To assess the awareness and acceptability of colorectal cancer (CRC) screening in noncompliant Singaporeans and to determine if their barriers can be overcome by education. A questionnaire developed from thematic analysis of open-ended interviews with 72 subjects was administered to 580 residents in a local high-rise housing estate. Participants aware of CRC screening were assessed for barriers and acceptability of CRC screening. All participants were subsequently educated about CRC screening and reassessed for barriers and acceptance. Those keen for fecal occult blood testing (FOBT) were offered FOBT kits and followed up. CRC screening awareness was poor. Having no symptoms was the most common barrier. More barriers to FOBT than to colonoscopy were reduced with education. After education, acceptability toward FOBT increased but rejection rates rose even higher. FOBT is probably Singapore's most acceptable screening modality. Education is limited by barriers, which need to be overcome by alternative measures.
Burrhole craniostomy is commonly performed for subdural hematoma (SDH) evacuation, but residual scalp depressions are often cosmetically suboptimal for patients. OsteoplugTM, a bioresorbable polycaprolactone burrhole cover, was introduced by the National University Hospital, Singapore, in 2006 to cover these defects, allowing osseous integration and vascular ingrowth. However, the cosmetic and safety outcomes of OsteoplugTM-C—the latest (2017) iteration, with a chamfered hole for subdural drains—remain unexplored. Data were collected from a single institution from April 2017 to March 2021. Patient-reported aesthetic outcomes (Aesthetic Numeric Analog (ANA)) and quality of life (EQ-5D-3L including Visual Analog Scale (VAS)) were assessed via telephone interviews. Clinical outcomes included SDH recurrence, postoperative infections, and drain complications. OsteoplugTM-C patients had significantly higher satisfaction and quality of life compared to those without a burrhole cover (ANA: 9 [7, 9] vs. 7 [5, 8], p = 0.019; VAS: 85 [75, 90] vs. 70 [50, 80], p = 0.021), and the absence of a burrhole cover was associated with poorer aesthetic outcomes after multivariable adjustment (adjusted OR: 4.55, 95% CI: 1.09–22.68, p = 0.047). No significant differences in other clinical outcomes were observed between OsteoplugTM-C, OsteoplugTM, or no burrhole cover. Our pilot study supports OsteoplugTM-C and its material polycaprolactone as suitable adjuncts to burrhole craniostomy, improving cosmetic outcomes while achieving comparable safety outcomes.
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