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Doris S F Yu - One of the best experts on this subject based on the ideXlab platform.

  • effects of a peer assisted tai chi qigong programme on social isolation and psychological wellbeing in chinese hidden elders a pilot randomised controlled trial
    The Lancet, 2016
    Co-Authors: Aileen W K Chan, Doris S F Yu, Kai Chow Choi, Helen Y L Chan, Eliza M L Wong
    Abstract:

    Abstract Background The term hidden elder is used in Chinese society to describe older adults who are socially isolated and refuse social participation. Substantial evidence has indicated the important role of social isolation in increasing psychiatric morbidity and mortality risks in later life. Innovative service is promptly needed to address the social and psychological health needs of hidden elders. We aimed to test the feasibility and the preliminary effectiveness of a peer-assisted tai-chi-qigong programme in strengthening social networks and enhancing psychosocial wellbeing of Chinese hidden elders. Methods This randomised controlled trial recruited 46 people aged 60 years or older who did not engage in any social activities, through the social network of two Community Centres in Hong Kong. Participants were randomised to receive either peer-assisted tai-chi-qigong (n=24) or usual care (n=22) with computer-generated random codes. In the 3-month tai-chi-qigong programme, participants practiced two 60-min sessions each week, during which they were paired up with socially active older adults. Both groups received usual care, which included regular home visits by social workers. The primary outcome was social network using the Lubben social network scale-6 (LSNS-6). Secondary outcomes were De Jong Gieveld loneliness scale score, SF-12 quality of life score, and mental health inventory score. Data were collected at baseline and 3 months thereafter. We used a generalised estimating equations model for intention-to-treat analysis. Ethics approval was obtained from the Joint Clinical Research Ethics Committee of the Chinese University of Hong Kong and New Territory East Cluster. Written informed consent was obtained from every eligible person. Trial registration number CUHK_CCRB00489. Findings The improvement in the primary outcome, LSNS-6, did not differ significantly between the groups (regression coefficient of group by time interaction B=0·76, 95% CI −1·39 to 2·92, p=0·487; Cohen's d effect size 0·304). Participants who received the peer-assisted tai-chi-qigong programme generally showed better improvement in outcomes than the control group. With support from peer elders, the compliance rate of elders participating in tai-chi-qigong was 71% (ranged from 66–100%). Interpretation This pilot study showed that peer-assisted tai-chi-qigong is a feasible social intervention for hidden elders. A full-scale trial is needed to assess the possible benefits for social and physical health. Funding This study was funded by the School Seeding Fund, the Nethersole School of Nursing, the Chinese University of Hong Kong.

  • insomnia severity index psychometric properties with chinese Community dwelling older people
    Journal of Advanced Nursing, 2010
    Co-Authors: Doris S F Yu
    Abstract:

    yu d.s.f. (2010) Insomnia Severity Index: psychometric properties with Chinese Community-dwelling older people. Journal of Advanced Nursing 66(10), 2350–2359. Abstract Aim.  This paper is a report of a study to evaluate the psychometric properties of the Chinese version of the Insomnia Severity Index. Background.  Despite the high prevalence of insomnia in older people and its detrimental impact on well-being and healthcare costs, this problem is almost always undetected and consequently under-treated. The Insomnia Severity Index is psychometrically sound in measuring perceived insomnia severity. However, it has had very limited application in non-White populations. Methods.  An instrument validation study was carried out between October 2008 and April 2009. The Insomnia Severity Index was translated into Chinese using Brislin’s model and administered to a convenience sample of 585 older Chinese people recruited from three Community Centres for elders. Other instruments were also administered, including the Chinese version of the Pittsburgh Sleep Quality Index and the Geriatric Depression Scale. Results.  Cronbach’s alpha of the Chinese version of the Insomnia Severity Index was 0·81, with item-to-total correlations in the range of 0·34–0·67. Construct validity was supported by its moderate relationship with the Chinese Pittsburgh Sleep Quality Index and sleep efficiency. The Chinese version of the Insomnia Severity Index also indicated more severe level of insomnia in older people who reported depressed mood on the Geriatric Depression Scale. Discriminant validity was supported as the Chinese version of the Insomnia Severity Index could discriminate poorer sleepers from normal sleepers. Exploratory factor analysis identified a two-factor structure for the Chinese version of the Insomnia Severity Index in measuring the severity and impacts of insomnia on the Chinese older people. Conclusion.  The Chinese version of the Insomnia Severity Index is a culturally-relevant and psychometrically-sound instrument for assessing severity and impact of insomnia in Chinese Community-dwelling older people. Nurses can use this tool to assess older people’s perceptions of insomnia.

  • Insomnia Severity Index: psychometric properties with Chinese Community‐dwelling older people
    Journal of Advanced Nursing, 2010
    Co-Authors: Doris S F Yu
    Abstract:

    yu d.s.f. (2010) Insomnia Severity Index: psychometric properties with Chinese Community-dwelling older people. Journal of Advanced Nursing 66(10), 2350–2359. Abstract Aim.  This paper is a report of a study to evaluate the psychometric properties of the Chinese version of the Insomnia Severity Index. Background.  Despite the high prevalence of insomnia in older people and its detrimental impact on well-being and healthcare costs, this problem is almost always undetected and consequently under-treated. The Insomnia Severity Index is psychometrically sound in measuring perceived insomnia severity. However, it has had very limited application in non-White populations. Methods.  An instrument validation study was carried out between October 2008 and April 2009. The Insomnia Severity Index was translated into Chinese using Brislin’s model and administered to a convenience sample of 585 older Chinese people recruited from three Community Centres for elders. Other instruments were also administered, including the Chinese version of the Pittsburgh Sleep Quality Index and the Geriatric Depression Scale. Results.  Cronbach’s alpha of the Chinese version of the Insomnia Severity Index was 0·81, with item-to-total correlations in the range of 0·34–0·67. Construct validity was supported by its moderate relationship with the Chinese Pittsburgh Sleep Quality Index and sleep efficiency. The Chinese version of the Insomnia Severity Index also indicated more severe level of insomnia in older people who reported depressed mood on the Geriatric Depression Scale. Discriminant validity was supported as the Chinese version of the Insomnia Severity Index could discriminate poorer sleepers from normal sleepers. Exploratory factor analysis identified a two-factor structure for the Chinese version of the Insomnia Severity Index in measuring the severity and impacts of insomnia on the Chinese older people. Conclusion.  The Chinese version of the Insomnia Severity Index is a culturally-relevant and psychometrically-sound instrument for assessing severity and impact of insomnia in Chinese Community-dwelling older people. Nurses can use this tool to assess older people’s perceptions of insomnia.

Helen Meng - One of the best experts on this subject based on the ideXlab platform.

  • blood pressure monitoring on the cloud system in elderly Community Centres a data capturing platform for application research in public health
    International Conference on Cloud Computing, 2016
    Co-Authors: Kelvin K F Tsoi, Benjamin Yip, Yonghong Kuo, Samuel Y S Wong, Jean Woo, Helen Meng
    Abstract:

    Technology on the cloud frameworks in healthcare data management and analytics has opened new horizons for public health research. Hypertension is a significant modifiable risk factor for cardiovascular diseases. Nowadays, telemonitoring blood pressure (BP) has been suggested as an effective tool for BP control. However, elderly people always have difficulties when using electronic health monitoring devices at home. BP data capturing with cloud technology in elderly Community Centres under guidance and with healthcare provider alert function is a pioneer. In this study, the infrastructure of data collection is constructed on the cloud to capture behavioral data on BP meter use and BP readings. BP data will be generated by the daily use of BP measurement and uploaded to the cloud. All personal characteristics, electronic health records, BP data and call log with nurse can be encrypted and store on the cloud. The remote platform on the cloud can provide efficient analytic performance on huge volume of data with high velocity of data creation in a population-based study. Data mining on the BP measurement will help to better understand the ways to control hypertension. This platform will also be potentially used in other epidemiological studies in public health.

Meaghan Sarah Christian - One of the best experts on this subject based on the ideXlab platform.

  • We still don’t know that our children need vitamin D daily: a study of parents’ understanding of vitamin D requirements in children aged 0-2 years
    BMC Public Health, 2019
    Co-Authors: Rhiannon Eleanor Day, Roxane Krishnarao, Pinki Sahota, Meaghan Sarah Christian
    Abstract:

    Background Vitamin D deficiency has been highlighted as a serious public health problem in the United Kingdom. One in four toddlers are not achieving the recommended intake for their healthy development. This study uses quantitative and qualitative methods to explore parents’ perceptions, awareness and behaviours around vitamin D intake, and the acceptability of and factors affecting purchasing of food and drink fortified with Vitamin D in children aged 0–2 years old. Methods One hundred and ninety-four parents completed an online questionnaire, advertised to parents with one child aged up to 2 years on popular social media websites. The majority of participants were mothers, White-British ethnic background, aged 25–44 years. Participants provided an email address if they wanted to be contacted about the focus groups. Recruitment posters advertising the focus groups were placed in Community Centres. Eighteen participated in 5 focus groups (13 parents), and 5 individual interviews. A thematic analysis methodology was applied. Results Fifty-seven percent ( n  = 110) of parents reported receiving information about vitamin D during pregnancy and 52% ( n  = 100) after the birth of their child. Parents reported a low level of satisfaction with vitamin D information: many thought it was limited and recommendations on supplements were unclear. Parents wanted more information about vitamin D requirements for their child (80%, n  = 153 out of 192 respondents, 2 non-response), about vitamin D and breastfeeding (56%, n  = 108) and vitamin D and pregnancy (49%, n  = 94). The recommendations were for simpler, easier to read, with specific and clearer guidelines; delivered regularly during routine appointments, at timely stages throughout pregnancy and after the birth. 23% ( n  = 45, out of 194 respondents) of parents did not know why vitamin D is important for health. Only 26% ( n  = 49, out of 192 respondents) of parents reported giving their youngest child a vitamin D supplement on most days of the week. The majority of parents (interview/focus group) wanted more information about foods/drinks fortified with vitamin D. Conclusion Parents were generally not aware of the importance of vitamin D, dietary requirements including supplementation and the availability of vitamin D fortified foods. Major improvements are required for the effective promotion of vitamin D information to parents.

Compass Investigators - One of the best experts on this subject based on the ideXlab platform.

  • rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease an international randomised double blind placebo controlled trial
    The Lancet, 2017
    Co-Authors: Compass Investigators
    Abstract:

    Summary Background Coronary artery disease is a major cause of morbidity and mortality worldwide, and is a consequence of acute thrombotic events involving activation of platelets and coagulation proteins. Factor Xa inhibitors and aspirin each reduce thrombotic events but have not yet been tested in combination or against each other in patients with stable coronary artery disease. Methods In this multicentre, double-blind, randomised, placebo-controlled, outpatient trial, patients with stable coronary artery disease or peripheral artery disease were recruited at 602 hospitals, clinics, or Community Centres in 33 countries. This paper reports on patients with coronary artery disease. Eligible patients with coronary artery disease had to have had a myocardial infarction in the past 20 years, multi-vessel coronary artery disease, history of stable or unstable angina, previous multi-vessel percutaneous coronary intervention, or previous multi-vessel coronary artery bypass graft surgery. After a 30-day run in period, patients were randomly assigned (1:1:1) to receive rivaroxaban (2·5 mg orally twice a day) plus aspirin (100 mg once a day), rivaroxaban alone (5 mg orally twice a day), or aspirin alone (100 mg orally once a day). Randomisation was computer generated. Each treatment group was double dummy, and the patients, investigators, and central study staff were masked to treatment allocation. The primary outcome of the COMPASS trial was the occurrence of myocardial infarction, stroke, or cardiovascular death. This trial is registered with ClinicalTrials.gov, number NCT01776424, and is closed to new participants. Findings Between March 12, 2013, and May 10, 2016, 27 395 patients were enrolled to the COMPASS trial, of whom 24 824 patients had stable coronary artery disease from 558 Centres. The combination of rivaroxaban plus aspirin reduced the primary outcome more than aspirin alone (347 [4%] of 8313 vs 460 [6%] of 8261; hazard ratio [HR] 0·74, 95% CI 0·65–0·86, p vs 460 [6%] of 8261; HR 0·89, 95% CI 0·78–1·02, p=0·094). Combined rivaroxaban plus aspirin treatment resulted in more major bleeds than treatment with aspirin alone (263 [3%] of 8313 vs 158 [2%] of 8261; HR 1·66, 95% CI 1·37–2·03, p vs 158 [2%] of 8261; HR 1·51, 95% CI 1·23–1·84, p vs 339 [4%] of 8261; HR 0·77, 95% CI 0·65–0·90, p=0·0012). Interpretation In patients with stable coronary artery disease, addition of rivaroxaban to aspirin lowered major vascular events, but increased major bleeding. There was no significant increase in intracranial bleeding or other critical organ bleeding. There was also a significant net benefit in favour of rivaroxaban plus aspirin and deaths were reduced by 23%. Thus, addition of rivaroxaban to aspirin has the potential to substantially reduce morbidity and mortality from coronary artery disease worldwide. Funding Bayer AG.

  • rivaroxaban with or without aspirin in patients with stable coronary artery disease an international randomised double blind placebo controlled trial
    The Lancet, 2017
    Co-Authors: Compass Investigators
    Abstract:

    Summary Background Coronary artery disease is a major cause of morbidity and mortality worldwide, and is a consequence of acute thrombotic events involving activation of platelets and coagulation proteins. Factor Xa inhibitors and aspirin each reduce thrombotic events but have not yet been tested in combination or against each other in patients with stable coronary artery disease. Methods In this multicentre, double-blind, randomised, placebo-controlled, outpatient trial, patients with stable coronary artery disease or peripheral artery disease were recruited at 602 hospitals, clinics, or Community Centres in 33 countries. This paper reports on patients with coronary artery disease. Eligible patients with coronary artery disease had to have had a myocardial infarction in the past 20 years, multi-vessel coronary artery disease, history of stable or unstable angina, previous multi-vessel percutaneous coronary intervention, or previous multi-vessel coronary artery bypass graft surgery. After a 30-day run in period, patients were randomly assigned (1:1:1) to receive rivaroxaban (2·5 mg orally twice a day) plus aspirin (100 mg once a day), rivaroxaban alone (5 mg orally twice a day), or aspirin alone (100 mg orally once a day). Randomisation was computer generated. Each treatment group was double dummy, and the patients, investigators, and central study staff were masked to treatment allocation. The primary outcome of the COMPASS trial was the occurrence of myocardial infarction, stroke, or cardiovascular death. This trial is registered with ClinicalTrials.gov, number NCT01776424, and is closed to new participants. Findings Between March 12, 2013, and May 10, 2016, 27 395 patients were enrolled to the COMPASS trial, of whom 24 824 patients had stable coronary artery disease from 558 Centres. The combination of rivaroxaban plus aspirin reduced the primary outcome more than aspirin alone (347 [4%] of 8313 vs 460 [6%] of 8261; hazard ratio [HR] 0·74, 95% CI 0·65–0·86, p vs 460 [6%] of 8261; HR 0·89, 95% CI 0·78–1·02, p=0·094). Combined rivaroxaban plus aspirin treatment resulted in more major bleeds than treatment with aspirin alone (263 [3%] of 8313 vs 158 [2%] of 8261; HR 1·66, 95% CI 1·37–2·03, p vs 158 [2%] of 8261; HR 1·51, 95% CI 1·23–1·84, p vs 339 [4%] of 8261; HR 0·77, 95% CI 0·65–0·90, p=0·0012). Interpretation In patients with stable coronary artery disease, addition of rivaroxaban to aspirin lowered major vascular events, but increased major bleeding. There was no significant increase in intracranial bleeding or other critical organ bleeding. There was also a significant net benefit in favour of rivaroxaban plus aspirin and deaths were reduced by 23%. Thus, addition of rivaroxaban to aspirin has the potential to substantially reduce morbidity and mortality from coronary artery disease worldwide. Funding Bayer AG.

Henry Lynn - One of the best experts on this subject based on the ideXlab platform.

  • a randomised controlled trial of tai chi and resistance exercise on bone health muscle strength and balance in Community living elderly people
    Age and Ageing, 2007
    Co-Authors: Athena W L Hong, Henry Lynn
    Abstract:

    BACKGROUND: The beneficial role of exercise in improving bone mineral density, muscle strength and balance, has been documented predominantly in younger populations. These findings may not apply to elderly populations with limited ability to perform exercises of high intensity. OBJECTIVE: To examine the effects of Tai Chi (TC) and resistance exercise (RTE) on bone mineral density (BMD), muscle strength, balance and flexibility in Community living elderly people. DESIGN: Randomised controlled trial, using blocked randomization with stratification by sex. SETTING: A Community in the New Territories Region of Hong Kong, China. SUBJECTS: One hundred eighty subjects (90 men, 90 women) aged 65-74, were recruited through advertisements in Community Centres. METHODS: Subjects were assigned to participate in TC, RTE three times a week, or no intervention (C) for 12 months. Measurements were carried out at baseline, 6 and 12 months. Analyses of covariance (ANCOVA) adjusted for age, and baseline values of variables that were significantly different between groups: i.e. smoking and flexibility for men; quadriceps strength for women. RESULTS: Compliance was high (TC 81%, RTE 76%). In women, both TC and RTE groups had less BMD loss at total hip compared with controls. No effect was observed in men. No difference in either balance, flexibility or the number of falls was observed between either intervention or controls after 12 months. CONCLUSION: The beneficial effects of TC or RTE on musculoskeletal health are modest and may not translate into better clinical outcomes.