BACKGROUND

Low back pain is a major global cause of disability, typically treated through traditional onsite rehabilitation. However, the advancement of telerehabilitation during the COVID-19 pandemic presents an opportunity to examine its effectiveness as a treatment option for low back pain. This study aims to seek and explore the experiences and perspectives of healthcare professionals about onsite or online management of LBP.

The study will employ a phenomenological qualitative study design that will use quota sampling to recruit a total of 16 participants, equally distributed among rehabilitation doctors, physical therapists, barangay healthworkers, and patients with low back pain, coming from hospitals and centers affiliated with the University of Santo Tomas in Metro Manila. Key informant interviews that follow a semi-structured interview format will be conducted either on-site or online, depending on the preference of the invited informant. The NVivo data analysis software will be utilized to produce codes and outline themes from the gathered data.

The research is expected to highlight the nuanced interplay between individual viewpoints and contextual factors that influence decision-making in rehabilitation settings, besides identifying these themes. Findings will be instrumental in informing best practices for managing low back pain, thereby helping physical therapists determine the most effective treatment approach—whether through telerehabilitation or traditional on-site care. The study can provide actionable recommendations through grounding the implications of the analysis to the anticipated findings that might affect the rehabilitation practices and patient outcomes in the Philippines.

Background: To enhance perioperative outcomes, a perioperative registry that integrates high-quality real-world data throughout the perioperative period is essential. Singapore General Hospital established the Perioperative and Anesthesia Subject Area Registry (PASAR) to unify data from the preoperative, intraoperative, and postoperative stages. This study presents the methodology employed to create this database. Methods: Since 2016, data from surgical patients have been collected from the hospital electronic medical record systems, de-identified, and stored securely in compliance with privacy and data protection laws. As a representative sample, data from initiation in 2016 to December 2022 were collected. Results: As of December 2022, PASAR data comprise 26 tables, encompassing 153,312 patient admissions and 168,977 operation sessions. For this period, the median age of the patients was 60.0 years, sex distribution was balanced, and the majority were Chinese. Hypertension and cardiovascular comorbidities were also prevalent. Information including operation type and time, intensive care unit (ICU) length of stay, and 30-day and 1-year mortality rates were collected. Emergency surgeries resulted in longer ICU stays, but shorter operation times than elective surgeries. Conclusions The PASAR provides a comprehensive and automated approach to gathering high-quality perioperative patient data.

Objective: To address the gap in timely diagnosis of dementia due to limited screening tools, we investigated the validity and reliability of the Hellocog, computerized neuropsychological test based on tablets for screening dementia. The higher the probability score on the Hellocog, the higher the likelihood of dementia. Methods: This study included 100 patients with dementia and 100 individuals with normal cognition who were aged 60 years or older and free of other major psychiatric, neurological, or medical conditions. They administered the Hellocog on a tablet under the supervision of a neuropsychologist. To determine test-retest reliability, 20 took the Hellocog again after 4 weeks. Diagnostic performance was assessed using the receiver operator characteristics (ROC) analysis. Results: The Hellocog showed adequate internal consistency (Cronbach’s alpha=0.69) and good test-retest reliability (intraclass correlation coefficient=0.86, p<0.001). Participants with dementia scored higher on the Hellocog than those with normal cognition (p<0.001), confirming its high criterion validity. Strong correlations with the Mini-Mental Status Examination (MMSE) score and the total score of the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Assessment Battery (CERAD-TS) highlight the concurrent validity of the Hellocog. The area under the ROC curve for dementia of the Hellocog was excellent (0.971) and comparable to that of the MMSE and CERAD-TS. The sensitivity and specificity for dementia were 0.945 and 0.872%, respectively, which were slightly better than those of the MMSE and CERAD-TS. Conclusion Hellocog stands out as a valid and reliable tool for self-administered dementia screening, with promise for improving early detection of dementia.

Purpose: Men are increasingly turning toward online direct-to-consumer (DTC) men’s health platforms to fulfill their health needs. Research surrounding these platforms is lacking and the motivations and predictors underlying this online health-seeking behavior is largely unknown. This review scopes the existing literature concerning DTC men’s health and identifies factors influencing engagement, as well as health outcomes of this platform. Materials and Methods: A structured search was performed following PRISMA guidelines. CINAHL via EBSCO, Embase, MEDLINE via Ovid, PsycINFO, PubMed and Web of Science were searched. Results: Peer-reviewed quantitative and qualitative studies with a focus on demographics and characteristics of those using DTC men’s health platforms, as well as studies related to patient outcomes using such platforms, were included. Ten of the 3,003 studies identified met the inclusion and exclusion criteria. Four cross-sectional descriptive studies evaluated the motivations behind men’s engagement with DTC platforms. Convenience, embarrassment and health motivation were identified as predominant factors associated with DTC platform use. The review identified a lack of qualitative studies, and major limitations were noted in the quantitative studies that impacted the accuracy of findings. Six further quantitative studies explored the quality of care provided by DTC platforms. DTC platforms were found to have a varying level of adherence to established clinical guidelines, but appeared to provide satisfactory patient outcomes with low levels of patient-reported side effects and adverse events. Conclusions There is a lack of research within the DTC men’s health space given the infancy of the field. Important predictors and motivations underlying men’s choices in accessing these platforms have been noted across several studies. However, further studies need to be conducted to investigate the psychosocial underpinnings of this behavior. Studies across a wider variety of male health conditions treated by these platforms will also help to provide insights to guide patient-centered care within the DTC landscape.

Introduction: Coronavirus disease 2019 (COVID-19) has severely influenced all aspects of life since its emergence and one of the strategies to end this pandemic rests on the vaccination to achieve herd immunity. While vaccinations are usually a safe and effective tool, the abbreviated development process of the available COVID-19 vaccines has increased uncertainties about the safety among the general population especially among patients with rheumatic and musculoskeletal diseases (RMD). Methods: A cross-sectional analysis was performed on rheumatic disease (RMD) patients from the rheumatology clinic at Hospital Tuanku Ja’afar Seremban (HTJS), investigating adverse events occurring within one month of receiving COVID-19 vaccines administered from 1st May 2021 to 30th September 2021. Results: 549 RMD patients were recruited in this study. Pfizer/BioNTech was the predominant vaccine (n = 257, 64.3%), followed by Sinovac (n = 60, 47.2%), Oxford/AstraZeneca (n = 7, 1.3%) and Moderna (n = 1, 0.2%). 330 (60.1%) patients experienced at least one adverse event, none of which required hospitalisation. Common side effects included pain at the site of injection (n = 169, 30.8%), generalised muscle pain (n = 91, 16.4%), fever (n = 90, 16.4%), arthralgia (n = 55, 10.0%), and lethargy (n = 43, 7.7%). Female patients (OR = 0.88, CI 0.79-0.97, p = 0.012), Sinovac recipients (OR = 0.51, CI 0.34-0.76, p = 0.001) and age >50 years (OR = 0.62, CI 0.44-0.89, p = 0.009) had significantly lower risks of experiencing adverse events. Among patients with autoimmune rheumatic disease (AIRD), 28 (6.4%) experienced disease flare. Patients with spondyloarthropathy (SpA) and overlap syndrome were more likely to experience disease flare following COVID-19 vaccination compared to rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients (OR = 2.87, CI 1.23 – 6.69, p = 0.014). The use of combination conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) was associated with a tendency toward increased risk of disease flare (OR = 2.34, CI: 0.97–5.64, p = 0.056). However, the use of glucocorticoids (OR = 2.02, CI 0.72–5.61, p = 0.17) and an active disease state (OR = 1.94, CI 0.75–5.02, p = 0.171) did not show a statistically significant impact on the frequency of disease flares. Conclusions The study affirms the overall safety of COVID-19 vaccines in rheumatic musculoskeletal disease patients, supporting efforts to address vaccine hesitancy in this population.
COVID-19 ; SARS-CoV-2 ; Vaccination

Humans ; Carcinoma, Hepatocellular/epidemiology* ; Liver Neoplasms/epidemiology* ; Prothrombin ; Biomarkers

INTRODUCTION: Singapore instituted lockdown measures from 7 February 2020 to 1 June 2020 in response to the coronavirus disease 2019 (COVID-19) pandemic. METHODS: A retrospective analysis of cases from the national trauma registry was carried out comparing the lockdown period (from 7 February 2020 to 1 June 2020) to the pre-lockdown period (from 7 February 2019 to 1 June 2019). Data extracted included the volume of Tier 1 (injury severity score [ISS] >15) and Tier 2 (ISS 9-15) cases and epidemiology. Subgroup analysis was performed for Tier 1 patient outcomes. RESULTS: Trauma volume decreased by 19.5%, with a 32% drop in Tier 1 cases. Road traffic and workplace accidents decreased by 50% (P < 0.01), while interpersonal violence showed an increase of 37.5% (P = 0.34). There was an 18.1% decrease in usage of trauma workflows (P = 0.01), with an increase in time to intervention for Tier 1 patients from 88 to 124 min (P = 0.22). Discharge to community facilities decreased from 31.4% to 17.1% (P < 0.05). There was no increase in inpatient mortality, length of stay in critical care or length of stay overall. CONCLUSION There was an overall decrease in major trauma cases during the lockdown period, particularly road traffic accidents and worksite injuries, and a relative increase in interpersonal violence. Redeployment of manpower and hospital resources may have contributed to decreased usage of trauma workflows and community facilities. In the event of further lockdowns, it is necessary to plan for trauma coverage and maintain the use of workflows to facilitate early intervention.
Humans ; COVID-19/epidemiology* ; Trauma Centers ; Retrospective Studies ; Singapore/epidemiology* ; Workload ; Communicable Disease Control