Community In Singapore Research Articles

Predictors of Participation in Supervised Therapy by Post-Stroke Patients in The Singapore Community: A One-Year Cohort Study

Predictors of Participation in Supervised Therapy by Post-Stroke Patients in The Singapore Community: A One-Year Cohort Study

Food Insecurity in Singapore: The Communicative (Dis)Value of the Lived Experiences of the Poor

ABSTRACTFood insecurity is a form of health disparity that results in adverse health outcomes, particularly among disenfranchised and vulnerable populations. Using the culture-centered approach, this article engages with issues of food insecurity, health, and poverty among the low-income community in Singapore. Through 30 in-depth interviews, the narratives of the food insecure are privileged in articulating their lived experiences of food insecurity and in co-constructing meanings of health informed by their sociocultural context, in a space that typically renders them invisible. Arguing that poverty is communicatively sustained through the erasure of subaltern voices from mainstream discourses and policy platforms, we ask the research question: What are the meanings of food insecurity in the everyday experiences of health among the poor in Singapore? Our findings demonstrate that the meanings of health among the food insecure are constituted in culture and materiality, structurally constrained, and ultimately complexify their negotiations of health and health decision making.

Feminist care ethics, becoming area

In rethinking area studies, I argue for a more open approach to standpoint theory, one that is rooted in a feminist ethics of care. The latter’s commitment to intimate knowing, and its problematisation of the distance between self and other, allows for a more relational approach to place. By drawing from feminist care ethics, it thus becomes possible to address criticisms of essentialism and distancing that place-based standpoint theory is also charged with. I address these theoretical debates as a researcher from an ‘Area’ who ‘never left’; and within the context of my own struggles with knowing how to place, and distance myself as an academic and member of the LGBTQ activist community in Singapore.

Singapore. Indians in Singapore, 1819–1945: Diaspora in the colonial port city By Rajesh Rai New Delhi: Oxford University Press. Pp. xxix + 325. Tables, Glossary, Bibliography, Index.

Indians in Singapore, 1819-1945: Diaspora in the colonial port city By RAJESH RAI New Delhi: Oxford University Press. Pp. xxix + 325. Tables, Glossary, Bibliography, Index. The Indians of Singapore constitute a small but uniquely situated part of the larger mosaic of what once used to be called 'overseas Indian communities' but now come under the rubric of 'Indian diaspora'. Their history of migration and settlement goes back to the early years of the nineteenth century, but it was for the most part seen as a segment of the Indian community in the Malay Peninsula rather than as a separate and distinct component of it. Moreover, the political and social concerns of this small community settled in a port-city in Southeast Asia did not quite resonate with the interests and concerns of Indian communities elsewhere, preoccupied as they were with issues of citizenship and political representation in colonial legislatures. The Indians of Singapore and Southeast Asia more generally were thus separated from Indian communities elsewhere by both geography as well as history (and historiography). Rajesh Rai's latest book goes a long way towards bridging this gap. He has now given us the historical evolution of the Indian community in Singapore in great detail with sober and authoritative research, and his book will remain the standard text on the subject for the foreseeable future. It is an important contribution to the literature on the Indian diaspora. The British settlement of Singapore goes back to 1819, but Indian merchants and traders had been arriving in the region long before then, and joined later by sepoys and lascars. Convicts and political prisoners arrived after the middle of the nineteenth century along with workers who came under an unregulated system of indentured labour. With time, the community diversified as its numbers increased, factions developed and social and educational institutions emerged. In a chapter titled 'Diasporic formations in the inter-war years', Rai describes the social and cultural evolution of the Indian community (religion, vernacular language education, regional and subregional movements), and the impact on the Singapore Indians of political and religious tensions and frictions on the Indian subcontinent, though not to the extent of having a 'monopolistic hold on diasporic political loyalties' (p. 195). Nonetheless, in contrast to other areas where Indian immigrants settled, the Indian influence on social and political developments in Singapore was far greater. Given the physical proximity of Singapore to India, it could not have been otherwise. The persistence of caste politics and prejudices among Singaporean Indians and the presence of the sectional, South Indian 'Dravidian Movement' among them are illustrations of this. These developments and others like them had no resonance in the more remote sugar colonies across the globe. …

Professional learning communities in Singapore and Shanghai: implications for teacher collaboration

Professional learning communities (PLCs) have been recognised as having the potential to raise the quality of teachers, teaching and student learning through structured teacher collaboration, and have been featured prominently in Singapore and Shanghai – both considered top-performing Asian societies in the Program for International Student Assessment (PISA). Although embedded in education systems that are considered centralised, there are still significant differences. Drawing out key implications from the experiences of Singapore and Shanghai, this paper highlights the potential challenges in implementing PLCs. These challenges include heavy teacher workload, ambiguities in the understanding and implementation of PLCs, and hierarchical work structures. The discussions emanating from the comparison between Singapore and Shanghai PLCs seek to contribute towards the international literature on fostering teacher collaboration through PLCs, which has been predominantly Western-centric.

Chronic Pain in a Low Socioeconomic Status Population in Singapore: A Cross-Sectional Study

. The authors sought to determine the prevalence of chronic pain in a low socioeconomic-status rental-flat community in Singapore and its associations. In Singapore, ≥85% own homes; public rental flats are reserved for the low-income. . Chronic pain was defined as pain ≥3 months. From 2009-2014, residents aged ≥ 40 years in five public rental-flat enclaves were surveyed for chronic pain, as well as sociodemographic factors. Subsequently, the authors conducted an additional study among elderly (aged ≥60) in two public rental-flat enclaves in 2012. The authors compared against residents staying in adjacent owner-occupied public housing. . Prevalence of chronic pain in the rental-flat population was 14.2% (133/936) compared with 14.4% (158/1101) in the owner-occupied population (p = 0.949). On multivariate analysis, among those aged 40-59 years, staying in the rental flat community was independently associated with higher prevalence of leg/ankle/foot pain, compared to staying in the owner-occupied flat community (aOR = 2.35, CI = 1.24-7.35, p = 0.008). In the rental-flat population, unemployment was associated with chronic pain (aOR = 1.92, 95%, CI = 1.05-2.78, p = 0.030); among the elderly, dependency in instrumental-activities-of-daily-living (iADLs) was associated with chronic pain (aOR = 2.38, CI = 1.11-5.00, p = 0.025), as well as female gender, being single, and having higher education (all p > 0.05). . In this low socioeconomic-status population, chronic pain associated with unemployment and functional limitation. There was no difference in pain prevalence between the rental-flat population and adjacent owner-occupied precincts.

NUTRITION DEFICIENCY RISK ASSESSMENT OF FREE-LIVING OLDER ADULTS IN SINGAPORE

Background: The need to identify those at risk of nutrition deficiency is critical in promoting good nutritional status in older adults. Objectives: The study aims to assess the risk of nutrition deficiency of free living, older adults in Singapore. Design, Setting and Participants: Free-living adults (aged 50 and above) were recruited from various community centres under the supervision of the Peoples’ Association of Singapore. Measurements: Nutrition deficiency risk assessment was performed with all participants in person using the validated 15-item Seniors in the Community Risk Evaluation for Eating and Nutrition II (SCREEN II) tool. Anthropometric assessments were also conducted. Results: Majority (88.1%) of the one hundred ninety three participants (83.9% women, 66.8±8.3 years of age) showed risk of nutrition deficiency. 68.4% of the participants fell under the “high risk” group. The women showed higher risk of nutrition deficiency than the men in the study group. Less than 12% of the participants consumed five or more servings of vegetables and fruits in a day, and approximately 25% ingested less than two servings per day. Almost half of the participants consumed dairy products less than once a day. Less than 20% of the participants consumed more than 2 servings of dietary protein source daily. More than 60% of the participants were overweight. Conclusions: A significant proportion of free-living older adults in Singapore community is experiencing high risk of nutrition deficiency as measured by the SCREEN II. The same older adults are overweight and thereby are exposed to the elevated health risk associated with obesity.

Two sides of the coin: A qualitative study of patient and provider perspectives on colorectal, breast and cervical cancer screening in a low-income Asian community

Objectives: Patient and provider barriers to cancer screening in disadvantaged Asian populations are understudied. We conducted a qualitative study of attitudes to screening for colorectal, cervical and breast cancer within low-income communities in Singapore. Methods: Interviewers elicited perceptions of barriers/enablers to cancer screening amongst patients eligible for fecal occult blood test (FOBT)/Pap smear/mammograms, and providers serving these low-income communities. Interview transcripts were analyzed thematically using established qualitative methodology. Results: Twenty patients and nine providers were interviewed. Patient and provider comments were grouped into seven content areas: primary care characteristics (PCC), procedural issues, knowledge, costs, priorities, attitudes, and information sources. For FOBT, the most frequently mentioned content areas were knowledge (61.2%) and attitudes (16.9%) for patients, and knowledge (19.5%) and PCC (18.6%) for providers. For Pap smears, it was knowledge (23.6%) and costs (20.5%) for patients, and PCC (33.8%) and knowledge (19.1%) for providers. For mammograms, it was knowledge (41.4%) and sources of information (15.9%) for patients, and knowledge (28.8%) and procedural issues (19.2%) for providers. Conclusion: While PCC, knowledge and costs were the main contributors as perceived by physicians, knowledge and attitudes were the biggest barriers from patients’ perspectives. Differences in perceptions of cancer screening exist between low-income patients and providers serving them.

Current knowledge, attitude and behaviour of hand and food hygiene in a developed residential community of Singapore: a cross-sectional survey.

BackgroundDiarrhoea incidence has been increasing progressively over the past years in developed countries, including Singapore, despite the accessibility and availability to clean water, well-established sanitation infrastructures and regular hygiene promotion. The aim of this study is to determine the current knowledge, attitude and behaviour of hand and food hygiene, and the potential risk factors of diarrhoea in a residential community of Singapore.MethodsA cross-sectional study was conducted within a residential area in the west of Singapore from June to August 2013. A total of 1,156 household units were randomly sampled and invited to participate in an interviewer-assisted survey using standardised questionnaires. Descriptive, univariate and multivariate analyses were performed using descriptive statistics, Fisher’s Exact test and multivariate logistic regression modelling, respectively. R program was used for all statistical analysis. All tests were conducted at 5 % level of significance with 95 % confidence intervals (CI) reported where applicable.ResultsA total of 240 units (20.8 %) consented and responded to the survey invitation. About 77 % of the expected knowledge and attitude were observed in at least 80 % of the participants, compared to only about 31 % of the expected behaviours and practises. Being single [adjusted odds ratio (AOR) = 2.29; 95 % CI = 1.16-4.48], having flu in the past six month (AOR = 3.24; 95 % CI = 1.74-6.06), preferred self-medication (AOR = 2.07; 95 % CI = 1.06–4.12) were risk factors of diarrhoea. Washing hands with water before attending to children or sick persons (AOR = 0.30; 95 % CI = 0.11–0.82), washing hands with water (AOR = 0.16; 95 % CI = 0.05–0.45) and water with soap (AOR = 0.29; 95 % CI = 0.12–0.72) after attending to children or sick persons, and hand washing between 30 s to a minute (AOR = 0.44; 95 % CI = 0.20-0.90) were protective factors against diarrhoea.ConclusionsGood knowledge and attitude of the participants did not positively translate into high compliance and motivation to perform good hygiene practices. This observation may have resulted in a significant extent on the increasing diarrhoea incidences. Current interventions may be improved with more active community partnership among the residents, schools and the relevant social organizations, to raise awareness on the importance of compliance to good hygiene practices, and the risk factors of diarrhoea. A large case–control study would be required to validate these findings in future.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1910-3) contains supplementary material, which is available to authorized users.

Coral settlement on a highly disturbed equatorial reef system.

Processes occurring early in the life stages of corals can greatly influence the demography of coral populations, and successful settlement of coral larvae that leads to recruitment is a critical life history stage for coral reef ecosystems. Although corals in Singapore persist in one the world’s most anthropogenically impacted reef systems, our understanding of the role of coral settlement in the persistence of coral communities in Singapore remains limited. Spatial and temporal patterns of coral settlement were examined at 7 sites in the southern islands of Singapore, using settlement tiles deployed and collected every 3 months from 2011 to 2013. Settlement occurred year round, but varied significantly across time and space. Annual coral settlement was low (~54.72 spat m-2 yr-1) relative to other equatorial regions, but there was evidence of temporal variation in settlement rates. Peak settlement occurred between March–May and September–November, coinciding with annual coral spawning periods (March–April and October), while the lowest settlement occurred from December–February during the northeast monsoon. A period of high settlement was also observed between June and August in the first year (2011/12), possibly due to some species spawning outside predicted spawning periods, larvae settling from other locations or extended larval settlement competency periods. Settlement rates varied significantly among sites, but spatial variation was relatively consistent between years, suggesting the strong effects of local coral assemblages or environmental conditions. Pocilloporidae were the most abundant coral spat (83.6%), while Poritidae comprised only 6% of the spat, and Acroporidae <1%. Other, unidentifiable families represented 10% of the coral spat. These results indicate that current settlement patterns are reinforcing the local adult assemblage structure (‘others’; i.e. sediment-tolerant coral taxa) in Singapore, but that the replenishment capacity of Singapore’s reefs appears relatively constrained, which could lead to less resilient reefs.

How strong is our grip? Comparison of Singapore community dwellers with consolidated norms

How strong is our grip? Comparison of Singapore community dwellers with consolidated norms

Prevalence of and risk factors for symptomatic dry eye disease in Singapore

BackgroundThe aim of this study was to describe the prevalence and risk factors of symptomatic dry eye disease (SDED) in Singapore.MethodsA cross‐sectional dry eye survey was carried out using the McMonnies dry eye questionnaire. Members of the public were interviewed at the 46 (out of 62) randomly‐selected mass rapid transit (MRT) stations and their vicinity. A total of 1,004 questionnaires were collected from participants aged between 15 and 83 years. Symptomatic dry eye disease (SDED) was defined as at least one of five self‐reported symptoms that were reported as often or constantly. Non‐dry eye (NDE) subjects were those with no related symptoms reported. Prevalence of symptomatic dry eye disease in the studied population and confidence interval (CI) were calculated. Risk factors were also evaluated using logistic regression analysis at 95% CI.ResultsThe prevalence for symptomatic dry eye disease was found to be 12.3 per cent with prevalence greater in females than males. Symptomatic dry eye disease was significantly associated with contact lens wear (odds ratio [OR] 2.96, 95% CI: 1.81 to 4.83), those having had previous treatment for dry eye (OR 2.09, 95% CI: 1.33 to 3.29), those taking medication (OR 1.84, 95% CI: 0.99 to 3.44), those with unusual sensitivity of eyes (OR 3.04, 95% CI: 1.92 to 4.83), constant mucous membrane dryness (OR 4.11, 95% CI: 1.62 to 10.45) and irritation on waking (OR 2.38, 95% CI: 1.34 to 4.22). Smoking was not found to be associated with symptomatic dry eye disease.ConclusionSingapore has a symptomatic dry eye disease prevalence of 12.3 per cent and was associated with contact lens wear, those who had previous treatment for dry eye, medication, those having unusual sensitivity of eyes, mucous membrane dryness and waking irritation. These new data will be of value to the eye‐care community in Singapore and elsewhere.

1819: Isa Kamari on the Foundation of Singapore

1819 is the year of the British “founding of Singapore.” Early in that year Sir Stamford Raffles signed a preliminary treaty with the Temenggung of Johor permitting the British to set up a trading post on the island (Turnbull 1). By 1824, the request for a trading post had grown into a treaty through which the British claimed control over the whole of Singapore. 1819 is also the title of the English translation of the novel by the major Singapore Malay writer Isa Kamari on that same series of events (Malay: Duka Tuan Bertakhta, Sadly You Rule, 2011). In that book, Raffles, the Temenggung and the newly-installed Sultan Hussein of Singapore all play leading roles, but their actions are also balanced by those of the saint Habib Nuh, the silat master Wak Cantuk and the writer Munsyi Abdullah, who provide their own perspectives on the impact of the British colonisation of Singapore. In this paper I am interested in the way Isa tells the story not of the founding of Singapore in 1819 but of its loss, specifically to the Malay community, and the implications that he draws from that story for the contemporary Malay community of Singapore.

Associations between disease awareness and health-related quality of life in a multi-ethnic Asian population.

BackgroundHealth related quality of life (HRQoL) is an important dimension of individuals' well-being, and especially in chronic diseases like diabetes and hypertension. The objective of this study was to evaluate the contributions of disease process, comorbidities, medication or awareness of the disease to HRQoL in diabetes mellitus, hypertension and dyslipidemia.MethodsThis was a cross-sectional study of 3514 respondents from the general community in Singapore, assessed for HRQoL, disease and comorbid conditions through self-report, clinical and laboratory investigations. HRQoL was assessed using SF-36 health survey version 2. For each condition, participants were categorized as having 1) no disease, 2) undiagnosed, 3) diagnosed, not taking medication, and 4) diagnosed, taking medication. Analysis used one-way ANOVA and multiple linear regression.ResultsDiagnosed disease was associated with lower physical health component summary (PCS) scores across all three conditions. After adjustment for comorbidities, this association remained significant only for those not on medication in diabetes (−2.7±1.2 points, p = 0.03) and dyslipidemia (−1.3±0.4 points, p = 0.003). Diagnosed hypertension (no medication −2.6±0.9 points, p = 0.002; medication −1.4±0.5 points, p = 0.004) and dyslipidemia (no medication −0.9±0.4 points, p = 0.03; medication −1.9±0.5 points, p<0.001) were associated with lower mental health component summary (MCS) scores. Undiagnosed disease was associated with higher MCS in diabetes (2.4±1.0 points, p = 0.01) and dyslipidemia (0.8±0.4 points, p = 0.045), and PCS in hypertension (1.2±0.4 points, p = 0.004).ConclusionsDisease awareness was associated with lower HRQoL across the diseases studied, with PCS associations partially mediated by comorbidities. Equally importantly, undiagnosed disease was not associated with HRQoL deficits, which may partly explain why these individuals do not seek medical care.

Principal Component Analysis on Differential Effect of Individual Activities of Daily Living in the Elderly

To (a) determine the amount of information lost when collapsing the data and treating it as a summative measure, (b) identify potential clusters of individual ADLs and (c) examine the relationship of individual ADLs on discharge functional status, length of hospital stay, discharge destinations and long-term survival. Cross-sectional study. Singapore Community Hospitals. National data of 12,804 acutely-disabled patients admitted for inpatient rehabilitation in Singapore community hospitals from 1996 through 2005 were followed up to 31 December 2011. Not applicable. Rehabilitation Outcomes, Discharge Destinations and Survival in the Elderly. The PCA on all ADL components suggested that five dimensions accounted for 90% of the variability in the initial 10 ADL. Patients with a better admission functional status (PC1) had higher discharge BI scores (adjusted beta: 9.58, 95% confidence interval (CI): 9.47 to 9.69), shorter length of stay (adjusted beta: -1.04, 95% CI: -1.20 to -0.88), lower odds of being discharge to nursing home (adjusted odds ratio (OR): 0.78, 95% CI: 0.76 to 0.80) and acute hospital (adjusted OR: 0.78, 95% CI: 0.76 to 0.80) compared to home, and lower mortality risk (adjusted hazard ratio (HR): 0.90, 95% CI: 0.89-0.91), even after adjusting for stairs (PC2), bowel and bladder control (PC3), ambulation and wheelchair (PC4), feeding (PC5). In research, admission BI was often treated as a summative score. We found that using admission functional status only accounted for 64% of initial variation in the 10 ADLs. Principal component 1 (PC1, admission BI score) accounted for 64% of variability in the underlying ADL variables and had almost equal loadings on all 10 ADL. In our analyses, despite adjusting for admission BI score, specific ADLs such as stairs, continence (bowel and bladder control), ambulation and feeding were strong independent predictors of outcomes such as discharge functional scores, length of stay, discharge destinations (home, nursing home or acute hospital) as well as survival.

The dynamics of multilingualism in contemporary Singapore

ABSTRACTHistorically, Singapore was home to a heterogeneous and highly multilingual population from across the Asian region and elsewhere in the world. In contrast with its historical past, or even the early days of the post‐colonial period, Singapore's earlier diverse and linguistically heterogeneous society has evolved into a multi‐ethnic nation state, with four official languages, of which three are recognised ‘mother tongues’. This paper reviews the historical and contemporary dynamics of multilingualism in the Singapore community, and also serves as an introduction to the five other papers in this symposium on ‘English in multilingual Singapore’.

Socio-Cultural Problems of the Malay Community in Singapore and in Penang: A Study of Kilat Senja and Aci Patmabi

The way of life of the Malay community cannot be separated from its traditional kampong or rural life, which forms the earliest template of life as family, community and nation, from the earliest stages to the developments of today. Changes over time have given rise to corresponding changes in the kampong, transforming them into advanced, modern towns and cities. This phenomenon occurred in Singapore and Penang, two cosmopolitan states of the Straits Settlements with close historical links. What occurred in Singapore may be discovered in Penang as well. The phenomena or dilemma of “cultural aridity” in Singapore may have similarities with the problem of “urban sprawl” in Penang. On this premis, initially the article discusses Hadijah Rahmat’s Kilat Senja . Do the socio-cultural issues of the Malay community in Singapore also occur in Penang? The answer to this question may be explicitly and implicitly resolved in Azmi Iskandar Merican’s work, Aci Patmabi . Subsequently the article raises and explores a variety of questions on the course of socio-cultural developments of the Malay community in Singapore and Penang. Keywords: socio-cultural issues, cultural aridity, urban sprawl, Singapore, Penang

The Secession of Singapore from Malaysia: a Historical Interpretation of the Novel Satu Bumi

History has often become the inspiration for writers, as it has for Isa Kamari in the case of his novel Satu Bumi ( One Earth ) (1998). What were the historical sources for this author, and how were they employed in his fiction? What was the author’s aim in fictonalizing these historical sources? These are the questions that receive attention in this paper. Using a historical approach and textual analysis, the historical facts found in the novel Satu Bumi and the author’s aims behind fictionalizing them are examined in this study. The study finds that the novel Satu Bumi is based on the history of Malaysia and Singapore, and fictionalizes the historical events using elements of romance and drama. However, even in this romantic and dramatic setting, the historical elements used do not merely serve to record the history of Malaysia and Singapore but are also employed to predict the future of the Malay community in Singapore. It is an alarming state due to the island state’s physical development and a political situation that could be deemed racist, apart from the attitude of the Malay community itself. Keywords: history, historical fiction, Malays, Singapore, Malaysia

Postoperated Hip Fracture Rehabilitation Effectiveness and Efficiency in a Community Hospital

This study aims to determine the inpatient rehabilitation effectiveness (REs) and rehabilitation efficiency (REy) of hip fracture in a Singapore community hospital (CH), its association with socio-demographic variables, medical comorbidities and admission Shah-modified Barthel Index (BI) score as well as change in independent ambulation from discharge to 4 months later. A retrospective cohort study using data manually extracted from medical records of all patients who had hip fracture within 90 days and admitted to a CH after the operation for rehabilitation. Multiple linear regressions are used to identify independent predictors of REs and REy. The mean REs was 40.4% (95% Confidence Interval (CI), 36.7 to 44.0). The independent predictors of poorer REs on multivariate analysis were older age, Malay (vs non-Malay) patients, fewer numbers of rehabilitative therapy sessions and dementia. The mean REy was 0.41 units per day [CI, 0.36 to 0.46]. The independent predictors of poorer REy on multivariate analysis were higher admission BI and being non-hypertensive patient. The prevalence of independent ambulation improved from 78.9% at the discharge to 88.3% 4 months later. CH inpatient rehabilitative therapy showed REs 40.4% and REy of 0.41 units per day and the optimum number of rehabilitative therapy session was from 28 to 41 in terms of rehabilitation effectiveness and the maximum rehabilitation efficiency was seen in those doing 14 to 27 sessions of rehabilitative therapy. The study also showed improvement in BI at discharge and improvement in the independent ambulation 4 months after discharge from the CH.

Malay Muslim Worldviews: Some Thoughts for Social Work Practice in Singapore

Singapore is a multicultural society with a population of about 5.1 million comprising mainly of people with Chinese, Malay, and Indian descent. This article focuses on a review of literature on the interface of religion and ethnic worldviews of the Malay-Muslim community in Singapore. In addition, it will utilize practice examples to show how these worldviews have implications for social work practice with the Malay-Muslim community particularly in the areas of health and family well-being. Help-seeking and the provision of help must acknowledge and use these worldviews as “strengths” in the delivery of social services. The article ends with an emphasis on the need for training in cultural competence for social workers in multicultural societies such as Singapore.