Dairy Food Intake Is Inversely Associated with Risk of Hypertension: The Singapore Chinese Health Study.

PubMed

Talaei, Mohammad; Pan, An; Yuan, Jian-Min; Koh, Woon-Puay

2017-02-01

Epidemiological evidence from Western populations suggests that dairy food intake may reduce the risk of hypertension, probably through its calcium content. However, there are no epidemiological studies among Asian populations with generally lower dairy and calcium consumption. The relation between dairy or calcium intake and risk of hypertension was evaluated in a Chinese population in Singapore. The analysis included 37,124 Chinese men and women aged 45-74 y who participated in the Singapore Chinese Health Study in 1993-1998. The subjects included in the present study had no history of cancer, hypertension, or cardiovascular disease at baseline and completed ≥1 follow-up interview. Diet at baseline was assessed by using a validated 165-item semiquantitative food-frequency questionnaire. The occurrence of new, physician-diagnosed hypertension was ascertained through follow-up interviews during 1999-2004 and 2006-2010. The Cox proportional hazard regression method was used to compute HRs and 95% CIs with adjustment for potential confounders. Dairy food intake was inversely associated with the risk of hypertension in a dose-dependent manner: HRs across quartiles were 1.00 (lowest quartile, reference), 0.97 (95% CI: 0.92, 1.02), 0.98 (95% CI: 0.92, 1.03), and 0.93 (95% CI: 0.88, 0.98) (P-trend = 0.01). Milk accounted for ∼80% of all dairy products consumed in this population. Daily milk drinkers had a lower risk of hypertension (HR: 0.94; 95% CI: 0.89, 0.99) than did nondrinkers. Nondairy calcium intake contributed 80% of total calcium intake. Although dairy calcium intake was associated with a lower risk of hypertension (HR comparing extreme quartiles: 0.88; 95% CI: 0.83, 0.94; P-trend < 0.001), there was no association for nondairy calcium intake (HR: 1.02; 95% CI: 0.94, 1.10; P-trend = 0.58). Baseline dairy food intake, and specifically that of milk, may reduce the risk of developing hypertension in Chinese adults, and this may not be associated with the

Dietary Cholesterol Increases the Risk whereas PUFAs Reduce the Risk of Active Tuberculosis in Singapore Chinese12

PubMed Central

Soh, Avril Z; Chee, Cynthia BE; Wang, Yee-Tang; Yuan, Jian-Min; Koh, Woon-Puay

2016-01-01

Background: Experimental studies suggest that cholesterol enhances the intracellular survival of Mycobacterium tuberculosis, whereas marine ω-3 (n–3) and ω-6 (n–6) fatty acids (FAs) may modulate responses to M. tuberculosis in macrophage and animal models. However, there are no epidemiologic data from prospective studies of the relation between dietary cholesterol and FAs and the risk of developing active tuberculosis. Objective: We aimed to investigate the relation between dietary intake of cholesterol and FAs and the risk of active tuberculosis in a prospective cohort in Singapore. Methods: We analyzed data from the Singapore Chinese Health Study, a cohort of 63,257 Chinese men and women aged 45–74 y recruited between 1993 and 1998. Dietary intake of cholesterol and FAs was determined with the use of a validated food-frequency questionnaire. Incident cases of active tuberculosis were identified via linkage with the nationwide tuberculosis registry. Analysis was performed with the use of Cox proportional hazards models. Results: As of 31 December 2013, 1136 incident cases of active tuberculosis were identified. Dietary cholesterol was positively associated with an increased risk of active tuberculosis in a dose-dependent manner. Compared with the lowest intake quartile, the HR was 1.22 (95% CI: 1.00, 1.47) for the highest quartile (P-trend = 0.04). Conversely, dietary marine n–3 and n–6 FAs were associated with a reduced risk of active tuberculosis in a dose-dependent manner. Compared with the lowest quartile, the HR for the highest intake quartile was 0.77 (95% CI: 0.62, 0.95) for marine n–3 FAs (P-trend = 0.01) and 0.82 (95% CI: 0.68, 0.98) for n–6 FAs (P-trend = 0.03). There was no association with saturated, monounsaturated, or plant-based n–3 FA intake. Conclusion: Dietary intake of cholesterol may increase the risk of active tuberculosis, whereas marine n–3 and n–6 FAs may reduce the risk of active tuberculosis in the Chinese population

Coffee intake and gastric cancer risk: the Singapore Chinese health study.

PubMed

Ainslie-Waldman, Cheryl E; Koh, Woon-Puay; Jin, Aizhen; Yeoh, Khay Guan; Zhu, Feng; Wang, Renwei; Yuan, Jian-Min; Butler, Lesley M

2014-04-01

Despite experimental evidence showing chemopreventive effects of coffee-related compounds on gastric carcinogenesis, epidemiologic studies generally do not support coffee-gastric cancer associations. Observational data are lacking among high-risk populations with sufficient regular coffee consumption. We examined the association between caffeinated coffee intake and gastric cancer risk in a population-based cohort that enrolled 63,257 Chinese men and women ages 45 to 74 years between 1993 and 1998 in Singapore. Incident gastric cancer cases (n = 647) were identified after a mean follow-up of 14.7 years. Biomarkers of Helicobacter pylori (H. pylori) infection were measured in a subset of gastric cancer cases with blood collected before cancer diagnosis and their matched controls. In the total cohort, daily versus nondaily coffee intake was associated with a statistically nonsignificant decrease in gastric cancer risk [HR = 0.85; 95% confidence interval (CI), 0.69-1.04]. In women, the inverse association strengthened and reached statistical significance (HR = 0.63; 95% CI, 0.46-0.87). In analyses restricted to never smokers and nondrinkers of alcohol, inverse associations strengthened in the total cohort (HR = 0.69; 95% CI, 0.52-0.91) and in women (HR = 0.52; 95% CI, 0.37-0.74). There was no coffee-gastric cancer risk association among men, regardless of smoking status or alcohol consumption. Similar results were observed in the nested case-control study after adjustment for H. pylori infection. Daily coffee consumption may reduce the risk of gastric cancer in high-risk populations, especially among women. Research aimed at identifying the compounds in coffee that may protect against gastric carcinogenesis is warranted.

Dairy Food Intake Is Inversely Associated with Risk of Hypertension: The Singapore Chinese Health Study12

PubMed Central

Yuan, Jian-Min; Koh, Woon-Puay

2017-01-01

Background: Epidemiological evidence from Western populations suggests that dairy food intake may reduce the risk of hypertension, probably through its calcium content. However, there are no epidemiological studies among Asian populations with generally lower dairy and calcium consumption. Objective: The relation between dairy or calcium intake and risk of hypertension was evaluated in a Chinese population in Singapore. Methods: The analysis included 37,124 Chinese men and women aged 45–74 y who participated in the Singapore Chinese Health Study in 1993–1998. The subjects included in the present study had no history of cancer, hypertension, or cardiovascular disease at baseline and completed ≥1 follow-up interview. Diet at baseline was assessed by using a validated 165-item semiquantitative food-frequency questionnaire. The occurrence of new, physician-diagnosed hypertension was ascertained through follow-up interviews during 1999–2004 and 2006–2010. The Cox proportional hazard regression method was used to compute HRs and 95% CIs with adjustment for potential confounders. Results: Dairy food intake was inversely associated with the risk of hypertension in a dose-dependent manner: HRs across quartiles were 1.00 (lowest quartile, reference), 0.97 (95% CI: 0.92, 1.02), 0.98 (95% CI: 0.92, 1.03), and 0.93 (95% CI: 0.88, 0.98) (P-trend = 0.01). Milk accounted for ∼80% of all dairy products consumed in this population. Daily milk drinkers had a lower risk of hypertension (HR: 0.94; 95% CI: 0.89, 0.99) than did nondrinkers. Nondairy calcium intake contributed 80% of total calcium intake. Although dairy calcium intake was associated with a lower risk of hypertension (HR comparing extreme quartiles: 0.88; 95% CI: 0.83, 0.94; P-trend < 0.001), there was no association for nondairy calcium intake (HR: 1.02; 95% CI: 0.94, 1.10; P-trend = 0.58). Conclusions: Baseline dairy food intake, and specifically that of milk, may reduce the risk of developing hypertension in

Myopia, lifestyle, and schooling in students of Chinese ethnicity in Singapore and Sydney.

PubMed

Rose, Kathryn A; Morgan, Ian G; Smith, Wayne; Burlutsky, George; Mitchell, Paul; Saw, Seang-Mei

2008-04-01

To compare the prevalence and risk factors for myopia in 6- and 7-year-old children of Chinese ethnicity in Sydney and Singapore. Two cross-sectional samples of age- and ethnicity-matched primary school children participated: 124 from the Sydney Myopia Study and 628 from the Singapore Cohort Study on the Risk Factors for Myopia. Cycloplegic autorefraction was used to determine myopia prevalence (spherical equivalent < or = -0.5 diopter). Lifestyle activities were ascertained by questionnaire. The prevalence of myopia in 6- and 7-year-old children of Chinese ethnicity was significantly lower in Sydney (3.3%) than in Singapore (29.1%) (P < .001). The prevalence of myopia in 1 or more parents was 68% in Sydney and 71% in Singapore. Children in Sydney read more books per week (P < .001) and did more total near-work activity (P = .002). Children in Sydney spent more time on outdoor activities (13.75 vs 3.05 hours per week; P < .001), which was the most significant factor associated with the differences in the prevalence of myopia between the 2 sites. The lower prevalence of myopia in Sydney was associated with increased hours of outdoor activities. We hypothesize that another factor contributing to the differences in the prevalence of myopia may be the early educational pressures found in Singapore but not in Sydney.

Dietary Soy Intake Is Not Associated with Risk of Cardiovascular Disease Mortality in Singapore Chinese Adults123

PubMed Central

Talaei, Mohammad; Koh, Woon-Puay; van Dam, Rob M.; Yuan, Jian-Min; Pan, An

2014-01-01

Although soy food has been recommended because of its presumed cardiovascular benefits, the long-term prospective association between habitual soy food intake and cardiovascular disease mortality remains unclear. This study aimed to evaluate the relation of soy protein and isoflavone intake with the risk of cardiovascular disease mortality in middle-aged and older Chinese adults residing in Singapore. The Singapore Chinese Health Study is a population-based study that recruited 63,257 Chinese adults aged 45–74 y from 1993 to 1998. Usual diet was measured at recruitment by using a validated semiquantitative food-frequency questionnaire, and mortality information was identified via registry linkage until 31 December 2011. Cox proportional hazards models were used to calculate HRs, with adjustment for potential confounders. The median intake was 5.2 g/d for soy protein, 15.8 mg/d for soy isoflavones, and 87.4 g/d for soy expressed as tofu equivalents. We documented 4780 cardiovascular deaths during 890,473 person-years of follow-up. After adjustment for sociodemographic, lifestyle, and other dietary factors, soy protein intake was not significantly associated with cardiovascular disease mortality: HRs (95% CIs) were 1.00 (reference), 1.02 (0.94, 1.11), 1.02 (0.93, 1.11), and 1.06 (0.97, 1.17) for increasing quartiles of soy protein (P-trend = 0.24). Similarly, no significant association was observed for soy isoflavones and total tofu equivalents and when deaths from coronary heart disease (n = 2697) and stroke (n = 1298) were considered separately. When stratified by sex, HRs for cardiovascular disease mortality across quartiles of soy protein were 1.00, 1.00, 1.05, and 1.16 (95% CI: 1.03, 1.31) in men (P-trend = 0.02) and 1.00, 1.01, 0.96, and 0.95 (95% CI: 0.81, 1.10) in women (P-trend = 0.31), although the interaction was not significant (P-interaction = 0.12). In conclusion, soy intake was not significantly associated with risk of cardiovascular disease

Coffee intake and gastric cancer risk: The Singapore Chinese Health Study

PubMed Central

Ainslie-Waldman, Cheryl E.; Koh, Woon-Puay; Jin, Aizhen; Yeoh, Khay Guan; Zhu, Feng; Wang, Renwei; Yuan, Jian-Min; Butler, Lesley M.

2014-01-01

Background Despite experimental evidence showing chemopreventive effects of coffee-related compounds on gastric carcinogenesis, epidemiologic studies generally do not support coffee-gastric cancer associations. Observational data are lacking among high-risk populations with sufficient regular coffee consumption. Methods We examined the association between caffeinated coffee intake and gastric cancer risk in a population-based cohort that enrolled 63,257 Chinese men and women aged 45–74 years between 1993 and 1998 in Singapore. Incident gastric cancer cases (n=647) were identified after a mean follow-up of 14.7 years. Biomarkers of Helicobacter pylori (H. pylori) infection were measured in a subset of gastric cancer cases with blood collected prior to cancer diagnosis and their matched controls. Results In the total cohort, daily versus non-daily coffee intake was associated with a statistically non-significant decrease in gastric cancer risk [hazards ratio (HR) = 0.85; 95% confidence interval (CI): 0.69, 1.04). In women, the inverse association strengthened and reached statistical significance (HR=0.63; 95% CI: 0.46, 0.87). In analyses restricted to never smokers and nondrinkers of alcohol, inverse associations strengthened in the total cohort (HR=0.69; 95% CI: 0.52, 0.91) and in women (HR=0.52; 95% CI: 0.37, 0.74). There was no coffee-gastric cancer risk association among men, regardless of smoking status or alcohol consumption. Similar results were observed in the nested case-control study after adjustment for H. pylori infection. Conclusion Daily coffee consumption may reduce the risk of gastric cancer in high-risk populations, especially among women. Impact: Research aimed at identifying the compounds in coffee that may protect against gastric carcinogenesis is warranted. PMID:24608187

Coffee, tea, and incident type 2 diabetes: the Singapore Chinese Health Study

PubMed Central

Odegaard, Andrew O; Pereira, Mark A; Koh, Woon-Puay; Arakawa, Kazuko; Lee, Hin-Peng; Yu, Mimi C

2009-01-01

Background Increasing coffee intake was inversely associated with risk of type 2 diabetes in populations of European descent; however, data from high-risk Asian populations are lacking as are data on tea intake in general. Objective We investigated the prospective associations between intakes of coffee, black tea, and green tea with the risk of type 2 diabetes in Singaporean Chinese men and women. Design We analyzed data from 36 908 female and male participants in the Singapore Chinese Health Study aged 45-74 y in 1993-1998 who had multiple diet and lifestyle measures assessed and then were followed up between 1999 and 2004. We used Cox regression models to investigate the association of baseline coffee and tea intakes with incident type 2 diabetes during follow-up, with adjustment for a number of possible confounding or mediating variables. Results In multivariate models participants reporting ≥4 cups of coffee/d had a 30% reduction in risk of diabetes [relative risk (RR): 0.70; 95% CI: 0.53, 0.93] compared with participants who reported nondaily consumption. Participants reporting ≥1 cup of black tea/d had a suggestive 14% reduction in risk of diabetes (RR: 0.86; 95% CI: 0.74, 1.00) compared with participants who reported 0 cups/d, and we observed no association with green tea. Conclusion Regular consumption of coffee and potentially black tea, but not green tea, is associated with lower risk of type 2 diabetes in Asian men and women in Singapore. PMID:18842784

[Commentary on self-compiled teaching materialsby Singapore Chinese Physician Training College].

PubMed

Chen, S H; Cai, H X

2017-05-28

The Singapore Chinese Physician Training College has been playing a role in the development of traditional Chinese medicine (TCM) and the training of TCM talents in modern and contemporary Singapore not to be ignored. Due to the limitations of the objective condition, the College had to creatively compile by themselves 115 volumes of teaching materials with rather complete subjects, which did pay attention to applying theory to practice, ran through the thought of Chinese integrating with western medicine, and is of literature and cultural significance.As a carrier of educational contents and methods, these teaching materials not only embodied the educational idea of the editor, but also reflected the status of TCM development in modern Singapore.

Reliability and validity of the English (Singapore) and Chinese (Singapore) versions of the Short-Form 36 version 2 in a multi-ethnic urban Asian population in Singapore.

PubMed

Thumboo, Julian; Wu, Yi; Tai, E-Shyong; Gandek, Barbara; Lee, Jeannette; Ma, Stefan; Heng, Derrick; Wee, Hwee-Lin

2013-11-01

We aimed to evaluate the measurement properties of the Singapore English and Chinese versions of the Short-Form 36 version 2 (SF-36v2) Questionnaire, an improved version of the widely used SF-36, for assessing health-related quality of life (HRQoL) in a multi-ethnic urban Asian population in Singapore. SF-36v2 scores and data on medical history, demographic and lifestyle factors from the Singapore Prospective Study Programme were analyzed. Convergent and divergent validity, internal consistency, floor and ceiling effects, known group validity and factor structure of the SF-36v2 were assessed for the English and Chinese versions, respectively. Complete data for 4,917 participants (45.8 %) out of 10,747 eligible individuals were analyzed (survey language: 4,115 English and 802 Chinese). Item-scale correlations exceeded 0.4 for all items of the English SF-36v2 and for all except one item of the Chinese SF-36v2 (bathe and dress: item-scale correlation: 0.36). In the English SF-36v2, Cronbach's alpha exceeded 0.70 for all scales. In the Chinese SF-36v2, Cronbach's alpha exceeded 0.7 on all scales except social functioning (Cronbach's alpha: 0.68). For known groups validity, respondents with chronic medical conditions expectedly reported lower SF-36v2 score on most English and Chinese SF-36v2 scales. In confirmatory factor analysis, the Singapore three-component model was favored over the United States two-component and Japan three-component models. The English and Chinese SF-36v2 are valid and reliable for assessing HRQoL among English and Chinese-speaking Singaporeans. Test-retest reliability and responsiveness of the English and Chinese SF-36v2 in Singapore remain to be evaluated.

Diabetes mellitus prevalence is increasing in South Asians but is stable in Chinese living in Singapore and Mauritius.

PubMed

Tan, Kristin H X; Barr, Elizabeth L M; Koshkina, Vira; Ma, Stefan; Kowlessur, Sudhir; Magliano, Dianna J; Söderberg, Stefan; Chia, Kee Seng; Zimmet, Paul; Lim, Wei-Yen

2017-09-01

Asia is experiencing a type 2 diabetes epidemic, but prevalence differs by ethnicity and level of socioeconomic development. Singapore and Mauritius have implemented comprehensive campaigns to address this public health problem. We compared diabetes and obesity prevalence trends among Chinese and South Asians living in Singapore and Mauritius to determine the contribution of ethnicity and economic development to diabetes. Age-specific data from serial national population-based surveys in Singapore and Mauritius between 1987 and 2010 were used to estimate age-standardized diabetes and obesity prevalence. Modified Breslow-Cox proportional hazard models were used to obtain rate ratios for diabetes risk factors. In Singapore, the age-standardized prevalence of diabetes remained stable for Chinese (men: 14% in 1992, 13% in 2010; women: 12% in 1992, 10% in 2010), but increases were observed for South Asians (men: 20% in 1992, 26% in 2010; women: 18% in 1992, 20% in 2010). There were similar patterns in Mauritius. In both countries, obesity prevalence trends were stable for Chinese women, but increased for Chinese men and South Asians. Associations between obesity and diabetes were stronger in Chinese than South Asians regardless of country. Despite different socioeconomic settings in Singapore and Mauritius, we observed rising diabetes prevalence among South Asians but stable prevalence in Chinese in both countries. This provides further evidence that ethnicity contributes to the development of diabetes, and that there should be an increased emphasis on future prevention strategies targeting South Asian populations in these countries. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Fried meat intake is a risk factor for lung adenocarcinoma in a prospective cohort of Chinese men and women in Singapore

PubMed Central

Butler, Lesley M.; Yu, Mimi C.

2013-01-01

Probable human carcinogens are generated during Chinese-style high-temperature cooking of meat and have been detected in the ambient air and on the meat surface. Although the inhalation of these compounds is an established risk factor for lung cancer, exposure via fried meat consumption has not yet been prospectively evaluated as a risk factor. The relationship between fried meat intake and lung cancer risk was investigated using data from a prospective cohort study among Chinese in Singapore. Lung cancer cases (n = 1130) were identified from 61 321 men and women, 70% of whom were lifetime never smokers. Proportional hazards regression methods were used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Overall, there was no association between fried meat intake and risk of all lung cancers combined. For lung adenocarcinoma, fried meat intake had a statistically significant association with increased risk. The association between fried meat intake and risk of lung adenocarcinoma became stronger when analyses were restricted to lifetime never smokers. Compared with the lowest tertile of fried meat intake, the HRs (95% CIs) for the second and third tertiles were 1.43 (0.98, 2.08) and 1.51 (1.03, 2.22), respectively (P for trend = 0.04). The positive association was present among both men and women. There was no association between fried meat intake and risk of non-adenocarcinomas of the lung. Our prospective results for fried meat intake support consumption as an important route of exposure to compounds from Chinese-style high-temperature cooking for the development of lung adenocarcinoma. PMID:23568952

Normative Data for the Singapore English and Chinese SF-36 Version 2 Health Survey.

PubMed

Sow, Wei Ting; Wee, Hwee Lin; Wu, Yi; Tai, E-Shyong; Gandek, Barbara; Lee, Jeannette; Ma, Stefan; Heng, Derrick; Thumboo, Julian

2014-01-01

The aim of this study is to report normative data for the Short-Form 36 version 2 (SF-36v2) for assessing health-related quality of life, in the Singapore general population. Data for English and Chinese-speaking participants of the Singapore Prospective Study Programme were analysed. The SF-36v2 scores were norm-based with the English-speaking Singapore general population as reference and reported by age (in decades), gender and ethnicity as well as for the 5 most prevalent chronic medical conditions. Scores were reported separately for the English and Chinese language versions. A total of 6151 English-speaking (61.5% Chinese and 19.2% Malay) and 1194 Chinese-speaking participants provided complete data. Mean (SD) age of all participants was 49.6 (12.58) years with 52.4% being women. In both languages, women reported lower scores than men on all scales. Among the chronic medical conditions, stroke had the largest impact on all English SF-36v2 scales and on 3 Chinese SF-36v2 scales (role-physical, general health and social functioning). We have provided detailed normative data for the Singapore English and Chinese SF-36v2, which would be valuable in furthering HRQoL research in Singapore and possibly the region.

A Standalone but Not Lonely Language: Chinese Linguistic Environment and Education in Singapore Context

ERIC Educational Resources Information Center

Min, Huang; Kangdi, Cheng

2016-01-01

Bilingual education policy in Singapore permits the students learn both English as working language and mother tongues, such as Chinese, as L2 anchoring to culture heritage. Starting from historical and sociolinguistic reasons, this paper is intended to provide a panoramic view of Chinese education in Singapore, clarify and compare Chinese…

Green and black tea intake in relation to prostate cancer risk among Singapore Chinese

PubMed Central

Montague, Julia A.; Wu, Anna H.; Genkinger, Jeanine M.; Koh, Woon-Puay; Wong, Alvin S.; Wang, Renwei; Yuan, Jian-Min; Yu, Mimi C.

2013-01-01

Purpose Tea is one of the most commonly consumed beverages worldwide. To date, observational data from prospective cohort studies investigating the relationship between green and black tea intake and prostate cancer risk are sparse and equivocal. In a population-based, prospective cohort study of Chinese men in Singapore, we investigated the relationship between green and black tea intake and prostate cancer risk. Methods Tea consumption data for 27,293 men were collected at baseline (between 1993 and 1998) using a validated food frequency questionnaire. After an average of 11.2 years of follow-up, 298 men had developed prostate cancer. Proportional hazards regression methods were used to assess the associations between tea intake and prostate cancer risk. Results There was no association between daily green tea intake and prostate cancer risk, compared with no green tea intake [hazard ratio (HR) = 1.08; 95 % confidence interval (CI) 0.79, 1.47]. For black tea, a statistically significant positive association and trend were observed for daily intake compared with no black tea intake (HR = 1.41, 95 % CI 1.03, 1.92; p for trend <0.01) Conclusions Few prospective data are available from populations that have both a high level and wide range of black and green tea intake; this study represents a unique opportunity to evaluate their individual effects on prostate cancer risk. Our findings support the notion that green tea intake does not protect against prostate cancer and that black tea intake may increase prostate cancer risk. PMID:22864870

Green and black tea intake in relation to prostate cancer risk among Singapore Chinese.

PubMed

Montague, Julia A; Butler, Lesley M; Wu, Anna H; Genkinger, Jeanine M; Koh, Woon-Puay; Wong, Alvin S; Wang, Renwei; Yuan, Jian-Min; Yu, Mimi C

2012-10-01

Tea is one of the most commonly consumed beverages worldwide. To date, observational data from prospective cohort studies investigating the relationship between green and black tea intake and prostate cancer risk are sparse and equivocal. In a population-based, prospective cohort study of Chinese men in Singapore, we investigated the relationship between green and black tea intake and prostate cancer risk. Tea consumption data for 27,293 men were collected at baseline (between 1993 and 1998) using a validated food frequency questionnaire. After an average of 11.2 years of follow-up, 298 men had developed prostate cancer. Proportional hazards regression methods were used to assess the associations between tea intake and prostate cancer risk. There was no association between daily green tea intake and prostate cancer risk, compared with no green tea intake [hazard ratio (HR) = 1.08; 95 % confidence interval (CI) 0.79, 1.47]. For black tea, a statistically significant positive association and trend were observed for daily intake compared with no black tea intake (HR = 1.41, 95 % CI 1.03, 1.92; p for trend <0.01) Few prospective data are available from populations that have both a high level and wide range of black and green tea intake; this study represents a unique opportunity to evaluate their individual effects on prostate cancer risk. Our findings support the notion that green tea intake does not protect against prostate cancer and that black tea intake may increase prostate cancer risk.

Standardising the Chinese Language in Singapore: Issues of Policy and Practice

ERIC Educational Resources Information Center

Shang, Guowen; Zhao, Shouhui

2017-01-01

The selection of standards and norms constitutes the first and most important step for language standardisation. In this paper, we examine the standard establishment for Huayu (or Singapore Mandarin), a new Chinese variety that has emerged in Singapore as a result of centralised planning and inter-linguistic contact. Huayu is the officially…

An Instrument for Investigating Chinese Language Learning Environments in Singapore Secondary Schools

ERIC Educational Resources Information Center

Chua, Siew Lian; Wong, Angela F. L.; Chen, Der-Thanq

2009-01-01

This paper describes how a new classroom environment instrument, the "Chinese Language Classroom Environment Inventory (CLCEI)", was developed to investigate the nature of Chinese language classroom learning environments in Singapore secondary schools. The CLCEI is a bilingual instrument (English and Chinese Language) with 48 items…

Regulatory control of Chinese Proprietary Medicines in Singapore.

PubMed

Yee, Shen-Kuan; Chu, Swee-Seng; Xu, Yi-Min; Choo, Peck-Lin

2005-02-01

In Singapore, there has been a growing public interest in traditional Chinese medicine (TCM), which plays an important role in the healthcare system. With effect from 1 September 1999, the control on Chinese Proprietary Medicines (CPM) was implemented in three phases over a span of 3 years. Under the CPM regulatory framework, CPM importers, wholesalers, manufacturers and re-packers must be licensed and CPM products assessed and listed by the health authority before they are allowed for sale. Product assessment is based on the criteria of safety and quality which include limits of toxic heavy metals and microbial contents. During the 3-year CPM listing exercise, irregularities were detected, including intrinsic toxicity, adulteration, substitution, contamination, misidentification, non-traditional and/or inappropriate usage, incorrect preparation, inappropriate labelling, exaggerated claims and/or advertising. The full implementation of CPM control by September 2001 saw the listing of 7943 CPM products and brought about an improvement in the quality and safety of CPM in Singapore as well as the removal of sub-standard, fake/imitation and adulterated products. The standards of practices by local CPM dealers have also been raised. These improvements have, in turn, increased the level of public confidence in CPM products in Singapore.

Chinese medicine in Malaysia and Singapore: the business of healing.

PubMed

Ooi, G L

1993-01-01

Traditional Chinese medicine as it persists in several East and Southeast Asian countries, has undergone major changes. Such changes have reinforced the trading aspects of traditional Chinese medical practice with relatively little advantage for the medical care component. This paper examines the nature of changes in contemporary ethnic Chinese medical practice in Malaysia and Singapore with the aim of understanding their implications for the persistence of this medical tradition.

Composite protective lifestyle factors and risk of developing gastric adenocarcinoma: the Singapore Chinese Health Study.

PubMed

Wang, Zhensheng; Koh, Woon-Puay; Jin, Aizhen; Wang, Renwei; Yuan, Jian-Min

2017-02-28

Incidence of gastric cancer is the highest in Eastern Asia. Multiple modifiable lifestyle factors have been identified as risk factors for gastric cancer. However, their aggregated effect on the risk of gastric cancer has not been examined among populations with high prevalence of Helicobacter pylori. A study was conducted to examine the association between multiple lifestyle factors together and the risk of developing gastric adenocarcinoma in the Singapore Chinese Health Study, a prospective cohort of 63 257 men and women between 45 and 74 years enroled during 1993-1998. Composite score of cigarette smoking, alcohol consumption, obesity, dietary pattern, and sodium intake at baseline was assessed with hazard ratio (HR) and 95% confidence interval (CI) of gastric adenocarcinoma using Cox regression method. Higher healthy composite lifestyle scores were significantly associated with reduced risk of gastric adenocarcinoma in a dose-dependent manner. Hazard ratios (95% CIs) for total, cardia, and non-cardia gastric adenocarcinoma for the highest (score 5) vs lowest composite score (score 0/1/2) were 0.42 (0.31-0.57), 0.22 (0.10-0.47), and 0.55 (0.39-0.78), respectively (all P trend <0.001). These lifestyles together accounted for 48% of total gastric adenocarcinoma cases in the study population. The inverse association was observed in both genders, and remained after exclusion of first 5 years of follow-up. The inverse association between the aggregated healthy lifestyle factors and the risk of gastric adenocarcinoma is in dose-dependent manner in this highly H. pylori-exposed population. These lifestyle factors together may account for up to half of disease burden in this study population.

BMI and diabetes risk in Singaporean Chinese.

PubMed

Odegaard, Andrew O; Koh, Woon-Puay; Vazquez, Gabrielle; Arakawa, Kazuko; Lee, Hin-Peng; Yu, Mimi C; Pereira, Mark A

2009-06-01

Increased BMI is a robust risk factor for type 2 diabetes. Paradoxically, South Asians have relatively low BMIs despite their high prevalence of type 2 diabetes. We examined the association between BMI and incident type 2 diabetes because detailed prospective cohort data on this topic in Asians are scarce. This study was a prospective analysis of 37,091 men and women aged 45-74 years in the Singapore Chinese Health Study, using Cox regression analysis. Risk of incident type 2 diabetes significantly increased beginning with BMIs 18.5-23.0 kg/m(2)(relative risk 2.47 [95% CI 1.75-3.48]) and continued in a monotonic fashion across the spectrum of BMI. Results were stronger for younger than for older adults. BMIs considered lean and normal in Singaporean Chinese are strongly associated with increased risk of incident type 2 diabetes. This association weakened with advanced age but remained significant.

Urine phyto-oestrogen metabolites are not significantly associated with risk of type 2 diabetes: the Singapore Chinese health study.

PubMed

Talaei, Mohammad; Lee, Bee L; Ong, Choon N; van Dam, Rob M; Yuan, Jian M; Koh, Woon P; Pan, An

2016-05-01

We evaluated the relationship between urine concentrations of phyto-oestrogens (isoflavones and lignans) and risk of incident type 2 diabetes in middle-aged and elderly Chinese residing in Singapore. Urine metabolites of isoflavones and lignans were assayed by HPLC among 564 diabetes cases and 564 matched controls in a case-control study nested within the Singapore Chinese Health Study cohort. Participants were free of diagnosed diabetes, CVD and cancer at morning urine collections during 1999-2004. Cases were participants who reported to have physician-diagnosed diabetes at follow-up visits during 2006-2010, whereas controls were randomly selected among those who remained free of diabetes and were matched to the index cases by age, sex, dialect group and date of urine collection. Conditional logistic regression models were used to calculate OR and 95 % CI with adjustment for potential confounders. The mean age of the participants at the time of urine collection was 59·8 years, and the average interval between urine collection and diabetes diagnosis was 4·0 years. The multivariate-adjusted OR for diabetes were 1·00 (reference), 0·76 (95 % CI 0·52, 1·11), 0·78 (95 % CI 0·53, 1·14) and 0·79 (95 % CI 0·54, 1·15) across quartiles of urine isoflavones (P for trend=0·54), and were 1·00 (reference), 0·87 (95 % CI 0·60, 1·27), 1·10 (95 % CI 0·77, 1·56) and 0·93 (95 % CI 0·63, 1·37) for lignans (P for trend=0·93). The results were similar in men and women, as well as for individual metabolites of isoflavones (genistein, daidzein, glycitin and equol) or lignans (enterodiol and enterolactone). The present study did not find a significant association between urine phyto-oestrogen metabolites and risk of type 2 diabetes in Chinese adults.

Asian population frequencies and haplotype distribution of killer cell immunoglobulin-like receptor (KIR) genes among Chinese, Malay, and Indian in Singapore.

PubMed

Lee, Yi Chuan; Chan, Soh Ha; Ren, Ee Chee

2008-11-01

Killer cell immunoglobulin-like receptors (KIR) gene frequencies have been shown to be distinctly different between populations and contribute to functional variation in the immune response. We have investigated KIR gene frequencies in 370 individuals representing three Asian populations in Singapore and report here the distribution of 14 KIR genes (2DL1, 2DL2, 2DL3, 2DL4, 2DL5, 2DS1, 2DS2, 2DS3, 2DS4, 2DS5, 3DL1, 3DL2, 3DL3, 3DS1) with two pseudogenes (2DP1, 3DP1) among Singapore Chinese (n = 210); Singapore Malay (n = 80), and Singapore Indian (n = 80). Four framework genes (KIR3DL3, 3DP1, 2DL4, 3DL2) and a nonframework pseudogene 2DP1 were detected in all samples while KIR2DS2, 2DL2, 2DL5, and 2DS5 had the greatest significant variation across the three populations. Fifteen significant linkage patterns, consistent with associations between genes of A and B haplotypes, were observed. Eighty-four distinct KIR profiles were determined in our populations, 38 of which had not been described in other populations. KIR haplotype studies were performed using nine Singapore Chinese families comprising 34 individuals. All genotypes could be resolved into corresponding pairs of existing haplotypes with eight distinct KIR genotypes and eight different haplotypes. The haplotype A2 with frequency of 63.9% was dominant in Singapore Chinese, comparable to that reported in Korean and Chinese Han. The A haplotypes predominate in Singapore Chinese, with ratio of A to B haplotypes of approximately 3:1. Comparison with KIR frequencies in other populations showed that Singapore Chinese shared similar distributions with Chinese Han, Japanese, and Korean; Singapore Indian was found to be comparable with North Indian Hindus while Singapore Malay resembled the Thai.

Education and State Formation Reappraised--Chinese School Identity in Postwar Singapore and Hong Kong

ERIC Educational Resources Information Center

Wong, Ting-Hong

2007-01-01

After World War II the Singapore government, wishing to blend the island's several ethnic communities into a national whole, endeavored to replace Chinese schools, which imparted students with cultural-linguistic traits sharply different from those promoted in other schools. This policy, nevertheless, elicited tough resistance from Singapore's…

Consumption of Red Meat, but Not Cooking Oils High in Polyunsaturated Fat, Is Associated with Higher Arachidonic Acid Status in Singapore Chinese Adults.

PubMed

Seah, Jowy Yi Hoong; Gay, Gibson Ming Wei; Su, Jin; Tai, E-Shyong; Yuan, Jian-Min; Koh, Woon-Puay; Ong, Choon Nam; van Dam, Rob M

2017-01-31

High arachidonic acid (AA; 20:4 n - 6) status may have adverse effects on inflammation and risk of cardiovascular diseases. Concerns about high intake of n - 6 polyunsaturated fatty acids (PUFAs) are based on the premise that endogenous conversion from linoleic acid (LA; 18:2 n - 6) is an important source of AA, but few population-based studies have investigated dietary determinants of AA status. In this study, we examined habitual food consumption in relation to plasma concentrations of AA and other PUFAs in population-based studies. We used cross-sectional data from 269 healthy, ethnic Chinese participants (25-80 years old) with contrasting intakes of fish and red meat from the Singapore Prospective Study Program and 769 healthy participants (44-74 years old) from the Singapore Chinese Health Study as a validation set. Multivariable linear regression was used to examine PUFA intake (% energy) and food sources of PUFA (fish, red meat, poultry, soy and cooking oils) in relation to plasma PUFAs (AA, LA, dihomo-gamma-linolenic acid (DGLA; 20:3 n - 6), alpha-linolenic acid (ALA; 18:3 n - 3), eicosapentaenoic acid (EPA; 20:5 n - 3), and docosahexaenoic acid (DHA; 22:6 n - 3)) concentrations. Higher intake of red meat was associated with higher plasma AA concentrations. High intake of PUFA or PUFA-rich oils was associated with higher plasma ALA but not with plasma AA. Higher intakes of soy were associated with higher ALA and fish with higher DHA and EPA concentrations. These associations were statistically significant (p < 0.05) in both studies. Red meat consumption, but not PUFA or PUFA-rich cooking oil, was associated with circulating AA suggesting that intake of pre-formed AA rather than LA is an important determinant of AA status. A diet high in fish, soy products and polyunsaturated cooking oil, and low in red meat may be associated with an optimal plasma profile of PUFA in this Chinese population.

Consumption of Red Meat, but Not Cooking Oils High in Polyunsaturated Fat, Is Associated with Higher Arachidonic Acid Status in Singapore Chinese Adults

PubMed Central

Seah, Jowy Yi Hoong; Gay, Gibson Ming Wei; Su, Jin; Tai, E-Shyong; Yuan, Jian-Min; Koh, Woon-Puay; Ong, Choon Nam; van Dam, Rob M.

2017-01-01

High arachidonic acid (AA; 20:4n-6) status may have adverse effects on inflammation and risk of cardiovascular diseases. Concerns about high intake of n-6 polyunsaturated fatty acids (PUFAs) are based on the premise that endogenous conversion from linoleic acid (LA; 18:2n-6) is an important source of AA, but few population-based studies have investigated dietary determinants of AA status. In this study, we examined habitual food consumption in relation to plasma concentrations of AA and other PUFAs in population-based studies. We used cross-sectional data from 269 healthy, ethnic Chinese participants (25–80 years old) with contrasting intakes of fish and red meat from the Singapore Prospective Study Program and 769 healthy participants (44–74 years old) from the Singapore Chinese Health Study as a validation set. Multivariable linear regression was used to examine PUFA intake (% energy) and food sources of PUFA (fish, red meat, poultry, soy and cooking oils) in relation to plasma PUFAs (AA, LA, dihomo-gamma-linolenic acid (DGLA; 20:3n-6), alpha-linolenic acid (ALA; 18:3n-3), eicosapentaenoic acid (EPA; 20:5n-3), and docosahexaenoic acid (DHA; 22:6n-3)) concentrations. Higher intake of red meat was associated with higher plasma AA concentrations. High intake of PUFA or PUFA-rich oils was associated with higher plasma ALA but not with plasma AA. Higher intakes of soy were associated with higher ALA and fish with higher DHA and EPA concentrations. These associations were statistically significant (p < 0.05) in both studies. Red meat consumption, but not PUFA or PUFA-rich cooking oil, was associated with circulating AA suggesting that intake of pre-formed AA rather than LA is an important determinant of AA status. A diet high in fish, soy products and polyunsaturated cooking oil, and low in red meat may be associated with an optimal plasma profile of PUFA in this Chinese population. PMID:28146136

Association between diabetes mellitus and cirrhosis mortality: the Singapore Chinese Health Study.

PubMed

Goh, George Boon-Bee; Pan, An; Chow, Wan-Cheng; Yuan, Jian-Min; Koh, Woon-Puay

2017-02-01

Diabetes mellitus has been linked to cirrhosis-related mortality in Western populations, but less is known about this relationship in Asian populations. We studied the impact of diabetes on the risk of cirrhosis mortality in a population-based cohort among Chinese in Singapore. We used data collected and analysed from the Singapore Chinese Health Study, a prospective community-based cohort of 63 275 subjects aged 45-74 years during enrolment between 1993 and 1998. Information on diet, lifestyle and medical history was collected via structured questionnaire. Mortality cases from cirrhosis in the cohort were identified via linkage with nationwide death registry up to 31 December 2014. Cox proportional regression models were used to estimate the associations with adjustment for risk factors of cirrhosis. After a mean follow-up of 16.9 years, there were 133 deaths from cirrhosis. Diabetes was associated with an increased risk of cirrhosis mortality (hazard ratio [HR]: 2.80; 95% confidence interval [CI]: 2.04-3.83), and for both viral (HR: 2.20; 95% CI: 1.18-4.11) and non-viral hepatitis-related cirrhosis mortality (HR: 3.06; 95% CI: 2.13-4.41). The association between diabetes and non-viral hepatitis-related cirrhosis mortality was stronger among participants of body mass index (BMI) less than 23 kg/m 2 (HR: 7.11; 95% CI: 3.42-14.79) compared to heavier individuals (HR: 2.28; 95% CI: 1.20-4.35) (P interaction =0.02). Diabetes is a risk factor for cirrhosis mortality, especially for non-viral hepatitis-related cirrhosis in population with BMI considered low or normal in Asia. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Suicide trends in Singapore: 1955-2004.

PubMed

Chia, Boon-Hock; Chia, Audrey; Yee, Ng Wai; Choo, Tai Bee

2010-01-01

The objective of this study was to investigate suicide trends in Singapore between 1955 and 2004. Suicide cases were identified from the Registry of Birth and Death, Singapore, and analyzed using Poisson regression. Overall, suicide rates in Singapore remained stable between 9.8-13.0/100,000 over the last 5 decades. Rates remain highest in elderly males, despite declines among the elderly and middle-aged males in recent years. Rates in ethnic Chinese and Indians were consistently higher than in Malays. While the rates among female Indians and Chinese have declined significantly between 1995 and 2004, some increase was noted in female Malays. Although there was no increase in overall suicide rates, risk within certain population segments has changed over time.

Methodology of the Singapore Indian Chinese Cohort (SICC) eye study: quantifying ethnic variations in the epidemiology of eye diseases in Asians.

PubMed

Lavanya, Raghavan; Jeganathan, V Swetha E; Zheng, Yingfeng; Raju, Prema; Cheung, Ning; Tai, E Shyong; Wang, Jie Jin; Lamoureux, Ecosse; Mitchell, Paul; Young, Terri L; Cajucom-Uy, Howard; Foster, Paul J; Aung, Tin; Saw, Seang Mei; Wong, Tien Y

2009-01-01

Current knowledge of ethnic variability in the epidemiology of major eye diseases in Asia is limited. This report summarizes the rationale and study design of the Singapore Indian Chinese Cohort (SICC) Eye Study, a population-based study of ethnic South Asian (Indians) and East Asian (Chinese) older adults in Singapore. The SICC examined a population-based cross-sectional sample of 3,300 ethnic Indians and 3,300 ethnic Chinese aged 40-80+ years residing in the South-Western part of Singapore. From two lists of 12,000 names of each ethnic group provided by the Ministry of Home Affairs, age-stratified random sampling was used to select 6,350 names in each group, with a target sample size of 3,300. Invitations were sent to attend a central clinic using letters, telephone calls and home visits. Examination procedures included interviews, measurement of blood pressure, anthropometry, presenting and best-corrected visual acuity, subjective refraction, ocular biometry, Goldmann applanation tonometry, slit-lamp biomicroscopy, optic disc imaging and digital photography of the lens and retina, using a standardized protocol. Selected participants underwent gonioscopic examination, visual field testing, and anterior and posterior segment optical coherence tomography. Blood, tear, and urine samples were collected for biochemical analyses, and stored for genetic and proteomic studies. In conjunction with the Singapore Malay Eye Study, the SICC study will permit an in-depth evaluation of the prevalence, risk factors, and impact of major eye diseases in Chinese, Indians and Malays, three distinct Asian ethnic groups, whose combined numbers represent half the world's population.

Musical Memories: Snapshots of a Chinese Family in Singapore

ERIC Educational Resources Information Center

Lum, Chee-Hoo

2009-01-01

This paper examines music in the home of a Chinese family in Singapore with specific attention to the children (aged five and seven) of the household: an exploration of what constitutes the lived 'musical' memory of a family enmeshed in the technology and media of a globalised world. The study is part of a larger ethnographic study on the musical…

Rates of hospital admissions for primary angle closure glaucoma among Chinese, Malays, and Indians in Singapore

PubMed Central

Wong, T. Y.; Foster, P.; Seah, S.; Chew, P.

2000-01-01

AIM—To estimate the rates of hospital admissions for primary angle closure glaucoma (PACG) in Chinese, Malays, and Indians in Singapore
METHODS—A population-wide hospital discharge database in Singapore was used to identify all hospital admissions with a primary discharge diagnosis of PACG (International Classification of Disease—CM code: 365.2). The Singapore census was used for denominator data.
RESULTS—Between 1993 and 1997 there were 894 hospital admissions for PACG. The mean annual rate of PACG admissions was 11.1 per 100 000 (95% confidence interval (CI), 10.4, 11.8) among people aged 30 years and over. The annual rate was highest for Chinese (age and sex adjusted rate: 12.2 per 100 000), which was twice that of Malays (6.0 per 100 000) and Indians (6.3 per 100 000). Females had two times higher rates than males in all three races (age adjusted relative risk: 2.0, 95% CI: 1.7, 2.3).
CONCLUSION—Malay and Indian people had identical rates of hospital admissions for PACG, which were only half the rates compared with Chinese.

 PMID:10966951

Adapting Western Pedagogies for Chinese Literacy Instruction: Case Studies of Hong Kong, Shenzhen, and Singapore Preschools

ERIC Educational Resources Information Center

Li, Hui; Rao, Nirmala; Tse, Shek Kam

2012-01-01

Research Findings: Western ideas and progressive pedagogies have been introduced to China (including Shenzhen), Hong Kong, and Singapore to replace traditional Chinese pedagogy. But these imported ideas are not congruent with traditional Chinese culture and thus have encountered resistance from Chinese teachers. The present study observed and…

Prevalence and risk factors for refractive errors in Indians: the Singapore Indian Eye Study (SINDI).

PubMed

Pan, Chen-Wei; Wong, Tien-Yin; Lavanya, Raghavan; Wu, Ren-Yi; Zheng, Ying-Feng; Lin, Xiao-Yu; Mitchell, Paul; Aung, Tin; Saw, Seang-Mei

2011-05-16

To determine the prevalence and risk factors for refractive errors in middle-aged to elderly Singaporeans of Indian ethnicity. A population-based, cross-sectional study of Indians aged over 40 years of age residing in Southwestern Singapore was conducted. An age-stratified (10-year age group) random sampling procedure was performed to select participants. Refraction was determined by autorefraction followed by subjective refraction. Myopia was defined as spherical equivalent (SE) < -0.50 diopters (D), high myopia as SE < -5.00 D, astigmatism as cylinder < -0.50 D, hyperopia as SE > 0.50 D, and anisometropia as SE difference > 1.00 D. Prevalence was adjusted to the 2000 Singapore census. Of the 4497 persons eligible to participate, 3400 (75.6%) were examined. Complete data were available for 2805 adults with right eye refractive error and no prior cataract surgery. The age-adjusted prevalence was 28.0% (95% confidence interval [CI], 25.8-30.2) for myopia and 4.1% (95% CI, 3.3-5.0) for high myopia. There was a U-shaped relationship between myopia and increasing age. The age-adjusted prevalence was 54.9% (95% CI, 52.0-57.9) for astigmatism, 35.9% (95% CI, 33.7-38.3) for hyperopia, and 9.8% (95% CI, 8.6-11.1) for anisometropia. In a multiple logistic regression model, adults who were female, younger, taller, spent more time reading and writing per day, or had astigmatism were more likely to be myopic. Adults who were older or had myopia or diabetes mellitus had higher risk of astigmatism. In Singapore, the prevalence of myopia in Indian adults is similar to those in Malays, but lower than those in Chinese. Risk factors for myopia are similar across the three ethnic groups in Singapore.

: health is my capital: a qualitative study of access to healthcare by Chinese migrants in Singapore.

PubMed

Tam, Wai Jia; Goh, Wei Leong; Chua, Jeffrey; Legido-Quigley, Helena

2017-06-15

Since the 1970s, Singapore has turned into one of the major receiving countries of foreign workers in Southeast Asia. Over the years, challenges surrounding access to healthcare by Chinese migrant workers have surfaced globally. This study aims to explore the experiences of Chinese migrants accessing primary and secondary/tertiary healthcare in Singapore, and the opportunities for overcoming these barriers. We conducted 25 in-depth interviews of 20 Chinese migrants and five staff from HealthServe, a non-governmental organization serving Chinese migrants in Singapore from October 2015 to January 2016. Interviews were transcribed and analysed inductively adopting thematic analysis. Chinese migrants in Singapore who were interviewed are mainly middle-aged breadwinners with multiple dependents. Their concept of health is encapsulated in a Chinese proverb ", meaning "health is my capital". Health is defined by them as a personal asset, needed to provide for their families. From their health-seeking behaviors, six pathways were identified, highlighting different routes chosen and resulting outcomes depending on whether their illness was perceived as major or minor, and if they sought help from the private or public sector private or public sector. Key barriers were identified relating to vulnerabilities during the migration process, during their illness, when consulting with healthcare providers, and during repatriation. A transactional doctor-patient culture in China contrasts with the trust migrants place in Singaporean's public health system, perceived as equitable and personable. However, challenges remain for injured migrants who sought help from the private sector and those with chronic diseases. Policy recommendations to increase patient autonomy enabling choice of healthcare provider and provide for non-work related illnesses are suggested. Partnerships between migrant advocacy organizations and various stakeholders such as hospitals, government agencies and

Ethnicity-specific prevalences of refractive errors vary in Asian children in neighbouring Malaysia and Singapore.

PubMed

Saw, S-M; Goh, P-P; Cheng, A; Shankar, A; Tan, D T H; Ellwein, L B

2006-10-01

To compare the prevalences of refractive errors in Malay, Chinese and Indian children in Malaysia and Singapore. Children aged 7-9 years from three schools in the Singapore Cohort study of the Risk factors for Myopia (n = 1962) and similarly aged children from a random cluster sample in the metropolitan Kuala Lumpur area in the Malaysia Refractive Error Study in Children (n = 1752) were compared. Cycloplegic autorefraction was conducted in both countries. The prevalence of myopia (spherical equivalent of at least -0.5 diopters (D) in either eye) was higher in Singapore Malays (22.1%) than in Malays in Malaysia (9.2%; 95% confidence interval (CI) 11.2 to 14.7; p<0.001). Similarly, Singapore Chinese (40.1%) had higher prevalences than Malaysian Chinese (30.9%; 95% CI 1.5 to 16.9). Singapore Indians had a higher prevalence (34.1%) than Malaysian Indians (12.5%; 95% CI 17.4 to 25.9). The multivariate odds ratio of astigmatism (cylinder at least 0.75 D in either eye) in Singapore Malays compared with Malaysian Malays was 3.47 (95% CI 2.79 to 4.32). Ethnicity-specific hyperopia rates did not differ in Singapore and Malaysia. The ethnicity-specific prevalences of myopia in Singapore Malays, Chinese and Indians are higher than those in Malaysian Malays, Chinese and Indians. As Malays, Chinese and Indians in Malaysia have genetic make-up similar to that of Malays, Chinese and Indians in Singapore, environmental factors may contribute to the higher myopia rates.

Ethnicity‐specific prevalences of refractive errors vary in Asian children in neighbouring Malaysia and Singapore

PubMed Central

Saw, S‐M; Goh, P‐P; Cheng, A; Shankar, A; Tan, D T H; Ellwein, L B

2006-01-01

Aim To compare the prevalences of refractive errors in Malay, Chinese and Indian children in Malaysia and Singapore. Methods Children aged 7–9 years from three schools in the Singapore Cohort study of the Risk factors for Myopia (n = 1962) and similarly aged children from a random cluster sample in the metropolitan Kuala Lumpur area in the Malaysia Refractive Error Study in Children (n = 1752) were compared. Cycloplegic autorefraction was conducted in both countries. Results The prevalence of myopia (spherical equivalent of at least −0.5 diopters (D) in either eye) was higher in Singapore Malays (22.1%) than in Malays in Malaysia (9.2%; 95% confidence interval (CI) 11.2 to 14.7; p<0.001). Similarly, Singapore Chinese (40.1%) had higher prevalences than Malaysian Chinese (30.9%; 95% CI 1.5 to 16.9). Singapore Indians had a higher prevalence (34.1%) than Malaysian Indians (12.5%; 95% CI 17.4 to 25.9). The multivariate odds ratio of astigmatism (cylinder at least 0.75 D in either eye) in Singapore Malays compared with Malaysian Malays was 3.47 (95% CI 2.79 to 4.32). Ethnicity‐specific hyperopia rates did not differ in Singapore and Malaysia. Conclusion The ethnicity‐specific prevalences of myopia in Singapore Malays, Chinese and Indians are higher than those in Malaysian Malays, Chinese and Indians. As Malays, Chinese and Indians in Malaysia have genetic make‐up similar to that of Malays, Chinese and Indians in Singapore, environmental factors may contribute to the higher myopia rates. PMID:16809384

Meat, Dietary Heme Iron, and Risk of Type 2 Diabetes Mellitus: The Singapore Chinese Health Study.

PubMed

Talaei, Mohammad; Wang, Ye-Li; Yuan, Jian-Min; Pan, An; Koh, Woon-Puay

2017-10-01

We evaluated the relationships of red meat, poultry, fish, and shellfish intakes, as well as heme iron intake, with the risk of type 2 diabetes mellitus (T2D).The Singapore Chinese Health Study is a population-based cohort study that recruited 63,257 Chinese adults aged 45-74 years from 1993 to 1998. Usual diet was evaluated using a validated 165-item semiquantitative food frequency questionnaire at recruitment. Physician-diagnosed T2D was self-reported during 2 follow-up interviews in 1999-2004 and 2006-2010. During a mean follow-up of 10.9 years, 5,207 incident cases of T2D were reported. When comparing persons in the highest intake quartiles with those in the lowest, the multivariate-adjusted hazard ratio for T2D was 1.23 (95% confidence interval (CI): 1.14, 1.33) for red meat intake (P for trend < 0.001), 1.15 (95% CI: 1.06, 1.24) for poultry intake (P for trend = 0.004), and 1.07 (95% CI: 0.99, 1.16) for fish/shellfish intake (P for trend = 0.12). After additional adjustment for heme iron, only red meat intake remained significantly associated with T2D risk (multivariate-adjusted hazard ratio = 1.13, 95% CI: 1.01, 1.25; P for trend = 0.02). Heme iron was associated with a higher risk of T2D even after additional adjustment for red meat intake (multivariate-adjusted hazard ratio = 1.14, 95% CI: 1.02, 1.28; P for trend = 0.03). In conclusion, red meat and poultry intakes were associated with a higher risk of T2D. These associations were mediated completely for poultry and partially for red meat by heme iron intake. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Intussusception and Monovalent Rotavirus Vaccination in Singapore: Self-Controlled Case Series and Risk-Benefit Study.

PubMed

Yung, Chee-Fu; Chan, Siew Pang; Soh, Sally; Tan, Adriana; Thoon, Koh Cheng

2015-07-01

To investigate the association between monovalent human rotavirus vaccine (RV1) and intussusception among Asian infants and the impact of older age of vaccination. To perform risk-benefit analysis of RV1 vaccination programs in Singapore. We performed a self-controlled case series by extracting intussusception cases in infants aged <12 months from hospital databases (2005-2012) and with vaccination histories from a national immunization registry. Relative incidences were calculated by comparing incidence during defined risk periods after vaccination with times outside these periods. In the risk benefit analysis, we estimated excess intussusception hospitalization in relation to the number of infants vaccinated for hypothetical vaccination coverage scenarios. There were 86 infants hospitalized with intussusception; 20 cases had received at least 1 dose of RV1. Nearly all (19) had received their first dose at age >12 weeks old. The age-adjusted relative incidence of intussusception in the 1- to 7-day period post dose one was 8.36 (95% CI 2.42-28.96). Of all childhood hospitalizations because of rotavirus, 71% (570 cases) could be prevented with 90% vaccination coverage. There would be approximately 1 excess intussusception case per 65,000 infants vaccinated. Risk of intussusception increases about 8-fold during 1-7 days after receipt of first dose RV1 in infants of Chinese, Malay, and Indian ethnicity in Singapore, Asia. High vaccine coverage program in Singapore would be beneficial with only a low risk of excess intussusception. The relative risk of intussusception post-RV1 vaccination is not higher in Asia despite differences in background intussusception incidence compared with US and Australia, or older age of vaccination. Copyright © 2015 Elsevier Inc. All rights reserved.

Epidemiology of injuries in Singapore.

PubMed

Emmanuel, S

1991-03-01

Injuries are a major public health problem in developed industrialised countries and are the leading cause of premature mortality. This study has shown the same picture for Singapore. Injuries are the fifth leading cause of crude death but the most important cause of premature mortality being responsible for 23,800 potential years of life lost before the age of 65 years. The most vulnerable ages are from the preschool to the economically active age groups. Singapore males have twice the death rate of females (52 vs 20 per 100,000 population) because of the relatively higher proportion of males (78.5% among males vs 48% among females) who work and are therefore at higher risk. Indian males have the highest ethnic-and-sex-specific mortality rates (107 vs 48 among Chinese males and 39 among Malay males per 1000 population). Road traffic accidents were the leading cause of mortality from injuries but this has been over taken by suicides. Information on the specific causes and specific high risk behaviour and factors for injuries in Singapore is weak. This needs to be strengthened to enable more effective cause-specific control programmes to be drawn up.

Frequent hospital admissions in Singapore: clinical risk factors and impact of socioeconomic status.

PubMed

Low, Lian Leng; Tay, Wei Yi; Ng, Matthew Joo Ming; Tan, Shu Yun; Liu, Nan; Lee, Kheng Hock

2018-01-01

Frequent admitters to hospitals are high-cost patients who strain finite healthcare resources. However, the exact risk factors for frequent admissions, which can be used to guide risk stratification and design effective interventions locally, remain unknown. Our study aimed to identify the clinical and sociodemographic risk factors associated with frequent hospital admissions in Singapore. An observational study was conducted using retrospective 2014 data from the administrative database at Singapore General Hospital, Singapore. Variables were identified a priori and included patient demographics, comorbidities, prior healthcare utilisation, and clinical and laboratory variables during the index admission. Multivariate logistic regression analysis was used to identify independent risk factors for frequent admissions. A total of 16,306 unique patients were analysed and 1,640 (10.1%) patients were classified as frequent admitters. On multivariate logistic regression, 16 variables were independently associated with frequent hospital admissions, including age, cerebrovascular disease, history of malignancy, haemoglobin, serum creatinine, serum albumin, and number of specialist outpatient clinic visits, emergency department visits, admissions preceding index admission and medications dispensed at discharge. Patients staying in public rental housing had a 30% higher risk of being a frequent admitter after adjusting for demographics and clinical conditions. Our study, the first in our knowledge to examine the clinical risk factors for frequent admissions in Singapore, validated the use of public rental housing as a sensitive indicator of area-level socioeconomic status in Singapore. These risk factors can be used to identify high-risk patients in the hospital so that they can receive interventions that reduce readmission risk. Copyright: © Singapore Medical Association

Tea Drinking and Its Association with Active Tuberculosis Incidence among Middle-Aged and Elderly Adults: The Singapore Chinese Health Study

PubMed Central

Soh, Avril Zixin; Pan, An; Chee, Cynthia Bin Eng; Wang, Yee-Tang; Yuan, Jian-Min; Koh, Woon-Puay

2017-01-01

Experimental studies showed that tea polyphenols may inhibit growth of Mycobacterium tuberculosis. However, no prospective epidemiologic study has investigated tea drinking and the risk of active tuberculosis. We investigated this association in the Singapore Chinese Health Study, a prospective population-based cohort of 63,257 Chinese aged 45–74 years recruited between 1993 and 1998 in Singapore. Information on habitual drinking of tea (including black and green tea) and coffee was collected via structured questionnaires. Incident cases of active tuberculosis were identified via linkage with the nationwide tuberculosis registry up to 31 December 2014. Cox proportional hazard models were used to estimate the relation of tea and coffee consumption with tuberculosis risk. Over a mean 16.8 years of follow-up, we identified 1249 incident cases of active tuberculosis. Drinking either black or green tea was associated with a dose-dependent reduction in tuberculosis risk. Compared to non-drinkers, the hazard ratio (HR) (95% confidence interval (CI)) was 1.01 (0.85–1.21) in monthly tea drinkers, 0.84 (0.73–0.98) in weekly drinkers, and 0.82 (0.71–0.96) in daily drinkers (p for trend = 0.003). Coffee or caffeine intake was not significantly associated with tuberculosis risk. In conclusion, regular tea drinking was associated with a reduced risk of active tuberculosis. PMID:28587081

Tea Drinking and Its Association with Active Tuberculosis Incidence among Middle-Aged and Elderly Adults: The Singapore Chinese Health Study.

PubMed

Soh, Avril Zixin; Pan, An; Chee, Cynthia Bin Eng; Wang, Yee-Tang; Yuan, Jian-Min; Koh, Woon-Puay

2017-05-25

Experimental studies showed that tea polyphenols may inhibit growth of Mycobacterium tuberculosis . However, no prospective epidemiologic study has investigated tea drinking and the risk of active tuberculosis. We investigated this association in the Singapore Chinese Health Study, a prospective population-based cohort of 63,257 Chinese aged 45-74 years recruited between 1993 and 1998 in Singapore. Information on habitual drinking of tea (including black and green tea) and coffee was collected via structured questionnaires. Incident cases of active tuberculosis were identified via linkage with the nationwide tuberculosis registry up to 31 December 2014. Cox proportional hazard models were used to estimate the relation of tea and coffee consumption with tuberculosis risk. Over a mean 16.8 years of follow-up, we identified 1249 incident cases of active tuberculosis. Drinking either black or green tea was associated with a dose-dependent reduction in tuberculosis risk. Compared to non-drinkers, the hazard ratio (HR) (95% confidence interval (CI)) was 1.01 (0.85-1.21) in monthly tea drinkers, 0.84 (0.73-0.98) in weekly drinkers, and 0.82 (0.71-0.96) in daily drinkers ( p for trend = 0.003). Coffee or caffeine intake was not significantly associated with tuberculosis risk. In conclusion, regular tea drinking was associated with a reduced risk of active tuberculosis.

The Tongue in Between: Some Thoughts on the Teaching of Chinese as a Second Language in Singapore

ERIC Educational Resources Information Center

Tan, Chee Lay

2014-01-01

In Singapore's unique and complex linguistic environment, it is common to have Chinese-language learners from many different backgrounds in the same school classroom, which is why Singapore is nicknamed as a "language laboratory." In this paper, I hope to examine our linguistic environment and response strategies from different angles,…

Parent Physical Punishment and Child Aggression in a Singapore Chinese Preschool Sample

ERIC Educational Resources Information Center

Ngee Sim, Tick; Ping Ong, Lue

2005-01-01

We examine how parental physical punishment (caning and slapping) and child aggression are related, and possible moderation by authoritative control and rejection. A sample of 286 Singapore Chinese preschoolers ages 4-6 reported on rejection; their parents reported on control, caning, and slapping; and their teachers rated child aggression.…

Investigating the Development of Chinese Oral Explanation and Justification in Singapore Primary Students

ERIC Educational Resources Information Center

Yan, Jing

2016-01-01

Explanation and justification require cognitive ability which selects and organises relevant information in a logical way, and linguistic ability which enables speakers to encode the information with linguistic knowledge. This study aims to investigate the development of Chinese oral explanation and justification in Singapore primary students. The…

Adaptation of Chinese and English versions of the Ankylosing Spondylitis quality of life (ASQoL) scale for use in Singapore.

PubMed

Leung, Ying Ying; Lee, Weixian; Lui, Nai Lee; Rouse, Matthew; McKenna, Stephen P; Thumboo, Julian

2017-08-17

To cross-culturally adapt and validate the Singapore Chinese and Singapore English versions of the Ankylosing Spondylitis Quality of Life (ASQoL) scales. Translation of the ASQoL into Singapore Chinese and English was performed by professional and lay translation panels. Field-testing for face and content validity was performed by interviewing ten Chinese speaking and ten English speaking axial spondyloarthritis (AxSpA) patients. AxSpA patients (either Chinese or English speaking) were invited to take part in validation surveys. The Health Assessment Questionnaire (HAQ), Short Form Health Survey (SF-36), Bath Indices, and other measures of disease activity were used as comparator scales for convergent validity. A separate sample of AxSpA patients were invited to participate in a test-retest postal study, with 2 weeks between administrations. The cross-sectional study included 183 patients (77% males, 82% English speaking), with a mean (SD) age of 39.4 (13.7) years. The ASQoL had excellent internal consistency (Cronbach's alpha = 0.88), and correlated moderately with all the comparator scales. The ASQoL was able to distinguish between patients grouped by disease activity and perceived general health. The ASQoL fulfilled the Rasch model analysis for fit, reliability and unidimensionality requirements. No significant differential item functioning was noted for gender, age below or above 50 years, and language of administration. Test-retest reliability was good (r = 0.81). The ASQoL was adapted into Singapore Chinese and English language versions, and shown to be culturally relevant, valid and reliable when used with combined samples of AxSpA patients who speak either Chinese or English.

Glucose-6-phosphate dehydrogenase deficiency in Singapore.

PubMed

Quak, S H; Saha, N; Tay, J S

1996-01-01

Glucose-6-phosphate dehydrogenase (G6PD) in man is an X-linked enzyme. The deficiency of this enzyme is one of the most common inherited metabolic disorders in man. In Singapore, three clinical syndromes associated with G6PD deficiency had been described: severe haemolysis in neonates with kernicterus, haemoglobinuria and "viral hepatitis"-like syndrome. The human G6PD monomer consists of 515 amino acids. Only the tetrameric or dimeric forms composed of a single type subunit are catylitically active. The complete amino acid sequence of G6PD had been elucidated in man and various other animals. The region of high homology among the enzymes of various animals is presumably functionally active. Among the Chinese in Singapore, three common molecular variants had been identified: Canton (nt 1376 G --> T), Kaiping (nt 1388 G --> A) and Mediterranean (nt 563 C --> T) in frequencies of 24%, 21% and 10% respectively. In addition, two common mutants (Gaozhou, nt 95 A --> G and Chinese 5, nt 1024 C --> T) have been detected in Singapore Chinese in low frequencies. In Malays, 6 different deficient variants are known in Singapore (3 new, 1 Mahidol, 1 Indonesian and 1 Mediterranean).

Mother Tongue Education in Singapore: Concerns, Issues and Controversies

ERIC Educational Resources Information Center

Ng, Chin Leong Patrick

2014-01-01

In 1966, the Singapore Government implemented the English-knowing bilingual policy which made it mandatory for all Chinese students to study English as a "First Language" and the Chinese language (CL) as a "Mother Tongue Language" in Singapore schools. Using key literature relevant to Singapore's bilingual educational policy…

Challenges of Chinese Language Education in Multi-Lingual Societies: Hong Kong and Singapore

ERIC Educational Resources Information Center

Tong, Ho-kin; Goh, Yeng-seng

2008-01-01

This paper aims to study the current challenges of Chinese language education in the multilingual societies of Hong Kong and Singapore through policy documents. After the handover of Hong Kong to China in 1997, the role of "Putonghua" is far more important than before due to political and economic reasons. However, the medium of…

Singapore's Aarden City Construction and Green Building Development

NASA Astrophysics Data System (ADS)

Xiong, Chenhui; Chen, Jian

2018-05-01

The government of Singapore has a high demand for city construction planning always adhere to the implementation of "garden city " theory. Singapore’s government has been following the "sustainable" of Singapore's requirement and fully embodies the "green building" and "environmental protection"concept. To set the ecological construction and protection of water resources as the total target, minimize damage to the environment of economic development, make Singapore a pioneer "green building". In recent years, the Chinese government is promoting green building but harvest little, in this case, for the development of "green building", China can draw lessons from Singapore's experience.

Singapore.

PubMed

1987-02-01

Singapore's population stands at 2.6 million, with an annual growth rate of 1.1%. The infant mortality rate is 8.9/1000, and life expectancy is 69 years for men and 74 years for women. Chinese account for 77% of the population, while Malays comprise another 15%. The work force of 1.2 million is distributed as follows: agriculture, 1%; industry and commerce, 58%; services, 35%; and government, 6%. The gross domestic product was US$16 billion in 1985, with a per capita income of $6200. Although the rate of population growth has fallen, Singapore is one of the most densely populated countries in the world. Singapore's strategic location has given it an economic importance in Southeast Asia out of proportion to its size. After independence in 1965, Singapore's economy expanded rapidly and its infrastructure was modernized. Singapore continues to upgrade worker skills and search for new products and markets for its export-led economy. A central goal is to make Singapore a complete business center, offering multinationals a manufacturing base, a developed financial infrastructure, and excellent communications to service regional and world markets. The government's development policy since independence has emphasized industrialization.

Prevalence and risk factors for refractive errors in the Singapore Malay Eye Survey.

PubMed

Saw, Seang-Mei; Chan, Yiong-Huak; Wong, Wan-Ling; Shankar, Anoop; Sandar, Mya; Aung, Tin; Tan, Donald T H; Mitchell, Paul; Wong, Tien Yin

2008-10-01

To describe the prevalence and risk factors for myopia and other refractive errors in an urban Malay population in Singapore. Population-based, cross-sectional study. Persons of Malay ethnicity, between 40 and 80 years of age, living in Singapore. Refractive error was determined by subjective refraction and if unavailable by autorefraction. Data were analyzed for 2974 adults without previous cataract surgery and who had right eye refraction data. Risk factor data, such as education levels and near work activity, were obtained from a face-to-face interview. Myopia, defined as spherical equivalent (SE) refraction less than -0.5 diopters (D), astigmatism as cylinder less than -0.5 D, hyperopia as SE greater than 0.5 D, and anisometropia as the difference in SE greater than 1.0 D. The prevalence of myopia in the right eye was 30.7% (9.4% unilateral myopia and 21.3% bilateral myopia), the prevalence of astigmatism in the right eye was 33.3% (95% confidence interval [CI, 33.0-33.5), the prevalence of hyperopia in the right eye was 27.4% (95% CI, 24.7-27.6), and the prevalence of anisometropia was 9.9% (95% CI, 9.7-10.0). There was a U-shaped relationship between increasing age and the prevalence of myopia, which was partially explained by the age-related increase in the prevalence of cataract. In a multiple logistic regression model, female sex, age, higher educational level, and cataract were associated with myopia. Adults with myopia were more likely to have astigmatism (P<0.001) in multivariate analyses. A quarter of older adult Malay people in Singapore had myopia. Compared with previous reports of similarly aged Singapore Chinese adults, the prevalence of myopia, astigmatism, and anisometropia was lower, whereas the prevalence of hyperopia was similar.

Prostate-specific antigen levels among Chinese, Malays and Indians in Singapore from a community-based study.

PubMed

Chia, Sin-Eng; Lau, Weber Ko; Cheng, Christopher; Chin, Chong Min; Tan, James; Ho, Siew Hong

2007-01-01

The purpose of this study was to examine the distribution of prostate-specific antigen levels among Chinese, Malays and Indians in Singapore, taking the effect of age into consideration. The study was carried out as part of the Singapore Prostate Awareness Week from 23-26th February 2004. Men above 50 years old went to four government-restructured hospitals to participate in the study. Participants filled up a questionnaire and provided 5 ml of blood for measurement of PSA levels using the Abbott IMx Total PSA assay (Abbott Laboratories). 3,486 men responded to the study, comprising 92.8% Chinese, 3.0% Malays, 2.5% Indians and 1.8% Others. 92.7% of them had PSA levels of 4 microg/L or less. There were no significant differences (p<0.05) between the mean PSA levels of Chinese (1.60 microg/L), Malays (1.39 microg/L), Indians (1.23 microg/L) and Others (1.70 microg/L). PSA levels were significantly associated with age (Spearman's r= 0.27, p<0.01). PSA levels increased with each 10-year age group and these trends were significant (p<0.0001) across both PSA group levels and age groupings. In the 50-60 years age groups, the prevalence of PSA levels >4 mug/L were 1.1% and 3.7% respectively. This rose rapidly to 11.3% and 23.5% for age groups >60-70 and >80 years respectively. Our study shows that the median PSA levels in the Caucasian population in the USA are higher than those of Chinese, Malays and Indians in Singapore. PSA levels were positively associated with age. It may be more appropriate to offer PSA testing to men who are >60 years old rather than the current >50 years.

Gene-diet interaction effects on BMI levels in the Singapore Chinese population.

PubMed

Chang, Xuling; Dorajoo, Rajkumar; Sun, Ye; Han, Yi; Wang, Ling; Khor, Chiea-Chuen; Sim, Xueling; Tai, E-Shyong; Liu, Jianjun; Yuan, Jian-Min; Koh, Woon-Puay; van Dam, Rob M; Friedlander, Yechiel; Heng, Chew-Kiat

2018-02-24

Recent genome-wide association studies (GWAS) have identified 97 body-mass index (BMI) associated loci. We aimed to evaluate if dietary intake modifies BMI associations at these loci in the Singapore Chinese population. We utilized GWAS information from six data subsets from two adult Chinese population (N = 7817). Seventy-eight genotyped or imputed index BMI single nucleotide polymorphisms (SNPs) that passed quality control procedures were available in all datasets. Alternative Healthy Eating Index (AHEI)-2010 score and ten nutrient variables were evaluated. Linear regression analyses between z score transformed BMI (Z-BMI) and dietary factors were performed. Interaction analyses were performed by introducing the interaction term (diet x SNP) in the same regression model. Analysis was carried out in each cohort individually and subsequently meta-analyzed using the inverse-variance weighted method. Analyses were also evaluated with a weighted gene-risk score (wGRS) contructed by BMI index SNPs from recent large-scale GWAS studies. Nominal associations between Z-BMI and AHEI-2010 and some dietary factors were identified (P = 0.047-0.010). The BMI wGRS was robustly associated with Z-BMI (P = 1.55 × 10 - 15 ) but not with any dietary variables. Dietary variables did not significantly interact with the wGRS to modify BMI associations. When interaction analyses were repeated using individual SNPs, a significant association between cholesterol intake and rs4740619 (CCDC171) was identified (β = 0.077, adjP interaction  = 0.043). The CCDC171 gene locus may interact with cholesterol intake to increase BMI in the Singaporean Chinese population, however most known obesity risk loci were not associated with dietary intake and did not interact with diet to modify BMI levels.

"Crossing" in Singapore

ERIC Educational Resources Information Center

Vaish, Viniti; Roslan, Mardiana

2011-01-01

This paper explores the way a group of pre-teens in Singapore use Malay, Chinese and English to perform identity. It is based on one case study of a Malay girl, Syafiqah, from a larger project called The Sociolinguistic Survey of Singapore 2006, and does not claim to be generalizable. The data are transcripts of recordings made on the speech…

Prevalence, subtypes, severity and determinants of ocular trauma: The Singapore Chinese Eye Study.

PubMed

Wong, Mark Yz; Man, Ryan Ek; Gupta, Preeti; Sabanayagam, Charumathi; Wong, Tien Yin; Cheng, Ching-Yu; Lamoureux, Ecosse Luc

2018-02-01

To describe the prevalence, subtypes, severity and determinants of ocular trauma (OT) in a population-based study in Singapore. We included 3353 Chinese adults aged ≥40 years from the Singapore Chinese Eye Study, a population-based study, conducted between 2009 and 2011. OT was defined as self-reported history of any eye injury requiring medical attention with or without hospitalisation, and further classified as blunt object, sharp object or chemical burns related. Age and gender-standardised prevalence was estimated using the 2010 Singapore Chinese population census. Multivariable models were used to assess the independent associations of OT with age, gender, income, education, literacy, alcohol consumption, smoking and history of falls. The mean (SD) age was 59.7 (9.9) years and 49.4% were male. There were 138 OT cases, giving a crude and age and gender-standardised prevalence of 4.1% (95% CI 3.5% to 4.8%) and 4.4% (95% CI 3.7% to 5.2%), respectively. Of these, 45 (32.6%), 56 (40.6%) and 10 (7.3%) were blunt object, sharp object and chemical burns-related trauma, respectively. Twenty eight (20.3%) required hospitalisation, with no difference between subtypes. In multivariable models, men (OR (95% CI): 2.80 (1.79-4.39)), younger persons (per year decrease in age (1.03 (1.00-1.05)) and lower education levels (1.8 (1.25-2.60); comparing ≤6 years vs >6 years of education) were independent determinants of OT. OT affected one in 25 adults, with 20% of these requiring hospitalisation. Because OT is preventable, raising awareness and education strategies in the population would allow prevention of vision loss particularly in men, and younger and lesser-educated individuals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Utility of genetic and non-genetic risk factors in predicting coronary heart disease in Singaporean Chinese.

PubMed

Chang, Xuling; Salim, Agus; Dorajoo, Rajkumar; Han, Yi; Khor, Chiea-Chuen; van Dam, Rob M; Yuan, Jian-Min; Koh, Woon-Puay; Liu, Jianjun; Goh, Daniel Yt; Wang, Xu; Teo, Yik-Ying; Friedlander, Yechiel; Heng, Chew-Kiat

2017-01-01

Background Although numerous phenotype based equations for predicting risk of 'hard' coronary heart disease are available, data on the utility of genetic information for such risk prediction is lacking in Chinese populations. Design Case-control study nested within the Singapore Chinese Health Study. Methods A total of 1306 subjects comprising 836 men (267 incident cases and 569 controls) and 470 women (128 incident cases and 342 controls) were included. A Genetic Risk Score comprising 156 single nucleotide polymorphisms that have been robustly associated with coronary heart disease or its risk factors ( p < 5 × 10 -8 ) in at least two independent cohorts of genome-wide association studies was built. For each gender, three base models were used: recalibrated Adult Treatment Panel III (ATPIII) Model (M 1 ); ATP III model fitted using Singapore Chinese Health Study data (M 2 ) and M 3 : M 2 + C-reactive protein + creatinine. Results The Genetic Risk Score was significantly associated with incident 'hard' coronary heart disease ( p for men: 1.70 × 10 -10 -1.73 × 10 -9 ; p for women: 0.001). The inclusion of the Genetic Risk Score in the prediction models improved discrimination in both genders (c-statistics: 0.706-0.722 vs. 0.663-0.695 from base models for men; 0.788-0.790 vs. 0.765-0.773 for women). In addition, the inclusion of the Genetic Risk Score also improved risk classification with a net gain of cases being reclassified to higher risk categories (men: 12.4%-16.5%; women: 10.2% (M 3 )), while not significantly reducing the classification accuracy in controls. Conclusions The Genetic Risk Score is an independent predictor for incident 'hard' coronary heart disease in our ethnic Chinese population. Inclusion of genetic factors into coronary heart disease prediction models could significantly improve risk prediction performance.

Chinese proprietary medicine in Singapore: regulatory control of toxic heavy metals and undeclared drugs.

PubMed

Koh, H L; Woo, S O

2000-11-01

Traditional Chinese medicine (TCM) is gaining popularity as a form of complementary and alternative medicine. Reports of efficacy of TCM are increasing in numbers. TCM includes both crude Chinese medicinal materials (plants, animal parts and minerals) and Chinese proprietary medicine (CPM) [final dosage forms]. Despite the belief that CPM and herbal remedies are of natural origin, unlike Western medicine, and are hence safe and without many adverse effects, there have been numerous reports of adverse effects associated with herbal remedies. Factors affecting the safety of herbal medicines include intrinsic toxicity, adulteration, substitution, contamination, misidentification, lack of standardisation, incorrect preparation and/or dosage and inappropriate labelling and/or advertising. Hence, new regulations on the control of CPM were enforced in Singapore with effect from 1 September 1999. These include licensing and labelling requirements, as well as control of microbial contamination. This article also reviews reports of excessive toxic heavy metals and undeclared drugs in CPM in Singapore between 1990 and 1997. The names, uses, toxic heavy metal or drug detected and the year of detection are tabulated. Information on the brand or manufacturer's name are provided whenever available. The public and healthcare professionals should be better informed of the basic concept of TCM and its usefulness, as well as the potential adverse effects associated with its use. Greater control over the safety and quality of CPM could be achieved through good manufacturing practice, regulatory control, research, education, reporting usage of Chinese medicine (as in drug history) as well as reporting of adverse events.

Prevalence of refractive errors in a multiethnic Asian population: the Singapore epidemiology of eye disease study.

PubMed

Pan, Chen-Wei; Zheng, Ying-Feng; Anuar, Ainur Rahman; Chew, Merwyn; Gazzard, Gus; Aung, Tin; Cheng, Ching-Yu; Wong, Tien Y; Saw, Seang-Mei

2013-04-09

To determine the prevalence of refractive errors in a multiethnic Asian population aged over 40 years and to examine secular trends and racial differences. A total of 10,033 adults (3353 Chinese, 3400 Indians, and 3280 Malays) participated in this study. Refractive error was determined by subjective refraction. Ocular biometric parameters were determined by partial coherence interferometry. Myopia and high myopia were defined as spherical equivalent (SE) of less than -0.5 diopters (D) and -5.0 D, respectively. Hyperopia was defined as SE of more than 0.5 D. Astigmatism was defined as cylinders less than -0.5 D. The prevalence of myopia, high myopia, hyperopia and astigmatism in Singapore adults aged over 40 years was 38.9% (95% confidence interval [CI] 37.1, 40.6); 8.4% (95% CI 8.0, 8.9); 31.5% (95% 30.5, 32.5); and 58.8% (95% CI 57.8, 59.9), respectively. Compared with the Tanjong Pagar Survey 12 years ago, there was a significant increase in the prevalence of astigmatism and mean axial length (AL) in Chinese adults aged over 40 years in Singapore. Chinese were most likely to be affected by myopia, high myopia, astigmatism, and had the longest AL among the three racial groups. The prevalence of myopia in Singapore adults is lower compared with the younger "myopia" generation in Singapore. The prevalence of astigmatism and mean AL have been increasing significantly within the past 12 years in the Chinese population. Chinese adults had higher prevalence of myopia, high myopia, astigmatism, as well as the longer AL compared with non-Chinese adults in Singapore.

Singapore: Background and U.S. Relations

DTIC Science & Technology

2008-12-18

measures, including a relaxation of censorship of political films and approval of peaceful demonstrations in a public park. Although Lee has...Sabah, and Sarawak to form the Federation of Malaysia in 1963. Within two years, friction between the Malay-dominated federation government and...the Chinese-dominated Singapore administration led to the separation of Singapore from Malaysia . Amid serious doubts about its viability, Singapore

Coffee and tea drinking in relation to risk of hip fracture in the Singapore Chinese Health Study.

PubMed

Dai, Zhaoli; Jin, Aizhen; Soh, Avril Zixin; Ang, Li-Wei; Yuan, Jian-Min; Koh, Woon-Puay

2018-07-01

Meta-analyses of studies conducted among Western populations suggest that coffee consumption does not affect osteoporotic fracture risk. However, experimental studies have shown that the effect of caffeine on bone health may depend on dosage. We examined the associations between consumption of coffee, tea and caffeine and risk of hip fracture in an Asian cohort. In a population-based prospective cohort of 63,257 Chinese men and women aged 45-74 years in Singapore, a validated semi-quantitative food frequency questionnaire was used to assess habitual consumption of coffee and tea at baseline. Cox proportional hazards regression models were used to estimate hazard ratio (HR) and 95% confidence interval (CI) for risk of hip fracture with adjustment for potential confounders. During a mean follow-up of 16.7 years, 2502 incident hip fracture cases were identified. Compared to coffee drinkers <1 cup/week, those who drank ≥4 cups/day had a statistically significant higher risk to develop hip fractures, the HR (95% CI) was 1.32 (1.07, 1.63) in the whole cohort analysis, 1.46 (1.01, 2.10) for men and 1.33 (1.02, 1.72) for women. Among postmenopausal women, compared to those who drank coffee <1 cup/week, drinking 2-3 cups/day was associated with the lowest risk [HR: 0.88 (0.76, 1.01)] and drinking ≥4 cups/day was associated with the highest risk [HR: 1.31 (1.00, 1.71)]. Similar associations with caffeine intake were found among postmenopausal women. Restricted spline analyses suggested a non-linear association between coffee/caffeine consumption and hip fracture risk in postmenopausal women (p for non-linearity ≤ 0.05). No association was found with tea consumption in either sex. These data suggest that drinking coffee ≥4 cups/day is associated with a higher hip fracture risk, while a moderate intake may alleviate risk in postmenopausal women. Future studies should corroborate these results to determine levels of optimal coffee consumption in

The Effects of Wiki-Based Recursive Process Writing on Chinese Narrative Essays for Chinese as a Second Language (CSL) Students in Singapore

ERIC Educational Resources Information Center

Chin, Chee Kuen; Gong, Cheng; Tay, Boon Pei

2015-01-01

This paper reports on the effects of using wiki-based process writing in Singapore's Chinese as a Second Language (CSL) scenarios. A group of 32 Secondary 1 (Seventh Grade) students ("Students") received various forms of online scaffolding at different steps of the writing process over two years. A whole set of teaching materials on 45…

Singapore High School Students' Creativity Efficacy

ERIC Educational Resources Information Center

Tan, Ai-Girl; Ho, Valerie; Yong, Lim-Chyi

2007-01-01

Background: Singapore education adopted nurturing creativity and developing creativity efficacy among their students and children. This study investigated Singapore high school students' creativity efficacy based on the contemporary model of creativity (Amabile, 1983, 1996), self efficacy (Bandura, 1989, 1997) and inclusion education. Aims:…

Adaptation of Chinese and English versions of the Psoriatic Arthritis Quality of Life (PsAQoL) scale for use in Singapore.

PubMed

Leung, Ying Ying; Thumboo, Julian; Rouse, Matthew; McKenna, Stephen P

2016-10-18

To develop Singapore Chinese and English versions of the Psoriatic Arthritis Quality of Life (PsAQoL) scale that were equivalent to and met the same psychometric and acceptability standards as the original UK measure. Translation of the original PsAQoL into contextualised English and Chinese versions for use in Singapore was performed by professional and lay translation panels. Ten Chinese speaking and ten English speaking local patients were interviewed to assess face and content validity. Psoriatic arthritis (PsA) patients (either Chinese or English speaking) fulfilling the Classification criteria of Psoriatic Arthritis were then invited to participate in a validation survey. Clinical variables, the Health Assessment Questionnaire (HAQ) and the Medical Outcome Short-form 36 (SF-36) were used as comparator instruments for convergent validity. A separate sample of PsA patients were invited to participate in a test-retest postal study, with two weeks between administrations. The validation sample included 98 patients (51 % men) with a mean (SD) age of 51.5 (13.8) years. The PsAQoL had excellent internal consistency (Cronbach's α = 0.92) and scores on the measure were moderately correlated with health status measures (pain, HAQ score, SF-36 scores) and patient and physician global assessments. The scale was able to distinguish between groups with active or inactive disease assessed by composite scores, HAQ and minimal disease activity. Test-retest reliability was excellent (r = 0.92). This study provides evidence that the adapted English and Chinese versions of the PsAQoL can be used in clinical studies with PsA patients in Singapore.

Knowledge, Attitude, and Practice of Dry Eye Treatment by Institutional Chinese Physicians in Singapore

PubMed Central

Lan, Wanwen; Lee, Sze Yee; Lee, Man Xin; Tong, Louis

2012-01-01

Dry eye is a common health problem worldwide, causing significant discomfort and inconvenience to sufferers. The conventional treatment of dry eye via topical administration of eye drops is deemed palliative and unsatisfactory to many. Traditional Chinese medicine (TCM) has shown some promise in dry eye treatment; however, the extent of its use and acceptance is uncertain. We evaluated the knowledge, attitude, and practice of institutional TCM practitioners in the treatment of dry eye in Singapore. A questionnaire was generated to address the study aims and sent to TCM practitioners listed in the Singapore TCM practitioners' board database. About three quarters of respondents thought that dry eye was not severe enough to be a public health burden but most thought that TCM was effective in the treatment of dry eye. Acupuncture and herbal medicine were most commonly used TCM modalities in dry eye treatment, and a single TCM treatment session would be charged S$20–50 by the practitioner. The majority of surveyed institutional TCM practitioners in Singapore believe that TCM is relevant in dry eye treatment. Public awareness should be raised regarding the availability of TCM as alternative medicine for dry eye. PMID:23213306

Determinants of prolactin in postmenopausal Chinese women in Singapore.

PubMed

Katz, Tiffany A; Wu, Anna H; Stanczyk, Frank Z; Wang, Renwei; Koh, Woon-Puay; Yuan, Jian-Min; Oesterreich, Steffi; Butler, Lesley M

2018-01-01

Mechanistic and observational data together support a role for prolactin in breast cancer development. Determinants of prolactin in Asian populations have not been meaningfully explored, despite the lower risk of breast cancer in Asian populations. Determinants of plasma prolactin were evaluated in 442 postmenopausal women enrolled in the Singapore Chinese Health Study, a population-based prospective cohort study. At baseline all cohort members completed an in-person interview that elicited information on diet, menstrual and reproductive history, and lifestyle factors. One year after cohort initiation we began collecting blood samples. Quantified were plasma concentrations of prolactin, estrone, estradiol, testosterone, androstenedione, and sex hormone-binding globulin (SHBG). Analysis of covariance method was used for statistical analyses with age at blood draw, time since last meal, and time at blood draw as covariates. Mean prolactin levels were 25.1% lower with older age at menarche (p value = 0.001), and 27.6% higher with greater years between menarche and menopause (p value = 0.009). Prolactin levels were also positively associated with increased sleep duration (p value = 0.005). The independent determinants of prolactin were years from menarche to menopause, hours of sleep, and the plasma hormones estrone and SHBG (all p values < 0.01). The role of prolactin in breast cancer development may involve reproductive and lifestyle factors, such as a longer duration of menstrual cycling and sleep patterns.

Psychometric analysis of an eating behaviour questionnaire for an overweight and obese Chinese population in Singapore.

PubMed

Chong, Mary Foong-Fong; Ayob, M Na'im M; Chong, Kok Joon; Tai, E-Shyong; Khoo, Chin Meng; Leow, Melvin Khee-Shing; Lee, Yung Seng; Tham, Kwang Wei; Venkataraman, Kavita; Meaney, Michael J; Wee, Hwee Lin; Khoo, Eric Yin-Hao

2016-06-01

Previous studies reveal that the Three-Factor Eating Questionnaire (TFEQ), which assesses eating behaviour, performs differently across population groups and cultures. We aimed to identify the factor structure that is most appropriate to capture eating behaviour in an overweight and obese Chinese population in Singapore. TFEQ-51 was administered to 444 Chinese subjects pooled from four separate studies and scored according to various alternative versions of the TFEQ. Confirmatory factor analyses and goodness of fit indices were used to determine the most appropriate factor structure. Known-group validity analyses were conducted. Niemeier's Disinhibition Factors and the TFEQ-R18 factor structures were found to be the most applicable in our population based on goodness of fit indices, with a x(2)/df ratio of <3, RMSEA of ≤ 0.6 and a CFI value of >0.9 for both. Only two of three factors (Emotional Eating and Uncontrolled Eating) of the TFEQ-R18 showed good internal consistency, while none of Niemeier's Disinhibition Factors showed good internal consistency. Known-group validity showed that Emotional Eating and Internal Disinhibition were significantly associated with higher BMI. We found that the TFEQ-R18 factor structure is the most appropriate and practical for use in measuring eating behaviour in an overweight and obese Chinese population in Singapore. Copyright © 2016 Elsevier Ltd. All rights reserved.

Exploring the Use of Color Photographs in Chinese Picture Composition Writings: An Action Research in Singapore Schools

ERIC Educational Resources Information Center

Qiyan, Wang; Kian Chye, Lim; Huay Lit Woo

2006-01-01

Writing picture compositions is part of the requirements for the mother tongue language learning in Singapore primary schools. For Chinese as a mother tongue, the prevailing materials used for learning picture composition are confined to only black-and-white drawn pictures. This has caused some problems: (1) not many good and suitable…

HLA association in Singapore children with Grave's disease.

PubMed

Tan Siok-Hoon; Chan Soh-Ha; Lee Bee-Wah; Wee Guan-Bock; Wong Hock-Boon

1988-06-01

HLA associations in patients with Grave's disease are B8 in whites and BW35 in Japanese. This study shows the HLA association of Singapore Chinese children with Grave's disease. Forty unrelated Chinese children with Grave's disease were typed. The control population consisted of 238 consecutive unrelated normal Chinese individuals. Patients with Grave's disease showed a significantly higher frequency of BW46 than control subjects (corrected P = .0005, relative risk (RR) = 4.61). Only two patients had BW35 and none had B8. There was an increased frequency of both homozygotes and heterozygotes in thyrotoxic patients compared with controls, the RR being slightly higher in the homozygotes. Among the patients, BW46 was most frequently associated with B40, B13, and B15. The joint occurrence of BW46/B40 in thyrotoxic children had a lower relative risk than BW46 alone, whereas the joint occurrence of BW46/B13 had a higher relative risk than BW46 alone.

Coffee, alcohol and other beverages in relation to cirrhosis mortality: the Singapore Chinese Health Study

PubMed Central

Goh, George Boon-Bee; Chow, Wan-Cheng; Renwei-Wang; Yuan, Jian-Min; Koh, Woon-Puay

2014-01-01

Limited experimental and epidemiologic data suggest that coffee may reduce hepatic damage in chronic liver disease. The association between consumption of coffee and other beverages, and risk of cirrhosis mortality was evaluated in The Singapore Chinese Health Study. This is a prospective population-based cohort of 63,275 middle-aged and older Chinese subjects who provided data on diet, lifestyle and medical histories through in-person interviews using structured questionnaire at enrollment between 1993 and 1998. Mortality from cirrhosis in the cohort was ascertained through linkage analysis with nationwide death registry. After a mean follow-up of 14.7 years, 114 subjects died from cirrhosis; 33 of them from viral hepatitis B (29%), two from hepatitis C (2%), and 14 from alcohol-related cirrhosis (12%). Compared to non-drinkers, daily alcohol drinkers had a strong dose-dependent positive association between amount of alcohol and risk of cirrhosis mortality. Conversely, there was a strong dose-dependent inverse association between coffee intake and risk of non-viral hepatitis related cirrhosis mortality (p for trend=0.014). Compared to non-daily coffee drinkers, those who drank two or more cups per day had 66% reduction in mortality risk (HR=0.34, 95% CI=0.14–0.81). However, coffee intake was not associated with hepatitis B related cirrhosis mortality. The inverse relationship between caffeine intake and nonviral hepatitis-related cirrhosis mortality became null after adjustment for coffee drinking. The consumption of black tea, green tea, fruit juices or soft drinks was not associated with risk of cirrhosis death. Conclusion This study demonstrates the protective effect of coffee on non-viral hepatitis related cirrhosis mortality, and provides further impetus to evaluate coffee as a potential therapeutic agent in patients with cirrhosis. PMID:24753005

Coffee, alcohol and other beverages in relation to cirrhosis mortality: the Singapore Chinese Health Study.

PubMed

Goh, George Boon-Bee; Chow, Wan-Cheng; Wang, Renwei; Yuan, Jian-Min; Koh, Woon-Puay

2014-08-01

Limited experimental and epidemiologic data suggest that coffee may reduce hepatic damage in chronic liver disease. The association between consumption of coffee and other beverages and risk of cirrhosis mortality was evaluated in the Singapore Chinese Health Study. This is a prospective population-based cohort of 63,275 middle-aged and older Chinese subjects who provided data on diet, lifestyle, and medical histories through in-person interviews using a structured questionnaire at enrollment between 1993 and 1998. Mortality from cirrhosis in the cohort was ascertained through linkage analysis with nationwide death registry. After a mean follow-up of 14.7 years, 114 subjects died from cirrhosis; 33 of them from viral hepatitis B (29%), two from hepatitis C (2%), and 14 from alcohol-related cirrhosis (12%). Compared to nondrinkers, daily alcohol drinkers had a strong dose-dependent positive association between amount of alcohol and risk of cirrhosis mortality. Conversely, there was a strong dose-dependent inverse association between coffee intake and risk of nonviral hepatitis-related cirrhosis mortality (P for trend = 0.014). Compared to non-daily coffee drinkers, those who drank two or more cups per day had a 66% reduction in mortality risk (hazard ratio [HR] = 0.34, 95% confidence interval [CI] = 0.14-0.81). However, coffee intake was not associated with hepatitis B-related cirrhosis mortality. The inverse relationship between caffeine intake and nonviral hepatitis-related cirrhosis mortality became null after adjustment for coffee drinking. The consumption of black tea, green tea, fruit juices, or soft drinks was not associated with risk of cirrhosis death. This study demonstrates the protective effect of coffee on nonviral hepatitis-related cirrhosis mortality, and provides further impetus to evaluate coffee as a potential therapeutic agent in patients with cirrhosis. © 2014 by the American Association for the Study of Liver Diseases.

Deep Culture Matters: Multiracialism in Singapore Schools

ERIC Educational Resources Information Center

Tan, Charlene

2012-01-01

Multiculturalism is more accurately described as "multiracialism" in Singapore as the government classifies everyone based on four racial identities according to one's paternal line: Chinese, Malay, Indian, and others. Exploring the principle and practice of multiracialism in Singapore schools, this article points out that the surface…

Suicide in the island of Singapore.

PubMed

Kua, E H; Tsoi, W F

1985-03-01

In a study of suicide in Singapore in 1980 there were 230 cases and the suicide rate for the general population was 9.5 per 100,000. The age-specific rates increased steeply after 50 years and there was a male preponderance especially in the age group 60 years and over. Comparing the three major ethnic groups in Singapore, the highest rate was seen in the Indians and Chinese, whereas the Malays had the lowest. Amongst the suicides there were 59 (25.7%) with mental illness, mainly schizophrenia, and they were of a younger age group, 20-39 years. The commonest method of suicide was jumping from high-rise flats.

Green leafy and cruciferous vegetable consumption and risk of type 2 diabetes: results from the Singapore Chinese Health Study and meta-analysis.

PubMed

Chen, Guo-Chong; Koh, Woon-Puay; Yuan, Jian-Min; Qin, Li-Qiang; van Dam, Rob M

2018-05-01

Several previous prospective studies suggest that consumption of green leafy and cruciferous vegetables may lower the risk of type 2 diabetes (T2D). We investigated the association between consumption of different types of vegetables in relation to T2D risk in an Asian Population. We included 45 411 participants (age range: 45-74 years) of the Singapore Chinese Health Study (SCHS) free of diabetes, cancer or CVD at baseline (1993-1998). Dietary information was collected using a validated FFQ. Physician-diagnosed incident diabetes was reported at follow-up I (1999-2004) and II (2006-2010) interviews. Cox proportional hazards regression was used to estimate hazard ratio (HR) and 95 % CI of T2D risk. An updated meta-analysis was also conducted to summarise results for green leafy and cruciferous vegetables. During 494 741 person-years of follow-up, 5207 incident T2D occurred. After adjustment for potential confounders, neither total vegetables (top v. bottom quintile HR=1·08; 95 % CI 0·98, 1·18, P trend=0·66) nor specific vegetables including dark green leafy vegetables (HR=1·05; 95 % CI 0·96, 1·15, P trend=0·21) and cruciferous vegetables (HR=0·97; 95 % CI 0·88, 1·06, P trend=0·29) were substantially associated with risk of T2D. A meta-analysis (eleven studies with 754 729 participants and 58 297 cases) including the SCHS and all previous prospective studies suggested borderline significant inverse associations between green leafy (summary relative risk (RR)=0·91; 95 % CI 0·84, 1·00) and cruciferous vegetable consumption (RR=0·87; 95 % CI 0·76, 1·00) and T2D risk, with moderate-to-high heterogeneity. In conclusion, green leafy or cruciferous vegetable consumption was not substantially associated with risk of T2D in an Asian population. Meta-analysis of available cohort data indicated that evidence for a beneficial effect of green leafy or cruciferous vegetable consumption on T2D risk is not convincing.

Cardiovascular responses to stress in Singapore and India.

PubMed

Kaur, Divjyot; Bishop, George D

2013-02-01

Epidemiological studies have shown significant ethnic differences in coronary heart disease death rates with South Asians showing significantly greater coronary heart disease mortality than other groups. This research examined ethnic differences in cardiovascular reactivity (CVR) among Chinese, Malays and Indians in Singapore as well as a sample of Indians living in India. Experiment 1 examined differences across 303 Chinese, Malay and Indian undergraduates in Singapore, while Experiment 2 looked at differences in CVR between Indian participants from Singapore, and 145 Indians living in India. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), cardiac index (CI) and total peripheral resistance index (TPRI) were measured during baselines and five laboratory tasks. Ethnicity main effects for SBP and CI reactivity were obtained in Experiment 1, with Indians showing significantly lower BP and CI reactivity than the Chinese and Malays. Significant main effects for sex were found with females showing lower reactivity than males for TPRI, and greater reactivity than males for HR and CI. Experiment 2 found that participants from India showed higher reactivity for SBP, HR and CI, while Indian participants from Singapore showed higher TPRI reactivity. These differences, however, often varied by task. These results point to differences in CVR among ethnic groups in Singapore as well as between Indians living in India and those living in Singapore. These differences may reflect cultural differences and need to be explored further with respect to their relationship to different rates of coronary heart disease among these groups. Copyright © 2012 Elsevier B.V. All rights reserved.

Leukocyte telomere length in relation to risk of lung adenocarcinoma incidence: Findings from the Singapore Chinese Health Study.

PubMed

Yuan, Jian-Min; Beckman, Kenneth B; Wang, Renwei; Bull, Caroline; Adams-Haduch, Jennifer; Huang, Joyce Y; Jin, Aizhen; Opresko, Patricia; Newman, Anne B; Zheng, Yun-Ling; Fenech, Michael; Koh, Woon-Puay

2018-06-01

Telomeres are crucial in the maintenance of chromosome integrity and genomic stability. Critically short telomeres can trigger programed cell death while cells with longer telomeres may have increased likelihood of replicative errors, resulting in genetic mutations and chromosomal alterations, and ultimately promoting oncogenesis. Data on telomere length and lung cancer risk from large prospective cohort studies are spare. Relative telomere length in peripheral blood leukocytes was quantified using a validated monochrome multiplex quantitative polymerase chain reaction (qPCR) method in 26,540 participants of the Singapore Chinese Health Study. After a follow-up of 12 years, 654 participants developed lung cancer including 288 adenocarcinoma, 113 squamous cell carcinoma and 253 other/unknown histological type. The Cox proportional hazard regression was used to estimate hazard ratio (HR) and 95% confidence interval (CI). HR of lung adenocarcinoma for individuals in the highest comparing the lowest 20 percentile of telomere length was 2.84 (95% CI 1.94-4.14, p trend  < 0.0001). This positive association was present in never smokers (p trend  < 0.0001), ever smokers (p trend  = 0.0010), men (p trend  = 0.0003), women (p trend  < 0.0001), and in shorter (p trend  = 0.0002) and longer (p trend  = 0.0001) duration of follow-up. There was no association between telomere length and risk of squamous cell carcinoma or other histological type of lung cancer in all or subgroups of individuals. The agreement of results from this prospective cohort study with those of previous prospective studies and Mendelian randomization studies suggest a possible etiological role of telomere length in the development of lung adenocarcinoma. © 2018 UICC.

Ship collision risk assessment for the Singapore Strait.

PubMed

Qu, Xiaobo; Meng, Qiang; Suyi, Li

2011-11-01

The Singapore Strait is considered as the bottleneck and chokepoint of the shipping routes connecting the Indian and the Pacific Ocean. Therefore, the ship collision risk assessment is of significant importance for ships passing through the narrow, shallow, and busy waterway. In this paper, three ship collision risk indices are initially proposed to quantitatively assess the ship collision risks in the Strait: index of speed dispersion, degree of acceleration and deceleration, and number of fuzzy ship domain overlaps. These three risk indices for the Singapore Strait are estimated by using the real-time ship locations and sailing speeds provide by Lloyd's MIU automatic identification system (AIS). Based on estimation of these three risk indices, it can be concluded that Legs 4W, 5W, 11E, and 12E are the most risky legs in the Strait. Therefore, the ship collision risk reduction solutions should be prioritized being implemented in these four legs. This study also finds that around 25% of the vessels sail with a speed in excess of the speed limit, which results in higher potentials of ship collision. Analysis indicates that the safety level would be significantly improved if all the vessels follow the passage guidelines. Copyright © 2011 Elsevier Ltd. All rights reserved.

An Ecologic Study of Trends in the Prevalence of Myopia in Chinese Adults in Singapore Born from the 1920s to 1980s.

PubMed

Sensaki, Sonoko; Sabanayagam, Charumathi; Verkicharla, Pavan K; Awodele, Adeola; Tan, Kok Hian; Chia, Audrey; Saw, Seang Mei

2017-06-01

This study aimed to investigate secular trends in the prevalence of myopia over 6 decades (from the 1920s to 1980s) in Chinese adults in Singapore. Parental myopia prevalence was estimated using a parent-completed questionnaire in paediatric cohorts that included: 1) The Singapore Cohort Of Risk factors for Myopia (SCORM), 2) The Strabismus, Amblyopia and Refractive Error in Singaporean Children (STARS), and 3) The Growing Up in Singapore Towards healthy Outcomes (GUSTO). Published estimates for myopia prevalence from 5 adult studies in Singapore were reviewed. Secular trends in the prevalence of myopia were correlated with changes in the education system. The prevalence of parental myopia in SCORM (n = 2943), STARS (n = 4938), and GUSTO (n = 1072) was 47.8%, 53.4%, and 73.4%, respectively; corresponding calendar years these parents might have started schooling were 1966, 1973, and 1983 (born in 1960, 1967, and 1977), respectively. Mean age of parents was 41.3, 40.1, and 33.4 years, respectively. Prevalence of myopia in adult studies in persons who started elementary school in 1928, 1934, 1938, 1939, 1942, 1948, 1952, 1958, 1962, 1972, 1982, and 1995 were 36.4%, 39.7%, 30.0%, 31.5%, 33.0%, 26.4%, 32.5%, 48.7%, 39.4%, 52.0%, 82.2%, and 85.9%, respectively. During the past few decades, the prevalence of myopia increased rapidly, especially in persons who started elementary school after the 1980s (born after 1970). The education system was expanded after Singapore's independence in 1965, and the new education system was introduced in 1978. These changes, together with increasing intensive schooling, may have contributed to the increase in myopia prevalence.

Thirty-eight years of water fluoridation--the Singapore scenario.

PubMed

Loh, T

1996-09-01

The high caries rate in Singapore school children was of great concern to dental administrators. Remedial measures alone were not the solution. The success of water fluoridation in Grand Rapids, USA and in Brantford, Canada in reducing dental caries in children in the early 1950s prompted Singapore to introduce fluoride into its drinking water. Singapore is the first country in Asia to institute a comprehensive fluoridation programme which covers 100 per cent of the population. The water was fluoridated at 0.7 ppm fluoride using sodium silicofluoride. The ten year study on the effects of water fluoridation in Singapore showed a decrease in caries prevalence in the children. In the permanent dentition the reduction was 52.3 per cent for Chinese and 31 per cent for Malays in the 7 to 9 year old age group. A similar trend was observed in the mixed dentition in which the decrease was 32.5 per cent for Chinese and 30.6 per cent for Malays. Because of the availability and use of other fluoride products, dental fluorosis was observed in children in later years. Although the decline in dental caries after 10 years of water fluoridation was not comparable to those achieved in other countries, this study further documents water fluoridation as the most cost-effective public health measure for the prevention of dental caries.

Prevalence and risk factors of depression in the elderly nursing home residents in Singapore.

PubMed

Tiong, Wei Wei; Yap, Philip; Huat Koh, Gerald Choon; Phoon Fong, Ngan; Luo, Nan

2013-01-01

Depression is a common health problem in elderly nursing home (NH) residents and is often under-recognized and under-treated. This study aimed to determine the prevalence rates of depression and identify the risk factors associated with depression in the elderly NH population in Singapore. A sample of 375 residents in six NHs in Singapore, aged 55 years and above, was assessed with the Structural Clinical Interview (SCID), based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. The association of demographic, functional and health-related characteristics with depression was examined using multivariate logistic regression analyses. Overall point prevalence for depression in the elderly NH residents was found to be 21.1% (95% confidence intervals (CI): 17.1%-25.6%). The prevalence rate for minor depression in the elderly NH residents was 14.4% (95% CI: 11.1%-18.5%) and 6.7% (95% CI: 4.5%-9.8%) for major depression. Significant risk factors that were found to be associated with depression were length of stay for more than 2 years, known history of depression, pain, and no or lack of social contact. The prevalence rates for depression were high among NH residents in Singapore. More attention is needed to care for the psychosocial needs of elderly NH residents in Singapore.

Genetic variation in peroxisome proliferator-activated receptor gamma, soy, and mammographic density in Singapore Chinese women.

PubMed

Lee, Eunjung; Hsu, Chris; Van den Berg, David; Ursin, Giske; Koh, Woon-Puay; Yuan, Jian-Min; Stram, Daniel O; Yu, Mimi C; Wu, Anna H

2012-04-01

PPARγ is a transcription factor important for adipogenesis and adipocyte differentiation. Data from animal studies suggest that PPARγ may be involved in breast tumorigenesis, but results from epidemiologic studies on the association between PPARγ variation and breast cancer risk have been mixed. Recent data suggest that soy isoflavones can activate PPARγ. We investigated the interrelations of soy, PPARγ, and mammographic density, a biomarker of breast cancer risk in a cross-sectional study of 2,038 women who were members of the population-based Singapore Chinese Health Study Cohort. We assessed mammographic density using a computer-assisted method. We used linear regression to examine the association between 26 tagging single-nucleotide polymorphisms (SNP) of PPARγ and their interaction with soy intake and mammographic density. To correct for multiple testing, we calculated P values adjusted for multiple correlated tests (P(ACT)). Out of the 26 tested SNPs in the PPARγ, seven SNPs were individually shown to be statistically significantly associated with mammographic density (P(ACT) = 0.008-0.049). A stepwise regression procedure identified that only rs880663 was independently associated with mammographic density which decreased by 1.89% per-minor allele (P(ACT) = 0.008). This association was significantly stronger in high-soy consumers as mammographic density decreased by 3.97% per-minor allele of rs880663 in high-soy consumers (P(ACT) = 0.006; P for interaction with lower soy intake = 0.017). Our data support that PPARγ genetic variation may be important in determining mammographic density, particularly in high-soy consumers. Our findings may help to identify molecular targets and lifestyle intervention for future prevention research. ©2012 AACR.

Smaller size of high metabolic rate organs explains lower resting energy expenditure in Asian-Indian Than Chinese men.

PubMed

Song, L L T; Venkataraman, K; Gluckman, P; Chong, Y S; Chee, M-W L; Khoo, C M; Leow, M-Ks; Lee, Y S; Tai, E S; Khoo, E Y H

2016-04-01

In Singapore, the obesity prevalence is disproportionately higher in the Asian-Indians and Malays than the Chinese. Lower resting energy expenditure (REE) may be a contributory factor. We explored the association between ethnicity and REE in Chinese, Asian-Indian and Malay men living in Singapore and determined the influence of body composition, mass/volume of high metabolic rate organs, represented by brain volume and trunk fat-free mass (FFM), and physical activity on ethnic differences. Two hundred and forty-four men from Singapore (n=100 Chinese, 70 Asian-Indians and 74 Malays), aged 21-40 years and body mass index of 18.5-30.0 kg m(-2), were recruited in this cross-sectional study. REE was assessed by indirect calorimetry and body composition by dual-energy X-ray absorptiometry. Brain volume was measured by magnetic resonance imaging. Physical activity was assessed by the Singapore Prospective Study Program Physical Activity Questionnaire. REE was significantly lower in Asian-Indians compared with that in Chinese after adjusting for body weight. FFM (total, trunk and limb) and total fat mass were important predictors of REE across all ethnic groups. Brain volume was positively associated with REE only in Malays. Moderate and vigorous physical activity was positively associated with REE only in Asian-Indians and Malays. The difference in REE between Asian-Indians and Chinese was attenuated but remained statistically significant after adjustment for total FFM (59±20 kcal per day), fat mass (67±20 kcal per day) and brain volume (54±22 kcal per day). The association between REE and ethnicity was no longer statistically significant after total FFM was replaced by trunk FFM (which includes heart, liver, kidney and spleen) but not when it was replaced by limb FFM (skeletal muscle). We have demonstrated a lower REE in Asian-Indians compared with Chinese who may contribute to the higher rates of obesity in the former. This difference could be accounted for

Heterocyclic aromatic amines in domestically prepared chicken and fish from Singapore Chinese households.

PubMed

Salmon, C P; Knize, M G; Felton, J S; Zhao, B; Seow, A

2006-04-01

Chicken and fish samples prepared by 42 Singapore Chinese in their homes were obtained. Researchers were present to collect data on raw sample weight, cooking time, maximum cooking surface temperature, and cooked sample weight. Each participant prepared one pan-fried fish sample and two pan-fried chicken samples, one marinated, one not marinated. The cooked samples were analyzed for five heterocyclic aromatic amine (HAA) mutagens, including MeIQx (2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline); 4,8-DiMeIQx (2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline); 7,8-DiMeIQx (2-amino-3,7,8-trimethylimidazo[4,5-f]quinoxaline); PhIP (2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine), and IFP (2-amino-(1,6-dimethylfuro[3,2-e]imidazo[4,5-b])pyridine). A paired Student's t-test showed that marinated chicken had lower concentrations of PhIP (p<0.05), but higher concentrations of MeIQx (p<0.05) and 4,8-DiMeIQx (p<0.001) than non-marinated chicken, and also that weight loss due to cooking was less in marinated chicken than in non-marinated chicken (p<0.001). Interestingly, the maximum cooking surface temperature was higher for fish than for either marinated or non-marinated chicken (p<0.001), yet fish was lower in 4,8-DiMeIQx per gram than marinated or non-marinated chicken (p<0.001), lower in PhIP than non-marinated chicken (p<0.05), and lost less weight due to cooking than either marinated or non-marinated chicken (p<0.001). Fish was also lower in MeIQx and 7,8-DiMeIQx than marinated chicken (p<0.05). This study provides new information on HAA content in the Singapore Chinese diet.

Heterocyclic Aromatic Amines in Domestically Prepared Chicken and Fish from Singapore Chinese Households

DOE Office of Scientific and Technical Information (OSTI.GOV)

Salmon, C P; Knize, M G; Felton, J S

Chicken and fish samples prepared by 42 Singapore Chinese in their homes were obtained. Researchers were present to collect data on raw meat weight, cooking time, maximum cooking surface temperature, and cooked meat weight. Each participant prepared one pan-fried fish sample and two pan-fried chicken samples, one marinated, one not marinated. The cooked samples were analyzed for five heterocyclic aromatic amine (HAA) mutagens, including MeIQx (2-amino 3,8-dimethylimidazo[4,5-f]quinoxaline); 4,8-DiMeIQx (2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline); 7,8-DiMeIQx (2-amino-3,7,8-trimethylimidazo[4,5-f]quinoxaline); PhIP (2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine), and IFP (2-amino-(1,6-dimethylfuro[3,2-e]imidazo [4,5-b])pyridine). A paired Student's t-test showed that marinated chicken had lower concentrations of PhIP (p<0.05), but higher concentrations of MeIQx (p<0.05) and 4,8-DiMeIQx (p<0.001)more » than non-marinated chicken, and also that weight loss due to cooking was less in marinated chicken than in non-marinated chicken (p<0.001). Interestingly, the maximum cooking surface temperature was higher for fish than for either marinated or non-marinated chicken (P<0.001), yet fish was lower in 4,8-DiMeIQx per gram than marinated or non-marinated chicken (p<0.001), lower in PhIP than non-marinated chicken (P<0.05), and lost less weight due to cooking than either marinated or non-marinated chicken (P<0.001). Fish was also lower in MeIQx and 7,8-DiMeIQx than marinated chicken (P<0.05). This study provides new information on HAA content in the Singapore Chinese diet.« less

Singapore Language Enhancer: Identity Included

ERIC Educational Resources Information Center

Wee, Desmond

2009-01-01

This article explores the rhetoric of the four official languages (English, Mandarin, Malay and Tamil) in Singapore and the domestic aversion towards Chinese "dialects" and colloquial "Singlish". The "Speak Mandarin Campaign" alongside the "Speak Good English Movement" represent a display of intercultural…

Prevalence, racial variations, and risk factors of age-related macular degeneration in Singaporean Chinese, Indians, and Malays.

PubMed

Cheung, Chui Ming Gemmy; Li, Xiang; Cheng, Ching-Yu; Zheng, Yingfeng; Mitchell, Paul; Wang, Jie Jin; Wong, Tien Yin

2014-08-01

To describe the prevalence and risk factors for age-related macular degeneration (AMD) in a multiethnic Asian cohort of Chinese, Malay, and Indian persons. Population-based cross-sectional study. A total of 10 033 persons (3280 Malay, 3400 Indian, and 3353 Chinese; response rate, 75%) 40 years of age or older residing in Singapore. We performed comprehensive systemic and ocular examinations, retinal photography, and laboratory investigations for all participants. We graded early and late AMD signs from retinal photographs using the modified Wisconsin AMD grading scale. We calculated the age-standardized prevalence of AMD using the 2010 Singapore adult population and analyzed risk factors for AMD using logistic regression models. Early and late AMD. Of the 9799 participants with gradable photographs, 588 had early AMD and 60 had late AMD. The age-standardized prevalence was 5.1% (95% confidence interval [CI], 4.6-5.5) for early AMD and 0.5% (95% CI, 0.4-0.6) for late AMD. The prevalence of early AMD was similar between Chinese (5.7%) and Indian (4.5%; P = 0.27) persons and lower in Malays (3.5%; P = 0.002 compared with Chinese; P = 0.09 compared with Indians); in contrast, the prevalence for late AMD was similar across ethnic groups (Chinese, 0.6%; Indian, 0.3%; and Malay, 0.3%; P = 0.20). Risk factors for early AMD were older age (odds ratio [OR], 1.40 per 5-year increase in age; 95% CI, 1.33-1.47), male gender (OR, 1.81; 95% CI, 1.43-2.29), hypertension (OR, 1.28; 95% CI, 1.02-1.61), and hyperopic refraction (OR, 1.17 per 1-diopter increase in spherical equivalent; 95% CI, 1.11-1.24). Risk factors for late AMD include older age (OR, 1.87 per 5-year increase in age; 95% CI, 1.54-2.19), smoking more than 5 packs per week (OR, 3.63; 95% CI, 1.34-9.80), and presence of chronic kidney disease (OR, 2.17; 95% CI, 1.22-3.88). Early AMD is more common in Chinese and Indians than in Malays, but there were no racial variations in the prevalence of late AMD. Copyright © 2014

Levels of cardiovascular disease risk factors in Singapore following a national intervention programme.

PubMed Central

Cutter, J.; Tan, B. Y.; Chew, S. K.

2001-01-01

OBJECTIVE: To evaluate the impact of the National Healthy Lifestyle Programme, a noncommunicable disease intervention programme for major cardiovascular disease risk factors in Singapore, implemented in 1992. METHODS: The evaluation was carried out in 1998 by the Singapore National Health Survey (NHS). The reference population was 2.2 million multiracial Singapore residents, 18-69 years of age. A population-based survey sample (n = 4723) was selected by disproportionate stratified and systematic sampling. Anthropometric and blood pressure measurements were carried out on all subjects and blood samples were taken for biochemical analysis. FINDINGS: The 1998 results suggest that the National Healthy Lifestyle Programme significantly decreased regular smoking and increased regular exercise over 1992 levels and stabilized the prevalence of obesity and diabetes mellitus. However, the prevalence of high total blood cholesterol and hypertension increased. Ethnic differences in the prevalence of diabetes mellitus, hypertension, and smoking; and in lipid profile and exercise levels were also observed. CONCLUSION: The intervention had mixed results after six years. Successful strategies have been continued and strengthened. PMID:11693972

The Alternative Healthy Eating Index Is Associated with a Lower Risk of Fatal and Nonfatal Acute Myocardial Infarction in a Chinese Adult Population123

PubMed Central

Neelakantan, Nithya; Naidoo, Nasheen; Koh, Woon-Puay; Yuan, Jian-Min; van Dam, Rob M

2016-01-01

Background: Indexes to quantify adherence to recommended dietary patterns have been developed for Western populations, but it is unclear whether these indexes can predict acute myocardial infarction (AMI) in Asian populations. Objectives: We aimed to investigate the association between the Alternative Healthy Eating Index (AHEI)–2010 and risk of AMI and to evaluate potential mediation by traditional cardiovascular risk factors in a Chinese population. Methods: A nested case-control study in 751 incident cases of AMI (564 nonfatal and 288 fatal) and 1443 matched controls was conducted within the prospective Singapore Chinese Health Study, a cohort of ethnic Chinese men and women aged 45–75 y. At baseline, habitual diet was assessed by using a validated, semiquantitative food-frequency questionnaire. AMI cases were ascertained via linkage with nationwide hospital databases (confirmed through medical record review) and the Singapore Birth and Death Registry. We evaluated the association between the AHEI-2010 and cardiovascular risk factors, including glycated hemoglobin, high-sensitivity C-reactive protein, creatinine, plasma lipids (LDL and HDL cholesterol, triglycerides), and blood pressure. ORs and 95% CIs were computed by using multivariable-adjusted conditional logistic regression models. Results: Higher AHEI-2010 scores were associated with a lower risk of AMI (OR for the highest quartile compared with the lowest quartile: 0.62; 95% CI: 0.47, 0.81; P-trend < 0.001), with similar associations for fatal (OR: 0.60; 95% CI: 0.39, 0.94; P-trend = 0.009) and nonfatal (OR: 0.59; 95% CI: 0.43, 0.81; P-trend = 0.002) AMI. This association was only slightly attenuated after adjustment for potential biological intermediates (OR: 0.64; 95% CI: 0.48, 0.86; P-trend = 0.003). Conclusions: Adherence to dietary recommendations as reflected in the AHEI-2010 was associated with a substantially lower risk of fatal and nonfatal AMI in an Asian population, and this association

Ethnicity Modifies Associations between Cardiovascular Risk Factors and Disease Severity in Parallel Dutch and Singapore Coronary Cohorts

PubMed Central

Gijsberts, Crystel M.; Seneviratna, Aruni; de Carvalho, Leonardo P.; den Ruijter, Hester M.; Vidanapthirana, Puwalani; Sorokin, Vitaly; Stella, Pieter; Agostoni, Pierfrancesco; Asselbergs, Folkert W.; Richards, A. Mark; Low, Adrian F.; Lee, Chi-Hang; Tan, Huay Cheem; Hoefer, Imo E.; Pasterkamp, Gerard; de Kleijn, Dominique P. V.; Chan, Mark Y.

2015-01-01

Background In 2020 the largest number of patients with coronary artery disease (CAD) will be found in Asia. Published epidemiological and clinical reports are overwhelmingly derived from western (White) cohorts and data from Asia are scant. We compared CAD severity and all-cause mortality among 4 of the world’s most populous ethnicities: Whites, Chinese, Indians and Malays. Methods The UNIted CORoNary cohort (UNICORN) simultaneously enrolled parallel populations of consecutive patients undergoing coronary angiography or intervention for suspected CAD in the Netherlands and Singapore. Using multivariable ordinal regression, we investigated the independent association of ethnicity with CAD severity and interactions between risk factors and ethnicity on CAD severity. Also, we compared all-cause mortality among the ethnic groups using multivariable Cox regression analysis. Results We included 1,759 White, 685 Chinese, 201 Indian and 224 Malay patients undergoing coronary angiography. We found distinct inter-ethnic differences in cardiovascular risk factors. Furthermore, the associations of gender and diabetes with severity of CAD were significantly stronger in Chinese than Whites. Chinese (OR 1.3 [1.1–1.7], p = 0.008) and Malay (OR 1.9 [1.4–2.6], p<0.001) ethnicity were independently associated with more severe CAD as compared to White ethnicity. Strikingly, when stratified for diabetes status, we found a significant association of all three Asian ethnic groups as compared to White ethnicity with more severe CAD among diabetics, but not in non-diabetics. Crude all-cause mortality did not differ, but when adjusted for covariates mortality was higher in Malays than the other ethnic groups. Conclusion In this population of individuals undergoing coronary angiography, ethnicity is independently associated with the severity of CAD and modifies the strength of association between certain risk factors and CAD severity. Furthermore, mortality differs among ethnic groups

The incidence of neuro-ophthalmic diseases in Singapore: a prospective study in public hospitals.

PubMed

Lim, Su Ann; Wong, Wan Ling; Fu, Esther; Goh, Kong Yong; Seah, Alvin; Tan, Clement; Tow, Sharon; Cullen, James F; Wong, Tien Y

2009-01-01

To describe the incidence of neuro-ophthalmic diseases in a multi-ethnic Asian population in Singapore. Prospective study in public hospitals in Singapore. All neuro-ophthalmic cases seen in four public sector hospitals over a 22-month period (September 2002 to June 2004) were identified using a standardized protocol. The 2004 Singapore population was used as a denominator to estimate annual incidence. The prevalence of ischemic risk factors (hypertension, diabetes, and hypercholesterolemia) among cases was compared to population data. A total of 1,356 patients with neuro-ophthalmic diseases were seen during the study period, of which 627 were new incident cases. The overall annual incidence of neuro-ophthalmic diseases was 9.81 per 100,000 (95% confidence interval, 8.80-10.90). The incidence increased with age. After controlling for age, the annual incidence was similar between men (10.75 per 100,000) and women (9.00 per 100,000), but was higher in Chinese (10.33 per 100,000) and Indians (9.34 per 100,000) than in Malays (6.62 per 100,000). The three commonest specific neuro-ophthalmic conditions were abducens nerve palsy (1.27 per 100,000), anterior ischemic optic neuropathy (1.08 per 100,000) and oculomotor nerve palsy (0.91 per 100,000). The incidence of optic neuritis was 0.83 per 100,000. Compared with the Singapore general population, the prevalence of diabetes was significantly higher in people aged 40-59, while the prevalence of hypercholesterolemia was significantly higher in 60-69 year age group. In this study of public hospitals in Singapore, the incidence of neuro-ophthalmic diseases was higher in Chinese and Indians compared to Malays.

The relationship of hostility, negative affect and ethnicity to cardiovascular responses: an ambulatory study in Singapore.

PubMed

Enkelmann, Hwee Chong; Bishop, George D; Tong, Eddie M W; Diong, Siew Maan; Why, Yong Peng; Khader, Majeed; Ang, Jansen

2005-05-01

This study tested the hypotheses that ambulatory heart rate and blood pressure would be higher for individuals high but not low in hostility when they experienced negative affect or social stress and that this interaction would be stronger for Indians compared with other Singapore ethnic groups. Ambulatory blood pressure monitoring was done on 108 male Singapore patrol officers as they went about their daily duties. After each BP measurement participants completed a computerized questionnaire including items on emotional experience. Individuals high in hostility showed higher systolic blood pressure when reporting negative affect whereas this was not true for those low in hostility. Ethnic differences were obtained such that Indians showed an increase in mean arterial pressure when angered whereas MAP was negatively related to anger for Malays and unrelated for Chinese. Also a three-way interaction between ethnicity, hostility, and social stress indicated that hostility and social stress interacted in their effects on DBP for Indian participants but not for Chinese or Malays. Finally, a three-way interaction was obtained between ethnicity, hostility and negative affect for heart rate in which heart rate increased with increasing levels of negative affect for Chinese high in hostility and Malays low in hostility but decreased with increasing negative affect for all other participants. These data are consistent with higher CHD rates among individuals high in hostility and also provide additional evidence on ethnic differences in cardiovascular reactivity in Singapore.

Towards a Typology of At-Risk Students: A Case Study in Singapore

ERIC Educational Resources Information Center

Dobele, Angela R.; Kopanidis, Foula; Gangemi, Michael; Thomas, Stuart; Janssen, Rabea; Blasche, Rose E.

2012-01-01

The purpose of this study is to examine at-risk students and the reasons they give to explain their poor academic performance, with a view to developing a typology of at-risk students. A case study methodology was used to investigate the total population of at-risk students for Semester 2, 2008 studying at the Singapore campus of an…

Sexual coercion and health-risk behaviors among urban Chinese high school students

PubMed Central

Song, Yi; Ji, Cheng-Ye; Agardh, Anette

2014-01-01

Objective To determine the association between health-risk behaviors and a history of sexual coercion among urban Chinese high school students. Design A cross-sectional study was performed among 109,754 high school students who participated in the 2005 Chinese Youth Risk Behavior Survey. Data were analyzed for 5,215 students who had experienced sexual intercourse (1,483 girls, 3,732 boys). Multivariate logistic regression was used to determine the relationship between sexual coercion and the related covariates, and data were stratified by gender. Results Of those students who had had sexual intercourse, 40.9% of the females and 29.6% of the males experienced sexual coercion (p<0.01). When analyses controlled for demographic characteristics, in the study sample, that is, students who had sexual intercourse, drug use (odds ratios [OR], 2.44), attempted suicide (OR, 2.30), physical abuse (OR, 1.74), binge drinking (OR, 1.62), verbal abuse (OR, 1.29), experience of being drunk (OR, 0.68), and smoking of cigarettes (OR, 0.52) were related to a history of sexual coercion. Patterns of health-risk behaviors also differed among female and male students who had experienced sexual coercion. Conclusions Sexual coercion is associated with health-risk behaviors. Initiatives to reduce the harm associated with sexual coercion among high school students are needed. PMID:24836445

Prevalence and risk factors for age-related macular degeneration in Indians: a comparative study in Singapore and India.

PubMed

Gemmy Cheung, Chui Ming; Li, Xiang; Cheng, Ching-Yu; Zheng, Yingfeng; Mitchell, Paul; Wang, Jie Jin; Jonas, Jost B; Nangia, Vinay; Wong, Tien Yin

2013-04-01

To compare the prevalence and risk factors for age-related macular degeneration (AMD) in 2 Indian populations, 1 living in urban Singapore and 1 in rural central India. Population-based, cross-sectional studies of Indians aged 40+ years. Our analysis included 3337 Singapore-residing participants and 3422 India-residing participants. All participants underwent comprehensive systemic and ocular examinations and retinal photography. AMD was graded from retinal photographs according to the Wisconsin Age-Related Maculopathy Grading System. Systemic and ocular risk factors were assessed for association with AMD. Singapore-residing participants were older (mean age 57.8 years vs 53.8 years) and, after adjusting for age and sex, were more likely to have previous cataract surgery, higher body mass index, hypertension, diabetes, previous myocardial infarction, higher cholesterol, and lower creatinine levels, but less likely to be current smokers, than India-residing participants. The age-standardized prevalence of early and late AMD was 4.45% and 0.34%, respectively, in Singapore and 5.80% and 0.16%, respectively, in India. Shorter axial length was associated with early AMD in both Singapore and India, whereas previous cataract surgery, higher body mass index, hypertension, and lower cholesterol were associated with early AMD in Singapore but not in India. The prevalence of AMD was similar among Indian adults living in urban Singapore and rural India, despite differences in cardiovascular risk factor profile and demographics. Copyright © 2013 Elsevier Inc. All rights reserved.

Misidentifying Factors Underlying Singapore's High Test Scores

ERIC Educational Resources Information Center

Usiskin, Zalman

2012-01-01

Singapore students have scored exceedingly well on international tests in mathematics. In response, there has been a desire in the United States--both at the policy level and at the school level--to emulate Singapore. Because what can be identified most easily about Singapore's school mathematics can be gleaned from curriculum documents from the…

The contribution of recently identified adult BMI risk loci to paediatric obesity in a Singaporean Chinese childhood dataset.

PubMed

Dorajoo, R; Ong, R T-H; Sim, X; Wang, L; Liu, W; Tai, E S; Liu, J; Saw, S-M

2017-12-01

Recent genome-wide association studies have identified 103 adult obesity risk loci; however, it is unclear if these findings are relevant to East-Asian childhood body mass index (BMI) levels. We evaluated for paediatric obesity associations at these risk loci utilizing genome-wide data from Chinese childhood subjects in the Singapore Cohort study Of the Risk factors for Myopia study (N = 1006). A weighted gene-risk score of all adult obesity risk loci in the Singapore Cohort study Of the Risk factors for Myopia study showed strong associations with BMI at age 9 (p-value = 3.40 × 10 -12 ) and 4-year average BMI (age 9 to 12, p-value = 6.67 × 10 -8 ). Directionally consistent nominal associations for 15 index single nucleotide polymorphisms (SNPs) (p-value < 0.05) were observed. Pathway analysis with genes from these 15 replicating loci revealed over-representation for the G-protein-coupled receptor (GPCR)-mediated integration of entero-endocrine signalling pathway exemplified by L-cell (adjusted p-value = 0.018). Evaluations of birth weight to modify the effects of BMI risk SNPs in paediatric obesity did not reveal significant interactions, and these SNPs were generally not associated with birth weight. At least some common adult BMI risk variants predispose to paediatric obesity risk in East-Asians. © 2016 World Obesity Federation.

Establishing multiple omics baselines for three Southeast Asian populations in the Singapore Integrative Omics Study.

PubMed

Saw, Woei-Yuh; Tantoso, Erwin; Begum, Husna; Zhou, Lihan; Zou, Ruiyang; He, Cheng; Chan, Sze Ling; Tan, Linda Wei-Lin; Wong, Lai-Ping; Xu, Wenting; Moong, Don Kyin Nwe; Lim, Yenly; Li, Bowen; Pillai, Nisha Esakimuthu; Peterson, Trevor A; Bielawny, Tomasz; Meikle, Peter J; Mundra, Piyushkumar A; Lim, Wei-Yen; Luo, Ma; Chia, Kee-Seng; Ong, Rick Twee-Hee; Brunham, Liam R; Khor, Chiea-Chuen; Too, Heng Phon; Soong, Richie; Wenk, Markus R; Little, Peter; Teo, Yik-Ying

2017-09-21

The Singapore Integrative Omics Study provides valuable insights on establishing population reference measurement in 364 Chinese, Malay, and Indian individuals. These measurements include > 2.5 millions genetic variants, 21,649 transcripts expression, 282 lipid species quantification, and 284 clinical, lifestyle, and dietary variables. This concept paper introduces the depth of the data resource, and investigates the extent of ethnic variation at these omics and non-omics biomarkers. It is evident that there are specific biomarkers in each of these platforms to differentiate between the ethnicities, and intra-population analyses suggest that Chinese and Indians are the most biologically homogeneous and heterogeneous, respectively, of the three groups. Consistent patterns of correlations between lipid species also suggest the possibility of lipid tagging to simplify future lipidomics assays. The Singapore Integrative Omics Study is expected to allow the characterization of intra-omic and inter-omic correlations within and across all three ethnic groups through a systems biology approach.The Singapore Genome Variation projects characterized the genetics of Singapore's Chinese, Malay, and Indian populations. The Singapore Integrative Omics Study introduced here goes further in providing multi-omic measurements in individuals from these populations, including genetic, transcriptome, lipidome, and lifestyle data, and will facilitate the study of common diseases in Asian communities.

Implementation of the Risk-Need-Responsivity Framework across the Juvenile Justice Agencies in Singapore.

PubMed

Chua, Jonathan Raphacis; Chu, Chi Meng; Yim, Grace; Chong, Dominic; Teoh, Jennifer

2014-11-02

The Risk-Need-Responsivity (RNR) framework is regarded as the forefront of offender rehabilitation in guiding youth offender risk assessment and interventions. This article discusses the juvenile justice system in Singapore and the local research that has been conducted in relation to the RNR framework and the associated Youth Level of Service (YLS) measures. It describes a journey that saw the implementation of the RNR framework across the juvenile justice agencies and highlights the challenges that were faced during the implementation process on the ground. Finally, the article concludes by providing future directions for the implementation of the RNR framework in Singapore.

Online Learning in Singapore Primary Schools: An Interview with Seng Chee Tan

ERIC Educational Resources Information Center

Hawthorne, Elizabeth; Tan, Seng Chee

2005-01-01

The Southeast Asian country of Singapore comprises a main island and numerous islets between Malaysia and Indonesia. Inhabited by Chinese, Malays, Indians, Eurasians, and other ethnic populations, Singapore is a vibrant mix of different cultures and religions. It is also reputed to be the most wired island in the world. This characteristic--along…

Assessment of the risk posed to Singapore by the 2015 Middle East respiratory syndrome outbreak in the Republic of Korea.

PubMed

Zhang, Emma Xuxiao; Oh, Olivia Seen Huey; See, Wanhan; Raj, Pream; James, Lyn; Khan, Kamran; Tey, Jeannie Su Hui

2016-01-01

To assess the public health risk to Singapore posed by the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea in 2015. The likelihood of importation of MERS cases and the magnitude of the public health impact in Singapore were assessed to determine overall risk. Literature on the epidemiology and contextual factors associated with MERS coronavirus infection was collected and reviewed. Connectivity between the Republic of Korea and Singapore was analysed. Public health measures implemented by the two countries were reviewed. The epidemiology of the 2015 MERS outbreak in the Republic of Korea remained similar to the MERS outbreaks in Saudi Arabia. In addition, strong infection control and response measures were effective in controlling the outbreak. In view of the air traffic between Singapore and MERS-affected areas, importation of MERS cases into Singapore is possible. Nonetheless, the risk of a serious public health impact to Singapore in the event of an imported case of MERS would be mitigated by its strong health-care system and established infection control practices. The MERS outbreak was sparked by an exported case from the Middle East, which remains a concern as the reservoir of infection (thought to be camels) continues to exist in the Middle East, and sporadic cases in the community and outbreaks in health-care settings continue to occur there. This risk assessment highlights the need for Singapore to stay vigilant and to continue enhancing core public health capacities to detect and respond to MERS coronavirus.

A cohort study to analyze the risk of venous thromboembolism mortality in patients admitted to the general medicine department, tan tock seng hospital, singapore.

PubMed

Sule, Ashish Anil; Chin, Tay Jam; Sinnathamby, Letchumi; Lee, Hwei Khien; Earnest, Arul

2011-06-01

The purpose of this study was to assess the risk of venous thromboembolism (VTE) in patients admitted to the Tan Tock Seng Hospital (TTSH), Singapore during October and November 2009. The primary outcome assessed was mortality due to VTE, or development of deep vein thrombosis or pulmonary embolism (PE) within 3 months from the day of admission. Both univariate and multivariate analyses were performed for all-cause mortality and deaths associated with PE. Seven hundred twenty-one patients admitted to the 5th floor of the General Medicine Department, TTSH, during the 2 months were analyzed. There were 368 (51.04%) female patients and 353 (48.96%) male patients. As per race distribution, 566 (78.50%) patients were Chinese, 100 (13.86%) patients were Malaysians, 46 (6.38%) patients were Indians, and 9 (1.26%) were other races. Four hundred ninety-two (68.24%) were independent for activities of daily living (ADL) and 229 (31.76%) were dependent for all ADL. There were in all 42 deaths. There were definite PE deaths in 2 (4.76%) patients, probable PE deaths in 3 (7.14%) patients, and suspected PE deaths in 8 (19.05%) patients. Twenty (47.62%) deaths were due to pneumonia, 3 (7.14%) deaths were due to urinary tract infections, and 4 (9.52%) deaths were due to other infections. Two (4.76%) deaths were due to myocardial infarction. The risk of VTE was high in acutely ill patients admitted to the General Medicine Department, TTSH, Singapore. The factors that predispose patients to a very high risk are ADL dependence, acute heart failure, past history of VTE, or if they are clinically dehydrated and have acute renal failure. This warrants increased awareness and need for VTE prophylaxis.

Systolic blood pressure and cardiovascular mortality in middle-aged and elderly adults - The Singapore Chinese Health Study.

PubMed

Koh, Angela S; Talaei, Mohammad; Pan, An; Wang, Renwei; Yuan, Jian-Min; Koh, Woon-Puay

2016-09-15

While elevated systolic blood pressure (SBP) is related to cardiovascular disease (CVD) mortality, it is unclear if the optimal SBP level may differ by age or the presence of underlying CVD. We investigated the association between SBP categories and CVD mortality among middle-aged and elderly adults with and without CVD history. We used data from 30,692 participants of the population-based Singapore Chinese Health Study who had blood pressures measured using a standard protocol at ages 48-85years between 1994 and 2005. Information on lifestyle factors were collected at recruitment (1993-1998) and during follow-up interviews (1999 and 2004). Mortality was identified via nationwide registry linkage up to 31 December 2014. SBP 120-139mmHg category was associated with lowest risk of CVD mortality in both age-groups of <60 and 60+years, as well as in those with and without underlying coronary heart disease or stroke. Overall, compared to this category, CVD risk was non-significantly increased in lower SBP categories and significantly increased in the higher SBP categories. The risk estimates associated with elevated SBP were higher among those <60years compared to their older counterparts, but less distinct between those with and without underlying CVD. SBP 120-139mmHg was associated with the lowest risk of CVD mortality in middle aged and elderly adults, regardless of underlying CVD. Although risks in both adult groups were similar, there is a greater risk associated with higher SBP among those aged below 60years, highlighting a greater urgency of treatment in this younger group. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Assessment of the risk posed to Singapore by the 2015 Middle East respiratory syndrome outbreak in the Republic of Korea

PubMed Central

Zhang, Emma Xuxiao; Oh, Olivia Seen Huey; See, Wanhan; Raj, Pream; James, Lyn; Khan, Kamran

2016-01-01

Objective To assess the public health risk to Singapore posed by the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea in 2015. Methods The likelihood of importation of MERS cases and the magnitude of the public health impact in Singapore were assessed to determine overall risk. Literature on the epidemiology and contextual factors associated with MERS coronavirus infection was collected and reviewed. Connectivity between the Republic of Korea and Singapore was analysed. Public health measures implemented by the two countries were reviewed. Results The epidemiology of the 2015 MERS outbreak in the Republic of Korea remained similar to the MERS outbreaks in Saudi Arabia. In addition, strong infection control and response measures were effective in controlling the outbreak. In view of the air traffic between Singapore and MERS-affected areas, importation of MERS cases into Singapore is possible. Nonetheless, the risk of a serious public health impact to Singapore in the event of an imported case of MERS would be mitigated by its strong health-care system and established infection control practices. Discussion The MERS outbreak was sparked by an exported case from the Middle East, which remains a concern as the reservoir of infection (thought to be camels) continues to exist in the Middle East, and sporadic cases in the community and outbreaks in health-care settings continue to occur there. This risk assessment highlights the need for Singapore to stay vigilant and to continue enhancing core public health capacities to detect and respond to MERS coronavirus. PMID:27508087

A comparative study of clinical characteristics, work-up, treatment, and association to malignancy in dermatomyositis between two tertiary skin centers in the USA and Singapore.

PubMed

Yosipovitch, Gil; Tan, Audrey; LoSicco, Katherine; Manabat, Catherine G; Kannagra, Ajith; Carroll, Christie; Chan, Yiong Huak; Ng, Patricia; Jorizzo, Joseph

2013-07-01

To date, no study has compared the clinical characteristics, malignancy associations, and treatment of dermatomyositis in predominantly Caucasian vs. Asian populations. This prospective study was conducted to compare clinical characteristics of dermatomyositis, its relationship to malignancy, and treatment between two tertiary medical centers in the USA and Singapore. A total of 19 newly-diagnosed patients in the USA and 15 patients in Singapore were enrolled. Dermatomyositis or amyopathic dermatomyositis were diagnosed based on clinical assessment, skin and muscle biopsies, and muscle testing. Ninety-five percent of patients in the USA group were of Caucasian descent, while 93% of patients in the Singapore group were of Chinese descent. Both groups were predominantly female. Pruritus was the most common initial symptom reported in both groups, while periungual erythema and Gottron's papules were the most common skin presentations. Heliotrope eruption was more common in the Singapore group, occurring in 80% of patients vs. 32% of patients in the USA group (P = 0.007). Three patients in the Singapore group developed a malignancy, with two of these patients having nasopharyngeal carcinoma. None of the USA patients developed malignancies in a follow- up period of 2-5 years. Immunosuppressive steroid sparing therapy with hydroxychloroquine was more frequently used in Singapore, while topical tacrolimus was more frequently used in the USA. The clinical presentations of dermatomyositis vary among different ethnic populations. Chinese patients with dermatomyositis have a significant risk for nasopharyngeal carcinoma. © 2012 The International Society of Dermatology.

Survey on the knowledge of age-related macular degeneration and its risk factors among Singapore residents.

PubMed

Sanjay, Srinivasan; Neo, Hui Yee; Sangtam, Tiakumzuk; Ku, Jae Yee; Chau, Shirley Y M; Rostihar, Abdul Karim; Au Eong, Kah-Guan

2009-11-01

To assess the awareness of age-related macular degeneration (AMD) and its risk factors among Singapore residents. A cross-sectional questionnaire-based telephone survey was conducted to ascertain the awareness of AMD with regards to knowledge of the disease entity and possible risk factors among Singapore residents. A Singapore residential telephone directory was used to identify potential households by choosing the first and last entries on randomly selected pages. Respondents included individuals from households with landline telephone connection who were willing to participate in the study after a brief introduction about the study. Verbal consent was sought before proceeding with the interview. Interpreters were used for respondents whose ability to converse in English was limited. Prior to commencement of the study, the protocol was reviewed and approved by Ethics committee of the Domain Specific Review Board. The interviewers contacted 796 subjects from different households, of which 520 participated (response rate, 65.3%). The age of the respondents ranged from 18 to 85 (median 41) years. Only 38 (7.3%) of them were aware of AMD, the majority of whom had completed secondary or higher education. Two hundred (38.5%) and 191 (36.7%) of the respondents considered age and smoking, respectively, to be risk factors for AMD. The awareness of AMD among Singapore residents is low. AMD awareness needs to be improved by educational programmes designed for this specific purpose.

A Comparison of Practices During the Confinement Period among Chinese, Malay, and Indian Mothers in Singapore

PubMed Central

Fok, Doris; Aris, Izzuddin M.; Ho, Jiahui; Lim, Sok Bee; Chua, Mei Chien; Pang, Wei Wei; Saw, Seang-Mei; Kwek, Kenneth; Godfrey, Keith M.; Kramer, Michael S.; Chong, Yap Seng

2016-01-01

Background Confinement (restrictions placed on diet and practices during the month right after delivery) represents a key feature of Asian populations. Few studies however, have focused specifically on ethnic differences in confinement practices. This study assesses the confinement practices of three ethnic groups in a multi-ethnic Asian population. Methods Participants were part of a prospective birth cohort study that recruited 1247 pregnant women (57.2% Chinese, 25.5% Malay, 17.3% Indian) during their first trimester. 1220 participants were followed up 3-weeks postpartum at home when questionnaires were administered to ascertain the frequency of adherence to the following confinement practices: showering; confinement-specific meals; going out with or without the baby; choice of caregiver assistance; and the use of massage therapy. Results Most participants reported that they followed confinement practices during the first three weeks post-partum (Chinese: 96.4%, Malay: 92.4%, Indian: 85.6%). Chinese and Indian mothers tended to eat more special confinement diets than Malay mothers (p<0.001), and Chinese mothers showered less and were more likely to depend on confinement nannies during this period than mothers from the two other ethnic groups (p<0.001 for all). Malay mothers tended to make greater use of massage therapy (p<0.001), whilst Indian mothers tended to have their mothers or mothers-in-law as assistant caregivers (p<0.001). Conclusion Most Singapore mothers follow confinement practices, but the three Asian ethnic groups differed in specific confinement practices. Future studies should examine whether ethnic differences persist in later child-rearing practices. PMID:27018256

A Comparison of Practices During the Confinement Period among Chinese, Malay, and Indian Mothers in Singapore.

PubMed

Fok, Doris; Aris, Izzuddin M; Ho, Jiahui; Lim, Sok Bee; Chua, Mei Chien; Pang, Wei Wei; Saw, Seang-Mei; Kwek, Kenneth; Godfrey, Keith M; Kramer, Michael S; Chong, Yap Seng

2016-09-01

Confinement (restrictions placed on diet and practices during the month right after delivery) represents a key feature of Asian populations. Few studies, however, have focused specifically on ethnic differences in confinement practices. This study assesses the confinement practices of three ethnic groups in a multi-ethnic Asian population. Participants were part of a prospective birth cohort study that recruited 1,247 pregnant women (57.2% Chinese, 25.5% Malay, and 17.3% Indian) during their first trimester. The 1,220 participants were followed up 3 weeks postpartum at home when questionnaires were administered to ascertain the frequency of adherence to the following confinement practices: showering; confinement-specific meals; going out with or without the baby; choice of caregiver assistance; and the use of massage therapy. Most participants reported that they followed confinement practices during the first 3 weeks postpartum (Chinese: 96.4%, Malay: 92.4%, Indian: 85.6%). Chinese and Indian mothers tended to eat more special confinement diets than Malay mothers (p < 0.001), and Chinese mothers showered less and were more likely to depend on confinement nannies during this period than mothers from the two other ethnic groups (p < 0.001 for all). Malay mothers tended to make greater use of massage therapy (p < 0.001), whilst Indian mothers tended to have their mothers or mothers-in-law as assistant caregivers (p < 0.001). Most Singapore mothers follow confinement practices, but the three Asian ethnic groups differed in specific confinement practices. Future studies should examine whether ethnic differences persist in later childrearing practices. © 2016 Wiley Periodicals, Inc.

Age-related nomograms for antral follicle count and anti-Mullerian hormone for subfertile Chinese women in Singapore.

PubMed

Loy, See Ling; Cheung, Yin Bun; Fortier, Marielle Valerie; Ong, Chiou Li; Tan, Heng Hao; Nadarajah, Sadhana; Chan, Jerry Kok Yen; Viardot-Foucault, Veronique

2017-01-01

Antral follicle count (AFC) and anti-Mullerian hormone (AMH) are known as the most reliable markers of a woman's ovarian reserve and are related to age. There is currently no specific local age-related centile charts for AFC and AMH. Therefore, we aim to examine the relationship between AFC and AMH with age and construct age-related nomograms among a subfertile Asian population. This is a study involving Chinese women who had their AFC and AMH measured as part of their subfertility screening from December 2010 until November 2014 in KK Women's and Children's Hospital, Singapore. Ordinary least squares regression analysis was used to estimate the relationship of AFC and AMH with age, while age-related AFC and AMH nomograms for the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentiles were produced using the lambda-mu-sigma method. A total of 1,009 women, aged 26 to 44 year-old, were included. On average, the AFC and AMH decreased respectively by 0.79 follicle (95% confidence interval -0.93, -0.64) and 0.38 ng/mL (95% confidence interval -0.43, -0.32) per year of age. The age-related nomograms of AFC showed an approximately linear pattern, inversely correlated with age, regardless of the percentile. For AMH, the pattern is linear for the 75th percentile and below but shows a slightly accelerating decline for the 90th and 97th percentile. Overall, there were large inter-individual variations in AFC and AMH up to about 40 year-old. The declines of AFC and AMH over age are mostly linear among subfertile Chinese women in Singapore. The age-related AFC and AMH nomograms could be used as a reference chart by fertility practitioners. However, future validation with longitudinal data is required.

Parasuicide: a Singapore perspective.

PubMed

Wai, B H; Heok, K E

1998-11-01

This study was undertaken to determine whether there were ethnic and social variations in parasuicide in the population of Singapore. All hospital records of parasuicide from a teaching hospital between 1991 and 1995 were reviewed. Demographic data, reasons precipitating the suicide attempt and the psychiatric diagnoses were recorded. Altogether 814 patients were identified. There was a general upward trend of cases admitted from 1991 to 1995. Young females appear to be the most vulnerable accounting for 60.5% of the study population. The Indian community has significantly higher risk of parasuicide compared to the Chinese and Malays. Overdose of medication was the most common method with paracetamol being implicated in 48.1% of all overdoses. Differences in parasuicide rates amongst the three ethnic communities can be attributed to various socio-cultural factors. The phenomenon of parasuicide is of increasing importance as it particularly involves adolescents and young adults. Suicide prevention will continue to present a challenge for mental health professionals in the foreseeable future.

Fast-food consumers in Singapore: demographic profile, diet quality and weight status.

PubMed

Whitton, Clare; Ma, Yi; Bastian, Amber Carla; Fen Chan, Mei; Chew, Ling

2014-08-01

To determine the demographic profile of fast-food consumers among adult Singapore residents and ascertain whether fast-food consumption frequency is associated with diet quality and weight status. A nationally representative cross-sectional survey including an FFQ and anthropometric measures. Participants were grouped based on their fast-food consumption frequency as non-consumer, occasional consumer or regular consumer, with regular defined as at least once per week. Individuals living in the community in Singapore. Singapore residents (n 1627) aged 18-69 years of Chinese, Malay and Indian ethnicity. Proportions of regular fast-food consumers were higher in younger age groups, higher income groups and middle education level groups. Mean daily energy intake was positively associated with fast-food consumption frequency (non-consumers 9636 kJ (2303 kcal); occasional consumers 11 159 kJ (2667 kcal); regular consumers 13 100 kJ (3131 kcal); P for trend < 0·001). Fast-food consumers were more likely to exceed the RDA for energy, fat and saturated fat, and less likely to meet wholegrain and fruit recommendations. Both regular consumers (OR = 1·24; 95 % CI 1·03, 1·51) and occasional consumers (OR = 1·52; 95 % CI 1·32, 1·77) were more likely to have a waist:hip ratio indicating abdominal obesity. Occasional consumers were more likely to have a BMI ≥ 23·0 kg/m2 (OR = 1·19; 95 % CI 1·04, 1·37), whereas regular consumers were less likely (OR = 0·76; 95 % CI 0·64, 0·91) to have an 'at-risk' BMI. Fast-food consumption is most prevalent in young adults, high income and middle education level groups. Frequent fast-food consumption in Singapore is associated with unfavourable dietary and nutrient profiles and abdominal obesity.

Soy intake and risk of type 2 diabetes mellitus in Chinese Singaporeans

PubMed Central

Odegaard, Andrew O.; Gross, Myron D.; Koh, Woon-Puay; Yu, Mimi C.; Yuan, Jian-Min; Pereira, Mark A.

2012-01-01

Purpose To examine the association between soy products and their components, isoflavones and protein, and incident type 2 diabetes in a population with varied soy intake and high rates of diabetes. Methods We used data from the Singapore Chinese Health Study, including 43,176 Chinese men and women aged 45–74 years, free of chronic disease at baseline (1993–1998) and followed through 2004. Intake of individual soy items, total unsweetened soy, and soy components was assessed by food-frequency questionnaire and examined with type 2 diabetes risk using Cox regression. Results During an average follow-up of 5.7 years, 2,252 of the 43,176 participants included in the current analyses developed diabetes. After adjustment for potential confounders and BMI, consumption of unsweetened soy was inversely associated with diabetes risk. Hazard ratios (HRs) and 95% CI for diabetes across unsweetened soy intake categories (none, 1–4/month, 1–2/week, 3–4/week, ≥5/week) were: 1 (referent), 0.81 (0.67–0.97), 0.76 (0.63–0.91), 0.76 (0.63–0.92), and 0.72 (0.59–0.89), respectively (Ptrend = 0.015). Conversely, in multivariate models, consuming sweetened soybean drink was positively associated with diabetes risk. HRs for diabetes across soybean drink intake categories (none, 1–3/month, 1/week, ≥2/week) were: 1 (referent), 1.07 (0.95–1.20), 1.12 (1.00–1.26), and 1.13 (1.00–1.28), respectively (Ptrend = 0.03). Furthermore, after full adjustment, including adjustment for sweetened soy items, we observed a marginally significant inverse association between isoflavone intake and diabetes (HR for the fifth compared to the first quintile: 0.76; 95% CI: 0.58–1.00; Ptrend = 0.08). Conclusions The current findings support a protective role for unsweetened soy foods and isoflavones on risk of type 2 diabetes. PMID:22094581

Interventions with Young Female Offenders and Teenage Girls at Risk: Alternative Educational Services in a Singapore Girls' Home

ERIC Educational Resources Information Center

Zhang, Kaili Chen; Choo, Andrew; Lim, Liping

2009-01-01

This article presents factors that place girls at risk of delinquency and offending as well as the patterns in juvenile delinquency trends for females in Singapore. The authors also describe Singapore's overall structure of services for young offenders and the current status of alternative education programmes for young women engaged in delinquent…

Prevalence of Cognitive Impairment and Dementia in Malays - Epidemiology of Dementia in Singapore Study.

PubMed

Hilal, Saima; Tan, Chuen S; Xin, Xu; Amin, Shaik M; Wong, Tien Y; Chen, Christopher; Venketasubramanian, Narayanaswamy; Ikram, Mohammad K

2017-01-01

To study the prevalence of cognitive impairment and dementia in communitydwelling Malays from Singapore; and to examine differences in prevalence among Chinese and Malays. Subjects (≥ 60 years) - drawn from the Malay component of the on-going multiethnic Epidemiology of Dementia in Singapore study - were screened using locally validated Abbreviated Mental Test and Progressive Forgetfulness Questionnaire. Subsequently, screen-positive participants underwent detailed neuropsychological assessments and neuroimaging. Cognitive impairment no dementia (CIND) and dementia were diagnosed based on accepted criteria. A total of 966 Malay subjects were included, of whom 102 had CIND-mild, 135 CINDmoderate, and 27 dementia. The overall age-standardized prevalence of any cognitive impairment was 25.5%, including 2% of dementia. The prevalence of any cognitive impairment increased with age from 14·9% in those aged 60-64 years to 40.2% in age ≥80 years. Women had a higher prevalence of CIND and dementia than men. Compared to previously published data from EDIS on Chinese, Malay were nearly twice more likely to have any cognitive impairment (Odds ratios adjusted for age, demographic and cardiovascular risk factors, and ApoEε4 carrier: 2.03, 95% confidence interval: 1.48-2.77). Among elderly Malays, the overall prevalence of any cognitive impairment was 25.5%. Even with a similar protocol of recruitment and assessment and adjusting for known risk factors, the prevalence of cognitive impairment was higher in Malays compared to Chinese. Further research is needed to unravel other factors that may underlie these ethnic differences in the occurrence of cognitive impairment. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Seroprevalence of antibodies against chikungunya virus in Singapore resident adult population.

PubMed

Ang, Li Wei; Kam, Yiu Wing; Lin, Cui; Krishnan, Prabha Unny; Tay, Joanne; Ng, Lee Ching; James, Lyn; Lee, Vernon J M; Goh, Kee Tai; Ng, Lisa F P; Lin, Raymond T P

2017-12-01

We determined the seroprevalence of chikungunya virus (CHIKV) infection in the adult resident population in Singapore following local outbreaks of chikungunya fever (CHIKF) in 2008-2009. Our cross-sectional study involved residual sera from 3,293 adults aged 18-79 years who had participated in the National Health Survey in 2010. Sera were tested for IgG antibodies against CHIKV and dengue virus (DENV) and neutralizing antibodies against CHIKV. The prevalence of CHIKV-neutralizing antibodies among Singapore residents aged 18-79 years was 1.9% (95% confidence interval: 1.4%- 2.3%). The CHIKV seroprevalence was highest in the elderly aged 70-79 years at 11.5%, followed by those aged 30-39 years at 3.1%. Men had significantly higher CHIKV seroprevalence than women (2.5% versus 1.3%, p = 0.01). Among the three main ethnic groups, Indians had the highest seroprevalence (3.5%) compared to Chinese (1.6%) and Malays (0.7%) (p = 0.02 and p = 0.01, respectively). Multivariable logistic regression identified adults aged 30-39 years and 70-79 years, men, those of Indian ethnicity and ethnic minority groups, and residence on ground floor of public and private housing apartments as factors that were significantly associated with a higher likelihood of exposure to CHIKV. The overall prevalence of anti-DENV IgG antibodies was 56.8% (95% CI: 55.1%- 58.5%), while 1.5% (95% CI: 1.1%- 2.0%) of adults possessed both neutralizing antibodies against CHIKV and IgG antibodies against DENV. Singapore remains highly susceptible to CHIKV infection. There is a need to maintain a high degree of vigilance through disease surveillance and vector control. Findings from such serological study, when conducted on a regular periodic basis, could supplement surveillance to provide insights on CHIKV circulation in at-risk population.

Public perceptions, knowledge and awareness of cholesterol management in Singapore: a prospective pilot study.

PubMed

Aung, Than Htike; Go, Yun Yun; Low, Lip Ping; Chua, Terrance

2013-01-01

Hyperlipidaemia is a major risk factor for coronary artery disease (CAD). Its effective treatment has been shown to reduce the incidence of cardiovascular events, both in secondary and primary prevention. An essential component of risk factor management at the community level is public awareness and knowledge of treatment benefits. However, this data is limited in Singapore. A cross-sectional survey questionnaire of public perception and knowledge on cholesterol treatment among adult Singaporeans aged 30-69 years was commissioned by the Singapore Heart Foundation and conducted by a professional market survey company. Regional quota sampling was performed to ensure that the sample was representative of the Singapore population. This was followed by random sampling of households and respondents. Of the 365 respondents, 40.9% were male, 70.3% were Chinese, 18.8% Malay and 10.9% Indian. The mean age was 47.5 years. Although 81.9% of respondents had medical check-ups involving blood tests, only 11.0% knew their actual cholesterol levels. A third of the respondents saw herbal medicine as healthier and safer than Western medication. More than 80% of respondents believed that diet and exercise were equally effective at lowering cholesterol as medication. About half of the respondents associated long-term use of statins with damage to the liver and kidney, while a third associated chronic statin use with the development of cancer. There are gaps in the level of public awareness and understanding of cholesterol treatment in Singapore. Common misconceptions should be addressed, as they could potentially impair effective management or treatment compliance.

Predictors of re-entry into the child protection system in Singapore: a cumulative ecological-transactional risk model.

PubMed

Li, Dongdong; Chu, Chi Meng; Ng, Wei Chern; Leong, Wai

2014-11-01

This study examines the risk factors of re-entry for 1,750 child protection cases in Singapore using a cumulative ecological-transactional risk model. Using administrative data, the present study found that the overall percentage of Child Protection Service (CPS) re-entry in Singapore is 10.5% based on 1,750 cases, with a range from 3.9% (within 1 year) to 16.5% (within 8 years after case closure). One quarter of the re-entry cases were observed to occur within 9 months from case closure. Seventeen risk factors, as identified from the extant literature, were tested for their utility to predict CPS re-entry in this study using a series of Cox regression analyses. A final list of seven risk factors (i.e., children's age at entry, case type, case closure result, duration of case, household income, family size, and mother's employment status) was used to create a cumulative risk score. The results supported the cumulative risk model in that higher risk score is related to higher risk of CPS re-entry. Understanding the prevalence of CPS re-entry and the risk factors associated with re-entry is the key to informing practice and policy in a culturally relevant way. The results from this study could then be used to facilitate critical case management decisions in order to enhance positive outcomes of families and children in Singapore's care system. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ancestry prediction in Singapore population samples using the Illumina ForenSeq kit.

PubMed

Ramani, Anantharaman; Wong, Yongxun; Tan, Si Zhen; Shue, Bing Hong; Syn, Christopher

2017-11-01

) was generally high in the absence of admixture. Misclassification occurred in admixed individuals, who were likely offspring of inter-ethnic marriages, and hence whose self-reported bio-geographic ancestries were dependent on that of their fathers, and in individuals of minority sub-populations with inter-ethnic beliefs. The ancestry prediction capabilities of the 59 SNPs on the ForenSeq kit were reasonably effective in differentiating the Singapore Chinese, Malay and Indian sub-populations, and will be of use for investigative purposes. However, there is potential for more accurate prediction through the evaluation of other AIM sets. Copyright © 2017 Elsevier B.V. All rights reserved.

Cardiovascular diseases and risk factors among Chinese immigrants.

PubMed

Gong, Zhizhong; Zhao, Dong

2016-04-01

The aim of this study is to identify the prevalence of cardiovascular disease (CVD) and major CVD risk factors, including diabetes, hypertension, dyslipidemia, obesity and smoking among Chinese immigrants by a systematic review of studies from various countries. PubMed and the China National Knowledge Infrastructure databases were searched for studies of the prevalence of major CVDs and risk factors, and of CVD mortality among Chinese immigrants. The search identified 386 papers, 16 of which met the inclusion criteria for this review. In mainland China, there is a pattern of high stroke prevalence but low coronary heart disease (CHD) prevalence. Among Chinese immigrants, there is a much lower prevalence and mortality of stroke, but a higher prevalence and mortality of CHD, even though these are lower than the rates in immigrants of other ethnicities in the host country. The prevalence of CVD risk factors is also markedly different in immigrants. Compared with mainland Chinese, Chinese immigrants have a higher prevalence of diabetes and hypertension, higher serum cholesterol, poorer dietary patterns, and higher prevalence of obesity and smoking. Thus, the epidemiological pattern of CVD among Chinese immigrants changes compared with resident mainland Chinese. The less healthy environmental factor after immigration may be a major trigger in the adverse CVD status of Chinese immigrants. It is important for policy-makers to pay more attention to specific minority immigrant groups, and to implement more effective preventive measures to improve the health of immigrant populations.

Bilingualism without Diglossia: The Indian Community in Singapore

ERIC Educational Resources Information Center

Vaish, Viniti

2007-01-01

This paper tells a tentative story from the preliminary findings of The Sociolinguistic Survey of Singapore, 2006 (SSS 2006). Though the main study reports on language use amongst Chinese, Malay and Indian communities, my focus is only on Indian homes. The paper reports results from five domains: school, family and friends, media, public space and…

Comparison of Corneal Biomechanical Properties between Indian and Chinese Adults.

PubMed

Chua, Jacqueline; Nongpiur, Monisha E; Zhao, Wanting; Tham, Yih Chung; Gupta, Preeti; Sabanayagam, Charumathi; Aung, Tin; Wong, Tien Yin; Cheng, Ching-Yu

2017-09-01

To investigate the difference in corneal hysteresis (CH) and corneal resistance factor (CRF) between Indian and Chinese populations. Population-based cross-sectional study. Three hundred eighty-two Singaporean Indian persons and 764 Singaporean Chinese 50 years of age or older were included from the Singapore Indian Eye Study and Singapore Chinese Eye Study, respectively. Participants underwent standardized systemic and ocular examinations and interviewer-administered questionnaires for risk factor assessment. The CH and CRF were measured with the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Buffalo, NY). Information on genetic ancestry was derived using principal component analysis. Linear regression models were used to investigate the association of CH and CRF with potential risk factors. Corneal hysteresis and CRF. After excluding participants with a history of intraocular surgery, a diagnosis of glaucoma suspect or glaucoma, refractive surgery, or presence of corneal abnormalities, CH and CRF readings were available for 382 Indian persons. For each Indian participant, 2 Chinese participants were selected and matched for age and gender (n = 764). There were no differences in the clinical measurements of CH (10.6±1.6 mmHg; P = 0.670) or CRF (10.3±1.7 mmHg; P = 0.103) between the ethnic groups. However, after adjusting for covariates, Indian persons had, on average, 0.18-mmHg higher CH levels than in Chinese (95% confidence interval [CI], 0.02-0.38; P = 0.031). Consistently, CH level was correlated significantly with genetic ancestry in the Southeast Asian population. Corneal resistance factor level was not associated independently with self-reported ethnicity (95% CI, -0.10 to 0.29; P = 0.335). Chinese have lower CH than Indian persons, and this disparity may reflect biomechanical differences of the cornea. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Does ethnicity matter in risk and protective factors for suicide attempts and suicide lethality?

PubMed Central

Choo, Carol C.; Harris, Keith M.; Chew, Peter K. H.; Ho, Roger C.

2017-01-01

This study explored ethnic differences in risk and protective factors for suicide attempts, for the major ethnic groups in Singapore, and ethnic differences in prediction of lethality. Three years of medical records related to suicide attempters (N = 666) who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to analysis. Of the sample, 69.2% were female, 30.8% male; 63.8% Chinese, 15.8% Indian, and 15.0% Malay. Indians were over-represented in this sample, as compared with the ethnic distribution in the general population. Ages ranged from 10 to 85 years old (M = 29.7, SD = 16.1). Ethnic differences were found in risk and protective factors, and perceived lethality of suicide attempts. All available variables were subjected to regression analyses for Chinese, Indian and Malay attempters to arrive at parsimonious models for prediction of perceived lethality. The findings were discussed in regards to implications in assessment of suicide risk and primary prevention for the multiethnic society in Singapore. PMID:28426687

Driving behaviours, traffic risk and road safety: comparative study between Malaysia and Singapore.

PubMed

Khan, Saif ur Rehman; Khalifah, Zainab Binti; Munir, Yasin; Islam, Talat; Nazir, Tahira; Khan, Hashim

2015-01-01

The present study aims to investigate differences in road safety attitude, driver behaviour and traffic risk perception between Malaysia and Singapore. A questionnaire-based survey was conducted among a sample of Singaporean (n = 187) and Malaysian (n = 313) road users. The data was analysed using confirmatory factor analysis and structural equation modelling applied to measure comparative fit indices of Malaysian and Singaporean respondents. The results show that the perceived traffic risk of Malaysian respondents is higher than Singaporean counterparts. Moreover, the structural equation modelling has confirmed perceived traffic risk performing the role of full mediation between perceived driving skills and perceived road safety for both the countries, while perceived traffic skills was found to perform the role of partial mediation between aggression and anxiety, on one hand, and road safety, on the other hand, in Malaysia and Singapore. In addition, in both countries, a weak correlation between perceived driving skills, aggression and anxiety with perceived road safety was found, while a strong correlation exists with traffic risk perception. The findings of this study have been discussed in terms of theoretical, practical and conceptual implications for both scholars and policy-makers to better understand the young drivers' attitude and behaviour relationship towards road safety measures with a view to future research.

Creating a Chinese suicide dictionary for identifying suicide risk on social media.

PubMed

Lv, Meizhen; Li, Ang; Liu, Tianli; Zhu, Tingshao

2015-01-01

Introduction. Suicide has become a serious worldwide epidemic. Early detection of individual suicide risk in population is important for reducing suicide rates. Traditional methods are ineffective in identifying suicide risk in time, suggesting a need for novel techniques. This paper proposes to detect suicide risk on social media using a Chinese suicide dictionary. Methods. To build the Chinese suicide dictionary, eight researchers were recruited to select initial words from 4,653 posts published on Sina Weibo (the largest social media service provider in China) and two Chinese sentiment dictionaries (HowNet and NTUSD). Then, another three researchers were recruited to filter out irrelevant words. Finally, remaining words were further expanded using a corpus-based method. After building the Chinese suicide dictionary, we tested its performance in identifying suicide risk on Weibo. First, we made a comparison of the performance in both detecting suicidal expression in Weibo posts and evaluating individual levels of suicide risk between the dictionary-based identifications and the expert ratings. Second, to differentiate between individuals with high and non-high scores on self-rating measure of suicide risk (Suicidal Possibility Scale, SPS), we built Support Vector Machines (SVM) models on the Chinese suicide dictionary and the Simplified Chinese Linguistic Inquiry and Word Count (SCLIWC) program, respectively. After that, we made a comparison of the classification performance between two types of SVM models. Results and Discussion. Dictionary-based identifications were significantly correlated with expert ratings in terms of both detecting suicidal expression (r = 0.507) and evaluating individual suicide risk (r = 0.455). For the differentiation between individuals with high and non-high scores on SPS, the Chinese suicide dictionary (t1: F 1 = 0.48; t2: F 1 = 0.56) produced a more accurate identification than SCLIWC (t1: F 1 = 0.41; t2: F 1 = 0.48) on different

Creating a Chinese suicide dictionary for identifying suicide risk on social media

PubMed Central

Liu, Tianli

2015-01-01

Introduction. Suicide has become a serious worldwide epidemic. Early detection of individual suicide risk in population is important for reducing suicide rates. Traditional methods are ineffective in identifying suicide risk in time, suggesting a need for novel techniques. This paper proposes to detect suicide risk on social media using a Chinese suicide dictionary. Methods. To build the Chinese suicide dictionary, eight researchers were recruited to select initial words from 4,653 posts published on Sina Weibo (the largest social media service provider in China) and two Chinese sentiment dictionaries (HowNet and NTUSD). Then, another three researchers were recruited to filter out irrelevant words. Finally, remaining words were further expanded using a corpus-based method. After building the Chinese suicide dictionary, we tested its performance in identifying suicide risk on Weibo. First, we made a comparison of the performance in both detecting suicidal expression in Weibo posts and evaluating individual levels of suicide risk between the dictionary-based identifications and the expert ratings. Second, to differentiate between individuals with high and non-high scores on self-rating measure of suicide risk (Suicidal Possibility Scale, SPS), we built Support Vector Machines (SVM) models on the Chinese suicide dictionary and the Simplified Chinese Linguistic Inquiry and Word Count (SCLIWC) program, respectively. After that, we made a comparison of the classification performance between two types of SVM models. Results and Discussion. Dictionary-based identifications were significantly correlated with expert ratings in terms of both detecting suicidal expression (r = 0.507) and evaluating individual suicide risk (r = 0.455). For the differentiation between individuals with high and non-high scores on SPS, the Chinese suicide dictionary (t1: F1 = 0.48; t2: F1 = 0.56) produced a more accurate identification than SCLIWC (t1: F1 = 0.41; t2: F1 = 0.48) on different

Chronic disease and lifestyle factors associated with change in sleep duration among older adults in the Singapore Chinese Health Study.

PubMed

Smagula, Stephen F; Koh, Woon-Puay; Wang, Renwei; Yuan, Jian-Min

2016-02-01

Identifying risk factors for future change in sleep duration can clarify whether, and if so how, sleep and morbidity are bidirectionally related. To date, only limited longitudinal evidence exists characterizing changes to sleep duration among older adults. This study aimed to identify factors associated with change in sleep duration in a large sample of older adults (≥ 60 years) residing in Singapore (n = 10 335). These adults were monitored as part of the Singapore Chinese Health Study, which collected information regarding daily sleep duration at baseline (assessed in 1993-1998) and at a follow-up wave conducted over a mean of 12.7 years later (assessed in 2006-2010). Among adults sleeping 6-8 h at baseline (n = 8265), most participants (55.6%) remained 6-8 h sleepers at follow-up, while 8.4% became short (< 6 h) and 36.0% became long (> 8 h) sleepers. A history of stroke, diabetes, cancer, hip fracture and greater age all independently increased the odds of having long sleep duration at follow-up, while greater educational attainment and weekly physical activity were both associated with reduced odds of becoming a long sleeper. Other than greater baseline age, the only factor related to higher odds of becoming a short sleeper was concurrent stomach/duodenal ulcer at follow-up. Long sleep duration among older adults may therefore reflect longstanding disease processes, whereas the aetiology of short sleep may predominately involve factors other than those examined. Future research is needed to distinguish if/when long sleep duration serves the disease recovery process, and when long sleep duration complicates disease and requires sleep medicine interventions. © 2015 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.

The music listening preferences and habits of youths in Singapore and its relation to leisure noise-induced hearing loss.

PubMed

Lee, Gary Jek Chong; Lim, Ming Yann; Kuan, Angeline Yi Wei; Teo, Joshua Han Wei; Tan, Hui Guang; Low, Wong Kein

2014-02-01

Noise-induced hearing loss (NIHL) is a preventable condition, and much has been done to protect workers from it. However, thus far, little attention has been given to leisure NIHL. The purpose of this study is to determine the possible music listening preferences and habits among young people in Singapore that may put them at risk of developing leisure NIHL. In our study, the proportion of participants exposed to > 85 dBA for eight hours a day (time-weighted average) was calculated by taking into account the daily number of hours spent listening to music and by determining the average sound pressure level at which music was listened to. A total of 1,928 students were recruited from Temasek Polytechnic, Singapore. Of which, 16.4% of participants listened to portable music players with a time-weighted average of > 85 dBA for 8 hours. On average, we found that male students were more likely to listen to music at louder volumes than female students (p < 0.001). We also found that the Malay students in our study listened to louder music than the Chinese students (p < 0.001). We found that up to one in six young persons in Singapore is at risk of developing leisure NIHL from music delivered via earphones. As additional risks due to exposure to leisure noise from other sources was not taken into account, the extent of the problem of leisure NIHL may be even greater. There is a compelling need for an effective leisure noise prevention program among young people in Singapore.

Elite Schools, Postcolonial Chineseness and Hegemonic Masculinities in Singapore

ERIC Educational Resources Information Center

Goh, Daniel P. S.

2015-01-01

The educational reproduction of elite masculinity in postcolonial societies has not been properly studied. This is partly because the postcolonial masculinities of non-western elites are accomplished through the cultivation of naturalized practices signifying the body politic of the nation-state. In Singapore, same-sex elite schools of colonial…

Validation of the "Chinese Language Classroom Learning Environment Inventory" for Investigating the Nature of Chinese Language Classrooms

ERIC Educational Resources Information Center

Lian, Chua Siew; Wong, Angela F. L.; Der-Thanq, Victor Chen

2006-01-01

The Chinese Language Classroom Environment Inventory (CLCEI) is a bilingual instrument developed for use in measuring students' and teachers' perceptions toward their Chinese Language classroom learning environments in Singapore secondary schools. The English version of the CLCEI was customised from the English version of the "What is…

The Chinese Input Challenges for Chinese as Second Language Learners in Computer-Mediated Writing: An Exploratory Study

ERIC Educational Resources Information Center

Wong, Lung-Hsiang; Chai, Ching-Sing; Gao, Ping

2011-01-01

This paper reports an exploratory study on Singapore secondary and primary school students' perceptions and behaviors on using a variety of Chinese input methods for Chinese composition writing. Significant behavioral patterns were uncovered and mapped into a cognitive process, which are potentially critical to the training of students in…

Singapore, Malaysia

NASA Technical Reports Server (NTRS)

1992-01-01

This view of the Malay Peninsula shows the city state of Singapore, Malaysia (1.5N, 104.0E) with all its urban, industrial and commercial land use areas. Singapore is located at the south tip of the Malay peninsula separated by the Johor Strait. The prosporous island state, once Asia's major trade center, is now highly industrialized despite its small size and its ideal location has made this island a hub of trade, shipping and service industries.

Singapore, Malaysia

NASA Image and Video Library

1992-07-09

This view of the Malay Peninsula shows the city state of Singapore, Malaysia (1.5N, 104.0E) with all its urban, industrial and commercial land use areas. Singapore is located at the south tip of the Malay peninsula separated by the Johor Strait. The prosporous island state, once Asia's major trade center, is now highly industrialized despite its small size and its ideal location has made this island a hub of trade, shipping and service industries.

Seroprevalence of antibodies against chikungunya virus in Singapore resident adult population

PubMed Central

Kam, Yiu Wing; Lin, Cui; Krishnan, Prabha Unny; Tay, Joanne; Ng, Lee Ching; James, Lyn; Lee, Vernon J. M.; Goh, Kee Tai; Ng, Lisa F. P.; Lin, Raymond T. P.

2017-01-01

Objectives We determined the seroprevalence of chikungunya virus (CHIKV) infection in the adult resident population in Singapore following local outbreaks of chikungunya fever (CHIKF) in 2008–2009. Methods Our cross-sectional study involved residual sera from 3,293 adults aged 18–79 years who had participated in the National Health Survey in 2010. Sera were tested for IgG antibodies against CHIKV and dengue virus (DENV) and neutralizing antibodies against CHIKV. Results The prevalence of CHIKV-neutralizing antibodies among Singapore residents aged 18–79 years was 1.9% (95% confidence interval: 1.4%– 2.3%). The CHIKV seroprevalence was highest in the elderly aged 70–79 years at 11.5%, followed by those aged 30–39 years at 3.1%. Men had significantly higher CHIKV seroprevalence than women (2.5% versus 1.3%, p = 0.01). Among the three main ethnic groups, Indians had the highest seroprevalence (3.5%) compared to Chinese (1.6%) and Malays (0.7%) (p = 0.02 and p = 0.01, respectively). Multivariable logistic regression identified adults aged 30–39 years and 70–79 years, men, those of Indian ethnicity and ethnic minority groups, and residence on ground floor of public and private housing apartments as factors that were significantly associated with a higher likelihood of exposure to CHIKV. The overall prevalence of anti-DENV IgG antibodies was 56.8% (95% CI: 55.1%– 58.5%), while 1.5% (95% CI: 1.1%– 2.0%) of adults possessed both neutralizing antibodies against CHIKV and IgG antibodies against DENV. Conclusions Singapore remains highly susceptible to CHIKV infection. There is a need to maintain a high degree of vigilance through disease surveillance and vector control. Findings from such serological study, when conducted on a regular periodic basis, could supplement surveillance to provide insights on CHIKV circulation in at-risk population. PMID:29281644

Managing the risk of non-indigenous marine species transfer in Singapore using a study of vessel movement.

PubMed

Lim, Chin Sing; Leong, Yi Lin; Tan, Koh Siang

2017-02-15

Shipping is recognized as a major vector for the global transfer of non-indigenous marine species (NIMS). As a major transshipment port, Singapore can minimize the risk of NIMS transfer by implementing pragmatic management strategies, such as using vessel movement information to assess the risk of NIMS transfer. Findings from vessel movement information in a major port terminal in Singapore showed that vessel residence time is short, with >92% of vessels spending seven days or less. There was little variation in vessel residence time to vessel arrival numbers, while the top three last ports of call were found to be from regional ports. Using two key features obtained from vessel movement records, 1) vessel residence time and 2) biogeographic origin of the vessels' last port of call, a simple risk assessment matrix was constructed and applied to assess the level of risk of NIMS transfer by transiting vessels. Copyright © 2016 Elsevier Ltd. All rights reserved.

Genetic and environmental predictors of serum 25(OH)D concentrations among middle-aged and elderly Chinese in Singapore

PubMed Central

Robien, Kim; Butler, Lesley M.; Wang, Renwei; Beckman, Kenneth B.; Walek, Dinesha; Koh, Woon-Puay; Yuan, Jian-Min

2012-01-01

Vitamin D is known for maintaining calcium homeostasis and bone structure, and may also decrease susceptibility to chronic and infectious diseases. However, data on vitamin D status and its predictors among Southeast Asian populations is limited. We evaluated the distribution and determinants (genetic and environmental) of serum 25-hydroxyvitamin D (25(OH)D) concentrations among 504 middle-aged and elderly participants (aged 45–74 years) in the Singapore Chinese Health Study. Data on dietary and other lifestyle factors were collected by trained interviewers. Serum 25(OH)D concentrations and genetic polymorphisms in vitamin D metabolism pathway enzymes [cytochrome P450 (CYP) 2R1, 3A4, 27B1, 24A1; vitamin D binding protein (GC); and vitamin D receptor (VDR)] were measured using stored biospecimens. Mean 25(OH)D concentration was 68.8 nmol/L. Serum 25(OH)D concentrations were positively associated with dietary vitamin D intake, and inversely associated with hours sitting at work. BMI was not associated with 25(OH)D concentrations. CYP2R1 rs10741657, rs12794714, rs1993116; CYP3A4 rs2242480; and GC rs4588, rs7041, rs16847015, rs2298849 were statistically significantly associated with 25(OH)D concentrations. Individuals with the Gc2-2 haplotype (rs4588AA/rs7041TT) had statistically significantly lower 25(OH)D concentrations compared to all other Gc haplotypes (p-trend<0.001). The majority of participants (86%) had 25(OH)D concentrations ≥50 nmol/L, which is consistent with the 2011 Institute of Medicine (United States) recommendation for bone health, and 32% had concentrations of ≥75 nmol/L that are thought to be required for broader health effects. Dietary vitamin D intake, hours spent indoors at work, and genetic variation in CYP2R1, CYP3A4 and GC are significant predictors of 25(OH)D concentrations among Singapore Chinese. PMID:22583563

Genetic and environmental predictors of serum 25-hydroxyvitamin D concentrations among middle-aged and elderly Chinese in Singapore.

PubMed

Robien, Kim; Butler, Lesley M; Wang, Renwei; Beckman, Kenneth B; Walek, Dinesha; Koh, Woon-Puay; Yuan, Jian-Min

2013-02-14

Vitamin D is known for maintaining Ca homeostasis and bone structure, and may also decrease susceptibility to chronic and infectious diseases. However, data on vitamin D status and its predictors among Southeast Asian populations are limited. We evaluated the distribution and determinants (genetic and environmental) of serum 25-hydroxyvitamin D (25(OH)D) concentrations among 504 middle-aged and elderly participants (aged 45-74 years) in the Singapore Chinese Health Study. Data on dietary and other lifestyle factors were collected by trained interviewers. Serum 25(OH)D concentrations and genetic polymorphisms in vitamin D metabolism pathway enzymes (cytochrome P450 (CYP) 2R1, 3A4, 27B1, 24A1; vitamin D binding protein (also known as group-specific component, GC); and vitamin D receptor) were measured using stored biospecimens. Mean 25(OH)D concentration was 68·8 nmol/l. Serum 25(OH)D concentrations were positively associated with dietary vitamin D intake, and inversely associated with hours spent sitting at work. BMI was not associated with 25(OH)D concentrations. CYP2R1 rs10741657, rs12794714, rs1993116; CYP3A4 rs2242480; and GC rs4588, rs7041, rs16847015, rs2298849 were statistically significantly associated with 25(OH)D concentrations. Individuals with the Gc2-2 haplotype (rs4588AA/rs7041TT) had statistically significantly lower 25(OH)D concentrations compared to all other Gc haplotypes (P-trend < 0·001). The majority of participants (86 %) had 25(OH)D concentrations ≥ 50 nmol/l, which is consistent with the 2011 Institute of Medicine (US) recommendation for bone health, and 32 % had concentrations of ≥ 75 nmol/l that are thought to be required for broader health effects. Dietary vitamin D intake, hours spent indoors at work and genetic variation in CYP2R1, CYP3A4 and GC are significant predictors of 25(OH)D concentrations among Singapore Chinese.

Three decades of breast-feeding trends in Singapore.

PubMed

Chua, S; Viegas, O A; Ratnam, S S

1990-03-01

In 1985, about 60% of well-to-do mothers in Singapore initiated breastfeeding (BF). This value compares favorably with the 36% of poor mothers BF, but is still unacceptably low compared with the 85-95% of well-to-do mothers and 90% of poor mothers who were BF their babies during the 1950s. There has been a general decline in the incidence and duration of BF in Singapore over the last 36 years, however, in the last decade, a larger proportion of well-to-do mothers had initiated and continued BF. Whilst the overall decline probably reflects increasing affluence and "westernization" of the population, the variation between these 2 economic groups is probably a result of differences in education. Among the 3 major ethnic communities, the Chinese favor BF the least and the Malays favor it the most. The differences are also believed to be related to cultural variations and the ability of the ethnic groups to resist the trend towards BF in favor of traditional practices and beliefs. In 1951, over 80% of infants were BF for 4 or more weeks, but by 1978 only 37% were being breast fed. In 1985, 39% of the well-to-do mothers chose to breastfed their infants. Differences between well-to-do and poor groups were originally small. During the 1960-1970 period, the differences widened. In the 1980s, they seem to have narrowed, however. Among the poor population, the proportion seems to be leveling off, while it is going up for well-to-do mothers. These changes are not unique to Singapore. The ethnic community has, and continues to have, a strong influence on the choice of feeding method. Ethnic Chinese throughout Southeast Asia are poor breast feeders. The most important traditional practice for the Malay and Indian mothers is support from relatives. Their religion may play an important role, too. Islam tells them to breastfeed. Chinese mothers often have false ideas about BF. They feel that it will ruin their figures, or that artificial formulas are better because they are more

Validation of the UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument 2.0 in English- and Chinese-speaking patients in a multi-ethnic Singapore systemic sclerosis cohort.

PubMed

Low, Andrea Hsiu Ling; Xin, Xiaohui; Law, Weng Giap; Teng, Gim Gee; Santosa, Amelia; Lim, Anita; Chan, Grace; Ng, Swee Cheng; Thumboo, Julian

2017-07-01

The aim of this study was to (1) translate the Gastrointestinal Tract Instrument (GIT) 2.0 from English to Chinese and (2) validate both versions in a multi-ethnic systemic sclerosis cohort in Singapore (SCORE). The English GIT2.0 was translated to Chinese using a standard forward-backward translation approach. Psychometric evaluation of the GIT2.0 included internal consistency reliability (using Cronbach's alpha), test-retest reliability (using intra-class correlation coefficient (ICC)), scale level factor analysis, and construct validity (using Spearman correlation) against the modified Scleroderma Health Assessment Questionnaire (S-HAQ) and the SF-36 v2. Most of the patients were females (88.6%) and Chinese (78.2%), with mean (SD) age of 51.0 (13.0) years and median disease duration of 4.5 years. We administered English (n = 146) and Chinese (n = 74) GIT2.0. The mean (SD) total GIT score was 0.29 (0.37). There was good internal consistency (Cronbach's alpha >0.70 for all subscales) and good test-retest reliability for the scale and all subscales (ICC 0.71-0.92) except for "diarrhoea" (ICC = 0.54). Our hypothesised a priori construct validity was supported by moderate correlations between the total GIT score and S-HAQ GI subscale (r = 0.446), and the social functioning subscale and SF36v2 role-social domain (r = 0.337), and weak-to-moderate correlation between the emotional subscale and SF-36v2 role-emotional (r = 0.295) and mental health (r = 0.298) domains and mental component summary (r = 0.356). Exploratory factor analysis of the seven subscales yielded a two-factor solution explaining 69.63% of the total variance. This study provides evidence for the reliability and validity of the English and Chinese GIT2.0 to be used in Singapore for research and routine practice.

Gender Differences in Risk Aversion Among Chinese University Students.

PubMed

Lam, Desmond

2015-12-01

This paper examines gender differences in risk aversion among Chinese university students. Chinese females are proposed to be more risk averse and require a higher risk premium when faced with a gamble option in the gain-domain frame as compared to Chinese males. Two groups of 100 participants each (male = 100 and female = 100 in total) were recruited to fill up questionnaires that included items relating to objective probability lotteries. Within each group, it was found that Chinese males and females did not differ in their risk aversion. However, results show that Chinese males tend to react more readily to rising risk premium by taking up options with higher expected values when compared to Chinese females. Current findings will have useful implications to marketers (particularly, promoters of gambling products) and problem gambling counselors.

Ferrochelatase gene mutation in Singapore and a novel frame-shift mutation in an Asian boy with erythropoietic protoporphyria.

PubMed

Alagappan, Uma; Pramono, Zacharias A D; Chong, Wei-Sheng

2017-03-01

Erythropoietic protoporphyria (EPP) is a rare inherited disorder of heme biosynthesis caused by decreased activity of the enzyme ferrochelatase (FECH ). The frequency of the hypomorphic c.333-48C allele in a population directly contributes to the prevalence of EPP in the same population. This study sought to identify the molecular basis of EPP in a Chinese patient from Singapore and the c.333-48C allele frequency among the Chinese population in Singapore. FECH gene was screened for mutation in the patient's DNA sample by polymerase chain reaction amplification and DNA sequencing. To validate the identified mutation, the FECH region harboring the mutation was screened in DNA samples from all healthy controls. One patient and 46 ethnically matched healthy controls were included in the study. A novel c.474dupC which leads to a frameshift and premature stop codon was identified in one allele, while the other allele showed to carry c.333-48C and c.337C>T variants in the patient's FECH. The frequency of the c.333-48C hypomorphic allele is 27% among Chinese population in Singapore. c.474dupC in one allele trans to hypomorphic c.333-48C and c.337C>T allele in FECH gene may be the underlying cause of the clinical EPP of the studied patient. The FECH hypomorphic c.333-48C allele frequency in Singapore is lower than the Han Chinese (41.3%) and Japanese (43%) populations but nearly the same as the Southeast Asian (31%) population and higher than the European (2.7-11%) population. © 2016 The International Society of Dermatology.

Problem Gambling in Chinese American Adolescents: Characteristics and Risk Factors

ERIC Educational Resources Information Center

Chiu, Eddie Yu-Wai; Woo, Kent

2012-01-01

This preliminary study examined the characteristics and risk factors of problem gambling among Chinese American adolescents. A total of 192 Chinese American students (aged 13-19) from 9th to 12th grades were recruited from three high schools in San Francisco, California. Students were administered the South Oaks Gambling Screen Revised for…

Personal Strengths and Perceived Teacher Support as Predictors of Singapore Students' Academic Risk Status

ERIC Educational Resources Information Center

Caleon, Imelda S.; Wui, Ma. Glenda L.; Chiam, Ching Leen; King, Ronnel B.; Tan, Jennifer Pei-Ling; Tan, Chee Soon

2017-01-01

This study explored the relative salience of students' personal strengths and teacher support in predicting academic risk status. The participants were Secondary One (S1, Grade Seven) students from Singapore who scored below the cohort's mean score in a national test administered at the end of primary education, and were identified as low risk…

PISA and High-Performing Education Systems: Explaining Singapore's Education Success

ERIC Educational Resources Information Center

Deng, Zongyi; Gopinathan, S.

2016-01-01

Singapore's remarkable performance in Programme for International Student Assessment (PISA) has placed it among the world's high-performing education systems (HPES). In the literature on HPES, its "secret formula" for education success is explained in terms of teacher quality, school leadership, system characteristics and educational…

Risk factors for obesity and high blood pressure in Chinese American children: maternal acculturation and children's food choices.

PubMed

Chen, Jyu-Lin; Weiss, Sandra; Heyman, Melvin B; Lustig, Robert

2011-04-01

The objective of this study is to explore risk factors associated with overweight and high blood pressure in Chinese American children. Students and their parents were recruited from Chinese language schools in the San Francisco Bay Area. Data were collected on 67 children and their mothers, and included children's weight, height, waist and hip circumferences, blood pressure, level of physical activity, dietary intake, usual food choice, knowledge about nutrition and physical activity, and self-efficacy regarding diet and physical activity. Mothers completed questionnaires on demographic data and acculturation. About 46% of children had a body mass index exceeding the 85th percentile. Lower level of maternal acculturation is a risk factor for overweight and higher waist to hip ratio. Children's unhealthy food choices were predictive of high body mass index and high systolic blood pressure, whereas older age and less physical activity in children were predictors of high diastolic blood pressure. Developing culturally sensitive and developmentally appropriate interventions to reduce overweight and high blood pressure is critical to reduce health disparities among minority children.

Prevalence of sleep-disordered breathing in a multiethnic Asian population in Singapore: A community-based study.

PubMed

Tan, Adeline; Cheung, Yan Yi; Yin, Jason; Lim, Wei-Yen; Tan, Linda W L; Lee, Chi-Hang

2016-07-01

Limited data exist on the prevalence variation in sleep-disordered breathing (SDB) across different Asian ethnicities. This population study aimed to estimate the prevalence of SDB in Singapore, a multiethnic nation, and to quantify the prevalence variation among Chinese, Malays and Indians. The Singapore Health Study 2012 was a cross-sectional population study conducted on adults aged 21-79 years. Among 2329 participants who completed baseline examination, a sample of 242 subjects completed home-based sleep testing with an Embletta device (type 3 monitor). Moderate-to-severe SDB, defined as an apnoea-hypopnoea index (AHI) of ≥15 events/h, was used to estimate prevalence. The weighted estimates of the population prevalence of moderate-to-severe SDB and sleep apnoea syndrome were 30.5% and 18.1%, respectively. Of subjects with AHI ≥15, 91.0% were previously undiagnosed. Moderate-to-severe SDB prevalence varied across the Chinese (32.1%), Malays (33.8%) and Indians (16.5%). The mean body mass index (BMI) was lowest in Chinese (23.3 kg/m(2) ) and highest among Malays (26.0 kg/m(2) ) and Indians (25.4 kg/m(2) ). Compared with Chinese, Indians had lower odds of moderate-to-severe SDB after adjustment for age, sex and BMI (odds ratio 0.82, 95% CI: 0.70-0.96, P = 0.02). Sleep-disordered breathing is prevalent but mostly undiagnosed among Asians in Singapore. There was a lower prevalence of SDB among Indians compared with Chinese that remained after adjustment for age, sex and BMI. Strategies are needed to optimize diagnosis and recognize ethnic differences in SDB prevalence. © 2016 Asian Pacific Society of Respirology.

Factors Influencing Academic Self-Concept of High-Ability Girls in Singapore

ERIC Educational Resources Information Center

Yeo, Melissa Mui Mei; Garces-Bacsal, Rhoda Myra

2014-01-01

This study aimed at investigating the impact of entering high-ability classes on the academic self-concept of high-ability primary girls in Singapore. Participants in this study are 91 Primary 4 girls, 30 high-ability pupils, and 61 pupils from classes that include high-, middle-, and low-ability pupils. This study utilized a mixed-method…

Serum urate levels and consumption of common beverages and alcohol among Chinese in Singapore.

PubMed

Teng, Gim Gee; Tan, Chuen Seng; Santosa, Amelia; Saag, Kenneth G; Yuan, Jian-Min; Koh, Woon-Puay

2013-09-01

Western studies suggest that beverages may affect serum urate (SU) levels, but data from Asian populations are scarce. We evaluated the associations between beverages and SU levels in Singaporean Chinese. The study population consisted of 483 subjects ages 45-74 years from the Singapore Chinese Health Study cohort, recruited between 1993 and 1998. Lifestyle factors, medical histories, and diet were collected through in-person interviews. SU levels and other biomarkers were measured from blood collected between 1994 and 1996. The mean age was 57.6 years and 44% were men. The geometric mean SU level was 321 μmoles/liter (range 157-719). Mean SU levels increased with alcohol consumption (P = 0.024 for trend). The mean SU level of daily alcohol drinkers was 42.6 μmoles/liter higher than that of nondrinkers. Similarly, increasing frequency of green tea intake was associated with rising SU levels. The highest mean SU level was observed in daily green tea drinkers (difference of 25.0 μmoles/liter) relative to nondrinkers (P = 0.009 for trend). Compared to nondrinkers, daily alcohol drinkers had an almost 5-fold increase in association with hyperuricemia (odds ratio [OR] 4.83, 95% confidence interval [95% CI] 1.10-21.23), whereas daily green tea drinkers had a 2-fold increase in association with hyperuricemia (OR 2.12, 95% CI 1.03-4.36). The present study did not show elevated levels of SU in individuals who consumed black tea, coffee, fruit juice, or soda. Alcohol consumption increases SU levels. The finding that daily drinking of green tea is associated with hyperuricemia needs validation in future studies. Copyright © 2013 by the American College of Rheumatology.

Age of onset of myopia predicts risk of high myopia in later childhood in myopic Singapore children.

PubMed

Chua, Sharon Y L; Sabanayagam, Charumathi; Cheung, Yin-Bun; Chia, Audrey; Valenzuela, Robert K; Tan, Donald; Wong, Tien-Yin; Cheng, Ching-Yu; Saw, Seang-Mei

2016-07-01

To investigate the effect of age of myopia onset on the severity of myopia later in life among myopic children. In this prospective study, school children aged 7-9 years from the Singapore Cohort Of the Risk factors for Myopia (SCORM) were followed up till 11 years (n = 928). Age of myopia onset was defined either through questionnaire at baseline (age 7-9 years) or subsequent annual follow-up visits. Age of onset of myopia was a surrogate indicator of duration of myopia progression till age 11 years. Cycloplegic refraction and axial length were measured at every annual eye examination. High myopia was defined as spherical equivalent of ≤-5.0 D. A questionnaire determined the other risk factors. In multivariable regression models, younger age of myopia onset (per year decrease) or longer duration of myopia progression was associated with high myopia (odds ratio (OR) = 2.86; 95% CI: 2.39 to 3.43), more myopic spherical equivalent (regression coefficient (β) = -0.86 D; 95% CI: -0.93 to -0.80) and longer axial length (β = 0.28 mm; 95% CI: 0.24 to 0.32) at aged 11 years, after adjusting for gender, race, school, books per week and parental myopia. In Receiver Operating Curve (ROC) analyses, age of myopia onset alone predicted high myopia by 85% (area under the curve = 0.85), while the addition of other factors including gender, race, school, books per week and parental myopia only marginally improved this prediction (area under the curve = 0.87). Age of myopia onset or duration of myopia progression was the most important predictor of high myopia in later childhood in myopic children. Future trials to retard the progression of myopia to high myopia could focus on children with younger age of myopia onset or with longer duration of myopia progression. © 2016 The Authors Ophthalmic & Physiological Optics © 2016 The College of Optometrists.

Parent Training with High-Risk Immigrant Chinese Families: A Pilot Group Randomized Trial Yielding Practice-Based Evidence

ERIC Educational Resources Information Center

Lau, Anna S.; Fung, Joey J.; Ho, Lorinda Y.; Liu, Lisa L.; Gudino, Omar G.

2011-01-01

We studied the efficacy and implementation outcomes of a culturally responsive parent training (PT) program. Fifty-four Chinese American parents participated in a wait-list controlled group randomized trial (32 immediate treatment, 22 delayed treatment) of a 14-week intervention designed to address the needs of high-risk immigrant families.…

Quit Now! A Psychoeducational Expressive Therapy Group Work Approach for At-Risk and Delinquent Adolescent Smokers in Singapore

ERIC Educational Resources Information Center

Kit, Phey Ling; Teo, Lan

2012-01-01

In this article, we review the risk and protective factors for adolescent smoking, as well as current research on evidence-based practices. The relevance of structured expressive therapy in meeting the maturational and emotional needs of at-risk and delinquent adolescents, and the multicultural context of adolescents in Singapore's Asian society…

Review of Chinese Environmental Risk Assessment Regulations and Case Studies

PubMed Central

Meng, Xiaojie; Zhang, Yan; Zhao, Yuchao; Lou, In Chio; Gao, Jixi

2012-01-01

Environmental risk assessment is an essential step in the development of solutions for pollution problems and new environmental regulations. An assessment system for environmental risks has been developed in China in recent decades. However, many of the Chinese technical guidelines, standards, and regulations were directly adapted from those of developed countries, and were not based on the Chinese environmental and socioeconomic context. Although existing environmental regulations for pollutants are usually obtained by extrapolations from high-dose toxicological data to low-dose scenarios using linear-non-threshold (LNT) models, toxicologists have argued that J-shaped or inverse J-shaped curves may dominate the dose–response relationships for environmental pollutants at low doses because low exposures stimulate biological protective mechanisms that are ineffective at higher doses. The costs of regulations based on LNT and J-shaped models could therefore be dramatically different. Since economic factors strongly affect the decision-making process, particularly for developing countries, it is time to strengthen basic research to provide more scientific support for Chinese environmental regulations. In this paper, we summarize current Chinese environmental policies and standards and the application of environmental risk assessment in China, and recommend a more scientific approach to the development of Chinese regulations. PMID:22740787

Gambling in Singapore: an overview of history, research, treatment and policy.

PubMed

Winslow, Munidasa; Cheok, Christopher; Subramaniam, Mythily

2015-09-01

This paper describes the current situation regarding gambling in Singapore in relation to its historical and cultural context. A computerized search was performed of two databases (PubMed and PsychINFO) and the reference lists from the papers searched manually to identify relevant studies. The findings were synthesized and their implications assessed. In addition to state lotteries and much informal gambling, Singapore has two large resort casinos, which rank third after Las Vegas and Macau in terms of gross revenues. The major ethnic subgroups in Singapore have different cultural connections to gambling, including the active involvement of the Chinese and religious prohibition among the Malay. A range of secondary prevention and treatment services has been developed to attempt to minimize potential negative impacts. Overall, the prevalence of pathological gambling and problem gambling has decreased in recent years: an estimated 0.2% are classified as probable pathological gamblers compared with 1.4% in 2011, 1.2% in 2008 and 2.1% in 2005. Singapore has experienced a reduction in problem gambling prevalence which may reflect the influence of multiple initiatives. © 2015 Society for the Study of Addiction.

The Health Belief Model: A Qualitative Study to Understand High-risk Sexual Behavior in Chinese Men Who Have Sex With Men.

PubMed

Li, Xianhong; Lei, Yunxiao; Wang, Honghong; He, Guoping; Williams, Ann Bartley

2016-01-01

The Health Belief Model (HBM) has been widely used to explain rationales for health risk-taking behaviors. Our qualitative study explored the applicability of the HBM to understand high-risk sexual behavior in Chinese men who have sex with men (MSM) and to elaborate each component of the model. HIV knowledge and perception of HIV prevalence contributed to perceived susceptibility. An attitude of treatment optimism versus hard life in reality affected perceived severity. Perceived barriers included discomfort using condoms and condom availability. Perceived benefits included prevention of HIV and other sexually transmitted illnesses. Sociocultural cues for Chinese MSM were elaborated according to each component. The results demonstrated that the HBM could be applied to Chinese MSM. When used with this group, it provided information to help develop a population- and disease-specific HBM scale. Results of our study also suggested behavioral interventions that could be used with Chinese MSM to increase condom use. Copyright © 2016 Association of Nurses in AIDS Care. All rights reserved.

Opt-out of voluntary HIV testing: a Singapore hospital's experience.

PubMed

Chua, Arlene C; Leo, Yee Sin; Cavailler, Philippe; Chu, Christine; Ng, Aloysius; Ng, Oon Tek; Krishnan, Prabha

2012-01-01

Since 2008, the Singapore Ministry of Health (MOH) has expanded HIV testing by increasing anonymous HIV test sites, as well as issuing a directive to hospitals to offer routine voluntary opt out inpatient HIV testing. We reviewed this program implemented at the end of 2008 at Tan Tock Seng Hospital (TTSH), the second largest acute care general hospital in Singapore. From January 2009 to December 2010, all inpatients aged greater or equal than 21 years were screened for HIV unless they declined or were not eligible for screening. We reviewed the implementation of the Opt Out testing policy. There were a total of 93,211 admissions; 41,543 patients were included based on HIV screening program eligibility criteria. Among those included, 79% (n = 32,675) opted out of HIV screening. The overall acceptance rate was 21%. Majority of eligible patients who were tested (63%) were men. The mean age of tested patients was 52 years. The opt out rate was significantly higher among females (OR: 1.5, 95%CI: 1.4-1.6), aged >60 years (OR: 2.3, 95%CI: 2.2-2.4) and Chinese ethnicity (OR: 1.7, 95%CI:1.6-1.8). The false positive rate of the HIV screening test is 0.56%. The proportion of patients with HIV infection among those who underwent HIV screening is 0.18%. All 16 confirmed HIV patients were linked to care. The default opt-in rate of inpatient HIV testing was low at Tan Tock Seng Hospital, Singapore. Efforts to address individual HIV risk perception and campaigns against HIV stigma are needed to encourage more individuals to be tested for HIV.

Vapor, Dust and Smoke Exposure in relation to adult-onset asthma and chronic respiratory symptoms: The Singapore Chinese Health Study

PubMed Central

LeVan, Tricia D.; Koh, Woon-Puay; Lee, Hin-Peng; Koh, David; Yu, Mimi C.; London, Stephanie J.

2006-01-01

Occupational factors contribute to a significant fraction of respiratory disease and symptoms. We evaluated the role of occupational exposures on asthma, chronic bronchitis, and respiratory symptoms in a population-based cohort, the Singapore Chinese Health Study. History of occupations, occupational exposures, and respiratory conditions were collected by interviews with 52,325 Singaporeans born 1918–1953. Exposure to dusts, from cotton, wood, metal, mineral and/or asbestos, was associated with non-chronic cough and/or phlegm (OR = 1.19, 95% CI = 1.08, 1.30), chronic bronchitis (OR = 1.26, 95% CI = 1.01, 1.57) and adult-onset asthma (OR = 1.14, 95% CI = 1.00, 1.30). Cotton dust was the major component contributing to respiratory symptoms. Vapor exposure, from chemical solvents, dyes, cooling oils, paints, wood preservatives and/or pesticides, was associated with non-chronic cough or phlegm (OR = 1.14, 95% CI = 1.03, 1.27), chronic dry cough (OR = 1.55, 95% CI = 1.19, 2.01) and adult-onset asthma (OR = 1.34, 95% CI = 1.15, 1.56). Chemical solvents, cooling oils and pesticides were the major sources contributing to respiratory symptoms. These data support the role of occupational exposures in the etiology of respiratory illness in a population-based cohort in Singapore with a low prevalence of atopic illness. PMID:16707657

Tea Consumption Reduces the Incidence of Neurocognitive Disorders: Findings from the Singapore Longitudinal Aging Study.

PubMed

Feng, L; Chong, M-S; Lim, W-S; Gao, Q; Nyunt, M S; Lee, T-S; Collinson, S L; Tsoi, T; Kua, E-H; Ng, T-P

2016-01-01

To examine the relationships between tea consumption habits and incident neurocognitive disorders (NCD) and explore potential effect modification by gender and the apolipoprotein E (APOE) genotype. Population-based longitudinal study. The Singapore Longitudinal Aging Study (SLAS). 957 community-living Chinese elderly who were cognitively intact at baseline. We collected tea consumption information at baseline from 2003 to 2005 and ascertained incident cases of neurocognitive disorders (NCD) from 2006 to 2010. Odds ratio (OR) of association were calculated in logistic regression models that adjusted for potential confounders. A total of 72 incident NCD cases were identified from the cohort. Tea intake was associated with lower risk of incident NCD, independent of other risk factors. Reduced NCD risk was observed for both green tea (OR=0.43) and black/oolong tea (OR=0.53) and appeared to be influenced by the changing of tea consumption habit at follow-up. Using consistent non-tea consumers as the reference, only consistent tea consumers had reduced risk of NCD (OR=0.39). Stratified analyses indicated that tea consumption was associated with reduced risk of NCD among females (OR=0.32) and APOE ε4 carriers (OR=0.14) but not males and non APOE ε4 carriers. Regular tea consumption was associated with lower risk of neurocognitive disorders among Chinese elderly. Gender and genetic factors could possibly modulate this association.

Breast-feeding and overweight in Singapore school children.

PubMed

Sabanayagam, Charumathi; Shankar, Anoop; Chong, Yap-Seng; Wong, Tien Yin; Saw, Seang Mei

2009-10-01

Studies from developed Western countries have shown inconsistent associations between breast-feeding and overweight/obesity in children and adolescents. Few data are available from Asian populations. The purpose of the present study was therefore to evaluate the association between breast-feeding and overweight/obesity in a study of 10-12-year-old children in Singapore. A total of 797 school children (49% girls, 76% Chinese) who participated in the Singapore Cohort Study of the Risk Factors for Myopia (SCORM) were examined. Overweight/obesity (n = 179) was defined as age-sex-specific body mass index (BMI) cut-offs corresponding to BMI of 25 kg/m(2) for overweight and 30 kg/m(2) for obesity at age 18 based on the International Obesity Task Force (IOTF) reference. The prevalence of overweight/obesity was 22.5%. Overall, breast-feeding was not found to be associated with overweight/obesity. After adjusting for potential confounders, the multivariable odds ratio (95% confidence interval) of overweight/obesity was 1.14 (0.80-1.63) for ever breast-fed compared with never breast-fed, 1.00 (0.57-1.72) for breast-fed for >3 months compared to < or =3 months and 0.79 (0.47-1.34) for exclusive/mostly breast-fed compared to partly breast-fed. No significant associations were detected among breast-feeding, its type, and duration with overweight/obesity in this Asian cohort of 10-12-year-old children.

Quality of life of family caregivers of cancer patients in Singapore and globally.

PubMed

Lim, Haikel A; Tan, Joyce Ys; Chua, Joanne; Yoong, Russell Kl; Lim, Siew Eng; Kua, Ee Heok; Mahendran, Rathi

2017-05-01

Family caregivers of cancer patients often suffer from impaired quality of life (QOL) due to stress arising from the responsibility of caregiving. Most research on such QOL impairments was conducted in Western populations. Thus, this exploratory study sought to (a) examine the QOL levels of family caregivers of cancer patients in an Asian population in Singapore, in relation to caregivers from other countries within and outside of Asia; and (b) investigate the association between sociodemographic factors and QOL impairments in family caregivers in Singapore. A total of 258 family caregivers of cancer patients who were receiving outpatient treatment completed the Caregiver Quality of Life Index-Cancer (CQOLC) and a sociodemographic survey. We compared the published CQOLC total scores from Turkey, Iran, Taiwan, South Korea, the United Kingdom, the United States and Canada with the Singapore dataset and examined the demographic relationships. Caregivers in Singapore and Asia had lower CQOLC total scores than their Western counterparts. Caregivers who were male, of Chinese ethnicity, had parental relationships with their care recipient, or cared for advanced-stage cancer patients were found to have impaired QOL. The findings of this study highlight possible areas in which support can be provided for family caregivers of cancer patients, and underscore the need to reconcile cultural diversity, values, societal expectations and demographic characteristics in Singapore. Copyright: © Singapore Medical Association

Distribution of PON1 polymorphisms PON1Q192R and PON1L55M among Chinese, Malay and Indian males in Singapore and possible susceptibility to organophosphate exposure.

PubMed

Chia, Sin Eng; Mohamed Ali, Safiyya; Yap, Peng Huat Eric; Gan, Linda; Ong, Yeong Bing; Chia, Kee Seng

2009-03-01

Organophosphate (OP)-containing pesticides are widely used worldwide for domestic and industrial purposes. Studies on acute and chronic exposure to OPs have revealed numerous health effects attributed mainly to acetylcholinesterase (AChE) inhibition. The enzyme human serum paraoxonase (PON1) is involved in the detoxification of OP compounds. PON1 polymorphisms have been shown to affect susceptibility to OP exposure. We studied the effect of OP exposure on pest control workers and assessed the distribution of two common PON1 polymorphisms in our local population. The exposed group consisted of 103 workers from various pest control companies under the Singapore Pest Management Association while the 91 unexposed workers were from a lead stabilizer factory. For all workers, the mean age was 36.9 (20-70) years and the ethnic distribution was 38.1% Chinese, 44.3% Malay and 17.5% Indian. The mean+/-S.D. exposure duration among the pesticide workers was 10.4+/-8.4 years. The mean+/-S.D. RBC cholinesterase level was 18436.2+/-2078U/L and 18079.6+/-1576U/L for the exposed and unexposed groups, respectively (p=0.216). The mean+/-S.D. serum pseudocholinesterase was 11028.4+/-2867.4U/L and 9433.6+/-2022.6U/L in the exposed and unexposed groups, respectively (p<0.0001). Mean paraoxonase activity was similar among Chinese and Malays (266.5 and 266.3U/L, respectively) whereas that of the Indians was significantly lower (165.6U/L). Our study showed that cholinesterase levels among the exposed were not lower than those in the unexposed group. PON1 polymorphisms differed among ethnic groups, implying that ethnicity could be an important surrogate for identifying susceptible groups in case of OP exposure. Although OP poisoning is rare among occupationally exposed workers in Singapore, this information is useful for other developing countries that have large populations of Chinese, Malays and Indians where OP exposure could be very high especially in agricultural settings.

Association of Television Viewing Time with Body Composition and Calcified Subclinical Atherosclerosis in Singapore Chinese

PubMed Central

Nang, Ei Ei Khaing; van Dam, Rob M.; Tan, Chuen Seng; Mueller-Riemenschneider, Falk; Lim, Yi Ting; Ong, Kai Zhi; Ee, Siqing; Lee, Jeannette; Tai, E. Shyong

2015-01-01

Objective Sedentary behavior such as television viewing may be an independent risk factor for coronary heart disease. However, few studies have assessed the impact of television viewing time on coronary artery calcification and it remains unclear how body fat contributes to this relationship. The aim of this study is to evaluate the association between television viewing time and subclinical atherosclerosis and whether effects on visceral or subcutaneous fat may mediate any associations observed. Methods This was a cross-sectional study of 398 Chinese participants (192 men and 206 women) from Singapore prospective study. Participants were free from known cardiovascular diseases and underwent interview, health screening, computed tomography scans of coronary arteries and abdomen. Spearman’s correlation was used to test the correlation between television viewing time, physical activity, body composition and abdominal fat distribution. The association between television viewing time and subclinical atherosclerosis was assessed by multiple logistic regression analysis. Results In men, television viewing time was significantly correlated with higher body fat mass index, percent body fat, subcutaneous and visceral fat. These associations were in the same direction, but weaker and not statistically significant in women. Television viewing time (hours/day) was associated with subclinical atherosclerosis in men (odds ratio: 1.41, 95% CI: 1.03-1.93) but no significant association was observed in women (odds ratio: 0.88, 95% CI: 0.59-1.31) after adjusting for potential socio-demographic and lifestyle confounders. Further adjustments for biological factors did not affect these associations. Conclusions Television viewing time was associated with greater adiposity and higher subcutaneous and visceral fat in men. TV viewing time was also associated with subclinical atherosclerosis in men and the potential mechanisms underlying this association require further investigation

The Anatomy of Singlish: Globalisation, Multiculturalism and the Construction of the "Local" in Singapore

ERIC Educational Resources Information Center

Goh, Robbie B. H.

2016-01-01

Singlish -- "the name given to the colloquial variety of English spoken in Singapore" [Wee, Lionel. 2014. "Linguistic Chutzpah and the Speak Good Singlish Movement." "World Englishes" 33 (1): 85-99], incorporating Chinese dialect (particularly Hokkien) and Malay lexical and grammatical elements -- has for some time…

Prevalence of foot problems in people with inflammatory arthritis in Singapore.

PubMed

Carter, K; Lahiri, M; Cheung, P P; Santosa, A; Rome, K

2016-01-01

Foot problems are highly prevalent in people with inflammatory arthritis reported from studies in the UK, Europe and New Zealand, but there is limited evidence from Southeast Asia. The study aim was to evaluate the prevalence of foot problems in people with inflammatory arthritis in Singapore. People with inflammatory arthritis were recruited from the rheumatology outpatient clinic of a tertiary hospital in Singapore. Disease and clinical characteristics included age, sex, disease duration, current blood tests and medications. The Leeds Foot Impact Scale was used to evaluate foot impairment/disability and the Modified Health Assessment Questionnaire was used to assess global function. We recruited 101 people with inflammatory arthritis, of which 50 % were female. The majority of participants were Chinese (70 %). The mean (SD) age was 52 (15) years, and the mean (SD) disease duration was 9.3 (0.3) years. The most commonly reported inflammatory arthritic conditions were rheumatoid arthritis (46), gout (31) and spondyloarthritis (15 %). The mean (SD) of the total Leeds Foot Impact Scale was 17 (13) indicating moderate to severe levels of foot impairment and activity limitation. Over 80 of participants reported foot pain during the course of their condition, and 48 % reported current foot pain. Despite the high prevalence of foot pain, only 21 participants (21 %) had been referred to a podiatrist. This is the first study to investigate the prevalence of foot problems in people with inflammatory arthritis from Singapore. The majority of the participants reported foot problems, but had not been referred to a podiatry service.

Germline mutations in 40 cancer susceptibility genes among Chinese patients with high hereditary risk breast cancer.

PubMed

Li, Junyan; Jing, Ruilin; Wei, Hongyi; Wang, Minghao; Qi, Xiaowei; Liu, Haoxi; Liu, Jian; Ou, Jianghua; Jiang, Weihua; Tian, Fuguo; Sheng, Yuan; Li, Hengyu; Xu, Hong; Zhang, Ruishan; Guan, Aihua; Liu, Ke; Jiang, Hongchuan; Ren, Yu; He, Jianjun; Huang, Weiwei; Liao, Ning; Cai, Xiangjun; Ming, Jia; Ling, Rui; Xu, Yan; Hu, Chunyan; Zhang, Jianguo; Guo, Baoliang; Ouyang, Lizhi; Shuai, Ping; Liu, Zhenzhen; Zhong, Ling; Zeng, Zhen; Zhang, Ting; Xuan, Zhaoling; Tan, Xuanni; Liang, Junbin; Pan, Qinwen; Chen, Li; Zhang, Fan; Fan, Linjun; Zhang, Yi; Yang, Xinhua; Li, Jingbo; Chen, Chongjian; Jiang, Jun

2018-05-12

Multigene panel testing of breast cancer predisposition genes have been extensively conducted in Europe and America, which is relatively rare in Asia however. In this study, we assessed the frequency of germline mutations in 40 cancer predisposition genes, including BRCA1 and BRCA2, among a large cohort of Chinese patients with high hereditary risk of BC. From 2015 to 2016, consecutive BC patients from 26 centers of China with high hereditary risk were recruited (n=937). Clinical information was collected and next-generation sequencing (NGS) was performed using blood samples of participants to identify germline mutations. In total, we acquired 223 patients with putative germline mutations, including 159 in BRCA1/2, 61 in 15 other BC susceptibility genes and 3 in both BRCA1/2 and non-BRCA1/2 gene. Major mutant non-BRCA1/2 genes were TP53 (n=18), PALB2 (n=11), CHEK2 (n=6), ATM (n=6), and BARD1 (n=5). No factors predicted pathologic mutations in non-BRCA1/2 genes when treated as a whole. TP53 mutations were associated with HER-2 positive BC and younger age at diagnosis; and CHEK2 and PALB2 mutations were enriched in patients with luminal BC. Among high hereditary risk Chinese BC patients, 23.8% contained germline mutations, including 6.8% in non-BRCA1/2 genes. TP53 and PALB2 had a relatively high mutation rates (1.9% and 1.2%). Although no factors predicted for detrimental mutations in non-BRCA1/2 genes, some clinical features were associated with mutations of several particular genes. This article is protected by copyright. All rights reserved. © 2018 UICC.

Cultural values and immigrant entrepreneurship: the Chinese in Singapore.

PubMed

Chan, K B; Chiang, S N

1994-01-01

"It is the intent of this paper to examine the interrelationships between early socialisation into core Chinese cultural values, international migration and Chinese immigrant entrepreneurship.... It is through a developmental socialisation process by which [cultural] values are articulated in family and kin network dynamics that social organisations begin to develop and define what is popularly understood as the 'Chinese way of doing business'. We argue that among the overseas Chinese, this way of doing business must be viewed historically and developmentally, as it is intimately intertwined with transmigration experiences and their consequences in shaping values necessary for the emergence and development of entrepreneurship." (SUMMARY IN FRE AND SPA) excerpt

Mass Communication in Singapore: An Annotated Bibliography. Asian Mass Communication Bibliography Series 6.

ERIC Educational Resources Information Center

Espejo, Cristina Y., Ed.; Fontgalland, Guy de, Ed.

This bibliography lists and describes published and unpublished material relating to mass communications in Singapore, from 1945 to 1973. Most of the items listed are written in English; a limited number are in Chinese. The bibliography is divided into 18 sections: bibliography and reference material; communication theory and research methods;…

A Tale of Two Cities' University Rankings: Comparing Hong Kong and Singapore

ERIC Educational Resources Information Center

Soh, Kay Cheng; Ho, Kwok Keung

2014-01-01

Hong Kong and Singapore were former British colonies, have a predominant Chinese population and value. They began to develop quickly in the late 1960s, become financial hubs of the world in the 21st century. This paper reviews the tertiary education development of the two cities, particularly on the perspective of university rankings. It first…

Temporal trends and ethnic variations in asthma mortality in Singapore, 1976-1995.

PubMed

Ng, T P; Tan, W C

1999-11-01

A study was undertaken to examine temporal trends and ethnic differences in the asthma mortality rate in Singapore. Asthma mortality rates in Singapore were estimated from vital data for the years from 1976 to 1995. Trends in sex and age specific (5-14, 15-34, 35-59, 60+ years) rates were obtained for four periods (1976-80, 1981-85, 1986-90, 1991-95) and for Chinese, Malay, and Indian subjects for the years when these data were available (1989-95). An increase in asthma mortality was observed in children aged 5-14 years from 0.21 per 100,000 person years in 1976-80 to 0.72 per 100,000 person years in 1991-95. No increases were noted in the other age groups but a small decrease was observed in the 1991-95 period for the 35-59 year age group. Marked ethnic differences in mortality rates were observed. In the group aged 5-34 years the asthma mortality rates were 0.5 per 100,000 in Chinese subjects, 1.3 per 100,000 in Indians, and 2.5 per 100,000 in Malay subjects. Similar 2-4 fold differences were observed in all other age groups. Apart from genetic factors, environmental exposures and medical care factors which influence asthma prevalence and severity are most likely to be the causes of the observed temporal trends and ethnic differences in the asthma mortality rate in Singapore, but further studies are needed to elucidate these more fully.

Opt-out of Voluntary HIV Testing: A Singapore Hospital's Experience

PubMed Central

Chua, Arlene C.; Leo, Yee Sin; Cavailler, Philippe; Chu, Christine; Ng, Aloysius; Ng, Oon Tek; Krishnan, Prabha

2012-01-01

Introduction Since 2008, the Singapore Ministry of Health (MOH) has expanded HIV testing by increasing anonymous HIV test sites, as well as issuing a directive to hospitals to offer routine voluntary opt out inpatient HIV testing. We reviewed this program implemented at the end of 2008 at Tan Tock Seng Hospital (TTSH), the second largest acute care general hospital in Singapore. Methods and Findings From January 2009 to December 2010, all inpatients aged greater or equal than 21 years were screened for HIV unless they declined or were not eligible for screening. We reviewed the implementation of the Opt Out testing policy. There were a total of 93,211 admissions; 41,543 patients were included based on HIV screening program eligibility criteria. Among those included, 79% (n = 32,675) opted out of HIV screening. The overall acceptance rate was 21%. Majority of eligible patients who were tested (63%) were men. The mean age of tested patients was 52 years. The opt out rate was significantly higher among females (OR: 1.5, 95%CI: 1.4–1.6), aged >60 years (OR: 2.3, 95%CI: 2.2–2.4) and Chinese ethnicity (OR: 1.7, 95%CI:1.6–1.8). The false positive rate of the HIV screening test is 0.56%. The proportion of patients with HIV infection among those who underwent HIV screening is 0.18%. All16 confirmed HIV patients were linked to care. Conclusion The default opt-in rate of inpatient HIV testing was low at Tan Tock Seng Hospital, Singapore. Efforts to address individual HIV risk perception and campaigns against HIV stigma are needed to encourage more individuals to be tested for HIV. PMID:22493708

[Application of three risk assessment models in occupational health risk assessment of dimethylformamide].

PubMed

Wu, Z J; Xu, B; Jiang, H; Zheng, M; Zhang, M; Zhao, W J; Cheng, J

2016-08-20

Objective: To investigate the application of United States Environmental Protection Agency (EPA) inhalation risk assessment model, Singapore semi-quantitative risk assessment model, and occupational hazards risk assessment index method in occupational health risk in enterprises using dimethylformamide (DMF) in a certain area in Jiangsu, China, and to put forward related risk control measures. Methods: The industries involving DMF exposure in Jiangsu province were chosen as the evaluation objects in 2013 and three risk assessment models were used in the evaluation. EPA inhalation risk assessment model: HQ=EC/RfC; Singapore semi-quantitative risk assessment model: Risk= (HR×ER) 1/2 ; Occupational hazards risk assessment index=2 Health effect level ×2 exposure ratio ×Operation condition level. Results: The results of hazard quotient (HQ>1) from EPA inhalation risk assessment model suggested that all the workshops (dry method, wet method and printing) and work positions (pasting, burdening, unreeling, rolling, assisting) were high risk. The results of Singapore semi-quantitative risk assessment model indicated that the workshop risk level of dry method, wet method and printing were 3.5 (high) , 3.5 (high) and 2.8 (general) , and position risk level of pasting, burdening, unreeling, rolling, assisting were 4 (high) , 4 (high) , 2.8 (general) , 2.8 (general) and 2.8 (general) . The results of occupational hazards risk assessment index method demonstrated that the position risk index of pasting, burdening, unreeling, rolling, assisting were 42 (high) , 33 (high) , 23 (middle) , 21 (middle) and 22 (middle) . The results of Singapore semi-quantitative risk assessment model and occupational hazards risk assessment index method were similar, while EPA inhalation risk assessment model indicated all the workshops and positions were high risk. Conclusion: The occupational hazards risk assessment index method fully considers health effects, exposure, and operating conditions

Health risk factors associated with presenteeism in a Chinese enterprise.

PubMed

Yu, J; Wang, S; Yu, X

2015-12-01

Chronic health problems are prevalent in China and may lead to loss of work productivity through presenteeism. To investigate the prevalence of potential risk factors for presenteeism in Chinese workers and the strength of their association with reported presenteeism. A cross-sectional survey of employees in a Chinese petrochemical corporation included a medical examination report and questionnaire data on demographic characteristics, potential risk factors for presenteeism and presenteeism evaluation. Data were analysed using Pearson's chi-square tests, t-tests and logistic regression modelling. There were 1506 responses available for analysis; response rate 92%. The prevalence of presenteeism was 15%. Univariate analysis indicated a significantly higher prevalence of presenteeism in employees who were male, age ≤35 years, single, divorced or widowed and overweight or obese. Higher presenteeism was found in participants with high blood pressure, hypertriglyceridemia, hypercholesterolemia, insufficient physical activity, cigarette smoking, alcohol use, insufficient cereal intake, life dissatisfaction and job dissatisfaction. The prevalence of presenteeism was significantly associated with the number of potential risk factors. Logistic regression disclosed six independent risk factors associated with presenteeism: hypercholesterolemia, high blood pressure, insufficient physical activity, alcohol drinking, insufficient cereal intake and life dissatisfaction. Chronic conditions, health risk factors and presenteeism were prevalent in employees of a Chinese petrochemical corporation. Risk factors for other health conditions were associated with presenteeism. Health management programmes should be implemented to reduce risk factors and promote the health of employees in an effort to reduce presenteeism. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Understanding domains of health-related quality of life concerns of Singapore Chinese patients with advanced cancer: a qualitative analysis.

PubMed

Lee, G L; Pang, G S Y; Akhileswaran, R; Ow, M Y L; Fan, G K T; Wong, C C F; Wee, H L; Cheung, Y B

2016-03-01

Quality of life concerns in patients with advanced diseases might be different from other patients and are shaped by sociocultural context. The objective of this qualitative study was to identify domains and themes of health-related quality of life (HRQoL) that Chinese patients with advanced cancer in Singapore considered relevant and important. English- and Chinese-speaking patients with advanced solid cancer were recruited from a tertiary cancer center and a community-based hospice for in-depth interview or focused group discussion. Thematic analysis was used to identify subthemes, themes, and domains from the transcripts. Forty-six ethnic Chinese (aged 26-86, 48% male) participated in the study. Six domains of HRQoL concerns were identified: pain and suffering, physical health, social health, mental health, financial well-being, and spiritual health. Pain and suffering are not limited to the physical domain, reflecting the multidimensional nature of this concept. Pain and suffering must also be understood within the cultural context. Healthcare relations (i.e., social health), existential well-being and religious well-being (i.e., spiritual health), and suffering (i.e., pain and suffering) are not fully captured in the existing HRQoL instruments. In addition, financial issues and the practice of secrecy in interpersonal relationships emerged as unique features possibly arising from our sociocultural context and healthcare financing landscape. Socioculturally specific issues not measured by the existing HRQoL instruments for use in patients with advanced cancers or terminal diseases were found in our study. These are non-physical pain and suffering, meaning of illness, meaning of death, financial issues, and practice of secrecy in interpersonal relationships.

Comparison of Body Mass Index (BMI), Body Adiposity Index (BAI), Waist Circumference (WC), Waist-To-Hip Ratio (WHR) and Waist-To-Height Ratio (WHtR) as predictors of cardiovascular disease risk factors in an adult population in Singapore.

PubMed

Lam, Benjamin Chih Chiang; Koh, Gerald Choon Huat; Chen, Cynthia; Wong, Michael Tack Keong; Fallows, Stephen J

2015-01-01

Excess adiposity is associated with cardiovascular disease (CVD) risk factors such as hypertension, diabetes mellitus and dyslipidemia. Amongst the various measures of adiposity, the best one to help predict these risk factors remains contentious. A novel index of adiposity, the Body Adiposity Index (BAI) was proposed in 2011, and has not been extensively studied in all populations. Therefore, the purpose of this study is to compare the relationship between Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR), Waist-to-Height Ratio (WHtR), Body Adiposity Index (BAI) and CVD risk factors in the local adult population. This is a cross sectional study involving 1,891 subjects (Chinese 59.1% Malay 22.2%, Indian 18.7%), aged 21-74 years, based on an employee health screening (2012) undertaken at a hospital in Singapore. Anthropometric indices and CVD risk factor variables were measured, and Spearman correlation, Receiver Operating Characteristic (ROC) curves and multiple logistic regressions were used. BAI consistently had the lower correlation, area under ROC and odd ratio values when compared with BMI, WC and WHtR, although differences were often small with overlapping 95% confidence intervals. After adjusting for BMI, BAI did not further increase the odds of CVD risk factors, unlike WC and WHtR (for all except hypertension and low high density lipoprotein cholesterol). When subjects with the various CVD risk factors were grouped according to established cut-offs, a BMI of ≥23.0 kg/m2 and/or WHtR ≥0.5 identified the highest proportion for all the CVD risk factors in both genders, even higher than a combination of BMI and WC. BAI may function as a measure of overall adiposity but it is unlikely to be better than BMI. A combination of BMI and WHtR could have the best clinical utility in identifying patients with CVD risk factors in an adult population in Singapore.

Singapore Healthy Older People Everyday (HOPE) Study: Prevalence of Frailty and Associated Factors in Older Adults.

PubMed

Merchant, Reshma A; Chen, Matthew Zhixuan; Tan, Linda Wei Lin; Lim, Moses YiDong; Ho, Han Kwee; van Dam, Rob M

2017-08-01

In the context of a rapidly ageing population, Singapore is anticipating a rise in multimorbidity, disability, and dependency, which are driven by physical frailty. Healthy Older People Everyday (HOPE) is an epidemiologic population-based study on community-dwelling older adults aged 65 years and older in Singapore. To investigate the prevalence of frail and prefrail states and their association with polypharmacy, multimorbidity, cognitive and functional status, and perceived health status among community-dwelling older adults in Singapore. Participants for HOPE were older adults aged 65 years and older recruited from a cohort study on the northwest region of Singapore. Analysis was performed on data collected from a combination of interviewer-administered questionnaires (including FRAIL scale, EQ-5D, Mini Mental State Examination, Barthel index, and Lawton IADL scale), clinical assessments, and physical measurements (including hand grip strength and Timed-Up-and-Go [TUG] test). A total of 1051 older adults (mean age 71.2 years) completed the study. More than half (57.2%) were female. The prevalence of frailty and prefrailty was 6.2% and 37%, respectively. Frailty was associated with older age, female gender, Indian (instead of Chinese) ethnicity, multimorbidity, polypharmacy, cognitive and functional impairment, weaker hand grip strength, longer TUG times, and poor perceived health status. Those with underlying cognitive impairment and frailty were at greater risk of adverse health outcome. Frailty is a complex health state with multiple domains and dimensions. In our study in a multiethnic Asian population, we identified nonmodifiable factors and modifiable risk factors (multimorbidity, polypharmacy, cognitive and functional impairment) that were associated with frailty. Interventions will have to be multipronged and will require a collaborated effort in order to effect change and improve the health span in rapidly ageing populations. Copyright © 2017 AMDA �

Attitudes to Mental Illness and Its Demographic Correlates among General Population in Singapore.

PubMed

Yuan, Qi; Abdin, Edimansyah; Picco, Louisa; Vaingankar, Janhavi Ajit; Shahwan, Shazana; Jeyagurunathan, Anitha; Sagayadevan, Vathsala; Shafie, Saleha; Tay, Jenny; Chong, Siow Ann; Subramaniam, Mythily

2016-01-01

Public attitudes to mental illness could influence how the public interact with, provide opportunities for, and help people with mental illness. This study aims to explore the underlying factors of the Attitudes to Mental Illness questionnaire among the general population in Singapore and the socio-demographic correlates of each factor. From March 2014 to April 2015, a nation-wide cross-sectional survey on mental health literacy with 3,006 participants was conducted in Singapore. Factor analysis revealed a 4-factor structure for the Attitudes to Mental Illness questionnaire among the Singapore general population, namely social distancing, tolerance/support for community care, social restrictiveness, and prejudice and misconception. Older age, male gender, lower education and socio-economic status were associated with more negative attitudes towards the mentally ill. Chinese showed more negative attitudes than Indians and Malays (except for prejudice and misconception). There is a need for culture-specific interventions, and the associated factors identified in this study should be considered for future attitude campaigns.

Rising incidence of thyroid cancer in Singapore not solely due to micropapillary subtype.

PubMed

Shulin, J H; Aizhen, J; Kuo, S M; Tan, W B; Ngiam, K Y; Parameswaran, R

2018-04-01

Introduction The annual incidence of thyroid cancer is known to vary with geographic area, age and gender. The increasing incidence of thyroid cancer has been attributed to increase in detection of micropapillary subtype, among other factors. The aim of the study was to investigate time trends in the incidence of thyroid cancer in Singapore, an iodine-sufficient area. Materials and methods Data retrieved from the Singapore National Cancer Registry on all thyroid cancers that were diagnosed from 1974 to 2013 were reviewed. We studied the time trends of thyroid cancer based on gender, race, pathology and treatment modalities where available. Results The age-standardised incidence rate of thyroid cancer increased to 5.6/100,000 in 2013 from 2.5/100,000 in 1974. Thyroid cancer appeared to be more common in women, with a higher incidence in Chinese and Malays compared with Indians. Papillary carcinoma is the most common subtype. The percentage of papillary microcarcinoma has remained relatively stable at around 38% of all papillary cancers between 2007 and 2013. Although the incidence of thyroid cancer has increased since 1974, the mortality rate has remained stable. Conclusion This trend of increase in incidence of thyroid cancer in Singapore compares with other published series; however, the rise seen was not solely due to micropapillary type. Thyroid cancer was also more common in Chinese and Malays compared with Indians for reasons that needs to be studied further.

Metabolic signatures and risk of type 2 diabetes in a Chinese population: an untargeted metabolomics study using both LC-MS and GC-MS.

PubMed

Lu, Yonghai; Wang, Yeli; Ong, Choon-Nam; Subramaniam, Tavintharan; Choi, Hyung Won; Yuan, Jian-Min; Koh, Woon-Puay; Pan, An

2016-11-01

Metabolomics has provided new insight into diabetes risk assessment. In this study we characterised the human serum metabolic profiles of participants in the Singapore Chinese Health Study cohort to identify metabolic signatures associated with an increased risk of type 2 diabetes. In this nested case-control study, baseline serum metabolite profiles were measured using LC-MS and GC-MS during a 6-year follow-up of 197 individuals with type 2 diabetes but without a history of cardiovascular disease or cancer before diabetes diagnosis, and 197 healthy controls matched by age, sex and date of blood collection. A total of 51 differential metabolites were identified between cases and controls. Of these, 35 were significantly associated with diabetes risk in the multivariate analysis after false discovery rate adjustment, such as increased branched-chain amino acids (leucine, isoleucine and valine), non-esterified fatty acids (palmitic acid, stearic acid, oleic acid and linoleic acid) and lysophosphatidylinositol (LPI) species (16:1, 18:1, 18:2, 20:3, 20:4 and 22:6). A combination of six metabolites including proline, glycerol, aminomalonic acid, LPI (16:1), 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid and urea showed the potential to predict type 2 diabetes in at-risk individuals with high baseline HbA1c levels (≥6.5% [47.5 mmol/mol]) with an AUC of 0.935. Combined lysophosphatidylglycerol (LPG) (12:0) and LPI (16:1) also showed the potential to predict type 2 diabetes in individuals with normal baseline HbA1c levels (<6.5% [47.5 mmol/mol]; AUC = 0.781). Our findings show that branched-chain amino acids and NEFA are potent predictors of diabetes development in Chinese adults. Our results also indicate the potential of lysophospholipids for predicting diabetes.

The joint effects of risk status, gender, early literacy and cognitive skills on the presence of dyslexia among a group of high-risk Chinese children.

PubMed

Wong, Simpson W L; McBride-Chang, Catherine; Lam, Catherine; Chan, Becky; Lam, Fanny W F; Doo, Sylvia

2012-02-01

This study sought to examine factors that are predictive of future developmental dyslexia among a group of 5-year-old Chinese children at risk for dyslexia, including 62 children with a sibling who had been previously diagnosed with dyslexia and 52 children who manifested clinical at-risk factors in aspects of language according to testing by paediatricians. The age-5 performances on various literacy and cognitive tasks, gender and group status (familial risk or language delayed) were used to predict developmental dyslexia 2 years later using logistic regression analysis. Results showed that greater risk of dyslexia was related to slower rapid automatized naming, lower scores on morphological awareness, Chinese character recognition and English letter naming, and gender (boys had more risk). Three logistic equations were generated for estimating individual risk of dyslexia. The strongest models were those that included all print-related variables (including speeded number naming, character recognition and letter identification) and gender, with about 70% accuracy or above. Early identification of those Chinese children at risk for dyslexia can facilitate better dyslexia risk management. Copyright © 2012 John Wiley & Sons, Ltd.

Counseling in Singapore

ERIC Educational Resources Information Center

Yeo, Lay See; Tan, Soo Yin; Neihart, Maureen F.

2012-01-01

Singapore, a tiny island nation, rose from 3rd- to 1st-world status in just 3 decades. Unlike in most developed countries, counseling in Singapore has a short history with faith-based beginnings and currently faces challenges to remain culturally relevant. The authors trace the development of Singapore's counseling services, provide an update…

Association of Maternal Vitamin D Status with Glucose Tolerance and Caesarean Section in a Multi-Ethnic Asian Cohort: The Growing Up in Singapore Towards Healthy Outcomes Study

PubMed Central

Loy, See Ling; Lek, Ngee; Yap, Fabian; Soh, Shu E.; Padmapriya, Natarajan; Tan, Kok Hian; Biswas, Arijit; Yeo, George Seow Heong; Kwek, Kenneth; Gluckman, Peter D.; Godfrey, Keith M.; Saw, Seang Mei; Müller-Riemenschneider, Falk; Chong, Yap-Seng; Chong, Mary Foong-Fong; Chan, Jerry Kok Yen

2015-01-01

Objective Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Methods Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26–28 weeks’ gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ≤75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section. Results In total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (β = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (β = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73). Conclusions 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay

Association of Maternal Vitamin D Status with Glucose Tolerance and Caesarean Section in a Multi-Ethnic Asian Cohort: The Growing Up in Singapore Towards Healthy Outcomes Study.

PubMed

Loy, See Ling; Lek, Ngee; Yap, Fabian; Soh, Shu E; Padmapriya, Natarajan; Tan, Kok Hian; Biswas, Arijit; Yeo, George Seow Heong; Kwek, Kenneth; Gluckman, Peter D; Godfrey, Keith M; Saw, Seang Mei; Müller-Riemenschneider, Falk; Chong, Yap-Seng; Chong, Mary Foong-Fong; Chan, Jerry Kok Yen

2015-01-01

Epidemiological studies relating maternal 25-hydroxyvitamin D (25OHD) with gestational diabetes mellitus (GDM) and mode of delivery have shown controversial results. We examined if maternal 25OHD status was associated with plasma glucose concentrations, risks of GDM and caesarean section in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Plasma 25OHD concentrations, fasting glucose (FG) and 2-hour postprandial glucose (2HPPG) concentrations were measured in 940 women from a Singapore mother-offspring cohort study at 26-28 weeks' gestation. 25OHD inadequacy and adequacy were defined based on concentrations of 25OHD ≤75nmol/l and >75nmol/l respectively. Mode of delivery was obtained from hospital records. Multiple linear regression was performed to examine the association between 25OHD status and glucose concentrations, while multiple logistic regression was performed to examine the association of 25OHD status with risks of GDM and caesarean section. In total, 388 (41.3%) women had 25OHD inadequacy. Of these, 131 (33.8%), 155 (39.9%) and 102 (26.3%) were Chinese, Malay and Indian respectively. After adjustment for confounders, maternal 25OHD inadequacy was associated with higher FG concentrations (β = 0.08mmol/l, 95% Confidence Interval (CI) = 0.01, 0.14), but not 2HPPG concentrations and risk of GDM. A trend between 25OHD inadequacy and higher likelihood of emergency caesarean section (Odds Ratio (OR) = 1.39, 95% CI = 0.95, 2.05) was observed. On stratification by ethnicity, the association with higher FG concentrations was significant in Malay women (β = 0.19mmol/l, 95% CI = 0.04, 0.33), while risk of emergency caesarean section was greater in Chinese (OR = 1.90, 95% CI = 1.06, 3.43) and Indian women (OR = 2.41, 95% CI = 1.01, 5.73). 25OHD inadequacy is prevalent in pregnant Singaporean women, particularly among the Malay and Indian women. This is associated with higher FG concentrations in Malay women, and increased risk of emergency

Attitudes towards Mandarin-English Bilingualism: A Study of Chinese Youths in Singapore

ERIC Educational Resources Information Center

Xie, Wenhan; Cavallaro, Francesco

2016-01-01

Not only does Singapore have a unique ethnic and multilingual makeup, it also boasts unique language policies, especially with regard to the learning of the official languages. Previous studies of Singaporean youths have largely focused on the differences in attitudes and code-switching between linguistic varieties (e.g. Colloquial Singapore…

A numerical study on flow and pollutant transport in Singapore coastal waters.

PubMed

Xu, Ming; Chua, Vivien P

2016-10-15

Intensive economic and shipping activities in Singapore Strait have caused Singapore coastal waters to be under high risk of water pollution. A nested three-dimensional unstructured-grid SUNTANS model is applied to Singapore coastal waters to simulate flow and pollutant transport. The small domain (~50m resolution) Singapore coastal model is nested within a large domain (~200m resolution) regional model. The nested model is able to predict water surface elevations and velocities with high R(2) values of 0.96 and 0.91, respectively. Model results delineate the characteristics of circulation pattern in Singapore coastal waters during the Northeast and Southwest monsoons. The pollutants are modeled as passive tracers, and are released at six key sailing locations Points 1-6 in Singapore coastal waters and are named as Passive Tracers 1-6, respectively. Our results show that the rate of dispersion is twice as large for the Northeast monsoon compared to the Southwest monsoon due to differences in large-scale monsoons and small-scale local winds. The volume averaged concentration (VAC) diminishes faster and the local flushing time is shorter during the Northeast monsoon than the Southwest monsoon. Dispersion coefficients K and the VAC decreasing rate are maximum for Tracers 2 and 3 with shortest local flushing time due to the strong surrounding currents and abrupt bathymetry changes near Senang and St. John Islands. Dispersion coefficients K and the VAC decreasing rate are minimum for Tracer 1 due to weak currents induced by the semi-enclosed coastline near Tuas. It is found that both the lateral dispersion coefficient Ky and the compound dispersion coefficient K obey a "4/3-law", which defines a linear correlation between dispersion coefficients and 4/3-power of selected length scale. Copyright © 2016 Elsevier Ltd. All rights reserved.

Validation of the Singapore nomogram for outcome prediction in breast phyllodes tumours: an Australian cohort.

PubMed

Chng, Tze Wei; Lee, Jonathan Y H; Lee, C Soon; Li, HuiHua; Tan, Min-Han; Tan, Puay Hoon

2016-12-01

To validate the utility of the Singapore nomogram for outcome prediction in breast phyllodes tumours. Histological parameters, surgical margin status and clinical follow-up data of 34 women diagnosed with phyllodes tumours were analysed. Biostatistics modelling was performed, and the concordance between predicted and observed survivals was calculated. Women with a high nomogram score had an increased risk of developing relapse, which was predicted using the parameters defined by the Singapore nomogram. The Singapore nomogram is useful in predicting outcome in breast phyllodes tumours when applied to an Australian cohort of 34 women. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Soil organic carbon distribution in roadside soils of Singapore.

PubMed

Ghosh, Subhadip; Scharenbroch, Bryant C; Ow, Lai Fern

2016-12-01

Soil is the largest pool of organic carbon in terrestrial systems and plays a key role in carbon cycle. Global population living in urban areas are increasing substantially; however, the effects of urbanization on soil carbon storage and distribution are largely unknown. Here, we characterized the soil organic carbon (SOC) in roadside soils across the city-state of Singapore. We tested three hypotheses that SOC contents (concentration and density) in Singapore would be positively related to aboveground tree biomass, soil microbial biomass and land-use patterns. Overall mean SOC concentrations and densities (0-100 cm) of Singapore's roadside soils were 29 g kg -1 (4-106 g kg -1 ) and 11 kg m -2 (1.1-42.5 kg m -2 ) with median values of 26 g kg -1 and 10 kg m -2 , respectively. There was significantly higher concentration of organic carbon (10.3 g kg -1 ) in the top 0-30 cm soil depth compared to the deeper (30-50 cm, and 50-100 cm) soil depths. Singapore's roadside soils represent 4% of Singapore's land, but store 2.9 million Mg C (estimated range of 0.3-11 million Mg C). This amount of SOC is equivalent to 25% of annual anthropogenic C emissions in Singapore. Soil organic C contents in Singapore's soils were not related to aboveground vegetation or soil microbial biomass, whereas land-use patterns to best explain variance in SOC in Singapore's roadside soils. We found SOC in Singapore's roadside soils to be inversely related to urbanization. We conclude that high SOC in Singapore roadside soils are probably due to management, such as specifications of high quality top-soil, high use of irrigation and fertilization and also due to an optimal climate promoting rapid growth and biological activity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Seroepidemiology of dengue virus infection in the adult population in tropical Singapore.

PubMed

Ang, L W; Cutter, J; James, L; Goh, K T

2015-06-01

To assess the impact of past dengue epidemics in Singapore, we undertook a national seroepidemiological study to determine the prevalence of past dengue virus (DENV) infection in the adult population in 2010 and make comparisons with the seroprevalence in 2004. The study involved residual sera from 3293 adults aged 18-79 years who participated in a national health survey in 2010. The overall prevalence of anti-DENV IgG antibodies was 56·8% (95% confidence interval 55·1-58·5) in 2010. The seroprevalence increased significantly with age. Males had significantly higher seroprevalence than females (61·5% vs. 53·2%). Among the three major ethnic groups, Malays had the lowest seroprevalence (50·2%) compared to Chinese (57·0%) and Indians (62·0%). The age-standardized seroprevalence in adults was significantly lower in 2010 (54·4%) compared to 2004 (63·1%). Older age, male gender, Indian ethnicity, permanent residency and being home-bound were independent risk factors significantly associated with seropositivity. About 43% of the Singapore adult resident population remain susceptible to DENV infection as a result of the successful implementation of a comprehensive nationwide Aedes surveillance and control programme since the 1970s. Vector suppression and concerted efforts of all stakeholders in the community remain the key strategy in the prevention and control of dengue.

Home Language Shift and Its Implications for Chinese Language Teaching in Singapore

ERIC Educational Resources Information Center

Li, Li; Tan, Chee Lay; Goh, Hock Huan

2016-01-01

In a bilingual society like Singapore, home language environment (HLE) of Singaporean children is becoming increasingly concerned, especially for those who are yet to have formal education in schools. The reported rapid shift of family language has increased the tensions among families, schools and communities. This study examined some of the many…

Risk factors for breast cancer in postmenopausal Caucasian and Chinese-Canadian women.

PubMed

Tam, Carolyn Y; Martin, Lisa J; Hislop, Gregory; Hanley, Anthony J; Minkin, Salomon; Boyd, Norman F

2010-01-01

Striking differences exist between countries in the incidence of breast cancer. The causes of these differences are unknown, but because incidence rates change in migrants, they are thought to be due to lifestyle rather than genetic differences. The goal of this cross-sectional study was to examine breast cancer risk factors in populations with different risks for breast cancer. We compared breast cancer risk factors among three groups of postmenopausal Canadian women at substantially different risk of developing breast cancer - Caucasians (N = 413), Chinese women born in the West or who migrated to the West before age 21 (N = 216), and recent Chinese migrants (N = 421). Information on risk factors and dietary acculturation were collected by telephone interviews using questionnaires, and anthropometric measurements were taken at a home visit. Compared to Caucasians, recent Chinese migrants weighed on average 14 kg less, were 6 cm shorter, had menarche a year later, were more often parous, less often had a family history of breast cancer or a benign breast biopsy, a higher Chinese dietary score, and a lower Western dietary score. For most of these variables, Western born Chinese and early Chinese migrants had values intermediate between those of Caucasians and recent Chinese migrants. We estimated five-year absolute risks for breast cancer using the Gail Model and found that risk estimates in Caucasians would be reduced by only 11% if they had the risk factor profile of recent Chinese migrants for the risk factors in the Gail Model. Our results suggest that in addition to the risk factors in the Gail Model, there likely are other factors that also contribute to the large difference in breast cancer risk between Canada and China.

Prehospital Trauma Care in Singapore.

PubMed

Ho, Andrew Fu Wah; Chew, David; Wong, Ting Hway; Ng, Yih Yng; Pek, Pin Pin; Lim, Swee Han; Anantharaman, Venkataraman; Hock Ong, Marcus Eng

2015-01-01

Prehospital emergency care in Singapore has taken shape over almost a century. What began as a hospital-based ambulance service intended to ferry medical cases was later complemented by an ambulance service under the Singapore Fire Brigade to transport trauma cases. The two ambulance services would later combine and come under the Singapore Civil Defence Force. The development of prehospital care systems in island city-state Singapore faces unique challenges as a result of its land area and population density. This article defines aspects of prehospital trauma care in Singapore. It outlines key historical milestones and current initiatives in service, training, and research. It makes propositions for the future direction of trauma care in Singapore. The progress Singapore has made given her circumstances may serve as lessons for the future development of prehospital trauma systems in similar environments. Key words: Singapore; trauma; prehospital emergency care; emergency medical services.

Assessment of Creative Writing: The Case of Singapore Secondary Chinese Language Curriculum

ERIC Educational Resources Information Center

Tung, Chan Kwong

2015-01-01

In Singapore and in elsewhere alike, educators nowadays are paying much more attention on the set of teaching and assessment recommendations called the 21st century skills that include creativity at the policy, programmatic, school and classroom levels. As these education systems develop and respond to the demands of the new century, educators are…

Indonesia, Sumatra, Singapore

NASA Technical Reports Server (NTRS)

1991-01-01

This view shows the area around Northeastern Sumatra, Indonesia (1.0N, 104.0E). The city of Singapore and the Singapore Strait is in the center at the southern tip of the Malay Peninsula. The Singapore Strait is the eastern extension of the Strait of Malacca and separates the Malay Peninsula from Sumatra. Large sediment plumes from the rivers attest to the local soil erosion and industrial dumping ofd wastes.

Indonesia, Sumatra, Singapore

NASA Image and Video Library

1991-08-11

This view shows the area around Northeastern Sumatra, Indonesia (1.0N, 104.0E). The city of Singapore and the Singapore Strait is in the center at the southern tip of the Malay Peninsula. The Singapore Strait is the eastern extension of the Strait of Malacca and separates the Malay Peninsula from Sumatra. Large sediment plumes from the rivers attest to the local soil erosion and industrial dumping ofd wastes.

Singapore.

PubMed

1982-09-01

Attention in this discussion of Singapore is directed to the following: history of the country's demographic situation; government's overall approach to population problems; population data systems and development planning; institutional arrangements for the integration of population within development planning; government's view of the importance of population policy in achieving development objectives; population size, growth and natural increase; morbidity and mortality; fertility; international migration; and spatial distribution. The Republic of Singapore has experienced high population growth rates for some time, with its population of 1.02 million in 1950 increasing to an estimated 2.39 million in 1980. In recent years the rate has declined significantly, decreasing from nearly 5% per year in the early 1950s to 2.8 in 1960-65 and 1.5 in 1970-75. At the present growth rate of about 1.2% per annum, and anticipating the further declines that have been projected for 1995-2000, the population of Singapore is expected to reach about 2.97 million by the end of this century. The government considers the stabilization of the country's population to be 1 of its important objectives. In 1961 population growth was recognized as a serious problem. Singapore has a long history of census taking, having recently conducted its 11th decennial census. Because of the rapid decline in fertility in recent years, the government perceives the nation's current rates of natural increase and fertility as satisfactory, neither constraining development nor inhibiting economic growth. Yet, the government has established as a social norm a goal of a 2 child family and supports policies that discourage early marriage and childbearing at very young ages. The government maintains that Singapore's current rate of population growth is satisfactory, which is a recent change of position that is based on the rapid decline in fertility in the 1960s and 1970s. The crude death rate declined from

Assessing cancer risk in China from γ-hexachlorocyclohexane emitted from Chinese and Indian sources.

PubMed

Xu, Yue; Tian, Chongguo; Ma, Jianmin; Wang, Xiaoping; Li, Jun; Tang, Jianhui; Chen, Yingjun; Qin, Wei; Zhang, Gan

2013-07-02

Three models, including an atmospheric transport model, a multimedia exposure model, and a risk assessment model, were used to assess cancer risk in China caused by γ-HCH (gamma-hexachlorocyclohexane) emitted from Chinese and Indian sources. Extensive model investigations revealed the contribution of different sources to the cancer risk in China. Cancer risk in Eastern China was primarily attributable to γ-HCH contamination from Chinese sources, whereas cancer risk in Western China was caused mostly by Indian emissions. The contribution of fresh use of lindane in India to the cancer risk in China was almost 1 order of magnitude higher than that of the reemission of γ-HCH from Indian soils. Of total population, 58% (about 0.79 billion) residents in China were found to live in the environment with high levels of cancer risk exceeding the acceptable cancer risk of 10(-6), recommended by the United States Environmental Protection Agency (U.S. EPA). The cancer risk in China was mostly induced by the local contamination of γ-HCH emitted from Chinese sources, whereas fresh use of lindane in India will become a significant source of the cancer risk in China if Indian emissions maintain their current levels.

Attitudes to Mental Illness and Its Demographic Correlates among General Population in Singapore

PubMed Central

Yuan, Qi; Abdin, Edimansyah; Picco, Louisa; Vaingankar, Janhavi Ajit; Shahwan, Shazana; Jeyagurunathan, Anitha; Sagayadevan, Vathsala; Shafie, Saleha; Tay, Jenny; Chong, Siow Ann; Subramaniam, Mythily

2016-01-01

Background Public attitudes to mental illness could influence how the public interact with, provide opportunities for, and help people with mental illness. Aims This study aims to explore the underlying factors of the Attitudes to Mental Illness questionnaire among the general population in Singapore and the socio-demographic correlates of each factor. Methods From March 2014 to April 2015, a nation-wide cross-sectional survey on mental health literacy with 3,006 participants was conducted in Singapore. Results Factor analysis revealed a 4-factor structure for the Attitudes to Mental Illness questionnaire among the Singapore general population, namely social distancing, tolerance/support for community care, social restrictiveness, and prejudice and misconception. Older age, male gender, lower education and socio-economic status were associated with more negative attitudes towards the mentally ill. Chinese showed more negative attitudes than Indians and Malays (except for prejudice and misconception). Conclusions There is a need for culture-specific interventions, and the associated factors identified in this study should be considered for future attitude campaigns. PMID:27893796

Body mass index, waist-hip ratio and risk of chronic medical condition in the elderly population: results from the Well-being of the Singapore Elderly (WiSE) Study.

PubMed

Fauziana, Restria; Jeyagurunathan, Anitha; Abdin, Edimansyah; Vaingankar, Janhavi; Sagayadevan, Vathsala; Shafie, Saleha; Sambasivam, Rajeswari; Chong, Siow Ann; Subramaniam, Mythily

2016-06-18

The aim of the current study was to establish the prevalence and relationship of Body Mass Index (BMI) and Waist-Hip Ratio (WHR) with chronic health conditions and their associated socio-demographic correlates in the elderly population of Singapore. The data was extracted from the Well-being of the Singapore Elderly (WiSE) study, a comprehensive single phase, cross-sectional, population-based, epidemiological study conducted in 2013 among Singaporean residents (n = 2565) aged 60 years and above with a mean age of 72.7 years (range 60 to 105, SD = 9.53). The respondents were assessed with anthropometric measurements including height, weight, BMI, waist circumference, hip circumference and WHR. Participants provided information on their socio-demographic details and chronic health conditions. Prevalence of those who were obese, overweight, normal and underweight based on BMI was 8.7 %, 33.4 %, 52.5 % and 5.5 % respectively. Malays were more likely to be overweight compared to Chinese and Indians, while Malays and Indians were more likely to be obese compared to Chinese. Participants who were never married were less likely to be overweight compared to married. Participants aged 85 years and above were more likely to be underweight compared to those aged 60-75 years. Prevalence of high WHR (above 0.90 for men and 0.80 for women) was 79.8 % and this was more pervasive amongst Indians. Participants who were homemakers were more likely to have high WHR while those with tertiary education tended to have low WHR. Being overweight was associated with hypertension and heart problems, while obesity was associated with hypertension and diabetes, and a high WHR was associated with hypertension and diabetes. There were no significant differences in the other chronic conditions in this elderly population. This study demonstrates the importance of anthropometric measurements in the elderly and its association with certain chronic physical conditions, indicating

Factor structure of the Singapore English version of the KINDL® children quality of life questionnaire

PubMed Central

Wee, Hwee-Lin; Ravens-Sieberer, Ulrike; Erhart, Michael; Li, Shu-Chuen

2007-01-01

Background Quality of life (QoL) outcomes are useful in the assessment of physical, mental and social well-being and for informed healthcare decision making. However, few studies have evaluated QoL issues among Asian children due largely to the lack of culturally valid and reliable QoL questionnaires. Hence, we aimed to report the psychometric properties, in particular factor structure, of KINDL (Singapore) questionnaires among school-going children. Methods Students aged 8–16 years from participating schools were selected by convenience sampling. Subjects self-completed KINDL-Kid (Singapore) and KINDL-Kiddo (Singapore) questionnaires, which were cross-culturally adapted from KINDL (Germany English) for use in Singapore. We evaluated floor and ceiling effects, internal consistency and performed factor analysis. Results A total of 328 respondents (mean (SD) age: 9.6 (1.31) years; 67% female; 75% Chinese, 16% Malays, 9% Indians and others) completed KINDL-Kid while 1,026 respondents (mean (SD) age: 14.0 (1.00) years; 82% female; 82% Chinese, 12% Malays; 6% Indians and others) completed KINDL-Kiddo. Mean (SD) TOTAL QoL score was 65.5 (12.76) and 56.6 (11.92) for KINDL-Kid and KINDL-Kiddo, respectively. Floor and ceiling effects were important in five of six KINDL-Kid and two of six KINDL-Kiddo subscales. Reliability coefficients ranged from 0.40 to 0.71 (KINDL-Kid) and 0.44 to 0.84 (KINDL-Kiddo). Factor analysis generated eight and seven factors in KINDL-Kid and KINDL-Kiddo, respectively. Conclusion KINDL-Kiddo exhibited good psychometric properties and may be used to assess QoL in this multi-ethnic English-speaking Asian population. However, psychometric properties of KINDL-Kid may need to be improved either by developing new items or modifying existing items. PMID:17239229

Parent Training With High-Risk Immigrant Chinese Families: A Pilot Group Randomized Trial Yielding Practice-Based Evidence

PubMed Central

Lau, Anna S.; Fung, Joey J.; Ho, Lori Y.; Liu, Lisa L.; Gudiño, Omar G.

2013-01-01

We studied the efficacy and implementation outcomes of a culturally responsive parent training (PT) program. Fifty-four Chinese American parents participated in a wait-list controlled group randomized trial (32 immediate treatment, 22 delayed treatment) of a 14-week intervention designed to address the needs of high-risk immigrant families. Parents were eligible for intervention if they were Chinese-speaking immigrants referred from schools, community clinics, or child protective services with concerns about parenting or child behavior problems. Retention and engagement were high with 83% of families attending 10 or more sessions. Results revealed that the treatment was efficacious in reducing negative discipline, increasing positive parenting, and decreasing child externalizing and internalizing problems. Treatment effects were larger among families with higher levels of baseline behavior problems and lower levels of parenting stress. Further augmentation of PT to address immigrant parent stress may be warranted. Qualitative impressions from group leaders suggested that slower pacing and increased rehearsal of skills may improve efficacy for immigrant parents unfamiliar with skills introduced in PT. PMID:21658524

Parent training with high-risk immigrant chinese families: a pilot group randomized trial yielding practice-based evidence.

PubMed

Lau, Anna S; Fung, Joey J; Ho, Lorinda Y; Liu, Lisa L; Gudiño, Omar G

2011-09-01

We studied the efficacy and implementation outcomes of a culturally responsive parent training (PT) program. Fifty-four Chinese American parents participated in a wait-list controlled group randomized trial (32 immediate treatment, 22 delayed treatment) of a 14-week intervention designed to address the needs of high-risk immigrant families. Parents were eligible for intervention if they were Chinese-speaking immigrants referred from schools, community clinics, or child protective services with concerns about parenting or child behavior problems. Retention and engagement were high with 83% of families attending 10 or more sessions. Results revealed that the treatment was efficacious in reducing negative discipline, increasing positive parenting, and decreasing child externalizing and internalizing problems. Treatment effects were larger among families with higher levels of baseline behavior problems and lower levels of parenting stress. Further augmentation of PT to address immigrant parent stress may be warranted. Qualitative impressions from group leaders suggested that slower pacing and increased rehearsal of skills may improve efficacy for immigrant parents unfamiliar with skills introduced in PT. Copyright © 2011. Published by Elsevier Ltd.

Singapore Students' Performance on Australian and Singapore Assessment Items

ERIC Educational Resources Information Center

Ho, Siew Yin; Lowrie, Tom

2012-01-01

This study describes Singapore students' (N = 607) performance on a recently developed Mathematics Processing Instrument (MPI). The MPI comprised tasks sourced from Australia's NAPLAN and Singapore's PSLE. In addition, the MPI had a corresponding question which encouraged students to describe how they solved the respective tasks. In particular,…

Elevated Levels of Mercapturic Acids of Acrolein and Crotonaldehyde in the Urine of Chinese Women in Singapore Who Regularly Cook at Home

PubMed Central

Hecht, Stephen S.; Koh, Woon-Puay; Wang, Renwei; Chen, Menglan; Carmella, Steven G.; Murphy, Sharon E.; Yuan, Jian-Min

2015-01-01

Lung cancer is unusually common among non-smoking women in Southeastern Asia but the causes of this frequently fatal disease are not well understood. Several epidemiology studies indicate that inhalation of fumes from high temperature Chinese style cooking with a wok may be a cause. Only one previous study investigated uptake of potential toxicants and carcinogens by women who cook with a wok. We enrolled three-hundred twenty-eight non-smoking women from Singapore for this study. Each provided a spot urine sample and answered a questionnaire concerning their cooking habits and other factors. The urine samples were analyzed by liquid chromatography-tandem mass spectrometry for mercapturic acid metabolites of acrolein (3-hydroxypropylmercapturic acid), crotonaldehyde (3-hydroxy-1-methylpropylmercapturic acid), and benzene (S-phenylmercapturic acid), accepted biomarkers of uptake of these toxic and carcinogenic compounds. We observed statistically significant effects of wok cooking frequency on levels of 3-hydroxypropylmercapturic acid and 3-hydroxy-1-methylpropylmercapturic acid, but not S-phenylmercapturic acid. Women who cooked greater than 7 times per week had a geometric mean of 2600 (95% CI, 2189-3090) pmol/mg creatinine 3-hydroxypropylmercapturic acid compared to 1901 (95% CI, 1510-2395) pmol/mg creatinine when cooking less than once per week (P for trend 0.018). The corresponding values for 3-hydroxy-1-methylpropylmercapturic acid were 1167 (95% CI, 1022-1332) and 894 (95% CI, 749-1067) pmol/mg creatinine (P for trend 0.008). We conclude that frequent wok cooking leads to elevated exposure to the toxicants acrolein and crotonaldehyde, but not benzene. Kitchens should be properly ventilated to decrease exposure to potentially toxic and carcinogenic fumes produced during Chinese style wok cooking. PMID:25807518

Musical Preference, Identification, and Familiarity: A Multicultural Comparison of Secondary Students from Singapore and the United Kingdom

ERIC Educational Resources Information Center

Teo, Timothy; Hargreaves, David J.; Lee, June

2008-01-01

The authors investigate whether there were significant differences in preferences for, familiarity with, and identification of Chinese, Malay, and Indian music between adolescent students from Singapore (n = 78) and the United Kingdom (n = 53). Also explored are the relationships among these three variables. Students were asked to rate their…

Physical Frailty, Cognitive Impairment, and the Risk of Neurocognitive Disorder in the Singapore Longitudinal Ageing Studies.

PubMed

Feng, Liang; Nyunt, Ma Shwe Zin; Gao, Qi; Feng, Lei; Lee, Tih Shih; Tsoi, Tung; Chong, Mei Sian; Lim, Wee Shiong; Collinson, Simon; Yap, Philip; Yap, Keng Bee; Ng, Tze Pin

2017-03-01

The independent and combined effects of physical and cognitive domains of frailty in predicting the development of mild cognitive impairment (MCI) or dementia are not firmly established. This study included cross-sectional and longitudinal analyses of physical frailty (Cardiovascular Health Study criteria), cognitive impairment (Mini-Mental State Examination [MMSE]), and neurocognitive disorder (DSM-5 criteria) among 1,575 community-living Chinese older adults from the Singapore Longitudinal Ageing Studies. At baseline, 2% were frail, 32% were prefrail, and 9% had cognitive impairment (MMSE score < 23). Frailty at baseline was significantly associated with prevalent cognitive impairment. Physical frailty categories were not significantly associated with incident NCD, but continuous physical frailty score and MMSE score showed significant individual and joint associations with incident mild NCD and dementia. Compared with those who were robust and cognitively normal, prefrail or frail old adults without cognitive impairment had no increased risk of incident NCD, but elevated odds of association with incident NCD were observed for robust with cognitive impairment (odds ratio [OR] = 4.04, p < .001), prefrail with cognitive impairment (OR = 2.22, p = .044), and especially for frail with cognitive impairment (OR = 6.37, p = .005). The prevalence of co-existing frailty and cognitive impairment (cognitive frailty) was 1% (95% confidence interval [CI]: 0.5-1.4), but was higher among participants aged 75 and older at 5.0% (95% CI: 1.8-8.1). Physical frailty is associated with increased prevalence and incidence of cognitive impairment, and co-existing physical frailty and cognitive impairment confers additionally greater risk of incident NCD. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Validity and reliability of the EQ-5D self-report questionnaire in Chinese-speaking patients with rheumatic diseases in Singapore.

PubMed

Luo, N; Chew, L H; Fong, K Y; Koh, D R; Ng, S C; Yoon, K H; Vasoo, S; Li, S C; Thumboo, J

2003-09-01

We assessed the psychometric properties of a Singaporean Chinese version of the EQ-5D, a health-related quality of life (HRQoL) instrument. Consecutive outpatients with rheumatic diseases seen for routine follow-up consultations at the National University Hospital, Singapore were interviewed twice within 2 weeks using a standardised questionnaire containing the EQ-5D, the Short-Form 36 Health Survey (SF-36), the Learned Helplessness Subscale, a pain Visual Analogue Scale (VAS) and assessing demographic and psychosocial characteristics. To assess the validity of the EQ-5D, 13 hypotheses relating the EQ-5D self-classifier (5 dimensions) or visual analogue scale (EQ-VAS) to SF-36 scores or other variables were examined using the Mann-Whitney U test, Kruskal-Wallis or Spearman's correlation coefficient. Test-retest reliability was assessed using Cohen's kappa. Forty-eight subjects were studied (osteoarthritis: 16; rheumatoid arthritis: 22; systemic lupus erythematosus: 8; spondyloarthropathy: 2; female: 93.8%; mean age: 56.4 years). Seven of 13 a-priori hypotheses relating EQ-5D to external variables were fulfilled, supporting the validity of the EQ-5D. For example, subjects reporting moderate or extreme problems for EQ-5D dimensions generally had lower median SF-36 scores than those without such problems. Cohen's kappa for test-retest reliability of the self-classifier ranged from 0.41 to 1.00 (n = 42; median interval: 7 days, interquartile range: 7 to 11 days). The Singaporean Chinese EQ-5D self-classifier appears to be a valid measure of HRQoL in Singaporeans with rheumatic diseases; however, the reliability of the EQ-VAS requires further investigation. These data provide a basis for further studies of the Singaporean Chinese EQ-5D.

Singapore's Global Schoolhouse Strategy: Retreat or Recalibration?

ERIC Educational Resources Information Center

Waring, Peter

2014-01-01

In 2002 a high-level economic review committee recommended that Singapore position itself as a "global schoolhouse". An ambitious target was set to attract 150,000 international students to Singapore by 2015 and to lift the education sector's contribution to GDP from 1.9% to 5% in the same timeframe. The global schoolhouse was viewed as…

A follow-up survey on the knowledge of age-related macular degeneration and its risk factors among Singapore residents after 5 years of nation-wide awareness campaigns.

PubMed

Sanjay, Srinivasan; Chin, You Chuen; Teo, Hui Ting; Ong, Shu Xuan; Toh, Serene Hui Fang; Khong, Ming Hui; Yeo, Anna C H; Au Eong, Kah-Guan

2014-08-01

To re-evaluate the awareness of age-related macular degeneration (AMD) and knowledge of its risk factors among Singapore residents after 5 years of awareness campaigns. Cross-sectional, questionnaire-based telephone survey (modified from the AMD Alliance International Global Report), conducted in Singapore in 2011. Participants were randomly selected using the Global Yellow Pages Singapore residential listings 2009/2010. Awareness of AMD and its risk factors was assessed among participants. Of 1773 Singapore residents contacted over the telephone, 559 participated (31.5% response rate). The mean age of participants was 43.1 years (range 21-85 years). A total of 157 participants (28.1%) were familiar with AMD. Among these, the number who correctly identified the risk factors were: smoking, n = 132 (84.1%); ageing, n = 123 (78.3%); lack of vitamins/nutrients, n = 121 (77.1%); genetics, n = 101 (64.3%); unprotected light exposure, n = 100 (63.7%) and; sex, n = 62 (39.5%). Participants aged >50 years (prevalence rate ratio, PRR 2.23, confidence interval, CI, 1.31-3.81) or who had undergone an eye test within the previous year (PRR 2.61, 95% CI 1.79-3.82) were more familiar with AMD, while females (PRR 0.68, 95% CI 0.47-0.98) were less familiar. Self-reported awareness of AMD among Singapore residents increased four-fold from 7.3% in 2006 to 28.1% in 2011 following 5 years of awareness campaigns. Participants who were >50 years or had undergone an eye test within the previous year were more aware of AMD while female participants were less aware of AMD.

Occurrence and distribution of bacteria indicators, chemical tracers and pathogenic vibrios in Singapore coastal waters.

PubMed

Goh, Shin Giek; Bayen, Stéphane; Burger, David; Kelly, Barry C; Han, Ping; Babovic, Vladan; Gin, Karina Yew-Hoong

2017-01-15

Water quality in Singapore's coastal area was evaluated with microbial indicators, pathogenic vibrios, chemical tracers and physico-chemical parameters. Sampling sites were grouped into two clusters (coastal sites at (i) northern and (ii) southern part of Singapore). The coastal sites located at northern part of Singapore along the Johor Straits exhibited greater pollution. Principal component analysis revealed that sampling sites at Johor Straits have greater loading on carbamazepine, while turbidity poses greater influence on sampling sites at Singapore Straits. Detection of pathogenic vibrios was also more prominent at Johor Straits than the Singapore Straits. This study examined the spatial variations in Singapore's coastal water quality and provided the baseline information for health risk assessment and future pollution management. Copyright © 2016 Elsevier Ltd. All rights reserved.

A large common-source outbreak of norovirus gastroenteritis in a hotel in Singapore, 2012.

PubMed

Raj, P; Tay, J; Ang, L W; Tien, W S; Thu, M; Lee, P; Pang, Q Y; Tang, Y L; Lee, K Y; Maurer-Stroh, S; Gunalan, V; Cutter, J; Goh, K T

2017-02-01

An outbreak of gastroenteritis affected 453 attendees (attack rate 28·5%) of six separate events held at a hotel in Singapore. Active case detection, case-control studies, hygiene inspections and microbial analysis of food, environmental and stool samples were conducted to determine the aetiology of the outbreak and the modes of transmission. The only commonality was the food, crockery and cutlery provided and/or handled by the hotel's Chinese banquet kitchen. Stool specimens from 34 cases and 15 food handlers were positive for norovirus genogroup II. The putative index case was one of eight norovirus-positive food handlers who had worked while they were symptomatic. Several food samples and remnants tested positive for Escherichia coli or high faecal coliforms, aerobic plate counts and/or total coliforms, indicating poor food hygiene. This large common-source outbreak of norovirus gastroenteritis was caused by the consumption of contaminated food and/or contact with contaminated crockery or cutlery provided or handled by the hotel's Chinese banquet kitchen.

Psychological and behavioural characteristics of females with anorexia nervosa in Singapore.

PubMed

Tan, Evangeline S L; Hawkins, Russell M F

2017-12-01

This study aimed to compare a sample of females with anorexia nervosa in Singapore with international clinical and population samples from published data in terms of endorsement of risk factors related to anorexia nervosa, severity of eating pathology and levels of psychosocial impairment and to explore the nature of the relationships between the anorexia nervosa risk factors and adherence to Asian cultural values. Data from the Eating Disorder Inventory-3 (EDI-3), the Eating Attitudes Test (EAT-26), the Perceived Sociocultural Pressure Scale (PSPS), the Ideal Body Stereotype Scale (IBSS), the Eating Disorder Examination Questionnaire (EDE-Q), the Clinical Impairment Assessment Questionnaire, and the Asian American Values Scale-Multidimensional (AAVS-M) were collected from 41 female patients (13-31 years old) who presented for treatment of anorexia nervosa at the Singapore General Hospital. The profile and presentation of anorexia nervosa in Singapore was comparable to that observed in the Western clinical samples in terms of levels of endorsement of the risk factors for anorexia nervosa. No protective benefit of orientation to Asian culture was found. The observed pattern of general similarity of presentation between Western data and Singaporean data, together with the finding that no protective benefit of orientation to Asian culture was observed, suggests that it may be appropriate to directly apply evidence-based Western models of intervention to the treatment of anorexia nervosa in Singapore.

Demographics and Personality Factors Associated with Burnout among Nurses in a Singapore Tertiary Hospital

PubMed Central

Dhaliwal, Satvinder S.; Ayre, Tracy Carol; Uthaman, Thendral; Fong, Kuan Yok; Tien, Choo Eng; Zhou, Huaqiong; Della, Phillip

2016-01-01

Background. The aim of the study was to evaluate the prevalence and extent of burnout among nurses in Singapore and investigate the influence of demographic factors and personal characteristics on the burnout syndrome. Methods. A cross-sectional survey design was adopted. All registered nurses working in Singapore General Hospital were approached to participate. A questionnaire eliciting data on demographics, burnout (measured using the Maslach Burnout Inventory, MBI), and personality profile (measured using the NEO Five-Factor Inventory, NEO-FFI) was used. Results. 1830 nurses out of 3588 responded (response rate: 51%). Results from 1826 respondents were available for analysis. The MBI identified 39% to have high emotional exhaustion (EE, cut-off score of >27), 40% having high depersonalization (DP, cut-off score of >10), and 59% having low personal accomplishment (PA, cut-off score of <33). In multivariable analysis, age, job grade, and neuroticism were significantly associated with each of the 3 components of the MBI. Staff nurses less than 30 years with high to very high neuroticism were more likely to experience high EE, high DP, and low PA. Conclusion. Younger nurses in Singapore are at increased risk of burnout. Personality traits also played a significant role in the experience of burnout. PMID:27478835

The menopause transition experiences of Chinese Singaporean women: an exploratory qualitative study.

PubMed

Lim, Hui-Koon; Mackey, Sandra

2012-06-01

Menopause, a developmental occurrence that takes place in midlife, marks the end of a woman's fertile phase. Cultural norms, social influences, and personal perceptions related to menopause may influence its meaning and how each woman experiences this transition. Little is known about the menopausal experiences of Asian women. This study explores the menopause transition experiences of ethnic Chinese women in Singapore. Using a qualitative design, the researchers conducted audio-taped interviews in 2010 with 14 menopausal and postmenopausal Chinese Singaporean women aged 40-60 years. Thematic analysis was used to analyze interviews. Two main themes were identified: (a) experiencing symptoms and (b) managing symptoms during menopause transition. The most commonly reported symptoms were abnormal bleeding, hot flushes, and emotional changes. Most participants described their transition to be uneventful and ordinary and reported two significant symptoms at most. The strategies women used to manage their transition included using Western and traditional Chinese medical interventions and seeking support from family and friends. This study provides new insights into how ethnic Chinese women in Singapore experience menopause transition. Findings can assist nurses and healthcare workers in the local context to better understand menopausal women's needs and guide nurses to implement suitable health promotional strategies for women under their care in both hospital and community settings. Although ethnicity is not necessarily a determinant of symptom experience during menopause transition, health education for menopausal women should be based on knowledge of culture-specific practices. Nurses caring for menopausal women in hospital and community settings in Singapore should evaluate the use of medications prescribed by Western and Chinese herbal medical professionals as well as those that are self-prescribed.

Cardiovascular risk prediction tools for populations in Asia.

PubMed

Barzi, F; Patel, A; Gu, D; Sritara, P; Lam, T H; Rodgers, A; Woodward, M

2007-02-01

Cardiovascular risk equations are traditionally derived from the Framingham Study. The accuracy of this approach in Asian populations, where resources for risk factor measurement may be limited, is unclear. To compare "low-information" equations (derived using only age, systolic blood pressure, total cholesterol and smoking status) derived from the Framingham Study with those derived from the Asian cohorts, on the accuracy of cardiovascular risk prediction. Separate equations to predict the 8-year risk of a cardiovascular event were derived from Asian and Framingham cohorts. The performance of these equations, and a subsequently "recalibrated" Framingham equation, were evaluated among participants from independent Chinese cohorts. Six cohort studies from Japan, Korea and Singapore (Asian cohorts); six cohort studies from China; the Framingham Study from the US. 172,077 participants from the Asian cohorts; 25,682 participants from Chinese cohorts and 6053 participants from the Framingham Study. In the Chinese cohorts, 542 cardiovascular events occurred during 8 years of follow-up. Both the Asian cohorts and the Framingham equations discriminated cardiovascular risk well in the Chinese cohorts; the area under the receiver-operator characteristic curve was at least 0.75 for men and women. However, the Framingham risk equation systematically overestimated risk in the Chinese cohorts by an average of 276% among men and 102% among women. The corresponding average overestimation using the Asian cohorts equation was 11% and 10%, respectively. Recalibrating the Framingham risk equation using cardiovascular disease incidence from the non-Chinese Asian cohorts led to an overestimation of risk by an average of 4% in women and underestimation of risk by an average of 2% in men. A low-information Framingham cardiovascular risk prediction tool, which, when recalibrated with contemporary data, is likely to estimate future cardiovascular risk with similar accuracy in Asian

Sexual activity and adolescent health risk behaviours amongst high school students in three ethnic Chinese urban populations.

PubMed

Ong, Jason; Wong, William; Lee, Albert; Holroyd, Eleanor; Huang, Song Yuen

2013-12-01

To compare sexually active Chinese high school students in three major Asian cities with their non-sexually active counterparts in order to determine prevalence and associations with selected health outcomes. There have been limited studies to date on the association between sexual activity and substance use in Chinese high schools. While the role of the school nurse in the development of sexual health and harm reduction education in secondary schools has been well documented in international studies, this has received little attention in Asia. Cross-sectional survey. This study was administered in 2003/2004 to 13,895 Grades 6 to 12 high school students in Hong Kong (3498), Macau (6286) and Taipei (4111). Descriptive analysis was conducted followed by univariate analysis comparing sexual behaviour with (1) substance use including alcohol, smoking, illicit drugs; (2) feeling depressed for greater than or equal to two weeks in last 12 months; contemplating suicide during the last 12 months; and (3) perception of poor health/academic performance. The students (8%) reported being sexually active had marked differences in selected health outcomes when compared with the nonsexually experienced students. More than 90% of the sexually active students had tried alcohol, with more than 50% being regular drinkers, more than 30% testifying to binge drinking and nearly 50% reported depression in the past 12 months. Substance use, poorer perception of health and academic performance were also significantly higher in the sexually experienced students relative to their nonexperienced counterparts. Sexually experienced Chinese high school students surveyed were at higher risk of substance abuse, poorer psychological health and academic performance. Community and public health nursing needs to address Asian adolescent sexual health education needs, in particular provide culturally targeted interventions for associated substance abuse and psychological health within the context of

Footwear characteristics in people with inflammatory arthritis in Singapore.

PubMed

Carter, K; Lahiri, M; Cheung, P P; Santosa, A; Rome, K

2016-01-01

Foot problems are common in people with inflammatory arthritis. Despite suitable footwear having the potential to alleviate pain, improve mobility and maintain independence, previous studies have found many people with inflammatory arthritis wearing poorly fitting and inappropriate footwear. Footwear styles and characteristics have not been reported in a Singapore inflammatory arthritis population. The objective of this study was to identify current footwear styles and characteristics of footwear worn by people with inflammatory arthritis in Singapore. One-hundred-and-one participants with inflammatory arthritis were recruited from the rheumatology outpatient clinic of a large public hospital in Singapore. Disease and clinical characteristics were recorded. A patient-reported outcome included current foot pain. An objective footwear assessment of style, age of shoe, fit and construction was conducted. The majority of participants were Chinese women with a mean (SD) age was 52.0 (15.0) years old and a mean (SD) disease duration of 9.3 (0.3) years. We found 50 % of participants (n = 51) reported footwear problems. Sandals (n = 27, 26 %), flip-flops (n = 19, 19 %) and moccasin type (n = 19, 19 %) was the most common footwear choice. Evaluation of footwear characteristics found that there was a lack of motion control features. Only 32 (32 %) participants had correctly fitting footwear with regard to length, width and depth. No participant was wearing therapeutic footwear. This study provides the first insight into footwear preferences of people with inflammatory arthritis in Singapore. Use of slip-on and poorly fitting footwear was found to be common in people with inflammatory arthritis. Further research on footwear preferences in Southeast-Asian communities needs to take into account cultural habit and preference, socio-economic status, footwear options and affordability.

Polymorphisms identified through genome-wide association studies and their associations with type 2 diabetes in Chinese, Malays, and Asian-Indians in Singapore.

PubMed

Tan, Jonathan T; Ng, Daniel P K; Nurbaya, Siti; Ye, Sandra; Lim, Xiu Li; Leong, Helen; Seet, Lin Tze; Siew, Wei Fong; Kon, Winston; Wong, Tien Yin; Saw, Seang Mei; Aung, Tin; Chia, Kee Seng; Lee, Jeannette; Chew, Suok Kai; Seielstad, Mark; Tai, E Shyong

2010-01-01

Novel type 2 diabetes mellitus (T2DM) susceptibility loci, identified through genome-wide association studies (GWAS), have been replicated in many European and Japanese populations. However, the association in other East Asian populations is less well characterized. To examine the effects of SNPs in CDKAL1, CDKN2A/B, IGF2BP2, HHEX, SLC30A8, PKN2, LOC387761, and KCNQ1 on risk of T2DM in Chinese, Malays, and Asian-Indians in Singapore. We genotyped these candidate single-nucleotide polymorphisms (SNPs) in subjects from three major ethnic groups in Asia, namely, the Chinese (2196 controls and 1541 cases), Malays (2257 controls and 1076 cases), and Asian-Indians (364 controls and 246 cases). We also performed a metaanalysis of our results with published studies in East Asians. In Chinese, SNPs in CDKAL1 [odds ratio (OR) = 1.19; P = 2 x 10(-4)], HHEX (OR = 1.15; P = 0.013), and KCNQ1 (OR = 1.21; P = 3 x 10(-4)) were significantly associated with T2DM. Among Malays, SNPs in CDKN2A/B (OR = 1.22; P = 3.7 x 10(-4)), HHEX (OR = 1.12; P = 0.044), SLC30A8 (OR = 1.12; P = 0.037), and KCNQ1 (OR = 1.19-1.25; P = 0.003-2.5 x 10(-4)) showed significant association with T2DM. The combined analysis of the three ethnic groups revealed significant associations between SNPs in CDKAL1 (OR = 1.13; P = 3 x 10(-4)), CDKN2A/B (OR = 1.16; P = 9 x 10(-5)), HHEX (OR = 1.14; P = 6 x 10(-4)), and KCNQ1 (OR = 1.16-1.20; P = 3 x 10(-4) to 3 x 10(-6)) with T2DM. SLC30A8 (OR = 1.06; P = 0.039) showed association only after adjustment for gender and body mass index. Metaanalysis with data from other East Asian populations showed similar effect sizes to those observed in populations of European ancestry. SNPs at T2DM susceptibility loci identified through GWAS in populations of European ancestry show similar effects in Asian populations. Failure to detect these effects across different populations may be due to issues of power owing to limited sample size, lower minor allele frequency, or differences

Smoke Engulfs Singapore [high res

NASA Image and Video Library

2017-12-08

On June 19, 2013, NASA’s Aqua satellite captured a striking image of smoke billowing from illegal wildfires on the Indonesian island of Sumatra. The smoke blew east toward southern Malaysia and Singapore, and news media reported that thick clouds of haze had descended on Singapore, pushing pollution levels to record levels. Singapore’s primary measure of pollution, the Pollutant Standards Index (PSI)—a uniform measure of key pollutants similar to the Air Quality Index (AQI) used by the U.S. Environmental Protection Agency—spiked to 371 on the afternoon of June 20, 2013, the highest level ever recorded. The previous record occurred in 1997, when the index hit 226. Health experts consider any level above 300 to be “hazardous” to human health. Levels above 200 are considered “very unhealthy.” The image above was captured by the Moderate Resolution Imaging Spectroradiometer (MODIS), an instrument that observes the entire surface of Earth’s every 1 to 2 days. The image was captured during the afternoon at 6:30 UTC (2:30 p.m. local time). Though local laws prohibit it, farmers in Sumatra often burn forests during the dry season to prepare soil for new crops. The BBC reported that Singapore’s Prime Minister Lee Hsien Loong warned that the haze could “easily last for several weeks and quite possibly longer until the dry season ends in Sumatra.” NASA image by Jeff Schmaltz, LANCE/EOSDIS Rapid Response. Caption by Adam Voiland. Credit: NASA Earth Observatory Instrument: Aqua - MODIS NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Multiethnic involvement in autosomal-dominant optic atrophy in Singapore.

PubMed

Loo, J L; Singhal, S; Rukmini, A V; Tow, S; Amati-Bonneau, P; Procaccio, V; Bonneau, D; Gooley, J J; Reynier, P; Ferré, M; Milea, D

2017-03-01

PurposeAutosomal-dominant optic atrophy (ADOA), often associated with mutations in the OPA1 gene (chromosome 3q28-q29) is rarely reported in Asia. Our aim was to identify and describe this condition in an Asian population in Singapore.Patients and methodsPreliminary cross-sectional study at the Singapore National Eye Centre, including patients with clinical suspicion of ADOA, who subsequently underwent genetic testing by direct sequencing of the OPA1 gene.ResultsAmong 12 patients (10 families) with clinically suspected ADOA, 7 patients (5 families) from 3 different ethnic origins (Chinese, Indian, and Malay) carried a heterozygous pathogenic variant in the OPA1 gene. The OPA1 mutations were located on exons 8, 9, 11, and 17: c.869G>A (p.Arg290Glu), c.892A>G (p.Ser298Gly), c.1140G>A (splicing mutation), and c.1669C>T (p.Arg557*), respectively. One splicing mutation (c.871-1G>A) was identified in intron 8. We also identified a novel mutation causing optic atrophy and deafness (c.892A>G (p.Ser298Gly)). Among the phenotypic features, colour pupillometry disclosed a dissociation between low vision and preserved pupillary light reflex in ADOA.ConclusionWe report the first cases of genetically confirmed OPA1-related ADOA from Singapore, including a novel mutation causing 'ADOA plus' syndrome. Further epidemiological studies are needed in order to determine the prevalence of ADOA in South-East Asia.

Multiethnic involvement in autosomal-dominant optic atrophy in Singapore

PubMed Central

Loo, J L; Singhal, S; Rukmini, A V; Tow, S; Amati-Bonneau, P; Procaccio, V; Bonneau, D; Gooley, J J; Reynier, P; Ferré, M; Milea, D

2017-01-01

Purpose Autosomal-dominant optic atrophy (ADOA), often associated with mutations in the OPA1 gene (chromosome 3q28-q29) is rarely reported in Asia. Our aim was to identify and describe this condition in an Asian population in Singapore. Patients and methods Preliminary cross-sectional study at the Singapore National Eye Centre, including patients with clinical suspicion of ADOA, who subsequently underwent genetic testing by direct sequencing of the OPA1 gene. Results Among 12 patients (10 families) with clinically suspected ADOA, 7 patients (5 families) from 3 different ethnic origins (Chinese, Indian, and Malay) carried a heterozygous pathogenic variant in the OPA1 gene. The OPA1 mutations were located on exons 8, 9, 11, and 17: c.869G>A (p.Arg290Glu), c.892A>G (p.Ser298Gly), c.1140G>A (splicing mutation), and c.1669C>T (p.Arg557*), respectively. One splicing mutation (c.871-1G>A) was identified in intron 8. We also identified a novel mutation causing optic atrophy and deafness (c.892A>G (p.Ser298Gly)). Among the phenotypic features, colour pupillometry disclosed a dissociation between low vision and preserved pupillary light reflex in ADOA. Conclusion We report the first cases of genetically confirmed OPA1-related ADOA from Singapore, including a novel mutation causing ‘ADOA plus' syndrome. Further epidemiological studies are needed in order to determine the prevalence of ADOA in South-East Asia. PMID:27858935

Dietary exposure to heterocyclic amines in a Chinese population.

PubMed

Wong, Kin-Yoke; Su, Jin; Knize, Mark G; Koh, Woon-Puay; Seow, Adeline

2005-01-01

Heterocyclic aromatic amines (HAAs) formed in meat during high-temperature cooking have been associated with risk of colorectal and breast cancer. Incidence of these cancers is increasing in Singapore, a country with 77% ethnic Chinese. The purpose of this study was to estimate HAA levels in the Chinese diet and individual levels of exposure to these compounds because little is known. Twenty-five samples (each pooled from three sources) of meat and fish, cooked as commonly consumed, were analyzed by high-performance liquid chromatography for concentrations (ng/g) of 2-amino-3-methylimidazo[4,5-f]quinoline, 2-amino-3, 4-dimethylimidazo[4,5-f]quinoline (MeIQ), 2-amino-3,8- dimethylimidazo[4,5-f]quinoxaline (MeIQx), 2-amino-3, 4,8-trimethylimidazo[4,5-f]quinoxaline (4,8-DiMeIQx), 2- amino-3,7,8-trimethylimidazo[4,5-f]quinoxaline, 2-amino -1,6-dimethylfuro[3,2-e]imidazo[4,5-b]pyridine, and 2- amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP). Dietary meat consumption data (g/day), including meat type and cooking method, were gathered from food-frequency questionnaires completed by 497 randomly sampled Chinese men and women aged 20-59 yr. PhIP, MeIQx, and 4,8-DiMeIQx were the most abundant HAAs detected. Total HAA concentrations ranged from <0.10 to 6.77 ng/g, of which Chinese-style roasted pork had the highest levels. The estimated mean daily exposure to HAA was 49.95 ng/day (P10 14.0 ng/day, P90 95.8 ng/day); this was 50% higher among younger (20-39 yr) compared with older individuals. Seven specific meat-cooking method combinations contributed 90.1% of this intake, namely, pan-fried fish, pork, and chicken, deep-fried chicken as well as fish, roasted/barbecued pork, and grilled minced beef.

Distributed Leadership and Teacher Job Satisfaction in Singapore

ERIC Educational Resources Information Center

García Torres, Darlene

2018-01-01

Purpose: Singapore is a country with low teacher attrition rates and high performance on international assessments (TIMSS 2011/2015 and PISA 2012/2015). Consequently, its education system is often considered as a model for other nations. The purpose of this paper is to extend research on teacher job satisfaction in Singapore and provide…

Higher Education and Entrepreneurial Citizenship in Singapore

ERIC Educational Resources Information Center

Christensen, Soren

2012-01-01

Focusing on Singapore's "Global Schoolhouse" project, this article discusses how efforts to transform Singapore into a "world class" knowledge economy entail changes to the status of citizenship in Singapore. The project of wooing top foreign universities to Singapore is permeated with an entrepreneurial ideal of Singapore as…

Prolepsis, Syncretism, and Synergy in Early Language and Literacy Practices: A Case Study of Family Language Policy in Singapore

ERIC Educational Resources Information Center

Ren, Li; Hu, Guangwei

2013-01-01

This article reports a case study of two Chinese-English bilingual families in Singapore and illustrates the importance of incorporating two hitherto disconnected fields of research--family language policy and family literacy practices--to an understanding of early language and literacy acquisition in the familial milieu. Specifically, this work…

Cross-cultural application of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): performances of elderly Chinese Singaporeans.

PubMed

Lim, May-Li; Collinson, Simon Lowes; Feng, Lei; Ng, Tze-Pin

2010-01-01

There is a paucity of normative studies outside of North America and on elderly populations with very low education level. In the present study we examined the performance of poorly educated elderly on the Repeatable Battery Assessment of Neuropsychological Status (RBANS) with 352 cognitively normal elderly Chinese persons living in the community in Singapore who were enrolled in the Singapore Longitudinal Ageing Study (SLAS). Those with no formal education performed significantly less well than those with some years of formal education across four of five RBANS indices as well as the Total Scale score. Age- and education-adjusted normative data for the RBANS were established for the sample. The means and standard deviations of each of 12 subtests raw scores, five Index scores and the Total Scale score were calculated and stratified by age and education. Data from the present study should considerably advance the clinical utility of the RBANS in Chinese geriatric evaluations in Singapore, and can serve as a reference source for poorly educated elderly Chinese from around the region and beyond.

Instructional Leadership Practices in Singapore

ERIC Educational Resources Information Center

Ng, Foo Seong David; Nguyen, Thanh Dong; Wong, Koon Siak Benjamin; Choy, Kim Weng William

2015-01-01

This paper presents a review of the literature on principal instructional leadership in Singapore. The authors investigated the dimensions of instructional leadership in the practices of Singapore principals and highlighted the strategies these leaders adopt to enact their instructional roles. Singapore principals were found to play an active role…

Interpretation and use of the 5-level EQ-5D response labels varied with survey language among Asians in Singapore.

PubMed

Luo, Nan; Wang, Ye; How, Choon How; Tay, Ee Guan; Thumboo, Julian; Herdman, Michael

2015-10-01

This study aimed to investigate the comparability of the English, Chinese, and Malay versions of the 5-level EQ-5D (EQ-5D-5L) response labels in Singapore. Visitors to a primary care institution in Singapore (n = 743) were asked to complete two exercises: (1) rating the severity of the EQ-5D-5L response labels presented in English, Chinese, or Malay using a 0-100 numeric rating scale and (2) using the labels to describe various hypothetical health problems. Label ratings and choices between language versions were compared using regression analysis. Perceived severity of the English and Chinese labels was similar. Compared with their English counterparts, the Malay label "slight(ly)" was rated as more severe (adjusted mean difference: 10.5 to 14.5) and "unable"/"extreme(ly)" as less severe (adjusted mean difference: -13.3 to -11.0) (P < 0.001 for all). The Malay labels "no(t)" and "unable"/"extreme(ly)" and the less severe Chinese labels were more frequently used to describe hypothetical health problems than their English counterparts. Interpretation and use of the EQ-5D-5L response labels vary among Singaporeans using different language versions of the instrument. Future studies need to investigate ways to reduce the variations and increase the cross-cultural measurement equivalence of the instrument. Copyright © 2015 Elsevier Inc. All rights reserved.

Trends in cerebrovascular disease mortality in Singapore: 1970-1994.

PubMed

Venketasubramanian, N

1998-02-01

Cerebrovascular disease has been the third leading cause of death in Singapore for the last 25 years. This study was carried out to examine recent trends in cerebrovascular disease mortality in Singapore, and to study corresponding changes in stroke risk factors in our population. The Registry of Births and Deaths, Singapore, publishes annual reports on births and deaths. The cause of death is coded using the International Classification of Diseases Revisions 8 (1969-1978) and 9 (1979 onwards). Data for this study were obtained using rubrics 430-438. Death rates were age- and sex-standardized to the World Standard Population, and separately for males and females. Cerebrovascular disease risk factor patterns were derived from national epidemiological health surveys conducted from 1970 and 1994. The absolute number of deaths annually from cerebrovascular disease rose from 1041 in 1970 to 1692 in 1994. Crude death rates remained stable at 50-60 per 100000, accounting for 10-12% of all deaths. Standardized death rates showed a distinct fall from 99 per 100000 in 1976 to 59 per 100000 in 1994, 101 to 60 per 100000 in males and 95 to 57 per 100000 in females. National health surveys have shown a fall in the prevalence of undetected hypertension, smoking and hyperlipidaemia; the prevalence of obesity was unchanged, while that of diabetes mellitus rose over the same period. The mortality trends found in this study are unlikely to be due to changing fashions in coding or inadequate data collection. As in many countries in the world, cerebrovascular disease mortality in Singapore has fallen over the last 25 years; this may in part be related to the decline in stroke risk factors in our population.

Epidemiological risk factors for adult dengue in Singapore: an 8-year nested test negative case control study.

PubMed

Yung, Chee Fu; Chan, Siew Pang; Thein, Tun Linn; Chai, Siaw Ching; Leo, Yee Sin

2016-07-08

Understanding changes in the ecology and epidemiology of dengue is important to ensure resource intensive control programmes are targeted effectively as well as to inform future dengue vaccination strategies. We analyzed data from a multicentre longitudinal prospective study of fever in adults using a nested test negative case control approach to identify epidemiological risk factors for dengue disease in Singapore. From April 2005 to February 2013, adult patients presenting with fever within 72 h at selected public primary healthcare clinics and a tertiary hospital in Singapore were recruited. Acute and convalescent blood samples were collected and used to diagnose dengue using both PCR and serology methods. A dengue case was defined as having a positive RT-PCR result for DENV OR evidence of serological conversion between acute and convalescent blood samples. Similarly, controls were chosen from patients in the cohort who tested negative for dengue using the same laboratory methods. The host epidemiological factors which increased the likelihood of dengue disease amongst adults in Singapore were those aged between 21 and 40 years old (2 fold increase) while in contrast, Malay ethnicity was protective (OR 0.57, 95%CI 0.35 to 0.91) against dengue disease. Spatial factors which increased the odds of acquiring dengue was residing at a foreign workers dormitory or hostel (OR 3.25, 95 % CI 1.84 to 5.73) while individuals living in the North-West region of the country were less likely to get dengue (OR 0.50, 95%CI 0.29 to 0.86). Other factors such as gender, whether one primarily works indoors or outdoors, general dwelling type or floor, the type of transportation one uses to work, travel history, as well as self-reported history of mosquito bite or household dengue/fever were not useful in helping to inform a diagnosis of dengue. We have demonstrated a test negative study design to better understand the epidemiological risk factors of adult dengue over multiple

Correlates of occupational, leisure and total sitting time in working adults: results from the Singapore multi-ethnic cohort.

PubMed

Uijtdewilligen, Léonie; Yin, Jason Dean-Chen; van der Ploeg, Hidde P; Müller-Riemenschneider, Falk

2017-12-13

Evidence on the health risks of sitting is accumulating. However, research identifying factors influencing sitting time in adults is limited, especially in Asian populations. This study aimed to identify socio-demographic and lifestyle correlates of occupational, leisure and total sitting time in a sample of Singapore working adults. Data were collected between 2004 and 2010 from participants of the Singapore Multi Ethnic Cohort (MEC). Medical exclusion criteria for cohort participation were cancer, heart disease, stroke, renal failure and serious mental illness. Participants who were not working over the past 12 months and without data on sitting time were excluded from the analyses. Multivariable regression analyses were used to examine cross-sectional associations of self-reported age, gender, ethnicity, marital status, education, smoking, caloric intake and moderate-to-vigorous leisure time physical activity (LTPA) with self-reported occupational, leisure and total sitting time. Correlates were also studied separately for Chinese, Malays and Indians. The final sample comprised 9384 participants (54.8% male): 50.5% were Chinese, 24.0% Malay, and 25.5% Indian. For the total sample, mean occupational sitting time was 2.71 h/day, mean leisure sitting time was 2.77 h/day and mean total sitting time was 5.48 h/day. Sitting time in all domains was highest among Chinese. Age, gender, education, and caloric intake were associated with higher occupational sitting time, while ethnicity, marital status and smoking were associated with lower occupational sitting time. Marital status, smoking, caloric intake and LTPA were associated with higher leisure sitting time, while age, gender and ethnicity were associated with lower leisure sitting time. Gender, marital status, education, caloric intake and LTPA were associated with higher total sitting time, while ethnicity was associated with lower total sitting time. Stratified analyses revealed different associations within

Negotiating biomedical and traditional Chinese medicine treatments among elderly Chinese Singaporean women.

PubMed

Chang, Leanne; Basnyat, Iccha

2015-02-01

In this article we examine how elderly Chinese Singaporean women navigated between biomedicine and traditional Chinese medicine in their practices of maintaining well-being. We interviewed 36 elderly women to understand their negotiation of medical choices in the interplay of structure, culture, and personal agency. Our findings show that participants made situational decisions under structural and cultural influences, such as family members' changing expectations and interpretations of medical practices, institutional preferences for biomedicine, and the patients' negotiating position between biomedicine and traditional Chinese medicine. Participants demonstrated their capacity to enact agency through their examination of the effects and side effects of each medical system and through their integrative use of different medical treatments, depending on the purpose. Through our findings, we unveil contextual meanings of health among elderly women and the unique coexistence of traditional and modern medical practices within the context of Singapore. © The Author(s) 2014.

High serum level of the soluble CD30 identifies Chinese kidney transplant recipients at high risk of unfavorable outcome.

PubMed

Iv, R; He, Q; Wang, H P; Jin, J; Chen, Y; Chen, J H

2008-12-01

We sought to investigate the relationship between serum level of sCD30 and recipient/graft survival rates, rejection types, as well as other prognostic factors among Chinese kidney transplant patients. We performed enzyme-linked immunosorbent assays of serum sCD30 levels in duplicate among retrospective cohort of 707 renal transplant patients. The incidences of rejection increased in relation to the pretransplant sCD30 level. The reversal rates of rejection were 100%, 90.6%, and 78.6% for the low, intermediate, and high sCD30 groups. This observation suggested that high levels of sCD30 and pretransplant panel-reactive antibody (PRA)-positive patients are risk factors for acute rejection with odds ratios of 6.862 and 1.756. High sCD30 was an independent risk factor for functional graft survival. The 5-year graft survival rates were 99.39% +/- 6.1%, 93.11% +/- 1.93%, and 82.07% +/- 3.97% among the low, intermediate, and high sCD30 groups, while the 5-year recipient survival rates were 89.25% +/- 2.41%, 91.82% +/- 1.64%, and 88.85% +/- 2.36%, respectively. Increased sCD30 levels were observed among patients who were PRA-positive, cytomegalovirus antigens or antibodies positive, on long-term dialysis, and

English Phonological Awareness in Bilinguals: A Cross-Linguistic Study of Tamil, Malay and Chinese English-Language Learners

ERIC Educational Resources Information Center

Dixon, L. Quentin; Chuang, Hui-Kai; Quiroz, Blanca

2012-01-01

To test the lexical restructuring hypothesis among bilingual English-language learners, English phonological awareness (PA), English vocabulary and ethnic language vocabulary (Mandarin Chinese, Malay or Tamil) were assessed among 284 kindergarteners (168 Chinese, 71 Malays and 45 Tamils) in Singapore. A multi-level regression analysis showed that…

The Singapore Myeloma Study Group Consensus Guidelines for the management of patients with multiple myeloma.

PubMed

de Mel, Sanjay; Chen, Yunxin; Gopalakrishnan, Sathish Kumar; Ooi, Melissa; Teo, Constance; Tan, Daryl; Teo, Min Li Claire; Tso, Allison Cy; Lee, Lian King; Nagarajan, Chandramouli; Goh, Yeow Tee; Chng, Wee Joo

2017-02-01

Multiple myeloma (MM) is an incurable plasma cell neoplasm with an incidence of 100 patients per year in Singapore. Major advances have been made in the diagnosis, risk stratification and treatment of MM in the recent past. The reclassification of a subset of patients with smouldering MM, based on high-risk biomarkers, and the development of the revised international staging system are among the key new developments in diagnosis and staging. The use of novel agent-based treatment has resulted in significant improvements in the survival and quality of life of many patients with MM. Determining the optimal use of proteasome inhibitors, immunomodulators and, more recently, monoclonal antibodies is an area of ongoing investigation. In this guideline, we aim to provide an overview of the management of MM, incorporating the latest developments in diagnosis and treatment. Copyright: © Singapore Medical Association.

Associations between multiple health risk behaviors and mental health among Chinese college students.

PubMed

Ye, Yong-ling; Wang, Pei-gang; Qu, Geng-cong; Yuan, Shuai; Phongsavan, Philayrath; He, Qi-qiang

2016-01-01

Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95% CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.

A multi-centre randomised trial comparing ultrasound vs mammography for screening breast cancer in high-risk Chinese women.

PubMed

Shen, S; Zhou, Y; Xu, Y; Zhang, B; Duan, X; Huang, R; Li, B; Shi, Y; Shao, Z; Liao, H; Jiang, J; Shen, N; Zhang, J; Yu, C; Jiang, H; Li, S; Han, S; Ma, J; Sun, Q

2015-03-17

Chinese women tend to have small and dense breasts and ultrasound is a common method for breast cancer screening in China. However, its efficacy and cost comparing with mammography has not been evaluated in randomised trials. At 14 breast centres across China during 2008-2010, 13 339 high-risk women aged 30-65 years were randomised to be screened by mammography alone, ultrasound alone, or by both methods at enrollment and 1-year follow-up. A total of 12 519 and 8692 women underwent the initial and second screenings, respectively. Among the 30 cancers (of which 15 were stage 0/I) detected, 5 (0.72/1000) were in the mammography group, 11 (1.51/1000) in the ultrasound group, and 14 (2.02/1000) in the combined group (P=0.12). In the combined group, ultrasound detected all the 14 cancers, whereas mammography detected 8, making ultrasound more sensitive (100 vs 57.1%, P=0.04) with a better diagnostic accuracy (0.999 vs 0.766, P=0.01). There was no difference between mammography and ultrasound in specificity (100 vs 99.9%, P=0.51) and positive predictive value (72.7 vs 70.0%; P=0.87). To detect one cancer, the costs of ultrasound, mammography, and combined modality were $7876, $45 253, and $21 599, respectively. Ultrasound is superior to mammography for breast cancer screening in high-risk Chinese women.

The Effect of Journal Writing on Mathematics Achievement among High-Ability Students in Singapore

ERIC Educational Resources Information Center

Tan, Tracy; Garces-Bacsal, Rhoda Myra

2013-01-01

This study examined the effect of journal writing on mathematics achievement in high-ability students in Singapore. It assessed both the cognitive benefits of journal writing (as evidenced through gains in math test scores) and the socio-affective benefits of journal writing (as demonstrated in their personal reflections) as the students learned…

Cholesterol-raising diterpenes in types of coffee commonly consumed in Singapore, Indonesia and India and associations with blood lipids: a survey and cross sectional study.

PubMed

Naidoo, Nasheen; Chen, Cynthia; Rebello, Salome A; Speer, Karl; Tai, E Shyong; Lee, Jeanette; Buchmann, Sandra; Koelling-Speer, Isabelle; van Dam, Rob M

2011-05-15

To measure the content of cholesterol-raising diterpenes in coffee sold at the retailer level in Singapore, Indonesia and India and to determine the relationship of coffee consumption with lipid levels in a population-based study in Singapore. Survey and cross-sectional study in local coffee shops in Singapore, Indonesia and India to measure the diterpene content in coffee, and a population-based study in Singapore to examine the relationship of coffee consumption and blood lipid levels. Interviews and coffee samples (n=27) were collected from coffee shops in Singapore, Indonesia and India. In addition, 3000 men and women who were Chinese, Malay, and Indian residents of Singapore participated in a cross-sectional study. The traditional 'sock' method of coffee preparation used in Singapore resulted in cafestol concentrations comparable to European paper drip filtered coffee (mean 0.09±SD 0.064 mg/cup). This amount would result in negligible predicted increases in serum cholesterol and triglyceride concentrations. Similarly low amounts of cafestol were found in Indian 'filter' coffee that used a metal mesh filter (0.05±0.05 mg/cup). Coffee samples from Indonesia using the 'sock' method (0.85±0.41 mg/cup) or a metal mesh filter (0.98 mg/cup) contained higher amounts of cafestol comparable to espresso coffee. Unfiltered coffee from Indonesia contained an amount of cafestol (4.43 mg/cup) similar to Scandinavian boiled, Turkish and French press coffee with substantial predicted increases in serum cholesterol (0.33 mmol/l) and triglycerides (0.20 mmol/l) concentrations for consumption of 5 cups per day. In the Singaporean population, higher coffee consumption was not substantially associated with serum lipid concentrations after adjustment for potential confounders [LDL-cholesterol: 3.07 (95% confidence interval 2.97-3.18) for <1 cup/week versus 3.12 (2.99-3.26) for ≥3 cups/day; p trend 0.12]. Based on the low levels of diterpenes found in traditionally prepared

Cholesterol-raising diterpenes in types of coffee commonly consumed in Singapore, Indonesia and India and associations with blood lipids: A survey and cross sectional study

PubMed Central

2011-01-01

Background To measure the content of cholesterol-raising diterpenes in coffee sold at the retailer level in Singapore, Indonesia and India and to determine the relationship of coffee consumption with lipid levels in a population-based study in Singapore. Methods Survey and cross-sectional study in local coffee shops in Singapore, Indonesia and India to measure the diterpene content in coffee, and a population-based study in Singapore to examine the relationship of coffee consumption and blood lipid levels. Interviews and coffee samples (n = 27) were collected from coffee shops in Singapore, Indonesia and India. In addition, 3000 men and women who were Chinese, Malay, and Indian residents of Singapore participated in a cross-sectional study. Results and Discussion The traditional 'sock' method of coffee preparation used in Singapore resulted in cafestol concentrations comparable to European paper drip filtered coffee (mean 0.09 ± SD 0.064 mg/cup). This amount would result in negligible predicted increases in serum cholesterol and triglyceride concentrations. Similarly low amounts of cafestol were found in Indian 'filter' coffee that used a metal mesh filter (0.05 ± 0.05 mg/cup). Coffee samples from Indonesia using the 'sock' method (0.85 ± 0.41 mg/cup) or a metal mesh filter (0.98 mg/cup) contained higher amounts of cafestol comparable to espresso coffee. Unfiltered coffee from Indonesia contained an amount of cafestol (4.43 mg/cup) similar to Scandinavian boiled, Turkish and French press coffee with substantial predicted increases in serum cholesterol (0.33 mmol/l) and triglycerides (0.20 mmol/l) concentrations for consumption of 5 cups per day. In the Singaporean population, higher coffee consumption was not substantially associated with serum lipid concentrations after adjustment for potential confounders [LDL-cholesterol: 3.07 (95% confidence interval 2.97-3.18) for <1 cup/week versus 3.12 (2.99-3.26) for ≥ 3 cups/day; p trend 0.12]. Conclusions Based on

Survey of health and licensing policies for taxi drivers in Singapore, Hong Kong and Australia: a perspective from evidence on older drivers.

PubMed

Chan, M L; Gustafsson, L; Liddle, J

2010-12-01

With an ageing population, policy makers need to balance active ageing needs with older driver safety. In 2009, a survey of licensing policies for taxi drivers in Singapore, Hong Kong and Australia was undertaken for an evidence-based review of policies. Licensing requirements collected using semi-structured questionnaires were compared descriptively and with evidence from licensing policies on older drivers. All the regions used medical certifications with vision screening. The frequency of medical certification varied according to the renewal cycle and age. Medical guidelines on fitness to drive were available in Australia and Singapore. Legislation for self-reporting of medical conditions by drivers existed in Australia and Hong Kong. Legislation for reporting at-risk drivers by doctors was limited to two Australian states. There were differences in the minimum age and driving experience criteria, the use of practical training, written and English tests, age-based screening, mandatory retirement age, refresher courses, off- and on-road tests. Medical screening for at-risk drivers remains crucial. Age-based mandatory retirement policy at 73 years in Singapore is contrary to evidence-based practice. The lack of legislation for self-reporting of illness by drivers, the high minimum age criteria and therapy driving assessments for healthy taxi drivers are also unique to Singapore. There was stricter age-based relicensing from the age of 65 years in some Australian states and in Singapore. Continuing education for doctors, multi-tier screening for at-risk drivers and licensing policy changes are indicated.

Singapore: Background and U.S. Relations

DTIC Science & Technology

2010-03-19

Address in August 2008, Lee announced some modest liberalizing measures, including a relaxation of censorship of political films and approval of peaceful...in its success. Singapore achieved home rule in 1959 and joined with Malaya, Sabah, and Sarawak to form the Federation of Malaysia in 1963...Singapore from Malaysia . Amid serious doubts about its viability, Singapore became a separate independent nation on August 9, 1965. SINGAPORE

Dietary guidelines in singapore.

PubMed

Lee, Benjamin Lc

2011-01-01

The 2011 Dietary Guidelines were developed with the aim of providing guidance on what dietary strategies can best address increasing rates of obesity and non-communicable chronic disease in Singapore. This set of dietary guidelines was developed with a local expert committee based on a review of scientific literature and data on current dietary patterns from the 2010 National Nutrition Survey. Projected nutrient intakes from a diet adhering to the 2011 Dietary Guidelines were calculated using a local food composition database (FOCOS) and validated against nutrient recommendations. Acknowledging that dietary requirements differ between age groups, different sets of dietary guidelines have been developed and customised for different segments of the population. To date, Singapore has produced dietary guidelines for children and adolescents (focusing on establishing healthy lifelong eating patterns), adults (focusing on preventing obesity and reinforcing healthy eating patterns), and most recently, guidelines for older adults (>50 years of age) that address the issue of potential dietary insufficiency caused by age-related increases in nutrient requirements combined with a reduction in energy requirements. In Singapore, dietary guidelines have been used to inform and direct public policy and promote dietary patterns that meet nutrient requirements while reducing the risk of non-communicable chronic diseases. Examples of public policy include: national guidelines on food advertising and standards for food served in nursing homes; examples of public health promotion programmes include: the Healthier Choice Symbol Programme for packaged food products and programmes encouraging provision of healthier meals in hawker centres, restaurants, and school or workplace canteens.

Beyond the Coral Triangle: high genetic diversity and near panmixia in Singapore's populations of the broadcast spawning sea star Protoreaster nodosus

PubMed Central

Tay, Y. C.; Chng, M. W. P.; Sew, W. W. G.; Rheindt, F. E.; Tun, K. P. P.

2016-01-01

The Coral Triangle is widely considered the most important centre of marine biodiversity in Asia while areas on its periphery such as the South China Sea, have received much less interest. Here, we demonstrate that a small population of the knobbly sea star Protoreaster nodosus in Singapore has similarly high levels of genetic diversity as comparable Indonesian populations from the Coral Triangle. The high genetic diversity of this population is remarkable because it is maintained despite decades of continued anthropogenic disturbance. We postulate that it is probably due to broadcast spawning which is likely to maintain high levels of population connectivity. To test this, we analysed 6140 genome-wide single nucleotide polymorphism (SNP) loci for Singapore's populations and demonstrate a pattern of near panmixia. We here document a second case of high genetic diversity and low genetic structure for a broadcast spawner in Singapore, which suggests that such species have high resilience against anthropogenic disturbances. The study demonstrates the feasibility and power of using genome-wide SNPs for connectivity studies of marine invertebrates without a sequenced genome. PMID:27853600

Beyond the Coral Triangle: high genetic diversity and near panmixia in Singapore's populations of the broadcast spawning sea star Protoreaster nodosus.

PubMed

Tay, Y C; Chng, M W P; Sew, W W G; Rheindt, F E; Tun, K P P; Meier, R

2016-08-01

The Coral Triangle is widely considered the most important centre of marine biodiversity in Asia while areas on its periphery such as the South China Sea, have received much less interest. Here, we demonstrate that a small population of the knobbly sea star Protoreaster nodosus in Singapore has similarly high levels of genetic diversity as comparable Indonesian populations from the Coral Triangle. The high genetic diversity of this population is remarkable because it is maintained despite decades of continued anthropogenic disturbance. We postulate that it is probably due to broadcast spawning which is likely to maintain high levels of population connectivity. To test this, we analysed 6140 genome-wide single nucleotide polymorphism (SNP) loci for Singapore's populations and demonstrate a pattern of near panmixia. We here document a second case of high genetic diversity and low genetic structure for a broadcast spawner in Singapore, which suggests that such species have high resilience against anthropogenic disturbances. The study demonstrates the feasibility and power of using genome-wide SNPs for connectivity studies of marine invertebrates without a sequenced genome.

The Elusive Goal of Nation Building: Asian/Confucian Values and Citizenship Education in Singapore during the 1980s

ERIC Educational Resources Information Center

Chia, Yeow Tong

2011-01-01

The term "Asian values" became popular in the political discourse in the 1980s and 1990s. The most vocal proponents of Asian values are Singapore's Lee Kuan Yew and Malaysia's Mahathir and their deputies and government officials, as well as post-Tiananmen Chinese leaders. Most notable of all these three strands of the Asian values debate…

[Relationship between Ghrelin polymorphism and serum lipoprotein levels in Han Chinese with or without coronary heart disease risk factors].

PubMed

Xie, Xuan; Zhang, Jing; Wang, Yu-huan; Wang, Jun-hong; Zhang, Chun-hong; Ni, Hong-yan; Yuan, Xiao-hong

2008-04-01

To investigate the relationship between polymorphism of Ghrelin gene and serum levels of lipoprotein in Han Chinese with or without coronary heart disease (CHD) risk factors. PCR restriction fragment length polymorphism assay was used to detect the distribution of genotypes of Ghrelin gene in 225 Han Chinese (40 to 69 years-old) with CHD risk factors, 78 subjects without CHD risk factors served as normal controls. Serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) and very low-density lipoprotein (VLDL) were measured to analyze the relationship with the polymorphism of Ghrelin gene. Ghrelin genotype frequencies of AA, AG, GG (0.975, 0.025, 0.00 in control group and 0.956, 0.040, 0.004 in the high-risk group, all P > 0.05) as well as the allele frequencies of A, G (0.987, 0.013 in control group and 0.976, 0.024 in the high-risk group, all P > 0.05) were similar between the groups. HDL-C levels of the Arg/Gln carriers were significantly lower than those of Arg/Arg carriers in control group and in the high-risk group (all P < 0.05). Arg/Gln carriers were associated lower HDL-C levels in Han Chinese.

Correlation of adiposity indices with cardiovascular disease risk factors in healthy adults of Singapore: a cross-sectional study.

PubMed

Bi, Xinyan; Tey, Siew Ling; Leong, Claudia; Quek, Rina; Loo, Yi Ting; Henry, Christiani Jeyakumar

2016-01-01

Obesity has long been highlighted for its association with increased incidence of cardiovascular disease (CVD). Nonetheless, the best adiposity indices to evaluate the CVD risk factors remain contentious and few studies have been performed in Asian populations. In the present study, we compared the association strength of percent body fat (PBF) to indirect anthropometric measures of general adiposity (body mass index (BMI) and body adiposity index (BAI)) and central adiposity (waist circumference (WC), and waist-to-hip ratio (WHR)) for the prediction of CVD risk factors in healthy men and women living in Singapore. A total of 125 individuals (63 men and 62 women) took part in this study. PBF was measured by using three different techniques, including bioelectrical impedance analysis (BIA), BOD POD, and dual-energy X-ray absorptiometry (DEXA). Anthropometric measurements (WC, hip circumference (HC), height, and weight), fasting blood glucose (FBG), fasting serum insulin (FSI), and lipid profiles were determined according to standard protocols. Correlations of anthropometric measurements and PBF with CVD risk factors were compared. Irrespective of the measuring techniques, PBF showed strong positive correlations with FSI, HOMA-IR, TC/HDL, TG/HDL, and LDL/HDL in both genders. While PBF was highly correlated with FBG, SBP, and DBP in females, no significant relationships were observed in males. Amongst the five anthropometric measures of adiposity, BAI was the best predictor for CVD risk factors in female participants (r = 0.593 for HOMA-IR, r = 0.542 for TG/HDL, r = 0.474 for SBP, and r = 0.448 for DBP). For males, the combination of WC (r = 0.629 for HOMA-IR, and r = 0.446 for TG/HDL) and WHR (r = 0.352 for SBP, and r = 0.366 for DBP) had the best correlation with CVD risk factors. Measurement of PBF does not outperform the simple anthropometric measurements of obesity, i.e. BAI, WC, and WHR, in the prediction of CVD risk factors in

Infectious diseases and migrant worker health in Singapore: a receiving country's perspective.

PubMed

Sadarangani, Sapna P; Lim, Poh Lian; Vasoo, Shawn

2017-07-01

Approximately 1.4 million migrant workers reside in Singapore, presenting unique infectious disease challenges to both migrants and Singapore. A Pubmed, MEDLINE (Ovid), EBSCO Host (Global Health) and Google Scholar search was performed for both peer, non-peer reviewed articles and reports relevant to migrant health in Singapore, published between 1 January 1989 and 1 September 2016. Additional studies were identified from citations within searched articles. We also reviewed published data and policy documents from the Ministries of Health and Manpower, Singapore. A significant proportion of malaria, enteric fevers, hepatitis A and E and tuberculosis diagnosed in Singapore involve migrant workers. From the 1990-2000 through 2009-11, while malaria and hepatitis A cases have decreased and remain sporadic, enteric fevers and tuberculosis cases have increased, possibly due to greater influx of migrant workers. Hepatitis E numbers remain low but migrant workers account for half of diagnosed cases. In an interplay of immune naivete, work and living conditions, migrants in the construction industry are at higher risk of arboviral infections such as dengue, Zika and chikungunya. Infections such as chikungunya were likely introduced into Singapore by travellers including migrant workers from the Indian subcontinent but autochthonous transmission continued due to the presence of competent mosquito vectors. There is less data regarding sexual health, networks and infections amongst migrant workers, an area which merits further attention. Migrant workers appear to be at higher risk than Singaporeans for specific infectious diseases, probably due to a complex interplay of several factors, including higher disease prevalence in their countries of origin, socio-economic factors, their living conditions in Singapore and financial, language and cultural barriers to healthcare access. Receiving countries need improved surveillance, expansion of preventive measures and decreased

Lung and gastrointestinal complications are leading causes of death in SCORE, a multi-ethnic Singapore systemic sclerosis cohort.

PubMed

Santosa, A; Tan, C S; Teng, G G; Fong, W; Lim, A; Law, W G; Chan, G; Ng, S C; Low, Ahl

2016-11-01

To assess contemporary outcomes and predictors of mortality in the well-characterized multi-ethnic systemic sclerosis cohort Singapore (SCORE). From 2008, patients diagnosed with systemic sclerosis (SSc) fulfilling the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) or Very Early Diagnosis of Systemic Sclerosis (VEDOSS) criteria were recruited from three major tertiary rheumatology centres in Singapore. Mortality was verified with the Singapore National Registry of Deaths and in-hospital cause of death was determined by two independent reviewers, up to 10 December 2013. A Cox proportional hazard (PH) regression analysis was used to examine the association between demographic and clinical indices and mortality, controlling for age and race. Of the 349 patients (86.8% female; 77.7% Chinese), 97.4% fulfilled the ACR/EULAR 2013 criteria. The mean age at diagnosis was 46.2 years. The prevalence of limited (lcSSc), diffuse (dcSSc) cutaneous SSc, and SSc-overlap syndromes was 34.4, 37.1, and 26.8%, respectively. Thirty-five patients died after a mean follow-up of 2.1 years (743.6 person-years). Fifty-seven per cent of deaths were attributed to SSc, with pulmonary arterial hypertension (PAH), interstitial lung disease (ILD), and gastrointestinal (GI) complications as the leading causes of death. Multivariate analysis (n = 275) showed that smoking [hazard ratio (HR) 4.0, 95% confidence interval (CI) 1.5-10.6], SSc-overlap (HR 6.0, 95% CI 1.8-19.1), baseline renal involvement (HR 2.5, 95% CI 1.1-6.0), pulmonary artery systolic pressure (PASP) ≥ 40 mmHg on echocardiography (HR 5.1, 95% CI 2.2-11.7), treatment for peripheral vasculopathy (HR 2.6, 95% CI 1.1-6.5), and parenteral nutrition (HR 8.8, 95% CI 2.2-34.3) were independent predictors of mortality. PAH, ILD, and GI complications were leading causes of death in this cohort. We identified a high-risk group of patients who would benefit from closer monitoring and early intervention.

[Analysis and countermeasure for quality risk in process of traditional Chinese medicine preparations].

PubMed

Yang, Ming; Yang, Yuan-Zhen; Wang, Ya-Qi; Wu, Zhen-Feng; Wang, Xue-Cheng; Luo, Jing

2017-03-01

Product quality relies on not only testing methods,but also the design and development, production control and product manufacturing all aspects of logistics management. Quality comes from the process control level.Therefore, it is very important to accurately identify the factors that may induce quality risk in the production process and quality control measures correspondingly.This article systematically analyzes the source of the quality risk of all aspects of the production process in traditional Chinese medicine preparation. Discussing ways and methods of quality risk identification of traditional Chinese medicine preparation and providing references for perfecting the whole process quality management of traditional Chinese medicine preparation. Copyright© by the Chinese Pharmaceutical Association.

Ethnic and gender specific life expectancies of the Singapore population, 1965 to 2009 – converging, or diverging?

PubMed Central

2013-01-01

Background The increase in life expectancy and the persistence of expectancy gaps between different social groups in the 20th century are well-described in Western developed countries, but less well documented in the newly industrialised countries of Asia. Singapore, a multiethnic island-state, has undergone a demographic and epidemiologic transition concomitant with economic development. We evaluate secular trends and differences in life expectancy by ethnicity and gender in Singapore, from independence to the present. Methods Period abridged life tables were constructed to derive the life expectancy of the Singapore population from 1965 to 2009 using data from the Department of Statistics and the Registry of Births and Deaths, Singapore. Results All 3 of Singapore’s main ethnic groups, and both genders, experienced an increase in life expectancy at birth and at 65 years from 1965 to 2009, though at substantially different rates. Although there has been a convergence in life expectancy between Indians and Chinese, the (substantial) gap between Malays and the other two ethnic groups has remained. Females continued to have a higher life expectancy at birth and at 65 years than males throughout this period, with no evidence of convergence. Conclusions Ethnic and gender differences in life expectancy persist in Singapore despite its rapid economic development. Targeted chronic disease prevention measures and health promotion activities focusing on people of Malay ethnicity and the male community may be needed to remedy this inequality. PMID:24160733

Cutaneous sarcoidosis in Asians: a report of 25 patients from Singapore.

PubMed

Chong, W-S; Tan, H-H; Tan, S-H

2005-03-01

Sarcoidosis is a systemic noncaseating granulomatous disorder of unknown origin involving multiple organ systems. There has been no report so far to describe the epidemiological pattern of cutaneous involvement in sarcoidosis in South-East Asia with diverse ethnic groups. A retrospective study examining the clinicopathological features of all patients diagnosed with sarcoidosis at a tertiary dermatology centre in Singapore from 1980 to 2003 was conducted. Cutaneous sarcoidosis was diagnosed in 25 patients: 13 were Indian, 11 were Chinese and one was Eurasian. Cutaneous manifestations included papules, nodules, plaques and scarring alopecia. Extracutaneous involvement of lymph nodes (four patients), lungs (eight patients) and eyes (two patients) was seen. Eight patients had abnormal chest radiographic findings. Histopathological examination of skin lesions revealed noncaseating, epithelioid granulomatous infiltration in the dermis without evidence of mycobacterial infection, deep fungal infection or polarizable birefringent material. Treatment modalities included corticosteroids, hydroxychloroquine, isotretinoin, methotrexate and surgical excision. Five patients had complete resolution of the cutaneous lesions. Cutaneous sarcoidosis is rare in Asia and indeed in Singapore. Extracutaneous involvement is not uncommon and a thorough clinical evaluation should be undertaken.

Time series analysis of demographic and temporal trends of tuberculosis in Singapore.

PubMed

Wah, Win; Das, Sourav; Earnest, Arul; Lim, Leo Kang Yang; Chee, Cynthia Bin Eng; Cook, Alex Richard; Wang, Yee Tang; Win, Khin Mar Kyi; Ong, Marcus Eng Hock; Hsu, Li Yang

2014-10-31

Singapore is an intermediate tuberculosis (TB) incidence country, with a recent rise in TB incidence from 2008, after a fall in incidence since 1998. This study identified population characteristics that were associated with the recent increase in TB cases, and built a predictive model of TB risk in Singapore. Retrospective time series analysis was used to study TB notification data collected from 1995 to 2011 from the Singapore Tuberculosis Elimination Program (STEP) registry. A predictive model was developed based on the data collected from 1995 to 2010 and validated using the data collected in 2011. There was a significant difference in demographic characteristics between resident and non-resident TB cases. TB risk was higher in non-residents than in residents throughout the period. We found no significant association between demographic and macro-economic factors and annual incidence of TB with or without adjusting for the population-at-risk. Despite growing non-resident population, there was a significant decrease in the non-resident TB risk (p < 0.0001). However, there was no evidence of trend in the resident TB risk over this time period, though differences between different demographic groups were apparent with ethnic minorities experiencing higher incidence rates. The study found that despite an increasing size of non-resident population, TB risk among non-residents was decreasing at a rate of about 3% per year. There was an apparent seasonality in the TB reporting.

Comparative research on NIMBY risk acceptability between Chinese and Japanese college students.

PubMed

Wu, Yunqing; Zhai, Guofang; Li, Shasha; Ren, Chongqiang; Tsuchida, Shoji

2014-10-01

Along with the progressive acceleration of urbanization, the need to identify potentially troublesome "Not In My Back Yard" (NIMBY) facilities in the city is inevitable. To resolve NIMBY conflict, it is important to know people's NIMBY risk acceptability for these facilities. A questionnaire survey was used among Chinese and Japanese college students to identify NIMBY risk acceptability. LISREL was used to construct a structural equation model to analyze the difference in NIMBY risk acceptability between the Chinese and Japanese college students. Factors that may affect NIMBY risk acceptability were analyzed: "perceiving utility," "perceiving risk," "trust in government," "reasonable compensation," and "procedural justice." The findings show that Japanese students' concerns were greater than Chinese students' concerns. Perceiving utility and perceiving risk were the most important factors that affect people's NIMBY risk acceptability, followed by procedural justice, trust in government, and reasonable compensation. There is a difference between the different cultural backgrounds in confronting the risk: Chinese students focus more on the reputation and value of real estate, while Japanese students pay more attention to environmental pollution and damage to health. Furthermore, cultural influences play a role in students' risk perception. To improve the risk acceptability for NIMBY facilities and provide a basis for resolving NIMBY conflicts, it is necessary to ensure the benefits of the NIMBY facility while reducing environmental pollution. The findings of this study may be of interest for policy makers and practitioners to devise future NIMBY strategies.

Statin-centric versus low-density lipoprotein-centric approach for atherosclerotic cardiovascular disease prevention: a Singapore perspective.

PubMed

Yan, Peter; Tan, Eng Kiat Kevin; Choo, Jason Chon Jun; Liew, Choon Fong Stanley; Lau, Titus; Waters, David D

2016-07-01

The link between cholesterol levels and atherosclerotic cardiovascular disease (ASCVD) is well-established. In Singapore, there is an increasing prevalence of risk factors for ASCVD. Like many Asian countries, Singapore's population is rapidly ageing and increasingly sedentary, which predisposes individuals to chronic health problems. Current international and local guidelines recommend statin therapy for the primary and secondary prevention of ASCVD. However, despite the effectiveness of statin therapy, some studies have highlighted that Asian patients with cardiovascular disease are not achieving target lipid goals. Furthermore, it is widely believed that the responses of Asians (both patients and physicians) to statin therapy are different from those of their Western counterparts. Experts convened in 2014 to determine the impact of current guidelines on clinical practice in Singapore. This review summarises the key findings and recommendations of these guidelines, and presents key principles to aid clinicians to manage the cardiovascular risk of their patients more effectively. Copyright: © Singapore Medical Association.

Demographics and clinical presentation of slipped capital femoral epiphysis in Singapore: comparing the East with the West.

PubMed

Lim, Yi-Jia; Kagda, Fareed; Lam, Khee Sien; Hui, James H P; Lim, Kevin B L; Mahadev, Arjandas; Lee, Eng Hin

2008-11-01

This study examines the demographics and clinical presentation of slipped capital femoral epiphysis in Singapore. Sixty-six patients (53 boys, 13 girls) with 77 involved hips were reviewed retrospectively. Local prevalence was 1.2/100,000 children. Twenty-four patients were Chinese, 12 were Malay, 27 were Indians, and three patients were Eurasians. A total of 76.6% of patients above the 90th percentile for body weight were present; 16.7% of patients had bilateral involvement. Seventeen patients had endocrine-related problems. We had a high male preponderance, and a disproportionately high number of Indian patients. A high proportion of patients were obese. Our incidence of bilateral involvement seems to be higher than our Indonesian neighbors. The differences seen may be due to genetic and sociocultural variations.

Exploring Singapore Primary School Students' Perceptions of Chinese Asynchronous Online Discussions

ERIC Educational Resources Information Center

Chin, Wong Wan; Sum, Cheung Wing; Foon, Hew Khe

2008-01-01

Background: Asynchronous online discussion (AOD) has found widespread use in tertiary education and adult learning environment; however, there has been little research on its use in elementary school, especially in the context of the teaching of the Chinese Language. This study explores the use of AOD in a Chinese Language class in a primary…

Singapore Chooses Teachers Carefully

ERIC Educational Resources Information Center

Sclafani, Susan K.

2015-01-01

At the heart of the plans and programs that launched Singapore's rise to the top of international education comparisons are the tiny nation-state's commitments to its teaching force beginning with its highly competitive selection process and carrying through its teacher training, its career-long professional development, and even an enhanced…

Psychometric validation of the Chinese version of the Johns Hopkins Fall Risk Assessment Tool for older Chinese inpatients.

PubMed

Zhang, Junhong; Wang, Min; Liu, Yu

2016-10-01

To culturally adapt and evaluate the reliability and validity of the Chinese version of the Johns Hopkins Fall Risk Assessment Tool among older inpatients in the mainland of China. Patient falls are an important safety consideration within hospitals among older inpatients. Nurses need specific risk assessment tools for older inpatients to reliably identify at-risk populations and guide interventions that highlight fixable risk factors for falls and consequent injuries. In China, a few tools have been developed to measure fall risk. However, they lack the solid psychometric development necessary to establish their validity and reliability, and they are not widely used for elderly inpatients. A cross-sectional study. A convenient sampling was used to recruit 201 older inpatients from two tertiary-level hospitals in Beijing and Xiamen, China. The Johns Hopkins Fall Risk Assessment Tool was translated using forward and backward translation procedures and was administered to these 201 older inpatients. Reliability of the tool was calculated by inter-rater reliability and Cronbach's alpha. Validity was analysed through content validity index and construct validity. The Inter-rater reliability of Chinese version of Johns Hopkins Fall Risk Assessment Tool was 97·14% agreement with Cohen's Kappa of 0·903. Cronbach's α was 0·703. Content of Validity Index was 0·833. Two factors represented intrinsic and extrinsic risk factors were explored that together explained 58·89% of the variance. This study provided evidence that Johns Hopkins Fall Risk Assessment Tool is an acceptable, valid and reliable tool to identify older inpatients at risk of falls and falls with injury. Further psychometric testing on criterion validity and evaluation of its advanced utility in geriatric clinical settings are warranted. The Chinese version of Johns Hopkins Fall Risk Assessment Tool may be useful for health care personnel to identify older Chinese inpatients at risk of falls and falls

Awareness of smoking risks and attitudes towards graphic health warning labels on cigarette packs: a cross-cultural study of two populations in Singapore and Scotland.

PubMed

Ng, D H L; Roxburgh, S T D; Sanjay, S; Au Eong, K G

2010-05-01

Little is known about the level of awareness of blindness as a smoking-related condition, although the relationship has been well established. To compare the awareness of smoking risks and the impact of graphic health warning labels on cigarette packs in discouraging smoking among adults in Singapore and Scotland. A cross-sectional survey using a structured interview of adults in ophthalmic, general medical, and general surgical outpatient clinics in Singapore and Scotland. One hundred and fifteen out of 163 (70.6%) outpatients in Singapore and 105 out of 112 (93.8%) outpatients in Scotland responded to the study. In both samples, awareness levels for smoking-related diseases such as lung cancer, mouth and throat cancer, heart disease, and stroke were all greater than 85%. These were found to be significantly higher than the level of awareness of blindness as a smoking-related condition (chi (2)-test, P<0.001). Although the awareness of blindness as a smoking-related condition was greater in Singapore (36.5%) than in Scotland (30.5%), this difference was not statistically significant. More than half of the respondents indicated that graphic health warning labels would be effective in discouraging them from smoking. Graphic health warning labels reading 'Smoking causes blindness' printed on cigarette packs may be useful in raising public awareness of blindness as a smoking-related condition and discouraging the habit of smoking in Singapore and Scotland.

Perceived Risk of Methamphetamine among Chinese Methamphetamine Users

PubMed Central

Kelly, Brian C; Liu, Tieqiao; Yang, Xiaozhao Yosef; Zhang, Guanbai; Hao, Wei; Wang, Jichuan

2014-01-01

Background Methamphetamine use has grown considerably in China in recent years. Information about perceptions of risk on methamphetamine is important to facilitate health promotion efforts. Methods Using both survey data and qualitative interview data, the authors evaluate the perceived risk of methamphetamine use among Chinese users using a mixed-methods approach. Through Respondent Driven Sampling, the authors recruited a sample of 303 methamphetamine users in Changsha, China. Results A majority (59.1%) perceive that infrequent methamphetamine use poses no risk to the user, while 11.2% perceive at least moderate risk for light use. A majority (56.7%) perceived at least moderate risk associated with regular methamphetamine use. Most (82.2%) also perceive methamphetamine to be easily obtainable. A path model indicates that perceived risk shapes intentions to use and expectations of future use, as does perceived availability. Qualitatively, while addiction was the most common risk discussed by users, they differed on whether they perceived the drug addictive. Other concerns raised by interviewees included impaired cognition, mental health problems, physical harm, and social dysfunction. Discussion While some users identify significant risks with methamphetamine, others do not perceive its use to be problematic. Collectively, these findings indicate that intervening upon perceptions of risk among Chinese methamphetamine users may be a means to influence intentions to use. PMID:24925820

Lived Experience of Caregivers of Persons with Dementia and the Impact on their Sense of Self: A Qualitative Study in Singapore.

PubMed

Tuomola, Jane; Soon, Jiaying; Fisher, Paul; Yap, Philip

2016-06-01

The prevalence of dementia is increasing, especially in Asia. Caregivers of people with dementia are at greater risk of psychological morbidity; however, most studies on caregiving have been conducted in Western populations. As a caregiver's experience can be influenced by cultural factors, this needs exploring further. This study explored the lived experience of caregivers of dementia patients in Singapore and the impact of caring on their sense of self. Six Chinese female spousal caregivers were interviewed and their experiences were analyzed using interpretative phenomenological analysis (IPA). Four super-ordinate themes were identified: impact of caregiving, acceptance of destiny, taking control, and view of self. The findings reflected the influence of Confucian values. Clinical implications are discussed, including more culturally sensitive services.

Psychological risk factors of addiction to social networking sites among Chinese smartphone users.

PubMed

Wu, Anise M S; Cheung, Vivi I; Ku, Lisbeth; Hung, Eva P W

2013-09-01

Smartphones allow users to access social networking sites (SNSs) whenever and wherever they want. Such easy availability and accessibility may increase their vulnerability to addiction. Based on the social cognitive theory (SCT), we examined the impacts of outcome expectancies, self-efficacy, and impulsivity on young Chinese smartphone users' addictive tendencies toward SNSs. Two hundred seventy-seven Macau young smartphone users (116 males and 161 females; mean age = 26.62) filled out an online Chinese questionnaire concerning their usage of social networking sites via smartphones, addiction tendencies toward SNSs, impulsivity trait, outcome expectancies toward the use, and Internet self-efficacy. The findings revealed that those who spent more time on SNSs also reported higher addictive tendencies. Addictive tendencies were positively correlated with both outcome expectancies and impulsivity, but negatively associated with Internet self-efficacy. These three psychological variables explained 23% of the variance in addictive tendencies. The findings of this study suggest that, compared to demographics, psychological factors provide a better account for addictive tendencies towards SNSs among Chinese smartphone users in Macau. The three psychological risk factors were low Internet self-efficacy, favorable outcome expectancies, and high impulsivity trait. Educational campaigns with screening procedures for high-risk groups are recommended for effective prevention and treatment.

Psychological risk factors of addiction to social networking sites among Chinese smartphone users

PubMed Central

Wu, Anise M. S.; Cheung, Vivi I.; Ku, Lisbeth; Hung, Eva P. W.

2013-01-01

Background and aims: Smartphones allow users to access social networking sites (SNSs) whenever and wherever they want. Such easy availability and accessibility may increase their vulnerability to addiction. Based on the social cognitive theory (SCT), we examined the impacts of outcome expectancies, self-efficacy, and impulsivity on young Chinese smartphone users' addictive tendencies toward SNSs. Methods: Two hundred seventy-seven Macau young smartphone users (116 males and 161 females; mean age = 26.62) filled out an online Chinese questionnaire concerning their usage of social networking sites via smartphones, addiction tendencies toward SNSs, impulsivity trait, outcome expectancies toward the use, and Internet self-efficacy. Results: The findings revealed that those who spent more time on SNSs also reported higher addictive tendencies. Addictive tendencies were positively correlated with both outcome expectancies and impulsivity, but negatively associated with Internet self-efficacy. These three psychological variables explained 23% of the variance in addictive tendencies. Conclusions: The findings of this study suggest that, compared to demographics, psychological factors provide a better account for addictive tendencies towards SNSs among Chinese smartphone users in Macau. The three psychological risk factors were low Internet self-efficacy, favorable outcome expectancies, and high impulsivity trait. Educational campaigns with screening procedures for high-risk groups are recommended for effective prevention and treatment. PMID:25215198

The prevalence of fatigue and associated health and safety risk factors among taxi drivers in Singapore

PubMed Central

Lim, See Ming; Chia, Sin Eng

2015-01-01

INTRODUCTION Driver fatigue is one of the biggest health and safety concerns within the road transport sector. This study aimed to determine the prevalence of fatigue among taxi drivers in Singapore, to better understand the general working and health conditions of this group of people, and to determine the risk factors associated with fatigued driving. METHODS A total of 340 taxi drivers were randomly selected for participation in a self-administered questionnaire survey, which included height and weight measurements. The response rate was 68.2%. The survey consisted of four main categories: personal particulars; social habits; work patterns; and sleep profile. The Epworth Sleepiness Scale was used to estimate the level of daytime sleepiness and fatigue. Multiple logistic regression analysis was used to estimate the adjusted odd ratios and 95% confidence intervals associated with risk factors related to fatigue among taxi drivers. RESULTS A high proportion of taxi drivers were obese and had self-reported hypertension, diabetes mellitus and high cholesterol. Driver fatigue was associated with very poor/poor self-rating of quality of sleep, having an additional part-time job, drinking three or more caffeinated drinks daily, and driving more than 10 hours a day. CONCLUSION We hope that the findings of the present study will improve awareness of the work and health conditions of taxi drivers, and contribute toward efforts to achieve a healthier workforce. A lower prevalence of fatigued driving may lead to lower risks of road traffic accidents, decreased economic loss, increased productivity, and safer roads for all. PMID:25532512

The prevalence of fatigue and associated health and safety risk factors among taxi drivers in Singapore.

PubMed

Lim, See Ming; Chia, Sin Eng

2015-02-01

Driver fatigue is one of the biggest health and safety concerns within the road transport sector. This study aimed to find out the prevalence of fatigue among taxi drivers in Singapore, to better understand the general working and health conditions of this group of people and to determine the risk factors associated with fatigued driving. A total of 340 taxi drivers were randomly selected for participation in this self-administered questionnaire survey, with height and weight measurements. The response rate was 68.2%. The survey consisted of four main categories: personal particulars; social habits; work patterns and sleep profile; and Epworth Sleepiness Scale, which was used to estimate the level of daytime sleepiness and fatigue. Multiple logistic regression analysis was used to estimate the adjusted odd ratios and 95% confidence intervals associated with the risk factors related to fatigue among the taxi drivers. A high proportion of the taxi drivers were obese and had self-reported hypertension, diabetes mellitus and high cholesterol. Driver fatigue was associated with very poor/poor self-rating of the quality of sleep, having an additional part-time job, drinking three or more caffeinated drinks daily, and driving more than 10 hours a day. We hope that the findings of the present study will improve the awareness regarding the work and health conditions of taxi drivers, and contribute toward the effort to achieve a healthier workforce. A lower prevalence of fatigued driving will lead to lower risks of road traffic accidents, decreased economic loss, increased productivity, and safer roads for all.

Risk mitigation of shared electronic records system in campus institutions: medical social work practice in singapore.

PubMed

Ow Yong, Lai Meng; Tan, Amanda Wei Li; Loo, Cecilia Lay Keng; Lim, Esther Li Ping

2014-10-01

In 2013, the Singapore General Hospital (SGH) Campus initiated a shared electronic system where patient records and documentations were standardized and shared across institutions within the Campus. The project was initiated to enhance quality of health care, improve accessibility, and ensure integrated (as opposed to fragmented) care for best outcomes in our patients. In mitigating the risks of ICT, it was found that familiarity with guiding ethical principles, and ensuring adherence to regulatory and technical competencies in medical social work were important. The need to negotiate and maneuver in a large environment within the Campus to ensure proactive integrative process helped.

Risk factors, cross-cultural stressors and postpartum depression among immigrant Chinese women in Japan.

PubMed

Jin, Qiongai; Mori, Emi; Sakajo, Akiko

2016-04-01

The purpose of this mixed-method design study was to examine factors contributing to depression among immigrant Chinese women (primipara and multipara) (n = 22) delivering a child for the first time in Japan. Data were obtained just after hospital discharge by using the Edinburgh Postnatal Depression Scale (EPDS), the Social Support Scale, a new scale to measure cross-cultural stressors in the postpartum setting and a visual analogue scale for stress and a demographic survey. The average EPDS score was 9.0 (SD ± 3.7) at 1-3 weeks postpartum; yet, more than half of the subjects (n = 12; 54.5%) were high risk for depression (EPDS ≥ 10). Low household income and primiparous status were associated with depression scores. New mothers with depression also reported more general stress and more cross-cultural stress in the postpartum setting, although social support appeared to mediate cross-cultural stressors. Semi-structured interviews were held with two immigrant women at high risk for depression; these new mothers described additional stress because they could not follow Zuoyuezi, an important postpartum Chinese tradition, in the Japanese hospital. These findings suggest that immigrant Chinese women are at higher risk for postpartum depression when they give birth for the first time in Japan. © 2016 John Wiley & Sons Australia, Ltd.

Timing of onset of evening activity of adult chinese rose beetles (Coleoptera: Scarabaeidae)

USDA-ARS?s Scientific Manuscript database

Adult Chinese rose beetles, Adoretus sinicus (Burmeister) (Coleoptera: Scarabaeidae: Adoretini), present in China, Taiwan, Indonesia, Cambodia, Laos, Singapore, Thailand, Vietnam, the Marianas Islands, the Caroline Islands, and the Hawaiian Islands, are nighttime defoliators that feed on a wide vari...

????--Implicit Learning and Imperceptible Influence: Syncretic Literacy of Multilingual Chinese Children

ERIC Educational Resources Information Center

Curdt-Christiansen, Xiao Lan

2013-01-01

This article reports on an ethnographic study involving the literacy practices of two multilingual Chinese children from two similar yet different cultural and linguistic contexts: Montreal and Singapore. Using syncretism as a theoretical tool, this inquiry examines how family environment and support facilitate children's process of becoming…

Evolution of Singapore's School Mathematics Curriculum

ERIC Educational Resources Information Center

Kaur, Berinderjeet

2014-01-01

The evolution of Singapore's school mathematics curriculum is in tandem with developments in the education system of Singapore. In the last six decades, economic policies of the government that are necessary for the survival of Singapore in a fast changing world have shaped the aims of the school mathematics curriculum. The present day curriculum…

The influence of sex, race and dialect on peptic ulcer and non-ulcer dyspepsia in Singapore.

PubMed

Kang, J Y; Guan, R; LaBrooy, S J; Lim, K P; Yap, I

1983-10-01

A consecutive series of 2,277 patients presenting for upper gastrointestinal endoscopy was analysed. The following groups of patients were studied with reference to sex, race and dialect groups: those presenting with dyspepsia but no haemorrhage, those presenting with upper gastrointestinal haemorrhage, those with non-ulcer dyspepsia, gastric ulcer and duodenal ulcer. Males out-numbered females in all diagnostic groups. Male and female Malays were under-represented in all diagnostic groups when compared to the Singapore population. Amongst female Chinese, there was an excess of Cantonese patients and an under-representation of Teochew patients in most diagnostic groups. These dialect differences were not remarkable amongst male Chinese. The possible reasons for these differences and their significance are discussed.

Fall risk in Chinese community-dwelling older adults: A physiological profile assessment study.

PubMed

Siong, Kar-Ho; Kwan, Marcella Mun-San; Lord, Stephen R; Lam, Andrew Kwok-Cheung; Tsang, William Wai-Nam; Cheong, Allen Ming-Yan

2016-02-01

The short-form Physiological Profile Assessment (PPA) is increasingly used in clinical practice for assessing fall risk in older people. However, a normative database is only available for Caucasian populations. The purpose of the present study was to develop a normative database for Hong Kong Chinese older people and examine the fall risk profile of this population. A total of 622 participants aged 60-95 years were recruited. Participants underwent the PPA (containing tests of contrast sensitivity, proprioception, quadriceps strength, reaction time and sway), and composite fall risk scores were computed. Participants were then followed up for falls for 1 year. Quadriceps strength and lower limb proprioception scores were comparable with those reported for Caucasian populations. However, contrast sensitivity, simple reaction time and postural sway scores were relatively poor. The average composite fall risk score was 1.7 ± 1.5, showing a "moderate" fall risk when compared with the Caucasian norms. Despite the relatively poor physical performances and moderately high fall risk scores, the incidence of one plus falls in the 1-year follow-up period was just 16.4%, with just 2.6% reporting two plus falls. The area under the curve for composite fall risk scores in discriminating fallers from non-fallers was 0.53 (95% CI 0.45-0.60). Despite poorer performance in PPA tests, the incidence of prospective falls in a Hong Kong Chinese population was low. In consequence, the PPA could not discriminate well between fallers and non-fallers. The present study provided normality data for short-form PPA measures for older Chinese people as a reference for further studies. © 2015 Japan Geriatrics Society.

Racialised Education in Singapore

ERIC Educational Resources Information Center

Barr, Michael D.

2006-01-01

The Singapore education system plays a central role in the mythology of the young country's nation building project. The education system is portrayed as the cradle of Singapore's multiracialism, fostering racial harmony and understanding. Yet this historical study of primary school English textbooks from the 1970s to the present reveals that…

Risk factors of early proximal gastric carcinoma in Chinese diagnosed using WHO criteria.

PubMed

Fang, Cheng; Huang, Qin; Lu, Lin; Shi, Jiong; Sun, Qi; Xu, Gui Fang; Gold, Jason; Mashimo, Hiroshi; Zou, Xiao Ping

2015-06-01

The incidence of proximal gastric carcinoma (PGC) is rising worldwide for unknown reasons. Herein we compare the risk factors of early PGC with distal gastric carcinoma (DGC) in patients treated at a single tertiary hospital in China. Risk factors of 379 consecutive surgically resected early gastric carcinoma (EGC) diagnosed according to the 2010 World Health Organization criteria were studied by reviewing their medical records and esophagogastroduodenoscopy/biopsy findings and interviewing patients and family members for the patients' history of environmental toxin exposure (ETE), dietary habits, family (FCH) and personal cancer history (PCH) and survival. Differences between PGC (n = 115), DGC (n = 264) and age-matched and gender-matched controls (n = 225) were compared. Proportion of early PGC in all EGC patients was increased significantly (P < 0.05). The independent risk factors for both PGC and DGC identified by multivariate analysis were intake of preserved food and little fruit, and gastric mucosal intestinal metaplasia and atrophy (all P < 0.05). Advanced age (odds ratio [OR] 9.83, P < 0.01), PCH (OR 5.09, P < 0.05), a high body mass index (>24 kg/m(2) ) (OR 2.79, P < 0.01) and ETE (OR 2.31, P < 0.05) were independent risk factors for PGC, but not male gender, tobacco or alcohol abuse, hiatus hernia, gastroesophageal reflux disease or columnar-lined esophagus. In contrast, FCH (OR 2.34, P < 0.01) and Helicobacter pylori infection (OR 2.81, P < 0.001) were independent risk factors for DGC. Independent risk factors for PGC in Chinese patients differ from those of DGC or esophageal adenocarcinoma, supporting the classification of PGC as a separate gastric carcinoma entity in the Chinese populations. © 2015 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Being Wholesaled: An Investigation of Chinese International Students' Higher Education Experiences

ERIC Educational Resources Information Center

Su, Mengwei; Harrison, Laura M.

2016-01-01

Using academic capitalism as a theoretical foundation, this phenomenological study examined the new study abroad experiences of Chinese college students in six popular English-speaking study destination countries--the U.S., the U.K., Australia, Canada, the Netherlands, and Singapore. Qualitative data collected from 20 interviews indicate some…

English Literatures in Post-Colonial Singapore

ERIC Educational Resources Information Center

Dass, Rozita

2015-01-01

The emergence of a vibrant literary, culture and arts scene promotes Singapore's claims as a hub for arts and culture in the Asian region, and as a global arts city by the 21st century. The richness and variety of Singapore literature from the early post-colonial years are evident in the evolution of a Singapore literary culture. The diaspora of…

Singapore Paediatric Resuscitation Guidelines 2016.

PubMed

Ong, Gene Yong Kwang; Chan, Irene Lai Yeen; Ng, Agnes Suah Bwee; Chew, Su Yah; Mok, Yee Hui; Chan, Yoke Hwee; Ong, Jacqueline Soo May; Ganapathy, Sashikumar; Ng, Kee Chong

2017-07-01

We present the revised 2016 Singapore paediatric resuscitation guidelines. The International Liaison Committee on Resuscitation's Pediatric Taskforce Consensus Statements on Science and Treatment Recommendations, as well as the updated resuscitation guidelines from the American Heart Association and European Resuscitation Council released in October 2015, were debated and discussed by the workgroup. The final recommendations for the Singapore Paediatric Resuscitation Guidelines 2016 were derived after carefully reviewing the current available evidence in the literature and balancing it with local clinical practice. Copyright: © Singapore Medical Association.

Prevalence of obesity and its associated risk factors among Chinese adults in a Malaysian suburban village

PubMed Central

Chew, Wai Fong; Masyita, Mamot; Leong, Pooi Pooi; Boo, Nem Yun; Zin, Thaw; Choo, Kong Bung; Yap, Sook Fan

2014-01-01

INTRODUCTION Obesity is a major modifiable risk factor associated with most chronic diseases. The aim of this study was to determine the prevalence of obesity, and its associated risk factors, among apparently healthy Chinese adults in a Malaysian suburban village. METHODS This was a cross-sectional study conducted among the Chinese residents in Seri Kembangan New Village, Klang Valley, Selangor, Malaysia. Convenience sampling was used for the selection of participants. Body weight, height, waist and hip circumferences, and blood pressure were measured. Fasting venous plasma was drawn for the measurement of fasting glucose level and lipid profile. Data on sociodemographic factors, dietary habits, physical activity, perceived stress level and sleep duration were collected using interviewer-administered, pretested and validated questionnaires. RESULTS Among the 258 Chinese residents (mean age 41.4 ± 10.0 years) recruited, the prevalence of obesity was 40%. The obese participants had significantly higher mean blood pressure, and triglyceride and fasting plasma glucose levels than the non-obese participants (p < 0.05). The obese participants also had a significantly lower high-density lipoprotein cholesterol level than the non-obese participants. Logistic regression analysis showed that drinking soy milk (adjusted odds ratio [OR] 0.447; 95% confidence interval [CI] 0.253–0.787; p < 0.05) and the perception that a balanced diet consists mainly of vegetables (adjusted OR 0.440; 95% CI 0.215–0.900; p < 0.05) were associated with a reduced risk of obesity. The risk of obesity was higher in younger participants (adjusted OR 2.714; 95% CI 1.225–6.011; p < 0.05). CONCLUSION The prevalence of obesity was high among the apparently healthy suburban Chinese. Our findings suggest that soy milk consumption and the perception that a balanced diet consists mainly of vegetables are associated with a lower risk of developing obesity in this population. PMID:24570317

Prevalence of obesity and its associated risk factors among Chinese adults in a Malaysian suburban village.

PubMed

Chew, Wai Fong; Masyita, Mamot; Leong, Pooi Pooi; Boo, Nem Yun; Zin, Thaw; Choo, Kong Bung; Yap, Sook Fan

2014-02-01

Obesity is a major modifiable risk factor associated with most chronic diseases. The aim of this study was to determine the prevalence of obesity, and its associated risk factors, among apparently healthy Chinese adults in a Malaysian suburban village. This was a cross-sectional study conducted among the Chinese residents in Seri Kembangan New Village, Klang Valley, Selangor, Malaysia. Convenience sampling was used for the selection of participants. Body weight, height, waist and hip circumferences, and blood pressure were measured. Fasting venous plasma was drawn for the measurement of fasting glucose level and lipid profile. Data on sociodemographic factors, dietary habits, physical activity, perceived stress level and sleep duration were collected using interviewer-administered, pretested and validated questionnaires. Among the 258 Chinese residents (mean age 41.4 ± 10.0 years) recruited, the prevalence of obesity was 40%. The obese participants had significantly higher mean blood pressure, and triglyceride and fasting plasma glucose levels than the non-obese participants (p < 0.05). The obese participants also had a significantly lower high-density lipoprotein cholesterol level than the non-obese participants. Logistic regression analysis showed that drinking soy milk (adjusted odds ratio [OR] 0.447; 95% confidence interval [CI] 0.253-0.787; p < 0.05) and the perception that a balanced diet consists mainly of vegetables (adjusted OR 0.440; 95% CI 0.215-0.900; p < 0.05) were associated with a reduced risk of obesity. The risk of obesity was higher in younger participants (adjusted OR 2.714; 95% CI 1.225-6.011; p < 0.05). The prevalence of obesity was high among the apparently healthy suburban Chinese. Our findings suggest that soy milk consumption and the perception that a balanced diet consists mainly of vegetables are associated with a lower risk of developing obesity in this population.

Abdominal adipose tissue compartments vary with ethnicity in Asian neonates: Growing Up in Singapore Toward Healthy Outcomes birth cohort study.

PubMed

Tint, Mya Thway; Fortier, Marielle V; Godfrey, Keith M; Shuter, Borys; Kapur, Jeevesh; Rajadurai, Victor S; Agarwal, Pratibha; Chinnadurai, Amutha; Niduvaje, Krishnamoorthy; Chan, Yiong-Huak; Aris, Izzuddin Bin Mohd; Soh, Shu-E; Yap, Fabian; Saw, Seang-Mei; Kramer, Michael S; Gluckman, Peter D; Chong, Yap-Seng; Lee, Yung-Seng

2016-05-01

A susceptibility to metabolic diseases is associated with abdominal adipose tissue distribution and varies between ethnic groups. The distribution of abdominal adipose tissue at birth may give insights into whether ethnicity-associated variations in metabolic risk originate partly in utero. We assessed the influence of ethnicity on abdominal adipose tissue compartments in Asian neonates in the Growing Up in Singapore Toward Healthy Outcomes mother-offspring cohort. MRI was performed at ≤2 wk after birth in 333 neonates born at ≥34 wk of gestation and with birth weights ≥2000 g. Abdominal superficial subcutaneous tissue (sSAT), deep subcutaneous tissue (dSAT), and internal adipose tissue (IAT) compartment volumes (absolute and as a percentage of the total abdominal volume) were quantified. In multivariate analyses that were controlled for sex, age, and parity, the absolute and percentage of dSAT and the percentage of sSAT (but not absolute sSAT) were greater, whereas absolute IAT (but not the percentage of IAT) was lower, in Indian neonates than in Chinese neonates. Compared with Chinese neonates, Malay neonates had greater percentages of sSAT and dSAT but similar percentages of IAT. Marginal structural model analyses largely confirmed the results on the basis of volume percentages with controlled direct effects of ethnicity on abdominal adipose tissue; dSAT was significantly greater (1.45 mL; 95% CI: 0.49, 2.41 mL, P = 0.003) in non-Chinese (Indian or Malay) neonates than in Chinese neonates. However, ethnic differences in sSAT and IAT were NS [3.06 mL (95% CI:-0.27, 6.39 mL; P = 0.0712) for sSAT and -1.30 mL (95% CI: -2.64, 0.04 mL; P = 0.057) for IAT in non-Chinese compared with Chinese neonates, respectively]. Indian and Malay neonates have a greater dSAT volume than do Chinese neonates. This finding supports the notion that in utero influences may contribute to higher cardiometabolic risk observed in Indian and Malay persons in our population. If such

Conducting clinical trials in Singapore.

PubMed

Woo, K T

1999-04-01

All clinical trials in Singapore will now have to conform to the Medicines (Clinical Trials) Amended Regulations 1998 and the Singapore Good Clinical Practice (GCP) Guidelines 1998. The Medical Clinical Research Committee (MCRC) has been established to oversee the conduct of clinical drug trials in Singapore and together with the legislations in place, these will ensure that clinical trials conducted in Singapore are properly controlled and the well-being of trial subjects are safe guarded. All clinical drug trials require a Clinical Trial Certificate from the MCRC before the trial can proceed. The hospital ethics committee (EC) vets the application for a trial certificate before it is sent to MCRC. The drug company sponsoring the trial has to indemnify the trial investigators and the hospital for negligence arising from the trial. The MCRC, apart from ensuring the safety of trial subjects, has to provide continuing review of the clinical trial and monitors adverse events in the course of the trial. The EC will conduct continuing review of clinical trials. When a non-drug clinical trial is carried out, the EC will ensure that the proposed protocol addresses ethical concerns and meets regulatory requirements for such trials. There is great potential for pharmaceutical Research & Development (R&D) in Singapore. We must develop our skills and infrastructure in clinical trials to enable Singapore to be a regional hub for R&D of drugs in Asia.

Casemix reimbursement: a Singapore Children's Hospital perspective.

PubMed

Yoong, S L

2001-07-01

Casemix reimbursement was introduced to Singapore in October 1999 using the Australian National Diagnosis Related Groups Version 3.1 (AN-DRGs 3.1). The possible impact of this classification system on a Singapore Children's Hospital is discussed. Data on paediatric patients in KK Women's and Children's Hospital (KKH) were drawn from the inhouse Datamart warehouse system, and reviewed with regards to volume of patients, length of stay and charges. Several high cost categories were selected for a more in-depth review and discussed. The classification system and reimbursement method did not take into account the higher cost of treating children, thus penalising the Children's Hospital. The wide variety of cases treated also gave rise to difficulty in obtaining appropriate reimbursement. The lack of severity of illness measures was a drawback in the Diagnosis Related Group (DRG) for ventilated patients. The lack of outcome measures gave rise to potentially inequitable reimbursement in some high cost neonatal DRGs. While Casemix is an improvement over previous methods of providing Government funding in Singapore, particular aspects need to be reviewed, and reimbursement criteria refined to ensure equitable funding to Children's Hospital.

Ethnic Differences in Body Composition and Obesity Related Risk Factors: Study in Chinese and White Males Living in China

PubMed Central

Wang, Dong; Li, Yanping; Lee, Simin Gharib; Wang, Lei; Fan, Jinhui; Zhang, Gong; Wu, Jiang; Ji, Yong; Li, Songlin

2011-01-01

The purpose of this cross-sectional observational study was to identify ethnic differences in body composition and obesity-related risk factors between Chinese and white males living in China. 115 Chinese and 114 white male pilots aged 28–63 years were recruited. Fasting body weight, height and blood pressure were measured following standard procedures. Whole-body and segmental body composition were measured using an 8-contact electrode bioimpedance analysis (BIA) system. Fasting serum glucose, fasting plasma total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, and triglycerides (TG) were assessed using automatic biochemistry analyzer. After adjusting for age and body mass index (BMI), Chinese males had significantly higher percentage of body fat (PBF) both with respect to whole body (Chinese: 23.7%±0.2% vs. Whites: 22.4%±0.2%) and the trunk area (Chinese: 25.0%±0.3% vs. Whites: 23.2%±0.3%) compared to their white counterparts. At all BMIs, Chinese males had significantly higher fasting glucose levels (Chinese: 5.7±1.0 mmol/L vs. Whites: 5.2±1.0 mmol/L) but lower high-density lipoprotein levels (Chinese: 0.8±1.0 mmol/L vs. Whites: 1.0±1.0 mmol/L) than white males. In addition, a marginally significantly higher diastolic blood pressure was found among Chinese men than that among white men (Chinese: 80±1.0 mmHg vs. Whites: 77±1.0 mmHg). Chinese males had more body fat and a greater degree of central fat deposition pattern than that seen in white males in the present study. Furthermore, data on blood pressure, fasting glucose and blood lipids suggest that Chinese men may be more prone to obesity-related risk factors than white men. PMID:21625549

The Joint Effects of Risk Status, Gender, Early Literacy and Cognitive Skills on the Presence of Dyslexia among a Group of High-Risk Chinese Children

ERIC Educational Resources Information Center

Wong, Simpson W. L.; McBride-Chang, Catherine; Lam, Catherine; Chan, Becky; Lam, Fanny W. F.; Doo, Sylvia

2012-01-01

This study sought to examine factors that are predictive of future developmental dyslexia among a group of 5-year-old Chinese children at risk for dyslexia, including 62 children with a sibling who had been previously diagnosed with dyslexia and 52 children who manifested clinical at-risk factors in aspects of language according to testing by…

The Chinese Woman in Southeast Asia, Changing Roles--Changing Life Styles.

ERIC Educational Resources Information Center

Baca, Fernie; Lundquist, Gerald W.

Women of Chinese descent living in Singapore, Malaysia, and Thailand were interviewed to provide educators in bilingual and multicultural education with insights that will help them to better prepare young women of ethnic minority backgrounds for adjustment to United States society. Additional descriptive data were gathered from written sources. A…

Residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women.

PubMed

Si, Lei; Winzenberg, Tania M; Chen, Mingsheng; Jiang, Qicheng; Palmer, Andrew J

2015-06-01

To determine the residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women. A validated state-transition microsimulation model was used. Microsimulation and probabilistic sensitivity analyses were performed to address the uncertainties in the model. All parameters including fracture incidence rates and mortality rates were retrieved from published literature. Simulated subjects were run through the model until they died to estimate the residual lifetime fracture risks. A 10 year time horizon was used to determine the 10 year fracture risks. We estimated the risk of only the first osteoporotic fracture during the simulation time horizon. The residual lifetime and 10 year risks of having the first osteoporotic (hip, clinical vertebral or wrist) fracture for Chinese women aged 50 years were 40.9% (95% CI: 38.3-44.0%) and 8.2% (95% CI: 6.8-9.3%) respectively. For men, the residual lifetime and 10 year fracture risks were 8.7% (95% CI: 7.5-9.8%) and 1.2% (95% CI: 0.8-1.7%) respectively. The residual lifetime fracture risks declined with age, whilst the 10 year fracture risks increased with age until the short-term mortality risks outstripped the fracture risks. Residual lifetime and 10 year clinical vertebral fracture risks were higher than those of hip and wrist fractures in both sexes. More than one third of the Chinese women and approximately one tenth of the Chinese men aged 50 years are expected to sustain a major osteoporotic fracture in their remaining lifetimes. Due to increased fracture risks and a rapidly ageing population, osteoporosis will present a great challenge to the Chinese healthcare system. While national data was used wherever possible, regional Chinese hip and clinical vertebral fracture incidence rates were used, wrist fracture rates were taken from a Norwegian study and calibrated to the Chinese population. Other fracture sites like tibia, humerus, ribs and pelvis were not included in the analysis, thus these

Exploratory investigation of obesity risk and prevention in Chinese Americans.

PubMed

Liou, Doreen; Bauer, Kathleen D

2007-01-01

To examine the beliefs and attitudes related to obesity risk and its prevention in Chinese Americans via in-depth, qualitative interviews using the guiding tenets of Health Belief Model, Theory of Planned Behavior, and social ecological models. A qualitative study using tenets of the Health Belief Model, the Theory of Planned Behavior, and social ecological models. The New York City metropolitan area. Forty young Chinese American adults (24 females; 16 males) were interviewed. Obesity risk and prevention. Common themes were identified, coded, and compared using NVivo computer software. Poor dietary habits and sedentary lifestyles were seen as major weight gain contributors. Obesity was seen predominantly as a non-Asian phenomenon, although 60% of the participants felt susceptible to obesity. Physical and social environmental factors were the overriding themes generated as to the causes of weight gain among young adult Chinese Americans. Physical factors included the powerful effect of media-generated advertisements and a plethora of inexpensive fast and convenience foods emphasizing large portion sizes of low nutrient density. The social environment encourages the consumption of large quantities of these foods. Traditional Chinese cuisine was seen as providing more healthful alternatives, but increasing acculturation to American lifestyle results in less traditional food consumption. Some traditional Chinese beliefs regarding the desirability of a slightly heavy physique can encourage overeating. Nutrition educators need to be public policy advocates for environments providing tasty, low cost, healthful foods. Young adult Chinese Americans seek knowledge and skills for making convenient healthful food selections in the midst of a culture that advocates and provides an abundance of unhealthy choices.

5-year survival and rehospitalization due to stroke recurrence among patients with hemorrhagic or ischemic strokes in Singapore.

PubMed

Sun, Yan; Lee, Sze Haur; Heng, Bee Hoon; Chin, Vivien S

2013-10-03

patients. Five year post-stroke survival and rehospitalization due to stroke recurrence as well as their associations with patient demographics were studied for different stroke types in Singapore. Specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke.

Forensic psychiatry in Singapore.

PubMed

Chan, Lai Gwen; Tomita, Todd

2013-12-01

Singapore is a geographically small nation-state that has transformed itself from a third-world country to a developed nation after attaining political independence 46 years ago. The pace of change has been tremendous and mental health care is no exception. This paper provides an overview of mental health care and a review of key mental health legislation, including a National Mental Health Blueprint that was rolled out in 2007. On this background, the paper focuses on a description of forensic psychiatric services in Singapore. The role of the Department of Forensic Psychiatry at the Institute of Mental Health, which is the only forensic psychiatry department in the country, will be highlighted. Civil commitment and the treatment of unfit accused persons and insanity acquittees is reviewed. The role of forensic psychiatric assessments in the Singapore courts is examined. The application of the insanity and diminished responsibility defenses are reviewed. A trend is identified in the Singapore courts towards a more rehabilitation-focused sentencing approach and the role that forensic psychiatric assessments play in cases involving mentally disordered offenders is highlighted. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

C-reactive protein and serum creatinine, but not haemoglobin A1c, are independent predictors of coronary heart disease risk in non-diabetic Chinese.

PubMed

Salim, Agus; Tai, E Shyong; Tan, Vincent Y; Welsh, Alan H; Liew, Reginald; Naidoo, Nasheen; Wu, Yi; Yuan, Jian-Min; Koh, Woon P; van Dam, Rob M

2016-08-01

In western populations, high-sensitivity C-reactive protein (hsCRP), and to a lesser degree serum creatinine and haemoglobin A1c, predict risk of coronary heart disease (CHD). However, data on Asian populations that are increasingly affected by CHD are sparse and it is not clear whether these biomarkers can be used to improve CHD risk classification. We conducted a nested case-control study within the Singapore Chinese Health Study cohort, with incident 'hard' CHD (myocardial infarction or CHD death) as an outcome. We used data from 965 men (298 cases, 667 controls) and 528 women (143 cases, 385 controls) to examine the utility of hsCRP, serum creatinine and haemoglobin A1c in improving the prediction of CHD risk over and above traditional risk factors for CHD included in the ATP III model. For each sex, the performance of models with only traditional risk factors used in the ATP III model was compared with models with the biomarkers added using weighted Cox proportional hazards analysis. The impact of adding these biomarkers was assessed using the net reclassification improvement index. For men, loge hsCRP (hazard ratio 1.25, 95% confidence interval: 1.05; 1.49) and loge serum creatinine (hazard ratio 4.82, 95% confidence interval: 2.10; 11.04) showed statistically significantly associations with CHD risk when added to the ATP III model. We did not observe a significant association between loge haemoglobin A1c and CHD risk (hazard ratio 1.83, 95% confidence interval: 0.21; 16.06). Adding hsCRP and serum creatinine to the ATP III model improved risk classification in men with a net gain of 6.3% of cases (p-value = 0.001) being reclassified to a higher risk category, while it did not significantly reduce the accuracy of classification for non-cases. For women, squared hsCRP was borderline significantly (hazard ratio 1.01, 95% confidence interval: 1.00; 1.03) and squared serum creatinine was significantly (hazard ratio 1.81, 95% confidence interval: 1.49; 2

Singapore

NASA Image and Video Library

2011-05-26

This image from NASA Terra spacecraft is of the Republic of Singapore, a city-state off the southern tip of the Malay Peninsula. An island country made up of 63 islands, the country is largely urbanized with very little rain forest left.

Prevalence of cataract surgery and visual outcomes in Indian immigrants in Singapore: the Singapore Indian eye study.

PubMed

Gupta, Preeti; Zheng, Yingfeng; Ting, Tay Wan; Lamoureux, Ecosse L; Cheng, Ching-Yu; Wong, Tien-Yin

2013-01-01

To determine the prevalence of cataract surgery and factors associated with post-surgical visual outcomes in migrant Indians living in Singapore. We conducted a population-based study in 3,400 Indian immigrants residing in Singapore-the Singapore Indian Eye Study (SINDI). All participants underwent comprehensive medical eye examination and a standardized interview. Post-operative visual impairment (VI) was defined as best-corrected or presenting visual acuity (BCVA or PVA) of 20/60 or worse. The age- and gender-standardized prevalence of cataract surgery was 9.7% (95% confidence interval [CI]: 8.9%, 10.7%) in Singapore resident Indians. Post-operative VI defined by BCVA occurred in 10.9% eyes (87/795). The main causes of post-operative VI were diabetic retinopathy (20.7%), posterior capsular opacification (18.4%), and age-related macular degeneration (12.6%). Undercorrected refractive error doubled the prevalence of post-operative VI when PVA was used. The rate of cataract surgery is about 10% in Indian residents in Singapore. Socioeconomic variables and migration had no significant impact on the prevalence of cataract surgery. Diabetic retinopathy was a major cause of post-operative VI in migrant Indians living in Singapore. Uncorrected postoperative refractive error remains an efficient way to improve vision.

Economic analysis of pandemic influenza vaccination strategies in Singapore.

PubMed

Lee, Vernon J; Tok, Mei Yin; Chow, Vincent T; Phua, Kai Hong; Ooi, Eng Eong; Tambyah, Paul A; Chen, Mark I

2009-09-22

All influenza pandemic plans advocate pandemic vaccination. However, few studies have evaluated the cost-effectiveness of different vaccination strategies. This paper compares the economic outcomes of vaccination compared with treatment with antiviral agents alone, in Singapore. We analyzed the economic outcomes of pandemic vaccination (immediate vaccination and vaccine stockpiling) compared with treatment-only in Singapore using a decision-based model to perform cost-benefit and cost-effectiveness analyses. We also explored the annual insurance premium (willingness to pay) depending on the perceived risk of the next pandemic occurring. The treatment-only strategy resulted in 690 deaths, 13,950 hospitalization days, and economic cost of USD$497 million. For immediate vaccination, at vaccine effectiveness of >55%, vaccination was cost-beneficial over treatment-only. Vaccine stockpiling is not cost-effective in most scenarios even with 100% vaccine effectiveness. The annual insurance premium was highest with immediate vaccination, and was lower with increased duration to the next pandemic. The premium was also higher with higher vaccine effectiveness, attack rates, and case-fatality rates. Stockpiling with case-fatality rates of 0.4-0.6% would be cost-beneficial if vaccine effectiveness was >80%; while at case-fatality of >5% stockpiling would be cost-beneficial even if vaccine effectiveness was 20%. High-risk sub-groups warrant higher premiums than low-risk sub-groups. The actual pandemic vaccine effectiveness and lead time is unknown. Vaccine strategy should be based on perception of severity. Immediate vaccination is most cost-effective, but requires vaccines to be available when required. Vaccine stockpiling as insurance against worst-case scenarios is also cost-effective. Research and development is therefore critical to develop and stockpile cheap, readily available effective vaccines.

Trends in patterns of anterior uveitis in a tertiary institution in singapore.

PubMed

Tan, Wai Jia; Poh, Eugenie W; Wong, Poh-Ying; Ho, Su-Ling; Lim, Wee-Kiak; Teoh, Stephen C

2013-08-01

To report the trends in etiology of patients with anterior uveitis (AU) in Singapore over 6 years. A retrospective review of the clinical records of all new patients who presented with anterior uveitis to the uveitis subspecialty clinic from 2005 to 2010 at Tan Tock Seng Hospital, Singapore. There were 552 new cases of AU. This comprised 59.5% of a total of 928 new patients diagnosed with uveitis from 2005 to 2010. The mean age was 48.0 ± 17.2 years. There was a male predominance (62.5%), with a male:female ratio of 1.7:1. The majority were of Chinese ethnicity (69%), followed by Malays (13.2%). Most cases were unilateral (79.5%) and idiopathic (50.4%). Common etiological causes included Fuchs heterochromic iridocyclitis (FHI) (5.6%), ankylosing spondylitis (AS)-related AU (5.1%), herpes simplex virus (HSV) (4.7%), and herpes zoster virus (HZV) (4.5%). There were increasing trends in AS-related AU from 3.2% in 2008 to 6.5% in 2010, and psoriasis-associated AU from 1.7% in 2005 to 4.0% in 2008. There were decreasing trends in the incidence of FHI from 10.6% in 2006 to 4.7% in 2009. No change in incidence of viral etiologies was noted, but cytomegalovirus-related immune-recovery uveitis (IRU) comprised 7.4%. IRU showed an increasing trend from 1.7% in 2005 to 11.9% in 2007, then decreased to 3.3% in 2010. Using the Pearson chi-square test, there was no statistically significant association between ethnicities (Chinese, Malay, Indian) comparing infectious and noninfectious cases (p = 0.788), idiopathic and nonidiopathic cases (p = 0.170), or between the various etiologies of uveitis (p = 0.168). AU was the predominant form of uveitis seen at our centers. Infectious etiologies (18.5%) are the most common among nonidiopathic cases, with herpes viruses (9.2%) being most prevalent. Despite increased use of polymerase chain reaction (PCR) in the detection of microbial and viral DNA, there was no overall increase in detection of infectious causes for

Certification of poliomyelitis eradication in Singapore and the challenges ahead.

PubMed

Lee, Hwee Ching; Tay, Joanne; Kwok, Cynthia Y H; Wee, Moi Kim; Ang, Li Wei; Kita, Yuske; Cutter, Jeffery L; Chan, Kwai Peng; Chew, Suok Kai; Goh, Kee Tai

2012-11-01

This study reviewed the epidemiological trends of poliomyelitis from 1946 to 2010, and the impact of the national immunisation programme in raising the population herd immunity against poliovirus. We also traced the efforts Singapore has made to achieve certification of poliomyelitis eradication by the World Health Organisation. Epidemiological data on all reported cases of poliomyelitis were obtained from the Communicable Diseases Division of the Ministry of Health as well as historical records. Coverage of the childhood immunisation programme against poliomyelitis was based on the immunisation data maintained by the National Immunisation Registry, Health Promotion Board. To assess the herd immunity of the population against poliovirus, 6 serological surveys were conducted in 1962, 1978, 1982 to 1984, 1989, 1993 and from 2008 to 2010. Singapore was among the fi rst countries in the world to introduce live oral poliovirus vaccine (OPV) on a mass scale in 1958. With the comprehensive coverage of the national childhood immunisation programme, the incidence of paralytic poliomyelitis declined from 74 cases in 1963 to 5 cases from 1971 to 1973. The immunisation coverage for infants, preschool and primary school children has been maintained at 92% to 97% over the past decade. No indigenous poliomyelitis case had been reported since 1978 and all cases reported subsequently were imported. Singapore was certified poliomyelitis free along with the rest of the Western Pacific Region in 2000 after fulfilling all criteria for poliomyelitis eradication, including the establishment of a robust acute flaccid paralysis surveillance system. However, post-certification challenges remain, with the risk of wild poliovirus importation. Furthermore, it is timely to consider the replacement of OPV with the inactivated poliovirus vaccine in Singapore's national immunisation programme given the risk of vaccine-associated paralytic poliomyelitis and circulating vaccine-derived polioviruses.

Neck circumference and early stage atherosclerosis: the cardiometabolic risk in Chinese (CRC) study.

PubMed

Liang, Jun; Wang, Yu; Li, Hongyan; Liu, Xuekui; Qiu, Qinqin; Qi, Lu

2014-07-08

Neck circumference (NC) has been previously related to cardiometabolic risk factors. In this study we examined the association between NC and early stage atherosclerosis in Chinese adults. The study samples were from a community-based health examination survey in central China. In total 2,318 men and women (18-64 y) were included in the final analyses. Carotid radial pulse wave velocity (crPWV), carotid femoral PWV (cfPWV), carotid artery dorsalis pedis PWV (cdPWV) and NC were measured. After adjustment for age, sex, lipids, glucose, blood pressure, heart rate, body mass index (BMI), high NC was significantly associated with an increasing trend of cfPWV, cdPWV and crPWV (P = 0.001, 0.049, and 0.038; respectively). In addition, we found significant interaction between hypertension status and NC level in relation to cfPWV, adjusted for age, sex, BMI, fasting glucose, lipids and heart rate(P for interaction = 0.034). The associations between NC and cfPWV were significant (P = 0.02) among those with hypertension, but not significant among those without hypertension. Our data showed that high NC was associated with an increased risk of early stage atherosclerosis in Chinese adults, independent of other metabolic risk factors. Hypertension might modify the association between NC and cfPWV.

Hand-grip strength among older adults in Singapore: a comparison with international norms and associative factors.

PubMed

Ong, Hui Lin; Abdin, Edimansyah; Chua, Boon Yiang; Zhang, Yunjue; Seow, Esmond; Vaingankar, Janhavi Ajit; Chong, Siow Ann; Subramaniam, Mythily

2017-08-04

Hand-grip strength (HGS) serves as a proxy measure for muscle function and physical health. Studies have shown that low HGS is associated with common age-related disorders including frailty and sarcopenia. The aim of the present study was to establish the normative values of HGS among older adults in Singapore and to compare it with data from Western and other Asian countries. The study also aimed to explore the sociodemographic and anthropometric correlates of HGS. Data were collected from 2043 men and women aged 60 years and above who took part in the Well-being of the Singapore Elderly study in 2013. HGS was obtained using a Jamar Plus + digital hand dynamometer. Normative data were stratified by; 5-year age groups, sex and ethnicity. Relationships between the HGS with various sociodemographic and anthropometric correlates were examined using multiple linear regression analysis. The mean HGS demonstrate a decreasing trend with increased age across all ethnic groups and sexes. HGS among Singapore older adults were relatively low compared to Western and other Asian countries. Males in the youngest age group (60-64) and of Chinese ethnicity attained greater HGS values than their counterparts. When the regression analysis was stratified for sex, significant associations were found between height, upper arm circumference with HGS in the males sample, and between height, weight, waist circumference and HGS in the females sample. Older adults in Singapore have a relatively weak HGS compared to other countries. Greater height and weight, and smaller waist circumference are independently associated with greater HGS in females but not males. These results facilitate the interpretation of HGS conducting using Jamar digital-type dynamometers among the older adults in Singapore.

Trends in Income Disparity and Equality Enhancing (?) Education Policies in the Development Stages of Singapore

ERIC Educational Resources Information Center

Mukhopadhaya, P.

2003-01-01

This paper examines the trends in income diversity in Singapore at the total and disaggregated level using Labour Force Survey data. The income inequality in Singapore is found to be significantly high. One reason is the selective migration policy of the government of Singapore. The government has made conscious efforts to bring equality in…

Comparison of electrocardiographic findings and associated risk factors between Taiwan Chinese and US White adults.

PubMed

Wu, Chih-Cheng; Yeh, Wen-Ting; Crow, Richard S; Bai, Chyi-Huey; Pan, Wen-Harn

2008-08-18

Electrocardiographic (ECG) findings are known to differ by race, however, systematic comparisons of findings between eastern and western countries are rare. To compare the ECG findings and associated coronary heart disease (CHD) risk factors between Taiwan Chinese and US White adults aged >or=40 years. We compared the prevalence rate of Minnesota Code criteria based ECG findings and associated CHD risk factors by using data from the third National Health and Nutrition Examination Survey (NHANES III) and the Nutrition and Health Survey in Taiwan (NAHSIT, 1993-1996). Examining all the ECG findings collectively, we observed a higher prevalence of major Minnesota Code findings in Taiwan Chinese women than in US White women (15.0% vs. 10.5%), particularly ST segment depression (5.4% vs. 2.4%) and T wave abnormalities (10.8% vs. 4.8%). The prevalence of major Minnesota Code findings was similar in both Taiwan Chinese and US White men (22.7% vs. 19.6%). Taiwan Chinese men had a higher prevalence of ST segment elevation (13.7% vs. 0.9%). Taiwan Chinese also had a higher prevalence of left ventricular hypertrophy with repolarization change than US Whites in both sexes (2.7% vs. 1.4% for men, 4.3% vs. 1.3% for women). Taiwan Chinese had more favorable CHD risk factor profiles than US Whites, including lipid profile, obesity, central obesity, and smoking status. The prevalence of hypertension was similar between the two groups, however, a lower percentage of Taiwan Chinese received treatment. Taiwan Chinese men had a lower prevalence of diabetes mellitus than US White men, whereas Taiwan Chinese women had a higher prevalence than US White women. These results suggest that substantial differences in ECG findings exist between Taiwan Chinese and US Whites which cannot be entirely explained by CHD risk factors alone.

Word Reading in L1 and L2 Learners of Chinese: Similarities and Differences in the Functioning of Component Processes

ERIC Educational Resources Information Center

Zhang, Dongbo

2017-01-01

This study examined the similarities and differences in the functioning of component processes underlying first language (L1) and second language (L2) word reading in Chinese. Fourth-grade Chinese children in Singapore were divided into L1 and L2 reader groups based on whether they used Mandarin or English as their home language. Both groups were…

Sports activity and risk of type 2 diabetes in Chinese.

PubMed

Chien, Kuo-Liong; Chen, Ming-Fong; Hsu, Hsiu-Ching; Su, Ta-Chen; Lee, Yuan-Teh

2009-06-01

An association between physical inactivity and obesity risk has been established. However, the relationship between sports activity and the risk of diabetes among Chinese populations is still unclear. We prospectively investigated the association between sports activity and incidence of type 2 diabetes in a Chinese population. Habitual physical activity in the presumed last year was obtained from a questionnaire developed by Baecke and colleagues. During a median 9.02-year follow-up period among the 1936 participants with complete questionnaire data, 312 participants developed diabetes. After adjusting for age, gender and body mass index, the relative risk (RR) of diabetes according to quartiles of sports activity were 0.86, 0.71 and 0.72 (95% Confidence Interval [CI], 0.52-0.99, P for trend, 0.048). Participants with the highest quartiles of sports activity had a significantly lower risk than the participants with the lowest quartiles among the obese group (multivariate RR, 0.61, 95% CI, 0.41-0.92, P for trend=0.018). Furthermore, the RRs of diabetes were 2.24 (95% CI, 1.58-3.19) for participants who were obese and sedentary, compared with those who were of a healthy weight and participated actively in sports. The findings suggest a significant inverse association between sports activity and incidence of type 2 diabetes in middle to older-aged Chinese individuals.

Barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia: a qualitative multicentre study

PubMed Central

Lim, Jennifer NW; Potrata, Barbara; Simonella, Leonardo; Ng, Celene WQ; Aw, Tar-Ching; Dahlui, Maznah; Hartman, Mikael; Mazlan, Rifhan; Taib, Nur Aishah

2015-01-01

Objective To explore and compare barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia. Design A qualitative interview study with thematic analysis of transcripts. Participants 67 patients with self-discovered breast symptoms were included in the analysis. Of these, 36% were of Malay ethnicity, 39% were Chinese and 25% Indian, with an average age of 58 years (range 24–82 years). The number of women diagnosed at early stages of cancer almost equalled those at advanced stages. Approximately three-quarters presented with a painless lump, one-quarter experienced a painful lump and 10% had atypical symptoms. Setting University hospital setting in Singapore and Malaysia. Results Patients revealed barriers to early presentation not previously reported: the poor quality of online website information about breast symptoms, financial issues and the negative influence of relatives in both countries, while perceived poor quality of care and services in state-run hospitals and misdiagnosis by healthcare professionals were reported in Malaysia. The pattern of presentation by ethnicity remained unchanged where more Malay delayed help-seeking and had more advanced cancer compared to Chinese and Indian patients. Conclusions There are few differences in the pattern of presentation and in the reported barriers to seek medical care after symptom discovery between Singapore and Malaysia despite their differing economic status. Strategies to reduce delayed presentation are: a need to improve knowledge of disease, symptoms and causes, quality of care and services, and quality of online information; and addressing fear of diagnosis, treatment and hospitalisation, with more effort focused on the Malay ethnic group. Training is needed to avoid missed diagnoses and other factors contributing to delay among health professionals. PMID:26692558

Barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia: a qualitative multicentre study.

PubMed

Lim, Jennifer N W; Potrata, Barbara; Simonella, Leonardo; Ng, Celene W Q; Aw, Tar-Ching; Dahlui, Maznah; Hartman, Mikael; Mazlan, Rifhan; Taib, Nur Aishah

2015-12-21

To explore and compare barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia. A qualitative interview study with thematic analysis of transcripts. 67 patients with self-discovered breast symptoms were included in the analysis. Of these, 36% were of Malay ethnicity, 39% were Chinese and 25% Indian, with an average age of 58 years (range 24-82 years). The number of women diagnosed at early stages of cancer almost equalled those at advanced stages. Approximately three-quarters presented with a painless lump, one-quarter experienced a painful lump and 10% had atypical symptoms. University hospital setting in Singapore and Malaysia. Patients revealed barriers to early presentation not previously reported: the poor quality of online website information about breast symptoms, financial issues and the negative influence of relatives in both countries, while perceived poor quality of care and services in state-run hospitals and misdiagnosis by healthcare professionals were reported in Malaysia. The pattern of presentation by ethnicity remained unchanged where more Malay delayed help-seeking and had more advanced cancer compared to Chinese and Indian patients. There are few differences in the pattern of presentation and in the reported barriers to seek medical care after symptom discovery between Singapore and Malaysia despite their differing economic status. Strategies to reduce delayed presentation are: a need to improve knowledge of disease, symptoms and causes, quality of care and services, and quality of online information; and addressing fear of diagnosis, treatment and hospitalisation, with more effort focused on the Malay ethnic group. Training is needed to avoid missed diagnoses and other factors contributing to delay among health professionals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A functional brain-derived neurotrophic factor (BDNF) gene variant increases the risk of moderate-to-severe allergic rhinitis.

PubMed

Jin, Peng; Andiappan, Anand Kumar; Quek, Jia Min; Lee, Bernett; Au, Bijin; Sio, Yang Yie; Irwanto, Astrid; Schurmann, Claudia; Grabe, Hans Jörgen; Suri, Bani Kaur; Matta, Sri Anusha; Westra, Harm-Jan; Franke, Lude; Esko, Tonu; Sun, Liangdan; Zhang, Xuejun; Liu, Hong; Zhang, Furen; Larbi, Anis; Xu, Xin; Poidinger, Michael; Liu, Jianjun; Chew, Fook Tim; Rotzschke, Olaf; Shi, Li; Wang, De Yun

2015-06-01

Brain-derived neurotrophic factor (BDNF) is a secretory protein that has been implicated in the pathogenesis of allergic rhinitis (AR), atopic asthma, and eczema, but it is currently unknown whether BDNF polymorphisms influence susceptibility to moderate-to-severe AR. We sought to identify disease associations and the functional effect of BDNF genetic variants in patients with moderate-to-severe AR. Tagging single nucleotide polymorphisms (SNPs) spanning the BDNF gene were selected from the human HapMap Han Chinese from Beijing (CHB) data set, and associations with moderate-to-severe AR were assessed in 2 independent cohorts of Chinese patients (2216 from Shandong province and 1239 living in Singapore). The functional effects of the BDNF genetic variants were determined by using both in vitro and ex vivo assays. The tagging SNP rs10767664 was significantly associated with the risk of moderate-to-severe AR in both Singapore Chinese (P = .0017; odds ratio, 1.324) and Shandong Chinese populations (P = .039; odds ratio, 1.180). The coding nonsynonymous SNP rs6265 was in perfect linkage with rs10767664 and conferred increased BDNF protein secretion by a human cell line in vitro. Subjects bearing the AA genotype of rs10767664 exhibited increased risk of moderate-to-severe AR and displayed increased BDNF protein and total IgE levels in plasma. Using a large-scale expression quantitative trait locus study, we demonstrated that BDNF SNPs are significantly associated with altered BDNF concentrations in peripheral blood. A common genetic variant of the BDNF gene is associated with increased risk of moderate-to-severe AR, and the AA genotype is associated with increased BDNF mRNA levels in peripheral blood. Together, these data indicate that functional BDNF gene variants increase the risk of moderate-to-severe AR. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Expected lifetime numbers, risks, and burden of osteoporotic fractures for 50-year old Chinese women: a discrete event simulation incorporating FRAX.

PubMed

Jiang, Yawen; Ni, Weiyi

2016-11-01

This work was undertaken to provide an estimation of expected lifetime numbers, risks, and burden of fractures for 50-year-old Chinese women. A discrete event simulation model was developed to simulate the lifetime fractures of 50-year-old Chinese women at average risk of osteoporotic fracture. Main events in the model included hip fracture, clinical vertebral fracture, wrist fracture, humerus fracture, and other fracture. Fracture risks were calculated using the FRAX ® tool. Simulations of 50-year-old Chinese women without fracture risks were also carried out as a comparison to determine the burden of fractures. A 50-year-old Chinese woman at average risk of fracture is expected to experience 0.135 (95 % CI: 0.134-0.137) hip fractures, 0.120 (95 % CI: 0.119-0.122) clinical vertebral fractures, 0.095 (95 % CI: 0.094-0.096) wrist fractures, 0.079 (95 % CI: 0.078-0.080) humerus fractures, and 0.407 (95 % CI: 0.404-0.410) other fractures over the remainder of her life. The residual lifetime risk of any fracture, hip fracture, clinical vertebral fracture, wrist fracture, humerus fracture, and other fracture for a 50-year-old Chinese woman is 37.36, 11.77, 10.47, 8.61, 7.30, and 27.80 %, respectively. The fracture-attributable excess quality-adjusted life year (QALY) loss and lifetime costs are estimated at 0.11 QALYs (95 % CI: 0.00-0.22 QALYs) and US $714.61 (95 % CI: US $709.20-720.02), totaling a net monetary benefit loss of US $1,104.43 (95 % CI: US $904.09-1,304.78). Chinese women 50 years of age are at high risk of osteoporotic fracture, and the expected economic and quality-of-life burden attributable to osteoporotic fractures among Chinese women is substantial.

Diverticular disease of the large bowel in Singapore. An autopsy survey.

PubMed

Lee, Y S

1986-05-01

One thousand fourteen consecutive large intestines were removed at autopsy from persons over the age of 14 years and examined for diverticular disease. Diverticulosis was encountered in 194 patients (19 percent). The lesion appeared early in life, after the second decade. Men were affected more frequently than women before the age of 60 years. Chinese men had significantly more diverticular disease than Malayan men (P less than 0.01) and Indian men (P less than 0.02). Chinese men also had significantly more diverticular disease than Chinese women. There was a predominance of right colon involvement, with the disease affecting especially the ascending colon and cecum. This pattern was observed in all three major ethnic groups, and in both the Singapore-born and foreign-born Singaporeans. The cause of right-sided diverticulosis is unknown. It appears that, while adoption of the western diet may influence the prevalence of diverticular disease, the site of predilection is determined more by racial or genetic predisposition. All diverticula examined histologically were false, including 39 (20 percent) solitary diverticula. The distribution of solitary diverticula was similar to that of multiple diverticulosis. It is suggested that solitary and multiple diverticulosis are part of the spectrum of the same disease.

A Pandora's Box in Singapore

ERIC Educational Resources Information Center

Overland, Martha Ann

2007-01-01

Singapore is no longer content to produce only engineers and technocrats, says Tharman Shanmugaratnam, minister for education. The government wants to foster a dynamic environment that can attract thinkers and leaders in many fields, not just science. Singapore's planners envision their city as the "Boston of the East"--where the alchemy…

East versus West: Effectiveness of Knowledge Acquisition and Impact of Cultural Dislocation Issues for Mainland Chinese Students across Ten Commonly Used Instructional Techniques

ERIC Educational Resources Information Center

Rajaram, Kumaran; Bordia, Sarbari

2013-01-01

The research analyses the new trend of training culturally diverse students in western style business education in Singapore where a substantial number of mainland Chinese students enroll in business courses. Building on ideas by Hosfede (1984), Morey and Frangioso (1998) and Rodrigues (2004), 402 mainland Chinese students who were enrolled in…

Cultural Effects on Cancer Prevention Behaviors: Fatalistic Cancer Beliefs and Risk Optimism Among Asians in Singapore.

PubMed

Kim, Hye Kyung; Lwin, May O

2017-10-01

Although culture is acknowledged as an important factor that influences health, little is known about cultural differences pertaining to cancer-related beliefs and prevention behaviors. This study examines two culturally influenced beliefs-fatalistic beliefs about cancer prevention, and optimistic beliefs about cancer risk-to identify reasons for cultural disparity in the engagement of cancer prevention behaviors. We utilized data from national surveys of European Americans in the United States (Health Information National Trends Survey 4, Cycle3; N = 1,139) and Asians in Singapore (N = 1,200) to make cultural comparisons. The odds of an Asian adhering to prevention recommendations were less than half the odds of a European American, with the exception of smoking avoidance. Compared to European Americans, Asians were more optimistic about their cancer risk both in an absolute and a comparative sense, and held stronger fatalistic beliefs about cancer prevention. Mediation analyses revealed that fatalistic beliefs and absolute risk optimism among Asians partially explain their lower engagement in prevention behaviors, whereas comparative risk optimism increases their likelihood of adhering to prevention behaviors. Our findings underscore the need for developing culturally targeted interventions in communicating cancer causes and prevention.

Overweight is an independent risk factor for cardiovascular disease in Chinese populations.

PubMed

Zhou, Beifan; Wu, Yangfeng; Yang, Jun; Li, Ying; Zhang, Hongye; Zhao, Liancheng

2002-08-01

measurements among populations within China. Thus, rates of overweight varied from 2.7% to 48.1% and obesity from 0% to 9.5% on the basis of the World Health Organization (WHO) classification, but these values were lower than those found in western populations. Data from the 10 cohort samples compared with baseline data in the early 1980s showed that the mean BMIs increased significantly in eight populations during the early 1990s with the differences ranging from 0.5 to 2.5 kg m(-2). Despite the lower level of BMI and the lower rate of overweight, cross-sectional analyses showed that the prevalence of hypertension, high fasting serum glucose, high serum total cholesterol and low high-density lipoprotein cholesterol (HDL-C) and their clustering were all raised with increases in BMI or waist circumference. The prospective cohort study showed that the BMI was one of the independent risk factors for stroke and CHD in Chinese populations. Hence, in a Chinese population characterized by lower levels of BMI and great variability in rates of overweight, variation of BMI was significantly related to the prevalence of other metabolic risk factors and their clustering. Overweight was one of the independent risk factors for stroke and CHD, both at population and individual levels. Given the increasing trends of BMI in the last 10 years, during the period of economic transition there is a need to encourage the population to adopt healthy dietary habits and to increase their physical activity. Health education and health promotion are important for the prevention and non-pharmacological therapy of cardiovascular disease in China.

Risk factors for ischemic stroke and its subtypes in Chinese vs. Caucasians: Systematic review and meta-analysis.

PubMed

Tsai, Chung-Fen; Anderson, Niall; Thomas, Brenda; Sudlow, Cathie L M

2015-06-01

Chinese populations are reported to have a different distribution of ischemic stroke subtypes compared with Caucasians. To understand this better, we aimed to evaluate the differences in prevalence of risk factors in ischemic stroke and their distributions among ischemic stroke subtypes in Chinese vs. Caucasians. We systematically sought studies conducted since 1990 with data on frequency of risk factors among ischemic stroke subtypes in Chinese or Caucasians. For each risk factor, we calculated study-specific and random effects pooled estimates in Chinese and Caucasians separately for: prevalence among ischemic stroke; odds ratios, comparing prevalence for each ischemic stroke subtype vs. all others. We included seven studies among 16,199 Chinese, and eleven among 16,189 Caucasian ischemic stroke patients. Risk factors studied were hypertension, diabetes, atrial fibrillation, ischemic heart disease, hypercholesterolemia, smoking and alcohol. Chinese ischemic stroke patients had younger onset of stroke than Caucasians, similar prevalence of hypertension, diabetes, smoking and alcohol, and significantly lower prevalence of atrial fibrillation, ischemic heart disease and hypercholesterolemia. Risk factor associations with ischemic stroke subtypes were mostly similar among Chinese and Caucasian ischemic stroke patients. Compared with all other ischemic subtypes, diabetes was more common in large artery stroke, atrial fibrillation and ischemic heart disease in cardioembolic stroke, and hypertension and diabetes in lacunar stroke. Our study showed a lower prevalence of atrial fibrillation, ischemic heart disease and hypercholesterolemia in Chinese, and mostly similar risk factor associations in Chinese and Caucasian ischemic stroke patients. Further analyses of individual patient data to allow adjustment for confounders are needed to confirm and extend these findings. © 2015 World Stroke Organization.

Scaffolding Singaporean Students to Write Vividly in the Chinese "Mother Tongue", Mandarin

ERIC Educational Resources Information Center

Chung, Tzemin; Anderson, Neil; Leong, Munkew; Choy, Waiyin

2014-01-01

This paper details results from a three-year study investigating how to help students in Singapore write vivid compositions in Mandarin, the Chinese "mother tongue". Mastery of the mother tongue by Singaporean students has become an important government priority in recent years. The strategies employed by this study included the use of…

Exploring the Relationships between Students' Ability of Computer-Based Chinese Input and Other Variables Associated to Their Performances in Composition Writing

ERIC Educational Resources Information Center

Chai, Ching Sing; Wong, Lung-Hsiang; Sim, Seok Hwa; Deng, Feng

2012-01-01

Computer-based writing is already a norm to a large extent in social communication for any major language around the world. From this perspective, it would be pedagogically sound for students to master the Chinese input system as early as possible. This poses some challenges to students in Singapore, most of which are learning Chinese as a second…

Alcohol and aldehyde dehydrogenase polymorphisms in Chinese and Indian populations.

PubMed

Tan, Ene-Choo; Lim, Leslie; Leong, Jern-Yi; Lim, Jing-Yan; Lee, Arthur; Yang, Jun; Tan, Chay-Hoon; Winslow, Munidasa

2010-01-01

The association between two functional polymorphisms in alcohol dehydrogenase (ADH2/ADH1B) and aldehyde dehydrogenase (ALDH2) genes and alcohol dependence was examined in 182 Chinese and Indian patients undergoing treatment for alcohol dependence and 184 screened control subjects from Singapore. All subjects were screened by the Alcohol Use Disorders Identification Test (AUDIT). Patients were also administered the Severity of Alcohol Dependence Questionnaire (SADQ). Polymorphisms were genotyped by allele-specific polymerase chain reaction and selected genotypes confirmed by DNA sequencing or restriction fragment length polymorphism. Our results showed that frequencies of ADH1B*2 and ALDH2*2 were higher in controls compared to alcohol-dependent subjects for both Chinese and Indians. Frequencies of these two alleles were also higher in the 104 Chinese controls compared to the 80 Indian controls. None of the eight Chinese who were homozygous for both protective alleles was alcohol dependent. The higher frequencies of the protective alleles could explain the lower rate of alcohol dependence in Chinese.

Is EQ-5D a valid quality of life instrument in patients with Parkinson's disease? A study in Singapore.

PubMed

Luo, Nan; Low, Serena; Lau, Puay-Ngoh; Au, Wing-Lok; Tan, Louis C S

2009-06-01

The purpose of the present study was to evaluate the validity of the EQ-5D in patients with Parkinson's disease (PD) in Singapore. In a cross-sectional survey, patients with PD completed English or Chinese version of the EQ-5D, the 8-item Parkinson's disease questionnaire (PDQ-8), and questions assessing socio-demographic and health characteristics. Clinical data were retrieved from patients' medical records. The validity of the EQ-5D was assessed by testing a-priori hypotheses relating the EQ-5D to the PDQ-8 and clinical data. Two hundred and eight PD patients (English speaking: 135) participated in the study. Spearman correlation coefficients between the EQ-5D and PDQ-8 ranged from 0.25 to 0.75 for English-speaking patients and from 0.16 to 0.67 for Chinese-speaking patients. By and large, the EQ-5D scores were weakly or moderately correlated with Hoehn and Yahr stage (correlation coefficients: 0.05 to 0.43), Schwab and England Activities of Daily Living score (correlation coefficients: 0.10 to 0.60), and duration of PD (correlation coefficients: 0.16 to 0.43). The EQ-5D index scores for patients with dyskinesia or "wearing off" periods were significantly lower than those without these problems. The EQ-5D Visual Analog Scale (EQ-VAS) scores also differed for English-speaking patients with deferring dyskinesia, "wearing off" periods, or health transition status; however, such differences were not observed in patients who completed the survey in Chinese. The EQ-5D questionnaire appears valid for measuring quality of life in patients with PD in Singapore. However, the validity of EQ-VAS in Chinese-speaking patients with PD should be further assessed.

The economic impact of sea-level rise on nonmarket lands in Singapore.

PubMed

Ng, Wei-Shiuen; Mendelsohn, Robert

2006-09-01

Sea-level rise, as a result of climate change, will likely inflict considerable economic consequences on coastal regions, particularly low-lying island states like Singapore. Although the literature has addressed the vulnerability of developed coastal lands, this is the first economic study to address nonmarket lands, such as beaches, marshes and mangrove estuaries. This travel cost and contingent valuation study reveals that consumers in Singapore attach considerable value to beaches. The contingent valuation study also attached high values to marshes and mangroves but this result was not supported by the travel cost study. Although protecting nonmarket land uses from sea-level rise is expensive, the study shows that at least highly valued resources, such as Singapore's popular beaches, should be protected.

Risk Perception and Risk-Taking Attitude: A Comparison between Hong Kong and Mainland Chinese Undergraduate Students

ERIC Educational Resources Information Center

Cheung, Hoi Yan; Wu, Joseph; Tao, Jun

2013-01-01

This paper compares risk perception and risk-taking attitude between Hong Kong and mainland China undergraduate students using a Chinese version of the 30-item domain-specific risk-taking (DOSPERT) scale (Blais and Weber 2006b). Compared with their counterparts from mainland China, Hong Kong university students reported higher levels of risk…

Measurement properties of the English and Chinese versions of the Functional Assessment of Cancer Therapy-Breast (FACT-B) in Asian breast cancer patients.

PubMed

Ng, Raymond; Lee, Chun Fan; Wong, Nan Soon; Luo, Nan; Yap, Yoon Sim; Lo, Soo Kien; Chia, Whay Kuang; Yee, Alethea; Krishna, Lalit; Goh, Cynthia; Cheung, Yin Bun

2012-01-01

The objective of the study was to examine the measurement properties of and comparability between the English and Chinese versions of the Functional Assessment of Cancer Therapy-Breast (FACT-B) in breast cancer patients in Singapore. This is an observational study of 271 Singaporean breast cancer patients. The known-group validity of FACT-B total score and Trial Outcome Index (TOI) were assessed in relation to performance status, evidence of disease, and treatment status cross-sectionally; responsiveness to change was assessed in relation to change in performance status longitudinally. Internal consistency and test-retest reliability were evaluated by the Cronbach's alpha and intraclass correlation coefficient (ICC), respectively. Multiple regression analyses were performed to compare the scores on the two language versions, adjusting for covariates. The FACT-B total score and TOI demonstrated known-group validity in differentiating patients with different clinical status. They showed high internal consistency and test-retest reliability, with Cronbach's alpha ranging from 0.87 to 0.91 and ICC ranging from 0.82 to 0.89. The English version was responsive to the change in performance status. The Chinese version was shown to be responsive to decline in performance status but the sample size of Chinese-speaking patients who improved in performance status was too small (N = 6) for conclusive analysis about responsiveness to improvement. Two items concerning sexuality had a high item non-response rate (50.2 and 14.4%). No practically significant difference was found in the total score and TOI between the two language versions despite minor differences in two of the 37 items. The English and Chinese versions of the FACT-B are valid, responsive, and reliable instruments in assessing health-related quality of life in breast cancer patients in Singapore. Data collected from the English and Chinese versions can be pooled and either version could be used for bilingual

Retinal Vein Occlusion in a Multi-Ethnic Asian Population: The Singapore Epidemiology of Eye Disease Study.

PubMed

Koh, Victor; Cheung, Carol Y; Li, Xiang; Tian, Dechao; Wang, Jie Jin; Mitchell, Paul; Cheng, Ching-Yu; Wong, Tien Y

2016-01-01

To describe the prevalence of retinal vein occlusion (RVO) and its risk factors in a multi-ethnic Asian population. This population-based study of 10,033 participants (75.7% response rate) included Chinese, Indian and Malay persons aged 40 years and older. A comprehensive ophthalmic examination, standardized interviews and laboratory blood tests were performed. Digital fundus photographs were assessed for presence of RVO following the definitions used in the Blue Mountains Eye Study. Regression analysis models were constructed to study the relationship between ocular and systemic factors and RVO. Age-specific prevalence rates of RVO were applied to project the number of people affected in Asia from 2013 to 2040. The overall crude prevalence of RVO was 0.72% (n = 71; 95% confidence interval, CI, 0.54-0.87%). The crude prevalence of RVO was similar in Chinese, Indian and Malay participants (p = 0.865). In multivariable regression models, significant risk factors of RVO included increased age (odds ratio, OR, 1.03, 95% CI 1.01-1.06), hypertension (OR 3.65, 95% CI 1.61-8.31), increased serum creatinine (OR 1.04, 95% CI 1.01-1.06, per 10 mmol/L increase), history of heart attack (OR 2.25, 95% CI 1.11-4.54) and increased total cholesterol (OR 1.31, 95% CI 1.07-1.59, per 1 mmol/L increase). None of the ocular parameters were associated with RVO. RVO is estimated to affect up to 16 and 21 million people in Asia by 2020 and 2040, respectively. RVO was detected in 0.72% of a multi-ethnic Asian population aged 40-80 years in Singapore. The significant systemic risk factors of RVO are consistent with studies in white populations.

Teleradiology in Singapore--taking stock and looking ahead.

PubMed

Cheng, Lionel T E; Ng, Samuel E S

2006-08-01

Teleradiology will have a significant impact on the delivery of healthcare and the practice of medicine. In order to ensure a positive outcome, the expected benefits, limitations and potential pitfalls of teleradiology must be carefully considered. For Singapore, teleradiology can be used to facilitate a quantum leap in the standards of radiological services. This can be achieved through the development of an integrated, nationwide, high-speed radiology network which will allow patients to have access to high-quality and responsive subspecialty radiology expertise located throughout the country. If judiciously implemented, teleradiology has the potential to propel Singapore radiology to an unprecedented level of professional quality and service delivery, and will provide the framework for sustainable radiological insourcing from other countries.

Assessing risk of breast cancer in an ethnically South-East Asia population (results of a multiple ethnic groups study).

PubMed

Gao, Fei; Machin, David; Chow, Khuan-Yew; Sim, Yu-Fan; Duffy, Stephen W; Matchar, David B; Goh, Chien-Hui; Chia, Kee-Seng

2012-11-19

Gail and others developed a model (GAIL) using age-at-menarche, age-at-birth of first live child, number of previous benign breast biopsy examinations, and number of first-degree-relatives with breast cancer as well as baseline age-specific breast cancer risks for predicting the 5-year risk of invasive breast cancer for Caucasian women. However, the validity of the model for projecting risk in South-East Asian women is uncertain. We evaluated GAIL and attempted to improve its performance for Singapore women of Chinese, Malay and Indian origins. Data from the Singapore Breast Screening Programme (SBSP) are used. Motivated by lower breast cancer incidence in many Asian countries, we utilised race-specific invasive breast cancer and other cause mortality rates for Singapore women to produce GAIL-SBSP. By using risk factor information from a nested case-control study within SBSP, alternative models incorporating fewer then additional risk factors were determined. Their accuracy was assessed by comparing the expected cases (E) with the observed (O) by the ratio (E/O) and 95% confidence interval (CI) and the respective concordance statistics estimated. From 28,883 women, GAIL-SBSP predicted 241.83 cases during the 5-year follow-up while 241 were reported (E/O=1.00, CI=0.88 to 1.14). Except for women who had two or more first-degree-relatives with breast cancer, satisfactory prediction was present in almost all risk categories. This agreement was reflected in Chinese and Malay, but not in Indian women. We also found that a simplified model (S-GAIL-SBSP) including only age-at-menarche, age-at-birth of first live child and number of first-degree-relatives performed similarly with associated concordance statistics of 0.5997. Taking account of body mass index and parity did not improve the calibration of S-GAIL-SBSP. GAIL can be refined by using national race-specific invasive breast cancer rates and mortality rates for causes other than breast cancer. A revised model

Cardiovascular risks and metabolic syndrome in Hong Kong Chinese women with polycystic ovary syndrome.

PubMed

Cheung, L P; Ma, R C W; Lam, P M; Lok, I H; Haines, C J; So, W Y; Tong, P C Y; Cockram, C S; Chow, C C; Goggins, W B

2008-06-01

Women with polycystic ovary syndrome (PCOS) frequently exhibit central obesity, glucose intolerance, atherogenic dyslipidaemia and hypertension which are characteristic features of the metabolic syndrome (MetS). A total of 295 premenopausal Chinese women with PCOS diagnosed by the Rotterdam criteria (mean age: 30.2 +/- 6.4 years) and 98 control subjects without PCOS were evaluated for prevalence of MetS and cardiovascular risk factors, including dyslipidaemia and dysglycaemia. Using the 2005 modified Adult Treatment Panel III criteria, MetS (presence of three or more risk factors) was found in 24.9% of PCOS women compared to 3.1% of controls. The prevalence of MetS in PCOS women increased from 16.7% at under 30 years of age to 53.3% at over 40 years. MetS was also more prevalent in overweight and obese (41.3%) than normal-weight PCOS women (0.9%). However, multivariate regression analysis showed that women with PCOS had a 5-fold increase in risk of MetS (odds ratio 4.90; 95% confidence interval: 1.35-17.84) compared with women without PCOS even after controlling for age and BMI, suggesting PCOS alone is an independent risk factor for MetS. There is high prevalence of MetS in Hong Kong Chinese women with PCOS despite their relatively young age. Recognition of these cardiometabolic risk factors requires a high level of awareness in conjunction with early and regular screening.

Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

PubMed

Ong, Alvin Cong Wei; Low, Sher Guan; Vasanwala, Farhad Fakhrudin

2016-07-16

Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996-2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary.

Childhood Injuries in Singapore: Can Local Physicians and the Healthcare System Do More to Confront This Public Health Concern?

PubMed Central

Ong, Alvin Cong Wei; Low, Sher Guan; Vasanwala, Farhad Fakhrudin

2016-01-01

Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996–2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary. PMID:27438844

Cross-cultural measurement equivalence of the 5-level EQ-5D (EQ-5D-5L) in patients with type 2 diabetes mellitus in Singapore.

PubMed

Wang, Ye; Tan, Ngiap-Chuan; Tay, Ee-Guan; Thumboo, Julian; Luo, Nan

2015-07-16

This study aimed to assess the measurement equivalence of the 5-level EQ-5D (EQ-5D-5L) among the English, Chinese, and Malay versions. A convenience sample of patients with type 2 diabetes mellitus were enrolled from a public primary health care institution in Singapore. The survey questionnaire comprised the EQ-5D-5L and questions assessing participants' socio-demographic and clinical characteristics. Multiple linear regression models were used to assess the difference in EQ-5D-5L index (calculated using an interim algorithm) and EQ-visual analog scale (EQ-VAS) scores across survey language (Chinese vs. English, Malay vs. English, and Malay vs. Chinese). Measurement equivalence was examined by comparing the 90% confidence interval of difference in the EQ-5D-5L index and EQ-VAS scores with a pre-determined equivalence margin. Multiple logistic regression models were used to assess the response patterns of the 5 Likert-type items of the EQ-5D-5L across survey language. Equivalence was demonstrated between the Chinese and English versions and between the Malay and English versions of the EQ-5D-5L index scores. Equivalence was also demonstrated between the Chinese and English versions and between the Malay and Chinese versions of the EQ-VAS scores. Equivalence could not be determined between the Malay and Chinese versions of the EQ-5D-5L index score and between the Malay and English versions of the EQ-VAS score. No significant difference was found in responses to EQ-5D-5L items between any languages, except that patients who chose to complete the Chinese version were more likely to report "no problems" in mobility compared to those who completed the Malay version of the questionnaire. This study provided evidence for the measurement equivalence of the different language versions of EQ-5D-5L in Singapore.

Psychological characteristics in high-risk MSM in China

PubMed Central

2012-01-01

Background Men who have sex with men (MSM) have become a high-risk group of HIV infection in China. To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk subpopulation of people extremely difficult. Methods A total of 714 questionnaires were retrieved from the database of a Chinese government-sponsored National Key Research Project titled "Risk Analysis and Strategic Prevention of HIV Transmission from MSM to the General Population in China". The respondents were categorized into a high-risk group and a control group. Their behavioral, social and psychological characteristics were comparatively analyzed. Results Of the 714 MSM analyzed, 59 (8.26%) had high-risk homosexual behaviors. This sub-group of MSM had a higher in-marriage rate, a higher monthly income, heavier alcohol consumption and more serious problems with sexual abuse in childhood, intentional suicide attempts and mistaken assumption on condom's role in protecting HIV infection, as compared with the control group (P < 0.05). In contrast, the two groups did not differ significantly the sexual orientation, level of education, types of profession, drug use, condom use and experience of social stigma and discrimination (P > 0.05). A vast majority of the individuals in both behavior categories expressed support of legally protected gay clubs as well as gay marriage legislation in China. There was a strong correlation between high-risk behaviors and sexual abuse in childhood, alcohol drinking, income level and a mistaken belief in perfect HIV protection through the use of condoms. Conclusions MSM with and without high-risk homosexual behaviors have different social and psychological characteristics, which should be taken into account when implementing behavioral and therapeutic interventions aimed at preventing HIV/AIDS transmission among MSM as well as from MSM to

Analysis of Lrrk2 R1628P as a risk factor for Parkinson's disease.

PubMed

Ross, Owen A; Wu, Yih-Ru; Lee, Mei-Ching; Funayama, Manabu; Chen, Meng-Ling; Soto, Alexandra I; Mata, Ignacio F; Lee-Chen, Guey-Jen; Chen, Chiung Mei; Tang, Michelle; Zhao, Yi; Hattori, Nobutaka; Farrer, Matthew J; Tan, Eng-King; Wu, Ruey-Meei

2008-07-01

Common genetic variants that increase the risk for Parkinson's disease may differentiate patient subgroups and influence future individualized therapeutic strategies. Herein we show evidence for leucine-rich repeat kinase 2 (LRRK2) c.4883G>C (R1628P) as a risk factor in ethnic Chinese populations. A study of 1,986 individuals from 3 independent centers in Taiwan and Singapore demonstrates that Lrrk2 R1628P increases risk for Parkinson's disease (odds ratio, 1.84; 95% confidence interval, 1.20-2.83; p = 0.006). Haplotype analysis suggests an ancestral founder for carriers approximately 2,500 years ago. These findings support the importance of LRRK2 variants in sporadic Parkinson's disease. Ann Neurol 2008.

The Construct and Measurement of Perceived Risk of Nonremunerated Blood Donation: Evidence from the Chinese Public

PubMed Central

Chen, Liangyong

2015-01-01

The perceived risk of nonremunerated blood donation (NRBD) is one of the most important factors which hinder the Chinese public from donating blood. To understand deeply and measure scientifically the public's perceived risk of NRBD, in this paper the qualitative and quantitative methods were used to explore the construct of perceived risk of NRBD in Chinese context. Firstly, the preliminary construct of perceived risk of NRBD was developed based on the grounded theory. Then, a measurement scale of perceived risk of NRBD was designed. Finally, the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were adopted for testing and verifying the construct. The results show that the construct of perceived risk of NRBD has three core dimensions, namely, trust risk, psychological risk, and health risk, which provides a clear construct and concise scale to better capture the Chinese public's perceived risk of NRBD. Blood collection agencies can strategically make polices about perceived risk reduction to maximize the public's NRBD behavior. PMID:26526570

The Construct and Measurement of Perceived Risk of Nonremunerated Blood Donation: Evidence from the Chinese Public.

PubMed

Chen, Liangyong; Ma, Zujun

2015-01-01

The perceived risk of nonremunerated blood donation (NRBD) is one of the most important factors which hinder the Chinese public from donating blood. To understand deeply and measure scientifically the public's perceived risk of NRBD, in this paper the qualitative and quantitative methods were used to explore the construct of perceived risk of NRBD in Chinese context. Firstly, the preliminary construct of perceived risk of NRBD was developed based on the grounded theory. Then, a measurement scale of perceived risk of NRBD was designed. Finally, the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were adopted for testing and verifying the construct. The results show that the construct of perceived risk of NRBD has three core dimensions, namely, trust risk, psychological risk, and health risk, which provides a clear construct and concise scale to better capture the Chinese public's perceived risk of NRBD. Blood collection agencies can strategically make polices about perceived risk reduction to maximize the public's NRBD behavior.

Meta-analysis of studies on breast cancer risk and diet in Chinese women

PubMed Central

Wu, Ying-Chao; Zheng, Dong; Sun, Jin-Jie; Zou, Zhi-Kang; Ma, Zhong-Li

2015-01-01

Objective: A meta-analysis was carried out to summarize published data on the relationship between breast cancer and dietary factors. Methods: Databases in Chinese (China National Knowledge Infrastructure [CNKI], China Biology Medicine [CBM], WanFang, VIP) and in English (PubMed and Web of Science) were searched for articles analyzing vegetable, fruit, soy food and fat consumption and breast cancer risk published through June 30, 2013. Random effects models were used to estimate summary odds ratios (OR) based on high versus low intake, and subgroup analysis was conducted according to region, study design, paper quality and adjustment for confounding factors to detect the potential source of heterogeneity. Every study was screened according to the inclusion criteria and exclusion criteria, evaluated in accordance with the Newcastle-Ottawa Scale. RevMan 5.2 software was used for analysis. Results: Of 785 studies retrieved, 22 met inclusion criteria (13 in Chinese and 9 in English), representing 23,201 patients: 10,566 in the experimental group and 12,635 in the control group. Thirteen included studies showed vegetables consumption to be a relevant factor in breast cancer risk, OR = 0.77 (95% CI [confidence interval] 0.62-0.96). Eleven studies showed fruits consumption to be relevant, OR = 0.68 (95% CI 0.49-0.93). Significant differences were also found between those who consumed soy foods, OR = 0.68 (95% CI 0.50-0.93) and those who ate a high-fat diet, OR = 1.15 (95% CI 1.01-1.30). Conclusion: This analysis confirms the association between intake of vegetables, fruits, soy foods and fat and the risk of breast cancer from published sources. It’s suggested that high consumption of vegetables, fruits and soy foods may reduce the risk of breast cancer, while increasing fat consumption may increase the risk. PMID:25784976

Chinese Dialects in Southeast Asia. Working Papers in Linguistics, Vol. 7 No. 4.

ERIC Educational Resources Information Center

Leok Har Chan

This paper discusses the dialects of the Chinese people who have settled in various countries of Southeast Asia, including Malaysia, Singapore, Indonesia, the Philippines, Burma, Thailand, Laos, North and South Vietnam, and the Khmer Republic. Data are first given regarding the area in general. The data are then broken down according to individual…

Knowledge, attitudes, and practices associated with menopause: a multi-ethnic, qualitative study in Singapore.

PubMed

Mackey, Sandra; Teo, Stephanie Swee Hong; Dramusic, Vesna; Lee, Hwee Khim; Boughton, Maureen

2014-05-01

We explored knowledge, attitudes, and practices associated with the menopause transition particular to women in the multi-ethnic cultural context of Singapore. Fifty-eight Chinese, Malay, and Indian Singaporean women participated in interviews that were audiorecorded, transcribed verbatim, and analyzed using thematic analysis. Women from all three ethnicities described an attitude of acceptance surrounding menopause and the changes associated with it. While they thought it was important to be informed, they did not seek out information about menopause and did not view health professionals as useful sources of information. Management practices were diverse and rarely involved accessing health professionals.

The Republic of Singapore: Informed Questions

DTIC Science & Technology

2003-01-01

Singaporean society has, until recently, exhibited a high degree of tolerance and social cohesion .7 Yet Singapore exists as a conspicuously wealthy...immigrants threatens to alter Singapore’s ethnic composition and thus undermine the social cohesion upon which the country’s stability and...bold measures in response to perceived threats to the nation’s prized social cohesion . In March 2001, the government initiated high-level dialog

Association between Perceived Stressfulness of Stressful Life Events and the Suicidal Risk in Chinese Patients with Major Depressive Disorder.

PubMed

Lin, Jing-Yu; Huang, Yu; Su, Yun-Ai; Yu, Xin; Lyu, Xiao-Zhen; Liu, Qi; Si, Tian-Mei

2018-04-20

Patients with major depressive disorder (MDD) usually have high risk of suicidality. Few studies have investigated the effects of stressful life events (SLEs) on the risk of suicide in Chinese patients who have developed MDD. This study aimed to investigate the impact of SLEs on suicidal risk in Chinese patients with MDD. In total, 1029 patients with MDD were included from nine psychiatric hospitals to evaluate the impact of SLEs on suicidal risk. Patients fulfilling the Mini-International Neuropsychiatric Interview (MINI) criteria for MDD were included in the study. Patients were excluded if they had lifetime or current diagnoses of psychotic disorder, bipolar disorder, and alcohol or substance dependence. Depressive symptoms were assessed by the 17-item Hamilton Depression Scale (HAMD-17). The suicidal risk of MDD patients was determined by the suicide risk module of MINI. SLEs were assessed by the Life Events Scale. No gender difference was found for suicidal risk in MDD patients. Patients with suicidal risk had younger ages, lower education levels, more drinking behavior, and lower marriage rate, and fewer people had child and more severe depressive symptoms than nonsuicidal risk group. High-level perceived stressfulness (HPS) and number of SLEs that patients were exposed to were significantly greater in patients with suicidal risk than patients without. In multivariate logistic analysis, HPS of SLEs (odds ratio [OR] = 1.54, 95% confidence interval [CI]: 1.16-2.05, P = 0.003) and depressive symptoms (OR = 1.08, 95% CI: 1.05-1.11, P < 0.001) were associated with suicidal risk even after adjustment of gender, age, marriage, drinking behavior, and childless. HPS of SLEs is associated with suicide risk in Chinese patients with MDD. Further suicide prevention programs targeting this risk factor are needed. ClinicalTrials.gov: NCT02023567; https://clinicaltrials.gov/ct2/show/NCT02023567?term=NCT02023567&rank=1.

Reducing hypersensitivity reactions with HLA-B*5701 genotyping before abacavir prescription: clinically useful but is it cost-effective in Singapore?

PubMed

Kapoor, Ritika; Martinez-Vega, Rosario; Dong, Di; Tan, Sharlene Yanying; Leo, Yee-Sin; Lee, Cheng-Chuan; Sung, Cynthia; Ng, Oon-Tek; Archuleta, Sophia; Teo, Yik-Ying

2015-02-01

Abacavir (ABC) is one of the more affordable antiretroviral drugs used for controlling HIV. Although with similar efficacy to current first-line drugs, its limited usage in Singapore can be attributed to its possible side effect of adverse hypersensitivity reactions (HSRs). HLA-B*5701 genotyping is a clinically relevant procedure for avoiding abacavir-induced HSRs. As patients who do not carry the risk allele are unlikely to develop HSRs, a simple rule can be developed to allow abacavir prescription for patients who are B*5701 negative. Here, we carry out a cost-effectiveness analysis of HLA-B*5701 genotyping before abacavir prescription in the context of the Singapore healthcare system, which caters predominantly to Han Chinese, Southeast-asian Malays, and South-asian Indians. In addition, we aim to identify the most cost-effective treatment regimen for HIV patients. A decision tree model was developed in TreeAge. The model considers medical treatment and genotyping costs, genotyping test characteristics, the prevalence of the risk allele, reduction in the quality of life, and increased expenditure due to side effects and other factors, evaluating independently over early-stage and late-stage HIV patients segmented by drug contraindications. The study indicates that genotyping is not cost-effective for any ethnicity irrespective of the disease stage, except for Indian patients with early-stage HIV who are contraindicated to tenofovir. Abacavir (as first-line) without genotyping is the cheapest and most cost-effective treatment for all ethnicities except for early-stage Indian HIV patients contraindicated to tenofovir. The HLA-B*5701 frequency, the mortality rate from abacavir-induced HSRs, and genotyping costs are among the major factors influencing the cost-effectiveness.

A Features-Based Approach for Teaching Singapore English

ERIC Educational Resources Information Center

Schaetzel, Kirsten; Lim, Beng Soon; Low, Ee Ling

2010-01-01

Research into Singapore English (SgE) has undergone many paradigm shifts from the 1970s to the present. This paper first begins with a consideration of how variation in the English language used in Singapore has been studied. It then identifies the two main varieties of English commonly described in Singapore, namely, Standard SgE (SSE) and…

Predicting influenza vaccination intent among at-risk chinese older adults in Hong Kong.

PubMed

Yu, Doris S F; Low, Lisa P L; Lee, Iris F K; Lee, Diana T F; Ng, Wai Man

2014-01-01

Older adults with major chronic illnesses are very susceptible to influenza and its serious complications, but many do not obtain vaccinations. Little is known about factors associated with intention to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong. The aim of this study was to identify factors associated with intent to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong. This multicenter descriptive correlational study recruited a convenience sample of 306 Chinese older adults with medical risk factors for influenza and its serious complications from the general outpatient clinics in Hong Kong. Interviews were conducted to assess intent to obtain influenza vaccination for the coming year, health beliefs about influenza, and discomfort following past vaccinations. The current influenza vaccination rate was 58.5%; only 36.3% intended to get vaccinated the following year. After controlling for clinical and demographic factors in a logistic regression model, perceived susceptibility predicted intention to obtain future vaccination (OR = 1.42, 95% CI [1.14, 1.78]), whereas postvaccination discomfort was negatively associated with intention (OR = 0.063, 95% CI [0.006, 0.63]). Intention to obtain influenza vaccination was low among at-risk Chinese older adults. Strengthening health beliefs and creating strategies to provide positive influenza vaccination experiences are possible approaches to interventions to improve uptake of influenza vaccination rates.

The bottom water exchange between the Singapore Strait and the West Johor Strait

NASA Astrophysics Data System (ADS)

Sun, Yunfang; Eltahir, Elfatih; Malanotte-Rizzoli, Paola

2017-08-01

As a part of the border between Singapore and Malaysia, the West Johor Strait (WJS) suffered newly from harmful algal blooms. There is no previous study showing the source of the nutrients in the WJS. This paper is investigating the possible water exchange between the water in the WJS and the bottom water in Singapore Strait. This paper adopts a two-level nesting atmosphere-ocean coupled models to downscale the global atmosphere-ocean model into the Singapore coastal water, keeping the large-scale and long-term ocean and climate circulation signals and the advantages of the high-resolution. Based on the high-resolution ocean circulation fields, a Lagrangian particle tracking model is used to trace the Singapore Strait's bottom water movement and the water mixing in the WJS. The results showed that the numerical models well resolved the Singapore coastal water regional circulation. There is a small but significant bottom water (1.25%) transport from the Singapore Strait to the WJS, which occurs from the southwest coastline of Singapore. The bottom water in the Singapore Strait prefers to enter the WJS during the spring tide and the flood period, and stay in Johor Strait for 6.4 days. The spring tide is the first-order factor for the water vertical mixing in the WJS, the wind is also very important for the vertical mixing especially in neap tide condition. An overall very important factor is the light perturbation. With the strongest vertical mixing of nutrients and bottom sediments due to the spring tide, the latter ones may inhibit the light penetration during the spring tide and reduce the algal bloom. The light penetration otherwise is greater during the neap tide, when the winds are the most important factor and hence favor the algal bloom. With the strongest wind in February and the longest permanence time in June and the sufficient nutrient supply in February and June, the most serious algal blooms may happen in February and June in the WJS.

Enhancing the earth-science content and inquiry basis of physical geography education in Singapore schools

NASA Astrophysics Data System (ADS)

McCaughey, J.; Chong, E.

2011-12-01

Singapore has a long tradition of geography education at the secondary and Junior College levels (ages 12-18). Although most geography teachers teach both human and physical geography, many of them have received more extensive university training in human geography. The Earth Obervatory of Singapore (EOS), a newly established research institute at Nanyang Technological University (NTU), is building an education and outreach program to integrate its research across formal and informal education. We are collaborating with the Singapore Ministry of Education to enhance the earth-science content and inquiry basis of physical geography education in Singapore classrooms. EOS is providing input to national curriculum, textbook materials, and teaching resources, as well as providing inquiry-based field seminars and workshops for inservice teachers. An upcoming 5-year "Our Dynamic Earth" exhibit at the Science Centre Singapore will be a centerpoint of outreach to younger students, their teachers and parents, and to the community at large. On a longer time scale, the upcoming undergraduate program in earth science at NTU, the first of its kind in Singapore, will provide a stream of earth scientists into the geography teaching workforce. Developing ties between EOS and the National Institute of Education will further enhance teacher training. With a highly centralized curriculum, small land area, high-performing student population, and key stakeholders eager to collaborate with EOS, Singapore presents an unusual opportunity to impact classrooms on a national scale.

Engaging Students in Higher Education through Mobile Learning: Lessons Learnt in a Chinese Entrepreneurship Course

ERIC Educational Resources Information Center

Menkhoff, Thomas; Bengtsson, Magnus Lars

2012-01-01

This evaluative-exploratory case study reports pedagogical experiences with using mobiles phones, wikis, and other mobile learning approaches such as podcasts and walking tours as educational tools in the context of an undergraduate course on Chinese Entrepreneurship and Asian Business Networks taught at a university in Singapore. Conceptualized…

Variants on 8q24 and prostate cancer risk in Chinese population: a meta-analysis.

PubMed

Ren, Xiao-Qiang; Zhang, Jian-Guo; Xin, Shi-Yong; Cheng, Tao; Li, Liang; Ren, Wei-Hua

2015-01-01

Previous studies have identified 8q24 as an important region to prostate cancer (PCa) susceptibility. The aim of this study was to investigate the role of six genetic variants on 8q24 (rs1447295, A; rs6983267, G; rs6983561, C; rs7837688, T; rs10090154, T and rs16901979, A) on PCa risk in Chinese population. Online electronic databases were searched to retrieve related articles concerning the association between 8q24 variants and PCa risk in men of Chinese population published between 2000 and 2014. Odds ratio (ORs) with its 95% correspondence interval (CI) were employed to assess the strength of association. Total eleven case-control studies were screened out, including 2624 PCa patients and 2438 healthy controls. Our results showed that three risk alleles of rs1447295 A (OR=1.35, 95% CI=1.19-1.53, P<0.00001), rs6983561 C (C vs. A: OR=1.41, 95% CI=1.21-1.63, P<0.00001) and rs10090154 T (T vs. C: OR=1.48, 95% CI=1.22-1.80, P<0.00001) on8q24 were significantly associated with PCa risk in Chinese population. Furthermore, genotypes of rs1447295, AA+AC; rs6983561, CC+AC and CC; rs10090154, TT+TC; and rs16901979, AA were associated with PCa as well (P<0.01). No association was found between rs6983267, rs7837688 and PCa risk. In conclusions, variants including rs1447295, rs6983561, rs10090154 and rs16901979 on 8q24 might be associated with PCa risk in Chinese population, indicating these four variations may contribute risk to this disease. This meta-analysis was the first study to assess the role of 8q24 variants on PCa risk in Chinese population.

The evolution of sports medicine in Singapore.

PubMed

Tan, Benedict

2013-10-01

Sports medicine is a relatively new subspecialty in Singapore. This commentary chronicles its evolution in Singapore from 1969, through various milestones, to the present day. The first sports medicine clinic in Singapore was established in 1971 at Farrer Park. Notable institutions that followed include the Sports Medicine and Research Centre (1973), Soldier Performance Centre, Changi Sports Medicine Centre (2003), Singapore Sports Medicine Centre (2006), and other multidisciplinary centres of restructured hospitals. Formal groundwork to establish sports medicine as a subspecialty began in 2005, with its first trainee commencing traineeship at the Changi Sports Medicine Centre in 2007, and culminated in the subspecialty register at the beginning of 2011. Also captured in this discussion are the broader scopes of sports medicine, including military sports medicine, the sports sciences, exercise medicine, and event medical coverage.

The influence of knowledge and perception of the risk of cervical cancer on screening behavior in mainland Chinese women.

PubMed

Gu, Can; Chan, Carmen W H; Twinn, Sheila; Choi, Kai Chow

2012-12-01

Theories of health behavior and empirical research highlight the risk perception as a significant factor for people adopting cancer screening. However, screening uptakes and risk perception of cervical cancer in mainland Chinese women remains unknown. This paper adopted the protection motivation theory (PMT) to examine Chinese women's knowledge and perceptions of cervical cancer risk and factors influencing utilization of cervical screening. A self-administered questionnaire was completed by 167 participants in mainland China (79 nonscreened and 88 screened women) in 2007 which consisted of four sections: background information, women's attendance pattern for cervical screening, perceptions related to body health and knowledge about cervical cancer and screening, and PMT measures. All women considered themselves at low risk of cervical cancer. No significant association was observed between previous screening uptake and PMT variables. Using multivariate analysis, having children, a perception that visiting doctors regularly is important to health, average and high levels of knowledge about cervical screening were significantly associated with having been received screening. Chinese women demonstrated an unrealistic optimism about their personal risk of cervical cancer. The findings do not support an association between risk perception and screening uptake. In spite of this, current findings revealed some possible factors influencing women's screening behavior. This study highlights the significance of knowledge and culturally-relevant health behavior and beliefs about cervical screening for Chinese women in determining whether or not they receive screening. The promotion of cervical cancer prevention and early detection should be integrated into public education about women's health. Copyright © 2011 John Wiley & Sons, Ltd.

Family size intentions and socioeconomic status in Singapore, 1974-1981.

PubMed

Salaff, J W

1985-01-01

Singapore has in recent years undergone a tremendous fertility decline that has affected couples at all socioeconomic levels. Using representative biographical sketches, this article presents the results of a panel study on family planning intentions and behavior among 45 young Chinese Singaporean couples. The couples, ranked as average or affluent working-class, or middle-class, were first interviewed in 1974-76 and were followed up in 1981. The study compares early childbearing intentions with actual childbearing behavior, examining the motivation for childbearing by socioeconomic group and highlighting the differences found. The follow-up interviews reveal that, on average, all couples in the sample bore 0.4 fewer children than originally intended. The motivation for changed childbearing intentions, however, differed according to socioeconomic status and the perceived role that children play in the family economy.

Singapore's E(Si)nglish-Knowing Bilingualism

ERIC Educational Resources Information Center

Chua, Siew Kheng Catherine

2011-01-01

This paper discusses Singapore's bilingual policy and looks at how the government's top-down and structured language policy has transformed the country into an English-knowing society. Education and language-in-education planning in Singapore are linked closely to the country's economic development and nation-building process. This pair of…

Risk Perceptions, Barriers, and Self-Efficacy of Hepatitis B Screening and Vaccination among Chinese Immigrants

ERIC Educational Resources Information Center

Ma, Grace X.; Shive, Steven S.; Toubbeh, Jamil; Wu, Dunli; Wang, Ping

2006-01-01

Hepatitis B (HBV) infection is a serious health problem among Asian Americans, including Chinese Americans. This study was conducted to measure the perceptions of risk, barriers, and self-efficacy of HBV screening and vaccination in Chinese immigrants. A cross-sectional study was conducted among 429 Chinese Americans in New York City. A…

Formulation of Policy and Strategy in Developing Creativity Education in Four Asian Chinese Societies: A Policy Analysis

ERIC Educational Resources Information Center

Hui, Anna N. N.; Lau, Sing

2010-01-01

The present study sought to compare and contrast educational policies on creativity education in four Asian Chinese societies, namely mainland China, Hong Kong, Singapore, and Taiwan. It establishes five criteria on creativity education policy, including policies regarding legislation on creativity education, definitions of creativity, standard…

The energy cost of water independence: the case of Singapore.

PubMed

Vincent, Lenouvel; Michel, Lafforgue; Catherine, Chevauché; Pauline, Rhétoré

2014-01-01

Finding alternative resources to secure or increase water availability is a key issue in most urban areas. This makes the research of alternative and local water resources of increasing importance. In the context of political tension with its main water provider (Malaysia), Singapore has been implementing a comprehensive water policy for some decades, which relies on water demand management and local water resource mobilisation in order to reach water self-sufficiency by 2060. The production of water from alternative resources through seawater desalination or water reclamation implies energy consumptive technologies such as reverse osmosis. In the context of increasing energy costs and high primary energy dependency, this water self-sufficiency objective is likely to be an important challenge for Singapore. The aim of this paper is to quantify the long-term impact of Singapore's water policy on the national electricity bill and to investigate the impact of Singapore's projects to reduce its water energy footprint. We estimate that 2.0% of the Singaporean electricity demand is already dedicated to water and wastewater treatment processes. If its water-energy footprint dramatically increases in the coming decades, ambitious research projects may buffer the energy cost of water self-sufficiency.

Serum carotenoid, retinol and tocopherol concentrations and risk of cervical cancer among Chinese women.

PubMed

Zhang, Yuan-Yuan; Lu, Ling; Abliz, Guzalnur; Mijit, Fatima

2015-01-01

Despite many epidemiological studies on the effects of dietary antioxidant micronutrients on risk of cervical cancer, the findings remain uncertain and little evidence is available for serum nutrient markers. The present study aimed to examine the relationship between serum carotenoid, retinol and tocopherol concentrations and risk of cervical cancer among Chinese women. We conducted a hospital-based case- control study in which 358 adults (158 incident cases and 200 controls) were recruited from Xinjiang, China. Serum levels of carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene and lutein/zeaxanthin), retinol, and tocopherols (α-tocopherol and γ-tocopherol) were assessed by reverse-phase high-performance liquid chromatography. We found inverse associations between serum carotenoid (α-carotene, β-carotene, and lutein/zeaxanthin) and tocopherol (α-tocopherol) concentrations and the risk of cervical cancer after adjusting for potential confounders, but a null association for retinol. The ORs for 1-SD increase were 0.71 (95% CI: 0.56- 0.92; p=0.003) for total carotenoids and 0.75 (95% CI: 0.60-0.94; p=0.008) for total tocopherols. These results show that higher serum concentrations of some carotenoids and tocopherols are associated with a lower risk of cervical cancer among Chinese women.

Islam and Citizenship Education in Singapore: Challenges and Implications

ERIC Educational Resources Information Center

Tan, Charlene

2007-01-01

The religious diversity of Singapore, coupled with the current phenomenon of Islamic revivalism, makes the management of religion a paramount concern for the Singapore government. By examining the developments of Islam in Singapore, this article explores the challenges and implications these developments have on citizenship education in the…

Improving biomass burning pollution predictions in Singapore using AERONET and Lidar observations.

NASA Astrophysics Data System (ADS)

Hardacre, Catherine; Chew, Boon Ning; Gan, Christopher; Burgin, Laura; Hort, Matthew; Lee, Shao Yi; Shaw, Felicia; Witham, Claire

2016-04-01

Every year millions of people are affected by poor air quality from trans-boundary smoke haze emitted from large scale biomass burning in Asia. These fires are a particular problem in the Indonesian regions of Sumatra and Kalimantan where peat fires, lit to clear land for oil palm plantations and agriculture, typically result in high levels of particulate matter (PM) emissions. In June 2013 and from August-October 2015 the combination of widespread burning, meteorological and climatological conditions resulted in severe air pollution throughout Southeast Asia. The Met Office of the United Kingdom (UKMO) and the Hazard and Risk Impact Assessment Unit of the Meteorological Service of Singapore (MSS) have developed a quantitative haze forecast to provide a reliable, routine warning of haze events in the Singapore region. The forecast system uses the UKMO's Lagrangian particle dispersion model NAME (Numerical Atmosphere-dispersion Modelling Environment) in combination with high resolution, satellite based emission data from the Global Fire Emissions System (GFAS). The buoyancy of biomass burning smoke and it's rise through the atmosphere has a large impact on the amount of air pollution at the Earth's surface. This is important in Singapore, which is affected by pollution that has travelled long distances and that will have a vertical distribution influenced by meteorology. The vertical distribution of atmospheric aerosol can be observed by Lidar which provides information about haze plume structure. NAME output from two severe haze periods that occurred in June 2013 and from August-October 2015 was compared with observations of total column aerosol optical depth (AOD) from AERONET stations in Singapore and the surrounding region, as well as vertically resolved Lidar data from a station maintained by MSS and from MPLNET. Comparing total column and vertically resolved AOD observations with NAME output indicates that the model underestimates PM concentrations throughout

Anthropometric parameters and their associations with cardio-metabolic risk in Chinese working population.

PubMed

Ouyang, Xiaojun; Lou, Qinlin; Gu, Liubao; Ko, Gary T; Mo, Yongzhen; Wu, Haidi; Bian, Rongwen

2015-01-01

There remains controversy regarding which of the anthropometric indicators best defines obesity. In this study, we compared the efficacy of using body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) in the diagnosis of obesity and assessed their associations with diabetes, hypertension, and dyslipidemia in an urban working population in China. Anthropometric measurements, blood pressure, plasma lipids, fasting and 2-hour plasma glucose (PG) levels by a 75 gram oral glucose tolerance test (OGTT) were obtained from 2603 working Chinese who had no history of cardiovascular diseases or diabetes. Cardio-metabolic risk factors including high blood pressure, dyslipidemia, and glucose intolerance were evaluated. The diagnoses of overweight and obesity were based on the WHO definitions with BMI for general obesity and WC and WHR for central obesity. Based on BMI, WC and WHR, there were 31.3%, 16.6%, 35.2% of the studied subjects, respectively, being overweight and 2.0%, 5.6%, 9.2% being obese. Among women but not men, more overweight and obese subjects were diagnosed using WHR and WC. The number of cardio-metabolic risks was higher by WC criterion than BMI and WHR in the whole group (p <0.05) and female subjects (p <0.01). Comparing the three anthropometric indexes predicting hypertension, hyperglycemia, dyslipidemia and multiple cardio-metabolic risks, for women, it was WC having the largest areas under ROC curves (0.759, 0.746, 0.701 and 0.773 respectively); while in men, it was WC for hypertension, WHR for hyperglycemia, BMI for dyslipidemia and WC for multiple cardio-metabolic risks (areas under ROC curves were 0.658, 0.686, 0.618 and 0.695 respectively). Among Chinese working population, the need of lower cutoff values to define overweight and obesity were observed. Central obesity indicator (WC) is the preferred measure to predict the presence of cardio-metabolic risk in Chinese female subjects.

Predicting the 10-Year Risks of Atherosclerotic Cardiovascular Disease in Chinese Population: The China-PAR Project (Prediction for ASCVD Risk in China).

PubMed

Yang, Xueli; Li, Jianxin; Hu, Dongsheng; Chen, Jichun; Li, Ying; Huang, Jianfeng; Liu, Xiaoqing; Liu, Fangchao; Cao, Jie; Shen, Chong; Yu, Ling; Lu, Fanghong; Wu, Xianping; Zhao, Liancheng; Wu, Xigui; Gu, Dongfeng

2016-11-08

The accurate assessment of individual risk can be of great value to guiding and facilitating the prevention of atherosclerotic cardiovascular disease (ASCVD). However, prediction models in common use were formulated primarily in white populations. The China-PAR project (Prediction for ASCVD Risk in China) is aimed at developing and validating 10-year risk prediction equations for ASCVD from 4 contemporary Chinese cohorts. Two prospective studies followed up together with a unified protocol were used as the derivation cohort to develop 10-year ASCVD risk equations in 21 320 Chinese participants. The external validation was evaluated in 2 independent Chinese cohorts with 14 123 and 70 838 participants. Furthermore, model performance was compared with the Pooled Cohort Equations reported in the American College of Cardiology/American Heart Association guideline. Over 12 years of follow-up in the derivation cohort with 21 320 Chinese participants, 1048 subjects developed a first ASCVD event. Sex-specific equations had C statistics of 0.794 (95% confidence interval, 0.775-0.814) for men and 0.811 (95% confidence interval, 0.787-0.835) for women. The predicted rates were similar to the observed rates, as indicated by a calibration χ 2 of 13.1 for men (P=0.16) and 12.8 for women (P=0.17). Good internal and external validations of our equations were achieved in subsequent analyses. Compared with the Chinese equations, the Pooled Cohort Equations had lower C statistics and much higher calibration χ 2 values in men. Our project developed effective tools with good performance for 10-year ASCVD risk prediction among a Chinese population that will help to improve the primary prevention and management of cardiovascular disease. © 2016 American Heart Association, Inc.

Forecasting the value-at-risk of Chinese stock market using the HARQ model and extreme value theory

NASA Astrophysics Data System (ADS)

Liu, Guangqiang; Wei, Yu; Chen, Yongfei; Yu, Jiang; Hu, Yang

2018-06-01

Using intraday data of the CSI300 index, this paper discusses value-at-risk (VaR) forecasting of the Chinese stock market from the perspective of high-frequency volatility models. First, we measure the realized volatility (RV) with 5-minute high-frequency returns of the CSI300 index and then model it with the newly introduced heterogeneous autoregressive quarticity (HARQ) model, which can handle the time-varying coefficients of the HAR model. Second, we forecast the out-of-sample VaR of the CSI300 index by combining the HARQ model and extreme value theory (EVT). Finally, using several popular backtesting methods, we compare the VaR forecasting accuracy of HARQ model with other traditional HAR-type models, such as HAR, HAR-J, CHAR, and SHAR. The empirical results show that the novel HARQ model can beat other HAR-type models in forecasting the VaR of the Chinese stock market at various risk levels.

The influence of climate variables on dengue in Singapore.

PubMed

Pinto, Edna; Coelho, Micheline; Oliver, Leuda; Massad, Eduardo

2011-12-01

In this work we correlated dengue cases with climatic variables for the city of Singapore. This was done through a Poisson Regression Model (PRM) that considers dengue cases as the dependent variable and the climatic variables (rainfall, maximum and minimum temperature and relative humidity) as independent variables. We also used Principal Components Analysis (PCA) to choose the variables that influence in the increase of the number of dengue cases in Singapore, where PC₁ (Principal component 1) is represented by temperature and rainfall and PC₂ (Principal component 2) is represented by relative humidity. We calculated the probability of occurrence of new cases of dengue and the relative risk of occurrence of dengue cases influenced by climatic variable. The months from July to September showed the highest probabilities of the occurrence of new cases of the disease throughout the year. This was based on an analysis of time series of maximum and minimum temperature. An interesting result was that for every 2-10°C of variation of the maximum temperature, there was an average increase of 22.2-184.6% in the number of dengue cases. For the minimum temperature, we observed that for the same variation, there was an average increase of 26.1-230.3% in the number of the dengue cases from April to August. The precipitation and the relative humidity, after analysis of correlation, were discarded in the use of Poisson Regression Model because they did not present good correlation with the dengue cases. Additionally, the relative risk of the occurrence of the cases of the disease under the influence of the variation of temperature was from 1.2-2.8 for maximum temperature and increased from 1.3-3.3 for minimum temperature. Therefore, the variable temperature (maximum and minimum) was the best predictor for the increased number of dengue cases in Singapore.

Chinese herbal medicines for hypercholesterolemia

PubMed Central

Liu, Zhao Lan; Liu, Jian Ping; Zhang, Anthony Lin; Wu, Qiong; Ruan, Yao; Lewith, George; Visconte, Denise

2011-01-01

Background Hypercholesterolemia is an important key contributory factor for ischemic heart disease and is associated with age, high blood pressure, a family history of hypercholesterolemia, and diabetes. Chinese herbal medicines have been used for a long time as lipid-lowering agents. Objectives To assess the effects of Chinese herbal medicines on hypercholesterolemia. Search strategy We searched the following databases: The Cochrane Library (issue 8, 2010), MEDLINE (until July 2010), EMBASE (until July 2010), Chinese BioMedical Database (until July 2010), Traditional Chinese Medical Literature Analysis and Retrieval System (until July 2010), China National Knowledge Infrastructure (until July 2010), Chinese VIP Information (until July 2010), Chinese Academic Conference Papers Database and Chinese Dissertation Database (until July 2010), and Allied and Complementary Medicine Database (until July 2010). Selection criteria We considered randomized controlled clinical trials in hypercholesterolemic participants comparing Chinese herbal medicines with placebo, no treatment, and pharmacological or non-pharmacological interventions. Data collection and analysis Two review authors independently extracted data and assessed the risk of bias. We resolved any disagreements with this assessment through discussion and a decision was achieved based by consensus. We assessed trials for the risk of bias against key criteria: random sequence generation, allocation concealment, blinding of participants, incomplete outcome data, selective outcome reporting and other sources of bias. Main results We included 22 randomized trials (2130 participants). The mean treatment duration was 2.3 ± 1.3 months (ranging from one to six months). Twenty trials were conducted in China and 18 trials were published in Chinese. Overall, the risk of bias of included trials was high or unclear. Five different herbal medicines were evaluated in the included trials, which compared herbs with conventional

Solar PV leasing in Singapore: enhancing return on investments with options

NASA Astrophysics Data System (ADS)

Song, Shuang; Poh, K. L.

2017-05-01

Renewable energy is getting more important nowadays as an alternative to traditional energies. Solar energy, according to Energy Market Authority, is the most viable in the context of Singapore compared to other renewable energy sources due to land constraints. In light of the increasing adoption of solar power in Singapore, this paper focuses on solar PV leasing using a case study. This paper assesses the prospect for solar PV leasing companies in Singapore through the lens of embedded real options. The recent news that solar power is becoming the cheapest form of new electricity presents the leasing company an option to expand the scale of solar PV system. Taking into account this option, the Net Present Value (NPV) of the investment increased significantly compared to the case without real options. Technological developments result in a continuously changing environment with uncertainties. Thus, decision makers need to be aware of the inherent risk associated and identify options to maximize NPV. This upside potential is realized by exercising the managerial flexibility and exploiting the uncertainty. The paper enables solar energy planners to consider possible managerial flexibilities under uncertainties, showing how option thinking can be incorporated in the valuation of solar energy.

Singapore Neonatal Resuscitation Guidelines 2016

PubMed Central

Yeo, Cheo Lian; Biswas, Agnihotri; Ee, Teong Tai Kenny; Chinnadurai, Amutha; Baral, Vijayendra Ranjan; Chang, Alvin Shang Ming; Ereno, Imelda Lustestica; Ho, Kah Ying Selina; Poon, Woei Bing; Shah, Varsha Atul; Quek, Bin Huey

2017-01-01

We present the revised Neonatal Resuscitation Guidelines for Singapore. The 2015 International Liaison Committee on Resuscitation Neonatal Task Force’s consensus on science and treatment recommendations (2015), and guidelines from the American Heart Association and European Resuscitation Council were debated and discussed. The final recommendations of the National Resuscitation Council, Singapore, were derived after the task force had carefully reviewed the current available evidence in the literature and addressed their relevance to local clinical practice. PMID:28741001

Singapore Cancer Network (SCAN) Guidelines for Systemic Therapy of Pancreatic Adenocarcinoma.

PubMed

2015-10-01

The SCAN pancreatic cancer workgroup aimed to develop Singapore Cancer Network (SCAN) clinical practice guidelines for systemic therapy for pancreatic adenocarcinoma in Singapore. The workgroup utilised a modified ADAPTE process to calibrate high quality international evidence-based clinical practice guidelines to our local setting. Five international guidelines were evaluated- those developed by the National Cancer Comprehensive Network (2014), the European Society of Medical Oncology (2012), Cancer Care Ontario (2013), the Japan Pancreas Society (2013) and the British Society of Gastroenterology, Pancreatic Society of Great Britain and Ireland, and the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (2005). Recommendations on the management of resected, borderline resectable, locally advanced and metastatic pancreatic adenocarcinoma were developed. These adapted guidelines form the SCAN Guidelines for systemic therapy for pancreatic adenocarcinoma in Singapore.

Refractive errors in medical students in Singapore.

PubMed

Woo, W W; Lim, K A; Yang, H; Lim, X Y; Liew, F; Lee, Y S; Saw, S M

2004-10-01

Refractive errors are becoming more of a problem in many societies, with prevalence rates of myopia in many Asian urban countries reaching epidemic proportions. This study aims to determine the prevalence rates of various refractive errors in Singapore medical students. 157 second year medical students (aged 19-23 years) in Singapore were examined. Refractive error measurements were determined using a stand-alone autorefractor. Additional demographical data was obtained via questionnaires filled in by the students. The prevalence rate of myopia in Singapore medical students was 89.8 percent (Spherical equivalence (SE) at least -0.50 D). Hyperopia was present in 1.3 percent (SE more than +0.50 D) of the participants and the overall astigmatism prevalence rate was 82.2 percent (Cylinder at least 0.50 D). Prevalence rates of myopia and astigmatism in second year Singapore medical students are one of the highest in the world.

Prevalence of and risk factors for pterygia in a rural Northern Chinese population.

PubMed

Li, Zhijian; Wu, Shubin; Mai, Jieying; Xu, Keke; Sun, Ying; Song, Zhen; Jin, Di; Wang, Haijing; Liu, Ping

2014-12-01

To determine the prevalence of and associated risk factors for pterygia development in a high-latitude-dwelling Northern Chinese population. A prospective population-based survey was conducted between November 2008 and July 2009. A stratified, clustered, randomized sampling procedure was used to select 8445 subjects, aged ≥18 years, all with diagnosed, graded pterygia. Risk factors associated with the occurrence of pterygia were evaluated according to logistic regression models. A total of 8445 residents (aged 18-94 years) from the Heilongjiang Province, China, participated in the study. Of these, 208 (2.5%) had at least one diagnosed pterygium. The prevalence of bilateral pterygia was 1.2% (95% confidence interval, CI, 1.0-1.4%). According to multivariable analysis, pterygia were significantly more likely to occur in persons aged 70-94 years than in those aged 18-39 years (odds ratio, OR, 29.0, 95% CI 13.6-61.6, p < 0.01). Pterygia were significantly associated with male sex (OR 1.9, 95% CI 1.4-2.6, p < 0.01) and outdoor work (OR 1.8, 95% CI 1.2-2.6, p < 0.01). Multivariable analysis indicated that pterygia were not associated with smoking status (OR 1.0, 95% CI 0.8-1.4) or alcohol intake (OR 1.0, 95% CI 0.7-1.4, p > 0.05). This study details the occurrence of and risk factors for pterygia in a Chinese population residing in a rural, high-latitude, cold-climate area of Northern China. The primary risk factors for pterygia were age, male sex, and outdoor work.

Refractive Status and Amblyopia Risk Factors in Chinese Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Wang, Jiaxing; Ding, Gang; Li, Ying; Hua, Ning; Wei, Nan; Qi, Xiaoli; Ning, Yuxian; Zhang, Ying; Li, Xue; Li, Jing; Song, Linlin; Qian, Xuehan

2018-01-01

Amblyopia risk factors in children with autism spectrum disorders (ASD) are usually hard to detect in early childhood due to poor cooperation and has not been reported in the Chinese population. We screened 168 Chinese children with ASD, aged between 3 and 8 years, and 264 age-matched neurotypical children with Spot photoscreener and basic…

Investigating obesity risk-reduction behaviours and psychosocial factors in Chinese Americans.

PubMed

Liou, Doreen; Bauer, Kathleen; Bai, Yeon

2014-11-01

The purpose of this research was to examine the attitudes, beliefs and behaviours related to obesity risk reduction in Chinese Americans. A questionnaire was administered to a convenience sample of 300 US-born and foreign-born Chinese Americans residing in the New York metropolitan area, ranging from 18 to 40 years of age. Obesity risk reduction behaviours and psychosocial variables derived from the Theory of Planned Behaviour and Health Belief Model were measured. Acculturation was assessed using a modified Suinn-Lew Asian Self-Identity Acculturation Scale. Frequency distributions were delineated and stepwise regression analyses were analysed for different acculturation groups. 65% of the respondents were female and the mean age of the sample was 26 years. Respondents indicated the most commonly practised behaviour to be eating home-cooked meals instead of restaurant-prepared foods. Perceived barriers to adopting obesity risk-reduction behaviours included convenience of consuming fast foods, cost, lack of time to prepare home-cooked meals, and the physical environment of unhealthy foods. In predicting intention to perform obesity risk-reduction behaviours, attitude was significant for 'western-identified' individuals. In 'Asian-identified' individuals, perceived behavioural control, self-efficacy and perceived benefits were salient. Nutrition educators working with Chinese Americans need to address self-efficacy in preparing plant-based, home-cooked meals and making healthy choices at fast-food restaurants with portion control. Concrete and perceived barriers such as lack of time and convenience need to be addressed in nutrition education interventions. Educators need to identify new channels and media outlets to disseminate practical, easy-to-implement behaviours for obesity risk reduction that are socially acceptable. © Royal Society for Public Health 2013.

A meta-analysis of the association between induced abortion and breast cancer risk among Chinese females.

PubMed

Huang, Yubei; Zhang, Xiaoliang; Li, Weiqin; Song, Fengju; Dai, Hongji; Wang, Jing; Gao, Ying; Liu, Xueou; Chen, Chuan; Yan, Ye; Wang, Yaogang; Chen, Kexin

2014-02-01

To evaluate the association between induced abortion (IA) and breast cancer risk among Chinese females. We searched three English databases (PubMed, ScienceDirect, and Wiley) and three Chinese databases (CNKI, WanFang, and VIP) for studies up to December 2012, supplemented by manual searches. Two reviewers independently conducted the literature searching, study selection, and data extraction and quality assessment of included studies. Random effects models were used to estimate the summary odds ratios (ORs) and the 95 % confidence intervals (CIs). A total of 36 articles (two cohort studies and 34 case-control studies) covering 14 provinces in China were included in this review. Compared to people without any history of IA, an increased risk of breast cancer was observed among females who had at least one IA (OR = 1.44, 95 % CI 1.29-1.59, I (2) = 82.6 %, p < 0.001, n = 34). No significant publication bias was found among the included studies (Egger test, p = 0.176). The risk increased to 1.76 (95 % CI 1.39-2.22) and 1.89 (95 % CI 1.40-2.55) for people who had at least two IAs and at least three IAs, respectively. Subgroup analyses showed similar results to the primary results. Meta-regression analysis of the included studies found that the association between IA and breast cancer risk attenuated with increasing percent of IA in the control group (β = -0.022, p < 0.001). IA is significantly associated with an increased risk of breast cancer among Chinese females, and the risk of breast cancer increases as the number of IA increases. If IA were to be confirmed as a risk factor for breast cancer, high rates of IA in China may contribute to increasing breast cancer rates.

Cross-cultural measurement equivalence of the EQ-5D-5L items for English-speaking Asians in Singapore.

PubMed

Luo, N; Wang, Y; How, C H; Wong, K Y; Shen, L; Tay, E G; Thumboo, J; Herdman, M

2015-06-01

To investigate how the response labels of the 5-level EQ-5D (EQ-5D-5L) items are interpreted and used by English-speaking Chinese and non-Chinese Singaporeans, as a means to assessing whether those items are cross-culturally equivalent health-status measures in this Asian population. In face-to-face interviews, Chinese, Malay and Indian visitors to a primary care institution in Singapore were asked to rate the relative severity conveyed by EQ-5D-5L response labels, each containing the keyword of 'no(t),' 'slight(ly),' 'moderate(ly),' 'severe(ly),' or 'unable'/'extreme(ly),' using a 0-100 numerical rating scale. Participants were also asked to describe 25 hypothetical health states using the EQ-5D-5L response labels. Differences between Chinese and Malay/Indian participants in label interpretation and selection were examined using multivariate regression analysis to adjust for participant characteristics. The differences in adjusted mean severity scores for individual EQ-5D-5L labels between Chinese (n = 148) and non-Chinese (Malay: n = 53; Indian: n = 56) participants ranged from 0.0 to 9.0. The relative severity of the labels to the participants supported the ordinality of the EQ-5D-5L response labels and was similar across ethnic groups. Chinese and non-Chinese participants selected similar response labels to describe each hypothetical health state, with the adjusted odds ratios of selecting any type of the five response labels for non-Chinese versus Chinese participants ranging from 0.92 to 1.15 (p > 0.05 for all). The EQ-5D-5L items are likely to generate equivalent health outcomes between English-speaking Chinese and non-Chinese Singaporeans.

[A Meta-analysis on tea drinking and the risk of lung cancer in Chinese population].

PubMed

Jin, Zi-yi; Han, Ren-qiang; Liu, Ai-min; Wang, Xu-shan; Wu, Ming; Zhang, Zuo-feng; Zhao, Jin-kou

2012-08-01

To examine the association between tea drinking and the risk of lung cancer in Chinese population. All relevant published articles in Chinese and English literature database were identified. Meta-analysis was conducted. Combined odds ratio (OR) and 95% confidence interval (CI) were calculated to estimate the associations and dose-response relationship between tea drinking and the risk of lung cancer. Twelve studies were included. An inverse association with lung cancer was observed on tea drinkers when compared to non-tea drinkers (OR = 0.66, 95%CI: 0.49 - 0.89). Tea drinking might serve as a protective factor on lung cancer in the Chinese population.

Self-Management Training for Chinese Obese Children at Risk for Metabolic Syndrome: Effectiveness and Implications for School Health

ERIC Educational Resources Information Center

Ling, Jiying; Anderson, Laura M.; Ji, Hong

2015-01-01

This article reviews the results of a school-based self-management intervention for Chinese obese children at risk for metabolic syndrome. Twenty-eight Chinese obese children (M age?=?10 years) and their parents participated in the study. Metabolic syndrome risk factors were measured pre- and post-intervention. The risk factors included Body Mass…

Reconciling Discourse about Geography and Teaching Geography: The Case of Singapore Pre-Service Teachers

ERIC Educational Resources Information Center

Seow, Tricia

2016-01-01

This study draws upon a Foucauldian notion of discourse to explore how four pre-service geography teachers in Singapore made decisions about what geography is and how to enact their understandings of geography in their classrooms. This analysis of discursive power is particularly relevant to Singapore because of the high level of state control…

State carnivals and the subvention of multiculturalism in Singapore.

PubMed

Goh, Daniel P S

2011-03-01

Increasing attention is being paid to the specificities of Asian multiculturalism in relation to ethnic pluralism, citizenship and developmental state formation. This article examines these relationships by analysing three carnival events in colonial and postcolonial Singapore that were organized by the state to promote its official multiculturalism. Through its cultural logics of horizontal racial segmentation, cascading symbolic authority from the state to co-opted communal representatives and multi-modal ritual iteration, the 1937 King George VI coronation celebrations proffered an imperial multiculturalism based on mediating plural groups and procedural norms. Adopting the same cultural logics in the 1970s, the newly-independent nation-state revived and transformed Chingay, a creole Chinese religious procession, into an annual parade celebrating the nation as comprising racially plural groups bound together by the modern ethos of progress the developmental state exemplified. In the 2000s, Chingay has been turned into an international spectacle celebrating Singapore as a cosmopolitan global city of hybridizing multiculturalism. But indicative of new racial-class segmentation, the old nation-building pluralism is promoted by Racial Harmony Day carnivals held in suburban public housing neighborhoods. This bifurcated multiculturalism reflects the developmental state's attempts to deal with new citizenship trends as they grind against the old ethnic pluralism. While faced with the same issues globalization brings, this postcolonial multiculturalism is distinctively different from liberal multiculturalism, not least because the subvention of multiculturalism is achieved through the state appropriation of vernacular cultural practices through its carnivals. © London School of Economics and Political Science 2011.

Validity and reliability of the Short Form 36 Health Surveys (SF-36) among patients with spondyloarthritis in Singapore.

PubMed

Kwan, Yu Heng; Fong, Warren Weng Seng; Lui, Nai Lee; Yong, Si Ting; Cheung, Yin Bun; Malhotra, Rahul; Østbye, Truls; Thumboo, Julian

2016-12-01

The Short Form 36 Health Survey (SF-36) is a popular health-related quality of life (HrQoL) tool. However, few studies have assessed its psychometric properties in patients with spondyloarthritis (SpA). We therefore aimed to assess the reliability and validity of the SF-36 in patients with SpA in Singapore. Cross-sectional data from a registry of 196 SpA patients recruited from a dedicated tertiary referral clinic in Singapore from 2011 to 2014 was used. Analyses were guided by the COnsensus-based Standards for the selection of health Measurement INstruments framework. Internal consistency reliability was assessed using Cronbach's alpha. Construct validity was assessed through 33 a priori hypotheses by correlations of the eight subscales and two summary scores of SF-36 with other health outcomes. Known-group construct validity was assessed by comparison of the means of the subscales and summary scores of the SF-36 of SpA patients and the general population of Singapore using student's t tests. Among 196 patients (155 males (79.0 %), median (range) age: 36 (17-70), 166 Chinese (84.6 %)), SF-36 scales showed high internal consistency ranging from 0.88 to 0.90. Convergent construct validity was supported as shown by fulfillment of all hypotheses. Divergent construct validity was supported, as SF-36 MCS was not associated with PGA, pain and HAQ. Known-group construct validity showed SpA patients had lower scores of 3.8-12.5 when compared to the general population at p < 0.001. This study supports the SF-36 as a valid and reliable measure of HrQoL for use in patients with SpA at a single time point.

[Suicide exposure and its modulatory effects on relations between life events and suicide risk in Chinese college students].

PubMed

Zhao, Jiubo; Zhao, Jingbo; Xiao, Rong; Yang, Xueling; Zhang, Xiaoyuan

2013-08-01

To explore the incidence of suicide exposure and its association with suicide risk in Chinese college students, and study the modulatory effects of suicide exposure on the relations between life events and suicide risks. A total of 8202 college students from 12 Chinese colleges and universities in mainland China completed a cross-sectional survey that included suicidal behaviors questionnaire-revised (SBQ-R), Adolescent Self-Rating Life Events Check List (ASLEC), suicide exposure questionnaire, social and demographic characteristics questionnaire. The incidence of exposure to suicide events involving close relatives and acquaintances were 3.9% and 11.8% among sampled Chinese college students, respectively. Students exposed to suicide events involving close relatives had significantly higher total SBQ-R scores than those who did not (5.51∓2.44 vs 4.68∓2.11, P<0.01), and suicide events of acquaintances were also associated with significantly increased total SBQ-R scores (5.51∓2.44 vs 4.68∓2.11, P<0.01); these suicides events all contributed to significantly increased rates of suicidal ideation, suicide plans and suicide attempts in the college students (P<0.05). The life events showed a significant positive correlation with suicide risks (0.11≤r≤0.26, P<0.01). The interactions of exposure to suicide events involving close relatives and acquaintances and the interactions of life events and suicide of close relatives for suicide risk were not significant (P>0.05), but exposure to acquaintance suicide events moderated the effects of life events on suicide risk (P<0.01), and the college students with a high level of life events and history of acquaintance suicide had the highest risk for suicide. In Chinese college students, the risk of suicide is closely associated with exposure to suicide events and life events, and exposure to suicide events involving acquaintances can modulate the effects of life events on suicide risk.

Social Support from Parents and Friends for Chinese Adolescents in Singapore

ERIC Educational Resources Information Center

Cheung, Hoi Shan; Sim, Tick Ngee

2017-01-01

This study tested the situational hypothesis, by examining the perceived availability of three types of social support (emotional, informational, and instrumental) from parents and friends, with respect to occupational and interpersonal relationships issues. Participants were 257 Chinese Singaporean adolescents (120 males, 137 females) between…

Venous thromboembolism risk and postpartum lying-in: Acculturation of Indian and Chinese women.

PubMed

Melov, Sarah J; Hitos, Kerry

2018-03-01

many cultures have a set time of traditional rest in the postpartum period. There is limited information on how this activity may potentially increase the risk of venous thromboembolism (VTE). We aimed to investigate VTE risk by determining the prevalence of the cultural practice of postpartum "lying-in", quantifying activity and determining the factors that influence this tradition in women from China and the Indian subcontinent (India, Bangladesh, Pakistan and Sri Lanka) at an Australian tertiary referral hospital. we surveyed a prospective cohort of 150 women aged ≥ 18 years who self-identified culturally as from the Indian subcontinent or Chinese, at baseline (≥ 32 weeks gestation) and at follow-up (six to eight weeks postpartum). Demographic details collected included VTE risk factors such as caesarean section, lack of graduated compression stockings (GCS), postpartum haemorrhage greater than 1000mL, comorbidities and immobility. We quantified postpartum activities and investigated factors that might influence inactivity. there were 100 women identifying as from the Indian subcontinent and 50 women identifying as Chinese recruited at the baseline of over 32 weeks' gestation. Most of the study participants (85%) rested in the postpartum period for cultural reasons. Of the women surveyed, 51% rested in bed as much as possible in the postpartum period. We found a significant correlation between increased number of children and decreased overall immobility or rest (P = 0.03). Overall, 91% of participants had relative live-in help, and this significantly increased the risk of immobility by more than six-fold (odds ratio [OR], 6.17; 95% CI, 1.6-23.5; P = 0.008). Furthermore, a vaginal compared to a caesarean birth increased immobility risk by almost 3.5 times (OR, 3.4; 95% CI, 1.20-9.4; P = 0.021). acculturation is highly individualised, however postpartum rest remains prevalent in women who identify themselves culturally as from the Indian subcontinent or as

Associations between depression risk, bullying and current smoking among Chinese adolescents: Modulated by gender.

PubMed

Guo, Lan; Hong, Lingyao; Gao, Xue; Zhou, Jinhua; Lu, Ciyong; Zhang, Wei-Hong

2016-03-30

This school-based study aimed to investigate the prevalence of being at risk for depression, bullying behavior, and current smoking among Chinese adolescents in order to explore gender differences in the vulnerability of adolescents with these behaviors to develop a smoking habit. A total of 35,893 high school students sampled from high schools in eighteen cities in China participated in the study from 2011 to 2012. Overall, the prevalence of current smoking was estimated at 6.4%. In total, 1.7% (618) of the participants admitted to bullying others, 5.8% (2071) reported being bullied, 3.5% (1269) were involved in both bullying others and being bullied, and 5.6% (2017) were at high risk for depression. Logistic regression analysis indicated that among girls, with high depression risk, bullying others, being bullied, and both bullying others and being bullied were independently and positively associated with current smoking habits, while the final results among boys showed that bullying others and both bullying others and being bullied were independently associated with an increased risk of current smoking. School-based prevention programs are highly recommended, and we should focus on high-risk students, particularly girls with high risk of depression or involved in school bullying and boys who are involved in school bullying. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Assessing risk of breast cancer in an ethnically South-East Asia population (results of a multiple ethnic groups study)

PubMed Central

2012-01-01

Background Gail and others developed a model (GAIL) using age-at-menarche, age-at-birth of first live child, number of previous benign breast biopsy examinations, and number of first-degree-relatives with breast cancer as well as baseline age-specific breast cancer risks for predicting the 5-year risk of invasive breast cancer for Caucasian women. However, the validity of the model for projecting risk in South-East Asian women is uncertain. We evaluated GAIL and attempted to improve its performance for Singapore women of Chinese, Malay and Indian origins. Methods Data from the Singapore Breast Screening Programme (SBSP) are used. Motivated by lower breast cancer incidence in many Asian countries, we utilised race-specific invasive breast cancer and other cause mortality rates for Singapore women to produce GAIL-SBSP. By using risk factor information from a nested case-control study within SBSP, alternative models incorporating fewer then additional risk factors were determined. Their accuracy was assessed by comparing the expected cases (E) with the observed (O) by the ratio (E/O) and 95% confidence interval (CI) and the respective concordance statistics estimated. Results From 28,883 women, GAIL-SBSP predicted 241.83 cases during the 5-year follow-up while 241 were reported (E/O=1.00, CI=0.88 to 1.14). Except for women who had two or more first-degree-relatives with breast cancer, satisfactory prediction was present in almost all risk categories. This agreement was reflected in Chinese and Malay, but not in Indian women. We also found that a simplified model (S-GAIL-SBSP) including only age-at-menarche, age-at-birth of first live child and number of first-degree-relatives performed similarly with associated concordance statistics of 0.5997. Taking account of body mass index and parity did not improve the calibration of S-GAIL-SBSP. Conclusions GAIL can be refined by using national race-specific invasive breast cancer rates and mortality rates for causes other than

Trends in high-risk sexual behaviors among general population groups in China: a systematic review.

PubMed

Cai, Rui; Richardus, Jan Hendrik; Looman, Caspar W N; de Vlas, Sake J

2013-01-01

The objective of this review was to investigate whether Chinese population groups that do not belong to classical high risk groups show an increasing trend of engaging in high-risk sexual behaviors. We systematically searched the English and Chinese literature on sexual risk behaviors published between January 1980 and March 2012 in PubMed and the China National Knowledge Infrastructure (CNKI). We included observational studies that focused on population groups other than commercial sex workers (CSWs) and their clients, and men who have sex with men (MSM) and quantitatively reported one of the following indicators of recent high-risk sexual behavior: premarital sex, commercial sex, multiple sex partners, condom use or sexually transmitted infections (STIs). We used generalized linear mixed model to examine the time trend in engaging in high-risk sexual behaviors. We included 174 observational studies involving 932,931 participants: 55 studies reported on floating populations, 73 on college students and 46 on other groups (i.e. out-of-school youth, rural residents, and subjects from gynecological or obstetric clinics and premarital check-up centers). From the generalized linear mixed model, no significant trends in engaging in high-risk sexual behaviors were identified in the three population groups. Sexual risk behaviors among certain general population groups have not increased substantially. These groups are therefore unlikely to incite a STI/HIV epidemic among the general Chinese population. Because the studied population groups are not necessarily representative of the general population, the outcomes found may not reflect those of the general population.

Trends in High-Risk Sexual Behaviors among General Population Groups in China: A Systematic Review

PubMed Central

Cai, Rui; Richardus, Jan Hendrik; Looman, Caspar W. N.; de Vlas, Sake J.

2013-01-01

Background The objective of this review was to investigate whether Chinese population groups that do not belong to classical high risk groups show an increasing trend of engaging in high-risk sexual behaviors. Methods We systematically searched the English and Chinese literature on sexual risk behaviors published between January 1980 and March 2012 in PubMed and the China National Knowledge Infrastructure (CNKI). We included observational studies that focused on population groups other than commercial sex workers (CSWs) and their clients, and men who have sex with men (MSM) and quantitatively reported one of the following indicators of recent high-risk sexual behavior: premarital sex, commercial sex, multiple sex partners, condom use or sexually transmitted infections (STIs). We used generalized linear mixed model to examine the time trend in engaging in high-risk sexual behaviors. Results We included 174 observational studies involving 932,931 participants: 55 studies reported on floating populations, 73 on college students and 46 on other groups (i.e. out-of-school youth, rural residents, and subjects from gynecological or obstetric clinics and premarital check-up centers). From the generalized linear mixed model, no significant trends in engaging in high-risk sexual behaviors were identified in the three population groups. Discussion Sexual risk behaviors among certain general population groups have not increased substantially. These groups are therefore unlikely to incite a STI/HIV epidemic among the general Chinese population. Because the studied population groups are not necessarily representative of the general population, the outcomes found may not reflect those of the general population. PMID:24236121

Attitudes to mental illness among mental health professionals in Singapore and comparisons with the general population.

PubMed

Yuan, Qi; Picco, Louisa; Chang, Sherilyn; Abdin, Edimansyah; Chua, Boon Yiang; Ong, Samantha; Yow, Kah Lai; Chong, Siow Ann; Subramaniam, Mythily

2017-01-01

attitudes on 'social restrictiveness' and 'prejudice and misconception'. Having family or close friends diagnosed with mental illness was negatively associated with 'social distancing' among the professionals. The AMI-SG is an effective tool to measure attitudes to mental illness among mental health professionals in Singapore. Although the professionals had significantly more positive attitudes to mental illness than the general public in Singapore, their attitudes on 'social distancing' resembled closely that of the general public. Professionals tended to have more negative attitudes if they were nurses, less educated, and of Chinese ethnicity. More studies are needed to explore the underlying reasons for the differences and to generalize these findings among mental health professionals elsewhere.

Ethnic differences in the frequency of subtypes of childhood acute lymphoblastic leukemia: results of the Malaysia-Singapore Leukemia Study Group.

PubMed

Ariffin, Hany; Chen, Siew-Peng; Kwok, Cecilia S; Quah, Thuan-Chong; Lin, Hai-Peng; Yeoh, Allen E J

2007-01-01

Childhood acute lymphoblastic leukemia (ALL) is clinically heterogeneous with prognostically and biologically distinct subtypes. Although racial differences in frequency of different types of childhood ALL have been reported, many are confounded by selected or limited population samples. The Malaysia-Singapore (MA-SPORE) Leukemia Study Group provided a unique platform for the study of the frequency of major subgroups of childhood ALL in a large cohort of unselected multiethnic Asian children. Screening for the prognostically important chromosome abnormalities (TEL-AML1, BCR-ABL, E2A-PBX1, and MLL) using multiplex reverse-transcription polymerase chain reaction was performed on 299 consecutive patients with ALL at 3 study centers (236 de novo, 63 at relapse), with the ethnic composition predominantly Chinese (51.8%) and Malay (34.8%). Reverse-transcription polymerase chain reaction was successful in 278 (93%) of cases screened. The commonest fusion transcript was TEL-AML1 (19.1%) followed by BCR-ABL (7.8%), MLL rearrangements (4.2%), and E2A-PBX1 (3.1%). Chinese have a significantly lower frequency of TEL-AML1 (13.3% in de novo patients) compared with Malays (22.2%) and Indians (21.7%) (P=0.04). Malays have a lower frequency of T-ALL (6.2%) compared with the Chinese and Indians (9.8%). Both Malays (7.4%) and Chinese (5.0%) have significantly higher frequency of BCR-ABL compared with the Indian population (P<0.05) despite a similar median age at presentation. Our study suggests that there are indeed significant and important racial differences in the frequency of subtypes of childhood ALL. Comprehensive subgrouping of childhood ALL may reveal interesting population frequency differences of the various subtypes, their risk factors and hopefully, its etiology.

A novel recurrent CHEK2 Y390C mutation identified in high-risk Chinese breast cancer patients impairs its activity and is associated with increased breast cancer risk.

PubMed

Wang, N; Ding, H; Liu, C; Li, X; Wei, L; Yu, J; Liu, M; Ying, M; Gao, W; Jiang, H; Wang, Y

2015-10-01

Certain predisposition factors such as BRCA1/2 and CHEK2 mutations cause familial breast cancers that occur early. In China, breast cancers are diagnosed at relatively younger age, and higher percentage of patients are diagnosed before 40 years, than that in Caucasians. However, the prevalence for BRCA1/2 mutations and reported CHEK2 germline mutations is much lower or absent in Chinese population, arguing for the need to study other novel risk alleles among Chinese breast cancer patients. In this study, we searched for CHEK2 mutations in young, high-risk breast cancer patients in China and detected a missense variant Y390C (1169A > G) in 12 of 150 patients (8.0%) and 2 in 250 healthy controls (0.8%, P = 0.0002). Four of the Y390C carriers have family history of breast and/or ovarian cancer. In patients without family history, Y390C carriers tend to develop breast cancer early, before 35 years of age. The codon change at Y390, a highly conserved residue located in CHEK2's kinase domain, appeared to significantly impair CHEK2 activity. Functional analysis suggested that the CHEK2 Y390C mutation is deleterious as judged by the mutant protein's inability to inactivate CDC25A or to activate p53 after DNA damage. Cells expressing the CHEK2 Y390C variant showed impaired p21 and Puma expression after DNA damage, and the deregulated cell cycle checkpoint and apoptotic response may help conserve mutations and therefore contribute to tumorigeneisis. Taken together, our results not only identified a novel CHEK2 allele that is associated with cancer families and confers increased breast cancer risk, but also showed that this allele significantly impairs CHEK2 function during DNA damage response. Our results provide further insight on how the function of such an important cancer gene may be impaired by existing mutations to facilitate tumorigenesis. It also offers a new subject for breast cancer monitoring, prevention and management.

Chinese lacto-vegetarian diet exerts favorable effects on metabolic parameters, intima-media thickness, and cardiovascular risks in healthy men.

PubMed

Yang, Shu-Yu; Li, Xue-Jun; Zhang, Wei; Liu, Chang-Qin; Zhang, Hui-Jie; Lin, Jin-Rong; Yan, Bing; Yu, Ya-Xin; Shi, Xiu-Lin; Li, Can-Dong; Li, Wei-Hua

2012-06-01

To investigate whether the Chinese lacto-vegetarian diet has protective effects on metabolic and cardiovascular disease (CVD). One hundred sixty-nine healthy Chinese lacto-vegetarians and 126 healthy omnivore men aged 21-76 years were enrolled. Anthropometric indexes, lipid profile, insulin sensitivity, pancreatic β cell function, and intima-media thickness (IMT) of carotid arteries were assessed and compared. Cardiovascular risk points and probability of developing CVD in 5-10 years in participants aged 24-55 years were calculated. Compared with omnivores, lacto-vegetarians had remarkably lower body mass index, systolic and diastolic blood pressure, and serum levels of triglyceride, total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, γ-glutamyl transferase, serum creatinine, uric acid, fasting blood glucose, as well as lower total cholesterol/high-density lipoprotein cholesterol ratio. Vegetarians also had higher homeostasis model assessment β cell function and insulin secretion index and thinner carotid IMT than the omnivores did. These results corresponded with lower cardiovascular risk points and probability of developing CVD in 5-10 years in vegetarians 24-55 years old. In healthy Chinese men, the lacto-vegetarian diet seems to exert protective effects on blood pressure, lipid profiles, and metabolic parameters and results in significantly lower carotid IMT. Lower CVD risks found in vegetarians also reflect the beneficial effect of the Chinese lacto-vegetarian diet.

Singapore's Literacy Policy and Its Conflicting Ideologies

ERIC Educational Resources Information Center

Chua, Catherine Siew Kheng

2004-01-01

Singapore's leading literacy policy is affected by a tension between the ideologies associated with English and those attached to Singapore's mother tongues. Singaporeans must safeguard their heritages, keeping themselves open to the places where their ancestors came from by learning their designated mother tongues. At the same time, Singaporeans…

Incidence, Risk Factors, and the Protective Effect of High Body Mass Index against Sarcopenia in Suburb-Dwelling Elderly Chinese Populations.

PubMed

Han, P; Zhao, J; Guo, Q; Wang, J; Zhang, W; Shen, S; Wang, X; Dong, R; Ma, Y; Kang, L; Fu, L; Jia, L; Han, X; He, Z; Bao, Y; Wang, L; Niu, K

2016-01-01

Few studies have explored the risk factors of sarcopenia in certain cohorts. The objective of this study was to examine the incidence of sarcopenia and associated factors over a 1-year period in an elderly Chinese suburban population. This study was conducted on 356 Chinese suburb-dwelling participants aged ≥60 years, for whom detailed information regarding sociodemographics, behavioral characteristics, and medical conditions had been documented. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. Sarcopenia incidence was documented after one year of follow-up, and correlated with several possible factors. At baseline, 64 (9.7%) of the initial 657 participants had sarcopenia. The prevalence of sarcopenia was 10.4% after one year. Between baseline and 1-year follow-up, 13 of the participants without sarcopenia at baseline had developed sarcopenia. After multivariate adjustments, it was found that the incidence of sarcopenia increased with age and high body mass index (BMI) is associated with less incidence of sarcopenia. Incidence was also higher among women. We found sarcopenia incidence increased with age, and women were more likely to have sarcopenia. A higher BMI is also associated with a lower incidence of sarcopenia. Maintaining a healthy weight could be beneficial in the prevention of sarcopenia.

The Chinese-born immigrant infant feeding and growth hypothesis.

PubMed

Bolton, Kristy A; Kremer, Peter; Hesketh, Kylie D; Laws, Rachel; Campbell, Karen J

2016-10-11

Rapid growth in the first six months of life is a well-established risk factor for childhood obesity, and child feeding practices (supplementation or substitution of breast milk with formula and early introduction of solids) have been reported to predict this. The third largest immigrant group in Australia originate from China. Case-studies reported from Victorian Maternal and Child Health nurses suggest that rapid growth trajectories in the infants of Chinese parents is common place. Furthermore, these nurses report that high value is placed by this client group on rapid growth and a fatter child; that rates of breastfeeding are low and overfeeding of infant formula is high. There are currently no studies which describe infant growth or its correlates among this immigrant group. We postulate that in Australia, Chinese-born immigrant mothers will have different infant feeding practices compared to non-immigrant mothers and this will result in different growth trajectories and risk of overweight. We present the Chinese-born immigrant infant feeding and growth hypothesis - that less breastfeeding, high formula feeding and early introduction of solids in infants of Chinese-born immigrant mothers living in Australia will result in a high protein intake and subsequent rapid growth trajectory and increased risk of overweight and obesity. Three related studies will be conducted to investigate the hypothesis. These will include two quantitative studies (one cross-sectional, one longitudinal) and a qualitative study. The quantitative studies will investigate differences in feeding practices in Chinese-born immigrant compared to non-immigrant mothers and infants; and the growth trajectories over the first 3.5 years of life. The qualitative study will provide more in-depth understanding of the influencing factors on feeding practices in Chinese-born immigrant mothers. This study will provide evidence of the potential modifiable feeding practices and risk of overweight faced

Developing Twenty-First Century Competencies through the Arts: A Case Study of A High Performing Secondary School Band in Singapore

ERIC Educational Resources Information Center

Tan, Leonard

2017-01-01

The purpose of this study was to examine the development of "21st Century Competencies" (21CC) through the secondary school band programme. The researcher used ethnographic research methods to document the lived musical experiences of students from a high performing secondary school band in Singapore, captured the voices of the…

The clinical profile of patients with anorexia nervosa in Singapore: a follow-up descriptive study.

PubMed

Kuek, Angeline; Utpala, Ranjani; Lee, Huei Yen

2015-06-01

The prevalence rate of anorexia nervosa is lower in Asia than in the West, although studies have found that it is on the rise in Asia. This study aims to present the clinical profile of patients presenting with anorexia nervosa in Singapore. The present study used archival data from the Eating Disorder Programme registry of the Department of Psychiatry, Singapore General Hospital, Singapore. Patient records from 2003 to 2010 were collected and analysed. Presenting characteristics of the patients were also compared with those of another local study conducted eight years earlier. From 2003 to 2010, a total of 271 patients were diagnosed with anorexia nervosa by a psychiatrist in our hospital. Of these, 251 (92.6%) were female and 238 (87.8%) were Chinese. Our patients had a lower mean weight (36.83 kg, p < 0.001) and a lower mean body mass index (BMI) (14.43 kg/m(2), p < 0.001) than patients from the previous local study. Almost half of all our patients (n = 135, 49.8%) were diagnosed with at least one psychiatric comorbidity and 50 (18.5%) had a history of self-harm. The presenting characteristics of our study cohort were similar to those of the Western population. However, the lower presenting weight and BMI in our cohort indicates that cases seen today are more severe than those seen eight years ago. Therefore, it is important to put in place prevention programmes to help adolescents cultivate a healthy body image as well as early intervention programmes to improve detection rates and treatment outcomes.

Development and external multicenter validation of Chinese Prostate Cancer Consortium prostate cancer risk calculator for initial prostate biopsy.

PubMed

Chen, Rui; Xie, Liping; Xue, Wei; Ye, Zhangqun; Ma, Lulin; Gao, Xu; Ren, Shancheng; Wang, Fubo; Zhao, Lin; Xu, Chuanliang; Sun, Yinghao

2016-09-01

Substantial differences exist in the relationship of prostate cancer (PCa) detection rate and prostate-specific antigen (PSA) level between Western and Asian populations. Classic Western risk calculators, European Randomized Study for Screening of Prostate Cancer Risk Calculator, and Prostate Cancer Prevention Trial Risk Calculator, were shown to be not applicable in Asian populations. We aimed to develop and validate a risk calculator for predicting the probability of PCa and high-grade PCa (defined as Gleason Score sum 7 or higher) at initial prostate biopsy in Chinese men. Urology outpatients who underwent initial prostate biopsy according to the inclusion criteria were included. The multivariate logistic regression-based Chinese Prostate Cancer Consortium Risk Calculator (CPCC-RC) was constructed with cases from 2 hospitals in Shanghai. Discriminative ability, calibration and decision curve analysis were externally validated in 3 CPCC member hospitals. Of the 1,835 patients involved, PCa was identified in 338/924 (36.6%) and 294/911 (32.3%) men in the development and validation cohort, respectively. Multivariate logistic regression analyses showed that 5 predictors (age, logPSA, logPV, free PSA ratio, and digital rectal examination) were associated with PCa (Model 1) or high-grade PCa (Model 2), respectively. The area under the curve of Model 1 and Model 2 was 0.801 (95% CI: 0.771-0.831) and 0.826 (95% CI: 0.796-0.857), respectively. Both models illustrated good calibration and substantial improvement in decision curve analyses than any single predictors at all threshold probabilities. Higher predicting accuracy, better calibration, and greater clinical benefit were achieved by CPCC-RC, compared with European Randomized Study for Screening of Prostate Cancer Risk Calculator and Prostate Cancer Prevention Trial Risk Calculator in predicting PCa. CPCC-RC performed well in discrimination and calibration and decision curve analysis in external validation compared

Implementation of the Risk–Need–Responsivity Framework across the Juvenile Justice Agencies in Singapore

PubMed Central

Chua, Jonathan Raphacis; Chu, Chi Meng; Yim, Grace; Chong, Dominic; Teoh, Jennifer

2014-01-01

The Risk–Need–Responsivity (RNR) framework is regarded as the forefront of offender rehabilitation in guiding youth offender risk assessment and interventions. This article discusses the juvenile justice system in Singapore and the local research that has been conducted in relation to the RNR framework and the associated Youth Level of Service (YLS) measures. It describes a journey that saw the implementation of the RNR framework across the juvenile justice agencies and highlights the challenges that were faced during the implementation process on the ground. Finally, the article concludes by providing future directions for the implementation of the RNR framework in Singapore. PMID:25866464

The Chinese High School Student's Stress in the School and Academic Achievement

ERIC Educational Resources Information Center

Liu, Yangyang; Lu, Zuhong

2011-01-01

In a sample of 466 Chinese high school students, we examined the relationships between Chinese high school students' stress in the school and their academic achievements. Regression mixture modelling identified two different classes of the effects of Chinese high school students' stress on their academic achievements. One class contained 87% of…

Sorting Citizens: Differentiated Citizenship Education in Singapore