Objective: The objectives of the present study were to assess the nutritional status, identify factors for malnutrition risk and evaluate barriers to adequate nutrition among recipients of the Public Assistance (PA) scheme for socio-economically disadvantaged Singaporeans. Design: Using a cross-sectional study design, we assessed PA recipients' malnutrition risk using the DETERMINE Nutritional Health checklist and the full Mini-Nutritional Assessment (MNA), as well as their nutritional knowledge, co-morbidity burden, depression risk, instrumental and basic activities of daily living (IADL and BADL), and awareness and utilization of available food services. In-depth interviews were also conducted on malnourished individuals (MNA score , 17) to understand barriers to adequate nutrition. Setting: Homes of community-living older adults and nursing homes of institutionalized older adults. Subjects: All PA recipients aged $55 years in Central Singapore District. Results: Four hundred and sixty-five of 511 (91?0 %) eligible PA recipients participated in the study. The prevalence of malnutrition in the study population was 2?8 %. However, 50?3 % were at risk of malnutrition. Among community-dwelling respondents, the risk of malnutrition was independently associated with age .75 years, currently unmarried, BADL impairment, depression risk and BMI , 19?0 kg/m 2 . Qualitative analysis revealed that financial, social and physical barriers and lack of knowledge were the main contributors to poor nutritional status. Only half were aware of subsidized food services and education increased interest in utilizing food services. Among nursing home respondents, those who were BADL impaired were more likely to be at risk of malnutrition. Conclusions: Among PA recipients, the prevalence of malnutrition is low but the risk of malnutrition is high. Education on adequate nutrition and food services are recommended.
Results:Of 103 eligible subjects, 54 responded with seizures recurring in 21 (38.9%). Initial seizure frequency was yearly at 57.9%. The RAS group had more risk factors (P=0.013) and greater frequency of abnormal initial development (P <0.005), abnormal neurological examination in this population (P=0.033) and abnormal current development (P=0.028). Quality of life differed in behavioural changes (P=0.022) and parental relationship with spouses (P=0.004). EEG and neuroimaging were not predictive. Number of initial seizure episodes showed a significant difference between 1AS and RAS groups (P=0.037).
Conclusion:Abnormal development and neurological examination are risk factors for seizure recurrence after the first afebrile seizure. Children with more than four seizures during the initial seizure presentation may be at an increased risk of seizure recurrence. Recurrent seizures affect quality of life of both the affected child and the family.
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