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Teachers' motivational strategies can be categorised into two types of motivating styles--autonomy-supportive style versus controlling style (Reeve in Educ Psychol 44:159-175, 2009). Several factors can affect the teachers' use of motivational strategies, and student-related factors are some influential reasons. In this study, we focussed on identifying the student-related reasons that could affect the teachers' motivating styles through 56 teacher interviews from 17 secondary schools across Singapore. From the teachers' accounts, we identified "student profiles", "students' behaviours", "students' engagements", and "students' feedback" as the student-related factors that could affect the teachers' motivating styles. By identifying these factors, we hope to raise awareness amongst the teachers (at the personal level) and their social environments (at the contextual level) on what can facilitate or thwart the expression of autonomy-supportive teaching. We also hope to provide useful information on what the social environments can do to support teachers in autonomy-supportive teaching.

In Singapore, preschool children with developmental disabilities receive developmental interventions by multidisciplinary teams of providers across various settings. Cessation of in-person sessions during the early stages of the COVID-19 pandemic necessitated providers to pivot rapidly and use virtual platforms to continue delivering interventions. This cross-sectional study assessed the effects of this challenging experience on providers' psychological wellbeing, including resilience, depression, stress, and anxiety. Ninety-five providers anonymously completed (i) an online questionnaire which included questions on their perceptions of the provision of virtual services and stress; (ii) the Connor-Davidson Resilience Scale (CD-RISC); and (iii) the Depression, Anxiety and Stress Scale (DASS). Among participants who used virtual platforms to continue providing interventions, 83.3% reported difficulties during sessions. Over half (57.9%; n = 55) reported increased stress compared to pre-COVID-19. The mean CD-RISC score (62.7; range: 36-88) was lower than that of general population samples, indicating reduced resilience. Lack of flexibility to work from home, difficulties providing interventions online, higher self-reported stress, and a non-hospital setting were significantly associated with lower resilience. Prevalence rates of depression, anxiety, and stress were 13.7% (n = 13), 42.1% (n = 40), and 56.8% (n = 54), respectively, with school-based settings significantly associated with a positive screen for depression. The results reveal the often-invisible psychological ill-effects in providers of children with developmental disabilities and underscore the need for targeted support to improve their resilience and overall mental wellbeing so that they can continue to effectively provide the crucial interventions needed by the children under their care.

The purpose of this study was to explore instructional designs for promoting inquiry practices in secondary school textbooks. Three criteria were employed to select the textbooks: (1) approved by the Ministry of Education in Singapore and the Ministry of Education and Culture in Indonesia, (2) used in secondary schools, and (3) included content and practices based on the current curriculum. Based on these criteria, six science textbooks from Singapore and three from Indonesia were selected for further coding in the dimensions of learning goals of inquiry skills, nature of scientific inquiry, and inquiry types. The results showed that more activities in both the Singaporean and Indonesian textbooks focus on observing and interpreting skills. However, few activities in the textbooks from either country provide an opportunity for students to engage nature of scientific inquiry. In addition, more activities in the Singaporean textbooks were designed as guided inquiry than those in the Indonesian textbooks. Finally, it is suggested that inquiry activities in textbooks should be revised to include nature of scientific inquiry, and more textbook analysis studies are needed to reveal characteristics of inquiry activities in textbooks for different subjects.

The number of low-income families in Singapore is increasing. Young children from impoverished backgrounds are at risk of development gaps and challenges. Research has shown that the accumulation of risk factors from adverse childhood experiences can lead to weaker outcomes later in life. The NTUC First Campus (NFC) launched the Child Support Model (CSM) to serve children and families from vulnerable, low-income backgrounds with a range of financial, social and learning support. A 3-year evaluation study using mixed-methods design was conducted to understand the effects of the CSM and the active ingredients in CSM. A cohort of 58 children from families making a monthly income of SGD$3,500 or less participated in the quantitative component where children's language and cognitive outcomes and classroom engagement were measured at three time points in 2019 (Kindergarten 1) and 2020 (Kindergarten 2). Participating children's parents and teachers were interviewed in the qualitative component and reported their perspectives and experiences in CSM.

The role of international students' English language proficiency has been extensively researched to understand its impact on academic achievement in English-medium universities, mainly because of students' non-English-speaking backgrounds. However, the relationship between language proficiency and academic achievement among English-speaking-background students remains under-researched, especially in multilingual societies, such as Singapore. The present study explored the relationship among university students' previous academic experience, English language proficiency, and their current academic performance within a sample of 514 Singaporean students (252 females and 262 males). Findings showed that students' proficiency scores significantly predicted their current grade point average (GPA) with their prior academic performance being controlled. Moreover, proficiency scores significantly strengthened the association between students' prior academic performance and their current GPA. Finally, academic discipline showed a marginally significant moderating effect in the relationship between proficiency scores and current GPA. Implications and limitations of the study are discussed.

With the advent of new technologies, assessment research has adopted technology-based methods to investigate test validity. This study investigated the neurocognitive processes involved in an academic listening comprehension test, using a biometric technique called functional near-infrared spectroscopy (fNIRS). Sixteen right-handed university students completed two tasks: (1) a linguistic task that involved listening to a mini-lecture (i.e., Listening condition) and answering of questions (i.e., Questions condition) and (2) a non-linguistic task that involved listening to a variety of natural sounds and animal vocalizations (i.e., Sounds condition). The hemodynamic activity in three left brain regions was measured: the inferior frontal gyrus (IFG), dorsomedial prefrontal cortex (dmPFC), and posterior middle temporal gyrus (pMTG). The Listening condition induced higher activity in the IFG and pMTG than the Sounds condition. Although not statistically significant, the activity in the dmPFC was higher during the Listening condition than in the Sounds conditions. The IFG was also significantly more active during the Listening condition than in the Questions condition. Although a significant gender difference was observed in listening comprehension test scores, there was no difference in brain activity (across the IFG, dmPFC, and pMTG) between male and female participants. The implications for test validity are discussed.

In this paper, we empirically examine and assess the effectiveness of a chatbot workshop as experiential teaching and learning tool to engage undergraduate students enrolled in an elective course "Doing Business with A.I." in the Lee Kong Chian School of Business (LKCSB) at Singapore Management University. The chatbot workshop provides non-STEM students with an opportunity to acquire basic skills to build a chatbot prototype using the 'Dialogflow' program. The workshop and the experiential learning activity are designed to impart conversation and user-centric design know how and know why to students. A key didactical aspect which informs the design and flow of the chatbot workshop is that novice learners with no or very little knowledge about A.I. recognize and create the important linkage between knowledge inputs and outputs of conversational agents powered by natural language processing (NLP) so that user queries can be effectively addressed. According to the study results, 90.7% of all surveyed students (n = 43) were satisfied with the experiential learning chatbot workshop; 81.4% of the respondents felt engaged while 81.3% of the participants reported moderate to high levels of competencies (81.3%) as result of the hands-on workshop. Almost all students surveyed (97.7%) felt that the experiential chatbot workshop had met the expected learning outcomes. Besides presenting empirical data that underscore the pedagogical usefulness of conducting an experiential Chatbot workshop in basic A.I. classes with special reference to NLP, we are trying to corroborate a conceptual model developed from learning theories and technology mediated learning (TML) models aimed at measuring the effects of a chatbot practicum on students' engagement and motivation as potential drivers of successfully acquiring basic NLP skills and learner satisfaction. The paper provides useful practical information for instructors interested in deploying a practical chatbot workshop as effective TML tool in a tertiary educational context aimed at making learners 'future-ready'.

A rich home literacy environment (HLE) fosters students' academic achievement. However, the link between HLE and children's reading comprehension is unclear. This study examined the effects of HLE factors on children's reading comprehension through a meta-analysis of 59 studies conducted between 1998 and 2018. Results of the meta-analysis indicated three main findings. First, the overall positive correlation between HLE and children's reading comprehension was moderate ([zeta] = 0.32). Second, sampling area, type of home literacy resource and parental involvement styles did not show a significant interaction effect between each HLE factor and children's reading comprehension. Third, parents' involvement and literacy expectations of children had a significantly higher correlation with children's reading comprehension than home literacy resources did. Findings of this study suggest that parental literacy activities involvement and parental literacy expectations contribute more to children's literacy knowledge enhancement. [Note: The month shown on the PDF (January) is incorrect. The correct month is April.]

The current research investigated the influence of the "Fear of Losing Out" (FoLO) mindset on learning strategy via performance goal orientation and its interaction with social comparison amongst Singaporean college students. In Study 1, a positive relationship between FoLO and performance goal orientations (i.e., avoidance and approach) was found. Study 2 replicated this finding and further revealed a downstream effect of FoLO on surface learning via performance goal orientations. In addition, social comparison moderated the link between performance goal orientation and surface learning in the mediation model. Specifically, in downward social comparison conditions, FoLO facilitated high performance-avoidance goal orientation, which in turn led to higher surface learning. Comparatively, in upward social comparison conditions, FoLO incited high performance-approach goal orientation, which in turn led to lower surface learning. Taken together, the findings yield significant theoretical and practical implications of FoLO on college students' goal orientations and learning outcomes.

Few of previous reading studies "comprehensively" examined the contributing factors of students' digital reading literacy. To fill this gap, based upon the ecological perspective, this study aims to investigate which factors from the student, home, and school context are more important in discriminating high-performing digital readers from non-high-performing digital readers. The data of the Progress in International Reading Literacy Study 2016 with 74,692 Grade 4 students from 14 countries and economies was analyzed using the machine learning approach of support vector machine with recursive feature elimination. Results showed that except print reading levels, students' reading self-efficacy, home resources for learning, talking about what have read in class, and the number of books in the home are the most influential contextual factors contributing to the high performance of digital readers. The selected 20 key contextual factors render a high prediction power for discriminating digital readers. Our findings show that, in general, home-related factors have overarching influences on children's digital reading development; at the school level, instruction-related features are more influential than school characteristics.

PURPOSE: The Accessible Cancer Care to Enable Support for Cancer Survivors (ACCESS) program adopts a multidisciplinary supportive care model with routine distress screening to triage newly diagnosed cancer survivors for additional support on the basis of distress levels. This study aimed to evaluate the clinical impact of ACCESS over 1 year. METHODS: We performed cluster random assignment at the oncologist level in a 1:1 ratio to receive ACCESS or usual care. Participants 21 years and older, newly diagnosed with breast or gynecologic cancer, and receiving care at National Cancer Centre Singapore were included. Outcomes assessed every 3 months for 1 year included quality of life (QoL) (primary), functioning, physical and psychological symptom burden, and activity levels. Data were analyzed using mixed-effects models. RESULTS: Participants from 16 clusters (control = 90, intervention = 83) were analyzed. The ACCESS program did not significantly improve QoL (primary outcome). However, compared with usual care recipients, ACCESS recipients reported higher physical functioning (P =.017), role functioning (P =.001), and activity levels (P <.001) at 9 months and lower psychological distress (P =.025) at 12 months. ACCESS recipients screened with high distress had poorer QoL, lower role and social functioning, and higher physical symptom distress at 3 months but had comparable scores with ACCESS recipients without high distress after 12 months. CONCLUSION: Compared with usual care, participation in the ACCESS program did not yield QoL improvement but showed earlier functioning recovery related to activities of daily living and reduced psychological distress. Routine distress screening is a promising mechanism to identify survivors with poorer health for more intensive supportive care. This RCT found that a supportive care model employing routine distress screening didn't boost the overall quality of life of survivors but led to earlier activities of daily living functioning recovery and reduced psychological distress. [ABSTRACT FROM AUTHOR]

This is the first study to investigate the effects of test methods (while-listening performance and post-listening performance) and gender on measured listening ability and brain activation under test conditions. Functional near-infrared spectroscopy (fNIRS) was used to examine three brain regions associated with listening comprehension: the inferior frontal gyrus and posterior middle temporal gyrus, which subserve bottom-up processing in comprehension, and the dorsomedial prefrontal cortex, which mediates top-down processing. A Rasch model reliability analysis showed that listeners were homogeneous in their listening ability. Additionally, there were no significant differences in test scores across test methods and genders. The fNIRS data, however, revealed significantly different activation of the investigated brain regions across test methods, genders, and listening abilities. Together, these findings indicated that the listening test was not sensitive to differences in the neurocognitive processes underlying listening comprehension under test conditions. The implications of these findings for assessing listening and suggestions for future research are discussed.

Purpose: This paper compares citizenship education in Singapore and Australia. While discussions have been made about education and neoliberalism, few have explored the direct connections between citizenship education and neoliberalism. Approach: Though a discussion of country contexts, citizenship education policies and curriculum, "Character and Citizenship Education" in Singapore and "Civics and Citizenship education" in Australia are examined to explore the meanings of "Character education" and "Civics education" and their connections with "Citizenship education". Findings: The distinct use of terms for citizenship education suggests that the two countries hold different citizenship ideals. Set within the context of globalisation, the paper argues that some approaches towards citizenship education can inadvertently work towards supporting the goals of neoliberalism, which can be at odds with the classical tradition of democracy.

This study aims to examine the motivational profiles of Malay students in Singapore-based self-regulated learning framework (Pintrich & De Groot, 1990) and self-determination theory (SDT; Deci & Ryan, 1985). The sample consisted of 740 secondary school students from 24 tuition centres for Malay students only. The students were from three academic streams in Singapore (Express, Normal-academic, and Normal-technical). Using cluster analysis, five different clusters of students were found based on their unique characteristics on self-regulation and learning strategies scores. The clusters were named from best to poor in numeric order. Cluster 1 is characterized by high scores on intrinsic value, self-efficacy, self-regulation, and lower scores on lack of learning strategies and anxiety compared to other clusters. On the other hand, cluster 5 has the lowest intrinsic values, self-efficacy, and self-regulation relative to their scores on other clustering variables. In addition, the more adaptive profiles were also found to score higher in enjoyment and effort, and lower in boredom, compared to other clusters. The findings suggest that intra-individual differences in self-regulated learning behaviour are associated with the expected differences in the type of motivation possessed, and learning outcome measures.

Architecture education may be able teach students more about real-life problem-solving than traditional subjects.

This study made explicit the discourses of 10 teachers working as university-based teacher educators in Singapore to understand their enacted identities. It framed identity as discursive, constructed through language and talk. Interview data were analyzed using descriptive discourse analysis tools, with critical discourse analysis influencing the process. The discourses are as follows: (a) The value of seconded teachers is located firmly within schools, with practice and practitioner elevated above theory and academics; (b) teaching is the core role of seconded teachers, and discourses about learning, development, and research are weak; and (c) an individualistic framing situates the locus of change on teacher-practitioners. Hybrid spaces that bring theory and practice together are discursive spaces. Both the strengths and limitations of existing discursive identities need to be acknowledged, and multifaceted and complex practitioner identities explored. This article contributes to the integration of practitioners into the wider community of teacher educators in the university.

Studying the processes involved in scaling technologically-mediated pedagogical innovations has moved into understanding how wider contexts relate to qualitative outcomes (depth, shift in reform ownership and spread). Understanding patterns in this relationship has been complicated by the diverse outcomes for a single innovation. This study examined the processes involved in scaling innovations, using the Cultural-Historical Activity Theory to view process as object, relating outcomes with the roles played by stakeholders in multiple layers of the school ecosystem (teachers, school leaders and cross-school personnel). The idea of multiple meanings in language facilitated the conceptualization of qualitatively different roles and outcomes. Multiple school cases (from different innovations) underwent cross-case comparison to create a typology of approaches to scaling. Three scaling models--sets of role combinations and related outcomes, were described: (1) Tech-Tools and Artifacts En Masse focused on across-the-board adoption of technology. (2) Deep Roots selected a core team to overhaul teaching approaches, with accompanying structural changes (in schedule, personnel involvement and professional learning communities). (3) Networks established partnerships among schools from the onset. The roles for each ecosystem level, for each model, were further explicated to relate roles and outcomes. This study emphasizes the importance of foregrounding the process objects--the meta-level--of scaling, articulating the processes that affect outcomes. The models offer school leaders and those involved in innovation implementation (e.g., innovation designers, academic consultants, teacher educators working across schools) a framework to dialog, evaluate existing implementation strategies, and articulate next steps in school innovation trajectories.

Simple Summary: Cervical cancer poses a major public health concern in Singapore, but it can be effectively prevented through cervical cancer screening. Unfortunately, many Singaporean women have never been screened. Our research examined factors influencing screening participation in cervical cancer screening. We analyzed data from 665 Singaporean women, examining how knowledge, beliefs, health practices, and interpersonal and healthcare system influences affected their screening participation. Our findings showed that Malay women, those aged 25–29 years, and unmarried individuals were less likely to undergo screening. Conversely, women were more likely to undergo screening if they had better cervical cancer screening knowledge, understood that primary care doctors could perform the screening, had prior experience seeking cancer information, or were open to self-sampling options. These results shed light on potential multifaceted approaches to increase cervical cancer screening uptake, ultimately improving women's health in Singapore. Background/Objectives: Cervical cancer screening uptake in Singapore remains suboptimal. This study employed the Social Ecological Model (SEM) to investigate factors influencing cervical cancer screening participation among Singaporean women. Methods: The study included 665 women, aged 25–69 years, who reported awareness of cancer screening and no personal cancer history. Data were collected through a previously described online survey. Hierarchical logistic regression analysis was conducted to identify significant factors influencing screening participation. Results: Only 30% of participants reported cervical cancer screening participation. Women aged 25–29 years (OR = 0.33; 95% CI = 0.12–0.77), Malay women (OR = 0.42; 95% CI = 0.20–0.83), and unmarried women (OR = 0.30; 95% CI = 0.18–0.48) were less likely to be screened. Positive associations with screening participation were observed with good cervical cancer screening knowledge (OR = 2.90; 95% CI = 1.96–4.32), awareness of primary care providers' role in delivering screening services (OR = 1.94; 95% CI = 1.24–3.10), cancer information seeking behavior (OR = 1.59; 95% CI = 1.07–2.39), and acceptance of self-sampling options (OR = 1.81; 95% CI = 1.22–2.70). Conclusions: Our study highlights the cumulative impact of factors at various SEM levels on screening participation and underscores the necessity for more targeted and multi-pronged strategies to improve cervical cancer screening uptake in Singapore. [ABSTRACT FROM AUTHOR]

Although nonsuicidal self-injury (NSSI) is prevalent among adolescents and is associated with an increased risk of adverse outcomes, many adolescents with NSSI do not seek help. However, there is a lack of research on the factors that may increase the likelihood of help-seeking, especially within Asia. To address this gap, the present study examined whether certain factors were associated with informal and formal help-seeking – specifically gender, severity of NSSI, functions of NSSI and authoritative parenting. 121 adolescents (M age = 16.2 years, 71.1% female) were recruited from specialist outpatient clinics and inpatient psychiatric wards from a public hospital in Singapore. One caregiver per adolescent was also recruited. Data from self-report questionnaires were analysed using logistics regression analyses. The results suggest that the severity of NSSI increases the likelihood of informal help-seeking, while adolescents who have parents with more authoritative parenting style are less likely to seek informal help. Gender and functions of NSSI were not found to be associated with help-seeking. The findings from this study can guide professionals in their efforts to encourage help-seeking within Asian populations, as well as inform prevention and treatment programs for Asian adolescents with NSSI. Plain language summary: Factors that encourage Asian youths who self-harm to get help from non-professionals and professionals: There are many youths who engage in self-harm for reasons other than suicide. Although self-harm could lead to various negative outcomes, many youths do not seek help. However, not much is known about what encourages these youths to seek help from non-professionals (e.g., family, friends) and professionals (e.g., psychologists), especially within Asia. This paper looked at certain factors that may be linked to whether youths seek help – including gender, severity of self-harm, reasons for self-harm, and parenting style. Youths and caregivers were recruited from a public hospital in Singapore. The study found that youths with more severe self-harm are more likely to seek help from non-professionals, whereas youths with parents who are highly responsive and provide consistent discipline are less likely to seek help from non-professionals. None of the factors studied were relevant in whether youths sought help from professionals. The findings from this study can guide professionals to prevent and treat self-harm in Asia, as well as improve efforts to encourage Asian youths to seek help. [ABSTRACT FROM AUTHOR]

Accents are an important differentiator between groups which influence social perception and interaction, especially in a diverse country like Singapore. Social identity theory suggests that individuals would exhibit favoritism towards their own accents. However, the accent prestige theory demonstrates instances whereby foreign accents are perceived as more prestigious than one's own accent and are associated with more positive characteristics. This paper sought to explore which of these two theories is more prevalent in Singapore by comparing the perceptions of American English accents and local Singaporean English accents along the competence‐warmth paradigm of the Stereotype Content Model. Further, the current research also sought to examine the mediating effect of competence/warmth on the relationship between accents and social influence. Study 1 showed that Singaporeans perceived American‐accented speakers as significantly more competent (but not warmer) than local accented speakers. Furthermore, increased perceived competence significantly mediated the relationship between American accents and social influence. Study 2 further investigated perceived threat as a potential moderator in this mediating relationship. The findings replicated the accent‐competence‐social influence relations in Study 1 but found no effect of perceived threat. Taken together, the findings supported accent prestige towards American accents within Singapore. Theoretical and practical implications were discussed. [ABSTRACT FROM AUTHOR]

The number of low-income families in Singapore is increasing. Young children from impoverished backgrounds are at risk of development gaps and challenges. Research has shown that the accumulation of risk factors from adverse childhood experiences can lead to weaker outcomes later in life. The NTUC First Campus (NFC) launched the Child Support Model (CSM) to serve children and families from vulnerable, low-income backgrounds with a range of financial, social and learning support. A 3-year evaluation study using mixed-methods design was conducted to understand the effects of the CSM and the active ingredients in CSM. A cohort of 58 children from families making a monthly income of SGD$3,500 or less participated in the quantitative component where children's language and cognitive outcomes and classroom engagement were measured at three time points in 2019 (Kindergarten 1) and 2020 (Kindergarten 2). Participating children's parents and teachers were interviewed in the qualitative component and reported their perspectives and experiences in CSM. [ABSTRACT FROM AUTHOR]

This study examined the antecedents of teachers' use of motivational strategies in the classroom using self-determination theory. It was found that teachers' autonomous causality orientation, perceived job pressure, and perception of student self-determined motivation influenced their need satisfaction. In turn, their need satisfaction had a positive direct impact on autonomous motivation. In addition, teachers' perception of their students' self-determined motivation directly predicted teachers' use of three motivational strategies in the classroom. Finally, their autonomous motivation positively predicted providing instrumental help and support and meaningful rationale, whereas controlled motivation negatively predicted providing instrumental help and support.

The purpose of the present study was to examine and compare Singaporean physical education teachers' attitudes towards information and communication technologies in physical education across different demographic groups that included gender, age, teaching experience, and school level. A total of 422 Singaporean full-time physical education teachers (mean age = 38.47 years, standard deviation = 8.31) completed the Physical Education Teachers' Subjective Theories Questionnaire to assess their perspectives towards the integration of information and communication technologies into physical education teaching practice. Mann-Whitney "U" and Kruskal-Wallis "H" tests were conducted to examine the differences in participants' attitudes across different demographic groups. Results revealed that attitudes towards information and communication technologies significantly differed between teachers of different gender, age, and teaching experience. However, no significant difference was found in attitudes towards information and communication technologies among teachers of different school levels. The findings of this study can inform policy-makers and stakeholders with an interest in promoting the integration of information and communication technologies in physical education.

The authors examine two Southeast Asian democratic countries and discuss how culture influences democratic participation and citizenship education.

The skills and knowledge of the employers of chemists have been explored in varying degrees of specificity. Some studies have argued that the current university curriculum does not prepare students for modern industry adequately, while others have provided an overview of the job market for graduates with a bachelor's degree in chemistry. In order to stay relevant, the chemistry undergraduate course syllabi need to evolve constantly to meet the needs of the modern-day chemist. This study examines the specific technical skills and knowledge in job advertisements required by graduates with a bachelor's degree in chemistry to successfully transition to a workplace. A relatively new initiative in the chemistry department of the National University of Singapore, namely, the final year internship program, is also evaluated in this paper. Additionally, the chemistry undergraduate course syllabi of the universities and the most researched chemistry topics are examined. The aim of this study is to bridge the gap between chemistry departments and industries or research institutes.

Chemical waste should be reduced to minimize environmental pollution, and it is important that the amount of waste is minimized in chemistry teaching laboratories to reduce the negative impact on environment as well as the disposal costs of university. There are several ways to minimize the waste generated in chemistry teaching laboratories, namely, (1) elimination or reduction of the source of pollution, (2) recycling and reusing the chemicals, (3) treatment of waste to minimize its hazards, (4) the use of microscale chemistry, and (5) better management of chemical inventories in the laboratories. In this study, the common course syllabi and laboratory techniques of chemistry undergraduate experiments in universities are evaluated. The masses and volumes of chemical reagents used in the chemistry teaching laboratories of National University of Singapore (NUS) are quantified. Chemical waste reduction practices of the universities are examined, and a checklist is used to evaluate the current waste reduction practices in the chemistry teaching laboratories of NUS. Although there are existing practices that reduce the amount of chemicals used and waste generated in teaching laboratories, more effort could be done to improve the situation further.

This paper was part of a larger study to examine one primary and one secondary teacher's classroom. The study analysed the classroom discourse to describe the types of interaction and illustrate how the teachers used talk moves to mediate talk for learning science around visual representations (VRs). The study employed ethnographic approaches to collect and analyse classroom data as "snapshots of practice" in two Singapore classrooms. The findings identified that both teachers featured interactive/authoritative discourse, with the primary teacher using talk moves to unpack science terms through eliciting student observations of diagrams followed by talk moves for students to make connections to the meanings represented in the associated graph. The secondary teacher featured an interactive/dialogic approach, using talk moves around student-generated VRs for students to predict, reason and revise their representations. The findings highlighted the value of examining talk from dialogic and authoritative approaches to better understand how teachers provide opportunities for students to learn science through talk around VRs.

Purpose: Trampoline parks are becoming popular in many countries, providing recreational facilities for children and adults. This study investigated the effects of trampoline training on knee muscles strength and balance in young adults. Methods: Twenty-six participants (14 males, 12 females) were randomized into trampoline training (TT) and resistance training (RT) groups to undergo a 6-week supervised intervention program (2 × 30 min per week). TT group performed basic trampoline exercises while the RT group performed resistance training targeting lower extremities muscles. Peak knee extension and flexion torque, postural sway characteristics, and Y balance test (YBT) performance were evaluated before and after the intervention. A mixed model analysis of variance (group × time) was applied. Results: After training there were significant improvements in knee extension torque (mean difference[subscript post-pre] [95% CI], TT: 0.27 [0.00, 0.54] N·m/kg, RT: 0.31 [0.09,0.54] N·m/kg, p = 0.001), knee flexion torque (TT: 0.25 [0.17,0.33] N·m/kg, RT: 0.21 [0.08,0.34] N·m/kg, p < 0.001), and dynamic balance (YBT composite scores, mean difference[subscript post-pre] [95% CI], TT: 4.9 [-0.3, 10.2]%, RT: 5.2 [2.4,8.0]%, p = 0.001). No difference between groups was found. Conclusion: Trampoline training can be as effective as resistance training for improving knee muscles strength and dynamic balance in young men and women.

Summary: Differences in demographic and environmental niches facilitate plant species coexistence in tropical forests. However, the adaptations that enable species to achieve higher demographic rates (e.g. growth or survival) or occupy unique environmental niches (e.g. waterlogged conditions) remain poorly understood. Anatomical traits may better predict plant environmental and demographic strategies because they are direct measurements of structures involved in these adaptations.We collected 18 leaf and twig traits from 29 tree species in a tropical freshwater swamp forest in Singapore. We estimated demographic parameters of the 29 species from growth and survival models, and degree of association toward swamp habitats. We examined pairwise trait–trait, trait–demography and trait–environment links while controlling for phylogeny.Leaf and twig anatomical traits were better predictors of all demographic parameters than other commonly measured leaf and wood traits. Plants with wider vessels had faster growth rates but lower survival rates. Leaf and spongy mesophyll thickness predicted swamp association.These findings demonstrate the utility of anatomical traits as indicators of plant hydraulic strategies and their links to growth–mortality trade‐offs and waterlogging stress tolerance that underlie species coexistence mechanisms in tropical forest trees. [ABSTRACT FROM AUTHOR]

In the 1970s and 1980s, several Asian governments, including those of Hong Kong, Malaysia, South Korea, and Taiwan, enacted varying measures to proscribe long hair on men. Singapore’s government was no exception in this regard, barring even longhaired global male celebrities from entry. Adopting a social semiotic perspective, this article traces the vicissitudes of the male hairscape in Singapore from the colonial period to contemporary times, with a view to uncovering its differential indexical meanings. It argues that the stigmatization of long hair was part of a moral-aesthetic regimen of hair hygiene that fashioned shorthaired men as poster boys of a young, disciplined, and aspirational nation, while longhaired men were discursively constructed as a bad influence and the archnemesis of a desired work culture and social life. Men’s hair, then, was not an innocuous sign with an organic meaning, but a loaded signifier for a cultural ethos tied to shifting social imperatives. [ABSTRACT FROM AUTHOR]

Background While persistence of chronic symptoms following dengue infection has been documented in small prospective cohorts, population-based studies are limited. The post-acute risk of new-incident multi-systemic complications following dengue infection was contrasted against that following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a multi-ethnic adult Asian population. Methods National testing and healthcare claims that databases in Singapore were utilized to build a retrospective population-based adult cohort with laboratory-confirmed infection during overlapping waves of SARS-CoV-2 and dengue transmission (1 July 2021 to 31 October 2022). Risks of new-incident cardiovascular/neuropsychiatric/autoimmune complications 31–300 days of post-dengue infection, contrasted with SARS-CoV-2 infection, were estimated using Cox regression with overlap weights. Risks were reported in terms of adjusted hazard ratio (aHR) and excess burden per 1000 persons. Results 11 707 dengue-infected individuals and 1 248 326 contemporaneous coronavirus disease 2019 (COVID-19) cases were included; the majority had mild initial infection not requiring hospitalization. Amongst dengue-infected individuals, there was 21% [aHR = 1.21 (1.06–1.38)] increased risk of any sequelae, with 55% [aHR = 1.55 (1.27–1.89)] increased risk of cardiovascular sequelae. Specifically, increased risk of dysrhythmias [aHR = 1.79(1.35–2.37)], ischemic heart disease [aHR = 1.45(1.12–1.89)], other cardiac disorders [aHR = 2.21(1.54–3.16)] and thrombotic disorders [aHR = 2.55(1.50–4.35)] was noted. Elevated risk of individual neuropsychiatric sequelae, including cerebrovascular disorders [aHR = 1.49(1.09–2.13)], cognition/memory disorders [aHR = 2.13(1.55–2.93)], extrapyramidal/movement disorders [aHR = 1.98(1.33–2.94)] and anxiety disorders [aHR = 1.61(1.01–2.56)], was observed in dengue-infected individuals compared to COVID-19 cases. Elevated risks of post-acute sequelae in dengue survivors were observed when contrasted against COVID-19 survivors infected during Delta/Omicron predominance, as well as across vaccination strata. Conclusion Increased risk of post-acute cardiovascular/neuropsychiatric complications was observed in dengue survivors, when contrasted against COVID-19 survivors infected during Delta/Omicron predominance. Research in context Evidence before this study Post-acute sequelae following SARS-CoV-2 infection has been extensively reported; however, long-term sequelae may also occur after other acute infections, such as dengue. While chronic symptom persistence has been reported in small cohorts of dengue survivors, population-based cohort studies are lacking, given dengue's disproportionate burden in tropical low-and-middle-income countries (LMICs) where access to diagnostic testing and follow-up is limited. We searched PubMed for studies published until 1 March 2024, using search terms 'dengue', 'chronic', 'long term', "with search terms found in abstract, title or MESH headings. Current research on post-acute sequelae following dengue is limited to small prospectively recruited cohorts, impairing generalizability to the population at-large. We only found four population-based retrospective cohort studies from a single country, Taiwan, which examined long-term risk of a limited set of autoimmune and cognitive sequelae following dengue infection. Evidence for post-acute sequelae was mixed, particularly when milder non-hospitalized cases were included. There are no reports on the risk of post-acute sequelae across multiple organ systems following dengue infection, and no reports contrasting the risk of post-acute sequelae in dengue versus SARS-CoV-2 infection. Added value of this study National testing and healthcare claims that databases in Singapore were utilized to build a retrospective population-based adult cohort of laboratory-confirmed dengue and SARS-CoV-2 infections during overlapping waves of COVID-19/dengue transmission. Increased overall risk of any post-acute sequelae and individual cardiovascular/neurological sequelae in dengue-infected adults was observed up to 300 days postinfection, compared against COVID-19 cases infected during Delta/Omicron predominance. While other studies have compared the risk of post-acute sequelae across different respiratory viral infections, such as influenza and SARS-CoV-2, to the best of our knowledge no prior studies have contrasted the potential risks of post-acute sequelae following dengue with that arising after SARS-CoV-2 infection. Implication of all the available evidence Risk of chronic multi-systemic sequelae arising post-dengue infection was significantly elevated when contrasted against post-acute sequelae following COVID-19. Post-acute sequelae may increase the burden of disease attributable to dengue in tropical countries where seasonal outbreaks occur; this is increasingly relevant, given that climate change has broadened the list of countries at risk of dengue endemicity. [ABSTRACT FROM AUTHOR]

Vaccination against COVID-19 was integral to controlling the pandemic that persisted with the continuous emergence of SARS-CoV-2 variants. Using a mathematical model describing SARS-CoV-2 within-host infection dynamics, we estimate differences in virus and immunity due to factors of infecting variant, age, and vaccination history (vaccination brand, number of doses and time since vaccination). We fit our model in a Bayesian framework to upper respiratory tract viral load measurements obtained from cases of Delta and Omicron infections in Singapore, of whom the majority only had one nasopharyngeal swab measurement. With this dataset, we are able to recreate similar trends in URT virus dynamics observed in past within-host modelling studies fitted to longitudinal patient data. We found that Omicron had higher R0,within values than Delta, indicating greater initial cell-to-cell spread of infection within the host. Moreover, heterogeneities in infection dynamics across patient subgroups could be recreated by fitting immunity-related parameters as vaccination history-specific, with or without age modification. Our model results are consistent with the notion of immunosenescence in SARS-CoV-2 infection in elderly individuals, and the issue of waning immunity with increased time since last vaccination. Lastly, vaccination was not found to subdue virus dynamics in Omicron infections as well as it had for Delta infections. This study provides insight into the influence of vaccine-elicited immunity on SARS-CoV-2 within-host dynamics, and the interplay between age and vaccination history. Furthermore, it demonstrates the need to disentangle host factors and changes in pathogen to discern factors influencing virus dynamics. Finally, this work demonstrates a way forward in the study of within-host virus dynamics, by use of viral load datasets including a large number of patients without repeated measurements. [ABSTRACT FROM AUTHOR]

Late Holocene relative sea-level (RSL) data are important to understand the drivers of RSL change, but there is a lack of precise RSL records from the Sunda Shelf. Here, we produced a Late Holocene RSL reconstruction from coral microatolls in Singapore, demonstrating for the first time the utility of Diploastrea heliopora microatolls as sea-level indicators. We produced 12 sea-level index points and three marine limiting data with a precision of < ± 0.2 m (2σ) and < ± 26 years uncertainties (95% highest density region). The data show a RSL fall of 0.31 ± 0.18 m between 2.8 and 0.6 thousand years before present (kyr BP), at rates between − 0.1 ± 0.3 and − 0.2 ± 0.7 mm/year. Surface profiles of the fossil coral microatolls suggest fluctuations in the rate of RSL fall: (1) stable between 2.8 and 2.5 kyr BP; (2) rising at ~ 1.8 kyr BP; and (3) stable from 0.8 to 0.6 kyr BP. The microatoll record shows general agreement with published, high-quality RSL data within the Sunda Shelf. Comparison to a suite of glacial isostatic adjustment (GIA) models indicate preference for lower viscosities in the mantle. However, more high quality and precise Late Holocene RSL data are needed to further evaluate the drivers of RSL change in the region and better constrain GIA model parameters. [ABSTRACT FROM AUTHOR]

Fulminant type 1 diabetes (FT1D) is a unique subtype of type 1 diabetes, characterized by acute absolute insulin deficiency, severe ketosis, and increased risk of hypoglycemia, glycemic variability and microvascular complications. Seven people with FT1D were identified from two tertiary centers in Singapore. Six were Chinese, the mean age was 35 years and all were lean (mean body mass index 20.3 kg/m2). All presented with diabetes ketosis or ketoacidosis and low C‐peptide. All but one had low glutamic acid decarboxylase antibodies. Nearly half had a missed/delayed diagnosis of FT1D. Three had frequent hypoglycemia, which improved after transition to continuous subcutaneous insulin infusion therapy. Individuals with FT1D experience unique diagnostic and management challenges associated with rapid absolute insulin deficiency. Greater awareness about this clinical entity is required. [ABSTRACT FROM AUTHOR]

By thinking with and through Buddhist cosmology, this paper explores the emergence of an ethical sensibility—what we call planetary cosmopolitanism—that is based on not just a spatially expanded ethic of care to ecological worlds, but also a temporally extended sense of justice to the future Earth. This transtemporal sense of ethical becoming reflects how the possibility of future 'rebirth' and accountability for past actions can motivate new ecological consciousness in the present. We forge these ideas through an empirical focus on popular Buddhist ecological practices in Singapore, where green recovery visions have primarily been driven by a secular and technocratic ethos. In negotiating the prevailing modernist ecological discourses, many Buddhists tap into an alternative imagining of cosmological time that regards Earth not simply as a place to be left behind at the end of one's life, but a permanent home for all future beings. This reading of human–ecology relations emphasises a causal responsibility to secure planetary well‐being, moving the making of cosmopolitan sensibilities from the realm of beneficence into justice. Yet, this renewed cosmopolitan sensibility to Earth is not simply a prescriptive ethical framework articulated on an abstract level, but materially performed and negotiated at the level of everyday life. Recycling becomes a site of rapprochement that allows Buddhists in Singapore to promote and negotiate their ecological consciousness within the strictures of the secular state. In doing so, it opens up new spaces of postcapitalist possibility that enable Buddhists, alongside people of other or no faith, to imagine alternative ways of inhabiting the planet. By developing an alternative account of cosmopolitanism grounded in Buddhist cosmology, we identify Buddhism as a decolonial lens through which we can critically reimagine human–ecology relations, and illuminate diverse modes and practices of ethical becoming in this age of ecological crisis. This paper develops an alternative account of cosmopolitanism ‐ 'planetary cosmopolitanism' ‐ that is grounded in Buddhist cosmology. This account is based on not just a spatially expanded ethic of care for ecological worlds, but also a temporally extended sense of justice to the future Earth, thus moving the making of cosmopolitan sensibilities from the realm of beneficence into that of justice. Overall, the paper advances Buddhism as a decolonial lens from and through which human–ecology relations could be reimagined to illuminate diverse modes and practices of ethical becoming in this age of ecological crisis. [ABSTRACT FROM AUTHOR]

Introduction: Nurturing professional identities instils behavioural standards of physicians, and this in turn facilitates consistent professional attitudes, practice and patient care. Identities are socioculturally constructed efforts; therefore, we must account for the social, cultural and local healthcare factors that shape physicians' roles, responsibilities and expectations. This study aimed to forward a programme to nurture professionalism among physicians in Singapore. Methods: A three-phase, evidenced-based approach was used. First, a systematic scoping review (SSR) was conducted to identify professionalism elements. Second, a questionnaire was created based on the findings of the SSR. Third, a modified Delphi approach, which involved local experts to identify socioculturally appropriate elements to nurture professionalism, was used. Results: A total of 124 articles were identified from the SSR; these articles revealed definitions, knowledge, skills and approaches to nurturing professionalism. Through the modified Delphi approach, we identified professional traits, virtues, communication, ethical, self-care, teaching and assessment methods, and support mechanisms. Conclusion: The results of this study formed the basis for a holistic and longitudinal programme focused on instilling professional traits and competencies over time through personalised and holistic support of physicians. The findings will be of interest to medical communities in the region and beyond. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore instructional designs for promoting inquiry practices in secondary school textbooks. Three criteria were employed to select the textbooks: (1) approved by the Ministry of Education in Singapore and the Ministry of Education and Culture in Indonesia, (2) used in secondary schools, and (3) included content and practices based on the current curriculum. Based on these criteria, six science textbooks from Singapore and three from Indonesia were selected for further coding in the dimensions of learning goals of inquiry skills, nature of scientific inquiry, and inquiry types. The results showed that more activities in both the Singaporean and Indonesian textbooks focus on observing and interpreting skills. However, few activities in the textbooks from either country provide an opportunity for students to engage nature of scientific inquiry. In addition, more activities in the Singaporean textbooks were designed as guided inquiry than those in the Indonesian textbooks. Finally, it is suggested that inquiry activities in textbooks should be revised to include nature of scientific inquiry, and more textbook analysis studies are needed to reveal characteristics of inquiry activities in textbooks for different subjects. [ABSTRACT FROM AUTHOR]

The Professional Practice and Inquiry (PPI) course was introduced to equip pre-service teachers with the knowledge, skills, and values required to develop them into reflective practitioners with a strong teacher identity. This study looks into the efficacy of the course in the preparation of thoughtful and reflective teachers. Self-reported questionnaires were administered to the pre-service teachers. Interviews were conducted to complement the quantitative findings. Findings suggested that pre-service teachers (1) were more aware of their teaching identity, (2) perceived themselves as teacher inquirers, (3) were more able to engage in cognitive self-regulation, and (4) were more cognizant of their Graduand Teacher Competencies.

Minimally invasive abdominal surgery (MAS) can exert a physical cost. Surgical trainees spend years assisting minimally-invasive surgeries, increasing the risk of workplace injury. This prospective questionnaire-based cohort study was conducted amongst general surgery residents in Singapore. Residents assisting major MAS surgery were invited to complete anonymous online survey forms after surgery. The Phase 1 survey assessed physical discomfort scores and risk factors. Intraoperative measures to improve ergonomics were administered and evaluated in Phase 2. During Phase 1 (October 2021 to April 2022), physical discomfort was reported in at least one body part in 82.6% (n = 38) of respondents. Over a third of respondents reported severe discomfort in at least one body part (n = 17, 37.0%). Extremes of height, training seniority, longer surgical duration and operative complexity were significant risk factors for greater physical discomfort. In Phase 2 (October 2022 to February 2023), the overall rate of physical symptoms and severe discomfort improved to 81.3% (n = 52) and 34.4% (n = 22) respectively. The ergonomic measure most found useful was having separate television monitors for the primary surgeon and assistants, followed by intraoperative feedback on television monitor angle or position. Close to 20% of survey respondents felt that surgeon education was likely to improve physical discomfort. [ABSTRACT FROM AUTHOR]

Despite seawalls becoming ubiquitous coastal features, and having some physical similarities to natural rocky shores, it remains unclear how these urban habitats influence predator–prey interactions. Predators can affect intertidal mobile prey densities through two pathways: (1) successful predation directly influences prey mortality rates, and (2) direct and indirect effects of predation can scare and induce motile prey to seek safer areas. In this study, we investigated whether intertidal predators affect the density of the marine gastropod, Nerita undata, at four seawall sites in Singapore. Using a tethering method that we developed, we monitored the mortality and other evidence of predation (shell state) of tethered N. undata. Field experiments revealed high (22.5%–82.5%) predation potential of N. undata across the four sites, with significantly higher predation risk at lower shore heights and for snails with mixed shell coloration. Observations and analysis of the shell state after 3 days showed that predation on seawalls was primarily by crushing predators such as fish. Other predators of N. undata include predatory snails, with various feeding methods that left behind different predator signatures. Our results add substantially to the limited knowledge on predator–prey interactions on seawalls, particularly for Nerita undata, and suggest that seawall systems are more dynamic than previously thought. This further highlights the role of these artificial structures as important habitats and feeding grounds in urban coastal ecosystems. [ABSTRACT FROM AUTHOR]

Aim: The quality of life in people with psychosis has been consistently demonstrated to be lower than those without, with self‐stigma contributing greatly to this impairment. Hence, it is imperative to address this gap in order to facilitate recovery‐oriented and other outcomes. This study investigates the potential of religiosity in moderating the effects of self‐stigma on quality of life among those with psychosis. Methods: Adults with psychosis (n = 99) were recruited from the Early Psychosis Intervention Programme in Singapore from 2018 to 2021, and administered the self‐report Religious Commitment Index, Internalized Stigma of Mental Illness scale, and Abbreviated World Health Organization Quality of Life instrument. Linear regression analyses were conducted and the interaction between self‐stigma and religious commitment scores calculated to investigate the moderation effects of religiosity on the relationship between stigma and quality of life. Results: Preliminary regression analyses revealed a significant association between sex and psychological quality of life. After controlling for sex, religiosity was found to moderate the relationship between self‐stigma and psychological quality of life. Conclusions: The results of the study demonstrate the potential of religiosity in buffering the effects of self‐stigma on quality of life. This reveals an area that can be easily targeted and addressed in treatment programs to improve outcomes beyond the clinical setting among people living with psychosis, to facilitate their recovery journey and beyond. [ABSTRACT FROM AUTHOR]

Introduction: This study explored the behaviours of people living with HIV in Singapore and Hong Kong in terms of achieving and maintaining their physical and psychological wellbeing in relation to HIV, to identify the challenges and support needed in HIV care. Methods: This qualitative study involved 90‐minute interviews among Singapore and Hong Kong people living with HIV aged ≥18 years to explore health‐related quality of life perceptions and gaps in patient empowerment in HIV care during February–May 2022. The COM‐B (C: Capability; O: Opportunity; M: Motivation; B: Behaviour) framework was used during data analysis to identify behaviour facilitators and barriers for people living with HIV to achieve and maintain their wellbeing. Detailed accounts of respondents' experience of living with and managing HIV, that is what worked well, unmet needs and perceived significance of wellbeing indicators, were analysed qualitatively via a combination of inductive content and deductive frameworks. Results: A total of 30 and 28 respondents were recruited from Singapore (SG) and Hong Kong (HK), respectively. Most respondents were aged 20−49 years (SG: 83.3%; HK: 64.3%), males (SG: 96.7%; HK: 92.9%), men who have sex with men (SG: 93.3%; HK: 71.4%), had university or higher education (SG: 73.3%; HK: 50.0%) and were fully employed (SG: 73.3%; HK: 57.1%). In both Singapore and Hong Kong, physical health was considered a key focus of overall wellbeing, albeit attention to long‐term health associated with cardiovascular and renal health was less salient. The impact of symptoms, side effects of treatment, mood and sleep were among the top wellbeing indicators of importance. Respondents felt that insufficient information was provided by physicians, citing consultation time and resource constraints impeding further expression of concerns to their physicians during consultation. Respondents prioritized functional wellness and delegated psychosocial health to supportive care professionals, patient groups, families and/or friends. Conclusions: There is a need in Singapore and Hong Kong to empower people living with HIV to establish better communications with their physicians and be more involved in their treatment journey and equally prioritize their psychosocial wellbeing. [ABSTRACT FROM AUTHOR]

Vector-borne infectious disease such as dengue fever (DF) has spread rapidly due to more suitable living environments. Considering the limited studies investigating the disease spread under climate change in South and Southeast Asia, this study aimed to project the DF transmission potential in 30 locations across four South and Southeast Asian countries. In this study, weekly DF incidence data, daily mean temperature, and rainfall data in 30 locations in Singapore, Sri Lanka, Malaysia, and Thailand from 2012 to 2020 were collected. The effects of temperature and rainfall on the time-varying reproduction number (Rt) of DF transmission were examined using generalized additive models. Projections of location-specific Rt from 2030s to 2090s were determined using projected temperature and rainfall under three Shared Socioeconomic Pathways (SSP126, SSP245, and SSP585), and the peak DF transmissibility and epidemic duration in the future were estimated. According to the results, the projected changes in the peak Rt and epidemic duration varied across locations, and the most significant change was observed under middle-to-high greenhouse gas emission scenarios. Under SSP585, the country-specific peak Rt was projected to decrease from 1.63 (95% confidence interval: 1.39–1.91), 2.60 (1.89–3.57), and 1.41 (1.22–1.64) in 2030s to 1.22 (0.98–1.51), 2.09 (1.26–3.47), and 1.37 (0.83–2.27) in 2090s in Singapore, Thailand, and Malaysia, respectively. Yet, the peak Rt in Sri Lanka changed slightly from 2030s to 2090s under SSP585. The epidemic duration in Singapore and Malaysia was projected to decline under SSP585. In conclusion, the change of peak DF transmission potential and disease outbreak duration would vary across locations, particularly under middle-to-high greenhouse gas emission scenarios. Interventions should be considered to slow down global warming as well as the potential increase in DF transmissibility in some locations of South and Southeast Asia. Author summary: Climate change has a significant impact worldwide, including the proliferation of infectious diseases in tropical areas. While the warmer and more humid living conditions in these regions are generally considered favorable for the transmission of vector-borne diseases, we argue that the effects of climate change on DF infection may vary across different locations. Unlike previous studies focusing primarily on the disease incidence, this study aims to estimate changes in peak DF transmissibility and the duration of disease epidemics in the future. By analyzing data from 30 locations in four tropical countries, we have found that changes in DF transmissibility and epidemic duration exhibit variations both within and between countries, particularly under the scenarios of moderate to high greenhouse gas emissions. In light of these findings, we recommend conducting location-specific evaluations of DF transmissibility under the influence of climate change, as well as implementing targeted interventions to mitigate the potential increase in DF transmission rates in specific tropical locations. [ABSTRACT FROM AUTHOR]

Background: It is known that many surgeons encounter intraoperative adverse events which can result in Second Victim Syndrome (SVS), with significant detriment to their emotional and physical health. There is, however, a paucity of Asian studies in this space. The present study thus aimed to explore the degree to which the experience of an adverse event is common among surgeons in Singapore, as well as its impact, and factors affecting their responses and perceived support systems. Methods: A self-administered survey was sent to surgeons at four large tertiary hospitals. The 42-item questionnaire used a systematic closed and open approach, to assess: Personal experience with intraoperative adverse events, emotional, psychological and physical impact of these events and perceived support systems. Results: The response rate was 57.5% (n = 196). Most respondents were male (54.8%), between 35 and 44 years old, and holding the senior consultant position. In the past 12 months alone, 68.9% recalled an adverse event. The emotional impact was significant, including sadness (63.1%), guilt (53.1%) and anxiety (45.4%). Speaking to colleagues was the most helpful support source (66.7%) and almost all surgeons did not receive counselling (93.3%), with the majority deeming it unnecessary (72.2%). Notably, 68.1% of the surgeons had positive takeaways, gaining new insight and improving vigilance towards errors. Both gender and surgeon experience did not affect the likelihood of errors and emotional impact, but more experienced surgeons were less likely to have positive takeaways (p = 0.035). Individuals may become advocates for patient safety, while simultaneously championing the cause of psychological support for others. Conclusions: Intraoperative adverse events are prevalent and its emotional impact is significant, regardless of the surgeon's experience or gender. While colleagues and peer discussions are a pillar of support, healthcare institutions should do more to address the impact and ensuing consequences. [ABSTRACT FROM AUTHOR]

With an ageing population, the use of mobility scooters by community-dwelling older adults with mobility limitations has been increasingly prevalent in Singapore. Their experiences in using mobility scooters remain unclear. This study aimed to explore the impact of mobility scooters on occupational performance and engagement among elderly Singaporeans. Mobility scooter users were recruited via purposive and snowballing sampling. Semi-structured interviews were conducted in English or Mandarin via phone call or face-to-face and audio-recorded with permission. Interviews were transcribed verbatim in their original language and translated to English (when applicable) for thematic analysis. Twelve eligible participants (mean age: 75 years) completed the interviews. They were predominantly female Chinese with 7 receiving training from occupational therapists (OT). Four main themes emerged from the interviews describing their experiences of using mobility scooters: factors of decision-making in getting a mobility scooter, enhanced occupational participation with the use of the mobility scooter, enablers for community participation and barriers to community participation. Despite having barriers, older adults with mobility limitations generally still had positive experiences to continue using mobility scooters to perform occupations in the community. This study highlights the benefits of mobility scooters in supporting users' occupational performance and engagement in the community. Continual efforts are required from all stakeholders to provide an accessible environment and improve societal attitudes to further support the mobility scooter users. Mobility scooter users can be deterred from performing their preferred occupations if they had a prior negative encounter and they mainly rely on self-developed coping strategies to overcome possible barriers in the community. Occupational therapists should identify and address the potential barriers when prescribing mobility scooters to older adult users. Occupational therapists should work collaboratively with other key stakeholders, such as external vendors and government agencies, to co-create a universal guideline to support and safeguard mobility scooter users. [ABSTRACT FROM AUTHOR]

Introduction: Clinical outcomes of long‐term ventricular septal pacing (VSP) without His‐Purkinje capture remain unknown. This study evaluated the differences in clinical outcomes between conduction system pacing (CSP), VSP, and right ventricular pacing (RVP). Methods: Consecutive patients with bradycardia indicated for pacing from 2016 to 2022 were prospectively followed for the clinical endpoints of heart failure (HF)‐hospitalizations and all‐cause mortality at 2 years. VSP was defined as septal pacing due to unsuccessful CSP implant or successful CSP followed by loss of His‐Purkinje capture within 90 days. Results: Among 1016 patients (age 73.9 ± 11.2 years, 47% female, 48% atrioventricular block), 612 received RVP, 335 received CSP and 69 received VSP. Paced QRS duration was similar between VSP and RVP, but both significantly longer than CSP (p <.05). HF‐hospitalizations occurred in 130 (13%) patients (CSP 7% vs. RVP 16% vs. VSP 13%, p =.001), and all‐cause mortality in 143 (14%) patients (CSP 7% vs. RVP 19% vs. VSP 9%, p <.001). The association of pacing modality with clinical events was limited to those with ventricular pacing (Vp) > 20% (pinteraction <.05). Adjusting for clinical risk factors among patients with Vp > 20%, VSP (adjusted hazard ratio [AHR]: 4.74, 95% confidence interval [CI]: 1.57–14.36) and RVP (AHR: 3.08, 95% CI: 1.44‐6.60) were associated with increased hazard of HF‐hospitalizations, and RVP (2.52, 95% CI: 1.19–5.35) with increased mortality, compared to CSP. Clinical endpoints did not differ between VSP and RVP with Vp > 20%, or amongst groups with Vp < 20%. Conclusion: Conduction system capture is associated with improved clinical outcomes. CSP should be preferred over VSP or RVP during pacing for bradycardia. [ABSTRACT FROM AUTHOR]

Background: Clinical practice guidelines on limitation of life-sustaining treatments (LST) in the intensive care unit (ICU), in the form of withholding or withdrawal of LST, state that there is no ethical difference between the two. Such statements are not uniformly accepted worldwide, and there are few studies on LST limitation in Asia. This study aimed to evaluate the predictors and outcomes of withholding and withdrawal of LST in Singapore, focusing on the similarities and differences between the two approaches. Methods: This was a multicentre observational study of patients admitted to 21 adult ICUs across 9 public hospitals in Singapore over an average of three months per year from 2014 to 2019. The primary outcome measures were withholding and withdrawal of LST (cardiopulmonary resuscitation, invasive mechanical ventilation, and vasopressors/inotropes). The secondary outcome measure was hospital mortality. Multivariable generalised mixed model analysis was used to identify independent predictors for withdrawal and withholding of LST and if LST limitation predicts hospital mortality. Results: There were 8907 patients and 9723 admissions. Of the former, 80.8% had no limitation of LST, 13.0% had LST withheld, and 6.2% had LST withdrawn. Common independent predictors for withholding and withdrawal were increasing age, absence of chronic kidney dialysis, greater dependence in activities of daily living, cardiopulmonary resuscitation before ICU admission, higher Acute Physiology and Chronic Health Evaluation (APACHE) II score, and higher level of care in the first 24 h of ICU admission. Additional predictors for withholding included being of Chinese race, the religions of Hinduism and Islam, malignancy, and chronic liver failure. The additional predictor for withdrawal was lower hospital paying class (with greater government subsidy for hospital bills). Hospital mortality in patients without LST limitation, with LST withholding, and with LST withdrawal was 10.6%, 82.1%, and 91.8%, respectively (p < 0.001). Withholding (odds ratio 13.822, 95% confidence interval 9.987–19.132) and withdrawal (odds ratio 38.319, 95% confidence interval 24.351–60.298) were both found to be independent predictors of hospital mortality on multivariable analysis. Conclusions: Differences in the independent predictors of withholding and withdrawal of LST exist. Even after accounting for baseline characteristics, both withholding and withdrawal of LST independently predict hospital mortality. Later mortality in patients who had LST withdrawn compared to withholding suggests that the decision to withdraw may be at the point when medical futility is recognised. [ABSTRACT FROM AUTHOR]

Background: Potentially inappropriate prescribing is common among older adults with multimorbidity due to various reasons, from concurrent application of multiple single-disease clinical guidelines to fragmentation of care. Interventions such as medication review have been implemented worldwide to reduce inappropriate prescribing for older adults. However, the implementability of such interventions are underexplored in the outpatient clinics in Singapore's public hospitals. Hence, the Pro-M study aims to assess the feasibility of implementing a physician-pharmacist collaborative care intervention in geriatric medicine outpatient clinics to facilitate appropriate prescribing for older adults in Singapore. Methods: This is a single-arm, non-randomised feasibility study using a pre-post evaluation design. This study consists of two parts: (1) implementation phase of the intervention (6 months) and an (2) evaluation phase (3 months). Eligible patients will be recruited from geriatric medicine outpatient clinics at two public hospitals in Singapore through convenience sampling. The main components of the Pro-M intervention are: (1) pharmacist-facilitated medication reviews with feedback on any medication issues and potential recommendations to physicians, and (2) physicians communicating changes to other relevant prescribers. The evaluation phase will involve surveying and interviewing physicians and pharmacists involved in the implementation of the intervention. A mixed-method approach will be employed for data collection and analysis. The quantitative and qualitative findings will be triangulated and reported using Proctor's implementation outcomes: appropriateness, penetration, acceptability, fidelity, feasibility, and sustainability. A basic cost analysis will be conducted alongside the study. Discussion: This is a phase 2 study to test the feasibility of implementing an intervention that was co-created with stakeholders during phase 1 development of an intervention to optimise prescribing for older adults with multimorbidity. The implementation will be assessed using Proctor's implementation outcomes to provide insights on the process and the feasibility of implementing medication reviews for older adults with multimorbidity as a routine practice in outpatient clinics. Data collected from this study will inform a subsequent scale-up study. Trial registration: ClinicalTrials.gov Identifier: NCT05756478. Registered on 06 March 2023. [ABSTRACT FROM AUTHOR]