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Huang DQ, Tan DJH, Ng CH, Amangurbanova M, Sutter N, Lin Tay PW, Lim WH, Yong JN, Tang A, Syn N, Muthiah MD, Tan EXX, Dave S, Tay B, Majzoub AM, Gerberi D, Kim BK, Loomba R. Hepatocellular Carcinoma Incidence in Alcohol-Associated Cirrhosis: Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 2023; 21:1169-1177. [PMID: 35940513 PMCID: PMC10792532 DOI: 10.1016/j.cgh.2022.06.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/31/2022] [Accepted: 06/25/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Alcohol is one of the leading causes of hepatocellular carcinoma (HCC). However, pooled estimates of HCC incidence in alcohol-associated cirrhosis have not been evaluated systematically. We performed a pooled analysis of time-to-event data to provide robust estimates for the incidence of HCC in alcohol-associated cirrhosis. METHODS Medline, Embase, Cochrane Central Register, Scopus, and Web of Science were searched from inception to August 2021. Individual patient data were reconstructed from published Kaplan-Meier curves, and a pooled analysis of cumulative HCC incidence was performed using a random-effects model. RESULTS We screened 5022 articles and included 18 studies (148,333 patients). In the pooled analysis, the cumulative incidence of HCC in alcohol-associated cirrhosis at 1, 5, and 10 years among studies that accounted for the competing risk of death without HCC was 1%, 3%, and 9%, respectively. A secondary analysis by traditional meta-analysis determined that the HCC incidence rate was higher in cohorts enrolled in a HCC surveillance program (18.6 vs 4.8 per 1000 person-years; P = .001) vs those who were not enrolled in a surveillance program. Meta-regression showed that diabetes, smoking, variceal bleeding, and hepatic decompensation were associated with a higher risk of HCC. CONCLUSIONS Our analysis determined that the 5- and 10- year cumulative risk of HCC in alcohol-associated cirrhosis was 3% and 9%, respectively, with a higher incidence in cohorts that were enrolled in a HCC surveillance program. These data should be validated further in large prospective studies, and may have important implications for HCC screening and surveillance among patients with alcohol-associated cirrhosis.
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Affiliation(s)
- Daniel Q Huang
- NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore.
| | - Darren J H Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cheng Han Ng
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Maral Amangurbanova
- NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California
| | - Nancy Sutter
- NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California
| | - Phoebe Wen Lin Tay
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wen Hui Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jie Ning Yong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ansel Tang
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nicholas Syn
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mark D Muthiah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Eunice X X Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Shravan Dave
- NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California
| | - Benjamin Tay
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore
| | - Abdul M Majzoub
- Division of Internal Medicine, Conemaugh Memorial Medical Center, Johnstown, Pennsylvania
| | | | - Beom Kyung Kim
- NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
| | - Rohit Loomba
- NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California.
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Xiao J, Ng CH, Chin YH, Tan DJH, Lim WH, Lim G, Quek J, Tang ASP, Chan KE, Soong RY, Chew N, Tay B, Huang DQ, Tamaki N, Foo R, Chan MY, Noureddin M, Siddiqui MS, Sanyal AJ, Muthiah MD. A Class Effect Network Meta-analysis of Lipid Modulation in Non-alcoholic Steatohepatitis for Dyslipidemia. J Clin Transl Hepatol 2022; 10:1042-1049. [PMID: 36381095 PMCID: PMC9634784 DOI: 10.14218/jcth.2022.00095] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/13/2022] [Accepted: 05/04/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS Pharmaceutical therapy for NASH is associated with lipid modulation, but the consensus on drug treatment is limited and lacks comparative analysis of effectiveness. A network meta-analysis was conducted to compare NASH drug classes in lipid modulation. METHODS Online databases were searched for randomized controlled trails (RCTs) evaluating NASH treatments in biopsy-proven NASH patients. Treatments were classified into four groups: (1) inflammation, (2) energy, (3) bile acids, and (4) fibrosis based on the mechanism of action. A Bayesian network analysis was conducted with outcome measured by mean difference (MD) with credible intervals (Crl) and surface under the cumulative ranking curve (SUCRA). RESULTS Forty-four RCTs were included in the analysis. Bile acid modulating treatments (MD: 0.05, Crl: 0.03-0.07) were the best treatment for improvement in high-density lipid (HDL) cholesterol, followed by treatments modulating energy (MD: 0.03, Crl: 0.02-0.04) and fibrosis (MD: 0.01, Crl: -0.12 to 0.14) compared with placebo. The top three treatments for reduction in triglycerides were treatments modulating energy (MD: -0.46, Crl: -0.49 to -0.43), bile acids (MD: -0.22, Crl: -0.35 to -0.09), and inflammation (MD: -0.08, Crl: -0.13 to -0.03) compared with placebo. SUCRA found treatment modulating fibrosis (MD: -1.27, Crl: -1.76 to -0.79) was the best treatment for reduction in low-density lipid (LDL) cholesterol followed by treatment modulating inflammation (MD: -1.03, Crl: -1.09 to -0.97) and energy (MD: -0.37, Crl: -0.39 to -0.34) compared with placebo, but LDL cholesterol was worsened by treatments modulating bile acids. CONCLUSIONS Network analysis comparing the class effects of dyslipidemia modulation in NASH found that treatment targets can include optimization of atherogenic dyslipidemia. Future studies are required to evaluate the cardiovascular outcomes.
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Affiliation(s)
- Jieling Xiao
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cheng-Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Correspondence to: Cheng-Han Ng, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 10 Medical Dr, Singapore 117597. ORCID: https://orcid.org/0000-0002-8297-1569. Tel: +65-67723737, Fax: +65-67785743, E-mail: ; Mark Muthiah, Division of Gastroenterology and Hepatology, Tower Block Level 10, 1E Kent Ridge Road, Singapore 119228. ORCID: https://orcid.org/0000-0002-9724-4743. Tel: +65-67724354, Fax: +65-67751518, E-mail:
| | - Yip-Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Darren Jun Hao Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wen-Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Grace Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Jingxuan Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ansel Shao Pin Tang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kai-En Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rou-Yi Soong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nicholas Chew
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Center, National University Hospital, Singapore
| | - Benjamin Tay
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Daniel Q. Huang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- National University Center for Organ Transplantation, National University Health System, Singapore
| | - Nobuharu Tamaki
- NAFLD Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California at San Diego, La Jolla, CA, USA
- Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - Roger Foo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Center, National University Hospital, Singapore
| | - Mark Y. Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Center, National University Hospital, Singapore
| | - Mazen Noureddin
- Cedars-Sinai Fatty Liver Program, Division of Digestive and Liver Diseases, Department of Medicine, Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Mohammad Shadab Siddiqui
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Arun J. Sanyal
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Mark D. Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
- National University Center for Organ Transplantation, National University Health System, Singapore
- Correspondence to: Cheng-Han Ng, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 10 Medical Dr, Singapore 117597. ORCID: https://orcid.org/0000-0002-8297-1569. Tel: +65-67723737, Fax: +65-67785743, E-mail: ; Mark Muthiah, Division of Gastroenterology and Hepatology, Tower Block Level 10, 1E Kent Ridge Road, Singapore 119228. ORCID: https://orcid.org/0000-0002-9724-4743. Tel: +65-67724354, Fax: +65-67751518, E-mail:
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Smith SW, Rahman NEB, Harrison ME, Shiodera S, Giesen W, Lampela M, Wardle DA, Chong KY, Agusti R, Wijedasa LS, Teo PY, Fatimah YA, Teng NT, Yeo JKQ, Alam MJ, Brugues Sintes P, Darusman T, Graham LLB, Katoppo DR, Kojima K, Kusin K, Lestari DP, Metali F, Morrogh‐Bernard HC, Nahor MB, Napitupulu RRP, Nasir D, Nath TK, Nilus R, Norisada M, Rachmanadi D, Rachmat HH, Ripoll Capilla B, Salahuddin, Santosa PB, Sukri RS, Tay B, Tuah W, Wedeux BMM, Yamanoshita T, Yokoyama EY, Yuwati TW, Lee JSH. Tree species that ‘live slow, die older’ enhance tropical peat swamp restoration: evidence from a systematic review. J Appl Ecol 2022. [DOI: 10.1111/1365-2664.14232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Stuart W. Smith
- Asian School of Environment Nanyang Technological University Singapore
- Department of Physical Geography Stockholm University Sweden
| | | | - Mark E. Harrison
- Centre for Ecology and Conservation, College of Life and Environmental Sciences University of Exeter UK
- School of Geography, Geology and the Environment University of Leicester UK
| | - Satomi Shiodera
- Department of Global Liberal Studies, Faculty of Global Liberal Studies Nanzan University Japan
- Centre for Southeast Asian Studies Kyoto University Japan
- Research Institute for Humanity and Nature Japan
| | - Wim Giesen
- Euroconsult Mott MacDonald the Netherlands
- Naturalis Biodiversity Centre the Netherlands
| | - Maija Lampela
- Environmental Research Institute National University of Singapore Singapore
- Department of Forest Sciences University of Helsinki Finland
| | - David A. Wardle
- Asian School of Environment Nanyang Technological University Singapore
| | - Kwek Yan Chong
- Singapore Botanic Gardens, National Parks Board Singapore
- Department of Biological Sciences National University of Singapore Singapore
| | - Randi Agusti
- Environmental Research Institute National University of Singapore Singapore
- Natural Kapital Indonesia Pontianak Indonesia
| | - Lahiru S. Wijedasa
- Environmental Research Institute National University of Singapore Singapore
- BirdLife International Cambridge UK
- ConservationLinks Pvt Ltd Singapore
| | - Pei Yun Teo
- Asian School of Environment Nanyang Technological University Singapore
- Future Cities Lab Global Singapore‐ETH Centre Singapore
| | - Yuti A. Fatimah
- Asian School of Environment Nanyang Technological University Singapore
| | | | - Joanne K. Q. Yeo
- Asian School of Environment Nanyang Technological University Singapore
| | - M. Jahangir Alam
- School of Environmental and Geographical Sciences University of Nottingham Malaysia Malaysia
| | | | | | - Laura L. B. Graham
- Borneo Orangutan Survival Foundation Indonesia
- Tropical Forests and People Research Centre University of the Sunshine Coast Australia
| | | | - Katsumi Kojima
- Asian Research Center for Bioresource and Environmental Sciences, Graduate School of Agricultural and Life Sciences The University of Tokyo Japan
| | - Kitso Kusin
- Centre for the International Cooperation in Sustainable Management of Tropical Peatlands University of Palangka Raya Indonesia
| | | | - Faizah Metali
- Faculty of Science, Universiti Brunei Darussalam Brunei Darussalam
| | - Helen C. Morrogh‐Bernard
- Centre for Ecology and Conservation, College of Life and Environmental Sciences University of Exeter UK
| | | | | | - Darmae Nasir
- Centre for the International Cooperation in Sustainable Management of Tropical Peatlands University of Palangka Raya Indonesia
| | - Tapan Kumar Nath
- School of Environmental and Geographical Sciences University of Nottingham Malaysia Malaysia
| | | | - Mariko Norisada
- Asian Research Center for Bioresource and Environmental Sciences, Graduate School of Agricultural and Life Sciences The University of Tokyo Japan
| | - Dony Rachmanadi
- Research Center of Ecology and Ethnobiology, National Research and Innovation Agency (BRIN) Indonesia
| | - Henti H. Rachmat
- Research Center of Ecology and Ethnobiology, National Research and Innovation Agency (BRIN) Indonesia
| | | | - Salahuddin
- Yayasan Borneo Nature Indonesia, Palangka Raya, Central Kalimantan Indonesia
- Centre for the International Cooperation in Sustainable Management of Tropical Peatlands University of Palangka Raya Indonesia
| | - Purwanto B. Santosa
- Research Center of Plant Conservation, Botanical Garden and Forestry, National Research and Innovation Agency (BRIN) Indonesia
| | - Rahayu S. Sukri
- Institute for Biodiversity and Environmental Research Universiti Brunei Darussalam Brunei Darussalam
| | | | - Wardah Tuah
- Institute for Biodiversity and Environmental Research Universiti Brunei Darussalam Brunei Darussalam
| | - Béatrice M. M. Wedeux
- Department of Plant Sciences University of Cambridge Conservation Research Institute Cambridge UK
| | - Takashi Yamanoshita
- Asian Research Center for Bioresource and Environmental Sciences, Graduate School of Agricultural and Life Sciences The University of Tokyo Japan
| | | | - Tri Wira Yuwati
- Research Center of Ecology and Ethnobiology, National Research and Innovation Agency (BRIN) Indonesia
| | - Janice S. H. Lee
- Asian School of Environment Nanyang Technological University Singapore
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Teh WL, Roystonn K, Vaingankar JA, Goh CMJ, Zhang Y, Chong SA, Verma S, Tay B, Subramaniam M. Caregivers' hopes, expectations and concerns surrounding the employment and future of young people with mental health conditions. Int J Soc Psychiatry 2021; 67:432-440. [PMID: 33012238 PMCID: PMC8290979 DOI: 10.1177/0020764020960763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Informal caregivers are often placed in a better position to understand and advocate for the vocational needs of young persons with mental health conditions. However, their opinions are largely ignored in the planning of vocational outcomes. This qualitative study had two broad aims: to explore (1) the perceptions of caregivers of young adults with mental health conditions on issues of paid employment and (2) their views and expectations of employment support services. METHODS A total of 30 semi-structured interviews were conducted. Caregivers were 45 years old on average, the majority were women (73%) and were of Chinese ethnicity (53%). Most participants (60%) were parents of the young persons with psychotic disorders (57%), or affective and mood disorders, such as depression or anxiety disorders (43%). RESULTS Thematic analyses of data revealed three superordinate themes: (1) caregiving roles, (2) caregivers' expectations and hopes, and (3) barriers to employmentof young persons with mental health conditions. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Caregivers strongly believed that employment support services should prioritise and advocate for recovery while securing employment. Local mental health employment support services should incorporate the views and expectations of caregivers of young persons with mental health conditions to foster better coordination between stakeholders, and enhance support for successful employment, reintegration into the community, and ultimately recovery for these individuals.
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Affiliation(s)
- Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore
| | | | | | | | - YunJue Zhang
- Research Division, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore
| | - Benjamin Tay
- National Council of Social Service, Ulu Pandan Community Building, Singapore
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Vaingankar JA, Teh WL, Roystonn K, Goh J, Zhang YJ, Satghare P, Shahwan S, Chong SA, Verma S, Tan ZL, Tay B, Maniam Y, Subramaniam M. Roles, Facilitators and Challenges of Employment Support Specialists Assisting Young People with Mental Health Conditions. J Occup Rehabil 2021; 31:405-418. [PMID: 33090356 PMCID: PMC8172398 DOI: 10.1007/s10926-020-09930-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Purpose The present study aimed to understand the roles, effective strategies and facilitators, and challenges of employment support specialists (ESS) in assisting young people with mental health conditions (MHCs) gain and sustain employment in Singapore. Methods An interpretative qualitative design using an inductive approach was adopted for this study. Using a semi-structured interview guide, in-depth interviews were conducted with twenty ESS employed with mental health service providers or other community-based centers. Verbatim transcripts of the interviews were thematically analyzed using inductive methods. ESS were broadly classified as "any professionals providing employment-related support to people with MHCs". Results Majority of the ESS were employed at a tertiary psychiatric institute. Participants included vocational and occupational specialists, case managers and other clinical professionals. Three key themes emerged from the data: (i) descriptions of roles undertaken by the ESS depicting a wide range of services and requisite skillsets; (ii) facilitators that benefit young people with MHCs' in terms of job placement, for example, ESS' attitudes and attributes, and their clients' disposition; and (iii) challenges that deter effective job placements, such as factors pertaining to the ESS themselves, their clients, and clients' employers. Under this theme, ESS also proposed ways to improve employment opportunities of people with MHCs. Conclusions This study provided insight into a range of tasks performed and challenges faced by ESS in Singapore while assisting their clients. There is a need to address ESS' challenges and expectations in order to enhance their efficiency and aid reintegration of young people with MHCs into the workforce and the society.
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Affiliation(s)
- Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janrius Goh
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Yun Jue Zhang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Pratika Satghare
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Zhuan Liang Tan
- Sector Strategy Group, National Council of Social Service, 170 Ghim Moh Road #01-02, Singapore, 279621, Singapore
| | - Benjamin Tay
- Sector Strategy Group, National Council of Social Service, 170 Ghim Moh Road #01-02, Singapore, 279621, Singapore
| | - Yogeswary Maniam
- Department of Psychosis, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
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Subramaniam M, Zhang Y, Shahwan S, Vaingankar JA, Satghare P, Teh WL, Roystonn K, Goh CMJ, Maniam Y, Tan ZL, Tay B, Verma S, Chong SA. Employment of young people with mental health conditions: making it work. Disabil Rehabil 2020; 44:2033-2043. [DOI: 10.1080/09638288.2020.1822932] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, Singapore
| | | | | | | | - Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore
| | | | | | - Yogeswary Maniam
- Department of Early Psychosis Intervention, Institute of Mental Health, Singapore
| | - Zhuan Liang Tan
- Sector Strategy Group, National Council of Social Service, Singapore
| | - Benjamin Tay
- Sector Strategy Group, National Council of Social Service, Singapore
| | - Swapna Verma
- Department of Early Psychosis Intervention, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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Suárez L, Tay B, Abdullah F. Psychometric properties of the World Health Organization WHOQOL-BREF Quality of Life assessment in Singapore. Qual Life Res 2018; 27:2945-2952. [PMID: 30046975 DOI: 10.1007/s11136-018-1947-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE This study validated the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire with 3400 respondents living in Singapore. METHODS The ethnic composition was 76.1% Chinese, 12.3% Malay, 9.6% Indian, and 2% Others. The sample included adults with disabilities (28.9%), adults recovering from mental health issues (14%), and adults from the general population (57.1%). Questionnaires about health-related conditions, the effects of disability on everyday functioning (WHODAS 2.0), the WHOQOL-BREF, and add-on modules of QOL of people with disabilities (WHOQOL-DIS) and QOL of elders (WHOQOL-OLD) were administrated. RESULTS Confirmatory factor analysis supported a construct of QOL made of four domains, revealing good construct validity. The four domains predicted overall QOL and health satisfaction. Good internal consistency was evidenced by high alpha coefficients for the physical (.79), psychological (.82), social relationships (.81), and environment (.83) domains. Convergent validity was shown by moderate correlations between the different questionnaires measuring QOL (WHOQOL-BREF, WHOQOL-DIS, and WHOQOL-OLD), and discriminant validity by a lower correlation between the WHOQOL-BREF and disability. Convergent and divergent validity were also indicated by higher correlations between similar constructs across the different measures, and lower correlations between dissimilar constructs across measures, respectively. Concurrent validity was supported by showing that individuals with chronic medical conditions had lower QOL than individuals without chronic medical conditions. CONCLUSIONS The results showed that the WHOQOL-BREF has sound psychometric properties and can be used to measure QOL in Singapore.
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Affiliation(s)
- Lidia Suárez
- Department of Psychology, James Cook University, 149 Sims Drive, Singapore, 387380, Singapore.
| | - Benjamin Tay
- National Council of Social Service, Singapore, Singapore
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Abstract
A cutaneous current perception threshold (CPT) sensory testing device measures both large and small diameter sensory nerve fiber function and may be useful in evaluating differential neural blockade. Eight subjects received both lumbar epidural saline and lumbar epidural lidocaine. Five milliliters of normal saline was administered and the CPTs were measured. After the saline, 10 mL of 2% plain lidocaine was administered. CPTs, and sensation to touch, pinprick, and cold were subsequently measured. Saline had no effect on any measurements. Lidocaine caused an increase in all CPTs at the umbilicus and the knee reaching a statistical significance at 5 Hz for the umbilicus only. The great toe showed a slight increase of the 5 Hz stimulus and no increase of the 2000 or 250 Hz stimulus. There was a significant decrease in touch, pinprick, and cold sensation at the umbilicus and knee and a significant decrease in the cold sensation at the great toe. There was no effect on any measurements made at the mastoid. Epidural lidocaine resulted in a differential neural blockade as measured by a CPT monitor but not with crude sensory measurements.
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Affiliation(s)
- B Tay
- Department of Anesthesiology, University of Texas, Houston, USA
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