Ann Acad Med Singap
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There has been extensive research on defining the appropriate body mass index (BMI) cut-off point for being overweight and obese in the Asian population since the World Health Organisation (WHO) Expert Consultation Meeting in 2002. ⋯ Further research would be needed to look at the all-cause mortality at same BMI levels between Asians and Caucasians in order to evaluate the BMI cut-off recommendations for Asian populations. It is necessary to develop and redefine appropriate BMI cut-off points which are country-specific and ethnic-specific for Asians. These will facilitate the development of appropriate preventive interventions to address the public health problem posed by obesity.
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Ann Acad Med Singap · Dec 2008
Newborn screening in China: phenylketonuria, congenital hypothyroidism and expanded screening.
This study was to investigate the current status of neonatal screening in China, to further clarify the incidences of hyperphenylalaninemia (HPA) and congenital hypothyroidism (CH). From 2000 to 2007, a total of 17,961,826 newborns had been screened for HPA and 1527 cases were detected, giving a HPA prevalence of 1:11,763. At the same time, 18,284,745 newborns had also been tested for CH, with 8918 cases being detected (1:2050). ⋯ The overall prevalence of an inborn errors of metabolism identified was 1 in 5800 healthy newborns, with hyperphenylalaninemia being the most common. Neonatal screening had developed rapidly in China in recent years, and a pilot study using tandem mass spectrometry has been started. The biggest challenge is still to increase coverage to the entire country, especially in the mid-western area.
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Ann Acad Med Singap · Dec 2008
A multidisciplinary approach to paediatric hearing loss: programme at the centre for hearing intervention and language development, National University Hospital, Singapore.
The objective is to describe the multidisciplinary management programme at the National University Hospital (NUH) in Singapore for children with hearing impairment (HI). Over 99.95% of babies born at NUH have hearing tested with both otoacoustic emission and automated auditory brainstem response tests by 6 weeks of age. The referral rate to Otolaryngology is 0.5%. ⋯ Other investigations are directed by history and clinical examination. There is now a very wide range of increasingly sophisticated medication, neuro-otologic external, middle and inner ear surgery, hearing aids, middle ear implants and cochlear implants available to improve hearing. A multidisciplinary team from neonatology, paediatrics, otolaryngology, audiology, auditory verbal and speech therapy, ophthalmology, radiology, and psychology working closely with the child, family and schools is needed to develop a cost-effective and comprehensive management programme for paediatric HI.
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Ann Acad Med Singap · Dec 2008
Development of a tool to evaluate health science students' experiences of an interprofessional education (IPE) programme.
The Rural Interprofessional Programme Emergency Retreat (RIPPER) is an educational programme collaboratively developed and evaluated by an interprofessional team from Schools within Faculty of Health Science (FHS), University of Tasmania (UTAS), Australia. The aims of RIPPER are to foster and facilitate positive and productive interprofessional learning experiences for undergraduate students in a rural setting; and to develop a firmly embedded and sustainable interprofessional healthcare module within the health science curriculum. This paper reports on the development of a reliable and valid survey tool to evaluate students' understandings and experiences of this interprofessional learning programme. ⋯ Factor analysis of the 12 statements identified 3 main factors including appreciation of professional roles and responsibilities, improved professional practice based on effective teamwork and the importance of students learning and working together for improved clinical practice. Reliability of the survey was established. The survey is able to evaluate students' understandings and experiences of this interprofessional learning programme.
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Issues pertaining to the diagnosis and management of inborn errors of metabolism (IEM) in Malaysia included low awareness of atypical and variable presentations in IEMs leading to delayed diagnosis or treatment, absence of reliable population data on IEMs and involvement of multiple siblings in the same family due to consanguinity. The importance of careful family history taking and genetic counselling are emphasised. Selected testing of ill infants and children for IEM yielded a positive 2% (264/13,500) results for IEMs in Malaysia. ⋯ Confirmatory studies of IEMs are an important aspect of management of IEMs. There is a need for more metabolic specialists and funding for diagnosis and treatment of IEMs in Malaysia. Long-term care issues and cost-effectiveness of IEM therapy, supportive and preventive aspects will need further studies in Malaysia.