The Relationship between Myopia and Ocular Alignment among Rural Adolescents

Purpose: The prevalence of myopia in school-age children and rural area in Taiwan has increased dramatically. The aim of this study was to explore the associated factors of myopia in rural ado-lescents. Methods: A cross sectional design with a rural junior high student was invited to partici-pate in this study. The relationship between refraction error (RE), spectacle fitting condition, and ocular alignment was determined by stereoacuity. The RE was determined using autorefractor. The ocular alignment was evaluated by cover-uncover test. Stereoacuity was measured by Titmus test. The examination about spectacle fitting included the lens power, lens transparency, pupil distance, frame size, and distortion of the frame. Multiple linear regression was used to determine the effect of the spectacle suitability and ocular alignment on the RE and stereoacuity. Results: The prevalence of myopia was 78% in a total of 338 adolescents, and the incidence of high myopia (≤-6 Diopter, D) accounted for 10.2%. Participant worn poor-fitting spectacles were found with more myopia (-3.95D vs -3.42D, p = 0.02). The exophoria or exotropia significantly increased RE (p < 0.01). The eye position was significantly associated with decreased steroacuity function (p = 0.03). Head position demonstrated to have a significant relationship with stereoacuity (p = 0.03). Conclusions: Good-fitting spectacles provided a good visual function and were associated with less RE condition. Exotrope showed a significant correlation with myopia and stereoacuity. The health care providers should be aware of the ocular alignment in myopic suffers.

Effect of Buerger’s Exercises on Improving Peripheral Circulation: A Systematic Review

The aim of this study was to systematically review the evidence for the effectiveness of Buerger’s exercise on the peripheral circulation or diabetic foot ulceration. A systematic search and 18 electronic databases were conducted. The intervention was predominantly focused on Buerger’s exercise as an outcome. Due to high heterogeneity, data were synthesized in a narrative format rather than by statistical methods. Nine studies that covered 592 participants were selected in the analysis, of which 8 of the 9 found an effect of Buerger’s exercise on peripheral circulation. The positive effects were indicative of improving blood flow, walking ability, reducing necrosis, reducing venous embolism, pain, swelling, cyanosis and the bed-rest times. However, the study design and quality appraisal were limited to Jadad score 2 and the sample size was small. Findings provide some evidence of the beneficial effects of Buerger’s exercises. It was seen as a low cost and low risk physical activity that most diabetic patients could undertake at home. This review highlighted a need for further investigation of standardized procedures of Buerger’s exercises. More high quality studies on the prevention of diabetic foot are required regarding Buerger’s exercises.

Health-promoting behavior is positively associated with diabetic control among type 2 diabetes patients

Background: The increasing prevalence of type 2 diabetes mellitus (T2DM) poses a major public health challenge throughout the world. It is a major healthcare issue among the elderly. This study was to identify the association between the health promoting behaviors and the diabetic control of type 2 diabetes mellitus (T2DM) patients. Methods: Cross sectional and descriptive research designs were used in this study. Participants were enrolled from three medical centers in northern, central and southern Taiwan during August, 2010 and June, 2011. The instruments encompassed biochemical indicators, and the preliminary developed scale of diabetes mellitus and health promotion (DMHP). Results: A total of 323 participants with T2DM were included in this study. The results showed 1) a high percentage of the participants used cigarette smoking, alcohol drinking and betel nut chewing, which were not conducive to adopting health promoting behaviors;2) a high percentage of patients showed abnormal blood glucose, dyslipidemia, and elevated blood pressure;3) few of the participants practiced ideally health promoting behaviors;and 4) practicing health-promoting behavior was positively associated with fasting blood glucose (FBG) and HbA1c levels. Conclusions: Patients with higher health promotion scores had better diabetic control. Less physical activity was found among those addicted to cigarette, alcohol and betel nut consumption. The findings suggest that health care providers should assess health promoting behaviors first for each diabetic patient.

The devil is in the detail: Prevention of diabetic foot ulceration in rural area is possible

Background: Foot self-care capability is an important factor in diabetic foot ulceration, especially in disadvantaged rural areas. Aim: To explore the causes of foot ulceration and practice foot self-care behaviors before and after diabetic foot ulceration. Method: A descriptive, retrospective design was conducted in a rural hospital in southern Taiwan. Results: A total of 49 participants with diabetic foot ulcers participated in this study. More than half were male (63.3%), still working in farming or fishing (61.2%). All participants were suffering from peripheral neuropathy (100%) and 71.5% showed claudication. Nearly two thirds reported not having received diabetic foot care education and 82% not having received regular vasculopathy assessment before the wound appeared. The common reasons for foot ulcers were unnoticed trauma, neglect of foot self-care. Conclusions: Most diabetic foot ulcers are preventable, since they result from a high prevalence of peripheral neuropathy, inadequate provision of vasculopathy assessment and inappropriate management of foot self-care. Community health nurses can focus care toward screen regularly for early diabetic foot problems.

Evidence of Specific Healthy Behaviors Positively Associated with General Life Satisfaction among Rural Adults

Background: Chronic diseases are the leading causes of death worldwide. Evidence suggests that infrequent adopting healthy behaviors correlated with many chronic diseases. Healthy behaviors can lead to a marked reduction of morbidity and mortality. Life satisfaction is an important parameter of well-being. Few studies have focused on the association between healthy behaviors and life satisfaction among adults in rural areas. Aim: To establish the determinant and modifiable lifestyle factors associated with life satisfaction among rural adults. Methods: We analyzed our previous health promotion program in a rural area in 2013 obtained from 27 villages (n = 8024) in Yunlin County, Taiwan. The assessment comprised one question assessing self-reported life satisfaction on a 5-point scale (dichotomous: low satisfaction/high satisfaction) and four domain-specific items of health-related behaviors (smoking, oral hygiene, exercise, healthy diet). Logistic regression was used to examine the association between health-related behaviors and life satisfaction adjusted for age, sex, and education. Findings: The mean age was 47.6 years (SD = 16.2), and 56.7% (n = 4551) of the participants were female. Participants with lower life satisfaction reported frequently perceived dissatisfaction with sleep quality (p < 0.001) and health status (p < 0.001). After adjusting for potential confounding variables, the associated risk factors for lower life satisfaction were smoking (OR = 1.20, p = 0.006), less frequently adopted healthy behaviors including dental check (OR = 1.23, p < 0.001), infrequent teeth brushing (OR = 1.12, p = 0.022), infrequent use of dental floss (OR = 1.12, p = 0.028), infrequent consumption of a balanced diet (OR = 1.64, p < 0.001), insufficient vegetable intake (OR = 1.19, p = 0.001), insufficient water intake (OR = 1.14, p = 0.009), and infrequent regular exercise (OR = 1.26, p < 0.001). Conclusions: The findings showed that many adults did not adopt healthy habits in their life. This study identified significant unhealthy behaviors associated with lower life satisfaction, including cigarette smoking, unhealthy diet, poor oral hygiene, and physical inactivity. The enhancement of health promotion programs to improve life satisfaction through decreasing unhealthy habits is necessary for rural adults.