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Approach to Simple Mental Health Conditions in Persons with Intellectual Disability 智力残疾人单纯心理健康状况的探讨
The Singapore family physician Pub Date : 2022-07-01 DOI: 10.33591/sfp.48.6.u2
K. Wei
{"title":"Approach to Simple Mental Health Conditions in Persons with Intellectual Disability","authors":"K. Wei","doi":"10.33591/sfp.48.6.u2","DOIUrl":"https://doi.org/10.33591/sfp.48.6.u2","url":null,"abstract":"Persons with Intellectual Disability (ID) have a higher incidence of mental health disorders compared to the general population. This article aims to provide practical approaches as well as clinical pointers to the assessment and treatment of common psychiatric conditions such as depression and anxiety disorders in persons with ID. It is hoped that these can help inform and be adopted into family practice settings, to increase accessibility and improve on the care available to this special population.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49332342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Common Physical Health Issues in Persons with Intellectual Disability 智障人士常见的身体健康问题
The Singapore family physician Pub Date : 2022-07-01 DOI: 10.33591/sfp.48.6.u3
B. Sriram
{"title":"Common Physical Health Issues in Persons with Intellectual Disability","authors":"B. Sriram","doi":"10.33591/sfp.48.6.u3","DOIUrl":"https://doi.org/10.33591/sfp.48.6.u3","url":null,"abstract":"Persons with Intellectual Disabilities (ID) have a higher prevalence of physical health impairments leading to morbidities and premature deaths. The common conditions implicated are epilepsy, gastrointestinal concerns such as constipation and dyspepsia, sensory impairments, musculoskeletal issues, and thyroid disorders. Chronic diseases including hypertension, type 2 diabetes, obesity, and metabolic syndromes occur at an earlier age and nearly half of these conditions are detected only by screening. Annual health checks by primary care teams in the community are being implemented in many countries. Comprehensive health checks using standard questionnaires and preventative health check guidelines specially designed for persons with intellectual disabilities are of great help to primary care physicians in busy clinical settings. Addressing the concerns raised by healthcare professionals on the lack of knowledge and understanding of health needs of persons with ID can be easily addressed by appropriate training programmes. Eliminating communication barriers can be achieved by appropriate training programmes and implementing the use of easy-read materials. Reasonable adjustments must be implemented in practices to facilitate better health experiences for persons with ID and their caregivers.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45358023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
A Pitstop for a Life in the Pits: The Care of the Severely Demented in a Community Hospital 维修站的生活在维修站:照顾严重痴呆的社区医院
The Singapore family physician Pub Date : 2022-07-01 DOI: 10.33591/sfp.48.6.uc1
Jyh Hean Foo, P. Wong
{"title":"A Pitstop for a Life in the Pits: The Care of the Severely Demented in a Community Hospital","authors":"Jyh Hean Foo, P. Wong","doi":"10.33591/sfp.48.6.uc1","DOIUrl":"https://doi.org/10.33591/sfp.48.6.uc1","url":null,"abstract":"We describe a case of an elderly lady’s journey with severe dementia through a community hospital. Community hospitals play an important role in transitional care for elders with complex needs and their families to recalibrate the goals of care and optimise function after tumultuous stays in acute hospitals. We explore how the community hospital helped to break the vicious cycle of re-hospitalisation of our patient despite her dismal disease trajectory and address the complications of feeding difficulties and high caregiver burden. We also share practical advice on how a stay in a community hospital added value to the long-term care of similar elders.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46792237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mixed Severe Eosinophilic and Allergic Asthma 重度嗜酸性粒细胞性哮喘和过敏性哮喘
The Singapore family physician Pub Date : 2022-07-01 DOI: 10.33591/sfp.48.6.uc3
T. Tay
{"title":"Mixed Severe Eosinophilic and Allergic Asthma","authors":"T. Tay","doi":"10.33591/sfp.48.6.uc3","DOIUrl":"https://doi.org/10.33591/sfp.48.6.uc3","url":null,"abstract":"Difficult-to-treat asthma is asthma that is uncontrolled despite high intensity treatment. Patients with severe asthma are a subset of this group who remain uncontrolled despite addressing contributory factors, necessitating the use of add-on therapies including biologics. Currently available asthma biologics largely target type 2 inflammatory pathways that drive allergic and eosinophilic asthma. As a proportion of patients may be eligible for more than one biologic, biomarker profile, comorbidities, asthma outcome targets, dosing regimen and costs are important considerations in biologic selection.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46204335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Chameleon of Hope: The Role of Community Hospitals for Complex Patients with Rapidly Evolving Care Needs 希望的变色龙：社区医院在快速发展的护理需求的复杂患者中的作用
The Singapore family physician Pub Date : 2022-07-01 DOI: 10.33591/sfp.48.6.uc2
Jing Xuan Koh, P. Wong
{"title":"The Chameleon of Hope: The Role of Community Hospitals for Complex Patients with Rapidly Evolving Care Needs","authors":"Jing Xuan Koh, P. Wong","doi":"10.33591/sfp.48.6.uc2","DOIUrl":"https://doi.org/10.33591/sfp.48.6.uc2","url":null,"abstract":"An 87-year-old male, with a background of ischaemic heart disease, chronic kidney disease, hypertension, and hyperlipidaemia, was admitted for an acute right frontoparietal stroke, which progressed to recurrent cortical infarcts. He was transferred to the community hospital for step-down care and slow stream rehabilitation. Although his acute issues resolved, he continued to require a high level of nursing care. Eventually, the goal of care switched to palliative as his condition deteriorated. This case report highlights the importance of a versatile hospitalist team in managing rapid changes in care, particularly in complex cases with great difficulty fitting into a neat care plan.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45094412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Future Care Planning with Families: Mental Capacity, Deputyship, and Its Implications 家庭未来护理规划：心理能力、代理权及其启示
The Singapore family physician Pub Date : 2022-07-01 DOI: 10.33591/sfp.48.6.u6
Ruby Lee
{"title":"Future Care Planning with Families: Mental Capacity, Deputyship, and Its Implications","authors":"Ruby Lee","doi":"10.33591/sfp.48.6.u6","DOIUrl":"https://doi.org/10.33591/sfp.48.6.u6","url":null,"abstract":"This article is intended to give an overview of the current state of the MCA and provide some thoughts on how deputyship works under the MCA framework. The article discusses the different categories of proxy decision makers and some of the limitations of proxy decision-making. It also seeks to stimulate some thoughts about the refinement of the current state of care for persons with no or reduced mental capacity.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47449624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
SG Enable and the Services Available for Persons with Intellectual disability in Singapore 新加坡为智障人士提供的服务
The Singapore family physician Pub Date : 2022-07-01 DOI: 10.33591/sfp.48.6.u5
SG Enable (MSF)
{"title":"SG Enable and the Services Available for Persons with Intellectual disability in Singapore","authors":"SG Enable (MSF)","doi":"10.33591/sfp.48.6.u5","DOIUrl":"https://doi.org/10.33591/sfp.48.6.u5","url":null,"abstract":"There are an estimated more than 100,000 Persons with Disabilities (PwDs) in Singapore, and these disabilities can include physical, sensory, intellectual disability, and developmental disabilities. The presence of a disability does not only affect the individual themselves but also impacts their caregivers and families significantly. Moreover, the care needs of a PwD often persist throughout their life, and change over the different life stages, leading to various challenges for the PwDs and their families. The Ministry of Social and Family Development (MSF) led the development of the Enabling Masterplans (EMP), which are 5-year road maps that serve to guide the development and support of disability-related services in Singapore. In 2013, MSF also established SG Enable as the focal agency that is the first stop for all disability matters in Singapore. SG Enable currently works closely with social service agencies (SSA) and community partners to provide effective and holistic support to PwDs and their caregivers. This article will outline briefly the different types of disabilities, the needs over the life course, and the role of SG Enable in addressing these needs.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46717831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Common drug-drug interactions in kidney transplant recipients – A practical guide for the family physician 肾移植受者常见的药物-药物相互作用-家庭医生的实用指南
The Singapore family physician Pub Date : 2022-05-01 DOI: 10.33591/sfp.48.5.uo2
Ian Tatt Liew, Yi Shern Terence Kee, Q. Ho, S. Thangaraju, P. Lee
{"title":"Common drug-drug interactions in kidney transplant recipients – A practical guide for the family physician","authors":"Ian Tatt Liew, Yi Shern Terence Kee, Q. Ho, S. Thangaraju, P. Lee","doi":"10.33591/sfp.48.5.uo2","DOIUrl":"https://doi.org/10.33591/sfp.48.5.uo2","url":null,"abstract":"Kidney transplantation offers improved mortality and morbidity compared to dialysis in patients with end-stage kidney disease (ESKD) and is the preferred renal replacement therapy of choice. With their improved health status, kidney transplant recipients (KTRs) may seek care in the community as the first line of medical attention. With the increasing prevalence of ESKD in Singapore, family physicians will play an expanded role in the care of the KTR. To avoid allograft rejection, KTRs are on lifelong immunosuppressive therapy which has potential for adverse drug-drug interactions and drug toxicity. It would be prudent to be aware of potential interactions between immunosuppressive agents and commonly prescribed medications in the primary care setting.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69456124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Oral Nutritional Supplements – Nutritionally Replete or Incomplete? 口服营养补充剂——营养补充还是不完整？
The Singapore family physician Pub Date : 2022-05-01 DOI: 10.33591/sfp.48.5.up1
F. Fung, G. Michael, Wei Ong Alvin Cong
{"title":"Oral Nutritional Supplements – Nutritionally Replete or Incomplete?","authors":"F. Fung, G. Michael, Wei Ong Alvin Cong","doi":"10.33591/sfp.48.5.up1","DOIUrl":"https://doi.org/10.33591/sfp.48.5.up1","url":null,"abstract":"This is a case study of severe hypokalemia in a 59-year-old lady who was reliant on a fruit based nutritional supplement to meet the majority of her caloric and protein requirements. Through this case study, we aim to highlight the importance of identifying red flags for patients at risk of dietary complications, understanding the contents of oral nutritional supplements, and working closely with dietitians in a multidisciplinary team to provide holistic patient care.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48307047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anticholinergics in Older Adults- Avoid, Replace and Monitor 老年人的抗胆碱能药物-避免、更换和监测
The Singapore family physician Pub Date : 2022-05-01 DOI: 10.33591/sfp.48.5.uo1
Wei Terk Chang, S. Au
{"title":"Anticholinergics in Older Adults- Avoid, Replace and Monitor","authors":"Wei Terk Chang, S. Au","doi":"10.33591/sfp.48.5.uo1","DOIUrl":"https://doi.org/10.33591/sfp.48.5.uo1","url":null,"abstract":"Many medicines have varying degrees of anticholinergic activity. Some of these drugs, particularly those with intermediate or low activity, are not commonly known to possess anticholinergic properties. Regardless of their anticholinergic potency, when used concurrently, they could collectively contribute to the anticholinergic burden in elderly patients. While most of the adverse effects from the anticholinergic burden are reversible upon withdrawal of the anticholinergics, some of the adverse effects on the central nervous system (CNS) may be permanent. Fortunately, for most of the indications for strong anticholinergics, safer alternatives, both non-pharmacological and pharmacological, are available. Therefore, strong anticholinergic should be avoided, especially in older patients already on multiple drugs with anticholinergic activity. This is particularly relevant to those with comorbidities that would put them at risk for the adverse anticholinergic effects. If the use of a drug with strong anticholinergic activity is necessary for an older patient, it should be given at the lowest effective dose for the shortest possible period. Last but not least, the risks and benefits of the drug should be reviewed regularly in a timely manner.","PeriodicalId":85774,"journal":{"name":"The Singapore family physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46550484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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