292P Erectile dysfunction among male lymphoma survivors in a developing country

Background: Although erectile dysfunction (ED) is one of the known long-term complications among male cancer survivors, it is not commonly reported particularly in South East Asian region. This study aims to determine the prevalence of ED in lymphoma survivors in Malaysia and to determine its association with anxiety and depression, and its effects on patients’ quality of life (QOL). Methods: This was a cross-sectional study conducted in an outpatient haematology clinic at a tertiary hospital inMalaysia. Patients were allmale lymphoma survivors who were age 18 years old and above. The International Index of Erectile Function (IIEF-5) Questionnairewere used to screen for ED.Hospital Anxiety and Depression Score (HADS) questionnaire were used to assess for anxiety and depression.Quality of life were assessed using EORTC QLQ-C30. Bio-demographic datawas analysed using descriptive analysis. The association of EDwith the bio-demographics was assessed using Chi square test. The correlation between ED and anxiety/depression scores andQOL scores were measured using Pearson correlation. P value of<0.05 is statistically significant. Results: A total of 106 male patients were recruited (response rate of 79.6%). The mean age of the participants was 55.7 years old (range from 18-85 years). More than half (61%) of the patients were above 50 years old and 50.7% had other comorbidities. Thirty-five percent of patients were not sexually active at the time of interview and the most common reason provided were ‘feeling too tired’ (48.1%). Among those who were sexually active patients, 81.7% reported presence of ED. However, 4.2% had severe ED. The prevalence of ED among younger age group (< 40 years old) was 61.5%. Age was the only factor found to be associated with ED and the severity of EDincreased with age (p value ¼ 0.002). There was no association between ED with symptoms of anxiety or depression. Quality of life was also not found to be significantly associated with ED. Conclusions: ED is more prevalent in the older population and this is consistent with many studies. However, the relatively high prevalence of ED in younger patients is of concerns. This should remind the treating clinicians to be more mindful of the sexual dysfunction of these groups of patients and perhaps intervention may offer some help

Erectile dysfunction in male lymphoma survivors in a Southeast Asian country

Introduction: Although erectile dysfunction (ED) is one of known long-term complications among male lymphoma survivors, it is not commonly reported, particularly in Southeast Asia. This study aimed to determine the prevalence of ED in lymphoma survivors in Malaysia and its association with anxiety and depression, and effects on quality of life. Methods: This was a cross-sectional study conducted at a tertiary hospital in Malaysia. Patients were all male lymphoma survivors. The self-administered International Index of Erectile Function questionnaire was used to screen for ED. The Hospital Anxiety and Depression Score questionnaire was used to assess for anxiety and depression, and quality of life was assessed using the European Organization for Research and Treatment of Cancer quality of life questionnaire. Results: Overall, 106 patients were recruited. Mean age was 55.7 years, with 61.3% of patients aged above 50 years. Only 67.0% of patients were sexually active and 81.7% of these reported the presence of ED, with only 4.2% having severe ED. Prevalence of ED among younger patients (age ≤ 50 years old) was 64.5%.The most common reason given by patients who were not sexually active was fatigue. Age was the only factor found to be associated with ED (p < 0.005) and severity of ED increased with age. There was no association between ED and psychological stress or quality of life. Conclusion: Prevalence of ED and absence of sexual activity in lymphoma survivors was high. This should serve as a reminder to the treating clinician to offer early treatment and counselling

Designettes: An Approach to Multidisciplinary Engineering Design Education

Design and other fundamental topics in engineering are often isolated to dedicated courses. An opportunity exists to foster a culture of engineering design and multidisciplinary problem solving throughout the curriculum. Designettes, charettelike design challenges, are rapid and creative learning tools that enable educators to integrate design learning in a single class, across courses, across terms, and across disciplines. When two or more courses join together in a designette, a multidisciplinary learning activity occurs; multiple subjects are integrated and applied to open-ended problems and grand challenges. This practice helps foster a culture of design, and enables the introduction of multidisciplinary design challenges. Studies at the Singapore University of Technology and Design (SUTD) demonstrate learning of engineering subject matter in a bio-inspired robotics designette (MechAnimal), an interactive musical circuit designette, and an automated milk delivery (AutoMilk) designette. Each challenge combines problem clarification, concept generation, and prototyping with subject content such as circuits, biology, thermodynamics, differential equations, or software with controls. From pre- and postsurveys of students, designettes are found to increase students' understanding of engineering concepts. From 321 third-semester students, designettes were found to increase students' perceptions of their ability to solve multidisciplinary problems

The nonhuman condition: Radical democracy through new materialist lenses

This Critical Exchange explores the nonhuman condition. It asks: What are the implications of decentering the human subject via a new materialist reading of radical democracy? Does this reading dilute political agency? Or should this be seen, on the contrary, as an invitation for new voices and demands to enter into democratic assemblages? How might engagement with the more-than-human disrupt or extend theories of radical democracy? In our introductory contribution, we engage with the radical democratic human subject and explore new materialist thinking and its challenge to anthropocentrism. We offer a preliminary answer to how democratic agency is reconfigured under the nonhuman condition. While these questions have no final answers, we show that engaging with them opens a fruitful conversation about the limits and content of radical democracy

Exploring autistic adults' psychosocial experiences affecting beginnings, continuity and change in camouflaging over time: A qualitative study in Singapore

Over their lifetimes, many autistic people learn to camouflage (hide or mask) their autism-related differences to forge relationships, find work and live independently in largely non-autistic societies. Autistic adults have described camouflaging as a 'lifetime of conditioning . . . to act normal' involving 'years of effort', suggesting that camouflaging develops over an autistic person's lifetime and may start early on, in childhood or adolescence. Yet, we know very little about why and how autistic people start to camouflage, or why and how their camouflaging behaviours continue or change over time. We interviewed 11 Singaporean autistic adults (9 male, 2 female, 22-45 years old) who shared their camouflaging experiences. We found that autistic adults' earliest motivations to camouflage were largely related to the desire to fit in and connect with others. They also camouflaged to avoid difficult social experiences (such as being teased or bullied). Autistic adults shared that their camouflaging behaviours became more complex and that, for some, camouflaging became a part of their self-identity over time. Our findings suggest that society should not pathologise autistic differences, but instead accept and include autistic people, to reduce the pressure on autistic people to hide who they truly are

Risk assessment of failure during transitioning from in-centre to home haemodialysis

Background: Introducing a de-novo home haemodialysis (HHD) program often raises safety concerns as errors could potentially lead to serious adverse events. Despite the complexity of performing haemodialysis at home without the supervision of healthcare staff, HHD has a good safety record. We aim to pre-emptively identify and reduce the risks to our new HHD program by risk assessment and using failure mode and effects analysis (FMEA) to identify potential defects in the design and planning of HHD. Methods: We performed a general risk assessment of failure during transitioning from in-centre to HHD with a failure mode and effects analysis focused on the highest areas of failure. We collaborated with key team members from a well-established HHD program and one HHD patient. Risk assessment was conducted separately and then through video conference meetings for joint deliberation. We listed all key processes, sub-processes, step and then identified failure mode by scoring based on risk priority numbers. Solutions were then designed to eliminate and mitigate risk. Results: Transitioning to HHD was found to have the highest risk of failure with 3 main processes and 34 steps. We identified a total of 59 areas with potential failures. The median and mean risk priority number (RPN) scores from failure mode effect analysis were 5 and 38, with the highest RPN related to vascular access at 256. As many failure modes with high RPN scores were related to vascular access, we focussed on FMEA by identifying the risk mitigation strategies and possible solutions in all 9 areas in access-related medical emergencies in a bundled- approach. We discussed, the risk reduction areas of setting up HHD and how to address incidents that occurred and those not preventable. Conclusions: We developed a safety framework for a de-novo HHD program by performing FMEA in high-risk areas. The involvement of two teams with different clinical experience for HHD allowed us to successfully pre-emptively identify risks and develop solutions

Managing for ocean biodiversity to sustain marine ecosystem services

Managing a complex ecosystem to balance delivery of all of its services is at the heart of ecosystem-based management. But how can this balance be accomplished amidst the conflicting demands of stakeholders, managers, and policy makers? In marine ecosystems, several common ecological mechanisms link biodiversity to ecosystem functioning and to a complex of essential services. As a result, the effects of preserving diversity can be broadly beneficial to a wide spectrum of important ecosystem processes and services, including fisheries, water quality, recreation, and shoreline protection. A management system that conserves diversity will help to accrue more “ecoservice capital” for human use and will maintain a hedge against unanticipated ecosystem changes from natural or anthropogenic causes. Although maintenance of biodiversity cannot be the only goal for ecosystem-based management, it could provide a common currency for evaluating the impacts of different human activities on ecosystem functioning and can act as a critical indicator of ecosystem status