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Biomedical subjects

J Cutter

Publications and source records attributed to J Cutter.

9 recordsLinked to original sources
PubMed2005

Public health measures implemented during the SARS outbreak in Singapore, 2003.

The SARS outbreak hit Singapore between March and May 2003. Public health control measures were applied along three fronts; prevention and control within healthcare settings, community and at the borders. Nosocomial spread composed majority of SARS cases in Singapore. To prevent infection within healthcare facilities, cases were centralized in a SARS-designated hospital, a no-visitors rule was applied and movement of patients and healthcare staff were restricted. For triaging purposes, fever clinics were established. A dedicated ambulance service was used to transport possible cases to the SARS-designated hospital. Hospitals were surveyed for fever clusters. The challenge was to identify cases with atypical presentation. Effective and safe discharge criteria were established from the lessons learnt. To prevent community spread, contacts of cases were stringently traced, quarantined in their homes and monitored daily. For prompt identification of a case and to reduce the time between onset of symptoms and isolation, the Infectious Diseases Act was amended. A large wholesale market closure resulted in massive quarantine thereby limiting the spread of infection. A mass education campaign was implemented in order to educate and raise awareness of the public. At all air, sea and land points-of-entry, exit and entry screening took place that resulted in zero importation and exportation of SARS cases after implementation of screening. Coordinated effort of the cross sectional inter-ministerial collaboration and strong coordination by the Task Force and commitment from different professionals made it possible to conquer the disease.

Contact Tracing↗
PubMed2003

Inoculation injuries: inter-professional differences in risk-taking and reporting.

Guidelines and protocols have been introduced to minimize the risk of transmission of blood-borne viral infections during surgical procedures. However, adherence to these guidelines is reported to be less than complete. A survey of operating theatre professionals was undertaken in one NHS Trust to explore the incidence of inoculation injuries and the extent of non-reporting, together with underlying reasons. A response rate of 72.5% (200/276) was achieved. Significantly more surgeons than nurses and midwives had sustained inoculation injuries: 79/90 (87.8%) compared with 66/106 (62.3%; P<0.001). However, surgeons were significantly less likely than other professionals to report their injuries 39/74 (52.7%) compared with 59/65 (90.8%; P<0.001). It would appear that surgeons' disregard for published guidelines is placing them at a greater risk of contracting blood-borne viral infections than other professionals.

Accidents, Occupational↗
PubMed2003

A preliminary investigation into bacterial contamination of Welsh emergency ambulances.

OBJECTIVES: The objective of this regional study across Wales was to perform a preliminary examination of Welsh emergency vehicles to determine levels of bacterial contamination. METHODS: Specific sites within emergency vehicles were swabbed, before and after vehicle cleaning, over a 12 month period, on a monthly basis. All swabs were sent to pathology laboratories for culturing and analysis. RESULTS: Results showed that most sites within emergency vehicles across Wales were contaminated with a range of bacterial species before vehicle cleaning. After vehicle cleaning, many sites in vehicles were still contaminated, and some sites that were previously uncontaminated, became freshly contaminated as a result of cleaning methods used. CONCLUSIONS: The authors conclude that the Welsh emergency vehicles examined exhibited an unacceptable level of bacterial contamination. This finding should be carefully considered and all attempts must be made to tackle the problem of vehicle cleanliness and infection control.

Ambulances↗
PubMed2002

Gender differences in outcome after an acute myocardial infarction in Singapore.

OBJECTIVES: To characterise gender and age-related differences in presentation and outcome after an acute myocardial infarction (AMI). DESIGN: Data were derived retrospectively from the Singapore Myocardial Infarction Registry from 1988 through 1997. This database comprised all AMI cases for ages between 20 and 64 years (group A). For approximately three months a year, data were also collected for all AMI cases above the age of 64 years (group B). There were 13,048 and 4,425 cases in groups A and B respectively. RESULTS: In age - standardised AMI rates, males outnumbered females by a factor of 4.0 and 1.7 for groups A and B respectively.The median age of presentation was higher in females for both age groups being 58 years versus 54 years for group A and 75 years versus 72 years for group B. Younger females had worse survival at 28 days and were more likely to have prior ischaemic heart disease and require resuscitation. They were also more likely to have atypical symptoms. Previous myocardial infarction was not different between the sexes in both groups. Among the older age group, there was no gender difference in prior ischaemic heart disease, 28-day survival and requirement for resuscitation. CONCLUSION: Women who have AMI tend to be older than men. Gender differences are age-specific. Women who are 64 years and below have more atypical symptoms, prior ischaemic heart disease and worse prognosis than men after AMI. These differences are not seen in those over the age of 64.

Adult↗
PubMed2001

Levels of cardiovascular disease risk factors in Singapore following a national intervention programme.

OBJECTIVE: To evaluate the impact of the National Healthy Lifestyle Programme, a noncommunicable disease intervention programme for major cardiovascular disease risk factors in Singapore, implemented in 1992. METHODS: The evaluation was carried out in 1998 by the Singapore National Health Survey (NHS). The reference population was 2.2 million multiracial Singapore residents, 18-69 years of age. A population-based survey sample (n = 4723) was selected by disproportionate stratified and systematic sampling. Anthropometric and blood pressure measurements were carried out on all subjects and blood samples were taken for biochemical analysis. FINDINGS: The 1998 results suggest that the National Healthy Lifestyle Programme significantly decreased regular smoking and increased regular exercise over 1992 levels and stabilized the prevalence of obesity and diabetes mellitus. However, the prevalence of high total blood cholesterol and hypertension increased. Ethnic differences in the prevalence of diabetes mellitus, hypertension, and smoking; and in lipid profile and exercise levels were also observed. CONCLUSION: The intervention had mixed results after six years. Successful strategies have been continued and strengthened.

Adolescent↗
PubMed1994

Recording patient temperature--are we getting it right?

Temperature recordings can provide important patient information in a variety of clinical settings, so it is vital that readings are correct. A survey of current practice, however, revealed disturbing variations from established guidelines.

Body Temperature↗