INTRODUCTION: The primary objective of this guideline is to establish evidence-based recommendations for the clinical use of parenteral nutrition (PN) in adult patients within the acute hospital setting in Singapore. METHOD: An expert workgroup, consisting of healthcare practitioners actively involved in clinical nutrition support across all public health institutions, systematically evaluated existing evidence and addressed clinical questions relating to PN therapy. RESULTS: This clinical practice guideline developed 30 recommendations for PN therapy, which cover these key aspects related to PN use: indications, patient assess-ment, titration and formulation of PN bags, access routes and devices, and monitoring and management of PN-related complications. CONCLUSION This guideline provides recommendations to ensure appropriate and safe clinical practice of PN therapy in adult patients within the acute hospital setting.
Humans ; Singapore ; Parenteral Nutrition/adverse effects* ; Adult

Introduction: Practice of infant massage by mothers has been reported previously to provide benefits such as nurturing touch, warmth and relaxation to infants and a more positive breastfeeding practice due to its stimulant for oxytocin release. This study aimed to determine the influence of infant massage by mothers on their breastfeeding practice in the local context. Methods: A quasi-experimental study was conducted among 310 mother-infant pairs who were recruited from five selected health centres within First Division of Sarawak. Intervention group participants (n=155) were taught to do infant-massage during the clinic session and instructed to practice 15 minutes twice daily throughout the two-months intervention period, while the control group (n=155) were not. Breastfeeding practice data were obtained using questionnaire from both groups pre-intervention at infants’ age one-month and post-intervention at age three-months. Results: Multinomial regression analysis showed that those in the intervention group were two times more likely than the control group for exclusive breastfeeding when compared to mothers who stopped breastfeeding (RR=2.022, 95% CI=1.007, 4.071; p-value=0.048). Similarly, mothers from the intervention group were two and half times more likely than control group for mixed feeding (RR=2.560, 95% CI=1.280, 5.121; p-value=0.008). Those who were housewives were nearly three times more likely than the private workers for exclusive breastfeeding (RR=2.734, 95% CI=1.246, 5.997; p-value=0.012). Conclusion: Infant massage influenced breastfeeding practice positively at infants’ age three-months, in particular, among mothers who were housewives. Healthcare providers should encourage infant massage practice by mothers as part of the maternal and child healthcare service.

Objective: The objective of this study is to determine the optimal cut-off score for the Centre for Epidemiologic Studies Depression scale (CESD) according to Malaysian adolescent norms. Methods: This is a cross-sectional study. Nine hundred and thirty-one adolescents aged 13 to 17 years-old completed the CESD and Hopkins Symptom Checklist-depression scale (HSCL-depression). Results: Results from the receiver operating characteristic (ROC) curve, kappa coefficients and odds ratio analysis showed that CESD cut-off score of 27 was suitable to be used according to Malaysian norms, demonstrating a specificity of 93%. Conclusion: The findings suggest a cut-off score 27 should be used for screening of depression for Malaysian adolescents using the CESD.