Lay See Ong

Background: Shared decision-making (SDM) can improve appropriate antibiotic prescribing in human primary care clinics, but little is known about it in the veterinary setting. This study examines the association between SDM and antibiotic prescribing for cats and dogs in veterinary clinics, then determines the key factors influencing SDM through a value-driven approach. Methods: This cross-sectional study surveyed 41 veterinarians practicing in Singapore veterinary clinics. Appropriate antibiotic prescribing was defined as concordance with local antibiotic guidelines for companion animals, while an adapted SDM-Q-9-Doc scale measured SDM on antibiotic prescribing with pet owners. Questions were developed to measure constructs of the VALUE model and factor analysis was conducted to identify latent factors. Multivariable logistic and linear regressions were performed to assess the association between SDM and antibiotic prescribing, and determinants of SDM, respectively. Results: Antibiotics were most inappropriately prescribed for cats/dogs with ear infections (cocci observed) (63%), and periodontal disease (59%). Engaging owners in SDM (AOR 1.31; 95% CI 1.05, 1.62; p = 0.014) was positively associated with appropriate antibiotic prescribing for cats/dogs with periodontal disease. After adjusting for age, gender, clinic role and practice type, veterinarians with a higher overall VALUE score (β = 0.14; 95% CI 0.02, 0.26; p = 0.021) were more likely to engage in SDM with owners on antibiotic prescribing. Conclusions: SDM with pet owners improves appropriate antibiotic prescribing for cats and dogs, though effects vary by clinical scenario. Aligning AMR-related values between veterinary clinics and veterinarians to enable effective communication with pet owners can promote SDM and subsequently drive appropriate antibiotic prescribing for pet cats and dogs.

The extent to which lifestyle practices at night influence sleep quality in pregnant women remains unknown. This study aimed to examine whether nocturnal behaviours were associated with poor sleep during pregnancy. We performed a cross-sectional analysis of a prospective cohort of pregnant women at 18–24 gestation weeks recruited from KK Women’s and Children’s Hospital, Singapore, between 2019 and 2021. Nocturnal behaviours were assessed with questionnaires, and sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) with a global score ≥5 indicative of poor sleep quality. Modified Poisson regression and linear regression were used to examine the association between nocturnal behaviour and sleep quality. Of 299 women, 117 (39.1%) experienced poor sleep. In the covariate-adjusted analysis, poor sleep was observed in women with nocturnal eating (risk ratio 1.51; 95% confidence interval [CI] 1.12, 2.04) and nocturnal artificial light exposure (1.63; 1.24, 2.13). Similarly, nocturnal eating (β 0.68; 95% CI 0.03, 1.32) and light exposure (1.99; 1.04, 2.94) were associated with higher PSQI score. Nocturnal physical activity and screen viewing before bedtime were not associated with sleep quality. In conclusion, reducing nocturnal eating and light exposure at night could potentially improve sleep in pregnancy.

We report the results of three high-powered replications of Troisi and Gabriel’s (2011) idea that writing about comfort food reduces feelings of loneliness amongst securely attached individuals after a belongingness threat. We conducted our studies amongst a large group of participants (Total N = 649) amongst American (MTurk), Dutch (Tilburg University; TiU), and Singaporean (Singapore Management University; SMU) samples. Participants first completed an attachment style scale, followed by writing two essays for manipulating a sense of belongingness and salience of comfort food, and then reporting their loneliness levels. We did not confirm the overall effect over all three countries. However, exploratory results provide the preliminary suggestion that 1) the comfort food explanation likely holds amongst the American samples (including Troisi & Gabriel’s), but not amongst the TiU and SMU samples, and potentially that 2) the TiU and SMU participants self-regulate through warmer (vs. colder) temperature foods. Both of these should be regarded with great caution as these analyses were exploratory, and because the Ns for the different temperature foods were small. We suspect we have uncovered first cross-cultural differences in self-regulation through food, but further confirmatory work is required to understand the cultural significance of comfort food for self-regulation.