Experiences of Formal and Informal Caregivers of Older Persons in Singapore.

The well-being of informal caregivers in the familial context is increasingly recognized as a critical area of concern affecting the care of older family members. This paper focuses on the dynamics of family caregiving for older members from the work-life perspective, contextualised in the highly developed and rapidly ageing society that is Singapore. Drawing from qualitative research on 30 adult family caregivers and 15 live-in foreign domestic workers (FDWs), the main themes identified from the qualitative interviews were: 1) Stresses and dilemmas faced by family caregivers; 2) Filial responsibility in the caring for one's parents; 3) Coping with work and caregiving - FDWs in family caregiving; 4) Coping with extra help - hiring of FDWs and challenges. This study highlights the complexities when paid and unpaid family care is juxtaposed in the family household. The findings point to the need for improvement in policies, training and support for caregivers.

Variations of generalized weak contractions in partially ordered b-metric space.

OBJECTIVES: This paper explored the fixed point results for the mappings satisfying generalized weak contractive conditions in a complete partially ordered b-metric space. These contractions are some variations of the work done by the authors (Mituku et al. in BMC Res Notes 13:537. https://doi.org/10.1186/s13104-020-05354-1 , 2020; Seshagiri et al. in BMC Res Notes 13:451. https://doi.org/10.1186/s13104-020-05273-1 , 2020, BMC Res Notes 14:390. https://doi.org/10.1186/s13104-021-05801-7 , 2021, BMC Res Notes 14:263. https://doi.org/10.1186/s13104-021-05649-x , 2021) in the same context. To validate the results a few examples are provided. RESULT: The aim of this work is to prove some fixed point results of the self mappings in ordered b-metric space satisfying variant generalized weak contraction conditions. These results generalize some known results in the provided literature.

Fixed point results of weakly contraction mappings in partially ordered b-metric spaces.

OBJECTIVES: We explored the results of fixed point, coincidence point and coupled coincidence point for the mappings in an ordered metric spaces. Our results generalized and extended the well-known results in the literature. Some numerical examples are provided for justifying the results obtained. RESULT: Some fixed point results are found for a self mapping in a partially ordered b-metric space which satisfies a generalized week contraction condition. Furthermore, these results are extended for two self mappings for obtaining coincidence point, coupled coincidence point and coupled common fixed point in the same context. A few examples are presented to support the findings.

Generalized fixed point results of rational type contractions in partially ordered metric spaces.

OBJECTIVES: We investigated the existence and uniqueness of a fixed point for the mapping satisfying generalized rational type contraction conditions in metric space endowed with partial order. Suitable examples are presented to justify the results obtained. RESULT: Some new fixed point results have been obtained for a mapping fulfilling generalized contractions. The uniqueness of the fixed point is also the part of the study based on an ordered relation. One example is given for a result which is not valid in the usual metric space.

Fixed point results for weak contractions in partially ordered b-metric space.

OBJECTIVES: We explore the existence of a fixed point as well as the uniqueness of a mapping in an ordered b-metric space using a generalized [Formula: see text]-weak contraction. In addition, some results are posed on a coincidence point and a coupled coincidence point of two mappings under the same contraction condition. These findings generalize and build on a few recent studies in the literature. At the end, we provided some examples to back up our findings. RESULT: In partially ordered b-metric spaces, it is discussed how to obtain a fixed point and its uniqueness of a mapping, and also investigated the existence of a coincidence point and a coupled coincidence point for two mappings that satisfying generalized weak contraction conditions.

Unique fixed point theorems in partially ordered metric spaces.

In this paper, we establish some fixed point results of a mapping satisfying certain rational type contractive conditions in the frame work of a metric space endowed with partial order. Our results generalize and extend the result of Singh and Chatterjee (1988) [7] in partially ordered metric spaces and some existing results in the literature. Few illustrative examples are given to support our results.

Urorectal septum malformation sequence: a report of seven cases.

Urorectal septum malformation (URSM) sequence is an extremely uncommon anomaly. We report herein seven cases of URSM sequence that were identified after reviewing all autopsies conducted at our hospital over a period of 26 years (1981-2006). The URSM spectrum includes partial and full URSM sequences. Absent perineal and anal openings with ambiguous genitalia are included under 'full URSM sequence', and a single perineal or anal opening draining a common cloaca with an imperforate anus is called 'partial URSM sequence'. Of our seven cases of URSM, three were full URSM sequence and four were partial URSM sequence. Associated renal anomalies were found in all of the cases. Three cases had unilateral renal agenesis and one each had bilateral renal agenesis and bilateral renal dysplasia, respectively. The remaining two cases had unilateral renal agenesis with contralateral kidney showing features of cystic dysplastic kidney and renal hypoplasia, respectively. Congenital anomalies involving other organs were also found in some of the cases. The longest survival period in our series was 10 days, in accordance with the short survival period usually associated with URSM. Five of the patients were females, one was male, and the sex of one neonate could not be ascertained. One of the neonates was from a twin pregnancy; the other twin was normal.

Lower levels of cerebrospinal fluid amyloid beta (Abeta) in non-demented Indian controls.

Prevalence of Alzheimer's disease in Indian population is lower than in developed countries. To determine whether limitation of amyloid beta (Abeta) concentration may be responsible for lower rate of incidence, we measured the levels of Abeta in cerebrospinal fluid (CSF) collected from 72 non-demented individuals ranging in the age from 20 years to 65 years. These samples were segregated into three groups ranging from 20-35 years, 36-50 years and 51-65 years of age. Levels of Abeta could be detected in all the age groups and they were much lower than the values reported in literature from the developed countries. No significant difference in the average level of Ass was observed with increase in age.

A macroeconomic review of dentistry in Canada in the 1990s.

OBJECTIVES: To document the trends in expenditures on dental health care services and the number of dental health care professionals in Canada from 1990 to 1999. METHODS: Information on dental and health expenditures, numbers of dentists, hygienists and dental therapists, and the population of Canada and the provinces were obtained from the Canadian Institute for Health Information; data on numbers of denturists were obtained from regional bodies and from Health Canada. Information on the costs of other disease categories was taken from studies by Health Canada (1993 and 1998). International comparisons were made on the basis of data published by the Organisation for Economic Co-operation and Development (OECD). Indices of change over the decade (in which the 1990 value served as the baseline [100]) were calculated. RESULTS: By 1999, the supply of all types of dental care providers had increased to 1 for every 904 people. Dental expenditures during the 1990s increased by 64% overall and by 49% per capita, a rate of increase that exceeded both inflation and costs of health care. Although the public share of dental costs decreased from 9.2% to 5.8%, the direct costs of dental care increased to rank second (6.30 billion dollars) after those for cardiovascular diseases (6.82 billion dollars). Among the OECD nations, Canada had the fourth highest per capita dental expenditures and the second lowest per capita public dental expenditures. CONCLUSIONS: The direct economic costs of dental conditions increased during the 1990s from 4.13 billion dollars to 6.77 billion dollars. Over the same period, the public share for expenditures on dental health care services declined.

Phacotrabeculectomy without mitomycin C in primary angle-closure and open-angle glaucoma.

PURPOSE: To compare the surgical outcomes of single site phacotrabeculectomy without mitomycin C (MMC) in primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG). METHODS: We retrospectively reviewed the records of all patients with a diagnosis of PACG and POAG, who underwent single site phacotrabeculectomy without MMC between January 2001 and December 2005 and had a minimum follow-up of 12 months. The primary outcome measure was cumulative success probability, defined as complete [intraocular pressure (IOP) ≤21 mm Hg without antiglaucoma medications or additional surgery] and qualified (IOP <21 mm Hg with medications). Secondary outcome measures were reduction of IOP, the number of antiglaucoma medications at last follow-up, and complication rates. RESULTS: Seventy-one eyes of 63 PACG patients (mean age 61.2 y) and 72 eyes of 57 POAG patients (mean age 64.0 y) were analyzed. Mean duration of follow-up was 38.7 and 41.7 months in the PACG and POAG groups, respectively. Complete success in PACG (72.1%) was more than the POAG group (56.1%), but the difference was not statistically significant (P=0.06). Qualified success in the PACG and POAG group was 87.4% and 92.8%, respectively (P=0.43). IOP reduction was greater (P=0.03) in the PACG group and PACG group required fewer antiglaucoma medications postoperatively (P=0.03) for IOP control. CONCLUSIONS: Survival probability of single site phacotrabeculectomy without MMC was not significantly different between the PACG and POAG groups. IOP reduction was greater and the need for antiglaucoma medications after surgery was lesser in the PACG group.

Ozonation of tannery effluent for removal of cod and color.

Ozonation of leather dye effluent for removal of color and COD reduction covering wide range in operating parameters forms the scope of the present work. The influence of parameters such as influent pH, ozone flow rate and initial effluent concentration on ozonation efficiency has been critically examined. It has been observed from the present investigation that a maximum of COD removal efficiency of 92% has been achieved under optimum operating conditions. Further the biodegradability index of the tannery effluent has increased from an initial value of 0.18 to 0.49 during ozonation indicating favorable adaptation of ozonation as a primer to the biochemical technique to enhance the efficiency of biochemical treatment.

Management challenges in a child with hyperinsulinemic hypoglycemia.

Malignant insulinoma is very rare in children. Herein, we present a case of a child with malignant insulinoma along with islet cell hyperplasia. She initially presented with features of hyperinsulinemic hypoglycemia at 18 mo of age. Magnetic resonance imaging (MRI) of the abdomen showed a mass at the junction of the head and body of the pancreas. The tumor was enucleated. Five months later symptoms of hypoglycemia recurred. A subtotal pancreatectomy was performed. She continued to have hypoglycemia, although less frequently. She was put on increasing doses of diazoxide. Seven months later, MRI of the abdomen and a PET scan revealed metastatic deposits in the liver, which were confirmed by histopathology and immunostaining. To the best of our knowledge, this is the youngest child with metastatic insulinoma reported so far.

A critical review of Singapore's policies aimed at supporting families caring for older members.

This article critically examines the family-oriented social policies of the Singapore government aimed at supporting families caring for older members. The sectors focused on are financial security, health, and housing. Singaporeans have been reminded that the family should be the first line of defense for aging families, followed by the community - the state would step in as the last resort. Drawing from recent research and examination of the state policies, the author argues that more should be done to help family caregivers looking after elder relatives. Recommendations for innovative ways to recognize and reward family carers conclude the paper.

Stress among family caregivers of older persons in Singapore.

It is projected that, in the 21st century, the majority of the world's older people will be living in Asia. After Japan, Singapore is the most rapidly aging country in Asia. With an increasing life expectancy, many older persons will require health and instrumental care during later life stages. In Singapore, close to 95% of older people co-reside with family members, highlighting the importance of community support for family caregivers. Using a study of 61 principal family caregivers in Singapore, this article highlights the nature of and relationship between caregivers' stress and gender, patients' activities of daily living (ADL) and instrumental ADL dependency, and caregivers' attitudes. Findings from the study suggest that female caregivers tended to be more stressed than male caregivers. Results also showed a significant inverse relationship between the level of stress experienced by caregivers and the ADL and instrumental ADL dependency of patients. Caregivers looking after patients suffering from dementia, Parkinson's disease, and hypertension were more likely to be stressed than those caring for persons with stroke, depression, and other illnesses. This article concludes by describing some implications of this research for social worker practice and for informal as well as formal support programs for family caregivers.

National policy approaches to social care for elderly people in the United Kingdom and Singapore 1945-2002.

The authors compare policy approaches in the United Kingdom and Singapore on social care for older persons. The context of these approaches is discussed showing the development of policies, in each country from the aftermath of the Second World War to the present. Given that Singapore is a former British colony, it is of interest to scholars of social policy to examine its welfare approach as compared to the welfare state approach espoused by the United Kingdom. Both nations are faced with the challenges of an aging population, which necessitates handling similar problems with strategies that are in harmony with their respective economic, social, and cultural contexts. This paper considers their divergence of philosophies and policies, concluding with the recognition that the major difference lies in national and governmental expectations regarding the extent of the financial and regulatory responsibility for care for older people carried by the individual, the family, and the state.