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ObjectivesIt is the aim of the current research to identify some common functionalities of postnatal application, and to determine the quality of the information content of postnatal depression application using validated scales that have been applied for applications in other specialties.Settings and participantsTo determine the information quality of the postnatal depression smartphone applications, the two most widely used smartphone application stores, namely Apple iTunes as well as Google Android Play store, were searched between 20May and 31 May. No participants were involved. The inclusion criteria for the application were that it must have been searchable using the keywords ‘postnatal’, ‘pregnancy’, ‘perinatal’, ‘postpartum’ and ‘depression’, and must be in English language.InterventionThe Silberg Scale was used in the assessment of the information quality of the smartphone applications.Primary and secondary outcomes measureThe information quality score was the primary outcome measure.ResultsOur current results highlighted that while there is currently a myriad of applications, only 14 applications are specifically focused on postnatal depression. In addition, the majority of the currently available applications on the store have only disclosed their last date of modification as well as ownership. There remain very limited disclosures about the information of the authors, as well as the references for the information included in the application itself. The average score for the Silberg Scale for the postnatal applications we have analysed is 3.0.ConclusionsThere remains a need for healthcare professionals and developers to jointly conceptualise new applications with better information quality and evidence base.

PurposeIn medical school, students may participate in various community involvement projects (CIP), which serve disadvantaged communities. However, several obstacles may arise during these projects. The authors conducted a qualitative study with the primary aim of understanding the obstacles and corresponding potential solutions when medical students in Singapore participate in local CIP (LCIP) and overseas CIP (OCIP).DesignThe authors recruited medical students from Yong Loo Lin School of Medicine, National University of Singapore, who were also leaders of a specific community service project done in medical school. Twelve one-to-one interviews were held for the participants from 6 to 8 January 2013. Participants were led in a discussion based on an interview guide. The interviews were audio-recorded and transcribed into free-flow text. Subsequently, content and thematic analyses of the transcripts were performed independently by three researchers.ResultsThe medical students faced many common obstacles during their community service projects. These obstacles include difficulties in recruiting and managing volunteers, attaining recognition or credibility for the project to acquire funding and resources, adjusting to a different culture or language, setting goals, and facing project-specific obstacles. Potential solutions were offered for some obstacles, such as building a strong executive committee for the project, grooming successive batches of leaders, and improving the project's public image, mentorship, reflections, and sustainability plans.ConclusionsMentorship, reflections, and sustainability are potential solutions that have been proposed to tackle the obstacles faced during community service participation in medical school. However, there may still be difficulty in solving some of the problems even after these measures are put into practice. Future research may focus on evaluating the effectiveness of these suggested solutions.

Community service in medical school enriches medical students by bringing about improved self-reported outcomes, leadership skills, and interpersonal skills. It has some bearing on residency choice and academic work.

Home is the most favored choice among patients and family members who have a preferred place of care.

Objective This meta-analysis evaluates the pooled prevalence of depression, anxiety, adjustment disorder, and posttraumatic stress disorder (PTSD) among heart transplant recipients globally and determines underlying moderators. Methods The authors searched PubMed, Embase, PsychINFO, BIOSIS, Science Direct, and Cochrane CENTRAL databases from inception to March 1, 2019, and 1321 records and 42 full-text articles were selected and reviewed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We calculated the pooled prevalence proportion of depression, anxiety, adjustment disorder, and PTSD using random-effects models. Meta-regression was performed to identify important moderators that contribute to heterogeneity. Results Twenty studies met the inclusion criteria and comprised 2169 patients. The pooled prevalence of depression was 21.6% (95% confidence interval [CI] = 16.8%–27.3%), anxiety 11.1% (95% CI = 3.8%–28.5%), adjustment disorder 11.0% (95% CI = 3.1%–32.1%), and PTSD 13.5% (95% CI = 8%–21.8%). There was significant heterogeneity. Meta-regression was conducted to account for the heterogeneity of the prevalence proportion. Predisposing factors, for example, New York Heart Association classes II and III/IV, steroid treatment, and acute rejection of transplant (<3 months), were associated with high prevalence of depression. Protective factors, for example, age and higher ejection fraction after transplant of patients, were associated with low prevalence of depression. Female sex, single status, and number of months since transplant were associated with high prevalence of anxiety. Single status was associated with high prevalence of both adjustment disorder and transplant-related PTSD. Conclusions The prevalence of psychiatric conditions, particularly depression, is high in heart transplant recipients. The identified protective and risk factors may guide psychological interventions in heart transplant recipients.

Background: The effect of maternal weight on pregnancy and birth outcomes is of great public health concern. For example, overweight and obesity among pregnant women is associated with adverse reproductive health outcomes including gestational diabetes, birth defects, macrosomia and infant mortality.Objectives: To understand the knowledge, perceptions and experiences during pregnancy among overweight and obese women in Singapore.Methods: This is a cross-sectional study which employed qualitative techniques. The inclusion criteria is as follows: (1) Women who were overweight or obese before or during first trimester of pregnancy, (2) are able to report their specific pre-pregnancy or first trimester Body Mass Index (BMI), or weight and height, (3) had singleton pregnancy when overweight, are post-delivery for the pregnancy in which they were overweight, and (4) are 21 to 55 years old. Fifteen interviews were voice-recorded and transcribed verbatim. Then, two researchers independently performed the thematic analysis of the transcripts.Results: The findings revealed that women had gaps in knowledge on the adverse effects of maternal overweight and obesity during pregnancy, and various misconceptions on diet and weight management during pregnancy were prevalent. Conflicting data was obtained for perceptions on the importance, difficulty and levels of motivation for weight management during pregnancy.Conclusion: There is a pressing need to address knowledge gaps and misconceptions of pregnant women who are overweight or obese. The importance of weight management during pregnancy should be emphasized, and enabling factors put in place.

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