The impact of social connections and discrimination to HIV risk among Asian gay and bisexual men in Australia

Background. Asian gay, bisexual, and other men who have sex with men (GBMSM) are overrepresented in new HIV diagnoses in Australia. Social engagement with other GBMSM has been associated with HIV testing and pre-exposure prophylaxis (PrEP) uptake. Asian GBMSM may be socially disconnected from LGBTQ+ people, which may increase their HIV risk. This analysis assessed the contribution of social connection on HIV risk among Asian GBMSM. Methods. Using an online cross-sectional survey of Asian GBMSM in Australia, we measured condomless anal intercourse (CLAI) in the last 6 months without PrEP or an undetectable viral load (UVL), i.e. CLAI with a risk of HIV transmission. Bivariable and multivariable logistic regression models were performed to compare demographic characteristics and social engagement of participants who had CLAI without PrEP or UVL to those who had not. Analyses were restricted to participants who reported sex with casual partners in the last 6 months. Results. Among 509 participants who had casual partners in the last 6 months, 151 (29.7%) reported CLAI without PrEP or UVL. CLAI without PrEP or UVL was negatively associated with full-time employment, and recently being tested for HIV and was positively associated with experiencing discrimination based on sexual orientation. Social engagement with LGBTQ+ people was not associated with CLAI without PrEP or UVL. Conclusions. CLAI without PrEP or UVL was not related to social connections with LGBTQ+ people but was more likely among Asian men who had experienced sexuality-related discrimination, suggesting that mitigating homophobia and biphobia may assist in improving HIV prevention among Asian GBMSM who live in Australia

A systematic scoping review of approaches to teaching and assessing empathy in medicine

10.1186/s12909-021-02697-6BMC Medical Education21129

Burnout, anxiety and depression in healthcare workers during the early COVID-19 period in Singapore

acceptedVersionPeer reviewe

Postgraduate ethics training programs: a systematic scoping review

BACKGROUND: Molding competent clinicians capable of applying ethics principles in their practice is a challenging task, compounded by wide variations in the teaching and assessment of ethics in the postgraduate setting. Despite these differences, ethics training programs should recognise that the transition from medical students to healthcare professionals entails a longitudinal process where ethics knowledge, skills and identity continue to build and deepen over time with clinical exposure. A systematic scoping review is proposed to analyse current postgraduate medical ethics training and assessment programs in peer-reviewed literature to guide the development of a local physician training curriculum. METHODS: With a constructivist perspective and relativist lens, this systematic scoping review on postgraduate medical ethics training and assessment will adopt the Systematic Evidence Based Approach (SEBA) to create a transparent and reproducible review. RESULTS: The first search involving the teaching of ethics yielded 7669 abstracts with 573 full text articles evaluated and 66 articles included. The second search involving the assessment of ethics identified 9919 abstracts with 333 full text articles reviewed and 29 articles included. The themes identified from the two searches were the goals and objectives, content, pedagogy, enabling and limiting factors of teaching ethics and assessment modalities used. Despite inherent disparities in ethics training programs, they provide a platform for learners to apply knowledge, translating it to skill and eventually becoming part of the identity of the learner. Illustrating the longitudinal nature of ethics training, the spiral curriculum seamlessly integrates and fortifies prevailing ethical knowledge acquired in medical school with the layering of new specialty, clinical and research specific content in professional practice. Various assessment methods are employed with special mention of portfolios as a longitudinal assessment modality that showcase the impact of ethics training on the development of professional identity formation (PIF). CONCLUSIONS: Our systematic scoping review has elicited key learning points in the teaching and assessment of ethics in the postgraduate setting. However, more research needs to be done on establishing Entrustable Professional Activities (EPA)s in ethics, with further exploration of the use of portfolios and key factors influencing its design, implementation and assessment of PIF and micro-credentialling in ethics practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-021-02644-5

Ethnobotanical study and nutrient potency of local traditional vegetables in Central Kalimantan

The Dayak people in Central Kalimantan, traditionally consumed local vegetable, either collected from the wild or traditionally cultivated. Unfortunately, many of the traditional vegetables are approaching extinction, even in their local market. This research is intended to conserve the traditional vegetable by collecting nutritional data and cultural information about the vegetable. Nineteen traditional Dayak vegetables were observed in local markets and in wild areas. Taxonomic identification revealed that the vegetables were Passiflora foetida L. (kemot), Diplazium esculentum (Retz). SW. (bajey fern), Spondias pinnata (L.f.) Kurtz (kedondong leaves), Neptunia oleracea Lour (malu-malu leaves), Manihot esculenta Crantz (cassava leaves). Vigna unguiculata (L.) Walp. (talak leaves), Etlingera elatiar (Jack) R.M. Smith (potok shoots, red and green cultivar), Calamus sp. (rotan shoots), Nauclea sp. (Taya leaves), Momordica charantia L. (paria leaves), Gymnopetalum cochinense Kurz (kanjat), Solanum torvum Swartz. (segau fruit), Colocasia esculenta (L.) Schott (sulur keladi shoots), Stenochlaena palutris (Burm.)Bedd. (kalakai leaves; red and white cultivar), lotus shoots (pucuk teratai), and Cnesmone javanica Blume (lampinak leaves). Nutrient analysis revealed that red kalakai (wild fern) has the potential nutrient value. It has a high amount of Fe (41.53 ppm), Cu (4.52 ppm), vitamin C (15.41 mg/100g), protein (2.36%), β-carotene (66.99 ppm), and folic acid (11.30 ppm). Other iron-rich vegetables were sulur keladi (49.25 ppm) and bajey (44.6 ppm). While other vitamin C-rich vegetables were paria leaves (18.34 mg/100 g wb), and bajaj fern (22.05 mg/100g w.b). Sulur keladi and bajey were also rich in folic acid. They had 16 and 6.3 ppm of folic acid respectively. The β-carotene content in bajey was 74.04 ppm while taya was 77.41 ppm

Conducting a high-stakes OSCE in a COVID-19 environment

The COVID-19 pandemic has presented significant challenges for medical schools. It is critical to ensure final year medical school students are not delayed in their entry to the clinical workforce in times of healthcare crisis. However, proceeding with assessment to determine competency for graduation from medical school, and maintaining performance standards for graduating doctors is an unprecedented challenge under pandemic conditions. This challenge is hitherto uncharted territory for medical schools and there is scant guidance for medical educators. In early March 2020, Duke-National University Singapore Medical School embraced the challenge for ensuring competent final year medical students could complete their final year of studies and graduate on time, to enter the medical workforce in Singapore without delay. This paper provides details of how the final year clinical performance examinations were planned and conducted during the COVID-19 pandemic. The aim of the paper is to provide guidance to other medical schools in similar circumstances who need to plan and make suitable adjustments to clinical skills examinations under current pandemic conditions. The paper illustrates how it is possible to design and implement clinical skills examinations (OSCEs) to ensure the validity and reliability of high-stakes performance assessments whilst protecting the safety of all participants, minimising risk and maintaining defensibility to key stakeholders

Rabies Post-Exposure Prophylaxis (PEP) in a Major Tertiary Hospital in Singapore

Rabies is one of the most feared human diseases as it is almost uniformly fatal once clinical symptoms set in. The majority of deaths were due to a lack of rabies post-exposure prophylaxis (PEP). We review the profile of travellers to Southeast Asia (SEA) seeking rabies PEP in Singapore General Hospital (SGH). Thirty-seven patients visited our travel clinic for rabies PEP from Dec 2010 to Dec 2013. Their mean age was 27.0 years. Twenty-four (65%) received rabies PEP within 24 hours of exposure. Rabies immunoglobulin (RIG) was indicated in 28 cases (76%) but only half were administered; two-thirds were given in our clinic. Only two received rabies pre-exposure prophylaxis and both were non-residents. There is an urgent need to increase the awareness of potential rabies infection amongst Asian travellers