Age-Friendly Health Systems 4Ms: Implementing Medication Management in Hamad Medical Corporation, Qatar.

PURPOSE: To implement the Age-Friendly Health Systems (AFHS) 4Ms framework, focusing on Medication and its impact on Mobility, Mentation, and What Matters, within Hamad Medical Corporation in Qatar. METHOD: A quality improvement approach was used to implement, extend, and sustain the AFHS 4Ms framework at Hamad Medical Corporation. The Medication "M" was described as the use case to illustrate the impact of high-risk medications on Mobility, Mentation, and What Matters, using an evidence-based, interdisciplinary approach. RESULTS: Implementation of the AFHS 4Ms framework revealed success in aligning multidisciplinary teams to prioritize patient-centered care and caregiver engagement. Through this collaboration, a process map, modified medication screening tool, documentation templates, and educational efforts were developed. CONCLUSION: Applying the AFHS 4Ms framework into health care settings is crucial to improve the care of older adults. Medication management is a cornerstone, involving interdisciplinary team input during screening and act phases to ensure proper medication prescribing and use in older adults. [Journal of Gerontological Nursing, 50(6), 6-9.].

Clinical Management of Metabolic Syndrome Among the Population Attending Geriatric Outpatient Clinics in Qatar.

INTRODUCTION: Research on the clinical management of metabolic syndrome (MetS) among older individuals in Qatar is limited. This study aimed to determine the clinical management of MetS and associated risk factors. METHODS: A retrospective study was conducted to examine the risk factors for MetS (hypertension, diabetes mellitus, obesity, and hyperlipidemia) among patients aged ≥ 60 years who visited geriatric outpatient clinics in Rumailah Hospital, Doha, Qatar between November 1, 2016, and November 1, 2018. RESULTS: The mean age of the patients was 70.1 years, and 50% were male. Of the study population, 97% had MetS with a 95% confidence interval (95.3-98.7). In addition, 45.5% of the patients were obese, 97.75% had diabetes mellitus, and 98.25% had hypertension. The most commonly prescribed medications for treatment included amlodipine for hypertension, metformin for diabetes mellitus, rosuvastatin for lipid reduction, and bisoprolol for cardiovascular management. CONCLUSION: This study found that MetS is common among the population attending geriatric outpatient clinics in Qatar. The majority of these individuals had high rates of diabetes, hypertension, and dyslipidemia. The early identification of at-risk patients through exercise programs may also delay or reverse the risks associated with MetS. More research, especially prospective and population-based studies, is required to improve preventative efforts and optimize treatment options for metabolic syndrome in older persons in Qatar.

Clinical features and management approaches for Urinary Incontinence in Older Adults: Evidence from Three Hospitals in Qatar.

Background: Urinary incontinence (UI) is a common medical problem that seriously affects patients' physical, psychological, social, and financial well-being. To identify the most effective drug management techniques, this retrospective study aimed to describe the demographics, etiology, and medical traits of people with UI. Methods: This retrospective study was conducted at Rumailah Hospital, Ambulatory Care Centre, and Hamad General Hospital to investigate UI risk factors, causes, and management practices in people aged ≥ 65 years within the Hamad Medical Corporation (HMC) in Qatar. Results: The 272 patients enrolled in the study had a marked male preponderance, and a larger percentage of non-Qatari residents than Qataris residents. Solifenacin (24.9%), Tolterodine (4.1%), and Oxybutynin (1.1%) were the most commonly administered anticholinergic drugs, while Tamsulosin (82.9%), Alfuzosin (14.5%), and Doxazosin (1.7%) were the most frequently prescribed alpha-blockers. Conclusion: This study underscores the importance of investigating UI in institutionalized older adult populations considering the limited research available in Qatar. The identified preventable risk factors can be proactively addressed to mitigate UI. This study also highlights the need for thorough documentation of the diagnosis and reasons for improving the standards of patient care. The findings of this study provide important information that can be used to design medication management methods for enhancing patient outcomes.

Pattern and associated factors of COVID-19 knowledge, attitude and practice (KAP) among COVID-19-comorbid patients: a systematic review and meta-analysis.

Background: The COVID-19 comorbid population is at higher risk of developing severe health issues like acute respiratory distress syndrome, coagulation syndrome, metabolic acidosis, and septic shock, potentially leading to patient death. Patients' knowledge, attitudes, and practices (KAP) significantly influence their response to the pandemic and aid in enhancing health policy implementation. Objective: To identify and evaluate the pattern and associated factors to COVID-19 knowledge, attitude, and practice among individuals with comorbidities. Methodology: The systematic review followed the PRISMA guidelines. Relevant studies assessing the KAP of comorbid patients were retrieved by carefully searching the PubMed and Google Scholar databases. The appraisal tool for cross-sectional studies was used to determine the quality of the included studies and the risk of biases. Results: Eighteen studies met the inclusion criteria and were included in the review. The pooled sample size of the included studies was 9,104. Different comorbidities reported in the studies include hypertension, diabetes, psychological disorders, and cancer. Pooled analysis showed that 65% of patients showed good knowledge, 57% of patients showed a positive attitude and 51% of patients followed good practices to manage the COVID-19 in presence of their comorbid condition. Significant factors impacting knowledge, attitude and practice in COVID-19 comorbid patients were ethnicity OR 1.78 [95% CI 1.35-2.32]; educational status 3.2 [2.79-3.58]; urban residence 2.43 [1.65-3.02]; employment Status 1.67[1.34-2.12]; financial Status 4.02[3.66-4.38]; occupation 3.65[3.31-4.25]; information Source 2.64[2.19-3.26]; comorbidity 3.28[2.78-3.61]; and duration of chronic illness 1.59[1.31-2.04]. Conclusion: Comorbid COVID-19 patients showed good knowledge, positive attitude and good practice towards the management of the disease.

Unravelling Structure, Localization, and Genetic Crosstalk of KLF3 in Human Breast Cancer.

Breast cancer is the most prevailing disease among women. It actually develops from breast tissue and has heterogeneous and complex nature that constitutes multiple tumor quiddities. These features are associated with different histological forms, distinctive biological characteristics, and clinical patterns. The predisposition of breast cancer has been attributed to a number of genetic factors, associated with the worst outcomes. Unfortunately, their behavior with relevance to clinical significance remained poorly understood. So, there is a need to further explore the nature of the disease at the transcriptome level. The focus of this study was to explore the influence of Krüppel-like factor 3 (KLF3), tumor protein D52 (TPD52), microRNA 124 (miR-124), and protein kinase C epsilon (PKCε) expression on breast cancer. Moreover, this study was also aimed at predicting the tertiary structure of KLF3 protein. Expression of genes was analyzed through real-time PCR using the delta cycle threshold method, and statistical significance was calculated by two-way ANOVA in Graphpad Prism. For the construction of a 3D model, various bioinformatics software programs, Swiss Model and UCSF Chimera, were employed. The expression of KLF3, miR-124, and PKCε genes was decreased (fold change: 0.076443, 0.06969, and 0.011597, respectively). However, there was 2-fold increased expression of TPD52 with p value < 0.001 relative to control. Tertiary structure of KLF3 exhibited 80.72% structure conservation with its template KLF4 and was 95.06% structurally favored by a Ramachandran plot. These genes might be predictors of stage, metastasis, receptor, and treatment status and used as new biomarkers for breast cancer diagnosis. However, extensive investigations at the tissue level and in in vivo are required to further strengthen their role as a potential biomarker for prognosis of breast cancer.