Publications by authors named "Ting Hui Woon"

Singapore's primary healthcare landscape is dominated by private sector general practitioners, who have more room to play in terms of safeguarding the health of the population. Through a transformative national policy, Healthier SG, Singapore is evolving its health system to lean on private-public partnerships. This is achieved through shared care protocols, interoperable IT requirements, new models of financing, shared responsibilities and human resources and, importantly, a bidirectional feedback channel.

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Introduction: Studies have shown that patients with rheumatoid arthritis (RA) have lower levels of physical activity (PA) than healthy controls, despite the benefits of PA in reducing pain and stiffness. We aimed to compare the levels of PA in patients with RA with that of the general population and identify factors associated with meeting the World Health Organization (WHO) recommendations for PA.

Methods: Consecutive patients with RA were recruited from an outpatient rheumatology clinic in a tertiary hospital in Singapore.

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Background: Physical activity is important in patients with rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA). Current literature suggests they engage in less physical activity compared to healthy controls. Reasons for this discrepancy has not been well studied in Asian populations.

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Article Synopsis
  • Advanced care planning (ACP) involves ongoing discussions among patients, families, and healthcare professionals about future healthcare needs.
  • Patients with rheumatic diseases often face significant symptoms and complications, but the rate of completed ACP in this group is low.
  • A quality improvement project in Singapore successfully increased ACP completion rates from 0 to 1 per month over a year through two Plan-Do-Study-Act cycles, indicating a need for further research on enhancing ACP engagement in these patients.
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Purpose: We aimed to (1) establish linguistic and ethnic equivalence (i.e. lack of bias) for the items in the English and Chinese versions of the Singapore Health and Well Being (SHAWS) Physical Functioning (PF), Positive Mindset (PM) and Social Relationship (SR) item banks (IBs); and (2) evaluate the preliminary efficiency of these IBs using Computer Adaptive Testing (CAT) simulations.

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Article Synopsis
  • The study aimed to compare the Health Index scores between patients with radiographic axial spondyloarthritis (r-axSpA) and non-radiographic axSpA (nr-axSpA), and to find factors linked to higher scores in both groups.
  • A total of 976 patients participated, with findings showing that r-axSpA patients reported worse Health Index scores compared to nr-axSpA patients, though the disease phenotype itself didn’t significantly correlate with these scores in the multivariable analysis.
  • Higher Health Index scores were significantly associated with being female, experiencing poorer physical function, higher disease activity, and increased anxiety and depressive symptoms, indicating a similar overall health impact across both disease types.
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Objectives: Chinese herbal medicine (CHM) has been shown to be effective in autoimmune rheumatic diseases, but harmful herb-drug interactions might be inherent. We aim to review the evidence regarding herb-drug interactions between immunosuppressive drugs used in autoimmune rheumatic diseases and CHM.

Methods: We searched PubMed, EMBASE and CINAHL from inception till 30 April 2023 using keywords that encompassed 'herb-drug interactions', 'herbs' and 'immunosuppressants'.

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Background: The COVID-19 pandemic has disrupted residency training. Several studies have been performed to investigate the impact of the pandemic on residency training in Accreditation Council for Graduate Medical Education-International (ACGME-I)-accredited institutions. However, these were either limited to certain specialties or failed to consider possible opportunities from the pandemic.

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Objective: To determine prevalence and factors associated with flares post Coronavirus disease 2019 (COVID-19) mRNA vaccination in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (SpA).

Methods: A retrospective multi-centre study was conducted (January 2021 to February 2022). Data were collected during index visit, defined as first post-vaccine visit in which the patient had a physician-defined flare, or if at least 3 months had elapsed since first vaccine dose, whichever came first.

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Objectives: To evaluate the association between anxiety, depression and resilience with overall health and functioning in axial spondyloarthritis (axSpA).

Design: Cross-sectional evaluation of baseline data from a prospective cohort study, with recruitment from January 2018 to March 2021.

Setting: Outpatient clinic in a tertiary hospital in Singapore.

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Background: The use of social media in health care may serve as a beneficial tool for education, information dissemination, telemedicine, research, networking, and communications. To better leverage the benefits of social media, it is imperative to understand the patterns of its use and potential barriers to its implementation in health care. A previous study in 2016 that investigated social media use among young clinical rheumatologists (≤45 years) and basic scientists showed that there was substantial social media use among them for social and professional reasons.

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Objective: Health-related quality of life (HRQOL) is an important aspect in the management of chronic diseases such as spondyloarthritis (SpA). A promising approach to reduce respondent burden when measuring HRQOL is the use of shorter patient-reported outcome measures (PROMs) delivered using computerized adaptive tests (CATs). However, the lack of an item bank that covers the entire continuum of the HRQOL domain impedes the development of CATs to measure HRQOL among patients with SpA.

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Article Synopsis
  • Evidence suggests that gut microbiota imbalances worsen diabetic kidney disease (DKD), and prebiotics can help restore balance and reduce inflammation.
  • The Traditional Chinese Medicine formula Qing-Re-Xiao-Zheng (QRXZF) shows promise for treating DKD, but its impact on gut microbiota regulation is not fully understood.
  • In a study using DKD mice models, QRXZF treatment resulted in improved kidney function, reduced inflammation, and enhanced gut barrier integrity, indicating its potential effectiveness through modulation of gut microbiota and inflammatory pathways.
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