Rasch analysis of Morse Fall Scale among the older adults with cognitive impairment in nursing homes.

This is a cross-sectional study to investigate the efficacy of Morse Fall Scale (MFS) in nursing homes for older adults with cognitive impairment. According to Rasch analysis, the person separation index was 0.95 (person reliability 0.48), and the item separation index was 9.23 (item reliability 0.99). Wright map showed all items can be considered appropriately directed to the older adults, but the items mainly located at both ends with the center missing. Each item was accepted with good infit and outfit statistics with positive PTMEA CORR. values from 0.49 to 0.68. Two items could be significant differential item functioning (DIF) between the two groups of different fall experience in the past year (item 1 and item 3). In conclusion, nursing assistant could adopt MFS to evaluate fall risk of older adults with cognitive impairment, but the risk grades are still not precise enough. In the future, MFS should be explored and refined further.

Effects of lifestyle intervention on adults with metabolic associated fatty liver disease: A systematic review and meta-analysis.

Introduction: This systematic review and meta-analysis evaluates the overall effects of lifestyle interventions upon hepatic fat content and metabolism-related indicators among adults with metabolic associated fatty liver disease. Methods: It was registered under PROSPERO (CRD42021251527). We searched PubMed, EMBASE, MEDLINE, Cochrane, CINAHL, Scopus, CNKI, Wan-fang, VIP, and CBM from the inception of each database to May 2021 for RCT studies of lifestyle interventions on hepatic fat content and metabolism-related indicators. We used Review Manager 5.3 for meta-analysis and used text and detailed tabular summaries when heterogeneity existed. Results: Thirty-four RCT studies with 2652 participants were included. All participants were obesity, 8% of whom also had diabetes, and none was lean or normal weight. Through subgroup analysis, we found low carbohydrate diet, aerobic training and resistance training significantly improved the level of HFC, TG, HDL, HbA1c, and HOMA-IR. Moreover, low carbohydrate diet is more effective in improving HFC than low fat diet and resistance training is better than aerobic training in reduction in HFC and TG (SMD, -0.25, 95% CI, -0.45 to -0.06; SMD, 0.24, 95% CI, 0.03 to 0.44, respectively). Discussion: Overall, this is the first review that systematically synthesizes studies focused on the effects of various lifestyle on adults with MAFLD. The data generated in this systematic review were more applicable to obesity MAFLD rather than lean or normal weight MAFLD. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier (CRD42021251527).