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The purpose of the Twin College Envoys (TWINCLE) program for Chiba University students was to visit secondary schools of the Association of Southeast Asian Nation countries and provide science lessons on cutting-edge technology. The focus of this research was to develop a learning program contextualized around the Global Positioning System (GPS) using the Science, Technology, Engineering, and Mathematics (STEM) model for Singapore students and to evaluate the science lessons. In total, 53 high school students received 100 min of instruction using two experiments with worksheets as part of the TWINCLE program, and then, they were asked to answer a questionnaire. The research yielded the following three results. First, by the end of the lesson, the students could explain how the GPS worked and list the benefits of GPS surveying. Second, the teaching materials and hands-on activities were well-received by the students and our Singapore counterparts. Finally, the science lesson based on STEM model was highly evaluated and awarded the 2017 best TWINCLE prize. In the future, it is recommended the TWINCLE program should be continued and funded by Chiba University to promote global opportunities for university students and teachers.

The word "test" comes to mind when a person, who is unacquainted with education discourses, reads about assessment issues. Beyond issues of reliability and validity in designing measurement constructs, assessment for school geography must result in better geographical learning. In other words, there must be "consequential validity" so that the way teachers collect information about students is aligned to the goals of improving learning. While geographical educators agree that finding out if someone has learnt what you intend for them to learn goes beyond performance in pen and paper examinations, school geography intends for children to learn beyond geographical knowledge. In fact, geographical educators are interested in evaluating if our students are better in developing skills that will help them be actively engaged and contributing citizens of the world that they are living in.

Literature suggests that state--market relations in Asian transnational education appear as a hybrid of economic socialism and economic liberalism as well as of supra-territoriality and sovereignty. Such a notion of hybrid focuses on how Asian states manage the struggles over the meaning and value of higher education, thereby addressing various ways in which states participate in neoliberal globalisation. This paper argues that Asian states' higher education policy choices are restricted by local politics and the resulting policy agendas. This argument explains the paradoxical situation that Malaysia continuously encounters when developing its regulatory regime to govern transnational education. The argument also illuminates the recalibrations that appeared in the transnational education policies of Singapore and Hong Kong. The paradox and recalibrations reveal how a political perspective on transnational education is important to understand Asian states' responses to globalisation in higher education regardless of the nature of their regulatory regimes.

This study identified secondary school students' alternative conceptions (ACs) of climate change and their resistance to instruction. Using a case-based approach, a diagnostic test was administered to Secondary 3 male students in a pre-test and post-test. The ACs identified in the pre-test were on the causes of climate change, the natural greenhouse effect and its properties, the enhancement of the greenhouse effect, the elements involved in heat-trapping and their characteristics. There were also notable ACs on the effects of climate change, mostly on how the phenomenon is related to nonatmospheric events such as tsunami, earthquakes, acid rain and skin cancer. The students confuse the Montreal with the Kyoto Protocol as the primary treaty aimed at curbing greenhouse gas emissions. Whereas there was significant improvement in students' understanding in the post-test, the distribution of responses for each of the ACs showed that the reduction in erroneous responses was not sufficient to reject the ACs fully. The authors recommend that instruction should move beyond patchwork pedagogy to a more explicit acknowledgement, incorporation and direct refutation of misconceived knowledge structures.

First conceived as spaces stocked with D.I.Y. tools and materials for community members to join together in the activity of making, makerspaces have begun popping up in schools, libraries, universities and museums across the world. The maker mindset summarizes the ideology of the maker movement--a set of values predicated on making, sharing, learning and playing. Through a critical review of research and practices of makerspaces in the U.S., Singapore, China and Ghana, this paper explores the respective national discourses surrounding the maker movement and maker education. By revealing some of the ways that the values have been embraced, reinterpreted, remixed or rejected as the movement has gained global momentum, this paper intends to establish a greater appreciation for the diversity and complexity of the maker movement and maker education in the global context. Ultimately, this complex, multifaceted remixing reveals a deeper understanding of why the movement has been or may be embraced by diverse nations across the globe.

For school geography in Singapore, geographical inquiry is identified as a "signature pedagogy" (Shulman 2005a) that can socialize students into the distinctive practices, concepts, and values of the discipline of geography. This article explores how field-based inquiry is applied across four secondary schools in Singapore to develop an understanding of teachers' knowledge and practices of disciplined inquiry. We outline the practical challenges and opportunities involved in adopting inquiry as a signature pedagogy for school geography. The results suggest a need to develop teachers' place-based knowledge and relevant scientific content knowledge to support the design of field-based learning experiences for students.

Despite heightened awareness about climate change, individuals remain rather indifferent to the issue. The reasons being that many public education programmes rely essentially on information dissemination and do not help individuals understand the given information. The authors believe that there is potential of environmental education for understanding and promoting pro-environmental behaviour. The proposed transformative education for climate change (TrEC) programme focuses on three elements (knowledge, skills and values) to help individuals understand environmental issues and to empower them to take pro-environmental action. This mixed method study was conducted in collaboration with various government agencies and 173 residents in a housing estate in Singapore. The findings suggest that with better understanding (knowledge) about the climate change issue, individuals can make informed decisions (attitude) and be encouraged to adopt pro-environmental behaviour (action).

Purpose: Obesity, defined as abnormal or excessive fat accumulation that presents a risk to health, rose from 8.6 to 10.5% in Singapore's residents. Bariatric surgery, the primary treatment for severe obesity, induces fat and muscle loss. Adequate protein intake is vital for preventing muscle loss. This study examines nitrogen balance in individuals with obesity pre- and post-surgery. Materials and Methods: Sixteen participants with severe obesity (BMI ≥ 32.5 kg/m2) undergoing bariatric surgery (14 sleeve gastrectomy, 2 Roux-en-Y gastric bypass) and 20 normal-weight controls (BMI < 25 kg/m2) were recruited. Nitrogen balance, calculated from dietary protein intake and urine nitrogen excretion, was assessed. Participants with obesity were re-evaluated 6 months post-surgery. Data were analyzed using parametric methods. Results: At baseline, controls had a BMI of 20.8 ± 2.1 kg/m2; those with obesity had 40.9 ± 7.3. Daily calorie and protein intake for participants with obesity were not statistically significantly different from controls (calorie intake at 1467 ± 430 vs. 1462 ± 391 kcal, p = 0.9701, protein intake 74.2 ± 28.7 vs. 64.6 ± 18.3 g, p = 0.2289). Post-surgery, BMI, fat-free mass, fat mass, total energy intake, carbohydrate, and protein intake decreased significantly (p < 0.01). Protein oxidation and urine nitrogen excretion did not change after bariatric surgery. However, nitrogen balance significantly reduced from 2.62 ± 5.07 to − 1.69 ± 5.07 g/day (p = 0.025). Conclusion: Dietary protein intake is inadequate in individuals with obesity at 6 months post-bariatric surgery and contributes to a state of negative nitrogen balance. [ABSTRACT FROM AUTHOR]

Background: This trial is a parallel, two-arm, non-blinded cluster randomised controlled trial that is under way in Singapore, with the aim of measuring the efficacy of male Wolbachia-infected Aedes aegypti deployments in reducing dengue incidence in an endemic setting with all four dengue serotypes in circulation. The trial commenced in July 2022 and is expected to conclude in September 2024. The original study protocol was published in December 2022. Here, we describe amendments that have been made to the study protocol since commencement of the trial. Methods: The key protocol amendments are (1) addition of an explicit definition of Wolbachia exposure for residents residing in intervention sites based on the duration of Wolbachia exposure at point of testing, (2) incorporation of a high-dimensional set of anthropogenic and environmental characteristics in the analysis plan to adjust for baseline risk factors of dengue transmission, and (3) addition of alternative statistical analyses for endpoints to control for post hoc imbalance in cluster-based environmental and anthropogenic characteristics. Discussion: The findings from this study will provide the first experimental evidence for the efficacy of releasing male-Wolbachia infected mosquitoes to reduce dengue incidence in a cluster-randomised controlled trial. The trial will conclude in 2024 and results will be reported shortly thereafter. Trial registration: ClinicalTrials.gov, identifier: NCT05505682. Registered on 16 August 2022. Retrospectively registered. Last updated 11 November 2023. [ABSTRACT FROM AUTHOR]

This study examines how Environmental, Social, and Governance (ESG) performance and state ownership affect firm valuation in Singapore and determines if the effects of ESG on firm valuation are more pronounced in state-owned companies. The data comprises 51 companies listed on the Singapore Stock Exchange with complete ESG and financial information during the five-year period from 2018 to 2022. This study finds that only social practices positively and statistically significantly affect stock prices. Overall ESG values, and the other two dimensions of ESG appear not to be statistically significant. State ownership appears to positively and significantly affect the stock price. The finding suggests that the Singapore government's substantial influence over corporate practices could accentuate the difference in market perception of ESG efforts between SOEs and companies. The study provides useful and practical implications to policymakers, managers and investors, which affect firm financial and operational performance. [ABSTRACT FROM AUTHOR]

Traditionally, psychotherapy aims to address distressing emotions, thoughts, and behaviours in individuals, but it can also foster positive mental health (PMH) and earlier recovery by including salutogenic approaches in clinical practice. This study aimed to understand psychotherapy recipients' perspectives on the meaning of PMH and how therapy could help them achieve it. A qualitative study was conducted among fifteen psychotherapy recipients seeking care at a mental health institute in Singapore. Their experiences were explored through semi-structured interviews. Inductive thematic analysis was conducted to identify key themes. Six themes on the meaning of PMH emerged – (i) acceptance of themselves and their emotions; (ii) positivity, which related to having a positive and optimistic outlook in different situations; (iii) resilience to bounce back from problems using healthy coping mechanisms; (iv) purpose in life which meant envisioning personal goals and working towards these; (v) social participation referred to having compassion, openness, and social skills to build supportive relationships; and (vi) euthymia represented being in a state without depression or anxiety and having better symptom management. Participants also narrated the ways in which psychotherapy had helped / can help them achieve their PMH goals. In this study, individuals receiving psychotherapy identified six key aspects of PMH as being relevant to them. By recognizing these unique perspectives around PMH, integrative and complementary therapy approaches can be designed to benefit people with mental health problems more effectively. [ABSTRACT FROM AUTHOR]

Aim: Myo‐inositol supplementation from ~13 weeks' gestation reportedly improves glycaemia regulation in metabolically at‐risk women, with speculation that earlier supplementation might bring further improvement. However, the NiPPeR trial of a myo‐inositol‐containing supplement starting preconception did not lower gestational glycaemia in generally healthy women. We postulated that the earlier timing of supplementation influences the maternal metabolic adaptation for gestational glycaemia regulation. Methods: In total, 585 women were recruited from Singapore, UK and New Zealand for the NiPPeR study. We examined associations of plasma myo‐inositol concentrations at 7 and 28 weeks' gestation with 28 weeks plasma glucose (PG; fasting, and 1 h and 2 h in 75 g oral glucose tolerance test) and insulin indices using linear regression adjusting for covariates. Results: Higher 7‐week myo‐inositol, but not 28‐week myo‐inositol, associated with higher 1 h PG [βadj (95% confidence intervals) 0.05 (0.01, 0.09) loge mmol/L per loge μmol/L, p =.022] and 2 h PG [0.08 (0.03, 0.12), p =.001]; equivalent to 0.39 mmol/L increase in 2 h PG for an average 7‐week myo‐inositol increase of 23.4 μmol/L with myo‐inositol supplementation. Higher 7‐week myo‐inositol associated with a lower 28‐week Stumvoll index (first phase), an approximation of insulin secretion [−0.08 (−0.15, −0.01), p =.020] but not with 28‐week Matsuda insulin sensitivity index. However, the clinical significance of a 7‐week myo‐inositol‐related increase in glycaemia was limited as there was no association with gestational diabetes risk, birthweight and cord C‐peptide levels. In‐silico modelling found higher 28‐week myo‐inositol was associated with lower gestational glycaemia in White, but not Asian, women after controlling for 7‐week myo‐inositol effects. Conclusion: To our knowledge, our study provides the first evidence that increasing first trimester plasma myo‐inositol may slightly exacerbate later pregnancy post‐challenge glycaemia, indicating that the optimal timing for starting prenatal myo‐inositol supplementation needs further investigation. [ABSTRACT FROM AUTHOR]

How school geography should be taught has been a longstanding issue for geography educators. In some countries, state or national level curriculum predicates how the subject should be taught in schools. This paper examines these questions in relation to existing frameworks of conceptualizing school geography, such as the International Charter on Geographical Education. School geography in Singapore has evolved from regional geography to thematic geography to systematic geography. A review of the curriculum in 2007 resulted in a distinct form of school geography unprecedented in Singapore's education history. Today, school geography in Singapore is learnt conceptually with national level assessment designed to that end. To what extent is this evolution in curriculum design in step with changes in our world? In response to the changes in school geography, pre-service and in-service teacher training has also responded by focusing on conceptual learning and inquiry. This paper will explore the state of school geography curricula in Singapore today, and the curriculum of teacher training, with the intent to critically discuss the state of geography education in Singapore. Although geography has remained a disciplinary subject whose place has yet been disputed, the big question of why study geography in the first place needs to be answered to ensure its continued survival. In particular, school geography will be examined for its relevance to a fast changing world. This critique ends by offering a reason to how geography plays an important role in education for sustainable development, and its relevance to Singaporeans or even any citizen of the world.

This study surveys the history of English language and the roles of English language education in Asian context. Through the historical survey on English dispersal in Asian countries, the first section of this study traces the dispersal of English from the 18th century and the development of English in Asian countries. The second section of this study explains the development and characteristics of English language education policies in Asian countries. These countries belong to the expanding circle according to Kachru's model, and in the expanding circle, English plays a very important role as a tool for interaction among nonnative speakers. This section surveys and compares the developmental characteristics of English language education in Asian countries. The third section emphasizes the important role of English education and the future of English language education in Asian countries. Also this section focuses on the characteristics of English as an International language, and emphasizes the role of English as a tool for inter-cultural communication in the world. The purpose of English language education in the Asian context is to cultivate young people who are well equipped with English capabilities and their own professional abilities. (Contains 1 figure and 1 footnote.)

This article discusses the implementation of a pedagogical tool aimed at the refutation of secondary school (grade ten-equivalent) students' persistent climate change misconceptions. Using a lesson study approach, the materials and intervention techniques used were developed collaboratively with geography teachers. The objective is two-pronged: to closely monitor how children learn through refutation-oriented approach and to document how teachers process the experience. A pretest and post-test comparison showed that there was significant improvement in the students' climate change conceptual understanding following the intervention.

Background: The mission of our education service as stated by the Ministry of Education (MOE) in Singapore: "is to mould the future of the nation, by moulding the people who will decide the future of the nation. The aim is to provide our children with a balanced and well-rounded education, develop them to their full potential, and nurture them into good citizens, aware of their responsibilities to family, society and country" (MOE, 2004). We want to develop the child morally, intellectually, physically, socially and aesthetically (MOE, 2004). In short, our Desired Outcomes of Education aim to foster a holistic child through a holistic education system. Comments: Although there are lots of concern and emphasis on holistic education in the teaching of all the various curricular subjects, there are little or no substantial elements of holistic learning in second language learning and teaching, in specific, Chinese language. The absence of holism in Chinese language learning hints that our Chinese pedagogy has yet to develop a holistic child in Chinese language learning. Aim: To address this issue, this paper attempts to construct a model framework promoting holism in Chinese language learning. The constructed framework will incorporate the Philosophy for Children (P4C) approach as a means through which to practice holistic education in Chinese language learning. Conclusion: The fundamental concern of someone who uses a language is making sense. For students learning a language, holistic learning is crucial to forming an understanding of the world. A holistic learning of the language would treat the learner as a legitimate conversation partner and someone who seeks meaning. (Contains 2 figures and 3 tables.)

This paper employs empirical data in three major Asian real estate markets - Hong Kong, Japan, and Singapore, from 2001 to 2021, to study the leverage strategies of two related types of real estate companies – real estate investment trusts (REITs) and real estate operating companies (REOCs). The business model of the former must adhere to a real-estate-focused investment strategy while the latter undertakes a whole range of real estate development activities including land acquisition, financial feasibility analysis, construction, investment and asset management to redevelopment and disposal, and are not subject to the REIT rules with respect to tax transparency, earning distribution, real estate holding and leverage limit. We find that REOCs use 18.96% more debt than REITs after controlling for the agency and market risks, dividend yields, and property sector, country, and year fixed effects of firms; dividend payout has no effect on the leverage strategies; and high tax ratio increases the debt usage of REOCs relative to REITs. We also analyze the liquidation costs and business uniqueness effects. We find real estate value to total firm value ratio, as a proxy of liquidation cost, has negative effects on debt ratios for both real estate firms. Due to their uniqueness, REOCs with a high concentration of rental revenue stream are more vulnerable to liquidation risks, and thus more likely to have lower debt ratio. REITs however tend to have higher debt usage as rental incomes enhance cash-flow liquidity. [ABSTRACT FROM AUTHOR]

In 2015 and 2016, two Barramundi (Lates calcarifer) farms in Singapore reported a disease outbreak characterized by lethargic behavior, pronounced inappetence, generalized skin lesions, erosions of the fins and tail, and ultimately high mortality in their fish. Next-generation sequencing and PCR confirmed presence of a novel virus belonging to the Alloherpesviridae family, Lates calcarifer herpesvirus (LCHV), which was subsequently isolated and cultured. We characterize, for the first time, the complete genome of two cultured LCHV isolates. The genome contains a long unique region of approximately 105,000 bp flanked by terminal repeats of approximately 24,800 bp, of which the first 8.2 kb do not show any similarity to described genomes in the Alloherpesviridae family. The two cultured isolates share 89% nucleotide identity, and their closest relatives are the viruses belonging to the genus Ictalurivirus. Experimental infections using one of the cultured LCHV isolates resulted in identical clinical signs as originally described in the index farm, both in intraperitoneal-injection infected fish and cohabitant fish, with mortality in both groups. Histopathological analysis showed pronounced abnormalities in the gills. Virus culture and PCR analysis confirmed the replication of LCHV in the infected fish, and thus Koch's postulates were fulfilled. [ABSTRACT FROM AUTHOR]

This study aimed to (a) describe the differences in the prevalence of alcohol use disorder (AUD), smoking, nicotine dependence (ND), and health conditions (physical and mental) across socioeconomic status (SES); (b) study the differences in alcohol-related characteristics (e.g., frequency, quantity); and (c) assess the association between SES with health behaviors (alcohol use, smoking) and health status. This cross-sectional study recruited participants (N = 6126) from a population registry through disproportionate stratified random sampling. Associations between SES with health behaviors and health status were examined using logistic or multinomial regressions adjusted for sociodemographic factors. Individuals in the low SES group had a higher prevalence of AUD than the high SES group (5.1% vs 4.6%). Low SES group had a higher proportion of current smokers (29.0% vs 15.2%) and those with ND (6.7% vs 3.0%). Those in the low SES group had higher prevalence of multi-morbidity (two or more chronic conditions) than the high SES group (46.8% vs 26.1%). Regression models showed that those in the low SES group had higher odds of AUD, smoking, and ND. Socio-environmental specific interventions should be strengthened in this group to promote health behaviors and early treatment entry to prevent potential health inequalities. [ABSTRACT FROM AUTHOR]

Introduction: Frailty has an important impact on the health outcomes of older patients, and frailty screening is recommended as part of perioperative evaluation. The Hospital Frailty Risk Score (HFRS) is a validated tool that highlights frailty risk using 109 International Classification of Diseases, 10th revision (ICD-10) codes. In this study, we aim to compare HFRS to the Charlson Comorbidity Index (CCI) and validate HFRS as a predictor of adverse outcomes in Asian patients admitted to surgical services. Method: A retrospective study of electronic health records (EHR) was undertaken in patients aged 65 years and above who were discharged from surgical services between 1 April 2022 to 31 July 2022. Patients were stratified into low (HFRS <5), intermediate (HFRS 5--15) and high (HFRS >15) risk of frailty. Results: Those at high risk of frailty were older and more likely to be men. They were also likely to have more comorbidities and a higher CCI than those at low risk of frailty. High HFRS scores were associated with an increased risk of adverse outcomes, such as mortality, hospital length of stay (LOS) and 30-day readmission. When used in combination with CCI, there was better prediction of mortality at 90 and 270 days, and 30-day readmission. Conclusion: To our knowledge, this is the first validation of HFRS in Singapore in surgical patients and confirms that high-risk HFRS predicts long LOS (≥7days), increased unplanned hospital readmissions (both 30-day and 270-day) and increased mortality (inpatient, 10-day, 30-day, 90-day, 270-day) compared with those at low risk of frailty. [ABSTRACT FROM AUTHOR]

This study investigated the relationship between gifted students' academic self-concept (ASC) and academic achievement (AC) in earth science with internationally representative high-school students from the third International Earth Science Olympiad (IESO) held in Taiwan in 2009. The results of regression analysis indicated that IESO students' ASC was significantly correlated with their AC (R[superscript 2] = 0.53, p<0.01) with large effect size, even when compared to other Asian countries such as Korea and Japan. It was found that Taiwan's students had the lowest ASC and exhibited poor interaction with other IESO students. The unique pattern of Taiwanese students exhibited through the 3rd IESO leads to the conclusion that: For the top notch gifted students, their social and psychological character such as their popularity and interaction skills, have much strongly effect on their ASC than cultural factors.

Nonlinear Pedagogy is an exploratory approach to teaching and learning Physical Education that can be potentially effective to help children acquire relevant twenty-first century competencies. Underpinned by Ecological Dynamics, the focus of Nonlinear Pedagogy is on the learner and includes the provision of less prescriptive instructions and guided discovery which serve to develop greater autonomy, competency, and relatedness in the learning process. This paper describes a study that examines the factors that contributed to motivation, enjoyment, and the development of twenty-first century competencies in Primary School Children. One hundred and thirty-three children were taught over seven weeks to play a modified-tennis game either with a Nonlinear Pedagogy or a Linear Pedagogy (i.e., more teacher-centred) approach in a Singapore school. While findings from the intrinsic motivation inventory (IMI) questionnaire showed that there was no difference for the subscales measured, student and teacher interviews indicated that the Nonlinear Pedagogy approach created a learning environment that facilitated perceived competence, autonomy, and relatedness, thus potentially enhancing intrinsic motivation and enjoyment during practice. Nonlinear Pedagogy encourages teachers to create representative learning designs through the inclusion of a variety of modified games, the freedom to choose, an emphasis on exploration and problem-solving, and can be relevant to develop twenty-first century competencies.

The inclusion of the climate change topic in the curriculum of school subjects in Singapore was pivotal, such that it positioned the discourse squarely in the structure of Singapore's education system. In an examination of the intersections and disjoints between state policies on climate change against the programmatic curriculum, results showed that there is no strong policy curriculum that mandates how climate change should be learned in Singapore, even though it is present in several school subjects. The topic is included in school subjects through the initiative of subject disciplinary specialists and middle managers of the education ministry. This exemplar has implications on how climate change education policy and practice can be shaped elsewhere.

Coral reefs are among the richest marine ecosystems on Earth, but there remains much diversity hidden within cavities of complex reef structures awaiting discovery. While the abundance of corals and other macroinvertebrates are known to influence the diversity of other reef‐associated organisms, much remains unknown on the drivers of cryptobenthic diversity. A combination of standardized sampling with 12 units of the Autonomous Reef Monitoring Structure (ARMS) and high‐throughput sequencing was utilized to uncover reef cryptobiome diversity across the equatorial reefs in Singapore. DNA barcoding and metabarcoding of mitochondrial cytochrome c oxidase subunit I, nuclear 18S and bacterial 16S rRNA genes revealed the taxonomic composition of the reef cryptobiome, comprising 15,356 microbial ASVs from over 50 bacterial phyla, and 971 MOTUs across 15 metazoan and 19 non‐metazoan eukaryote phyla. Environmental factors across different sites were tested for relationships with ARMS diversity. Differences among reefs in diversity patterns of metazoans and other eukaryotes, but not microbial communities, were associated with biotic (coral cover) and abiotic (distance, temperature and sediment) environmental variables. In particular, ARMS deployed at reefs with higher coral cover had greater metazoan diversity and encrusting plate cover, with larger‐sized non‐coral invertebrates influencing spatial patterns among sites. Our study showed that DNA barcoding and metabarcoding of ARMS constitute a valuable tool for quantifying cryptobenthic diversity patterns and can provide critical information for the effective management of coral reef ecosystems. [ABSTRACT FROM AUTHOR]

Bronchiectasis, a previously neglected condition, now has renewed research interest. There are a few systematic reviews that have reported on the economic and societal burden of bronchiectasis in adults, but none have reported on children. We undertook this systematic review to estimate the economic burden of bronchiectasis in children and adults. What is the health care resource utilization and economic burden of bronchiectasis in adults and children? We performed a systematic review identifying publications from Embase, PubMed, Web of Science, Cochrane (trials, reviews, and editorials), and EconLit about the economic burden and health care utilization in adults and children with bronchiectasis between January 1, 2001, and October 10, 2022. We used a narrative synthesis approach and estimated aggregate costs for several countries. We identified 53 publications reporting on the economic burden and/or health care utilization of people with bronchiectasis. Total annual health care costs per adult patient ranged from 2021 $3,579 to $82,545 USD and were predominantly driven by hospitalization costs. Annual indirect costs including lost income because of illness (reported in only five studies) ranged from $1,311 to $2,898 USD. Total health care costs in children with bronchiectasis were $23,687 USD annually in the one study that estimated them. Additionally, one publication found that children with bronchiectasis missed 12 school days per year. We estimated aggregate annual health care costs for nine countries, ranging from $101.6 million per year in Singapore to $14.68 billion per year in the United States. We also estimated the aggregate cost of bronchiectasis in Australian children to be $17.77 million per year. This review highlights the substantial economic burden of bronchiectasis for patients and health systems. To our knowledge, it is the first systematic review to include the costs for children with bronchiectasis and their families. Future research to examine the economic impact of bronchiectasis in children and economically disadvantaged communities, and to further understand the indirect burden of bronchiectasis on individuals and the community, is needed. [Display omitted] [ABSTRACT FROM AUTHOR]

With a plethora of digital technologies, and some having high capital and running costs, it is critical to know which of these give architectural, engineering, and construction (AEC) firms a comparative advantage. Comparative advantage is measured using these metrics: higher project quality (Y1), productivity (Y2), ability to win tenders (Y3), and reputation (Y4), compared to AEC firms' nearest competitors. This study investigated which specific digital technologies give rise to a comparative advantage for adopters in the AEC sector. The research design was an online survey using a structured questionnaire. Data were collected from AEC professionals in Singapore. The research found that the adoption of five digital technologies is significantly associated with higher project quality, productivity, and reputation compared to AEC firms' nearest competitors. These 'super technologies' are cloud-based technology, design for manufacturing and assembly (DfMA), Internet-of-Things (IoT), robotic technology, and artificial intelligence (AI). The study discovered some digital technologies that are not correlated with any comparative advantage metrics. The contribution to knowledge is the creation of the digital technology adoption model that potential adopters may use to help them decide which specific digital technologies to adopt to achieve comparative advantage. For firms that are already adopting digital technologies, the adoption model serves as a benchmarking tool to measure comparative advantage. The implication for practice is for potential adopters to zoom in on the 'super technologies' and eschew those that do not provide comparative advantages. [ABSTRACT FROM AUTHOR]

Given the persistent and endemic educational inequalities and increasingly diverse and yet politically divisive societies, teaching that is inclusive for all students with a commitment to recognizing and seeking ways to challenge systemic inequity is one approach to addressing persistent disparities. To support teachers' professional growth and provide evidence for research/evaluation on teacher learning, this study validates the Teaching Equity Enactment Scenario (TEES) Scale, an existing instrument first conceptualized and developed in mostly Western contexts, among Singapore teachers. A mixed-method design, integrating a survey of 78 teachers and a follow-up interview using the think-aloud technique to illicit pedagogical practices of five survey participants, is used. The quantitative results indicate that the TEES Scale measures a unidimensional construct of enacting equity-centered teaching practice from the lower to the higher level as hypothesized and can provide reliable and meaningful interpretations of participants' scores. The qualitative results provide contextualized information about participants' survey experiences and the patterns of practice among higher- and lower-scoring teachers. Specifically, despite the common boundaries, structure, and parameters that condition Singapore teachers' work, higher- and lower-scoring teachers diverge in their views of learners, knowledge and knowledge construction, perceived professional roles and identities, and instructional practices in important manners. Findings of the two components confirm each other and offer a fuller picture of the degree to which the TEES Scale can provide reliable and meaningful information about Singapore teachers' practice for equity for the intended uses. Limitations and future studies are discussed. [ABSTRACT FROM AUTHOR]

The grad trip entails travelling overseas with one's closest group of friends to commemorate the completion of tertiary and formal education and is bookended by the carefree freedom in one's youth and the commencement of an adulthood defined by formal employment. This article conceptualises the grad trip as a phenomenon in youth tourism, based on empirical study of how it is experienced in Singapore. Our conceptualisation of the timing and duration that defines a grad trip demonstrates the dominance of time productivity reflective of Singapore's work culture. Drawing on a precedence of studies based in the Western concept of the gap year, we reveal commonalities in employment society's influence on time for youth tourism. While the gap year seeks to maximise the length of time offered by a 'gap', the grad trip contrarily minimises the culturally perceived wastefulness of a prolonged break. [ABSTRACT FROM AUTHOR]

Identification of the risk factors and the high-risk groups which are most vulnerable is critical in COVID-19 disease management at a population level. Evaluating the efficacy of vaccination against infections is necessary to determine booster vaccination strategies for better protection in high-risk groups. In this study, we recruited 158 mRNA-vaccinated individuals during the Delta wave of SARS-CoV-2 infections in Singapore and examined the antibody profiles of infected individuals. We found that, despite high exposure due to communal living conditions in proximity, 4% of individuals (6/158) had PCR-confirmed infections and 96% (152/158) remained uninfected. Time-course analysis of the antibody profile at the start and the end of quarantine period showed Delta-specific boosting of anti-spike antibody response in 57% of the uninfected individuals (86/152). In the remaining 43% of the uninfected individuals (66/152) with no Delta-specific antibody boost, we found a higher Delta-specific antibody response at the start of quarantine period, which correlated with higher Delta pseudovirus neutralizing capacity. Our findings indicate that a higher basal variant-specific antibody response in the mRNA-vaccinated individuals contributes to better protection against infections by the new emerging SARS-CoV-2 variants. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the impact of corrected refractive power on the corneal denervation and ocular surface in small-incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK). Setting: Singapore National Eye Center, Singapore. Design: Prospective study. Methods: 88 eyes undergoing SMILE or LASIK were divided into low-moderate (manifest refractive spherical equivalent [MRSE] <-6.0 diopters [D]) and high myopic (MRSE ≥ -6.0 D) groups. In vivo confocal microscopy and clinical assessments were performed preoperatively and at 1 month, 3 months, 6 months, and 12 months postoperatively. Results: In SMILE, high myopic treatment presented with significantly greater reduction in the corneal nerve fiber area (CNFA) and nerve fiber fractal dimension (CFracDim) compared with lowmoderate myopic treatment (both P < .05). There was a significant and negative correlation between the corrected MRSE and the reduction in corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD), corneal nerve fiber length, CNFA, and CFracDim after SMILE (r = -0.38 to -0.66, all P < .05). In LASIK, a significant correlation between the MRSE and the changes in CNBD, corneal nerve fiber total branch density, CNFA (r = -0.37 to -0.41), and corneal nerve fiber width (r = 0.43) was observed (all P < .05). Compared with SMILE, LASIK had greater reduction in CNBD and CNFA for every diopter increase in the corrected MRSE. High myopic SMILE, compared with low-moderate myopic SMILE, resulted in significantly lower tear break-up time at 1 and 6 months (both P < .05). The changes in CNFA and CFracDim were significantly associated with Schirmer test values (both P < .001). Conclusions: Postoperative corneal denervation was related to corrected refractive power in both SMILE and LASIK. With the same refractive correction, LASIK led to more prominent corneal denervation. [ABSTRACT FROM AUTHOR]

Private home dining (PHD) is gaining popularity around the world. The PHD is an example of a sharing economy in which guests enter the homes of amateur chefs for a shared experiential meal. This paper explores the social and spatial dimensions of PHD in Singapore from the perspectives of hosts and guests. For the hosts, PHD events mean opening their home to the public and in the process, taking on new roles as cook, guide and cultural ambassador. From the guests' perspective, dining in a novel environment brings new experiences, exposing them to new people, knowledge and skills. A mixed-methods approach comprising mainly interviews and participant observations was adopted in this research. The findings reveal that PHD transforms home spaces yet retains the essence of home; compels members of a household to perform multiple roles simultaneously; facilitates the process of home-making; and encourages guests to actively engage as co-producers of their own cultural and culinary experiences. [ABSTRACT FROM AUTHOR]

Aims: We aim to compare and correlate Gold and Clarke questionnaire scores with hypoglycaemic symptomatic responses between insulin‐treated type 2 diabetes participants with and without IAH in a real‐life study. Methods: Insulin‐treated type 2 diabetes participants attending an outpatient diabetes clinic in Singapore were asked to complete the Gold and Clarke questionnaires, record capillary blood glucose (CBG) and hypoglycaemic symptoms for 4 weeks. Results: Data were collected from 153 participants (M:F = 98:55) with mean age 61.0 ± 9.4 years, duration of diabetes 19.5 ± 8.8 years and HbA1c 68 ± 17 mmol/mol (8.4 ± 1.5%). Gold and Clarke methods classified 19.6% and 26.8% of participants with IAH, respectively. Using CBG threshold of <3 mmol/L, significantly greater proportion of participants with intact awareness were experiencing autonomic symptoms than those with IAH with either method (Gold: 69% vs. 18%, p = 0.006; Clarke: 85% vs. 46%, p = 0.010). Significantly greater proportion of participants with IAH experienced no hypoglycaemia symptoms than those with intact awareness (Gold: 3.4% vs. 36%, p = 0.015; Clarke: 3.7% vs. 31%, p = 0.031). Participants with IAH had significantly higher rates of severe hypoglycaemia in the preceding year compared to those without (Gold: 17% vs. 3.3%; Clarke: 15% vs. 2.7%, p = 0.012). Conclusions: Gold and Clarke questionnaires are appropriate tools in ascertaining IAH status in insulin‐treated type 2 diabetes participants. This is the first time whereby the hypoglycaemia symptomology has robustly validated the Gold and Clarke questionnaire in insulin‐treated type 2 diabetes participants. [ABSTRACT FROM AUTHOR]

In this article, the authors suggest a project that social studies teachers can do with students, using the location of the school as a starting point to address the inquiry question: "Whose place is this space?" They provide resources, such as a sample case study and worksheets, to conduct a field-based exercise so that students can trace how their perceptions of their school's neighborhood can change through multiple direct and indirect experiences. The field-based exercise also encourages students to think about how their perceptions of a place might differ from other people's, and how and why this may be so. Recognizing that there are differing perceptions of places can help students appreciate how tensions, conflicts and struggles over place can occur. After analyzing how different sources of information may have influenced their (changed) perception of the neighborhood, students can follow through with a decision-making exercise to cultivate a heightened sensitivity to diversity within their social environment. Students can decide on appropriate activities regarding how to challenge negative stereotypes about their neighborhood and the associated occupants or uses of the place. Teachers in the United States can adapt the Singapore case study provided in this article to suit their different contexts, or else use its methods to study their school's neighborhood. This unit allows educators the opportunity to teach their grades 9-12 students how culture and experience influence people's perceptions of places.

Climate change is an important theme in the investigation of human-environment interactions in geographic education. This study explored the nature of students' understanding of concepts and processes related to climate change. Through semi-structured interviews, data was collected from 27 Secondary 3 (Grade 9) students from Singapore. The data was subjected to thematic analysis using Chi and Roscoe's conceptual change framework. The results showed that the students' base knowledge of climate change is composed of incomplete and incorrect elements built within coherent and structurally sound mental models. Due to the consistency of the models in expanding the logic, albeit erroneous, of explaining the climate change conundrum, it is posited that students are unaware of mistakes inherent in their judgements. Transformation of these mental models through multiple and deliberate refutations should be foremost in a geography teacher's pedagogical approach.

"Choreographies of Multilingualism: Writing and Language Ideology in Singapore" by Tong King Lee explores the unique multilingualism of Singapore and how it is performed across various modalities. The book focuses on written forms of language, including public signs, literary anthologies, Singlish (Singapore English), and the Singapore Poetry Writing Month. The author examines the balance between institutional, top-down multilingualism and bottom-up, grassroots multilingualism. The book concludes by proposing a contrapuntal multilingualism that envisions a shifting negotiation between top-down management and ground-up practice in Singapore's transition to a postmultilingual society. [Extracted from the article]

This paper investigates the geographic and professional mobility of scientists employed in Singapore's publicly funded research institutes in various techno-and lifescience specialisations. Using Bourdieu's conceptual framework, we analyse the capital portfolios of individual scientists against the structures of power which have informed Singapore's developmental history, the culture of its westernised political elite and its present day aspirations to become a knowledge-based economy. Using survey and interview data, we examine how individual scientists mobilize their portfolios of social and cultural capital in order to extract maximum value from the transnational field of research and development. These processes of mobilization require individuals to negotiate alignments between their habitus and the political-cultural field in Singapore. This empirical grounding enables us to offer some preliminary ideas about transformations to the scientific habitus.

Advances in technology have created new opportunities for enhanced delivery of teaching to improve the acquisition of game skills in physical education (PE). The availability of a motion-tracking system (i.e. the A-Eye), which determines positional information of students in a practice context, might offer a suitable technology to support pedagogical approaches in the teaching of movement skills in game situations. This paper explores the possibility and potential of using this technology to augment pedagogical practices in PE. Using examples from its implementation in sports science investigations and pilot work in a Singapore school, we discuss how such motion-tracking systems can be incorporated in schools, assisting practitioners in refining pedagogical practices. The implications of its wider use in a PE context will also be discussed.

In understanding the divergences and commonalities in the representations of geography across different national settings, the case of Singapore is examined through the notion of politicisation of school curricula to meet the needs of "significant power groups". In particular, the development of school geography in Singapore and its response to changes in the education system are discussed, followed by an analysis of its development in relation to changes in academic geography. This is followed by a discussion on the place of school geography in responding to social and cultural concerns. Through content analyses of syllabus documents and secondary data, this article examines the role of each of the significant power groups in academic geography and the state and how they have shaped Singapore's school geography curriculum. While Singapore's school geography has been very responsive to changing educational processes, social demands and, to some extent, the development in academic geography, this has come at a price where the subject is now under threat from falling student intakes and what could be described as an abridged geography. The author argues that while responsiveness is a key factor to ensure the continued existence of the subject, stakeholders should not lose sight of a holistic understanding of geography as a discipline of study.

Background: Diabetic retinopathy (DR) screening using colour retinal photographs is cost-effective and time-efficient. In real-world clinical settings, DR severity is frequently graded by individuals of different expertise levels. We aim to determine the agreement in DR severity grading between human graders of varying expertise and an automated deep learning DR screening software (ADLS). Methods: Using the International Clinical DR Disease Severity Scale, two hundred macula-centred fundus photographs were graded by retinal specialists, ophthalmology residents, family medicine physicians, medical students, and the ADLS. Based on referral urgency, referral grading was divided into no referral, non-urgent referral, and urgent referral to an ophthalmologist. Inter-observer and intra-group variations were analysed using Gwet's agreement coefficient, and the performance of ADLS was evaluated using sensitivity and specificity. Results: The agreement coefficient for inter-observer and intra-group variability ranged from fair to very good, and moderate to good, respectively. The ADLS showed a high area under curve of 0.879, 0.714, and 0.836 for non-referable DR, non-urgent referable DR, and urgent referable DR, respectively, with varying sensitivity and specificity values. Conclusion: Inter-observer and intra-group agreements among human graders vary widely, but ADLS is a reliable and reasonably sensitive tool for mass screening to detect referable DR and urgent referable DR. [ABSTRACT FROM AUTHOR]