Weight management during pregnancy: a qualitative thematic analysis on knowledge, perceptions and experiences of overweight and obese women in Singapore.

BACKGROUND: The effect of maternal weight on pregnancy and birth outcomes is of great public health concern. For example, overweight and obesity among pregnant women is associated with adverse reproductive health outcomes including gestational diabetes, birth defects, macrosomia and infant mortality. OBJECTIVES: To understand the knowledge, perceptions and experiences during pregnancy among overweight and obese women in Singapore. METHODS: This is a cross-sectional study which employed qualitative techniques. The inclusion criteria is as follows: (1) Women who were overweight or obese before or during first trimester of pregnancy, (2) are able to report their specific pre-pregnancy or first trimester Body Mass Index (BMI), or weight and height, (3) had singleton pregnancy when overweight, are post-delivery for the pregnancy in which they were overweight, and (4) are 21 to 55 years old. Fifteen interviews were voice-recorded and transcribed verbatim. Then, two researchers independently performed the thematic analysis of the transcripts. RESULTS: The findings revealed that women had gaps in knowledge on the adverse effects of maternal overweight and obesity during pregnancy, and various misconceptions on diet and weight management during pregnancy were prevalent. Conflicting data was obtained for perceptions on the importance, difficulty and levels of motivation for weight management during pregnancy. CONCLUSION: There is a pressing need to address knowledge gaps and misconceptions of pregnant women who are overweight or obese. The importance of weight management during pregnancy should be emphasized, and enabling factors put in place.

Voluntary community service in medical school: A qualitative study on student leaders' motivations, experiences, and outcomes.

BACKGROUND: Participation in community service within underprivileged communities among medical students is associated with numerous positive outcomes, such as promoting empathy, enhancing leadership qualities, and fostering civic and social responsibility. We conducted a qualitative study to understand the experiences, motivations and student-reported outcomes on personal growth, when medical students in a developed Asian country participate in local and overseas community services. METHODS: We recruited medical students from Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, who were leaders of a community service project organized in medical school. Twelve one-to-one interviews were held for the participants from 6 to 8 January 2013. Interviews were audio-recorded and transcribed into free-flow text. Thematic analysis was performed independently by three researchers. RESULTS: Motivations to participate in community service include past-positive community service experience and present motivations such as compassion, self-discovery etc. Students reported higher empathy levels, improved communication, organization, decision-making, interpersonal, and leadership skills. The degree of influence on academic work and residency choice were varied. CONCLUSION: Community service in medical school enriches medical students by bringing about improved self-reported outcomes, leadership skills, and interpersonal skills. It has some bearing on residency choice and academic work.

Place of Care at End of Life: What Factors Are Associated With Patients' and Their Family Members' Preferences?

BACKGROUND: Few Asian studies have elucidated factors influencing patients and their family members on their preferred place of care at the end of life. This pilot study describes the perceptions of Singaporean patients with cancer and their family members that affect their choices in place of care. METHODOLOGY: Patients with cancer and their family members were surveyed at a tertiary hospital in Singapore. This convenience sample was recruited from April to July 2012. RESULTS: Fourteen pairs of patients and their family members (N = 28) were recruited. A majority of patients (64.3%) and family members (71.4%) were found to have a preferred place of care at the end of life. Of the respondents who expressed a preference (n = 19), 88.9% of patients and 90.0% of family members named "home" as their preferred place of care. Quality of care at home was rated "good" or "excellent" by all patients and 85.7% of family members. CONCLUSION: Home is the most favored choice among patients and family members who have a preferred place of care.

Voluntary community service in medical school: a qualitative study on obstacles faced by student leaders and potential solutions.

PURPOSE: In medical school, students may participate in various community involvement projects (CIP), which serve disadvantaged communities. However, several obstacles may arise during these projects. The authors conducted a qualitative study with the primary aim of understanding the obstacles and corresponding potential solutions when medical students in Singapore participate in local CIP (LCIP) and overseas CIP (OCIP). DESIGN: The authors recruited medical students from Yong Loo Lin School of Medicine, National University of Singapore, who were also leaders of a specific community service project done in medical school. Twelve one-to-one interviews were held for the participants from 6 to 8 January 2013. Participants were led in a discussion based on an interview guide. The interviews were audio-recorded and transcribed into free-flow text. Subsequently, content and thematic analyses of the transcripts were performed independently by three researchers. RESULTS: The medical students faced many common obstacles during their community service projects. These obstacles include difficulties in recruiting and managing volunteers, attaining recognition or credibility for the project to acquire funding and resources, adjusting to a different culture or language, setting goals, and facing project-specific obstacles. Potential solutions were offered for some obstacles, such as building a strong executive committee for the project, grooming successive batches of leaders, and improving the project's public image, mentorship, reflections, and sustainability plans. CONCLUSIONS: Mentorship, reflections, and sustainability are potential solutions that have been proposed to tackle the obstacles faced during community service participation in medical school. However, there may still be difficulty in solving some of the problems even after these measures are put into practice. Future research may focus on evaluating the effectiveness of these suggested solutions.