ORCID Profile
0000-0001-6114-8533
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Publisher: SAGE Publications
Date: 20-08-2016
Abstract: The main aim of this study is to present the socio-demographic, clinical, and functional characteristics of home medical care patients admitted into one of the oldest home care service over a 10-year period. Data were manually retrospectively extracted from the non-computerized medical records of all patients admitted into Code 4 Home Medical Service from January 1, 2000, to December 31, 2009. Records of 1,069 patients were examined. Over the 10-year period, there was an increasing proportion of patients older than 70 years ( B [95% CI], 1.08 [0.43, 1.73]) and dependency on foreign domestic workers as primary caregivers ( B [95% CI], 4.65 [3.71, 5.58]). Cognitive impairment and functional dependency of the patients increased over the years, as assessed using Abbreviated Mental Test score 7 ( B [95% CI], 1.73 [0.71-2.76]) and Barthel Index = 0 ( B [95% CI], 4.32 [2.74-5.91]). Knowledge about these trends may be helpful to project future demands for home medical care in Singapore.
Publisher: Public Library of Science (PLoS)
Date: 12-2022
DOI: 10.1371/JOURNAL.PONE.0278479
Abstract: Health care workers’ (HCWs) lived experiences and perceptions of the pandemic can prove to be a valuable resource in the face of a seemingly persistent Novel coronavirus disease 2019 (COVID-19)–to inform ongoing efforts, as well as identify components essential to a crisis preparedness plan and the issues pertinent to supporting relevant, immediate change. We employed a phenomenological approach and, using purposive s ling, conducted 39 semi-structured interviews with senior healthcare professionals who were employed at a designated COVID-19 facility in New South Wales (NSW), Australia during the height of the pandemic in 2020. Participants comprised administrators, heads of department and senior clinicians. We obtained these HCWs’ (i) perspectives of their lived experience on what was done well and what could have been done differently and (ii) recommendations on actions for current and future crisis response. Four themes emerged: minimise the spread of disease at all times maintain a sense of collegiality and informed decision-making plan for future crises and promote corporate and clinical agility. These themes encapsulated respondents’ insights that should inform our capacity to meet current needs, direct meaningful and in situ change, and prepare us for future crises. Respondents’ observations and recommendations are informative for decision-makers tasked with mobilising an efficacious approach to the next health crisis and, in the interim, would aid the governance of a more robust workforce to effect high quality patient care in a safe environment.
Publisher: Elsevier BV
Date: 08-2016
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.JDENT.2022.104085
Abstract: The objectives of this study were to determine the relationship between reported self-efficacy and dental status in older adults, identify factors which might influence self-efficacy and, their willingness to pay (WTP) for preventive care. Participants aged 60-90 years of age living in Singapore were recruited. All participants completed an oral health questionnaire and a clinical examination. Details of participants' socio-economic status and educational attainment were collected, and participants also answered a range of questions related to self-efficacy, oral health attitudes, beliefs and dental attendance patterns. Participants were asked to indicate their willingness to pay for preventive care using contingent valuation. The clinical examination recorded decayed, missing and filled teeth [DMFT], root caries, periodontal attachment loss, bleeding on probing index, occlusal status and, denture wearing status. Associations between self-efficacy, self-report and clinical variables were assessed using Kendall's Tau B coefficient. 614 participants [mean age 68.07 (5.99) years] were recruited. There was a high level of dental awareness and nearly 70% of the participants reported visiting a dentist once or twice a year. Self-efficacy was associated with levels of bleeding on probing and self-reported satisfaction with oral health. Nearly 60% of participants were not willing to pay for preventive advice from an oral healthcare professional. Older adults with a high level of self-efficacy had good gingival health, with low reported levels of bleeding on probing. Participants with low reported self-efficacy had higher disease levels and were less satisfied with their oral health. Self-efficacy in relation to oral hygiene practices is variable, and participants with low self-efficacy had higher gingival bleeding scores. However, willingness to pay for preventive advice is low, and further work is required to increase the value proposition of preventive care to older adults.
Publisher: Research Square Platform LLC
Date: 13-10-2020
DOI: 10.21203/RS.3.RS-89918/V1
Abstract: Objective The objective of this study was to explore dental caries experience in older Singaporeans (60-90 years old), a country with over 60 years of water fluoridation, and to examine what risk factors contribute to prevalence of oral disease, in particular root caries, and to assess the impact of service utilisation on treatment of root caries. Methodology 500 community dwelling older adults, aged 60 years and above were invited to participate in this cross-sectional study. Participants completed a survey which included questions related to demographics (e.g. age, gender, ethnicity, education level) self-rated oral health, oral health attitudes and frequency of dental visits. A clinical examination recorded details of decayed, missing and filled teeth stimulated saliva flow was also measured. The main outcome of this study was prevalence of decayed and filled root surfaces (DFRS) of older adults, categorised as “low” [DFRS ≤3] and “high” [DFRS ]. The regression models were controlled for age, gender, ethnicity, education, marital status, housing type, oral health related factors and salivary parameters. Results 84.2% of the participants ethnicity was Chinese and 15.2% were Non-Chinese. The mean DFRS score was [Mean (SD), 3(3.5)], decayed [Total (Mean), 68(13.6)] and filled [Total (Mean), 287 (57.4)]. In bivariate analysis, age, ethnicity, education, dental visits, recession, restored coronal surfaces and oral health attitude were found to be significantly associated with DFRS. In final multivariate model it was found that age, ethnicity, education, pattern of dental visits, gingival recession eriodontal attachment loss and number of restored coronal surfaces are independent predictors of root caries experience in older adults. The selected risk factors in the final model explained about 20% of the variation. Conclusion Higher education and awareness increase dental care utilization which corresponds to a high filled (F) component of DFRS. Previous coronal caries experience and gingival recession/attachment loss are risk indicators of higher root caries experience.
Publisher: Springer Science and Business Media LLC
Date: 08-08-2019
Publisher: Elsevier BV
Date: 08-2022
Publisher: Informa UK Limited
Date: 13-10-2016
Publisher: Springer Science and Business Media LLC
Date: 04-02-2021
DOI: 10.1186/S12903-021-01408-3
Abstract: There is little knowledge about factors which may affect oral health among older adults. The objective of this study was to determine the relationship between Streptococcus mutans (MS) and Lactobacilli (LB) counts and caries among older adults. In this community-based observation study, 141 participants aged 60 years and above were recruited from the west district of Singapore. Alongside the clinical examination, saliva s les were collected to determine Streptococcus mutans (MS) and Lactobacilli (LB) counts, as well as to record salivary flow rate and buffering capacity of saliva. Of the 141 participants, 63.8% were female and 94.3% were of Chinese ethnicity. The mean DMFT was 11.08 (s.d. 8.27). 9.9% of participants had at least one decayed tooth, 52.5% had minimum one missing tooth and 86.5% had at least one filled tooth. 67.4% had MS counts of ≥ 10 5 while LB counts were ≥ 10 5 for 48.2%. 83.7% had normal salivary flow or hypersalivation ( = 1 mL/min), the buffering capacity of the saliva was alkaline in 61% of the participants. Multivariate analysis showed that participants who had high MS counts were less likely to have a DMFT 12 [OR (95% CI), 0.29 (0.11–0.77)] whereas participants who had high LB counts were less likely to have a DMFT ≤ 14 [OR (95% CI), 0.45 (0.20–1.002)]. Our study showed a positive correlation between MS and LB counts and caries experience in older adults. The mean DMFT was on the low side in our s le despite having a relatively high MS count. This suggests that there are many other factors which vary according to host environment, physiological and biological conditions that may affect MS and LB counts in the oral cavity. Our study supports the knowledge that the aetiology of dental caries among older adults is a complex process and it would be wrong to consider caries as a same problem with the same solution for all age groups.
Publisher: Informa UK Limited
Date: 02-10-2017
DOI: 10.1080/01621424.2017.1381868
Abstract: The primary aim was to determine the trend and predictors of unplanned hospitalization of home medical patients. Records of 1,069 patients were obtained from the medical records. Out of 1,069, we analyzed 512 patients who had utilized services across all four quarters in the first year of admission. There was a significant decline in unplanned hospitalization between the first two quarters. The potential risk factors were the male gender, IRR (95% CI), 1.29 (0.99-1.67) chronic pulmonary disease, 1.53 (1.08-2.16) dementia, 1.29 (1.00-1.66) ischemic heart disease, 1.33 (1.02-1.74) and history of fractures, 1.49 (1.13-1.96).
Publisher: Informa UK Limited
Date: 24-08-2016
Publisher: Elsevier BV
Date: 08-2018
Location: India
No related grants have been discovered for Dr. Rakhi Mittal.