General Public’s knowledge, awareness, and perception of Cardiometabolic diseases: data from a Singapore study population

BackgroundHealth literacy and illness perception play crucial roles in tackling the cardiometabolic disease epidemic. We aim to compare the attitudes, knowledge, self-perceived risks and actions taken, between individuals with and without metabolic risk factors (MFs).MethodsFrom 5 June to 5 October 2022, participants of the general public were invited to complete a self-administered questionnaire. MF status was defined as the presence of hypertension, hyperlipidemia, diabetes mellitus and/or current/previous smoking. Participants were assessed based on four categories (knowledge-based, attitude-based, perceived risk, and action-based) of questions pertaining to four cardiometabolic diseases – diabetes mellitus, hypertension, hyperlipidemia, and non-alcoholic fatty liver disease.ResultsA total of 345 participants were enrolled, of whom 34.5% had at least one MF. Compared to those without MFs, participants with MFs had lower knowledge scores, but higher perceived risk scores across all cardiometabolic diseases. The largest knowledge gap pertained to hypertension-related questions. After adjustment, linear regression demonstrated that the presence of MFs (β:2.752, 95%CI: 0.772–4.733, p = 0.007) and higher knowledge scores (β:0.418, 95%CI: 0.236–0.600, p < 0.001) were associated with higher perceived risk. Despite increased perceived risk in those with MFs, this translated to only few increased self-reported preventive actions, when compared to those without MFs, namely the reduction in red meat/processed food consumption (p = 0.045) and increase in fruits/vegetables consumption (p = 0.009).ConclusionThis study identified a vulnerable subpopulation living with MFs, with high perceived risks, and discordant levels of knowledge and preventive actions taken. Nationwide efforts should be channeled into addressing the knowledge-to-action gap

Retroperitoneal liposarcomas: The experience of a tertiary Asian center

10.1186/1477-7819-9-12World Journal of Surgical Oncology9

A study on the effects of dialectical inquiry, devil's advocacy and consensus-based decision making approaches on the group conflict variables.

Past researches have looked at the study of group conflict in Group Support System (GSS) environment via the employment of various decision approaches - Dialectical Inquiry, Devil's Advocacy, and Consensus-based approach. These studies have been conducted to evaluate outcomes such as the performance outcome quality, process and solution satisfaction and attraction to group. However, no prior study has looked at the process level variables such as the level and management strategies of conflict, nor the productivity of the conflict resulting from the use of these approaches. The effect of national culture (Singapore v United States of American) on the above variables have also be incorporated in prior research. This research project used an experiment consisting of 17 groups of 6 members each to compare the consensus-based (C) approach against dialectical inquiry (Dl) and devil's advocacy (DA) approaches to decision making in a GSS environment. The variables investigated in this study are the types and amount of conflicts, conflict management strategies, and conflict productivity. DI and DA approaches are expected to generate the highest level of issue-based and interpersonal conflict respectively. In terms of conflict management strategies, DI group is expected to have the greatest tendency to adopt integrative strategy; DA and C groups are expected to have the greatest tendency to adopt distributive strategy and strategy approach respectively. Conflicts generated under the DI approach is perceived by many groups to be the most productive in decision making. The results in this study indicated that DA groups actually generate the highest level of issue-based conflict. On the other hand, there is no significant difference between the three decision making approaches in terms ofinterpersonal conflict generated. DI and DA groups have similar tendency to adopt the integrative strategy to conflict management, while C groups have the greatest tendency to adopt the avoidance strategy. As for the distributive strategy, DA groups demonstrated the greatest tendency to adopt it. The results also indicated that the highest level of conflict productivity is perceived in groups using the DI approach to decision making. Task types have apparently no effect on the three decision making approaches in terms of the variables being investigated in this research.ACCOUNTANC

General Public's knowledge, awareness, and perception of Cardiometabolic diseases: data from a Singapore study population

10.3389/fmed.2023.1193829FRONTIERS IN MEDICINE1

Antibiotic treatment failure of uncomplicated urinary tract infections in primary care

Abstract Background Higher resistance rates of > 20% have been noted in Enterobacteriaceae urinary isolates towards ciprofloxacin and co-trimoxazole (C + C) in Singapore, compared with amoxicillin-clavulanate and nitrofurantoin (AC + N). This study examined if treatment failure varied between different antibiotics, given different resistant rates, for uncomplicated urinary tract infections (UTIs) managed in primary care. We also aimed to identify gaps for improvement in diagnosis, investigations, and management. Methods A retrospective cohort study was conducted from 2019 to 2021 on female patients aged 18–50 with uncomplicated UTIs at 6 primary care clinics in Singapore. ORENUC classification was used to exclude complicated UTIs. Patients with uncomplicated UTIs empirically treated with amoxicillin-clavulanate, nitrofurantoin, ciprofloxacin or co-trimoxazole were followed-up for 28 days. Treatment failure was defined as re-attendance for symptoms and antibiotic re-prescription, or hospitalisation for UTI complications. After 2:1 propensity score matching in each group, modified Poisson regression and Cox proportional hazard regression accounting for matched data were used to determine risk and time to treatment failure. Results 3194 of 4253 (75.1%) UTIs seen were uncomplicated, of which only 26% were diagnosed clinically. Urine cultures were conducted for 1094 (34.3%) uncomplicated UTIs, of which only 410 (37.5%) had bacterial growth. The most common organism found to cause uncomplicated UTIs was Escherichia coli (64.6%), with 92.6% and 99.4% of isolates sensitive to amoxicillin-clavulanate and nitrofurantoin respectively. Treatment failure occurred in 146 patients (4.57%). Among 1894 patients treated with AC + N matched to 947 patients treated with C + C, patients treated with C + C were 50% more likely to fail treatment (RR 1.49, 95% CI 1.10–2.01), with significantly higher risk of experiencing shorter time to failure (HR 1.61, 95% CI 1.12–2.33), compared to patients treated with AC + N. Conclusion Treatment failure rate was lower for antibiotics with lower reported resistance rates (AC + N). We recommend treating uncomplicated UTIs in Singapore with amoxicillin-clavulanate or nitrofurantoin, based on current local antibiograms. Diagnosis, investigations and management of UTIs remained sub-optimal. Future studies should be based on updating antibiograms, highlighting its importance in guideline development