Oral health literacy and related factors of mid-aged and older adults in the community

Health literacy is defined the abilities with which an individual acquires, processes, and understands basic health-related messages and chooses services, it\u27s highly related to health promotion and patient education

Effectiveness of Mobile Health-Delivered Cognitive Behavioural Therapy for Insomnia in Adults: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Aims: To determine the treatment effectiveness associated with mobile health-delivered cognitive behavioural therapy for insomnia (mCBT-I) interventions for adults with insomnia and to identify the potential characteristics associated with better treatment outcomes.Design: A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines.Methods: Seven English- and two Chinese-language databases were searched, without restrictions on publication dates, up to July 2024. Reference lists of relevant reviews and grey literature were included in the search. Randomised controlled trials evaluating mCBT-I in adults with insomnia and published in either English or Chinese were included in this meta-analysis. A random-effects model was used for data analysis, accompanied by additional subgroup analyses and meta-regression.Results: Sixteen studies involving 2146 participants were included in this meta-analysis. mCBT-I interventions were associated with significantly reduced insomnia symptoms and improved sleep quality at post intervention, at 1–3-month follow-up, and at 4–6-month follow-up. Interventions that included five components of CBT-I, were delivered for 6 weeks or longer, and were conducted in a group format were linked to better treatment outcomes; the differences in other subgroup categories were not statistically significant. Studies involving participants with comorbid conditions showed a greater effect in reducing insomnia symptoms than those without such participants. In addition, mCBT-I interventions delivered by healthcare professionals resulted in statistically larger effect sizes for improving sleep quality than self-help regimens.Conclusions: The systematic review and meta-analysis identified the effectiveness of mCBT-I in reducing insomnia symptoms and improving sleep quality and offered practical implications for the development of effective mCBT-I interventions in clinical practice. However, future robust studies are needed to explore the long-term effects of mCBT-I interventions

Association of combination antiretroviral therapy with risk of neurological diseases in patients with HIV/AIDS in Taiwan: a nested case-control study

Heterogeneous neurocognitive impairment remains an important issue, even in the era of combination antiretroviral therapy (cART), with an incidence ranging from 15% to 65%. Although ART drugs with higher penetration scores to the central nervous system (CNS) show better HIV replication control in the CNS, the association between CNS penetration effectiveness (CPE) scores and neurocognitive impairment remains inconclusive. To explore whether ART exposure is associated with the risk of neurological diseases among patients with HIV/AIDS, this study in Taiwan involved 2,571 patients with neurological diseases and 10,284 matched, randomly selected patients without neurological diseases between 2010 and 2017. A conditional logistic regression model was used in this study. The parameters for ART exposure included ART usage, timing of exposure, cumulative defined daily dose (DDD), adherence, and cumulative CPE score. Incident cases of neurological diseases, including CNS infections, cognitive disorders, vasculopathy, and peripheral neuropathy, were obtained from the National Health Insurance Research Database in Taiwan. Odds ratios (ORs) for the risk of neurological diseases were conducted using a multivariate conditional logistic regression model. Patients with a history of past exposure (OR: 1.68, 95% confidence interval [CI]:1.22–2.32), low cumulative DDDs (< 2,500) (OR: 1.28, 95% CI: 1.15–1.42), low adherence (0 < adherence (ADH) ≤ 0.8) (OR: 1.46, 95% CI: 1.30–1.64), or high cumulative CPE scores (>14) (OR: 1.34, 95% CI: 1.14–1.57) had a high risk of neurological diseases. When stratified by classes of ART drugs, patients with low cumulative DDDs or low adherence had a high risk of neurological diseases, including NRTIs, PIs, NNRTIs, INSTIs, and multi-drug tablets. Subgroup analyses also suggested that patients with low cumulative DDDs or low adherence had a high risk of neurological diseases when they had high cumulative CPE scores. Patients with high cumulative DDDs or medication adherence were protected against neurological diseases only when they had low cumulative CPE scores (≤ 14). Patients may be at risk for neurological diseases when they have low cumulative DDDs, low adherence, or usage with high cumulative CPE scores. Continuous usage and low cumulative CPE scores of ART drugs may benefit neurocognitive health in patients with HIV/AIDS

Development and validation of a multiple-choice question-based delirium care knowledge quiz for critical care nurses

ABSTRACTAimsTo develop and psychometrically test a multiple choice questions (MCQs)-based quiz of delirium care knowledge for critical care nurses.DesignInstrument development and psychometric evaluation study.MethodsThe development and validation process including two phases. Phase I focused on the quiz development, conducted by the following steps: (1) generated initial 20-item pool; (2) examined content validity and (3) face validity; (4) conducted pilot testing, data were collected from 217 critical care nurses via online survey during 01 October to 07 November, 2020; (5) performed item analysis and eliminated items based on the item difficulty and discrimination indices. The MCQs quiz was finalised through the development process. Then, phases II emphasised the quiz validation, to estimate the internal consistency, split-half and test-retest reliability, and construct validity using parallel analysis with the exploratory factor analysis (EFA).ResultsA final 16-item MCQs quiz was emerged from the item analysis. The Kuder– Richardson Formula 20 coefficient for the overall quiz showed good internal consistency (0.85), and the intraclass correlation coefficient with a 30-day interval also indicated that the questionnaire had satisfactory stability (0.96). The EFA confirmed appropriate construct validity for the quiz, four factors could explain the total variance of 60.87%.ConclusionThis study developed the first MCQs quiz for delirium care knowledge and it is a reliable and valid tool that can be implemented to assess the level of delirium care knowledge.ImpactThis study offers an evidence-based quiz designed for future research and education purposes in delirium care that has significant implications for knowledge test by using MCQs in clinical practice.</jats:sec

Driving decision-making among older adults with dementia in Taiwan: A longitudinal study

[[abstract]]Background Driving is a complex skill that requires the integration of cognition and motor functions. However, these functions are all impacted by dementia. Aim We investigated the driving status among persons with dementia and the effects of a Dementia and Driving Decision Aid (DDDA) on changes in driving decisions, depressive symptoms and anxiety. Methods A longitudinal study with a 6-month observation was undertaken. Participants were clients in an Integrated Dementia Care Center (IDCC) who were diagnosed with a mild dementia. The primary outcome was changes in driving decisions; secondary outcomes included depressive symptoms, anxiety, and views on the booklet. Data were collected at four time points: baseline (T0), and 1 month (T1), 3 months (T2), 6 months (T3) after implementing DDDA. A logistic regression was used to examine changes in driving decisions, and a repeated-measures ANOVA was adopted to compare changes in secondary outcomes across time. Findings The number of participants who decided to continue driving significantly decreased (p < 0.001), while those who decided to drive less significantly increased (p < 0.001). A significant improvement in depressive symptoms was found in participants over time (F = 9.192; p < 0.001), the mean scores at all post-test time points were lower compared to the baseline measure. Discussion We report successful implementation of a DDDA booklet in an IDCC in Taiwan. In addition, participants’ satisfaction level toward the booklet was high. Conclusion We suggest the DDDA booklet can be widely utilised in community-based dementia care centres