Evaluating the Effects of Capacity Building Initiatives and Primary Care Networks in Singapore: Outcome Harvesting of System Changes to Chronic Disease Care Delivery.

The high tertiary healthcare utilisation in Singapore due to an ageing population and increasing chronic disease load has resulted in the establishment of primary care networks (PCNs) for private general practitioners (GPs) to provide team-based, community care for chronic diseases. A total of 22 PCN leaders and programme managers from 10 PCNs participated in online group discussions and a survey. Outcome harvesting was used to retrospectively link the intended and unintended outcomes to the programme initiatives and intermediate results (IRs).

Factors of COVID-19 Vaccine Perception among Transport Drivers in Singapore: A Cross-Sectional Pilot Study.

Transport drivers have high risk of exposure to SARS-CoV-2 during COVID-19 pandemic. Vaccines can reduce disease severity. However, COVID-19 vaccine perception among transport drivers is unknown.

Chronic disease self-management competency and care satisfaction between users of public and private primary care in Singapore.

Introduction: Primary healthcare providers play a crucial role in educating their patients on chronic disease self-management (CDSM). This study aims to evaluate CDSM competency and satisfaction in patients receiving their healthcare from public or private healthcare providers.

Methods: A cross-sectional household study was conducted in a public housing estate using a standardised questionnaire to interview Singaporeans and permanent residents aged 40 years and above, who were diagnosed with at least 1 of these chronic diseases: hyperlipidaemia, hypertension or diabetes mellitus.

Facilitators and barriers of Hepatitis B screening and vaccination.

Background: Hepatitis B virus (HBV) infection is the most common cause of liver disease and liver cancer in Singapore, being endemic despite availability of an efficacious vaccine.

Objective: To assess the factors associated with HBV screening and vaccination.

Methods: Using mixed methods analysis, focus group discussions were conducted alongside a cross-sectional study amongst 784 Singapore Citizens and Permanent Residents aged 25-69 residing in Housing and Development Board (HDB) flats.

Using peer review to distribute group work marks equitably between medical students.

Background: Although peer assessment has been used for evaluating performance of medical students and practicing doctors, it has not been studied as a method to distribute a common group work mark equitably to medical students working in large groups where tutors cannot observe all students constantly.

Methods: The authors developed and evaluated a mathematical formulation whereby a common group mark could be distributed among group members using peer assessment of individual contributions to group work, maintaining inter-group variation in group work scores. This was motivated by community health projects undertaken by large groups of year four medical students at the National University of Singapore, and the new and old formulations are presented via application to 263 students in seven groups of 36 to 40 during the academic year 2012/2013.

Caregivers: Do They Make a Difference to Patient Recovery in Subacute Stroke?

Objective: To evaluate the relationship between caregiver nature and availability, and rehabilitation outcomes in subacute stroke.

Design: Retrospective cohort study.

Setting: Four community rehabilitation hospitals.

Quality of life and related factors of nursing home residents in Singapore.

Background: Litter is known about the well-being of nursing home (NH) residents in Singapore. This study aimed to identify predictors of self-reported quality of life (QOL) of NH residents in Singapore.

Methods: In face-to-face interviews, trained medical students assessed each consenting resident recruited from 6 local NHs using a modified Minnesota QOL questionnaire, and rating scales and questions assessing independence, cognitive function, depression, and communication.

Rehabilitation Outcomes After Inpatient Rehabilitation for Lower Extremity Amputations in Patients With Diabetes.

Objective: To identify factors associated with functional gain, discharge destination, and long-term survival after inpatient rehabilitation in patients with lower extremity amputation and diabetes.

Design: Retrospective medical records review.

Setting: All community hospitals.

Mortality of older persons living alone: Singapore Longitudinal Ageing Studies.

Background: We investigated the association of living alone with mortality among older persons, independently of marital, health and other factors, and explored its effect modification by age group, sex, marital status and physical functional disability.

Method: Using data from 8 years of mortality follow up (1 September 2003 to 31 December 2011) of 2553 participants in the Singapore Longitudinal Ageing Studies (SLAS) cohort, we estimated hazard ratio (HR) of mortality associated with living alone using Cox proportional hazard models.

Results: At baseline, 7.

The synergistic effect of functional status and comorbidity burden on mortality: a 16-year survival analysis.

Objectives: The relationship between disability and comorbidity on mortality is widely perceived as additive in clinical models of frailty.

Design: National data were retrospectively extracted from medical records of community hospital.

Data Sources: There were of 12,804 acutely-disabled patients admitted for inpatient rehabilitation in Singapore rehabilitation community hospitals from 1996 through 2005 were followed up for death till 31 December 2011.

Factors and trade-offs with rehabilitation effectiveness and efficiency in newly disabled older persons.

Objective: To determine the factors for rehabilitation effectiveness (REs) and rehabilitation efficiency (REy) among newly disabled older persons and if there is any trade-off between REs and REy.

Design: Retrospective cohort study.

Setting: Rehabilitation hospitals.

Factors associated with nursing home placement of all patients admitted for inpatient rehabilitation in Singapore community hospitals from 1996 to 2005: a disease stratified analysis.

Objectives: To (1) identify social and rehabilitation predictors of nursing home placement, (2) investigate the association between effectiveness and efficiency in rehabilitation and nursing home placement of patients admitted for inpatient rehabilitation from 1996 to 2005 by disease in Singapore.

Design: National data were retrospectively extracted from medical records of community hospital.

Data Sources: There were 12,506 first admissions for rehabilitation in four community hospitals.

Trends in length of stay, functional outcomes, and discharge destination stratified by disease type for inpatient rehabilitation in Singapore community hospitals from 1996 to 2005.

Objective: To determine the trends in length of stay (LOS), rehabilitation functional outcome, and discharge destination of patients admitted for inpatient rehabilitation from 1996 to 2005 and stratified by disease in Singapore.

Design: Retrospective national data were extracted from medical records of community-based inpatient rehabilitation admissions in Singapore from 1996 to 2005.

Setting: Four community hospitals.

Socio-demographic and clinical profile of admissions to community hospitals in Singapore from 1996 to 2005: a descriptive study.

Introduction: Little data is available on community hospital admissions. We examined the differences between community hospitals and the annual trends in sociodemographic characteristics of all patient admissions in Singaporean community hospitals over a 10- year period from 1996 to 2005.

Materials And Methods: Data were manually extracted from medical records of 4 community hospitals existent in Singapore from 1996 to 2005.

Do parents talk to their adolescent children about sex?--findings from a community survey in Singapore.

Introduction: Sexually transmitted infections have increased sharply among adolescents both locally and internationally in recent years. Parents play an important role in their children's sexual health development. An integral part of this includes effective parent-child sexuality communication.

Effect of duration, participation rate, and supervision during community rehabilitation on functional outcomes in the first poststroke year in Singapore.

Objective: To examine the effect of duration, participation rate, and supervision during community rehabilitation on functional outcome during the first poststroke year.

Design: Prospective longitudinal study with interviews at admission, discharge, 1 month, 6 months, and 1 year after discharge.

Setting: Two subacute inpatient rehabilitation units and the community after discharge in Singapore.

Trade-offs between effectiveness and efficiency in stroke rehabilitation.

Background: Most stroke research has studied rehabilitation effectiveness and rehabilitation efficiency separately and not investigated the potential trade-offs between these two indices of rehabilitation.

Aims: To determine whether there is a trade-off between independent factors of rehabilitation effectiveness and rehabilitation efficiency.

Methods: Using a retrospective cohort study design, we studied all stroke patients (n = 2810) from two sub-acute rehabilitation hospitals from 1996 to 2005, representing 87·5% of national bed-years during the same period.

Colorectal cancer screening: the effectiveness of education on its barriers and acceptability.

To assess the awareness and acceptability of colorectal cancer (CRC) screening in noncompliant Singaporeans and to determine if their barriers can be overcome by education. A questionnaire developed from thematic analysis of open-ended interviews with 72 subjects was administered to 580 residents in a local high-rise housing estate. Participants aware of CRC screening were assessed for barriers and acceptability of CRC screening.

Comorbid cognitive impairment and depression is a significant predictor of poor outcomes in hip fracture rehabilitation.

Background: The effects of depression and cognitive impairment on hip fracture rehabilitation outcomes are not well established. We aimed to evaluate the associations of depressive symptoms and cognitive impairment (individually and combined) with ambulatory, living activities and quality of life outcomes in hip fracture rehabilitation patients.

Methods: A cohort of 146 patients were assessed on depressive symptoms (Geriatric Depression Scale, GDS > or = 5), cognitive impairment (Mini-mental State Examination, MMSE < or = 23), and other variables at baseline, and on ambulatory status, Modified Barthel Index (MBI), and SF-12 PCS and MCS quality of life on follow ups at discharge, 6 months and 12 months post fracture.

Risk perception and impact of Severe Acute Respiratory Syndrome (SARS) on work and personal lives of healthcare workers in Singapore: what can we learn?

Introduction: Healthcare workers (HCWs) were at the frontline during the battle against Severe Acute Respiratory Syndrome (SARS). Understanding their fears and anxieties may hold lessons for handling future outbreaks, including acts of bioterrorism.

Method: We measured risk perception and impact on personal and work life of 15,025 HCWs from 9 major healthcare institutions during the SARS epidemic in Singapore using a self-administered questionnaire and Impact of Events Scale and analyzed the results with bivariate and multivariate statistics.