Effectiveness of Vitamin D Supplements in Reducing the Risk of Falls among Older Adults: A Meta-Analysis of Randomized Controlled Trials

Background The role of vitamin D in reducing the risk of falls in older adults has not been clearly demonstrated. This study examined the effectiveness of vitamin D supplementation in reducing the risk of falls in older adults. Methods Four databases (Cochrane Library, Embase, PubMed, and CINAHL) were searched without language restrictions or time limitations. These articles were comprehensively screened using EndNote version 20.1 software. A manual search of the reference lists of the identified studies was also performed. The analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta–Analyses (PRISMA) guidelines. The pooled evidence was analyzed using RevMan software version 5.4. Results Seventeen studies met inclusion criteria among 550 potentially relevant studies. The pooled analysis of 38,598 older adults showed that vitamin D supplementation decreased the odds of having at least one fall by 1% (odds ratio [OR]=1.01; 95% confidence interval [CI], 0.92–1.11; p=0.86); however, the difference was not statistically significant. Of eight studies with 19,946 older adults, the pooled analysis showed a 12% (OR=1.12; 95% CI, 0.97–1.29; p=0.11) decrease in the odds of having at least one fracture among older adults; however, the difference was also not statistically significant. Pooled subgroup analysis showed that neither low (<2,000 IU/day) nor high (≥2,000 and <4,000 IU/day) doses of vitamin D supplementation had any significant effect on the incidence of falls and fractures. Conclusion Vitamin D supplementation had no beneficial effect in reducing fall and fracture incidence among older adults

Sebuah Kajian Literatur Tentang Pengalaman Pasien Kanker Dalam Menghadapi Pandemi Covid-19

The COVID 19 pandemic has caused various problems for cancer patients. Complaints related to changes in the medication process to the high risk of contracting COVID-19. This qualitative literature study aims to find out what the experiences of cancer patients are like during the COVID-19 pandemic. Articles were searched through Sciencedirect, Sage, Pubmed, and Scopus databases. Keywords using the PCC approach (Population (or participants)/Concept/Context) namely population "patient with cancer OR cancer patient"; concept "experience AND qualitative study" and context "COVID-19 pandemic". The methodological quality of the article findings used assessment tools for Qualitative Research from the Joanna Briggs Institute. A total of 10 articles were analysed. The COVID-19 pandemic provides cancer patients with experiences in decision making and undergoing therapy and has a positive and negative impact on cancer patients and caregivers. During the pandemic, cancer patients have many considerations related to information, family involvement, and treatment decisions during the pandemic. The anxiety experienced is a special challenge felt by cancer patients and caregivers during a pandemic. It is hoped that care services are aware of this situation, reduce the worries of cancer patients and treatment can still run well during a pandemic.   Keywords: COVID-19 pandemic, experience, cancer patient, caregive

Efficacy of smartphone-based virtual reality relaxation in providing comfort to patients with cancer undergoing chemotherapy in oncology outpatient setting in Indonesia: protocol for a randomised controlled trial

Introduction Patients with cancer undergoing chemotherapy experience various physical and psychological problems and discomfort. Virtual reality (VR) can be used in technology-based non-pharmacological therapy that can serve as a potential distractor in the symptom management of patients with cancer undergoing chemotherapy. We propose a smartphone-based virtual reality relaxation (S-VR) technique as a complementary modality to provide comfort to patients with cancer, and we will evaluate its effect on patients with cancer undergoing chemotherapy.Methods and analysis We will recruit 80 patients from the One Day Chemotherapy ‘Tulip’ Center of Dr. Sardjito General Hospital, Yogyakarta, Indonesia. This will be a two-arm parallel randomised controlled trial, with a 1:1 allocation and the primary outcome assessor blinded. This study will be divided into two groups: (1) an intervention group, with participants receiving 360° panoramic video content and music relaxation intervention through a VR device (head-mounted display) placed on their head during chemotherapy for ±10 min plus standard care and (2) a control group, with participants receiving guided imagery relaxation therapy in the form of a leaflet plus standard care. We will measure the outcomes after one chemotherapy cycle for each participant. The primary outcome is the effectiveness of the S-VR in improving the comfort of patients. The secondary outcome is the effect of the S-VR on the patients’ symptom management self-efficacy, pain, anxiety, blood pressure (systolic blood pressure and diastolic blood pressure) and pulse rate.Ethics and dissemination This study was approved by the Medical and Health Research Ethics Committee of the Faculty of Medicine, Public Health and Nursing of Universitas Gadjah Mada—Dr. Sardjito General Hospital, Yogyakarta, Institutional Review Board (approval number: KE/FK/0301/EC/2023). Written informed consent will be obtained from all participants who enrol in the study. Dissemination will be conducted through peer-reviewed publications and conference presentations.Trial registration number NCT05756465