Pub Date : 2022-06-01DOI: 10.1177/20101058221111655
S. S. Kho, C. Soo, M. Nasaruddin, K. Ngan, J. A. Abdul Rahaman
Isolated mediastinal lymphadenopathy represents a common diagnostic dilemma whereby morphological analysis of tissue specimens are frequently needed to ascertain the diagnosis. Cryobiopsy by linear endobronchial ultrasound (EBUS) guidance had recently been described in literature. We described a multimodality biopsy approach of a case of isolated tuberculous mediastinal lymphadenitis in which we employed the 22-gauge transbronchial aspiration needle, mini-forceps and a flexible cryoprobe sequentially. We aim to highlight the novel technique of linear EBUS guided cryobiopsy in acquiring superior histological specimen from mediastinal lymphadenopathy for diagnosis purposes. We also compared the histopathological quality of the specimens acquired from these three different biopsy modalities.
{"title":"Multimodal linear endobronchial ultrasound guided mediastinal lymph node biopsy in the diagnosis of isolated mediastinal lymphadenopathy","authors":"S. S. Kho, C. Soo, M. Nasaruddin, K. Ngan, J. A. Abdul Rahaman","doi":"10.1177/20101058221111655","DOIUrl":"https://doi.org/10.1177/20101058221111655","url":null,"abstract":"Isolated mediastinal lymphadenopathy represents a common diagnostic dilemma whereby morphological analysis of tissue specimens are frequently needed to ascertain the diagnosis. Cryobiopsy by linear endobronchial ultrasound (EBUS) guidance had recently been described in literature. We described a multimodality biopsy approach of a case of isolated tuberculous mediastinal lymphadenitis in which we employed the 22-gauge transbronchial aspiration needle, mini-forceps and a flexible cryoprobe sequentially. We aim to highlight the novel technique of linear EBUS guided cryobiopsy in acquiring superior histological specimen from mediastinal lymphadenopathy for diagnosis purposes. We also compared the histopathological quality of the specimens acquired from these three different biopsy modalities.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47579524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1177/20101058221138834
Jeremy Meng-Yeow Koh, H. Ang, Jeffrey Lee, Y. Pua
Backgroud: Globally, employee engagement in healthcare organisations is low, with career advancement one of its main determinants. It may be useful for healthcare organisations to determine the factors of career advancement, to guide them to more effectively engage their workforce. Leadership competency is factor that may be crucial in influencing career advancement for healthcare employees. To our knowledge, a comprehensive analysis on its impact on the perception of career advancement within the healthcare setting has not been conducted. Research Design: An ecological, cross-sectional study was conducted, aimed at examining the association between leadership competency of healthcare professionals and perceptions of career advancement. Poisson generalized-estimating-equation models were fitted to estimate the adjusted rate ratios with bootstrap 95% confidence intervals for the associations of the AHEAD items with the number of favourable responses on the career advancement items. In each model, we accounted for clustering by departments and controlled for length of service as a confounder. Results: Statistically significant predictors of perception of career advancement were found, and included skills - Interpersonal Skills (aRR 1.53 CI 1.12–2.96), Motivating (aRR 1.31 CI 1.10–2.16), and Mentoring (aRR 1.30 CI 1.08–1.13); and values - Compassion (aRR 1.37 CI 1.17–3.40), and Collegiality (aRR 1.31 CI 1.00–1.99). Conclusion: Our findings show an association between some components of leadership competency and the perception of career advancement. These results provide initial evidence that apart from hard skills, soft skills may play an equally (or more important) role in influencing the perception of career advancement.
背景：在全球范围内，医疗机构的员工参与度较低，职业发展是其主要决定因素之一。医疗保健组织可能有助于确定职业发展的因素，引导他们更有效地参与工作。领导能力是影响医护人员职业发展的关键因素。据我们所知，尚未对其对医疗环境中职业发展感知的影响进行全面分析。研究设计：进行了一项生态学的横断面研究，旨在检验医疗保健专业人员的领导能力与职业发展观念之间的关系。对泊松广义估计方程模型进行拟合，以估计AHEAD项目与职业发展项目上的有利反应数量之间的关联的调整率比率，该比率具有bootstrap 95%置信区间。在每个模型中，我们考虑了按部门进行的聚类，并将服务年限作为混杂因素进行控制。结果：发现了职业发展感知的统计学显著预测因素，包括技能-人际技能（aRR 1.53 CI 1.12–2.96）、激励（aRR 1.31 CI 1.10–2.16）和辅导（aRR 1.3 0 CI 1.08–1.13）；以及价值观——同情心（aRR 1.37 CI 1.17–3.40）和大学精神（aRR 1.331 CI 1.00–1.99）。结论：我们的研究结果表明，领导能力的某些组成部分与职业发展感知之间存在关联。这些结果提供了初步证据，表明除了硬技能外，软技能在影响职业发展的感知方面可能发挥同样（或更重要）的作用。
{"title":"The hard truth about soft skills: Exploring the association between leadership competency and career advancement of allied health professionals","authors":"Jeremy Meng-Yeow Koh, H. Ang, Jeffrey Lee, Y. Pua","doi":"10.1177/20101058221138834","DOIUrl":"https://doi.org/10.1177/20101058221138834","url":null,"abstract":"Backgroud: Globally, employee engagement in healthcare organisations is low, with career advancement one of its main determinants. It may be useful for healthcare organisations to determine the factors of career advancement, to guide them to more effectively engage their workforce. Leadership competency is factor that may be crucial in influencing career advancement for healthcare employees. To our knowledge, a comprehensive analysis on its impact on the perception of career advancement within the healthcare setting has not been conducted. Research Design: An ecological, cross-sectional study was conducted, aimed at examining the association between leadership competency of healthcare professionals and perceptions of career advancement. Poisson generalized-estimating-equation models were fitted to estimate the adjusted rate ratios with bootstrap 95% confidence intervals for the associations of the AHEAD items with the number of favourable responses on the career advancement items. In each model, we accounted for clustering by departments and controlled for length of service as a confounder. Results: Statistically significant predictors of perception of career advancement were found, and included skills - Interpersonal Skills (aRR 1.53 CI 1.12–2.96), Motivating (aRR 1.31 CI 1.10–2.16), and Mentoring (aRR 1.30 CI 1.08–1.13); and values - Compassion (aRR 1.37 CI 1.17–3.40), and Collegiality (aRR 1.31 CI 1.00–1.99). Conclusion: Our findings show an association between some components of leadership competency and the perception of career advancement. These results provide initial evidence that apart from hard skills, soft skills may play an equally (or more important) role in influencing the perception of career advancement.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48727770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1177/20101058221129715
L. P. Ng, Prawira Oka, C. Lim, W. K. Aau, E. Koh, A. Ee, N. Tan
Introduction Angiotensin II Receptor Blockers (ARB) are widely utilized in the treatment of hypertension and nephropathy. In March 2019, a mass recall of selected brands of an ARB, losartan due to reported elevated levels of potentially carcinogenic nitrosamine impurities was implemented in a Singapore primary care institution. Objective To describe the crisis management of the mass losartan recall in a public primary healthcare institution in Singapore. Methods The crisis management framework was adapted from the Gonzalez-Herrero and Pratt model. This crisis was managed over three phases: identification of impending crisis based on risk reports by local health authorities, formation of a task force to develop turnaround strategies and measures, implementation and monitoring of the remedial measures. Data to plan and chart implementation was retrieved from the institution databases, including the Electronic Health Intelligence System for patient medical and prescription records, Outpatient Administrative System for reimbursement of medications and other expenditures incurred. An exigency scheme, Losartas® Review Service (LRS), was established to expedite the replacement of the affected medication with another ARB or another anti-hypertensive medication. Results SingHealth Polyclinics completed the recall of 29,794 (92.1%) patients within 14 weeks. The majority of the patients (76.2%) were attended to by doctors, while 16.5% and 7.3% were managed using the LRS and pharmacy respectively. The institution incurred a cost of SGD2,824,760 (estimated SGD95 per patient) to manage the crisis. Conclusion The successful implementation of a mass medication recall hinged on timely intervention, cross-departmental coordination, effective communication and judicious resource allocation.
{"title":"Crisis management in the community mass recall of angiotensin II receptor blocker losartan due to nitrosamine impurities","authors":"L. P. Ng, Prawira Oka, C. Lim, W. K. Aau, E. Koh, A. Ee, N. Tan","doi":"10.1177/20101058221129715","DOIUrl":"https://doi.org/10.1177/20101058221129715","url":null,"abstract":"Introduction Angiotensin II Receptor Blockers (ARB) are widely utilized in the treatment of hypertension and nephropathy. In March 2019, a mass recall of selected brands of an ARB, losartan due to reported elevated levels of potentially carcinogenic nitrosamine impurities was implemented in a Singapore primary care institution. Objective To describe the crisis management of the mass losartan recall in a public primary healthcare institution in Singapore. Methods The crisis management framework was adapted from the Gonzalez-Herrero and Pratt model. This crisis was managed over three phases: identification of impending crisis based on risk reports by local health authorities, formation of a task force to develop turnaround strategies and measures, implementation and monitoring of the remedial measures. Data to plan and chart implementation was retrieved from the institution databases, including the Electronic Health Intelligence System for patient medical and prescription records, Outpatient Administrative System for reimbursement of medications and other expenditures incurred. An exigency scheme, Losartas® Review Service (LRS), was established to expedite the replacement of the affected medication with another ARB or another anti-hypertensive medication. Results SingHealth Polyclinics completed the recall of 29,794 (92.1%) patients within 14 weeks. The majority of the patients (76.2%) were attended to by doctors, while 16.5% and 7.3% were managed using the LRS and pharmacy respectively. The institution incurred a cost of SGD2,824,760 (estimated SGD95 per patient) to manage the crisis. Conclusion The successful implementation of a mass medication recall hinged on timely intervention, cross-departmental coordination, effective communication and judicious resource allocation.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48251887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1177/20101058221129713
Jing Chen, C. Bok, Y. Ren, Hongyun Xu, Yi Chiong
Background Postoperative hip fracture rehabilitation in Singapore has historically been carried out in both acute and community hospitals (CH). An increasing majority of patients with hip fractures now receive inpatient rehabilitation in CH, and it is often believed that Acute hospital (AH) - based rehabilitation may be less cost-effective than their CH counterparts. Objective: This retrospective study aims to review the effectiveness of an AH-based hip fracture postoperative rehabilitation program. Methods This study retrospectively reviewed the database of postoperative hip fracture patients who underwent a physiatrist-led AH-based inpatient rehabilitation from Jan 2010 to Dec 2016. The primary outcomes were the functional improvement assessed by functional independence measure (FIM) and FIM efficiency. The secondary outcome included the length of stay (LOS), successful discharge to home rate, mortality rate, and complication rate. Results A total of 293 cases were included in the study. After participation in the inpatient rehabilitation program, the mean total FIM increased from 83.9 ± 12.7 (mean ± SD) to 93.9 ± 16.2 (p < .001). The motor FIM increased from 47.1 ± 10.9 to 56.1 ± 10.1 (p < .001). 269 (91.8%) patients were successfully discharged home. Inpatient mortality was 0.3% (1/293). The complications rate during inpatient rehabilitation was 16.0% with urinary tract infection being the most frequent complication (10.2%). The median LOS for inpatient rehabilitation was 19 days (15, 28). Conclusions After completing a physiatrist-led postoperative hip fracture inpatient rehabilitation program in an acute hospital, patients demonstrated significant functional improvement (p < .0001). The inpatient rehabilitation program has a high discharge home rate and low in-hospital mortality.
{"title":"The effectiveness of a physiatrist-led acute hospital based postoperative hip fracture inpatient rehabilitation program: A single-center retrospective study","authors":"Jing Chen, C. Bok, Y. Ren, Hongyun Xu, Yi Chiong","doi":"10.1177/20101058221129713","DOIUrl":"https://doi.org/10.1177/20101058221129713","url":null,"abstract":"Background Postoperative hip fracture rehabilitation in Singapore has historically been carried out in both acute and community hospitals (CH). An increasing majority of patients with hip fractures now receive inpatient rehabilitation in CH, and it is often believed that Acute hospital (AH) - based rehabilitation may be less cost-effective than their CH counterparts. Objective: This retrospective study aims to review the effectiveness of an AH-based hip fracture postoperative rehabilitation program. Methods This study retrospectively reviewed the database of postoperative hip fracture patients who underwent a physiatrist-led AH-based inpatient rehabilitation from Jan 2010 to Dec 2016. The primary outcomes were the functional improvement assessed by functional independence measure (FIM) and FIM efficiency. The secondary outcome included the length of stay (LOS), successful discharge to home rate, mortality rate, and complication rate. Results A total of 293 cases were included in the study. After participation in the inpatient rehabilitation program, the mean total FIM increased from 83.9 ± 12.7 (mean ± SD) to 93.9 ± 16.2 (p < .001). The motor FIM increased from 47.1 ± 10.9 to 56.1 ± 10.1 (p < .001). 269 (91.8%) patients were successfully discharged home. Inpatient mortality was 0.3% (1/293). The complications rate during inpatient rehabilitation was 16.0% with urinary tract infection being the most frequent complication (10.2%). The median LOS for inpatient rehabilitation was 19 days (15, 28). Conclusions After completing a physiatrist-led postoperative hip fracture inpatient rehabilitation program in an acute hospital, patients demonstrated significant functional improvement (p < .0001). The inpatient rehabilitation program has a high discharge home rate and low in-hospital mortality.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46511146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1177/20101058221129722
Tzy Harn Chua, S. Lai, K. Sittampalam
Ossifying fibromyxoid tumour (OFMT) is a soft tissue neoplasm of uncertain differentiation, with potential for recurrences and metastases depending on the presence of atypical or malignant histological features. Most cases show an incomplete shell of mature bone in the periphery of the lesion. Recurrent PHF1 gene rearrangements were also recently reported in OFMTs, with the most common rearrangement involving a fusion to EP400. We report a case of a 75-year-old male that was diagnosed with an OFMT showing an unusually prominent central ossification. Further, this lesion also harboured the less commonly reported EPC1-PHF1 gene fusion, thus further characterising the morphological features that are associated with this molecular event in this entity. Differential diagnoses of lesions with prominent ossification and emerging molecular findings associated with this entity are discussed.
{"title":"Ossifying fibromyxoid tumour with an unusually prominent central ossification harbouring EPC1-PHF1 gene fusion: A case report and literature review","authors":"Tzy Harn Chua, S. Lai, K. Sittampalam","doi":"10.1177/20101058221129722","DOIUrl":"https://doi.org/10.1177/20101058221129722","url":null,"abstract":"Ossifying fibromyxoid tumour (OFMT) is a soft tissue neoplasm of uncertain differentiation, with potential for recurrences and metastases depending on the presence of atypical or malignant histological features. Most cases show an incomplete shell of mature bone in the periphery of the lesion. Recurrent PHF1 gene rearrangements were also recently reported in OFMTs, with the most common rearrangement involving a fusion to EP400. We report a case of a 75-year-old male that was diagnosed with an OFMT showing an unusually prominent central ossification. Further, this lesion also harboured the less commonly reported EPC1-PHF1 gene fusion, thus further characterising the morphological features that are associated with this molecular event in this entity. Differential diagnoses of lesions with prominent ossification and emerging molecular findings associated with this entity are discussed.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44955968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1177/20101058221144114
Pamela Chia, S. Cheng, Sze-Chin Tan, B. Sng
Morbidly obese obstetric patients present multiple challenges to the anaesthetist for labour analgesia and anaesthesia for caesarean section. The superiority of regional anaesthesia (RA) using local anaesthetics (LA) to all other techniques in the obese parturient, as well as avoiding complications of general anaesthesia (GA) in a caesarean delivery makes LA allergy in parturients an important issue. We report the first known case of lignocaine allergy in a morbidly obese parturient.
{"title":"Anaesthesia for caesarean section in a morbidly obese parturient with history of lignocaine allergy: A case report","authors":"Pamela Chia, S. Cheng, Sze-Chin Tan, B. Sng","doi":"10.1177/20101058221144114","DOIUrl":"https://doi.org/10.1177/20101058221144114","url":null,"abstract":"Morbidly obese obstetric patients present multiple challenges to the anaesthetist for labour analgesia and anaesthesia for caesarean section. The superiority of regional anaesthesia (RA) using local anaesthetics (LA) to all other techniques in the obese parturient, as well as avoiding complications of general anaesthesia (GA) in a caesarean delivery makes LA allergy in parturients an important issue. We report the first known case of lignocaine allergy in a morbidly obese parturient.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48621569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1177/20101058221111577
Bernice X Lee, Joyce C Tiew, Jovan G Lim, D. Sani, Clement C Yan, S. Patman, Melissa Y Chan, M. Yeung
Background Physiotherapists play a crucial role in rehabilitating critically ill patients in intensive care units (ICU). However, variations are found in clinical practice amongst physiotherapists working in the ICU, both locally and internationally, due to the lack of minimum clinical standards and varying knowledge on critical care rehabilitation resulting in inconsistent quality of care. Purpose To establish a framework of the minimum standards of clinical practice for physiotherapists working in ICU in Singapore and compare the standards with existing literature. Methods A three-round modified Delphi questionnaire survey technique collated responses from ICU physiotherapists. The questionnaire contained 222 items, categorised into assessments, conditions and treatments. Responses to the items were either: “Yes, it is essential”, “No, it is not essential”, or “I am not sure”. Consensus for an item was reached when 70% of participants ranked it essential or non-essential. Participants comprised registered physiotherapists who have worked in the ICU for at least six months in the last 12 months and are currently working in the ICU. Results 23 physiotherapists (median ICU-experience 7.0 (4.3–9.8) years) gave consent and completed the initial survey. 13 completed all three rounds of questionnaires. Overall, 163 items were regarded as essential, 21 as non-essential, and 38 did not reach consensus. The identified 163 items varied from similar studies due to different scopes of physiotherapy practice and professional autonomy. Conclusion This framework may guide the content of the physiotherapy education curriculum on critical care rehabilitation and minimise variability in clinical practice across different healthcare institutions in Singapore.
{"title":"Minimum standards of clinical practice for physiotherapists working in adult intensive care units in Singapore","authors":"Bernice X Lee, Joyce C Tiew, Jovan G Lim, D. Sani, Clement C Yan, S. Patman, Melissa Y Chan, M. Yeung","doi":"10.1177/20101058221111577","DOIUrl":"https://doi.org/10.1177/20101058221111577","url":null,"abstract":"Background Physiotherapists play a crucial role in rehabilitating critically ill patients in intensive care units (ICU). However, variations are found in clinical practice amongst physiotherapists working in the ICU, both locally and internationally, due to the lack of minimum clinical standards and varying knowledge on critical care rehabilitation resulting in inconsistent quality of care. Purpose To establish a framework of the minimum standards of clinical practice for physiotherapists working in ICU in Singapore and compare the standards with existing literature. Methods A three-round modified Delphi questionnaire survey technique collated responses from ICU physiotherapists. The questionnaire contained 222 items, categorised into assessments, conditions and treatments. Responses to the items were either: “Yes, it is essential”, “No, it is not essential”, or “I am not sure”. Consensus for an item was reached when 70% of participants ranked it essential or non-essential. Participants comprised registered physiotherapists who have worked in the ICU for at least six months in the last 12 months and are currently working in the ICU. Results 23 physiotherapists (median ICU-experience 7.0 (4.3–9.8) years) gave consent and completed the initial survey. 13 completed all three rounds of questionnaires. Overall, 163 items were regarded as essential, 21 as non-essential, and 38 did not reach consensus. The identified 163 items varied from similar studies due to different scopes of physiotherapy practice and professional autonomy. Conclusion This framework may guide the content of the physiotherapy education curriculum on critical care rehabilitation and minimise variability in clinical practice across different healthcare institutions in Singapore.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47656619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1177/20101058221117894
Eng Koon Ong
The medical humanities have the potential to develop empathy in junior doctors through perspective taking and critique of deep-seated beliefs. An education intervention to develop empathy was integrated into an internal medicine residency curriculum in Singapore. All junior residents currently in the programme were invited to participate in individual interviews after the humanities sessions. Data collected was analysed qualitatively using thematic analysis. A total of three sessions were conducted over one year from April 2020. Two participants were recruited successfully for the study. A total of 4 interviews were completed and themes relating to the role of the humanities in empathy education, barriers to its implementation, and cynicism to the sessions were elicited. The results provided insight about how residents experienced a novel humanities-based postgraduate medical education program. However, the low recruitment is a major limitation in this study and data collected may not be confidently interpreted. There is still significant work needed to create greater awareness about the role of the humanities in medical education and research. Improvement in the pandemic situation may also improve participation in future studies.
{"title":"Insight from a novel humanities-based education intervention to teach empathy to internal medicine residents locally","authors":"Eng Koon Ong","doi":"10.1177/20101058221117894","DOIUrl":"https://doi.org/10.1177/20101058221117894","url":null,"abstract":"The medical humanities have the potential to develop empathy in junior doctors through perspective taking and critique of deep-seated beliefs. An education intervention to develop empathy was integrated into an internal medicine residency curriculum in Singapore. All junior residents currently in the programme were invited to participate in individual interviews after the humanities sessions. Data collected was analysed qualitatively using thematic analysis. A total of three sessions were conducted over one year from April 2020. Two participants were recruited successfully for the study. A total of 4 interviews were completed and themes relating to the role of the humanities in empathy education, barriers to its implementation, and cynicism to the sessions were elicited. The results provided insight about how residents experienced a novel humanities-based postgraduate medical education program. However, the low recruitment is a major limitation in this study and data collected may not be confidently interpreted. There is still significant work needed to create greater awareness about the role of the humanities in medical education and research. Improvement in the pandemic situation may also improve participation in future studies.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48560226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1177/20101058221111580
Yam Hock Ng, Sa’adon B. Ibrahim, Y. Chai
Breast carcinoma is one of the most common carcinomas among women around the world. Most of the women with breast carcinoma will present with signs and symptoms of breast problems to the health facility. Upper limb swelling is one of the rare initial presentations although it is rather common in patients as a sequelae of breast carcinoma treatment. We herein would like to report a case where a post-menopausal female presented with left upper limb swelling with initial history suggestive of traumatic injury of biceps muscle. Subsequent investigations of ultrasound, mammography, biopsy sample of the left breast found that the left upper limb swelling was due to a newly diagnosed invasive lobular carcinoma of the breast, staging of cT4cN2Mx which caused a rapidly progressing stage 2 lymphedema of the left upper limb. Lymphedema of the upper limb is a common complication of breast carcinoma treatment, especially those who require axillary lymph nodes clearance. Breast carcinoma with initial presentation of lymphedema of the upper limb is rare. Due to the rare presentation, diagnosis of breast carcinoma can be delayed. Clinicians should have high awareness to exclude breast cancer when a patient presents with unilateral upper limb swelling.
{"title":"A case report of lymphedema as an unusual initial presentation of breast carcinoma","authors":"Yam Hock Ng, Sa’adon B. Ibrahim, Y. Chai","doi":"10.1177/20101058221111580","DOIUrl":"https://doi.org/10.1177/20101058221111580","url":null,"abstract":"Breast carcinoma is one of the most common carcinomas among women around the world. Most of the women with breast carcinoma will present with signs and symptoms of breast problems to the health facility. Upper limb swelling is one of the rare initial presentations although it is rather common in patients as a sequelae of breast carcinoma treatment. We herein would like to report a case where a post-menopausal female presented with left upper limb swelling with initial history suggestive of traumatic injury of biceps muscle. Subsequent investigations of ultrasound, mammography, biopsy sample of the left breast found that the left upper limb swelling was due to a newly diagnosed invasive lobular carcinoma of the breast, staging of cT4cN2Mx which caused a rapidly progressing stage 2 lymphedema of the left upper limb. Lymphedema of the upper limb is a common complication of breast carcinoma treatment, especially those who require axillary lymph nodes clearance. Breast carcinoma with initial presentation of lymphedema of the upper limb is rare. Due to the rare presentation, diagnosis of breast carcinoma can be delayed. Clinicians should have high awareness to exclude breast cancer when a patient presents with unilateral upper limb swelling.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46712955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01DOI: 10.1177/20101058221122305
Mansharan Kaur Chainchel Singh, P. S. Lai, Sabrilhakim Sidek, Mohamad Helmee Mohd Noor, S. N. Abdul Rashid, S. Siew
Background Stature estimation is important in medical investigations to identify victims and is most accurate using anatomical methods utilizing the entire skeleton. However, in cases of mass fatalities, it has been calculated using regression analysis formulas of different body parts. Radiology especially post-mortem computed tomography (PMCT) is increasingly being used in victim identification as it is non- invasive and allows for multi planar reconstruction. Methods This study aims to generate stature estimation formulae using regression analysis of the vertebral column incorporating population that form the Malaysian ancestry i.e. Malay, Chinese and Indian using PMCT. This was a retrospective study involving 115 subjects who had a PMCT. Subjects consisted of Malaysian males and females (92 males and 23 females) aged 18–70 years. Cervical length (CL), thoracic length (TL), lumbar length and the whole spine length (WSL) incorporating cervical, thoracic and lumbar length were compared against cadaveric length. Results Whole spine length had the highest correlation coefficient of 0.570 and showed highest correlation with cadaveric length among female subjects compared to males. Whole spine length amongst the Malay was the highest followed by the Chinese and Indian ethnic groups (r = 0.671, 0.629, 0.402). Conclusion Our study concluded that the use of WSL from PMCT images can be used for body height estimation amongst Malaysians. This study has also successfully generated population-specific database for Malaysian experts to perform stature estimation using measurements of the vertebral column.
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