Background:
Epilepsy is a chronic and debilitating neurological condition affecting people of all ages globally. A seizure diary is one method used to track patients' seizures.

Aim:
This scoping review sought to identify current norms and practices for using seizure diaries to manage epilepsy.

Method:
A scoping review was done by screening relevant studies and identifying themes, categories, and subcategories.

Results:
A total of 1125 articles were identified from the database; 46 full-text articles were evaluated for eligibility, of which 23 were selected. The majority (48%) of the studies were prospective studies, most (65%) of which were conducted in the United States of America. The identified themes were types of seizure diaries used in clinical practice, the contents and structure of a standardised seizure diary, the use and efficacy of seizure diaries in medicine and challenges relating to using a seizure diary for patient management.

Conclusion:
The study revealed that a seizure diary remains a relevant tool in epilepsy management. The two forms of diaries in use are electronic and paper-based diaries. The high cost of data and the expensive devices required to access electronic diaries make it unsuitable in a resource-limited setting. Notwithstanding its disadvantages, imperfections and inadequacies, the paper-based diary is still relevant for managing patients with epilepsy in resource-limited settings.

Goal:
This study reviewed the literature to determine the current norms and practices in using seizure diaries. The benefits of the various formats were highlighted.

1. Challenges associated with the use of the seizure diary
2. Types of seizure diaries used in clinical practice
3. The current relevance of the paper-based seizure diary in a resource-limited environment

Background
Non-alcoholic fatty liver disease (NAFLD) is caused by fat accumulation in hepatocytes in the absence of excessive alcohol intake or other secondary causes. The disease may progress to fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). After the campaign of HCV eradication, NAFLD will become the most common cause of HCC. Effective screening tools or pathways for the identification of high-risk groups should be developed.

Methods
A total of 138 subjects were recruited from the outpatient clinic of family medicine between 2021 and 2022. Anthropometric measurements, lifestyle questionnaires, laboratory tests, abdominal ultrasonography, and transient elastography were collected. Fibrosis-4 was used as non-invasive test for advanced fibrosis. The prevalence of NAFLD was analyzed among participants with or without type 2 diabetes and obesity (defined as a body mass index ≥ 27 kg/m2). Two clinical care pathways from the European association for the study of liver (EASL) in 2016 and American Gastroenterological Association (AGA) in 2021 were used for identifying high-risk patients with advanced fibrosis.

Results
The mean patient age was 54.2±15.7 years old, of which 32.6% were older than or equal to 65 years old. The cases were divided into diabetic group (52.2%), obese group (29.7%) and control group (18.1%). The prevalence of NAFLD among diabetic, obese, and control group was 75.0%, 87.8%, and 28%, respectively. 4.3% of participants would be referred to hepatologist clinics when applying AGA clinical care pathway, compared to 26.8% of referral rate when applying EASL clinical care pathway.

Conclusion
In this study, the prevalence of NAFLD was 75.0% in the diabetic group and 87.8% in the obese group which had a significant increase compared with 28% in the control group. Different clinical care pathways demonstrate significantly different referral rates. This study looks forward to raising the concern of patients with high risk of NAFLD.

1.The prevalence of NAFLD was 75.0% in the diabetic group and 87.8% in the obese group which had a significant increase compared with 28% in the control group.
2.Different clinical care pathways demonstrate significantly different referral rates.
3.This study looks forward to raising the concern of patients with high risk of NAFLD.

Background
Understanding patient experiences and perceptions of healthcare is vital to improving care quality. Interprofessional Collaborative Practice occurs when multiple health professionals work together with the patient as part of the team. This integrative review explored how patients with chronic conditions experience Interprofessional Collaborative Practice in primary care.
Methods
Medline, Embase, CINAHL and Web of Science were searched in duplicate for qualitative, quantitative, and mixed-methods primary studies. Empirical full-text studies in primary care that reported experiences of Interprofessional Collaborative Practice by adults with chronic conditions, in any language or publication year were included. Study quality was appraised with Mixed Method Appraisal Tool. Primary care patients’ experiences and perceptions of Interprofessional Collaborative Practice were extracted and meta-synthesised to inductively generate themes and present findings.
Results
Forty-eight studies with a total of n = 3803 participants were included. Three themes were developed: (1) Interacting with Healthcare Teams: patients acknowledged the need to widen their network and involve a range of health professionals, patients built relationships with professionals who provided holistic approaches to overcome management challenges. (2) Valuing Convenient Healthcare: patients preferred co-located healthcare teams, having a care plan outlining shared goals, and having a care coordinator. (3) Engaging Self-care: patient engagement was circumstantial, some patients were actively involved and led health professionals, whilst others were passive due to convenience and competing needs. Quality appraisal of individual studies identified limitations due to incomplete reporting, poor study design, and likely positive publication bias.
Conclusions
Overall, patients had positive experiences of Interprofessional Collaborative Practice. Patients reported better experiences when they felt they had a more engaged role in their care. Poorer experiences came from situations where Interprofessional Collaborative Practice was either conducted poorly or did not occur. Primary healthcare professionals should explore ways to encourage patient involvement and better teamwork to support Interprofessional Collaborative Practice.

1. Patients experience better care when they have an engaged role
2. Poorer patient experiences come from poor Interprofessional Collaborative Practice
3. Health professionals should explore ways to encourage patient involvement and better teamwork

Trans-theoretical Model (TTM) or Stages of Change Model was developed by Prochaska and DiClemente in the 1980s to understand why some people were capable of making changes on their own. The main idea is that people will progress in stages, from pre-contemplation to contemplation, then from preparation to action, and finally into maintenance. The aim of the research is to extend its stages of change to the process of change in the common chronic conditions in the primary care setting in Singapore.

The model is commonly applied in healthcare issues of different age groups such as smoking cessation, physical activity, and medication adherence in chronic disease management. TTM focuses on the decision-making of the individual and is a model of intentional change, particularly at the preparation stage. It assumes that people do not change behaviours quickly and decisively. Instead, a change of behaviour, especially habitual behaviour, occurs continuously through a cyclical process. It recognises that the change may not be permanent as the person can relapse to the previous stage.

The research explores key issues such as resistance to changes in patients with “3-Highs” chronic diseases in a multicultural context in Singapore. Reasons for their resistance include fear of side effects of medications as shared by their friends and fear of losing one’s freedom from the choice of food and activities. From TTM different behavioural theories can be applied to an individual stage for which they are effective. The application of TTM is useful in achieving effective communications with these patients in behavioural change for better control.

1. Appreciation of trans-theoretical model - its stages of change and process of change
2. Application of trans-theoretical model in chronic disease management in primary care
3. Attitude of clinicians to be more engaging to help patients overcome resistance to change

Objective: To analyze the related factors of three-vessel disease (TVD) in patients with stable coronary artery disease (SCAD). Methods: This study is a cross-sectional study. The clinical data of 447 patients with SCAD diagnosed in Zhongshan Hospital from May 2019 to April 2020 were retrospectively analyzed, including 108 cases of single-vessel disease (SVD), 136 cases of the two-vessel disease, and 203 cases of TVD. We selected SVD and TVD groups as research subjects. Univariate analysis was used to analyze the differences in general data and hematological indexes between the two groups, and multivariate logistic regression was used to analyze the related factors for TVD in SCAD patients. Results: There were 244 males (78.5 %) and 67 females (21.5 %). Age 57 (64, 69) years. Univariate analysis showed that there were significant differences in diabetes history (χ²=7.75， P=0.005), uric acid (Z=-2.10, P=0.036), glycosylated hemoglobin (Z=-2.77, P=0.006) and high-density lipoprotein cholesterol (HDL-C) (Z=-2.99, P=0.003) levels between SVD and TVD groups. Multivariate analysis showed that the high level of blood uric acid (OR=1.003, 95%CI: 1.00-1.01, P<0.05) and the low level of HDL-C (OR=3.29, 95%CI:1.23-8.85, P<0.05) were the related factors of TVD. Conclusions: High blood uric acid levels and low HDL-C levels are related factors for TVD in patients with SCAD. Attention should be paid to the health management of high-risk SCAD patients, to reduce the occurrence of TVD.

1. Stable coronary artery disease
2. Three-vessel coronary artery disease
3. Related risk factors