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PubMed2004

Dietary fiber and reduced cough with phlegm: a cohort study in Singapore.

Smoking is the major risk factor for chronic respiratory symptoms, but dietary factors may also play a role. Most studies of diet and lung disease have been cross-sectional and conducted in populations with a Western-style diet. We analyzed the relation between dietary intake at baseline and new onset of cough with phlegm in a population-based cohort of 63,257 middle-aged Chinese men and women initiated in Singapore between 1993 and 1998. Beginning in 1999, we ascertained respiratory symptoms by telephone interview and have identified 571 incident cases of cough with phlegm among the 49,140 cohort members with completed follow-up. Nonstarch polysaccharides, a major component of dietary fiber, total fruit, and soy isoflavones had the strongest associations. Odds ratios comparing highest and lowest quartiles after adjustment for age, sex, dialect group, total energy intake, and smoking were 0.61 (95% confidence interval [CI]: 0.47, 0.78; p for trend < 0.001) for nonstarch polysaccharides, 0.67 (95% CI: 0.52, 0.87; p for trend = 0.006) for fruit, and 0.67 (95% CI: 0.53, 0.86; p for trend = 0.001) for soy isoflavones. These data suggest that a diet high in fiber from fruit and, possibly, soyfoods may reduce the incidence of chronic respiratory symptoms. Associated nutrients, such as flavonoids, may contribute to this association.

Age Distribution↗

PubMed1984

Quality assurance in the Third World--the Singapore experience.

This paper reviews the current status of quality assurance in clinical biochemistry laboratories in Third World countries, particularly the developments in Singapore which in some respects are very similar to those of other developing countries. Some of the common problems are highlighted and recommendations for improvement proposed.

Asia↗

PubMed2005

Brief communication: factors affecting rehospitalisation in psychiatric patients in Singapore.

OBJECTIVES: To study the patterns of readmission in Singapore using a cohort of first admission schizophrenia patients to the state mental health institute. METHODS: A retrospective analysis of case records was done of first admission schizophrenia patients to the hospital from April 1993 to March 1994. Patients who had only one admission in the five years of follow up were compared to 'revolving door patients'. RESULTS: The cohort comprised 133 males (56.8%) and 101 females (43.2%). Seventy-eight patients (33.3%) had one admission to the hospital while 56 (23.9%) fulfilled the revolving door criteria. On performing a logistic regression we found sex (p = 0.02), shorter duration of illness (p = 0.01) and CPN referral (0.006) were significantly associated with revolving door phenomena. CONCLUSIONS: Our study has identified male gender, history of self-harm and a short duration of illness to be risk factors for 'revolving door' phenomena.

Adult↗

PubMed2005

Determinants of duration of untreated psychosis and the pathway to care in Singapore.

INTRODUCTION: Delays in providing effective treatment for a patient with psychosis has significant negative effects on the outcome. This includes more hospitalizations, longer periods of inpatient care, slower and less complete recovery, and more frequent relapses. In this study, we established the Duration of Psychosis (DUP) in a sample of patients with first-episode psychosis and examined the pathways to care. METHODS: The sample comprised patients presenting with first-episode psychosis to the psychiatric services of the Institute of Mental Health, Singapore, from January to December 2000. The association between the DUP and demographic, clinical and social variables was examined. RESULTS: The DUP ranged from 0.1 to 336 months. The mean DUP was 32.6 (SD = 59.8) months, with a median of 12 months. Twenty four percent of the patients had sought consultation with a traditional healer prior to consulting a psychiatrist. The DUP of this group of patients was not significantly different from those who sought help elsewhere. CONCLUSIONS: The DUP of our patients was longer than that reported in studies done in the West. The attitudes and beliefs of family in the Asian society are likely to be crucial in the pathways to care.

Adult↗

PubMed2002

The sexual profile of rapists in Singapore.

To our knowledge, this is the first paper that examines the sexual profile of rapists in Singapore. A semi-structured interview based on a questionnaire about sexual habits was conducted on 62 convicted rapists and a control group of 63 prisoners comprising 32 convicted for violent non-sexual offences and 31 for non-violent non-sexual offences. Significantly more rapists masturbated at least once a month and were exposed to pornography within six months before the offence when compared to non-violent controls. Violent controls did not differ significantly from rapists in any aspect of the sexual history. The greater similarity between rapists and violent controls lends support to the concept of rape as a violent rather than sexual offence. A subgroup of 17 'hypersexual' rapists were identified who were either having sex or masturbating very frequently but had still resorted to rape. Compared to the other 46 rapists, the 'hypersexual' rapists were more likely to have fantasised predominantly about rape or bondage and to cite domination, aggression or hostility as reasons for committing rape, suggesting an even stronger element of power and aggression than in their less sexually active counterparts.

Adult↗

PubMed1990

Suicide and parasuicide in Singapore (1986).

Suicide and parasuicide rates have increased in Singapore since 1980 and in 1986 were estimated to be 13.1 per 100,000 and 92 per 100,000 respectively. Those most prone to suicidal behaviour are the Indians and the aged above 70 years. Jumping from a height is still the commonest method of suicide and self-poisoning is the most popular method of parasuicide.

Adult↗

PubMed1993

Season, climate and suicide in Singapore.

In Singapore, an island city state in the tropics, climatic variables like sunlight, windspeed, temperature, rainfall and humidity are significantly correlated with subgroups of suicidal subjects such as Malays, young adults and youths. In the young age group (0-19 years) the relationship between meteorological factors and suicide appear to be greater than in the other two groups.

Adolescent↗

PubMed1997

Transience and settlement: Singapore's foreign labor policy.

"Foreigners constitute 15 percent of the population and over 20 percent of the labor force in Singapore.... This large foreign labor force is managed by a comprehensive and highly selective foreign labor policy, which is described in this paper. The strict enforcement of a guestworker policy of transience on the one hand, and the liberal encouragement of settlement on the other, are the twin pillars of this policy. Seen originally as a dispensable appendage to a labor-scarce economy, foreign labor has now become integral to the economic and increasingly, population policy of the country, as evidenced by the recent announcement of a national policy to ¿attract foreign talent'."

Asia↗

PubMed2005

Life on the atoll: Singapore ecology as a neglected dimension of social order.

Based on field interviews in Singapore in 1985, 1997, and 2003, this article addresses the issue of how island ecology helps explain the remarkable low rates of crime that are often attributed mainly to cultural and government policies. Understanding crime and control on this most densely populated Southeast Asian atoll must begin with how people are dispersed over the limited spatial area. Ecology also influences how styles of some crimes are defined and controlled. Several of Donald Black's propositions are given further consideration.

Community Participation↗

PubMed2004

How severe acute respiratory syndrome (SARS) affected the department of anaesthesia at Singapore General Hospital.

The effects of the outbreak of severe acute respiratory syndrome (SARS) on the Singapore General Hospital's Department of Anaesthesia are described. Urgent measures to protect staff and patients were implemented. Clear direction in administration issues and clinical pathways with good logistic support were essential. Anaesthetists were at risk and anaesthetic practice had to change in view of strict infection control provisions. Contingency planning for future infectious diseases outbreaks is required. Lessons can be learnt by hospitals yet to be visited by this virulent infection.

Anesthesia Department, Hospital↗

PubMed1990

Clinical and laboratory study of first episode genital herpes in Singapore.

A prospective study of the epidemiology, clinical aspects and laboratory features of first episode genital herpes was carried out in Middle Road Hospital, Singapore between June 1986 and December 1987. A total of 68 patients were studied. There were more women than men in the study population with a female to male ratio of 7.5 to 1. The peak incidence of first episode genital herpes was between 20 and 29 years of age. Specimens from 63 patients yielded positive culture for herpes simplex virus (HSV). HSV-1 was isolated from 21 patients (30.9%), HSV-2 from 41 patients (60.3%) and untyped HSV from one patient (1.5%). True primary genital herpes was diagnosed in 43 patients (68.3%) using a test for complement fixing antibodies to HSV. HSV-1 was found to be the causative agent in 18 (41.9%) of the true primary infections, HSV-2 in 24 (55.8%) and untyped HSV in one (2.3%). In comparison, HSV-1 was isolated in only 2 (10%) of the 20 patients with non-primary first episode genital herpes; HSV-2 was found in 13 patients (65%) and the culture was negative in 5 (25%).

Adolescent↗

PubMedDate not supplied

Evidence of HTLV-I infection in Singapore prostitutes.

Sera obtained in 1987 from 63 male and 632 female Singapore prostitutes were screened for antibody to human T-cell leukaemia virus (HTLV)-I with a particle agglutination test. Of the 3 males and 4 females who were positive one had antibody to HTLV-I core and envelope antigen on Western Blot. Two subjects had presumptive antibody to HTLV-I core antigen and a third subject had such antibody on a repeat specimen in 1989. These sera were negative for HIV-1 antibody. There is evidence of infection with HTLV-I or a variant virus in this population. The infection is likely to have been sexually transmitted.

Adult↗

PubMedDate not supplied

Factors associated with sexually transmitted diseases among prostitutes in Singapore.

From June to December 1990, 806 prostitutes registered with the STD programme in Singapore for regular screening for sexually transmitted diseases (STD) were investigated for factors associated with STD incidence in the preceding year. The majority were foreigners (92.7% Malaysians and 3.1% Thais). Anal sex (0.4%) and intravenous drug use (0.9%) were rare. The overall STD incidence rate was 47.7 per 100. None was human immunodeficiency virus (HIV) positive. The crude and age-adjusted risk of STD was found to increase significantly with client load. An inverse relationship between condom use and STD risk was also observed. Mean condom use among clients was reported as 56.1% for spontaneous use and estimated as 75.4% following negotiation for condom use by prostitutes. Although the prostitutes negotiated for condom use with majority of the clients (85.5%) who did not use condoms spontaneously, they were successful with only about half of them (54.4%). Health education should be targeted at clients on the protective effects of condom use and at the prostitutes on skills in negotiating condom use.

Adult↗

PubMedDate not supplied

Evaluation of a safe-sex intervention programme among sex workers in Singapore.

The purpose of this study was to evaluate the effects of a brief intervention programme on STD knowledge, condom use and gonorrhoea incidence among sex workers in Singapore. A controlled before-and-after study design with non-random assignment of sex workers was used, supplemented by multivariate analysis to adjust for baseline differences. Control (n = 221, denoted C1) and experimental (n = 221, denoted E1) groups were interviewed on 2 occasions 3 months apart. Two supplementary groups were interviewed once each at the end of the 3-month period (n = 145 who had received the intervention and n = 151 who had not). Basic knowledge of STD symptoms and HIV transmission was high in all groups. There were misconceptions about casual transmission of HIV which improved dramatically at the second interview for group E1 (from 37-56% correct responses to 82-90%). Overall condom use was high (about 75%) and did not change after the intervention. Gonorrhoea rates were correspondingly low (0.4 episodes/worker/year) and also did not change. This brief intervention improved the STD knowledge of sex workers. However, behaviour as measured by reported condom use and gonorrhoea incidence did not change. Implications for future intervention programmes are discussed.

Adult↗

PubMed2006

Family physicians' experiences, behaviour, and use of personal protection equipment during the SARS outbreak in Singapore: do they fit the Becker Health Belief Model?

Singapore experienced the SARS outbreak in 2003. The study aimed to describe the experience and behaviour of family physicians and the use of personal protection equipment (PPE) in their encounters with SARS patients. 8 such participants were interviewed and the content was analysed using qualitative research method. They highlighted the difficulties in procuring PPE due to severe shortage, the discomfort and inconvenience associated with its use. Despite the increasing operating cost, declining patient attendance and high price of the PPE, they persist in using PPE and change their behaviour in order to reduce the perceived threat to their lives. It fits into the Becker Health Belief Model, which explains that behaviour change depends on the balance of perceived vulnerability, severity, effectiveness, and barriers. The vulnerability and severity of SARS to healthcare workers were verified by the hospital experience. Perceived effectiveness of PPE amongst the family physicians outweighed the barriers of shortage, cost and discomfort of the PPE.

Disease Outbreaks↗

PubMed1989

Prevention of intellectual and other disabilities: the Singapore experience.

In Singapore, first level prevention, aimed at reducing the occurrence of disabilities, has included neonatal screening for glucose-6-phosphate dehydrogenase deficiency, a programme of universal vaccination, screening for congenital hypothyroidism, and improvements in obstetric and neonatal care. Non-specific measures, such as improved housing, better nutrition and higher standards of education, have also contributed to the reduction in serious illnesses that can potentially cause disabilities. Second level prevention, designed to limit or reverse a disability, has included a developmental screening programme carried out in the primary health care sector. Centralised multi-disciplinary developmental assessment clinics have been established to define better the disabilities and to advise on rehabilitation. An early intervention programme has been started, and special schools are being upgraded. Third level prevention, aimed at preventing a disability from becoming a handicap, has included the setting up of comprehensive rehabilitation programmes, provision of aids and appliances, vocational training, and job opportunities. The integration of the handicapped back into society is currently being promoted.

Child↗

PubMed1994

An economic analysis of AIDS--towards a proposed model of costing: a Singapore experience.

With the increasing prevalence of HIV infection/AIDS and the extending range of care and treatment, the economic implications of the various prevention and control strategies, and of treatment, have become the subject of interest to policy-makers, public health specialists and health economists. This paper presents an overview of the methods used for the economic analysis of AIDS/HIV infection. It proposes an activity-oriented, cost center-based model for the costing of the economic impact of AIDS, using cost figures in Singapore since 1985, when the National AIDS Control Program was started. Priorities for future research are also identified.

Acquired Immunodeficiency Syndrome↗

PubMed2002

Improving adherence to regular pap smear screening among Asian women: a population-based study in Singapore.

This study addresses the issue of adherence to regular screening for cervical cancer in Asian women and factors that would promote this. A community-based cross-sectional survey was carried out among 726 women (30-59 years) in Singapore. Although the overall screening prevalence was 62.4%, only 42% reported having regular smears. Women in the irregular group were more likely to have a Pap smear as part of postnatal or family planning visits, whereas the primary reason for attendance among the regular group was likely to be screening or a health checkup. Chief barriers to regular screening were low perceived susceptibility (46.5%) and low accessibility (37.1%). One third of women who have ever had a smear do not return for regular screening. Appropriate windows of opportunity in contact between women and the health care services should be used to convey the importance of adherence to screening.

Adult↗