BackgroundThis cross-sectional and correlational survey examines the association between different types of living arrangements and life satisfaction in older Malaysians, while taking into account the mediating effects of social support function.Methodology and FindingsA total of 1880 of older adults were selected by multistage stratified sampling. Life satisfaction and social support were measured with the Philadelphia Geriatric Center Morale Scale and Medical Outcomes Study Social Support Survey. The result shows living with children as the commonest type of living arrangement for older adults in peninsular Malaysia. Compared to living alone, living only with a spouse especially and then co-residency with children were both associated with better life satisfaction (p<.01) and social support function (p<.01). The mediating effect of social support function enhanced the relation between living arrangements and life satisfaction.ConclusionThis study revealed that types of living arrangement directly, and indirectly through social support function, play an important role in predicting life satisfaction for older adults in Malaysia. This study makes remarkable contributions to the Convoy model in older Malaysians.

IntrOductIOnHospital triage in the emergency department (ED) is defined as allocating priority for the provision of care and cure for the patients in the emergency department [1]. In response to overcrowding in emergency departments and in order to ensure critically-ill patients receive services in a timely manner, so hospital triage is developed by using reliable and valid guidelines in order to improve effectiveness [2]. Since the triage decision making process has been introduced as a context-dependent process which is affected by significant internal and external factors [3][4][5][6][7][8], so the complexity of triage decision making has resulted in special attention to the validity and reliability while using triage scales in the emergency departments [6][7][8][9][10][11].The reliability of the Emergency severity index (ESI) triage has been assessed using inter-rater agreement mainly and test-retest among nurses and physicians [2,[12][13][14][15]. The validity of triage has been assessed by key indicators such as emergency department admission [13][14][15][16][17][18][19][20][21] or ICU admission [13,14,19], length of ED [16,19] or hospital stay [13,22], mortality [17,19,20], Hospital discharge [13,14] or left without being seen [16][17][18][19] and resource utilization [13,20,22].Being simple and objective has made the ESI triage system reasonable to be accepted worldwide. The reliability and validity of the ESI has been approved in U.S. [23][24][25] but in the other countries need more investigation and verification. Kyranou in Greece [16] demonstrated that the establishment of the ESI in the ED had good reliability and validity but improvement of nurses` experience and long-term follow-up are necessary to succeed. Grossmann in Switzerland [13] revealed that using the ESI in the ED of an urban tertiary care center is valid, reliable and culturally adapted. Chi in Taiwan [19] found that the ESI produces more accurate discrimination on the basis of patient acuity than the Taiwan triage system. Elshove-Bolk in Norway [21] showed that the ESI triage reliably predicts patient acuity in a population of self-referred patients. Selman [26] revealed that the ESI triage system assists the practitioner in identifying the priorities of care and has the potential for significantly improve patient outcomes. But there are serious concerns about using the ESI in emergency departments of other countries because there are significant differences in the structure of their health care system and culture of care comparing to U.S. Therefore, it is essential to consider the compliance of the triage process in emergency departments with the ESI The ESI has been shown to have good reliability and validity in EDs of many developed countries [12,13,16,19,21]. The importance of applying valid and reliable scales in EDs has been recommended [27,28] however, little information on the ESI reliability and validity in emergency departments of Iran is available [29]. In early 2011, there were only a few emergency departments which used...

Formation of necrotic tissues is a major issue affecting treatment of full-thickness burns. This study was designed to compare topical effectiveness of applying kiwifruit versus fibrinolysin on removal of necrotic tissue of burns. Ten adult male Wistar rats were randomly assigned to three groups. For group 1, the right-side wounds were treated with kiwifruit and the other side with fibrinolysin. For group 2, the wounds on the right side were treated with kiwifruit or fibrinolysin, and the left sides were kept as control group 2. All wounds in group 3 were considered as control group 1. The control wounds were left to heal naturally. In each group and for each wound, the time of debridement were noted. The results indicated that for the wounds where kiwifruit was applied, the average time for removal of dead tissue was 5.7 days, which is significantly shorter than the average 18.5 days it took for treatment with fibrinolysin (p = 0.02). However, there were no significant differences between control wounds 1 and 2. Findings of the present study can open new horizons and provide a new treatment modality for patients with deep burns.

Purpose Screening for fall risks is an important part of fall and fracture prevention. This study aims to investigate cross-sectional inter-instrumental agreement and participants’ preferences of the self-rated Falls Risk Questionnaire (FRQ) and Activities Specific Balance Confidence 6 items (ABC-6). This study also aimed to compare FRQ and ABC-6 scores in older adults with and without a history of falls. Design/methodology/approach Through an online and snowball sampling survey, 114 respondents were recruited from six countries. Respondents were asked to perform FRQ and ABC-6 surveys. Findings The mean respondent age was 67 years, and 44.8% reported falls in the past year. The mean of rescored FRQ and ABC-6 scores were 68.6% and 66.2%, respectively. The FRQ and ABC-6 scores for fallers were lower than non-fallers. Bland and Altman’s method indicated the mean −2.6 and two standard deviations 20.9 differences between ABC-6 and FRQ, which means an overall agreement between these tools. Most of the respondents, 36% had no preference between ABC-6 and FRQ, 34% preferred none, 21% preferred the ABC-6 and 9% preferred the FRQ for screening future falls risk. Originality/value Both ABC-6 and FRQ can distinguish between fallers and non-fallers, and findings of this study can be used to support the use of the FRQ for falls screening in older adults.

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