the older person.

Methods
Data was obtained from the geriatric clinic database in HKL from 2015-2018. The data for fallers were extracted from the Falls Clinic while data for the control group of non-fallers were extracted from the General Geriatric clinic. Socio-demographic details, types of falls, types of medications, and risk factors of falls were analysed.

Results
117 of the cases who were fallers and 39 cases of non-fallers were analysed. Univariate logistic regression revealed that age, Parkinson’s disease and hypertension to have significant association with falls. The fallers were then analysed to assess falls risk with the use of antihypertensive medications. Those on one anti-hypertensive medication had an increased risk of recurrent falls (AOR = 3.16; 95% CI: 1.47–6.82) compared to those without antihypertensive medications (AOR = 0.37; CI: 0.13-1.03) and those with two or more antihypertensive medications (AOR = 0.56; CI: 0.27-1.16). Multivariate logistic regression also revealed that the use of all antihypertensive classes were not associated with recurrent falls and injuries from falls. However, patients who were on diuretics had significant odds of admission for falls (AOR 3.05; 95% CI 1.14-8.21) compared to ACE inhibitors or angiotensin receptor blockers (AOR 0.88; CI 0.38-2.10), beta blockers (AOR 0.88; CI 0.35-2.24), calcium channel blockers (AOR 0.96; CI 0.42-2.23) or alpha blockers (AOR 0.41; CI 0.09-1.99).

Conclusion
Older person with advanced age and Parkinson’s disease should be screened for risk of falling. In addition, all older people on antihypertensive medications especially diuretics should also be monitored for increased risk of falls.
147 Prevalence and Drug Classes of Medication Discrepancies among Elderly Patients Discharged from a Tertiary Hospital
Authors: Zaki Izzati Abdul Halim , Razali Rizah Mazzuin , Karuppannan Mahmathi , Gnanasan Shubashini , Alias Rosmaliah 
Published: December 2019

Abstract

Introduction
Medication-related hospital admission may lead to the development of harmful and unwanted side effects that increase the risk of mortality and morbidity. Multiple steps are being executed to overcome the medication errors and one of the strategies is through conducting the medication reconciliation process. This process involves creating an accurate list of patient’s medications which to be compared with the current medications list upon transfer from different point of care or discharge. Any differences detected are categorized as medication discrepancies either being intentional or unintentional. This study aims to determine the prevalence and drug classification of medications discrepancies among patient discharged from a geriatric ward.

Method
This study was conducted retrospectively for three months in a geriatric ward. Comparisons were made between medications list on admission from the Medication History Assessment Form with the in-patient medication chart and medications upon discharge by a pharmacist to detect any discrepancies. Descriptive analysis was used to identify prevalence and the drug classification of medication discrepancies among elderly patients discharged from tertiary hospital.

Results
1056 medications for 74 patients were screened for discrepancies. 689 (65.3%) discrepancies were detected with a mean of 9.31 ± SD 4.02. The highest number of intentional and unintentional medication discrepancies were detected in cardiovascular drugs (29.1%, n = 155) and (36.5%, n = 57). The drugs on admission and upon discharged that involved in discrepancies were diuretics, antihypertensives and antilipemic agents.

Conclusion
The number of medication discrepancies was found to be common among elderly patients discharged from the geriatric wards. Findings from this study have highlighted the importance of comprehensive medication reconciliation process prior to discharge in preventing medication discrepancies.
150 Falls in Malaysia: Magnitude, Risk, Disparities, and Solutions
Authors: Tan Maw Pin , Mat Sumaiyah , Alex Deepa , Kamaruzzaman Shahrul Bahyah 
Published: December 2019

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.