Objectives: We investigated new-onset constipation in patients with stroke compared with orthopaedic conditions and explored the predictors associated with constipation during acute hospitalisation. Methods: This was a prospective matched cohort study of 110 patients comparing stroke patients (n = 55) with orthopaedic patients (n = 55) admitted to a large tertiary acute hospital. Both cohorts were matched by age and sex. The incidence of new-onset constipation which occurred during a patient's acute hospitalisation was determined. Demographics, comorbidity, clinical factors, laboratory parameters and medications were evaluated as possible predictors of constipation. Results: The incidence of newonset constipation was high for both stroke (33%) and orthopaedic patients (27%; p = 0.66). Seven stroke patients (39%) and four orthopaedic patients (27%) developed their first onset of constipation on day 2 of admission. Mobility gains (RR 0.741, p < 0.001) and the use of prophylactic laxatives (RR 0.331, p < 0.01) had a protective effect against constipation. Bedpan use (RR 2.058, p < 0.05) and longer length of stay (RR 1.032, p < 0.05) increased the risk of developing new-onset constipation. Conclusions: New-onset constipation is common among patients admitted for stroke and orthopaedic conditions during acute hospitalisation. The early occurrence, on day 2 of admission, calls for prompt preventive intervention for constipation. What's known• Constipation is one of the most common medical complications for patients who have experienced stroke. However, there are limited numbers of studies on constipation as a poststroke complication.What's new• The incidence of new-onset constipation is similarly high for both patients with acute stroke and orthopaedic conditions. Our data reveal its early onset and associated predictors during acute hospitalisation.

Objectives To evaluate the effectiveness of online memory training interventions in improving memory of patients diagnosed with early‐stage dementia. The secondary outcomes comprised cognitive and psychological outcomes. Design This review was conducted for accordance to the Cochrane Handbook for Systematic Reviews of Interventions. Data source A comprehensive search from six electronic databases: PubMed, Embassy, The Cochrane Library, The Cumulative Index to Nursing and Allied Health Literature, Scopus and Web of Science was conducted (2000–2020). Review methods The populations included in this review comprised adults who had been clinically diagnosed with early‐stage dementia and involved in online memory training interventions. Two reviewers appraised the risks of bias through the Cochrane Collaboration's tool and performed the meta‐analysis, including the assessment of heterogeneity. Results Eleven randomized controlled trials retrieved from six databases demonstrated low to moderate levels of quality of evidence according to the GRADE approach. The meta‐analysis revealed that online memory training interventions have demonstrated a moderate effect size in improving memory outcomes (d = 0.57; 95% confidence interval 0.28‐0.85; p = 0.0001). Additionally, such interventions have shown improvements in secondary outcomes of cognition and psychological with small to medium effects. Duration of each online memory training session and its frequencies did not affect the memory outcome. As opposed to the conventional face‐to‐face interventions conducted for a group, it is more effective to be conducted for an individual setting. Conclusions Online memory training intervention was effective in improving the memory for adults with dementia. Impact Memory interventions have the prospect of reducing everyday problems caused by lapses in memory and improving well‐being. With factors such as limited resources and restriction of social gathering due to pandemic, this review could offer relevant information for clinical decision‐makers when planning online memory training interventions for adults with dementia.

Background The Singapore General Hospital COVID-19 Virtual Ward is a “hospital at home” (HaH) programme for the supervised home recovery of higher-acuity COVID-19 patients from the hospital and the community. Objective To describe how an existing HaH programme was redesigned so that COVID-19 patients could be remotely monitored at home and report the outcomes of the first 100 patients in this Virtual Ward. Methods Patients received an admission package comprising instructions and equipment for home monitoring, and uploaded their parameters into a clinical dashboard via a secure messaging app. Medical staff conducted video or telephone consultations daily. Patients were discharged according to time-based criteria, although some required SARS-CoV-2 PCR testing, which were conducted at home by a third-party medical provider. De-identified data of the first 100 patients were analysed by demographic details, indication for enrolment into the Virtual Ward, and the need for subsequent inpatient readmission. Results Of the first 100 patients admitted into the Virtual Ward, 58 were female, mean age was 63.1 years old (23–95 years), and 76 were fully vaccinated. There were 77 hospital referrals and 23 community referrals. The number of days of inpatient hospitalisation avoided was 717 days (average of 7.9 days per patient). Three hospital referrals (3.9%) were readmitted, while seven community referrals (30.4%) required subsequent hospitalisation. Conclusion The Virtual Ward programme demonstrates that selected COVID-19 patient can safely recover at home with remote medical support and monitoring, thereby expanding hospital capacity.

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