Search

This scoping review explores the causal relationship between morphological instruction and reading development in young L2 learners by synthesizing 12 primary studies published between 2004 and 2019 (N = 1,535). These studies focused on reading English as the target language and involved participants between kindergarten and Grade 12 from four countries (China, Egypt, Singapore, and the USA). Findings suggested that (a) morphological instruction led to consistent and positive gains in L2 children's morphological awareness and vocabulary knowledge, and the effect sizes (Cohen's "d"s) ranged from small to large; and (b) the relationship between morphological instruction and other outcomes such as phonological awareness, word reading accuracy, word reading fluency, spelling, and reading comprehension was inconclusive. Notably, transfer effects of L2 English morphological instruction on novel word learning in English or on reading development in an additional language were only examined and observed in four primary studies. Discussion was provided regarding future instructional and research design.

We examine recent research across countries and cultures in regard to the issues related to the formation of gifted and talented education perspectives, policies, and practices. Many modern cultures and subcultures have developed formal and informal definitions of what it means to be gifted and talented, and when we compare the perceptions, policies, and practices across nations, we discover very different constructs of intelligence and ability. These understandings of giftedness and gifted and talented education can be grouped into four binary dimensions, scholarly versus co-curricular capabilities, aptitude versus achievement, nature versus nurture, and individualistic versus collective, that have significant implications for policy and practice. These constructs can serve as a foundation for countries that are looking to formalize or expand their gifted and talented education models or can be used to challenge the norms of established systems. We put forward recommendations to address some of the challenges in advancing gifted education cross-nationally, an area that is often assumed to introduce risks of enlarging social inequity. We also provide a cross-national matrix that captures known elements of gifted education policies and programs from over 20 subnational jurisdictions, countries, and world regions.

The authors examined the complexity of the simple view of reading, focusing on morphological decoding fluency in fourth-grade readers of English in Singapore. The participants were three groups of students who all learned to become bilingual and biliterate in the English language (EL) and their respective ethnic language in school but differed in the home language they used. The first group was ethnic Chinese students who used English as the dominant home language (Chinese EL1); the other two groups were ethnic Chinese and Malay students whose dominant home language was not English but Chinese (Chinese EL2) and Malay (Malay EL2), respectively. The measures included pseudoword decoding (phonemic decoding), timed decoding of derivational words (morphological decoding fluency), oral vocabulary, and passage comprehension. Path analysis showed that oral vocabulary significantly predicted reading comprehension across all three groups, yet a significant effect of morphological decoding fluency surfaced in the Chinese EL1 and Malay EL2 groups but not the Chinese EL2 group. Multigroup path analysis and commonality analysis further confirmed that morphological decoding played a larger role in the Chinese EL1 and Malay EL2 groups. These findings are discussed in light of the joint influence of target-language experience and cross-linguistic influence on second-language or bilingual reading development.

This statement on social work practice research highlights the contributions of scholars, practitioners, and conference participants in the Fourth International Conference on Practice Research (ICPR) in 2017, hosted by The Hong Kong Polytechnic University in May 2017. It focuses on the contexts and challenges of carrying out practice research in the Far East and beyond as well as raises pertinent questions about the development of practice research. It begins with a brief description of the context of social work practice research in the Far East. The second part explores the organizational and community contexts and challenges of practice research with special attention to the perspectives of practitioners. It concludes with reviewing some of the continuing challenges that will guide the program planning for the Fifth ICPR in 2020 in Melbourne, Australia, located at the crossroads between East and West.

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]

Background: Specialist palliative care is often provided late in the patient's disease trajectory in response to uncontrolled symptoms. Shifting from this reactionary illness-stress paradigm to a proactive health-wellness approach, the ENABLE (Educate, Nurture, Advise, Before Life Ends) telehealth model aims to enhance the coping, stress and symptom management, self-care, and advance care planning skills of patients with advanced cancers and their caregivers. The ENABLE model has been culturally adapted to Singapore (ENABLE-SG) and pilot-tested. A hybrid type 1 effectiveness-implementation design will be used to evaluate the effectiveness of ENABLE-SG while collecting real-world implementation data. Methods: This single-centre, assessor-blind, wait-list (immediately vs. 6 months) randomized controlled trial will recruit 300 adult patients within 60 days of an advanced cancer diagnosis and their family caregivers from the National Cancer Centre of Singapore. ENABLE-SG comprises structured psychoeducational sessions with a telehealth coach, covering essential topics of early palliative care. Participants will be assessed at baseline and every 3 months until patient's death, 12 months (caregivers), or end of study (patients). The primary outcome is patient quality of life 6 months after baseline. Secondary patient-reported outcomes include mood, coping, palliative care concerns, and health status. Secondary caregiver-reported outcomes include caregiver quality of life, mood, coping, and care satisfaction. Mixed-effects regression modelling for repeated measurements will be used. To assess the effectiveness of ENABLE-SG versus usual care, patient and caregiver outcomes at 6 months will be compared. To compare earlier versus delayed ENABLE-SG, patient and caregiver outcomes at 12 months will be compared. Within the hybrid type 1 effectiveness-implementation design, implementation outcomes will be evaluated in both the early and delayed groups. Acceptability, adoption, appropriateness, and feasibility will be assessed using a feedback survey and semi-structured interviews with a purposive sample of patients, caregivers, and healthcare providers. Transcribed interviews will be analysed thematically. Other implementation outcomes of penetration, fidelity, and cost will be assessed using records of study-related processes and summarized using descriptive statistics. A cost-effectiveness analysis will also be conducted. Discussion: This study will assess both effectiveness and implementation of ENABLE-SG. Insights into implementation processes can facilitate model expansion and upscaling. Trial registration: Registered prospectively on ClinicalTrials.gov, NCT06044441. Registered on 21/09/2023. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has exerted a huge emotional strain on mental health professionals (MHP) in Singapore. As Singapore transited into an endemic status, it is unclear whether the psychological strain has likewise lessened. The aims of this study were to investigate the levels of stress and burnout experienced by MHP working in a tertiary psychiatric hospital in Singapore during this phase of COVID-19 endemicity (2022) in comparison to the earlier pandemic years (2020 and 2021) and to identify factors which contribute to as well as ameliorate stress and burnout. A total of 282 MHP participated in an online survey in 2022, which included 2 validated measures, namely the Perceived Stress Scale and the Oldenburg Burnout Inventory (OLBI). Participants were also asked to rank factors that contributed the most to their stress and burnout. Between-group comparisons were conducted regarding stress and burnout levels among MHP across different demographic groupings and working contexts. In addition, OLBI data completed by MHP in 2020 and 2021 were extracted from 2 published studies, and trend analysis was conducted for the proportion of MHP meeting burnout threshold across 3 time points. We found that the proportion of MHP meeting burnout threshold in 2020, 2021 and 2022 were 76.9%, 87.6% and 77.9% respectively. Professional groups, age, years of experience and income groups were associated with stress and/or burnout. High clinical workload was ranked as the top factor that contributed to stress and burnout while flexible working arrangement was ranked as the top area for improvement so as to reduce stress and burnout. As such, policy makers and hospital management may want to focus on setting clear mental health targets and facilitate manageable clinical workload, build manpower resiliency, optimize resources and provide flexible work arrangements to alleviate stress and burnout among MHP. [ABSTRACT FROM AUTHOR]

Several comprehensive information literacy (IL) standards have been developed worldwide for use in the education sector, specifically for students and teachers. Apart from the more generic International Federation of Library Associations (IFLA) IL standards, such standards are more appropriate for their countries of origins. If these standards are to be applied to schools in Southeast Asia, then some form of contextualization and customization is necessary to cater for gaps that surface due to their different and unique education environments and cultures. In addition, as a result of the growth of Web 2.0, information seeking moves rapidly in the social dimension. It is therefore timely to review ongoing research in the areas of collaborative information seeking and behavior, as well as education values in order to derive a set of up-to-date, relevant and holistic IL standards for schools. This paper proposes a model to help to develop IL standards for schools in Singapore that was constructed using the aforementioned standards as a guide, based on the paradigm of a popular information and technology literacy process model known as the Big6, and steered by related educational initiatives and education values that have been recently implemented in Singapore. The proposed model expounds each of the Big6 categories in terms of "Techniques" and "Tools", and supplements those categories with three important mindsets of "Ethics and Social Responsibility," "Collaborative Information Behavior," and "Attitudes and Perceptions." (Contains 3 figures and 2 tables.)

Data have never been more essential to the success of decision making. However, data are often messy. A perennial data challenge is missing values, which frequently occur in real-world data, such as unreported data items in public firms' financial statements and skipped product ratings from consumers. What is the influence of missing values and how should they be handled? Although we are in a big data era, missing values are not ignorable if data are missing for nonrandom reasons. In the case of product ratings, if only people who favor the product provide ratings while others put aside the product and do not respond, then even a simple mean estimation of the product rating would be significantly biased. Such bias challenges the validity of data analysis, and it cannot be eliminated simply by increasing the sample size of the data. To correct the bias arising from nonrandom missing values, it is necessary to examine and model what causes the missing values. We propose and demonstrate the superior performance of a Monte Carlo likelihood approach to correct the bias. Overall, we recommend well-designed data collection processes with documentation of the possible reasons for missing values, cautious adoption of missing value handling methods, and structured missing value reporting practices. In today's big data environment, missing values continue to be a problem that harms data quality. The bias caused by missing values raises the highest concern, as it cannot be eliminated simply by increasing the sample size. Although the statistics literature has developed approaches to handling missing values and formulated assumptions regarding when these approaches generate valid statistical inferences, these prescriptions have yet to be broadly accepted by many social science disciplines, including the information systems (IS) discipline. By reviewing recently published empirical research in information systems, we find that missing values are indeed an important and pervasive problem. We believe that a review of missing value theory is necessary and timely for the IS community to understand the nature of missing values and to promote more rigorous research practice when missing values are often unavoidable. In addition, the missing not at random (MNAR) mechanism brings about challenges in parameter estimation. We contribute to research practice by proposing and demonstrating the superior performance of a Monte Carlo likelihood approach in correcting bias in parameter estimation. We conclude by suggesting that research validity can be enhanced through a reasoned adoption of the missing value handling method and structured missing value reporting practices. History: Giri Kumar Tayi, Senior Editor; Pei-Yu Chen, Associate Editor. Funding: This work was supported by the Singapore Ministry of Education [Grants R-253-000-136-114, R-253-000-149-490, and R-253-000-158-114] the National Natural Science Foundation of China [Approval No. 72201288], and the Program for Innovation Research in Central University of Finance and Economics. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not reflect the views of the Singapore Ministry of Education, the Singapore Government or the Central University of Finance and Economics. Supplemental Material: The online appendices are available at https://doi.org/10.1287/isre.2022.1104. [ABSTRACT FROM AUTHOR]

The Nurturing Early Learners (NEL) curriculum framework in Singapore, as outlined by the Ministry of Education (2022), places strong emphasis on cultivating social and emotional competencies during preschool education. Among the five socio and emotional competencies highlighted, social awareness, which focuses on understanding others' viewpoints and empathetic responses stands out. This competency aligns with the Theory of Mind (ToM), a concept rooted in recognising diverse thoughts and emotions in individuals, as established by Premack and Woodruff (1978). ToM deficits can profoundly impact social relationships, influencing perspective-taking, conversation quality, and friendship formation. Prior studies in Singapore regarding ToM has been focused on understanding the impact of socio-cultural factors on ToM in preschool children (Hashim, Kim, Fischer, Yeung & Yu, 2021; Qu & Shen, 2013a; Qu, Shen & Qianqian, 2013b). Using a flexible online training module, this qualitative study aims to strengthen educators' confidence in incorporating ToM strategies when facilitating children's play and social skills following a flexible training module on the application of ToM strategies in the classroom. The results of the study will provide insights into the effectiveness of using such a training method to support educator's capacity building. This will contribute towards fostering a more comprehensive and impactful learning environment for young children, nurturing their social and emotional growth. [ABSTRACT FROM AUTHOR]

Singapore grouper iridovirus (SGIV) infection is associated with high mortality in mariculture, and effective treatments are urgently required. Given the wide‐ranging applications of metformin, we aimed to assess the effects of metformin against SGIV. The safe and effective concentration of metformin in grouper spleen cells was determined as 250 μg/mL. We detected the inhibitory activity of metformin against SGIV infection in grouper spleen cells using an aptamer‐based fluorescent molecular probe and reverse transcription‐quantitative real‐time polymerase chain reaction. Metformin effectively inhibited SGIV infection in a dose‐dependent manner and showed an excellent inhibitory effect against SGIV in vitro (70%). We further investigated metformin's possible antiviral mechanism and showed that metformin did not damage SGIV invading host cells, but could damage SGIV particles (59.57%) and interfere with SGIV binding (23.25%) and replication (29.48%) in host cells. Metformin mainly inhibited SGIV by damaging SGIV particles. Overall, these results suggested that metformin had direct and host‐mediated antiviral effects against SGIV and thus had great potential for the development of effective drugs to control SGIV infection in aquaculture. [ABSTRACT FROM AUTHOR]

English and Mandarin Chinese differ in the voice onset times (VOTs) of /b/ and /p/. Hence the way bilinguals perceive these sounds may show 'tuning' to the language-specific acoustic structure of a bilingual's languages (a discrete model), or a shared representation across languages (a unitary model). We investigated whether an individual's early childhood exposure influences their model of phoneme perception across languages, in a large sample of early English-Mandarin bilingual adults in Singapore (N = 66). As preregistered, we mapped identification functions on a /b/-/p/ VOT continuum in each language. Bilingual balance was estimated using principal components analysis and entered into GLMMs of phoneme boundary and slope. VOT boundaries were earlier for English than Mandarin, and bilingual balance predicted the slope of the transition between categories across both languages: Those who heard more English from an earlier age showed steeper category boundaries than those who heard more Mandarin, suggesting early bilinguals may transfer their model for how phonemes differ from their earlier/stronger languages to later/weaker languages. We describe the transfer model of discrete phoneme representations and its implications for use of the phoneme identification task in diverse populations. [ABSTRACT FROM AUTHOR]

Data-driven fault detection and diagnosis (FDD) methods, referring to the newer generation of artificial intelligence (AI) empowered classification methods, such as data science analysis, big data, Internet of things (IoT), industry 4.0, etc., become increasingly important for facility management in the smart building design and smart city construction. While data-driven FDD methods nowadays outperform the majority of traditional FDD approaches, such as the physically based models and mathematically based models, in terms of both efficiency and accuracy, the interpretability of those methods does not grow significantly. Instead, according to the literature survey, the interpretability of the data-driven FDD methods becomes the main concern and creates barriers for those methods to be adopted in real-world industrial applications. In this study, we reviewed the existing data-driven FDD approaches for building mechanical & electrical engineering (M&E) services faults and discussed the interpretability of the modern data-driven FDD methods. Two data-driven FDD strategies integrating the expert reasoning of the faults were proposed. Lists of expert rules, knowledge of maintainability, international/local standards were concluded for various M&E services, including heating, ventilation air-conditioning (HVAC), plumbing, fire safety, electrical and elevator systems based on surveys of 110 buildings in Singapore. The surveyed results significantly enhance the interpretability of data-driven FDD methods for M&E services, potentially enhance the FDD performance in terms of accuracy and promote the data-driven FDD approaches to real-world facility management practices. [ABSTRACT FROM AUTHOR]

Background: Evidence regarding the relationship between the type of anaesthesia and length of hospital stay is controversial. Therefore, the objective of this research was to investigate whether the type of anaesthesia was independently related to the length of hospital stay in patients undergoing unilateral total knee arthroplasty (TKA) after adjusting for other covariates. Methods: The present study was a cohort study. A total of 2622 participants underwent total knee arthroplasty (TKA) at a hospital in Singapore from 2013 to 1-1 to 2014-6-30. The target independent variable and the dependent variable were two types of anaesthesia and length of hospital stay, respectively. The covariates included age, BMI, hemoglobin (Hb), length of stay (LOS), duration of surgery, sex, ethnicity, American Society of Anesthesiologist (ASA) Status, smoking, obstructive sleep apnea (OSA), diabetes mellitus (DM), DM on insulin, ischemic heart disease (IHD), congestive cardiac failure (CCF), cerebrovascular accident (CVA), creatinine > 2 mg/dl, day of week of operation. Multivariate linear and logistic regression analyses were performed on the variables that might influence the choice of the two types of anaesthesia and the LOS. This association was then tested by subgroup analysis using hierarchical variables. Results: The average age of 2366 selected participants was 66.57 ± 8.23 years old, and approximately 24.18% of them were male. The average LOS of all enrolled patients was 5.37 ± 4.87 days, 5.92 ± 6.20 days for patients receiving general anaesthesia (GA) and 5.09 ± 3.98 days for patients receiving regional anaesthesia (RA), P < 0.05. The results of fully adjusted linear regression showed that GA lasted 0.93 days longer than RA (β = 0.93, 95% CI (0.54, 1.32)), P < 0.05. The results of fully adjusted logistic regression showed that LOS > 6 days was 45% higher for GA than for RA (OR = 1.45, 95% CI (1.15, 1.84)), P < 0.05. Through the subgroup analysis, the results were basically stable and reliable. Conclusion: Our study showed that GA increased the length of stay during unilateral TKA compared with RA. This finding needs to be validated in future studies. [ABSTRACT FROM AUTHOR]

Background: Burnout has adverse implications in healthcare settings, compromising patient care. Allied health professionals (AHPs) are defined as individuals who work collaboratively to deliver routine and essential healthcare services, excluding physicians and nurses. There is a lack of studies on burnout among AHPs in Singapore. This study explored factors associated with a self-reported burnout level and barriers to seeking psychological help among AHPs in Singapore. Methods: We conducted a cross-sectional study in a sample of AHPs in a tertiary hospital from October to December 2019. We emailed a four-component survey to 1127 eligible participants. The survey comprised four components: (1) sociodemographic characteristics, (2) Maslach Burnout Inventory (MBI-HSS), (3) Areas of Worklife Survey, and (4) Perceived Barriers to Psychological Treatment (PBPT). We performed a multiple logistic regression analysis to identify factors associated with burnout. Adjusted odds ratios (AORs) and associated 95% confidence intervals (CIs) were computed. Results: In total, 328 participants completed the questionnaire. The self-reported burnout level (emotional exhaustion>27 and/or depersonalization>10) was 67.4%. The majority of the respondents were female (83.9%), Singaporean (73.5%), aged 40 years and below (84.2%), and Chinese ethnicity (79.9%). In the multiple logistic regression model, high burnout level was negatively associated with being in the age groups of 31 to 40 (AOR 0.39, 95% CI 0.16–0.93) and 40 years and older (AOR 0.30, 95% CI 0.10–0.87) and a low self-reported workload (AOR 0.35, 95% CI 0.23–0.52). High burnout level was positively associated with a work experience of three to five years (AOR 5.27, 95% CI 1.44–20.93) and more than five years (AOR 4.24; 95% CI 1.16–16.79. One hundred and ninety participants completed the PBPT component. The most frequently cited barriers to seeking psychological help by participants with burnout (n = 130) were 'negative evaluation of therapy' and 'time constraints.' Conclusions: This study shows a high self-reported burnout level and identifies its associated factors among AHPs in a tertiary hospital. The findings revealed the urgency of addressing burnout in AHPs and the need for effective interventions to reduce burnout. Concurrently, proper consideration of the barriers to seeking help is warranted to improve AHPs' mental well-being. [ABSTRACT FROM AUTHOR]

Purpose: Work-related issues among Asian adolescent and young-adult (AYA) cancer survivors are poorly described in the literature. There has also been a paucity of reports regarding insurance-related concerns in this patient population. Focus groups were therefore carried out in Singapore to understand survivorship issues related to work and insurance coverage among Asian AYA cancer survivors. Methods: Twenty-three AYA survivors and 18 healthcare professionals (HCPs) who care for AYA cancer patients were recruited for 11 focus group sessions. Thematic content analysis was carried out to identify major themes that emerged. Results: Similar themes emerged from AYA and HCP focus groups. The majority of AYA survivors were eager to return to work post-treatment. However, some survivors were worried about not keeping up with expectations and struggled with disclosure of their medical history. In contrast, several survivors leveraged on their experience with cancer to bolster job opportunities. Despite facing challenges due to complications from cancer and restrictions at work, AYA survivors preferred to be treated normally. AYA survivors also expressed concerns about inadequate insurance coverage and a lack of information on this topic. Conclusion: Contrary to expectations, Asian AYA survivors are motivated to return to work and address work-related challenges. Inadequate insurance coverage remains a pressing concern despite the availability of public health insurance and subsidies. Career coaches and financial counselors should be incorporated into survivorship care to aid AYA survivors. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study is to explore patients' experiences with community-based care programmes (CCPs) and develop dimensions of patient experience salient to community-based care in Singapore. Most countries like Singapore are transforming its healthcare system from a hospital-centric model to a person-centered community-based care model to better manage the increasing chronic disease burden resulting from an ageing population. It is thus critical to understand the impact of hospital to community transitions from the patients' perspective. The exploration of patient experience will guide the development of an instrument for the evaluation of CCPs for quality improvement purposes. Methods: A qualitative exploratory study was conducted where face-to-face in-depth interviews were conducted using a purposive sampling method with patients enrolled in CCPs. In total, 64 participants aged between 41 to 94 years were recruited. A deductive framework was developed using the Picker Patient Experience instrument to guide our analysis. Inductive coding was also conducted which resulted in emergence of new themes. Results: Our findings highlighted eight key themes of patient experience: i) ensuring care continuity, ii) involvement of family, iii) access to emotional support, vi) ensuring physical comfort, v) coordination of services between providers, vi) providing patient education, vii) importance of respect for patients, and viii) healthcare financing. Conclusion: Our results demonstrated that patient experience is multi-faceted, and dimensions of patient experience vary according to healthcare settings. As most patient experience frameworks were developed based on a single care setting in western populations, our findings can inform the development of a culturally relevant instrument to measure patient experience of community-based care for a multi-ethnic Asian context. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is prevalent and has high cure rates. The resultant increase in numbers of breast cancer survivors (BCS) may overwhelm the current oncology workforce in years to come. We postulate that primary care physicians (PCPs) could play an expanded role in comanaging survivors, provided they are given the appropriate tools and training to do so.Objective: To explore the perspectives of PCPs towards managing BCS in a community-based shared-care programme with oncologists.Methods: Eleven focus groups and six in-depth interviews were conducted with seventy PCPs recruited by purposive sampling. All sessions were audio-recorded, transcribed verbatim and coded by three independent investigators. Thematic data analysis was performed and the coding process facilitated by NVivo 12.Results: Majority of PCPs reported currently limited roles in managing acute and non-cancer issues, optimizing comorbidities and preventive care. PCPs aspired to expand their role to include cancer surveillance, risk assessment and addressing unmet psychosocial needs. PCPs preferred to harmonize cancer survivorship management of their primary care patients who are also BCS, with defined role distinct from oncologists. Training to understand the care protocol, enhancement of communication skills, confidence and trust were deemed necessary. PCPs proposed selection criteria of BCS and adequacy of their medical information; increased consultation time; contact details and timely access to oncologists (if needed) in the shared-care programme.Conclusions: PCPs were willing to share the care of BCS with oncologists but recommended role definition, training, clinical protocol, resources and access to oncologist's consultation to optimize the programme implementation. [ABSTRACT FROM AUTHOR]

Background: Neurocognitive dysfunction is a common complication of coronary artery bypass grafting (CABG) with incidence of 19-38%. The miniaturized cardiopulmonary bypass (MCPB) system was developed to reduce hemodilution and inflammation and provides better cerebral protection than conventional cardiopulmonary bypass (CCPB). In a meta-analysis, MCPB was associated with a 10-fold reduction in the incidence of strokes. However, its effect on postoperative cognitive decline (POCD) is unknown. We assessed if MCPB decreases POCD after CABG and compared the risk factors.Methods: A total of 71 Asian patients presenting for elective CABG at a tertiary center were enrolled. They were randomly assigned to MCPB (n = 36) or CCPB group (n = 35) and followed up in a single-blinded, prospective, randomized controlled trial. The primary outcome was POCD as measured by the repeatable battery of neuropsychological status (RBANS). Inflammatory markers (tumor necrosis factor-alpha and interleukin-6), hematocrit levels, and neutron-specific enolase (NSE) levels were studied.Results: Overall, the incidence of POCD at 3 months was 50%, and this was not significantly different between both groups (51.4 vs 50.0%, P = 0.90). Having <6 years of formal education [risk ratio (RR) = 3.014, 95% confidence interval (CI) = 1.054-8.618, P = 0.040] was significantly associated with POCD in the CCPB group, while the lowest hematocrit during cardiopulmonary bypass was independently associated with POCD in the MCPB group (RR = 0.931, 95% CI = 0.868-0.998, P = 0.044). The postoperative inflammatory markers and NSE levels were similar between the two groups.Conclusions: This study shows that the MCPB was not superior to CCPB with cell salvage and biocompatible tubing with regard to the neurocognitive outcomes measured by the RBANS. [ABSTRACT FROM AUTHOR]

Purpose: With an increasing focus on developing survivorship services tailored for adolescent and young adult (AYA) cancer survivors, incorporation of viewpoints from both survivors and health care professionals (HCPs) is important. This study aims to explore the perceptions of current and prospective survivorship services from both groups in Singapore to propose service design and delivery strategies. Methods: Focus group discussions with 23 AYA cancer survivors between the ages of 16 and 39 years at diagnosis and 18 HCPs were conducted in National Cancer Centre Singapore (NCCS) and Singapore Cancer Society (SCS). All focus group discussions were transcribed verbatim. Deductive thematic analysis was performed according to the components of a design thinking model: empathizing with AYA survivors, defining care gaps, proposing services, and implementation strategies. Results: AYA survivors preferred age-specific services that are aligned with their personal goals. Current survivorship care failed to address the needs of survivors' dependents (caregivers and children) and to consider the utility of each service temporally. Prospective services should clarify disease disclosure obligation in job search and introduce a care navigator. Key implementation strategies included (1) training HCPs on communication techniques with AYA, (2) selecting engagement platforms that complement survivors' information-seeking behavior, (3) improving outreach to survivors through appropriate branding and publicity, and (4) consolidating services from multiple providers. Conclusions: The design of survivorship care services for AYA survivors should be systematic in its conceptualization process and employ implementation strategies. The coordination of the wide spectrum of services warrants a concerted effort by cancer centers, community partners, and the government. [ABSTRACT FROM AUTHOR]

Background: Accessibility to efficient and person-centered healthcare delivery drives healthcare transformation in many countries. In Singapore, specialist outpatient clinics (SOCs) are commonly congested due to increasing demands for chronic care. To improve this situation, the National University Health System (NUHS) Regional Health System (RHS) started an integrated care initiative,the Right-Site Care (RSC) program in 2014. Through collaborations between SOCs at the National University Hospital and primary and community care (PCC) clinics in the western region of the county, the program was designed to facilitate timely discharge and appropriate transition of patients, who no longer required specialist care, to the community. The aim of this study was to evaluate the implementation fidelity of the NUHS RHS RSC program using the modified Conceptual Framework for Implementation Fidelity (CFIF), at three distinct levels; providers, organizational, and system levels to explain outcomes of the program and to inform further development of (similar) programs.Methods: A convergent parallel mixed methods study using the realist evaluation approach was used. Data were collected between 2016 and 2018 through non-participatory observations, reviews of medical records and program database, together with semi-structured interviews with healthcare providers. Triangulation of data streams was applied guided by the modified CFIF.Results: Our findings showed four out of six program components were implemented with low level of fidelity, and 9112 suitable patients were referred to the program while 3032 (33.3%) declined to be enrolled. Moderating factors found to influence fidelity included: (i) complexity of program, (ii) evolving providers' responsiveness, (iii) facilitation through synergistic partnership, training of PCC providers by specialists and supportive structures: care coordinators, guiding protocols, shared electronic medical record and shared pharmacy, (iv) lack of organization reinforcement, and (v) mismatch between program goals, healthcare financing and providers' reimbursement.Conclusion: Functional integration alone is insufficient for a successful right-site care program implementation. Improvement in relationships between providers, organizations, and patients are also warranted for further development of the program. [ABSTRACT FROM AUTHOR]

Purpose: To investigate information literacy (IL) skills of secondary students in Singapore after integration of these skills into school curriculum. The study also explored cyber wellness skills of the students. Design/methodology/approach: A survey questionnaire was used to collect data from 14 secondary schools, located in different geographical zones of the country. A total of 3,306 secondary students participated in this survey. A scoring scheme was devised to assess IL skills of the students. Findings: The students achieved an overall mean score of 52.6%, which is considered as a "middle" level of IL competency. The students obtained high mean scores for two IL skills: "defining information task and analysing information gaps" (60.5%) and cyber wellness (60.1%). Lowest scores were achieved for two IL skills: "selecting information sources" (47.4%) and "appraising the information process and product" (48.0%). Research limitations/implications: This study has not investigated IL knowledge of teachers, responsible for teaching IL components. Similarly, content analysis of school textbooks, integrating IL skills, could be useful. Practical implications: It appeared that integration of IL skills into school curriculum showed limited success in imparting these skills. This paper suggests measures for improving the integration of IL skills into school curriculum. Findings of this survey will be useful to curriculum planners, education administrators, instructors teaching IL skills and school librarians. Originality/value: This study was unique as, in addition to standard IL skills, it also investigated cyber wellness skills. It was desirable as now social media have become a popular source for information seeking and sharing. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to assess knowledge of Singapore Grade 5 (11 years old) students’ understanding and proficiency in basic information literacy (IL) skills of defining information tasks, selecting information sources, seeking information from sources and synthesising and using information.Design/methodology/approach A 38-item multiple-choice question assessment instrument was used to assess the students’ IL skills based on the i-Competent IL model. The instrument first developed in 2010 was refined and expanded to increase the robustness and accuracy of assessment for the study. It was administered to 17 primary schools in Singapore in November 2015. The maximum possible score of 54 was scaled up to 100 to report the overall mean score for ease of reference and comparison. A total of 2,399 returns were obtained and analysed using Statistical Package for the Social Sciences 22.0 to compute the mean scores, IL stage-level scores. The study also investigated for any significant differences in performance between male and female students, and students with or without access to the internet at home.Findings The students achieved an overall mean score of 53.39 which is below a recommended acceptable score of 60 or 70 advocated in a number of past studies. The two worst performing areas of IL skills were synthesising and using information and seeking information from sources with mean scores of 45.89 and 48.81, respectively. A review of the highest number of incorrect answers suggests that students had difficulty in identifying key information from an information task narrative, understanding the use of reference sources and role of librarians, distinguishing between a fact and opinion, and adopting the best strategy for searching. Girls outperformed boys with an overall mean score of 55.38 vs 51.50. Students with internet access at home fared better than those without access to it with a score of 53.67 vs 45.81. The overall poor results of the survey suggest an urgent need to review the IL education landscape in the Singapore school system, revisit polices, priorities and assess the relevance and effectiveness of the IL curriculum, practical hands-on classes, and interventions that are currently employed in schools.Practical implications The study helped identify areas of IL skills strengths and weakness among Grade 5 students in Singapore schools. It provides recommendations for follow up actions for education authority and schools to improve the situation.Originality/value This study was prompted to provide an assessment after a national IL initiative was launched in 2012 to inculcate IL skills among the school-going children as part of creating a value-driven education system. This is the first reported set of findings for a large-scale survey conducted to measure and ascertain the IL skills level among Grade 5 students. [ABSTRACT FROM AUTHOR]

One-dimensional boring presents limitations on mapping the refuse profile in old landfills owning to waste heterogeneity. Electrical imaging (EI) and multiple-analysis of surface wave (MASW) were hereby deployed at an old dumping ground in Singapore to explore the subsurface in relation to geotechnical analysis. MASW estimated the refuse boundary with a higher precision as compared to EI, due to its endurance for moisture variation. EI and MASW transection profiles suggested spots of interest, e.g., refuse pockets and leachate mounds. 3D inversion of EI and MASW data further illustrated the transformation dynamics derived by natural attenuation, for instance the preferential infiltration pathway. Comparison of geophysical surveys at different years uncovered the subterranean landfill conditions, indicating strong impacts induced by aging, precipitation, and settlement. This study may shed light on a characterization framework of old landfills via combined geophysical models, thriving landfill knowledge with a higher creditability. [ABSTRACT FROM AUTHOR]

The purpose of this study was to track the refuse profile in Lorong Halus Dumping Ground, the largest landfill in Singapore, by electrical resistivity and surface wave velocity after 25 years of closure. Data were analyzed using an orthogonal set of plots by spreading 24 lines in two perpendicular geophone-orientation directions. Both geophysical techniques determined that refuse boundary depth was 13 ± 2 m. The refuse boundary revealed a certain degree of variance, mainly ascribed to the different principle of measurements, as well as the high heterogeneity of the subsurface. Discrepancy was higher in spots with greater heterogeneity. 3D analysis was further conducted detecting refuse pockets, leachate mounding and gas channels. Geotechnical monitoring (borehole) confirmed geophysical outcomes tracing different layers such as soil capping, decomposed refuse materials and inorganic wastes. Combining the geophysical methods with borehole monitoring, a comprehensive layout of the dumping site was presented showing the hot spots of interests. [ABSTRACT FROM AUTHOR]

Preliminary analysis on dredged marine sediments from Benoi basin in Singapore was carried out showing elevated concentrations of Zn, Cu, Pb, Cd, Cr and Ni. Ethylenediamine tetraacetic acid (EDTA) thermal washing experiments were conducted for heavy metal extraction at temperature 100 °C. Results indicated the significant efficiency of thermal washing to extract Pb, Zn and Ni. However, there was little or no influence in the removal of Cu and Cr and a slight effect to Cd indicating multiple mechanisms. In addition, agitation was found to have great influence on the removal efficiency of heavy metals as experiments without agitation performed lesser or no extraction due to limited contact of the washing solution and the dredged sediment. Sequencing processes of thermal treatment followed by EDTA washing showed limited performance, likely due to thermal stabilization of the contaminants particularly at low liquid-to-soil (L/S) ratio. Furthermore, sequential extraction analysis on the metal speciation was performed before and after thermal washing. It was revealed that metals mainly extracted from fractions bound to carbonates and Fe-Mn oxides, the relative mobile fraction. On the contrary, metals in the residual fraction displayed a considerable stability. [ABSTRACT FROM AUTHOR]

Purpose – This study aimed to acquire knowledge about Singapore secondary school (ages 13 to 16 years old) students' skills in searching, evaluating and using information. Design/methodology/approach – A comprehensive instrument encompassing the basic information literacy (IL) skills, as well as a new dimension of ethical usage of information and collaborative information seeking was used for data collection. From August to November 2010, a total of eight schools comprising 3,164 students participated in this study. Findings – It was a matter of concern that various kinds of libraries, including school libraries, were found to be under-utilized. From the test that was administered to assess the IL skills of students, the results were found to be generally unsatisfactory as each of the major categories of IL skills recorded a score that is below 50 (out of a maximum of 100) except for “task definition”. For skills related to “information seeking strategies”, “location & access” and “information use”, the types of schools, academic streams of study, and students' family background seemed to have significant influences. Originality/value – This study is the first large-scale survey conducted in Singapore that sought to test the IL skills of secondary school students. The findings are useful in assessing the current effectiveness of IL integration, and the need for a more planned approach towards IL competency training within the school curriculum in Singapore. [ABSTRACT FROM AUTHOR]

As former and current STEM (science, technology, engineering, and mathematics) school teachers in Singapore, we explore the challenges we both experienced while teaching at different STEM schools. Through this article, we make a case for the teacher preparation programs locally and around the world to give more attention to a changing education landscape with emerging specialized STEM schools. Nonetheless, even though specialized STEM teacher preparation is needed, we also caution that having such a specialized program may limit teachers' horizontal transition to mainstream schools and awareness of the contextualized needs of more diverse learners. [ABSTRACT FROM PUBLISHER]

Measuring and assessing information literacy (IL) competencies is essential to understand its educational impact as well as to explore pedagogies to improve it. This study is the first to acquire knowledge about Singapore tertiary students' skills in searching, evaluating, and using information. A total of 534 students from the College of Humanities, Arts, and Social Sciences, Nanyang Technological University, Singapore participated in this study through an online survey. Moderate IL skills scores of the respondents showed room for improvement especially in higherlevel skills related to information use, synthesis, and evaluation. Students receiving pretertiary education in Singapore scored higher than those from overseas did, which, to some extent, showed that IL education in Singapore is still more effective than that in some other countries. The IL course offered in the university was found to be useful and to lead to higher IL assessment scores. [ABSTRACT FROM AUTHOR]

Background: A study was conducted at Singapore's National University Hospital to elicit registered nurses' attitudes, knowledge, barriers, facilitating factors, education, and training regarding evidence-based practice. Methods: A 13-question survey that was administered to all registered nurses yielded 1,114 (75.4%) usable returns for analysis. Results: Findings showed that Singapore nurses had a positive and supportive attitude toward evidence-based practice but lacked the competence and knowledge to conduct it. Time constraints were identified as the main barrier to implementing evidence-based practice. There is a need for proper training, mentoring by senior nurses, and adequate time for evidence-based practice. Nurses with a higher level of nursing education who indicated the greatest perceived barriers tended to have less difficulty applying evidence-based practice but identified a need for more training in information skills. Conclusion: Evidence-based practice is still in its infancy in Singapore compared with hospitals in other developed countries. [ABSTRACT FROM AUTHOR]

Objective: Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population. The objective of this study was to explore nurses' awareness of, knowledge of, and attitude toward EBP and factors likely to encourage or create barriers to adoption. In addition, information sources used by nurses and their literature searching skills were also investigated. Method: A total of 2,100 copies of the questionnaire were distributed to registered nurses in 2 public hospitals in Singapore, and 1,486 completed forms were returned, resulting in a response rate of 70.8%. Results: More than 64% of the nurses expressed a positive attitude toward EBP. However, they pointed out that due to heavy workload, they cannot keep up to date with new evidence. Regarding self-efficacy of EBP-related abilities, the nurses perceived themselves to possess moderate levels of skills. The nurses also felt that EBP training, time availability, and mentoring by nurses with EBP experience would encourage them to implement EBP. The top three barriers to adopting EBP were lack of time, inability to understand statistical terms, and inadequate understanding of the jargon used in research articles. For literature searching, nurses were using basic search features and less than one-quarter of them were familiar with Boolean and proximity operators. Conclusion: Although nurses showed a positive attitude toward EBP, certain barriers were hindering their smooth adoption. It is, therefore, desirable that hospital management in Southeast Asia, particularly in Singapore, develop a comprehensive strategy for building EBP competencies through proper training. Moreover, hospital libraries should also play an active role in developing adequate information literacy skills among the nurses. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether presenting distance visual acuity is related to subsequent academic school performance in Singaporean children between 9 to 10 years of age. Methods: Singapore children (n = 1143 children) were examined during their visits at ages 9 to 10 years (grades 3 to 4) as part of the Singapore Cohort Study of the Risk Factors for Myopia (SCORM) longitudinal study. Each child underwent an annual comprehensive eye examination, including the assessment of presenting logarithm of the minimum angle of resolution (LogMAR) distance visual acuity (VA). The individual marks of a nation-wide standard examination in grade 4 were used as the outcome measure for academic school performance. Children with any known eye disease, (such as media opacities) were excluded from the analysis. Results: The mean presenting distance VA of the better eye was 0.10 and 0.08 when the children were in grades 3 and 4, respectively. There was a statistically significant difference for mean presenting VA with 9 and 10 year old boys scoring better (0.08 and 0.07) compared to girls (0.12 and 0.09) for the same ages, ( p = 0.001 and p = 0.007), respectively. After adjusting for gender, ethnicity, school, reading, intelligence quotient and father’s education, no significant relationships were found between average examination marks at the end of grade 4 and presenting VA obtained (better eye and worst eye) in grade 3 ( p = 0.38 and p = 0.98) and 4 ( p = 0.27 and p = 0.16). Conclusion: In our sample of Singaporean children without ocular disease, distance VA did not play a significant role in predicting academic school performance. [ABSTRACT FROM AUTHOR]

Several comprehensive information literacy (IL) standards have been developed worldwide for use in the education sector, specifically for students and teachers. Apart from the more generic International Federation of Library Associations (IFLA) IL standards, such standards are more appropriate for their countries of origins. If these standards are to be applied to schools in Southeast Asia, then some form of contextualization and customization is necessary to cater for gaps that surface due to their different and unique education environments and cultures. In addition, as a result of the growth of Web 2.0, information seeking moves rapidly in the social dimension. It is therefore timely to review ongoing research in the areas of collaborative information seeking and behavior, as well as education values in order to derive a set of up-to-date, relevant and holistic IL standards for schools. This paper proposes a model to help to develop IL standards for schools in Singapore that was constructed using the aforementioned standards as a guide, based on the paradigm of a popular information and technology literacy process model known as the Big6, and steered by related educational initiatives and education values that have been recently implemented in Singapore. The proposed model expounds each of the Big6 categories in terms of Techniques and Tools, and supplements those categories with three important mindsets of Ethics and Social Responsibility, Collaborative Information Behavior, and Attitudes and Perceptions. [ABSTRACT FROM AUTHOR]

The genetic polymorphism of HLA-A and HLA-B loci was investigated in 505 Chaoshanese using PCR-SSP method. Among the HLA-A alleles detected, A*11 (35.64%) was most frequent, followed by A*02 (31.78%). Of 34 HLA-B alleles tested, 30 were observed, in which B*60 (21.68%), B*46 (14.46%), and B*58 (10.69%) were highly predominant. Comparison was made with other nine Chinese Han ethnic groups covering the Mainland China, Taiwan, Hong Kong, and Singapore. The high frequent alleles found in Chaoshanese were also common in other Chinese groups compared though the frequency levels varied from group to group. The phylogenic tree analysis based on the HLA-A and -B allele frequencies of all the 10 Chinese ethnic groups revealed that Chaoshanese, while clustering in general with the southern China-related Han Chinese, had the highest affinity to the Mainland Minnanese, but separated distinctively from the northern Han Chinese. The study, however, was yet to confirm the hypothesis of the Central Plains Han origin of Chaoshanese. Interestingly, the alleles (B*46, B*38, and B*58) and the related haplotypes (A*02-B*46 and A*33-B*58) that are positively associated with nasopharyngeal carcinoma (NPC), a disease prevailing predominantly among southern Chinese, were always at much higher frequencies among southern Chinese than among northern Chinese, whereas A*31 and B*13, the two alleles with highly protective effects for NPC, and the associated haplotype A*30-B*13 were predominantly high in northern Chinese. The different genetic background between northern and southern China may explain, at least partially, the prevalence of NPC among southern Chinese. [ABSTRACT FROM AUTHOR]

This research is conducted in response to the lack of empirical studies on how e-government projects are managed. We extend the contingency framework of project management proposed by Barki and his colleagues (2001) to the context of e-government projects. In particular, we contend that the digital divide is another risk factor for e-government projects and therefore bridging the digital divide should be part of e-government projects' management profiles. To test our research model we conducted a case study with a ministry in Singapore. Theoretical contributions and managerial implications of this study are discussed. [ABSTRACT FROM AUTHOR]

An experiment involving 140 Singaporean students with four advertisements classified as either high or moderate in degrees of incongruity is used to investigate the influence of incongruity on the effectiveness of humorous advertisements. As predicted, participants' perceived humor, attitudes toward the advertisement and the brand, and purchase intention are higher for humorous advertisements containing moderate incongruity than for those containing extreme incongruity. [ABSTRACT FROM PUBLISHER]

This Mini-Special Issue of the IEEE TRANSACTIONS ON MICROWAVE THEORY AND TECHNIQUES (TMTT) is devoted to the 2019 Asia-Pacific Microwave Conference (APMC 2019), Singapore, December 10–13, 2019. APMC is one of the premier international conferences in the microwave community. The conference brought in a unique mix of high-quality keynote, invited, and contributed papers by world-class speakers from academia and industry, providing an opportunity for microwave family members to exchange their visions, insights, challenges, and progress in microwaves. It received a total submission of 1064 papers covering microwave to terahertz spectrum with a variety of applications by the authors from 56 countries/regions and finally accepted 720 papers after careful and rigorous peer review. The conference consisted of 71 technical oral and poster sessions from 53 technical tracks, eight workshops/short courses, 29 invited talks, and two plenary talks. In particular, 17 special sessions are convened by session organizers to discuss emerging technologies. [ABSTRACT FROM AUTHOR]

Estimates of the projected changes in precipitation and temperature have great significance for adaption planning in the context of climate change. To obtain the climate change information at regional or local scale, downscaling approaches are required to downscale the coarse global climate model (GCM) outputs to finer resolutions in both spatial and temporal dimensions. The multi-site, multi-variate downscaling approach has received considerable attention recently due to its advantage in providing distributed, physically coherent downscaled meteorological fields for subsequent impact modeling. In this study, a newly developed multi-site multivariate statistical downscaling approach based on empirical copula was applied to downscale grid-based, monthly precipitation, maximum and minimum temperature outputs from nine global climate models to site-specific, daily data over four weather stations in Singapore. The advantage of this approach lies in its ability to reflect the at-site statistics, inter-site and inter-variable dependencies, and temporal structure in the downscaled data. The downscaling was conducted for two projection periods (i.e., the 2021–2050 and 2071–2100 periods) under two emission scenarios (i.e., representative concentration pathway (RCP)4.5 and RCP8.5 scenarios). Based on the downscaling results, projected changes in daily precipitation, maximum and minimum temperatures were examined. The results show that there is no consensus on the projected change in average precipitation over the two future periods. The major uncertainty for precipitation projection comes from the GCMs. For daily maximum and minimum temperatures, all downscaled GCMs project an increase of average temperature in the future. These change signals could be different from those of the original GCM data, both in magnitude and in direction. These findings could assist in adaption planning in Singapore in response to emerging climate risks. [ABSTRACT FROM AUTHOR]

[Display omitted] • Commercially treated incineration bottom ashes show distinctive characteristics. • Seawater promotes leaching of elements and needs attention in coastal regions. • Elements are categorized with different mobilities and controlled mechanisms. • Element leaching behaviors are categorized to improve long-term assessment. Leaching of potentially hazardous substances, especially the heavy metals from Incineration Bottom Ash (IBA) is a major problem in its recyclable usage. To address this concern, treatment of IBA is indispensable before it can be reused. IBA subjected to laboratory-scale treatment typically yields clearer conclusions in terms of leaching behaviors, benefiting from the controlled laboratory environment. However, the leaching behaviors of commercially treated IBA appear to be more ambiguous due to the complex and comprehensive nature of industrial-scale treatments, where multiple treatment techniques are involved concurrently. Furthermore, treatment efficiencies vary among different plants. In this study, three types of commercially treated IBA were sampled from leading waste treatment companies in Singapore. Characterization and leaching tests were performed on the treated IBAs in both standardized and modified manners to simulate various scenarios. Besides deionized water, artificial seawater was used as a leachant in leaching tests for simulating seawater intrusion. The results reveal the promoting effect of seawater on the leaching levels of several elements from three types of treated IBA, which may require special attention for IBA application and landfill near the coast. Furthermore, the elements examined in these three types of commercially treated IBA generally comply with the non-hazardous waste acceptance criteria outlined in Council Decision, 2003 /33/EC (2003), except Sb. By combining two leaching tests, the elements were categorized into different types of leaching behavior, making it possible to prepare and respond to the concerning leaching scenarios in future engineering applications. [ABSTRACT FROM AUTHOR]

Aim Singapore is one of the fastest-aging countries in the world, and the demand for acute hospital care for older adults is expected to triple in the next 25 years. Hence, it is crucial to understand the opportunities in reducing potentially avoidable bed days (PABD), which are days spent in acute hospitals delivering only non-acute services. We aimed to access the prevalence, causes and consequences of PABD among geriatric patients. Methods We examined all hospitalizations from 1 August through 31 December 2013 in the geriatric wards of an acute hospital in Singapore. PABD were identified using a modified Appropriateness Evaluation Protocol. Non-acute services were classified as subacute care, rehabilitative care, long-term care or social care. Hospitalization patterns were determined based on the presence or absence of non-acute services, and multinomial logistic regression was used to determine predictors of different patterns. Results Of the 273 bed days used by 254 patients, 49% were potentially avoidable. The most common non-acute services provided were rehabilitative care (19%), subacute care (12%) and long-term care (8%). New acute issues arose after the admission conditions subsided in 2.4% of hospitalizations, 61% of which were nosocomial infections. Being socially at risk as assessed on admission predicted the development of new acute issues (sensitivity = 62%; specificity = 88%). Conclusions In the present study, almost half of the bed days were potentially avoidable. New acute issues can arise after PABD, which are dangerous to these frail older adults. Proactive discharge planning and increasing access to intermediate and long-term care services are required to reduce PABD. Geriatr Gerontol Int 2017; 17: 1575-1583. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to investigate the relationship between five domain-specific skills of health literacy: Find Health Information (FHI), Appraise Health Information (AHI), Understand Health Information to act (UHI), Actively Manage One's Health (AMH), and E-health literacy (e-Heals), and health information seeking behaviors and three categories of health outcomes.Methods: A survey was implemented and data was collected from 1062 college going adults and analyzed using bivariate tests and multiple regression analysis.Results: Among the five domain-specific Health Literacy skills, AHI and e-Heals were significantly associated with the use of traditional sources and the Internet for healthcare information respectively. Similarly and AMH and e-Heals were significantly associated with the use of traditional sources and the Internet for health lifestyle information respectively. Lastly AHI, AMH and e-Heals were significantly associated with the three categories of outcomes, and AFH was significantly associated with cognitive and instrumental outcomes, but not doctor-patient communication outcomes.Conclusion: Consumers' ability to use different health sources for both healthcare and health lifestyle information, and the three categories of health outcomes are associated with different domain-specific health literacy skills.Practice Implications: Health literacy initiatives may be improved by focusing on clients to develop domain-specific skills that increase the likelihood of using health information sources and accrue benefits. [ABSTRACT FROM AUTHOR]

Purpose To meet increasing demand for cancer genetic testing and improve value-based cancer care delivery, National Cancer Centre Singapore restructured the Cancer Genetics Service in 2014. Care delivery processes were redesigned. We sought to improve access by increasing the clinic capacity of the Cancer Genetics Service by 100% within 1year without increasing direct personnel costs. Methods Process mapping and plan-do-study-act (PDSA) cycles were used in a quality improvement project for the Cancer Genetics Service clinic. The impact of interventions was evaluated by tracking the weekly number of patient consultations and access times for appointments between April 2014 and May 2015. The cost impact of implemented process changes was calculated using the time-driven activity-based costing method. Results Our study completed two PDSA cycles. An important outcome was achieved after the first cycle: The inclusion of a genetic counselor increased clinic capacity by 350%. The number of patients seen per week increased from two in April 2014 (range, zero to four patients) to seven in November 2014 (range, four to 10 patients). Our second PDSA cycle showed that manual preappointment reminder calls reduced the variation in the nonattendance rate and contributed to a further increase in patients seen per week to 10 in May 2015 (range, seven to 13 patients). There was a concomitant decrease in costs of the patient care cycle by 18% after both PDSA cycles. Conclusion This study shows how quality improvement methods can be combined with time-driven activity-based costing to increase value. In this paper, we demonstrate how we improved access while reducing costs of care delivery. [ABSTRACT FROM AUTHOR]

Semantic segmentation in 3D point-clouds plays an essential role in various applications, such as autonomous driving, robot control, and mapping. In general, a segmentation model trained on one source domain suffers a severe decline in performance when applied to a different target domain due to the cross-domain discrepancy. Various Unsupervised Domain Adaptation (UDA) approaches have been proposed to tackle this issue. However, most are only for uni-modal data and do not explore how to learn from the multi-modality data containing 2D images and 3D point clouds. We propose an Adversarial Unsupervised Domain Adaptation (AUDA) based 3D semantic segmentation framework for achieving this goal. The proposed AUDA can leverage the complementary information between 2D images and 3D point clouds by cross-modal learning and adversarial learning. On the other hand, there is a highly imbalanced data distribution in real scenarios. We further develop a simple and effective threshold-moving technique during the final inference stage to mitigate this issue. Finally, we conduct experiments on three unsupervised domain adaptation scenarios, ie., Country-to-Country (USA →Singapore), Day-to-Night, and Dataset-to-Dataset (A2D2 →SemanticKITTI). The experimental results demonstrate the effectiveness of proposed method that can significantly improve segmentation performance for rare classes. Code and trained models are available at https://github.com/weiliu-ai/auda. [ABSTRACT FROM AUTHOR]

The dual-specificity phosphatase (DUSP) family plays key roles in the maintenance of cellular homeostasis and apoptosis etc. In this study, the DUSP member DUSP1 of Epinephelus coioides was characterized: the length was 2371 bp including 281 bp 5′ UTR, 911 bp 3′ UTR, and a 1125 bp open reading frame encoding 374 amino acids. E. coioides DUSP1 has two conserved domains, a ROHD and DSPc along with a p38 MAPK phosphorylation site, localized at Ser308. E. coioides DUSP1 mRNA can be detected in all of the tissues examined, and the subcellular localization showed that DUSP1 was mainly distributed in the nucleus. Singapore grouper iridovirus (SGIV) infection could induce the differential expression of E. coioides DUSP1. Overexpression of DUSP1 could inhibit SGIV-induced cytopathic effect (CPE), the expressions of SGIV key genes, and the viral titers. Overexpression of DUSP1 could also regulate SGIV-induced apoptosis, and the expression of apoptosis-related factor caspase 3. The results would be helpful to further study the role of DUSP1 in viral infection. • The character Epinephelus coioides DUSP1 was analyzed. • E. coioides DUSP5 regulated the infection and replication of SGIV. • E. coioides DUSP5 regulated the SGIV-induced cell apoptosis. [ABSTRACT FROM AUTHOR]