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SummaryHealth informatics has benefitted from the development of Info-Communications Technology (ICT) over the last fifty years. Advances in ICT in healthcare have now started to spur advances in Data Technology as hospital information systems, electronic health and medical records, mobile devices, social media and Internet Of Things (IOT) are making a substantial impact on the generation of data. It is timely for healthcare institutions to recognize data as a corporate asset and promote a data-driven culture within the institution. It is both strategic and timely for IMIA, as an international organization in health informatics, to take the lead to promote a data-driven culture in healthcare organizations. This can be achieved by expanding the terms of reference of its existing Working Group on Data Mining and Big Data Analysis to include (1) data analytics with special reference to healthcare, (2) big data tools and solutions, (3) bridging information technology and data technology and (4) data quality issues and challenges.

Uterine activity measured by quantifying active contraction area in induced labour showed an initial significant steep increase (incremental phase) followed by a stable phase when the uterine activity was about 1750 k Pas/15 min in nulliparae and multi-parae with poor cervical score; it was 1500 k Pas/15 min in multiparae with good cervical score. Once this was achieved, further increase in oxytocin dosage did not increase uterine activity but instead revealed a tendency to hypertonic uterine contractions. A marked rise in uterine activity was observed in the late first stage of labour (terminal phase) despite no increase in oxytocin in patients with good cervical scores (>6) at induction but not in those with poor cervical scores (

Use of contraceptives by some selected characteristics was studied for married women in the reproductive age range (MWRA) in 3 southeast Asian countries. The data were obtained from each countrys national family planning/fertility survey conducted around the mid-1970s. Only the gross relationship between each of the selected characteristics and contraceptive use was compared. The proportion of MWRA using contraceptives for Singapore was almost twice as high as the corresponding proportions for Peninsular Malaysia and Thailand. The pattern of contraceptive use was largely similar for Thailand and Malaysia but different from Singapore. The differences were largely attributed to the absence of a large rural population in Singapore the apparently greater tendency of women in Singapore to use reversible contraceptive methods for birth spacing and the easier access by women to family planning information and services particularly sterilization than in Peninsular Malaysia and Thailand. (authors)

Early studies have established that birth weight is influenced by a host of genetic and environmental factors. For this reason, the merit of examining the relationship of this anthropometric measurement with any one factor in isolation using simple bivariate studies is suspect. Although stratified analysis has been used as an alternative approach, its limitation becomes immediately obvious as the number of confounding factors requiring control increases. Later studies on factors affecting birth weight variation have recoursed to the use of the Multiple Linear Regression (MLR) technique. This paper reports the effects of seven factors on variation in a Singapore sample of 23, 591 singleton birth weights collected between 1967 through 1974. The dummy variable approach was adopted for the MLR analysis to relax the restriction of a linear relationship between some of the measurement variables, such as gestational length and maternal age, with birth weight. The results show that sex, birth order, father's occupation and ethnic group are significant factors affecting birth weight variation. Maternal age appears to be significant for mothers below 35 years as is gestational length before 42 weeks. Place of residence has no significant effect. The concordance of the findings with results from studies done elsewhere is discussed.

Developing countries have the burden of acute and chronic diseases with the greatest health disparities. There is also a shortfall of more than four million healthcare workers worldwide, and the proportion is higher in less economically viable countries where the lack of proper trained healthcare workers is also compromised by the migration and departure of skilled personnel together with a frail infrastructure and a shortage of resources that cannot provide a proper scenario for an adequate healthcare system that will fulfill the population needs. The need for both technology infrastructure and individuals who have the skills to develop these systems is great, but so are the challenges in developing the needed workforce who are well-trained in informatics. This chapter describes the current informatics education efforts in three regions: Latin America, Sub-Saharan Africa and the Asia-Pacific region. The description of specific healthcare informatics education programs, the educational methods used and the challenges encountered are explored.

In a cross-sectional random survey of the whole of Singapore (2143 subjects aged 18-69 years), cardiovascular risk factors were measured by standardized techniques. For the analysis in the 18-69 year age group there was adjustment for ethnic group, age, body mass index, alcohol consumption and physical activity. Among serum lipids, high density lipoprotein (HDL-) cholesterol and fasting triglyceride were inversely related with partial correlation coefficients (r) of males -0.34 (P < 0.001) and females -0.26 (P < 0.001). There were no relationships between blood pressure and serum lipids except for direct ones with fasting triglyceride, being males (systolic r = 0.06, P = 0.066 and diastolic r = 0.12, P < 0.001) and females (systolic r = 0.11, P < 0.001 and diastolic r = 0.13, P < 0.001). Cigarette smoking, in males, was related to systolic blood pressure (inversely), with, compared to non-smokers, a reduction of 1.3 mm Hg (1.1%) in light smokers, 3.8 mm Hg (3.1%) in moderate smokers and 4.6 mm Hg (3.7%) in heavy smokers; there was no clear relation with diastolic blood pressure. Cigarette smoking, in males, was related to HDL-cholesterol (inversely), even after further adjustment for fasting triglyceride, with compared to non-smokers reductions of 0.03 mmol/l (3.4%) in light smokers, 0.09 mmol/l (10.3%) in moderate smokers and 0.12 mmol/l (13.8%) in heavy smokers. Cigarette smoking was related to fasting triglyceride (directly) but this was removed by further adjustment for HDL-cholesterol. Cigarette smoking was not related to low density lipoprotein cholesterol. These results are compared to those of other surveys.

A retrospective study of 672 sampled records of patients of a major institutions providing Chinese traditional medicine in Singapore reveals that 97.3% of the patients were Chinese, with a dialect group distribution following closely that of the Singapore Chinese. The male-to-female patient ratio was 1.0:1.13. There were fewer patients of the pediatric age group and more of those from age 30 upwards. Some 43% of the patients sought treatment for ''infective'' and ''internal, emotional and weakness'' diseases. The prevalent disease conditions seen among patients from the different age groups are also analyzed and discussed in this paper.

Although the government of the Republic of Singapore do not give official recognition to the estimated 1000 Chinese physicians in the country, these practitioners of traditional herbal medicine still enjoy the patronage of a certain segment of the population, 76% of whom are ethnically Chinese. In an earlier paper, we have reported on the characteristics of Chinese physicians who volunteer their service for institutions that provide Chinese traditional health care in Singapore. This complementary paper reports the findings of a survey of 55 physicians who run their own private practice about whom, prior to our study, very litle was known.

All singleton live births occurring in Singapore in the three years 1981-3 were computed, and birthweight was examined in the different ethnic groups (Chinese, Malay, and Indian). Overall the proportions of babies of very low birthweight (less than 1500 g) and low birthweight (less than 2500 g) were: Chinese 0.3% and 6.1%, Malays 0.4% and 8.5%, and Indians 0.5% and 10.0%. The important finding was that in all gestational periods and virtually all maternal age and live birth order groups Indians had the highest proportion of very low and low birthweight babies. However for prematurity Indians at 6.7% had a higher rate than Chinese (5.1%) but lower than Malays (9.9%). Likewise for neonatal mortality Indians at 8.7 per 1000 live births were between Chinese (7.1) and Malays (9.1). The evidence seems to indicate that the reason for Indians having a higher proportion of low birthweight babies is partly ethnic/genetic, and the cut-off point of 2500 g should perhaps be lowered for babies from the Indian subcontinent when international comparisons are being made.

Between September 22 and October 29, 1976, a socio-epidemiologic survey of venereal diseases (VD) was carried out at a hospital for VD and skin diseases in Singapore. The study subjects comprised 401 national servicemen from the Singapore Armed Forces who were selected by periodic stratified random sampling from among army patients at the hospital. These subjects were divided into two groups, one consisting of those suffering solely from venereal diseases and the other from non-venereal skin diseases only. Studies were made to compare the personal characteristics, educational and social backgrounds and sexual behavior between these two groups. On the basis of the results, a profile of a soldier likely to contract venereal diseases was made. The study showed that soldiers have inadequate knowledge of venereal diseases. Suggestions are made to improve education as to venereal diseases and to reduce risk of infection in the armed forces.