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Maternal diet during pregnancy influences the short- and long-term health of mothers and their offspring(1). Pregnant women from culturally and linguistically diverse (CALD) backgrounds potentially have challenges achieving a healthy diet due to language barriers, cultural differences and poor nutrition knowledge. Data from 2021 shows that ~7200 women who gave birth in Australia were of Chinese background(2), however, data on the dietary patterns and nutrition knowledge of pregnant women in Australia from CALD backgrounds are limited. This pilot, cross-sectional study aimed to: assess the food group, nutrient intakes and diet quality of pregnant/recently pregnant women in Australia with Chinese-speaking backgrounds, compare the intakes with national nutrition recommendations, and assess the nutrition knowledge of the women. Participants were recruited in partnership with Hunter New England Local Health District Multicultural and Refugee Health to complete an online survey, which was translated to simplified Chinese language. Eligible participants were pregnant women and women who had given birth in the previous 12-months, who were living in, but not born in Australia, who were ≥ 19 years, and primarily spoke a Chinese language. Dietary intake was assessed via the Australian Eating Survey, diet quality via the Australian Recommended Food Score (ARFS), and nutrition knowledge via a questionnaire adapted from the General Nutrition Knowledge Questionnaire. Food group serves, macronutrient, micronutrient and energy intake, and diet quality were reported as median (IQR) due to non-normal distributions. Intake of food group serves, macronutrients and micronutrients were compared with national nutrition recommendations. The mean (SD) nutrition knowledge score out of 23 was reported. Fifty participants (31.8 ± 4.3 years, mostly pregnant (66%), born in China (66%) with Mandarin as first language (62%)) reported median consumption of all five food groups below recommendations, with the poorest alignment for grain (4%) and dairy foods (4%). Median consumption of carbohydrate (46.5% EI), fat (34.5% EI) and protein (20.0% EI) met recommendations for pregnant women, but not saturated fat (12.5% EI) or dietary fibre (18.6 grams). The alignment of 16 micronutrients from food intake to recommendations was poor, particularly for iron (4%) and iodine (12%). The highest alignment to recommendations was for vitamin C (92%) and retinol (78%). The median (IQR) ARFS was 23 (18, 39) points out of 73, indicating poor overall diet quality. The mean (SD) nutrition knowledge score was 10.2 (2.9) out of 23. This sample of pregnant and recently pregnant women living in Australia with Chinese-speaking background reported suboptimal food group and nutrient intakes and overall diet quality that does not align with national nutrition recommendations. The low nutrition knowledge score suggests poor knowledge of pregnancy dietary recommendations. These findings warrant further investigation in larger samples of pregnant women from CALD backgrounds with regard to dietary intake and nutrition knowledge.
To assess the outcomes of a protocol-led, same-day discharge for elective tonsillectomy patients.
Design
A retrospective case-series of all tonsillectomies performed from January 2018 to May 2023 at a tertiary hospital in Adelaide, Australia. The primary outcome was rate of readmission within 24 hours for same-day surgery compared to hospital-stay tonsillectomy patients. Secondary outcomes included post-tonsillectomy haemorrhage.
Results
During the study period, 1658 elective tonsillectomies were performed, with 664 patients (40.0 per cent) discharged the same day following tonsillectomy. The readmission rate within 24 hours was comparable between the two groups: 0.60 per cent for day surgery and 0.64 per cent for those who stayed overnight in hospital (Χ2(1, N = 1600) = 0.009, p = 0.9244). The primary post-tonsillectomy haemorrhage rate for day-surgery patients was 0.3 per cent, with a relative risk of 0.5 (Χ2(1, N = 1658) = 0.751, p = 0.3862).
Conclusion
The low readmission and primary post-tonsillectomy haemorrhage rates indicate that a protocol-led, same-day tonsillectomy is safe and feasible to implement in carefully selected patients.
Particle-laden horizontal turbulent pipe flow is studied experimentally in the two-way coupling regime with a focus on delineating the effects of particle-to-fluid density ratio $\rho _{p}/\rho _{f}=1$ and 1.05 on the fluid and particle statistics. Particle volume fraction $\phi _{v}$ up to $1\,\%$ and viscous Stokes numbers ranging from $St^+ \approx 1.2$ to $St^+ \approx 3.8$ are investigated at friction Reynolds number $Re_\tau \approx 195$ using time-resolved two-dimensional particle image and tracking velocimetry. Substantial differences are observed between the statistics of neutrally buoyant (i.e. $\rho _{p}/\rho _{f}=1$) and denser (i.e. $\rho _{p}/\rho _{f}=1.05$) settling particles (with settling velocities 0.12–0.32 times the friction velocity), which, at most instances, show opposing trends compared to unladen pipe flow statistics. Neutrally buoyant particles show a slightly increased overall drag and suppressed turbulent stresses, but elevated particle–fluid interaction drag and results in elongated turbulent structures compared to the unladen flow, whereas $\rho _{p}/\rho _{f}=1.05$ particles exhibit a slight overall drag reduction even with increased radial turbulent stresses, and shorter streamwise structures compared to the unladen flow. These differences are enhanced with increasing $St^+$ and $\phi _v$, and can be attributed to the small but non-negligible settling velocity of denser particles, which also leads to differing statistics in the upper and lower pipe halves.
The diverse implant landscape, the rising and disparate costs of implants in public healthcare institutions (PHIs), and the limited application of health technology assessment (HTA) impede fair and sustainable implant subsidies in Singapore. This study described the Agency for Care Effectiveness (ACE) Implant Subsidy List (ISL) methodology and the key enablers for supporting government subsidy of clinically effective and cost-effective implants in Singapore.
Methods
A multi-tiered implant grouping scheme on the ISL was established by adapting overseas implant classifications, consulting clinicians, and conducting HTA evaluations, with subsidy extensions at the product group tier. Implants within a product group share similar biomechanical actions and patient outcomes and are subject to the same clinical criteria and pricing requirement. Implants on the ISL must be approved by the regulatory authority. Patients who meet the clinical criteria for ISL implants are eligible for subsidy. ACE conducted value-based pricing (VBP) and partnered with the public healthcare supply chain agency to harmonize PHI implant prices. The ISL is updated three times per year.
Results
Implants listed on the ISL were deemed clinically and cost effective. Underpinned by HTA principles, the implant grouping scheme promoted parsimonious classification, while allowing the creation of new product groups for implants offering superior benefits for patients. Reasonable prices set for the product groups aided affordability and cost sustainability. The ISL clinical criteria and standardized implant identifiers encouraged the appropriate use of subsidized implants and facilitated implementation. By ISL implementation in December 2023, ACE assessed 42,165 implants and listed 22,689 ISL implants spanning 143 product groups. Industry can apply for ISL listing three times per year, which keeps the ISL updated and relevant.
Conclusions
The ISL adopts a fit-for-purpose methodology to standardize implant classifications, enable scalable application of HTA, drive appropriate use of subsidized implants, and bring cost sustainability to the government subsidy of implants in Singapore. A strategic partnership with the public healthcare supply chain agency to concurrently establish national procurement contracts reduced disparate implant prices in PHIs and provided greater leverage for better implant prices.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
Seahorses Hippocampus spp. are commercially and culturally important to many communities. Although seahorses are widely used in traditional medicine, as curios and as aquarium fishes in Southeast Asia, documentation on the current nature and extent of culturally motivated seahorse uses in Malaysia is lacking. To examine how ethnicity and other socio-demographic drivers shape traditional medicinal use and underlying cultural beliefs involving seahorses, we administered a questionnaire-based survey during March 2021–April 2022 to members of the general public and fishers in Malaysia. Approximately one-fifth (21.0%) of respondents reported consuming seahorses (34.4% of these used seahorses for medicinal purposes, 55.2% for other non-medicinal uses and 10.4% for both types). Consumers of seahorses were from all ethnic groups except for Indigenous groups. In the general public group, medicinal use was more common amongst the Chinese respondents, whereas in the fisher group, other uses were more common amongst the Malay respondents. Amongst the threats facing seahorses, which include overfishing, habitat destruction, bycatch and ocean plastic pollution, only bycatch was perceived as a major threat by most of the general public and fisher respondents. The relatively low prevalence of reported seahorse use amongst Malaysians is an encouraging finding from a conservation perspective. However, the high proportion of non-medicinal uses indicates the need to focus on such other uses to ensure the sustainability of seahorse use in Malaysia.
Multiple copies of a particular clay sealing bearing the Buddhist Bodhigarbhālaṅkāralakṣa-dhāraṇī (mantra) inscription were discovered in Gua Berhala—a cave in Perlis, Malaysia. These sealings can be roughly assigned to the tenth century and they appear to have been stamped with an identical seal. However, critical reading of the textual rendition of the dhāraṇī had not yet been done despite several attempts to study it. Therefore, based on several fragments of these sealings, this article provides a detailed reading and translation of the dhāraṇī and considers the cultural significance of their production. The article also examines the textual structure of this Perlis dhāraṇī and compares it with similar dhāraṇīs preserved in a palm-leaf manuscript and other materials found across Asia. This includes a survey on the wider transmission of the dhāraṇī in the continent. In this comparative exercise, the physical characteristics of the Perlis sealing appear to be unique and express a distinct artistic style, while its textual tradition is slightly compressed compared with others, with no identical equivalent found elsewhere. This observation suggests that Perlis, with its proximity to the Bujang Valley, participated in the wider network of dhāraṇī culture rooted in Eastern India and was just not a passive recipient of this practice.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
RAMPPS (Recognising and assessing medical problems in Psychiatric settings) training was set up over a decade ago by the then Health Education Yorkshire and Humber Task Group of Clinical skills project workers. Main aim was to address the Physical health agenda in mental health. It was felt that the clinical and support staff in psychiatric settings lacked confidence in recognising and managing physical health issues early on, possibly due to inadequate training in this area. RAMPPS course was designed to address this gap. The course is set up as a face to face multidisciplinary, interprofessional simulation based training with simulated actors, mannequins and other hybrid teaching models .Like any such training, there is a constant need for resources, mannequins, simulated actors, space and funding which could limit the extensive use of this training. We adapted this face to face teaching model for virtual audience to deliver an interprofessional interactive adaptable teaching module using realistic scenarios.
Methods
We adapted some of the scenarios from the RAMPPS module which suited the virtual audience and incorporated into Power point presentation and using an interactive teaching software called Slido we developed Virtual RAAMPPS.
Conducted a few trial sessions within the team and later produced a sample scenario and presented to the medical education team at the trust. The main teaching is the interactive discussion whilst going through the scenarios allowing an impact as close to a face to face teaching as possible.
Next is to do a PILOT Virtual RAMPPS morning session delivered to a group of trainees (psychiatry and foundation trainees) and gather detailed feedback and continue to deliver the pilot teaching a few more times at other avenues and continuously modify the teaching based on the feedback.
Results
Collecting Qualitative feedback from PILOT conducted.
Conclusion
The aim is not to replace simulation based face to face training, but to provide a near enough realistic virtual experience of real life scenarios and to think through them in a systematic and structured way thus enabling better management of some of the physical health dilemmas faced in our psychiatric settings.
It provides the multidisciplinary staff a functional working knowledge of common physical health conditions and its complications encountered in psychiatric setting. The teaching can be modified based on the audience by changing the scenarios relevant to that area of clinical practise or of the patient group.
Allowing anonymity in responses provides a non-judgemental and safe place to make mistakes and eventually improving patient safety and staff experience within Psychiatry.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.