EMR based telegeriatric system.

PubMed

Pallawala, P M; Lun, K C

2001-05-01

As medical services improve due to new technologies and breakthroughs, it has lead to an increasingly aging population. There has been much discussion and debate on how to solve various aspects such as psychological, socioeconomic and medical problems related to aging. Our effort is to implement a feasible telegeriatric medical service with the use of the state of the art technology to deliver medical services efficiently to remote sites where elderly homes are based. Telegeriatric system will lead to rapid decision-making in the presence of acute or subacute emergencies. This triage will also lead to a reduction of unnecessary admission. It will enable the doctors who visit these elderly homes on a once-a-week basis to improve their geriatric management skills by communication with geriatric specialist. Nursing skills in geriatric care will also benefit from this system. Integrated EMR service will be indispensable in the face of emergency admissions to hospitals. Evolution of EMR database would lead to future research in telegeriatrics and will help to identify the areas where telegeriatrics can be optimally used. This system is based on current web browsing technology and broadband communication. EMR web based server is developed using Java Technology. EMR database was developed using Microsoft SQL server. Both are based at the Medical Informatics Programme, National University of Singapore. Two elderly homes situated in the periphery of Singapore and a leading government hospital in geriatric care has been chosen for the project. These three institutions and National University of Singapore are connected via ADSL protocol, which support high bandwidth, which is necessary for high quality videoconferencing. Each time a patient needs a teleconsultation, a nurse or doctor in the remote site sends the history to the EMR server. EMR server forwards the request to the Alexandra Hospital for consultation. Geriatrics specialists at Alexandra Hospital carry out teleward rounds twice weekly and on demand basis. Following the implementation of the system, a trial run has been done. This shows a high degree of coordination and cooperation between remote site and the Alexandra Hospital Also the patient compliance is very high and they prefer teleconsultation. Initial results show that telegeriatric system has definite advantages in managing geriatric patients at a remote site. As the system evolves, further research will show the areas where telegeriatrics can be used optimally.

Influenza-Associated Hospitalizations, Singapore, 2004–2008 and 2010–2012

PubMed Central

Lim, Cindy; Lee, Vernon Jian Ming; Ma, Stefan; Tiong, Wei Wei; Ooi, Peng Lim; Lin, Raymond Tzer Pin; James, Lyn; Cutter, Jeffery

2014-01-01

Studies of influenza-associated hospitalizations in tropical settings are lacking. To increase understanding of the effect of influenza in Singapore, we estimated the age-specific influenza-associated hospitalizations for pneumonia and influenza during 2004–2008 and 2010–2012. The rate of hospitalization was 28.3/100,000 person-years during 2004–2008 and 29.6/100,000 person-years during 2010–2012. The age-specific influenza-associated hospitalization rates followed a J-shaped pattern: rates in persons >75 years of age and in children <6 months of age were >47 times and >26 times higher, respectively, than those for persons 25–44 years of age. Across all ages during these 2 study periods, ≈12% of the hospitalizations for pneumonia and influenza were attributable to influenza. The rates and proportions of hospitalizations for influenza, particularly among the very young and the elderly, are considerable in Singapore and highlight the importance of vaccination in protecting populations at risk. PMID:25275710

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.

Telesurgical laparoscopic cholecystectomy between two countries.

PubMed

Cheah, W K; Lee, B; Lenzi, J E; Goh, P M

2000-11-01

Telesurgery is a form of operative videoconferencing in which a remotely located surgeon observes a procedure through a camera and provides visual and auditory feedback to the operative site. With the use of more robotic devices in laparoscopic surgery, various forms of telesurgery have been tried. We describe the first two international telesurgical, telementored, robot-assisted laparoscopic cholecystectomies performed in the world, between the Johns Hopkins Institute, Baltimore, Maryland, USA, and the National University Hospital, Singapore.

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

Nearing World-Class: Singapore's Two Universities in QSWUR 2015/16

ERIC Educational Resources Information Center

Soh, Kaycheng

2016-01-01

Many universities strive to become world-class and two of Singapore's universities are almost there, being ranked 12th and 13th in the QSWUR 2015/16. This study looked into the details of indicator rankings and found that the two universities are comparable to those in the top 10 universities in the same ranking in practically all indicators with…

The Quest for Global Competitiveness: Promotion of Innovation and Entrepreneurial Universities in Singapore

ERIC Educational Resources Information Center

Mok, Ka Ho

2015-01-01

The economy of Singapore has been continuously reforming since its independence. In the late 1980s, the economy of Singapore depended heavily on the vibrant manufacturing sector formed by foreign direct investment and multinational companies. This article critically reviews the policies and reform measures adopted by the Singapore government in…

Urban simulation evaluation with study case of the Singapore Management University, Singapore

NASA Astrophysics Data System (ADS)

Seanders, O.

2018-01-01

This paper reports and discusses about the urban simulation evaluation with a study case, The Singapore Managemant University (SMU), the first major university to be located in the city centre. It is located in Bras Basah District, with some controversy on the geographical establishment, the physical realization of the University in the original plan required some demolishes, urban historical building, a public park and in the end will impact the lose of some certain qualities of the urban space. From this case we can see that the urban design and cultural heritage principles could come into conflicts with the more practical concerns of space constraints and transportation efficiency. This SMU case reflect the problem of the developing countries that have to decide between conservation of buildings and green spaces and space demands. In this case, for Singapore, it marks a progress in the step of greater community involvement in the planning process.

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.

Prospective surveillance and molecular characterization of seasonal influenza in a university cohort in Singapore.

PubMed

Virk, Ramandeep Kaur; Tambyah, Paul Anantharajah; Inoue, Masafumi; Lim, Elizabeth Ai-Sim; Chan, Ka-Wei; Chua, Catherine; Tan, Boon-Huan

2014-01-01

Southeast Asia is believed to be a potential locus for the emergence of novel influenza strains, and therefore accurate sentinel surveillance in the region is critical. Limited information exists on sentinel surveillance of influenza-like illness (ILI) in young adults in Singapore in a University campus setting. The objective of the present study was to determine the proportion of ILI caused by influenza A and B viruses in a university cohort in Singapore. We conducted a prospective surveillance study from May through October 2007, at the National University of Singapore (NUS). Basic demographic information and nasopharyngeal swabs were collected from students and staff with ILI. Reverse-transcriptase PCR (RT-PCR) and viral isolation were employed to detect influenza viruses. Sequencing of hemagglutinin (HA) and neuraminidase (NA) genes of some representative isolates was also performed. Overall proportions of influenza A and B virus infections were 47/266 (18%) and 9/266 (3%) respectively. The predominant subtype was A/H3N2 (55%) and the rest were A/H1N1 (45%). The overall sensitivity difference for detection of influenza A viruses using RT-PCR and viral isolation was 53%. Phylogenetic analyses of HA and NA gene sequences of Singapore strains showed identities higher than 98% within both the genes. The strains were more similar to strains included in the WHO vaccine recommendation for the following year (2008). Genetic markers of oseltamivir resistance were not detected in any of the sequenced Singapore isolates. HA and NA gene sequences of Singapore strains were similar to vaccine strains for the upcoming influenza season. No drug resistance was found. Sentinel surveillance on university campuses should make use of molecular methods to better detect emerging and re-emerging influenza viral threats.

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.

University students and mental health. Canada, Britain and Singapore.

PubMed

Gold, J H

1979-01-01

There are many crucial determinants of the individual outcome and benefit of a university education including the stressful interplay of cultural and socioeconomic factors which are of growing importance in the inflationary 1970's. An epidemiological study of university students from 1969-1972 in Canada, 1973-1974 in Britain, and 1975 in Singapore, attempted to identify stresses leading to mental ill-health in these students. Singapore was chosen as an example of a culture bridging the developed Northern and developing Southern nations of the world. Cultural differences affecting the results of the study are discussed as is the role of social change.

EMR-based TeleGeriatric system.

PubMed

Pallawala, P M; Lun, K C

2001-01-01

As medical services improve due to new technologies and breakthroughs, it has lead to an increasingly aging population. There has been much discussion and debate on how to solve various aspects such as psychological, socio-economic and medical problems related to aging. Our effort is to implement a feasible telegeriatric medical service with the use of the state of the art technology to deliver medical services efficiently to remote sites where elderly homes are based. The TeleGeriatric system will lead to rapid decision-making in the presence of acute or subacute emergencies. This triage will also lead to a reduction of unnecessary admission. It will enable the doctors who visit these elderly homes once a week basis to improve their geriatric management skills by communication with geriatric specialist. Nursing skills in the geriatric care will also benefit from this system. Integrated electronic medical record (EMR) system will be indispensable in the face of emergency admissions to hospitals. Evolution of EMR database would lead to future research in telegeriatrics and will help to identify the areas where telegeriatrics can be optimally used. This system is based on current web browsing technology and broadband communication. The TeleGeriatric web based server is developed using Java Technology. The TeleGeriatric database server was developed using Microsoft SQL server. Both are based at the Medical Informatics Programme, National University of Singapore. Two elderly homes situated in the periphery of Singapore and a leading government hospital in geriatric care have been chosen for the project. These 3 institutions and National University of Singapore are connected via ADSL protocol. ADSL connection supports high bandwidth, which is necessary for high quality videoconferencing. Each time a patient needs a teleconsultation a nurse or a doctor in the remote site sends the patient's record to the TeleGeriatric server. The TeleGeriatric server forwards the request to the Alexandra Hospital for consultation. Geriatrics specialists at the Alexandra Hospital carry out teleward rounds twice weekly and on demand basis. Following the implementation of the system, a trial run has been done. Total results have demonstrated a high degree of coordination and cooperation between remote site and the Alexandra Hospital. Also the patient compliance is very high and they prefer teleconsultation. Initial results show that the TeleGeriatric system has definite advantages in managing geriatric patients at a remote site. As the system evolves, further research will show the areas where telegeriatrics can be used optimally.

The teaching of obstetrics and gynaecology in Singapore from 1905 to the present.

PubMed

Singh, K; Yong, E L; Wong, P C

2005-07-01

Medical education commenced a century ago in 1905. In 1922, the Department of Midwifery and Gynaecology was established. This was renamed the Department of Obstetrics in 1951. Medical undergraduate curriculum in Obstetrics and Gynaecology has evolved and undergone radical changes. From a compulsory 11-week residential posting in Kandang Kerbau Hospital, medical students are now only expected to be resident when they are scheduled for night duties. Having been an examination subject by itself in the Final MBBS Examination, Obstetrics and Gynaecology has in the latest revised undergraduate medical curriculum been incorporated into the Surgical tract and has ceased to be evaluated as a subject on its own. In this review, the establishment of postgraduate training in Obstetrics and Gynaecology is traced over the last 50 years and the important changes over the years are described. The first local Master of Medicine (Obstetrics and Gynaecology) was awarded in 1971. Currently, the specialist training for Obstetrics and Gynaecology in Singapore spans a period of 6 years, comprising 3 years of basic structural training and 3 years of advanced structural training. Over the years, the Department of Obstetrics and Gynaecology, National University of Singapore, has played a pivotal role in the teaching of clinical and laboratory research. This has added substantially to Singapore's efforts to become a world-class knowledge hub, especially in the areas of relevance to Obstetrics and Gynaecology.

Fusing Social Media and Mobile Analytics for Urban Sense-Making

DTIC Science & Technology

2017-05-09

AFRL-AFOSR-JP-TR-2017-0037 Fusing Social Media and Mobile Analytics for Urban Sense-Making Archan Misra SINGAPORE MANAGEMENT UNIVERSITY Final Report...CONTRACT NUMBER 5b.  GRANT NUMBER FA2386-14-1-0002 5c.  PROGRAM ELEMENT NUMBER 61102F 6. AUTHOR(S) Archan Misra 5d.   PROJECT NUMBER 5e.  TASK...NUMBER 5f.  WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) SINGAPORE MANAGEMENT UNIVERSITY 81 VICTORIA STREET SINGAPORE, 188065 SG 8

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.

The Quest for Innovation and Entrepreneurship in Singapore: Strategies and Challenges

ERIC Educational Resources Information Center

Ng, Pak Tee

2012-01-01

Innovation and entrepreneurship are two very important ingredients in the continuous economic growth of Singapore. This article describes and analyses how Singapore attempts to develop innovation and entrepreneurship through initiatives at the national level and at the universities and schools level. In particular, the article examines the recent…

"Hottest Brand, Coolest Pedagogy": Approaches to Corporate Branding in Singapore's Higher Education Sector

ERIC Educational Resources Information Center

Ng, Carl Jon Way

2016-01-01

This article examines the corporate branding efforts of Singapore's publicly funded higher education institutions within a context of neoliberal marketization. Adopting a discourse-analytic perspective, it examines the kind of branding approaches employed by Singapore's universities and polytechnics, and how these approaches are realized…

University Programme Preferences of High School Science Students in Singapore and Reasons That Matter in Their Preferences: A Rasch Analysis

ERIC Educational Resources Information Center

Oon, Pey-Tee; Subramaniam, R.

2015-01-01

This study explored an under-researched area in science education--the university programmes preferred by high school students who take physical science subjects and the reasons that matter in their preferences. A total of 1,071 upper secondary and pre-university students in Singapore, who take physical science subjects among their range of…

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/

Geography's Place in Higher Education in Singapore

ERIC Educational Resources Information Center

Kong, Lily

2007-01-01

Unlike the other papers in this symposium, which deal with countries where there are large numbers of universities, and comparison can be made over time and across space of geography's place in higher education, this paper focuses on a country that was for a long time described as a "one-university town": Singapore. What interesting…

University 2.0: A View from Singapore

ERIC Educational Resources Information Center

Tan, Daniel; Lee, Chye Seng; Chan, Lay Kock; Lu, Adrian Din How

2009-01-01

This article highlights the processes and best practices adopted by Nanyang Technological University (NTU) in Singapore in implementing their mission-critical e-learning services for a population of 28,000 students and 1,100 faculty members. The various phases of this rapid growth in e-learning from the initial genesis in achieving mass buy-in by…

Transborder Tourism, Borderless Classroom: Reflections on a Hawaii-Singapore Experience

ERIC Educational Resources Information Center

Chang, T.C.

2004-01-01

This paper discusses a virtual or borderless classroom exercise conducted by the National University of Singapore (NUS) and the University of Hawaii, Manoa (UHM). By reflecting on the experiences and views of the NUS participants, the article explores the possibility of virtual explorations as a substitute for conventional fieldtrips and…

The University-Innovation Nexus in Singapore. Go8 Backgrounder 28

ERIC Educational Resources Information Center

Group of Eight (NJ1), 2012

2012-01-01

Singapore, like Australia, is one of the world's most prosperous countries. However, the basis for Singapore's prosperity is quite different from that of Australia's and for this reason it provides an interesting and complementary case study. While much of Australia's current affluence flows from its rich endowment of mineral resources,…

Area Handbook Series: Singapore: A Country Study.

DTIC Science & Technology

1989-12-01

built to house 12,000 Asian work- ers, with cinemas , hospitals, churches, and seventeen soccer fields. Above-ground tanks held enough fuel for the...the Malaysian general election in April 1964. UMNO was unable to win any seats in the Singapore election, and PAP won only one seat on the penin...of Malaya, Singapore, Sabah, and Sarawak merged to form a Malaysian National Alliance Party. The follow- ing month, the PAP and four opposition

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

CYTOTOXICITY AND CELL SIGNALING IN MH-S CELLS: RELATIVE POTENCY OF DIESEL AND COAL COMBUSTION PARTICLES

EPA Science Inventory

Cytotoxicity and Cell Signaling in MH-S Cells: Relative Potency of Diesel and Coal Combustion Particles P. Singh1, Y. Kostetski2, M. Daniels1, T. Stevens3 and MI Gilmour 1USEPA, RTP, NC, 2National University of Singapore, Singapore, 3University of North Carolina, Chapel Hill, NC<...

Positioning as Regional Hub of Higher Education: Changing Governance and Regulatory Reforms in Singapore and Malaysia

ERIC Educational Resources Information Center

Mok, Ka Ho

2008-01-01

With strong intention to enhance the global competitiveness of their university systems, the Singapore and Malaysia governments have made attempts to develop their societies into regional hubs of education. Specifically, they have invited foreign universities to set up their campuses to offer academic programs or to establish private institutions…

Reflections on a decade of research by ASEAN dental faculties: analysis of publications from ISI-WOS databases from 2000 to 2009.

PubMed

Sirisinha, Stitaya; Koontongkaew, Sittichai; Phantumvanit, Prathip; Wittayawuttikul, Ruchareka

2011-05-01

This communication analyzed research publications in dentistry in the Institute of Scientific Information Web of Science databases of 10 dental faculties in the Association of South-East Asian Nations (ASEAN) from 2000 to 2009. The term used for the "all-document types" search was "Faculty of Dentistry/College of Dentistry." Abstracts presented at regional meetings were also included in the analysis. The Times Higher Education System QS World University Rankings showed that universities in the region fare poorly in world university rankings. Only the National University of Singapore and Nanyang Technological University appeared in the top 100 in 2009; 19 universities in the region, including Indonesia, Malaysia, the Philippines, Singapore, and Thailand, appeared in the top 500. Data from the databases showed that research publications by dental institutes in the region fall short of their Asian counterparts. Singapore and Thailand are the most active in dental research of the ASEAN countries. © 2011 Blackwell Publishing Asia Pty Ltd.

Sustained meticillin-resistant Staphylococcus aureus control in a hyper-endemic tertiary acute care hospital with infrastructure challenges in Singapore.

PubMed

Fisher, D; Tambyah, P A; Lin, R T P; Jureen, R; Cook, A R; Lim, A; Ong, B; Balm, M; Ng, T M; Hsu, L Y

2013-10-01

Meticillin-resistant Staphylococcus aureus (MRSA) has been entrenched in Singapore hospitals since the 1980s, with an excess of 600 non-duplicate cases of infections (120 bacteraemia episodes) each year in our 995-bed university hospital. Approximately 5% of our hospital beds are used as isolation facilities. To study the impact of an MRSA control bundle that was implemented via gradual geographic extension across hospital wards. The bundle included active surveillance on admission and transfer/discharge to identify ward-based acquisition of MRSA, isolation and cohorting of MRSA-infected patients, enhanced hand hygiene initiatives, and publicly displayed feedback of MRSA acquisition and hand hygiene compliance rates. Implementation was between October 2006 and June 2010 in order to provide lead-time for the incremental development of infrastructural capacity, and to develop an ethic of infection prevention among staff. Results were analysed via interrupted time-series analysis. MRSA infections fell midway through the implementation, with MRSA bacteraemia declining from 0.26 [95% confidence interval (CI): 0.18-0.34] cases per 1000 inpatient-days in the first quarter of 2004 to 0.11 (95% CI: 0.07-0.19) cases per 1000 inpatient-days in the first quarter of 2012. MRSA acquisition rates fell a year after the programme had been fully implemented, whereas hand hygiene compliance rose significantly from 47% (95% CI: 44-49) in the first quarter of 2009 to 69% (95% CI: 68-71) in the first quarter of 2012. Successful staged implementation of an MRSA bundle in a hyper-endemic setting is sustainable and represents a model that may be adapted for similar settings. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

"Countability Not Answerability?" Accountability in Hong Kong and Singapore Universities

ERIC Educational Resources Information Center

Currie, Jan; Vidovich, Lesley; Yang, Rui

2008-01-01

Singapore and Hong Kong are vying to be the principal educational hub for the Asia-Pacific region and have begun to compete with Australia, Britain, Canada and the USA in providing cross-border education. Although these four Anglo-American countries still dominate cross-border education, Singapore and Hong Kong hope to make inroads into this…

English-Medium Instruction in Singapore Higher Education: Policy, Realities and Challenges

ERIC Educational Resources Information Center

Bolton, Kingsley; Botha, Werner; Bacon-Shone, John

2017-01-01

Within the Asian region, Singapore has long been seen as a leader within the field of higher education, with an unmatched record of success in implementing English-medium instruction (EMI) at all levels of education, including colleges and universities. This present study reports on a large-scale survey carried out at one of Singapore's major…

Translating the family medicine vision into educational programmes in Singapore.

PubMed

Wong, Teck Yee; Cheong, Seng Kwing; Koh, Gerald Ch; Goh, Lee Gan

2008-05-01

The core of the Family Medicine (FM) vision is patient-centred care, requiring specific education and vocational training. We traced how FM education started and what have been achieved. FM training began in 1971 with the formation of the College of General Practitioners Singapore. Previously, training consisted of self-directed learning, lunchtime talks and examination preparation courses run by hospital specialists. Formal FM vocational training programmes in the United Kingdom and Australia provided the model for a 3-year programme in 1988. The tripartite relationship between the local university, College of Family Physicians and Ministry of Health, together with a structured training programme, contributed to its success. To date, more than 240 Family Physicians in Singapore have been awarded the Masters in Medicine (FM) degree. The Graduate Diploma in Family Medicine programme (GDFM) was introduced in 2000 for Family Physicians who wished to practice at an enhanced level. This programme has trained 194 doctors since then. Behind the scenes, the following were important developments: counterculture with a difference, tripartite stake-holding, training the trainers and learning from others. For the FM undergraduate programme, our aim is to develop the knowledge base, core values and roles of the Family Physician. Sustaining the value of Family Medicine as a career choice is the enduring vision.

An Inclusion Initiative in Singapore for Preschool Children with Special Needs

ERIC Educational Resources Information Center

Yeo, Lay See; Neihart, Maureen; Tang, Hui Nee; Chong, Wan Har; Huan, Vivien S.

2011-01-01

This paper describes a preschool inclusion initiative in Singapore, which currently has no mandate for integrating children with special needs in mainstream schools. This very small-scale qualitative study involving children with mild learning disabilities discusses a therapy outreach programme by a local children's hospital. It explores the…

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…

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.

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.

Safety and cost savings of reducing adult dengue hospitalization in a tertiary care hospital in Singapore.

PubMed

Lee, Linda K; Earnest, Arul; Carrasco, Luis R; Thein, Tun L; Gan, Victor C; Lee, Vernon J; Lye, David C; Leo, Yee-Sin

2013-01-01

Previously, most dengue cases in Singapore were hospitalized despite low incidence of dengue hemorrhagic fever (DHF) or death. To minimize hospitalization, the Communicable Disease Centre at Tan Tock Seng Hospital (TTSH) in Singapore implemented new admission criteria which included clinical, laboratory, and DHF predictive parameters in 2007. All laboratory-confirmed dengue patients seen at TTSH during 2006-2008 were retrospectively reviewed for clinical data. Disease outcome and clinical parameters were compared over the 3 years. There was a 33.0% mean decrease in inpatients after the new criteria were implemented compared with the period before (p < 0.001). The proportion of inpatients with DHF increased significantly from 31.7% in 2006 to 34.4% in 2008 (p = 0.008); 68 DHF cases were managed safely on an outpatient basis after compared with none before implementation. DHF inpatients had more serious signs such as clinical fluid accumulation (15.5% vs 2.9% of outpatients), while most DHF outpatients had hypoproteinemia (92.7% vs 81.3% of inpatients). The eight intensive care unit admissions and five deaths during this time period all occurred among inpatients. The new criteria resulted in a median cost saving of US$1.4 million to patients in 2008. The new dengue admission criteria were effective in sustainably reducing length of hospitalization, yielding considerable cost savings. A minority of DHF patients with mild symptoms recovered uneventfully through outpatient management.

Postnatal experiences and support needs of first-time mothers in Singapore: a descriptive qualitative study.

PubMed

Ong, Shu Fen; Chan, Wai-Chi Sally; Shorey, Shefaly; Chong, Yap Seng; Klainin-Yobas, Piyanee; He, Hong-Gu

2014-06-01

to explore first-time mothers' postnatal experiences and support needs after hospital discharge in Singapore. a descriptive qualitative study was adopted in this study. Participants were recruited from a public tertiary hospital in Singapore. Semi-structured interviews were used for data collection and the interview transcripts were analysed using thematic analysis. a purposive sample of 13 English-speaking first-time mothers of age 21 years and above were interviewed within 7-11 days after their hospital discharge. five themes emerged from the thematic analysis: (1) mixed emotions: participants experienced anxiety, labile emotions and stress over infant care; (2) breast feeding concerns: low breast milk supply and physical discomfort; (3) social support: many participants had sufficient social support from family members except their husbands; (4) cultural postnatal practice: majority of participants followed traditional postnatal practices of their culture; and (5) professional support needs: participants needed more information, access to health care services and continuity of care. this study highlighted the importance of providing professional postnatal care to first-time mothers after their discharge from the hospital. Future studies are needed to explore new practices that will enhance the quality of maternity health care and promote positive maternal experiences and well-being in Singapore. there is a need for more innovative advertisement to promote antenatal classes and improve attendance rate. Health care providers should assist women in establishing proper breast feeding techniques. Alternative models of care in the postnatal period, such as midwifery-led care, could facilitate a more woman-centred approach. Postnatal home visits may be considered within the first week of the mothers' hospital discharge, which may be legislated by public health care policies. © 2013 Elsevier Ltd. 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.

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

Surface or Deep Change? How Is a Curriculum Change Implemented at Ground Level?

ERIC Educational Resources Information Center

Sng, Bee Bee

2008-01-01

Purpose: The purpose of this paper is to find out how organizational and contextual factors affect a curriculum change in a University in Singapore. There is a need to research the processes of educational change in Singapore as rapid changes can result in complex problems. The university is chosen as it is at the forefront of the government's…

A Cross-Cultural Examination of University Students' Motivation toward Band and Academics in Singapore and the United States

ERIC Educational Resources Information Center

Tan, Leonard; Miksza, Peter

2018-01-01

The purpose of the study was to investigate how university band students' (non--music majors) motivational goal orientations toward band and academics differ across participants from Singapore (n = 200) and the United States (n = 227) and examine how they relate to a suite of adaptive dispositions (i.e., flow, grit, and commitment) relevant for…

The Use of the Internet for Business: The Experience of Early Adopters in Singapore.

ERIC Educational Resources Information Center

Soh, Christina; Mah, Quee Yong; Gan, Fong Jek; Chew, Daniel; Reid, Edna

1997-01-01

A survey of Singapore-based firms in computer/information technology, hospitality, manufacturing, retail, travel, publishing, and banking/finance that use the Internet for business found that most of the respondents use the Internet for marketing and advertising, customer service and support, information gathering, and, to a lesser degree,…

Diarrheagenic pathogens in adults attending a hospital in Singapore.

PubMed

Chau, Man Ling; Hartantyo, Sri Harminda Pahm; Yap, Min; Kang, Joanne Su Lin; Aung, Kyaw Thu; Gutiérrez, Ramona Alikiiteaga; Ng, Lee Ching; Tam, Clarence C; Barkham, Timothy

2016-01-28

Singapore's diarrhoeal notification system is based on specific pathogens. Official data may thus be skewed towards notifiable diseases. Limited information is available on the profiles of aetiological agents responsible for acute gastroenteritis (AGE) cases, especially among the adult population. To understand the frequency and distribution of potential causative agents of diarrheal disease in Singapore, we screened adults' stool samples collected from a large public hospital. The stool samples were screened for 18 diarrheagenic pathogens using a combination of commercial multiplex polymerase chain reaction (PCR), in-house singleplex PCR and immunochromatographic assays. One hundred adult faecal samples that were collected from October 2013 to January 2014 for routine diagnostic purposes and submitted for culture at Tan Tock Seng Hospital, Singapore were used. Pathogens were detected in 32% of the samples. The predominant organisms encountered were norovirus genogroup II (11%), Aeromonas spp. (9%) and Campylobacter spp. (5%). One sample was positive for both verocytotoxigenic E. coli (VTEC) and E. coli O157:H7. Two other samples were positive for VTEC only, and one other sample was positive for E. coli O157:H7 only. Astrovirus, C. perfringens, Shigella spp. and toxigenic C. difficile were each detected in 2% of the samples. Cryptosporidium parvum, Giardia lamblia, group A rotavirus, Salmonella spp. and Vibrio spp. were each detected in 1% of the samples. No L. monocytogenes, Y. enterocolitica, enteric adenovirus, or norovirus genogroup I were detected. Our preliminary findings suggest that pathogens causing non-notifiable diseases might have contributed considerably to the adult hospitalised AGE cases. However, as the samples were from an adult hospital, the data obtained may not be representative of the whole community. Thus, a larger study to collect clinical samples and risk exposure data from primary healthcare clinics and children hospital is planned for, to gain a more holistic perspective on the epidemiology of AGE in Singapore. A larger study may also offer valuable insights for improving the approach of microbiological surveillance of food, as well as strategizing inspection efforts along the food supply chain by public health authorities.

Learning Needs of Hospitalized Patients With Heart Failure in Singapore: A Descriptive Correlational Study.

PubMed

Ong, Shu-Fen; Foong, Pamela Pei-Mei; Seah, Juanna Shen-Hwei; Elangovan, Lavanya; Wang, Wenru

2017-11-28

Understanding the learning needs of patients with heart failure (HF) is important in reducing the incidence of HF-related hospital readmissions. Sociocultural differences are known to influence patient learning needs. However, most HF learning needs studies have been conducted on Western populations. The aim of this study was to investigate the learning needs of hospitalized patients with HF in Singapore. A cross-sectional, descriptive correlational design was adopted using a questionnaire survey that included the Heart Failure Learning Needs Inventory and sociodemographic and clinical datasheets. A convenience sample of 97 patients with HF was recruited from an acute hospital in Singapore. Findings revealed that education topics relating to signs and symptoms, risk factors, general HF information, and medications were perceived by participants as the most important. Contrastingly, education topics relating to diet, activity, and psychological factors were poorly valued. The only significant demographic factor that was correlated to the patients' learning needs was monthly household income, which correlated to education on HF risk factors and general HF information. This study supports the necessity of carefully prioritizing patient education topics in line with patient learning needs. Furthermore, education should be culturally sensitive and take into account the unique values, needs, and situations of patients.

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.

Place of death and its determinants for patients with cancer in Singapore: an analysis of data from the Singapore Cancer Registry, 2000-2009.

PubMed

Hong, Ching Ye; Chow, Khuan Yew; Poulose, Jissy; Jin, Ai Zhen; Devi, Anju; Chee, Eddie Meng Fai; Goh, Cynthia

2011-10-01

To describe the place of death for patients with cancer in Singapore from 2000 to 2009, and determinants of death at home and in in-patient hospice compared to death in hospital. Cross-sectional analysis of all patients registered with the Singapore Cancer Registry who had died in the study period (N=52120). Places of death were grouped as homes, in-patient hospices, hospitals and others. For determinants of death at home and in in-patient hospice, covariates adjusted for in logistic regression analyses were age group, gender, ethnic group, primary tumour site, stage at diagnosis, duration and cause of death. In the 10-year period, 52.9% of patients with cancer had died in the hospital, 30.3% died at home and 10.7% in in-patient hospice. Determinants of death at home were older age, female (odds ratio OR 1.23, 95% confidence interval, CI 1.17-1.29), Malay (OR 2.28, 95% CI 2.13-2.44), cancers of the colo-rectum, liver, stomach, pancreas and nasopharynx (compared to lung cancer), duration of illness of 1-5 years (OR 1.40, 95% CI 1.34-1.48), primary cause of death being 'neoplasms' (OR 2.97, 95% CI 2.79-3.17). Determinants of death in in-patient hospice were older age, distant metastasis (OR 1.35, 95% CI 1.21-1.50) and primary cause of death being 'neoplasms' (OR 20.07, 95% CI 16.05-25.09). Knowledge about place of death and its determinants will facilitate the planning of healthcare services to enable patients with terminal cancer to die at home and in in-patient hospices, thereby avoiding inappropriate hospitalization at the end of life.

Emerging Education Hubs: The Case of Singapore

ERIC Educational Resources Information Center

Sidhu, Ravinder; Ho, K.-C.; Yeoh, Brenda

2011-01-01

In anticipation of a globalising post-Fordist political economy, countries and universities are increasingly pursuing strategic transnational education and research alliances. This article analyses the Global Schoolhouse, a key education policy platform that aims to transform Singapore into a knowledge and innovation hub by establishing networks…

Internationalization of MBA Programs in Asia-Pacific: Looking beyond Business Study Missions.

ERIC Educational Resources Information Center

Teck-Meng, Tan; And Others

1997-01-01

Internationalization of the curriculum in the Nanyang University (Singapore) master's program in business administration (MBA) is described, highlighting its parallels with formation of government policy initiatives that encourage regional expansion of Singapore businesses. Lessons learned from the internationalization experiences of MBA programs…

Gender Representation in Geography: Singapore. Symposium

ERIC Educational Resources Information Center

Yeoh, Brenda S. A.; Huang, Shirlena; Wong, Theresa

2004-01-01

In Singapore, geography emerged as a strongly masculinist university discipline during the interwar years under colonial rule. Localizing staff hires in the postcolonial era did not immediately produce gender-balanced staff profiles. Instead, a more equitable gender representation was achieved only in the last decade, following the increasing…

Englishising African Cultures: Revisiting Acculturated Forms of English in Botswana

ERIC Educational Resources Information Center

Bagwasi, Mompoloki Mmangaka

2014-01-01

Many "African English" researchers (see Kachru, B. B. (1983). "The Indianization of English." "The English language in India." Singapore: Singapore University Press.) have argued that when English is used in non-native environments, many aspects of its lexicon, grammar and pronunciation are modified and…

Seeking Resilience and Sustainability: Outdoor Education in Singapore

ERIC Educational Resources Information Center

Martin, Peter; Ho, Susanna

2009-01-01

Outdoor education is not a universal value. Rather, outdoor education's contributions need to be grounded in time, place and culture. In this paper we describe the historical and cultural milieu that has enabled the emergence of outdoor education in Singapore and report on exploratory survey research into Singaporean teachers' conceptions of…

Teaching Innovation and Entrepreneurship: Building on the Singapore Experiment

ERIC Educational Resources Information Center

Hampden-Turner, Charles

2009-01-01

Is it possible to teach someone to be an entrepreneur? Is innovation something that can be assessed and taught in a classroom? Teaching Innovation and Entrepreneurship answers these and other questions by focusing on a teaching experiment in Singapore at Nanyang Technological University, wherein classes of English-speaking Singaporeans and…

Higher Education in East Asia and Singapore: Rise of the Confucian Model

ERIC Educational Resources Information Center

Marginson, Simon

2011-01-01

The paper reviews Asia-Pacific higher education and university research, focusing principally on the "Confucian" education nations Japan, Korea, China, Hong Kong China, Taiwan, Singapore and Vietnam. Except for Vietnam, these systems exhibit a special developmental dynamism--still playing out everywhere except Japan--and have created a…

Compulsory Education in Singapore--Who Benefits?

ERIC Educational Resources Information Center

Tan, Jason

2010-01-01

Compulsory education was legislated in Singapore in 2000. This came several decades after the attainment of universal primary education and after numerous assertions on the part of the government that such legislation was unnecessary. Also interesting is that the period of compulsory education was limited to six years. The article discusses the…

A 17-Month Review of the Care Model, Service Structure, and Design of THRIVE, a Community Mental Health Initiative in Northern Singapore.

PubMed

Cheang, K M; Cheok, C C S

2015-12-01

Effective delivery of psychiatric care requires the development of a range of services. The existing Singapore health care system provides a comprehensive range of psychiatric services based in restructured hospitals. The Ministry of Health Community Mental Health Masterplan (2012-2017) aims to build novel services for the community. This Masterplan envisions the development of ASCATs (Assessment Shared Care Teams) and COMITs (Community Intervention Teams) to build the capacity and capability for psychiatric care to be delivered outside the hospital in the community. A community mental health plan comprising a fast access clinic, internet-delivered self-help and building a community network of providers was devised for the North of Singapore through the THRIVE (Total Health Rich In Vitality and Energy) programme. This article provides an introduction to the care model, service structure and design of the THRIVE, and reviews its milestones and achievements from its inception in August 2012 until December 2013.

Are University Students in Singapore Meeting the International and National Recommended Daily Servings of Fruits and Vegetables?

PubMed

Lim, Raymond Boon Tar; Tham, Dede Kam Tyng; Müller-Riemenschneider, Falk; Wong, Mee Lian

2017-04-01

Data are lacking on fruit and vegetable (FV) consumption among young adults in the Asia-Pacific region. The aim of this study is to assess the prevalence of students who met the international and national recommendation of daily consumption of 5 and 4 FV servings, respectively, in a university in Singapore and the factors associated with meeting the national recommendation. A cross-sectional survey using proportional stratified random sampling was conducted on 884 undergraduates in 2013. The prevalence of meeting the international and national recommendation was 13.6% and 27.1%, respectively. The significant factors of meeting national recommendation were those from higher socioeconomic status, those making conscious effort to eat food high in fiber, those not skipping breakfast, those having a lower frequency of deep fried food consumption and those with higher meal frequency. Behavioral and structural interventions to educate, motivate and nudge university students to promote FV consumption are required 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

English Language and Literature Academic Group at the National Institute of Education, Singapore

ERIC Educational Resources Information Center

Lee, Benny P. H.

2010-01-01

The National Institute of Education in Singapore (which is part of the Nanyang Technological University) is the leading national pre-service and in-service teacher training tertiary institution. It offers diploma, undergraduate and postgraduate programmes. The academic departments are called Academic Groups (AGs). The English Language and…

WebQuests and Collaborative Learning in Teacher Preparation: A Singapore Study

ERIC Educational Resources Information Center

Yang, Chien-Hui; Tzuo, Pei-Wen; Komara, Cecile

2011-01-01

This research project aimed to introduce WebQuests to train special education preservice teachers in Singapore. The following research questions were posed: (1) Does the use of WebQuests in teacher preparation promote special education teacher understanding on Universal Design for Learning in accommodating students with diverse learning needs? (2)…

Mobility and Desire: International Students and Asian Regionalism in Aspirational Singapore

ERIC Educational Resources Information Center

Collins, Francis L.; Sidhu, Ravinder; Lewis, Nick; Yeoh, Brenda S. A.

2014-01-01

Higher education is playing an important role in Singapore's most recent cycle of modernization: to re-make itself into a global city through the continued accumulation of capital, "talent," and knowledge. This paper is a critical analysis of the accounts of a group of international students enrolled at the National University of…

Singapore's Global Education Hub Ambitions: University Governance Change and Transnational Higher Education

ERIC Educational Resources Information Center

Mok, Ka Ho

2008-01-01

Purpose: The principal goal of the article is to examine how Singapore, one of the East Asian tiger economies, has attempted to diversify its higher education system by developing "transnational education" in the island state. Design/methodology/approach: With particular reference to the most recent education reforms and changing higher…

The Singapore-Cambridge General Certificate of Education Advanced-Level General Paper Examination

ERIC Educational Resources Information Center

Hassan, Nurul Huda; Shih, Chih-Min

2013-01-01

This article describes and reviews the Singapore-Cambridge General Certificate of Education Advanced Level General Paper (GP) examination. As a written test that is administered to preuniversity students, the GP examination is internationally recognised and accepted by universities and employers as proof of English competence. In this article, the…

Compilation of Theses Abstracts

DTIC Science & Technology

2004-12-01

Lieutenant, United States Navy Master of Business Administration–December 2004 Jonathan C. Byrom–Captain, United States Army Master of Business...Hyperspectral Imagery, Principal Components Analysis, Minimum Noise Transform ALTERNATE CONFIGURATIONS FOR BLOCKED-IMPURITY-BAND DETECTORS Jonathan C...Yew Sing Quek –Captain, Republic of Singapore Armed Forces B.E., Nanyang Technological University-Singapore, 1999 Master of Science in Combat

Experiences of adolescents living with cancer: A descriptive qualitative study.

PubMed

Ang, Sin Hui; Koh, Serena Siew Lin; Lee, Xiu Hua Hideka Tamamura; Shorey, Shefaly

2018-01-01

This study aimed to explore the experiences of adolescents from Singapore, aged 10-18 years old, living with cancer and their perceptions on how their psychosocial outcomes can be improved. A descriptive qualitative study design was used. Convenience sampling was used to recruit 10 participants from a pediatric oncology ward in a Singapore hospital. Individual semi-structured interviews were conducted. Thematic analysis was used to analyze the data. Five major themes emerged: (1) experience of physical symptoms, (2) emotional response to their condition, (3) changes in social dynamics, and (4) falling behind in academics. The psychosocial outcomes of Singaporean adolescents with cancer could be improved by thorough pain assessments and creating a more conducive hospital environment.

Current status of subfamily Ichneumoninae (Hymenoptera: Ichneumonidae) from Malaysia and Singapore

NASA Astrophysics Data System (ADS)

Norhafiza, A. F.; Idris, A. B.

2013-11-01

In this paper, 25 genera and 38 species under 10 tribes (Alomyini, Compsophorini, Goedartiini, Heresiarchini, Ichneumonini, Ischnojoppini, Joppocryptini, Listrodromini, Oedicephalini and Platylabini) of the subfamily Ichneumoninae housed in the Centre for Insect Systematics, UKM and Raffles Museum of Biodiversity Research (National University of Singapore) are reported from Malaysia and Singapore. The tribe Heresiarchini has the greatest number of species (13) followed by Ichneumonini with six species. Imeria is the largest genus which contains five species recorded. Six species in this study are new records for Malaysia.

Hepatitis E in Singapore: A Case-Series and Viral Phylodynamics Study.

PubMed

Teo, Esmeralda Chi-Yuan; Tan, Boon-Huan; Purdy, Michael A; Wong, Pui-San; Ting, Pei-Jun; Chang, Pik-Eu Jason; Oon, Lynette Lin-Ean; Sue, Amanda; Teo, Chong-Gee; Tan, Chee-Kiat

2017-04-01

AbstractThe incidence of hepatitis E in Singapore appears to be increasing. A retrospective case-series study of patients diagnosed with hepatitis E in a tertiary hospital from 2009 to 2013 was conducted. Of 16 cases, eight (50%) were solid-organ transplant recipients (SOTRs), and 14 (88%) were found infected by genotype 3 hepatitis E virus (HEV-3). Bayesian inferences based on HEV subgenomic sequences from seven cases suggest that HEV-3 strains were introduced to Singapore as two principal lineages. Within limitations of the study, it can be inferred that one lineage, in the 3efg clade, emerged about 83 years ago, probably originating from Japan, whereas the other, in the 3abchij clade, emerged about 40 years ago, from the United States. Establishment and subsequent transmissions of strains from these two lineages likely contribute to the current endemicity of hepatitis E in Singapore.

Nursing management of aggression in a Singapore emergency department: A qualitative study.

PubMed

Tan, Mei Fen; Lopez, Violeta; Cleary, Michelle

2015-09-01

In Singapore, anecdotal evidence suggests that nurses are concerned about managing aggressive incidents in the emergency department. In this study, registered nurses' perceptions of managing aggressive patients in an emergency department were explored. Ten registered nurses from the emergency department of an acute public hospital in Singapore were interviewed. Four overarching themes emerged from the thematic analysis: (i) impact of aggressive patients on nurses; (ii) nursing assessment of aggressive behaviors; (iii) nursing management of aggressive behaviors; and (iv) organizational support and responsiveness. Further research is required to better support nurses to deliver optimal care for aggressive patients and achieve positive and effective outcomes. © 2015 Wiley Publishing Asia Pty Ltd.

Review of Doctoral Research in English Language Education in the Philippines, Singapore and Malaysia (2007-2010)

ERIC Educational Resources Information Center

Rubdy, Rani; Tupas, T. Ruanni F.; Villareal, Corazon D.; David, Maya Khemlani; Dumanig, Francisco Perlas

2012-01-01

This review highlights recent doctoral research in English language education and related areas completed between 2007 and 2010 in three countries in Southeast Asia: Singapore, Malaysia and the Philippines. Out of sixty dissertations initially chosen from major universities in these countries, five from the Philippines, four from Malaysia and…

Chemistry Teaching: Impact of Educational Research on the Practices of Chemistry Teachers in Singapore

ERIC Educational Resources Information Center

Tan, Kim Chwee Daniel; Gilbert, John K.

2014-01-01

This paper reports the findings of a study which investigated the role that educational research plays in influencing 29 Singapore pre-university (Grades 11 and 12) and secondary (Grades 9 and 10) chemistry teachers' curricular and instructional decision-making process. Twenty-five teachers were interviewed while four preferred to submit written…

Perceived Effects of Sexually Explicit Internet Content: The Third-Person Effect in Singapore.

ERIC Educational Resources Information Center

Wu, Wei; Koo, Soh Hoon

2001-01-01

Investigates the third-person effect of pornography on the Internet. Notes that congruent with the third-person effect, students from a major Singapore university judged pornographic material on the Internet to have a greater impact on others than on themselves. Reveals evidence for a perceived social distance corollary with children to be more…

Hybridity, the Developmental State and Globalisation: The Case of Singapore's Universities

ERIC Educational Resources Information Center

Loke, Hoe Yeong; Chia, Yeow-Tong; Gopinathan, S.

2017-01-01

This article revisits Gopinathan's and Lee's and Gopinathan's arguments about the relationship and role of the developmental state and education in the era of globalisation. The paper first discusses the role and impact of the developmental state and globalisation on Singapore's higher education since 1990 to set the context. Drawing upon…

Cross-Cultural and Global Interdependency Development in STEM Undergraduate Students: Results from Singapore Study Abroad Program

ERIC Educational Resources Information Center

Alexis, Frank; Casco, M.; Martin, J.; Zhang, G.

2017-01-01

The goal of study abroad programs is to educate and train future global leaders. This article examines the effectiveness of Clemson University's Singapore Study Abroad program in meeting this goal by exposing students to global perspectives of science technology, engineering and math (STEM) research and learning through an international summer…

An Outcomes Study on the Effects of the Singapore General Hospital Burns Protocol.

PubMed

Liang, Weihao; Kok, Yee Onn; Tan, Bien Keem; Chong, Si Jack

2018-01-01

The Singapore General Hospital Burns Protocol was implemented in May 2014 to standardize treatment for all burns patients, incorporate new techniques and materials, and streamline the processes and workflow of burns management. This study aims to analyze the effects of the Burns Protocol 2 years after its implementation. Using a REDCap electronic database, all burns patients admitted from May 2013 to April 2016 were included in the study. The historical preimplementation control group composed of patients admitted from May 2013 to April 2014 (n = 96). The postimplementation prospective study cohort consisted of patients admitted from May 2014 to April 2016 (n = 243). Details of the patients collected included age, sex, comorbidities, total body surface area (TBSA) burns, time until surgery, number of surgeries, number of positive tissue and blood cultures, and length of hospital stay. There was no statistically significant difference in the demographics of both groups. The study group had a statistically significant shorter time to surgery compared with the control group (20.8 vs 38.1, P < 0.0001). The study group also averaged fewer surgeries performed (1.96 vs 2.29, P = 0.285), which, after accounting for the extent of burns, was statistically significant (number of surgeries/TBSA, 0.324 vs 0.506; P = 0.0499). The study group also had significantly shorter length of stay (12.5 vs 16.8, P = 0.0273), a shorter length of stay/TBSA burns (0.874 vs 1.342, P = 0.0101), and fewer positive tissue cultures (0.6 vs 1.3, P = 0.0003). The study group also trended toward fewer positive blood culture results (0.09 vs 0.35, P = 0.0593), although the difference was just shy of statistical significance. The new Singapore General Hospital Burns Protocol had revolutionized Singapore burns care by introducing a streamlined, multidisciplinary burns management, resulting in improved patient outcomes, lowered health care costs, and improved system resource use.

Integrating Ancient Nanyin Music within an Interdisciplinary and National Education School-Wide Curriculum: An Australian-Singaporean Collaborative Arts Education Project

ERIC Educational Resources Information Center

Leong, Samuel

2005-01-01

This article describes a school-wide arts education project that incorporates an interdisciplinary approach involving an Australian university, the Singapore Ministry of Education, the Singapore National Arts Council, a community music association, and a local primary school. The Project engages young school children with Nanyin music, an ancient…

The Singapore Heart Failure Outcomes and Phenotypes (SHOP) study and Prospective Evaluation of Outcome in Patients with Heart Failure with Preserved Left Ventricular Ejection Fraction (PEOPLE) study: rationale and design.

PubMed

Santhanakrishnan, Rajalakshmi; Ng, Tze P; Cameron, Vicky A; Gamble, Greg D; Ling, Lieng H; Sim, David; Leong, Gerard Kui Toh; Yeo, Poh Shuan Daniel; Ong, Hean Yee; Jaufeerally, Fazlur; Wong, Raymond Ching-Chiew; Chai, Ping; Low, Adrian F; Lund, Mayanna; Devlin, Gerry; Troughton, Richard; Richards, A Mark; Doughty, Robert N; Lam, Carolyn S P

2013-03-01

Heart failure (HF) with preserved ejection fraction (EF) accounts for a substantial proportion of cases of HF, and to date no treatments have clearly improved outcome. There are also little data comparing HF cohorts of differing ethnicity within the Asia-Pacific region. The Singapore Heart Failure Outcomes and Phenotypes (SHOP) study and Prospective Evaluation of Outcome in Patients with Heart Failure with Preserved Left Ventricular Ejection Fraction (PEOPLE) study are parallel prospective studies using identical protocols to enroll patients with HF across 6 centers in Singapore and 4 in New Zealand. The objectives are to determine the relative prevalence, characteristics, and outcomes of patients with HF and preserved EF (EF ≥50%) compared with those with HF and reduced EF, and to determine initial data on ethnic differences within and between New Zealand and Singapore. Case subjects (n = 2,500) are patients hospitalized with a primary diagnosis of HF or attending outpatient clinics for management of HF within 6 months of HF decompensation. Control subjects are age- and gender-matched community-based adults without HF from Singapore (n = 1,250) and New Zealand (n = 1,073). All participants undergo detailed clinical assessment, echocardiography, and blood biomarker measurements at baseline, 6 weeks, and 6 months, and are followed over 2 years for death or hospitalization. Substudies include vascular assessment, cardiopulmonary exercise testing, retinal imaging, and cardiac magnetic resonance imaging. The SHOP and PEOPLE studies are the first prospective multicenter studies defining the epidemiology and interethnic differences among patients with HF in the Asia-Oceanic region, and will provide unique insights into the pathophysiology and outcomes for these patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Perioperative glycaemic control in diabetic patients undergoing cataract surgery under local anaesthesia: a survey of practices of Singapore ophthalmologists and anaesthesiologists.

PubMed

Woo, Jyh Haur; Ng, Wei Di; Salah, Maaz Mohammad; Neelam, Kumari; Au Eong, Kah-Guan; Kumar, Chandra Mohan

2016-02-01

Perioperative glycaemic control is an important aspect of clinical management in diabetic patients undergoing cataract surgery under local anaesthesia. While poor long-term glycaemic control has significant implications for surgery, perioperative hypoglycaemia or hyperglycaemia may also compromise patient safety and surgical outcomes. We aimed to survey ophthalmologists and anaesthesiologists on their approach and to identify the prevalent practice patterns in Singapore. This was a cross-sectional questionnaire-based survey conducted in four public hospitals in Singapore with established ophthalmology and anaesthesia units. Respondents were approached individually, and the self-administered questionnaires comprised questions related to practice patterns, clinical scenarios and awareness of pre-existing guidelines. A total of 129 doctors responded to the questionnaire survey. 76 (58.9%) were from ophthalmology departments and 53 (41.1%) were from anaesthesia departments. The majority chose to withhold oral hypoglycaemic agents (82.9%) and/or insulin (69.8%), and keep the patient fasted preoperatively. A blood glucose level ≥ 17 mmol/L prompted 86.0%-93.8% of respondents to adopt a treat-and-defer strategy, while a level ≥ 23 mmol/L prompted 86.0%-96.9% of respondents to cancel the cataract surgery. The respondents were consistently more concerned about perioperative hyperglycaemia (n = 99, 76.7%) than intraoperative hypoglycaemia (n = 83, 64.3%). The current study presented the prevalent practice patterns of ophthalmologists and anaesthesiologists in the perioperative management of diabetic patients undergoing cataract surgery in four public hospitals in Singapore. Further research in this field is required, and may be useful for the future formulation of formal guidelines and protocols. Copyright © Singapore Medical Association.

Design and development of a novel balancer with variable difficulty for training and evaluation.

PubMed

Ang, W T; Tan, U-X; Tan, H G; Myo, T; Ng, C K; Koh, K L; Cheam, B S

2008-11-01

This paper presents a novel, portable and cost-effective balance trainer with the necessary important features to improve the reach of rehabilitation to the masses. There are three factors that contribute to a person's ability to maintain standing balance: Proprioceptive feedback (from the joints), vision, and the vestibular system. These systems can be affected by injury, infection, or brain damage caused by stroke. One example of such injuries is ankle injury. A large focus of the physiotherapy and sports medicine community is using postural-control tasks to prevent, assess and rehabilitate patients. Unfortunately, there are presently two extreme ends of balance training devices. On one end, there is high-end equipment which only large hospitals are capable of buying. On the other end are the simple balance boards which offer limited features. To develop the new balance trainer - the Pro.Balance - therapists at the Singapore General Hospital drafted a new 'wish list' of requirements. The prototype was built at the Nanyang Technological University, Singapore, and was commercialized by Lab Rehab Pte Ltd as the Pro.Balance. The device has a small footprint, incorporating only the most important and frequently used functions. These functions include being able to provide different levels of difficulty, setting different difficulties in different directions, the storing of a patient's performance, real-time visual feedback to aid the patient and different types of modes for different purposes. Springs are used to vary the amount of supporting moments, thus varying the difficulty levels. This paper describes the design and features of the Pro.Balance.

Intra-articular glucocorticoid injections in patients with juvenile idiopathic arthritis in a Singapore hospital.

PubMed

Leow, Olivia Min Yi; Lim, Lee Kean; Ooi, Pei Ling; Shek, Lynette Pei Chi; Ang, Elizabeth You Ning; Son, Mary Beth

2014-05-01

This study aimed to evaluate the efficacy and safety of intra-articular glucocorticoid (IAG) injections in our institution in children with juvenile idiopathic arthritis (JIA). This is a retrospective assessment of IAG injections performed by the Department of Paediatrics, National University Hospital, Singapore, from October 2009 to October 2011. A total of 26 procedures were evaluated for efficacy, considering parameters such as clinical response, changes in systemic medication, length of time between repeat injections, safety, consent-taking, pre- and post-procedural advice, compliance with aseptic technique, and post-procedural complications. A total of 26 IAG injections of triamcinolone hexacetonide were administered over 17 occasions (i.e. patient encounters) to ten patients with JIA during the study period. After the injections, clinical scoring by a paediatric rheumatologist showed overall improvement by an average of 2.62 points out of 15. Besides six patient encounters that had an increase in systemic medication on the day of the injection, five required an increase within six months post injection, two required no adjustments, and one resulted in a decrease in medications. In all, 21 injections did not require subsequent injections. The mean interval between repeat injections was 7.8 months. Cutaneous side effects were noted in three anatomically difficult joints. Medical documentation with regard to patient progress was found to be lacking. As per the recommendations of the American College of Rheumatology, we safely used IAG injections as the first-line therapy in our group of patients with oligoarticular JIA, and/or as an adjunct to systemic therapy in our patients with JIA.

Intra-articular glucocorticoid injections in patients with juvenile idiopathic arthritis in a Singapore hospital

PubMed Central

Leow, Olivia Min Yi; Lim, Lee Kean; Ooi, Pei Ling; Shek, Lynette Pei Chi; Ang, Elizabeth You Ning; Son, Mary Beth

2014-01-01

INTRODUCTION This study aimed to evaluate the efficacy and safety of intra-articular glucocorticoid (IAG) injections in our institution in children with juvenile idiopathic arthritis (JIA). METHODS This is a retrospective assessment of IAG injections performed by the Department of Paediatrics, National University Hospital, Singapore, from October 2009 to October 2011. A total of 26 procedures were evaluated for efficacy, considering parameters such as clinical response, changes in systemic medication, length of time between repeat injections, safety, consent-taking, pre- and post-procedural advice, compliance with aseptic technique, and post-procedural complications. RESULTS A total of 26 IAG injections of triamcinolone hexacetonide were administered over 17 occasions (i.e. patient encounters) to ten patients with JIA during the study period. After the injections, clinical scoring by a paediatric rheumatologist showed overall improvement by an average of 2.62 points out of 15. Besides six patient encounters that had an increase in systemic medication on the day of the injection, five required an increase within six months post injection, two required no adjustments, and one resulted in a decrease in medications. In all, 21 injections did not require subsequent injections. The mean interval between repeat injections was 7.8 months. Cutaneous side effects were noted in three anatomically difficult joints. Medical documentation with regard to patient progress was found to be lacking. CONCLUSION As per the recommendations of the American College of Rheumatology, we safely used IAG injections as the first-line therapy in our group of patients with oligoarticular JIA, and/or as an adjunct to systemic therapy in our patients with JIA. PMID:24862747

Singapore: Bridgehead of the West or Counterforce? The S[t]imulation of Creative and Critical Thought in Singapore's Higher Education Policies

ERIC Educational Resources Information Center

Hoofd, Ingrid

2010-01-01

This paper argues that the welcoming by western humanists of pedagogies of critical and creative thinking in Asian universities--as if such thinking will breed an eastern counter-voice to western neo-liberalism--is misguided. The paper will question the rise of creative and critical thinking in higher education in Asia by analysing the…

International Ergonomics Association Activities and Constituent Societies

DTIC Science & Technology

1988-05-01

science, home economics, psychology and social science. The research papers presented at the annual meeting reflect this broad range of interests...of health of the Polish population, general problems of social and human development, as well as ergonomic issues in architecture, design, and the...Ergonomics Society C. N. Ong Department of Social Medicine and Public Health National University of Singapore Lower Kent Ridge Road Singapore 0511

Reflective Dialogues in Community Music Engagement: An Exploratory Experience in a Singapore Nursing Home and Day-Care Centre for Senior Citizens

ERIC Educational Resources Information Center

Lum, Chee-Hoo

2011-01-01

This study documents a reflective journey of a community music programme initiated by a university music education faculty member and an occupational therapist within the setting of a nursing home and day-care centre in Singapore. Weekly music interaction sessions in conjunction with reminiscence therapy were conducted over a period of five…

Academics as Part-Time Marketers in University Offshore Programs: An Exploratory Study

ERIC Educational Resources Information Center

Poole, David; Ewan, Craig

2010-01-01

Australian universities maintain almost 900 offshore programs delivered to more than 100 000 students, primarily in the nations of Singapore, Malaysia, China, and Hong Kong (Universities Australia, 2009; IDP, 2009a). Although offshore students comprise an estimated 30 per cent of international student enrolments at Australian universities (IDP,…

Plant Viruses and Mycoplasmas. Proceedings of a Workshop on Plant Viruses and Mycoplasmas Held at the Botany Department, National University of Singapore, Singapore, May 24-27, 1983.

ERIC Educational Resources Information Center

Lim, G., Ed.; And Others

A workshop on plant viruses and mycoplasmas brought together scientists and researchers working on these microorganisms in the countries of eastern Asia, and enabled them to discuss their studies, to exchange ideas, and to become familiar with their counterparts These proceedings of the workshop contain papers which include country reports,…

Developing an Instrument for Self-Evaluation of Teaching and Learning Competencies: A Review of Faculty Professional Development and the Changing Higher Education Landscape in Singapore

ERIC Educational Resources Information Center

Cheong, Grace

2017-01-01

This paper forms part of a doctoral study focused on the development and validation of an instrument for the self-evaluation of teaching and learning competencies for the purpose of faculty professional development. The rapid expansion of the higher education sector in Singapore has called for new approaches to university teaching that are…

Association between preoperative anaemia with length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a single-centre retrospective study.

PubMed

Abdullah, Hairil Rizal; Sim, Yilin Eileen; Hao, Ying; Lin, Geng Yu; Liew, Geoffrey Haw Chieh; Lamoureux, Ecosse L; Tan, Mann Hong

2017-06-08

Studies in western healthcare settings suggest that preoperative anaemia is associated with poor outcomes after elective orthopaedic surgery. We investigated the prevalence of preoperative anaemia among patients with primary unilateral total knee arthroplasty (TKA) in Singapore and its association with length of hospital stay (LOS), perioperative blood transfusion and hospital readmission rates. Retrospective cohort study performed in a tertiary academic medical centre in Singapore, involving patients who underwent primary unilateral TKA between January 2013 and June 2014. Demographics, comorbidities, preoperative haemoglobin (Hb) level, LOS and 30-day readmission data were collected. Anaemia was classified according to WHO definition. Prolonged LOS was defined as more than 6 days, which corresponds to >75th centile LOS of the data. We analysed 2394 patients. The prevalence of anaemia was 23.7%. 403 patients (16.8%) had mild anaemia and 164 patients (6.8%) had moderate to severe anaemia. Overall mean LOS was 5.4±4.8 days. Based on multivariate logistic regression, preoperative anaemia significantly increased LOS (mild anaemia, adjusted OR (aOR) 1.71, p<0.001; moderate/severe anaemia, aOR 2.29, p<0.001). Similar effects were seen when preoperative anaemia was defined by Hb level below 13 g/dL, regardless of gender. Transfusion proportionately increased prolonged LOS (1 unit: aOR 2.12, p=0.006; 2 or more units: aOR 6.71, p<0.001). Repeat operation during hospital stay, previous cerebrovascular accidents, general anaesthesia and age >70 years were associated with prolonged LOS. Our 30-day related readmission rate was 1.7% (42) cases. Anaemia is common among patients undergoing elective TKA in Singapore and is independently associated with prolonged LOS and increased perioperative blood transfusion. We suggest measures to correct anaemia prior to surgery, including the use of non-gender-based Hb cut-off for establishing diagnosis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Association of Prehypertension With Meals Eaten Away From Home in Young Adults in Singapore.

PubMed

Seow, Dominique Y B; Haaland, Benjamin; Jafar, Tazeen H

2015-10-01

Elevated blood pressure (BP) during early life years is associated with future risk of hypertension and cardiovascular morbidity and mortality. This study aimed to determine the prevalence and lifestyle factors associated with prehypertension (systolic BP (SBP) 120-139 mm Hg and/or diastolic BP (DBP) 80-89 mm Hg) or hypertension (SBP ≥ 140 mm Hg and/or DBP ≥ 90 mm Hg or on antihypertensive medications) among young adults at a Singapore university. A cross-sectional survey of 501 university-going young adults aged 18-40 years in Singapore was conducted using convenience sampling. Data on BP, body mass index (BMI), and lifestyle factors (meals eaten away from home/week, physical activity) was collected, and their association with prehypertension or hypertension was determined. Prehypertension was found in 27.4% (95% confidence interval (95% CI) = 24-32) of the population: 49% (44-58) in men and 9% (6-13) in women (P < 0.001). 2.2% (1.2-3.9) had hypertension. In a multivariable model, those with prehypertension or hypertension tended to eat more meals away from home per week (per meal/week odds ratio (OR) = 1.05, 95% CI = 1.01-1.09), have higher BMI (per kg/m2 OR = 1.15, 95% CI = 1.02-1.30), and low physical activity (low vs. moderate/high activity OR = 2.14, 95% CI = 1.20-3.82). Other associates were male gender (OR = 7.01, 95% CI = 3.97-12.4) and older age (per year OR = 1.06, 95% CI = 1.01-1.11). Prehypertension may be common among university-going young adults in Singapore and is associated with potentially preventable lifestyle factors. Our findings call for large-scale population-based studies, including lifestyle modification trials for prevention of hypertension among young adults in Singapore. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Globalization and Academic Work in Singapore. RIHE International Seminar Reports. No. 23

ERIC Educational Resources Information Center

Ho, Kong Chong; Kang, Trivina

2015-01-01

East Asian higher education has experienced an important shift by it's national universities to pay increasing attention to rankings in the wake of globalization. This critical feature influences inter-university competition for resources, faculty and students. During this process, these universities have restructured their organizations and…

Interview with Brian Tomlinson on Humanising Education

ERIC Educational Resources Information Center

Nimehchisalem, Vahid

2016-01-01

Brian Tomlinson is a Visiting Professor at The University of Liverpool and a Teaching English to Speakers of Other Languages (TESOL) Professor at Anaheim University. He has worked as a teacher, teacher trainer, curriculum developer, university academic and soccer coach in Indonesia, Japan, Nigeria, Oman, Singapore, Vanuatu, UK and Zambia and has…

High prevalence of missed opportunities for secondary fracture prevention in a regional general hospital setting in Singapore.

PubMed

Gani, Linsey; Reddy, Saripalli K; Alsuwaigh, Rayan; Khoo, Joan; King, Thomas F J

2017-12-01

This study aims at assessing the gap in secondary fracture prevention at a regional general hospital setting in Singapore. Male patients have significantly lower rate of being investigated and treated for osteoporosis than their female counterparts. Vitamin D deficiency is prevalent in our population. Secondary fracture prevention services are not routine in Singapore; we seek to assess the treatment gap that exists in the lack of diagnosis and treatment of osteoporosis in fragility fracture patients. We performed a retrospective analysis of all admissions for fragility fractures between December 2013 and December 2014. Demographic data, rates of BMD performance, serum vitamin D investigation and calcium and vitamin D supplementation as well as antiresorptive initiation 1 year post admission were analysed. There were 125 fragility fractures in patients below 65 and 615 fractures in older patients. There was a slightly higher proportion of males in the younger population, whereas females predominated in the older population. Median vitamin D levels were low in both younger (19.1 μg/L) and older (22.0 μg/L) groups, but supplementation was lower in younger patients (4.8 versus 16.6%, p = 0.003). Rate of BMD performance was lower in younger patients (34.4 versus 64.6%, p < 0.01); there was a significant difference of BMD performance between male and female patients in the younger population (19.1 versus 52.8%, p < 0.01) which was not present in the older age group. Antiresportive initiation was significantly lower in the younger age group versus older (10.4 versus 31.5%, p < 0.01); male patients in the younger and older age groups had significantly lower antiresorptive initiation rate compared to the females. There is a significant treatment gap in diagnosis and treatment of osteoporosis in fragility fracture patients in a regional hospital setting in Singapore. Male osteoporosis remains inadequately investigated and treated in both age groups.

Navy Carrier Battle Groups: The Structure and Affordability of the Future Force

DTIC Science & Technology

1993-02-01

Embassy, Tokyo, Japan U.S. Embassy, Kuala Lumpur, Malaysia U.S. Embassy, Singapore U.S. Embassy, Bangkok, Thailand U.S. Embassy, Ankara, Turkey U.S...Ministry of Foreign Affairs Malaysia Institute of Strategic and International Studies, Kuala Lumpur University of Malaysia , Kuala Lumpur Singapore...1591 1992 Calendar year Mediterraniean Sao - Western Pacific Ocean " Nestl Indian 0asan/Arabian Seam WOO I Total Note: Because theso deployment levels

Serotype Distribution and Antimicrobial Resistance of Streptococcus pneumoniae Isolates from Pediatric Patients in Singapore

PubMed Central

Soh, Shirlena Wee-Ling; Poh, Chit Laa; Lin, Raymond V. Tzer Pin

2000-01-01

One hundred eighty Streptococcus pneumoniae strains isolated from children at a pediatric hospital in Singapore from 1997 to 1999 were serotyped and their antimicrobial susceptibility patterns were determined. Sixty-three percent of the isolates were resistant to penicillin. Significantly large numbers of the strains investigated were resistant to trimethoprim-sulfamethoxazole (87.8%), tetracycline (71.7%), erythromycin (67.8%), and chloramphenicol (40%). Penicillin and multidrug resistance was mostly associated with the frequently isolated S. pneumoniae isolates of serotypes (serotypes 19F, 23F, 6B, and 14). Isolates of serotype 19F, the serotype most commonly encountered in Singapore (41.1%), had the highest prevalence of penicillin (78.4%) and multidrug resistance (94.6%). Most of the invasive S. pneumoniae isolates (8 of 17; 47.1%) were of serotype 14. PMID:10898701

The clinical profile of patients with anorexia nervosa in Singapore: a follow-up descriptive study

PubMed Central

Kuek, Angeline; Utpala, Ranjani; Lee, Huei Yen

2015-01-01

INTRODUCTION 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. METHODS 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. RESULTS 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/m2, 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. CONCLUSION 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. PMID:26106239

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.

Clinical and economic impact of school-based nonavalent human papillomavirus vaccine on women in Singapore: a transmission dynamic mathematical model analysis.

PubMed

Tay, S K; Hsu, T-Y; Pavelyev, A; Walia, A; Kulkarni, A S

2018-03-01

To examine the epidemiological and economic impact of a nine-valent (nonavalent) human papillomavirus (HPV) 6/11/16/18/31/33/45/52/58 vaccine programme for young teenagers in Singapore. Mathematical modelling. Pharmaco-economic simulation projection. Singapore demography. Clinical, epidemiological and financial data from Singapore were used in a validated HPV transmission dynamic mathematical model to analyse the impact of nonavalent HPV vaccination over quadrivalent and bivalent vaccines in a school-based 2-dose vaccination for 11- to 12-year-old girls in the country. The model assumed routine cytology screening in the current rate (50%) and vaccine coverage rate of 80%. Changes over a 100-year time period in the incidence and mortality rates of cervical cancer, case load of genital warts, and incremental cost-effectiveness ratio (ICER). Compared with bivalent and quadrivalent HPV vaccination programmes, nonavalent HPV universal vaccination resulted in an additional reduction of HPV31/33/45/52/58 related CIN1 of 40.5%, CIN 2/3 of 35.4%, cervical cancer of 23.5%, and cervical cancer mortality of 20.2%. Compared with bivalent HPV vaccination, there was an additional reduction in HPV-6/11 related CIN1 of 75.7%, and genital warts of 78.9% in women and 73.4% in men. Over the 100 years, after applying a discount of 3%, disease management cost will be reduced by 32.5% (versus bivalent) and 7.5% (versus quadrivalent). The incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year gained was SGD 929 compared with bivalent vaccination and SGD 9864 compared with quadrivalent vaccination. Universal two-dose nonavalent HPV vaccination for 11- to 12-year-old adolescent women is very cost-effective in Singapore. Nonavalent HPV vaccination of 11- to 12-year-old girls is cost-effective in Singapore. © 2017 Royal College of Obstetricians and Gynaecologists.

Formula one night race in Singapore: a 4-year analysis of a planned mass gathering.

PubMed

Ho, Weng Hoe; Koenig, Kristi L; Quek, Lit Sin

2014-10-01

Every mass gathering presents its unique characteristics that influence medical resource utilization. Medical planning for mass gatherings involves both use of predictive models and analysis of data from similar past events. This study aimed to describe the medical presentations and the unique challenges influencing medical planning at the Formula One Singtel Singapore Grand Prix, the inaugural Formula One night race. Patient presentation characteristics, rates of patient presentation, and transportation to hospitals in association with attendance and heat index were evaluated over a 4-year period from 2009 through 2012. This will facilitate medical planning for similar events. A database containing patient presentations from the 3-day Singapore Grand Prix in 2009, 2010, 2011, and 2012 was analyzed. Patient presentations were categorized by time of day and presenting complaints. Patient presentation rates (PPRs) were analyzed to determine correlation with attendance numbers and heat index. The average annual attendance at the Singapore Grand Prix was 81,992 from 2009 through 2012. The average PPR was 2.17 (SD=0.63)/1,000 attendees. The average transport to hospital rate (TTHR) was 0.033 (SD=0.026)/1,000 attendees. While medical coverage was provided at the circuit park between 2:00 pm to 1:00 am daily, most attendees presented from 5:00 pm to 10:00 pm. The most common presenting complaints included: musculoskeletal conditions (59%) and heat related illnesses (19%). There was no correlation between attendance numbers and PPR and the heat index and PPR. Musculoskeletal conditions and heat-related illnesses were the most common presenting complaints at the Singapore Grand Prix from 2009-2012. The lack of correlation between heat index and PPR is a new finding compared with prior studies. This could be due to the minimal heat variation that occurred during the night event. Further study is required to refine models that can be used in specialized events.

East Meets West--Online.

ERIC Educational Resources Information Center

Feller, Gordon

1995-01-01

Nanyang University (Singapore) and a university in the People's Republic of China have made arrangements with MIT's Sloan School of Management to launch a graduate level business administration (MBA) program that uses the Internet. The project centers on combining videoconferencing with asynchronous communications tools. A sidebar provides names…

Comparisons of the interactions of health care delivery and medico-legal practice between Australia and Singapore.

PubMed

Kandiah, D

2006-09-01

Australia and Singapore have similar standards of health care. The one major difference in the two health care systems is the cost to the patient at the point of care. The Medicare system in Australia provides partial to complete subsidy for health care delivery in the public hospitals. In Singapore, the patient has to bear the cost of their health care when needed, with some government subsidies. Studies in the variations between two health care systems, where the costs to the government and individuals are clearly dissimilar, but the health outcomes are similar, can be educational for health law specialists. The methods in which patients obtain recompense for their grievances can help both countries understand how to determine and improve standards of health care communication. Having worked in both systems, the relative values of each and their effects on medical litigation will be discussed.

Thematic Analysis of Medical Notes Offers Preliminary Insight into Precipitants for Asian Suicide Attempters: An Exploratory Study.

PubMed

Choo, Carol C; Ho, Roger C; Burton, André A D

2018-04-20

One important dynamic risk factor for suicide assessment includes suicide precipitant. This exploratory study used a qualitative paradigm to look into the themes surrounding precipitants for suicide attempts in Singapore. Medical records related to suicide attempters who were admitted to the emergency department of a large teaching hospital in Singapore over a three year period were subjected to analysis. A total of 666 cases were examined (69.2% females; 63.8% Chinese, 15% Malays, 15.8% Indians), ages ranged from 10 years old to 85 years old (Mean = 29.7, Standard Deviation = 16.1). The thematic analysis process that was applied to the textual data elicited key concepts labelled as Relationship issues, Financial strain, Socio-legal-academic—environmental stress, and Physical and mental illness and pain. Interpreted with other recent local research on suicide attempters in Singapore, the findings have implications for informing suicide interventions.

Industrial accident-related ocular emergencies in a tertiary hospital in Singapore.

PubMed

Ngo, C S; Leo, S W

2008-04-01

We present a review of industrial accident-related ocular trauma, from the perspective of the emergency setting of a tertiary hospital in Singapore. A retrospective analysis of patients seen by Tan Tock Seng Hospital's emergency ophthalmology service over a six-month period was performed. Data on clinical presentation, cause of injury, use of protective eyewear and subsequent losses of days-of-work were collected via a standardised telephone interview and review of case-sheets. A total of 300 persons presented with a diagnosis of industrial accident-related ocular trauma, out of the 1,460 patients seen during the study period. 95.7 percent were non-residents and the average age was 31 years. 99.3 percent were males. 66.0 percent were provided with protective eyewear, while 44.7 percent of those were non-compliant. The most common types of injuries were superficial foreign body (71.3 percent), chemical injury (10 percent) and blunt trauma (4 percent), while severe injury requiring admission and emergency surgery occurred in 15 cases. Average loss of days of work was 3.4 days. Industrial accident-related ocular trauma comprises a relatively large proportion of the patients requiring ophthalmic review at the emergency service level in Singapore. These patients are mainly young, non-resident men and the injuries were generally minor. These are largely preventable with the use of well-fitting protective eyewear and strict compliance. This would greatly reduce the unnecessary loss of workdays. Therefore, there is a need to review the design, and reinforce the strict implementation of occupational eye safety programmes, especially among non-resident workers.

One size fits all? Challenges faced by physicians during shift handovers in a hospital with high sender/recipient ratio

PubMed Central

Yang, Xi Jessie; Park, Taezoon; Siah, Tien Ho Kewin; Ang, Bee Leng Sophia; Donchin, Yoel

2015-01-01

INTRODUCTION The aim of the present study was to investigate the challenges faced by physicians during shift handovers in a university hospital that has a high handover sender/recipient ratio. METHODS We adopted a multifaceted approach, comprising recording and analysis of handover information, rating of handover quality, and shadowing of handover recipients. Data was collected at the general medical ward of a university hospital in Singapore for a period of three months. Handover information transfer (i.e. senders’ and recipients’ verbal communication, and recipients’ handwritten notes) and handover environmental factors were analysed. The relationship between ‘to-do’ tasks and information transfer, handover quality and handover duration was examined using analysis of variance. RESULTS Verbal handovers for 152 patients were observed. Handwritten notes on 102 (67.1%) patients and handover quality ratings for 98 (64.5%) patients were collected. Although there was good task prioritisation (information transfer: p < 0.005, handover duration: p < 0.01), incomplete information transfer and poor implementation of non-modifiable identifiers were observed. The high sender/recipient ratio of the hospital made face-to-face and/or bedside handover difficult to implement. Although the current handover method (i.e. use of telephone communication) allowed for interactive communication, it resulted in systemic information loss due to the lack of written information. The handover environment was chaotic in the high sender/recipient ratio setting, and the physicians had no designated handover time or location. CONCLUSION Handovers in high sender/recipient ratio settings are challenging. Efforts should be made to improve the handover processes in such situations, so that patient care is not compromised. PMID:25532519

University Builders.

ERIC Educational Resources Information Center

Pearce, Martin

This publication explores a diverse collection of new university buildings. Ranging from the design of vast new campuses, such as that by Wilford and Stirling at Temasek, Singapore, through to the relatively modest yet strategically important, such as the intervention by Allies and Morrison at Southampton, this book examines the new higher…

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.

Perioperative glycaemic control in diabetic patients undergoing cataract surgery under local anaesthesia: a survey of practices of Singapore ophthalmologists and anaesthesiologists

PubMed Central

Woo, Jyh Haur; Ng, Wei Di; Salah, Maaz Mohammad; Neelam, Kumari; Eong, Kah-Guan Au; Kumar, Chandra Mohan

2016-01-01

INTRODUCTION Perioperative glycaemic control is an important aspect of clinical management in diabetic patients undergoing cataract surgery under local anaesthesia. While poor long-term glycaemic control has significant implications for surgery, perioperative hypoglycaemia or hyperglycaemia may also compromise patient safety and surgical outcomes. We aimed to survey ophthalmologists and anaesthesiologists on their approach and to identify the prevalent practice patterns in Singapore. METHODS This was a cross-sectional questionnaire-based survey conducted in four public hospitals in Singapore with established ophthalmology and anaesthesia units. Respondents were approached individually, and the self-administered questionnaires comprised questions related to practice patterns, clinical scenarios and awareness of pre-existing guidelines. RESULTS A total of 129 doctors responded to the questionnaire survey. 76 (58.9%) were from ophthalmology departments and 53 (41.1%) were from anaesthesia departments. The majority chose to withhold oral hypoglycaemic agents (82.9%) and/or insulin (69.8%), and keep the patient fasted preoperatively. A blood glucose level ≥ 17 mmol/L prompted 86.0%–93.8% of respondents to adopt a treat-and-defer strategy, while a level ≥ 23 mmol/L prompted 86.0%–96.9% of respondents to cancel the cataract surgery. The respondents were consistently more concerned about perioperative hyperglycaemia (n = 99, 76.7%) than intraoperative hypoglycaemia (n = 83, 64.3%). CONCLUSION The current study presented the prevalent practice patterns of ophthalmologists and anaesthesiologists in the perioperative management of diabetic patients undergoing cataract surgery in four public hospitals in Singapore. Further research in this field is required, and may be useful for the future formulation of formal guidelines and protocols. PMID:26892742

Burnout, psychological morbidity and use of coping mechanisms among palliative care practitioners: A multi-centre cross-sectional study.

PubMed

Koh, Mervyn Yong Hwang; Chong, Poh Heng; Neo, Patricia Soek Hui; Ong, Yew Jin; Yong, Woon Chai; Ong, Wah Ying; Shen, Mira Li Juan; Hum, Allyn Yin Mei

2015-07-01

The prevalence of burnout, psychological morbidity and the use of coping mechanisms among palliative care practitioners in Singapore have not been studied. We aimed to study the prevalence of burnout and psychological morbidity among palliative care practitioners in Singapore and its associations with demographic and workplace factors as well as the use of coping mechanisms. This was a multi-centre, cross-sectional study of all the palliative care providers within the public healthcare sector in Singapore. The study was conducted in hospital palliative care services, home hospice and inpatient hospices in Singapore. The participants were doctors, nurses and social workers. The prevalence of burnout among respondents in our study was 91 of 273 (33.3%) and psychological morbidity was 77 (28.2%). Working >60 h per week was significantly associated with burnout (odds ratio: 9.02, 95% confidence interval: 2.3-35.8, p = 0.002) and psychological morbidity (odds ratio: 7.21, 95% confidence interval: 1.8-28.8, p = 0.005). Home hospice care practitioners (41.5%) were more at risk of developing psychological morbidity compared to hospital-based palliative care (17.5%) or hospice inpatient care (26.0%) (p = 0.007). Coping mechanisms like physical well-being, clinical variety, setting boundaries, transcendental (meditation and quiet reflection), passion for one's work, realistic expectations, remembering patients and organisational activities were associated with less burnout. Our results reveal that burnout and psychological morbidity are significant in the palliative care community and demonstrate a need to look at managing long working hours and promoting the use of coping mechanisms to reduce burnout and psychological morbidity. © The Author(s) 2015.

Short-term poor glycemic control and retinal microvascular changes in pediatric Type 1 Diabetes patients in Singapore: a pilot study.

PubMed

Li, Ling-Jun; Lamoureux, Ecosse; Wong, Tien Yin; Lek, Ngee

2017-06-15

Poor glycemic control in Type 1 Diabetes (T1D) patients is strongly associated with an increased risk of diabetes-related microvascular complications later in life, but it is unclear whether short period of poor glycemic control in children with T1D can cause evident microvascular morphological changes long before any pathological manifestation. Our study aimed to investigate the longitudinal association between poor glycemic control and subsequent changes in retinal microvasculature, in a pilot study of 55 pediatric T1D patients from Singapore after a one-year follow-up. This is a hospital-based, exposure-matched and retrospective longitudinal study. A total of 55 T1D patients were included from Singapore KK Women's and Children Hospital, 28 of whom had poor glycemic control (average glycated hemoglobin [HbA1c] ≥8% during the year) while the other 27 age- and gender-matched subjects had good glycemic control (HbA1c <8%). Retinal photography was taken at diabetes annual screening and images were graded by trained graders using a semi-automated computer-based program (Singapore I Vessel Assessment [SIVA], version 4.0, Singapore Eye Research Institute, Singapore) and a spectrum of retinal vascular parameters (e.g. caliber, tortuosity, branching angle and fractal dimension) were measured quantitatively from 0.5 to 2.0 disc diameters. There was no significant difference in ethnicity, duration of T1D, blood pressure, body mass index (BMI) and low-density cholesterol lipoprotein (LDL) between the two groups. Retinal imaging was obtained at the end of 1 year of glycemic control assessment. In multiple linear regression adjusting for ethnicity, BMI, LDL and duration of T1D, patients with poor glycemic control tended to have marginally wider retinal arteriolar caliber (6.0 μm, 95% CI: -0.9, 12.8) and had significantly larger retinal arteriolar branching angle (10.1 degrees, 95% CI: 1.4, 18.9) compared with their age- and gender- matched counterparts with good glycemic control. Our findings showed that abnormal retinal microvascular morphology was evident in pediatric patients with T1D after one-year's poor glycemic control. Such morphological abnormalities may lead to future development of microvascular complications among T1D pediatric patients with poor glycemic control.

Characteristics of overdose and non-overdose suicide attempts in a multi-ethnic Asian society.

PubMed

Mak, Kwok Kei; Ho, Cyrus S H; Zhang, Melvyn W B; Day, Jeffrey R; Ho, Roger C M

2013-10-01

Overdosing is an accessible method adopted by people attempting suicide in city settings. This study aimed to compare the trends and characteristics of people attempting suicide by drug overdose and by other methods in Singapore. This study examined the medical records of 628 patients who were admitted to a university hospital in Singapore, between January 2004 and December 2006. Patients were classified as overdose and non-overdose persons attempting suicide for comparisons of demographic and suicidal characteristics. Logistic regression was used to determine the odds ratios of various factors associated with self-perceived lethality of the suicide attempt. Patterns of monthly and weekly variations in the frequencies of suicide attempts were also analyzed. The percentages of Chinese people was higher in the non-overdose group (71.5% vs. 62.9%), while the percentages of Malay and Indian people were higher in the overdose group (31.6% vs. 18.5%). The female gender (OR=0.36, p=0.04) and admission of suicide intention (OR=7.11, p<0.001) were significantly associated with higher perceived lethality of the suicide method in the non-overdose group. Suicide attempts occurred more frequently between May and November, and on Tuesdays. Gender and ethnic differences between overdose and non-overdose people attempting suicide were found. Temporal variations of suicidal cases were also noted. Copyright © 2013 Elsevier B.V. All rights reserved.

PREFACE: Preface

NASA Astrophysics Data System (ADS)

Luo, Qingming; Wang, Lihong V.; Tuchin, Valery V.

2011-02-01

The 9th International Conference on Photonics and Imaging in Biology and Medicine (PIBM 2010), combined with the 3rd Photonics and Optoelectronics Meetings (POEM 2010), was held from November 2-5, 2010, at Wuhan Science & Technology Convention & Exhibition Center, Wuhan, PR China. The present volume contains papers from a selection from the invited, oral, and poster presentations. PIBM is the largest international biomedical photonics conference series in Asia. It was initially held at HUST bi-yearly from 1999. After being held three times in Wuhan (1999, 2001 and 2003), it was hosted once in Tianjin (2005), before returning to Wuhan every year since 2006. PIBM is designed to bring together scientists, engineers and clinical researchers from a variety of disciplines engaged in applying optical science, photonics and imaging technologies to problems in biology and medicine. The scope of this conference ranges from basic research to instrumentation engineering, and biological and clinical studies. It is recognized as one of the largest and most comprehensive international conferences in China, and represents the highest level of worldwide research in this field. In the past ten years, 7 volumes of proceedings with a total of 672 papers were published by SPIE (International Society for Optical Engineering), and a volume with 75 papers was published by World Scientific Publishing Co. in 2007. Proceedings of PIBM 1999, 2001, 2003, 2005, 2006, 2008 and 2009 were indexed by EI Compendex, while proceedings of PIBM 1999, 2001, 2003, 2005, 2006, and 2007 were indexed by SCI. Some excellent papers were recommended for publication in the peer-reviewed Journal of Innovative Optical Health Sciences (JIOHS). An increasing number of young researchers present and exchange their innovative ideas on this friendly and professional platform, which has made PIBM an unforgettable annual meeting in Wuhan. This year PIBM attracted distinguished scholars in the field of biomedical photonics and imaging from all over the world, including the United States, Russia, Australia, Canada, Israel, France, Ireland, Japan, Korea and China. The major topics covered at the conference and presented in this volume include: Photonic Therapeutics, Diagnostics and Instrumentations; Tissue Optics and Laser Tissue Interaction; Biomedical Spectroscopy and Microscopy; Multimodal and Hybrid Biomedical Imaging; and Optical Molecular Imaging. The conference voted for the three best student papers; awards were presented to the participant students whose posters were recognized as excellent and who took part in the oral presentation competition. The conference received 133 submitted abstracts, and this volume of the Journal of Physics: Conference Series includes a selection of 53 excellent submissions. The Conference Secretariat and Local Organizing Committee deserve recognition for planning a smoothly run and productive conference with comprehensive, instructive lectures and innovative work displayed in poster presentations. The faculties and students from Britton Chance Center for Biomedical Photonics were dedicated to their work in reception and service during the conference. It is a pleasure to thank all of them for their efficient and hard work. We are also grateful for the financial support from 111 Project (B07038), and the assistance in organization and coordination from Wuhan National Laboratory for Optoelectronics and Huazhong University of Science and Technology. Finally, we would like to thank all the authors for their contributions to PIBM 2010 and all the members of the Committees for their cooperation and time spent reviewing submissions. Special thanks are due to the Advisory Committee members Shu Chien, Aaron Ciechanover, Steve Dahms, Da Hsuan Feng, Steven R Goodman, Brian Salzberg, Fujia Yang, Jianquan Yao, Baoyong Zheng and Olivia Ho Cheng for their participation on-site, and their significant contributions to the conference. Wuhan, PR ChinaDecember, 2010 Qingming LuoLihong V WangValery V TuchinConference Chairs 9th International Conference on Photonics and Imaging in Biology and Medicine (PIBM 2010)2-5 November 2010Wuhan, China EditorsQingming Luo, Huazhong University of Science and Technology (China)Lihong V Wang , Washington University in St. Louis (USA)Valery V Tuchin, Saratov State University (Russia) Sponsored and Organized byHuazhong University of Science and Technology (China)Wuhan National Laboratory for Optoelectronics (China)Britton Chance Center for Biomedical Photonics (China) Technical Co-sponsored byIBOS-International Biomedical Optics SocietyThe Chinese Optical SocietyThe Biophysical Society of China Co-organized byKey Laboratory of Biomedical Photonics, Ministry of Education (China)Virtual Research Center of Biomedical Photonics, Ministry of Education (China)Hubei Bioinformatics and Molecular Imaging Key Laboratory (China) CONFERENCE COMMITTEES Honorary ChairsBritton Chance, University of Pennsylvania (USA)Bingkun Zhou, Tsinghua University (China) Conference ChairsQingming Luo, Huazhong University of Science and Technology (China)Lihong V Wang , Washington University in St. Louis (USA)Valery V Tuchin, Saratov State University (Russia) Advisory CommitteeSydney Brenner, The Salk Institute in La Jolla, California (USA)Howard Chen, K&L Gates (USA)Jing Cheng, Tsinghua University (China)Shu Chien, University of California, San Diego (USA)Paul Ching-Wu Chu, University of Houston (USA)Aaron Ciechanover, Technion-Israel Institute of Technology, Haifa (Israel)A Stephen Dahms, Alfred E Mann Foundation for Biomedical Engineering (USA)Da Hsuan Feng, National Cheng Kung University (Taiwan, China)Steven R Goodman, SUNY Upstate Medical University (USA)Barry Halliwell, National University of Singapore (Singapore)John Hart, The University of Texas at Dallas (USA)George Radda, Agency for Science, Technology and Research (A*STAR) (Singapore)Zihe Rao, Nankai University (China)Brian M Salzberg, University of Pennsylvania (USA)Ruey-Jen Sung, Stanford University (USA)A Dean Sherry, The University of Texas at Dallas (USA)Bruce Tromberg, University of California/Irvine (USA)Fujia Yang, Nottingham University (UK)Jianquan Yao, Tianjin University (China)Yixin Zeng, Sun Yat-sen University Cancer Center (China)Baoyong Zheng, Hua Wei Technologies Corporation, Inc (China) Program CommitteeWei R Chen, University of Central Oklahoma (USA)Zhongping Chen, University of California/Irvine (USA)Arthur Chiou, National Yang-Ming University (Taiwan, China)Frank Y S Chuang, University of California, Davis (USA)Zhihua Ding, Zhejiang University (China)Congwu Du, Brookhaven National Laboratory (USA)Stefan Haacke, Strasbourg University - IPCMS-DON (France)Weiping Han, Agency for Science, Technology and Research (A*STAR) (Singapore)Zheng Huang, University of Colorado Health Sciences Center (USA)Zhiwei Huang, National University of Singapore (Singapore)Steven L Jacques, Oregon Health & Science University (USA)Fu-Jen Kao, National Yang-Ming University (Taiwan, China)Hideaki Koizumi, Hitachi, Ltd (Japan)Xingde Li, Johns Hopkins University (USA)Yong-qing Li, East Carolina University (USA)Chengyi Liu, South China Normal University (China)Hong Liu, University of Oklahoma (USA)Zuhong Lu, Southeast University (China)Dennis L Matthews, University of California/Davis (USA)Avraham Mayevsky, Bar Ilan University (Israel)Stephen P Morgan, University of Nottingham (UK)Shoko Nioka, University of Pennsylvania (USA)Yingtian Pan, State University of New York at Stony Brook (USA)Alexander V Priezzhev, MV Lomonosov Moscow State University (Russia)Jianan Y Qu, The Hongkong University of Science and Technology (Hong Kong, China)Colin J R Sheppard, National University of Singapore (Singapore)Mamoru Tamura, Tsinghua University (China)Sergey Ulyanov, Saratov State University (Russia)Ruikang K Wang, Oregon Health & Science University (USA)Xunbin Wei, Fudan University (China)Da Xing, South China Normal University (China)Haishan Zeng, BC Cancer Research Centre (Canada)Gang Zheng, University of Toronto (Canada)Dongping Zhong, The Ohio State University (USA) Organizing CommitteeLing Fu (Chair), Huazhong University of Science and Technology (China)Yuandi Zhao (Chair), Huazhong University of Science and Technology (China)Hui Gong, Huazhong University of Science and Technology (China)Pengcheng Li, Huazhong University of Science and Technology (China)Bifeng Liu, Huazhong University of Science and Technology (China)Qian Liu, Huazhong University of Science and Technology (China)Shaoqun Zeng, Huazhong University of Science and Technology (China)Zhihong Zhang, Huazhong University of Science and Technology (China)Dan Zhu, Huazhong University of Science and Technology (China) Local SecretariatHua Shi, Huazhong University of Science and Technology (China)

An Investigation on the Scientific Thinking Ability of Fourth Year University Students.

ERIC Educational Resources Information Center

Boo, Hong-Kwen; Toh, Kok-Aun

1998-01-01

Fourth-year university students (n=12) in a secondary-science-education degree program in Singapore were interviewed after demonstrations of five familiar chemical reactions. The majority of interviewees used perceptually-dominated rather than conceptually-dominated thinking and were unable to use scientific concepts consistently across the five…

The Internationalization of Higher Education in East Asia: A Comparative Ethnographic Narrative of Japanese Universities

ERIC Educational Resources Information Center

Howe, Edward R.

2009-01-01

How is Japan becoming "internationalized"? A common response is "through student mobility". But can Japanese universities continue to attract thousands of East Asian students annually, given increasing competition from other Pacific Rim nations like Australia, South Korea and Singapore? Japan's "internationalization",…

Online Health Education on SARS to University Students during the SARS Outbreak

ERIC Educational Resources Information Center

Wong, Mee Lian; Koh, David; Iyer, Prasad; Seow, Adeline; Goh, Lee Gan; Chia, Sin Eng; Lim, Meng Kin; Ng, Daniel; Ong, Choon Nam; Phua, Kai Hong; Tambyah, Paul; Chow, Vincent T K; Chew, Suok Kai; Chandran, Ravi; Lee, Hin Peng

2005-01-01

Little is known about how online learning may be used to disseminate health information rapidly and widely to large university populations if there is an infectious disease outbreak. During the SARS outbreak in Singapore in 2003, a six-lesson elearning module on SARS was developed for a large university population of 32,000 students. The module…

Impact of a hospital-wide hand hygiene promotion strategy on healthcare-associated infections.

PubMed

Ling, Moi Lin; How, Kue Bien

2012-03-23

During the Severe Acute Respiratory Syndrome (SARS) outbreak, high compliance in healthcare workers to hand hygiene was primarily driven by fear. However, the post-SARS period confirmed that this practice was not sustainable. At the Singapore General Hospital, a 1,600-bedded acute tertiary care hospital, the hand hygiene program was revised in early 2007 following Singapore's signing of the pledge to the World Health Organization (WHO) "Clean Care is Safer Care" program. A multi-prong approach was used in designing the hand hygiene program. This included system change; training and education; evaluation and feedback; reminders in the workplace; and institutional safety climate. Hand hygiene compliance rate improved from 20% (in January 2007) to 61% (2010). Improvement was also seen annually in the compliance to each of the 5 moments as well as in all staff categories. Healthcare-associated MRSA infections were reduced from 0.6 (2007) to 0.3 (2010) per 1000 patient-days. Leadership's support of the program evidenced through visible leadership presence, messaging and release of resources is the key factor in helping to make the program a true success. The hospital was recognised as a Global Hand Hygiene Expert Centre in January 2011. The WHO multi-prong interventions work in improving compliance and reducing healthcare associated infections.

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.

Effectiveness of a Technology-Based Supportive Educational Parenting Program on Parental Outcomes in Singapore: Protocol for a Randomized Controlled Trial.

PubMed

Shorey, Shefaly; Ng, Yvonne Peng Mei; Siew, An Ling; Yoong, Joanne; Mörelius, Evalotte

2018-01-10

Supportive educational programs during the perinatal period are scarce in Singapore. There is no continuity of care available in terms of support from community care nurses in Singapore. Parents are left on their own most of the time, which results in a stressful transition to parenthood. There is a need for easily accessible technology-based educational programs that can support parents during this crucial perinatal period. The aim of this study was to describe the study protocol of a randomized controlled trial on a technology-based supportive educational parenting program. A randomized controlled two-group pretest and repeated posttest experimental design will be used. The study will recruit 118 parents (59 couples) from the antenatal clinics of a tertiary public hospital in Singapore. Eligible parents will be randomly allocated to receive either the supportive educational parenting program or routine perinatal care from the hospital. Outcome measures include parenting self-efficacy, parental bonding, postnatal depression, social support, parenting satisfaction, and cost evaluation. Data will be collected at the antenatal period, immediate postnatal period, and at 1 month and 3 months post childbirth. Recruitment of the study participants commenced in December 2016 and is still ongoing. Data collection is projected to finish within 12 months, by December 2017. This study will identify a potentially clinically useful, effective, and cost-effective supportive educational parenting program to improve parental self-efficacy and bonding in newborn care, which will then improve parents' social support-seeking behaviors, emotional well-being, and satisfaction with parenting. It is hoped that better supported and satisfied parents will consider having more children, which may in turn influence Singapore's ailing birth rate. International Standard Randomized Controlled Trial Number (ISRCTN): 48536064; https://www.isrctn.com/ISRCTN48536064 (Archived by WebCite at http://www.webcitation.org/6wMuEysiO). ©Shefaly Shorey, Yvonne Peng Mei Ng, An Ling Siew, Joanne Yoong, Evalotte Mörelius. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 10.01.2018.

The multi-facets of sustainable nanotechnology - Lessons from a nanosafety symposium.

PubMed

George, Saji; Ho, Shirley S; Wong, Esther S P; Tan, Timothy Thatt Yang; Verma, Navin Kumar; Aitken, Robert J; Riediker, Michael; Cummings, Christopher; Yu, Liya; Wang, Zheng Ming; Zink, Daniele; Ng, Zhihan; Loo, Say Chye Joachim; Ng, Kee Woei

2015-05-01

An international symposium for nanosafety was held recently at the Nanyang Technological University in Singapore. Topics relating to understanding nanomaterial properties, tools, and infrastructure required for predicting hazardous outcomes, measuring nanomaterial exposure levels, systems approach for risk assessment and public's perception of nanotechnology were covered. The need for a multidisciplinary approach, across both natural and social sciences, for developing sustainable nanotechnology solutions was heavily emphasized. This commentary highlights the major issues discussed and the commitment of the nanosafety research community in Singapore to contribute collectively to realise the vision of sustainable nanotechnology.

Diagnostic performance of short portable mental status questionnaire for screening dementia among patients attending cognitive assessment clinics in Singapore.

PubMed

Malhotra, Chetna; Chan, Angelique; Matchar, David; Seow, Dennis; Chuo, Adeline; Do, Young Kyung

2013-07-01

The Short Portable Mental Status Questionnaire (SPMSQ) is a brief cognitive screening instrument, which is easy to use by a healthcare worker with little training. However, the validity of this instrument has not been established in Singapore. Thus, the primary aim of this study was to determine the diagnostic performance of SPMSQ for screening dementia among patients attending outpatient cognitive assessment clinics and to assess whether the appropriate cut-off score varies by patient's age and education. A secondary aim of the study was to map the SPMSQ scores with Mini-Mental State Examination (MMSE) scores. SPMSQ and MMSE were administered by a trained interviewer to 127 patients visiting outpatient cognitive assessment clinics at the Singapore General Hospital, Changi General Hospital and Tan Tock Seng Hospital. The geriatricians at these clinics then diagnosed these patients with dementia or no dementia (reference standard). Sensitivity and specificity of SPMSQ with different cut-off points (number of errors) were calculated and compared to the reference standard using the Receiver Operator Characteristic (ROC) analysis. Correlation coefficient was also calculated between MMSE and SPMSQ scores. Based on the ROC analysis and a balance of sensitivity and specificity, the appropriate cut-off for SPMSQ was found to be 5 or more errors (sensitivity 78%, specificity 75%). The cut-off varied by education, but not by patient's age. There was a high correlation between SPMSQ and MMSE scores (r = 0.814, P <0.0001). Despite the advantage of being a brief screening instrument for dementia, the use of SPMSQ is limited by its low sensitivity and specificity, especially among patients with less than 6 years of education.

Does routine gowning reduce nosocomial infection and mortality rates in a neonatal nursery? A Singapore experience.

PubMed

Tan, S G; Lim, S H; Malathi, I

1995-11-01

A 1 year prospective study on routine gowning before entering a neonatal unit was conducted in a maternity hospital in Singapore. This study was done based on previous work by Donowitz, Haque and Chagla and Agbayani et al., as there have been no known studies done in Singapore. The aim of the study was to test the hypothesis that routine gowning before entering a neonatal nursery does not reduce nosocomial infection and mortality rate. A total of 212 neonates from the neonatal intensive care unit (NICU) and 1694 neonates from the neonatal special care unit (NSCU) were studied. Neonates admitted during the 1 year study were assigned to the gowning (control) and no routine gowning (trial) group on every alternate 2 months. The hospital infection control nurse provided data on nosocomial infection. The overall nosocomial infection rate in the NICU was 24% (25 of 104 admissions) during gowning periods compared to 16.6% (18 of 108 admissions) when plastic aprons were not worn before entry. In the NSCU, the overall infection rate was 1.5% (12 of 800 admissions) during gowning periods compared to 2.1% (19 of 894 admissions) when no gown was worn before entry. Results of the study found no significant differences in the incidences of nosocomial infection and mortality in the neonates. The cost of gowns used during the no routine gowning periods was S$2012.8 compared to S$3708 used during the routine gowning procedure. The investigators recommend that routine gowning before entering a neonatal unit is not essential and cost effective for the purpose of reducing infection. Rather the focus should be on adequate handwashing by all hospital personnel and visitors before handling neonates.

Carbon monoxide poisoning: a five year review at Tan Tock Seng Hospital, Singapore.

PubMed

Handa, P K; Tai, D Y H

2005-11-01

Carbon monoxide poisoning (COP) is one of the leading causes of death from poisoning worldwide. There is no published study of COP in Singapore so far. All patients admitted with the diagnosis of COP to Tan Tock Seng Hospital (TTSH) over 5 years from 1999 to 2003 were retrospectively reviewed. The diagnosis was based on a history of potential exposure to carbon monoxide (CO) and elevated levels of carboxyhaemoglobin (COHb). The causes, demographic data, clinical presentations, management and complications were analysed. There were 12 patients with COP. Their average age was 38.9 (+/-11.8) years, with a male-to-female ratio of 3:1. Accidental COP (58.3%) was more common than intentional COP (41.7%). The most common cause of accidental COP was smoke inhalation from a faulty vehicle. Gas stove was the most preferred source for intentional poisoning. Presenting features were headache (83.3%), confusion (83.3%), coma (12.7%) and agitation (8.3%). The mean COHb level on admission was 35.9% (+/-13.6). All were treated with 100% oxygen. All the patients achieved normal levels of COHb within 24 hours of admission. Two (16.7%) required intubation for airway protection as they were comatose on arrival, of which 1 presented with very high level of COHb (48.1%) and was the only patient to be treated with hyperbaric oxygen. Acute complications were globus pallidus infarction (16.6%), acute respiratory distress syndrome (8.3%) and myocardial ischaemia (8.3%). Most of the patients (91.7%) were discharged well from the hospital. One patient developed parkinsonism after a follow-up of 2 years. There were no deaths. COP is relatively uncommon in Singapore. It has a low rate of short- and long-term complications.

Evaluation of a practical expert defined approach to patient population segmentation: a case study in Singapore.

PubMed

Low, Lian Leng; Kwan, Yu Heng; Liu, Nan; Jing, Xuan; Low, Edwin Cheng Tee; Thumboo, Julian

2017-11-23

Segmenting the population into groups that are relatively homogeneous in healthcare characteristics or needs is crucial to facilitate integrated care and resource planning. We aimed to evaluate the feasibility of segmenting the population into discrete, non-overlapping groups using a practical expert and literature driven approach. We hypothesized that this approach is feasible utilizing the electronic health record (EHR) in SingHealth. In addition to well-defined segments of "Mostly healthy", "Serious acute illness but curable" and "End of life" segments that are also present in the Ministry of Health Singapore framework, patients with chronic diseases were segmented into "Stable chronic disease", "Complex chronic diseases without frequent hospital admissions", and "Complex chronic diseases with frequent hospital admissions". Using the electronic health record (EHR), we applied this framework to all adult patients who had a healthcare encounter in the Singapore Health Services Regional Health System in 2012. ICD-9, 10 and polyclinic codes were used to define chronic diseases with a comprehensive look-back period of 5 years. Outcomes (hospital admissions, emergency attendances, specialist outpatient clinic attendances and mortality) were analyzed for years 2012 to 2015. Eight hundred twenty five thousand eight hundred seventy four patients were included in this study with the majority being healthy without chronic diseases. The most common chronic disease was hypertension. Patients with "complex chronic disease" with frequent hospital admissions segment represented 0.6% of the eligible population, but accounted for the highest hospital admissions (4.33 ± 2.12 admissions; p < 0.001) and emergency attendances (ED) (3.21 ± 3.16 ED visits; p < 0.001) per patient, and a high mortality rate (16%). Patients with metastatic disease accounted for the highest specialist outpatient clinic attendances (27.48 ± 23.68 visits; p < 0.001) per patient despite their relatively shorter course of illness and high one-year mortality rate (33%). This practical segmentation framework can potentially distinguish among groups of patients, and highlighted the high disease burden of patients with chronic diseases. Further research to validate this approach of population segmentation is needed.

The Effectiveness of Orton-Gillingham-Based Instruction with Singaporean Children with Specific Reading Disability (Dyslexia)

ERIC Educational Resources Information Center

Hwee, Noel Chia Kok; Houghton, Stephen

2011-01-01

This article, written by Assistant Professor Noel Chia from the National Institute of Education, Nanyang Technological University, Singapore and Professor Stephen Houghton from the Centre for Child and Adolescent Related Disorders, University of Western Australia, reports an empirical evaluation of a one-year Orton-Gillingham instruction based…

English-Medium Instruction in Japanese Universities: Policy Implementation and Constraints

ERIC Educational Resources Information Center

Chin Leong, Patrick N. G.

2017-01-01

English-medium instruction (EMI) is gaining momentum in Japan as politicians constantly highlight the need for Japanese universities to cultivate students with English skills to participate in the global market. Adopting a framework on the failure of policy implementation [Schiffman, H. (2007). Tamil language policy in Singapore. The role of…

University Programme Preferences of High School Science Students in Singapore and Reasons that Matter in their Preferences: A Rasch analysis

NASA Astrophysics Data System (ADS)

Oon, Pey-Tee; Subramaniam, R.

2015-01-01

This study explored an under-researched area in science education-the university programmes preferred by high school students who take physical science subjects and the reasons that matter in their preferences. A total of 1,071 upper secondary and pre-university students in Singapore, who take physical science subjects among their range of subjects, participated in this study. A survey method was adopted and the Rasch model was used to analyse the data. Overall, Business Studies was ranked as the predominant choice; nonetheless, scientific programmes such as Science, Engineering, and Mathematics are generally still well liked by the students. When gender differences were examined, we found that students largely followed gender-typical programme preferences, in which males tend to incline towards Engineering while females tend to incline towards Arts and Social Sciences. Students prefer a university programme based on their individual interest and ability, with career aspiration and remuneration coming next. Interestingly, females place greater emphasis on career aspiration than males. Some implications of the study are discussed.

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 barriers to healthcare access for migrant workers. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Simulating Residential Demand in Singapore through Five Decades of Demographic Change

NASA Astrophysics Data System (ADS)

Davis, N. R.; Fernández, J.

2011-12-01

Singapore's rapid and well-documented development over the last half-century provides an ideal case for studying urban metabolism. Extensive data [1, 2] facilitate the modeling of historical dynamics of population and resource consumption. This paper presents an agent-based population model that simulates key demographic factors - number, size, and relative income of households - through fifty years of development in Singapore. This is the first step in a broader study linking demographic factors to residential demand for urban land, materials, water, and energy. Previous studies of the resource demands of housing stock have accounted for demographics by modifying the important population driver with a single, aggregated "lifestyle" term [3, 4]. However, demographic changes that result from development can influence the nature of the residential sector, and warrant a closer look. Increasing levels of education and affluence coupled with decreasing birth rates have yielded an aging population and changing family structures in Singapore [5]. These factors all contribute to an increasingly resource-intense residential sector. Singaporeans' elevated per capita income and life expectancy have created demand for larger household area, which means a growing percentage of available land must be dedicated to residential use [6]. While the majority of Singapore's housing is public - a strategy designed to maximize land use efficiency - residents are increasingly seeking private alternatives [7]. In the private sector, lower density housing puts even greater pressure on the finite supply of undeveloped land. Agent-based modeling is used to study the selected aspects of demography. The population is disaggregated into historical time-series distributions of age, family size, education, and income. We propose a simplified methodology correlating average education level with birth rate, and income to categorize households and establish housing unit demand. Aggregated lifestyle variables have proven useful for simulating past resource consumption in some cases, but demographic shifts are important causal factors in future demand that would not be captured by these simple terms. For this reason disaggregated population modeling provides better insight into the size and income distributions of households that ultimately drive residential resource consumption. References [1] Yearbook of Statistics Singapore. Dept. of Statistics, Ministry of Trade & Industry, 1960-2011. [2] HDB Annual Report. Housing & Development Board, Ministry of National Development, 1960-2011. [3] B. Muller, "Stock dynamics for forecasting material flows-case study for housing in the Netherlands," Ecol Econ, vol. 59, no. 1, pp. 142-156, 2006. [4] H. Bergsdal, et al., "Dynamic material flow analysis for Norway's dwelling stock," Build Res Inf, vol. 35, no. 5, pp. 557-570, 2007. [5] D. Phillips and H. Bartlett, "Aging trends-Singapore," J Cross Cult Gerontol, vol. 10, no. 4, pp. 349-356, 1995. [6] T. Wong and A. Yap, Four decades of transformation: Land use in Singapore, 1960-2000. Eastern University Press, 2004. [7] -, "From universal public housing to meeting the increasing aspiration for private housing in Singapore," Habitat Int, vol. 27, no. 3, pp. 361-380, 2003.

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.

A descriptive quantitative study on multi-ethnic patient satisfaction with nursing care measured by the Revised Humane Caring Scale.

PubMed

Goh, Mien Li; Ang, Emily N K; Chan, Yiong-Huak; He, Hong-Gu; Vehviläinen-Julkunen, Katri

2016-08-01

To determine patients' satisfaction with nursing care during hospitalization. Limited studies reporting patients' satisfaction with quality of nursing care in Singapore. A descriptive study was conducted in a tertiary hospital in Singapore. Data were collected from 270 adult patients using the Revised Humane Caring Scale. Patients were moderately satisfied with the nursing care. There were significant differences of patients' level of satisfaction between/among socio-demographic subgroups including ethnicity, gender, reasons for admission and disciplines. Chinese patients were least satisfied with nursing care. The patients were most satisfied with 'Respecting patient's feeling' (mean=82.29, SD=14.50) and least satisfied with 'Communication and participation' (mean=62.00, SD=16.46). Our results reinforced the need to pay more attention to patient information provision and effective communication, which could improve patient satisfaction. The multi-ethnic patients valued respect as an influential attribute in quality nursing care. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of the patient safety Leadership Walkabout programme of a hospital in Singapore.

PubMed

Lim, Raymond Boon Tar; Ng, Benjamin Boon Lui; Ng, Kok Mun

2014-02-01

The Patient Safety Leadership Walkabout (PSLWA) programme is a commonly employed tool in the West, in which senior leaders visit sites within the hospital that are involved in patient care to talk to healthcare staff about patient safety issues. As there is a lack of perspective regarding PSLWA in Asia, we carried out an evaluation of its effectiveness in improving the patient safety culture in Tan Tock Seng Hospital, Singapore. A mixed methods analysis approach was used to review and evaluate all documents, protocols, meeting minutes, post-walkabout surveys, action plans and verbal feedback pertaining to the walkabouts conducted from January 2005 to October 2012. A total of 321 patient safety issues were identified during the study period. Of these, 308 (96.0%) issues were resolved as of November 2012. Among the various categories of issues raised, issues related to work environment were the most common (45.2%). Of all the issues raised during the walkabouts, 72.9% were not identified through other conventional methods of error detection. With respect to the hospital's patient safety culture, 94.8% of the participants reported an increased awareness in patient safety and 90.2% expressed comfort in openly and honestly discussing patient safety issues. PSLWA serves as a good tool to uncover latent errors before actual harm reaches the patient. If properly implemented, it is an effective method for engaging leadership, identifying patient safety issues, and supporting a culture of patient safety in the hospital setting.

Changes in the Singapore University Student Demand since the Currency Crash.

ERIC Educational Resources Information Center

Patton, Mark Allan

1999-01-01

Details what has happened to demand for overseas university education by Singaporeans since the economic crisis of 1997. The demand has risen over the last year, but fear of future economic conditions has caused students to switch their target preferences. Most students cannot afford to enroll in higher education programs in Europe and North…

The Relationship between Lattice Enthalpy and Melting Point in Magnesium and Aluminium Oxides. Science Notes

ERIC Educational Resources Information Center

Talbot, Christopher; Yap, Lydia

2013-01-01

This "Science Note" presents a study by Christopher Talbot and Lydia Yap, who teach IB Chemistry at Anglo-Chinese School (Independent), Republic of Singapore, to pre-university students. Pre-university students may postulate the correlation between the magnitude of the lattice enthalpy compound and its melting point, since both…

The Strategic Positioning of Australian Research Universities in the East Asian Region

ERIC Educational Resources Information Center

Marginson, Simon

2015-01-01

Regional tendencies in higher education are increasingly important, for example the common rise of North-East Asian universities in China, Hong Kong SAR, Taiwan and South Korea, and Singapore in South-East Asia, to a major global role, following the prior trajectory of Japan. Though the rapidly modernizing Post-Confucian countries do not…

Writing for International Publication: An Interview with Nugrahenny T. Zacharias, Handoyo P. Widodo and Willy A. Renandya

ERIC Educational Resources Information Center

Floris, Flora Debora

2012-01-01

Three productive TESOL scholars from Indonesia: Nugrahenny T. Zacharias of Satya Wacana Christian University, Handoyo Puji Widodo of Politeknik Negeri Jember, and Willy A. Renandya, who currently works at the National Institute of Education, Nanyang Technological University, Singapore, were interviewed to not only showcase their work, but also…

Global Learning Partnerships in "the Café": Peer Feedback as a Formative Assessment Tool for Animation Students

ERIC Educational Resources Information Center

McCarthy, Josh

2016-01-01

This paper reports on a global learning partnership using "the Café: the collaborative application for education" as an e-learning environment within the Facebook framework, for first-year animation students at the University of South Australia (USA) in Australia and Nanyang Technological University in Singapore. "The Café" has…

The Self-Perceptions of Young Men as Singers in Singaporean Pre-University Schools

ERIC Educational Resources Information Center

Freer, Patrick K.; Tan, Leonard

2014-01-01

The persistence of young men in choral singing activity has been widely studied in North America, with emerging parallel research in Europe (Freer, 2013; Harrison & Welch, 2012). There has been little such research in Asia. This study, of 12 young men enrolled in Singapore's pre-university schools, collected both written narratives and drawn…

The Quest for Innovation and Entrepreneurship: The Changing Role of University in East Asia

ERIC Educational Resources Information Center

Mok, Ka Ho

2012-01-01

This article critically reviews the national innovation systems of the four little tigers in East Asia, namely Hong Kong, Singapore, Taiwan and South Korea, in fostering R&D and technological research. A national innovation system is characterised by the interactions between the state, industries and universities in promoting innovation. This…

Effectiveness of Personal Protective Equipment and Isolation Precautions in Protecting Healthcare Workers from Acquiring Severe Acute Respiratory Syndrome

DTIC Science & Technology

2005-07-21

workers in Singapore. 9 Epidemiol Infect. 2004; 132:797-803. 0 - Q: Risk and protective factors for nosocomial transmission of SARS in Tan Tock Seng ...transmission include wearing of a mask and hand hygiene. In order to improve hospital preparedness for possible future disease outbreaks, efforts in... hospital laundry attendant in Taiwan who continued working in spite of worsening symptoms. Ultimately this one worker was responsible for at least

The multi-facets of sustainable nanotechnology – Lessons from a nanosafety symposium

PubMed Central

George, Saji; Ho, Shirley S.; Wong, Esther S. P.; Tan, Timothy Thatt Yang; Verma, Navin Kumar; Aitken, Robert J.; Riediker, Michael; Cummings, Christopher; Yu, Liya; Wang, Zheng Ming; Zink, Daniele; Ng, Zhihan; Loo, Say Chye Joachim; Ng, Kee Woei

2015-01-01

Abstract An international symposium for nanosafety was held recently at the Nanyang Technological University in Singapore. Topics relating to understanding nanomaterial properties, tools, and infrastructure required for predicting hazardous outcomes, measuring nanomaterial exposure levels, systems approach for risk assessment and public’s perception of nanotechnology were covered. The need for a multidisciplinary approach, across both natural and social sciences, for developing sustainable nanotechnology solutions was heavily emphasized. This commentary highlights the major issues discussed and the commitment of the nanosafety research community in Singapore to contribute collectively to realise the vision of sustainable nanotechnology. PMID:25976321

Enteric Fever in a Tertiary Paediatric Hospital: A Retrospective Six-Year Review.

PubMed

Ahmad Hatib, Nur Adila; Chong, Chia Yin; Thoon, Koh Cheng; Tee, Nancy Ws; Krishnamoorthy, Subramania S; Tan, Natalie Wh

2016-07-01

Enteric fever is a multisystemic infection which largely affects children. This study aimed to analyse the epidemiology, clinical presentation, treatment and outcome of paediatric enteric fever in Singapore. A retrospective review of children diagnosed with enteric fever in a tertiary paediatric hospital in Singapore was conducted from January 2006 to January 2012. Patients with positive blood cultures for Salmonella typhi or paratyphi were identified from the microbiology laboratory information system. Data was extracted from their case records. Of 50 enteric fever cases, 86% were due to Salmonella typhi, with 16.3% being multidrug resistant (MDR) strains. Sixty-two percent of S. typhi isolates were of decreased ciprofloxacin susceptibility (DCS). Five cases were both MDR and DCS. The remaining 14% were Salmonella paratyphi A. There were only 3 indigenous cases. Ninety-four percent had travelled to typhoid-endemic countries, 70.2% to the Indian subcontinent and the rest to Indonesia and Malaysia. All patients infected with MDR strains had travelled to the Indian subcontinent. Anaemia was a significant finding in children with typhoid, as compared to paratyphoid fever (P = 0.04). Although all children were previously well, 14% suffered severe complications including shock, pericardial effusion and enterocolitis. None had typhoid vaccination prior to their travel to developing countries. Enteric fever is largely an imported disease in Singapore and has contributed to significant morbidity in children. The use of typhoid vaccine, as well as education on food and water hygiene to children travelling to developing countries, needs to be emphasised.

Clinical features and treatment outcomes of vancomycin-intermediate Staphylococcus aureus (VISA) and heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) in a tertiary care institution in Singapore.

PubMed

Fong, R K C; Low, J; Koh, T H; Kurup, A

2009-08-01

This retrospective case-control study was undertaken to review the clinical features associated with heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) and vancomycin-intermediate S. aureus (VISA) infections and the local impact they have on clinical outcome. Compared with vancomycin-susceptible S. aureus (n = 30), hVISA and VISA infections (n = 10) are found to be associated with a longer period of prior glycopeptide use (P = 0.01), bone/joint (P < 0.01) and prosthetic infections (P = 0.04), as well as treatment failure, as evidenced by longer bacteremic (P < 0.01) and culture positivity (P < 0.01) periods. This was observed to have resulted in longer hospital length of stay (P < 0.01) and total antibiotic therapy duration (P = 0.01). There was, however, no significant difference in the overall patient mortality or the hospitalization cost (P = 0.12) in both groups. Clinicians should be cognizant of the association between hVISA/VISA with high bacterial load deep-seated infections. We recommend targeted and even universal screening for hVISA/VISA in methicillin-resistant S. aureus (MRSA) infections.

Lymphomas involving Waldeyer's ring: placement, paradigms, peculiarities, pitfalls, patterns and postulates.

PubMed

Tan, L H

2004-07-01

This review revisits Waldeyer's ring lymphomas as classified by the World Health Organisation. Sources of data include international studies on Waldeyer's ring lymphomas as well as from personal observations gleaned from lymphoma statistics of Singapore General Hospital, Changi General Hospital, Tan Tock Seng Hospital and National University Hospital within the last decade or so. Waldeyer's ring shares many of the histopathological trends of the rest of mucosa-associated lymphoid tissue (MALT), such as the high frequency of diffuse large B-cell lymphomas, and the relative rarity of follicular lymphomas in spite of its rich endowment with reactive lymphoid follicles. However, extranodal marginal zone lymphoma or "MALToma" may not be as frequently encountered as in other mucosal sites. Furthermore, the placement of Waldeyer's ring is unique in that stark comparisons with the lymphopathology of the immediately anterior oronasal cavities can be made, with intriguing peculiarities such as the abrupt reversal of the ratio of B-cell to T/NK-cell lymphoma frequency upon crossing the imaginary line that separates the 2 regions. The differential diagnosis with regionally common lymphoma mimics, in particular reactive parafollicular hyperplasia and nasopharyngeal undifferentiated (lymphoepithelial) carcinoma of Schmincke pattern, both often aetiologically related to Epstein-Barr viral infection, is also discussed. Recognition of the peculiarities and patterns of Waldeyer's ring lymphomas is important for accurate pathologic assessment. Postulates that attempt to account for the patterns and peculiarities of Waldeyer's ring lymphopathology can be used to direct further research.

Influenza A (H1N1-2009) pandemic in Singapore--public health control measures implemented and lessons learnt.

PubMed

Tay, Joanne; Ng, Yeuk Fan; Cutter, Jeffery L; James, Lyn

2010-04-01

We describe the public health control measures implemented in Singapore to limit the spread of influenza A (H1N1-2009) and mitigate its social effects. We also discuss the key learning points from this experience. Singapore's public health control measures were broadly divided into 2 phases: containment and mitigation. Containment strategies included the triage of febrile patients at frontline healthcare settings, admission and isolation of confirmed cases, mandatory Quarantine Orders (QO) for close contacts, and temperature screening at border entry points. After sustained community transmission became established, containment shifted to mitigation. Hospitals only admitted H1N1-2009 cases based on clinical indications, not for isolation. Mild cases were managed in the community. Contact tracing and QOs tapered off, and border temperature screening ended. The 5 key lessons learnt were: (1) Be prepared, but retain flexibility in implementing control measures; (2) Surveillance, good scientific information and operational research can increase a system's ability to manage risk during a public health crisis; (3) Integrated systems-level responses are essential for a coherent public health response; (4) Effective handling of manpower surges requires creative strategies; and (5) Communication must be strategic, timely, concise and clear. Singapore's effective response to the H1N1-2009 pandemic, founded on experience in managing the 2003 SARS epidemic, was a whole-of-government approach towards pandemic preparedness planning. Documenting the measures taken and lessons learnt provides a learning opportunity for both doctors and policy makers, and can help fortify Singapore's ability to respond to future major disease outbreaks.

Effectiveness of a transitional home care program in reducing acute hospital utilization: a quasi-experimental study.

PubMed

Low, Lian Leng; Vasanwala, Farhad Fakhrudin; Ng, Lee Beng; Chen, Cynthia; Lee, Kheng Hock; Tan, Shu Yun

2015-03-14

Improving healthcare utilization is essential as health systems around the world grapple with the escalating demands for acute hospital resources. Evidence suggests that transitional care programs are effective to improve utilization of healthcare. However, the evidence for transitional care programs that enhance the home medical care model and provide multi-disciplinary patient-centered care is not well established. We evaluated if a transitional home care program operated by the Singapore General Hospital was effective in reducing acute hospital utilization. We performed a quasi-experimental study using a pre-post design to evaluate the effectiveness of a transitional home care program in reducing hospital admissions and emergency department attendances of medically complex patients enrolled into the program in a tertiary hospital in Singapore. Patients received a comprehensive needs assessment performed by the physician and a nurse case manager in the home setting, followed by an individualized care plan that included medical and nursing care, patient education and coordination of care with hospital specialists and community services. Primary study outcomes were emergency department attendances and hospital admissions to all hospitals. These were extracted from hospital administrative data and national health records. Wilcoxon Signed Ranks Test was used for assess differences in pre and post continuous data. Overall, 262 patients were enrolled into the program and 259 were analyzed. Patients had a 51.6% and 52.8% reduction in hospital admissions in the three-month and six-month post enrollment, respectively. Similarly, a 47.1% and 48.2% reduction was observed for emergency department attendances in the three and six months post enrollment, respectively. The average difference in per patient hospital bed days in the pre- and post-enrollment periods were 12.05 days and 20.03 days at the 3-month and 6-month periods, respectively. Patients enrolled in the transitional home care program had significantly lower acute hospital utilization through the reduction of emergency department attendances and hospital admissions. A comprehensive assessment of patients' medical and social needs in the home setting and formulation of an individualized care plan optimized post-discharge care for medically complex patients.

A review of accessibility of administrative healthcare databases in the Asia-Pacific region.

PubMed

Milea, Dominique; Azmi, Soraya; Reginald, Praveen; Verpillat, Patrice; Francois, Clement

2015-01-01

We describe and compare the availability and accessibility of administrative healthcare databases (AHDB) in several Asia-Pacific countries: Australia, Japan, South Korea, Taiwan, Singapore, China, Thailand, and Malaysia. The study included hospital records, reimbursement databases, prescription databases, and data linkages. Databases were first identified through PubMed, Google Scholar, and the ISPOR database register. Database custodians were contacted. Six criteria were used to assess the databases and provided the basis for a tool to categorise databases into seven levels ranging from least accessible (Level 1) to most accessible (Level 7). We also categorised overall data accessibility for each country as high, medium, or low based on accessibility of databases as well as the number of academic articles published using the databases. Fifty-four administrative databases were identified. Only a limited number of databases allowed access to raw data and were at Level 7 [Medical Data Vision EBM Provider, Japan Medical Data Centre (JMDC) Claims database and Nihon-Chouzai Pharmacy Claims database in Japan, and Medicare, Pharmaceutical Benefits Scheme (PBS), Centre for Health Record Linkage (CHeReL), HealthLinQ, Victorian Data Linkages (VDL), SA-NT DataLink in Australia]. At Levels 3-6 were several databases from Japan [Hamamatsu Medical University Database, Medi-Trend, Nihon University School of Medicine Clinical Data Warehouse (NUSM)], Australia [Western Australia Data Linkage (WADL)], Taiwan [National Health Insurance Research Database (NHIRD)], South Korea [Health Insurance Review and Assessment Service (HIRA)], and Malaysia [United Nations University (UNU)-Casemix]. Countries were categorised as having a high level of data accessibility (Australia, Taiwan, and Japan), medium level of accessibility (South Korea), or a low level of accessibility (Thailand, China, Malaysia, and Singapore). In some countries, data may be available but accessibility was restricted based on requirements by data custodians. Compared with previous research, this study describes the landscape of databases in the selected countries with more granularity using an assessment tool developed for this purpose. A high number of databases were identified but most had restricted access, preventing their potential use to support research. We hope that this study helps to improve the understanding of the AHDB landscape, increase data sharing and database research in Asia-Pacific countries.

International study on antidepressant prescription pattern at 20 teaching hospitals and major psychiatric institutions in East Asia: Analysis of 1898 cases from China, Japan, Korea, Singapore and Taiwan.

PubMed

Uchida, Naoki; Chong, Mian-Yoon; Tan, Chay Hoon; Nagai, Hiroshi; Tanaka, Mariko; Lee, Min-Soo; Fujii, Senta; Yang, Shu-Yu; Si, Tainmei; Sim, Kang; Wei, Hao; Ling, He Yan; Nishimura, Ryoji; Kawaguchi, Yoshichika; Edwards, Glen; Sartorius, Norman; Shinfuku, Naotaka

2007-10-01

The purpose of the present study was to review the prescription patterns of antidepressants in different countries in East Asia. The survey was conducted in China, Japan, Korea, Singapore and Taiwan from October 2003 to March 2004 using the unified research protocol and questionnaire. Twenty teaching hospitals and major psychiatric hospitals participated and a total of 1898 patients receiving antidepressants were analyzed. The survey provided a number of interesting characteristics on the prescription patterns of antidepressant in East Asia. Out of 56 antidepressants listed in the Anatomical Therapeutic Chemical Classification (ATC) index by the World Health Organization (WHO) Collaborating Center for Drug Statistics Methodology (Oslo), only 26 antidepressants were prescribed in participating countries in East Asia. On average 38.4% of prescriptions of antidepressants were for patients with diagnoses other than depressive disorders. The availability and commonly prescribed antidepressants varied greatly by country. The selective serotonin re-uptake inhibitors (SSRI) and other newer antidepressants were prescribed in approximately 77.0% of all cases. At the time of the survey, only two SSRI medications were available in Japan. However, five types of SSRI were available and were often prescribed in Korea.

National survey of outcomes and practices in acute respiratory distress syndrome in Singapore.

PubMed

Siddiqui, Shahla; Puthucheary, Zudin; Phua, Jason; Ho, Benjamin; Tan, Jonathan; Chuin, Siau; Lim, Noelle Louise; Soh, Chai Rick; Loo, Chian Min; Tan, Addy Y H; Mukhopadhyay, Amartya; Khan, Faheem Ahmed; Johan, Azman; Tan, Aik Hau; MacLaren, Graeme; Taculod, Juvel; Ramos, Blesilda; Han, Tun Aung; Cove, Matthew E

2017-01-01

In the past 20 years, our understanding of acute respiratory distress syndrome (ARDS) management has improved, but the worldwide incidence and current outcomes are unclear. The reported incidence is highly variable, and no studies specifically characterise ARDS epidemiology in Asia. This observation study aims to determine the incidence, mortality and management practices of ARDS in a high income South East Asian country. We conducted a prospective, population based observational study in 6 public hospitals. During a one month period, we identified all ARDS patients admitted to public hospital intensive care units (ICU) in Singapore, according to the Berlin definition. Demographic information, clinical management data and ICU outcome data was collected. A total of 904 adult patients were admitted to ICU during the study period and 15 patients met ARDS criteria. The unadjusted incidence of ARDS was 4.5 cases per 100,000 population, accounting for 1.25% of all ICU patients. Most patients were male (75%), Chinese (62%), had pneumonia (73%), and were admitted to a Medical ICU (56%). Management strategies varied across all ICUs. In-hospital mortality was 40% and median length of ICU stay was 7 days. The incidence of ARDS in a developed S.E Asia country is comparable to reported rates in European studies.

National survey of outcomes and practices in acute respiratory distress syndrome in Singapore

PubMed Central

Puthucheary, Zudin; Phua, Jason; Ho, Benjamin; Tan, Jonathan; Chuin, Siau; Lim, Noelle Louise; Soh, Chai Rick; Loo, Chian Min; Tan, Addy Y. H.; Mukhopadhyay, Amartya; Khan, Faheem Ahmed; Johan, Azman; Tan, Aik Hau; MacLaren, Graeme; Taculod, Juvel; Ramos, Blesilda; Han, Tun Aung; Cove, Matthew E.

2017-01-01

Introduction In the past 20 years, our understanding of acute respiratory distress syndrome (ARDS) management has improved, but the worldwide incidence and current outcomes are unclear. The reported incidence is highly variable, and no studies specifically characterise ARDS epidemiology in Asia. This observation study aims to determine the incidence, mortality and management practices of ARDS in a high income South East Asian country. Methods We conducted a prospective, population based observational study in 6 public hospitals. During a one month period, we identified all ARDS patients admitted to public hospital intensive care units (ICU) in Singapore, according to the Berlin definition. Demographic information, clinical management data and ICU outcome data was collected. Results A total of 904 adult patients were admitted to ICU during the study period and 15 patients met ARDS criteria. The unadjusted incidence of ARDS was 4.5 cases per 100,000 population, accounting for 1.25% of all ICU patients. Most patients were male (75%), Chinese (62%), had pneumonia (73%), and were admitted to a Medical ICU (56%). Management strategies varied across all ICUs. In-hospital mortality was 40% and median length of ICU stay was 7 days. Conclusion The incidence of ARDS in a developed S.E Asia country is comparable to reported rates in European studies. PMID:28622342

Two-year outcome of normal-birth-weight infants admitted to a Singapore neonatal intensive care unit.

PubMed

Lian, W B; Yeo, C L; Ho, L Y

2002-03-01

To describe the characteristics, the immediate and short-term outcome and predictors of mortality in normal-birth-weight (NBW) infants admitted to a tertiary neonatal intensive care unit (NICU) in Singapore. We retrospectively reviewed the medical records of 137 consecutive NBW infants admitted to the NICU of the Singapore General Hospital from January 1991 to December 1992. Data on the diagnoses, clinical presentation of illness, intervention received, complications and outcome as well as follow-up patterns for the first 2 years of life, were collected and analysed. NBW NICU infants comprised 1.8% of births in our hospital and 40.8% of all NICU admissions. The main reasons for NICU admissions were respiratory disorders (61.3%), congenital anomalies (15.3%) and asphyxia neonatorum (11.7%). Respiratory support was necessary in 81.8%. Among those ventilated, the only predictive factor contributing to mortality was the mean inspired oxygen concentration. The mortality rate was 11.7%. Causes of death included congenital anomalies (43.75%), asphyxia neonatorum (31.25%) and pulmonary failure secondary to meconium aspiration syndrome (12.5%). The median hospital stay among survivors (88.3%) was 11.0 (range, 4 to 70) days. Of 42 patients (out of 117 survivors) who received follow-up for at least 6 months, 39 infants did not have evidence of any major neurodevelopmental abnormalities at their last follow-up visit, prior to or at 2 years of age. Despite their short hospital stay (compared to very-low-birth-weight infants), the high volume of NBW admissions make the care of this population an important area for review to enhance advances in and hence, reduce the cost of NICU care. With improved antenatal diagnostic techniques (allowing earlier and more accurate diagnosis of congenital malformations) and better antenatal and perinatal care (allowing better management of at-risk pregnancies), it is anticipated that there should be a reduction in such admissions with better outcomes. Close follow-up of this high-risk group of infants is also important in order to offer early intervention to those who may possibly have perinatally-related developmental difficulties.

Economic Impact of Dengue Illness and the Cost-Effectiveness of Future Vaccination Programs in Singapore

PubMed Central

Carrasco, Luis R.; Lee, Linda K.; Lee, Vernon J.; Ooi, Eng Eong; Shepard, Donald S.; Thein, Tun L.; Gan, Victor; Cook, Alex R.; Lye, David; Ng, Lee Ching; Leo, Yee Sin

2011-01-01

Background Dengue illness causes 50–100 million infections worldwide and threatens 2.5 billion people in the tropical and subtropical regions. Little is known about the disease burden and economic impact of dengue in higher resourced countries or the cost-effectiveness of potential dengue vaccines in such settings. Methods and Findings We estimate the direct and indirect costs of dengue from hospitalized and ambulatory cases in Singapore. We consider inter alia the impacts of dengue on the economy using the human-capital and the friction cost methods. Disease burden was estimated using disability-adjusted life years (DALYs) and the cost-effectiveness of a potential vaccine program was evaluated. The average economic impact of dengue illness in Singapore from 2000 to 2009 in constant 2010 US$ ranged between $0.85 billion and $1.15 billion, of which control costs constitute 42%–59%. Using empirically derived disability weights, we estimated an annual average disease burden of 9–14 DALYs per 100 000 habitants, making it comparable to diseases such as hepatitis B or syphilis. The proportion of symptomatic dengue cases detected by the national surveillance system was estimated to be low, and to decrease with age. Under population projections by the United Nations, the price per dose threshold for which vaccines stop being more cost-effective than the current vector control program ranged from $50 for mass vaccination requiring 3 doses and only conferring 10 years of immunity to $300 for vaccination requiring 2 doses and conferring lifetime immunity. The thresholds for these vaccine programs to not be cost-effective for Singapore were $100 and $500 per dose respectively. Conclusions Dengue illness presents a serious economic and disease burden in Singapore. Dengue vaccines are expected to be cost-effective if reasonably low prices are adopted and will help to reduce the economic and disease burden of dengue in Singapore substantially. PMID:22206028

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

The inter-rater reliability test of the modified Morse Fall Scale among patients ≥ 55 years old in an acute care hospital in Singapore.

PubMed

Tang, Wing Sze; Chow, Yeow Leng; Koh, Serena Siew Lin

2014-02-01

A prospective, descriptive study was conducted in an acute care hospital in Singapore to determine the inter-rater reliability of the modified Morse Fall Scale by evaluating the degrees of agreement on the ratings of the individual items and overall score between the 'gold standard' assessor and the facility assessors. One hundred and forty-two subjects were recruited during the 1.5 month data collection period. The simple and weighted κ-values were all > 0.8 except for the item 'effects of medications' (κ and κw  = 0.63), and the correlation coefficient (rs  = 0.89) was significantly high at a significance level of < 0.001. The modified Morse Fall Scale was shown to be a reliable fall risk assessment tool having a relative high inter-rater reliability level for the overall score and individual items. This study provides evidence-based psychometric support for the clinical application of this tool. © 2013 Wiley Publishing Asia Pty Ltd.

The use of law to encourage smaller families in Singapore.

PubMed

Smith, T W

1980-01-01

To pursue its goal of rapid economic development, Singapore provides family planning services and has vigorously encouraged its citizens to limit family size. The government has legislated disincentives for families to have more than 2 children. This discussion reviews the history of these legal measures and their usefulness as a tool to promote social change and development. Singapore has used the law as a means to encourage family planning in order to supplement the overall thrust for economic development in the late 1960s. Freed from obligations to the Malaysian Federation and lacking the support of the British military as of 1969, Lee Kuan Yew led his people's economic development along a Western model. Reduction of population growth is an essential component of that model. Lee stressed family planning by providing clinics, by advertising, by promoting housing and lifestyles conducive to nuclear families, and by gradually adopting a set of laws favoring small families. These laws were introduced in different sectors of the economy at different times and were revised as social conditions changed. Typically, they set a minor monetary or priority penalty for parents of 3 or more children. The laws discourage additional births rather than prohibit them, guiding rather than forcing family planning decisions. To what extent the laws were the cause of decreasing family size in Singapore is uncertain, but they contributed to some extent to the country's phenomenal progress in income and lifestyle. The Abortion Act of 1969 legalized abortion on nonmedical grounds with the Singapore Family Planning and Population Board (SFPPB) approval. The Act was amended twice in 1974 to make abortions available "on demand." The charging of progressive delivery (accouchement) fees in government hospitals for mothers with 2 or more children might be considered as the focal point of the total disincentives system. The fees placed financial pressure directly on those who violated the government's stated small family norm. The program, initially instituted in 1969, has proven particularly effective, since 80% of all births in Singapore occur in government hospitals, where the rule may be consistently enforced. In August 1973 women with 2 or more children were made ineligible for maternity benefits, but female government employees could receive paid medical leave if they were sterilized after delivery. In August 1973 income tax relief was limited to the 1st 3 children. Other measures have been in the following areas: child employment; education; sterilization; and housing. The psychological impact of the disincentives may be their greatest effect, but it is difficult to measure. It is also difficult to determine the net effect of the disincentives on individuals. Indications are that the disincentives prohibited parents from attaining their desired family size in a very small number of cases.

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.

Dietary cholesterol, fats and risk of Parkinson's disease in the Singapore Chinese Health Study

PubMed Central

Tan, Louis C; Methawasin, Kulthida; Tan, Eng-King; Tan, June H; Au, Wing-Lok; Yuan, Jian-Min; Koh, Woon-Puay

2016-01-01

Background Prospective studies on lipids and risk of Parkinson's disease (PD) in Asian populations are sparse. This study prospectively examined the associations between dietary cholesterol and major fatty acids, and risk of PD among the Chinese in Singapore. Methods This study used data from the Singapore Chinese Health Study, a population-based prospective cohort of 63 257 men and women aged 45–74 years in Singapore enrolled in 1993–1998. Dietary intakes of cholesterol and fatty acids were derived from a validated semiquantitative food frequency questionnaire and the Singapore Food Composition Table. Incident PD cases were identified either through follow-up interviews or record linkage analysis with hospital discharge and PD outpatient registries. Results After an average of 14.6 years, 218 men and 193 women in the cohort developed PD. Dietary cholesterol was associated with statistically significantly lower risk of PD in a dose–dependent manner among men after adjustment for established risk factors for PD and intakes of major fatty acids. Compared to the lowest quartile, HR (95% CI) for the highest quartile was 0.53 (95% CI 0.33 to 0.84) (P for trend=0.006). Among women, dietary monounsaturated fatty acid was inversely associated with PD risk (P for trend=0.033). Compared to the lowest quartile, HR for the highest quartile was 0.44 (95% CI 0.22 to 0.88). There was no statistically significant association between dietary saturated, n-3 and n-6 fatty acids and PD risk. Conclusions Higher intakes of cholesterol and monounsaturated fatty acids may reduce risk of PD in men and women, respectively. PMID:25669745

Dietary cholesterol, fats and risk of Parkinson's disease in the Singapore Chinese Health Study.

PubMed

Tan, Louis C; Methawasin, Kulthida; Tan, Eng-King; Tan, June H; Au, Wing-Lok; Yuan, Jian-Min; Koh, Woon-Puay

2016-01-01

Prospective studies on lipids and risk of Parkinson's disease (PD) in Asian populations are sparse. This study prospectively examined the associations between dietary cholesterol and major fatty acids, and risk of PD among the Chinese in Singapore. This study used data from the Singapore Chinese Health Study, a population-based prospective cohort of 63 257 men and women aged 45-74 years in Singapore enrolled in 1993-1998. Dietary intakes of cholesterol and fatty acids were derived from a validated semiquantitative food frequency questionnaire and the Singapore Food Composition Table. Incident PD cases were identified either through follow-up interviews or record linkage analysis with hospital discharge and PD outpatient registries. After an average of 14.6 years, 218 men and 193 women in the cohort developed PD. Dietary cholesterol was associated with statistically significantly lower risk of PD in a dose-dependent manner among men after adjustment for established risk factors for PD and intakes of major fatty acids. Compared to the lowest quartile, HR (95% CI) for the highest quartile was 0.53 (95% CI 0.33 to 0.84) (P for trend=0.006). Among women, dietary monounsaturated fatty acid was inversely associated with PD risk (P for trend=0.033). Compared to the lowest quartile, HR for the highest quartile was 0.44 (95% CI 0.22 to 0.88). There was no statistically significant association between dietary saturated, n-3 and n-6 fatty acids and PD risk. Higher intakes of cholesterol and monounsaturated fatty acids may reduce risk of PD in men and women, respectively. 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/

Renal and obstetric outcomes in pregnancy after kidney transplantation: Twelve-year experience in a Singapore transplant center.

PubMed

Kwek, Jia Liang; Tey, Vanessa; Yang, Liying; Kanagalingam, Devendra; Kee, Terence

2015-09-01

Renal and obstetric outcomes in pregnancy after kidney transplantation in Singapore were last studied in 2002. A review of these outcomes in Singapore is now timely following advances in transplant and obstetric medicine. The aim was to evaluate the renal and obstetric outcomes in pregnancy after kidney transplantation in a Singapore tertiary center. Kidney transplant recipients who underwent pregnancy after transplantation at Singapore General Hospital between January 2001 and December 2012 were identified. Data on demographics, comorbidities and clinical outcomes were collected. There were 10 pregnancies identified in nine recipients. The median age of recipient at childbearing was 34.6 years (IQR, 32.8-36.8) and the median interval from transplantation to conception was 69 months (IQR, 38-97). There was no difference between the median pre-pregnancy estimated glomerular filtration rate (eGFR) (47.9 mL/min/1.73 m(2); IQR, 38.4-56.8) and median eGFR at time of last post-partum follow up (43.9 mL/min/1.73 m(2); IQR, 34.5-48.7, P = 0.549). Borderline allograft rejection occurred in one recipient (10.0%) 36 days after birth due to non-adherence to immunosuppressive medication, with subsequent allograft loss 37 months after birth. No mortalities were recorded during the study period. All the 10 pregnancies (100%) ended in singleton live births. Pre-eclampsia occurred in five pregnancies (50.0%), and there were seven (70.0%) preterm deliveries. The median gestational age was 35.4 weeks (IQR, 32.6-38.2) and the median birthweight was 2353 g (IQR, 1811-2648). Post-transplantation pregnancies ended successfully with no significant worsening of allograft function, but they were associated with risks to both recipients and newborns. © 2015 Japan Society of Obstetrics and Gynecology.

: 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 employers can be strengthened.

Learning to Lead Reading Comprehension Discussion

ERIC Educational Resources Information Center

Silver, Rita Elaine; Png, Jessie

2016-01-01

In this article, we describe and reflect on a collaborative, school-based professional development project (an "intervention") intended to encourage innovation in classroom teaching. Specifically, the intervention included a collaboration between university-based researchers/mentors and primary school teachers in Singapore who were…

Acute care nurses' perceptions of spirituality and spiritual care: an exploratory study in Singapore.

PubMed

Chew, Brendan Wk; Tiew, Lay Hwa; Creedy, Debra K

2016-09-01

To investigate acute care nurses' perceptions of spirituality and spiritual care and relationships with nurses' personal and professional characteristics. Spirituality and spiritual care are often neglected or absent in daily nursing practice. Nurses' perceptions of spirituality can be influenced by personal, professional and social factors and affect the provision of spiritual care. A cross-sectional, exploratory, nonexperimental design was used. All nursing staff (n = 1008) from a large acute care hospital in Singapore were invited to participate. Participants completed a demographic form and the Spiritual Care-Giving Scale. Completed surveys were received from 767 staff yielding a response rate of 76%. Descriptive statistics and General Linear Modelling were used to analyse data. Acute care nurses reported positive perceptions of spirituality and spiritual care. Religion, area of clinical practice and view of self as spiritual were associated with nurses' reported perspectives of spirituality and spiritual care. Nurses working in this acute care hospital in Singapore reported positive perceptions of spirituality and spiritual care. Respondents tended to equate religion with spirituality and were often unclear about what constituted spiritual care. They reported a sense of readiness to apply an interprofessional approach to spiritual care. However, positive perceptions of spirituality may not necessarily translate into practice. Spiritual care can improve health outcomes. Nurses' understanding of spirituality is essential for best practice. Interprofessional collaboration with clinicians, administrators, educators, chaplains, clergy and spiritual leaders can contribute to the development of practice guidelines and foster spiritual care by nurses. Further research is needed on the practical applications of spiritual care in nursing. © 2016 John Wiley & Sons Ltd.

The trends of burns epidemiology in a tropical regional burns centre.

PubMed

Hwee, Jolie; Song, Christopher; Tan, Kok Chai; Tan, Bien Keem; Chong, Si Jack

2016-05-01

Singapore General Hospital (SGH) is a regional burns centre in Southeast Asia and is the only dedicated burns facility providing specialized burns care in Singapore. A cohort study was performed for burns patients admitted to SGH from 2011 to 2013. We compared our data with earlier studies and observed the trends of burns epidemiology in Singapore. Results were analyzed using the SPSS programme. 655 patients were admitted during this study period, a 35.9% increase from 2003 to 2005. Scalding by water and flame injury remain the top causes of burns and the mean extent of burn is 9.5%. TBSA correlates with the incidence of burn infection, bacteremia and mortality. Patients with ≥20% TBSA are at a higher risk of bacteremia, and ≥ 34% TBSA is a predictor of mortality. 4.9% (n=32) of our patients developed bacteremia. Bacteremia was associated with a surgical duration of ≥80min. Patients with bacteremia incurred longer hospitalization, and had higher mortality rates. Overall mortality rate of our burns patients has decreased from 4.5% to 2.7% (n=18). Key factors of mortality include inhalational injury, bacteremia and ≥20% TBSA. This is a large epidemiology study of a tropical region burns centre. A total of 655 burns cases over a 3-year period were analyzed. We analysed the key factors associated with adverse outcomes including burns infection, bacteremia and mortality, factors associated with mortality, and discussed strategies on the optimization of burns care. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Investigating nurses' quality of life and work-life balance statuses in Singapore.

PubMed

Kowitlawkul, Y; Yap, S F; Makabe, S; Chan, S; Takagai, J; Tam, W W S; Nurumal, M S

2018-04-06

To investigate the key determinants of nurses' quality of life and work-life balance statuses in a tertiary hospital in Singapore. Nurses' quality of life can directly and indirectly impact patients' safety and quality of care. Therefore, identifying key factors that influence nurses' quality of life is essential in the healthcare delivery system. A descriptive quantitative study design was adopted, and validated questionnaires were used. Data were collected in a period of 3 months (March to May 2014) at a 600-bed tertiary hospital in Singapore. One thousand and forty nurses participated in the study. Social support and sense of coherence were found to be significant predictors for high quality of life in all domains. Most nurses in this study spent more time on work than their private lives. However, there was no significant difference in job satisfaction among the four groups of nurses' proportions of percentages of actual time spent on work and private life. Cultivating social support from family, friends/colleagues and supervisors can help an individual cope with stress and enhance a nurse's quality of life. Even though nurses who spent more time at work were still satisfied with their job, they might need to be aware of their physical health and work environment. Nursing policy related to nurses' physical health and environment should be established. Health promotion programmes such as physical exercise and mindfulness interventions should be conducted to promote nurses' well-being and healthy workplace environments to enhance nurses' quality of life. © 2018 International Council of Nurses.

Review of a two-year methicillin-resistant Staphylococcus aureus screening program and cost-effectiveness analysis in Singapore.

PubMed

Win, Mar-Kyaw; Soliman, Tarek Abdellatif Aly; Lee, Linda Kay; Wong, Chia Siong; Chow, Angela; Ang, Brenda; Roman, Carrasco L; Leo, Yee-Sin

2015-09-29

Methicillin-resistant Staphylococcus aureus (MRSA) poses an increasingly large disease and economic burden worldwide. The effectiveness of screening programs in the tropics is poorly understood. The aims of this study are: (i) to analyze the factors affecting MRSA colonization at admission and acquisition during hospitalization and (ii) to evaluate the cost-effectiveness of a screening program which aims to control MRSA incidence during hospitalization. We conducted a retrospective case-control study of patients admitted to the Communicable Disease Centre (CDC) in Singapore between Jan 2009 and Dec 2010 when there was an ongoing selective screening and isolation program. Risk factors contributing to MRSA colonization on admission and acquisition during hospital stay were evaluated using a logistic regression model. In addition, a cost-effectiveness analysis was conducted to determine the cost per disability-adjusted life year (DALY) averted due to implementing the screening and isolation program. The average prevalence rate of screened patients at admission and the average acquisition rate at discharge during the study period were 12.1 and 4.8 % respectively. Logistic regression models showed that older age (adjusted odds ratio (OR) 1.03, 95 % CI 1.02-1.04, p < 0.001) and dermatological conditions (adjusted OR 1.49, 95 % CI 1.11-1.20, p = 0.008) were independently associated with an increased risk of MRSA colonization at admission. Age (adjusted OR 1.02, 95 % CI 1.01-1.03, p = 0.002) and length of stay in hospital (adjusted OR 1.04, 95 % CI 1.03-1.06, p < 0.001) were independent factors associated with MRSA acquisition during hospitalization. The screening and isolation program reduced the acquisition rate by 1.6 % and was found to be cost saving. For the whole study period, the program cost US$129,916, while it offset hospitalization costs of US$103,869 and loss of productivity costs of US$50,453 with -400 $/DALY averted. This study is the first to our knowledge that evaluates the cost-effectiveness of screening and isolation of MRSA patients in a tropical country. Another unique feature of the analysis is the evaluation of acquisition rates among specific types of patients (dermatological, HIV and infectious disease patients)and the comparison of the cost-effectiveness of screening and isolation between them. Overall our results indicate high MRSA prevalence that can be cost effectively reduced by selective screening and isolation programs in Singapore.

Hospital design for better infection control

PubMed Central

Lateef, Fatimah

2009-01-01

The physical design and infrastructure of a hospital or institution is an essential component of its infection control measure. Thus is must be a prerequisite to take these into consideration from the initial conception and planning stages of the building. The balance between designing a hospital to be an open, accessible and public place and the control to reduce the spread of infections diseases is a necessity. At Singapore General Hospital, many lessons were learnt during the SARS outbreak pertaining to this. During and subsequent to the SARS outbreak, many changes evolved in the hospital to enable us to handle and face any emerging infectious situation with calm, confidence and the knowledge that staff and patients will be in good stead. This paper will share some of our experiences as well as challenges PMID:20009307

Establishing a photonics teaching facility and program in a Singapore secondary school

NASA Astrophysics Data System (ADS)

Lai, Theresa; Wee, Mark; Sabaratnam, Andrew T.; Hegde, Gopalkrishna M.

2002-05-01

As a premier school, Raffles Institution (RI) seeks relevant and forward-looking educational initiatives. Bringing emerging technologies into the school encourages the students to cultivate skills and attitudes that will empower them to ride the present and future waves of information and technology most meaningfully and innovatively. Photonics has diverse applications in the modern technological world, and Singapore aims to become a center of excellence for optics and photonics in the region. However, a serious study of photonics begins only at the college level (K - 11/12). Entrusted with Singapore's brightest young minds, RI pioneered the development of a Photonics Exploratory Laboratory (X-LAB), being the first among secondary (K-7 to K- 10) schools in Singapore and possibly in the region. Young RI students are learning photonics fundamentals and recognizing photonics as a potentially rewarding field of study. With the expertise of lecturers from tertiary institutions, selected RI students are instructed in basic theory and trained in fundamental experiments. These students progress to embark on projects and in-depth studies under the wing of tertiary institutions and universities. Studies on Haidinger Fringes, Laser Doppler Anemometry and Optical Gratings have thus been successfully completed. Furthermore, the X-LAB acts as a focal point for students to experiment with Holography and Laser Animation.

The application of telemedicine in orthopedic surgery in singapore: a pilot study on a secure, mobile telehealth application and messaging platform.

PubMed

Daruwalla, Zubin Jimmy; Wong, Keng Lin; Thambiah, Joseph

2014-06-05

The application of telemedicine has been described for its use in medical training and education, management of stroke patients, urologic surgeries, pediatric laparoscopic surgeries, clinical outreach, and the field of orthopedics. However, the usefulness of a secure, mobile telehealth application, and messaging platform has not been well described. A pilot study was conducted to implement a health insurance portability and accountability act (HIPAA) compliant form of communication between doctors in an orthopedic clinical setting and determine their reactions to MyDoc, a secure, mobile telehealth application, and messaging platform. By replacing current methods of communication through various mobile applications and text messaging services with MyDoc over a six week period, we gained feedback and determined user satisfaction with this innovative system from questionnaires handed to the program director, program coordinator, one trauma consultant, all orthopedic residents, and six non-orthopedic residents at the National University Hospital in Singapore. Almost everyone who completed the questionnaire strongly agreed that MyDoc should replace current systems of peer to peer communication in the hospital. The majority also felt that the quality of images, videos, and sound were excellent. Almost everyone agreed that they could communicate easily with each other and would feel comfortable doing so routinely. The majority felt that virtual consults through MyDoc should be made available to inpatients as well as outpatients to potentially lessen clinic loads and provide a secure manner in which patients can communicate with their primary teams any time convenient to both. It was also agreed by most that the potential of telerounding had advantages, especially on weekends as a supplement to normal rounds. Potential uses of MyDoc in an orthopedic clinical setting include HIPAA-compliant peer to peer communication, clinical outreach in the setting of trauma, supervision in the operating room or watching procedures being performed remotely, providing both patient and parent reassurance in pediatric orthopedic patients, and finally in the setting of outpatient clinics. With our pilot study having excellent results in terms of acceptance and satisfaction, the integration of a secure, mobile telehealth application, and messaging platform, not only in the orthopedic department but also the hospital in general, has an exciting and limitless potential. More so in this era where downsizing hospital costs is beneficial, doing so may also be mandatory in order to comply with the soon to be introduced personal data protection act.

Global Education and Its Tensions: Case Studies of Two Schools in Singapore and the United States

ERIC Educational Resources Information Center

Choo, Suzanne S.

2017-01-01

Countering the drive to erect walls between nations and communities, the burden is increasingly on educators to develop in students essential skills and dispositions for a more hospitable future. Global education is essentially aimed at addressing the realities of increasingly networked societies and porous exchanges of knowledge, capital, and…

The Internet as a Medium of Training for Picture Archival and Communication Systems (PACS).

ERIC Educational Resources Information Center

Majid, Shaheen; Misra, Ramesh Kumar

2002-01-01

Explores the potential of Web-based training for PACS (Picture Archival and Communication Systems) used in radiology departments for the storage and archiving of patients' medical images. Reports results of studies in three hospitals in Malaysia, Singapore and the Philippines that showed that the Internet can be used effectively for training.…

Enterovirus infections in Singaporean children: an assessment of neurological manifestations and clinical outcomes.

PubMed

Thong, Wen Yi; Han, Audrey; Wang, S J Furene; Lin, Jeremy; Isa, Mas Suhaila; Koay, Evelyn Siew Chuan; Tay, Stacey Kiat-Hong

2017-04-01

Enterovirus infections in childhood can be associated with significant neurological morbidity. This study aimed to describe the prevalence and range of neurological manifestations, determine the clinical characteristics and assess differences in clinical outcomes for Singaporean children diagnosed with enterovirus infections. In this single-centre, case-control study, clinical data was collected retrospectively from patients admitted to National University Hospital, Singapore, from August 2007 to October 2011 and diagnosed with enterovirus infection, based on the enterovirus polymerase chain reaction test, or cultures from throat and rectal swabs or cerebrospinal fluid samples. The occurrence of neurological manifestations was reviewed and clinical outcomes were assessed. A total of 48 patients (age range: six days-17.8 years) were included in the study. Neurological manifestations were seen in 75.0% of patients, 63.9% of whom presented with aseptic meningitis. Other neurological manifestations included encephalitis, acute cerebellitis, transverse myelitis and autonomic dysfunction. The incidence of neurological manifestations was significantly higher in patients aged > 1 year as compared to younger patients (p = 0.043). In patients without neurological manifestations, a significantly higher proportion presented with hand, foot and mouth disease and poor feeding. Long-term neurological sequelae were seen in 16.7% of patients with neurological manifestations. A wide spectrum of neurological manifestations resulting in a relatively low incidence of long-term neurological sequelae was observed in our study of Singaporean children with enterovirus infections. As some of these neurological morbidities were severe, careful evaluation of children with neurological involvement is therefore necessary. Copyright: © Singapore Medical Association

Short communication: risk factors for methicillin-resistant Staphylococcus aureus colonization among HIV patients at hospital admission.

PubMed

Lee, Linda K; Win, Mar Kyaw; Veeraraghavan, Meyyur A; Wong, Chia Siong; Chow, Angela L; Leo, Yee-Sin

2013-05-01

Methicillin-resistant Staphylococcus aureus (MRSA) is a nosocomial pathogen that has become increasingly prominent in hospitals and the community. HIV-positive patients may be one of the most MRSA-susceptible populations because of their immunocompromised status. At the Communicable Disease Centre, Tan Tock Seng Hospital, Singapore, we implemented a universal MRSA screening program and performed a case-control study to identify risk factors for MRSA colonization among 294 HIV patients at admission from January 2009 to January 2010. Among 54 HIV-positive patients who were MRSA positive at hospital admission, 16 (29.6%) were positive at the nares/axilla/groin (NAG; one combined swab), 14 (25.9%) were NAG and perianal positive, 3 (5.6%) were NAG and throat positive, 10 (18.5%) were NAG, perianal, and throat positive, 6 (11.1%) were throat positive, and 5 (9.3%) were perianal positive. Upon multivariate analysis, we found that age [odds ratio (OR)=1.04, 95% confidence interval (CI): 1.01-1.07, p=0.006] and CD4 count <200/μl within the past 6 months (OR=4.29, 95% CI: 1.83-10.06, p=0.001) were significant risk factors for MRSA colonization. We generated a receiver operating characteristic curve using these two variables and found that the area under the curve was 0.69, indicating that age and CD4 count <200/μl performed moderately well in discriminating between those with MRSA colonization and those without. The results of our study indicate that HIV patients of older age and reduced CD4 count may have increased risk of MRSA colonization. These risk factors may serve as indicators for cohorting or isolating HIV patients at hospital admission.

Reversible Causes in Cardiovascular Collapse at the Emergency Department Using Ultrasonography (REVIVE-US).

PubMed

Chua, Mui Teng; Chan, Gene Wh; Kuan, Win Sen

2017-08-01

Ultrasonographic evaluation of patients in cardiac arrest is currently not protocolised in the advanced cardiac life support (ACLS) algorithm. Potentially reversible causes may be identified using bedside ultrasonography that is ubiquitous in most emergency departments (EDs). This study aimed to evaluate the incidence of sonographically detectable reversible causes of cardiac arrest by incorporating an ultrasonography protocol into the ACLS algorithm. Secondary objectives include rates of survival to hospital admission, hospital discharge, and 30-day mortality. We conducted a prospective study using bedside ultrasonography to evaluate for potentially reversible causes in patients with cardiac arrest at the ED of National University Hospital, Singapore, regardless of the initial electrocardiogram rhythm. A standardised ultrasonography protocol was performed during the 10-second pulse check window. Between June 2015 and April 2016, 104 patients were recruited, corresponding to 65% of all out-of-hospital cardiac arrest patients conveyed to the ED. Median age was 71 years (interquartile range, 55 to 80) and 71 (68.3%) patients were male. The most common rhythm on arrival was asystole (45.2%). Four (3.8%) patients had ultrasonographic findings suggestive of massive pulmonary embolism while 1 received intravenous thrombolysis and survived until discharge. Pericardial effusion without tamponade was detected in 4 (3.8%) patients and 6 (5.8%) patients had intra-abdominal free fluid. Twenty (19.2%) patients survived until admission, 2 of whom (1.9%) survived to discharge and beyond 30 days. Bedside ultrasonography can be safely incorporated into the ACLS protocol. Detection of any reversible causes may alter management and improve survival in selected patients.

The UK-SEA-ME Psychosocial-Cultural Cancer Research Network: setting the stage for applied qualitative research on cancer health behaviour in southeast Asia and the Middle East.

PubMed

Lim, Jennifer N W

2011-01-01

Psychosocial and cultural factors influencing cancer health behaviour have not been systematically investigated outside the western culture, and qualitative research is the best approach for this type of social research. The research methods employed to study health problems in Asia predominantly are quantitative techniques. The set up of the first psychosocial cancer research network in Asia marks the beginning of a collaboration to promote and spearhead applied qualitative healthcare research in cancer in the UK, Southeast Asia and the Middle East. This paper sets out the rationale, objectives and mission for the UK-SEA-ME Psychosocial-Cultural Cancer Research Network. The UK-SEA-ME network is made up of collaborators from the University of Leeds (UK), the University of Malaya (Malaysia), the National University of Singapore (Singapore) and the University of United Arab Emirates (UAE). The network promotes applied qualitative research to investigate the psychosocial and cultural factors influencing delayed and late presentation and diagnosis for cancer (breast cancer) in partner countries, as well as advocating the use of the mixed-methods research approach. The network also offers knowledge transfer for capacity building within network universities. The mission of the network is to improve public awareness about the importance of early management and prevention of cancer through research in Asia.

A Study on the Campus Landscape Design of the National University of Singapore

NASA Astrophysics Data System (ADS)

Lin, Lusheng; Dong, Ya

2018-01-01

In this paper, we analyzed the functions, structure, layout, landscape and engineering measure of the campus of NUS by the way of such research methods as present situation research, interview and comparative study. And we get the spatial characteristics of landscape environment affected by political economy, human geography, geographical conditions which will provide a new perspective for building international, modern, high-level research universities.

Application of Universal Design for Learning (Udl1) and Living (Udl2) in Virtual Dolphin-Assisted Intervention (Vdai) for Children with Autism

ERIC Educational Resources Information Center

Chia, Noel Kok Hwee; Kee, Norman Kiak Nam

2014-01-01

In Singapore, the Special Education for Autism (SEA) calls for a more focused, systematically structured framework to cater to the needs of children with autism in schools. As autism is a syndrome with co-morbid subtypes and different degrees of severity, a universal design for both learning and living becomes necessary to meet all the various…

Mapping infectious disease hospital surge threats to lessons learnt in Singapore: a systems analysis and development of a framework to inform how to DECIDE on planning and response strategies.

PubMed

Singh, Shweta R; Coker, Richard; Vrijhoef, Hubertus J-M; Leo, Yee Sin; Chow, Angela; Lim, Poh Lian; Tan, Qinghui; Chen, Mark I-Cheng; Hildon, Zoe Jane-Lara

2017-09-04

Hospital usage and service demand during an Infectious Disease (ID) outbreak can tax the health system in different ways. Herein we conceptualize hospital surge elements, and lessons learnt from such events, to help build appropriately matched responses to future ID surge threats. We used the Interpretive Descriptive qualitative approach. Interviews (n = 35) were conducted with governance and public health specialists; hospital based staff; and General Practitioners. Key policy literature in tandem with the interview data were used to iteratively generate a Hospital ID Surge framework. We anchored our narrative account within this framework, which is used to structure our analysis. A spectrum of surge threats from combinations of capacity (for crowding) and capability (for treatment complexity) demands were identified. Starting with the Pyramid scenario, or an influx of high screening rates flooding Emergency Departments, alongside fewer and manageable admissions; the Reverse-Pyramid occurs when few cases are screened and admitted but those that are, are complex; during a 'Black' scenario, the system is overburdened by both crowding and complexity. The Singapore hospital system is highly adapted to crowding, functioning remarkably well at constant near-full capacity in Peacetime and resilient to Endemic surges. We catalogue 26 strategies from lessons learnt relating to staffing, space, supplies and systems, crystalizing institutional memory. The DECIDE model advocates linking these strategies to types of surge threats and offers a step-by-step guide for coordinating outbreak planning and response. Lack of a shared definition and decision making of surge threats had rendered the procedures somewhat duplicative. This burden was paradoxically exacerbated by a health system that highly prizes planning and forward thinking, but worked largely in silo until an ID crisis hit. Many such lessons can be put into play to further strengthen our current hospital governance and adapted to more diverse settings.

Changing molecular epidemiology and high rates of mupirocin resistance among meticillin-resistant Staphylococcus aureus in Singaporean hospitals.

PubMed

Hon, Pei Yun; Koh, Tse Hsien; Tan, Thean Yen; Krishnan, Prabha; Leong, Janice Wai-Yeng; Jureen, Roland; Chan, Joey; Tee, Nancy Wen-Sim; Murugesh, Jagadeesan; Chan, Kian Sing; Hsu, Li Yang

2014-03-01

A prospective cross-sectional study was performed to determine the continuing shift in the molecular epidemiology of meticillin-resistant Staphylococcus aureus (MRSA) in Singapore. In total, 666 MRSA isolates from screening cultures performed between 7 and 20 January 2013 were obtained from all seven public sector hospitals in Singapore and were subjected to molecular typing using multilocus variable-number tandem-repeat fingerprinting with confirmatory multilocus sequencing typing for clustered isolates. Isolates were also tested for the presence of the orfX-ACME insert and the high-level mupirocin resistance gene ileS-2. The major circulating clones in Singaporean hospitals were ST22 (63.2%), ST45 (18.9%) and ST239 (10.7%). The orfX-ACME insert was only found in ST239 isolates (31/71, 43.7%), but ileS-2 was found in 207 (31.1%) of the MRSA isolates, varying between 10.0% and 47.8% among the hospitals. In conclusion, the molecular epidemiology of MRSA in Singaporean hospitals has continued to change, with ST45 now replacing ST239 in addition to the ongoing replacement of the latter by ST22. Although a greater proportion of ST239 isolates carry the orfX-ACME insert, the actual clinical impact may be marginal as ST239 MRSA continues to decline. Finally, high-level mupirocin resistance rates are remarkably high in local healthcare-associated MRSA, with implications for MRSA decolonisation and infection prevention. Further surveillance is required to monitor the changing epidemiological trends. Copyright © 2013 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

Cost of Osteoporotic Fractures in Singapore.

PubMed

Ng, Charmaine Shuyu; Lau, Tang Ching; Ko, Yu

2017-05-01

To estimate the 3-month direct and indirect costs associated with osteoporotic fractures from both the hospital's and patient's perspectives in Singapore and to compare the cost between acute and prevalent osteoporotic fractures. Resource use and expenditure data were collected using interviewer-administered questionnaires at baseline and at a 3-month follow-up between July 2013 and January 2014. Estimated osteoporotic fracture-related costs included hospitalizations, accident and emergency room visits, outpatient physician visits, laboratory tests, medications, transportation, health care and community services, special equipment and home/car modifications, and productivity loss. A total of 67 patients agreed to participate, giving a response rate of 64.4%. The mean (median) 3-month direct medical cost from the hospital's perspective was found to be SGD 3,886.90 (SGD 413.10), of which 74.2% was accounted for by inpatient services, 25.2% by outpatient services, and 0.6% by accident and emergency services. Moreover, considerable variation (SD = SGD 2,615.40) was observed in the costs of outpatient rehabilitation services. Findings were similar when the patient's perspective was taken. The total costs, with both direct and indirect costs included, were SGD 11,438.70 (acute) and SGD 1,015.40 (prevalent), of which 34.7% and 8.0%, respectively, were accounted for by inpatient services. Hospitalization was associated with the highest cost borne by both the hospital and the patient, and informal care dominated indirect costs. Better knowledge of the financial consequences of fragility fractures could enable proactive and preventive measures to be undertaken, especially at sites of care with high cost drivers. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

What Does Successful Aging Mean? Lay Perception of Successful Aging Among Elderly Singaporeans.

PubMed

Feng, Qiushi; Straughan, Paulin Tay

2017-03-01

We explore the culturally specific meaning of successful aging in Singapore, an ethnically diverse city-state in Asia. We aim to investigate lay perceptions of successful aging among the elderly individuals in Singapore and further examine variations of these perceptions. We applied a mixed-method research design. Firstly, we conducted qualitative interviews with 49 elderly respondents, generating 12 main subjective components of successful aging. Next, we did a national survey with a sample of 1,540 local residents aged 50 to 69 years, in which respondents were asked to evaluate the importance of each subjective component of successful aging. We used the regression models and latent class analysis to analyze the correlatives of successful aging and to classify the elderly individuals by perception types. Among 12 components of successful aging, those related to self-sufficiency received the highest acknowledgment among the elderly individuals in Singapore. At least half of them simultaneously highlighted independence from family and dependence on family. Malays and Indians in Singapore valued more of the roles of spouse and children in successful aging, as compared with Chinese. The latent class analysis classified four groups of the elderly individuals according to their lay views on successful aging. As compared with the western model of successful aging, the elderly individuals in Singapore perceived successful aging with a strong focus on familism. These lay perceptions also significantly varied among these elderly individuals. © 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.

Piracy the Somali Way

DTIC Science & Technology

2009-04-01

University Press, August 2008. “Anger as Piracy Gets Out of Control,” Australian, 21 November 2008. Bateman, Sam, Catherine Zara Raymond, and Joshua, Ho...Contemporary Piracy and Maritime Terrorism, 18. 23 Sam Batemen, Catherine Zara Raymond and Joshua Ho, “Safety and Security in the Malacca and Singapore

Comparing patient and healthcare worker experiences during a dengue outbreak in Singapore: understanding the patient journey and the introduction of a point-of-care test (POCT) toward better care delivery.

PubMed

Tan, Qinghui; Hildon, Zoe J-L; Singh, Shweta; Jing, Jin; Thein, Tun Linn; Coker, Richard; Vrijhoef, Hubertus J M; Leo, Yee Sin

2017-07-19

In the aftermath of an upsurge in the number of dengue cases in 2013 and 2014, the SD BIOLINE Dengue Duo rapid diagnostic Point-of-Care Test (POCT) kit was introduced in Tan Tock Seng Hospital, Singapore in June 2013. It is known that the success of POCT usage is contingent on its implementation within the health system. We evaluated health services delivery and the Dengue Duo rapid diagnostic test kit application in Singapore from healthcare workers' perspectives and patient experiences of dengue at surge times. Focus group discussions were conducted with dengue patients, from before and after the POCT implementation period. In-depth interviews with semi-structured components with healthcare workers were carried out. A patient centred process mapping technique was used for evaluation, which mapped the patient's journey and was mirrored from the healthcare worker's perspective. Patients and healthcare workers confirmed a wide range of symptoms in adults, making it challenging to determine diagnosis. There were multiple routes to help seeking, and no 'typical patient journey', with patients either presenting directly to the hospital emergency department, or being referred there by a primary care provider. Patients groups diagnosed before and after POCT implementation expressed some differences between speed of diagnoses and attitudes of doctors, yet shared negative feelings about waiting times and a lack of communication and poor information delivery. However, the POCT did not in its current implementation do much to help waiting times. Healthcare workers expressed that public perceptions of dengue in recent years was a major factor in changing patient management, and that the POCT kit was helpful in improving the speed and accuracy of diagnoses. Health service delivery for dengue patients in Singapore was overall perceived to be of an acceptable clinical standard, which was enhanced by the introduction of the POCT. However, improvements can be focused on Adapting to outbreaks by reducing and rendering Waiting experiences more comfortable; Advancing education about symptom recognition, while also Recognising better communication strategies; and Expanding follow-up care options. This is presented as the Dengue AWARE model of care delivery.

Securing and sustaining employment: concerns of HIV patients in Singapore.

PubMed

Tan, Si Ying; Ow Yong, Lai Meng; Foong, Jasmin Yuet Ee; Wong, Nicole Huay Sze; Chew, Li Ling; Koh, Yin Ling

2013-01-01

Employment sustainability is one of the most pressing issues inflicting people living with HIV (PLHIV). A qualitative approach was used to elucidate the perceived challenges in sustaining their employment and the perceived barriers in re-entering the workforce for HIV patients. In-depth interviews were conducted with 16 patients from an acute hospital in Singapore. The main challenges raised in sustaining employment were: (1) ability to ensure secrecy of diagnosis from employers, (2) ability to secure financial resources for treatment and sustenance, (3) ability to ensure stable health to meet job requirements, (4) ability to cognitively sit with the concerns of uncertainty and limitations in career, and (5) ability to work through discriminatory workplace practices. The perceived barriers in gaining workforce re-entry were: (1) fear of pre-employment medical screening and potential discriminatory practices at workplace, (2) concerns over health (frequent hospital admissions, physical weakness, and existing medical co-morbidities), and (3) psychosocial challenges (unstable accommodation, older age, financial issues, and trade skills limitation). The overarching factor that influences the success of sustaining and securing an employment among HIV patients is secrecy of the diagnosis. The individuals' health status, financial status and access to healthcare, and other psychosocial challenges further compound the issue.

Charity colonoscopy event to commemorate the 185th anniversary of Singapore General Hospital.

PubMed

Ng, Kheng Hong; Lim, Jit Fong; Ho, Kok Sun; Ooi, Boon Swee; Tang, Choong Leong; Eu, Kong Weng

2008-03-01

Colorectal cancer is now the cancer with the highest incidence in Singapore. However, the overall mortality rate is still about 50% because the majority of the patients present at a late stage of disease. A charity event of screening colonoscopy was offered to the public in conjunction with the 185th anniversary of Singapore General Hospital. The aim of this event was to raise awareness about early detection of colorectal cancer and the safety of colonoscopy. We conducted a one-off free screening event for colorectal cancer using colonoscopy. Four hundred and ninety individuals responded to a multimedia advertisement for the event. Of these, 220 individuals were selected for the screening based on National Guidelines for colorectal cancer screening and financial status. One hundred and fifty-two individuals turned up for the colonoscopy. The median age was 55 years (range, 22 to 82), with 84 males. Significant pathology was found in 33% of the individuals (n = 51). Colorectal polyps were detected in 34 individuals (22%). A total of 45 polyps were removed, with 20 hyperplastic polyps and 25 adenomas. Eight out of 25 adenomas were located proximal to the splenic flexure. Rectal cancer was diagnosed in 1 individual (0.6%). One individual had a large dysplastic rectosigmoid ulcer and refused further intervention. There were no significant complications from any of the colonoscopies. Colonoscopy is an invaluable screening modality as it has a high pick-up rate for colorectal polyp and cancer in an asymptomatic population. It is also proven to be safe in our study. It has the added advantage over flexible sigmoidoscopy of detecting a significant number of proximal lesions. Also, therapeutic polypectomy can be performed in the same setting.

Streptococcus pneumoniae bacteraemia due to parotitis in a patient with systemic sclerosis and secondary Sjögren's syndrome.

PubMed

Yii, Irene Yuen Lin; Tan, Jamie Bee Xian; Fong, Warren Weng Seng

2016-10-01

Invasive pneumococcal disease is an uncommon and notifiable disease in Singapore. It is often associated with significant morbidity and mortality. We report a rare case of invasive pneumococcal bacteraemia due to parotitis in a patient with systemic sclerosis and secondary Sjögren's syndrome. We also present a retrospective review of Streptococcus pneumoniae bacteraemia cases in Singapore General Hospital from January 2011 to April 2016. A 59-year-old Malay lady with a history of systemic sclerosis with secondary Sjögren's syndrome presented with fever and left parotid gland swelling. Clinical examination revealed poor salivary pooling and left parotid swelling without fluctuance. Ultrasound of the left parotid gland confirmed acute parotitis without evidence of abscess or sialolithiasis. Blood cultures were positive for S. pneumoniae . She was diagnosed to have invasive pneumococcal bacteraemia secondary to acute parotitis, and treated with intravenous benzylpenicillin with clearance of bacteraemia after 3 days. Upon discharge, her antibiotics were changed to intravenous ceftriaxone to facilitate outpatient parenteral antibiotic therapy for another 2 weeks. She responded favourably to antibiotics at follow-up, with no complications from the bacteraemia. A review of the microbiological records of the Singapore General Hospital revealed 116 cases of pneumococcal bacteraemia, most (80.3 %) of which were due to pneumonia. None were due to parotitis. S. pneumoniae parotitis and subsequent bacteraemia is rare. Prompt recognition of the disease and appropriate use of antibiotics are important. This case highlights that close communication between healthcare workers (microbiologist, rheumatologist and infectious disease specialist) is essential in ensuring good clinical outcomes in patients with a potentially fatal disease.

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.

An observational study describing the geographic-time distribution of cardiac arrests in Singapore: what is the utility of geographic information systems for planning public access defibrillation? (PADS Phase I).

PubMed

Ong, Marcus Eng Hock; Tan, Eng Hoe; Yan, Xiuyuan; Anushia, P; Lim, Swee Han; Leong, Benjamin Sieu-Hon; Ong, Victor Yeok Kein; Tiah, Ling; Yap, Susan; Overton, Jerry; Anantharaman, V

2008-03-01

Public access defibrillation (PAD) has shown potential to increase cardiac arrest survival rates. To describe the geographic epidemiology of prehospital cardiac arrest in Singapore using geographic information systems (GIS) technology and assess the potential for deployment of a PAD program. We conducted an observational prospective study looking at the geographic location of pre-hospital cardiac arrests in Singapore. Included were all patients with out-of-hospital cardiac arrest (OHCA) presented to emergency departments. Patient characteristics, cardiac arrest circumstances, emergency medical service (EMS) response and outcomes were recorded according to the Utstein style. Location of cardiac arrests was spot-mapped using GIS. From 1 October 2001 to 14 October 2004, 2428 patients were enrolled into the study. Mean age for arrests was 60.6 years with 68.0% male. 67.8% of arrests occurred in residences, with 54.5% bystander witnessed and another 10.5% EMS witnessed. Mean EMS response time was 9.6 min with 21.7% receiving prehospital defibrillation. Cardiac arrest occurrence was highest in the suburban town centers in the Eastern and Southern part of the country. We also identified communities with the highest arrest rates. About twice as many arrests occurred during the day (07:00-18:59 h) compared to night (19:00-06:59 h). The categories with the highest frequencies of occurrence included residential areas, in vehicles, healthcare facilities, along roads, shopping areas and offices/industrial areas. We found a definite geographical distribution pattern of cardiac arrest. This study demonstrates the utility of GIS with a national cardiac arrest database and has implications for implementing a PAD program, targeted CPR training, AED placement and ambulance deployment.

The Alignment of Small States: Singapore and Vietnam

DTIC Science & Technology

2011-12-01

University Press, 1998. Geiss, Imanuel. German Foreign Policy, 1871–1914. Boston: Routledge & Kegan Paul Ltd, 1976. Goh, Evelyn. “Great Powers and...Meeting the China Challenge: The U.S. in Southeast Asian Regional Security Strategies. Washington, D.C.: East-West Center Washington. Green , Michael J

Scholars, Spies, and Global Studies

ERIC Educational Resources Information Center

Dirks, Nicholas B.

2012-01-01

No one doubts that globalization is one of the most important trends of today. As American universities expand their global footprint with branch campuses in Singapore, Abu Dhabi, and elsewhere, many faculty are concerned about oppressive governance, human-rights violations, and lack of academic freedom abroad. Meanwhile administrators grapple…

South Korea Powers Ahead with Globalization Plans

ERIC Educational Resources Information Center

McNeill, David

2009-01-01

For government officials in South Korea, it's a vision worth savoring: Within the next decade, South Korea becomes Southeast Asia's top higher-education destination, poaching thousands of Chinese, Indian, and Japanese students from American universities and overtaking rivals Singapore, Malaysia, and Hong Kong. The higher-education system's…

Life support course for nurses in Singapore.

PubMed

Heng, W J K; Seow, E; Tham, K Y

2011-08-01

Nurses are usually the first caregivers for cardiac arrest patients in an in-hospital environment, and subsequently partner with doctors in the further resuscitation of patients. The skills of basic life support are crucial for their practice. The Advanced Cardiac Life Support programme is traditionally geared toward training of medical staff in advanced resuscitation skills. The need for a bridging course that focuses on the knowledge and skills required by nurses to become effective members of the resuscitation team has resulted in the creation of the Life Support Course for Nurses (LSCN) in Singapore. The components of the LSCN programme have evolved over the years, taking into consideration the modifications to resuscitation guidelines. The LSCN programme is gradually including a larger proportion of nurses in the emergency and critical care environments as well as those in the general ward.

Five for Sydney 2009

ERIC Educational Resources Information Center

Education in Science, 2009

2009-01-01

The Professor Harry Messel International Science School is organised by the Science Foundation for Physics within the University of Sydney. In 1968, the Foundation extended the participation to the UK and Japan and each country sends five scholars to the Science Schools, which are held every second year. Nowadays, scholars from Singapore,…

Experiences with the Situation Approach in Asia.

ERIC Educational Resources Information Center

Zimmer, Jurgen

This paper relates the experiences of an early childhood professor from the Freie University of Berlin on a trip through East Asia to provide advice and assistance on the situational approach to preschool education. Impressions of the sociopolitical and educational environment and needs of Thailand, Hong Kong, Indonesia, Singapore, Malaysia, and…

A Participants' DSS for a Management Game with a DSS Generator.

ERIC Educational Resources Information Center

Yeo, Gee Kin; Nah, Fui Hoon

1992-01-01

Describes the design of a decision support system (DSS) for a management game called MAGNUS (Management Game for National University of Singapore). Built-in models for performance analysis and decision making are explained; database query and model building are described; and future work is discussed. (11 references) (LRW)

Toward a Multilingual, Experiential Environment for Learning Decision Technology.

ERIC Educational Resources Information Center

Yeo, Gee Kin; Tan, Seng Teen

1999-01-01

Describes work at the National University of Singapore on the Internet in expanding a simulation game used in supporting a course in decision technology. Topics include decision support systems, multilingual support for cross-cultural decision studies, process support in a World Wide Web-enhanced multiuser domain (MUD) learning environment, and…

Negotiating Critical Literacies in Classrooms.

ERIC Educational Resources Information Center

Comber, Barbara, Ed.; Simpson, Anne, Ed.

This book brings together accounts of educators who have sought to make a difference in the lives of their students through literacy education--from university classrooms in the United States, England, and South Africa, to policy and curriculum development in Singapore and Australia. The literacy classrooms explored in the book range from the…

University Governance: An Issue for Our Time

ERIC Educational Resources Information Center

Shattock, Michael

2012-01-01

In a conversation between Francis Fukuyama, the Stanford-based political scientist, to publicise his new book "The Origins of Political Order," and Martin Wolf, the distinguished financial journalist, Fukuyama compares political systems in countries like China and Singapore with the liberal West. Without taking the analogy too far the…

Cross-National Comparison of Consumer Attitudes toward Consumerism in Four Developing Countries.

ERIC Educational Resources Information Center

Darley, William K.; Johnson, Denise M.

1993-01-01

Comparison of university student attitudes (n=305) in Kenya, Nigeria, India, and Singapore found some consumer discontent regardless of the economic status of the country. Singaporeans were most skeptical of business, Indians the least. Results show how consumerism is becoming a worldwide phenomenon. (SK)

A review of accessibility of administrative healthcare databases in the Asia-Pacific region

PubMed Central

Milea, Dominique; Azmi, Soraya; Reginald, Praveen; Verpillat, Patrice; Francois, Clement

2015-01-01

Objective We describe and compare the availability and accessibility of administrative healthcare databases (AHDB) in several Asia-Pacific countries: Australia, Japan, South Korea, Taiwan, Singapore, China, Thailand, and Malaysia. Methods The study included hospital records, reimbursement databases, prescription databases, and data linkages. Databases were first identified through PubMed, Google Scholar, and the ISPOR database register. Database custodians were contacted. Six criteria were used to assess the databases and provided the basis for a tool to categorise databases into seven levels ranging from least accessible (Level 1) to most accessible (Level 7). We also categorised overall data accessibility for each country as high, medium, or low based on accessibility of databases as well as the number of academic articles published using the databases. Results Fifty-four administrative databases were identified. Only a limited number of databases allowed access to raw data and were at Level 7 [Medical Data Vision EBM Provider, Japan Medical Data Centre (JMDC) Claims database and Nihon-Chouzai Pharmacy Claims database in Japan, and Medicare, Pharmaceutical Benefits Scheme (PBS), Centre for Health Record Linkage (CHeReL), HealthLinQ, Victorian Data Linkages (VDL), SA-NT DataLink in Australia]. At Levels 3–6 were several databases from Japan [Hamamatsu Medical University Database, Medi-Trend, Nihon University School of Medicine Clinical Data Warehouse (NUSM)], Australia [Western Australia Data Linkage (WADL)], Taiwan [National Health Insurance Research Database (NHIRD)], South Korea [Health Insurance Review and Assessment Service (HIRA)], and Malaysia [United Nations University (UNU)-Casemix]. Countries were categorised as having a high level of data accessibility (Australia, Taiwan, and Japan), medium level of accessibility (South Korea), or a low level of accessibility (Thailand, China, Malaysia, and Singapore). In some countries, data may be available but accessibility was restricted based on requirements by data custodians. Conclusions Compared with previous research, this study describes the landscape of databases in the selected countries with more granularity using an assessment tool developed for this purpose. A high number of databases were identified but most had restricted access, preventing their potential use to support research. We hope that this study helps to improve the understanding of the AHDB landscape, increase data sharing and database research in Asia-Pacific countries. PMID:27123180

Remote sensing helps to assess natural hazards and environmental changes in Asia-Pacific region

NASA Astrophysics Data System (ADS)

Thouret, Jean-Claud; Liew, Soo Chin; Gupta, Avijit

2012-04-01

Conference on Remote Sensing, Natural Hazards, and Environmental Change; Singapore, 28-29 July 2011 Natural hazards and anthropogenic environmental changes, both significant in the Asia-Pacific region, were the two themes of a conference organized by the National University of Singapore's Centre for Remote Imaging, Sensing and Processing (CRISP) and the Université Blaise Pascal's Laboratoire Magmas et Volcans. The application of satellite imagery at a wide range of resolutions, from 500 meters to 50 centimeters, was a unifying approach in many of the studies presented. The recent arrival of a new generation of satellites with extremely high resolution (50 centimeters) has improved scientists' ability to carry out detailed studies of natural hazards and environmental change.

ValuedCare program: a population health model for the delivery of evidence-based care across care continuum for hip fracture patients in Eastern Singapore.

PubMed

Mittal, Chikul; Lee, Hsien Chieh Daniel; Goh, Kiat Sern; Lau, Cheng Kiang Adrian; Tay, Leeanna; Siau, Chuin; Loh, Yik Hin; Goh, Teck Kheng Edward; Sandi, Chit Lwin; Lee, Chien Earn

2018-05-30

To test a population health program which could, through the application of process redesign, implement multiple evidence-based practices across the continuum of care in a functionally integrated health delivery system and deliver highly reliable and consistent evidence-based surgical care for patients with fragility hip fractures in an acute tertiary general hospital. The ValuedCare (VC) program was developed in three distinct phases as an ongoing collaboration between the Geisinger Health System (GHS), USA, and Changi General Hospital (CGH), Singapore, modelled after the GHS ProvenCare® Fragile Hip Fracture Program. Clinical outcome data on consecutive hip fracture patients seen in 12 months pre-intervention were then compared with the post-intervention group. Both pre- and post-intervention groups were followed up across the continuum of care for a period of 12 months. VC patients showed significant improvement in median time to surgery (97 to 50.5 h), as well as proportion of patients operated within 48 h from hospital admission (48% from 18.8%) as compared to baseline pre-intervention data. These patients also had significant reduction (p value < 0.001) of acute inpatient complications such as delirium, pneumonia, urinary tract infections, and pressure sores. VC program has shown significant reduction in median length of stay for acute hospital (13 to 9 days) as well as median combined length of stay for acute and sub-acute rehabilitation hospital (46 to 39 days), thus reducing the total duration of hospitalization and saving total hospital bed days. Operative and inpatient mortality, together with readmission rates, remained low and comparable to international Geriatric Fracture Centers (GFCs). The implementation of VC methodology has enabled consistent delivery of high-quality, reliable and comprehensive evidence-based care for hip fracture patients at Changi General Hospital. This has also reflected successful change management and interdisciplinary collaboration within the organization through the program. There is potential for testing this methodology as a quality improvement framework replicable to other disease groups in a functionally integrated healthcare system.

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.

Bell's palsy in Singapore: a view from the patient's perspective.

PubMed

Charn, Tze Choong; Subramaniam, Somasundaram; Yuen, Heng-Wai

2013-02-01

Bell's palsy is a well-recognised disease with robust research on its possible aetiologies and epidemiology, but scant information on patients' concerns and concepts regarding the condition is available. We aimed to evaluate the ideas, concerns and expectations of patients with Bell's palsy in Singapore. A cross-sectional study was conducted at a single tertiary-care hospital in Singapore. Participants were all patients with newly diagnosed Bell's palsy referred to the otolaryngology department either from the emergency department or by general practitioners. Participants were given a self-administered questionnaire and their facial nerve palsies were graded by the consultant doctor. A total of 52 patients were recruited, of which 41 were available for analysis. 78.0% of patients were concerned that they were having a stroke upon presentation of the symptoms. Other beliefs about the cause of the disease included overwork or stress (36.6%), something that the patient had eaten (9.8%) and supernatural forces (2.4%). About 50% of patients had tried some form of complementary or alternative therapy other than the steroids/medicines prescribed by their general practitioner or emergency physician. While 39.0% of patients agreed that the Internet had helped them understand more about their condition in addition to the information provided by the physician, 9.8% of them specifically disagreed with this statement. We have found that patients with Bell's palsy in Singapore are not very knowledgeable about the disease. Although the Internet is a useful resource, a physician's explanation of the disease and its natural progression remains of utmost importance.

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.

Premenopausal women with recurrent urinary tract infections have lower quality of life.

PubMed

Ennis, Siobhan S; Guo, Huifang; Raman, Lata; Tambyah, Paul A; Chen, Swaine L; Tiong, Ho Yee

2018-05-22

To examine the impact on quality of life of recurrent acute uncomplicated urinary tract infection among premenopausal Singaporean women, and to determine the risk factors for lower quality of life among these patients. A total of 85 patients with recurrent acute uncomplicated urinary tract infection who were referred to the Urology Department at the National University Hospital, Singapore, were prospectively recruited over a 3-year period to complete the validated Short Form 36 Health Survey version 1. In addition, demographic and clinical details including symptomology and medical history were analyzed for factors impacting quality of life. Short Form 36 Health Survey version 1 results were compared with published population norms. After adjusting for age, gender and race, recurrent acute uncomplicated urinary tract infection patients had significantly lower quality of life on seven out of eight Short Form 36 Health Survey version 1 domains when compared with age-, gender- and race-adjusted population norms for Singapore. Among those with recurrent acute uncomplicated urinary tract infection, those who also reported caffeine consumption had significantly lower Short Form 36 Health Survey version 1 scores than those who did not. Those who reported chronic constipation also had consistently lower Short Form 36 Health Survey version 1 scores across all domains. Recurrent acute uncomplicated urinary tract infection has a negative impact on the quality of life of premenopausal, otherwise healthy women. Recurrent acute uncomplicated urinary tract infection patients who also have chronic constipation or consume caffeine have lower quality of life than those who do not. More studies are required to understand the relationships between these common problems and risk factors. © 2018 The Japanese Urological Association.

Second Malignant Neoplasms in Childhood Cancer Survivors Treated in a Tertiary Paediatric Oncology Centre.

PubMed

Lim, Jia Wei; Yeap, Frances Sh; Chan, Yiong Huak; Yeoh, Allen Ej; Quah, Thuan Chong; Tan, Poh Lin

2017-01-01

Introduction : One of the most feared complications of childhood cancer treatment is second malignant neoplasms (SMNs). This study evaluates the incidence, risk factors and outcomes of SMNs in a tertiary paediatric oncology centre in Singapore. Materials and Methods : A retrospective review was conducted on patients diagnosed with childhood cancer under age 21 and treated at the National University Hospital, Singapore, from January 1990 to 15 April 2012. Case records of patients with SMNs were reviewed. Results : We identified 1124 cases of childhood cancers with a median follow-up of 3.49 (0 to 24.06) years. The most common primary malignancies were leukaemia (47.1%), central nervous system tumours (11.7%) and lymphoma (9.8%). Fifteen cases developed SMNs, most commonly acute myeloid leukaemia/myelodysplastic syndrome (n = 7). Median interval between the first and second malignancy was 3.41 (0.24 to 18.30) years. Overall 20-year cumulative incidence of SMNs was 5.3% (95% CI, 0.2% to 10.4%). The 15-year cumulative incidence of SMNs following acute lymphoblastic leukaemia was 4.4% (95% CI, 0% to 8.9%), significantly lower than the risk after osteosarcoma of 14.2% (95% CI, 0.7% to 27.7%) within 5 years ( P <0.0005). Overall 5-year survival for SMNs was lower than that of primary malignancies. Conclusion : This study identified factors explaining the epidemiology of SMNs described, and found topoisomerase II inhibitor use to be a likely risk factor in our cohort. Modifications have already been made to our existing therapeutic protocols in osteosarcoma treatment. We also recognised the importance of other risk management strategies, including regular long-term surveillance and early intervention for detected SMNs, to improve outcomes of high risk patients.

A study of sports-related orbital fractures in Singapore.

PubMed

Lock, Jing Zhan; Hegde, Raghuraj; Young, Stephanie; Lim, Thiam Chye; Amrith, Shantha; Sundar, Gangadhara

2017-10-01

With an increased popularity of sport and active living worldwide, our study aims to explore the incidence and features of sports-related orbital fractures in Singapore. 1421 computer tomography (CT) imaging scans of the face and orbits done at the National University Hospital over a 24-month period from January 2013 and December 2014 were reviewed retrospectively for orbital fractures. We identified 483 orbital fractures of which sports injury was the fourth most common etiology (n = 65; 13.5%) after road traffic accident (n = 131; 27.1%), geriatric fall (n = 81; 16.8%) and workplace injury (n = 67; 13.9%). The three most common sport in orbital fractures were soccer (n = 20; 30.8%), bicycling (n = 11; 16.9%) and jogging (n = 8; 12.3%). The three most common fracture patterns were zygomatico-maxillary complex fractures (n = 24; 36.9%), isolated one wall blowout fractures (n = 19; 29.2%) and naso-orbito-ethmoid fractures (n = 7; 10.8%). Sports-related orbital fractures were associated with a low mean age of patients (45.9 years, range, 14-79 years), a higher proportion of males (n = 58; 89.2%) than that from geriatric falls (n = 37, 45.6%) (P < 0.01), a higher likelihood of unilaterality (n = 62; 95.4%) than that from traffic accidents (n = 99; 75.6%) (P < 0.01) and a lower likelihood of pan-facial involvement (n = 4; 6.15%) than that from traffic accident (n = 60; 45.8%) (P < 0.01). Sports-related orbital fractures are the fourth most common cause of orbital fractures. Though commonly seen in young male adults, in view of the aging population and people exercising more regularly, education of safety measures among sports users is paramount to preventing sports-related orbital fractures.

Profiles of women presenting for abortions in Singapore: focus on teenage abortions and late abortions.

PubMed

Lim, Limin; Wong, Hungchew; Yong, Euleong; Singh, Kuldip

2012-02-01

Teenage abortions predispose women to adverse pregnancy outcomes in subsequent pregnancies such as anemia, stillbirths, preterm deliveries and low birth weight babies. We aim to profile the women presenting for abortions in our institution and determine risk factors for late presentation for abortions. In this retrospective cohort study, all women who underwent an abortion at the National University Hospital, Singapore, from 2005 to 2009 were recruited. Data was obtained from a prepared questionnaire during the mandatory pre-abortion counseling sessions. Profiles of women aged <20 years were compared with those ≥ 20 years old using Chi-square test if the assumptions for Chi-square test were met; otherwise, Fisher's exact test was carried out. Logistic regression was used to investigate the risk factors for second trimester termination of pregnancy. 2109 women presented for induced abortions, of which 1998 had single abortion throughout the course of the study. The mean age of women with single abortion was 29.1 years (sd 7). In the group of women with single abortion, 182 (9.1%) were teenage abortions. In contrast to women ≥ 20 years of age, pregnant teenagers were more likely not to have used any contraception (51.1% vs. 25.2%) and more likely to present late for abortions (39.6% vs. 15.9%). Other risk factors for late presentation for abortions include Malay ethnicity, singlehood, nulliparity and lack of prior usage of contraception. Teenagers are more likely to have no prior contraceptive usage and to present late for abortions. Lack of proper sexual education and awareness of contraceptive measures may have a major contributory factor to such a trend in teenage abortions. Recommendations have been made in order to curb this societal problem. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Exploring if day and time of admission is associated with average length of stay among inpatients from a tertiary hospital in Singapore: an analytic study based on routine admission data.

PubMed

Earnest, Arul; Chen, Mark I C; Seow, Eillyne

2006-01-22

It has been postulated that patients admitted on weekends or after office hours may experience delays in clinical management and consequently have longer length of stay (LOS). We investigated if day and time of admission is associated with LOS in Tan Tock Seng Hospital (TTSH), a 1,400 bed acute care tertiary hospital serving the central and northern regions of Singapore. This was a historical cohort study based on all admissions from TTSH from 1st September 2003 to 31st August 2004. Data was extracted from routinely available computerized hospital information systems for analysis by episode of care. LOS for each episode of care was log-transformed before analysis, and a multivariate linear regression model was used to study if sex, age group, type of admission, admission source, day of week admitted, admission on a public holiday or eve of public holiday, admission on a weekend and admission time were associated with an increased LOS. In the multivariate analysis, sex, age group, type of admission, source of admission, admission on the eve of public holiday and weekends and time of day admitted were independently and significantly associated with LOS. Patients admitted on Friday, Saturday or Sunday stayed on average 0.3 days longer than those admitted on weekdays, after adjusting for potential confounders; those admitted on the eve of public holidays, and those admitted in the afternoons and after office hours also had a longer LOS (differences of 0.71, 1.14 and 0.65 days respectively). Cases admitted over a weekend, eve of holiday, in the afternoons, and after office hours, do have an increased LOS. Further research is needed to identify processes contributing to the above phenomenon.

Adolescent health in Asia: insights from Singapore.

PubMed

Oh, Jean-Yin; Rajasegaran, Kumudhini

2016-08-01

The introduction of adolescent medicine as a medical subspecialty in Singapore was a welcome in an evolving health care system that is unique in terms of both efficiency, in financing and the results achieved in community health outcomes. The Ministry of Health (MOH) already recognized the need to accommodate the health care concerns related to adolescent psychosocial health risk behaviors and an increased prevalence of young people living with chronic illness. The challenge for the pioneer team of physicians trained in adolescent medicine was to develop and sustain a model of care that integrated (i) core clinical services that include quality measures of care to adolescents; (ii) professional development and capacity building needing an expansive teaching agenda at every level of health education; (iii) strong inter-sectorial collaborations within hospital and community partners; and (iv) robust research and evaluation strategies that keep clinical practice relevant and evidence based.

Experiences of Patients Living With Heart Failure: A Descriptive Qualitative Study.

PubMed

Seah, Alvin Chuen Wei; Tan, Khoon Kiat; Huang Gan, Juvena Chew; Wang, Wenru

2016-07-01

The purpose of this study was to explore the experiences, needs, and coping strategies of patients living with heart failure in Singapore. A descriptive qualitative design was used. A purposive sample of 15 informants was recruited from two cardiology wards of a tertiary public hospital in Singapore. Individual face-to-face interviews were conducted with a semistructured interview guideline that was developed based on a review of the literature and a pilot study. Content analysis was adopted to analyze the data, and four main categories were identified: perceived causes, manifestations, and prognosis; enduring emotions; managing the condition; and needs from health care professionals. The informants were overwhelmed with the experience of living with heart failure due to the disruptive and uncertain nature of the condition. This study offers health care professionals practical and useful suggestions when providing holistic care for patients with heart failure. © The Author(s) 2015.

Complexities and Challenges of Singapore Nurses Providing Postacute Home Care in Multicultural Communities: A Grounded Theory Study.

PubMed

Wong, Alfred Ka-Shing; Ong, Shu Fen; Matchar, David Bruce; Lie, Desiree; Ng, Reuben; Yoon, Kirsten Eom; Wong, Chek Hooi

2017-10-01

Studies are needed to inform the preparation of community nurses to address patient behavioral and social factors contributing to unnecessary readmissions to hospital. This study uses nurses' input to understand challenges faced during home care, to derive a framework to address the challenges. Semistructured interviews were conducted to saturation with 16 community nurses in Singapore. Interviews were transcribed verbatim and transcripts independently coded for emergent themes. Themes were interpreted using grounded theory. Seven major themes emerged from 16 interviews: Strained social relationships, complex care decision-making processes within families, communication barriers, patient's or caregiver neglect of health issues, building and maintaining trust, trial-and-error nature of work, and dealing with uncertainty. Community nurses identified uncertainty arising from complexities in social-relational, personal, and organizational factors as a central challenge. Nursing education should focus on navigating and managing uncertainty at the personal, patient, and family levels.

Dedicated cytogenetics factor is critical for improving karyotyping results for childhood leukaemias - experience in the National University Hospital, Singapore 1989-2006.

PubMed

Heng, J L; Chen, Y C; Quah, T C; Liu, T C; Yeoh, A E J

2010-02-01

Childhood leukaemia accounts for more than 40% of new childhood cancer cases. Karyotyping of cytogenetic abnormalities in such cases continues to provide critical prognostic information which allows the delivery of an appropriate intensity of treatment. Unfortunately, karyotyping of childhood leukaemia is difficult, laborious and often unsuccessful. Banding resolution tends to be poor unlike routine antenatal cytogenetics. The aim of the study is to highlight the benefit of dedicated cytogenetics in improving karyotyping results. We analysed the impact of setting up a team of cytogeneticists in the National University Hospital (NUH) on the success of karyotyping, evaluating cytogenetic data collected from 1989 to 2006. From 1989 to 2006, 4789 cases have been processed. Among them, 369 newly diagnosed and relapsed childhood acute leukaemia cases [281 acute lymphoblastic leukaemia (ALL) and 88 acute myeloid leukaemia (AML)] have been diagnosed at NUH. A dedicated cytogenetics laboratory with clearly defined standard operating procedures and quality control was set up in 2002. It used the established recommendation of a complete analysis of at least 20 metaphases per analysis. Overall, the frequency of successful karyotyping was significantly higher (P = 0.002) at 90.7% (185/204) from 2002-2006 compared to 79.4% (131/165) from 1989-2001. For ALL cases, the success rate improved from 77.6% (97/125) in 1989 to 2001 to 89.1% (139/156) in the 2002 to 2006 cohort. For AML, the success rate also was significantly improved (P = 0.04) from 85% (34/40) to 95.8% (46/48). Significantly, this high rate of success is still maintained despite a yearly increase in volume. The establishment of a dedicated cytogenetics service leads to an improvement in results.

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…

Understanding the Difficulties Faced by Engineering Undergraduates in Learning Mathematical Modelling

ERIC Educational Resources Information Center

Soon, Wanmei; Lioe, Luis Tirtasanjaya; McInnes, Brett

2011-01-01

The teaching of mathematics in Singapore continues, in most cases, to follow a traditional model. While this traditional approach has many advantages, it does not always adequately prepare students for University-level mathematics, especially applied mathematics. In particular, it does not cultivate the ability to deal with "non-routine…

The McLuhan Global Classroom: A Singapore-U.S. One-Year Instructional Interaction.

ERIC Educational Resources Information Center

Aune, Adonica Schultz; Lim, Dan

WebCT was integrated and modeled in a global Instructional Technology (IT) Certification Summer Institute offered through the University of Minnesota. Courses were first introduced with an on-site certification where technology integration was modeled in each course through the use of highly interactive web-based learning applications and games…

Internationalizing Higher Education in Singapore: Government Policies and the NUS Experience

ERIC Educational Resources Information Center

Daquila, Teofilo C.

2013-01-01

The internationalization of higher education has become an important policy and research agenda. At the national level, different countries have responded differently with some countries becoming more open than others. At the local level, universities have also reacted differently with some becoming more liberal and innovative than others. Thus,…

An Expert System Approach to Online Catalog Subject Searching.

ERIC Educational Resources Information Center

Khoo, Christopher S. G.; Poo, Danny C. C.

1994-01-01

Reviews methods to improve online catalogs for subject searching and describes the design of an expert system front-end to improve subject access in online public access catalogs that focuses on search strategies. Implementation of a prototype system at the National University of Singapore is described, and reformulation strategies are discussed.…

A Scale for Measuring Student Perceptions of Quality: An Australian Asian Perspective.

ERIC Educational Resources Information Center

Gatfield, Terry

2000-01-01

Focused on student understandings of quality by developing a scale that identified the quality variables related to student perceptions of the university experience. Responses by 351 students from Australia, Singapore, and Hong Kong make it possible to make inferences about how educational marketing practitioners can be assisted. (SLD)

Dietary and fluid restriction perceptions of patients undergoing haemodialysis: an exploratory study.

PubMed

Hong, Leting Isabella; Wang, Wenru; Chan, Ee Yuee; Mohamed, Fatimah; Chen, Hui-Chen

2017-11-01

To explore the perspectives of patients undergoing haemodialysis in Singapore on an imposed dietary and fluid restriction regime. Adherence to prescribed dietary and fluid restriction constructs the fundamental basis of self-care with improved morbidity and mortality. However, most patients have struggled to adhere in this aspect. Existing studies have presented limited understanding on the facilitators and barriers of dietary and fluid adherence among haemodialysis patients. An exploratory qualitative study. A purposive sample of 14 patients undergoing haemodialysis was recruited from a renal unit of a tertiary hospital in Singapore. Data were collected through face-to-face individual interviews and subsequently analysed by thematic analysis. Four themes emerged: (1) Pessimism, (2) Existing struggles, (3) Perceived quality of support, and (4) Immensity of self-discipline. The imposed dietary and fluid restriction is a constant struggle and a cause of suffering among haemodialysis patients in Singapore. Nonetheless, they are generally submissive to their fluid restrictions for the sake of survival or to meet the expectations of their loved ones. The imposed dietary restrictions are generally neglected. The findings from this study can provide useful information in reviewing existing educational strategies, policies and nursing care. This is especially important because most patients exhibit high reliance on healthcare professionals. © 2017 John Wiley & Sons Ltd.

ONR Far East Scientific Bulletin. Volume 10, Number 3, July-September 1985,

DTIC Science & Technology

1985-09-01

to alpha and beta interferon. " Vaccines Using recombinant DNA technology, researchers at Osaka University have developed a vaccine against the Chicken ... Pox virus. Using recombinant DNA technology, researchers at Kyushu University have developed a vaccine against the Herpes simplex virus. " Drugs...Germany 9 Norway 8 Holland 7 U.K. 6 France 4 Denmark 4 Austria 4 U.S.S.R. 3 Australia 2 Singapore 2 Spain 2 Poland I Egypt I Israel I Mexico I 20

United States-Vietnam Relations 1945-1967 (Book 1 of 12)

DTIC Science & Technology

1971-01-01

Virginia W. C. (DAN) DANIEL, Virginia G. V. (SONNY) MONTGOMERY. Mississippi MICHAEL J. HARRINGTON, Massachusetts HAROLD RUNNELS, New Mexico LES ASPIN...Committee established and who chose it? Will Front policy be followed and will there be communication with the Front? Adn since this assembly is...Went to Singapore, arrested again and sent back to Hong Kong. Admitted to hospital for . tuberculosis . 1933 Nguyen Ai Quoc reported dead in Hong

Causes of death in hospitalised HIV-infected patients at a National Referral Centre in Singapore: a retrospective review from 2008 to 2010.

PubMed

Wong, Chen Seong; Lo, Francis A; Cavailler, Philippe; Ng, Oon Tek; Lee, Cheng Chuan; Leo, Yee Sin; Chua, Arlene C

2012-12-01

Highly active antiretroviral therapy (HAART) has improved outcomes for individuals infected with human immunodeficiency virus (HIV). This study describes the causes of death in hospitalised HIV-positive patients from 2008 to 2010 in Tan Tock Seng Hospital, the national referral centre for HIV management in Singapore. Data were retrospectively collected from HIV-positive patients who died in Tan Tock Seng Hospital from January 2008 to December 2010. Sixty-seven deaths occurred in the study period. A majority of patients died of non-acquired immune deficiency syndrome (AIDS)-defining illnesses (54.7%). The median CD4 count was 39.5 (range, 20.0 to 97.0), and 7 patients had HIV viral loads of <200 copies/mL. There were 27 deaths due to opportunistic infections, 27 due to non AIDS-defining infections, 4 due to non AIDS-associated malignancies. This study also describes 3 deaths due to cardiovascular events, and 1 due to hepatic failure. Patients who had virologic suppression were more likely to die from non AIDS-defining causes. Causes of death in HIV-positive patients have changed in the HAART era. More research is required to further understand and address barriers to testing and treatment to further improve outcomes in HIV/AIDS.

Quest for a good life: spiritual values, life goals, and college students.

PubMed

Zhang, Kaili Chen; Yu, Esther Dawen

2014-03-01

Values and life goals are associated with one's general well-being and quality of life. However, there is insufficient documentation about issues that are linked with the notions of spiritual values and life goals among college students in Asia. This study addressed this lack of research by focusing on the spiritual values and life goals among students in Singapore. Four hundred and ninety structured surveys and 64 follow-up interviews were taken in two government-sponsored universities in Singapore. Statistics showed that spiritual values were positively correlated with intrinsic goals, which had been shown to strongly relate to subjective well-being (SWB). Developing spiritual values may promote subjective well-being by enabling college students to find meaning and purpose in life. Copyright © 2012 Blackwell Publishing Asia Pty Ltd.

Ethnobotanical survey of usage of fresh medicinal plants in Singapore.

PubMed

Siew, Yin-Yin; Zareisedehizadeh, Sogand; Seetoh, Wei-Guang; Neo, Soek-Ying; Tan, Chay-Hoon; Koh, Hwee-Ling

2014-09-29

The use of medicinal plants in human health has been documented since ancient times and they provide a useful source of new therapeutics. In Singapore, despite the accessibility to modern healthcare, there still exist pockets of the population who choose to use locally grown fresh medicinal plants for health promotion and even therapeutic purposes. However to date, there is no published report of first-hand account of their usage in Singapore. As land is scarce and rapidly used for re-development, such important knowledge may be lost if not properly documented in time. This work safeguards the local folk knowledge, and provides information on common and scarcely reported fresh medicinal plants. The objective of this study is to gather information regarding the usage of fresh medicinal plants in Singapore through face-to-face interviews. Information on demographic data and plant-use methods were collated via face-to-face interviews of 200 fresh medicinal plant users who have used fresh medicinal plants in the last five years. The survey protocol was approved by the National University of Singapore Institutional Review Board and informed consent was obtained from every participant. A total of 414 plants represented by 104 plant species from 44 families were reportedly used by the 200 participants. The five most commonly used plants were Clinacanthus nutans (34 users), Strobilanthes crispus (31 users), Pereskia bleo (25 users), Aloe vera (18 users) and Zingiber officinale (16 users). Leaves were the most commonly used plant part while preparing a decoction was the most common method of preparation. The majority of interviewees used plants for general health purposes and to treat diseases related to the respiratory system and cancer. Our survey has successfully documented the rich wealth of traditional usage and knowledge on 414 fresh medicinal plants grown in Singapore through face-to-face interviews with 200 users. This study will serve as a useful resource for identifying promising plants for future drug discovery efforts. Scientific evaluations of these medicinal plants are warranted and should be carried out. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

77 FR 65713 - Certain Optoelectronic Devices for Fiber Optic Communications, Components Thereof, and Products...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-30

..., as amended, 19 U.S.C. 1337, on behalf of Avago Technologies Fiber IP (Singapore) Pte. Ltd. of Singapore; Avago Technologies General IP (Singapore) Pte. Ltd. of Singapore; and Avago Technologies U.S. Inc... Technologies Fiber IP, (Singapore) Pte. Ltd., 1 Yishun Avenue 7, Singapore 768923. Avago Technologies General...

A qualitative study of factors influencing family physicians' prescription of the Written Asthma Action Plan in primary care in Singapore.

PubMed

Tan, N C; Tay, I H; Ngoh, A; Tan, M

2009-02-01

The Written Asthma Action Plan (WAAP) educates patients on the early recognition and treatment of deteriorating asthma. It has been adopted in Singapore polyclinics and restructured hospitals in the past few years as recommended by the Singapore National Asthma Programme. Local asthma patients can choose to be treated by family physicians at public polyclinics or by private general practitioners (GPs). In a previous study, half of the physicians in primary care self-reported that they formulated an asthma action plan for their patients, but little is known about their actual practices. This qualitative study explored family physicians' views of WAAP and its implementation in primary care in Singapore. Qualitative data was obtained for 29 participants from polyclinics, GP clinics or locum doctors at five separate focus group discussions. The data was coded using NVivo-7 software, audited and analysed to identify emergent themes. The participants generally perceived the usefulness of WAAP. While WAAP was widely used in polyclinics, GPs rarely used it. Even in polyclinics, usage varied and was associated with participants' training and practice of WAAP and task substitution to nurses. They perceived that WAAP would benefit only selected motivated patients who could understand and use it. They were hampered by language barriers in educating their multiracial patients and the perceived lack of time related to patient loads in polyclinics. The GPs lacked training and practice, role models and relied on verbal instructions as a personalised form of care delivery. Family physicians generally perceived WAAP as useful, but implementation was hampered by lack of training and practice, language barriers and perceived benefits for patients.

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.

Clinical and microbiological characteristics of cryptococcosis in Singapore: predominance of Cryptococcus neoformans compared with Cryptococcus gattii.

PubMed

Chan, Monica; Lye, David; Win, Mar Kyaw; Chow, Angela; Barkham, Tim

2014-09-01

To describe the clinical features, treatments, outcomes, and subtype prevalence of cryptococcosis in Singapore. All patients with laboratory confirmed cryptococcal infections admitted from 1999 to 2007 to a teaching hospital in Singapore were reviewed retrospectively. Identification and molecular types of Cryptococcus neoformans variants and Cryptococcus gattii were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Serotypes were inferred with a multiplex PCR method. Of 62 patients with cryptococcosis, C. neoformans var. grubii was the predominant subtype (in 95%), affecting mainly immunocompromised hosts (91%) with HIV infection (80%). Patients with HIV were younger (median age 36.5 vs. 49.5 years, p=0.006) and less likely to present with an altered mental status (14% vs. 50%, p=0.013). In contrast, delayed treatment (median 7 days vs. 2 days, p=0.03), pulmonary involvement (58% vs. 14%, p=0.03), and initial treatment with fluconazole (25% vs. 2%, p=0.02) were more common in HIV-negative patients. C. gattii was uncommon, affecting only three patients, all of whom were immunocompetent and had disseminated disease with pulmonary and neurological involvement. All C. gattii were RFLP type VG II, serotype B and all C. neoformans var. grubii were RFLP type VN I, serotype A, except for one that was RFLP type VN II. C. neoformans var. grubii, subtype VN I, was the predominant subtype in Singapore, infecting younger, mainly immunocompromised hosts with HIV. C. gattii was uncommon, causing pulmonary manifestations in older, immunocompetent patients and were RFLP type VG II. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Knowledge of diabetes mellitus and safe practices during Ramadan fasting among Muslim patients with diabetes mellitus in Singapore.

PubMed

Zainudin, Sueziani Binte; Ang, Dun Yong; Soh, Abel Wah Ek

2017-05-01

This study aimed to explore the level of knowledge of Muslim patients with diabetes mellitus (DM) regarding DM and the self-management of DM when fasting during Ramadan. Muslim patients with DM attending the Diabetes Centre of Singapore General Hospital, Singapore, were surveyed on their knowledge of DM and self-management of DM when fasting during Ramadan. Data on patient demographics, DM history and management of DM during the previous Ramadan was also collected. A total of 92 patients (34 male, 58 female) were surveyed. The mean age of the patients was 53.4 ± 13.3 years. The patients were either Malay (91.3%) or Indian (8.7%), and most (66.3%) had at least a secondary school education. Most (89.1%) had Type 2 DM. The mean duration of DM was 8.7 ± 5.1 years and mean pre-Ramadan haemoglobin A1c was 8.4% ± 1.8%. DM treatment consisted of insulin therapy (37.0%), oral glucose-lowering drugs (35.9%) and combined therapy (22.8%). The mean DM knowledge score was 58.8% for general knowledge and 75.9% for fasting knowledge. During the previous Ramadan, although 71.4% of the patients consulted their physicians, 37.3% did not monitor their blood glucose levels and 47.0% had hypoglycaemic episodes. Among those who had hypoglycaemia, 10.8% continued to fast. Unsafe self-management practices were observed among DM patients who fasted during Ramadan. Efforts should be made to bridge the gap between knowledge of DM and self-management of DM. Copyright: © Singapore Medical Association

A systematic review of health status, health seeking behaviour and healthcare utilisation of low socioeconomic status populations in urban Singapore.

PubMed

Chan, Catherine Qiu Hua; Lee, Kheng Hock; Low, Lian Leng

2018-04-02

It is well-established that low socioeconomic status (SES) influences one's health status, morbidity and mortality. Housing type has been used as an indicator of SES and social determinant of health in some studies. In Singapore, home ownership is among the highest in the world. Citizens who have no other housing options are offered heavily subsidised rental housings. Residents staying in such rental housings are characterised by low socioeconomic status. Our aim is to review studies on the association between staying in public rental housing in Singapore and health status. A PubMed and Scopus search was conducted in January 2017 to identify suitable articles published from 1 January 2000 to 31 January 2017. Only studies that were done on Singapore public rental housing communities were included for review. A total of 14 articles including 4 prospective studies, 8 cross-sectional studies and 2 retrospective cohort studies were obtained for the review. Topics addressed by these studies included: (1) Health status; (2) Health seeking behaviour; (3) Healthcare utilisation. Staying in public rental housing was found to be associated with poorer health status and outcomes. They had lower participation in health screening, preferred alternative medicine practitioners to western-trained doctors for primary care, and had increased hospital utilisation. Several studies performed qualitative interviews to explore the causes of disparity and concern about cost was one of the common cited reason. Staying in public rental housing appears to be a risk marker of poorer health and this may have important public health implications. Understanding the causes of disparity will require more qualitative studies which in turn will guide interventions and the evaluation of their effectiveness in improving health outcome of this sub-population of patients.

Transnational Governances in Higher Education: New Universities, Rhetorics, and Networks in Postwar Singapore

ERIC Educational Resources Information Center

Chou, Grace Ai-Ling

2015-01-01

At the close of World War II, Japan's ouster from Malaya led to the resumption of British control and a new outlook toward political independence. Higher education would play a central role in this complex transition, where the forces of decolonization and nation-building converged with drives toward both interethnic competition and multiethnic…

Degrees of Doubt? Towards Eradicating Fraudulent Cross-Border Institutions and Diplomas

ERIC Educational Resources Information Center

Observatory on Borderless Higher Education, 2010

2010-01-01

Six higher education institutions in Singapore and four universities in New Zealand have reportedly been placed on a list of unaccredited institutions and so-called "degree mills", which has been compiled by the Office of Degree Authorisation of the state of Oregon in the United States (US). As one of the first US states that introduced…

Gender, Space, and Discourse across Borders: Talking Gender in Cyberspace

ERIC Educational Resources Information Center

Maher, JaneMaree; Hoon, Chng Huang

2008-01-01

The possibility of online student collaboration over cyberspace for two groups of students in Australia and Singapore was conceived by JaneMaree Maher at Monash University in Australia in 2005 after hearing a paper given by a colleague that detailed the experience of a three-way cross-country dialogue using flexible learning technologies. A recent…

Virtual Reality Simulations and Animations in a Web-Based Interactive Manufacturing Engineering Module

ERIC Educational Resources Information Center

Ong, S. K.; Mannan, M. A.

2004-01-01

This paper presents a web-based interactive teaching package that provides a comprehensive and conducive yet dynamic and interactive environment for a module on automated machine tools in the Manufacturing Division at the National University of Singapore. The use of Internet technologies in this teaching tool makes it possible to conjure…

Singapore Pre-Service Secondary Mathematics Teachers' Content Knowledge: Findings from an International Comparative Study

ERIC Educational Resources Information Center

Toh, Tin Lam; Kaur, Berinderjeet; Koay, Phong Lee

2013-01-01

In this article, we explore the mathematical content knowledge of one entire cohort of pre-service teachers (N = 107) through analysing their performance in a Secondary Mathematics Audit that was developed for the International Comparative Studies in Mathematics Teacher Training that was initiated by the University of Plymouth. We study how their…

Emerging Technologies in Global Communication: Using Appreciative Inquiry to Improve the Preparation of School Administrators

ERIC Educational Resources Information Center

Calabrese, Raymond L.; Roberts, B. E.; McLeod, Scott; Niles, Rae; Christopherson, Kelly; Singh, Paviter; Berry, Miles

2008-01-01

Purpose: The purpose of this paper is to describe how practitioners from Canada, the UK, Singapore, and the USA, university educational administration faculty from the USA, and the editor of a premier international journal of educational management engaged in a collaborative process to discover how to improve the preparation and practice of…

Student Recruitment at International Branch Campuses: Can They Compete in the Global Market?

ERIC Educational Resources Information Center

Wilkins, Stephen; Huisman, Jeroen

2011-01-01

The majority of international branch campuses are located in competitive higher education hubs, such as Singapore and the United Arab Emirates. Many find themselves having to recruit students regionally, and some, even globally, which results in them competing head-to-head with the home campuses of well-respected Western universities. The purpose…

The Value Simulation-Based Learning Added to Machining Technology in Singapore

ERIC Educational Resources Information Center

Fang, Linda; Tan, Hock Soon; Thwin, Mya Mya; Tan, Kim Cheng; Koh, Caroline

2011-01-01

This study seeks to understand the value simulation-based learning (SBL) added to the learning of Machining Technology in a 15-week core subject course offered to university students. The research questions were: (1) How did SBL enhance classroom learning? (2) How did SBL help participants in their test? (3) How did SBL prepare participants for…

Minfong Ho: Politics in Prose

ERIC Educational Resources Information Center

Wiggins, Joy L.

2006-01-01

In this article, the author interviews Minfong Ho, an award-winning Thai writer of children's and young adult novels. Ho was born in Burma to Chinese parents in 1951, raised in Singapore and Thailand, educated in Bangkok, Taiwan, and at Cornell University in New York. Ho's first novel, "Sing to the Dawn," won first prize from the Council of…

Social Involvement and Development as a Response to the Campus Student Culture

ERIC Educational Resources Information Center

Yang, Min; Chau, Albert Wai Lap

2011-01-01

Given the widely accepted notion of whole person education in Confucian societies such as Hong Kong, Mainland China and Singapore, it is surprising that research literature originated in these societies pays little attention to how students learn and develop through out-of-class experiences at university. There is little research evidence on how…

Evolutionary dynamics of methicillin-resistant Staphylococcus aureus within a healthcare system.

PubMed

Hsu, Li-Yang; Harris, Simon R; Chlebowicz, Monika A; Lindsay, Jodi A; Koh, Tse-Hsien; Krishnan, Prabha; Tan, Thean-Yen; Hon, Pei-Yun; Grubb, Warren B; Bentley, Stephen D; Parkhill, Julian; Peacock, Sharon J; Holden, Matthew T G

2015-04-23

In the past decade, several countries have seen gradual replacement of endemic multi-resistant healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) with clones that are more susceptible to antibiotic treatment. One example is Singapore, where MRSA ST239, the dominant clone since molecular profiling of MRSA began in the mid-1980s, has been replaced by ST22 isolates belonging to EMRSA-15, a recently emerged pandemic lineage originating from Europe. We investigated the population structure of MRSA in Singaporean hospitals spanning three decades, using whole genome sequencing. Applying Bayesian phylogenetic methods we report that prior to the introduction of ST22, the ST239 MRSA population in Singapore originated from multiple introductions from the surrounding region; it was frequently transferred within the healthcare system resulting in a heterogeneous hospital population. Following the introduction of ST22 around the beginning of the millennium, this clone spread rapidly through Singaporean hospitals, supplanting the endemic ST239 population. Coalescent analysis revealed that although the genetic diversity of ST239 initially decreased as ST22 became more dominant, from 2007 onwards the genetic diversity of ST239 began to increase once more, which was not associated with the emergence of a sub-clone of ST239. Comparative genomic analysis of the accessory genome of the extant ST239 population identified that the Arginine Catabolic Mobile Element arose multiple times, thereby introducing genes associated with enhanced skin colonization into this population. Our results clearly demonstrate that, alongside clinical practice and antibiotic usage, competition between clones also has an important role in driving the evolution of nosocomial pathogen populations.

Unplanned reattendances at the paediatric emergency department within 72 hours: a one-year experience in KKH.

PubMed

Goh, Guan Lin; Huang, Peiqi; Kong, Man Ching Patrick; Chew, So-Phia; Ganapathy, Sashikumar

2016-06-01

Unscheduled reattendances at the paediatric emergency department may contribute to overcrowding, which may increase financial burdens. The objectives of this study were to determine the rate of reattendances and characterise factors influencing these reattendances and hospital admission during the return visits. Medical records of all patients who attended the emergency department at KK Women's and Children's Hospital, Singapore, from 1 June 2013 to 31 May 2014 were retrospectively reviewed. We collected data on patient demographics, attendance data and clinical characteristics. Planned reattendances, recalled cases, reattendances for unrelated complaints and patients who left without being seen were excluded. A multivariate analysis was conducted to determine the odds ratio of variables associated with hospital admission for reattendances. Of 162,566 children, 6,968 (4.3%) returned within 72 hours, and 2,925 (42.0% of reattendance group) were admitted on their return visits. Children more likely to reattend were under three years of age, Chinese, triaged as Priority 2 at the first visit, and were initially diagnosed with respiratory or gastrointestinal conditions. However, children more likely to be admitted on their return visits were over 12 years of age, Malay, had a higher triage acuity or were uptriaged, had the presence of a comorbidity, and were diagnosed with gastrointestinal conditions. We identified certain subgroups in the population who were more likely to be admitted if they reattended. These findings would help in implementing further research and directing strategies to reduce potentially avoidable reattendances and admissions. Copyright: © Singapore Medical Association.

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.

Committees

NASA Astrophysics Data System (ADS)

2012-11-01

Leadership Team of the IAHR Committee for Hydraulic Machinery and Systems Eduard EGUSQUIZA, UPC Barcelona, Spain, Chair François AVELLAN, EPFL-LMH, Switzerland, Past Chair Richard K FISHER, Voith Hydro Inc., USA, Past Chair Fidel ARZOLA, Edelca, Venezuela Michel COUSTON, Alstom Hydro, France Niklas DAHLBÄCKCK, Vatenfall, Sweden Normand DESY, Andritz VA TECH Hydro Ltd., Canada Chisachi KATO, University of Tokyo, Japan Andrei LIPEJ, Turboinstitut, Slovenija Torbjørn NIELSEN, NTNU, Norway Romeo SUSAN-RESIGA, 'Politehnica' University Timisoara, Romania Stefan RIEDELBAUCH, Stuggart University, Germany Albert RUPRECHT, Stuttgart University, Germany Qing-Hua SHI, Dong Fang Electrical Machinery Co., China Geraldo TIAGO, Universidade Federal de Itajubá, Brazil International Advisory Committee Shouqi YUAN (principal) Jiangsu University China QingHua SHI (principal) Dong Fang Electrical Machinery Co. China Fidel ARZOLA EDELCA Venezuela Thomas ASCHENBRENNER Voith Hydro GmbH & Co. KG Germany Anton BERGANT Litostroj Power doo Slovenia B C BHAOYAL Research & Technology Centre India Hermod BREKKE NTNU Norway Stuart COULSON Voith Hydro Inc. USA Paul COOPER Fluid Machinery Research Inc USA V A DEMIANOV Power Machines OJSC Russia Bart van ESCH Technische Universiteit Eindhoven Netherland Arno GEHRER Andritz Hydro Graz Austria Akira GOTO Ebara Corporation Japan Adiel GUINZBURG The Boeing Company USA D-H HELLMANN KSB AG Germany Ashvin HOSANGADI Combustion Research and Flow Technology USA Byung-Sun HWANG Korea Institute of Material Science Korea Toshiaki KANEMOTO Kyushu Institute of Technology Japan Mann-Eung KIM Korean Register of Shipping Korea Jiri KOUTNIK Voith Hydro GmbH & Co. KG Germany Jinkook LEE Eaton Corporation USA Young-Ho LEE Korea Maritime University Korea Woo-Seop LIM Hyosung Goodsprings Inc Korea Jun MATSUI Yokohama National University Japan Kazuyoshi Mitsubishi H I Ltd, Japan MIYAGAWA Christophe NICOLET Power Vision Engineering Srl Switzerland Maryse PAGE Hydro Quebec IREQ, Varennes Canada Etienne PARKINSON Andritz Hydro Ltd. Switzerland B V S S S PRASAD Indian Institute of Technology Madras India Stefan RIEDELBAUCH Stuttgart University Germany Michel SABOURIN Alstom Hydro Canada Inc Canada Bruno SCHIAVELLO Flowserve Corporation USA Katsumasa SHIMMEI Hitachi Ltd Japan Christoph SINGRTüN VDMA Germany Ale? SKOTAK CKD Blansko Engineering, a s Czech Republic Toshiaki SUZUKI Toshiba Corporation Japan Andy C C TAN Queensland University of Technology Australia Geraldo TIAGO FILHO Universidade Federal de Itajuba Brazi Thi C VU Andritz Hydro Ltd Canada Satoshi WATANABE Kyushu University Japan S H WINOTO National University of Singapore Singapore Woo-Seong WOO STX Institute of Technology Korea International Technical Committee François AVELLAN (principal) EPFL-LMH Switzerland Xingqi LUO (principal) Xi'an University of Technology China Martin BÖHLE Kaiserslautern University Germany Gerard BOIS ENSAM France Young-Seok CHOI KITECH Korea Luca d'AGOSTINO University of Pisa Italy Eduard EGUSQUIZA Polytechnical University Catalonia Spain Arpad FAY University of Miskolcz Hungary Richard FISHER Voith Hydro Inc USA Regiane FORTES-PATELLA Institute Polytechnique de Grenoble France Aleksandar GAJIC University of Belgrade Serbia José GONZÁLEZ Universidad de Oviedo Spain François GUIBAULT Ecole Polytechnique de Montreal Canada Toshiaki IKOHAGI Tohoku University Japan Chisachi KATO University of Tokyo Japan Kwang-Yong KIM Inha University Korea Youn-Jea KIM Sungkyunkwan University Korea Smaine KOUIDRI Université Pierre et Marie Curie (Paris 6) France Shengcai LI Warwick University UK Adrian LUNGU Dunarea de Jos University of Galati Romania Torbjøm K NIELSEN NTNU Norway Michihiro NISHI Tsinghua University China Peter PELZ Darmstadt University Germany Frantisek POCHYLY Brno University Czech Republic Albert RUPRECHT University of Stuttgart Germany Rudolf SCHILLING Technische University München Germany Wei SHYY HKUST Hong Kong,China Romeo SUSAN-RESIGA Politehnica University of Timisoara Romania Kazuhiro TANAKA Kyushu Institute of Technology Japan Yoshinobu TSUJIMOTO Osaka University Japan Local Organizing Committee Chairman Yulin WU Tsinghua University Beijing Executive Chairman Zhengwei WANG Tsinghua University Beijing Members Shuliang CAO Tsinghua University Beijing Cichang CHEN South West University of Petroleum Chengdu Hongxun CHEN Shanghai University Shanghai Jiang DAI China Sanxia General Co Yichang Huashu DOU National University of Singapore Singapore Fengqin HAN Huanan University of Sci & Tech Guangzhou Kun LI Hefei Inst of General Machinery Hefei Rennian LI Lanzhou University of Sci & Tech Lanzhou Wanhong LI National Natural Science Foundation of China Beijing Chao LIU Yangzhou University Yangzhou Li LU China Inst of Water Resources and Hydropower Research Beijing Xingqi LUO Xi'an University of Tech Xi'an Zhenyue MA Dalian University of Sci & Tech Dalian Jiegang MU Zhejiang University of Tech Hangzhou Daqing QIN Harbin Electric Machinery Group Harbin Fujun WANG China Agriculture University Beijing Guoyu WANG Beijing Institute of Technology (BIT) Beijing Leqin WANG Zhejiang University Hangzhou Yuzhen WU NERCSPV Beijing Hongyuan XU Tsinghua University Beijing Jiandong YANG Wuhan University Wuhan Minguan YANG Jiangsu University Zhenjiang Shouqi YUAN Jiangsu University Zhenjiang Lefu ZHANG Harbin Electric Machinery Group Harbin Lixiang ZHANG Yunnan University of Sci & Tech Kunming Shengchang ZHANG Zhejiang University of Tech Hangzhou Kun ZHAO China Water & Electric Consulting Corp Beijing Yuan ZHENG Hehai University Nanjing Jianzhong ZHOU Huazhong University of Sci & Tech Wuhan Lingjiu ZHOU China Agriculture University Beijing Hongwu ZHU China Petroleum University Beijing Zuchao ZHU Zhejiang Sci-Tech University Hangzhou Secretaries Shuhong LIU (Academic), liushuhong@tsinghua.edu.cn Xianwu LUO (Registration), luoxw@tsinghua.edu.cn Baoshan ZHU (Finance), bszhu@mail.tsinghua.edu.cn

Intimate partner violence-related experiences and mental health among college students in Japan, Singapore, South Korea and Taiwan.

PubMed

Kamimura, Akiko; Nourian, Maziar M; Assasnik, Nushean; Franchek-Roa, Kathy

2016-05-01

Intimate partner violence (IPV) is a significant public health threat that contributes to a wide range of mental and physical health problems for victims. The purpose of this study was to examine IPV-related experiences and mental health outcomes among college students in Japan, Singapore, South Korea and Taiwan. The data were obtained from the Inter-University Consortium for Political and Social Research (ICPSR), the International Dating Violence Study (IDVS) 2001-2006 (ICPSR 29583; N = 981; Japan n = 207; Singapore n = 260; South Korea n = 256; Taiwan n = 258). Co-experience of physical IPV victimization and perpetration was associated with borderline personality traits and posttraumatic stress disorder (PTSD), but not with depression. Childhood sexual abuse, gender hostility and violence socialization were significant predictors of borderline personality traits, depression and PTSD. While country and gender variations in mental health are noted, there are two specific populations that may need special attention for mental health interventions: Taiwanese women especially for borderline personality traits and PTSD, and Japanese men especially for depression. IPV victimization and perpetration, childhood sexual abuse, gender hostility and violence socialization have a significant impact on the mental health of college students in Japan, Singapore, South Korea and Taiwan. Since IPV and mental health are significant public health issues, research on IPV and mental health consequences of IPV victimization and perpetration in these countries should be further expanded in order to better understand the interventions that will be effective in treating victims, perpetrators and victim/perpetrators of IPV. © The Author(s) 2016.

Representation of Nonstationary Narrowband Random Processes and Their Application and Effectiveness as Jamming Signals in Spread Spectrum Communication Systems.

DTIC Science & Technology

1987-03-01

of Defense, Singapore COMMUNICATIONS DIVISION PAYA LEBAR AIRPORT SINGAPORE 1953 Republic of Singapore 7. Mr. Low Kah Meng 2 Blk. 6, #04-168 REDHILL CLOSE Singapore 0315 Republic of Singapore 90 - *I r - -: :’I ’’ I 𔃻

Analysis of the barriers and enablers to implementing lifestyle management practices for women with PCOS in Singapore.

PubMed

Ko, Henry; Teede, Helena; Moran, Lisa

2016-06-16

Polycystic ovary syndrome (PCOS) is a condition that affects women of reproductive age and manifests with adverse reproductive, metabolic and psychological consequences. Evidence-based PCOS guidelines recommend lifestyle management first line for infertility. In Singapore women with PCOS can attend the PCOS Clinic at the Kandang Kerbau Women and Children's Hospital for infertility treatment. However lifestyle integration into infertility management is currently limited and barriers and enablers to progress remain unclear. All PCOS clinic staff undertook semi-structured interviews to investigate perceived barriers for staff and consumers for the integration of lifestyle into infertility management. This study utilised various tools including an 8P Ishikawa diagram model to identify and categorise barriers. A modified Hanlon method was then used to prioritise barriers within the Singaporean context considering organisational, cultural and financial constraints. Propriety, economics, acceptability, resources and legality (PEARL) criteria were also incorporated into this decision-making tool. In the 8P model, there were five factors contributing to the 'procedure (consultations and referral processes)' barrier, one 'policy (government and hospitals)' factor, five 'place' factors, two 'product (lifestyle management programme)' barriers, two 'people (programme capacity)' factors, four 'process (integration)' factors, three 'promotion' barriers and three 'price' factors. Of the prioritised barriers, two were identified across each of 'procedures', 'place', 'product' and 'people' and four related to 'processes'. There were no barriers identified that for 'policies', 'promotion' and 'price' that can be addressed. There is a clear need to integrate lifestyle into infertility management in PCOS, in line with current national and international evidence-based guidelines. The highest priority identified improvement opportunity was to develop a collaborative lifestyle management programme across hospital services. Reductions in variation of delivery and strengthening support within the lifestyle programme are other identified priorities. The strength of this study is that this is the first study to utilise a pragmatic quality improvement method for barriers identification and prioritisation in the area of lifestyle management for women with PCOS. This project identified factors that may provide easy improvements, but also identified some local factors that may be very difficult to change. The major limitation of this study is that it is only looking at the Singapore setting, so may have limited applicability to other countries. However, results from quality improvement projects are meant to be context specific.

77 FR 46684 - In the Matter of: Universal Industries Limited, Inc., 3050 SW 14th Place Unit 3, Boynton Beach...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-06

... export from the United States to Singapore military aircraft parts, that is approximately 200 J-85 Stage... owned, possessed or controlled by the Denied Person, or service any item, of whatever origin, that is... the foreign-produced direct product of U.S.-origin technology. V. This Order is effective immediately...

Becoming Global Elites through Transnational Language Learning?: The Case of Korean Early Study Abroad in Singapore

ERIC Educational Resources Information Center

Bae, Sohee; Park, Joseph Sung-Yul

2016-01-01

Since the late 1990s, early study abroad (ESA) in English-speaking countries has been a popular educational strategy for pre-university Korean students to acquire important language skills such as global English, which is imagined to help them prepare for the competition in global educational and occupational market. However, as ESA, commonly…

Strategies for the Emerging Global Higher Education Market in East Asia: A Comparative Study of Singapore, Malaysia and Japan

ERIC Educational Resources Information Center

Yonezawa, Akiyoshi

2007-01-01

In this paper, the author tries to set up the framework for understanding the qualitative change of the nature of national policies for higher education through the increasing aspects as "industry" in universities and other higher education sector. Based on this framework, the author analyses, comparatively, the national policies for…

Spontaneous subarachnoid haemorrhage and outcome--results from Tan Tock Seng Hospital, Singapore.

PubMed

Wong, S H; Yeo, T T; Seow, W T; Tan, K K; Ong, P L

1999-07-01

To ascertain the number of cases of spontaneous (aneurysmal) subarachnoid haemorrhage presenting to Tan Tock Seng Hospital, Singapore, over a one year period, the demographics of the patients involved, their treatment and their eventual outcome. A retrospective study from June 1995 to June 1996. There were 62 patients admitted over this period with an average of 5 patients per month. Their ages ranged from 9 to 85 years with a mean of 54 years. All 62 patients underwent 4-vessel cerebral angiograms. Forty-three patients (69%) underwent clipping of their aneurysms. Twelve patients (19%) had negative angiograms. Four patients (6%) underwent coiling of their aneurysms via interventional neuroradiology techniques. Patients with subarachnoid haemorrhage of Grades 1 to 3 on the WFNS (World Federation of Neurological Surgeons) grading had a favourable outcome (Glasgow Outcome Score of 4 and 5) in 85% of the cases. The overall mortality rate for the operated group (all grades) was 11%. However for the group with good WFNS grading, namely the Grade 1 to 2 groups, there were no deaths. Twenty-four percent of patients developed clinically symptomatic vasospasm. Eighteen percent of patients required ventriculo-peritoneal shunting for hydrocephalus secondary to the subarachnoid haemorrhage. The overall management mortality (operated and non-operated cases) was 14% for proven aneurysmal and angiographically-negative spontaneous subarachnoid haemorrhage. These results are comparable to that of other reputable centers reported in the literature.

A pilot trial of tele-ophthalmology for diagnosis of chronic blurred vision.

PubMed

Tan, Johnson Choon Hwai; Poh, Eugenie Wei Ting; Srinivasan, Sanjay; Lim, Tock Han

2013-02-01

We evaluated the accuracy of tele-ophthalmology in diagnosing the major causes of chronic blurring of vision. Thirty consecutive patients attending a primary eye-care facility in Singapore (the Ang Mo Kio Polyclinic, AMKP) with the symptom of chronic blurred vision were recruited. An ophthalmic technician was trained to perform Snellen acuity; auto-refraction; intraocular pressure measurement; red-colour perimetry; video recordings of extraocular movement, cover tests and pupillary reactions; and anterior segment and fundus photography. Digital information was transmitted to a tertiary hospital in Singapore (the Tan Tock Seng Hospital) via a tele-ophthalmology system for teleconsultation with an ophthalmologist. The diagnoses were compared with face-to-face consultation by another ophthalmologist at the AMKP. A user experience questionnaire was administered at the end of the consultation. Using face-to-face consultation as the gold standard, tele-ophthalmology achieved 100% sensitivity and specificity in diagnosing media opacity (n = 29), maculopathy (n = 23) and keratopathy (n = 30) of any type; and 100% sensitivity and 92% specificity in diagnosing optic neuropathy of any type (n = 24). The majority of the patients (97%) were satisfied with the tele-ophthalmology workflow and consultation. The tele-ophthalmology system was able to detect causes of chronic blurred vision accurately. It has the potential to deliver high-accuracy diagnostic eye support to remote areas if suitably trained ophthalmic technicians are available.

Implementing chronic disease management in the public healthcare sector in Singapore: the role of hospitals.

PubMed

Cheah, J; Heng, B H

2001-01-01

The public health care delivery system in Singapore faces the challenges of a rapidly ageing population, an increasing chronic disease burden, increasing healthcare cost, rising expectations and demand for better health services, and shortage of resources. It is also fragmented, resulting in duplication and lack of coordination between institutions. A disease management approach has been adopted by the National Healthcare Group (NHG) as a critical strategy to provide holistic, cost-effective, seamless and well-coordinated care across the continuum. The framework in the development of the disease management plan included identifying the diseases and defining the target population, organizing a multi-disciplinary team lead by a clinician champion, defining the core components, treatment protocols and evaluation methods, defining the goals, and measuring and managing the outcomes. As disease management and case management for chronic diseases are new approaches adopted in the healthcare delivery system, there is a lack of understanding by healthcare professionals. The leadership and participation of hospital physicians was sought in the planning, design and outcomes monitoring to ensure their 'buy-in' and the successful implementation and effectiveness of the program. The episodic diagnosis related group (DRG)-based framework of funding and subvention for healthcare, and the shortage of step-care care facilities, have been recognized by the Ministry of Health as an impediments to the implementation, and these are currently being addressed.

An exploratory study of traditional birthing practices of Chinese, Malay and Indian women in Singapore.

PubMed

Naser, Eliana; Mackey, Sandra; Arthur, David; Klainin-Yobas, Piyanee; Chen, Helen; Creedy, Debra K

2012-12-01

to explore the traditional birthing practices of Singaporean women. a qualitative study using a phenomenological approach. Data were collected using individual interviews, which were audio-recorded and transcribed verbatim. Colaizzi's phenomenological method was used to analyse the data. obstetric outpatient clinics in a tertiary hospital in Singapore. a purposive sample of 30 women, 1-3 months postpartum. two broad themes emerged-following tradition and challenging tradition. Singaporean women experiencing pregnancy and childbirth follow tradition through the influence of their mother and mother-in-law and because of worry over consequences that may result if they do not. Tradition is also challenged through the modification or rejection of traditional practices and changing family roles and expectations. health professionals need to provide accurate information on traditional birthing practices and scientific evidence to support or refute such practices with the aim of preventing women from adhering to practices that are hazardous to them and the baby. Copyright © 2011 Elsevier Ltd. All rights reserved.

Outbreak of Zika virus infection in Singapore: an epidemiological, entomological, virological, and clinical analysis.

PubMed

2017-08-01

An outbreak of Zika virus infection was detected in Singapore in August, 2016. We report the first comprehensive analysis of a national response to an outbreak of Zika virus infection in Asia. In the first phase of the outbreak, patients with suspected Zika virus infection were isolated in two national referral hospitals until their serum tested negative for the virus. Enhanced vector control and community engagement measures were deployed in disease clusters, including stepped-up mosquito larvicide and adulticide use, community participation in source reduction (destruction of mosquito breeding sites), and work with the local media to promote awareness of the outbreak. Clinical and epidemiological data were collected from patients with confirmed Zika virus infection during the first phase. In the second phase, admission into hospitals for isolation was stopped but vector control efforts continued. Mosquitoes were captured from areas with Zika disease clusters to assess which species were present, their breeding numbers, and to test for Zika virus. Mosquito virus strains were compared with human strains through phylogenetic analysis after full genome sequencing. Reproductive numbers and inferred dates of strain diversification were estimated through Bayesian analyses. From Aug 27 to Nov 30, 2016, 455 cases of Zika virus infection were confirmed in Singapore. Of 163 patients with confirmed Zika virus infection who presented to national referral hospitals during the first phase of the outbreak, Zika virus was detected in the blood samples of 97 (60%) patients and the urine samples of 157 (96%) patients. There were 15 disease clusters, 12 of which had high Aedes aegypti breeding percentages. Captured mosquitoes were pooled into 517 pools for Zika virus screening; nine abdomen pools (2%) were positive for Zika virus, of which seven head and thorax pools were Zika-virus positive. In the phylogenetic analysis, all mosquito sequences clustered within the outbreak lineage. The lineage showed little diversity and was distinct from other Asian lineages. The estimated most recent common ancestor of the outbreak lineage was from May, 2016. With the deployment of vector control and community engagement measures, the estimated reproductive number fell from 3·62 (95% CI 3·48-3·77) for July 31 to Sept 1, 2016, to 1·22 (95% CI 1·19-1·24) 4 weeks later (Sept 1 to Nov 24, 2016). The outbreak shows the ease with which Zika virus can be introduced and spread despite good baseline vector control. Disease surveillance, enhanced vector control, and community awareness and engagement helped to quickly curb further spread of the virus. These intensive measures might be useful for other countries facing the same threat. National Medical Research Council Singapore, Centre for Infectious Disease Epidemiology and Research, and A*STAR Biomedical Research Council. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effect of a nurse-led telephone-based care coordination program on the follow-up and control of cardiovascular risk factors in patients with coronary artery disease.

PubMed

Wong, Ningyan; Chua, Siang Jin Terrance; Gao, Fei; Sim, Sok Tiang Rosalind; Matchar, David; Wong, Sung Lung Aaron; Yeo, Khung Keong; Tan, Wei Chieh Jack; Chin, Chee Tang

2016-12-01

We sought to analyse the impact of a care coordination protocol on transiting patients with coronary artery disease who had undergone percutaneous coronary intervention (PCI) to primary care and its effect on cardiovascular risk factor control. A prospective observational study involving 492 patients who had undergone PCI either electively or after an acute coronary syndrome. A tertiary institution in Singapore. Patients who had undergone a PCI either electively or after an acute coronary syndrome. The SCORE (Standardized Care for Optimal Outcomes, Right-Siting and Rapid Re-evaluation) program was a nurse-led, telephone-based, care coordination protocol. Transition to primary care within 1 year of enrolment, the achievement of low-density lipoprotein (LDL) level of <2.6 mmol/l within 1 year and hospital admissions related to cardiovascular causes within 1 year were studied. Under the SCORE protocol, a significantly higher number of patients transited to primary care and achieved the LDL target within 1 year, as compared with non-SCORE patients. Discharge to primary care and achievement of target LDL continued to be higher among those under the SCORE protocol even after multivariate analysis. Rates of hospital admission due to cardiovascular causes were not significantly different. Care coordination improved the rate of transition of post-PCI patients to primary care and improved LDL control, with no difference in the rate of hospital admissions due to cardiovascular causes. These findings support the implementation of a standardized follow-up protocol in patients who have undergone PCI. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Molecular pathways reflecting poor intrauterine growth are found in Wharton's jelly-derived mesenchymal stem cells.

PubMed

Sukarieh, Rami; Joseph, Roy; Leow, Shi Chi; Li, Ying; Löffler, Mona; Aris, Izzuddin M; Tan, Jun Hao; Teh, Ai Ling; Chen, Li; Holbrook, Joanna D; Ng, Kai Lyn; Lee, Yung Seng; Chong, Yap Seng; Summers, Scott A; Gluckman, Peter D; Stünkel, Walter

2014-10-10

Are molecular pathways reflecting the biology of small for gestational age (SGA) neonates preserved in umbilical cord-derived mesenchymal stem cells (MSCs)? MSCs from SGA newborns were found to express an altered EGR-1-dependent gene network involved in the regulation of cell proliferation and oxidative stress. Individuals with suboptimal intrauterine development are at greater risk of metabolic diseases such as type II diabetes, obesity and cardiovascular disease. Umbilical cords (n = 283) from the GUSTO (growing up in Singapore towards healthy outcomes) birth cohort study, and primary MSC isolates established from SGA and matched control cases (n = 6 per group), were subjected to gene expression analysis and candidate genes were studied for functional validation. Umbilical cord specimens were derived from babies born at the National University Hospital (NUH) in Singapore. Local ethical approval was obtained. MSC isolates were established in Wharton's jelly and molecular analysis was conducted by gene expression microarrays and RT-PCR. Cells from SGA and control groups were compared in the presence and absence of insulin and candidate gene function was studied via siRNA-mediated gene knockdown and over-expression experiments in MSCs. Using repeated measure ANOVAs, proliferation rates of MSCs isolated from SGA neonates were found to be significantly increased (P < 0.01). In the absence of insulin, EGR-1 levels were found to be significantly reduced in the group of SGA-derived MSCs, whereas EGR-1 expression was found to be up-regulated in the same group in the presence of insulin (P < 0.01). EGR-1 was found to induce expression of COX-2 in the SGA group (P < 0.01) and both, EGR-1 and COX-2 stimulated glucose uptake in MSCs (P < 0.01). EGR-1 and COX-2 levels were associated in whole umbilical cords (n = 283, P < 0.01) and EGR-1 positively correlated with abdominal circumference and birthweight (n = 91, P < 0.01 and n = 91, P < 0.01). Cell models may not entirely reflect the physiology of the host and patient follow-up studies will be necessary for further clinical validation. Our study suggests that Wharton's jelly-derived MSCs are useful in identifying pathways specific for fetal growth restriction. This work is supported by the Translational Clinical Research (TCR) Flagship Program on Developmental Pathways to Metabolic Disease funded by the National Research Foundation (NRF) and administered by the National Medical Research Council (NMRC), Singapore- NMRC/TCR/004-NUS/2008'. SICS Investigators are supported through the Agency for Science Technology and Research (A*STAR) funding. No potential conflicts of interest relevant to this article were reported. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Understanding the psychosocial and physical work environment in a Singapore medical school.

PubMed

Chan, G C T; Koh, D

2007-02-01

This study aims to understand the physical and psychosocial work environment, expectations and the perceived levels of stress encountered of medical students in Singapore. A cross-sectional study employing a self-administered work environment questionnaire was applied over a one-week period to the entire 2003/2004 medical school cohort (1,069 students, response rate 85 percent) from the first to fifth (final) years at the National University of Singapore. 3.3 percent had at least one needlestick injury within the academic year. The majority (especially the clinical students) also had musculoskeletal complaints (neck and back mainly) within the last three months. Using the General Health Questionnaire, it was found that 49.6 percent encountered significant stress and 64.6 percent reported that more than 60 percent of their total life stress was due to medical school. The most important psychosocial stressors were: too much work and difficulty in coping. The clinical students were particularly concerned about being good medical students and doctors. The reasons for choosing Medicine as a career and social health (health, study and sleep habits) were also studied. The health risks of a medical student are primarily psychosocial in nature. The biggest challenges are work demands, maintaining a work-life balance and managing the psychosocial work environment.

Preoperative ANemiA among the elderly undergoing major abdominal surgery (PANAMA) study: Protocol for a single-center observational cohort study of preoperative anemia management and the impact on healthcare outcomes.

PubMed

Abdullah, Hairil Rizal; Sim, Yilin Eileen; Sim, Yi Tian Mary; Lamoureux, Ecosse

2018-05-01

Preoperative anemia and old age are independent risk factors for perioperative morbidity and mortality. However, despite the high prevalence of anemia in elderly surgical patients, there is limited understanding of the impact of anemia on postoperative complications and postdischarge quality of life in the elderly. This study aims to investigate how anemia impacts elderly patients undergoing major abdominal surgery in terms of perioperative morbidity, mortality and quality of life for 6 months postoperatively. We will conduct a prospective observational study over 12 months of 382 consecutive patients above 65 years old, who are undergoing elective major abdominal surgery in Singapore General Hospital (SGH), a tertiary public hospital. Baseline clinical assessment including full blood count and iron studies will be done within 1 month before surgery. Our primary outcome is presence of morbidity at fifth postoperative day (POD) as defined by the postoperative morbidity survey (POMS). Secondary outcomes will include 30-day trend of POMS complications, morbidity defined by Clavien Dindo Classification system (CDC) and Comprehensive Complication Index (CCI), 6-month mortality, blood transfusion requirements, days alive out of hospital (DaOH), length of index hospital stay, 6-month readmission rates and Health Related Quality of Life (HRQoL). HRQoL will be assessed using EuroQol five-dimensional instrument (EQ-5D) scores at preoperative consult and at 1, 3, and 6 months. The SingHealth Centralised Institutional Review Board (CIRB Ref: 2017/2640) approved this study and consent will be obtained from all participants. This study is funded by the National Medical Research Council, Singapore (HNIG16Dec003) and the findings will be published in peer-reviewed journals and presented at academic conferences. Deidentified data will be made available from Dryad Repository upon publication of the results.

Was it easy to use an Asthma Control Test (ACT) in different clinical practice settings in a tertiary hospital in Singapore?

PubMed

Prabhakaran, Lathy; Earnest, Arul; Abisheganaden, John; Chee, Jane

2009-12-01

The Asthma Control Test (ACT) is a 5-item self-administered tool designed to assess asthma control. It is said to be simple, easy and can be administered quickly by patients in the clinical practice setting. This stated benefit has yet to be demonstrated in our local clinical practice setting. The aim was to identify factors associated with difficulty in the administration of the ACT in different clinical practice settings in a tertiary hospital in Singapore. This is a prospective study performed from April to June 2008. All patients diagnosed with asthma and referred to an asthma nurse from the in-patient and out-patient clinical practice setting in Tan Tock Seng Hospital were enrolled. Four hundred and thirty-four patients were asked to complete the ACT tool. In the univariate model, we found that age, clinical setting and medical history to be significantly associated with the completion of the ACT. The odds of completion decreased by a factor of 0.92 (95% CI, 0.89 to 0.94) for every year's increase in age, and this was statistically significant (P <0.001). Similarly, the odds ratio of completion for those with more than 3 medical conditions by history were 0.59 (95% CI, 0.48 to 0.71) as compared to those with less than 3 medical conditions by history, and this was also significant (P <0.001). In the multivariate model, we only found age to be an independent and significant factor. After adjusting for age, none of the other variables initially significant in the univariate model remained significant. The results show that the ACT was simple and easy to be administered in younger-aged patients.

The evolution of teaching and learning medical microbiology and infectious diseases at NUS.

PubMed

Taylor, M B; Chow, V T K

2005-07-01

Infectious diseases were rife during the early years of the Singapore Medical College, which was established in 1905. The current Department of Microbiology in the National University of Singapore (NUS) has its historical roots in the Departments of Bacteriology and Parasitology, which were established in 1925 and 1950 respectively. With the achievements since its inception, and with its present research focus on Infectious Diseases, Immunology, Applied and Environmental Microbiology, it is poised to face the microbiological challenges of the 21st century. Over the decades, the structure of the medical microbiology course in NUS has modernised, culminating in the current emphasis on its practical utility in clinical practice. Coordinated by the Department of Microbiology, the Microbiology and Infectious Diseases module and the Immunology module both adopt integrated multidisciplinary approaches that aim to introduce students to the language and fundamental concepts in microbiology, infectious diseases and immunology.

Review of psychiatric services to mentally disordered offenders around the Pacific Rim.

PubMed

Every-Palmer, Susanna; Brink, Johann; Chern, Tor P; Choi, Wing-Kit; Hern-Yee, Jerome Goh; Green, Bob; Heffernan, Ed; Johnson, Sarah B; Kachaeva, Margarita; Shiina, Akihiro; Walker, David; Wu, Kevin; Wang, Xiaoping; Mellsop, Graham

2014-03-01

This article was commissioned to collate and review forensic psychiatric services provided in a number of key Pacific Rim locations in the hope that it will assist in future dialogue about service development. The Board of the Pacific Rim College of Psychiatrists identified experts in forensic psychiatry from Australia, Canada, China, Hong Kong, Japan, Russia, Singapore, Taiwan, and the US. Each contributor provided an account of issues in their jurisdiction, including mental health services to mentally disordered offenders in prison, competence or fitness to stand trial, legal insanity as a defense at trial, diminished responsibility, and special forensic services available, including forensic hospitals and community forensic mental health services. Responses have been collated and are presented topic by topic and country by country within the body of this review. The availability of mental health screening and psychiatric in-reach or forensic liaison services within prisons differed considerably between countries, as did provisioning of community forensic mental health and rehabilitation services. Diversion of mentally disordered offenders to forensic, state, or hybrid hospitals was common. Legal constructs of criminal responsibility (insanity defense) and fitness to stand trial ("disability") are almost universally recognized, although variably used. Disparities between unmet needs and resourcing available were common themes. The legislative differences between contributing countries with respect to the mental health law and criminal law relating to mentally disordered offenders are relatively subtle. The major differences lie in operationalizing and resourcing forensic services. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

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

75 FR 41891 - In the Matter of Certain Optoelectronic Devices, Components Thereof, and Products Containing the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-19

..., 2009 based on a complaint filed on February 3, 2009, by Avago Technologies Fiber IP (Singapore) Pte. Ltd. of Singapore; Avago Technologies General IP (Singapore) Pte. Ltd. of Singapore; and Avago...

Pediatric Asthma Mortality and Hospitalization Trends Across Asia Pacific Relationship With Asthma Drug Utilization Patterns

PubMed Central

2009-01-01

Background The wide variability in prevalence of childhood asthma across Asia Pacific is well documented, but less is known about its trends in mortality and hospitalization. Objectives To examine pediatric asthma mortality and hospitalization trends of selected countries across Asia Pacific, and also patterns of asthma drug utilization. Materials and Methods Mortality and population data were sourced from the World Health Organization's mortality database. Data on hospitalization were obtained by direct inquiry and from government and scientific publications. Drug use for asthma was expressed as a controller-to-reliever (C:R) ratio (ie, units of inhaled corticosteroids/units of short-acting β-agonists, sold in each country). Time-series regression analyses were used to examine temporal patterns and study association between deaths, hospitalizations, and drug use. Results Japan showed a decreasing trend in pediatric asthma mortality whereas an increase was observed in Thailand. Hospitalizations decreased in Australia and Singapore but increased in Taiwan, Republic of China. C:R ratios increased significantly across the countries. Conclusions Mixed trends in pediatric asthma mortality and hospitalization rates were observed, which coincided with a uniform increase in C:R ratios. This may reflect importance of other aspects of asthma management besides pharmacotherapy. PMID:23283014

Proceedings of the Second International Congress on Recent Developments in Air- and Structure-Borne Sound and Vibration (2nd) Held in Auburn University, Alabama on 4-6 March 1992. Volume 2

DTIC Science & Technology

1992-03-06

elastic data (uncorrected) on Lithium- Zinc and Lithium- Cadmium ferrites Ferrite Bulk X-ray Per- V Vs E n Composition density density cen- 0 3K -3 10 3 K...weight with increasing zinc and cadmium contents. In the case of Li-Cd ferrites, the values of VI/P , V s /P Vm and eD are also increases continuously...585 Wu Ounli, Nanyang Technololical University, Singapore RECIPROCITY METHOD FOR QUANTIFICATION OF AIRBORNE SOUND TRANSFER FROM MACHINERY

MRSA Transmission Dynamics Among Interconnected Acute, Intermediate-Term, and Long-Term Healthcare Facilities in Singapore.

PubMed

Chow, Angela; Lim, Vanessa W; Khan, Ateeb; Pettigrew, Kerry; Lye, David C B; Kanagasabai, Kala; Phua, Kelvin; Krishnan, Prabha; Ang, Brenda; Marimuthu, Kalisvar; Hon, Pei-Yun; Koh, Jocelyn; Leong, Ian; Parkhill, Julian; Hsu, Li-Yang; Holden, Matthew T G

2017-05-15

Methicillin-resistant Staphylococcus aureus (MRSA) is the most common healthcare-associated multidrug-resistant organism. Despite the interconnectedness between acute care hospitals (ACHs) and intermediate- and long-term care facilities (ILTCFs), the transmission dynamics of MRSA between healthcare settings is not well understood. We conducted a cross-sectional study in a network comprising an ACH and 5 closely affiliated ILTCFs in Singapore. A total of 1700 inpatients were screened for MRSA over a 6-week period in 2014. MRSA isolates underwent whole-genome sequencing, with a pairwise single-nucleotide polymorphism (Hamming distance) cutoff of 60 core genome single-nucleotide polymorphisms used to define recent transmission clusters (clades) for the 3 major clones. MRSA prevalence was significantly higher in intermediate-term (29.9%) and long-term (20.4%) care facilities than in the ACH (11.8%) (P < .001). The predominant clones were sequence type [ST] 22 (n = 183; 47.8%), ST45 (n = 129; 33.7%), and ST239 (n = 26; 6.8%), with greater diversity of STs in ILTCFs relative to the ACH. A large proportion of the clades in ST22 (14 of 21 clades; 67%) and ST45 (7 of 13; 54%) included inpatients from the ACH and ILTCFs. The most frequent source of the interfacility transmissions was the ACH (n = 28 transmission events; 36.4%). MRSA transmission dynamics between the ACH and ILTCFs were complex. The greater diversity of STs in ILTCFs suggests that the ecosystem in such settings might be more conducive for intrafacility transmission events. ST22 and ST45 have successfully established themselves in ILTCFs. The importance of interconnected infection prevention and control measures and strategies cannot be overemphasized. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Prevalence of carpal fracture in Singapore.

PubMed

Hey, Hwee Weng Dennis; Dennis, Hey Hwee Weng; Chong, Alphonsus Khin Sze; Sze, Alphonsus Chong Khin; Murphy, Diarmuid

2011-02-01

To determine the prevalence of carpal fracture in Singapore, to compare demographic differences between isolated scaphoid and other carpal fractures, and to identify parameters associated with multiple carpal fractures. A total of 149 patients with 162 carpal fractures seen at the National University Hospital in 2009 were enrolled into the study. We retrospectively reviewed their case records and radiographic studies. Pertinent demographic data including patient age, gender, occupation, injured wrist, dominant hand, mechanism of injury, and type of carpal fracture were then recorded and statistically analyzed. We also performed a separate analysis of isolated scaphoid versus other carpal fractures and single versus multiple carpal fractures. Patients with carpal fracture were predominantly male (132), below 40 years of age (116), and usually right hand dominant (136). The more common occupations were students (30), full-time military national servicemen (24), and construction workers (14). Most presented after a fall on an outstretched hand from standing height (81). The scaphoid was the most common single carpal fracture (99). This was followed by triquetrum (27), hamate (5), pisiform (4), lunate (2), capitate (1), and trapezium (1). No fracture of the trapezoid was encountered. Ten patients had multiple carpal fractures, of which 4 were perilunate fracture dislocations. The mean age and male/female ratio for isolated scaphoid and other carpal fractures was 26 years versus 41 years (p<.001) and 13:1 versus 4:1 (p=.036), respectively. A high-energy mechanism of injury was the only parameter associated with multiple carpal fractures (p=.009). The prevalence of carpal fracture in our population was consistent with studies performed in other countries. Military conscription was identified as an at-risk activity predisposing to carpal fracture. Isolated scaphoid and other carpal fractures exhibit different demographics in terms of age and gender, which may be related to differences in the mechanism of injury. A high-energy mechanism of injury was associated with multiple carpal fractures. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Validation of the Stroke and Aphasia Quality of Life Scale in a multicultural population.

PubMed

Guo, Yiting Emily; Togher, Leanne; Power, Emma; Koh, Gerald C H

2016-12-01

This study aimed to determine the reliability and validity of the Stroke and Aphasia Quality of Life Scale (SAQOL-39 g) and its Mandarin adaptation SAQOL-CSg in Singaporean stroke patients. First-time stroke survivors were recruited at three months post-stroke and underwent a series of questionnaires in their dominant language (English/Mandarin). This included: SAQOL-39 g/CSg, National University Hospital System (NUHS) Aphasia Screening Test, Barthel Index, Modified Rankin Scale, Mini Mental State Examination, Frontal Assessment Battery, Center for Epidemiologic Studies Depression Scale and the Eurol-Qol Health Questionnaire (EQ-5D). The SAQOL-39 g/SAQOL-CSg was repeated within 1 week (± 6 days). Ninety-four participants (96.9%) were able to self-report and their results presented here. Both the SAQOL-39 g/SAQOL-CSg showed good internal consistency (α = 0.96/0.97), test-retest reliability (ICC= 0.99/0.98), convergent (rs  =0.64-0.81 and 0.66-0.88, respectively) and discriminant (rs = 0.35-0.53 and 0.48-0.62, respectively) validity. The correlation between the SAQOL-39 g and the EQ-5D Visual Analogue Scale was 0.27. Further inspection of the EQ-5DVAS scores revealed correlations in different directions for Malay versus Chinese participants. Both the SAQOL-39 g and SAQOL-CSg demonstrated good reliability and validity. Our results suggested some influence of ethnicity in self-rating of health status in relation to SAQOL-39 g scores. Further research is warranted to examine its use with stroke survivors with greater stroke severity and over time. Implications for Rehabilitation Validation of SAQOL in Singapore: Both the SAQOL-39g and the SAQOL-CSg may be used to measure the HRQoL of stroke survivors with and without aphasia in Singapore. Further investigation is required to examine use with stroke survivors with greater stroke severity and over time.

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.

Clinical nurse leaders' and academics' perspectives in clinical assessment of final-year nursing students: A qualitative study.

PubMed

Wu, Xi Vivien; Enskär, Karin; Pua, Lay Hoon; Heng, Doreen Gek Noi; Wang, Wenru

2017-09-01

The nature of nursing practice is diverse; therefore, clinical assessment is a complex process. This study explores the perceptions of clinical nurse leaders and academics on clinical assessment for undergraduate nursing education during transition to practice. An explorative qualitative approach was applied. Eight nurse managers, six clinical nurse educators, and eight academics from two tertiary hospitals and a university in Singapore participated in four focus group discussions. Thematic analysis was conducted. Four overriding themes were revealed: the need for a valid and reliable clinical assessment tool, preceptors' competency in clinical assessment, challenges encountered by the students in clinical assessment, and the need for close academic and clinical collaboration to support preceptors and students. Closer academic-clinical partnership is recommended to review the clinical education curriculum. Clinical and educational institutions need to work closely to design a learning program to enhance preceptors' competence in clinical pedagogy and assessment. Furthermore, a stress management program could build students' resiliency in coping with unfamiliar clinical environments. Ongoing support needs to be provided for both preceptors and students to enrich the preceptorship and learning experiences. © 2017 John Wiley & Sons Australia, Ltd.

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…

Can the 2014 Comprehensive Agreement on the Bangsamoro (CAB) Succeed in Mindanao Where Previous Agreements Failed?

DTIC Science & Technology

2015-03-01

International Studies (RSIS) at Nanyang Technological University , Singapore, argues that “small arms proliferation and a weak rule of law” will hurt...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited CAN THE 2014...0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing

Proceedings of the Symposium on Research in Biology and Biotechnology in Developing Countries (National University of Singapore, November 2-4, 1983). Selected Papers.

ERIC Educational Resources Information Center

Rao, A. N., Ed.

These proceedings of a symposium designed to increase public awareness of current research in biology and biotechnology include: welcoming addresses by Chau Sian Eng and S. Radhakrishna; an opening address by Tay Eng Soon; five papers; four abstracts; summary; symposium program; and list of participants. The five papers are: (1) "The Role of…

Modelling Operational Command Structures Using ORGAHEAD

DTIC Science & Technology

2005-07-01

1999 he was awarded a PhD from the University of South Australia. Dr. Sproles works part-time with DSTO Edinburgh under contract between the...Australia. Manchester, W, 1978, American Caesar. Douglas MacArthur 1880-1964, Dell Publishing Co., New York, NY, USA. Manuel, K.T., and...Egypt Jordon Canada Italy HQ INTERFET HQ 3 Bde (Australia) Singapore Malaysia Fiji UK NZThailand Philipinnes S Korea Kenya Brazil Eire FranceNorway

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…

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…

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…

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,…

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

Stroke is the 4th leading cause of death and 1st leading cause of disability in Singapore. However the information on long-term post stroke outcomes for Singaporean patients was limited. This study aimed to investigate the post stroke outcomes of 5-year survival and rehospitalization due to stroke recurrence for hemorrhagic and ischemic stroke patients in Singapore. The outcomes were stratified by age, ethnic group, gender and stroke types. The causes of death and stroke recurrence were also explored in the study. A multi-site retrospective cohort study. Patients admitted for stroke at any of the three hospitals in the National Healthcare Group of Singapore were included in the study. All study patients were followed up to 5 years. Kaplan-Meier was applied to study the time to first event, death or rehospitalization due to stroke recurrence. Cox proportional hazard model was applied to study the time to death with adjustment for stroke type, age, sex, ethnic group, and admission year. Cumulative incidence model with competing risk was applied for comparing the risks of rehospitalization due to stroke recurrence with death as the competing risk. Totally 12,559 stroke patients were included in the study. Among them, 59.3% survived for 5 years; 18.4% were rehospitalized due to stroke recurrence in 5 years. The risk of stroke recurrence and mortality increased with age in all stroke types. Gender, ethnic group and admitting year were not significantly associated with the risk of mortality or stroke recurrence in hemorrhagic stroke. Male or Malay patient had higher risk of stroke recurrence and mortality in ischemic stroke. Hemorrhagic stroke had higher early mortality while ischemic stroke had higher recurrence and late mortality. The top cause of death among died stroke patients was cerebrovascular diseases, followed by pneumonia and ischemic heart diseases. The recurrent stroke was most likely to be the same type as the initial stroke among rehospitalized stroke 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.

Factors associated with diabetes-related distress over time among patients with T2DM in a tertiary hospital in Singapore.

PubMed

Tan, Maudrene L; Tan, Chuen S; Griva, Konstadina; Lee, Yung S; Lee, Jeannette; Tai, E S; Khoo, Eric Y; Wee, Hwee-Lin

2017-06-23

Persistent diabetes-related distress (DRD) is experienced by patients with Type 2 Diabetes Mellitus. Knowing factors associated with persistent DRD will aid clinicians in prioritising interventions efforts. A total of 216 patients were recruited from a tertiary hospital in Singapore, an Asian city state, and followed for 1.5 years (2011-2014). Data was collected by self-completed questionnaires assessing DRD (measured by the Problem Areas in Diabetes score) and other psychosocial aspects such as social support, presenteeism, depression, health-related quality of life (HRQoL) and excessive daytime sleepiness (EDS) at three time points. Clinical data (body-mass-index and glycated haemoglobin) was obtained from medical records. Change score was calculated for each clinical and psychosocial variable to capture changes in these variables from baseline. Generalized Linear Model with Generalized Estimating Equation method was used to assess whether baseline and change scores in clinical and psychosocial are associated with DRD over time. Complete data was available for 73 patients, with mean age 44 (SD 12.5) years and 67% males. Persistent DRD was experienced by 21% of the patients. In the final model, baseline HRQoL (OR = 0.56, p < 0.05) and change score of EDS (OR = 1.22, p < 0.05) was significantly associated with DRD over time. EDS might be a surrogate marker for persistent DRD and should be explored in larger samples of population to confirm the findings from this study.

A case series of complicated infective otitis media requiring surgery in adults.

PubMed

Heah, Harold; Soon, Sue Rene; Yuen, Heng-Wai

2016-12-01

With the advent of antibiotics, complications of otitis media have become less common. It is crucial for physicians to recognise otitis media and treat its complications early. Herein, we present our institution's experience with patients who required emergency surgical intervention for complications of otitis media. Data on patients who underwent emergency surgery for complications of otitis media from 2004 to 2011 was retrieved from the archives of the Department of Otolaryngology, Changi General Hospital, Singapore. A total of 12 patients (10 male, two female) underwent emergency surgery for complications of otitis media. The median age of the patients was 25 years. Otalgia, otorrhoea, headache and fever were the main presenting symptoms. Extracranial complications were observed in 11 patients, and six patients had associated intracranial complications. The primary otologic disease was acute otitis media in six patients, chronic otitis media without cholesteatoma in three patients and chronic otitis media with cholesteatoma in three patients. Mastoidectomy and drainage of abscess through the mastoid, with insertion of grommet tube, was the main surgical approach. Two patients required craniotomy. The mean length of hospital stay was 16.2 days and the mean follow-up period was 16.3 months. Five patients had residual conductive hearing loss; two patients with facial palsy had full recovery. Otitis media can still result in serious complications in the post-antibiotic era. Patients with otitis media should be monitored, and prompt surgical intervention should be performed when necessary to attain good outcomes. Copyright: © Singapore Medical Association

Major workplace related accidents in Singapore: A major trauma centre's experience.

PubMed

Ng, Zhi Xu; Teo, Li Tserng; Go, Karen T S; Yeo, Yen Teng; Chiu, Ming Terk

2010-12-01

Major workplace related accidents pose a significant healthcare resource challenge in Singapore. Our study looks at the epidemiology of patients who were admitted for workplace related accidents, in a single institution, with an Injury Severity Score of >9. There were 196 cases of major workplace related accidents admitted between January 2006 and December 2007. The median age of patients admitted was 37 years with a large percentage being males (95.4%) and non-residents (57.1%). The most common ethnic group was Chinese (53.1%) followed by Indians (23.5%). The most common mechanism of injury was fall from height (66.3%) followed by injuries as a result of falling objects at work (21.9%). The percentage of patients who required surgical intervention was 69.9%. Patients admitted for major workplace related accidents had a median length of stay of 5 days in the hospital, a median length of 24 days of medical leave (ML), certifying them unfit for duty and the average cost of stay for each patient was S$11,000. We have a better understanding of the epidemiology and socio-economic impact of workplace related accidents through this study. Workplace related accidents result in significant number of man-days lost from work and monetary cost to employers, medical insurance and the hospital. With an improved understanding, we propose methods to prevent and reduce such accidents in future. A direct consequence of which will be the possible reduction of hospitalisation costs and better allocation of healthcare resources in the future.

What's buzzing on your feed? Health authorities' use of Facebook to combat Zika in Singapore.

PubMed

Vijaykumar, Santosh; Meurzec, Rianne Wally; Jayasundar, Karthikayen; Pagliari, Claudia; Fernandopulle, Yohan

2017-11-01

In 2016, Singapore grappled with one of the largest Zika outbreaks in Southeast Asia. This study examines the use of Facebook for Zika-related outreach by the Ministry of Health (MOH) and the National Environmental Agency (NEA) from March 1, 2015, to September 1, 2016, and public response to this effort. Despite nearly equivalent outreach, MOH's Facebook posts received more likes (µ = 3.49) and shares (µ = 30.11), whereas NEA's posts received more comments (µ = 4.55), with NEA posting mostly on prevention (N = 30) and MOH on situational updates (N = 24). Thematic analyses identified prevention-related posts as garnering the most likes (N = 1277), while update-related posts were most shared (N = 1059) and commented upon (N = 220). Outreach ceased briefly for 2 months after Singapore's first imported case of Zika, but increased following the outbreak of locally transmitted cases in August 2016. Public engagement was significantly higher during Zika compared with prior haze and dengue outbreaks. The results indicate the value of Facebook as a tool for rapid outreach during infectious disease outbreaks, and as a "listening" platform for those managing the situation. We discuss implications for public health communication research and policy. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Relationship between Natural Park Usage and Happiness Does Not Hold in a Tropical City-State

PubMed Central

Saw, Le E.; Lim, Felix K. S.; Carrasco, Luis R.

2015-01-01

Previous studies have shown that contact with urban green spaces can produce positive effects on people's stress, health and well-being levels. However, much of this research has been conducted in the temperate regions of Europe or North America. Additionally, most studies have only compared the effects of urban and natural areas on health and well-being, but not made a finer distinction between different types of urban green spaces. We tested the relationship between well-being and the access or use of different types of green spaces among young adults in Singapore, a tropical city-state. The results showed that extraversion and emotional stability increased subjective well-being, positive affect and life satisfaction and decreased stress and negative affect. In addition, we found that level of physical activity increased positive affect and health problems increased negative affect. Neither access to green spaces nor the use of green spaces in Singapore significantly affected the well-being metrics considered, contradicting findings in the temperate regions of the world. We hypothesize that the differences in temperature and humidity and the higher greenery and biodiversity levels outside parks in Singapore could explain this phenomenon. Our results thus question the universality of the relationship between well-being and park usage and highlight the need for more research into the multifaceted effects of green spaces on well-being in the tropics. PMID:26222280

Singapore Math®. What Works Clearinghouse Intervention Report. Updated December 2015

ERIC Educational Resources Information Center

What Works Clearinghouse, 2015

2015-01-01

This report on "Singapore Math®" updates the 2009 WWC review of the curriculum to include seven new studies. Despite the additional research, no studies meet WWC design standards and therefore, no conclusions can be made about the effectiveness of "Singapore Math®." [For the 2009 report, "Singapore Math," see…

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…

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…

Preoperative patient characteristics and outcomes of total knee arthroplasty in a multiethnic Asian population stratified by ethnicity.

PubMed

Jiang, Lei; Bin Abd Razak, Hamid Rahmatullah; Chong, Hwei Chi; Tan, Andrew

2014-02-01

We aim to compare the patient profile and outcomes after TKA between the different racial groups in Singapore. Prospective data were collected from 364 patients who underwent TKA in Singapore General Hospital from January 2006 to May 2010. Patients were stratified according to ethnicity and we compared their preoperative demographic data, Short-Form 36 (SF-36), Oxford Knee (OKS) as well as Knee Society Scores (KSS). Malays were younger (62.0 ± 5.3) at time of surgery (p=0.05) and the body mass index of Chinese (27.9 ± 4.7) was lower than Malay (30.4 ± 5.0) and Indian (31.5 ± 4.5) patients (P<0.005). Malay (40.3 ± 11.0) and Indian (39.2 ± 9.3) patients had less favourable preoperative OKS than Chinese (35.9 ± 7.8) patients (P<0.05). All 3 ethnic groups achieved statistically significant improvements in outcome measures but did not differ significantly between the ethnicities. Copyright © 2014 Elsevier Inc. All rights reserved.

Singapore National Medical Image Resource Centre (SN.MIRC): a world wide web resource for radiology education.

PubMed

Yang, Guo-Liang; Lim, C C Tchoyoson

2006-08-01

Radiology education is heavily dependent on visual images, and case-based teaching files comprising medical images can be an important tool for teaching diagnostic radiology. Currently, hardcopy film is being rapidly replaced by digital radiological images in teaching hospitals, and an electronic teaching file (ETF) library would be desirable. Furthermore, a repository of ETFs deployed on the World Wide Web has the potential for e-learning applications to benefit a larger community of learners. In this paper, we describe a Singapore National Medical Image Resource Centre (SN.MIRC) that can serve as a World Wide Web resource for teaching diagnostic radiology. On SN.MIRC, ETFs can be created using a variety of mechanisms including file upload and online form-filling, and users can search for cases using the Medical Image Resource Center (MIRC) query schema developed by the Radiological Society of North America (RSNA). The system can be improved with future enhancements, including multimedia interactive teaching files and distance learning for continuing professional development. However, significant challenges exist when exploring the potential of using the World Wide Web for radiology education.

A Score for Predicting Acute Kidney Injury After Coronary Artery Bypass Graft Surgery in an Asian Population.

PubMed

Mithiran, Harish; Kunnath Bonney, Glenn; Bose, Saideep; Subramanian, Srinivas; Zhe Yan, Zan Ng; Zong En, Seth Yeak; Papadimas, Evangelos; Chauhan, Ishaan; MacLaren, Graeme; Kofidis, Theodoros

2016-10-01

To develop a scoring system to predict acute kidney injury in Asian patients after coronary artery bypass grafting. A retrospective analysis of data collected in an institutional cardiac database. A tertiary academic hospital in a large metropolitan city. The study comprised 954 patients with coronary artery disease. All patients underwent coronary artery bypass surgery with cardiopulmonary bypass but did not undergo any other concomitant procedures. The main outcome measured was acute kidney injury as defined by the Acute Kidney Injury Network criteria. The following 6 clinical variables were independent predictors of kidney injury: age>60 years, diabetes requiring insulin, estimated glomerular filtration rate<60 mL/min/1.73 m(2), ejection fraction<40%, cardiopulmonary bypass time>140 minutes, and aortic cross-clamp time>100 minutes. These variables were used to develop the Singapore Acute Kidney Injury score. The Singapore Acute Kidney Injury score is a simple way to predict, at the time of admission to the intensive care unit, an Asian patient's risk of developing acute kidney injury after coronary artery bypass surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Complexity of Language Ideologies in Transnational Movement: Korean "Jogi Yuhak" Families' Ambivalent Attitudes towards Local Varieties of English in Singapore

ERIC Educational Resources Information Center

Bae, So Hee

2015-01-01

This paper discusses the complex and competing language ideologies that Korean educational migrant families in Singapore hold about the normativity and legitimacy of English language varieties. During their educational migration in Singapore, Korean families show ambivalent attitudes toward the local variety of English in Singapore, Singlish.…

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…

Academically Elite Students in Singapore: A Collective Moral Stance toward Aspirations and Trajectories

ERIC Educational Resources Information Center

Lu, Luke

2016-01-01

This paper draws on a Linguistic Ethnography (Blommaert & Rampton 2011) of a group of academically elite students in Singapore. The group comprises locals born in Singapore, as well as immigrants from China and Vietnam. My informants all attended a top-ranked secondary school in Singapore. I present data from interviews and a focus group…

Towards Evidence-Based Initial Teacher Education in Singapore: A Review of Current Literature

ERIC Educational Resources Information Center

Low, Ee-Ling; Hui, Chenri; Taylor, Peter G.; Ng, Pak Tee

2012-01-01

Initial teacher education (ITE) in Singapore is shifting towards evidence-based practice. Despite a clear policy orientation, ITE in Singapore has not yet produced the evidence base that it is anticipating. This paper presents an analytical review of previous research into ITE in Singapore and makes comparisons to the larger international context.…

Singapore Math: Problem-Solving Secrets from the World's Math Leader

ERIC Educational Resources Information Center

Hogan, Bob

2005-01-01

Using this four CD-ROM disc set, teachers can have their very own math problem solving mentor as a leading expert in Singapore Math guides them through a lively presentation, working through math problems and explaining how Singapore has become the world's leading method in math. The expert's explanation of how to use Singapore's model-drawing…

The Enactment of the Policy Initiative for Critical Thinking in Singapore Schools

ERIC Educational Resources Information Center

Tan, Charlene

2017-01-01

This article examines the enactment of the policy initiative to promote critical thinking in Singapore schools from the perspectives of educators in Singapore. It is argued that teachers in Singapore are not passive recipients or mere implementers of top-down policy decisions. Rather, they enact the policy initiative by making sense of,…

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…

Rupture and Adaptation: British Technical Expertise to the Singapore Polytechnic and the Transition to a Nation-State

ERIC Educational Resources Information Center

Seng, Loh Kah

2015-01-01

The Singapore Polytechnic underwent a period of both rupture and adaptation as British advisers worked with the post-colonial government to facilitate technical education reform and Singapore's transition to a nation-state. Established in 1958 and based on the metropolitan model, the Singapore Polytechnic constituted an imperial project for…

Bouguer gravity map of Indonesia

NASA Astrophysics Data System (ADS)

Green, R.; Adkins, J. S.; Harrington, H. J.; Untung, M.

1981-01-01

A Bouguer gravity map of Indonesia on Mercator projection at a scale of 1: 5,000,000 and with a contour interval 20 mGal has been prepared over the past few years as part of a joint research program of the Geological Survey of Indonesia and the University of New England, Armidale. A new base station network was set up throughout Indonesia and tied to the IGSN stations at Sydney and Singapore. A discussion of the gravity features and the tectonic implications are given. The map is obtainable, in folded form only, from the Publications Department, University of New England, Armidale, N.S.W., Australia 2351 for $ A 5.- plus postage.

The medical students' societies and medical students' publications.

PubMed

Lim, K H

2005-07-01

The rich corporate life of the medical student and the medical students' societies at our medical school (at the present National University of Singapore) is generally unappreciated by its graduates and regrettably, even more unknown to the medical student of today. The present generation of medical students of NUS do not know of their rich history. We have published documentation of student activities from the founding of the medical school in 1905 till the establishment of the then University of Malaya in 1950, reviewed herein. Materials presented after 1950 were gathered from personal communications from key players in the students' societies and from editors of the medical students' publications.

BKCASE (trademark): Body of Knowledge and Curriculum to Advance Systems Engineering

DTIC Science & Technology

2010-09-01

i l IEEE USc   a r ey ,  Alain Faisandier Association Francaise d‘lingeniere Systeme, France Tim  Ferris University of South Australia, Australia...Lawson Lawson Konsult AB, Sweden Yeaw lip “Alex”  Lee Defence Science and Technology Agency,  Singapore Ray Madachy Naval Postgraduate School, US James...9/2010 Sven‐Olaf Schulze Berner & Mattner, Germany Seiko Shiraska KEIO University, Japan Hillary Sillitto Thales Group, UK John Snoderly Defense

Malaysia’s Experience in War Against Communist Insurgency and Its Relevance to the Present Situation in Iraq

DTIC Science & Technology

2005-01-01

Shangri - La Hotel , Makati City 48 Ibid. 49 Stanley S. Bedlington. Malaysia and Singapore. The Building of New States. Cornell University Press Ltd...Page Preface i Contents ii Executive Summary iii Map on Malaya iv INTRODUCTION 1 THE INSURGENCY AGAINST THE MCP 3 The First Emergency...will be a good start. MAP OF MALAYA (Peninsular Malaysia) iv 1 INTRODUCTION In mid June 1948 the

Translations on Narcotics and Dangerous Drugs, Number 308

DTIC Science & Technology

1977-07-01

17 June (AFP)—A Swedish girl, Annica Carrson, 21, was today sentenced to 2 and a half months jail for possession of heroin. Four Malaysians (words...visiting Malaysia by two Malaysians in Sweden and fell into bad company here. CSO: 5300 SINGAPORE BRIEFS DRUG TRAFFICKER SENTENCED—In the...Vincennes University in the cinema and music depart- ments. The arrest was made on two separate occasions. On 25 May, Commissioner Andre Soleres

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

Erratum to: Rectocutaneous fistula with transmigration of the suture: a rare delayed complication of vault fixation with the sacrospinous ligament.

PubMed

Kadam, Pratima Datta; Chuan, Han How

2016-03-01

There was an oversight in the Authorship of a recent Images in Urogynecology article titled: Rectocutaneous fistula with transmigration of the suture: a rare delayed complication of vault fixation with the sacrospinous ligament (DOI 10.1007/ s00192-015-2823-5). We would like to include Adj A/P Han How Chuan’s name in the list of authors. Adj A/P Han is a Senior Consultant and Department Head of Urogynaecology at the KK Hospital for Women and Children, Singapore.

76 FR 42730 - In the Matter of Certain Univeral Serial Bus (“USB”) Portable Storage Devices, Including USB...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

..., as amended, 19 U.S.C. 1337, on behalf of Trek 2000 International Ltd., of Singapore; Trek Technology (Singapore) Pte. Ltd. of Singapore; and S-Com System (S) Pte. Ltd. of Singapore. The complaint alleges...''). The complaint further alleges that an industry in the United States exists as required by subsection...

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…

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

Buckling up in Singapore: residency and other risk factors for seatbelt non-compliance - a cross-sectional study based on trauma registry data.

PubMed

Wong, Ting Hway; Lim, Gek Hsiang; Chow, Khuan Yew; Zaw, Nyi Nyi; Nguyen, Hai Van; Chin, Hoong Chor; Ong, Marcus Eng Hock

2016-05-14

Seatbelt non-compliance is a problem in middle income countries, and little is known about seatbelt compliance in populations with a high proportion of non-residents. This study analyses the profile of seatbelt non-compliance in Singapore based on trauma registry data from five of the six public hospitals. This is a cross-sectional study of seatbelt compliance of patients aged over 18 years, attending the emergency departments of five public hospitals in Singapore after road collisions from 2011-2014. Seatbelt data was obtained from paramedic and patient history. There were 4,576 patients studied. Most were Singapore citizens (83.4 %) or permanent residents (2.4 %), with the largest non-resident groups from Malaysia, India, and China. Overall seatbelt compliance was 82.1 %. On univariate analysis, seatbelt compliance was higher in older patients (OR 1.02, 95 % CI 1.001-1.021, p < 0.0001); drivers, followed by front passengers (OR 0.65, 95 % CI 0.51-0.83, p < 0.0001), were more compliant than rear passengers (OR 0.08, 0.06-0.09, p < 0.0001); occupants of larger vehicle types (buses, heavy transport vehicles, minibuses and vans) were more non-compliant compared to occupants of private cars and taxis. Morning peak travel (0700 h-0900 h) and being a non-resident were other risk factors for non-compliance. On multivariable analysis, older age (OR 1.01, 95 % CI 1.001-1.014, p = 0.03) was associated with compliance, while non-residents from China (OR 0.43, 95 % CI 0.18-0.99, p = 0.05), seat position (front passenger compared to driver, OR 0.64, 95 % CI 0.48-0.85, p = 0.002; rear passenger compared to driver, OR 0.067, 95 % CI 0.05-0.09, p < 0.0001), vehicle type (bus compared to car, OR 0.04, 95 % CI 0.017-0.11, p < 0.0001, van compared to car, OR 0.55, 95 % CI 0.36-0.83, p = 0.004), and travel at morning peak periods were independent predictors of seatbelt non-compliance. When the sub-group of drivers was analysed, only vehicle type was a significant predictor of seatbelt compliance, with bus drivers least likely to be compliant to seatbelts (multivariable analysis, OR 0.057 compared to cars, 95 % CI 0.019-0.18, p < 0.0001). While overall seatbelt compliance in our study is high, efforts can be made to increase compliance for morning rush hour passengers, rear seat passengers, and occupants of buses, heavy transport vehicles, and vans or pickups.

Linear unsaturating magnetoresistance in disordered systems

NASA Astrophysics Data System (ADS)

Lai, Ying Tong; Lara, Silvia; Love, Cameron; Ramakrishnan, Navneeth; Adam, Shaffique

Theoretical works have shown that disordered systems exhibit classical magnetoresistance (MR). In this talk, we examine a variety of experimental systems that observe linear MR at high magnetic fields, including silver chalcogenides, graphene, graphite and Weyl semimetals. We show that a careful analysis of the magnitude of the MR, as well as the field strength at which the MR changes from quadratic to linear, reveal important properties of the system, such as the ratio of the root-mean-square fluctuations in the carrier density and the average carrier density. By looking at other properties such as the zero-field mobility, we show that this carrier density inhomogeneity is consistent with what is known about the microscopic impurities in these experiments. The application of this disorder-induced MR to a variety of different experimental scenarios underline the universality of these theoretical models. This work is supported by the Singapore National Research Foundation (NRF-NRFF2012-01) and the Singapore Ministry of Education and Yale-NUS College through Grant Number R-607-265-01312.

Lost Keys: Understanding Service Providers' Impressions of Frequent Visitors to Psychiatric Emergency Services in Singapore.

PubMed

Poremski, Daniel; Kunjithapatham, Ganesh; Koh, Doris; Lim, Xin Ya; Alexander, Mark; Lee, Cheng

2017-04-01

This study used administrative data to identify characteristics of frequent users of Singapore's largest specialized psychiatric emergency department (ED). Qualitative interviews were conducted to understand staff opinions of frequent visitors. Data were from administrative records of all adult visits to the ED (N=16,123 visits of 10,108 individual users) in 2014. Random-effects logistic regressions were used to identify demographic and diagnostic characteristics of frequent visitors. To facilitate interpretation of administrative data in a convergent mixed-methods study design, interviews were conducted with 26 service providers who worked in the ED. Frequent use was defined as five or more visits in 2014. This cutoff distinguished the top 3% of users (N=331), and this group accounted for 16% of service use. Frequent users were more likely to have a diagnosis of a psychotic disorder, personality disorder, or alcohol use disorder. Service provider groups (for example, physicians, nurses, and assistants) described similar groups of frequent users and noted that frequent use was related to lack of social supports outside the hospital and feelings of belonging within it. The most frequently cited challenges were managing intoxicated service seekers, managing expectations for admission, and dealing with threats of self-harm. The profiles of frequent ED users in Singapore resembled those reported in other large urban centers. The opinions of service providers and their reactions to difficult situations were similar to those of providers in nonpsychiatric settings. The service providers' perspectives highlight how societal pressures influence the way in which individuals with mental illnesses use services.

Caregiving and Its Resulting Effects-The Care Study to Evaluate the Effects of Caregiving on Caregivers of Patients with Advanced Cancer in Singapore.

PubMed

Chua, Cheryl Kai Ting; Wu, Jun Tian; Wong, Yin Yee; Qu, Limin; Tan, Yung Ying; Neo, Patricia Soek Hui; Pang, Grace Suyin

2016-11-15

Informal caregivers (IC) are key to enabling home deaths, where preferred, at the end-of-life. Significant morbidity from advanced cancer can make caregiving burdensome. However, knowledge about the nature of the caregiving burden for caregivers in Singapore is limited. Hence, the key objective in this study was to examine the impact of the caregiving burden on quality of life (QOL), mental health and work capacity among local ICs. Eligible English-speaking ICs of hospitalized advanced cancer patients were recruited through non-random sampling. The Zarit Burden Interview (ZBI), Caregiver Quality of Life Index-Cancer (CQOLC), Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), and Work Productivity and Activity Impairment Questionnaire (WPAI) were interviewer-administered to eligible ICs. Altogether, 16 ICs were surveyed. The mean age of ICs was 43.8 years. Most were children of patients (43.8%), and eight ICs had high burden (ZBI > 17). Those with ZBI > 17 had lower QOL, higher depression scores as well as greater work and activity impairment. In conclusion, high caregiver burden has adverse effects on QOL, mental health and work productivity. Non-physical elements of caregiving (particularly financial and decision-making) and increased number of care roles undertaken by a single IC contribute to high burden. Future interventions for caregiving burden in Singapore should also address the financial and decision-making aspects of caregiving. Outsourcing selected aspects of the caregiving role to community services may reduce the number of caregiving aspects undertaken by a single IC and caregiver burden.

Internet and smartphone application usage in eating disorders: A descriptive study in Singapore.

PubMed

Tan, Tina; Kuek, Angeline; Goh, Shih Ee; Lee, Ee Lian; Kwok, Victor

2016-02-01

Eating disorders are associated with significant morbidity and mortality. The Internet is a popular medium for individuals with eating disorders to discuss and reinforce their affliction. However, the available literature on Internet usage and eating disorders is scarce, especially in the area of social media and smartphone application ("app") usage. This study looked at the Internet and smartphone app usage patterns of participants who presented with an eating disorder in Singapore, and whether it corresponded to severity of illness. Individuals who presented to the Eating Disorders clinic at the Singapore General Hospital completed a self-reported questionnaire on Internet and app usage. They also completed the EDE-Q, EAT-26 and CIA 3.0. 55 participants completed the study. 41.8% had anorexia nervosa, 34.5% had bulimia nervosa, and 9.1% were ED-NOS. 41.8% felt that apps helped to perpetuate their illness while 32.7% felt that the apps were helpful for recovery. Overall, any smartphone application usage was associated with younger age and greater eating disorder psychopathology and psychosocial impairment. While 30.9% had encountered eating disorder-related content on Facebook, only 12.7% visited Facebook groups related to eating disorders. For YouTube, "Cooking and Food" and "Beauty and Fashion" videos were among the top 3 types of videos that participants watched. In conclusion, Internet and smartphone app usage is significant, and they are associated with greater severity of illness. It is necessary to include interventions in this aspect as part of treatment of eating disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

Direct medical cost of stroke in Singapore.

PubMed

Ng, Charmaine Shuyu; Toh, Matthias Paul Han Sim; Ng, Jiaying; Ko, Yu

2015-10-01

Globally, stroke is recognized as one of the main causes of long-term disability, accounting for approximately 5·7 million deaths each year. It is a debilitating and costly chronic condition that consumes about 2-4% of total healthcare expenditure. To estimate the direct medical cost associated with stroke in Singapore in 2012 and to determine associated predictors. The National Healthcare Group Chronic Disease Management System database was used to identify patients with stroke between the years 2006 and 2012. Estimated stroke-related costs included hospitalizations, accident and emergency room visits, outpatient physician visits, laboratory tests, and medications. A total of 700 patients were randomly selected for the analyses. The mean annual direct medical cost was found to be S$12 473·7, of which 93·6% were accounted for by inpatient services, 4·9% by outpatient services, and 1·5% by A&E services. Independent determinants of greater total costs were stroke types, such as ischemic stroke (P = 0·005), subarachnoid hemorrhage (P < 0·001) and intracerebral haemorrhage (P < 0·001), shorter poststroke period, more than one complications (P = 0·045), and a greater number of comorbidities (P = 0·001). There is a considerable economic burden associated with stroke in Singapore. The type of stroke, length of poststroke period, and stroke complications and comorbidities are found to be associated with the total costs. Efforts to reduce inpatient costs and to allocate health resources to focus on the primary prevention of stroke should become a priority. © 2015 World Stroke Organization.

Road traffic accidents in children: the 'what', 'how' and 'why'.

PubMed

Lee, Yue Yen; Fang, Eric; Weng, Yanyi; Ganapathy, Sashikumar

2018-04-01

Road traffic accidents (RTAs) in Singapore involving children were evaluated, with particular focus on the epidemiology, surrounding circumstances and outcomes of these accidents. Key factors associated with worse prognosis were identified. We proposed some measures that may be implemented to reduce the frequency and severity of such accidents. This was a retrospective study of RTAs involving children aged 0-16 years who presented to the Children's Emergency at KK Women's and Children's Hospital, Singapore, from January 2011 to June 2014. Data was obtained from the National Trauma Registry and analysed in tiers based on the Injury Severity Score (ISS). A total of 1,243 accidents were reviewed. RTA victims included motor vehicle passengers (60.4%), pedestrians (28.5%), cyclists (9.9%) and motorcycle pillion riders (1.2%). The disposition of emergency department (ED) patients was consistent with RTA severity. For serious RTAs, pedestrians accounted for 63.6% and 57.7% of Tier 1 (ISS > 15) and Tier 2 (ISS 9-15) presentations, respectively. Overall use of restraints was worryingly low (36.7%). Not restraining increased the risk of serious RTAs by 8.4 times. Young age, high ISS and low Glasgow Coma Scale score predicted a longer duration of intensive care unit stay. The importance of restraints for motor vehicle passengers or helmets for motorcycle pillion riders and cyclists in reducing morbidity requires emphasis. Suggestions for future prevention and intervention include road safety education, regulation of protective restraints, use of speed enforcement devices and creation of transport policies that minimise kerbside parking. Copyright: © Singapore Medical Association.

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.

West Meets East in Malaysia and Singapore. Participants' Papers. Fulbright-Hays Summer Seminars Abroad Program 1999 (Malaysia and Singapore).

ERIC Educational Resources Information Center

Malaysian-American Commission on Educational Exchange, Kuala Lumpur.

These projects were completed by participants in the Fulbright-Hays summer seminar in Malaysia and Singapore in 1999. The participants represented various regions of the U.S. and different grade levels and subject areas. The seminar offered a comprehensive overview of how the people of Malaysia and Singapore live, work, and strive towards their…

What the United States Can Learn From Singapore's World-Class Mathematics System (and What Singapore Can Learn from the United States): An Exploratory Study

ERIC Educational Resources Information Center

Ginsburg, Alan; Leinwand, Steven; Anstrom, Terry; Pollock, Elizabeth

2005-01-01

This exploratory study compares key features of the Singapore and U.S. mathematics systems in the primary grades, when students need to build a strong mathematics foundation. It identifies major differences between the mathematics frameworks, textbooks, assessments, and teachers in Singapore and the United States. It also presents initial results…

Social Foundations of Public-Private Partnerships in Education: The Historical Cases of Post-War Singapore and Hong Kong

ERIC Educational Resources Information Center

Wong, Ting-Hong

2015-01-01

This paper compares public-private partnerships (PPPs) in education in post-war Singapore and Hong Kong. After the Second World War the Singapore government shied away from PPPs, while the state in Hong Kong collaborated extensively with the non-state sector in education. Singapore was a small city-state flanked by two Muslim nations, and its…

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.

Investing in Our Future: The Early Years. First Singapore Conference on Preschool Education: Promoting Quality Care and Education for Preschoolers (Singapore, December 2-3, 1998).

ERIC Educational Resources Information Center

Tan-Niam, Carolyn, Ed.; Ling, Quah May, Ed.

Informed by current thinking and supported by data gathered in Singapore, this volume compiles a selection of papers presented at the First Singapore Conference on Preschool Education: Promoting Quality Care and Education for Preschoolers. The papers are: (1) "Introduction: Issues in Quality Provision for Preschool Care and Education"…

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.

Contribution of forest fires to concentrations of particulate matter in Singapore

NASA Astrophysics Data System (ADS)

Spracklen, D. V.; Reddington, C.; Yoshioka, M.; Arnold, S.; Balasubramanian, R.

2013-12-01

Singapore is regularly exposed to substantial levels of transboundary air pollution arising from uncontrolled forest and peat fires from specific regions within Southeast Asia. This air pollution has detrimental impacts on the lives of Singapore residents and on sensitive ecosystems. In June 2013, forest fires resulted in concentrations of particulate matter greatly exceeding levels recommended for human health, causing substantial public concern. We apply two different methods to quantify the impact of forest fires on the concentrations of particulate matter with diameter less than 2.5 micrometres (PM2.5) in Singapore. Firstly, we use a global aerosol model (GLOMAP) in combination with fire emissions from GFED3 to simulate PM2.5 concentrations over the period 1998-2009. We evaluate simulated PM2.5 concentrations against long-term observations from Singapore. To identify the contributions of fires from different source regions to PM2.5 concentrations we run multiple simulations with and without fire emissions from specific regions across Southeast Asia. Secondly, we apply an atmospheric back trajectory model in combination with the GFED3 fire emissions to calculate exposure of air masses arriving in Singapore to fire emissions. Both methods use meteorology from the European Centre for Medium Range Weather Forecasts and are consistent with the large-scale atmospheric flow from the assimilated observations. We find that both methods give consistent results, with forest fires increasing PM2.5 concentrations in Singapore predominately during April to October. Forest and peat fires in Sumatra and Kalimantan cause the greatest degradation of air quality in Singapore. The contribution of fires to PM2.5 concentrations in Singapore exhibits strong interannual variability. During years with a strong contribution from fires, our simulations show that the prevention of fires in southern Sumatra would reduce regional PM2.5 concentrations around Singapore by more than a factor of two, potentially allowing Singapore to meet World Health Organisation guidelines for annual mean concentrations of PM2.5. Acting to reduce forest and peat fires in southern Sumatra, in particular provinces of Lampung, South Sumatra and Jambi, and southern Kalimantan would likely have the greatest environmental benefits to Singapore and surrounding regions.

Clinical outcomes and hospital length of stay in 2,756 elderly patients with hip fractures: a comparison of surgical and non-surgical management.

PubMed

Tan, Stephen Thong Soon; Tan, Wei Ping Marcus; Jaipaul, Josephine; Chan, Siew Pang; Sathappan, Sathappan S

2017-05-01

The purpose of this study was to compare the clinical outcomes of elderly hip fracture patients who received surgical treatment with those who received non-surgical treatment. This retrospective study involved 2,756 elderly patients with hip fractures who were admitted over a six-year period. The patients' biodata, complications, ambulatory status at discharge and length of hospital stay were obtained from the institution's hip fracture registry. Among the 2,756 hip fracture patients, 2,029 (73.6%) underwent surgical intervention, while 727 (26.4%) opted for non-surgical intervention. The complication rate among the patients who underwent surgical intervention was 6.6%, while that among the patients who underwent non-surgical intervention was 12.5% (p < 0.01). The mean length of hospital stay for the surgical and non-surgical hip fracture patients was 15.7 days and 22.4 days, respectively (p < 0.01). Surgical management of hip fractures among the elderly is associated with a lower complication rate, as well as a reduced length of hospital stay. Copyright: © Singapore Medical Association

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.

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.

[Emergency eye care in French university hospitals].

PubMed

Bourges, J-L

2018-03-01

The patient's request for urgent care in ophthalmology (PRUCO) at health care centers is constantly growing. In France, university hospitals are managing 75% of these cases. We sought to quantify PRUCO referred to French university hospital emergency units as well as to approach the structure and the territorial distribution of emergency eye care provided by French university hospitals. We conducted a quick cross-sectional survey sent to the 32 metropolitan and overseas French university hospitals. It inquired for each hospital whether emergency eye care units were available, whether ophthalmologists were on duty or on call overnight and how many PRUCO were managed in 2016. The 32 university hospitals completed the survey. A total of 398650 PRUCO were managed in French university hospitals in 2016. The emergency unit was exclusively dedicated to eye care for 70% of the hospitals, with 47% (15/32) of them employing an ophthalmologist on duty overnight. Every hospital but one had at least one ophthalmologist on call. The city of Paris set aside, university hospitals took care of an annual mean of 9000 PRUCO (min=500; max=32,250). The 32 French university hospitals are actively responding to patient's requests for urgent care in ophthalmology with very heterogeneous patient volumes and organizational systems. Half of them employ ophthalmologists on duty. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

[Subjective Workload, Job Satisfaction, and Work-Life-Balance of Physicians and Nurses in a Municipal Hospital in a Rural Area Compared to an Urban University Hospital].

PubMed

Körber, Michael; Schmid, Klaus; Drexler, Hans; Kiesel, Johannes

2018-05-01

Medical and nursing shortages in rural areas represent a current serious public health problem. The healthcare of the rural population is at risk. This study compares perceived workload, job satisfaction and work-life balance of physicians and nurses at a clinic in a rural area with two clinics of a University hospital. Physicians and nurses were interviewed anonymously with a standardized questionnaire (paper and pencil), including questions on job satisfaction, subjective workload and work-life balance. The response rate was almost 50% in the University hospital as well as in the municipal hospital. 32 physicians and 54 nurses from the University hospital and 18 physicians and 137 nurses from the municipal hospital participated in the survey. Nurses at the University hospital assessed the organization of the daily routine with 94.1% as better than those at the municipal hospital (82.4%, p=0.03). Physicians at the University hospital were able to better implement acquired knowledge at a University clinic with 87.5% than their counterparts at the municipal hospital (55.5%, p=0.02). In contrast to their colleagues at the municipal hospital, only 50% of the physicians at the University hospital subjectively considered their workload as just right (83.3% municipal, p=0.02). 96.9% of the physicians at the University hospital were "daily" or "several times a week" under time pressure (municipal 50%, p<0.01). Nurses of both hospitals had sufficient opportunity to reconcile work and family life (62.9% University hospital, 72.8% Municipal hospital). In contrast, only 20% of the physicians at the University Hospital but 42.9% of the physicians of the municipal hospital had sufficient opportunities to balance workload and family (p=0.13). The return rate of almost 50% can be described as good. Due to the small number of physicians, especially from the municipal hospital, it can be assumed that some interesting differences could not be detected. There were only slight differences between the nurses from the two hospitals. In contrast, subjective workload and stress factors reported by physicians at the University Hospital were significantly higher than those by doctors at the municipal hospital. © Georg Thieme Verlag KG Stuttgart · New York.

Evaluating a novel Integrated Community of Care (ICoC) for patients from an urbanised low-income community in Singapore using the participatory action research (PAR) methodology: a study protocol.

PubMed

Low, Lian Leng; Maulod, Adlina; Lee, Kheng Hock

2017-10-08

Poorer health outcomes and disproportionate healthcare use in socioeconomically disadvantaged patients is well established. However, there is sparse literature on effective integrated care interventions that specifically target these high-risk individuals. The Integrated Community of Care (ICoC) is a novel care model that integrates hospital-based transitional care with health and social care in the community for high-risk individuals living in socially deprived communities. This study aims to evaluate the effectiveness of the ICoC in reducing acute hospital use and investigate the implementation process and its effects on clinical outcomes using a mixed-methods participatory action research (PAR) approach. This is a single-centre prospective, controlled, observational study performed in the SingHealth Regional Health System. A total of 250 eligible patients from an urbanised low-income community in Singapore will be enrolled during their index hospitalisation. Our PAR model combines two research components: quantitative and qualitative, at different phases of the intervention. Outcomes of acute hospital use and health-related quality of life are compared with controls, at 30 days and 1 year. The qualitative study aims at developing a more context-specific social ecological model of health behaviour. This model will identify how influences within one's social environment: individual, interpersonal, organisational, community and policy factors affect people's experiences and behaviours during care transitions from hospital to home. Knowledge on the operational aspects of ICoC will enrich our evidence-based strategies to understand the impact of the ICoC. The blending of qualitative and quantitative mixed methods recognises the dynamic implementation processes as well as the complex and evolving needs of community stakeholders in shaping outcomes. Ethics approval was granted by the SingHealth Centralised Institutional Review Board (CIRB 2015/2277). The findings from this study will be disseminated by publications in peer-reviewed journals, scientific meetings and presentations to government policy-makers. NCT02678273. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluating a novel Integrated Community of Care (ICoC) for patients from an urbanised low-income community in Singapore using the participatory action research (PAR) methodology: a study protocol

PubMed Central

Maulod, Adlina; Lee, Kheng Hock

2017-01-01

Introduction Poorer health outcomes and disproportionate healthcare use in socioeconomically disadvantaged patients is well established. However, there is sparse literature on effective integrated care interventions that specifically target these high-risk individuals. The Integrated Community of Care (ICoC) is a novel care model that integrates hospital-based transitional care with health and social care in the community for high-risk individuals living in socially deprived communities. This study aims to evaluate the effectiveness of the ICoC in reducing acute hospital use and investigate the implementation process and its effects on clinical outcomes using a mixed-methods participatory action research (PAR) approach. Methods and analysis This is a single-centre prospective, controlled, observational study performed in the SingHealth Regional Health System. A total of 250 eligible patients from an urbanised low-income community in Singapore will be enrolled during their index hospitalisation. Our PAR model combines two research components: quantitative and qualitative, at different phases of the intervention. Outcomes of acute hospital use and health-related quality of life are compared with controls, at 30 days and 1 year. The qualitative study aims at developing a more context-specific social ecological model of health behaviour. This model will identify how influences within one’s social environment: individual, interpersonal, organisational, community and policy factors affect people’s experiences and behaviours during care transitions from hospital to home. Knowledge on the operational aspects of ICoC will enrich our evidence-based strategies to understand the impact of the ICoC. The blending of qualitative and quantitative mixed methods recognises the dynamic implementation processes as well as the complex and evolving needs of community stakeholders in shaping outcomes. Ethics and dissemination Ethics approval was granted by the SingHealth Centralised Institutional Review Board (CIRB 2015/2277). The findings from this study will be disseminated by publications in peer-reviewed journals, scientific meetings and presentations to government policy-makers. Trial registration number NCT02678273 PMID:28993391

Cross-Cultural Studies of Implicit Theories of Creativity: A Comparative Analysis between the United States and the Main Ethnic Groups in Singapore

ERIC Educational Resources Information Center

Ramos, Suzanna J.; Puccio, Gerard J.

2014-01-01

This article explores the extent of influence of culture on implicit theories of creativity among laypeople from the United States and Singapore, as well as the ethnic groups in Singapore. Adaptive and innovative styles of creativity were examined, as well as their own conceptions of creativity. Laypersons from the United States and Singapore were…

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.

Metamaterials at the University of Southampton and beyond

NASA Astrophysics Data System (ADS)

Zheludev, Nikolay I.

2017-08-01

At the University of Southampton, research on metamaterials started in 2000 with a paper describing a metallic microstructure, comprising an ensemble of fully metallic ‘molecules’. In the years since then, metamaterials have evolved from an approach for designing unusual electromagnetic properties by structuring matter at the sub-wavelength scale to become a universal paradigm for active functional media with optical properties on demand at any given point in time and space. Metamaterials are now recognized as a promising enabling technology and one of the most buoyant and exciting research disciplines at the crossroads between photonics and nanoscience. Many ‘made in Southampton’ concepts have influenced the global research community, and we are now working in collaboration with our sister research centre in Nanyang Technological University, Singapore. In this article, I provide a historical overview of the metamaterials research field, from early studies to recent developments through the lens of the Southampton group, and discuss promising future directions.

[Issues related to national university medical schools: focusing on the low wages of university hospital physicians].

PubMed

Takamuku, Masatoshi

2015-01-01

University hospitals, bringing together the three divisions of education, research, and clinical medicine, could be said to represent the pinnacle of medicine. However, when compared with physicians working at public and private hospitals, physicians working at university hospitals and medical schools face extremely poor conditions. This is because physicians at national university hospitals are considered to be "educators." Meanwhile, even after the privatization of national hospitals, physicians working for these institutions continue to be perceived as "medical practitioners." A situation may arise in which physicians working at university hospitals-performing top-level medical work while also being involved with university and postgraduate education, as well as research-might leave their posts because they are unable to live on their current salaries, especially in comparison with physicians working at national hospitals, who focus solely on medical care. This situation would be a great loss for Japan. This potential loss can be prevented by amending the classification of physicians at national university hospitals from "educators" to "medical practitioners." In order to accomplish this, the Japan Medical Association, upon increasing its membership and achieving growth, should act as a mediator in negotiations between national university hospitals, medical schools, and the government.

2015 Epidemic of Severe Streptococcus agalactiae Sequence Type 283 Infections in Singapore Associated With the Consumption of Raw Freshwater Fish: A Detailed Analysis of Clinical, Epidemiological, and Bacterial Sequencing Data.

PubMed

Kalimuddin, Shirin; Chen, Swaine L; Lim, Cindy T K; Koh, Tse Hsien; Tan, Thean Yen; Kam, Michelle; Wong, Christopher W; Mehershahi, Kurosh S; Chau, Man Ling; Ng, Lee Ching; Tang, Wen Ying; Badaruddin, Hishamuddin; Teo, Jeanette; Apisarnthanarak, Anucha; Suwantarat, Nuntra; Ip, Margaret; Holden, Matthew T G; Hsu, Li Yang; Barkham, Timothy

2017-05-15

Streptococcus agalactiae (group B Streptococcus [GBS]) has not been described as a foodborne pathogen. However, in 2015, a large outbreak of severe invasive sequence type (ST) 283 GBS infections in adults epidemiologically linked to the consumption of raw freshwater fish occurred in Singapore. We attempted to determine the scale of the outbreak, define the clinical spectrum of disease, and link the outbreak to contaminated fish. Time-series analysis was performed on microbiology laboratory data. Food handlers and fishmongers were screened for enteric carriage of GBS. A retrospective cohort study was conducted to assess differences in demographic and clinical characteristics of patients with invasive ST283 and non-ST283 infections. Whole-genome sequencing was performed on human and fish ST283 isolates from Singapore, Thailand, and Hong Kong. The outbreak was estimated to have started in late January 2015. Within the study cohort of 408 patients, ST283 accounted for 35.8% of cases. Patients with ST283 infection were younger and had fewer comorbidities but were more likely to develop meningoencephalitis, septic arthritis, and spinal infection. Of 82 food handlers and fishmongers screened, none carried ST283. Culture of 43 fish samples yielded 13 ST283-positive samples. Phylogenomic analysis of 161 ST283 isolates from humans and fish revealed they formed a tight clade distinguished by 93 single-nucleotide polymorphisms. ST283 is a zoonotic GBS clone associated with farmed freshwater fish, capable of causing severe disease in humans. It caused a large foodborne outbreak in Singapore and poses both a regional and potentially more widespread threat. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

The implementation of e-learning tools to enhance undergraduate bioinformatics teaching and learning: a case study in the National University of Singapore

PubMed Central

2009-01-01

Background The rapid advancement of computer and information technology in recent years has resulted in the rise of e-learning technologies to enhance and complement traditional classroom teaching in many fields, including bioinformatics. This paper records the experience of implementing e-learning technology to support problem-based learning (PBL) in the teaching of two undergraduate bioinformatics classes in the National University of Singapore. Results Survey results further established the efficiency and suitability of e-learning tools to supplement PBL in bioinformatics education. 63.16% of year three bioinformatics students showed a positive response regarding the usefulness of the Learning Activity Management System (LAMS) e-learning tool in guiding the learning and discussion process involved in PBL and in enhancing the learning experience by breaking down PBL activities into a sequential workflow. On the other hand, 89.81% of year two bioinformatics students indicated that their revision process was positively impacted with the use of LAMS for guiding the learning process, while 60.19% agreed that the breakdown of activities into a sequential step-by-step workflow by LAMS enhances the learning experience Conclusion We show that e-learning tools are useful for supplementing PBL in bioinformatics education. The results suggest that it is feasible to develop and adopt e-learning tools to supplement a variety of instructional strategies in the future. PMID:19958511

19 CFR 10.521 - Goods eligible for tariff preference level claims.

Code of Federal Regulations, 2010 CFR

2010-04-01

... States-Singapore Free Trade Agreement Tariff Preference Level § 10.521 Goods eligible for tariff... assembled in Singapore from fabric or yarn produced or obtained outside the territory of Singapore or the...

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.

Residency hospital type and career paths in Japan: an analysis of physician registration cohorts.

PubMed

Koike, Soichi; Kodama, Tomoko; Matsumoto, Shinya; Ide, Hiroo; Yasunaga, Hideo; Imamura, Tomoaki

2010-01-01

In 2004, a new postgraduate medical training system was introduced in Japan and a shift of new graduates from university hospitals to other postgraduate education hospitals happened. The aim of this study is to analyse the past trends on postgraduate medical education choices and subsequent career options to discuss possible outcomes of the current shift and policy implications. Data from the national physician survey from 1976 to 2006 were analysed. The proportion change of physicians started their career in university hospitals was calculated. The career paths for physicians by different residency type were presented. More than 90% of physicians experienced university hospital work at least once in their 20-year careers. In their first 10 years of their career, physicians who started their residency in a university hospital tended to spend more years working in university hospitals, and those who started in other post-graduate training hospitals tended to spend less in university hospitals. Then, these groups presented quite similar patterns in their career choices. University hospitals need to strengthen their function as continuing education and career development centres and to adopt a less paternalistic approach, as fewer residents start their career in university hospitals.

Increasing podiatry referrals for patients with inflammatory arthritis at a tertiary hospital in Singapore: A quality improvement project.

PubMed

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

2017-06-01

Foot disease is highly prevalent in people with inflammatory arthritis and is often under-recognized. Podiatry intervention can significantly reduce foot pain and disability, with timely access being the key factor. The aim of this study was to plan and implement a quality improvement project to identify the barriers to, and improve, uptake of podiatry services among patients with inflammatory arthritis-related foot problems seen at a tertiary hospital in Singapore. A 6-month quality improvement program was conducted by a team of key stakeholders using quality improvement tools to identify, implement and test several interventions designed to improve uptake of podiatry services. The number of patients referred for podiatry assessment was recorded on a weekly basis by an experienced podiatrist. The criterion for appropriate referral to podiatry was those patients with current or previous foot problems such as foot pain, swelling and deformity. Interventions included education initiatives, revised workflow, development of national guidelines for inflammatory arthritis, local podiatry guidelines for the management of foot and ankle problems, routine use of outcome measures, and introduction of a fully integrated rheumatology-podiatry service with reduced cost package. Referral rates increased from 8% to 11%, and were sustained beyond the study period. Complete incorporation of podiatry into the rheumatology consultation as part of the multidisciplinary team package further increased referrals to achieve the target of full uptake of the podiatry service. Through a structured quality improvement program, referrals to podiatry increased and improved the uptake and acceptance of rheumatology-podiatry services. Copyright © 2016 Elsevier Ltd. All rights reserved.

Factors influencing first-time fathers' involvement in their wives' pregnancy and childbirth: A correlational study.

PubMed

Xue, Weilin Lynn; He, Hong-Gu; Chua, Ying Jie; Wang, Wenru; Shorey, Shefaly

2018-07-01

To examine factors influencing first-time fathers' involvement in their wives' pregnancy and childbirth in Singapore. A cross-sectional descriptive correlational study was conducted in a public tertiary hospital in Singapore. A total of 182 first-time fathers whose wives were hospitalized at four obstetric wards were recruited from November 2015 to January 2016. Data were collected by three newly developed and validated instruments, namely Father's Involvement in Pregnancy and Childbirth, Father's Informational and Sources of Support, and Father's Attitude Towards Involvement in Pregnancy and Childbirth, as well as the 16-item Couple Satisfaction Index and Family of Origin Questionnaire. The participants were generally involved in their wives' pregnancy and childbirth, with 35.2% being highly involved. There was no significant difference in fathers' levels of involvement between or among any sociodemographic subgroups. Significant Spearman's correlations were found between fathers' levels of involvement and levels of informational support as well as fathers' attitudes towards involvement. However, the logistic regression showed the level of informational support was the only significant factor that influenced first-time fathers' high levels of involvement in their wives' pregnancy and childbirth. The study revealed the importance of providing sufficient informational support to first-time fathers so that they can be highly involved in their wife's pregnancy and childbirth. Future studies can develop technology-based intervention programmes to improve fathers' involvement in their wife's pregnancy and childbirth. Healthcare professionals should examine and improve the existing informational support for first-time fathers and ensure its relevance and convenient access. Copyright © 2018 Elsevier Ltd. All rights reserved.

Live birth rates and safety profile using dydrogesterone for luteal phase support in assisted reproductive techniques

PubMed Central

Nadarajah, Ravichandran; Rajesh, Hemashree; Wong, Ker Yi; Faisal, Fazlin; Yu, Su Ling

2017-01-01

INTRODUCTION Assisted reproductive techniques (ARTs) result in a deficient luteal phase, requiring the administration of intramuscular, intravaginal or oral exogenous progesterone. Dydrogesterone, an oral retroprogesterone with good bioavailability, has been used in assisted reproductive cycles with outcomes that are comparable to those of vaginal or intramuscular progesterone. However, there are limited reviews on its use for luteal phase support in ARTs, in terms of pregnancy outcomes and associated fetal anomalies. This study aimed to review the live birth rates and associated fetal anomalies of women who were given dydrogesterone for luteal phase support in assisted reproductive cycles at a tertiary hospital in Singapore. METHODS This retrospective descriptive study included 1,050 women who underwent in vitro fertilisation/intracytoplasmic sperm injection at the Centre for Assisted Reproduction of Singapore General Hospital between 2000 and 2011. The women were given dydrogesterone for luteal phase support. The main outcome measures were rates of pregnancy, live birth, miscarriage and fetal anomalies. RESULTS The pregnancy and live birth rates were 34.7% and 27.7%, respectively. Among those who achieved pregnancy, 17.0% miscarried, 0.8% had ectopic pregnancies and 0.3% had molar pregnancies. Fetal anomalies were detected in 1.9% of pregnancies, all of which were terminated by choice. CONCLUSION Since the outcomes of dydrogesterone are comparable to those of intramuscular and vaginal progesterone, it is a reasonable option to provide luteal phase support for women who are uncomfortable with injections or vaginal insertions. Randomised controlled studies are needed to determine the optimal dosage of dydrogesterone for luteal phase support in ARTs. PMID:27090598

Safety and potential anticoagulant effects of nebulised heparin in burns patients with inhalational injury at Singapore General Hospital Burns Centre.

PubMed

Yip, Lian Yee; Lim, Yen Fang; Chan, Hong Ngee

2011-11-01

Nebulised heparin, N-acetylcysteine (NAC) and salbutamol were shown to decrease reintubation rates, incidence of atelectasis and mortality in paediatric patients and reduce lung injury scores in adult burns patients with inhalational lung injury (ILI). Nebulised heparin, NAC and salbutamol treatment protocol was introduced in Singapore General Hospital (SGH) Burns Centre in 2006. However, safety data on the use of nebulised heparin and NAC for burns patients with ILI is not well established. In this study, we investigated the safety and potential anticoagulant effects of nebulised heparin in burns patients with ILI. A retrospective study with historical control was conducted. The treatment group consisted of 52 mechanically ventilated adult patients, with a diagnosis of ILI as confirmed by bronchoscopy, admitted to burn intensive care unit (BICU) from the year 2006 to 2009. The group was treated with nebulised heparin, NAC and salbutamol. The control group consists of 11 mechanically ventilated BICU ILI patients treated from year 2001 to 2005 before protocol initiation. Blood coagulation indices (prothrombin time (PT), activated partial thromboplastin time (APTT) and platelet count) were monitored and bleeding incidences were assessed. Blood coagulation indices did not suggest an increase risk of bleeding with nebulised heparin. The APTT, PT and platelet count followed a similar trend for both groups over 7 days. No clinically significant increase in bleeding risk was found to be associated with nebulised heparin. Nebulised heparin was not found to potentiate the risk of bleeding in burns patients with ILI. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

Retracted: Nurses learning in the workplace: a comparison of workplace attributes in acute care settings in Australia and Singapore.

PubMed

Chan, S W; Chan, M F; Lee, S-Y; Henderson, A

2014-03-01

Workplaces need to foster teaching and learning interactions so staff collaborate and learn from each other. Internationally, many countries provide support to graduates and experienced staff to foster engagement necessary for learning and quality care. Workplace attributes can differ across countries depending on managerial, contextual, social and policy issues. This study compared workplace attributes of two Australian hospitals with a Singaporean hospital. A representative sample of nurses in two acute care facilities in Australia (n = 203) and a comparable facility in Singapore (n = 154) during 2010 and 2011 responded to a survey requesting demographic data and responses about workplace attributes. Attributes were determined through validated tools that measure staff perception of support when facilitating others learning (Support Instrument for Nurses Facilitating the Learning of Others) and the clinical learning organizational culture (Clinical Learning Organizational Culture Survey). Results indicated Singaporean nurses rated perception of acknowledgement, workload management and teamwork support in facilitating learners in their hospital as significantly better than the Australian cohort despite similar provisions for support and development. There were no significant differences across the two sites in the clinical learning culture. Analysis across three health facilities only provides a snapshot. Targeting more facilities would assist in confirming the extent of reported trends. Findings indicate differences in nurses' perceptions of support when facilitating learners. Further exploration of Singaporean nurses' increased perceptions of support is worthy. Clinical learning organizational culture findings across Australian and Singaporean acute care facilities suggest common attributes within the nursing profession that transcend contextual factors, for example, a strong sense of task accomplishment. Nurses across both countries demonstrate strengths in accomplishing tasks but less so in recognizing nurses' contributions that may also impact nurses' influence in the practice context. As these attributes are common, nursing can collectively lobby and develop policy, thereby strengthening their cause to be recognized. © 2014 International Council of Nurses.

The clinical and economic benefits of school-based quadrivalent HPV vaccination in Singapore.

PubMed

Tay, Sun Kuie; Hsu, Tun-Ying; Shcheprov, Andrei; Walia, Anuj; Kulkarni, Amit S

2017-05-01

To investigate the clinical and economic impacts of school-based administration of the quadrivalent HPV vaccine. A retrospective health-economic analysis was conducted using data collected in Singapore between 2004 and 2005. A dynamic transmission model was adapted for universal vaccination that provided 80% coverage among students aged 11-12 years. Strategy 1 involved only girls, with a 5-year catch-up vaccination to provide 50% coverage among those aged 13-17 years. Strategy 2 included both girls and boys with no catch-up vaccination. Outcomes included the predicted incidence of HPV-related disease over 100 years. Current coverage was assumed to be 5%. Strategy 1 would reduce cervical intraepithelial neoplasia grade 1 (CIN1) by 63.8%, cervical intraepithelial neoplasia grade 2-3 (CIN2-3) by 62.9%, cervical cancer by 50.9%, and genital warts by 78.0% (female individuals) and 73.6% (male individuals). Strategy 2 would reduce CIN1 by 64.0%, CIN2-3 by 63.1%, cervical cancer by 50.7%, and genital warts by 79.9% (female individuals) and 80.1% (male individuals). The incremental cost-effectiveness ratio was S$12 464 for strategy 1 and $27 837 for Strategy 2. These values decreased to $7477 and $22 574, respectively, if a two-dose regimen was adapted. School-based quadrivalent HPV vaccination offered clinical and economic benefits, and is cost-effective in Singapore. © 2017 International Federation of Gynecology and Obstetrics.

Leninism with a Human Face: National Strategy in Lee Kuan Yew’s Singapore

DTIC Science & Technology

1996-09-13

1 c ?I. Turnball, A H_zstory of Singapore, 1819-1988 Singapore- Oxford Unlverslty Tress, 1988) 297. --How to maintain domestic political stability given... political stability . Accordingly, many 2rc3grams wit-? obszenslbly dl5ferent goals carried a "unlzyl twist. For example, the housing modernization program...transforming Singapore into an economic sowerhouse, enztancinq political stability , while maintaining :and perhaps even increasing) social cohesion is an

New species of small scaly crickets of genus Micrornebius (Orthoptera: Mogoplistidae; Mogoplistinae) from Singapore.

PubMed

Tan, Ming Kai

2014-12-12

The small and cryptic scaly crickets of the genus Micrornebius from Singapore are reviewed. The Henningian species concept was applied and morphology was used to estimate species boundaries. Three new species are described: Micrornebius distinctus sp. n., Micrornebius eclipsus sp. n. and Micrornebius mandai sp. n. This increases the number of species Micrornebius from Singapore to five. A tentative key to the species of Micrornebius from Singapore is provided.

University hospitals as drivers of career success: an empirical study of the duration of promotion and promotion success of hospital physicians

PubMed Central

2014-01-01

Background German hospitals have a well-defined career structure for clinicians. In this hierarchical career system university hospital are stepping stones for career advancement. This longitudinal study investigates the impact of working in university hospitals on the career success of junior physicians and senior physicians. Methods Consideration of the career trajectories of 324 hospital physicians. Discrete-time event history analysis is used to study the influence of working in university hospitals on the chance of promotion from junior physician to senior physician and senior physician to chief physician. A comparison of medians provides information about the impact of working in university hospitals on the duration of promotion to senior and chief physician positions. Results Working in university hospitals has a negative impact for advancement to a senior physician position in terms of promotion duration (p = 0.005) and also in terms of promotion success, where a short time span of just 1–2 years in university hospitals has a negative effect (OR = 0.38, p < 0.01), while working there for a medium or long term has no significant effect. However, working in universities has a positive effect on the duration of promotion to a chief physician position (p = 0.079), and working in university hospitals for 3–4 years increases the chance of promotion to a chief physician position (OR = 4.02, p < 0.05), while working there > =7 years decreases this chance (OR = 0.27, p < 0.05). In addition, physicians have a higher chance of promotion to a chief physician position through career mobility when they come to the position from a university hospital. Conclusion Working at university hospitals has a career-enhancing effect for a senior physician with ambitions to become a chief physician. For junior physicians on the trajectory to a senior physician position, however, university hospitals are not drivers of career success. PMID:24755299

University hospitals as drivers of career success: an empirical study of the duration of promotion and promotion success of hospital physicians.

PubMed

Degen, Christiane; Kuntz, Ludwig

2014-04-23

German hospitals have a well-defined career structure for clinicians. In this hierarchical career system university hospital are stepping stones for career advancement. This longitudinal study investigates the impact of working in university hospitals on the career success of junior physicians and senior physicians. Consideration of the career trajectories of 324 hospital physicians. Discrete-time event history analysis is used to study the influence of working in university hospitals on the chance of promotion from junior physician to senior physician and senior physician to chief physician. A comparison of medians provides information about the impact of working in university hospitals on the duration of promotion to senior and chief physician positions. Working in university hospitals has a negative impact for advancement to a senior physician position in terms of promotion duration (p = 0.005) and also in terms of promotion success, where a short time span of just 1-2 years in university hospitals has a negative effect (OR = 0.38, p < 0.01), while working there for a medium or long term has no significant effect. However, working in universities has a positive effect on the duration of promotion to a chief physician position (p = 0.079), and working in university hospitals for 3-4 years increases the chance of promotion to a chief physician position (OR = 4.02, p < 0.05), while working there > =7 years decreases this chance (OR = 0.27, p < 0.05). In addition, physicians have a higher chance of promotion to a chief physician position through career mobility when they come to the position from a university hospital. Working at university hospitals has a career-enhancing effect for a senior physician with ambitions to become a chief physician. For junior physicians on the trajectory to a senior physician position, however, university hospitals are not drivers of career success.

Resting Stage of Plankton Diversity from Singapore Coastal Water: Implications for Harmful Algae Blooms and Coastal Management

NASA Astrophysics Data System (ADS)

Trottet, Aurore; Wilson, Bryan; Sew Wei Xin, Genevieve; George, Christaline; Casten, Lemuel; Schmoker, Claire; Rawi, Nurul Syazana Binte Modh; Chew Siew, Moon; Larsen, Ole; Eikaas, Hans S.; Tun, Karenne; Drillet, Guillaume

2018-02-01

Resting strategies of planktonic organisms are important for the ecological processes of coastal waters and their impacts should be taken into consideration in management of water bodies used by multiple industries. We combined different approaches to evaluate the importance of resting stages in Singapore coastal waters. We used molecular approaches to improve the knowledge on Singapore biodiversity, we sampled and extracted cysts from sediments to evaluate the density of resting stages in Johor Strait, and we compared systematically information on Singapore planktonic biodiversity to existing published information on resting stages from these reported organisms. This is the first study evaluating the importance of resting stages in Singapore waters. Above 120 species reported in Singapore are known to produce resting stages though no previous work has ever been done to evaluate the importance of these strategies in these waters. The results from the resting stage survey confirmed 0.66 to 5.34 cyst g-1 dry weight sediment were present in the Johor Strait suggesting that cysts may be flushed by tidal currents into and out of the strait regularly. This also suggest that the blooms occurring in Singapore are likely due to secondary growth of Harmful Algae Bloom species in the water rather than from direct germination of cysts from sediment. Finally, we discuss the importance of these resting eggs for three main national industries in Singapore (shipping, marine aquaculture and provision of drinking water through seawater desalination). We argue that this study will serve as a baseline for some of the future management of Singapore waters.

Universality of oscillating boiling in Leidenfrost transition

NASA Astrophysics Data System (ADS)

Tran, Tuan; Khavari, Mohammad

2017-11-01

The Leidenfrost transition leads a boiling system to the boiling crisis, a state in which the liquid loses contact with the heated surface due to excessive vapor generation. Here, using experiments of liquid droplets boiling on a heated surface, we report a new phenomenon, termed oscillating boiling, at the Leidenfrost transition. We show that oscillating boiling results from the competition between two effects: separation of liquid from the heated surface due to localized boiling, and rewetting. We argue theoretically that the Leidenfrost transition can be predicted based on its link with the oscillating boiling phenomenon, and verify the prediction experimentally for various liquids. This work was funded by Nanyang Technological University and A*STAR, Singapore.

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.

Population norms for the EQ-5D index scores using Singapore preference weights.

PubMed

Abdin, Edimansyah; Subramaniam, Mythily; Vaingankar, Janhavi Ajit; Luo, Nan; Chong, Siow Ann

2015-06-01

To provide norms for the EQ-5D index scores based on Singapore preference weights according to age, sex, ethnicity, and language version and compare the EQ-5D index scores for respondents with and without psychiatric disorders and chronic medical conditions. The Singapore Mental Health Study was a cross-sectional epidemiological survey of a nationally representative sample of the resident (citizens and permanent residents) population in Singapore. The diagnoses of psychiatric disorders were established using the World Mental Health Composite International Diagnostic Interview version 3.0 (CIDI 3.0). Index scores were derived using the Singapore preference weights. In general, the mean EQ-5D index score using Singapore preference weights decreased with increased age. The EQ-5D Malay version reported lower mean EQ-5D index than the English version. In multivariate analysis, the mean EQ-5D index for respondents with MDD, dysthymia, bipolar disorder, GAD, OCD, diabetes, hypertension, arthritis or rheumatism, neurological condition, stroke or major paralysis, heart attack, back problems, stomach ulcer, kidney failure, migraine headaches, and chronic lung disease was significantly lower than those without these conditions. These findings support the use of the Singapore preference weights for EQ-5D valuations when measuring health-related quality of life and comparing the health burden of psychiatric and chronic physical conditions among adults in Singapore.

A comparative analysis of human thermal conditions in outdoor urban spaces in the summer season in Singapore and Changsha, China.

PubMed

Yang, Wei; Wong, Nyuk Hien; Zhang, Guoqiang

2013-11-01

This paper presents the comparative analysis between the findings from two field surveys of human thermal conditions in outdoor urban spaces during the summer season. The first survey was carried out from August 2010 to May 2011 in Singapore and the second survey was carried out from June 2010 to August 2010 in Changsha, China. The physiologically equivalent temperature (PET) was utilized as the thermal index to assess the thermal conditions. Differences were found between the two city respondents in terms of thermal sensation, humidity sensation, and wind speed sensation. No big difference was found between the two city respondents regarding the sun sensation. The two city respondents had similar neutral PET of 28.1 °C for Singapore and 27.9 °C for Changsha, respectively. However, Singapore respondents were more sensitive to PET change than Changsha respondents and the acceptable PET range for Changsha respondents was wider than that for Singapore respondents. Besides, the two city respondents had different thermal expectations with the preferred PET of 25.2 °C and 22.1 °C for Singapore and Changsha, respectively. The results also reveal that Changsha respondents were more tolerant than Singapore respondents under hot conditions. Finally, two regression models were proposed for Singapore and Changsha to predict the human thermal sensation in a given outdoor thermal environment.

Attribution of the Main Sources of Biomass Burning in South East Asia that Impact on Air Quality in Singapore

NASA Astrophysics Data System (ADS)

Hansen, A. B.; Kendall, E.; Chew, B. N.; Chong, W. M.; Gan, C.; Hort, M. C.; Shaw, F.; Witham, C. S.

2017-12-01

Biomass burning in South East Asia causes intense haze episodes in Singapore, these are of major concern to the local government and the population exposed to the haze. Using a Lagrangian dispersion model we have studied haze in the seven most recent years (2010 - 2016) to gain a deeper understanding of intense haze in Singapore. In this study, modelled haze time-series at one eastern and one western monitoring station in Singapore are compared to local observed PM10 and PM2.5 air concentrations. The haze time-series are broken down by season or month, source region, and monitoring location.The analysis, presented as time series and pie charts, illustrates the relative contribution to haze in Singapore from different regions, variations between seasons and the correlation of impact to the combined timing of burning activity and meteorological patterns. Air history maps, showing where air arriving in Singapore originates from and/or has travelled through, are used to isolate the meteorological dependence of impacts. These show a strong monsoonal variation and help explain the inter-annual differences between sources and actual concentrations of biomass burning PM in Singapore. For example, there is a strong correlation in 2013 between burning in Riau and haze in Singapore, but a weak correlation in other years when a significant part of haze originates from, e.g., Peninsula Malaysia, but emissions are seemingly negligible. We see that, in spite of the size of Singapore, there is significant difference in concentrations and major contributing source regions between the two monitoring stations, annually and seasonally. The differences at the two monitoring stations are seen in varying degrees in the years 2011, 2012, 2014, and 2015, throughout different seasons. Although only biomass burning is considered in the simulations, our modelled results are in good agreement with local observations. We have identified the source regions with the biggest contributions to haze in Singapore as Riau and Peninsula Malaysia, with secondary contributions from South Sumatra, Jambi, Central and West Kalimantan, Riau Islands, and Bangka-Belitung. We show that both regional burning and regional weather has significant impact on local haze conditions in Singapore.

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 about 10.6/1000 in 1950-55 to 7.1 in 1960-65 and to 5.1 in both 1970-75 and 1975-80, according to UN estimates. The average life expectancy at birth for both sexes has been improving. To reduce the need for high cost hospital services, the government has recently given more attention to promotive and preventive medicine. The crude birthrate, which was estimated to be around 44 births/1000 in 1950-55, has declined in the past several decades, decreasing to 17.2/1000 in 1975-80 according to UN estimates. The government regards the current level of fertility as satisfactory and has implemented incentive and disincentive schemes to maintain low rates. The government considers levels and trends of immigration to be not significant and satisfactory. The government regards the spatial distribution of the population to be appropriate and has no policies of intervention concerning either internal migration or the rural and urban configuration of settlement.

Does medical students' clinical performance affect their actual performance during medical internship?

PubMed

Han, Eui-Ryoung; Chung, Eun-Kyung

2016-02-01

This study examines the relationship between the clinical performance of medical students and their performance as doctors during their internships. This retrospective study involved 63 applicants to a residency programme conducted at the Chonnam National University Hospital, South Korea, in November 2012. We compared the performance of the applicants during their internship with the clinical performance of the applicants during their fourth year of medical school. The performance of the applicants as interns was periodically evaluated by the faculty of each department, while the clinical performance of the applicants as fourth year medical students was assessed using the Clinical Performance Examination (CPX) and the Objective Structured Clinical Examination (OSCE). The performance of the applicants as interns was positively correlated with their clinical performance as fourth year medical students, as measured by CPX and OSCE. The performance of the applicants as interns was moderately correlated with the patient-physician interactions items addressing communication and interpersonal skills in the CPX. The clinical performance of medical students during their fourth year in medical school was related to their performance as medical interns. Medical students should be trained to develop good clinical skills, through actual encounters with patients or simulated encounters using manikins, so that they are able to become competent doctors. Copyright © Singapore Medical Association.

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:…

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.

The social transformation of Singapore medicine through 55 years of the SMJ.

PubMed

Kua, Ee Heok; Kua, Jade Phek Hui

2016-11-01

The Singapore Medical Journal (SMJ) has in the past 55 years reflected the phenomenal socioeconomic progress of Singapore. Publications in the pre-independent years were mainly on diseases like cholera, diphtheria, leprosy, tetanus and worm infestation. In the new millennium, the research papers included molecular genetics, health economics, obesity, Internet medicine, cancer, cosmetic surgery and palliative medicine. The annual SMA Lecture published in the SMJ provides an ethical compass for doctors to remind them of primum non nocere. Copyright: © Singapore Medical Association.

BKCASE(TM) Body of Knowledge and Curriculum to Advance Systems Engineering

DTIC Science & Technology

2010-04-28

Lawson, Lawson Konsult AB, Sweden Johann Amsenga, Eclipse RDC, South Africa Alex Lee , Defence Science and Technology Agency, Singapore Erik Aslaksen...Engineering Division, US Tim Ferris, University of South Australia and INCOSE, Australia Jean-Claude Roussel, EADS, France Kevin Forsberg, Center for...Systems Management and INCOSE, US Sven-Olaf Schulze, Berner & Mattner Systemtechnik GmbH, Germany Richard Freeman, Air Force Center for Systems

1st college of physicians lecture: the role of internal medicine as a specialty in the era of subspecialisation.

PubMed

Chee, Y C

2004-11-01

This paper is divided into 4 parts. The first deals with the definition of specialties and traces its roots from the early 20th century in the United States of America with the formation and growth of Specialty Boards. The second is a reflection on the scene in Singapore from the 1960s to the present, describing the change from public healthcare institutions run by the civil service to the autonomous restructured public service hospitals towards the end of the 20th century. The third section deals with what the 4ps have expressed about changes necessary to the Singapore system in the 21st century. The 4ps are the politicians, the payers, the patients and the public. It is about value for money, better coordination and better communication. Finally, just what is Internal Medicine - its competencies and its practice. A review of the systems in Australia, New Zealand, and the USA is presented. The idea of the "hospitalist" is discussed. Concluding remarks deal with the viability of Internal Medicine because of low reimbursement, administrative burdens and brief patient visits.

Traditional Chinese Medicine Physicians' Insights into Interprofessional Tensions between Traditional Chinese Medicine and Biomedicine: A Critical Perspective.

PubMed

Chang, Leanne; Lim, Jing Ci Jill

2017-11-22

In Singapore, the institutional preference for biomedicine and the cultural importance of traditional Chinese medicine (TCM) have created tensions between the two medical systems and erected barriers to a more collaborative health-care system. This study foregrounds TCM physicians' voice to reveal ideological struggles and power imbalances that underlie the interprofessional tensions and accompanying marginalization of TCM. Through in-depth interviews with 22 TCM physicians in Singapore, this study reveals the incongruences in ideological underpinnings between biomedicine and TCM, reflected in their different worldviews and epistemological approaches to knowledge formation and evaluation. Power differentials between the two medical systems are manifest in TCM physicians' inferior position in relation to their biomedical peers, the patients' internalization of biomedical standards to question the TCM profession and their own interest in seeking TCM treatments, and the state's limited support for TCM research, subsidies, and service provision in hospital settings. The results suggest that more open dialogue about the dichotomous framings of biomedicine and TCM is key to disrupting the mutual reinforcement of ideology and power, as well as to creating increased mutual understanding between the two medical systems.

Psychometric properties of the Family Resilience Assessment Scale: A Singaporean perspective.

PubMed

Chew, Judith; Haase, Anne M

2016-08-01

Families of young people with chronic illnesses are more likely to experience higher levels of stress. In turn, their ability to cope with multiple demands is likely to affect young people's adaptation. The purpose of this study was to examine psychometric properties of the Family Resilience Assessment Scale (FRAS), an assessment tool that measures the construct of family resilience. A total of 152 young people with epilepsy, aged 13 to 16years old, from KK Women's and Children's Hospital, Singapore, completed the FRAS along with the Rosenberg Self-Esteem Scale. Factor structure of the FRAS was examined. Exploratory factor analysis resulted in a 7-factor solution - meaning-making and positive outlook, transcendence and spirituality, flexibility and connectedness, social and economic resources (community), social and economic resources (neighbors), clarity and open emotional expression, and collaborative problem-solving - accounting for 83.0% of the variance. Internal consistency of the scale was high (α=0.92). Family resilience was significantly correlated with higher levels of self-esteem. Our study provides preliminary findings that suggest that FRAS is a reliable and valid scale for assessing the construct of family resilience among young people with epilepsy in Singapore. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Factors influencing medication adherence in patients with gout: A descriptive correlational study.

PubMed

Chua, Xin Hui Jasmine; Lim, Siriwan; Lim, Fui Ping; Lim, Yee Nah Anita; He, Hong-Gu; Teng, Gim Gee

2018-01-01

To examine the factors influencing adherence to urate-lowering therapy in patients with gout in Singapore. Gout is the most common type of chronic inflammatory arthritis. Urate-lowering therapy is used to treat gout by reducing serum uric acid levels. However, adherence to urate-lowering therapy among patients remains poor. To date, there have been no available studies based on a conceptual framework that examined factors influencing medication adherence in patients with gout. Cross-sectional, descriptive correlational study. A convenience sample of outpatients (n = 108) was recruited between October 2014-January 2015 from a tertiary hospital in Singapore. Outcomes were measured by relevant valid and reliable instruments. Descriptive statistics and parametric tests including multiple linear regression were used to analyse the data. Although 44.4% of the participants were high adherers to urate-lowering therapy, the mean adherence level was moderate. Significant differences in medication adherence scores were found among the subgroups of gender, ethnicity, marital status, employment status and presence of comorbidity. Medication adherence was positively significantly correlated with age, number of comorbidities and beliefs about medicines. Linear regression showed that higher level of beliefs about medicines, presence of comorbidity and being married were factors positively influencing medication adherence. This study revealed moderate adherence to urate-lowering therapy in patients with gout in Singapore, indicating the need for strategies to improve adherence by considering its main influencing factors. Future research should be conducted to develop interventions targeted at modifying patients' beliefs about medicines in order to improve medication adherence. Findings from this study allow healthcare providers to quickly and easily identify patients who may have low adherence. Nurses should take the lead in educating patients on the mechanism of urate-lowering therapy and highlight the importance of adhering to it. © 2017 John Wiley & Sons Ltd.

Validation of Chinese and English versions of the Holistic Well-being Scale in patients with cancer.

PubMed

Lee, Geok Ling; Fan, Gilbert Kam Tong; Chan, Sally Wai Chi

2015-12-01

The study aims to examine the psychometric properties of the Holistic Well-Being Scale (HWS), a new instrument developed on the Eastern concepts of affliction, and equanimity in a new sample involving patients with cancer. A cross-sectional survey was conducted with 300 patients with cancer in Singapore. The patients completed the HWS, WHO-5 Well-Being Index (WHO-5), and Hospital Anxiety and Depressions Scale (HADS). Thirty-two patients participated in the 2-week retest. Mixed findings were obtained from the original seven-factor model in our sample: six factors had acceptable internal reliabilities (Cronbach's α; range, 0.657-0.809), and construct validities were partially supported. Factor analysis suggested three factors: Blissful-self (α = 0.874), Disturbed-self (α = 0.885) and Embittered-others (α = 0.709). The novel factors demonstrated good test-retest reliability (ICC; range, 0.894-0.930) and construct validities, which were shown by significant correlations with HADS and WHO-5 in the predicted directions. The present study is the first step taken to validate a scale that is essential in the development of culturally appropriate psychosocial interventions to support and promote personal well-being of cancer patients. The findings suggest that the three-factor model may be more applicable to the Singapore context, but it does not necessarily invalidate the original HWS. The results were discussed in terms of the meaning of the original HWS factors and cultural differences in coping behaviors between Singapore and Hong Kong, though both are Asian countries. The HWS could be further tested in other Asian populations as achieving holistic well-being is a common goal for patients in many cultures.

Pandemic (H1N1) 2009: clinical and laboratory findings of the first fifty cases in Singapore.

PubMed

Chan, Monica; Chen, Mark I; Chow, Angela; Lee, Caroline P S; Tan, Adriana S H; Lye, David Chien; Leo, Yee Sin

2010-04-01

Since the fi rst imported case on 26 May 2009, pandemic (H1N1) 2009 has spread from travellers and has resulted in sustained community transmission. Singapore began with a strict containment policy where all suspected and confirmed cases of pandemic (H1N1) 2009 were admitted for testing. We describe here the clinical and laboratory characteristics of the fi rst 50 adult cases with confirmed pandemic (H1N1) 2009. A review was conducted of medical notes of adult patients with confirmed pandemic (H1N1) 2009 by polymerase chain reaction assay from combined nasal and throat swabs admitted to the Communicable Disease Centre, Tan Tock Seng Hospital. From 26 May to 18 June 2009, 50 patients with a median age of 27 years old were admitted at a median of 3 days from illness onset. Half were male and all were travellers arriving in Singapore. Non-Singaporean citizens (38%) and other ethnic groups (40%) were over-represented. History of fever was reported in 90% and respiratory symptoms in 92%. Gastrointestinal symptoms were uncommon, present in 4% only. Temperatures on presentation of >or=38.0 degrees C, >or=37.8 degrees C and >or=37.5 degrees C were present in 48%, 56% and 76%, respectively. Only 46% of patients met the United States Centers for Disease Control and Prevention (US CDC) case definition of influenza-like illness (ILI). Clinical and laboratory findings were unremarkable for the majority. All cases were treated with oseltamivir and had uncomplicated recovery. Pandemic (H1N1) 2009 had mild clinical and laboratory findings in immunocompetent patients. Use of the US CDC ILI criteria alone would have detected less than half of confirmed cases.

Inpatient cost for hip fracture patients managed with an orthogeriatric care model in Singapore.

PubMed

Tan, Lester Teong Jin; Wong, Seng Joung; Kwek, Ernest Beng Kee

2017-03-01

The estimated incidence of hip fractures worldwide was 1.26 million in 1990 and is expected to double to 2.6 million by 2025. The cost of care for hip fracture patients is a significant economic burden. This study aimed to look at the inpatient cost of hip fractures among elderly patients placed under a mature orthogeriatric co-managed system. This study was a retrospective analysis of 244 patients who were admitted to the Department of Orthopaedics of Tan Tock Seng Hospital, Singapore, in 2011 for hip fractures under a mature orthogeriatric hip fracture care path. Information regarding costs, surgical procedures performed and patient demographics was collected. The mean cost of hospitalisation was SGD 13,313.81. The mean cost was significantly higher for the patients who were managed surgically than for the patients who were managed non-surgically (SGD 14,815.70 vs. SGD 9,011.38; p < 0.01). Regardless of whether surgery was performed, the presence of complications resulted in a higher average cost (SGD 2,689.99 more than if there were no complications; p = 0.011). Every additional day from admission to time of surgery resulted in an increased cost of SGD 575.89, and the difference between the average cost of surgery within 48 hours and that of surgery > 48 hours was SGD 2,716.63. Reducing the time to surgery and preventing pre- and postoperative complications can help reduce overall costs. A standardised care path that empowers allied health professionals can help to reduce perioperative complications, and a combined orthogeriatric care service can facilitate prompt surgical treatment. Copyright: © Singapore Medical Association

Barriers to dispatcher-assisted cardiopulmonary resuscitation in Singapore.

PubMed

Ho, Andrew Fu Wah; Sim, Zariel Jiaying; Shahidah, Nur; Hao, Ying; Ng, Yih Yng; Leong, Benjamin S H; Zarinah, Siti; Teo, Winston K L; Goh, Geraldine Shu Yi; Jaafar, Hamizah; Ong, Marcus E H

2016-08-01

Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA). Singapore has recently implemented a DA-CPR program. We aimed to characterize barriers to commencement of chest compressions by callers in Singapore. We analyzed dispatch recordings of OHCA cases received by the ambulance call center between July 2012 and March 2015. Audio recordings of poor quality were excluded. Trained reviewers noted the sequential stages of the dispatcher's recognition of CPR, delivering CPR instructions and caller performing CPR. Time taken to reach these milestones was noted. Barriers to chest compressions were identified. A total of 4897 OHCA occurred during the study period, overall bystander CPR rate was 45.7%. 1885 dispatch recordings were reviewed with 1157 cases qualified for dispatcher CPR. In 1128 (97.5%) cases, the dispatcher correctly recognized the need for CPR. CPR instructions were delivered in 1056 (91.3%) cases. Of these, 1007 (87.0%) callers performed CPR to instruction. One or more barriers to chest compressions were identified in 430 (37.2%) cases. The commonest barrier identified was "could not move patient" (27%). Cases where barriers were identified were less likely to have the need for CPR recognized by the dispatcher (94.9% vs. 99.0%, p<0.001), CPR instructions given (79.3% vs. 98.3%, p<0.001) and CPR started (67.9% vs. 98.3%, p<0.001), while the time taken to reach each of these stages were significantly longer (p<0.001). Barriers were present in 37% of cases. They were associated with lower proportion of CPR started and longer delay to CPR. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Spatial analysis of ambulance response times related to prehospital cardiac arrests in the city-state of Singapore.

PubMed

Earnest, Arul; Hock Ong, Marcus Eng; Shahidah, Nur; Min Ng, Wen; Foo, Chuanyang; Nott, David John

2012-01-01

The main objective of this study was to establish the spatial variation in ambulance response times for out-of-hospital cardiac arrests (OHCAs) in the city-state of Singapore. The secondary objective involved studying the relationships between various covariates, such as traffic condition and time and day of collapse, and ambulance response times. The study design was observational and ecological in nature. Data on OHCAs were collected from a nationally representative database for the period October 2001 to October 2004. We used the conditional autoregressive (CAR) model to analyze the data. Within the Bayesian framework of analysis, we used a Weibull regression model that took into account spatial random effects. The regression model was used to study the independent effects of each covariate. Our results showed that there was spatial heterogeneity in the ambulance response times in Singapore. Generally, areas in the far outskirts (suburbs), such as Boon Lay (in the west) and Sembawang (in the north), fared badly in terms of ambulance response times. This improved when adjusted for key covariates, including distance from the nearest fire station. Ambulance response time was also associated with better traffic conditions, weekend OHCAs, distance from the nearest fire station, and OHCAs occurring during nonpeak driving hours. For instance, the hazard ratio for good ambulance response time was 2.35 (95% credible interval [CI] 1.97-2.81) when traffic conditions were light and 1.72 (95% CI 1.51-1.97) when traffic conditions were moderate, as compared with heavy traffic. We found a clear spatial gradient for ambulance response times, with far-outlying areas' exhibiting poorer response times. Our study highlights the utility of this novel approach, which may be helpful for planning emergency medical services and public emergency responses.

Impact of a Newly Implemented Burn Protocol on Surgically Managed Partial Thickness Burns at a Specialized Burns Center in Singapore.

PubMed

Tay, Khwee-Soon Vincent; Chong, Si-Jack; Tan, Bien-Keem

2016-03-01

This study evaluated the impact of a newly implemented protocol for superficial to mid-dermal partial thickness burns which involves early surgery and rapid coverage with biosynthetic dressing in a specialized national burns center in Singapore. Consecutive patients with 5% or greater total body surface area (TBSA) superficial to mid-dermal partial thickness burns injury admitted to the Burns Centre at the Singapore General Hospital between August and December 2014 for surgery within 48 hours of injury were prospectively recruited into the study to form the protocol group. Comparable historical cases from the year 2013 retrieved from the burns center audit database were used to form the historical control group. Demographics (age, sex), type and depth of burns, %TBSA burnt, number of operative sessions, and length of stay were recorded for each patient of both cohorts. Thirty-nine burns patients managed under the new protocol were compared with historical control (n = 39) comparable in age and extensiveness of burns. A significantly shorter length of stay (P < 0.05) per TBSA burns was observed in the new protocol group (0.74 day/%TBSA) versus historical control (1.55 day/%TBSA). Fewer operative sessions were needed under the new protocol for burns 10% or greater TBSA burns (P < 0.05). The authors report their promising experience with a newly implemented protocol for surgically managed burns patients which involves early surgery and appropriate use of biosynthetic dressing on superficial to mid-dermal partial thickness burns. Clinically, shorter lengths of stay, fewer operative sessions, and decreased need for skin grafting of burns patient were observed.

[Physician shortage in Japan: the new postgraduate medical education program and physicians as a human medical resource].

PubMed

Nomura, Kyoko

2011-01-01

Japan now faces a serious physician shortage. After introducing the new postgraduate medical education (PGME) system and doctor-to-facility matching system, residents shifted their teaching hospitals from university hospitals to non-university hospitals. Because university hospitals had played a central role in allocating physicians to communities, the decrease in the number of physicians at university hospitals has driven this physician shortage. Japanese policymakers blame the new PGME for exacerbating this physician shortage and have tentatively agreed to reform the PGME to encourage residents to return to university hospitals. However, the PGME system should not be reformed only for political reasons; such a change requires a scientific basis. First, after the introduction of the new PGME, residents showed an improved clinical competence; therefore, it has accomplished its ultimate goal. Second, the residents' satisfaction level in terms of the residency system and clinical skills training was significantly higher at non-university hospitals than at university hospitals. This implies that training conditions at university hospitals are not as good as at non-university hospitals, which explains the decrease in the number of physicians at university hospitals. Third, in 2009, the Japanese government increased the maximum medical school enrollment to mitigate the physician shortage. However, a simple increase does not solve the problem of physician shortage unless it also addresses the problem of physician maldistribution. Fourth, the number of females entering medicine is increasing, and women constituted 30% of newly certified physicians in 2010. In this era of physician shortage, female physicians are highly recommended as a human medical resource.

How Singapore Junior College Science Teachers Address Curriculum Reforms: A Theory

ERIC Educational Resources Information Center

Lim, Patrick; Pyvis, David

2012-01-01

Using grounded theory research methodology, a theory was developed to explain how Singapore junior college science teachers implement educational reforms underpinning the key initiatives of the "Thinking Schools, Learning Nation" policy. The theory suggests Singapore junior college science teachers "deal with" implementing…

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…

19 CFR 10.501 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Singapore Free Trade Agreement General... applicable to imported goods under the United States-Singapore Free Trade Agreement (the SFTA) signed on May 6, 2003, and under the United States-Singapore Free Trade Agreement Implementation Act (the Act; 117...

Aviation Medicine: global historical perspectives and the development of Aviation Medicine alongside the growth of Singapore's aviation landscape.

PubMed

Gan, W H; Low, R; Singh, J

2011-05-01

Aviation Medicine traces its roots to high altitude physiology more than 400 years ago. Since then, great strides have been made in this medical specialty, initially catalysed by the need to reduce pilot medical attrition during the World Wars, and more recently, fuelled by the explosive growth in globalised commercial air travel. This paper traces the historical milestones in Aviation Medicine, and maps its development in Singapore since the 1960s. Advancements in military aviation platforms and technology as well as the establishment of Singapore as an international aviation hub have propelled Aviation Medicine in Singapore to the forefront of many domains. These span Aviation Physiology training, selection medical standards, performance maximisation, as well as crew and passenger protection against communicable diseases arising from air travel. The year 2011 marks the centennial milestone of the first manned flight in Singapore, paving the way for further growth of Aviation Medicine as a mature specialty in Singapore.

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.

Impact of the June 2013 Riau province Sumatera smoke haze event on regional air pollution

NASA Astrophysics Data System (ADS)

Dewi Ayu Kusumaningtyas, Sheila; Aldrian, Edvin

2016-07-01

Forest and land fires in Riau province of Sumatera increase along with the rapid deforestation, land clearing, and are induced by dry climate. Forest and land fires, which occur routinely every year, cause trans-boundary air pollution up to Singapore. Economic losses were felt by Indonesia and Singapore as the affected country thus creates tensions among neighboring countries. A high concentration of aerosols are emitted from fire which degrade the local air quality and reduce visibility. This study aimed to analyze the impact of the June 2013 smoke haze event on the environment and air quality both in Riau and Singapore as well as to characterize the aerosol properties in Singapore during the fire period. Air quality parameters combine with aerosols from Aerosol Robotic Network (AERONET) data and some environmental parameters, i.e. rainfall, visibility, and hotspot numbers are investigated. There are significant relationships between aerosol and environmental parameters both in Riau and Singapore. From Hysplit modeling and a day lag correlation, smoke haze in Singapore is traced back to fire locations in Riau province after propagated one day. Aerosol characterization through aerosol optical depth (AOD), Ångstrom parameter and particle size distribution indicate the presence of fine aerosols in a great number in Singapore, which is characteristic of biomass burning aerosols. Fire and smoke haze even impaired economic activity both in Riau and Singapore, thus leaving some accounted economic losses as reported by some agencies.

A Tale of Two Countries: Comparing Civic Education in the Philippines and Singapore

ERIC Educational Resources Information Center

Baildon, Mark; Sim, Jasmine B.-Y.; Paculdar, Agnes

2016-01-01

This article provides a comparative analysis of citizenship education in the Philippines and Singapore. Through an analysis of historical contexts, citizenship education policy and curriculum, it examines "Makabayan" in the Philippines and "National Education" in Singapore. It identifies particular policy and curriculum…

Let Your Participants Star in Your Singapore Trainings

ERIC Educational Resources Information Center

Jacobs, George

2013-01-01

This article explains the why and how of active learning, which is based on cognitive psychology. Also explained is the Singapore Ministry of Education's slogan, "Teach Less, Learn More," a good slogan for promoting active learning. [This article was published in "Singapore Business Review," Apr 1 2013.

Educational Inclusion in Singapore for Children with Physical Disabilities

ERIC Educational Resources Information Center

Yeo, Lay See; Tan, Su-Lynn

2018-01-01

Under Singapore's inclusive education policy, children with mild physical disabilities are integrated into mainstream schools. There is currently no known published research yet in Singapore on the outcomes of inclusion for children with physical disabilities. Internationally, recent research had compared the school experience of children with…

19 CFR 10.553 - Textile and apparel site visits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Singapore Free...) Visits to enterprises of Singapore. U.S. officials may undertake to conduct site visits to enterprises in the territory of Singapore. U.S. officials will conduct such visits together with responsible...

Effect of long-term glycemic variability on estimated glomerular filtration rate decline among patients with type 2 diabetes mellitus: Insights from the Diabetic Nephropathy Cohort in Singapore.

PubMed

Low, Serena; Lim, Su C; Yeoh, Lee Y; Liu, Yan L; Liu, Jian J; Fun, Sharon; Su, Chang; Zhang, Xiao; Subramaniam, Tavintharan; Sum, Chee F

2017-10-01

In the present study, we examined the association between HbA1c variability and renal disease progression based on estimated glomerular filtration rate (eGFR) decline in patients with type 2 diabetes mellitus (T2DM) in Singapore. Glycemic burden and renal function were retrospectively assessed in 1628 patients in 2002-2014. Multivariable logistic regression was used to assess the relationships between HbA1c variability (expressed as HbA1c coefficient of variation [HbA1c-CV] in quartiles), HbA1c intrapersonal mean (HbA1c-IM), and eGFR decline, adjusted for baseline covariates. Among patients with relatively good glycemic control (i.e. HbA1c-IM below the median cohort value [8.0%]), HbA1c-CV Quartile 4 was associated with eGFR decline (odds ratio [OR] 1.88; 95% confidence interval [CI] 1.10-3.25). The OR for HbA1c-CV Quartile 4 was 2.20 (95% CI 1.24-3.89) after additional adjustment for HbA1c-IM. Where HbA1c-IM was above the median cohort value, HbA1c-CV Quartiles 3 and 4 were associated with eGFR decline, with ORs of 2.60 (95% CI 1.48-4.55) and 3.29 (95% CI 1.89-5.76) respectively. After further adjusting for HbA1c-IM, the ORs for Quartiles 3 and 4 were 2.69 (95% CI 1.53-4.74) and 3.51 (95% CI 1.98-6.21), respectively. Variability in HbA1c is strongly and independently associated with eGFR decline in patients with T2DM independent of mean HbA1c. The findings may highlight the importance of sustained stable glycemic control in management of diabetes mellitus. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Effect of a Computerized Provider Order Entry (CPOE) System on Medication Orders at a Community Hospital and University Hospital

PubMed Central

Wess, Mark L.; Embi, Peter J.; Besier, James L.; Lowry, Chad H.; Anderson, Paul F.; Besier, James C.; Thelen, Geriann; Hegner, Catherine

2007-01-01

Computerized Provider Order Entry (CPOE) has been demonstrated to improve the medication ordering process, but most published studies have been performed at academic hospitals. Little is known about the effects of CPOE at community hospitals. With a pre-post study design, we assessed the effects of a CPOE system on the medication ordering process at both a community and university hospital. The time from provider ordering to pharmacist verification decreased by two hours with CPOE at the community hospital (p<0.0001) and by one hour at the university hospital (p<0.0001). The rate of medication clarifications requiring signature was 2.80 percent pre-CPOE and 0.40 percent with CPOE (p<0.0001) at the community hospital. The university hospital was 2.76 percent pre-CPOE and 0.46 percent with CPOE (p<0.0001). CPOE improved medication order processing at both community and university hospitals. These findings add to the limited literature on CPOE in community hospitals. PMID:18693946

Healthy Competition and Unsound Comparison: Reforming Educational Competition in Singapore

ERIC Educational Resources Information Center

Christensen, Søren

2015-01-01

It is frequently claimed that the "competition state" responds to external competition by making competition increasingly central to its internal processes as well. This article discusses education reform in Singapore as departing from the opposite position. In Singapore "excessive" competition in education is now targeted by…

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…

The Complexities in Fostering Critical Thinking through School-Based Curriculum Innovation: Research Evidence from Singapore

ERIC Educational Resources Information Center

Tan, Liang See; Koh, Elizabeth; Lee, Shu Shing; Ponnusamy, Letchmi Devi; Tan, Keith Chiu Kian

2017-01-01

Singapore's strong performance in international benchmarking studies--Trends in International Mathematics and Science Study (TIMSS) and Programme for International Student Assessment (PISA)--poses a conundrum to researchers who view Singapore's pedagogy as characterized by the teaching of facts and procedures, and lacking in constructivist…

Sorting Citizens: Differentiated Citizenship Education in Singapore

ERIC Educational Resources Information Center

Ho, Li-Ching

2012-01-01

Using Singapore as a case study, this paper examines how the discourses of democratic elitism and meritocracy help allocate different citizen roles to students and define the nature of the social studies citizenship education programmes for different educational tracks. While the Singapore education system is not unique in its stratification of…

Teacher Involvement in School Change: Perceptions of Singapore Principals

ERIC Educational Resources Information Center

Lim, Lee Hean

2006-01-01

Background: Data were collected in Singapore as part of a ten-country international study that focuses on cross-cultural comparison of principal attitudes towards teacher involvement. Aim: This paper presents secondary school principals' perceptions with regard to teachers' responsibility-taking in the context of school change in Singapore.…

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…

The Singapore Armed Forces: Are Citizen-Soldiers Still Relevant Today?

DTIC Science & Technology

2011-03-14

Defence and Strategic Studies." Shangri - La Hotel , Singapore: IDSS, January 13, 2005. MINDEF. "News by Deputy Prime Minister and Minister for Defence... Introduction ............................................................................................................................... ! 1.1 Background of... INTRODUCTION Conscription will remain relevant for Singapore even as global trends indicate more countries are gravitating towards an All-Volunteer

Saving Chinese-Language Education in Singapore

ERIC Educational Resources Information Center

Lee, Cher Leng

2012-01-01

Three-quarters of Singapore's population consists of ethnic Chinese, and yet, learning Chinese (Mandarin) has been a headache for many Singapore students. Recently, many scholars have argued that the rhetoric of language planning for Mandarin Chinese should be shifted from emphasizing its cultural value to stressing its economic value since…

Parental Perspectives and Challenges in Inclusive Education in Singapore

ERIC Educational Resources Information Center

Wong, Meng Ee; Poon, Kenneth K.; Kaur, Sarinajit; Ng, Zi Jia

2015-01-01

Relatively little work has focused on inclusive education in Singapore. This study examines the experiences and perceptions of parents whose children with disabilities are attending mainstream secondary schools in Singapore. Data was drawn from interviews with 13 parents of children with mild disabilities. Our findings reveal that parental…

Doing Business in the Global Village: Japanese Professionals on EL Needs in Singapore

ERIC Educational Resources Information Center

Yoneda, Mitaka

2015-01-01

This paper presents an analysis of English language (EL) education from the perspectives of Japanese and non-Japanese professionals in Singapore, based on their experiences of "doing business" in Singapore. As established career business people, the perspectives of Japanese participants offer a retrospective evaluation of their…

Creating "Good Citizens" and Maintaining Religious Harmony in Singapore

ERIC Educational Resources Information Center

Tan, Charlene

2008-01-01

This article discusses how the concept of "good citizens" in Singapore is linked to the principle of harmony, characterised by collectivism and a strong interventionist government. The value of religious harmony is actively promoted by the Singapore government and supported by the religious leaders. This article argues that the principle…

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…

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…

Food allergy in Singapore: opening a new chapter

PubMed Central

Lee, Alison Joanne; Shek, Lynette Pei-Chi

2014-01-01

With the exception of shellfish, the overall food allergy rates in Singapore have not reached the epidemic proportions of the West. The rates of egg, milk and fish allergies remain low. However, the patterns of some food allergies in Singapore have changed over the last decade. For example, peanut allergy, once rare in Singapore, is now the most common cause of anaphylaxis in children. Studies analysing lifestyle practices, particularly with respect to prevention of food allergy, are necessary in order for practitioners to understand global differences and maintain this low prevalence. PMID:24862746

Empathy and burnout: a study on residents from a Singapore institution.

PubMed

Lee, Phong Teck; Loh, Julian; Sng, Gerald; Tung, Joshua; Yeo, Khung Keong

2018-01-01

Empathy and burnout are two entities that are important in a physician's career. They are likely to relate to each other and can be heavily influenced by surrounding factors, such as medical education, local practices and cultural expectations. To our knowledge, empathy and burnout studies have not been performed in Singapore. This study was designed to evaluate empathy and burnout levels using the Jefferson Scale of Physician Empathy (JSPE) and Maslach Burnout Inventory (MBI) among residents in Singapore, and compare them with the United States (US) literature. The JSPE, MBI and a self-designed questionnaire were completed by 446 trainees at a residency-sponsoring institution in Singapore. Residents in Singapore had lower empathy and higher rates of burnout compared to US literature. Physician empathy was associated with burnout: residents with higher empathy scores had higher personal accomplishment (p < 0.001, r = 0.477, r 2 = 0.200); and lower emotional exhaustion (p < 0.001, r = 0.187, r 2 = 0.035) and depersonalisation (p < 0.001, r = 0.321, r 2 = 0.103) scores. Residents in Singapore had lower empathy and higher burnout scores compared to the US literature. Further research into the underlying cause is imperative to guide intervention. Copyright: © Singapore Medical Association.

An international comparison of women's health issues in the Philippines, Thailand, Malaysia, Canada, Hong Kong, and Singapore: the CIDA-SEAGEP Study.

PubMed

Choi, Bernard C K

2004-11-19

This was an international study of women's health issues, based on an Official Study Tour in Southeast Asia (the Philippines, Thailand, Malaysia, Hong Kong, and Singapore) and Canada. The objectives of the study were to identify and compare current gaps in surveillance, research, and programs and policies, and to predict trends of women's health issues in developing countries based on the experience of developed countries. Key informant interviews (senior government officials, university researchers, and local experts), self-administered questionnaires, courtesy calls, and literature searches were used to collect data. The participating countries identified women's health as an important issue, especially for reproductive health (developing countries) and senior's health (developed countries). Cancer, lack of physical activity, high blood pressure, diabetes, poverty, social support, caring role for family, and informing, educating, and empowering people about women's health issues were the main concerns. Based on this study, 17 recommendations were made on surveillance, research, and programs and policies. A number of forthcoming changes in women''s health patterns in developing countries were also predicted.

Spin orbit coupling in graphene through gold intercalation

NASA Astrophysics Data System (ADS)

Mukherjee, Paromita; O'Farrell, Eoin; Tan, Jun You; Yeo, Yuting; Koon, G. K. W.; Özyilmaz, Barbaros; Watanabe, K.; Taniguchi, T.

Graphene has a very low value of spin orbit coupling. There have been several efforts to enhance the spin orbit interaction in graphene. Our previous work has provided clear evidence that spin orbit coupling can be induced in graphene through Rashba interaction with intercalated gold. By applying an additional electric field, this splitting can be increased or decreased depending on its relative direction with the internal electric field induced by gold in graphene. A large negative magnetoresistance due to an in-plane magnetic field has been observed which can be attributed to the fact that a magnetic moment is induced in gold due to spin-orbit coupling. Anomalous Hall Effect which decreases with an in-plane magnetic field further suggests the formation of a collective magnetic phase. We would like to further elaborate on the spin-orbit coupling in graphene using non local measurements. Hence, by intercalating graphene with gold, we can have a direct electric manipulation of the spin degrees of freedom and lead to its much awaited applications in spintronics, quantum computing. National University of Singapore, Singapore.

High Spectral Resolution Lidar and MPLNET Micro Pulse Lidar Aerosol Optical Property Retrieval Intercomparison During the 2012 7-SEAS Field Campaign at Singapore

NASA Technical Reports Server (NTRS)

Lolli, Simone; Welton, Ellsworth J.; Campbell, James R.; Eloranta, Edwin; Holben, Brent N.; Chew, Boon Ning; Salinas, Santo V.

2014-01-01

From August 2012 to February 2013 a High Resolution Spectral Lidar (HSRL; 532 nm) was deployed at that National University of Singapore near a NASA Micro Pulse Lidar NETwork (MPLNET; 527 nm) site. A primary objective of the MPLNET lidar project is the production and dissemination of reliable Level 1 measurements and Level 2 retrieval products. This paper characterizes and quantifies error in Level 2 aerosol optical property retrievals conducted through inversion techniques that derive backscattering and extinction coefficients from MPLNET elastic single-wavelength datasets. MPLNET Level 2 retrievals for aerosol optical depth and extinction/backscatter coefficient profiles are compared with corresponding HSRL datasets, for which the instrument collects direct measurements of each using a unique optical configuration that segregates aerosol and cloud backscattered signal from molecular signal. The intercomparison is performed, and error matrices reported, for lower (0-5km) and the upper (>5km) troposphere, respectively, to distinguish uncertainties observed within and above the MPLNET instrument optical overlap regime.

Stressors and expectations of undergraduate nursing students during clinical practice in Singapore.

PubMed

Suen, Wei Qi; Lim, Siriwan; Wang, Wenru; Kowitlawakul, Yanika

2016-12-01

Nursing students have experienced stress because they need to focus on academic performance while being exposed to a clinical environment. The study aimed to identify the contributing factors of stress and the clinical environment expectations of undergraduate nursing students during their clinical practice at a university in Singapore. A cross-sectional descriptive study design using validated surveys was adopted. The Stressors in Nursing Students and the Clinical Learning Environment Inventory questionnaires were used to collect the data in January 2014. A total of 285 nursing students participated in this study. The results showed that third year nursing students had higher stress levels than first year and second year students. Satisfaction in terms of fulfilment among nursing students during clinical practice was found to be the most influential factor in predicting stress. The study suggests that the nursing faculty needs to be more concerned about nursing students' stress level and provide more support to third year students. In addition, students' satisfaction should be considered when developing a clinical curriculum. © 2016 John Wiley & Sons Australia, Ltd.

Implementing electronic handover: interventions to improve efficiency, safety and sustainability.

PubMed

Alhamid, Sharifah Munirah; Lee, Desmond Xue-Yuan; Wong, Hei Man; Chuah, Matthew Bingfeng; Wong, Yu Jun; Narasimhalu, Kaavya; Tan, Thuan Tong; Low, Su Ying

2016-10-01

Effective handovers are critical for patient care and safety. Electronic handover tools are increasingly used today to provide an effective and standardized platform for information exchange. The implementation of an electronic handover system in tertiary hospitals can be a major challenge. Previous efforts in implementing an electronic handover tool failed due to poor compliance and buy-in from end-users. A new electronic handover tool was developed and incorporated into the existing electronic medical records (EMRs) for medical patients in Singapore General Hospital (SGH). There was poor compliance by on-call doctors in acknowledging electronic handovers, and lack of adherence to safety rules, raising concerns about the safety and efficiency of the electronic handover tool. Urgent measures were needed to ensure its safe and sustained use. A quality improvement group comprising stakeholders, including end-users, developed multi-faceted interventions using rapid PDSA (P-Plan, D-Do, S-Study, A-Act ) cycles to address these issues. Innovative solutions using media and online software provided cost-efficient measures to improve compliance. The percentage of unacknowledged handovers per day was used as the main outcome measure throughout all PDSA cycles. Doctors were also assessed for improvement in their knowledge of safety rules and their perception of the electronic handover tool. An electronic handover tool complementing daily clinical practice can be successfully implemented using solutions devised through close collaboration with end-users supported by the senior leadership. A combined 'bottom-up' and 'top-down' approach with regular process evaluations is crucial for its long-term sustainability. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

State University of New York Stony Brook University Hospital: Selected Expenditure Controls. Report 92-S-66.

ERIC Educational Resources Information Center

New York State Office of the Comptroller, Albany. Div. of Management Audit.

An audit was done of selected expenditure controls at the State University of New York (SUNY) at Stony Brook University Hospital particularly payroll costs and procurement practices. The Hospital reported an operating loss of $24 million in 1992. The audit reviewed Hospital management and staff and applicable policies and procedures as well as…

Assessing advertising content in a hospital advertising campaign: An application of Puto and Wells (1984) measure of informational and transformational advertising content.

PubMed

Menon, Mohan K; Goodnight, Janelle M; Wayne, Robin J

2006-01-01

The following is a report of a study designed to measure advertising content based on the cognitive and affective elements of informational (i.e., information processing) and transformational (i.e., experiential) content using the measure of advertising informational and transformational content developed by Puto and Wells (1984). A university hospital advertising campaign designed to be high in transformational content did not appear to affect perceived quality of local university hospitals relative to private hospitals or increase the likelihood of choosing a university hospital in the future. Further, experiences with university hospitals that seemed to be in direct contrast to the content of the advertisements based on subject perceptions affected how university hospital advertisements were perceived in terms of content. Conclusions and implications for hospital advertising campaigns are discussed.

Financial Analysis of National University Hospitals in Korea.

PubMed

Lee, Munjae

2015-10-01

This paper provides information for decision making of the managers and the staff of national university hospitals. In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry.

Financial Analysis of National University Hospitals in Korea

PubMed Central

Lee, Munjae

2015-01-01

Objectives This paper provides information for decision making of the managers and the staff of national university hospitals. Methods In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. Results The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. Conclusion These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry. PMID:26730356

Improving awareness, knowledge and heart-related lifestyle of coronary heart disease among working population through a mHealth programme: study protocol.

PubMed

Wang, Wenru; Zhang, Hui; Lopez, Violeta; Wu, Vivien Xi; Poo, Danny Chiang Choon; Kowitlawakul, Yanika

2015-09-01

To develop a mHealth programme, entitled 'Care4Heart' for the working population in Singapore and thereafter examine its feasibility and effectiveness in increasing the awareness and knowledge of coronary heart disease and improving their heart-related lifestyle. Teaching and encouraging the working population to adopt a healthier lifestyle could result in preventing and/or decreasing the incidence of coronary heart disease among this population. The use of mobile application (app) is the next logical wave of healthcare support tools to prevent and manage chronic diseases like coronary heart disease. A quasi-experimental longitudinal study design. The study will be conducted in a tertiary university in Singapore. A non-probability, quota sampling of 200 participants will be recruited including 100 academic and research staff, 50 administrative staff and 50 support staff and business owners. Once consent is obtained, the newly developed mobile app will be installed onto the participants' smartphones and a well-trained research assistant will brief the participant on the use of the app. The main outcomes will be measured using the survey questionnaires: Awareness of coronary heart disease, Heart Disease Fact Questionnaire-2, Behavioural Risk Factor Surveillance System and Perceived Stress Scale. Data will be collected at baseline and at the 4th week and 6th month thereafter. If this project is successful, Care4Heart - a mHealth and novel prevention educational programme for the working population in Singapore - can be used to promote knowledge and positive heart-related lifestyle changes to prevent coronary heart disease. © 2015 John Wiley & Sons Ltd.

An update on finances and financial support for medical students in Yong Loo Lin School of Medicine

PubMed Central

Sayampanathan, Andrew Arjun; Tan, Yeong Tze Wilnard; Fong, Jie Ming Nigel; Koh, Yun Qing; Ng, Chew Lip; Mohan, Niraj; Jang, Jin Hao Justin; Tambyah, Paul Anantharajah

2017-01-01

INTRODUCTION Increasing financial challenges have resulted in great debt among medical graduates worldwide. In Singapore, more scholarships and bursaries have been disbursed in recent years to support students who are financially challenged. We aimed to study the financial status of medical students in National University of Singapore (NUS) Yong Loo Lin School of Medicine (i.e. NUS Medicine), Singapore, and the financial support available to them. METHODS A cross-sectional quantitative study was performed. Surveys were distributed and completed by medical students of NUS Medicine. Information regarding household income, financial assistance, monthly allowance and expense, and concurrent occupations was collected. We compared our findings with the results of a similar study performed in 2007 and national income data. RESULTS A total of 956 (66.2%) out of 1,445 medical students completed the survey. 19.5% and 58.5% of respondents came from households with monthly incomes < SGD 3,000 and > SGD 7,000, respectively. 20.6% of students had loans, 18.9% had scholarships and bursaries, and 14.4% worked to support themselves. CONCLUSION Medical school fees have risen by more than 50% over the past ten years. Our study found that there were increases in the proportion of students from both the lower- and higher-income segments, with proportionally fewer students from the middle-income segment. A large number of students were working and/or had some form of financial support. More should be done to meet the needs of financially challenged medical students to ensure equal access to quality medical education. PMID:27516114

Prevalence of diphtheria and tetanus antibodies among adults in Singapore: a national serological study to identify most susceptible population groups.

PubMed

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

2016-03-01

In view of waning antitoxin titres over time after the last vaccine dose against diphtheria and tetanus, we determined the immunity levels in adults to identify most susceptible groups for protection in Singapore. Our study involved residual sera from 3293 adults aged 18-79 who had participated in a national health survey in 2010. IgG antibody levels were determined using commercial enzyme-linked immunosorbent assay. Overall, 92.0% (95% confidence interval [CI]: 91.1-92.9%) had at least basic protection against diphtheria (antibody levels ≥0.01 IU/ml), while 71.4% (95% CI: 69.8-72.9%) had at least short-term protection against tetanus (antibody levels >0.1 IU/ml). The seroprevalence declined significantly with age for both diseases; the drop was most marked in the 50- to 59-year age group for diphtheria and 60- to 69-year age group for tetanus. There was a significant difference in seroprevalence by residency for diphtheria (92.8% among Singapore citizens versus 87.1% among permanent residents; P = 0.001). The seroprevalence for tetanus was significantly higher among males (83.2%) than females (62.4%) (P < 0.0005). It may be of value to consider additional vaccination efforts to protect older adults at higher risk for exposure against diphtheria and tetanus, particularly those travelling to areas where diphtheria is endemic or epidemic. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Analysis and Outcomes of Cataract Surgery in Patients with Acquired Immunodeficiency Syndrome.

PubMed

Chew, Grace W M; Teoh, Stephen C B; Agrawal, Rupesh

2017-08-01

To investigate the surgical outcomes, complications and postoperative progression in HIV patients undergoing cataract surgery in a teaching hospital. A retrospective cohort study of patients with HIV/AIDS who had cataract surgery from January 2000 until December 2011 at a tertiary referral multidisciplinary hospital in Singapore. We identified 44 eyes from 29 patients. Preoperatively, 41.3% had no ophthalmic manifestations of HIV/AIDS, while 16 eyes had quiescent cytomegalovirus retinitis (CMVR). Postoperatively, 1 eye developed new CMVR, while 1 eye had reactivation of previous CMVR. Of eyes with new or previous CMVR, 1 eye developed rhegmatogenous retinal detachment (RD) postoperatively. Only 3 eyes had prolonged postoperative inflammation. There were no cases of endophthalmitis or cystoid macular edema. Postoperative improvement of at least two Snellen lines was achieved in 86.6% of eyes. Cataract surgery in HIV patients is generally safe, regardless of CD4 count, but their general and ocular health should be optimized preoperatively.

Bipolar patients sing more in singapore: singing as a signal for mania in psychotic patients.

PubMed

Lim, Leslie; Leow, Me Lye; Soh, Bee Leng; Chan, Yiong Huak; Parker, Gordon

2013-10-01

Singing in psychotic patients has received little attention in the psychiatric literature. In this preliminary study, we test the hypothesis that manic patients sing more than schizophrenic patients (SPs). Manic patients and SP inpatients and outpatients were interviewed using a semi-structured questionnaire which included questions on musical interests, and how much they felt like singing prior to their most recent admission to hospital. They were asked if they were willing to sing during the interview and responses were observed. Of the 69 manic patients and 68 SPs interviewed, manic patients were more likely to report singing than SPs (76% vs 24%) prior to their most recent admission to hospital. There was a trend for manic inpatients to be more willing to sing during the interview. Increased singing is suggested as a useful symptom and sign in patients suffering from a manic illness.

Management of penile cancer in a Singapore tertiary hospital.

PubMed

Tan, Teck Wei; Chia, Sing Joo; Chong, Kian Tai

2017-06-01

To present our experience of managing penile squamous cell carcinoma (SCC) in a tertiary hospital in Singapore and to evaluate the prognostic value of the inflammatory markers neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR). We reviewed our prospectively maintained Institutional Review Board-approved urological cancer database to identify men treated for penile SCC at our centre between January 2007 and December 2015. For all the patients identified, we collected epidemiological and clinical data. In all, 39 patients were identified who were treated for penile SCC in our centre. The median [interquartile range (IQR)] follow-up was 34 (16.5-66) months. Although very few (23%) of our patients with high-risk clinical node-negative underwent prophylactic inguinal lymph node dissection (ILND), they still had excellent 5-year recurrence-free survival (RFS; 90%) and cancer-specific survival (CSS; 90%). At multivariate analysis, higher N stage was significantly associated with worse RFS and CSS. Patients with a high NLR (≥2.8) had significantly higher T-stage ( P  = 0.006) and worse CSS ( P  < 0.001) than those with a low NLR. Patients with a low LMR (<3.3) had significantly higher T-stage ( P  = 0.013) and worse RFS ( P  = 0.009) and CSS ( P  < 0.022) than those with a high LMR. Although very few of our patients with intermediate- and high-risk clinical node-negative SCC underwent prophylactic ILND, they still had excellent 5-year RFS and CSS. However, survival was poor in patients with node-positive disease. The pre-treatment NLR and LMR could serve as biomarkers to predict the prognosis of patients with penile cancer.

Clinical and Socio-Demographic Predictors of Home Hospice Patients Dying at Home: A Retrospective Analysis of Hospice Care Association's Database in Singapore.

PubMed

Lee, Yee Song; Akhileswaran, Ramaswamy; Ong, Eng Hock Marcus; Wah, Win; Hui, David; Ng, Sheryl Hui-Xian; Koh, Gerald

2017-06-01

Hospice care can be delivered in different settings, but many patients choose to receive it at home because of familiar surroundings. Despite their preferences, not every home hospice patient manages to die at home. To examine the independent factors associated with home hospice patient dying at home. Retrospective analysis of Hospice Care Association's database. Hospice Care Association is the largest home hospice provider in Singapore. The study included all patients who were admitted into home hospice service from January 1, 2004 to December 31, 2013. Cox proportional hazards modeling with time as constant was used to study the relationship between independent variables and home death. A total of 19,721 patients were included in the study. Females (adjusted risk ratio [ARR] 1.09, 95% CI 1.04-1.15), older patients (ARR 1.01, 95% CI 1.00-1.01), shorter duration of home hospice stay (ARR 0.88, 95% CI 0.82-0.94), fewer episodes of hospitalization (ARR 0.81, 95% CI 0.75-0.86), living with caregivers (ARR 1.54, 95% CI 1.05-2.26), doctor (ARR 1.05, 95% CI 1.01-1.08) and nurse (ARR 1.06, 95% CI 1.04-1.08) visits were positive predictors of dying-at-home. Diagnosis of cancer (ARR 0.93, 95% CI 0.86-1.00) was a negative predictor of dying-at-home. Female, older age, living with a caregiver, non-cancer diagnosis, more doctor and nurse visits, shorter duration of home hospice stays, and fewer episodes of acute hospitalizations are predictive of dying-at-home for home hospice patients. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Comparison of emergency medical services systems across Pan-Asian countries: a Web-based survey.

PubMed

Shin, Sang Do; Ong, Marcus Eng Hock; Tanaka, Hideharu; Ma, Matthew Huei-Ming; Nishiuchi, Tatsuya; Alsakaf, Omer; Karim, Sarah Abdul; Khunkhlai, Nalinas; Lin, Chih-Hao; Song, Kyoung Jun; Ryoo, Hyun Wook; Ryu, Hyun Ho; Tham, Lai Peng; Cone, David C

2012-01-01

There are great variations in out-of-hospital cardiac arrest (OHCA) survival outcomes among different countries and different emergency medical services (EMS) systems. The impact of different systems and their contribution to enhanced survival are poorly understood. This paper compares the EMS systems of several Asian sites making up the Pan-Asian Resuscitation Outcomes Study (PAROS) network. Some preliminary cardiac arrest outcomes are also reported. This is a cross-sectional descriptive survey study addressing population demographics, service levels, provider characteristics, system operations, budget and finance, medical direction (leadership), and oversight. Most of the systems are single-tiered. Fire-based EMS systems are predominant. Bangkok and Kuala Lumpur have hospital-based systems. Service level is relatively low, from basic to intermediate in most of the communities. Korea, Japan, Singapore, and Bangkok have intermediate emergency medical technician (EMT) service levels, while Taiwan and Dubai have paramedic service levels. Medical direction and oversight have not been systemically established, except in some communities. Systems are mostly dependent on public funding. We found variations in available resources in terms of ambulances and providers. The number of ambulances is 0.3 to 3.2 per 100,000 population, and most ambulances are basic life support (BLS) vehicles. The number of human resources ranges from 4.0 per 100,000 population in Singapore to 55.7 per 100,000 population in Taipei. Average response times vary between 5.1 minutes (Tainan) and 22.5 minutes (Kuala Lumpur). We found substantial variation in 11 communities across the PAROS EMS systems. This study will provide the foundation for understanding subsequent studies arising from the PAROS effort.

Singapore's Anopheles sinensis Form A is susceptible to Plasmodium vivax isolates from the western Thailand-Myanmar border.

PubMed

Pang, Sook-Cheng; Andolina, Chiara; Malleret, Benoit; Christensen, Peter R; Lam-Phua, Sai-Gek; Razak, Muhammad Aliff Bin Abdul; Chong, Chee-Seng; Li, Daiqin; Chu, Cindy S; Russell, Bruce; Rénia, Laurent; Ng, Lee-Ching; Nosten, Francois

2017-11-16

Singapore has been certified malaria-free by the World Health Organization since November 1982. However, sporadic autochthonous malaria outbreaks do occur. In one of the most recent outbreaks of vivax malaria, an entomological investigation identified Anopheles sinensis as the most probable vector. As metaphase karyotype studies divided An. sinensis into two forms, A and B, with different vector competence: the investigation of vector competence of An. sinensis found in Singapore was thus pursued using Plasmodium vivax field isolates from the Thailand-Myanmar border. Adults and larvae An. sinensis were collected from Singapore from 14 different locations, using various trapping and collection methods between September 2013 and January 2016. Molecular identification of An. sinensis species were conducted by amplifying the ITS2 and CO1 region using PCR. Experimental infections of An. sinensis using blood from seven patients infected with P. vivax from the Thailand-Myanmar border were conducted with Anopheles cracens (An. dirus B) as control. Phylogenetic analysis showed that An. sinensis (F 22 , F 2 and collected from outbreak areas) found in Singapore was entirely Form A, and closely related to An. sinensis Form A from Thailand. Artificial infection of these Singapore strain An. sinensis Form A resulted in the development of oocysts in four experiments, with the number of sporozoites produced by one An. sinensis ranging from 4301 to 14,538. Infection experiments showed that An. sinensis Form A from Singapore was susceptible to Thai-Myanmar P. vivax strain, suggesting a potential role as a malaria vector in Singapore.

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

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.

Children's Rights: Television Programmes Aired in Singapore

ERIC Educational Resources Information Center

Warrier, Sheela; Ebbeck, Marjory

2014-01-01

This article focuses on aspects of children's rights as portrayed in television. The results of a six-month research study show analyses of television content of Channel 5, which is the only free-to-air, 24-hour, English-language entertainment channel in Singapore. The results identify the role of television in assisting Singapore to meet its…

Globalisation, the Singapore State and Educational Reforms: Towards Performativity

ERIC Educational Resources Information Center

Tan, Charlene

2008-01-01

In response to the challenges of globalisation, the Singapore government has introduced an array of neo-liberal educational strategies to promote two goals: (a) greater diversity and choice in the educational landscape; and (b) greater autonomy and innovation at the school level. This article argues that the Singapore government uses the tactic of…

Status of Tamil Language in Singapore: An Analysis of Family Domain

ERIC Educational Resources Information Center

Kadakara, Shanmugam

2015-01-01

This paper addresses the phenomenon of Language Maintenance and Language Shift through a qualitative study of Tamil language in the family domain in Singapore. The influence of Singapore's bilingual policy and the institutional support offered for maintenance of Tamil language provide the context in which the central research problem of the status…

A Review of Singapore Principals' Leadership Qualities, Styles, and Roles

ERIC Educational Resources Information Center

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

2015-01-01

Purpose: The purpose of this paper is to present a review of empirical studies on principal leadership in Singapore. It seeks to provide a general picture of Singapore principals' leadership qualities, styles, and roles. Design/methodology/approach: This is a systematic review of empirical studies, using a "bounded" approach with a focus…

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…

Linguistic Landscape in Singapore: What Shop Names Reveal about Singapore's Multilingualism

ERIC Educational Resources Information Center

Shang, Guowen; Guo, Libo

2017-01-01

The visibility and salience of specific languages in public spaces are important parameters of their ethnolinguistic vitality in a society. Drawing upon data from first-hand fieldwork, this paper explores the display of multiple languages in shop names presented in Singapore's neighbourhood centres in order to reveal how local shop owners address…

Perceived Teaching Practice and Its Prediction of Student Engagement in Singapore

ERIC Educational Resources Information Center

Luo, Wenshu

2017-01-01

This study examined teaching practice in Singapore mathematics classrooms and its prediction of student engagement. A large sample of Singapore Secondary 2 students first reported perceived teaching practice in their mathematics classrooms in Term 1 and their engagement in mathematics study in Term 2. Based on Rasch analysis of teaching practice,…

Creating Thinking Schools through Authentic Assessment: The Case in Singapore

ERIC Educational Resources Information Center

Koh, Kim H.; Tan, Charlene; Ng, Pak Tee

2012-01-01

Using Singapore as an example, we argue that schools need to equip and encourage teachers to adopt authentic assessment in teaching and learning so as to develop the students' higher-order thinking. The importance of teaching and assessing higher-order thinking in Singapore classrooms is encapsulated in the vision of "Thinking Schools"…

Meritocracy, Elitism, and Egalitarianism: A Preliminary and Provisional Assessment of Singapore's Primary Education Review

ERIC Educational Resources Information Center

Lim, Leonel

2013-01-01

Meritocracy functions in Singapore as the key principle of governance and educational distribution. However, the concept of meritocracy itself contains a number of inherent contradictions, most evidently witnessed in the tension between its egalitarian and elitist strands. This tension is documented in the recommendations of Singapore's recent…

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…

An Activity Theory Approach to Research of ICT Integration in Singapore Schools

ERIC Educational Resources Information Center

Lim, Cher Ping; Hang, David

2003-01-01

This paper explains how activity theory is used as a framework to study the information and communication technologies (ICT) integration processes in Singapore schools, both from the sociocultural and pedagogical perspectives. The research study addresses the pertinent question of "How has ICT been integrated in Singapore schools such that…

The Purposes Outdoor Education Does, Could and Should Serve in Singapore

ERIC Educational Resources Information Center

Ho, Susanna

2014-01-01

This paper discusses the purposes that outdoor education does, could and should serve in Singapore. Gert Biesta's conceptualisation of three functions of education is adapted to frame deliberations on the purposes of outdoor education in Singapore's socio-political and educational milieu. The author suggests that outdoor education in Singapore…

"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…

Value Orientation of Singapore Adolescents Towards Truthfulness, Justice and Compassion.

ERIC Educational Resources Information Center

Seng, SeokHoon; Siang, Low Meow; Wei, Tan Tai

This study examined the value orientation of Singapore adolescents toward the three fundamental values of truthfulness, justice, and compassion. A random sample of 315 secondary school students from 4 schools in Singapore (135 males and 180 females) completed a questionnaire, and a select sample of 19 students completed interviews about their…

Mathematical Modelling for Singapore Primary Classrooms: From a Teacher's Lens

ERIC Educational Resources Information Center

Seto, Cynthia; Magdalene, Thomas Mary; Ng Kit Ee, Dawn; Chan Chun Ming, Eric; Widjaja, Wanty

2012-01-01

Limited Singapore research indicated a lack of exposure of modelling tasks at primary levels. Teacher reflection is used as a tool in design research cycles exploring the potentials of modelling tasks in a Singapore primary five classroom. Findings reveal that the teacher identified three potentials of a modelling task on children's…

Instructional Leadership Structure in Singapore: A Co-Existence of Hierarchy and Heterarchy

ERIC Educational Resources Information Center

Nguyen, Dong Thanh; Ng, David; Yap, Pui San

2017-01-01

Purpose: The purpose of this paper is to explore the instructional leadership practices and structure in Singapore primary schools. Design/methodology/approach: The study employs a qualitative approach. Data were collected from interviews of 30 Singapore primary school principals and 25 working-day observations of five principals. A grounded…

The Curriculum of Climate Change Education: A Case for Singapore

ERIC Educational Resources Information Center

Chang, Chew-Hung; Pascua, Liberty

2017-01-01

The inclusion of the climate change topic in the curriculum of school subjects in Singapore was pivotal, such that it positioned the discourse squarely in the structure of Singapore's education system. In an examination of the intersections and disjoints between state policies on climate change against the programmatic curriculum, results showed…

Adult Learners Understanding in Learning Islam Using the Andragogy Approach in Singapore

ERIC Educational Resources Information Center

Kadir, Mohd Amin Bin

2016-01-01

This study describes adult learners understanding in learning Islam using the andragogy approach in Singapore comprising multicultural and multi-religious society. Singapore is a secular state where freedom of religion is encrypted in the constitution and Malay/Muslim comprises 13.3% of the population. Adults learn Islam to deepen their…

DNA-Based Analyses of Molds in Singapore Public Buildings Results in a Proposed Singapore Environmental Relative Moldiness Index

EPA Science Inventory

Dust samples (n=75) were collected from shopping malls, hotels and libraries in Singapore and then analyzed using Mold Specific Quantitative Polymerase Chain Reaction(MSQPCR) for the 36 molds that make up the Environmental Relative Moldiness Index (ERMI). Most of these molds (23/...

Challenging and Co-Opting Globalisation: Singapore's Strategies in Higher Education

ERIC Educational Resources Information Center

Gopinathan, S.; Lee, Michael H.

2011-01-01

Since its independence in 1965, Singapore has adopted a developmental state orientation and has placed a strong emphasis on education to meet its socio-economic development needs. In line with its aspirations to be a regional education hub, the Singapore higher education system hosts a number of prestigious institutions and international…

The Psychometric Properties of the School Engagement Measure in Adolescents in Singapore

ERIC Educational Resources Information Center

Yusof, Noradlin; Ang, Rebecca P.; Oei, Tian Po S.

2017-01-01

This study examined the psychometric properties of the school engagement measure (SEM) in Singapore. The sample consisted of 1,027 students from a multi-ethnic Singapore adolescent community. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) confirmed that the two-factor solution, namely, (a) Emotional and (b) Cognitive…

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…

Distributed Leadership to Support PLCs in Asian Pragmatic Singapore Schools

ERIC Educational Resources Information Center

Hairon, Salleh; Goh, Jonathan Wee Pin; Lin, Tzu-Bin

2014-01-01

Nation states around the world, including Singapore, are endeavouring to reform their education systems in order to successfully compete in the global economy (Carnoy, 1999). With human capital as Singapore's primary resource, it is unsurprising that the state has placed great emphasis on strengthening the economic-education nexus. This tight…

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…

Is Singapore's School Geography Becoming Too Responsive to the Changing Needs of Society?

ERIC Educational Resources Information Center

Chang, Chew-Hung

2014-01-01

In understanding the divergences and commonalities in the representations of geography across different national settings, the case of Singapore is examined through the notion of politicisation of school curricula to meet the needs of "significant power groups". In particular, the development of school geography in Singapore and its…

The work-family interface in the United States and Singapore: conflict across cultures.

PubMed

Galovan, Adam M; Fackrell, Tamara; Buswell, Lydia; Jones, Blake L; Hill, E Jeffrey; Carroll, Sarah June

2010-10-01

This article examines the work-family interface in a cross-cultural comparison between two nationally representative samples from the United States (n = 1,860) and Singapore (n = 1,035) with emphasis on work-family conflict. Family-to-work conflict was negatively related to marital satisfaction in both Singapore and the United States, although the effect was stronger in the United States. Similarly, family-to-work conflict was positively related to job satisfaction in the United States but was negatively related in Singapore. As expected, schedule flexibility was negatively related to depression in the United States, but in Singapore the relationship was positive. These findings suggest that theoretical relationships in the work-family interface developed in the more culturally individualistic West may need to be adapted when studying populations in the more collectivist East.

Physiotherapists' Beliefs About Whiplash-associated Disorder: A Comparison Between Singapore and Queensland, Australia.

PubMed

Ng, Tze Siong; Pedler, Ashley; Vicenzino, Bill; Sterling, Michele

2015-06-01

Healthcare providers' beliefs may play a role in the outcome of whiplash-associated disorders (WAD), a condition which is proposed to be culturally dependent. Clinical practice guidelines recommend an active approach for the management of WAD, which is often delivered by physiotherapists. However, there is no data on physiotherapists' whiplash beliefs. Our primary objective was to determine physiotherapists' beliefs from Queensland (Australia) and Singapore, two cultures with differing prevalence of chronic musculoskeletal pain and chronic WAD. A pen and paper survey of musculoskeletal physiotherapists practicing in Queensland and Singapore was conducted. Participants completed questionnaires consisting of patient vignettes and statements inquiring knowledge and attitudes towards WAD. Chi-square tests of significance were used to compare the responses of physiotherapists from both samples. Ninety-one (response rate 45%) Queensland-based and 94 (response rate 98%) Singapore-based physiotherapists participated in the study. The beliefs in the management strategies for the patient vignettes were generally consistent with practice guidelines. A higher proportion of Queensland-based physiotherapists expected permanent disabilities for the patient vignette depicting chronic WAD (Queensland: 55% Singapore: 28% Pearson chi-sq 18.76, p < 0.005).Up to 99% of the physiotherapists from both samples believed in encouragement of physical activity, the effectiveness of exercise and multimodal physiotherapy for WAD. Significantly higher proportions of Singapore-based physiotherapists believed in ordering radiographs for acute WAD (Pearson chi-sq 41.98, p < 0.001) and also believed in a psychogenic origin of chronic WAD (Pearson chi-sq 22.57, p  0.001). The majority of beliefs between physiotherapists in Queensland and Singapore were similar but there were specific differences. Physiotherapists' whiplash beliefs in Queensland and Singapore did not clearly reflect the difference in prevalence of chronic musculoskeletal pain or chronic WAD in Queensland and Singapore. Copyright © 2014 John Wiley & Sons, Ltd.

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.

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

Factors influencing warfarin control in Australia and Singapore.

PubMed

Bernaitis, Nijole; Ching, Chi Keong; Teo, Siew Chong; Chen, Liping; Badrick, Tony; Davey, Andrew K; Crilly, Julia; Anoopkumar-Dukie, Shailendra

2017-09-01

Warfarin is widely used for patients with non-valvular atrial fibrillation (NVAF). Variations in warfarin control, as measured by time in therapeutic range (TTR), have been reported across different regions and ethnicities, particularly between Western and Asian countries. However, there is limited data on comparative factors influencing warfarin control in Caucasian and Asian patients. Therefore, the aim of this study was to determine warfarin control and potential factors influencing this in patients with NVAF in Australia and Singapore. Retrospective data was collected for patients receiving warfarin for January to June 2014 in Australia and Singapore. TTR was calculated for individuals with mean patient TTR used for analysis. Possible influential factors on TTR were analysed including age, gender, concurrent co-morbidities, and concurrent medication. The mean TTR was significantly higher in Australia (82%) than Singapore (58%). At both sites, chronic kidney disease significantly lowered this TTR. Further factors influencing control were anaemia and age<60years in Australia, and vascular disease, CHA 2 DS 2 -VASc score of 6, and concurrent platelet inhibitor therapy in Singapore. Warfarin control was significantly higher in Australia compared to Singapore, however chronic kidney disease reduced control at both sites. The different levels of control in these two countries, together with patient factors further reducing control may impact on anticoagulant choice in these countries with better outcomes from warfarin in Australia compared to Singapore. Copyright © 2017 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

The ability to predict bio-geographic ancestry can be valuable to generate investigative leads towards solving crimes. Ancestry informative marker (AIM) sets include large numbers of SNPs to predict an ancestral population. Massively parallel sequencing has enabled forensic laboratories to genotype a large number of such markers in a single assay. Illumina's ForenSeq DNA Signature Kit includes the ancestry informative SNPs reported by Kidd et al. In this study, the ancestry prediction capabilities of the ForenSeq kit through sequencing on the MiSeq FGx were evaluated in 1030 unrelated Singapore population samples of Chinese, Malay and Indian origin. A total of 59 ancestry SNPs and phenotypic SNPs with AIM properties were selected. The bio-geographic ancestry of the 1030 samples, as predicted by Illumina's ForenSeq Universal Analysis Software (UAS), was determined. 712 of the genotyped samples were used as a training sample set for the generation of an ancestry prediction model using STRUCTURE and Snipper. The performance of the prediction model was tested by both methods with the remaining 318 samples. Ancestry prediction in UAS was able to correctly classify the Singapore Chinese as part of the East Asian cluster, while Indians clustered with Ad-mixed Americans and Malays clustered in-between these two reference populations. Principal component analyses showed that the 59 SNPs were only able to account for 26% of the variation between the Singapore sub-populations. Their discriminatory potential was also found to be lower (G ST =0.085) than that reported in ALFRED (F ST =0.357). The Snipper algorithm was able to correctly predict bio-geographic ancestry in 91% of Chinese and Indian, and 88% of Malay individuals, while the success rates for the STRUCTURE algorithm were 94% in Chinese, 80% in Malay, and 91% in Indian individuals. Both these algorithms were able to provide admixture proportions when present. Ancestry prediction accuracy (in terms of likelihood ratio) 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.

Smart information system for gachon university gil hospital.

PubMed

Park, Dong Kyun; Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

2012-03-01

In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.

Smart Information System for Gachon University Gil Hospital

PubMed Central

Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

2012-01-01

Objectives In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. Methods This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. Results The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Conclusions Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future. PMID:22509476

An Assessment of the Use of Geographical Information Systems (GIS) in Teaching Geography in Singapore Schools

ERIC Educational Resources Information Center

Yap, Lee Yong; Tan, Geok Chin Ivy; Zhu, Xuan; Wettasinghe, Marissa C.

2008-01-01

In 1998, geographical information systems (GIS) were introduced to secondary schools in Singapore as a tool for teaching geography at the secondary and junior college levels. However, general observations and feedback from school teachers suggested that only a small number of secondary schools and junior colleges in Singapore were actually using…

Attitudes towards Literary Tamil and Standard Spoken Tamil in Singapore

ERIC Educational Resources Information Center

Saravanan, Vanithamani

2007-01-01

This is the first empirical study that focused on attitudes towards two varieties of Tamil, Literary Tamil (LT) and Standard Spoken Tamil (SST), with the multilingual state of Singapore as the backdrop. The attitudes of 46 Singapore Tamil teachers towards speakers of LT and SST were investigated using the matched-guise approach along with…

The Teaching of Religious Knowledge in a Plural Society: The Case for Singapore

ERIC Educational Resources Information Center

Tan, Charlene

2008-01-01

This paper discusses the issues and challenges involved in the teaching of religious knowledge in Singapore schools, where it is taught in a historical, descriptive and non-evaluative fashion, adopting the phenomenological approach. The government in Singapore hopes that the teaching of religious knowledge will help to inculcate moral values and…

My Country, My Music: Imagined Nostalgia and the Crisis of Identity in a Time of Globalization

ERIC Educational Resources Information Center

Lum, Chee-Hoo

2017-01-01

This qualitative research study seeks to examine definitions of Singapore music, music by Singapore composers and musics of/in Singapore through the eyes of tertiary music educators in a local institute of teacher education, and to determine pedagogical implications of such definitions in the space of the music classroom. Extensive informal…

Bridging East and West Educational Divides in Singapore

ERIC Educational Resources Information Center

Kumar, Prem

2013-01-01

In Asia, we are witnessing an era where the pendulum of power is swaying towards the East with the rising economic strength of China and India. Singapore is at the "crossroads" between the East and West of these most populous nations on earth. Although Singapore may appear the most Westernised country in Asia, she is nevertheless a…

Implicit Theories of Creativity: A Comparison of Student-Teachers in Hong Kong and Singapore

ERIC Educational Resources Information Center

Seng, Quek Khiok; Keung, Ho Kwok; Cheng, Soh Kay

2008-01-01

This study attempts to uncover the beliefs regarding various aspects of creativity among trainee-teachers in Hong Kong and Singapore. Trainee-teachers from Hong Kong (N = 188) and Singapore (N = 127) completed a questionnaire on beliefs about creativity. The 30-item questionnaire covering 15 aspects of beliefs regarding creativity was presented to…

Constructing the Cosmopolitan Subject: Teaching Secondary School Literature in Singapore

ERIC Educational Resources Information Center

Poon, Angelia Mui Cheng

2010-01-01

This article discusses the ambitious educational reforms of the Singapore government in response to the challenges of globalization vis-a-vis the specific issues arising from the case of teaching Literature in secondary schools. It shows how the Singapore state is invested in a particular view of globalization and argues how recent scholarly moves…

Lifelong Learning through the SkillsFuture Movement in Singapore: Challenges and Prospects

ERIC Educational Resources Information Center

Tan, Charlene

2017-01-01

This article examines the promotion of lifelong learning (LLL) in Singapore through a new national initiative known as the SkillsFuture movement. It is argued that the attainment of LLL is confronted with three key challenges, the first being the sociocultural preference for academic rather than vocational education in Singapore. Secondly, there…

Mathematics Education in Singapore--An Insider's Perspective

ERIC Educational Resources Information Center

Kaur, Berinderjeet

2014-01-01

Singapore's Education System has evolved over time and so has Mathematics Education in Singapore. The present day School Mathematics Curricula can best be described as one that caters for the needs of every child in school. It is based on a framework that has mathematical problem solving as its primary focus. The developments from 1946 to 2012…

Singapore's Response to the Global War for Talent: Politics and Education

ERIC Educational Resources Information Center

Ng, Pak Tee

2011-01-01

This paper describes and analyses how Singapore engages in the global war for talent. The paper discusses how Singapore demonstrates a Foucauldian perspective of "governmentality" in trying to mould citizens into a way of thinking that is geared suitably to an engagement in a global talent war. It first examines the social, political and…

An Evaluation of Learning Objects in Singapore Primary Education: A Case Study Approach

ERIC Educational Resources Information Center

Grace, Tay Pei Lyn; Suan, Ng Peck; Wanzhen, Liaw

2008-01-01

Purpose: The purpose of this paper is to evaluate the usability and interface design of e-learning portal developed for primary schools in Singapore. Design/methodology/approach: Using Singapore-based learning EDvantage (LEAD) portal as a case study, this paper reviews and analyses the usability and usefulness of embedded learning objects (LOs)…

Disciplinary Boundaries and Climate Change Education: Teachers' Conceptions of Climate Change Education in the Philippines and Singapore

ERIC Educational Resources Information Center

Ho, Li-Ching; Seow, Tricia

2017-01-01

This qualitative study examines how climate change scientific knowledge is framed and positioned within the Singapore and Philippines school curricula in relation to broader citizenship concepts and ideas. The findings reveal that climate change is taught in very different ways within both education systems. The Singapore case demonstrates the…

Sex, Grade-Level and Stream Differences in Learning Environment and Attitudes to Science in Singapore Primary Schools

ERIC Educational Resources Information Center

Peer, Jarina; Fraser, Barry J.

2015-01-01

Learning environment research provides a well-established approach for describing and understanding what goes on in classrooms and has attracted considerable interest in Singapore. This article reports the first study of science classroom environments in Singapore primary schools. Ten scales from the What Is Happening In this Class?,…

Mother Tongues, English, and Religion in Singapore

ERIC Educational Resources Information Center

Vaish, Viniti

2008-01-01

This paper reports on an investigation of the effect of religion on language use in Singapore. Data come from the Sociolinguistic Survey of Singapore, 2006, a large-scale language survey linked to follow-up studies. The conceptual framework was based upon Castells' idea of a new social order in the network society; the main research questions were…

Training School Counselors in Singapore: First Impressions of a Multicultural Challenge

ERIC Educational Resources Information Center

Rivera, Edil Torres; Nash, Sara; Wah, Bernard Sew Chun; Ibrahim, Surayah Bte

2008-01-01

Since the publication of 2 important articles, by E. Tan (2002) on career counseling and by W. H. Chong (2005) on group counseling in schools, changes have taken place in the school counseling field in Singapore. In this article, the authors review these articles and describe the development of the school counseling profession in Singapore based…

Doing Class Analysis in Singapore's Elite Education: Unravelling the Smokescreen of "Meritocratic Talk"

ERIC Educational Resources Information Center

Koh, Aaron

2014-01-01

This paper examines the specificity of the education-class nexus in an elite independent school in Singapore. It seeks to unravel the puzzle that meritocracy is dogmatically believed in Singapore in spite of evidences that point to the contrary. The paper draws on discursive (analysis of media materials) and institutional (analysis of interview…

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…

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…

Developing Transnational Higher Education: Comparing the Approaches of Hong Kong and Singapore

ERIC Educational Resources Information Center

Chan, David; Ng, Pak Tee

2008-01-01

This article examines the approaches that Hong Kong and Singapore have adopted in trying to develop themselves as regional hubs of higher education through their developments of transnational higher education. Hong Kong and Singapore compete for this market share of global higher education because it can be a lucrative business. Adapting a model…

Simulation of Smoke-Haze Dispersion from Wildfires in South East Asia with a Lagrangian Particle Model

NASA Astrophysics Data System (ADS)

Hertwig, D.; Burgin, L.; Gan, C.; Hort, M.; Jones, A. R.; Shaw, F.; Witham, C. S.; Zhang, K.

2014-12-01

Biomass burning, often related to agricultural deforestation, not only affects local pollution levels but periodically deteriorates air quality in many South East Asian megacities due to the transboundary transport of smoke-haze. In June 2013, Singapore experienced the worst wildfire related air-pollution event on record following from the escalation of peatland fires in Sumatra. An extended dry period together with anomalous westerly winds resulted in severe and unhealthy pollution levels in Singapore that lasted for more than two weeks. Reacting to this event, the Met Office and the Meteorological Service Singapore have explored how to adequately simulate haze-pollution dispersion, with the aim to provide a reliable operational forecast for Singapore. Simulations with the Lagrangian particle model NAME (Numerical Atmospheric-dispersion Modelling Environment), running on numerical weather prediction data from the Met Office and Meteorological Service Singapore and emission data derived from satellite observations of the fire radiative power, are validated against PM10 observations in South East Asia. Comparisons of simulated concentrations with hourly averages of PM10 measurements in Singapore show that the model captures well the severe smoke-haze event in June 2013 and a minor episode in March 2014. Different quantitative satellite-derived emissions have been tested, with one source demonstrating a consistent factor of two under-prediction for Singapore. Confidence in the skill of the model system has been substantiated by further comparisons with data from monitoring sites in Malaysia, Brunei and Thailand. Following the validation study, operational smoke-haze pollution forecasts with NAME were launched in Singapore, in time for the 2014 fire season. Real-time bias correction and verification of this forecast will be discussed.

Recruitment constraints in Singapore's fluted giant clam (Tridacna squamosa) population—A dispersal model approach

PubMed Central

Neo, Mei Lin; Erftemeijer, Paul L. A.; van Beek, Jan K. L.; van Maren, Dirk S.; Teo, Serena L-M.; Todd, Peter A.

2013-01-01

Recruitment constraints on Singapore's dwindling fluted giant clam, Tridacna squamosa, population were studied by modelling fertilisation, larval transport, and settlement using real-time hydrodynamic forcing combined with knowledge of spawning characteristics, larval development, behaviour, and settlement cues. Larval transport was simulated using a finite-volume advection-diffusion model coupled to a three-dimensional hydrodynamic model. Three recruitment constraint hypotheses were tested: 1) there is limited connectivity between Singapore's reefs and other reefs in the region, 2) there is limited exchange within Singapore's Southern Islands, and 3) there exist low-density constraints to fertilisation efficacy (component Allee effects). Results showed that connectivity among giant clam populations was primarily determined by residual hydrodynamic flows and spawning time, with greatest chances of successful settlement occurring when spawning and subsequent larval dispersal coincided with the period of lowest residual flow. Simulations suggested poor larval transport from reefs located along the Peninsular Malaysia to Singapore, probably due to strong surface currents between the Andaman Sea and South China Sea combined with a major land barrier disrupting larval movement among reefs. The model, however, predicted offshore coral reefs to the southeast of Singapore (Bintan and Batam) may represent a significant source of larvae. Larval exchange within Singapore's Southern Islands varied substantially depending on the locations of source and sink reefs as well as spawning time; but all simulations resulted in low settler densities (2.1–68.6 settled individuals per 10,000 m2). Poor fertilisation rates predicted by the model indicate that the low density and scattered distribution of the remaining T. squamosa in Singapore are likely to significantly inhibit any natural recovery of local stocks. PMID:23555597

Biochemical characteristics of glucose-6-phosphate dehydrogenase variants among the Malays of Singapore with report of a new non-deficient (GdSingapore) and three deficient variants.

PubMed

Saha, N; Hong, S H; Wong, H A; Jeyaseelan, K; Tay, J S

1991-12-01

Biochemical characteristics of one non-deficient fast G6PD variant (GdSingapore) and six different deficient variants (three new, two Mahidol, one each of Indonesian and Mediterranean) were studied among the Malays of Singapore. The GdSingapore variant had normal enzyme activity (82%) and fast electrophoretic mobilities (140% in TEB buffer, 160% in phosphate and 140% in Tris-HCl buffer systems respectively). This variant is further characterized by normal Km for G6P; utilization of analogues (Gal6P, 2dG6P; dAmNADP), heat stability and pH optimum. The other six deficient G6PD variants had normal electrophoretic mobility in TEB buffer with enzyme activities ranging from 1 to 12% of GdB+. The biochemical characteristics identity them to be 2 Mahidol, 1 Indonesian and 1 Mediterranean variants and three new deficient variants.

Anxieties in Mainland Chinese and Singapore Chinese adolescents in comparison with the American norm.

PubMed

Li, Huijun; Ang, Rebecca P; Lee, Jiyoon

2008-10-01

There is a growing literature base on child and adolescent anxiety. Cross-cultural research on child and adolescent anxiety, however, has been relatively limited. This study examined whether there were similarities and differences in the self reported anxieties in Mainland Chinese and Singapore Chinese adolescents (12-17 years of age), and whether these similarities or differences were related to gender and/or grade. This study also compared anxiety levels of Mainland Chinese and Singapore Chinese adolescents with the American normative sample (12-17 years of age). The results indicate that the levels of anxieties did not differ based on country (China and Singapore). Gender differences were evident. Gender and grade interaction effects were found on the anxiety scales. Mixed results were found when comparing Mainland Chinese and Singapore Chinese with the American normative sample on the different anxiety scales.

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.

Research the Mechanism of Land Subsidence in Typical Area, Beijing

NASA Astrophysics Data System (ADS)

Liu, H.; Zhang, Y.; Wang, R.; Gu, Z.

2014-12-01

In recently years, the subsidence develop rapidly in Beijing. It can not be ignored the influence of the security of major project. Beijing Singapore city is located at the junction of Daxing and Hebei. The per captia water resources is 190m3.,far below the internationally safety limit 1000m3. The region is the dryland water resource and continued extraction groundwater caused land subsidence issue become increasingly prominent. With the Beijing Singapore city put into use, the amount of water shortages must further seriously and land subsidence subsidence area must be further increased. Therefore, monitor the land subsidence of Beijing Singapore city area and research its settlement mechanism, it is so important to ensure the safe operation of Beijing Singapore city . Explore the soil and water coupling mechanism of Beijing Singapore citya during land subsidence process, and optimize groundwater extraction program to ensure the safe operation of Beijing's second largest airport.

Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis.

PubMed

Medin, Emma; Anthun, Kjartan S; Häkkinen, Unto; Kittelsen, Sverre A C; Linna, Miika; Magnussen, Jon; Olsen, Kim; Rehnberg, Clas

2011-12-01

This paper estimates cost efficiency scores using the bootstrap bias-corrected procedure, including variables for teaching and research, for the performance of university hospitals in the Nordic countries. Previous research has shown that hospital provision of research and education interferes with patient care routines and inflates the costs of health care services, turning university hospitals into outliers in comparative productivity and efficiency analyses. The organisation of patient care, medical education and clinical research as well as available data at the university hospital level are highly similar in the Nordic countries, creating a data set of comparable decision-making units suitable for a cross-country cost efficiency analysis. The results demonstrate significant differences in university hospital cost efficiency when variables for teaching and research are entered into the analysis, both between and within the Nordic countries. The results of a second-stage analysis show that the most important explanatory variables are geographical location of the hospital and the share of discharges with a high case weight. However, a substantial amount of the variation in cost efficiency at the university hospital level remains unexplained.

On the Conceptual Understanding of the Photoelectric Effect

NASA Astrophysics Data System (ADS)

Foong, S. K.; Lee, P.; Wong, D.; Chee, Y. P.

2010-07-01

We attempt an in-depth literature review that focuses on some finer aspects of the photoelectric effect that will help build a more coherent understanding of the phenomenon. These include the angular distribution of photoelectrons, multi-photon photoelectron emission and the work function in the photoelectric equation as being that associated with the collector rather than the emitter. We attempt to explain the intricacies of the related concepts in a way that is accessible to teachers and students at the Singapore GCE A-level or pre-university level.