Culture ; Drugs, Chinese Herbal ; standards ; Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional ; Singapore

Child ; Cranial Nerves ; pathology ; Eyelids ; Female ; Humans ; Male ; Ophthalmoplegia ; etiology ; Polyradiculopathy ; complications

Adolescent ; Adult ; Apgar Score ; Birth Weight ; Breast Feeding ; Congenital Abnormalities ; epidemiology ; Delivery, Obstetric ; Female ; Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; epidemiology ; Male ; Mass Screening ; Middle Aged ; Singapore

Humans ; Maxillary Sinus/diagnostic imaging* ; Tomography, X-Ray Computed

INTRODUCTIONComplementary and alternative medicine (CAM) is garnering increasing interest and acceptance among the general population. Although usage is thought to be widespread among paediatric cancer patients, local studies have not been done. We aimed to investigate the prevalence and predictors of CAM usage in paediatric cancer patients in a single institution.

MATERIALS AND METHODSParents of 73 paediatric cancer patients treated at KK Women's & Children's Hospital completed an interviewer-administered questionnaire. Data about the types of CAM therapies used, motivations for use, adverse effects, costs and discussion of usage with the patient's physician were obtained. General perceptions towards CAM and conventional medicine were explored. A subsequent telephone survey enquired about spirituality, benefits of CAM use and overall satisfaction with the therapies.

RESULTSTwo-thirds of patients used at least 1 CAM treatment, mainly as supportive adjuncts to conventional cancer treatment. Dietary changes, health supplements, herbal tea and bird's nest were the most common therapies used. Few patients (8.1%) consulted a CAM practitioner. Positive predictors of CAM usage included being of Chinese race, the practice of Buddhism or Taoism, the use of CAM prior to diagnosis, perception of CAM effectiveness and dissatisfaction with conventional treatment. Significantly, 55.1% of the parents had not discussed their CAM usage with their child's physician.

CONCLUSIONSA substantial proportion of paediatric cancer patients utilises CAM therapies, often without their physician's knowledge. Healthcare providers need to remain cognisant of the potential implications of CAM usage in order to proactively counsel patients. This would ensure that conventional therapy remains uncompromised.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Medical Oncology ; methods ; Medicine, Chinese Traditional ; Neoplasms ; epidemiology ; therapy ; Patient Satisfaction ; Pediatrics ; methods ; Prevalence ; Singapore ; epidemiology

Adult ; Aged ; Antimalarials ; therapeutic use ; Female ; Humans ; Immune Reconstitution Inflammatory Syndrome ; drug therapy ; JC Virus ; immunology ; Leukoencephalopathy, Progressive Multifocal ; drug therapy ; Male ; Mefloquine ; therapeutic use ; Middle Aged ; Treatment Outcome

Antimicrobial resistance and emerging infectious diseases, including avian influenza, Ebola virus disease, and Zika virus disease have significantly affected humankind in recent years. In the premodern era, no distinction was made between animal and human medicine. However, as medical science developed, the gap between human and animal science grew deeper. Cooperation among human, animal, and environmental sciences to combat emerging public health threats has become an important issue under the One Health Initiative. Herein, we presented the history of One Health, reviewed current public health threats, and suggested opportunities for the field of public health through better understanding of the One Health paradigm.
Animals ; Communicable Diseases ; Communicable Diseases, Emerging ; Drug Resistance, Microbial ; Ecology ; Hemorrhagic Fever, Ebola ; Humans ; Influenza in Birds ; Korea ; Public Health* ; Zika Virus Infection ; Zoonoses

INTRODUCTIONAssertive Community Treatment (ACT) was introduced in the 1970s as a comprehensive and assertive approach to community-based case management of patients with chronic and serious mental illness. Launched in Singapore in 2003, the Assertive Community Management (ACM) was modelled after the ACT, but with the main difference of 24 hour availability for the latter only. In line with the move towards de-institutionalisation of psychiatric patients, ACM was introduced to provide a mobile community-based multidisciplinary team approach to manage patients with severe chronic psychiatric illness. This article aims to evaluate and provide an update on this service programme in Singapore following an earlier study by Fam Johnson in 2007.

MATERIALS AND METHODSA naturalistic and retrospective study was conducted. One hundred and fifty-five patients recruited into ACM from 1 September 2008 to 1 September 2009 and had completed 1 year of ACM were included in our study. Outcomes were defined as number of admissions (NOA) and length of stay (LOS) one year before and one year following induction into the programme. Baseline socio-demographic factors were also investigated to see if they predicted outcome with ACM.

RESULTSThe mean NOA was 1.9 pre-ACM and 0.6 post-ACM, with mean reduction in NOA of 1.3 (P <0.01). The mean LOS was 72.2 days pre-ACM and 17.1 days post ACM, mean reduction in LOS 55.1 days (P <0.01). In addition, it was found that gender, diagnoses and ethnicity were not predictive of the outcome measures of NOA or LOS.

CONCLUSIONACM in Singapore had been well established since its inception and continued to show effectiveness in reducing inpatient hospitalisation among the chronically mentally ill.

Adult ; Bipolar Disorder ; therapy ; Case Management ; Community Mental Health Services ; Female ; Humans ; Length of Stay ; Male ; Mental Disorders ; therapy ; Outcome Assessment (Health Care) ; Patient Admission ; Psychotic Disorders ; therapy ; Schizophrenia ; therapy ; Singapore