Examining live-in foreign domestic helpers as a coping resource for family caregivers of people with dementia in Singapore

In Singapore, the responsibility of caring for persons with dementia falls on family members who cope with long - term caregiver burden depending on available support resources. Hiring foreign domestic workers to alleviate caregiver burden becomes a prevalent coping strategy that caregivers adopt. This strategy allows caregivers to provide home care as part of fulfilling family obligations while managing caregiver burden. This study aimed to investigate primary caregivers’ relationship with hired support and its impact on coping with caregiver burden. Twenty in-depth interviews were conducted with primary caregivers who hired live-in domestic helpers to take care of their family members with dementia. The findings revealed that caregivers perceived the normative obligations to provide home care to family members with dementia. They sought support from domestic helpers to cope with physical and mental burnout, disruption of normal routines, and avoidance of financial strain. A mutual-support relationship was built between caregivers and domestic helpers through trust and interdependence. The presence of domestic helpers as a coping resource reveals the positive outcomes of problem, emotional, and diversion focused coping. This study illustrates that coping strategies are employed in different ways depending on the needs of caregivers, access to infrastructure, cultural expectations, and available resources

Traditional Chinese medicine physicians’ insights into inter-professional tensions between traditional Chinese medicine and biomedicine: a critical perspective

In Singapore, the institutional preference for biomedicine and the cultural importance of traditional Chinese medicine (TCM) have created tensions between the two medical systems and erected barriers to a more collaborative healthcare system. This study foregrounds TCM physicians’ voice to reveal ideological struggles and power imbalances that underlie the inter-professional tensions and accompanying marginalization of TCM. Through in-depth interviews with 22 TCM physicians in Singapore, this study reveals the incongruences in ideological underpinnings between biomedicine and TCM, reflected in their different worldviews and epistemological approaches to knowledge formation and evaluation. Power differentials between the two medical systems are manifest in TCM physicians’ inferior position in relation to their biomedical peers, the patients’ internalization of biomedical standards to question the TCM profession and their own interest in seeking TCM treatments, and the state’s limited support for TCM research, subsidies, and service provision in hospital settings. The results suggest that more open dialogue about the dichotomous framings of biomedicine and TCM is key to disrupting the mutual reinforcement of ideology and power, as well as to creating increased mutual understanding between the two medical systems

Procedural Justice in Online Deliberation: Theoretical Explanations and Empirical Findings

This article reviews extant conceptualizations of procedural justice and reports the results of an empirical study testing the effects of fair deliberation. From a communicative action perspective, we argue that Habermas’s conceptions of speech conditions and validity conditions can be used to evaluate the discursive and substantive dimensions of procedural justice in deliberation. That is, fair deliberation is built on the fulfillment of discourse norms and the communicativeness of dialogic interactions. The communicative measures are compatible with extant procedural justice measures and provide a communication-centered ground for evaluating deliberative outcomes related to procedural justice. The case study involves public discussion of the Singaporean government’s population policies on an online deliberative platform. The results show that when procedural justice is presented in the realization of both speech conditions and validity conditions, it fosters participants’ beliefs in the rightfulness of deliberative policymaking. Additionally, speech conditions play a more important role than validity conditions in predicting citizens’ specific policy support after online deliberation. The findings illustrate one instance of how communicative norms are prioritized in different deliberative settings and what deliberative benefits a fair procedure can achieve. The results shed light on the theorization of procedural justice and advance the extant knowledge of evaluating procedural justice in deliberation

Examining live-in foreign domestic helpers as a coping resource for family caregivers of people with dementia in Singapore

In Singapore, the responsibility of caring for persons with dementia falls on family members who cope with long - term caregiver burden depending on available support resources. Hiring foreign domestic workers to alleviate caregiver burden becomes a prevalent coping strategy that caregivers adopt. This strategy allows caregivers to provide home care as part of fulfilling family obligations while managing caregiver burden. This study aimed to investigate primary caregivers’ relationship with hired support and its impact on coping with caregiver burden. Twenty in-depth interviews were conducted with primary caregivers who hired live-in domestic helpers to take care of their family members with dementia. The findings revealed that caregivers perceived the normative obligations to provide home care to family members with dementia. They sought support from domestic helpers to cope with physical and mental burnout, disruption of normal routines, and avoidance of financial strain. A mutual-support relationship was built between caregivers and domestic helpers through trust and interdependence. The presence of domestic helpers as a coping resource reveals the positive outcomes of problem, emotional, and diversion focused coping. This study illustrates that coping strategies are employed in different ways depending on the needs of caregivers, access to infrastructure, cultural expectations, and available resources

Interplay of Support, Comparison, and Surveillance in Social Media Weight Management Interventions: Qualitative Study

Background:The trend of using social media as a platform to deliver weight management interventions is substantial. This illustrates a need to develop a holistic understanding of doctor-patient communication and patient-patient communication in social media and the impacts on overweight and obese adults’ weight management. Studies like this will shed light on how social media can be more effectively integrated into weight management programs to enhance individuals’ short-term and long-term weight management behaviors and to improve the end result of preferred weight outcomes. Objective:This qualitative study explored the interplay of three social influence factors: social support, social comparison, and surveillance derived from two sources: doctor-patient communication and peer interactions in a social media-based weight management program. The study aimed to address how social media support, comparison, and surveillance affect overweight and obese adults’ self-regulation of weight management. The program, designed and implemented by the research team based in a tertiary referral hospital in a southeastern province in China, included both diet and physical activity components. Methods:We conducted in-depth interviews with 32 program participants with variations in age (M = 35.59, SD = 7.67), gender, duration of program membership (M = 1.4 years), and weight loss outcomes (-9.4% to 54.2% weight loss). All interview data were audio-recorded, transcribed, and translated using the translation-back-translation technique. Nvivo software was used to facilitate the coding process. Results:Results of thematic analysis indicated the distinct functions of professionally-led support and peer support. Professional support was presented in the form of capacity building. Peer support fostered empathy and sense of belonging and had a mutually constitutive relationship with peer comparison and peer-based surveillance. Peer comparison enhanced motivation and positive competition. However, it could also reinforce negative group norms and resulted in downturns in reference standards. Social media surveillance prompted participants’ reactions to the gaze from medical professionals and peers that could be cooperative or resisting. Findings from this study illustrated the interrelated and fluctuant influences of support, comparison, and surveillance. Conclusions:This study revealed that the interactive characteristics of social media eased the practices of social support and social comparison and created new forms of surveillance related to weight management. The theoretical contribution of the study was an in-depth understanding of social media influences on individuals’ weight management behaviors. Practical implications of the study concerned improved strategies for maintaining the positive dynamics of social media interactions and preventing negative resistance to surveillance technology

Lower workforce participation is associated with more severe persisting breathlessness

Background: Not being able to work has negative health, social and financial consequences. Persisting breathlessness is prevalent in working-aged people. Is it associated with lower workforce participation? This study, using the South Australian Health Omnibus, aimed to explore associations between paid workforce participation and persisting breathlessness intensity, and economic impacts on income in people of working age. Methods: This cross-sectional study conducted face-to-face interviews with a random sample of adults in South Australia (n = 8916). Questions included key demographic data, workforce participation and the presence and intensity of persisting breathlessness. Data from working-aged respondents (20–65years of age) were standardised to the census for regression analyses. Work was coded to paid full- or part-time work or ‘other’. Persisting breathlessness (more than three of the last six months) used the modified Medical Research Council breathlessness scale (aggregated to 0, 1, 2–4). Opportunity cost valuations compared annual income foregone by persisting breathlessness severity. Results: Of people interviewed, 6,608 were working-aged (49.9% male; 67.5% had post-secondary qualifications; 70.9% were in paid full- or part-time work; and 1.7% had mMRC score 2–4). Workforce participation dropped in working aged people with increasing breathlessness: mMRC 0, 70.6%; mMRC 1, 51.7%; mMRC 2–4, 20.3%. In the regression model, people with the most severe breathlessness were much less likely to work (OR 0.14; 95% CI 0.09, 0.22). Annual income foregone by people with persisting breathlessness was AU$10.7 billion (AU$9.1b for full-time and AU$1.6b for part-time work; range AU$5.9b, AU$49.7b). Conclusion: Worsening persisting breathlessness is associated with lower workforce participation with direct financial consequences, greatest for older males

An integrative approach unveils FOSL1 as an oncogene vulnerability in KRAS-driven lung and pancreatic cancer

KRAS mutated tumours represent a large fraction of human cancers, but the vast majority remains refractory to current clinical therapies. Thus, a deeper understanding of the molecular mechanisms triggered by KRAS oncogene may yield alternative therapeutic strategies. Here we report the identification of a common transcriptional signature across mutant KRAS cancers of distinct tissue origin that includes the transcription factor FOSL1. High FOSL1 expression identifies mutant KRAS lung and pancreatic cancer patients with the worst survival outcome. Furthermore, FOSL1 genetic inhibition is detrimental to both KRAS-driven tumour types. Mechanistically, FOSL1 links the KRAS oncogene to components of the mitotic machinery, a pathway previously postulated to function orthogonally to oncogenic KRAS. FOSL1 targets include AURKA, whose inhibition impairs viability of mutant KRAS cells. Lastly, combination of AURKA and MEK inhibitors induces a deleterious effect on mutant KRAS cells. Our findings unveil KRAS downstream effectors that provide opportunities to treat KRAS-driven cancers

Factors associated with mobile health information seeking among Singaporean women

This study examined effects of age and social psychological factors on women’s willingness to be mobile health information seekers. A national survey of 1,878 Singaporean women was conducted to obtain information on women’s mobile phone usage, experiences of health information seeking, and appraisals of using mobile phones to seek health information. Results showed that young, middle-aged, and older women exhibited distinct mobile phone usage behaviors, health information-seeking patterns, and assessments of mobile health information seeking. Factors that accounted for their mobile information-seeking intention also varied. Data reported in this study provide insights into mobile health interventions in the future

SARS-CoV-2 Infects Human Pluripotent Stem Cell-Derived Cardiomyocytes, Impairing Electrical and Mechanical Function

COVID-19 patients often develop severe cardiovascular complications, but it remains unclear if these are caused directly by viral infection or are secondary to a systemic response. Here, we examine the cardiac tropism of SARS-CoV-2 in human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) and smooth muscle cells (hPSC-SMCs). We find that that SARS-CoV-2 selectively infects hPSC-CMs through the viral receptor ACE2, whereas in hPSC-SMCs there is minimal viral entry or replication. After entry into cardiomyocytes, SARS-CoV-2 is assembled in lysosome-like vesicles and egresses via bulk exocytosis. The viral transcripts become a large fraction of cellular mRNA while host gene expression shifts from oxidative to glycolytic metabolism and upregulates chromatin modification and RNA splicing pathways. Most importantly, viral infection of hPSC-CMs progressively impairs both their electrophysiological and contractile function, and causes widespread cell death. These data support the hypothesis that COVID-19-related cardiac symptoms can result from a direct cardiotoxic effect of SARS-CoV-2