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Objectives: COVID-19 had significant influences on everyone's lives. This study aimed to explore impacts of COVID-19 on mental and sexual health and access to health services among gay, bisexual and other men who have sex with men (GBMSM) in Singapore., Methods: This qualitative study recruited 16 self-identified GBMSM via purposive sampling and semi-structured individual interviews were conducted. Three themes and seven sub-themes were derived from analysis done using the framework method., Results: Participants shared how COVID-19 led to negative emotions and experiences at an intrapersonal level and interpersonal level (with families or partners), which were also worsened by prevailing stigma that GBMSM already face in Singapore and within their social networks. Sexual behaviours associated with HIV and other sexually transmitted infections risk and substance use were seen to be maladaptive coping methods of social isolation due to COVID-19. These dynamics were all exacerbated by the closure of "non-essential" services, which included many important services for mental and sexual health that were relevant to the GBMSM community., Conclusions: Changes in policies and community efforts should be explored to improve these areas, enhancing the psychosocial and sexual well-being of GBMSM.

Purpose: The purposes of this study were to (i) describe the lived experiences of participating in a Singaporean vocational rehabilitation (VR) program among individuals with stroke and spinal cord injury and (ii) identify salient features of the program that facilitated their return-to-work process., Materials and Methods: This was a qualitative phenomenological study. Participants were invited to complete an interview about their return-to-work process after acquiring a disability vis-à-vis their participation in a local VR program. The qualitative data were analyzed inductively., Results: Twenty-four middle-aged participants with a stroke or spinal cord injury completed the interviews. The participants' experiences with the local VR program were largely positive. Several key features of the VR program were identified. These were: (i) providing a multi-disciplinary and individualized program; (ii) building positive collaborations between service providers and participants; and (iii) supporting personal growth among participants., Conclusion: The Singaporean VR program demonstrated internationally recommended best practices. These best practices were beneficial for the participants' return-to-work process, as reflected by their positive feedback about the program. Our study emphasizes the need for comprehensive and evidence-based VR programs to meet the complex needs of individuals with disabilities who want to return to work.Implications for rehabilitationMulti- or inter-disciplinary care services are needed in vocational rehabilitation (VR) programs to support the complex return-to-work process of clients.VR programs should have the capacity to provide client-centered care as their clients may experience diverse, yet unique challenges during their return-to-work processVR service providers play a crucial role in engaging and motivating their clients throughout the program to achieve their return-to-work goalsVR service providers should address concurrent or future concerns that could impact on their clients' ability to return to or remain at work.

Background: Post-stroke return-to-work (RTW) rates reported in Singapore ranged between 38% and 55%, indicating challenges in the RTW process among individuals with stroke., Objective: We sought to understand the lived experience of returning to work among individuals with stroke in Singapore., Methods: This was a qualitative study using a phenomenological approach. We recruited individuals with stroke who were citizens or permanent residents of Singapore. We conducted semi-structured interviews to collect data on their lived experience of returning to work and analyzed the interview data inductively., Results: Twenty-seven participants completed the interviews. Their median age was 61 years (interquartile range = 54 - 64). They were mostly male (n = 19, 70.4%) and married (n = 21, 78%). Twenty participants (74%) returned to work after their stroke. Three major themes emerged from the interviews that underpinned the participants' RTW experience. They were i) direct impact of stroke, ii) realignment of life priorities, and iii) engagement with support and resources., Conclusion: RTW after stroke is complex and influenced by personal and environmental factors. Our findings suggest that individuals with stroke need continuing support to overcome stigma and discrimination, to manage expectations of their recovery process, and to better navigate resources during their RTW process in Singapore. We recommend future studies to design and test the feasibility of appropriate interventions based on our proposed strategies to better support individuals with stroke to return to work.

Introduction: The aim of this research was to evaluate the impact of a novel tele-rehabilitation system on self-reported functional outcomes compared to usual care during the first three months after stroke., Methods: A parallel, two-arm, evaluator-blinded, randomised controlled trial was conducted. Adults aged ≥40 years who had suffered a stroke within four weeks of the start of the study were recruited from the general community. The intervention group received access to a novel tele-rehabilitation system and programme for three months. The primary outcome measures utilised were the frequency and limitation total scores of the Late-Life Function and Disability Instrument (LLFDI) at three months., Results: A total of 124 individuals were recruited. The mean differences in the LLDFI frequency and limitation total scores at three months comparing the intervention and control groups were -3.30 (95% confidence interval (CI) -7.81 to 1.21) and -6.90 (95% CI -15.02 to 1.22), respectively. Adjusting for the respective baseline covariates and baseline Barthel Index also showed no significant difference between interventions in the LLFDI outcomes., Discussion: The intervention and control groups self-reported similar improvements in functional outcomes. Tele-rehabilitation may be a viable option to provide post-stroke rehabilitation services in Singapore while reducing barriers to continue rehabilitation conventionally after discharge from hospital and encouraging more participation.

Importance: Return to work after stroke is an important rehabilitation outcome. Vocational rehabilitation may support people with stroke to return to work., Objective: To report the return-to-work rate of people with stroke who completed a local community-based vocational rehabilitation program and to describe the program's impact on their community reintegration., Design: Retrospective database study., Setting: Community-based voluntary welfare organization., Participants: Fifty-eight men and women ages 21 to 55 yr, formally diagnosed with stroke, with no significant cognitive impairment, and fit to undergo rehabilitation., Intervention: A pilot community-based interdisciplinary vocational rehabilitation program implemented between 2014 and 2017. The program included physical rehabilitation, psychosocial support, employment support, and caregiver support services., Outcomes and Measures: Return-to-work rate and community reintegration as measured by the Community Integration Questionnaire (CIQ)., Results: Fifty participants completed the program. Their median age was 44 yr, and most were male (n = 37; 74%). Forty-four participants (88%) returned to work after completing the program. Statistically significant differences (p < .001) were found between their CIQ scores at program enrollment and at completion., Conclusions and Relevance: The program appeared to benefit people with stroke in their return-to-work process. Future studies are recommended to determine the effectiveness of such programs and identify features contributing to their success. Potential implications for occupational therapy practice are that vocational rehabilitation interventions can be initiated earlier, comprehensive return-to-work programs can better address the unique needs of people with stroke, and interdisciplinary evaluations are needed to assess suitability for return to work., What This Article Adds: One of occupational therapy's unique goals is to facilitate performance and participation in valued activities such as work. Occupational therapists can play a pivotal role across the continuum of care to support their clients to explore and achieve their vocational goals after stroke., (Copyright © 2020 by the American Occupational Therapy Association, Inc.)

Study Design: Retrospective analysis of data collected as part of a pilot program., Objectives: The primary objective of our study was to document the return-to-work rate of individuals with SCI who participated in a community-based interdisciplinary vocational rehabilitation program. The secondary objectives were to assess changes in their levels of community integration and functional independence., Setting: A community-based rehabilitation center in Singapore., Methods: Participants were individuals with SCI between 21 and 55 years. They identified return to work as a rehabilitation goal, and were certified fit to undergo rehabilitation by their physicians. Primary outcome was the return-to-work rate at discharge from the program. Secondary outcomes were community integration and functional independence, measured by the Community Integration Questionnaire (CIQ) and the Spinal Cord Independence Measure III (SCIM-III), respectively. We summarized participants' clinical and socio-demographic characteristics descriptively, and used inferential statistics to compare pre- and postprogram scores for secondary outcome measures., Results: Thirty-nine participants were included for this study. Thirty-two completed the program, of which 84% (n = 27) reported returning to work. Participants who completed the program had mean change in total CIQ and SCIM-III scores of 7 (95% CI, 5-8) and 11 (95% CI, 7-15), respectively. There were differences (p < 0.05) between pre- and postprogram scores for both secondary outcome measures., Conclusions: Our findings suggest that our vocational rehabilitation program facilitated participants with SCI in Singapore to return to work and was beneficial to enhance their levels of community integration and functional independence. Future interventional studies are recommended to estimate the efficacy of such programs.

Childhood obesity is a growing concern worldwide. Though multifactorial, the family environment exerts significant influence on children's eating habits. Grandparents are increasingly involved as caregivers and they can significantly influence their grandchildren's eating habits. Yet, literature on this topic is lacking. This exploratory sequential mixed methods study (qualitative interview and interviewer-administered questionnaire) aims to understand grandparents' knowledge, attitudes, and practices on the feeding of their grandchildren in Singapore. A total of 11 interview participants and 396 questionnaire respondents with at least one grandchild, aged 12 years and below were included. Qualitative interviews informed the questionnaire development. Responses to interview questions about knowledge, attitudes, and practices revealed sub-themes such as knowledge on the impact of feeding, attitude toward feeding role, and challenges to feeding. Of the 396 participants, 35% were primary caregivers (defined as the person who spends the most time with the grandchild and performs most of the caregiving tasks). Nutritional knowledge was fair (median score 5/8), with misconceptions centered around healthy feeding practices. Grandparents who were primary caregivers, female, Malay, and younger than 70 years old believed that they played an important role in feeding their grandchild ( p < 0.05). Overall, 47.2% of the grandparents rarely or never set a maximum limit on the amount of unhealthy food eaten, of which 77.1% are non-primary caregivers. In comparison, primary caregivers tend to set a maximum limit to the amount of unhealthy food their grandchildren eat and choose a wide variety of food ( p < 0.05). These findings support the need for further improvement of grandparents' feeding knowledge and practices as part of tackling childhood obesity., Competing Interests: The authors declare no conflict of interest.