Singapore medical journal最新文献

{"title":"Effectiveness of palliative care curriculum in a single medical school: a cross-sectional study among students.","authors":"Ashiley Annushri Thenpandiyan, Joanna Jia Wen Yang, Isabella Ming Zhen Liu, Zubair Amin, Le Ye Lee","doi":"10.4103/singaporemedj.SMJ-2024-074","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2024-074","url":null,"abstract":"<p><strong>Introduction: </strong>Caring for dying patients is a quotidian responsibility within medicine. The aim of this study was to better understand how well a medical school's curriculum and clinical exposure prepared students to cope with palliative care and improved their clinical confidence in palliative care medicine.</p><p><strong>Methods: </strong>This was a cross-sectional study. A modified version of the Bereavement/End-of-life Attitudes about Care of Neonatal Nurses Scale (BEACONNS) questionnaire was administered to students of clinical years from Yong Loo Lin School of Medicine, National University of Singapore, from June 2021 to April 2022. An overall comfort score (OCS), a composite marker of students' comfort in participating in palliative care, was formulated from the summation of Likert-scale responses. A higher OCS denotes higher comfort with palliative care.</p><p><strong>Results: </strong>Of the 920 medical students of clinical years, 219 (23.8%) responded to the questionnaire. Across the clinical years, the percentage of students who felt unprepared to take care of palliative care patients and families was similar, with mean ± standard deviation OCS of 46.3 ± 12.6, 45.9 ± 9.4 and 44.9 ± 8.1 for years 3, 4 and 5 students, respectively. Prior experience in caring for dying relatives (P = 0.045) and knowledge of palliative care protocols and policies (P = 0.031) were significant positive factors in relation to improved OCS. Female gender was associated with higher OCS. Medical students recommended increased exposure to actual palliative care patients, rather than relying solely on simulated patients, to better equip them to care for patients at the end of life.</p><p><strong>Conclusion: </strong>Medical students expressed a lack of confidence in palliative care medicine regardless of their year of study, and felt that there was insufficient teaching and exposure to palliative care education.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392882","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}

{"title":"Knowledge, attitudes and perceptions of advance care planning among specialist healthcare professionals in neurology, neuro-oncology and surgery.","authors":"Zheting Zhang, Jing Ni Ng, Felicia Jin Yee Sie, Kai Jie Ng, Min Yuan Tan, Ming Yang, Jia Jun Goh, Amy Quek, Andrea Li Ann Wong, Balamurugan A Vellayappan, Will Loh, Ker-Kan Tan, Nicole Keong, Vincent Diong Weng Nga, Noreen Chan, Mervyn Jun Rui Lim","doi":"10.4103/singaporemedj.SMJ-2024-065","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2024-065","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the knowledge, attitudes and perceptions (KAP) of advance care planning (ACP) among specialist healthcare professionals (HCPs) in neurology, neuro-oncology and surgery.</p><p><strong>Methods: </strong>This was a cross-sectional study of HCPs in Singapore. A standardised questionnaire was developed using validated questionnaires from the international literature, concepts of the Theory of Planned Behaviour and consultation with multidisciplinary palliative care specialists. The 45-item questionnaire included sections on sociodemographics, ACP experience and practices, ACP Knowledge, ACP Attitudes, ACP Perceptions and ACP Engagement.</p><p><strong>Results: </strong>A total of 114 doctors, nurses and allied health professionals (AHPs) responded to the survey. Neurological, neuro-oncological and surgical HCPs generally have positive KAP towards ACP, but confidence to advocate for and conduct ACP could be improved. Doctors scored higher on KAP and intentions to engage in ACP as compared to nurses and AHPs. Significantly more doctors and nurses had attended formal ACP training than AHPs, while more doctors had conducted ACP conversations than nurses and AHPs. Attitudes towards ACP were independently and significantly associated with willingness to advocate for ACP, while perceptions of ACP, perceived relevance of ACP and readiness to engage in ACP were independently and significantly associated with both willingness and confidence to advocate for and to conduct ACP. The most common barriers to ACP among HCPs were disinterest or distress of patients and families and the lack of time.</p><p><strong>Conclusion: </strong>Enhanced ACP support, such as protocols, supervision and training, could improve ACP practice and engagement among specialist HCPs.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392883","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}

{"title":"Virtual simulation mobile application for teaching medical emergencies: attitudes and behaviours of postgraduate year one doctors and faculty.","authors":"Ada Pei Yu Ng, Nicholas Beng Hui Ng, Mae Yue Tan, Emmett Tsz Yeung Wong, Shuh Shing Lee, Nasyitah Binte Abd Aziz, Isabelle Tjuatja Jia Ying Chua, Marion Margaret Aw, Marcus Kai Xuan Tan, Jin Yang Ho, Rodney Yu Hang Soh, Meng Ying Sim, Nicholas Jing Hao Ngiam, Vanice Su Yee Wong, Jeremy Bingyuan Lin, Charmaine Si Min Sia","doi":"10.4103/singaporemedj.SMJ-2024-014","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2024-014","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392794","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}

{"title":"The Singapore Medical Journal Reviewer Recognition Awards 2024.","authors":"","doi":"10.4103/singaporemedj.SMJ-2025-014","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2025-014","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":"66 2","pages":"119"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495147","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}

{"title":"Enhancing post-resuscitation care to optimise neurological outcomes: a call to action.","authors":"Ruth Weixian Chen, Yew Woon Chia, Andrew Fu Wah Ho","doi":"10.4103/singaporemedj.SMJ-2025-016","DOIUrl":"10.4103/singaporemedj.SMJ-2025-016","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":"66 2","pages":"64-65"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Singapore Medical Journal Reviewer Recognition Awards 2024.","authors":"","doi":"10.4103/singaporemedj.SMJ-2025-014","DOIUrl":"10.4103/singaporemedj.SMJ-2025-014","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":"66 2","pages":"119"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461401","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}

{"title":"Skin and soft tissue infections in primary care.","authors":"Jen Yi Ling, Choon How How, Jaime Mei Fong Chien, Vijo Poulose, Mark Chung Wai Ng","doi":"10.4103/singaporemedj.SMJ-2022-151","DOIUrl":"10.4103/singaporemedj.SMJ-2022-151","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":"66 2","pages":"108-113"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Singapore Medical Journal Reviewer Recognition Awards 2024.","authors":"","doi":"10.4103/singaporemedj.SMJ-2025-014","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2025-014","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":"66 2","pages":"119"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442658","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}

{"title":"Understanding medical professionalism.","authors":"T Thirumoorthy, Vishalkumar G Shelat","doi":"10.4103/singaporemedj.SMJ-2023-059","DOIUrl":"10.4103/singaporemedj.SMJ-2023-059","url":null,"abstract":"","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":"66 2","pages":"114-118"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomised controlled trials of dual antiplatelet therapy versus aspirin in patients with stroke or transient ischaemic attack: an updated meta-analysis.","authors":"Muhammad Basil Raza, Ali Akhtar, Maham Khan","doi":"10.4103/singaporemedj.SMJ-2024-064","DOIUrl":"https://doi.org/10.4103/singaporemedj.SMJ-2024-064","url":null,"abstract":"<p><strong>Introduction: </strong>We explored the efficacy and safety of dual antiplatelet therapy (DAPT) for individuals diagnosed with stroke or transient ischaemic attack (TIA), incorporating the latest insights from randomised controlled trials (RCTs). The emerging evidence surrounding DAPT in stroke and TIA plays a pivotal role in guiding clinical decisions.</p><p><strong>Methods: </strong>Our study included five RCTs (INSPIRES, THALES, POINT, CHANCE, FASTER) on DAPT (aspirin + P2Y12 inhibitor) initiated within 72 hours of acute stroke or TIA, which evaluated DAPT efficacy and safety over 21-90 days, focusing on new strokes and major bleeding. Secondary outcomes included cardiovascular events and recurrent strokes. Pooled odds ratios (OR) were computed using a random effects model.</p><p><strong>Results: </strong>The five RCTs involved 27,559 patients. Our analysis showed that DAPT significantly reduced stroke recurrence (OR 0.75; 95% confidence interval [CI] 0.68-0.82; P <0.001, I2 = 0%) but increased major bleeding risk (OR 2.20; 95% CI 1.38-3.51, P = 0.0009, I2 = 30%). It lowered major adverse cardiovascular events (OR 0.76; 95% CI 0.67-0.85, P < 0.001, I2 = 5%) and recurrent ischaemic events (OR 0.73; 95% CI 0.66-0.80, P < 0.001, I2 = 0%), but raised haemorrhagic stroke risk (OR 2.09; 95% CI 1.14-3.84, P = 0.02, I2 = 8%).</p><p><strong>Conclusion: </strong>Dual antiplatelet therapy - a combination of aspirin with either ticagrelor or clopidogrel - initated within 72 hours of a high-risk TIA or mild moderate ischaemic stroke is superior to aspirin alone in reducing the risk of recurrent stroke. However, DAPT comes with a higher risk of major bleeding.</p>","PeriodicalId":94289,"journal":{"name":"Singapore medical journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928968","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}