LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 6 of total 6

Search options

  1. Article ; Online: Impact of a rapid access chest pain clinic in Singapore to improve evaluation of new-onset chest pain.

    Toh, Lay Cheng / Khoo, Christina / Goh, Cheng Huang / Choa, Gary / Quek, Lit Sin / Phang, Jonathan / Wong, Franco / Tsou, Keith / Kwan, Yew Seng / Kojodjojo, Pipin

    Postgraduate medical journal

    2023  Volume 99, Issue 1171, Page(s) 500–505

    Abstract: Background: Chest pain (CP) accounts for 5% of emergency department (ED) visits, unplanned hospitalisations and costly admissions. Conversely, outpatient evaluation requires multiple hospital visits and longer time to complete testing. Rapid access ... ...

    Abstract Background: Chest pain (CP) accounts for 5% of emergency department (ED) visits, unplanned hospitalisations and costly admissions. Conversely, outpatient evaluation requires multiple hospital visits and longer time to complete testing. Rapid access chest pain clinics (RACPCS) are established in the UK for timely, cost-effective CP assessment. This study aims to evaluate the feasibility, safety, clinical and economic benefits of a nurse-led RACPC in a multiethnic Asian country.
    Methods: Consecutive CP patients referred from a polyclinic to the local general hospital were recruited. Referring physicians were left to their discretion to refer patients to the ED, RACPC (launched in April 2019) or outpatients. Patient demographics, diagnostic journey, clinical outcomes, costs, HEART (History, ECG, Age, Risk Factors, Troponin) scores and 1-year overall mortality were recorded.
    Results: 577 CP patients (median HEAR score of 2.0) were referred; 237 before the launch of RACPC. Post RACPC, fewer patients were referred to the ED (46.5% vs 73.9%, p < 0.01), decreased adjusted bed days for CP, more non-invasive tests (46.8 vs 39.2 per 100 referrals, p = 0.07) and fewer invasive coronary angiograms (5.6 vs 12.2 per 100 referrals, p < 0.01) were performed. Time from referral to diagnosis was shortened by 90%, while requiring 66% less visits (p < 0.01). System cost to evaluate CP was reduced by 20.7% and all RACPC patients were alive at 12 months.
    Conclusions: An Asian nurse-led RACPC expedited specialist evaluation of CP with less visits, reduced ED attendances and invasive testing whilst saving costs. Wider implementation across Asia would significantly improve CP evaluation.
    MeSH term(s) Humans ; Pain Clinics ; Singapore ; Chest Pain/diagnosis ; Chest Pain/etiology ; Coronary Angiography ; Hospitalization ; Emergency Service, Hospital
    Language English
    Publishing date 2023-06-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 80325-x
    ISSN 1469-0756 ; 0032-5473
    ISSN (online) 1469-0756
    ISSN 0032-5473
    DOI 10.1136/postgradmedj-2021-141427
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Ua VI Zs.340: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  2. Article ; Online: Cannabinoids as an Emerging Therapy for Posttraumatic Stress Disorder and Substance Use Disorders.

    Cohen, Jacob / Wei, Zelan / Phang, Jonathan / Laprairie, Robert B / Zhang, Yanbo

    Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society

    2019  Volume 37, Issue 1, Page(s) 28–34

    Abstract: Posttraumatic Stress Disorder (PTSD) is a leading psychiatric disorder that mainly affects military and veteran populations but can occur in anyone affected by trauma. PTSD treatment remains difficult for physicians because most patients with PTSD do not ...

    Abstract Posttraumatic Stress Disorder (PTSD) is a leading psychiatric disorder that mainly affects military and veteran populations but can occur in anyone affected by trauma. PTSD treatment remains difficult for physicians because most patients with PTSD do not respond to current pharmacological treatment. Psychotherapy is effective, but time consuming and expensive. Substance use disorder is often concurrent with PTSD, which leads to a significant challenge for PTSD treatment. Cannabis has recently received widespread attention for the potential to help many patient populations. Cannabis has been reported as a coping tool for patients with PTSD and preliminary legalization data indicate Cannabis use may reduce the use of more harmful drugs, such as opioids. Rigorous clinical studies of Cannabis could establish whether Cannabis-based medicines can be integrated into treatment regimens for both PTSD and substance use disorder patients.
    MeSH term(s) Adult ; Cannabinoids/therapeutic use ; Female ; Humans ; Male ; Medical Marijuana/therapeutic use ; Stress Disorders, Post-Traumatic/drug therapy ; Substance-Related Disorders/drug therapy
    Chemical Substances Cannabinoids ; Medical Marijuana
    Language English
    Publishing date 2019-12-31
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605640-4
    ISSN 1537-1603 ; 0736-0258
    ISSN (online) 1537-1603
    ISSN 0736-0258
    DOI 10.1097/WNP.0000000000000612
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 1921: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  3. Article: Evaluating user satisfaction with an electronic prescription system in a primary care group.

    Tan, Woan Shin / Phang, Jonathan Sk / Tan, Lay Kheng

    Annals of the Academy of Medicine, Singapore

    2009  Volume 38, Issue 6, Page(s) 494–497

    Abstract: Introduction: Electronic prescribing has been proposed as an important strategy to reduce medication errors, improve the quality of patient care and create savings in health care costs. Despite these potential advantages, user satisfaction plays a ... ...

    Abstract Introduction: Electronic prescribing has been proposed as an important strategy to reduce medication errors, improve the quality of patient care and create savings in health care costs. Despite these potential advantages, user satisfaction plays a significant role in the success of its implementation. Hence, this study aims to examine users' satisfaction and factors associated with satisfaction regarding an electronic prescription system implemented in the National Healthcare Group Polyclinics in Singapore.
    Materials and methods: An anonymous survey was administered in October 2007 to all physicians, pharmacists and pharmacy technicians working in the 9 National Healthcare Group Polyclinics.
    Results: Respondents included 118 doctors and 61 pharmacy staff. The overall level of satisfaction with electronic prescribing was high. Doctors and pharmacists reported a high degree of agreement that electronic prescribing reduces prescribing errors and interventions, and they did not want to go back to the paper-based system. Users were generally satisfied with the functionality of the system but there was some degree of workflow interference particularly for the pharmacy staff. Only 56.9% of the pharmacy respondents expressed satisfaction with the review function of the electronic prescription system and only 51.8% and 60% were satisfied when processing prescriptions that included items to be purchased from an external pharmacy or prescriptions with amendments. The results also revealed that satisfaction with the system was more associated with users' perceptions about the electronic prescription system's impact on productivity than quality of care.
    Conclusion: The survey results indicate that the implementation of the electronic prescription system has gone reasonably well. The survey findings provide opportunities for system and workflow enhancement, which is important as these issues could affect the acceptability of a new technology and the speed of diffusion within an organisation.
    MeSH term(s) Consumer Behavior ; Cross-Sectional Studies ; Diffusion of Innovation ; Electronic Prescribing ; Health Care Surveys ; Humans ; Medical Order Entry Systems ; Pharmaceutical Services ; Pharmacists/psychology ; Physicians/psychology ; Singapore
    Language English
    Publishing date 2009-06-30
    Publishing country Singapore
    Document type Journal Article
    ZDB-ID 604527-3
    ISSN 0304-4602
    ISSN 0304-4602
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.B 2420: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  4. Article: Peripheral arterial disease in community-based patients with diabetes in Singapore: Results from a Primary Healthcare Study.

    Lekshmi Narayanan, Raj Mohan / Koh, Woon Puay / Phang, Jonathan / Subramaniam, Tavintharan

    Annals of the Academy of Medicine, Singapore

    2010  Volume 39, Issue 7, Page(s) 525–527

    Abstract: Introduction: Peripheral arterial disease (PAD) is an important complication of diabetes mellitus (DM), significantly associated with increased morbidity and mortality secondary to amputations, strokes and coronary artery disease. Information on DM ... ...

    Abstract Introduction: Peripheral arterial disease (PAD) is an important complication of diabetes mellitus (DM), significantly associated with increased morbidity and mortality secondary to amputations, strokes and coronary artery disease. Information on DM patients with PAD is limited in our ethnically diverse population in Singapore. We aimed to determine the prevalence, risk factors and co-morbidities of PAD in patients managed for DM in the primary care setting.
    Materials and methods: A cross-sectional study was conducted among 521 diabetics in 9 of the 18 government-aided clinics in the community. Data including demographics, presence of co-morbidities and vascular risk factors were collected using an interviewer-administered questionnaire, and Ankle-Brachial Index (ABI) was calculated from systolic ankle and brachial pressure measurements.
    Results: The prevalence of PAD, defi ned as resting ABI of <0.9 on either leg and/or a history of gangrene or non-traumatic amputation was 15.2% [95% confidence interval (CI), 12.3-18.5]. This prevalence of PAD was higher in patients with pre-existing microvascular and other macrovascular complications. In multivariate analysis, prevalence of PAD was positively associated with increasing age (OR, 1.08; 95% CI, 1.05-1.12), Malay versus Chinese ethnicity (OR, 2.27; 95% CI, 1.09-4.70), low HDL-cholesterol (OR, 1.87; 95% CI, 1.04- 3.37), and insulin treatment (OR, 2.98; 95%CI, 1.39-6.36).
    Conclusion: PAD is an important cause of concern among patients with diabetes, with a high prevalence which further increases with increasing age and duration of DM, and exhibits ethnic variation. Risk factors identified in this study may improve early identification of PAD, allowing for prompt interventions, with a potential to reduce long-term morbidity and mortality.
    MeSH term(s) Adult ; Age Distribution ; Aged ; Ambulatory Care Facilities/statistics & numerical data ; China ; Diabetic Angiopathies/epidemiology ; Diabetic Angiopathies/ethnology ; Female ; Humans ; India ; Indonesia/ethnology ; Male ; Middle Aged ; Peripheral Arterial Disease/epidemiology ; Peripheral Arterial Disease/ethnology ; Prevalence ; Sex Distribution ; Singapore/epidemiology
    Language English
    Publishing date 2010-07-23
    Publishing country Singapore
    Document type Journal Article ; Multicenter Study
    ZDB-ID 604527-3
    ISSN 0304-4602
    ISSN 0304-4602
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.B 2420: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  5. Article: Validation of a Natural Language Processing Algorithm for Detecting Infectious Disease Symptoms in Primary Care Electronic Medical Records in Singapore.

    Hardjojo, Antony / Gunachandran, Arunan / Pang, Long / Abdullah, Mohammed Ridzwan Bin / Wah, Win / Chong, Joash Wen Chen / Goh, Ee Hui / Teo, Sok Huang / Lim, Gilbert / Lee, Mong Li / Hsu, Wynne / Lee, Vernon / Chen, Mark I-Cheng / Wong, Franco / Phang, Jonathan Siung King

    JMIR medical informatics

    2018  Volume 6, Issue 2, Page(s) e36

    Abstract: Background: Free-text clinical records provide a source of information that complements traditional disease surveillance. To electronically harness these records, they need to be transformed into codified fields by natural language processing algorithms. ...

    Abstract Background: Free-text clinical records provide a source of information that complements traditional disease surveillance. To electronically harness these records, they need to be transformed into codified fields by natural language processing algorithms.
    Objective: The aim of this study was to develop, train, and validate Clinical History Extractor for Syndromic Surveillance (CHESS), an natural language processing algorithm to extract clinical information from free-text primary care records.
    Methods: CHESS is a keyword-based natural language processing algorithm to extract 48 signs and symptoms suggesting respiratory infections, gastrointestinal infections, constitutional, as well as other signs and symptoms potentially associated with infectious diseases. The algorithm also captured the assertion status (affirmed, negated, or suspected) and symptom duration. Electronic medical records from the National Healthcare Group Polyclinics, a major public sector primary care provider in Singapore, were randomly extracted and manually reviewed by 2 human reviewers, with a third reviewer as the adjudicator. The algorithm was evaluated based on 1680 notes against the human-coded result as the reference standard, with half of the data used for training and the other half for validation.
    Results: The symptoms most commonly present within the 1680 clinical records at the episode level were those typically present in respiratory infections such as cough (744/7703, 9.66%), sore throat (591/7703, 7.67%), rhinorrhea (552/7703, 7.17%), and fever (928/7703, 12.04%). At the episode level, CHESS had an overall performance of 96.7% precision and 97.6% recall on the training dataset and 96.0% precision and 93.1% recall on the validation dataset. Symptoms suggesting respiratory and gastrointestinal infections were all detected with more than 90% precision and recall. CHESS correctly assigned the assertion status in 97.3%, 97.9%, and 89.8% of affirmed, negated, and suspected signs and symptoms, respectively (97.6% overall accuracy). Symptom episode duration was correctly identified in 81.2% of records with known duration status.
    Conclusions: We have developed an natural language processing algorithm dubbed CHESS that achieves good performance in extracting signs and symptoms from primary care free-text clinical records. In addition to the presence of symptoms, our algorithm can also accurately distinguish affirmed, negated, and suspected assertion statuses and extract symptom durations.
    Language English
    Publishing date 2018-06-11
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2798261-0
    ISSN 2291-9694
    ISSN 2291-9694
    DOI 10.2196/medinform.8204
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  6. Article: Bridging the gap between primary and specialist care--an integrative model for stroke.

    Venketasubramanian, Narayanaswamy / Ang, Yan Hoon / Chan, Bernard Pl / Chan, Parvathi / Heng, Bee Hoon / Kong, Keng He / Kumari, Nanda / Lim, Linda Lh / Phang, Jonathan Sk / Toh, Matthias Phs / Widjaja, Sutrisno / Wong, Loong Mun / Yin, Ann / Cheah, Jason

    Annals of the Academy of Medicine, Singapore

    2007  Volume 37, Issue 2, Page(s) 118–127

    Abstract: Stroke is a major cause of death and disability in Singapore and many parts of the world. Chronic disease management programmes allow seamless care provision across a spectrum of healthcare facilities and allow appropriate services to be brought to the ... ...

    Abstract Stroke is a major cause of death and disability in Singapore and many parts of the world. Chronic disease management programmes allow seamless care provision across a spectrum of healthcare facilities and allow appropriate services to be brought to the stroke patient and the family. Randomised controlled trials have provided evidence for efficacious interventions. After the management of acute stroke in a stroke unit, most stable stroke patients can be sent to their family physician for continued treatment and rehabilitation supervision. Disabled stroke survivors may need added home-based services. Suitable community resources will need to be harnessed. Clinic-based stroke nurses may enhance service provision and coordination. Close collaboration between the specialist and family physician would be needed to right-site patients and also allow referrals in either direction where necessary. Barriers to integration can be surmounted by trust and improved communication. Audits would allow monitoring of care provision and quality care enhancement. The Wagner model of chronic care delivery involves self-management support, shared clinical information systems, delivery system redesign, decision support, healthcare organisation and community resources. The key and critical feature is the need for an informed, activated (or motivated) patient, working in collaboration with the specialist and family physician, and a team of nursing and allied healthcare professionals across the continuum of care. The 3-year Integrating Services and Interventions for Stroke (ISIS) project funded by the Ministry of Health will test such an integrative system.
    MeSH term(s) Delivery of Health Care, Integrated/organization & administration ; Evidence-Based Medicine ; Humans ; Ischemic Attack, Transient ; Medicine ; Middle Aged ; Models, Organizational ; Neurology ; Primary Health Care ; Rehabilitation Nursing ; Singapore ; Specialization ; Stroke/nursing ; Stroke Rehabilitation
    Language English
    Publishing date 2007-11-19
    Publishing country Singapore
    Document type Journal Article
    ZDB-ID 604527-3
    ISSN 0304-4602
    ISSN 0304-4602
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.B 2420: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

To top