Daily Archives: 29 August 2024

Research Indicates Fear of Falls and Related Injuries Troubles Constant Wheelchair and Motorized Scooter Users

The research community has traditionally concentrated on studying falls among ambulatory individuals suffering from ailments like multiple sclerosis or Parkinson’s disease. However, the incidence of falls among those who utilise wheelchairs or motorised scooters has been relatively underexplored, according to a recent publication in the journal Disability and Rehabilitation. This new study highlights the vulnerabilities that full-time users of these mobility aids face, including frequent falls, associated injuries, and persistent fear of subsequent falls.

The U.S. Census Bureau reports that approximately 5.5 million Americans depend on wheelchairs or motorised scooters for mobility. These individuals, particularly those using these aids for 40 or more hours a week, often face physical barriers that impede their movement and pose significant risks of falls. This insight comes from the work of Laura A. Rice, a professor of health and kinesiology at the University of Illinois Urbana-Champaign. Rice, alongside University of Illinois graduate student Sahel Moein and Elizabeth W. Peterson, a clinical professor of occupational therapy at the University of Illinois Chicago, has led this groundbreaking study.

Peterson explains that the factors contributing to falls among wheelchair and scooter users are multifaceted, encompassing physical, behavioural, environmental, and psychological elements. For instance, manoeuvring over uneven terrain, transitioning between different surfaces, or reaching beyond one’s stable base can significantly increase the risk of a fall. The repercussions of these falls vary, ranging from minor abrasions and bruises to more severe injuries like fractures. For those with reduced sensation, even minor injuries can escalate into significant complications, adds Rice.

This team of researchers revisited data from an earlier investigation involving 156 full-time wheelchair or scooter users who had reported at least one fall within the past three years. Through an online survey, participants provided detailed information regarding their demographic profiles, as well as their mental health status, including levels of anxiety and depression. The survey further explored the history and extent of their wheelchair or scooter usage, their experience with fall-prevention training, and the frequency of falls within the last year. Notably, a significant majority of respondents, 96% in fact, reported experiencing at least one fall in the preceding year, with 74% sustaining injuries and over 94% living with the fear of falling again.

The findings of this study underscore the complexity of the issues at hand. While falls are commonly associated with the elderly in the general population, this study found that younger wheelchair and scooter users reported a higher incidence of injuries, suggesting that riskier behaviours might be more prevalent in younger demographics. Peterson notes that while the study does not establish causation, there is an evident correlation between fear of falling and reduced physical activity, which can lead to a decline in physical capabilities and increased vulnerability to falls— a cycle she describes as a ‘disuse disability cycle’.

In response to these challenges, the researchers advocate for specific interventions to reduce the risk of falls among wheelchair and scooter users. These interventions should include an assessment of fall risk and comprehensive safety training. The team is currently piloting a targeted intervention designed to address these needs. The intervention employs self-management strategies, such as problem-solving and resource utilisation, physical exercises, transfer techniques, and wheelchair-handling skills, delivered by occupational or physical therapists. Participants also learn to develop proactive plans to manage falls should they occur.

As the findings of this study gain broader recognition, the hope is that caregivers and healthcare providers will become more attuned to the risks of falls in this demographic. Rice criticises a common misconception among healthcare providers who believe that merely providing a wheelchair or scooter is sufficient to prevent falls. She stresses the necessity for comprehensive training in using these devices and strategies to manage the accompanying challenges, highlighting the need for a paradigm shift in how mobility aids are integrated into those who rely on them. This research not only sheds light on the overlooked aspects of wheelchair and scooter use but also sets the stage for more informed, effective interventions that can enhance the safety and quality of life for millions of users.

More information: Sahel Moein et al, Factors associated with fear of falling and fall-related injuries among people who use wheelchairs and motorized mobility scooters: a cross-sectional study, Disability and Rehabilitation. DOI: 10.1080/09638288.2024.2365984

Journal information: Disability and Rehabilitation Provided by University of Illinois at Urbana-Champaign, News Bureau

Pesco-Vegetarian Diets Linked to Lower Mortality Rates in the Elderly

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A variety of vegetarian diets offer protection against mortality risks and associated conditions, with the pesco-vegetarian diet, which includes fish, standing out as particularly beneficial for elderly individuals. This finding comes from a study conducted by researchers at Loma Linda University Health, which indicates that vegetarian diets are linked to a lower risk of all-cause mortality and numerous specific-cause mortalities, especially notable among men and those in middle age. However, they also observed a slight increase in risk among vegetarians over the age of 80 for neurological issues such as stroke, dementia, and Parkinson’s Disease, though the pesco-vegetarian diet continued to offer significant advantages in reducing mortality risks compared to other diets.

As the principal investigator of the Study and a distinguished professor at the School of Public Health at Loma Linda University, Gary Fraser, MBCHB, PhD, provided valuable insights into the protective effects of vegetarian diets. He noted that these diets are effective up to middle age, after which the overall benefits tend to diminish for strict vegetarians. Fraser also expressed concern over the mild increase in neurological conditions among elderly vegetarians, suggesting that this area requires further attention to maintain the benefits of vegetarianism into later life.

The study, titled ‘Cause-specific and all-cause mortalities in vegetarian compared to non-vegetarian participants from the Adventist Health Study-2 cohort,’ was published in the American Journal of Clinical Nutrition. It utilized data from the Adventist Health Study-2, a large cohort of nearly 96,000 Seventh-day Adventists living in the USA and Canada. The study analyzed data from more than 88,000 participants and approximately 12,500 deaths within the cohort, categorizing dietary patterns into five groups: non-vegetarian, semi-vegetarian, pesco-vegetarian, lacto-ovo-vegetarian, and vegan.

The current study analyzed data from more than 88,000 participants and approximately 12,500 deaths within the cohort. Dietary patterns were identified through questionnaires and categorized into five groups: non-vegetarian, semi-vegetarian, pesco-vegetarian, lacto-ovo-vegetarian, and vegan. Fraser and his team found that Adventist vegetarians overall had about a 12% lower risk of death compared to Adventist non-vegetarians.

Study participants following a pesco-vegetarian diet experienced an 18% lower risk of death, while those on a lacto-ovo-vegetarian diet, which includes dairy and eggs, saw a 15% reduction. Vegans had a less than 3% decreased risk of death, with male vegans, in particular, showing significantly better outcomes than their non-vegetarian counterparts, a contrast to the outcomes seen in female vegans.

Fraser concluded that the study provides clear evidence that American vegetarians are generally better protected from premature death than non-vegetarians, emphasizing the potential health benefits of incorporating vegetarian and particularly pesco-vegetarian diets into dietary practices, especially as individuals age.

More information: Grace P Abris et al, Cause-specific and all-cause mortalities in vegetarian compared with those in nonvegetarian participants from the Adventist Health Study-2 cohort, American Journal of Clinical Nutrition. DOI: 10.1016/j.ajcnut.2024.07.028

Journal information: American Journal of Clinical Nutrition Provided by Loma Linda University Adventist Health Sciences Center

Anxiety about Being Left Out: A Crucial Risk Factor for Mental Well-being and Burnout in the Workplace

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Fear of Missing Out (FoMO) poses a significant risk to employee mental health and can escalate burnout, especially when combined with the challenges of information overload, according to recent research. Conducted by the University of Nottingham’s Schools of Psychology and Medicine, the study analysed survey data from 142 employees to examine the negative aspects of digital work environments. The results, published in SAGE Open, reveal that employees burdened with the fear of missing out on crucial information and an overload of data are more susceptible to stress and burnout.

Elizabeth Marsh, a PhD student at the School of Psychology who led the quantitative analysis, emphasised the importance of digital workspaces as strategic organisational assets. These platforms enhance worker productivity and adaptability, particularly in hybrid working contexts. However, she highlighted the potential negative impacts on employee well-being, exacerbated by the surge in digital communication tools and channels following the COVID-19 pandemic.

This study builds on previous research that mindfulness in digital workplaces can protect employees from stress, anxiety, and information overload. FoMO is defined in this study as the anxiety associated with missing essential updates and information, as well as opportunities for interaction and relationship building. Although FoMO has traditionally been linked to social media, this research demonstrates its significant impact in professional settings.

Participants in the study reported on their experiences with the ‘dark side’ of digital workplaces, including stress, overload, anxiety, and FoMO, and how these factors affected their well-being. The findings indicated that issues specifically linked to information—the fear of missing out on it and feeling overwhelmed—were particularly harmful. These issues directly affected well-being and amplified the overall stress associated with digital work.

Elizabeth Marsh further discussed the challenges posed by the constant flow of information through emails, intranets, and collaborative tools, which can overwhelm employees and make them feel left out. She advocates for a comprehensive approach to managing this information glut, optimising information management, and enhancing information literacy to alleviate the feeling of being overwhelmed. The research suggests that employers should invest in strategies to control the volume and distribution of information, which could also inform HR policies and training programs to help employees manage and utilise information more effectively.

Dr Alexa Spence, a Psychology professor, emphasised the importance of considering digital workplaces in job design to boost productivity and employee well-being. Inadequate attention to this aspect can lead to increased stress, burnout, and deteriorating mental health. The study highlights the information ecosystem within organisations as a critical area for internal policy focus and broader research engagement, underscoring the need for a balanced approach to digital work environments.

More information: Elizabeth Marsh et al, Overloaded by Information or Worried About Missing Out on It: A Quantitative Study of Stress, Burnout, and Mental Health Implications in the Digital Workplace, SAGE Open. DOI: 10.1177/21582440241268830

Journal information: SAGE Open Provided by University of Nottingham

Cleveland Clinic Research Associates Sugar Substitute with Higher Heart Attack and Stroke Risk

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Researchers at the Cleveland Clinic have discovered that higher concentrations of the sugar alcohol Xylitol are linked to an increased risk of cardiovascular incidents such as heart attacks and strokes.

Stanley Hazen, M.D., Ph.D., spearheaded the research, which was corroborated through extensive patient analysis, animal research models, and a clinical intervention study. The results were published in the European Heart Journal today.

Xylitol is widely used as a sugar replacement in sugar-free confections, chewing gums, baked items, and dental products like toothpaste. Over the last ten years, there has been a notable rise in the use of sugar alternatives in processed foods marketed as healthy options, including sugar alcohols and artificial sweeteners.

The same team of researchers previously identified a similar correlation between erythritol and cardiovascular risk. Although Xylitol is not as commonly used as erythritol in keto and sugar-free products in the U.S., it is frequently found in other nations.

Dr. Hazen, who holds the position of Chair of Cardiovascular and Metabolic Sciences at Cleveland Clinic’s Lerner Research Institute and also serves as Co-Section Head of Preventive Cardiology at the Heart, Vascular & Thoracic Institute, emphasized the urgent need to investigate sugar alcohols and artificial sweeteners further. He noted that while these findings do not suggest discarding toothpaste containing Xylitol, they do indicate that high consumption of products containing Xylitol could raise the risk of events related to blood clots.

In their latest study, the researchers observed that elevated Xylitol levels in the bloodstream were associated with a higher risk of cardiovascular events over three years, based on data from over 3,000 patients across the U.S. and Europe. Individuals with the highest levels of Xylitol in their plasma were significantly more likely to suffer a cardiovascular event. The findings were validated through preclinical tests, which showed that Xylitol increased platelet clotting and the risk of thrombosis. Additionally, the study monitored platelet activity in individuals who consumed a Xylitol-sweetened beverage compared to those who drank a glucose-sweetened beverage, revealing a significant increase in clotting potential immediately after consuming the Xylitol but not the glucose.

More information: Marco Witkowski et al, Xylitol is prothrombotic and associated with cardiovascular risk, European Heart Journal. DOI: 10.1093/eurheartj/ehae244

Journal information: European Heart Journal Provided by Cleveland Clinic