Children and adolescents who have sustained a traumatic brain injury (TBI) may be left with multiple deficits and impairments that can impact adversely their abilities to return to premorbid functioning in the home, school and community. Early rehabilitation has been shown to improve functional outcome; the rehabilitation programme itself has to be based on real-world demands and experiences. Rehabilitation has to be continued beyond the post-acute stage in order to promote neuronal re-organisation, monitor the child's development as well as identify and manage new issues that may appear with growth, development and maturation. The availability of relevant research data and findings for children is much less than those for adults. It is not always appropriate to apply data for adults to the younger persons due to important differences in the 2 groups and these are discussed in more detail in the article. Multiple factors have been found to affect recovery and functional outcome. Apart from age and developmental stage at injury, other variables can be grouped as injury-related, patient-related and treatment-related factors. The goals and components of the rehabilitation process are examined for the various stages of recovery and the last section of the article describes the paediatric rehabilitation scene in Singapore.
Adolescent ; Brain ; physiopathology ; Brain Injuries ; epidemiology ; physiopathology ; rehabilitation ; Child ; Humans ; Neuronal Plasticity ; Recovery of Function

INTRODUCTIONHypertension is a common chronic condition usually managed by primary-care practitioners in Singapore. This study assessed the characteristics, control and complications of non-diabetic hypertensive patients managed at government primary healthcare clinics.

MATERIALS AND METHODSA cross-sectional study involving 9 clinics was conducted over 1-week in 2006. Five hundred and six non-diabetic hypertensive patients were systematically sampled from all clinic attendees. Data relating to socio-demographic, lifestyle factors, treatment and complications were collected by interviewer-administered questionnaires and review of clinic medical records. Blood pressure (BP) measurements were taken with validated automated sets following a standard protocol.

RESULTSThe prevalence of good BP control (<140/90 mmHg) was 37.7% (95% CI: 33.6% to 41.8%). Ninety seven percent were on medication with about half on monotherapy. Seventy percent of patients had a body mass index (BMI) of 23.0 kg/m(2) or higher, 64% did not exercise regularly and 8% were current smokers. After adjusting for age and lifestyle factors, male hypertensive patients had poorer BP control compared to females. Nineteen percent of patients reported at least 1 complication of hypertension, especially cardiac disease. After multivariate analysis and duration of disease, age and the male gender were associated with the presence of hypertensive complications.

CONCLUSIONSMore than half of the patients were not controlled to target levels. Male patients were more likely to have poorer control of hypertension and significantly higher risks of complications. Control of BP could be further improved by lifestyle modifications - weight reduction, promotion of physical activity, healthier eating habits and smoking cessation.

Aged ; Blood Pressure ; Body Mass Index ; Community-Based Participatory Research ; Confidence Intervals ; Cross-Sectional Studies ; Diet, Reducing ; Female ; Humans ; Hypertension ; complications ; diagnosis ; epidemiology ; prevention & control ; Life Style ; Male ; Middle Aged ; Motor Activity ; Multivariate Analysis ; Prevalence ; Primary Health Care ; statistics & numerical data ; Risk ; Sex Factors ; Singapore ; epidemiology ; Surveys and Questionnaires ; Weight Loss

COVID-19 ; Humans ; Pandemics ; Reproduction ; SARS-CoV-2 ; Singapore/epidemiology*

Background: Physical examination in nursing practice is a systematic process of checking patients from head to toe using inspection, palpation, percussion, and auscultation techniques. This is part of a process to assist nurses in determining nursing diagnoses for patients’ care needs. A trained nurse with competent assessment skills can monitor treatment outcome and rapidly detect early signs of deterioration in patients. Objective: The purpose of this study was to determine the perceived personal competence, the frequency of use of physical examination techniques, the factors that influenced physical examination practices and to identify training needs on physical examination skills among the registered nurses (RNs) in a selected private hospital in Malaysia. Methods: This is a cross-sectional descriptive study. A self-reporting questionnaire was adapted with permission and pilot tested to ensure its suitability for use in this local study. A total of 154 registered nurses (RNs) from various clinical areas responded to this survey. Results: The regularly used physical examination techniques by the RNs were mostly inspection and vital signs assessment. The frequency of physical examination skills used was higher among RNs with 4-5 years of working experience. Lack of time, role boundaries/scope of practice and ward culture were some of the factors identified that influenced nurses’ physical examination practices. Physical examinations of the cardiovascular, neurological and respiratory systems were the top three skills asserted as training needs by the RNs. Conclusions Inspection technique and vital signs checking are commonly practiced at ease by the RNs, but they perceived that they were least competent with palpation, percussion and auscultation techniques. Physical examination training is vital to ensure that the RNs keep their skills current in their nursing practice.

Aims: Plant growth-promoting bacteria are the key components of a biofertilizer. This study was aimed to isolate and identify the predominant bacteria found in a foliar biofertilizer and characterizes the potential of the bacterial isolates as plant growth promoters. Methodology and results: Potential bacteria with plant growth-promoting activities were isolated from a foliar biofertilizer on HiCrome™ Bacillus agar and Nutrient agar. Bacteria with unique colonial morphology were selected and categorized by Gram’s differential staining. Subsequently, the bacterial isolates were being further characterized for plant growth-promoting potentials, such as the production of indole acetic acid (IAA), 1-aminocyclopropane-1-carboxylate (ACC) deaminase and siderophore; as well as the ability of nitrogen fixation and phosphate/potassium solubilization. Based on the characterized traits, three bacterial isolates, namely M17, M22 and M52 showed great potential for being a plant growth promoter. Based on their 16S rRNA gene sequence analysis, M17, M22 and M52 were identified as Leclercia adecarboxylata, Margalitia shackletonii and Lysinibacillus pakistanensis, respectively. Conclusion, significance and impact of study Bacterial isolates exhibiting plant growth-promoting activities were successfully isolated from a biofertilizer and identified in this study. This finding provides an insight into the potential bacteria of a foliar fertilizer that may promote plant growth. Identification of these plant-growth promoters may help the scientists and agrochemical manufacturers to determine and disclose the key microorganisms of their biofertilizers, thereby contributing to the improvement of biofertilizers and promoting them as reliable alternatives to chemical fertilizers.
Bacteria--isolation & ; purification ; Fertilizers--microbiology

Introduction: Self-assessment is a mechanism to evaluate one’s own performance and identify strengths and weaknesses. However, there is paucity of information on the the validity of self-assessment in the literature. This study is planned to assess the validity of medical students’ self-assessment skills in clinical examinations with long case during their postings in Obstetrics and Gynaecology. Methods: A cross sectional study was conducted during Obstetrics and Gynaecology (O&G) rotation assessing the students performance in the clinical long case examination. Participants were 80 fourth year medical students who were in their last week of their O&G rotation between August and December 2019. Each student was given a random case from the obstetric ward for the clinical long case examination during their final week of posting. At the end of examination, both student and examiner were tasked to independently evaluate the performance with a standardized grading sheet. Students were assessed in three areas namely Case Presentation (4 items), Case Discussion (4 items) and Professionalism and Overall approach to the practice of medicine (2 items). Results: The correlation coefficient was identified to be 0.307, p<0.01, indicating validity in self-assessment in the context of a clinical examination. The overall bias index was -0.97. Students underrated themselves in all areas with bias indexes of -0.35 in case presentation, -0.26 for case discussion and -0.35 in the professionalism and overall approach to practice. The correlation coefficients were 0.186, 0.360 and 0.170 respectively, indicating that in isolation only the component of case discussion showed significant correlation (p<0.01). Conclusion: Self-assessment in clinical examination is shown to be a valid assessment method when multiple assessment items are combined.

Aims: Expression of recombinant proteins across a range of different host organisms has profound contribution to the advancement in biotechnology. In this study, we aimed to construct a highly versatile broad host range (BHR) expression vector, designated as pYL101C. Methodology and results: The Golden Gate cloning approach was used to construct pYL101C. Key features of pYL101C include a strong integron promoter (PINTc), a BHR pBBR1 origin of replication (ori), gentamycin resistance gene (GmR) as a selectable marker and a multiple cloning site (MCS) downstream of the promoter for easy-cloning purpose. To verify the functionality of pYL101C, we cloned the superfolder green fluorescent protein (sfGFP) reporter gene into pYL101C and transferred the resultant recombinant plasmid pYL101C::sfGFP into various Gram-negative bacteria. Transformants obtained stably expressed strong green fluorescence under blue light excitation even without selection after four passages. Conclusion, significance and impact of study The constructed BHR expression vector, pYL101C and recombinant pYL101C::sfGFP are stable and can be used to monitor the presence of Gram-negative bacteria, such as endophytes and pathogens in their hosts and environment.
Host Specificity ; Plasmids ; Cloning, Molecular