Community-Based Rehabilitation\u27s Effectiveness In Reducing Singapore Juvenile Recidivism

Singapore\u27s juvenile recidivism rate has climbed by around 5% since 2013, putting the country at risk of increased youth crime. With several mandatory rehabilitative programmes classified into two categories, Community-Based Rehabilitation (CBR) and Institutional-Based Rehabilitation (IBR), it is unclear whether the mandatory individual rehabilitative programmes for offenders were actually effective in achieving their corrective goals. This proposal would undertake a regression analysis to compare the effectiveness of CBR and IBR programmes utilizing secondary data gathered by the Ministry of Social and Family Development (MSF) and primary data from a survey. The survey will provide previously unstudied insights into the offender\u27s profile, conviction, rehabilitation path, recidivism, and attitudes toward the programmes\u27 effectiveness for a sample of approximately 7,150 Singaporean juveniles who have participated in or are currently participating in MSF\u27s mandatory rehabilitative programmes. The regression analysis will be run to determine which class of programme is more important between IBR and CBR, as well as which specific programmes within those two classes are more effective at reducing reoffending juveniles. Understanding the effectiveness of these programmes may result in additional improvements or the abolition of inefficient mandated rehabilitative programmes that are expensive to implement. Finally, rehabilitation programmes in Singapore should be strengthened in order to preserve and nurture our younger generations, who are crucial to the country\u27s future growth and development

Evaluating a Thrombosed Azygous Vein Aneurysm Combined with Pulmonary Arterial Thromboembolism by ECG-Gated Multidetector CT: a Case Report

Azygous vein aneurysm is a rare congenital lesion that needs to be differentiated from mediastinal mass lesions. Although almost of these anomalies are asymptomatic lesions, we experienced an interesting case in which a thrombus within an azygous vein aneurysm in a 75-year-old woman caused pulmonary thromboembolism. The patient was managed by medical treatment for one month and then the thrombus within both the azygous vein aneurysm and the pulmonary arteries completely resolved

A fatal case of acute pulmonary embolism caused by right ventricular masses of acute lymphoblastic lymphoma-leukemia in a 13 year old girl

We report a case of a 13-year-old girl with acute lymphoblastic lymphoma-leukemia, who presented with a cardiac metastasis in the right ventricle, resulting in a pulmonary embolism. At the time of her leukemia diagnosis, a cardiac mass was incidentally found. The differential diagnosis for this unusual cardiac mass included cardiac tumor, metastasis, vegetation, and thrombus. Empirical treatment was initiated, including anticoagulation and antibiotics. She underwent plasmapheresis and was administered oral prednisolone for her leukemia. Five days later, she experienced sudden hemodynamic collapse and required extracorporeal membrane oxygenation insertion and emergency surgery. These interventions proved futile, and the patient died. Pathology revealed that the cardiac mass comprised an aggregation of small, round, necrotic cells consistent with leukemia. This is the first known case of acute lymphoblastic leukemia presenting as a right ventricular mass, with consequent fatal acute pulmonary embolism. A cardiac mass in a child with acute leukemia merits investigation to rule out every possible etiology, including vegetation, thrombus, and even a mass of leukemic cells, which could result in the fatal complication of pulmonary embolism

Polypoid Endobronchial Lung Cyst with Bronchoscopic Removal : A Case Report

Pulmonary bronchogenic cyst in adults is rare and the typical appearance is a sharply circumscribed, round or oval nodule or mass, usually in the medial third of the lungs. Bronchial polyps are rare histopathologically distinct nonneoplastic endobronchial lesions and are classified as multiple papillomas, solitary papillomas, and inflammatory polyps. We herein report a patient with polypoid endobronchial lung cyst. A 68-yr-old woman presented with a discomfort and pain in the right upper chest of four weeks??duration. Chest radiography revealed a cystic lesion in the right upper lung. Computed tomography revealed a 4×5 cm sized large cyst. Neither enlarged mediastinal lymph nodes nor extrabronchial involvements were observed. Flexible bronchoscopy revealed a peduncular polyp about 2 cm in length originating from the anterior segment of right upper lung. After bronchoscopic removal of polyp, cystic lesion of the right upper lung disappeared

Transcatheter Closure of Fenestration with Detachable Coils After the Fontan Operation

We report our experience in 13 patients who underwent transcatheter closure of Fontan fenestration with the Cook® detachable coils. These patients underwent the extracardiac type Fontan operation with a short conduit fenestration (n=7) or lateral tunnel type with a punch-hole fenestration (n=6). Fenestration closure was done at the mean age of 5.1±2.4 yr, average of 32 months after the Fontan operation. We used one to three coils depending on the fenestration type, size, and residual shunt. Aortic oxygen saturations increased by an average of 5.4 (2-9)% and mean pressures in the Fontan circuit increased by an average of 2.1 (0-6) mmHg. During fol-low-up (median of 23 months), five patients (4 in extracardiac, 1 in lateral tunnel) had complete occlusion of the fenestration on echocardiography. There was no immediate or late complication. Transcatheter closure of fenestration in Fontan operation using the Cook® detachable coil is a safe and feasible technique. However, the coil was ineffective for closure of a punch-hole fenestration in the lateral tunnel type operation. In the conduit type fenestration, some modification of fenestration method instead of a short conduit for coil closure or use of new device is necessary to increase complete closure rate

The Effect of Passive Smoking on Asthma Symptoms, Atopy, and Airway Hyperresponsiveness in Schoolchildren

Passive smoking is a major cause of respiratory morbidity, and is associated with increased bronchial responsiveness in children. To evaluate the effect of smoking by a parent on asthma symptoms, atopy, and airway hyperresponsiveness (AHR), we conducted a cross-sectional survey of 503 schoolchildren that involved questionnaires, spirometry, allergy testing, and a bronchial challenge test. If the PC20 methacholine was less than 16 mg/mL, the subject was considered to have AHR. The prevalence of a parent who smoked was 68.7%. The prevalence of AHR was 45.0%. The sensitization rate to common inhalant allergens was 32.6%. Nasal symptoms such as rhinorrhea, sneezing, nasal itching, and nasal obstruction were present in 42.7%. Asthma symptoms such as cough and wheezing were present in 55.4%. The asthma symptoms were significantly more prevalent in children who had a parent who smoked than in those whose parents did not. The nasal symptoms, atopy, and AHR did not differ according to whether a parent smoked. In a multiple logistic regression model, the asthma symptoms and atopy were independently associated with AHR, when adjusted for confounding variables. Passive smoking contributed to asthma symptoms in schoolchildren and was not an independent risk factor of airway hyperresponsiveness in an epidemiological survey