Displaying publications 1 - 20 of 42 in total

Abstract:
Sort:
  1. Yi X, Yin S, Huang L, Li H, Wang Y, Wang Q, et al.
    Sci Total Environ, 2021 Jun 01;771:144644.
    PMID: 33736175 DOI: 10.1016/j.scitotenv.2020.144644
    Chlorine radical plays an important role in the formation of ozone and secondary aerosols in the troposphere. It is hence important to develop comprehensive emissions inventory of chlorine precursors in order to enhance our understanding of the role of chlorine chemistry in ozone and secondary pollution issues. Based on a bottom-up methodology, this study presents a comprehensive emission inventory for major atomic chlorine precursors in the Yangtze River Delta (YRD) region of China for the year 2017. Four primary chlorine precursors are considered in this study: hydrogen chloride (HCl), fine particulate chloride (Cl-) (Cl- in PM2.5), chlorine gas (Cl2), and hypochlorous acid (HClO) with emissions estimated for twelve source categories. The total emissions of these four species in the YRD region are estimated to be 20,424 t, 15,719 t, 1556 and 9331 t, respectively. The emissions of HCl are substantial, with major emissions from biomass burning and coal combustion, together accounting for 68% of the total HCl emissions. Fine particulate Cl- is mainly emitted from industrial processing, biomass burning and waste incineration. The emissions of Cl2 and HClO are mainly associated with usage of chlorine-containing disinfectants, for example, water treatment, wastewater treatment, and swimming pools. Emissions of each chlorine precursor are spatially allocated based on the characteristics of individual source category. This study provides important basic dataset for further studies with respect to the effects of chlorine chemistry on the formation of air pollution complex in the YRD region.
  2. Wang J, Yi X, Cui J, Chang Y, Yao D, Zhou D, et al.
    Sci Total Environ, 2019 Jun 20;670:1060-1067.
    PMID: 31018421 DOI: 10.1016/j.scitotenv.2019.03.245
    With the population growth, urbanization and industrialization, China has become a hotspot of atmospheric deposition nitrogen (ADN), which is a threat to ecosystem and food safety. However, the impacts of increased ADN on rice growth and grain metal content are little studied. Based on previous long-term ADN studies, greenhouse experiment was conducted with four simulated ADN rates of 0, 30, 60 and 90 kg N ha-1 yr-1 (CK, N1, N2 and N3 as δ15N, respectively) to assess rice growth and metal uptake in a red soil ecosystem of southeast China during 2016-2017. Results showed that simulated ADN could promote rice growth and increase yields by 15.68-24.41% (except N2) and accumulations of cadmium (Cd) or copper (Cu) in organs. However, there was no linear relationship between ADN rate and rice growth or Cd or Cu uptake. The 15N-ADN was mainly accumulated in roots (21.31-67.86%) and grains (25.26-49.35%), while Cd and Cu were primarily accumulated in roots (78.86-93.44% and 90.00-96.24%, respectively). 15N-ADN and Cd accumulations in roots were significantly different between the two growing seasons (p 
  3. Cui J, Cui J, Peng Y, Yao D, Chan A, Chen Z, et al.
    Sci Total Environ, 2020 Jun 27;744:140558.
    PMID: 32711301 DOI: 10.1016/j.scitotenv.2020.140558
    Fluxes and composition dynamics of atmospheric nitrogen deposition play key roles in better balancing economic development and ecological environment. However, there are some knowledge gaps and difficulties in urban ecosystems, especially for small and medium-sized cities. In this study, both flux and composition (ratio of NH4+-N to NO3--N, RN) of wet-deposited dissolved inorganic nitrogen (DIN, sum of NO3--N and NH4+-N) were estimated and sources were identified at a long-term urban observation station in Tongling, a typical medium-sized city in eastern China during 2010-2016, respectively. Results showed that wet-deposited DIN fluxes were 33.20 and 28.15 kgN ha-1 yr-1 in Tongling city during 2010-2011 and 2015-2016, respectively. Compared to these two periods, both DIN and NO3--N fluxes decreased by 15.2% and 31.8% for a series of NOx abatement measures applied effectively, respectively. At the same time, the NH4+-N flux remained stable and ranged from 19.53 to 20.62 kgN ha-1 yr-1, and the RN increased from 1.7 to 2.2. Seasonally, winds from the southwest and west-southwest with higher frequencies and speeds in spring and summer brought more NH4+-N and DIN wet deposition from an ammonia plant, which could threaten the safety of regional hydrosphere ecosystems. On the whole, the wet-deposited NH4+-N was threatening regional ecosystems of both the hydrosphere and forest. The wet-deposited DIN including NH4+-N in Tongling city stemmed mainly from a combined source of coal combustion and dust from Cu extraction and smelting, ammonia production, and roads. Therefore, production lines should be updated for Cu extraction and smelting industries, thermal power generations and the ammonia plant, old vehicles should be eliminated, and the use of new energy vehicles should be promoted for regional sustainable development and human health in the medium-sized city.
  4. Li L, Li Q, Huang L, Wang Q, Zhu A, Xu J, et al.
    Sci Total Environ, 2020 Aug 25;732:139282.
    PMID: 32413621 DOI: 10.1016/j.scitotenv.2020.139282
    The outbreak of COVID-19 has spreaded rapidly across the world. To control the rapid dispersion of the virus, China has imposed national lockdown policies to practise social distancing. This has led to reduced human activities and hence primary air pollutant emissions, which caused improvement of air quality as a side-product. To investigate the air quality changes during the COVID-19 lockdown over the YRD Region, we apply the WRF-CAMx modelling system together with monitoring data to investigate the impact of human activity pattern changes on air quality. Results show that human activities were lowered significantly during the period: industrial operations, VKT, constructions in operation, etc. were significantly reduced, leading to lowered SO2, NOx, PM2.5 and VOCs emissions by approximately 16-26%, 29-47%, 27-46% and 37-57% during the Level I and Level II response periods respectively. These emission reduction has played a significant role in the improvement of air quality. Concentrations of PM2.5, NO2 and SO2 decreased by 31.8%, 45.1% and 20.4% during the Level I period; and 33.2%, 27.2% and 7.6% during the Level II period compared with 2019. However, ozone did not show any reduction and increased greatly. Our results also show that even during the lockdown, with primary emissions reduction of 15%-61%, the daily average PM2.5 concentrations range between 15 and 79 μg m-3, which shows that background and residual pollutions are still high. Source apportionment results indicate that the residual pollution of PM2.5 comes from industry (32.2-61.1%), mobile (3.9-8.1%), dust (2.6-7.7%), residential sources (2.1-28.5%) in YRD and 14.0-28.6% contribution from long-range transport coming from northern China. This indicates that in spite of the extreme reductions in primary emissions, it cannot fully tackle the current air pollution. Re-organisation of the energy and industrial strategy together with trans-regional joint-control for a full long-term air pollution plan need to be further taken into account.
  5. Zhou F, Cui J, Zhou J, Yang J, Li Y, Leng Q, et al.
    Sci Total Environ, 2018 Aug 15;633:776-784.
    PMID: 29602116 DOI: 10.1016/j.scitotenv.2018.03.217
    Atmospheric deposition nitrogen (ADN) increases the N content in soil and subsequently impacts microbial activity of soil. However, the effects of ADN on paddy soil microbial activity have not been well characterized. In this study, we studied how red paddy soil microbial activity responses to different contents of ADN through a 10-months ADN simulation on well managed pot experiments. Results showed that all tested contents of ADN fluxes (27, 55, and 82kgNha-1 when its ratio of NH4+/NO3--N (RN) was 2:1) enhanced the soil enzyme activity and microbial biomass carbon and nitrogen and 27kgNha-1 ADN had maximum effects while comparing with the fertilizer treatment. Generally, increasing of both ADN flux and RN (1:2, 1:1 and 2:1 with the ADN flux of 55kgNha-1) had similar reduced effects on microbial activity. Furthermore, both ADN flux and RN significantly reduced soil bacterial alpha diversity (p<0.05) and altered bacterial community structure (e.g., the relative abundances of genera Dyella and Rhodoblastus affiliated to Proteobacteria increased). Redundancy analysis demonstrated that ADN flux and RN were the main drivers in shaping paddy soil bacteria community. Overall, the results have indicated that increasing ADN flux and ammonium reduced soil microbial activity and changed the soil bacterial community. The finding highlights how paddy soil microbial community response to ADN and provides information for N management in paddy soil.
  6. Li Q, Zhang K, Li R, Yang L, Yi Y, Liu Z, et al.
    Sci Total Environ, 2023 May 10;872:162071.
    PMID: 36775179 DOI: 10.1016/j.scitotenv.2023.162071
    Biomass burning (BB) has significant impacts on air quality and climate change, especially during harvest seasons. In previous studies, levoglucosan was frequently used for the calculation of BB contribution to PM2.5, however, the degradation of levoglucosan (Lev) could lead to large uncertainties. To quantify the influence of the degradation of Lev on the contribution of BB to PM2.5, PM2.5-bound biomass burning-derived markers were measured in Changzhou from November 2020 to March 2021 using the thermal desorption aerosol gas chromatography-mass spectrometry (TAG-GC/MS) system. Temporal variations of three anhydro-sugar BB tracers (e.g., levoglucosan, mannosan (Man), and galactosan (Gal)) were obtained. During the sampling period, the degradation level of air mass (x) was 0.13, indicating that ~87 % of levoglucosan had degraded before sampling in Changzhou. Without considering the degradation of levoglucosan in the atmosphere, the contribution of BB to OC were 7.8 %, 10.2 %, and 9.3 % in the clean period, BB period, and whole period, respectively, which were 2.4-2.6 times lower than those (20.8 %-25.9 %) considered levoglucosan degradation. This illustrated that the relative contribution of BB to OC could be underestimated (~14.9 %) without considering degradation of levoglucosan. Compared to the traditional method (i.e., only using K+ as BB tracer), organic tracers (Lev, Man, Gal) were put into the Positive Matrix Factorization (PMF) model in this study. With the addition of BB organic tracers and replaced K+ with K+BB (the water-soluble potassium produced by biomass burning), the overall contribution of BB to PM2.5 was enhanced by 3.2 % after accounting for levoglucosan degradation based on the PMF analysis. This study provides useful information to better understand the effect of biomass burning on the air quality in the Yangtze River Delta region.
  7. Zheng Y, Ooi MCG, Juneng L, Wee HB, Latif MT, Nadzir MSM, et al.
    Sci Total Environ, 2023 Nov 25;901:166430.
    PMID: 37607626 DOI: 10.1016/j.scitotenv.2023.166430
    Climate change is thought to influence the composition of atmospheric air, but little is known about the direct relationship between these variables, especially in a hot tropical climate like that of Malaysia. This work summarizes and analyzes the climate state and air quality of Peninsular Malaysia based on selected ground-based observations of the temperature, precipitation, relative humidity, wind speed, wind direction and concentrations of PM10, O3, CO, NO2, and SO2 over the last 20 years (2000-2019). The relationship between the climate state and air quality is analyzed using the Pearson correlation and canonical correlation analysis (CCA) methods is employed to predict the degree of change in the future air quality under different warming scenarios. It is found that the Peninsular Malaysia mainly experienced strong precipitation in the central and mountainous regions, while air pollutants are primarily concentrated in densely populated areas. Throughout the period of study (interannual, monthly, and diurnal time series analyses), Peninsular Malaysia became warmer and drier, with a significant increase in temperature (+4.2 %), decrease in the relative humidity (-4.5 %), and greater fluctuation in precipitation amount. The pollution conditions have worsened; there has been an increase in the PM10 (+16.4 %), O3 (+39.5 %), and NO2 (+2.1 %) concentration over the last 20 years. However, the amount of SO2 (-53.6 %) and CO (-20.6 %) decreased significantly. The analysis of the monthly variation shows a strong bimodality of the PM10 and O3 concentrations that corresponds to the monsoon transition. Intensive diurnal fluctuations and correlations are observed for all the variables in this study. According to the CCA, the air quality factors are strongly correlated with meteorological factors; in particular, the CO, O3, and PM10 concentrations interact strongly with the air temperature. These findings show that the future air quality in Peninsular Malaysia has high possibility to deteriorate under warming condition.
  8. Chan AC, Rohan MJ, Hamid A, Azam A
    Med J Malaysia, 2007 Jun;62(2):166-7.
    PMID: 18705456 MyJurnal
    Emphysematous pyelonephritis is a rare but life threatening infection of kidney that is characterized by gas formation within or around the kidney. We describe a case of emphysematous pyelonephritis as a consequence of inadequately treated pelvic-ureteric stone in a diabetic man and complement this with a brief review of the literature pertaining in particular to the management of this condition.
  9. Chan AYK, Hooi LS, Liu WJ
    Med J Malaysia, 2001 Mar;56(1):82-7.
    PMID: 11503302
    Retrospective analysis was done on 235 recipients, 133 males and 102 females, who were transplanted between 25th September 1979 and 25th June 1999. 85.1% were Chinese, 7.7% were Indians and 7.2% Malays. 23% (54) were living related renal transplants (LRRT) all except 5 done at Hospital Kuala Lumpur. 60% (141) were living unrelated donor renal transplants (LURT) done in India. 17% (40) were cadaveric transplants (CADT) (all done in China except 2 at Hospital Kuala Lumpur and one in London). 97% (228) were first transplants. Primary renal disease was unknown in 69.4%, 17% (40) glomerulonephritis, 5.5% diabetic nephropathy and 8.1% 19 others. All were on prednisolone, 93.2% were on azathioprine and 96.6% were on cyclosporin A. The acute rejection rate was 23.4% (55 episodes). Patient survival was 88% at five years and patients alive with functioning graft was 84% at 5 years. LRRT had significantly better survival compared to LURT. 34 grafts were lost to chronic allograft nephropathy. 46 recipients died (33 died with functioning graft).
  10. Chan AYK, Hooi LS
    Med J Malaysia, 2000 Mar;55(1):14-20.
    PMID: 11072485
    Retrospective analysis was done on 85 patients (76 female, 9 male) with lupus nephritis who started intravenous cyclophosphamide between 1/1/1989 and 31/12/1998. The initial renal biopsy (World Health Organisation) classification was III (4.7%), IV (89.4%) and V (5.9%). Average serum creatinine at time of biopsy was 0.12 +/- 0.12 mmol/l. Median duration of nephritis before biopsy was 2 months (range 0-133). Median duration of follow-up from time of biopsy to outcome (death or end-stage renal failure) was 3.3 years (range 0.3-11.8). Nineteen patients died. The calculated proportion alive at 5 years was 75% and at 10 years 64%. The calculated proportion alive with renal function was 74% and 54% at 5 and 10 years respectively. Fifty-two patients completed cyclophosphamide therapy at the end of the study. There were ten episodes of herpes zoster, the most common infection seen. No malignancy was reported.
  11. Malhotra R, Bautista MAC, Müller AM, Aw S, Koh GCH, Theng YL, et al.
    Gerontologist, 2019 05 17;59(3):401-410.
    PMID: 30517628 DOI: 10.1093/geront/gny160
    The juxtaposition of a young city-state showing relative maturity as a rapidly aging society suffuses the population aging narrative in Singapore and places the "little red dot" on the spotlight of international aging. We first describe population aging in Singapore, including the characteristic events that shaped this demographic transition. We then detail the health care and socioeconomic ramifications of the rapid and significant shift to an aging society, followed by an overview of the main aging research areas in Singapore, including selected population-based data sets and the main thrust of leading aging research centers/institutes. After presenting established aging policies and programs, we also discuss current and emerging policy issues surrounding population aging in Singapore. We aim to contribute to the international aging literature by describing Singapore's position and extensive experience in managing the challenges and maximizing the potential of an aging population. We hope that similar graying populations in the region will find the material as a rich source of information and learning opportunities. Ultimately, we aspire to encourage transformative collaborations-locally, regionally, and internationally-and provide valuable insights for policy and practice.
  12. Ng T, Toh MR, Cheung YT, Chan A
    Support Care Cancer, 2015 Nov;23(11):3193-200.
    PMID: 25791392 DOI: 10.1007/s00520-015-2700-2
    PURPOSE: The aim of this study is to evaluate the perspectives of Asian oncology practitioners on the physical and psychosocial issues experienced by breast cancer survivors (BCS), current survivorship care practices, and the barriers to follow-up care.

    METHODS: This was a cross-sectional survey study. Oncology practitioners were recruited from a major cancer center in Singapore and through two regional cancer meetings that took place in Singapore and Malaysia in 2013.

    RESULTS: A total of 126 oncology practitioners from various Southeast Asian countries, mostly nurses (58.7 %) and physicians (37.3 %), were recruited. The majority of the respondents agreed that fatigue (78.4 %) and anxiety (69.1 %) were the most common physical and psychosocial problems experienced by BCS. Monitoring for physical and treatment-related adverse effects (80.7 %) and reviewing patients' noncancer medical history (65.3 %) were the most practiced aspects of follow-up care. Compared with the other practitioners, the physicians were more likely to communicate with other healthcare professionals (adjusted OR = 4.24, 95 % CI 1.54 to 11.72; p = 0.005). Most of the respondents also agreed that patient-specific barriers were the main impediments to follow-up care.

    CONCLUSION: This study provides insights into the various aspects of breast cancer survivorship care from the perspectives of oncology practitioners and shows that survivorship care is relatively inadequate in Asia. There is a need for new survivorship care models to meet the needs of Asian BCS and to complement the unique healthcare systems of Asia.

  13. Chanthawong S, Lim YH, Subongkot S, Chan A, Andalusia R, Ahmad Bustamam RS, et al.
    Support Care Cancer, 2019 Mar;27(3):1109-1119.
    PMID: 30112718 DOI: 10.1007/s00520-018-4400-1
    PURPOSE: Recent studies suggested that olanzapine, together with dexamethasone and serotonin-3 receptor antagonist (5HT3RA), is effective in preventing chemotherapy-induced nausea and vomiting (CINV) following highly emetogenic chemotherapy (HEC). This regimen is particularly useful in Southeast Asia (SEA) countries where resources are limited. We aimed to evaluate the cost-effectiveness of incorporating olanzapine into standard antiemetic regimens for the prevention of CINV in patients receiving HEC among SEA countries.

    METHODS: Using a decision tree model, clinical and economic outcomes associated with olanzapine-containing regimen and standard antiemetic regimen (doublet antiemetic regimen: dexamethasone+first generation 5HT3RA) in most SEA countries except in Singapore (triplet antiemetic regimen: dexamethasone+first generation 5HT3RA + aprepitant) for CINV prevention following HEC were evaluated. This analysis was performed in Thailand, Malaysia, Indonesia, and Singapore, using societal perspective method with 5-day time horizon. Input parameters were derived from literature, network meta-analysis, government documents, and hospital databases. Outcomes were incremental cost-effectiveness ratio (ICER) in USD/quality-adjusted life year (QALY) gained. A series of sensitivity analyses including probabilistic sensitivity analysis were also performed.

    RESULTS: Compared to doublet antiemetic regimen, addition of olanzapine resulted in incremental QALY of 0.0022-0.0026 with cost saving of USD 2.98, USD 27.71, and USD 52.20 in Thailand, Malaysia, and Indonesia, respectively. Compared to triplet antiemetic regimen, switching aprepitant to olanzapine yields additional 0.0005 QALY with cost saving of USD 60.91 in Singapore. The probability of being cost-effective at a cost-effectiveness threshold of 1 GDP/capita varies from 14.7 to 85.2% across countries.

    CONCLUSION: The use of olanzapine as part of standard antiemetic regimen is cost-effective for the prevention of CINV in patients receiving HEC in multiple SEA countries.

  14. Kumaran A, Chan A, Yong K, Shen S
    Orbit, 2019 Apr;38(2):95-102.
    PMID: 29482415 DOI: 10.1080/01676830.2018.1441316
    AIM: To describe differences in the deep lateral orbital wall (specifically, trigone) between Chinese, Malay, Indian and Caucasian subjects Methods: Single-centre retrospective Computed Tomogram (CT)-based study; 20 subjects of each ethnicity were used from existing databases, matched for gender, average age and laterality. Subjects below 16 years of age were excluded. DICOM image viewing software CARESTREAM Vue PACS (Carestream Health Inc., USA) and OsiriX version 7.5 (Pixmeo., Switzerland) were used to measure deep lateral wall length, thickness and volume, as well as orbital depth and statistical analyses performed using Statistical Package for Social Sciences version 21 (IBM, USA).

    RESULTS: In each group, there were 12 males (60%) and average age was not significantly different (p = 0.682-0.987). Using Chinese subjects as a reference, in Chinese, Malay, Indian and Caucasian subjects, mean trigone thickness was 13.68, 14.02, 11.60 (p 

  15. D'cruz A, Lin T, Anand AK, Atmakusuma D, Calaguas MJ, Chitapanarux I, et al.
    Oral Oncol, 2013 Sep;49(9):872-877.
    PMID: 23830839 DOI: 10.1016/j.oraloncology.2013.05.010
    Head and neck cancer (HNC) is a disease of the upper aerodigestive tract and is one of the most frequently diagnosed cancers worldwide. A high rate of cancers involving the head and neck are reported across the Asian region, with notable variations between countries. Disease prognosis is largely dependent on tumor stage and site. Patients with early stage disease have a 60-95% chance of cure with local therapy. Early diagnosis and appropriate treatment are important to increase the likelihood of cure and survival. However, the majority of patients present with locally advanced disease and require multimodality treatment. This necessitates, a multidisciplinary approach which is essential to make appropriate treatment decisions, particularly with regards to tolerability, costs, available infrastructure and quality of life issues. Unfortunately, majority of the studies that dictate current practice have been developed in the west where diseases biology, patient population and available infrastructure are very different from those in the Asian continent. With this in mind an expert panel of Head and Neck Oncologists was convened in May 2012 to review the National Comprehensive Cancer Network (NCCN) and the European Society for Medical Oncology (ESMO) clinical practice guidelines and develop practical recommendations on the applicability of these guidelines on the management of head and neck cancer for Asian patients. The objective of this review and consensus meeting was to suggest revisions, to account for potential differences in demographics and resources, to the NCCN and ESMO guidelines, to better reflect current clinical management of head and neck cancer within the Asian region for health care providers. These recommendations, which reflect best clinical practice within Asia, are expected to benefit practitioners when making decisions regarding optimal treatment strategies for their patients.
  16. Maiwall R, Sarin SK, Kumar S, Jain P, Kumar G, Bhadoria AS, et al.
    Liver Int, 2017 Oct;37(10):1497-1507.
    PMID: 28393476 DOI: 10.1111/liv.13443
    BACKGROUND AND AIM: There is limited data on predictors of acute kidney injury in acute on chronic liver failure. We developed a PIRO model (Predisposition, Injury, Response, Organ failure) for predicting acute kidney injury in a multicentric cohort of acute on chronic liver failure patients.

    PATIENTS AND METHODS: Data of 2360 patients from APASL-ACLF Research Consortium (AARC) was analysed. Multivariate logistic regression model (PIRO score) was developed from a derivation cohort (n=1363) which was validated in another prospective multicentric cohort of acute on chronic liver failure patients (n=997).

    RESULTS: Factors significant for P component were serum creatinine[(≥2 mg/dL)OR 4.52, 95% CI (3.67-5.30)], bilirubin [(<12 mg/dL,OR 1) vs (12-30 mg/dL,OR 1.45, 95% 1.1-2.63) vs (≥30 mg/dL,OR 2.6, 95% CI 1.3-5.2)], serum potassium [(<3 mmol/LOR-1) vs (3-4.9 mmol/L,OR 2.7, 95% CI 1.05-1.97) vs (≥5 mmol/L,OR 4.34, 95% CI 1.67-11.3)] and blood urea (OR 3.73, 95% CI 2.5-5.5); for I component nephrotoxic medications (OR-9.86, 95% CI 3.2-30.8); for R component,Systemic Inflammatory Response Syndrome,(OR-2.14, 95% CI 1.4-3.3); for O component, Circulatory failure (OR-3.5, 95% CI 2.2-5.5). The PIRO score predicted acute kidney injury with C-index of 0.95 and 0.96 in the derivation and validation cohort. The increasing PIRO score was also associated with mortality (P

  17. Chazan G, Jupp J, Bauters T, Duncan N, Weddle KJ, Nomura H, et al.
    J Oncol Pharm Pract, 2021 Oct 23.
    PMID: 34693814 DOI: 10.1177/10781552211048892
    INTRODUCTION: The coronavirus of 2019 pandemic has necessitated vast and rapid changes in the way oncology pharmacy services are delivered around the world.

    METHODS/AIMS: An international survey of oncology pharmacists and technicians was conducted via the International Society of Oncology Pharmacy Practitioners and collaborating global pharmacy organisations to determine the impact that the coronavirus of 2019 has had on pharmacy service delivery, pharmacy practitioners and oncology practice.

    RESULTS: The survey received 862 responses from 40 different countries from September to October 2020. The majority of respondents were pharmacists (n = 841, 97.6%), with 24% involved in the direct care of patients with the coronavirus of 2019. Of the survey participants, 55% increased their time working remotely, with remote activities including dispensing, patient assessment/follow-up and attending multi-disciplinary rounds. Respondents reported a 72% increase in the use of technology to perform remote patient interaction activities and that participation in educational meetings and quality improvement projects was reduced by 68% and 44%, respectively. Workforce impacts included altered working hours (50%), cancelled leave (48%) and forced leave/furloughing (30%). During the pandemic, respondents reported reduced access to intensive care (19%) and anti-cancer (15%) medications. In addition, 39% of respondents reported reduced access to personal protective equipment, including N95 masks for chemotherapy compounding. Almost half of respondents (49%) reported that cancer treatments were delayed or intervals were altered for patients being treated with curative intent. A third of practitioners (30%) believed that patient outcomes would be adversely impacted by changes to pharmacy services. Sixty-five percent of respondents reported impacts on their mental health, with 12% utilising support services.

    CONCLUSION: The coronavirus of 2019 pandemic has altered the way oncology pharmacy services are delivered. These results demonstrate the adaptability of the oncology pharmacy profession and highlight the importance of formal evaluation of the varied practice models to determine the evidence-based practices that enhance pharmacy services and, thus, should be reinstated as soon as practical and reasonable.

  18. Chan A, Abdullah MM, Ishak WZBW, Ong-Cornel AB, Villalon AH, Kanesvaran R
    J Glob Oncol, 2017 Dec;3(6):801-813.
    PMID: 29244998 DOI: 10.1200/JGO.2016.005728
    A meeting of regional experts was convened in Manila, Philippines, to develop a resource-stratified chemotherapy-induced nausea and vomiting (CINV) management guideline. In patients treated with highly emetogenic chemotherapy in general clinical settings, triple therapy with a serotonin (5-hydroxytryptamine-3 [5-HT3]) antagonist (preferably palonosetron), dexamethasone, and aprepitant is recommended for acute CINV prevention. In resource-restricted settings, triple therapy is still recommended, although a 5-HT3 antagonist other than palonosetron may be used. In both general and resource-restricted settings, dual therapy with dexamethasone (days 2 to 4) and aprepitant (days 2 to 3) is recommended to prevent delayed CINV. In patients treated with moderately emetogenic chemotherapy, dual therapy with a 5-HT3 antagonist, preferably palonosetron, and dexamethasone is recommended for acute CINV prevention in general settings; any 5-HT3 antagonist can be combined with dexamethasone in resource-restricted environments. In general settings, for the prevention of delayed CINV associated with moderately emetogenic chemotherapy, corticosteroid monotherapy on days 2 and 3 is recommended. If aprepitant is used on day 1, it should be continued on days 2 and 3. Prevention of delayed CINV with corticosteroids is preferred in resource-restricted settings. The expert panel also developed CINV management guidelines for anthracycline plus cyclophosphamide combination schedules, multiday cisplatin, and chemotherapy with low or minimal emetogenic potential, and its recommendations are detailed in this review. Overall, these regional guidelines provide definitive guidance for CINV management in general and resource-restricted settings. These consensus recommendations are anticipated to contribute to collaborative efforts to improve CINV management in Southeast Asia.
  19. Choudhury A, Kumar M, Sharma BC, Maiwall R, Pamecha V, Moreau R, et al.
    J Gastroenterol Hepatol, 2017 Dec;32(12):1989-1997.
    PMID: 28374414 DOI: 10.1111/jgh.13799
    BACKGROUND AND AIM: Systemic inflammatory response syndrome (SIRS) is an early marker of sepsis and ongoing inflammation and has been reported in large proportion of acute-on-chronic liver failure (ACLF) patients. Whether sepsis is the cause or the result of liver failure is unclear and is vital to know. To address this, the study investigated the course and outcome of ACLF patients without SIRS/sepsis.

    METHODS: Consecutive ACLF patients were monitored for the development of SIRS/sepsis and associated complications and followed till 90 days, liver transplant or death.

    RESULTS: Of 561 patients, 201 (35.8%) had no SIRS and 360 (64.2%) had SIRS with or without infection. New onset SIRS and sepsis developed in 74.6% and 8% respectively in a median of 7 (range 4-15) days, at a rate of 11% per day. The cumulative incidence of new SIRS was 29%, 92.8%, and 100% by days 4, 7, and 15. Liver failure, that is, bilirubin > 12 mg/dL (odds ratio [OR] = 2.5 [95% confidence interval {CI} = 1.05-6.19], P = 0.04) at days 0 and 4, and renal failure at day 4 (OR = 6.74 [95%CI = 1.50-13.29], P = 0.01), independently predicted new onset SIRS. Absence of SIRS in the first week was associated with reduced incidence of organ failure (20% vs 39.4%, P = 0.003), as was the 28-day (17.6% vs 36%, P = 0.02) and 90-day (27.5% vs 51%,P = 0.002) mortality. The 90-day mortality was 61.6% in the total cohort and that for those having no SIRS and SIRS at presentation were 42.8% and 65%, respectively (P 

  20. Chan A, Davanzo J
    J Cross Cult Gerontol, 1996 Mar;11(1):29-59.
    PMID: 24389944 DOI: 10.1007/BF00116264
    In this paper we use data from the Second Malaysian Family Life Survey (MFLS-2) to examine the extent to which ethnic differences in the living arrangements of the older population in Peninsular Malaysia can be explained by ethnic differences in demographic and socioeconomic characteristics. We also investigate whether the three main ethnic groups of Malaysia differ in the extent to which their living arrangements are influenced by these factors. For the married, the higher incidence of remarriage and lower housing costs for Malays each contribute importantly to their lower coresidence rates. The relatively poorer health of Indians and better health of Malays also contribute to the ethnic differences in coresidence rates for the married, as does the higher incidence of daughter-only families among Malays. The explanatory variables considered here explain less of the ethnic differences in coresidence rates for the unmarried.
    Study name: Malaysian Family Life Survey (MFLS-2)
Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links