Adopting a "Digital First" Mindset for Workplace Safety and Health in Singapore.

Digital and technological solutions constitute a key enabler to achieving better workplace safety and health outcomes. Fundamentally, the success of their implementation is underscored by a need for employers, employees, industry stakeholders and policymakers to collaborate in adopting a "digital first" mindset. This review provides a background on the evolution of work and the workforce in post-independence Singapore, and introduces pertinent local workplace safety and health trends. It delves into how a "digital first" approach may be adopted and effected, followed by challenges and opportunities in the digitalization of Singapore's workplace safety and health landscape. Illustrative examples are used to highlight applications of digital and technological solutions in the control of occupational hazards. In our discussion, workplace strategies are built around the hierarchy of controls framework, whereas worker-related strategies are divided into workspace optimization for productivity/performance enhancement, training/education, and instituting surveillance/open reporting mechanisms. We demonstrate that with an open and forward-looking mind, and well-executed change management, we will be able to capitalize on technological advances to improve work and working conditions for all workers.

Applicability and benefits of telemedicine in the monitoring of monkeypox close contacts.

Monkeypox is a zoonotic disease caused by the monkeypox virus and classically presents as a vesicular rash accompanied by fever and lymphadenopathy. Singapore reported the first imported case of monkeypox infection on 21 June 2022, the first local unlinked case on 6 July 2022, and the first local linked case on 5 August 2022. Telemedicine was used in the management of monkeypox close contacts to (1) screen for the development of signs and symptoms consistent with monkeypox infection, (2) assess for successful post-exposure prophylaxis via direct visualisation of vaccination site morphological progression, (3) detect serious reactions arising from post-exposure prophylaxis administration, and (4) evaluate for deterioration in mental health status during the 21-day quarantine period. A case series of 13 close contacts who received post-exposure prophylaxis in the form of the ACAM2000 live Vaccinia virus preparation is presented, illustrating the safe and efficacious application of telemedicine in the clinical follow-up of quarantined close contacts throughout the 21-day incubation period, and post-exposure prophylaxis monitoring. Inherent limitations included difficulties in the assessment of sensitive areas such as the peri-genital and peri-anal regions and video quality-related issues.

Proposed Data-Driven Approach for Occupational Risk Management of Aircrew Fatigue.

BACKGROUND: Fatigue is pervasive, under-reported, and potentially deadly where flight operations are concerned. The aviation industry appears to lack a standardized, practical, and easily replicable protocol for fatigue risk assessment which can be consistently applied across operators. AIM: Our paper sought to present a framework, supported by real-world data with subjective and objective parameters, to monitor aircrew fatigue and performance, and to determine the safe crew configuration for commercial airline operations. METHODS: Our protocol identified risk factors for fatigue-induced performance degradation as triggers for fatigue risk and performance assessment. Using both subjective and objective measurements of sleep, fatigue, and performance in the form of instruments such as the Karolinska Sleepiness Scale, Samn-Perelli Crew Status Check, Psychomotor Vigilance Task, sleep logs, and a wearable actigraph for sleep log correlation and sleep duration and quality charting, a workflow flagging fatigue-prone flight operations for risk mitigation was developed and trialed. RESULTS: In an operational study aimed at occupational assessment of fatigue and performance in airline pilots on a three-men crew versus a four-men crew for a long-haul flight, we affirmed the technical feasibility of our proposed framework and approach, the validity of the battery of assessment instruments, and the meaningful interpretation of fatigue and work performance indicators to enable the formulation of safe work recommendations. CONCLUSION: A standardized occupational assessment protocol like ours is useful to achieve consistency and objectivity in the occupational assessment of fatigue and work performance.

Retrograde Flow Digital Artery Flaps.

Retrograde flow digital artery flaps are a versatile single-stage option for the coverage of fingertip and dorsal digit defects. There are technical challenges associated with pedicle dissection and preparation. Techniques vary predominantly in the vessel utilized (either the proper digital artery or its branches) and the incorporation of the digital nerve or its branches in the pedicle with subsequent neurorrhaphy. Venous failure is more common. There is often mild but perceivable donor site morbidity. Evidence favors an innervated flap for better sensory recovery. Cold intolerance follows sacrifice of a digital artery.

Tactile sensibility on the fingernail.

PURPOSE: To measure tactile discrimination (static and moving 2-point discrimination) and threshold levels (Weinstein enhanced sensory test) over the nail plate in normal subjects and compare these values with those at the corresponding finger pulps. METHODS: Tactile discrimination and threshold values over the nail plates and finger pulps were measured on 300 digits in 30 healthy subjects with a mean age of 23 years. Subjects with cosmetic nail modifications, injuries, neurological deficits, dermatological conditions, or history of upper limb surgery were excluded. Equivalence testing was conducted to look for clinical equivalence between values obtained at both sites. RESULTS: The mean static 2-point discrimination, moving 2-point discrimination, and threshold value over the human nail were 6.7 mm, 2.4 mm, and 0.06 g, respectively. The corresponding values for the finger pulp were 2.4 mm, 2.2 mm, and 0.01 g, respectively. The static 2-point discrimination and threshold values were superior for the finger pulp, whereas moving 2-point discrimination values at both sites were clinically equivalent. CONCLUSIONS: Our study suggests that tactile discrimination and threshold levels can be measured over the nail plate and that moving 2-point discrimination values are clinically equivalent to those obtained on the corresponding pulp. This highlights the importance of the nail plate in the sensory function of the fingertip. The normative data from this study may be useful in establishing the impact of nail injury and the contribution of the nail to the overall function of the hand. TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic II.