Overnutrition among older persons in a Maltese nursing home

Background: International studies on nursing home residents have demonstrated that undernutrition is a prevalent and serious health issue among this population of older persons. On the other hand, obesity is prevalent among the elderly in Malta. However, to date, there has been no published study on the nutritional status of elderly nursing home residents in Malta. Objective: To assess the nutritional status of Maltese nursing home residents and determine the prevalence of underweight, overweight and obesity. Method: Cross-sectional quantitative survey research was undertaken from 19 Jan to 23 Feb 04 using the full MiniNutritional Assessment (MNA) tool which includes Body Mass Index (BMI) measurement. Subjects: 43 eligible residents (23 females and 19 males) from one female and one male ward of St Vincent de Paul Residence (SVPR). Results: The prevalence of undernutrition was 9.5% and risk of undernutrition was 71.5%. The prevalence of underweight, overweight and obese residents was 7.1%, 35.7% and 26.2% respectively.peer-reviewe

The effect of cotton-based collection methods on eosinophil cationic protein (ECP) concentrations detected in saliva

Teck Yee Wong, David Koh, Andrew Wee, Vivian Ng, Yong Tat Koh, Zhenjie Sum, Gerald KohDepartment of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, SingaporeBackground: Salivary eosinophil cationic protein (ECP) level has the potential to be an assessment tool for asthma. Its measurement is not well-established and needs standardization. We studied how passive drool (PD) and two commercial devices, Salivette® (cotton-based device) and Sorbette® (cellulose–cotton-based-device), may affect ECP levels during collection among healthy subjects.Methods: Study I (n = 10) involved direct sampling of healthy adult subjects with Salivette® and Sorbette®. Study II (n = 33) involved ‘indirect’ sampling of previously collected PD by both devices.Results: In study I, ECP levels were detected in all PD samples but only in three with Sorbette® and none with Salivette® (collection order: PD, Sorbette® and Salivette®). We changed the order of collection (Salivette®, Sorbette®, PD) and the results were similar (ECP levels detected in all PD samples, three with Sorbette® and only one with Salivette®). In study II, ECP levels in saliva collected by PD was 12.8 μg/L (median) and using Sorbette® and Salivette® were < 2.0 μg/L and 3.4 μg/L respectively (p < 0.01). ECP levels in PD correlated with Sorbette® (rs = 0.79, p < 0.01) and Salivette® (rs = 0.62, p 0.01).Conclusion: Compared to PD, saliva collected using cotton or cellulose-based collection devices resulted in lower measurable ECP levels.Keywords: salivary ECP, collection method

RNA Isolation of Pseudomonas aeruginosa Colonizing the Murine Gastrointestinal Tract

Pseudomonas aeruginosa (PA) infections result in significant morbidity and mortality in hosts with compromised immune systems, such as patients with leukemia, severe burn wounds, or organ transplants1. In patients at high-risk for developing PA bloodstream infections, the gastrointestinal (GI) tract is the main reservoir for colonization2, but the mechanisms by which PA transitions from an asymptomatic colonizing microbe to an invasive, and often deadly, pathogen are unclear. Previously, we performed in vivo transcription profiling experiments by recovering PA mRNA from bacterial cells residing in the cecums of colonized mice 3 in order to identify changes in bacterial gene expression during alterations to the host’s immune status

Colorectal cancer screening: Barriers to the faecal occult blood test (FOBT) and colonoscopy in Singapore

Introduction: This study aims to identify the barriers to adopting faecal occult blood test (FOBT) and colonoscopy as colorectal cancer (CRC) screening methods among the eligible target population of Singapore. Materials and methods: This study was previously part of a randomised controlled trial reported elsewhere. Data was collected from Singapore residents aged 50 and above, via a household sample survey. The study recruited subjects who were aware of CRC screening methods, and interviewed them about the barriers to screening that they faced. Collected results on barriers to each screening method were analysed separately. Results: Out of the 343 subjects, 85 (24.8%) recruited knew about FOBT and/or colonoscopy. Most of the respondents (48.9%) cited not having symptoms as the reason for not using the FOBT. This is followed by inconvenience (31.1%), not having any family history of colon cancer (28.9%), lack of time (28.9%) and lack of reminders/recommendation (28.9%). Of the respondents who indicated not choosing colonoscopy as a screening method, more than one-half (54.8%) identified not having any symptoms as the main barrier for them, followed by not having any family history (38.7%) and having a healthy/low-risk lifestyle (29.0%). There was no difference between the reported barriers to each of the screening methods and the respondents\u27 dwelling types. Conclusions: Lack of knowledge, particularly the misconceptions of not having symptoms and being healthy, were identified as the main barriers to FOBT and colonoscopy as screening methods. Interventions to increase the uptake of CRC screening in this population should be tailored to address this misconception

Comparison of Body Mass Index (BMI), Body Adiposity Index (BAI), Waist Circumference (WC), Waist-To-Hip Ratio (WHR) and Waist-To-Height Ratio (WHtR) as predictors of cardiovascular disease risk factors in an adult population in Singapore

10.1371/journal.pone.0122985PLoS ONE104e012298

Mucosal Damage and Neutropenia Are Required for Candida albicans Dissemination

Candida albicans fungemia in cancer patients is thought to develop from initial gastrointestinal (GI) colonization with subsequent translocation into the bloodstream after administration of chemotherapy. It is unclear what components of the innate immune system are necessary for preventing C. albicans dissemination from the GI tract, but we have hypothesized that both neutropenia and GI mucosal damage are critical for allowing widespread invasive C. albicans disease. We investigated these parameters in a mouse model of C. albicans GI colonization that led to systemic spread after administration of immunosuppression and mucosal damage. After depleting resident GI intestinal flora with antibiotic treatment and achieving stable GI colonization levels of C. albicans, it was determined that systemic chemotherapy with cyclophosphamide led to 100% mortality, whereas selective neutrophil depletion, macrophage depletion, lymphopenia or GI mucosal disruption alone resulted in no mortality. Selective neutrophil depletion combined with GI mucosal disruption led to disseminated fungal infection and 100% mortality ensued. GI translocation and dissemination by C. albicans was also dependent on the organism's ability to transform from the yeast to the hyphal form. This mouse model of GI colonization and fungemia is useful for studying factors of innate host immunity needed to prevent invasive C. albicans disease as well as identifying virulence factors that are necessary for fungal GI colonization and dissemination. The model may also prove valuable for evaluating therapies to control C. albicans infections

Comparison of EFTEM and STEM EELS plasmon imaging of gold nanoparticles in a monochromated TEM

We present and compare two different imaging techniques for plasmonic excitations in metallic nanoparticles based on high energy-resolution electron energy-loss spectroscopy in a monochromated transmission electron microscope. We demonstrate that a recently developed monochromated energy-filtering (EFTEM) approach can be used in addition to the well established scanning technique to directly obtain plasmon images in the energy range below 1 eV. The EFTEM technique is described in detail, and a double experiment performed on the same, triangular gold nanoparticle compares equivalent data acquired by both techniques, respectively

Patients with more comorbidities have better detection of chronic conditions, but poorer management and control:findings from six middle-income countries

Background The burden of non-communicable diseases (NCDs) is rising rapidly in middle-income countries (MICs), where NCDs are often undiagnosed, untreated and uncontrolled. How comorbidity impacts diagnosis, treatment, and control of NCDs is an emerging area of research inquiry and have important clinical implications as highlighted in the recent National Institute for Health and Care Excellence guidelines for treating patients suffering from multiple NCDs. This is the first study to examine the association between increasing numbers of comorbidities with being undiagnosed, untreated, and uncontrolled for NCDs, in 6 large MICs. Methods Cross-sectional analysis of the World Health Organisation Study of Global Ageing and Adult Health (WHO SAGE) Wave 1 (2007–10), which consisted of adults aged ≥18 years from 6 populous MICs, including China, Ghana, India, Mexico, Russia and South Africa (overall n = 41, 557). Results A higher number of comorbidities was associated with better odds of diagnosis for hypertension, angina, and arthritis, and higher odds of having treatment for hypertension and angina. However, more comorbidities were associated with increased odds of uncontrolled hypertension, angina, arthritis, and asthma. Comorbidity with concordant conditions was associated with improved diagnosis and treatment of hypertension and angina. Conclusion Patients with more comorbidities have better diagnosis of chronic conditions, but this does not translate into better management and control of these conditions. Patients with multiple NCDs are high users of health services and are at an increased risk of adverse health outcomes. Hence, improving their access to care is a priority for healthcare systems

Explaining the continuum of social participation among older adults in Singapore: from 'closed doors' to active ageing in multi-ethnic community settings.

OBJECTIVES: This study aims to identify and explain the continuum in which older people in Singapore participate in community and social life, highlighting the influence of culture and policy context on social participation. METHODS: Using an ethnographic approach in a neighbourhood (n=109), we conducted focus groups with older adults of different ethnicities, exploring experiences of social participation. Next, participants took 50 photographs relating to 'lives of elders', showcasing the socio-ecological context that influenced social participation. Lastly, go-along interviews were conducted in various precincts with community leaders. RESULTS: A continuum of social participation emerged among older adults, ranging from (1) marginalization and exclusion, to (2) 'comfort-zoning' alone (3) seeking consistent social interactions, (4) expansion of social network, and (5) giving back to society. Seeking consistent social interactions was shaped by a preference for cultural grouping and ethnic values, but also a desire for emotional safety. Attitudes about expanding one's social network depended on the psychosocial adjustment of the older person to the prospect of gossip and 'trouble' of managing social relations. Despite the societal desirability of an active ageing lifestyle, cultural scripts emphasizing family meant older adults organized participation in social and community life, around family responsibilities. Institutionalizing family reliance in Singapore's welfare approach penalized lower-income older adults with little family support from accessing subsidies, and left some living on the margins. DISCUSSION: To promote inclusiveness, ageing programs should address preferences for social participation, overcoming barriers at the individual, ethnic culture and policy level