The Psychological Impact of Hand Injuries Among Foreign Workers in Singapore.

INTRODUCTION:  Foreign workers comprise a significant portion of Singapore's workforce. They face multiple challenges when working there. A hand injury may add to these stressors, causing profound psychological and social impact. There are few studies in the literature that have analyzed this effect. The primary objective of this study, the first of its kind in Singapore, is to investigate the psychological impact and functional outcomes of hand injuries among foreign workers. By assessing the prevalence of psychological conditions such as stress, anxiety, and depression, along with measuring functional impairment using validated tools, this study aims to provide insights into the psycho-social challenges faced by this vulnerable population. METHODS:  A single-encounter interview was conducted for eligible patients. Psychological impact was measured using the DASS-21, symptom severity and function with the QuickDASH, and pain with the VAS. Injury-specific and demographic data were also collected. The Mann-Whitney U test and the Chi-Squared test were applied for non-parametric variables and categorical data, respectively. The adjusted p-value was <0.05. RESULTS: Eighty foreign workers were recruited. The mean age was 33 years, and the median age was 31.5 years (28.2 to 37.0). The majority were male (97.5%), married (60%), and had a salary of less than SGD1500 (USD1077) per month (81.3%). The most common mechanism of injury was penetrating (60%, n=48). Stress, anxiety, and depression were positively associated with limitations in daily function. Multivariate analysis found that limitations in daily function were independently associated with stress, anxiety, and depression, regardless of hand dominance.  Conclusion: This study has shown a significant psychological and social impact of hand injuries among foreign workers in Singapore. There is potential for the development of screening and support programs for at-risk workers to cater to their mental well-being. We recommend that the psychological impact of hand injuries be factored into holistic management and rehabilitation with adequate time and resource allocation. An ancillary benefit is the improvement of productivity and overall contribution to Singapore's economy.

"I Am Not Taking Sides as a Female At All": Co-Facilitation and Gendered Positioning in a Domestic Abuse Perpetrator Program.

The facilitation of domestic abuse perpetrator programs (DAPPs) by mixed gender co-facilitation pairs brings different facilitator perspectives and enables the modeling of egalitarian and respectful male-female relationships. This study analyzed 22 video and audio recordings of community-based DAPP groups featuring male participants, and male and female facilitators. Using thematic analysis, we aimed to understand how facilitators engaged participants and whether the facilitator's gender affected this. We found an asymmetry in the positioning of the facilitators. Group participants challenged both facilitators, but especially the female facilitators. Facilitator strategies toward behavior change included softening direct challenges (female facilitators) and mobilizing the shared category of men (male facilitators). Implications from this study are for reflective practice in facilitator management and supervision specifically focused on gendered power dynamics. Skilled facilitation is key to behavior change and the gendered interplay within groups may be a crucial element in the reduction of interpersonal violence and abuse.

Lymphoedema specialists embedded into community nurse and wound services: impacts and outcomes.

BACKGROUND: Lymphoedema is a progressive condition causing significant alterations to life, exerting pressures on unscheduled care from complications including cellulitis and wounds. An on the ground education programme (OGEP) was implemented to raise knowledge, competence and confidence in lymphoedema management in community clinical services. The aim of this study was to explore the impact and outcomes of the OGEP intervention. METHODS: Data were captured before and after OGEP on 561 lymphoedema patients in the community setting. Data recorded included resource use, costs and outcomes (EQ-5D-5L and LYMPROM). RESULTS: Data demonstrated statistically significant reductions in resource allocations including staff visits (P<0.001), cellulitis admissions (P<0.001), compression consumables and wound dressing costs (P<0.001). Overall, the total mean per patient cost decreased from £1457.10 to £964.40 (including intervention) with outcomes significantly improved in EQ-5D-5L/LYMPROM scores. CONCLUSION: The analysis suggests the OGEP intervention may offer reductions in resource costs and improvements in patient outcomes. OGEP may therefore provide an innovative solution in future care delivery.

Randomised pilot and feasibility trial of a group intervention for men who perpetrate intimate partner violence against women.

BACKGROUND: There is a need for robust evidence on the effectiveness and cost-effectiveness of domestic abuse perpetrator programmes in reducing abusive behaviour and improving wellbeing for victim/survivors. While any randomised controlled trial can present difficulties in terms of recruitment and retention, conducting such a trial with domestic abuse perpetrators is particularly challenging. This paper reports the pilot and feasibility trial of a voluntary domestic abuse perpetrator group programme in the United Kingdom. METHODS: This was a pragmatic individually randomised pilot and feasibility trial with an integrated qualitative study in one site (covering three local-authority areas) in England. Male perpetrators were randomised to either the intervention or usual care. The intervention was a 23-week group programme for male perpetrators in heterosexual relationships, with an average of three one-to-one sessions, and one-to-one support for female current- or ex-partners delivered by third sector organisations. There was no active control treatment for men, and partners of control men were signposted towards domestic abuse support services. Data were collected at three-monthly intervals for nine months from male and female participants. The main objectives assessed were recruitment, randomisation, retention, data completeness, fidelity to the intervention model, and acceptability of the trial design. RESULTS: This study recruited 36 men (22 randomly allocated to attend the intervention group programme, 14 to usual care), and 15 current- or ex-partners (39% of eligible partners). Retention and completeness of data were high: 67% of male (24/36), and 80% (12/15) of female participants completed the self-reported questionnaire at nine months. A framework for assessing fidelity to the intervention was developed. In interviews, men who completed all or most of the intervention gave positive feedback and reported changes in their own behaviour. Partners were also largely supportive of the trial and were positive about the intervention. Participants who were not allocated to the intervention group reported feeling disappointed but understood the rationale for the trial. CONCLUSIONS: It was feasible to recruit, randomise and retain male perpetrators and female victim/survivors of abuse and collect self-reported outcome data. Participants were engaged in the intervention and reported positive benefits. The trial design was seen as acceptable. TRIAL REGISTRATION: ISRCTN71797549, submitted 03/08/2017, retrospectively registered 27/05/2022.

Methodological Challenges in Group-based Randomised Controlled Trials for Intimate Partner Violence Perpetrators: A Meta-summary / [Desafíos metodológicos en los ensayos controlados aleatorizados con grupos de intervención para agresores de pareja: un meta-resumen]

Evidence for treatment effects of group-based Intimate Partner Violence (IPV) perpetrators programmes remains, at best, inconclusive. In the present review, systematic/meta-analytic reviews were used to identify randomised controlled trials and a meta-summary approach was employed to identify methodological challenges in the design and conduct of these trials. Of the fifteen studies identified, seven were comparative effectiveness trials. A range of methodological challenges were also identified by the trialists; source of outcome data, treatment modality, attrition and sample characteristics were the most frequently mentioned. Although there are only a few randomised controlled trials compared to non randomised studies, the findings of both highlight the need to invest in the development of innovative and/or combined IPV treatment programmes to address co-occurring issues such as substance use and trauma. The summary of methodological challenges will provide the first step in the development of methods guidance for researchers working in this area.(AU)

La evidencia del efecto del tratamiento de los programas de intervención grupal para agresores de pareja (IPV) siguen siendo, en el mejor de los casos, no concluyentes. En la presente revisión se emplearon revisiones sistemáticas/meta-analíticas para identificar ensayos controlados aleatorizados y se empleó un enfoque de meta-resumen para identificar los desafíos metodológicos en el diseño y la realización de estos ensayos. De los quince estudios identificados, siete fueron ensayos de comparación de la efectividad. Los autores de los ensayos también identificaron una serie de desafíos metodológicos: la fuente de la que se obtienen los datos relativos a los resultados, la modalidad de tratamiento, la mortalidad de la muestra y sus características fueron los mencionados con más frecuencia. Aunque son todavía escasos los ensayos controlados aleatorizados en comparación con los estudios no aleatorizados, los resultados de ambos tipos de estudios han destacado la importancia de invertir en el desarrollo de programas de tratamiento de IPV innovadores y/o combinados para tratar problemáticas conjuntas tales como consumo de substancias y trauma. El resumen de los desafíos metodológicos proporcionará el primer paso para el desarrollo de guías metodológicas para los investigadores que trabajan en este área.(AU)

The lift pool method for isolation of cDNA clones from lambda phage libraries

A PCR based strategy was developed to screen a Xenopus oocyte ëgt10 cDNA library. The PCR-based lift pool (LP) method follows the same two tiered strategy as conventional screening of phage libraries by filter hybridization. Two rounds of plating, one at high density to detect the clone, and one at low density to purify the clone to homogeneity, are performed. In the first round, lysates from high density plates, termed plate pools (PP), serve as template for PCR. In the second round, phage particles adhering to plaque lifts of low density plates are washed off nitrocellulose filters to create LPs, which are used as template for PCR. The integrity of the plaques on the low-density plates is preserved. Once a positive LP has been identified, plaques on the corresponding plate are screened individually by PCR. Using isoform specific primer pairs for Xenopus myosin 7a and myosin 1d, two lambda clones were isolated. Subsequent DNA sequence analysis confirmed their identities as myosin isoforms (GenBank accession numbers: DQ100353 and AF540952). This method offers a time saving, cost-effective alternative to other hierarchical pooling strategies for the repeated screening by PCR of an arrayed lambda phage library.