This paper gives an overview of what the GP Partnership Programme (GPPP), an integrated care programme, has achieved over a span of ten years, since its implementation in 2003 by the Institute of Mental Health, a tertiary mental health institution in Singapore. The GPPP is a collaboration between the GPs and IMH, for the care and management of stable patients with mental illness in the community and primary care setting. Since 2003, more than 1300 patients have been referred through the GPPP to a team of 51 GP-Partners for continued care within the community.

Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurilemmoma ; diagnosis ; Rectal Neoplasms ; diagnosis ; Tomography, X-Ray Computed

Carcinoma ; diagnostic imaging ; secondary ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; Pancreatic Neoplasms ; diagnostic imaging ; secondary ; Ultrasonography

INTRODUCTIONThe Multiple Sclerosis International Quality of Life questionnaire (MusiQoL) is a self-administered, multi-dimensional, patient-based health-related quality of life (HRQoL) instrument. With increasing prevalence of multiple sclerosis (MS) in Asian countries, a valid tool to assess HRQoL in those patients is needed. The aim of this study was to evaluate patient acceptability, content validity and psychometric properties of an Asian version of the English MusiQoL in Singapore, Malaysia and India.

MATERIALS AND METHODSEnglish speaking patients older than 18 years of age with a defi nite diagnosis of MS were included. The self-administered survey material included the adapted HRQoL questionnaire, a validated generic HRQoL questionnaire: the short-form 36 (SF-36), as well as a checklist of 14 symptoms. We assessed the internal and external validity of the adapted MusiQoL.

RESULTSA total of 81 patients with MS were included in the study. The questionnaire was generally well accepted. In the samples from Malaysia and Singapore, all scales exhibited good internal consistency (Cronbach's alpha >0.70). Correlation to SF-36 was generally good, demonstrating high construct validity (P <0.001) in some aspects of the MusiQoL.

CONCLUSIONThe Asian adaptation of the English version of the MusiQoL in evaluating HRQoL seems to be a valid, reliable tool with adequate patient acceptability and internal consistency.

Activities of Daily Living ; Asia ; Female ; Health Surveys ; Humans ; India ; Language ; Malaysia ; Male ; Multiple Sclerosis ; drug therapy ; psychology ; Outcome Assessment (Health Care) ; Psychometrics ; standards ; Quality of Life ; psychology ; Singapore ; Statistics, Nonparametric ; Surveys and Questionnaires

COVID-19/prevention & control* ; COVID-19 Vaccines ; Health Personnel ; Humans ; Singapore ; Vaccination

Advance Care Planning ; ethics ; legislation & jurisprudence ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Decision Making ; ethics ; Female ; Humans ; Male ; Middle Aged ; Patient Preference ; statistics & numerical data ; Risk Assessment ; Singapore ; Terminal Care ; ethics ; methods ; Third-Party Consent ; ethics ; legislation & jurisprudence

AIM: To study the effects of Sodium Hyaluronate (HA) and Bion Tears on corneal thickness in adult myopic patients.METHODS: A total of 38 cases (76 eyes) were involved in this study. Three consecutive corneal measurements (the thinnest point of the cornea,THN) were evaluated before and half an hour after the instillation of one drop of HA in one eye and Bion Tears in the other at random with the Orbscan Corneal Topography System II (Orbscan,Inc,Salt Lake City,UT,USA,Version 3.00E).RESULTS: There were no significant between-group differences in baseline variable (t=0.264). Thirty minutes after the instillation of HA and Bion tears,THN were significantly increased by 5.57±7.00μm (t=4.906,P<0.01) and 7.89±7.64μm (t=6.369,P<0.01) respectively. However,there were no between-group differences in THN changes(t=1.381,P>0.05).Increase in the corneal thickness were found in 32 eyes (84%) and 33 eyes (87%) for the HA and Bion tears group,respectively.CONCLUSION: Artificial tears including HA and Bion Tears can significantly increase the corneal thickness in a short period of time. Corneal thickness can be used as one of the objective indices for evaluating the quality and therapeutic role of artificial tears.

INTRODUCTIONThe near terminal patient with skeletal metastasis may suitably be palliated with an intramedullary nail whereas another patient with good survival potential may benefit from a more extensive resection and reconstructive procedure. In a previous study by the senior author (Nathan et al, 2005), life expectancy in patients operated on for bone metastases correlated with clinical and haematological parameters in a normogram. We performed a cross-cultural comparison to validate this normogram.

MATERIALS AND METHODSWe randomly selected 73 patients who had undergone surgery for metastatic bone disease between 28 December 2000 and 11 March 2009. The time to deaths was recorded from hospital records and telephone interviews. Multiple parameters including clinical, radiological and haematological were evaluated for significant prognostic value using Kaplan-Meier survivorship analysis. Statistically significant parameters were entered into a Cox regression model for statistically independent significance. A multi-tier prediction of survival was performed by workers from various levels of seniority.

RESULTSAt the time of analysis, there were 40 deaths (55%). Median survival was 15.8 (95% CI, 7.9 to 23.7) months. Kaplan-Meier analysis showed that low haemoglobin (P = 0.0000005), presence of lymph node metastases (P = 0.00008), multiple bone metastases (P = 0.003), presence of visceral metastases, (P = 0.007), low lymphocyte count (P = 0.02) and low serum albumin (P = 0.02) were significantly associated with poor survival. By Cox regression analysis, presence of visceral metastases (P = 0.002), presence of lymph node metastases (P = 0.0002) and low haemoglobin (P = 0.01) were shown to be independent factors in the prediction of survival. Survivorship readings were superimposed onto the previous normogram and found to be similar. Independent blinded use of the normogram allowed good prediction of survival. There was a tendency to underestimate survival when patients survived beyond 1 year of skeletal metastasis.

CONCLUSIONOur findings are similar to that of the previous study in showing a relationship between the above-mentioned parameters and survival. This is despite differences in patient demographic characteristics and management protocols. Use of the tools may allow better siting of most appropriate surgery in metastatic bony disease.

Bone Neoplasms ; mortality ; surgery ; Decision Support Systems, Clinical ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Survival Analysis ; Terminal Care