Development and validation of observational and qualitative study protocol reporting checklists for novice researchers (ObsQual checklist).

INTRODUCTION: Currently, no reporting guidelines exist for observational and qualitative study protocols. In an effort to enhance the quality of research protocols, we introduce two study protocol reporting checklists that we have developed. MAIN RECOMMENDATIONS: These checklists include educational components and examples intended to assist novice researchers. Through the analysis of 333 study protocols submitted for ethical review, our checklists have been developed and validated, demonstrating their applicability across various observational and qualitative study designs. CHANGES IN MANAGEMENT: We provide insights into the systematic implementation of these checklists alongside complementary elements that support their effectiveness. We recommend longitudinal monitoring and evaluation of checklist utilization.

Nonpharmacologic Management of Orthostatic Hypotension in Older People: A Systematic Review. The SENATOR ONTOP Series.

OBJECTIVES: Nonpharmacologic therapies are often recommended as a first-line treatment for orthostatic hypotension (OH). However, the true effect of nonpharmacologic therapy remains unclear, particularly in the older population. We undertook a systematic review evaluating the efficacy of nonpharmacologic interventions in older people with OH to provide evidence-based recommendations. DESIGN: Systematic review of systematic reviews. SETTING AND PARTICIPANTS: MEDLINE, PubMed, EMBASE, and Cochrane Database of Systematic Reviews, CINHAL, and PsycINFO were searched up to June 2018. Two reviewers identified eligible systematic reviews from which primary studies were selected. We included both randomized and nonrandomized studies that evaluated any type of nonpharmacologic intervention and reported outcomes of change in postural drop in systolic blood pressure (SBP) and/or orthostatic symptoms measured using any validated instrument. The Cochrane risk of bias tool was used, with recommendations based on the GRADE approach. RESULTS: Eleven trials were included. Meta-analysis of lower limb compression showed a reduction in the postural drop in SBP of 9.83 mmHg [95% confidence interval (CI) -12.56, -7.11], whereas abdominal compression showed a larger reduction in postural drop in SBP of 12.30 mmHg (95% CI -18.20, -6.39). Compression therapy was also beneficial in reducing OH symptoms. However, the quality of the evidence for compression therapy was very poor. One study each was identified for sleeping with head-up (SHU), home-based resistance training (HBRT), and multicomponent intervention but did not significantly reduce postural SBP drop. Bolus water drinking was effective in 1 study but the study was of low quality. CONCLUSIONS/IMPLICATIONS: There is no high-quality evidence to recommend any of the nonpharmacologic therapies for the management of OH in older people. Yet, we make a weak recommendation for lower limb and abdominal compression therapy based on very low quality evidence. Large-scale trials are warranted in older people to substantiate the efficacy of nonpharmacologic therapies in OH.

Prevalence and determinants of frailty and associated comorbidities among older Gurkha welfare pensioners in Nepal.

AIM: Population aging is increasing in low-income countries. Despite this, there is distinct lack of knowledge about the prevalence of comorbidities and determinants of frailty among older people in these countries. METHODS: We examined data from "Health and Social Care Needs Assessment Survey of the Gurkha Welfare Pensioners" carried out in 2014. Participants were aged ≥60 years from the Gorakha, Lamjung and Tanahu districts of Nepal. Face-to-face interviews were carried out using validated questionnaires. Demographic data, socioeconomic status, and self-reported symptoms and illnesses were collected. Frailty was assessed using the Canadian Study of Health and Aging scale. Univariable and multivariable regression models were constructed to identify the determinants of frailty defined as Canadian Study of Health and Aging scale ≥4. RESULTS: A total of 253 participants (32.0% men) were included in the present study. Most (82.2%) participants were from the Janajati ethnic background. Men who were ex-servicemen had higher educational attainment than women, most of whom (95.3%) were widows of ex-servicemen (P < 0.01). A total of 48.5% of women lived with their sons, whereas 43% of the male participants lived with their wives. Women reported a higher prevalence of mental health issues, such as anxiety and insomnia, compared with men. The prevalence of frailty was 46.2% (46.3% in men and 46.1% in women). In this population, frailty was significantly associated with older age, smoking, living with son, breathing problems, unspecified pain and fatigue, poor dental health, and history of falls and fracture (P < 0.001 for all) after controlling for potential confounders. CONCLUSIONS: The present study highlights the growing nature of the comorbidity burden, and frailty and its determinants in a low-income setting. Concerted efforts should be made with regard to how best to tackle this globally. Geriatr Gerontol Int 2017; 17: 2493-2499.