Beliefs, barriers, and promotion practices of Indian nurses' regarding healthy eating for cancer survivors in a tertiary care hospital-A cross sectional survey.

Purpose: To describe the beliefs, barriers and promotion practices of Indian nurses' regarding healthy eating (HE) behaviours amongst cancer survivors, and to gain insights into whether their educational qualifications might affect the promotion of HE. Methods: Data was gathered using a validated questionnaire, 388 of the approached 400 nurses who worked at a tertiary care hospital in India gave informed consent to participate in the study. The Mann-Whitney U test and the Chi square analysis (for continuous and categorical variables respectively) were performed to carry out sub-group comparisons based on the qualification of the nurses i.e., Bachelor of Science in Nursing (BSc) and General Nursing and Midwifery (GNM). Results: The nurses believed that dieticians/nutritionists were primarily responsible for educating the cancer survivors regarding HE. HE was promoted by nurses' relatively equally across multiple treatment stages ("during" treatment 24.4%, "post" treatment 23.1%; and "pre" treatment 22.3%). Nurses' believed HE practices had numerous benefits, with improved health-related quality of life (HRQoL) (75.7%), and mental health (73.9%) being the most frequent responses. The most frequently cited barriers by the nurses in promoting HE were lack of time (22.2%), and lack of adequate support structure (19.9%). Sub-group comparisons generally revealed no significant difference between the BSc and GNM nurses in their perceptions regarding HE promotion to cancer survivors. Exceptions were how the GNM group had significantly greater beliefs regarding whether HE can "reduce risk of cancer occurrence" (p = 0.004) and "whether or not I promote HE is entirely up to me" (p = 0.002). Conclusion: The nurses in India believe in the promotion of HE practices among cancer survivors across various stages of cancer treatments. However, they do face a range of barriers in their attempt to promote HE. Overcoming these barriers might facilitate effective promotion of HE among cancer survivors and help improve survivorship outcomes. Implications for cancer survivors: Indian nurses employed in the two tertiary care hospitals wish to promote HE among cancer survivors, but require further knowledge and support services for more effective promotion of HE.

Muscle fatigue response of rotator cuff muscles in different postures.

INTRODUCTION: Muscle fatigue is a leading cause of rotator cuff (RC) pathologies. Scapular orientation affected by changes in the thoracic spine account for differences in body postures leading to altered RC muscle activation. This posture-related alteration in RC muscle activation and its fatigue response needs to be analyzed. MATERIALS AND METHODS: This study included 50 healthy shoulders with no coexisting spine pathologies. Raw data were recorded using electromyography sensors for RC muscles during two isometric maneuvers of abduction and external rotation, performed at 30% maximum voluntary contraction at 30°, 45°, and 90° arm elevation in sitting and standing. The raw data were analyzed in DataLITE® software, and the mean power frequency (MPF) was extracted to analyze the fatigue response of RC muscles. The Wilcoxon signed-rank test and Kruskal-Wallis test with Bonferroni corrections analyzed fatigue differences between postures and various activities. P < 0.05 was considered significant for the results. RESULTS: Supraspinatus muscle demonstrated significant fatigue at 90° of arm elevation in standing as compared to sitting (MPF -5.40: -5.41; P = 0.03) posture. Between the three elevation angles, all the RC muscles showed increased fatigue at 90° (MPF range -5.22 to -6.64). When compared between abduction and external rotation, only infraspinatus showed fatigue in external rotation (MPF range -5.42 to -6.08). Among all the three RC muscles, infraspinatus showed the maximum fatigue of MPF -6.64 when compared to supraspinatus -5.22 and teres minor -5.36. CONCLUSION: The findings indicate that alterations in the body postures and different elevation angles affect the RC muscles' fatigue response.

Indian nurses' beliefs on physical activity promotion practices for cancer survivors in a tertiary care hospital-a cross-sectional survey.

Purpose: To describe the physical activity (PA) promotion practices, beliefs, and barriers of Indian nurses working with cancer survivors, and to gain preliminary insights into how their educational qualification might affect PA promotion practices. Methods: A validated questionnaire was used to obtain the data (N = 388). Sub-group comparisons were performed based on nursing qualification i.e., Bachelor of Science in Nursing (BSc) and General Nursing and Midwifery (GNM) using Mann-Whitney U test and chi square analysis for continuous and categorical variables, respectively. Results: The nurses believed that oncologists (47%) followed by physiotherapists (28.9%) were primarily responsible for providing information regarding PA to cancer survivors. The most common period in which the nurses' promoted PA was post treatment (31.7%), although very few nurses (13.3%) promoted PA across more than one of the three treatment periods. Nurses felt that PA had many benefits for cancer survivors; improved mental health (87.7%) and HRQoL (81.1%). Lack of knowledge (42.2%) and lack of time (41.6%) were the most frequently cited barriers. The comparisons based on educational qualification did not typically reveal many significant differences. Conclusion: Indian nurses both BSc and GNM qualified, wish to promote PA to cancer survivors despite numerous barriers, across various stages of treatment and believe PA is beneficial to the survivors in the process of recovery. Overcoming these barriers might aid in better promotion of PA to cancer survivors. Implication for cancer survivors: Nurses working in a tertiary care hospital in India are willing to promote PA amongst cancer survivors but require more training and support in this area of practice.

Proportion and distribution of upper extremity musculoskeletal disorders and its association with disability in type 2 diabetes mellitus.

STUDY DESIGN: Cross-sectional INTRODUCTION: Globally, diabetes is a leading cause of disability with an increased prevalence rate in the past three decades. Chronic diabetes has been shown to affect collagenous tissue which often leads to subsequent musculoskeletal complications. Despite increasing prevalence of musculoskeletal disorders, the proportion and distribution of types of upper extremity musculoskeletal disorders resulting in disabilities is poorly understood. PURPOSE OF THE STUDY: This cross-sectional study aims to gather data on the prevalence, proportion and distribution of upper extremity musculoskeletal disorders among individuals with Type 2 Diabetes Mellitus. Further, this study examines the relationship between common upper extremity disorders and the resulting disability among individuals with Type 2 Diabetes Mellitus. METHODS: 170 individuals diagnosed with Type 2 Diabetes Mellitus were recruited at a tertiary care hospital. Routine upper extremity assessments were performed to identify the presence of Frozen Shoulder (FS), Limited Joint Mobility (LJM), Trigger Finger, Carpal Tunnel Syndrome (CTS), and Dupuytren's Contracture. Disability was measured using the Disabilities of arm, shoulder, and hand (DASH) questionnaire. Descriptive statistics, one-way analysis of variance, Tukey's test, and Pearson's test were used to examine the prevalence, proportion and distribution of musculoskeletal disorders and disabilities among individuals with type 2 Diabetes Mellitus. RESULTS: 83(48.9%) participants had one or a combination of multiple musculoskeletal disorders of the upper extremity. The proportion of LJM, FS, CTS, Trigger Finger, and Dupuytren's Contracture were n = 46(27.1%); n = 43(25.3%); n = 16(9.4%); n = 8(4.7%); n = 5(2.9%) respectively. Disability scores on the DASH were 25.8 ± 14.5, 10.3 ± 11.9, and 10.6 ± 10.4 respectively for individuals with FS, LJM and Trigger Finger. DASH scores were highest in individuals with both CTS and FS, 29.8 ± 19.3. Duration of diabetes was significantly associated (r = 0 .19; P < .01) with the disability scores on DASH. CONCLUSION: The prevalence of musculoskeletal disorders in people with type 2 Diabetes mellitus remains high despite advances in medical management over the last two decades. The overall prevalence of hand disorders (LJM, CTS, Dupuytren's contracture, Trigger Finger) was higher than shoulder disorders (FS), e.g. frozen shoulder. People with a diabetes that had a diagnosed upper extremity conditon had more upper extremity disability, than those with diabetes but no diagnosed hand condition, Disability was highest for frozen shoulder and lowest for Dupuytren's diagnoses. Carpal tunnel syndrome was the most disabling hand condition. People with diabetes should be screened for upper extremity diagnoses that could limit their function. Poeple with disability resulting from hand disorders was lower than the shoulder disorders. A combination of hand and shoulder disorders resulted in greater disability.