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This paper delves into the multifaceted landscape of dyslexia within the context of digital environments, aiming to explore the nuanced challenges faced by dyslexic individuals and propose design interventions to cater to their diverse needs. Dyslexia, recognised as a neurobiological learning disability characterised by difficulties in language processing and reading comprehension, continues to pose unique challenges despite advancements in its understanding and diagnosis. The study draws from interviews conducted with dyslexic individuals, highlighting the spectrum of challenges encountered. It reveals the varied nature of dyslexia experiences, spanning struggles in languagespecific domains, reading difficulties, and individualised approaches to coping with the disability. Furthermore, it critically examines existing digital assistive technologies, emphasising their limitations in meeting the tailored requirements of dyslexic learners, often failing to align with individual learning approaches and impeding effective learning experiences. Acknowledging the dichotomy between the aid provided by assistive tools and the need to cultivate personal skills, this paper advocates for a balanced approach. It explores a range of tools and educational tactics employed by dyslexic individuals, emphasising the importance of personalised, adaptable solutions to accommodate diverse experiences and preferences. The study progresses to present low-fidelity design probes as potential interventions in the digital sphere, focusing on tools that allow gradual skill development and customisation. These prototypes aim to provide tailored support while fostering the growth of personal tactics and skills, aiming to strike a harmonious balance between assistance and skill enhancement. Despite these contributions, this study faces limitations, including a restricted sample size and a lack of longitudinal data. The research methodology could benefit from a more comprehensive approach, integrating quantitative measures and expanding participant diversity to enhance generalisability. Furthermore, a deeper synthesis of existing literature and a more explicit theoretical framework could strengthen the theoretical underpinnings of this study. [ABSTRACT FROM AUTHOR]

Background: Online peer support is a useful source of support for parents during the perinatal period, associated with improved psychological outcomes. Past research has found that peer support providers themselves gain from providing peer support as well, making it mutually beneficial. As current maternity care services are insufficient to meet the support needs of parents, the Supportive Parenting App (SPA) intervention was developed to offer them informational, appraisal and emotional support during the perinatal period. It consists of mobile health application-based educational support and online peer support provided by trained peer volunteers, to prevent the development of postnatal depression. Objective: To explore the experiences of peer volunteers with providing online peer support to parents during the perinatal period, as well as to identify areas of improvement for the SPA intervention. Methods: A qualitative descriptive design was adopted. This study took place from October 2020 to August 2021 in two tertiary public healthcare institutions in Singapore. A total of 18 peer volunteers were invited for individual semi- structured interviews. The interviews were audio recorded and transcribed verbatim, and thematic analysis was used to analyse the data. Results: Four themes were emerged as follows: (1) 'Being there': Reminiscing about and healing of own postnatal depression experience; (2) Building rapport with parents; (3) Parents in mind: Mutual sharing of knowledge and how to support new parents better; (4) Ensuring good quality peer support. Conclusions: The peer volunteers felt that their experience was fulfilling and healing. Frequent contact, sharing of SPA resources and self-disclosure were found to help engage the new parents and build rapport between peer volunteers and parents. Challenges described by the peer volunteers have identified possible areas in which the SPA intervention can be improved. Implications for care: Communication between peer program facilitators, managers and peer volunteers can be enhanced to ensure that peer volunteers are more sensitive and precise when providing support or information. This can improve rapport building between parents and peer volunteers, which will in turn maximize the benefits that parents can reap through online peer-to-peer support. Impact: • This study explored the perceptions of peer volunteers who provided online peer support to parents across the perinatal period. • Peer volunteers felt that the SPA intervention was meaningful and that providing peer support was a healing experience. They were able to learn about the experiences of other mothers with postpartum depression while sharing their own past experiences. Thus, both parents and peer volunteers can benefit from engaging in online peer support programs. • Technology-based interventions like the Supportive Parenting App (SPA) can be a suitable complement to maternity care services by providing parents access to medically accurate information and social support. Additionally, more experienced mothers can engage in fulfilling experiences through volunteering for new mothers who may benefit from informational, appraisal and emotional support. Reporting method: This study follows the reporting guidelines as stated by the Consolidated criteria for reporting qualitative research (COREQ) checklist. Patient or Public Contribution: Parents and peer volunteers contributed ideas that aided with the design of the mobile app. Many topics added to the educational materials were suggested by these parents as well. What does this paper contribute to the wider global clinical community? This study showed that sufficient training can be provided to lay peer volunteers to help them support other parents, buffering the pressure exerted on the healthcare industry due to the rising demand for healthcare services. The provision of such support is also beneficial for the peer volunteers themselves, as they find it meaningful and educational. Program developers of parenting and peer volunteering interventions can draw on the findings of this study to improve the effectiveness of these programs. [ABSTRACT FROM AUTHOR]

This paper examines how older adults interact with fitness trackers and how that interaction influences their physical activity. We carried out qualitative interviews with 22 individuals between the ages of 55 and 72 who had used fitness trackers as part of a six-week field experiment investigating the effects of feedback from fitness trackers and the social influence of their spouses. From their comments, we derived an explorative process model explaining the mechanisms and the four stages of effects arising from personalised feedback, namely, cognitive, affective, conative, and intuitive. These effects were grouped into internal and external dimensions. Three types of goal-related decisions determined whether interviewees moved from the internal responses of cognition and emotion to the external response of behaviour change. The findings from this study elucidate how real-time personalised feedback can motivate physical activity among older adults and highlight the goal-related factors that influence this effect. [ABSTRACT FROM AUTHOR]

• In a bid to resist a medical-moralist paradigm dominating public health ideologies, we make a case for understanding chemsex among men in Singapore vis-à-vis Deleuzean lines of flight. • Through a queer deleuzean framing, we illustrate how chemically inflected sexual encounters can offer deterritorialising flights of fantasy and freedom from a heteronormative social structure that stigmatises gay sex, among other normative regimes. • We explored how lines of flight generated by chemsex are dynamic (i.e. they can turn into lines of non-flight) and have to be unpacked contextually (i.e. in relation to unfolding senses of self and the social environment). We have also demonstrated that such deterritorialising flights of freedom can catalyse unplanned outcomes, including the propensity to reterritorialise. • Our analysis has not shied away from incorporating heartfelt anecdotes that perpetuate medico-moral, public health perspectives even as we are committed to a critical-political discussion on chemical-sexual intimacies. • Future research in this arena could potentially investigate the complicated, conflicted and protracted intimate relationships that users may have with their drug(s) of choice, as well as the varied lines of (non-)flight that these chemicals can endow over a longitudinal study. Public health scholars informed by a dominant biomedical paradigm have in their 'rush to risk' emphasised the problematic aspects of chemsex. Meanwhile, critical chemsex scholars have attemped to destigmatise such sexual-chemical practices and foreground how they can be transformative. Taking these two perspectives as points of departure, we make a case for understanding chemsex vis-à-vis Deleuzean lines of flight. Semi-structured in-depth interviews were conducted with 33 purposively sampled sexual minority men seeking therapy for chemsex dependency in Singapore. Interview topics included participants' experiences and histories of chemsex, substance use, and their ongoing recovery. Interviews were audio-recorded, transcribed and then analysed according to key themes. We illustrate how chemically inflected sexual encounters can offer deterritorialising flights of fantasy and freedom from a heteronormative social structure that pathologises gay sex. At the same time, we argue that these flight lines are not static, neither do they extend indefinitely in space-time. Rather, we show how flights of freedom can evolve into lines of fright (or non-flight) when chemsex practitioners are met with critical thresholds that reveal the less-than-desirable aspects of being intoxicated. Consequently, they may eventually consider the reterritorialisation of their lives (i.e. abstinence and recovery) as a more constructive option. Regardless of their decisions to ride on chemically-induced flight lines or to take a step back from such deterritorialising pathways, they have troubled stereotypical perspectives of drug users as passive automatons. This paper enriches the chemsex scholarship by presenting a Deleuzean conceptualisation of chemical-sexual intimacies without romantacising and/or overstating the 'escape'/'freedom' that chemsex can facilitate. Future research in this arena could explore the complicated intimate relationships that users may have with their drug(s) of choice, and their varied lines of (non-)flight over a longitudinal study. [ABSTRACT FROM AUTHOR]

Background: Journeying with patients throughout their cancer trajectory and caring for them at the end of life can lead to emotional and moral distress in oncologists, negatively impacting their personal and professional identities. A better understanding of how transitions in care goals affect oncologists can shed light on the challenges faced and the support required. This study explored the impact of care transitions on oncologists' professional identity formation (PIF). Methods: From September to December 2023, semi-structured interviews were conducted with oncologists in a palliative care center in Singapore. The Ring Theory of Personhood (RToP) was used as a framework to capture the effects of experiences with patients transitioning from curative to palliative care on the oncologists' sense of self and identity. Data were analyzed using both inductive and deductive qualitative analysis. Results: Participants included six female and six male physicians, aged 30 to 53 years (mean 38 years), with an average of 9.75 years of experience as oncologists. The main domains identified were 1) challenges faced in transitioning patients to palliative care, 2) the impact of dealing with dying patients on oncologists, and 3) coping mechanisms. Conclusion: Oncologists experience self-doubt and moral distress as they manage transitions in care. The PIF of oncologists can be supported through reflection and introspection, peer support, and interventions to promote self-care — ultimately enabling them to make meaning of their experiences, renew family ties, and reaffirm their commitment to the profession. [ABSTRACT FROM AUTHOR]

This research critically examines the imperative of systematically training Educational Therapists for optimal educational technology integration within the Dyslexia Association of Singapore's (DAS) Main Literacy Programme, accelerated by the COVID-19 pandemic's shift to remote learning. Employing a multifaceted approach, including surveys, observations, focus groups, and interviews, the study identifies seven principal performance issues among therapists, categorizing them into skills, knowledge, and attitude. Recommendations for targeted training efforts offer actionable insights for DAS management, acknowledging the intentional exclusion of student voices in this phase. Future research will address this limitation by exploring student perspectives post-implementation of interventions for teachers, aiming for a comprehensive understanding of technology's impact on the learning environment. The study's limitations encompass a specific sample (DAS Educational Therapists) and setting, potentially restricting generalisability. However, the proposed Integrated Model and solutions may prove adaptable to diverse educational contexts. The research design, employing varied data collection methods, mitigates response bias concerns, enhancing the authenticity of findings. Time constraints impact the study's depth, warranting future longitudinal investigations. The absence of student perspectives regarding technology's impact and learning goals is acknowledged, prompting future research directions. While providing valuable insights into DAS Educational Therapists' needs, this study advocates for future endeavors that include student perspectives, exploring the effectiveness of interventions post-teacher training. The Integrated Model can serve as a foundation for broader applications in diverse educational settings, contributing to industry-wide best practices. Longitudinal studies are proposed to capture evolving attitudes and practices, offering a nuanced understanding of technology integration's dynamic nature in educational settings. Future research should prioritise student engagement, ensuring a holistic exploration of technology's impact on learning outcomes across diverse educational landscapes. [ABSTRACT FROM AUTHOR]

School closures were implemented in the first quarter of 2020 to halt the spread of the COVID-19 epidemic. Without adequate preparation time, students and teachers faced the problem of transitioning from face-to-face to online classes. Educational therapy sessions in the Dyslexia Association of Singapore were affected too. This study sought to explore educational therapists' experiences and perceptions of online teaching and learning with school-going age students with dyslexia in an online environment during the COVID-19 pandemic. To accomplish this, a phenomenological approach was employed using in-depth interview techniques with ten educational therapists from the DAS. A six-stage thematic analysis by Braun and Clark (2006) was employed to determine the themes for this study. The findings revealed four key themes: a) benefits of virtual educational therapy, b) challenges of virtual educational therapy, c) perceived success factors and conditions for an effective virtual educational therapy, and d) after-effects of educational therapy for educational therapists. Details in the findings could help educational therapists design better virtual lessons in the future. While online platforms may not be ideal for dyslexic learners, educational therapists believe that age and technological capability contribute significantly to the feasibility of virtual educational therapy. Recommendations for further research include a) a study to explore dyslexic learners' perspectives and experience of online learning, b) a survey of online learning with other programmes, not just the literacy programme and lastly, c) an investigation into the mental health and well-being of dyslexic learners and educational therapists while participating in online learning. [ABSTRACT FROM AUTHOR]

Purpose: There are over 300,000 male migrant workers in Singapore. Around 600 major workplace injuries are reported in Singapore each year, mainly in the manufacturing and construction injuries. Migrant workers who are affected by workplace injuries often face many challenges, including not being able to work and thus may be repatriated to their home countries, which affects their financial status and that of their families, whom they support. This research aims to explore the knowledge, attitudes and beliefs of injured migrant workers in Singapore, towards disability and vocational rehabilitation. Design/methodology/approach: Fifteen male migrant workers, from Bangladesh, China and India, who had acquired disabling injuries in their workplaces in Singapore, were identified through purposive sampling. They were interviewed by a male interviewer, either in Mandarin Chinese or with the assistance of interpreters for Bengali-English and Tamil-English. Interviews were recorded, transcribed, translated to English, then analysed thematically. Findings: The interviewees generally had a pessimistic outlook on their disability, which often impacted negatively on their self-worth and familial relationships. Many of them also had little knowledge of vocational rehabilitation and had not yet seriously considered future job prospects. Originality/value: To the best of the authors' knowledge, there are no similar studies exploring the knowledge, attitudes and beliefs of injured migrant workers in Singapore towards disability and vocational rehabilitation. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine how divine struggles moderate the association between interpersonal workplace conflict and worker well-being in Singapore. Using data from the Work, Religion, and Health survey (2021), the analyses show that interpersonal workplace conflict is positively associated with psychological distress and negatively associated with job satisfaction. Although divine struggles fail to function as a moderator in the former, these moderate its association in the latter. Specifically, the negative association between interpersonal conflict at work and job satisfaction is stronger for those with higher levels of divine struggles. These findings support the idea of stress amplification, indicating that troubled relationships with God may exacerbate the deleterious psychological effects of antagonistic interpersonal relationships at work. Ramifications of this aspect of religion, job stressor, and worker well-being will be discussed. [ABSTRACT FROM AUTHOR]

Background: Despite the potential advantages of Internet-based diabetes self-management education, its adoption was not widespread among Singapore's public primary care clinics (polyclinics). An interactive online tool was thus developed to help educate patients with Type 2 diabetes mellitus (T2DM), and was now ready for user testing before implementation. Aim: To explore the perceived utility and usability of the educational tool in patients with suboptimally-controlled T2DM in a Singapore primary care setting. Methods: In-depth interviews were used to gather qualitative data from multi-ethnic Asian adults who had suboptimally-controlled T2DM. A total of 17 IDIs were conducted between April 2022 to March 2023, audio-recorded, transcribed, and analyzed to identify emergent themes via thematic analysis. Results: Regarding utility, users found the educational tool useful because it provided them with information that was comprehensive, accessible, reliable, and manageable. Regarding usability, the majority of users reported that the educational tool was easy to use, and suggested ways to improve navigational cues, visual clarity, readability and user engagement. Conclusion: Participants generally found the educational tool useful and easy to use. A revised educational tool will be developed based on their feedback and implemented in clinical practice. [ABSTRACT FROM AUTHOR]

Background: The interdisciplinary realm of medical humanities explores narratives and experiences that can enhance medical education for physicians through perspective-taking and reflective practice. However, there is a gap in comprehension regarding its appropriateness at the postgraduate level, especially when utilising art therapists as faculty. This study aims to assess the acceptability of an innovative art therapy-focused educational initiative among junior doctors during a palliative care rotation, with the goal of cultivating empathy and promoting well-being. Methods: A qualitative research project was conducted at the Division of Supportive and Palliative Care (DSPC) in the National Cancer Centre Singapore (NCCS). The study involved the recruitment of junior doctors who had successfully completed a three-month palliative care rotation program, spanning from January 2020 to April 2021. In a single small-group session lasting 1.5 h, with 3 to 4 participants each time, the individuals participated in activities such as collage making, group reflection, and sharing of artistic creations. These sessions were facilitated by an accredited art therapist and a clinical psychologist, focusing on themes related to empathy and wellbeing. To assess the acceptability of the program, two individual interviews were conducted three months apart with each participant. An independent research assistant utilised a semi-structured question guide that considered affective attitude, burden, perceived effectiveness, coherence, and self-efficacy. Thematic analysis of the transcribed data was then employed to scrutinise the participants' experiences. Results: A total of 20 individual interviews were completed with 11 participants. The three themes identified were lack of pre-existing knowledge of the humanities, promotors, and barriers to program acceptability. Conclusions: The participants have mixed perceptions of the program's acceptability. While all completed the program in its entirety, the acceptability of the program is impeded by wider systemic factors such as service and manpower needs. It is vital to address these structural limitations as failing to do so risks skewing current ambivalence towards outright rejection of future endeavours to integrate humanities programs into medical education. [ABSTRACT FROM AUTHOR]

Background—There is no validated dementia screening tool for multi-ethnic Asian populations comprising Chinese, Malays, and Indians. This study aimed to establish the psychometric properties of the Community Screening Instrument for Dementia (CSI-D), Chinese Mini Mental State Examination (CMMSE), and Elderly Cognitive Assessment Questionnaire (ECAQ) in multi-ethnic Singapore. Methods—Participants were randomly drawn from a community-based neurological diseases study of older adults conducted in Singapore, with oversampling to allow similar subject numbers from the three major ethnicities: Chinese, Malay, and Indian. The CSI-D, CMMSE, and ECAQ were administered by trained research nurses using a standardised translated questionnaire in a language the participant was most conversant in. Participants were independently diagnosed as a case/non-case of dementia using the DSM-IV. Results—There were 259 participants (85 Chinese, 85 Malays, and 89 Indians, mean age 70.15 years, 65.4% female, 58.8% had no/minimal formal education); 22.8% (n = 59) had dementia. Correlations between the measures were substantial. All the measures had acceptable overall discriminative abilities. Diagnostic accuracies of the instruments did not differ across the ethnic groups. Effects of education were present in the cognitive screening measures. Conclusions—The CSI-D, CMMSE, and ECAQ are valid dementia instruments in this multi-ethnic Asian setting. [ABSTRACT FROM AUTHOR]

Since the approvals of several vaccines against COVID-19 by the World Health Organization, a large body of research has studied the determinants of individuals' intention to be vaccinated against COVID-19 in a variety of societies. Vaccine intention is a complex construct rooted in the social context that informs the decision-making process. The underlying reasons for older adults' intention to receive the vaccination is even more important to health authorities in societies with large proportions of older adults. In this paper, we interview 27 women over age 55 in Singapore about their COVID-19 vaccine decision-making. Using a social-ecological framework of trust, we identify factors at both individual and institutional levels that build or undermine trust and underlie older women's decisions to receive COVID-19 vaccinations in an authoritarian regime. Findings show that both interpersonal trust and institutional trust contribute to vaccine uptake, however, trust can also contribute to delays in vaccination. Moreover, a sizable minority of respondents report that they were vaccinated not because of institutional trust, but because they felt compelled to do so. The results shed light on directions for future vaccination campaigns. • We focus on older women in an authoritarian state. • We adopt a social-ecological framework of trust. • Both interpersonal trust and institutional trust contribute to vaccine uptake as well as delays in vaccination. • This study provides policy implications for future vaccination campaigns. [ABSTRACT FROM AUTHOR]