1.Mindfulness: A New Paradigm of Psychosocial Care in the Palliative Care Setting in Southeast Asia.
Seng Beng TAN ; David Paul CAPELLE ; Nor Zuraida ZAINAL ; Ee Jane LIM ; Ee Chin LOH ; Chee Loong LAM
Annals of the Academy of Medicine, Singapore 2017;46(9):339-346
Alleviation of suffering in palliative care needs a combination of good symptom control and psychosocial care. The capacity of mindfulness to promote psychological flexibility opens up possibilities of creating a paradigm shift that can potentially change the landscape of psychosocial care. In this review, we attempt to introduce 4 methods to establish mindfulness based on 'The Discourse on the Foundations of Mindfulness', a core text of Theravada Buddhism, followed by a brief comparison of the concepts and practices of mindfulness in different cultures and religions in Southeast Asia. Next, 2 mindfulness-based interventions specifically designed for palliative psychosocial care - mindfulness-based supportive therapy (MBST) and mini-mindfulness meditation (MMM) are introduced. We hypothesise that mindful practices, tailored to the palliative setting, can promote positive psychosocial outcomes.
2.Perceptions of a night float system for intern doctors in an internal medicine program: an Asian perspective
Benjamin Yong Qiang TAN ; Nicholas Jinghao NGIAM ; Zi Yun CHANG ; Sandra Ming Yien TAN ; Xiayan SHEN ; Shao Feng MOK ; Srinivas SUBRAMANIAN ; Shirley Beng Suat OOI ; Adrian Chin Leong KEE
Korean Journal of Medical Education 2019;31(3):271-276
Long duty hours have been associated with significant medical errors, adverse events, and physician “burn-out”. An innovative night float (NF) system has been implemented in our internal medicine program to reduce the negative effects of long duty hours associated with conventional full-call systems. However, concerns remain if this would result in inadequate training for interns. We developed a structured questionnaire to assess junior doctors’ perceptions of the NF system compared to full calls, in areas of patient safety, medical training, and well-being. Ninety-seven (71%) of the 137 doctors polled responded. Ninety-one (94%) felt the NF system was superior to the full call system. A strong majority felt NF was beneficial for patient safety compared to full call (94% vs. 2%, p<0.001). The NF system was also perceived to reduce medical errors (94% vs. 2%, p<0.001) and reduce physician “burn-out” (95% vs. 5%, p<0.001). Beyond being a practical solution to duty-hour limitations, there was a significant perceived benefit of the NF system compared to the full call in terms of overall satisfaction, patient safety, reducing medical errors and physician “burn-out”.
After-Hours Care
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Asian Continental Ancestry Group
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Education, Medical
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Humans
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Internal Medicine
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Medical Errors
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Patient Safety
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Patient Satisfaction
3.Perceptions of a night float system for intern doctors in an internal medicine program: an Asian perspective
Benjamin Yong Qiang TAN ; Nicholas Jinghao NGIAM ; Zi Yun CHANG ; Sandra Ming Yien TAN ; Xiayan SHEN ; Shao Feng MOK ; Srinivas SUBRAMANIAN ; Shirley Beng Suat OOI ; Adrian Chin Leong KEE
Korean Journal of Medical Education 2019;31(3):271-276
Long duty hours have been associated with significant medical errors, adverse events, and physician “burn-outâ€. An innovative night float (NF) system has been implemented in our internal medicine program to reduce the negative effects of long duty hours associated with conventional full-call systems. However, concerns remain if this would result in inadequate training for interns. We developed a structured questionnaire to assess junior doctors’ perceptions of the NF system compared to full calls, in areas of patient safety, medical training, and well-being. Ninety-seven (71%) of the 137 doctors polled responded. Ninety-one (94%) felt the NF system was superior to the full call system. A strong majority felt NF was beneficial for patient safety compared to full call (94% vs. 2%, p<0.001). The NF system was also perceived to reduce medical errors (94% vs. 2%, p<0.001) and reduce physician “burn-out†(95% vs. 5%, p<0.001). Beyond being a practical solution to duty-hour limitations, there was a significant perceived benefit of the NF system compared to the full call in terms of overall satisfaction, patient safety, reducing medical errors and physician “burn-outâ€.
4.Efficacy and tolerability of vardenafil in Asian men with erectile dysfunction.
Hui Meng TAN ; Chong Min CHIN ; Chong Beng CHUA ; Edsal GATCHALIAN ; Apichat KONGKANAND ; Clarence Lei Chang MOH ; Foo Cheong NG ; Krisada RATANA-OLARN ; Dennis SERRANO ; Akmal TAHER ; Ismail TAMBI ; Anupan TANTIWONG ; Michael Wong Yuet CHEN ; Wai-Chun YIP
Asian Journal of Andrology 2008;10(3):495-502
AIMTo evaluate the efficacy and tolerability of vardenafil, a phosphodiesterase type-5 (PDE-5) inhibitor, in men of Asian ethnicity with erectile dysfunction (ED).
METHODSIn this prospective, double-blind, multinational study, Asian men were randomized to receive vardenafil (10 mg) or placebo (4:1 ratio) for 12 weeks. The primary efficacy variables were the International Index of Erectile Function erectile function domain (IIEF-EF), and Sexual Encounter Profile (SEP) questions related to penetration and intercourse completion. Significant mean improvements were required in all three measures to show positive benefits of vardenafil treatment. Secondary efficacy variables included the Global Assessment Question (GAQ) on erection improvement.
RESULTSLeast-squares mean baseline IIEF-EF domain scores (vardenafil 14.6, placebo 13.4) were consistent with moderate ED. After 12 weeks, vardenafil treatment was associated with significant increases from the baseline in IIEF-EF domain scores compared with the placebo (22.4 vs. 14.3; P<0.001). Vardenafil was associated with significant improvements from baseline in least squares (LS) mean success rates for SEP-2 (vardenafil 82.2 vs. placebo 43.6; P<0.001) and SEP-3 (vardenafil 66.1 vs. placebo 24.0; P<0.001). Positive GAQ responses were reported by 81.8% of vardenafil recipients vs. 24.3% of placebo recipients. Adverse events were reported by 25.4% of the vardenafil group, the majority mild and transient.
CONCLUSIONVardenafil (10 mg) is a highly effective and well-tolerated treatment for moderate ED in Asian men. These results add to the increasing amount of data demonstrating the safety and efficacy of vardenafil for the treatment of ED in a range of patient populations.
Adult ; Aged ; Double-Blind Method ; Erectile Dysfunction ; drug therapy ; Humans ; Imidazoles ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Phosphodiesterase Inhibitors ; adverse effects ; therapeutic use ; Piperazines ; adverse effects ; therapeutic use ; Prospective Studies ; Sulfones ; adverse effects ; therapeutic use ; Triazines ; adverse effects ; therapeutic use ; Vardenafil Dihydrochloride
5.Demographic characteristics are associated with children’s nutritional status: Findings from a pilot study on food insecure households in Simunjan district, Sarawak
Tan Beng Chin ; Cheah Whye Lian ; Law Leh Shii
Malaysian Journal of Nutrition 2023;29(No.3):467-480
Introduction: Food insecurity is a public health concern that may lead to malnutrition
in children. The purpose of this study was to determine the relationship between
demographic characteristics and food security level with nutritional status among
children from food-insecure households in Simunjan District, Sarawak. Methods:
This study involved a total of 171 mother-and-child pairs from two Maternal and
Child Health Clinics (Simunjan and Gedong) using non-probability convenience
sampling technique. Food insecurity status was determined using Radimer/Cornell
Hunger Food Insecurity Instrument, while child’s weight and height were measured
following standard procedures. Chi-squared test of independence and binary logistic
regression were used during data analysis. Results: The prevalences for household
food insecurity, individual food insecurity, and child hunger were 70.8%, 15.2%, and
14.0%, respectively. The main nutritional problems for children aged 24–59 months
were underweight (17.9%) and stunting (17.9%), while for children aged 60–144
months were overweight and obesity (27.5%). Children of mothers over 34 years old
(AOR=2.367; 95% CI: 1.085, 5.164), and those aged 60–144 months (AOR=3.619;
95% CI: 1.521, 8.613) had increased odds of being overweight or obese. Meanwhile,
children of working mothers (AOR=6.526; 95% CI: 1.108, 38.449) were more likely
to have a thinness problem than children of unemployed mothers. However, no
association was found between the severity of food insecurity with children’s
nutritional status. Conclusion: Malnutrition in children remains a public health
concern in Simunjan District, and it is linked to mother’s age and employment
status. An intervention programme is required to ameliorate the situation.
6.Consensus Guidelines in Usage of Biologics in Dermatology during COVID-19 Pandemic: Biologic Advisory Group Malaysia
Steven Kim Weng Chow ; Siew Eng Choon ; Chan Lee Chin ; Noor Zalmy Azizan ; Pubalan Muniandy ; Henry Boon Bee Foong ; Agnes Yoke Hui Heng ; Benji Tze Yuen Teoh ; Felix Boon Bin Yap ; Wooi Chiang Tan ; Peter Wee Beng Ch&rsquo ; ng ; Kwee Eng Tey ; Latha Selvarajah ; Suganthi Thevarajah
Malaysian Journal of Dermatology 2020;45(2):2-10
The aim of this Biologic Advisory Group (BAG)
Malaysia consensus guideline is to provide
clinicians managing cutaneous diseases with
biologics relevant parameters to consider prior to
initiating or stopping or continuing any biologic
treatment in the current landscape of the COVID-19
pandemic. Besides reviewing the medical literatures
on COVID-19 and evidences related to other
human coronavirus or influenza, expert opinions
and clinical experiences are shared and debated in
formulation of this biologic consensus guideline.
7.Cholesterol goal achievement and lipid-lowering therapy in patients with stable or acute coronary heart disease in Singapore: results from the Dyslipidemia International Study II.
Kian-Keong POH ; Chee Tang CHIN ; Khim Leng TONG ; Julian Ko Beng TAN ; Jee Seong LIM ; Weixuan YU ; Martin HORACK ; Ami VYAS ; Dominik LAUTSCH ; Baishali AMBEGAONKAR ; Philippe BRUDI ; Anselm K GITT
Singapore medical journal 2019;60(9):454-462
INTRODUCTION:
Dyslipidaemia is a major risk factor for coronary heart disease (CHD). There is a lack of data on the extent of lipid abnormalities and lipid-lowering therapy (LLT) in Singapore.
METHODS:
The Dyslipidemia International Study (DYSIS) II was a multinational observational study of patients with stable CHD and hospitalised patients with an acute coronary syndrome (ACS). A full lipid profile and use of LLT were documented at baseline, and for the ACS cohort, at four months post-hospitalisation.
RESULTS:
325 patients were recruited from four sites in Singapore; 199 had stable CHD and 126 were hospitalised with an ACS. At baseline, 96.5% of the CHD cohort and 66.4% of the ACS cohort were being treated with LLT. In both cohorts, low-density lipoprotein cholesterol (LDL-C) levels were lower for the treated than the non-treated patients; accordingly, a higher proportion of patients met the LDL-C goal of < 70 mg/dL (CHD: 28.1% vs. 0%, p = 0.10; ACS: 20.2% vs. 0%, p < 0.01). By the four-month follow-up, a higher proportion of the ACS patients that were originally not treated with LLT had met the LDL-C goal (from 0% to 54.5%), correlating with the increased use of medication. However, there was negligible improvement in the patients who were treated prior to the ACS.
CONCLUSION
Dyslipidaemia is a significant concern in Singapore, with few patients with stable or acute CHD meeting the recommended European Society of Cardiology/European Atherosclerosis Society goal. LLT was widely used but not optimised, indicating considerable scope for improved management of these very-high-risk patients.