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2.
Int J Cancer ; 146(3): 839-849, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31001807

RESUMO

Specific organochlorines (OCs) have been associated with non-Hodgkin lymphoma (NHL) with varying degrees of evidence. These associations have not been evaluated in Asia, where the high exposure and historical environmental contamination of certain OC pesticides (e.g., dichlorodiphenyltrichloroethane [DDT], hexachlorocyclohexane [HCH]) are different from Western populations. We evaluated NHL risk and prediagnostic blood levels of OC pesticides/metabolites and polychlorinated biphenyl congeners in a case-control study of 167 NHL cases and 167 controls nested within three prospective cohorts in Shanghai and Singapore. Conditional logistic regression was used to analyze lipid-adjusted OC levels and NHL risk. Median levels of p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), the primary DDT metabolite, and ß-HCH were up to 12 and 65 times higher, respectively, in samples from the Asian cohorts compared to several cohorts in the United States and Norway. An increased risk of NHL was observed among those with higher ß-HCH levels both overall (3rd vs. 1st tertile OR = 1.8, 95%CI = 1.0-3.2; ptrend = 0.049) and after excluding cases diagnosed within 2 years of blood collection (3rd vs. 1st tertile OR = 2.0, 95%CI = 1.1-3.9; ptrend = 0.03), and the association was highly consistent across the three cohorts. No significant associations were observed for other OCs, including p,p'-DDE. Our findings provide support for an association between ß-HCH blood levels and NHL risk. This is a concern because substantial quantities of persistent, toxic residues of HCH are present in the environment worldwide. Although there is some evidence that DDT is associated with NHL, our findings for p,p'-DDE do not support an association.


Assuntos
Poluentes Ambientais/sangue , Hidrocarbonetos Clorados/sangue , Linfoma não Hodgkin/epidemiologia , Praguicidas/sangue , Idoso , Estudos de Casos e Controles , China/epidemiologia , Poluentes Ambientais/efeitos adversos , Feminino , Seguimentos , Humanos , Hidrocarbonetos Clorados/efeitos adversos , Linfoma não Hodgkin/sangue , Linfoma não Hodgkin/etiologia , Masculino , Pessoa de Meia-Idade , Praguicidas/efeitos adversos , Estudos Prospectivos , Fatores de Risco , Singapura/epidemiologia
3.
J Environ Manage ; 254: 109794, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31780268

RESUMO

Pharmaceuticals are a subset of micropollutants, present in the environment in trace concentrations. Because of their persistent nature, these chemicals are of particular concern. Little is known about how mixtures of pharmaceutical residues, found in WWTP effluents, affect the environment or public health. Yet, numerous studies show negative outcomes for both aquatic and terrestrial organisms, suggesting that they are given both to bioaccumulation and uptake in plants. Israel leads the world in effluent reuse (86%), almost exclusively utilized for purposes of agricultural irrigation. Pharmaceuticals, however, are not included in Israel's water regulatory oversight or management, essentially creating an epidemiological experiment among its citizens and environment. Globally, these compounds also are not commonly subject to monitoring or regulation. This study reviews and analyzes water policies and regulation worldwide that address the presence of pharmaceuticals in water resources, with a particular focus on Australia, Singapore, Switzerland, and the USA. Furthermore, the study investigates the reasons why these chemicals are not yet regulated in Israel. Based on a comprehensive evaluation of the data and analysis of the regulatory rationale in other countries, a list of recommended pharmaceutical standards that should be measured and monitored in Israel's wastewater treatment system is proposed. The suggested prioritization criteria should be at the heart of a new regulatory agenda for controlling pharmaceutical contamination in wastewater.


Assuntos
Preparações Farmacêuticas , Poluentes Químicos da Água , Austrália , Monitoramento Ambiental , Israel , Singapura , Suíça , Eliminação de Resíduos Líquidos , Águas Residuárias
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(12): 1198-1202, 2019 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-31795574

RESUMO

The unbalanced economic development, the lifestyle changes of the residents, the aging before getting rich and the burden of non-communicable chronic diseases in China have brought great pressure on China's health system. However, the prevention and control mechanism of chronic diseases in China is far from mature, which restricts the development of the prevention and control of chronic diseases in China. Singapore's new concept on chronic disease management and the the 3-level theoretical framework are good experience in the world and deserve to be learned by China. This article introduced the Healthy Living Master Plan in health promotion practice in Singapore, and made suggestions on construction of health management system to cope with the disease burden in China.


Assuntos
Promoção da Saúde , Estilo de Vida , Doenças não Transmissíveis/prevenção & controle , China/epidemiologia , Humanos , Doenças não Transmissíveis/epidemiologia , Singapura
5.
J Law Med ; 26(4): 896-921, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31682366

RESUMO

This article examines the evolution of advance care planning (ACP) in Singapore through the development of a less-formal, communications-based model - the Living Matters program - and its experience with local cultural and community responses to the process and its outcomes. Living Matters is, in practice, arguably a communitarian approach to ACP. The article then examines the challenges Living Matters poses to the overarching legal framework for ACP and suggests improvements to the proxy decision-making framework under the Mental Capacity Act (Singapore, cap 177A, 2010 rev ed), offering more flexible legal tools for ACP, and more regulatory support for the means to implement ACP outcomes effectively.


Assuntos
Planejamento Antecipado de Cuidados , Diretivas Antecipadas , Tomada de Decisões , Humanos , Procurador , Singapura
6.
BMC Neurol ; 19(1): 267, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31684922

RESUMO

AIM: To study the association of caregiver factors and stroke patient factors with rehospitalizations over the first 3 months and subsequent 3-12 months post-stroke in Singapore. METHODS: Patients with stroke and their caregivers were recruited in the Singapore Stroke Study, a prospective yearlong cohort. While caregiver and patient variables were taken from this study, hospitalization data were extracted from the national claims database. We used Poisson modelling to perform bivariate and multivariable analysis with counts of hospitalization as the outcome. RESULTS: Two hundred and fifty-six patient with stroke and caregiver dyads (N = 512) were analysed, with patients having spouse (60%), child (29%), sibling (4%) and other (7%) as their caregivers. Among all participants, 89% of index strokes were ischemic, 57% were mild in severity and more than half (59%) of the patients had moderate or severe disability post-stroke as measured on the Modified Rankin Scale. Having social support in the form of a foreign domestic worker for general help of caregiver reduced the hospitalization rate over 3 months post-stroke by 66% (IRR: 0.342; 95% CI: 0.180, 0.651). Compared to having a spousal caregiver, those with a child caregiver had an almost three times greater rate of hospitalizations over 3-12 months post-stroke (IRR: 2.896; 95% CI: 1.399, 5.992). Higher reported caregiving burden at the 3-month point was associated with the higher subsequent rate of hospitalization. CONCLUSION: Recommendations include the adoption of a dyadic or holistic approach to post-stroke care provision by healthcare practitioners, giving due importance to both patients with stroke and their caregivers, integrating caregivers in the healthcare system to extend the care continuum to include informal care in the community and provision of timely support for caregivers.


Assuntos
Cuidadores/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Acidente Vascular Cerebral , Família , Humanos , Estudos Prospectivos , Singapura , Cônjuges , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapia
7.
Zootaxa ; 4629(3): zootaxa.4629.3.9, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31712514

RESUMO

This study describes a new genus and new species of Tanaidacea that was collected from inside the tests of dead Tetraclita barnacles in Singapore. Xenosinelobus n. gen. is most similar to Sinelobus but can be distinguished by the (1) unusually short antennal fifth article, (2) tooth-like lacinia mobilis on right mandible, (3) long terminal seta on epignath, (4) plumose inner seta near dactylus insertion on cheliped propodus, (5) spiniform seta on pereopod 1 coxa, (6) presence of setae on inner margins of pereopod 1 propodus and dactylus, (7) claw-like terminal articles on pereopods 2 and 3, (8) row of setulose and flattened denticulate setae along distal margin of pereopod 6 propodus, (9) dorsal seta on claws of pereopods 4-6, (10) complete row of dorso-transverse setae on pleonites 1 and 2, (11) one seta on pleopod basis outer margin, (12) two or three setae on pleopod endopod inner margin and (13) three-articled uropod with final article 1.6 times as long as preceding article. A new diagnosis and key to genera is provided for the subfamily Sinelobinae.


Assuntos
Thoracica , Animais , Crustáceos , Mandíbula , Singapura
8.
Zootaxa ; 4624(3): zootaxa.4624.3.9, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31716216

RESUMO

Accurate identification of mosquitoes is crucial for the management and control of vector species. Although Singapore is a tropical country with high mosquito diversity, there are no identification keys specific to its mosquito fauna. An illustrated identification key to the genera of the adult female mosquitoes of Singapore is presented. Twenty genera are characterized and two genera found in Malaysia, Culiseta and Topomyia, are also included. The key will aid non-taxonomically trained operational officers in adult mosquito identification. The key to the genera provides the first crucial step in the process to species identification.


Assuntos
Culicidae , Animais , Vetores de Doenças , Feminino , Malásia , Mosquitos Vetores , Singapura
9.
Zootaxa ; 4564(2): zootaxa.4564.2.7, 2019 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-31716506

RESUMO

Twenty new species of Agrilus jewel beetles from the Oriental region are described and illustrated: Agrilus cicadelloides sp. nov. (Malaysia: Sarawak); A. draco sp. nov. (Malaysia: Sabah); A. hergovitsi sp. nov. (Malaysia: Johor); A. hik sp. nov.(Cambodia); A. ika sp. nov. (Solomon Islands); A. jankae sp. nov. (Indonesia: Sumatra, Singapore); A. jum sp. nov. (Laos); A. kon sp. nov. (Cambodia); A. mimicus sp. nov. (Laos); A. qom sp. nov. (Laos); A. titi sp. nov. (Malaysia: Perak); A. uxo sp. nov. (Vietnam); A. wos sp. nov. (Laos); A. xen sp. nov. (Laos); A. xia sp. nov. (Laos); A. xis sp. nov. (Laos); A. yoa sp. nov. (Laos, Vietnam); A. yuk sp. nov. (Laos); A. zao sp. nov. (Indonesia: Java and Sumba Islands); A. zim sp. nov. (Malaysia: Pahang).


Assuntos
Besouros , Distribuição Animal , Estruturas Animais , Animais , Tamanho Corporal , Camboja , Indonésia , Laos , Malásia , Melanesia , Tamanho do Órgão , Singapura , Vietnã
10.
BMC Public Health ; 19(1): 1287, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31615456

RESUMO

BACKGROUND: Gestational diabetes (GDM) is a known risk factor for type 2 diabetes mellitus (T2DM), and women with a history of GDM have a 7-fold increased risk of developing the disease. Achieving a healthy weight post-delivery is key in reducing the risk of future diabetes in these women. The aim of this trial is to investigate the use of an interactive smartphone application (APP) to restore women to optimal weight following delivery. METHODS: This will be an open-label randomized controlled trial. Two hundred women with gestational diabetes will be randomized to receive the intervention or standard care following delivery. Participants will be reviewed at 6 weeks and 4 months post-delivery. The intervention is an APP serving as a platform for weight, diet and physical activity tracking. The APP provides 3-5 min educational videos suggesting suitable lifestyle adjustments relevant to postnatal period such as breast feeding, diet and exercise. Lastly, the APP will allow real-time interaction between users and the team of dietitians, physiotherapists and occupational therapists to encourage restoration of optimal weight. Women in the control arm will be informed about the increased risk of developing T2DM and advised to maintain a healthy weight. Primary outcome measure is the restoration of participants' booking weight if booking BMI ≤ 23, or weight loss of at least 5% from booking weight if booking BMI > 23 over the 4 month period. Secondary outcome measures will assess serum metabolic and inflammatory markers, quality of life via questionnaires and cost-effectiveness of the intervention at each follow-up visit. DISCUSSION: This will be the first randomised controlled trial investigating the use of a smartphone application for postpartum weight loss in women with gestational diabetes. The major ethnic groups in our study population represent the majority of ethnic groups in Asia, amongst which the prevalence of diabetes is high. If shown to be effective, this APP may be used in wider clinical settings to improve postpartum weight loss and reduce the risk of developing T2DM in these women. TRIAL REGISTRATION: This study was registered on clintrials.gov on the 30th of October 2017, under the trial registration number: NCT03324737 .


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Gestacional/epidemiologia , Aplicativos Móveis , Smartphone , Programas de Redução de Peso/métodos , Adulto , Protocolos Clínicos , Feminino , Humanos , Gravidez , Singapura/epidemiologia
11.
Epidemiol Health ; 41: e2019025, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31623427

RESUMO

The development of underground workspaces is a strategic effort towards healthy urban growth in cities with ever-increasing land scarcity. Despite the growth in underground workspaces, there is limited information regarding the impact of this environment on workers' health. The Health Effects of Underground Workspaces (HEUW) study is a cohort study that was set up to examine the health effects of working in underground workspaces. In this paper, we describe the rationale for the study, study design, data collection, and baseline characteristics of participants. The HEUW study recruited 464 participants at baseline, of whom 424 (91.4%) were followed-up at 3 months and 334 (72.0%) at 12 months from baseline. We used standardized and validated questionnaires to collect information on socio-demographic and lifestyle characteristics, medical history, family history of chronic diseases, sleep quality, health-related quality of life, chronotype, psychological distress, occupational factors, and comfort levels with indoor environmental quality parameters. Clinical and anthropometric parameters including blood pressure, spirometry, height, weight, and waist and hip circumference were also measured. Biochemical tests of participants' blood and urine samples were conducted to measure levels of glucose, lipids, and melatonin. We also conducted objective measurements of individuals' workplace environment, assessing air quality, light intensity, temperature, thermal comfort, and bacterial and fungal counts. The findings this study will help to identify modifiable lifestyle and environmental parameters that are negatively affecting workers' health. The findings may be used to guide the development of more health-promoting workspaces that attempt to negate any potential deleterious health effects from working in underground workspaces.


Assuntos
Meio Ambiente , Saúde do Trabalhador/estatística & dados numéricos , Local de Trabalho/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos de Pesquisa , Singapura , Inquéritos e Questionários , Adulto Jovem
13.
East Asian Arch Psychiatry ; 29(3): 91-94, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31566185

RESUMO

OBJECTIVE: We aimed to evaluate the prevalence of depressive and anxiety symptoms and mental health literacy (MHL) in outpatients with or without cancer in Singapore. METHODS: Oncology outpatients and outpatients without cancer (controls) were assessed for severity of anxiety and depressive symptoms (using the Hospital Anxiety and Depression Scale) and MHL regarding major depressive disorder and generalised anxiety disorder in terms of diagnosis, aetiology, treatment, and attitudes toward mental health services. RESULTS: A total of 89 oncology outpatients and 61 controls were recruited. Those with primary and secondary education had significantly lower MHL scores than those with university education (p = 0.001). Oncology outpatients and controls were comparable in terms of anxiety (13.5% vs 9.8%, p = 0.5), depression (2.2% vs 1.6%, p > 0.99), and total MHL score (7.94 vs 9.13, p = 0.102). CONCLUSIONS: MHL is comparable between oncology outpatients and controls and is positively associated with education level.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Alfabetização em Saúde , Serviços de Saúde Mental , Saúde Mental , Neoplasias/psicologia , Pacientes Ambulatoriais/psicologia , Adulto , Estudos de Casos e Controles , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Singapura/epidemiologia , Adulto Jovem
14.
J Environ Manage ; 250: 109505, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31518799

RESUMO

Water stress is an increasing burden in regions with arid climates, aquifer vulnerability, and erratic rainfall. Population growth and competing domestic, industrial, and agricultural uses are also stretching the capacity of water supply systems. Beyond groundwater extraction, surface water overuse, and inter-basin transfers, governments are exploring alternative sources amidst looming supply threats. These alternatives include desalination, greywater recycling, and reclaimed or recycled wastewater. The latter, also known as water reuse with varying levels of treatment, has been applied for irrigation, street cleaning, industrial processes, and groundwater recharge. However, reused water for potable purposes has seen limited uptake, due in part to lack of public acceptance. This article examines the dynamics of public acceptance for potable water reuse. The article's theoretical contribution is a formal mathematical model for understanding public acceptance of water reuse. The model conceptualizes how governments, water utilities and the public interact to facilitate or hinder acceptance of water supply sources, including potable reuse. The article concludes by applying the model to cases of water reuse in Windhoek, Namibia, and Singapore.


Assuntos
Água Potável , Purificação da Água , Conservação dos Recursos Naturais , Namíbia , Singapura , Águas Residuárias , Abastecimento de Água
16.
Artigo em Inglês | MEDLINE | ID: mdl-31510094

RESUMO

OBJECTIVE: This study examined the physical and social environment (facilities and activities) of Singapore's Recreational Centres (RCs) and female patrons' (>50 years) perception of the RC facilities and activities. MATERIALS AND METHODS: A total of 100 RCs were audited, and 22 face-to-face interviews were undertaken. RESULTS: Physical activity classes were the main activity offered (mean = eight classes per month), with walking (29.8%) and aerobics sessions (17.5%) being the most frequent. Nutrition classes and social activities were offered less often (mean = one class per month). The activities were well received by patrons, offering opportunities to interact while participating in physical activity and nutrition classes. However, the need for staff training, consideration of patron's abilities and the desire to engage in alternative activities were expressed. CONCLUSION: Overall, RCs' facilities and activities were well liked by the patrons but opportunities for improvements were identified. Regular reviews of facilities and activities through consultation with the RC patrons and managers are needed to ensure that the facilities and activities remain relevant and practical to the patrons. This will help to support active lifestyles and healthy eating practices among older adults residing within the community.


Assuntos
Envelhecimento Saudável , Instalações Esportivas e Recreacionais , Idoso , Exercício , Feminino , Humanos , Pessoa de Meia-Idade , Singapura
17.
BMC Public Health ; 19(1): 1107, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412824

RESUMO

BACKGROUND: As the incidence and prevalence rates of end stage renal disease (ESRD) rise globally, a disproportionate increase has been observed in the elderly population. Singapore has the fifth highest incidence of treated ESRD worldwide, with the upward trend of ESRD being most apparent among those aged 70 years and older. Although it is well-documented that ESRD patients suffer an impaired quality of life compared to the general population, there is limited research focusing on the unique experiences and needs of elderly ESRD patients in Asian populations. To address the knowledge gap, this study seeks to explore the impact of ESRD and dialysis on the quality of life of elderly (≥70 years old) ESRD patients in Singapore and examine the coping strategies utilised by these patients. METHODS: This qualitative study involved semi-structured, in-depth interviews with 7 peritoneal dialysis patients, 5 haemodialysis patients, 4 patients on non-dialysis supportive care and 7 caregivers in Singapore. Interviews were conducted in English, Chinese, and Malay and fully transcribed. QSR NVivo 11 software was used for analysis. RESULTS: Participants reported that ESRD and dialysis had an impact on three highly interconnected areas of their quality of life: (a) biological/physical (general symptoms, neuromuscular problems, skin problems and poor sleep quality); (b) psychological (depressive symptoms, anxiety and fears, stress and negative self-perceptions); and (c) social (increased dependence on family and loss of social life). There were four key strategies that participants used to cope with these biopsychosocial challenges: (a) family support (financial, practical and emotional support); (b) religious/spiritual support (experiencing gratitude/contentment, the power of prayer and belonging to a faith community); (c) avoidance (cognitive avoidance and distraction techniques); and (d) acceptance (positive thinking and problem solving). CONCLUSIONS: This study has provided insights into the biopsychosocial impact of ESRD and dialysis, as well as cultural and religious factors that shape the experiences and coping mechanisms of elderly ESRD patients and caregivers in Singapore, which can be used to further the development and implementation of more holistic and person-centred services to help each patient achieve a better quality of life.


Assuntos
Adaptação Psicológica , Falência Renal Crônica/psicologia , Falência Renal Crônica/terapia , Diálise Renal/psicologia , Idoso , Idoso de 80 Anos ou mais , Cuidadores/psicologia , Feminino , Saúde Holística , Humanos , Masculino , Assistência Centrada no Paciente , Pesquisa Qualitativa , Qualidade de Vida , Singapura
18.
BMC Public Health ; 19(1): 1105, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412830

RESUMO

BACKGROUND: Evidence from randomized control trials suggest that coupled with smoking cessation interventions, CVD events can be reduced significantly if hypertension and diabetes patients are properly managed, raising practical what-if questions at the population level. This research aims to develop a dynamic simulation model using the systems modelling methodology of system dynamics, to evaluate the medium to long-term impact of hypertension and diabetes management, as well as smoking cessation intervention on CVD events, CVD deaths and post-CVD population. METHODS: The systems modelling methodology of system dynamics was used to develop a simulation model to evaluate the impact of aggressive hypertension, diabetes and smoking cessation management on CVD outcomes at the population level. RESULT: The insights from this research suggest that despite that at the individual level, hypertension management is associated with the highest risk reduction for CVD (50%) compared to diabetes and smoking (20%) and is also the most prevalent risk factor, at the population level, diabetes management interventions are projected to have higher impact on reducing CVD events compared to hypertension management or smoking cessation interventions. However, a combined intervention of diabetes and hypertension management, as well as smoking cessation has the most impact on CVD outcomes. CONCLUSION: Due to aging population and the increasing prevalence of chronic conditions in Singapore, the number of CVD events in Singapore is projected to rise significantly in the near future-hence the need for proactive planning to implement needed interventions. Findings from this research suggest that CVD events and its associated deaths and disabilities could be reduced significantly if diabetes and hypertension patients are aggressively managed.


Assuntos
Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/prevenção & controle , Promoção da Saúde/métodos , Hipertensão/prevenção & controle , Abandono do Hábito de Fumar/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Avaliação de Programas e Projetos de Saúde , Fatores de Risco , Singapura/epidemiologia , Fumar/epidemiologia , Análise de Sistemas , Adulto Jovem
19.
Vet J ; 250: 24-27, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31383416

RESUMO

Epiglottic entrapment is a condition in racing horses, associated with abnormal respiratory noises and exercise intolerance. Epiglottic entrapment has been linked to both poor and superior athletic performance, leading to concerns regarding whether surgery is indicated, and whether surgical correction may have a deleterious effect on future race performance. The objective of the current study was to assess the race-day performance of horses racing with epiglottic entrapment and the effect of surgical correction on performance outcomes using an intra-oral technique in anaesthetised horses. A case-control study was conducted at the Singapore Turf Club from 2008 to 2011. Controls were selected 1:1 to cases, based on Malaysian Racing Authority number. The performance of horses racing with epiglottic entrapment was recorded and post-surgery race performance was described. Further, post-surgery race performance was compared between cases and with non-case controls. Twenty horses raced with epiglottic entrapment were retrospectively enrolled. There was a significant difference in racing performance in case horses racing with and without epiglottic entrapment (P < 0.001). Fourteen horses finished in the top three post-surgery, compared to one horse finishing in the top three when running with epiglottic entrapment present. There was no significant difference between the performance of case horses (n = 33) post-surgery and controls (number of wins P = 0.20; and places P = 0.62). The intra-oral release of epiglottic entrapment is a suitable technique to resolve epiglottic entrapment. This study may assist veterinarians advising clients in the decision-making process when epiglottic entrapment is diagnosed in a racehorse.


Assuntos
Doenças dos Cavalos/fisiopatologia , Doenças dos Cavalos/cirurgia , Cavalos/fisiologia , Doenças da Laringe/veterinária , Condicionamento Físico Animal/fisiologia , Esportes , Animais , Estudos de Casos e Controles , Feminino , Cavalos/cirurgia , Doenças da Laringe/fisiopatologia , Doenças da Laringe/cirurgia , Masculino , Estudos Retrospectivos , Corrida , Singapura
20.
Transplant Proc ; 51(6): 1651-1654, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31399156

RESUMO

BACKGROUND: Singapore has had an opt-out organ donation system since the inception of the Human Organ Transplant Act in 2009. This law allows all Singapore citizens and permanent residents to donate their organs after confirmation of brain death, usually in the setting of devastating brain injury or stroke in an intensive care unit (ICU) setting, and such cases are referred to the National Organ Transplant Unit team by intensivists after the presumed clinical brain stem death testing. The further confirmatory tests, coordination with surgeons to find suitable recipients, and communication with family members is then carried out by the transplant coordinators from the National Organ Transplant Unit and not the clinicians. Despite a decade of the institution of the Act, the rates of organ donation remain low. This survey is the first aimed to assess the concerns and recommendations of the intensivists in Singapore. METHODS: This was an anonymous survey sent to 120 intensivists registered in Singapore with a 58% response rate. The survey included 14 open-ended questions. The respondents included both private and public sector intensivists. A qualitative analysis was carried out to analyze the emergent themes from the survey. RESULTS: A total of 79% of the respondents mentioned raising awareness through publicity, education, and advertising; 34% mentioned educating physicians and engaging ICU physicians in further planning of the organ transplant program in Singapore; 35% felt that publicizing more real stories of recipients would help. Generally, there was unease at the opt-out system infringing basic rights. CONCLUSION: This is the first survey to elicit the responses of the referring physicians for organ transplant. Their opinions suggest that a wider awareness and buy-in is needed both by the public and the ICU physicians, and addressing their valid moral concerns is essential in bridging this gap.


Assuntos
Atitude do Pessoal de Saúde , Transplante de Órgãos/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Médicos/psicologia , Obtenção de Tecidos e Órgãos/legislação & jurisprudência , Feminino , Humanos , Masculino , Transplante de Órgãos/legislação & jurisprudência , Pesquisa Qualitativa , Singapura , Inquéritos e Questionários
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