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لملخص العربي: الملخص العربي: الأهداف: كان الهدف من هذه الدراسة هو وصف مستويات الفلوريد في زجاجات المياه المعبأة والمتوفرة تجارياً ولتحديد دقة ملصقات مستويات الفلوريد على الزجاجات. الطريقة: تم الحصول على (28) ملصق مياة معبأة من أسواق المدينة المنورة. تم تخفيف عينات المياه بكميات متساوية من إجمالي عازلة تعديل القوة الأيونية في الإدارة العامة لخدمات المياه. تمت مقارنة جهود المحاليل الكهربية بشكل مباشر مع محاليل الفلوريد القياسية. تم أخذ قراءتين لكل عينة وتم تسجيل المتوسط. تم قياس مستويات أيون الفلوريد باستخدام قطب فلوريد أيون انتقائي ومقياس أيون رقمي. النتائج: كان متوسط مستويات الفلورايد للزجاجات حسب الملصق الموجود بالزجاجات 0.94 ±0.14 جزء في المليون. كان متوسط مستويات الفلوريد لمحتوى الفلورايد الفعلي بعد التحليل 1.13 ±0.31 .جزء في المليون تم العثور على تضارب بين الملصقات التجاريه في الزجاجات وبين نتيجه التحليل الفعلي . وجدت نتيجة علامة تجارية واحدة فقط تناسبت بها مستويات الفلورايد على ملصقاتها وتحليل مستوى الفلورايد الفعلي. 85.71٪ فقط من العلامات التجارية كانت تحتوي على مستويات فلوريد ضمن نطاق الفلورايد المسموح به (0.6-1.5 جزء في المليون) ، 10.71٪ كان لديها مستويات فلوريد أعلى من نطاق الفلورايد المسموح به ، و 3.57٪ كان لديها مستويات فلوريد أقل من نطاق الفلورايد المسموح به. الاستنتاجات: في المملكة العربية السعودية تحتوي معظم زجاجات المياه المعبأة على مستويات من الفلوريد أعلى من المستويات المثالية والحيوية لمنع تسوس الأسنان. حيث وجد اختلاف في مستويات الفلوريد بين ما هو موجود على ملصقات العلامات التجارية وما وجد في التحليل الفعلي . لتحقيق الفوائد المرجوه والتجميلية اللازمة يجب التاكد من مستويات الفلورايد بدقة. يجب أن تستوفي المياه المعبأة معايير الجودة اللازمه لتجنب النتائج السلبية لارتفاع مستويات الفلوريد. يجب أن يكون أطباء الأسنان وأولياء الأمور على دراية بهذا التناقض Abstract: Objectives: This research aimed to determine the fluoride levels in commercially available bottled waters and assess the accuracy of the fluoride levels labels on the bottles. Methods: We obtained the labels from 28 water bottles from markets in Almadinah Almunawwarah. Water samples were diluted with an equal volume of total ionic strength adjustment buffer at the General Administration for Water Services. The electrode potential of each sample was then directly compared to standard fluoride solutions. For each sample, two readings were taken, and the average was recorded. Fluoride-ion levels were determined using a fluoride-ion-selective electrode and a digital readout ion meter. Results: On average, the mean fluoride levels in the labelled bottles were 0.94 ± 0.14 PPM. The level of the actual fluoride content was 1.13 ± 0.31 PPM. Inconsistencies between the brand labels and true levels of fluoride were detected. Only one brand of bottled water was comparable in terms of the fluoride levels on the labels and the analysed fluoride levels. Only 85.71% of the brands tested had fluoride levels within the permissible fluoride range (0.6–1.5 PPM), 10.71% had fluoride levels above the permissible fluoride range, and 3.57% had fluoride levels below the permissible fluoride range. Conclusions: In the KSA, most brands of bottled waters had fluoride levels above the ideal levels that are vital to the prevention of dental caries. There were differences in the fluoride levels recorded on the labels and the true levels determined in the laboratory. Fluoride levels must be accurately reported if we are to achieve necessary aesthetic and cosmetic benefits. Bottled water must meet critical quality standards to avoid the negative consequences of higher fluoride levels. Dentists and parents should be aware of this discrepancy.

As an unprecedented, shared global experience in crisis, the Covid-19 pandemic witnessed unusual behaviours amongst populations. Large-scale panic buying was observed in numerous countries. Such behaviours can be detrimental to the population's wellbeing and societal functioning. As global pandemics are a relatively rare phenomenon in history, research examining panic buying behaviours during pandemics and actual panic buying behaviours has been scarce. Within the context of the Covid-19 pandemic, the prevalence of social media has made it possible to monitor panic buying discourse real-time. The present research aims to study the relationship between online public discourse and its relationship with abnormal surges in buying behaviours. We first examined Singapore residents' supermarket purchase patterns based on daily supermarket sales data during Covid-19 and investigated its relationship with parallel social media information on the internet. Analysis involving these two large-scale social media and supermarket datasets revealed distinct purchasing patterns for various types of products such as staple food items and home electronic products. While significant positive correlation was found between purchasing patterns of staple and long-lasting canned foods and online discourse, this was absent for items such as home appliances and entertainment products. The findings point to the potential role of social media data in predicting future abnormal food demand episodes, with implications on food security and crisis management.

Abstract Background Public health strategies to improve patient adherence to antibiotics rely mostly on raising awareness of the threat of antimicrobial resistance (AMR) and improving knowledge about antibiotics. We aimed to evaluate how adherence to antibiotics relates to knowledge and the threat perceptions proposed by the Protection Motivation Theory (PMT). Method A cross-sectional online survey was conducted in September-December 2020 with 1002 participants aged 21-70 years in Singapore. Two items, which were reverse coded, evaluated adherence to antibiotics: ‘how often do you obtain antibiotics that were left over from the previous prescription’ and ‘how often did you treat yourself with antibiotics in the past year’. Questions about the PMT-related constructs, and knowledge regarding antibiotics and AMR knowledge were also included. Hierarchical regression models were performed at a 5% significance level. Results Adherence to antibiotics was associated with knowledge level (β = 0.073, p

IntroductionThe potential for deployment of Artificial Intelligence (AI) technologies in various fields of medicine is vast, yet acceptance of AI amongst clinicians has been patchy. This research therefore examines the role of antecedents, namely trust, attitude, and beliefs in driving AI acceptance in clinical practice.MethodsWe utilized online surveys to gather data from clinicians in the field of gastroenterology.ResultsA total of 164 participants responded to the survey. Participants had a mean age of 44.49 (SD = 9.65). Most participants were male (n = 116, 70.30%) and specialized in gastroenterology (n = 153, 92.73%). Based on the results collected, we proposed and tested a model of AI acceptance in medical practice. Our findings showed that while the proposed drivers had a positive impact on AI tools’ acceptance, not all effects were direct. Trust and belief were found to fully mediate the effects of attitude on AI acceptance by clinicians.DiscussionThe role of trust and beliefs as primary mediators of the acceptance of AI in medical practice suggest that these should be areas of focus in AI education, engagement and training. This has implications for how AI systems can gain greater clinician acceptance to engender greater trust and adoption amongst public health systems and professional networks which in turn would impact how populations interface with AI. Implications for policy and practice, as well as future research in this nascent field, are discussed.

Background: Low awareness about palliative care among the global public and healthcare communities has been frequently cited as a persistent barrier to palliative care acceptance. Given that knowledge shapes attitudes and encourages receptiveness, it is critical to examine factors that influence the motivation to increase knowledge. Health information-seeking from individuals and media has been identified as a key factor, as the process of accessing and interpreting information to enhance knowledge has been shown to positively impact health behaviours. Objective: Our study aimed to uncover public sentiments toward palliative care in Singapore. A conceptual framework was additionally developed to investigate the relationship between information-seeking preferences and knowledge, attitudes, receptiveness of palliative care, and comfort in death discussion. Design and Methods: A nationwide survey was conducted in Singapore with 1226 respondents aged 21 years and above. The data were analysed through a series of hierarchical multiple regression to examine the hypothesised role of information-seeking sources as predictors. Results: Our findings revealed that 53% of our participants were aware of palliative care and about 48% were receptive to receiving the care for themselves. It further showed that while information-seeking from individuals and media increases knowledge, attitudes and receptiveness to palliative care, the comfort level in death conversations was found to be positively associated only with individuals, especially healthcare professionals. Conclusion: Our findings highlight the need for public health authorities to recognize people’s deep-seated beliefs and superstitions surrounding the concept of mortality. As Asians view death as a taboo topic that is to be avoided at all costs, it is necessary to adopt multipronged communication programs to address those fears. It is only when the larger communicative environment is driven by the media to encourage public discourse, and concurrently supported by timely interventions to trigger crucial conversations on end-of-life issues between individuals, their loved ones, and the healthcare team, can we advance awareness and benefits of palliative care among the public in Singapore.

Abstract Background The first wave of COVID-19 during April to July 2020 in Singapore largely affected the migrant workers living in residential dormitories. A government taskforce working with dormitory operators, employers and non-government agencies came together to deliver behavioral interventions and health care services for migrant worker as dorms were imposed movement restrictions. To fill the research gap in understanding movement restriction experiences of migrant workers, this research seeks to describe dormitory contexts and explore behavior change related to both prevention of transmission as well as healthcare seeking for COVID-19 among male migrant workers. Methods With social constructivism as the foundation for this study, 23 telephone interviews were conducted with Bangladeshi and Indian migrant workers. A theory-informed, data-driven conceptual framework, characterized by the “Four Ss”: Sensitization, Surveillance, Self-preservation, and Segregation was first generated and later used to frame second-stage, more in-depth, thematic analyses. An effective multipronged approach was documented, persuading migrant workers in our case-study to improve hygiene and follow some safe distancing measures, and adhere to help-seeking when symptomatic. Results Rapid collective adaptation was demonstrated; it was propped up by effective harnessing of infrastructure and technology. While technology and digital platforms were central to shaping Sensitization for prevention-related behaviors, interpersonal communication, especially peer-sharing, was key to normalizing and accepting healthcare delivery and norms about healthcare seeking. Interpersonal factors particularly supported successful implementation of case-detection Surveillance, stimulating Self-preserving and acceptance of rules, and was found helpful to those Segregated in recovery facilities. In contrast, encouraging prevention-related behaviors relied more heavily on multiple online-platforms, phone-based e-learning/knowledge testing, e-monitoring of behavior, as well as interpersonal exchanges. Conclusion Overall, the findings showed that the conception of the Four Ss helped inform intervention strategies. Anchoring these towards optimal use of technology and harnessing of interpersonal communication for prevention and promotion of healthcare seeking in the planning of future Infectious Disease outbreaks in closed institutional settings is recommended.

Singapore, a highly urbanized Asian tropical country that experiences periodic dengue outbreaks, is piloting field releases of male Wolbachia-carrying Aedes aegypti mosquitoes with the aim of suppressing urban populations of the primary dengue vector Aedes aegypti. This study proposes and assesses a model to explain the roles of hesitancy and receptivity towards Project Wolbachia-Singapore in influencing reactive mosquito prevention behaviors (reactive behaviors) towards the release of Wolbachia-Aedes mosquitoes for residents living in the release sites. Interestingly, both hesitancy and receptivity predicted greater instances of reactive behaviors. The model also examines the roles of general knowledge about Wolbachia technology, perceived severity of mosquito bites, perceived density of mosquitoes, and social responsibility as predictors of hesitancy, receptivity, and reactive behaviors towards the release of Wolbachia-Aedes mosquitoes. Hesitancy towards the project mediated the effects of general knowledge, perceived severity of mosquito bites, and perceived density of mosquitoes on reactive behaviors towards the releases, although receptivity towards the project did not. Having less knowledge about Project Wolbachia-Singapore was associated with higher hesitancy towards the project and higher likelihood of performing reactive behaviors towards the releases. Individuals who perceive mosquito bites to be more severe and think that there are more mosquitoes in their living environments were also more likely to be hesitant about the project and practice reactive behaviors. However, both hesitancy and receptivity towards the project mediated the effect of social responsibility on reactive behaviors. Receptivity towards the project was driven by social responsibility, which was also associated with reduced hesitancy towards the project. Our findings suggest that, to address the hesitancy reported by a minority of participants, future outreach efforts should focus on strengthening the public's sense of social responsibility and on tailored education campaigns targeting groups with low levels of knowledge of the project.

This study made a preliminary attempt to conduct a needs assessment of teachers' utilization of the SSI-based approach in teaching Science by exploring Filipino teachers' awareness, perceived need, readiness, and willingness. It also aimed to determine which among the demographic profiles of the teachers had significant differences in their perceived need and readiness. A needs assessment using a quantitative survey research design was used in this study. The data-gathering procedure was done using a validated online survey questionnaire with a Cronbach alpha of 0.89. A total of 124 science teachers participated in this study throughout the two-week implementation. Descriptive and inferential statistics were used to analyze the data gathered from this study. Results revealed that more than fifty percent of the teachers were highly aware of the SSI-based approach and perceived the need for its implementation in science classes. Teachers were also willing to participate in an SSI training program to learn more about it and develop their own SSI-related materials. Furthermore, gender and specialization significantly differed in teachers' perceived needs, while specialization significantly differed in readiness. Results obtained from this study can be used as a basis for exploring teachers' perceptions and views of implementing the SSI-based approach.

Introduction Measures to mitigate the COVID-19 outbreak in the migrant worker dormitories in Singapore included lockdown and isolation of residents for prolonged periods. In this paper, we explore efforts to ease tensions and support mental health under these conditions.Methods Case study of dormitory residents under lockdown from April to August 2020 comprises a nested mixed-method approach using an online questionnaire (n=175) and semistructured interviews (n=23) of migrant workers sampled from the survey (August to September 2020). Logistic regression models were used to analyse survey data. Semistructured interviews were analysed using applied thematic analysis.Results Survey and interview data showed that mental health was largely protected despite initial rising tensions over restrictions during lockdown. Sources of tension negatively affecting low stress responses included job related worries, OR=0.07 (95% CI 0.03 to 0.18, p

Background: Short-term peripheral venous catheters-related bloodstream infections (PVCR-BSIs) rates have not been systematically studied, and data on their incidence by number of device-days is not available. Methods: Prospective, surveillance study on PVCR-BSI conducted from September 1st, 2013 to 31st Mays, 2019 in 246 intensive care units (ICUs), members of the International Nosocomial Infection Control Consortium (INICC), from 83 hospitals in 52 cities of 14 countries in the Middle East (Bahrain, Egypt, Iran, Jordan, Kingdom of Saudi Arabia, Kuwait, Lebanon, Morocco, Pakistan, Palestine, Sudan, Tunisia, Turkey, and United Arab Emirates). We applied U.S. Results: We followed 31,083 ICU patients for 189,834 bed-days and 202,375 short term peripheral venous catheter (PVC)-days. We identified 470 PVCR-BSIs, amounting to a rate of 2.32/1000 PVC-days. Mortality in patients with PVC but without PVCR-BSI was 10.38%, and 29.36% in patients with PVC and PVCR-BSI. The mean length of stay in patients with PVC but without PVCR-BSI was 5.94 days, and 16.84 days in patients with PVC and PVCR-BSI. The microorganism profile showed 55.2 % of gram-positive bacteria, with Coagulase-negative Staphylococci (31%) and Staphylococcus aureus (14%) being the predominant ones. Gram-negative bacteria accounted for 39% of cases, and included: Escherichia coli (7%), Klebsiella pneumoniae (8%), Pseudomonas aeruginosa (5%), Enterobacter spp. (3%), and others (29.9%), such as Serratia marcescens. Conclusions: PVCR-BSI rates found in our ICUs were much higher than rates published from USA, Australia, and Italy. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs.

BackgroundPublic sentiments are an important indicator of crisis response, with the need to balance exigency without adding to panic or projecting overconfidence. Given the rapid spread of the COVID-19 pandemic, governments have enacted various nationwide measures against the disease with social media platforms providing the previously unparalleled communication space for the global populations. ObjectiveThis research aims to examine and provide a macro-level narrative of the evolution of public sentiments on social media at national levels, by comparing Twitter data from India, Singapore, South Korea, the United Kingdom, and the United States during the current pandemic. MethodsA total of 67,363,091 Twitter posts on COVID-19 from January 28, 2020, to April 28, 2021, were analyzed from the 5 countries with “wuhan,” “corona,” “nCov,” and “covid” as search keywords. Change in sentiments (“very negative,” “negative,” “neutral or mixed,” “positive,” “very positive”) were compared between countries in connection with disease milestones and public health directives. ResultsCountry-specific assessments show that negative sentiments were predominant across all 5 countries during the initial period of the global pandemic. However, positive sentiments encompassing hope, resilience, and support arose at differing intensities across the 5 countries, particularly in Asian countries. In the next stage of the pandemic, India, Singapore, and South Korea faced escalating waves of COVID-19 cases, resulting in negative sentiments, but positive sentiments appeared simultaneously. In contrast, although negative sentiments in the United Kingdom and the United States increased substantially after the declaration of a national public emergency, strong parallel positive sentiments were slow to surface. ConclusionsOur findings on sentiments across countries facing similar outbreak concerns suggest potential associations between government response actions both in terms of policy and communications, and public sentiment trends. Overall, a more concerted approach to government crisis communication appears to be associated with more stable and less volatile public sentiments over the evolution of the COVID-19 pandemic.

Abstract The Asia Pacific region, home to two-thirds of the world’s population and ten of the least developed countries, is considered a regional hot-spot for the emergence and spread of antimicrobial resistance (AMR). Despite this, there is a dearth of high-quality regional data on the extent of AMR. Recognising the urgency to close this gap, Singapore organised a meeting to discuss the problems in the region and frame a call for action. Representatives from across the region and beyond attended the meeting on the “Antimicrobial Resistance in the Asia Pacific & its impact on Singapore” held in November 2018. This meeting report is a summary of the discussions on the challenges and progress in surveillance, drivers and levers of AMR emergence, and the promising innovations and technologies that could be used to combat the increasing threat of AMR in the region. Enhanced surveillance and research to provide improved evidence-based strategies and policies are needed. The major themes that emerged for an action plan are working towards a tailored solution for the region by harnessing the One Health approach, enhancing inter-country collaborations, and collaboratively leverage upon new emerging technologies. A regionally coordinated effort that is target-driven, sustainable and builds on a framework facilitating communication and governance will strengthen the fight against AMR in the Asia Pacific region.

Abstract Background Dengue is a serious problem around the globe, with 3.9 billion people at risk of the disease. Sri Lanka has recently seen unprecedented rates of dengue with 4.3 times more cases than during the same period over the previous six years. The paper discusses the development of an integrated health systems framework, aided by mobile technology, to combat and contain dengue via a health hackathon in Sri Lanka. Results The framework addresses the key functions of surveillance, health communication and civic engagement through innovations including digitisation of hospital forms; digital aid to Public Health Inspectors (PHIs); data consolidation and analytics; education for construction workers, GPs, and schools; and educating the general public. Conclusions We present the impact of the disease burden in tropical countries, such as Sri Lanka, current technological solutions, and the process of developing the mobile application modules developed via the health hackathon.

Abstract Background The family is an important social context where children learn and adopt eating behaviors. Specifically, parents play the role of health promoters, role models, and educators in the lives of children, influencing their food cognitions and choices. This study attempts to systematically review empirical studies examining the influence of parents on child food consumption behavior in two contexts: one promotive in nature (e.g., healthy food), and the other preventive in nature (e.g., unhealthy food). Methods From a total of 6,448 titles extracted from Web of Science, ERIC, PsycINFO and PubMED, seventy eight studies met the inclusion criteria for a systematic review, while thirty seven articles contained requisite statistical information for meta-analysis. The parental variables extracted include active guidance/education, restrictive guidance/rule-making, availability, accessibility, modeling, pressure to eat, rewarding food consumption, rewarding with verbal praise, and using food as reward. The food consumption behaviors examined include fruits and vegetables consumption, sugar-sweetened beverages, and snack consumption. Results Results indicate that availability (Healthy: r = .24, p

Ann-Dorthe Zwisler,1 Henriette Knold Rossau,1 Anne Nakano,2,3 Sussie Foghmar,4 Regina Eichhorst,5 Eva Prescott,6 Charlotte Cerqueira,7 Anne Merete Boas Soja,4 Gunnar H Gislason,8–10 Mogens Lytken Larsen,5 Ulla Overgaard Andersen,11 Ida Gustafsson,4 Kristian K Thomsen,12 Lene Boye Hansen,13 Signe Hammer,14 Lone Viggers,15 Bo Christensen,16 Birgitte Kvist,17 Cecilie Lindström Egholm,18 Ole May19 On behalf of the Working Group of Preventive Cardiology and Rehabilitation, Danish Society of Cardiology, and the Working Group of Cardiac Clinical Registries, Danish Society of Cardiology 1Danish Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Odense, 2Department of Clinical Epidemiology, Aarhus University Hospital, 3Registry Support Centre (West) – Clinical Quality Improvement & Health Informatics, Aarhus, 4Department of Cardiology, Copenhagen University Hospital, Hvidovre, 5Department of Cardiology, Aalborg University Hospital, Aalborg, 6Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, 7Registry Support Centre (East) – Epidemiology and Biostatistics, Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup, 8Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, 9The Danish Heart Foundation, Copenhagen, 10The National Institute of Public Health, University of Southern Denmark, 11Department of Cardiology, Holbaek Hospital, University of Copenhagen, Copenhagen, 12Department of Cardiology, Hospital of Southwest Jutland, Esbjerg, 13Department of Cardiology, Gentofte Hospital, Gentofte, 14Department of Occupational Therapy and Physiotherapy, Herlev Hospital, Herlev, 15Department of Nutrition, Regional Hospital West Jutland, Holstebro, 16Department of General Medicine, School of Public Health, Aarhus University, Aarhus, 17Department of Health Care and Prevention, Municipality of Frederikshavn, Frederikshavn, 18The Regional Research Unit, Region Zealand, Roskilde, 19Department of Medicine, Cardiovascular Research Unit, Regional Hospital Herning, Herning, Denmark Aim of database: The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD).Study population: Hospitalized patients with CHD with stenosis on coronary angiography treated with percutaneous coronary intervention, coronary artery bypass grafting, or medication alone. Reporting is mandatory for all hospitals in Denmark delivering CR. The database was initially implemented in 2013 and was fully running from August 14, 2015, thus comprising data at a patient level from the latter date onward.Main variables: Patient-level data are registered by clinicians at the time of entry to CR directly into an online system with simultaneous linkage to other central patient registers. Follow-up data are entered after 6 months. The main variables collected are related to key outcome and performance indicators of CR: referral and adherence, lifestyle, patient-related outcome measures, risk factor control, and medication. Program-level online data are collected every third year.Descriptive data: Based on administrative data, approximately 14,000 patients with CHD are hospitalized at 35 hospitals annually, with 75% receiving one or more outpatient rehabilitation services by 2015. The database has not yet been running for a full year, which explains the use of approximations.Conclusion: The DHRD is an online, national quality improvement database on CR, aimed at patients with CHD. Mandatory registration of data at both patient level as well as program level is done on the database. DHRD aims to systematically monitor the quality of CR over time, in order to improve the quality of CR throughout Denmark to benefit patients. Keywords: secondary prevention, coronary heart disease, cardiovascular prevention, clinical quality registry, clinical database, quality improvement

The objective of this study was to assess adolescents‘ receptivity to the use of new interactive media for dissemination of sensitive health messages. We propose a conceptual framework based on the Extended Parallel Process Model (EPPM) to design a game-based HIV/AIDS intervention for adolescents. Amongst key findings, we found that Game Play led to changes in attitudes and intentions.

This study investigated the effect of using a comic-based learning module in Physics as a learning tool on students' conceptual understanding and motivation. A mixed method approach using a quasi-experimental pre-test-post-test design was used in this study. An adapted 50-multiple choice test items and the physics version of the "Science Motivation Questionnaire-II' (SMQ-II) were used to measure changes of students" conceptual understanding and motivation respectively. Two intact classes of 68 Grade 8 students in a public school in Cavite, the Philippines participated in this study with corresponding parental consent. Quantitative data were analyzed using Paired-Sample t-test and qualitative data were gathered from students' interviews. After the integration of the comic-based learning module for 4 weeks, results showed that it provided significant increase on students' conceptual understanding in Physics. Meanwhile, the four components of students' motivation such as intrinsic motivation, self-efficacy, self-determination, and grade motivation showed significant increase. Finally, students' learning experience on the use of the module as revealed on focus group discussion showed that the module helped them to understand better the Physics topics being discussed and to become more motivated to learn Physics. Future studies would have to consider the appropriateness and suitability of comic-based learning module in other subject areas and grade levels.

We assessed the effects of the patient education strategy 'Learning and Coping' (LC) in cardiac rehabilitation (CR) on mortality and readmissions by exploring results from the LC-REHAB trial. In all, 825 patients with ischaemic heart disease or heart failure were randomized to the intervention arm (LC-CR) or the control arm (standard CR) at three hospitals in Denmark. LC-CR was situational and inductive, with experienced patients as co-educators supplemented with two individual interviews. Group-based training and education hours were the same in both arms. Outcomes were time to death or readmission, length of stay and absolute number of deaths or readmissions. No between-arm differences were found in time to death, first readmission, or length of stay. Within 30 days after completion of CR, the absolute number of all-cause readmissions was 117 in the LC arm and 146 in the control arm, adjusted odds ratio 78 (95% CI: 0.61-1.01), P = 0.06. This trend diminished over time. Adding LC strategies to standard CR showed a short term but no significant long-term effect on mortality or readmissions. However, the study was not powered to detect differences in mortality and morbidity. Thus, a risk of overseeing a true effect was present.

Objective To evaluate how public perceptions and trust in government communications affected the adoption of protective behaviour in Singapore during the coronavirus disease 2019 (COVID-19) pandemic. Methods We launched our community-based cohort to assess public perceptions of infectious disease outbreaks in mid-2019. After the first case of COVID-19 was reported in Singapore on 23 January, we launched a series of seven COVID-19 surveys to both existing and regularly enrolled new participants every 2 weeks. As well as sociodemographic properties of the participants, we recorded changing responses to judge awareness of the situation, trust in various information sources and perceived risk. We used multivariable logistic regression models to evaluate associations with perceptions of risk and self-reported adopted frequencies of protective behaviour. Findings Our cohort of 633 participants provided 2857 unique responses during the seven COVID-19 surveys. Most agreed or strongly agreed that information from official government sources (99.1%; 528/533) and Singapore-based news agencies (97.9%; 522/533) was trustworthy. Trust in government communication was significantly associated with higher perceived threat (odds ratio, OR: 2.2; 95% confidence interval, CI: 1.6-3.0), but inversely associated with perceived risk of infection (OR: 0.6; 95% CI: 0.4-0.8) or risk of death if infected (OR: 0.6; 95% CI: 0.4-0.9). Trust in government communication was also associated with a greater likelihood of adopting protective behaviour. Conclusion Our findings show that trust is a vital commodity when managing an evolving outbreak. Our repeated surveys provided real-time feedback, allowing an improved understanding of the interplay between perceptions, trust and behaviour. [phrase omitted] Objectif Evaluer dans quelle mesure la perception du public et la confiance envers les communications du gouvernement ont influence l'adoption d'un comportement de protection a Singapour durant la pandemie de maladie a coronavirus (COVID-19). Methodes Nous avons lance notre cohorte communautaire afin d'identifier la maniere dont le public percevait les epidemies de maladies infectieuses au milieu de l'annee 2019. Apres l'annonce du premier cas de COVID-19 a Singapour le 23 janvier, nous avons debute une serie de sept sondages sur la COVID-19 aupres de participants existants et de nouveaux inscrits a intervalles reguliers, toutes les deux semaines. Nous avons pris note des caracteristiques sociodemographiques de ces participants ainsi que de l'evolution des reponses afin de determiner le degre de sensibilisation a la situation, la confiance vis-a-vis de diverses sources d'information et le risque pergu. Nous avons employe des modeles de regression logistique multivariee pour examiner les liens qui existent entre la perception du risque et la frequence a laquelle les repondants declarent avoir adopte un comportement de protection. Resultats Notre cohorte de 633 participants a fourni 2857 reponses uniques lors des sept sondages sur la COVID-19. La plupart etaient d'accord ou totalement d'accord pour dire que les informations provenant de sources gouvernementales officielles (99,1%; 528/533) et d'agences de presse etablies a Singapour (97,9%; 522/533) etaient fiables. La confiance envers la communication du gouvernement etait etroitement liee a l'intensite de la menace ressentie (odds ratio, OR: 2,2; intervalle de confiance de 95%, IC: 1,6--3,0), mais inversement proportionnelle au risque d'infection pergu (OR: 0,6; IC de 95%: 0,4-0,8) ou au risque de deces en cas d'infection (OR: 0,6; IC de 95%: 0,4-0,9). Cette confiance etait egalement associee a une probabilite accrue d'adoption d'un comportement de protection. Conclusion Nos resultats montrent que la confiance est un outil indispensable pour gerer la progression d'une epidemie. Les multiples etudes realisees par nos soins ont livre un retour d'experience en temps reel qui a permis de mieux comprendre les interactions entre perception, confiance et comportement. [phrase omitted] Objetivo Evaluar como las percepciones y la confianza del publico en las comunicaciones del gobierno influyeron en la adopcion de un comportamiento protector en Singapur durante la pandemia de la enfermedad por coronavirus de 2019 (COVID-19). Metodos A mediados de 2019, se inicio el estudio de cohorte de la poblacion local para evaluar la percepcion que tiene el publico sobre los brotes epidemicos de las enfermedades infecciosas. Tras la notificacion del primer caso de la COVID-19 en Singapur el 23 de enero, se iniciaron una serie de siete sondeos sobre la COVID-19, tanto a personas que ya estaban participando como a personas nuevas que se inscribian con regularidad, cada dos semanas. Ademas de las propiedades sociodemograficas de las personas participantes, se registraron las nuevas respuestas para juzgar el conocimiento de la situacion, la confianza en las diversas fuentes de informacion y la percepcion del riesgo. Se emplearon modelos de regresion logistica multivariante para evaluar las asociaciones con las percepciones de riesgo y las frecuencias adoptadas de comportamientos protectores que facilitaron las personas participantes. Resultados La cohorte de esta investigacion integrada por 633 personas aporto 2857 respuestas unicas durante los siete sondeos de la COVID-19. La mayoria estuvo de acuerdo o muy de acuerdo en que la informacion de las fuentes oficiales del gobierno (99,1 %; 528/533) y de las agencias de noticias con sede en Singapur (97,9 %; 522/533) era fiable. La confianza en las comunicaciones del gobierno se asocio de manera significativa con una mayor percepcion de amenaza (oportunidad relativa, OR: 2,2; intervalo de confianza del 95 %, IC: 1,6-3,0), pero se asocio de manera inversa con la percepcion de riesgo de infeccion (OR: 0,6; IC del 95 %: 0,4-0,8) o de riesgo de muerte si habia contagio (OR: 0,6; IC del 95 %: 0,4-0,9). La confianza en las comunicaciones del gobierno tambien se asocio con una mayor probabilidad de adoptar comportamientos protectores. Conclusion Los resultados indican que la confianza es un elemento vital para gestionar un brote epidemico en evolucion. Los estudios que se realizaron de manera repetida aportaron informacion en tiempo real, lo que permitio mejorar la comprension de la interaccion entre las percepciones, la confianza y el comportamiento., Introduction The emergence of coronavirus disease 2019 (COVID-19) in China in December 2019 resulted in a global and rapidly rising number of cases and deaths. (1) Many countries responded with [...]

Objective: This study investigated the extent to which the efficacy of a hypertension awareness programme in Singapore may differ based on age, gender, race and housing type (as proxy for income). Method: Pre- and post-programme survey responses on blood pressure (BP) knowledge and beliefs from 9,960 grade 5 students were assessed. Post-programme responses from 5,361 adult family members were also evaluated. Results: Female students were more likely to show better BP knowledge and beliefs. As compared to Chinese students, Malay students had lower levels of BP knowledge and attitudes, while Indian students possessed stronger attitudes. Programme efficacy among students in the most affordable housing was the least favourable. In the adult family member sample, Malay and Indian adults had higher self-confidence and intention to measure their BP in the future than the Chinese. Adult respondents in the most affordable housing possessed the least favourable beliefs towards BP measurement. Older adults, men, Malays and residents in affordable housing types had higher odds of being found with hypertension when tested at home. Conclusion: Despite the same hypertension education programme being implemented, disparities in programme impact were apparent in both student and adult sample across race, housing type and, to a lesser extent, gender. Future interventions should consider these disparities when developing health education programmes.