Pub Date : 2024-01-01DOI: 10.1177/20101058231224488
Trina Arifin, W. Ong, Yu Ling Juliana Chia, Agnes Lai Yin Chow, Anupama Roy Chowdhury, Johan Chan, Wei Chong Tan, M. B. Ramalingam, T. Rajasekaran, Tira J Tan, L. Krishna, O. Lai, S. Chen, R. Kanesvaran
Geriatric assessment (GA) has been shown to be pivotal to the prognosis of elderly cancer patients. A G8 screening tool could act as a potential surrogate to identify patients who would benefit from further GA in a busy oncology clinic and a digital version would allow for a wider application. To develop a digital self-reported version of G8, and to compare its outcomes with in-person G8 administered by a healthcare professional. A total of 483 cancer patients aged 70 years and older who received an in-person G8 assessment at the National Cancer Centre Singapore (NCCS) clinic, and another 544 who completed the digital self-reported G8 were analysed. Total G8 score ≤14 was defined as positive screen. Response rate of the digital self-reported G8 was 50%. Median G8 total score was lower among online screeners than in-person screeners (11 vs 12.5, p < 0.001). The odds of a G8 positive screen among online screeners was higher than that of in-person screeners on multivariable logistic regression analysis (odds ratio = 1.56, 95% CI 1.08-2.26). Some 20 in-person screeners had also completed the digital self-reported G8, and the agreement between their in-person and online G8 total scores was high (concordance correlation coefficient = 0.798, 95% CI 0.635-0.962). A digital self-reported G8 is feasible. However, given the higher positive screen rate among the online screeners, replacement of the in-person G8 with the digital self-reported G8 should be implemented only after more conclusive evidence on the agreement between in-person and online G8 score is available.
{"title":"A digital self-reported G8 screening tool: A comparison study","authors":"Trina Arifin, W. Ong, Yu Ling Juliana Chia, Agnes Lai Yin Chow, Anupama Roy Chowdhury, Johan Chan, Wei Chong Tan, M. B. Ramalingam, T. Rajasekaran, Tira J Tan, L. Krishna, O. Lai, S. Chen, R. Kanesvaran","doi":"10.1177/20101058231224488","DOIUrl":"https://doi.org/10.1177/20101058231224488","url":null,"abstract":"Geriatric assessment (GA) has been shown to be pivotal to the prognosis of elderly cancer patients. A G8 screening tool could act as a potential surrogate to identify patients who would benefit from further GA in a busy oncology clinic and a digital version would allow for a wider application. To develop a digital self-reported version of G8, and to compare its outcomes with in-person G8 administered by a healthcare professional. A total of 483 cancer patients aged 70 years and older who received an in-person G8 assessment at the National Cancer Centre Singapore (NCCS) clinic, and another 544 who completed the digital self-reported G8 were analysed. Total G8 score ≤14 was defined as positive screen. Response rate of the digital self-reported G8 was 50%. Median G8 total score was lower among online screeners than in-person screeners (11 vs 12.5, p < 0.001). The odds of a G8 positive screen among online screeners was higher than that of in-person screeners on multivariable logistic regression analysis (odds ratio = 1.56, 95% CI 1.08-2.26). Some 20 in-person screeners had also completed the digital self-reported G8, and the agreement between their in-person and online G8 total scores was high (concordance correlation coefficient = 0.798, 95% CI 0.635-0.962). A digital self-reported G8 is feasible. However, given the higher positive screen rate among the online screeners, replacement of the in-person G8 with the digital self-reported G8 should be implemented only after more conclusive evidence on the agreement between in-person and online G8 score is available.","PeriodicalId":509768,"journal":{"name":"Proceedings of Singapore Healthcare","volume":"59 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139394497","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 : 2024-01-01DOI: 10.1177/20101058231224492
Youxiang Jonathan Han, Xinyi Li, Wei Sian Wileen Lim, Linghui Belinda Huang, Manisha Mathur
With the advent of augmented reality (AR), our team developed a prototype teaching module using the abdominal hysterectomy as a case study for the teaching of in-depth pelvic anatomy and the steps for performing a hysterectomy. Through this interactive module, trainees will be able to identify and fill knowledge gaps in pelvic anatomy with the benefit of spatial visualisation, and familiarise themselves with the steps of performing a hysterectomy in a safe controlled setting. The prototype teaching module has eight sections, each with its specific aims, objectives and multiple choice questions to assess the participant’s knowledge and understanding. The scores will be tabulated and a final report will be generated upon completion of the entire module. This includes the breakdown of the scores, mistakes identified and recommended suggestions to facilitate learning. Following completion of the prototype teaching module, we aim to carry out a trial on our residents and assess its effects on self-perceived preparedness, knowledge and impact on training. We believe that this can translate to better awareness with reduced errors in surgery and ultimately better patient outcomes and safety. Our new prototype teaching module promises to be well-received, relevant and will take our training to a new level. There is enormous potential in using AR technology to provide realistic, interactive and safe training and this can be harnessed for the future development of other modules in the O&G curriculum.
随着增强现实技术（AR）的出现，我们的团队开发了一个原型教学模块，以腹部子宫切除术为案例，深入讲授盆腔解剖学和子宫切除术的操作步骤。通过这一互动模块，学员将能够利用空间可视化的优势，发现并填补盆腔解剖学方面的知识空白，并熟悉在安全可控的环境中实施子宫切除术的步骤。原型教学模块有八个部分，每个部分都有具体的目的、目标和选择题，以评估学员的知识和理解能力。在完成整个模块后，将对分数进行统计并生成最终报告。报告内容包括分数明细、发现的错误和促进学习的建议。教学模块原型完成后，我们将在住院医师中进行试验，评估其对自我认知准备、知识和培训影响的效果。我们相信，这将有助于提高意识，减少手术中的失误，最终改善患者的治疗效果和安全性。我们的新教学模块原型将广受欢迎，并将把我们的培训提升到一个新的水平。利用 AR 技术提供逼真、互动和安全的培训具有巨大的潜力，我们可以将其用于今后开发泌尿外科课程的其他模块。
{"title":"Harnessing augmented reality technology for medical education – a virtual abdominal hysterectomy","authors":"Youxiang Jonathan Han, Xinyi Li, Wei Sian Wileen Lim, Linghui Belinda Huang, Manisha Mathur","doi":"10.1177/20101058231224492","DOIUrl":"https://doi.org/10.1177/20101058231224492","url":null,"abstract":"With the advent of augmented reality (AR), our team developed a prototype teaching module using the abdominal hysterectomy as a case study for the teaching of in-depth pelvic anatomy and the steps for performing a hysterectomy. Through this interactive module, trainees will be able to identify and fill knowledge gaps in pelvic anatomy with the benefit of spatial visualisation, and familiarise themselves with the steps of performing a hysterectomy in a safe controlled setting. The prototype teaching module has eight sections, each with its specific aims, objectives and multiple choice questions to assess the participant’s knowledge and understanding. The scores will be tabulated and a final report will be generated upon completion of the entire module. This includes the breakdown of the scores, mistakes identified and recommended suggestions to facilitate learning. Following completion of the prototype teaching module, we aim to carry out a trial on our residents and assess its effects on self-perceived preparedness, knowledge and impact on training. We believe that this can translate to better awareness with reduced errors in surgery and ultimately better patient outcomes and safety. Our new prototype teaching module promises to be well-received, relevant and will take our training to a new level. There is enormous potential in using AR technology to provide realistic, interactive and safe training and this can be harnessed for the future development of other modules in the O&G curriculum.","PeriodicalId":509768,"journal":{"name":"Proceedings of Singapore Healthcare","volume":" 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139393277","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 : 2024-01-01DOI: 10.1177/20101058241227335
NC Tan, CC Goh, Yle Koh, Sfi Tan, D. Ponraj, ZQ Luo
Poor medication adherence (MA) is prevalent globally. MA assessment, often based on scales or pill count, lacks actionability. A mobile application (app), MediEasy, targeting patients on multiple daily medications, has been developed to engage their caregivers to enhance their MA. This pilot single-arm study aimed to determine the feasibility, acceptability, utility and glycaemic control of the MediEasy-app by patients with type-2 diabetes mellitus and their caregivers. 20 Multi-ethnic Asian patients aged 51 to 70 years with suboptimal glycaemic control (HbA1c>7.5%) and their caregivers were recruited at a Primary care outpatient clinic in Singapore. The Medieasy app that contains the following major functionalities such as the alerts to take medications, embedded medication details, personalized dosing options (such as frequency and scheduling dosage settings) is twinned to their designated caregivers. The Caregivers can remind the patients who missed the scheduled medication intake when the paired device was alerted. 85% (17/20) of the participants used the app for the entire 4 weeks, reflecting feasibility; 3 dropped out due to technical glitches or failure to adhere to protocol. The app was activated with an average of 2.8 times per day showing adequate utility. The 17 participants and their caregivers agreed that the app supported medication adherence. Their mean HbA1c decreased by 0.2% after 12 weeks of app usage. The results showed feasibility, utility and acceptability of the MediEasy-app, with improved glycaemic control after its usage.
{"title":"Patient-caregiver twinned mobile phone application to promote medication adherence","authors":"NC Tan, CC Goh, Yle Koh, Sfi Tan, D. Ponraj, ZQ Luo","doi":"10.1177/20101058241227335","DOIUrl":"https://doi.org/10.1177/20101058241227335","url":null,"abstract":"Poor medication adherence (MA) is prevalent globally. MA assessment, often based on scales or pill count, lacks actionability. A mobile application (app), MediEasy, targeting patients on multiple daily medications, has been developed to engage their caregivers to enhance their MA. This pilot single-arm study aimed to determine the feasibility, acceptability, utility and glycaemic control of the MediEasy-app by patients with type-2 diabetes mellitus and their caregivers. 20 Multi-ethnic Asian patients aged 51 to 70 years with suboptimal glycaemic control (HbA1c>7.5%) and their caregivers were recruited at a Primary care outpatient clinic in Singapore. The Medieasy app that contains the following major functionalities such as the alerts to take medications, embedded medication details, personalized dosing options (such as frequency and scheduling dosage settings) is twinned to their designated caregivers. The Caregivers can remind the patients who missed the scheduled medication intake when the paired device was alerted. 85% (17/20) of the participants used the app for the entire 4 weeks, reflecting feasibility; 3 dropped out due to technical glitches or failure to adhere to protocol. The app was activated with an average of 2.8 times per day showing adequate utility. The 17 participants and their caregivers agreed that the app supported medication adherence. Their mean HbA1c decreased by 0.2% after 12 weeks of app usage. The results showed feasibility, utility and acceptability of the MediEasy-app, with improved glycaemic control after its usage.","PeriodicalId":509768,"journal":{"name":"Proceedings of Singapore Healthcare","volume":"5 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139632065","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 : 2024-01-01DOI: 10.1177/20101058241227353
Christel Li Hui Chue, Kimberly Wanxian Soh, Nurul Jannah Mohamed Alias, J. Loo
Speech audiometry is utilised for diagnostic and rehabilitative purposes. Speech audiometry involves materials linguistic in nature. The ideal protocol is to have a tester who is a native or at least a fluent speaker of that language to conduct the test on a native listener. Except for a set of psychometrically equivalent word recordings that have yet to be validated, no other existing speech audiometry materials have been developed in Singapore English. This study aims to develop and validate a local set of phonemically balanced English word lists for use on Singaporeans. The first phase encompassed the development of spondaic and phonemically-balanced monosyllabic word lists for Speech Reception Threshold (SRT) and Word Recognition Score (WRS) testing. The second phase established perceptual equivalence across the monosyllabic word lists. The third phase encompassed the validation of these materials on 72 normal-hearing and hearing-impaired Singaporeans between 21 to 80 years old. Participants were tested with two spondaic and six monosyllabic word lists. Participants’ SRT and WRS values were analysed. The mean SRT and pure tone audiometry (PTA) average difference was 5.79 dB. All 43 normal-hearing participants achieved a maximum WRS of 100%, at an average presentation level of 28.1 dB above their PTA average. Test-retest analysis revealed clinically insignificant differences across all word lists. The test materials are validated to be suitable for testing on Singaporean English speakers. Normative SRT and WRS data for Singaporeans have also been established.
{"title":"Development of Singapore English speech audiometry test materials","authors":"Christel Li Hui Chue, Kimberly Wanxian Soh, Nurul Jannah Mohamed Alias, J. Loo","doi":"10.1177/20101058241227353","DOIUrl":"https://doi.org/10.1177/20101058241227353","url":null,"abstract":"Speech audiometry is utilised for diagnostic and rehabilitative purposes. Speech audiometry involves materials linguistic in nature. The ideal protocol is to have a tester who is a native or at least a fluent speaker of that language to conduct the test on a native listener. Except for a set of psychometrically equivalent word recordings that have yet to be validated, no other existing speech audiometry materials have been developed in Singapore English. This study aims to develop and validate a local set of phonemically balanced English word lists for use on Singaporeans. The first phase encompassed the development of spondaic and phonemically-balanced monosyllabic word lists for Speech Reception Threshold (SRT) and Word Recognition Score (WRS) testing. The second phase established perceptual equivalence across the monosyllabic word lists. The third phase encompassed the validation of these materials on 72 normal-hearing and hearing-impaired Singaporeans between 21 to 80 years old. Participants were tested with two spondaic and six monosyllabic word lists. Participants’ SRT and WRS values were analysed. The mean SRT and pure tone audiometry (PTA) average difference was 5.79 dB. All 43 normal-hearing participants achieved a maximum WRS of 100%, at an average presentation level of 28.1 dB above their PTA average. Test-retest analysis revealed clinically insignificant differences across all word lists. The test materials are validated to be suitable for testing on Singaporean English speakers. Normative SRT and WRS data for Singaporeans have also been established.","PeriodicalId":509768,"journal":{"name":"Proceedings of Singapore Healthcare","volume":"33 s1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139633160","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 : 2024-01-01DOI: 10.1177/20101058241227358
Jonathan Gao, P. Lun, Jia Ying Tang, Khalid Abdul Jabbar, Pradeep Paul George, Philip Yap
Studies on caregiving burden in Singapore typically focus on issues at a personal or micro level. There is a paucity of research focused at a meso or macro level on caregiving. The purpose of this narrative review is to explore the influence of meso and macro factors on caregiving by informal caregivers of older persons in Singapore. Studies were identified from sources such as CINAHL, PsycINFO, PubMed, Scopus, Web of Science, Google Scholar, as well as other websites for grey literature. Studies focusing on informal caregivers, defined as family, friends, or foreign domestic workers providing care to an older adult (60 and above) were included. Other inclusion criteria include: (a) studies focusing on meso factors (e.g., social norms, community resource, social network) and/or studies focusing on macro factors (e.g., caregiver support policies, workplace policies, care services policies, or caregiver payment policies), (b) studies with outcome measures on caregivers/caregiving such as burden, gains, or grief, and (c) in Singapore. A total of 43 studies were included in this review. A range of meso factors influencing caregivers/caregiving were identified. Examples include filial piety, norm of women as caregivers, interventions aimed at helping caregivers, and care services such as day cares. However, the influence of macro level factors (e.g., national level policies) was limited due to a relative paucity of research in this area. Areas for further research were also identified.
{"title":"The influence of meso and macro factors on caregiving of older persons in Singapore: A narrative review","authors":"Jonathan Gao, P. Lun, Jia Ying Tang, Khalid Abdul Jabbar, Pradeep Paul George, Philip Yap","doi":"10.1177/20101058241227358","DOIUrl":"https://doi.org/10.1177/20101058241227358","url":null,"abstract":"Studies on caregiving burden in Singapore typically focus on issues at a personal or micro level. There is a paucity of research focused at a meso or macro level on caregiving. The purpose of this narrative review is to explore the influence of meso and macro factors on caregiving by informal caregivers of older persons in Singapore. Studies were identified from sources such as CINAHL, PsycINFO, PubMed, Scopus, Web of Science, Google Scholar, as well as other websites for grey literature. Studies focusing on informal caregivers, defined as family, friends, or foreign domestic workers providing care to an older adult (60 and above) were included. Other inclusion criteria include: (a) studies focusing on meso factors (e.g., social norms, community resource, social network) and/or studies focusing on macro factors (e.g., caregiver support policies, workplace policies, care services policies, or caregiver payment policies), (b) studies with outcome measures on caregivers/caregiving such as burden, gains, or grief, and (c) in Singapore. A total of 43 studies were included in this review. A range of meso factors influencing caregivers/caregiving were identified. Examples include filial piety, norm of women as caregivers, interventions aimed at helping caregivers, and care services such as day cares. However, the influence of macro level factors (e.g., national level policies) was limited due to a relative paucity of research in this area. Areas for further research were also identified.","PeriodicalId":509768,"journal":{"name":"Proceedings of Singapore Healthcare","volume":"46 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139640211","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 : 2024-01-01DOI: 10.1177/20101058241227356
Darren Lee, Li Qing Lim, J. Leow, L. Chew
On 1st September 2022, the Cancer Drug List (CDL) was implemented to ensure the long-term affordability of chemotherapy and insurance premiums. This project aimed to determine the financial impact of CDL on out-of-pocket expenses (OOPE), acceptability and financial toxicity (FT) after CDL implementation. A cross-sectional study was conducted at National Cancer Center Singapore. We analyzed OOPE before and after implementation of CDL by reviewing billing transactions in Aug-Sept 2022. Acceptability and FT were determined using theoretical framework of acceptability (TFA) and COmprehensive Score for financial Toxicity (COST) tool respectively via survey. Of the 314 patients finalized bills examined, majority (68.8%) experienced no change in their OOPE, and 69.1% had no OOPE. Most patients (72.6%) were unaware of implementation of CDL. Among patients aware of CDL, majority (61.9%) were accepting, but unsure on how it benefits them. FT was reported as low (mean COST score = 22.4 ± 9.9), and patients ≥65 years old or have at least pre-university education were less likely to experience FT. Despite best efforts from policymakers, it is challenging to achieve a one-size fits funding or subsidy framework that can cater to the needs of all patients. Some groups of patients would inevitably still experience high OOPE and FT due to their personal or clinical circumstances. Patients can be better empowered to seek financial assistance or resources.
{"title":"Assessing the financial impact of cancer drug list (CDL) implementation on patients receiving chemotherapy in an ambulatory cancer centre in Singapore","authors":"Darren Lee, Li Qing Lim, J. Leow, L. Chew","doi":"10.1177/20101058241227356","DOIUrl":"https://doi.org/10.1177/20101058241227356","url":null,"abstract":"On 1st September 2022, the Cancer Drug List (CDL) was implemented to ensure the long-term affordability of chemotherapy and insurance premiums. This project aimed to determine the financial impact of CDL on out-of-pocket expenses (OOPE), acceptability and financial toxicity (FT) after CDL implementation. A cross-sectional study was conducted at National Cancer Center Singapore. We analyzed OOPE before and after implementation of CDL by reviewing billing transactions in Aug-Sept 2022. Acceptability and FT were determined using theoretical framework of acceptability (TFA) and COmprehensive Score for financial Toxicity (COST) tool respectively via survey. Of the 314 patients finalized bills examined, majority (68.8%) experienced no change in their OOPE, and 69.1% had no OOPE. Most patients (72.6%) were unaware of implementation of CDL. Among patients aware of CDL, majority (61.9%) were accepting, but unsure on how it benefits them. FT was reported as low (mean COST score = 22.4 ± 9.9), and patients ≥65 years old or have at least pre-university education were less likely to experience FT. Despite best efforts from policymakers, it is challenging to achieve a one-size fits funding or subsidy framework that can cater to the needs of all patients. Some groups of patients would inevitably still experience high OOPE and FT due to their personal or clinical circumstances. Patients can be better empowered to seek financial assistance or resources.","PeriodicalId":509768,"journal":{"name":"Proceedings of Singapore Healthcare","volume":"134 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139537480","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 : 2024-01-01DOI: 10.1177/20101058241227338
Feng-Yi Cheo, Henry Soeharno, Y. L. Woo
The advent of 3-Dimensional (3D) printing technology is one of the most revolutionising breakthroughs of the generation. Its benefits in surgical practice are undeniable, however a steep learning curve and concerns regarding costs may pose a barrier to large scale implementation. We set up an in-house 3D printing facility in our institution and described our workflow. Using the described workflow, we 3D printed models which were used in the surgical management of three patients with differing conditions. We present three case examples to display the uses that 3D printing technology is able to provide in our experience, and show how 3D printing technology can be beneficial in the field of orthopaedic oncology and surgically complex cases. 3D printing has proven to be useful and improved quality of care in these case examples. The processes for each case were described individually. The benefits of our in-house 3D printing facility were discussed in detail. An in-house office 3D printing facility is advantageous and cost-efficient. Its benefits can be maximised if implemented on a larger scale and has the potential to be standard of care in many institutions.
三维（3D）打印技术的出现是当代最具革命性的突破之一。它在外科实践中的优势毋庸置疑，但陡峭的学习曲线和对成本的担忧可能会成为大规模应用的障碍。我们在本机构建立了内部 3D 打印设施，并介绍了我们的工作流程。利用所描述的工作流程，我们打印出了三维模型，并将其用于对三名病情不同的患者进行手术治疗。我们介绍了三个病例，以展示 3D 打印技术在我们的经验中所能提供的用途，并说明 3D 打印技术如何在骨科肿瘤学领域和手术复杂病例中发挥作用。事实证明，在这些病例中，3D 打印技术非常有用，而且提高了护理质量。每个病例的过程都有单独描述。详细讨论了我们内部 3D 打印设备的优势。办公室内部 3D 打印设备具有优势和成本效益。如果在更大范围内实施，其优势将最大化，并有可能成为许多机构的护理标准。
{"title":"Cost-effective office 3D printing process in orthopaedics and its benefits: A case presentation and literature review","authors":"Feng-Yi Cheo, Henry Soeharno, Y. L. Woo","doi":"10.1177/20101058241227338","DOIUrl":"https://doi.org/10.1177/20101058241227338","url":null,"abstract":"The advent of 3-Dimensional (3D) printing technology is one of the most revolutionising breakthroughs of the generation. Its benefits in surgical practice are undeniable, however a steep learning curve and concerns regarding costs may pose a barrier to large scale implementation. We set up an in-house 3D printing facility in our institution and described our workflow. Using the described workflow, we 3D printed models which were used in the surgical management of three patients with differing conditions. We present three case examples to display the uses that 3D printing technology is able to provide in our experience, and show how 3D printing technology can be beneficial in the field of orthopaedic oncology and surgically complex cases. 3D printing has proven to be useful and improved quality of care in these case examples. The processes for each case were described individually. The benefits of our in-house 3D printing facility were discussed in detail. An in-house office 3D printing facility is advantageous and cost-efficient. Its benefits can be maximised if implemented on a larger scale and has the potential to be standard of care in many institutions.","PeriodicalId":509768,"journal":{"name":"Proceedings of Singapore Healthcare","volume":"17 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139539674","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 : 2024-01-01DOI: 10.1177/20101058241227334
Mingwei Ng, R. Ponampalam
{"title":"Characteristics of adverse drug reactions to N-acetylcysteine for paracetamol overdose in a tertiary Institution in Singapore","authors":"Mingwei Ng, R. Ponampalam","doi":"10.1177/20101058241227334","DOIUrl":"https://doi.org/10.1177/20101058241227334","url":null,"abstract":"","PeriodicalId":509768,"journal":{"name":"Proceedings of Singapore Healthcare","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139637604","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 : 2024-01-01DOI: 10.1177/20101058241227345
Chin Kwang Chong, Wei Ting Chua, Susie Ling Yii Wong, T. Y. Tham
The Agency for Care Effectiveness of Singapore has advised primary care physicians to use osteoporosis screening tools to risk-stratify patients in the primary care setting. This paper aims to report the uptake of a “Predict and Prevent” workflow for osteoporosis using risk scoring and BMD measurement in patients with chronic diseases seen in a network of primary care clinics in Singapore from 2020 to 2021. A “Predict and Prevent” osteoporosis preventive care programme was implemented at a network of 11 primary care clinics. The programme included all adult patients that consulted at the clinic for a chronic condition. OSTA score was computed for each patient. All patients who consented to further fracture risk screening underwent FRAX scoring. Female patients with a high-risk OSTA score and females with diabetes with intermediate-risk OSTA score (per protocol), or those with high-risk FRAX score were recommended to undergo BMD measurement. Of the 6,332 adult patients with chronic diseases without baseline osteoporosis seen in the various clinics, 81.1% underwent OSTA scoring; 28.1% were intermediate risk and 7.0% were high risk. Among the per-protocol population ( n = 531), 38 (7.1%) underwent BMD testing. FRAX scoring (without BMD) was done on 939 patients (17.3%); 31.5% had a high hip fracture risk. Only 14 patients had FRAX with BMD; 57.1% had a high hip fracture risk. A “Predict and Prevent” workflow could be implemented to screen, detect and potentially treat patients at high risk of osteoporosis. The rate of BMD measurement is low and needs to be improved.
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