Place In Singapore Research Articles

Follow-up care practices and barriers to breast cancer survivorship: perspectives from Asian oncology practitioners.

The aim of this study is to evaluate the perspectives of Asian oncology practitioners on the physical and psychosocial issues experienced by breast cancer survivors (BCS), current survivorship care practices, and the barriers to follow-up care. This was a cross-sectional survey study. Oncology practitioners were recruited from a major cancer center in Singapore and through two regional cancer meetings that took place in Singapore and Malaysia in 2013. A total of 126 oncology practitioners from various Southeast Asian countries, mostly nurses (58.7 %) and physicians (37.3 %), were recruited. The majority of the respondents agreed that fatigue (78.4 %) and anxiety (69.1 %) were the most common physical and psychosocial problems experienced by BCS. Monitoring for physical and treatment-related adverse effects (80.7 %) and reviewing patients' noncancer medical history (65.3 %) were the most practiced aspects of follow-up care. Compared with the other practitioners, the physicians were more likely to communicate with other healthcare professionals (adjusted OR = 4.24, 95 % CI 1.54 to 11.72; p = 0.005). Most of the respondents also agreed that patient-specific barriers were the main impediments to follow-up care. This study provides insights into the various aspects of breast cancer survivorship care from the perspectives of oncology practitioners and shows that survivorship care is relatively inadequate in Asia. There is a need for new survivorship care models to meet the needs of Asian BCS and to complement the unique healthcare systems of Asia.

Singapore. Singapore and the Silk Road of the Sea, 1300–1800 By John N. Miksic Singapore: NUS Press, 2013. Pp. xi + 491. Maps, Illustrations, Images, Bibliography, Index.

Singapore and the Silk Road of the Sea, 1300-1800 By JOHN N. MIKSIC Singapore: NUS Press, 2013. Pp. xi + 491. Maps, Illustrations, Images, Bibliography, Index. doi: 10.1017/S0022463414000769 The precolonial history of Singapore is an area of wilful ignorance and self-denial among many residents and scholars of the nation-state. To acknowledge that the island has a history prior to the landing of Thomas Stamford Raffles and the English East India Company in 1819 would open the door to numerous contestations that do not fit neatly into the dominant state narrative of a small, insignificant fishing village that British guidance and the modern developmental state has willed into modernity, and has been largely ignored in official accounts and textbooks in the nation-state until recently. With this work, John N. Miksic--an archaeologist who has worked throughout Southeast Asia from a base in Singapore for over thirty years--has meticulously presented a history of Singapore prior to 1819 that places it within larger networks of trade as well as given it a prominence that will influence Singaporean and Southeast Asian historiography for decades to come. Following an introduction that outlines archaeological research in Singapore since 1819, Miksic divides the book into three sections. The first section consists of four chapters that summarise much of the research on coastal Southeast Asian trade ports prior to 1300 and then focuses on what is known about Singapore through ancient historical texts. This section makes up the first half of the book, and provides much needed context, as early Singapore was part of this network of trade ports that linked East and South Asia with Southeast Asia. In this section, Miksic argues that these early maritime trade routes were vastly more important than the more reknown 'Silk Road' as it allowed for an exchange of more trade goods at much higher volumes. Despite its importance, little is known about this trade route, however, as the water and humidity of island Southeast Asia has left few traces of the vast network that was built of easily destroyed wood and fragile trade products. Miksic also provides a valuable survey of sites--with a particular emphasis on summarising the finds of recent marine archaeological sites--as well as a general history of what can be understood from the available record about trade and urbanisation of early Southeast Asia that explains why there are various tales about Singapore and how they fit into the larger economic and cultural history of precolonial Southeast Asia. The following section of the book--consisting of three chapters--focuses on archaeological evidence from Singapore. Archaeological digs, often under the supervision of the author, have taken place in Singapore since 1984. In the first of these chapters Miksic discusses each major excavation, and provides details of the sites and what was discovered. …

Water quality management in Singapore: the role of institutions, laws and regulations

The paper analyses the legal and regulatory instruments for water quality management that have been set in place in Singapore for control of water pollution, and their evolution since the time of independence in 1965. The role of institutions in the strict implementation of the laws and regulations is also discussed, with special emphasis on the efficient inter-institutional coordination machinery that has made it possible. The analyses show that overall long-term planning and policy-making and a strong political will have been instrumental to give all aspects of water management high priority in the national agenda, thus directly supporting urban, industrial and commercial growth.Editor Z.W. Kundzewicz

Confucianism vs. Modernity: Expired, Incompatible or Remedial?

This paper is an exploration of the reappraisal that has been taking place since the 1980s of Confucianism’s suitability for a modernized society. The first section focuses in particular on the discussion that took place in Singapore on Confucianism as a stimulant for economic activity, arguing that it was first and foremost a politically motivated attempt to establish Confucianism as a convenient ideology. I then move to a discussion of recent attempts to rehabilitate Confucianism in the PRC. In the final section, I suggest how Confucianism can be a healthy antidote to some of the ills produced by contemporary capitalist practice.

Singapore’s Phantom Workers

In 2009, the Singapore state prosecuted a string of businesses for listing fictitious local workers on their books in order to stretch their foreign worker entitlement. These “phantom” worker scams, prevalent since the 1980s, appear out of place in Singapore – a country with a strong international reputation for its government’s efficiency and strict legal enforcement. This paper examines the state’s prosecutions of the phantom worker scams in the context of the exceptional economic and political stresses in 2009, when Singapore was most severely affected by the global economic crisis, in order to address the employment regime in Singapore. It argues that the belated efforts to tackle the phantom worker scams reflected the pro-business state’s reluctance to tackle illegalities crucial to facilitating employers’ otherwise unlawful access to wealth and resources in Singapore.

The (bio)politics of engagement: shifts in Singapore's policy and public discourse on civics education

This article provides a historical overview of civic educational policy and political discourse in Singapore from 1959 to 2011, focusing on changes in the role attributed to students in the education process. A review of educational programmes and analysis of political speeches reveals that an earlier transmissionist approach that focused on value inculcation and factual knowledge has been supplemented recently by policy and discourse emphasizing student engagement. The authors link their analysis to larger political changes that have been taking place in Singapore. They argue that the push for more participatory forms of civics education parallels an ongoing shift in the ruling party's political ideology from economic pragmatism to a communitarian ideology that emphasizes citizens' responsibility. From the point of view of political rationality, promoting active student engagement in civics education can be seen as governmental efforts to build a strong civil society through early socialization into civic responsibility and voluntarism. Viewed as a technology of power, engagement is also seen as a new biopolitical intervention aimed at regulating political participation.

Criminal Justice and Diversionary Programmes in Singapore

The politics of crime and punishment generally pushes Governments to adopt harsher measures to fight crime, yet there is a movement in Singapore toward a softer approach in some areas. Singapore has a robust – many would say tough – criminal justice system, for some aspects of which it has and will continue to receive international criticism. Less known is the fact that it has recently invested in more holistic and compassionate strategies, through criminal diversion programs and community sentencing. This article explains this shift in the context of significant social and political changes taking place in Singapore, heralding a more liberal society and open Government. The paper also engages with some of the theoretical and philosophical arguments in favor of criminal diversion and provides a brief overview of the recent diversionary programs in Singapore.

New Voices in Global Health

The World Health Summit, held in Berlin, celebrates its fi fth anniversary this year. It has survived all the dangers of early childhood. Indeed, earlier this year the fi rst regional meeting of the World Health Summit took place in Singapore. During this gathering, the University of Makerere, Uganda, became the fi rst member of the M8 Alliance from sub-Saharan Africa. The M8 Alliance is a collaboration between academic health centres, universities, and national academies. Its vision is to harness academic excellence to improve global health. Following a successful fi rst event in 2012, The Lancet, together with the M8 Alliance, issued a further call for abstracts to fi nd the most inspiring “New Voices in Global Health”. Young researchers from 39 countries have submitted 122 abstracts. Five outstanding abstracts for oral presentation and 13 abstracts for poster presentation at the Summit have been chosen through careful peer review. This booklet contains those 18 abstracts. This year’s topics range from short message services to improve infant feeding practices in China, to a global economic and epidemiological analysis of investments in cholera vaccines; from research on universal health coverage in the Palestinian territory, to a key question for all of us: can we change research to change health? Research is also the focus of WHO’s World Health Report 2013, which will be presented and discussed at the Summit. Choosing the theme of “Research for Universal Health Coverage” is timely, since the UN is moving towards the fi nal stages of devising a post-2015 framework. The report of the HighLevel Panel on the Post-2015 Development Agenda proved that the global health community still needs to do considerably more work to ensure that health is fi rmly anchored in life after the Millennium Development Goals. This year, the Summit welcomes the contribution of Jose Manuel Barroso, President of the European Commission. In his message, Barroso notes that “there is no better indicator of the true wealth of a society than the state of its health systems, their eff ectiveness and inclusiveness”. The World Health Summit 2013 will focus on this interplay between health and prosperity, development and inequality, research and education, and on the role of health in all aspects of foreign policy. The voices we showcase here will send out strong signals that a new generation of scientists has already embraced and responded to this urgent call.

Acknowledging the relevance of cognitive changes in cancer patients: perspectives of oncology practitioners in Asia

Previous studies have suggested that cognitive impairment can affect cancer patients' health-related quality of life (HRQoL) and daily functioning. This study investigated oncology practitioners' perceptions of the relevance, effects, and causes of such cognitive changes in cancer patients, and their awareness of coping strategies. Oncology practitioners completed a self-administered cross-sectional survey. Practitioners were recruited from four major cancer centers in Singapore and Thailand, and through a regional cancer meeting that took place in Singapore in September 2011. The sample (n = 193) consisted of nurses (51.3 %), oncologists (35.2 %), and pharmacists (13.5 %). Cognitive changes were frequently observed among cancer patients, particularly in the domains of memory (77.1 %) and concentration (74.6 %). The majority (86.5 %) of respondents agreed that cognitive changes adversely effected patients' HRQoL. The majority (65.3 %) of the respondents also recognized the need to implement routine neuropsychological assessments in clinical settings. The following factors were perceived as contributing to cognitive changes: aging (77.6 %), cancer-related fatigue (65.2 %), and anxiety (61.2 %). Compared with other healthcare professionals, oncologists were less likely to agree that chemotherapy was a major contributing factor to cognitive changes (25.0 % vs. 9.8 %, p = 0.038). Psychosocial support and the use of complementary alternative medicines (CAM) were identified as coping strategies for cognitive changes. Healthcare professionals do not perceive a uniform set of contributing factors to cognitive impairment among cancer patients, although they all acknowledge that cancer patients' experience of cognitive impairment is a relevant issue. It is important to equip clinicians with the knowledge necessary for monitoring and managing the cognitive disturbances and psychological distress experienced by at risk patients in a clinical setting.

Singapore s Chinatown

This paper focuses on the pivotal role played by the state in refashioning the Chinatown landscape as part of both nation-building and heritage tourism projects, and the ensuing cultural politics. After a brief history of the creation of Singapore’s Chinatown, the paper discusses, first, Chinatown’s place in Singapore’s post-independence nation-building project and, second, the reconfiguration of the Chinatown landscape as a tourism asset. The final section reflects on the changing politics of place as Chinatown gains legitimacy in state discourses on heritage, tourism and multiculturalism, as well as in the popular imagination as an ethnic precinct par excellence.

Green building project management: obstacles and solutions for sustainable development

ABSTRACTGreen building construction is earning a place in Singapore's construction industry, and, with augmenting cognizance of environmental issues and growing concern over climate change, sustainable construction is gradually being put forth globally. However, construction of green buildings in Singapore still encounters impediments, as there is a lack of proper project management framework for such projects. Based on survey and interview results from 31 industry experts, this study aims to identify common obstacles encountered during management of green construction projects, ultimately proposing some solutions to overcome the barriers. The findings from this study reveal that, although project cost is the paramount barrier among others in green building construction management, there is no paucity in sustainable knowledge in Singapore's construction industry. To deal with the cost related problem, the coverage of government incentives should be widened to include the usage of green products and technologies. Furthermore, a project management framework for green building construction should be developed to overcome the barriers, possibly promoting adoption of sustainable construction in future projects. Copyright © 2010 John Wiley & Sons, Ltd and ERP Environment.

Transaction Tax: The Double-edged Sword Effects on Price Stability

This paper examines the impact of a policy change in transaction tax on speculators. The policy intervention took place in Singapore’ housing market; it effectively raised the transaction cost in a segment favored by short-term speculators. Relative to the unaffected control sample, we find that the rise in transaction cost substantially reduced speculative trading in the treatment segment, significantly raised its price volatility and reduced price informativeness. We further show that the results are likely due to a relatively greater withdrawal by informed speculators than by destabilizing speculators following the transaction cost increase.

Global Summit of National Ethics Committees: an essential tool for international dialogue and consensus-building

July 2010, important decisions were taken to ensure the continuity Held for the first time in 1996, the Global Summit of National of activities between the Summits. This article intends to briefly Ethics Committees (NECs) is a key platform for dialogue and retrace the history and analyse the role and functioning of the fostering consensus on ethical issues at a global level. At the Global Summit. It also discusses future challenges for international Eighth Global Summit meeting, which took place in Singapore in collaboration of NECs.

The Singapore Statement on Research Integrity

The Singapore Statement on Research Integrity, drafted at the Second World Conference on Research Integrity, which took place in Singapore from July 21 to 24, 2010, is an important step toward prom...

In This Issue/Abstract Thinking: Persistence of Symptoms in Child Psychiatry

This month's Journal highlights the richness and diversity of the issues, symptoms, and treatment approaches encompassed in the practice of child and adolescent psychiatry. This issue is international, including studies that took place in Singapore, the Netherlands, and Sierra Leone. Diverse diagnoses are considered, including autism, posttraumatic stress disorder and associated symptoms, substance abuse, attention-deficit/hyperactivity disorder (ADHD), and early-onset schizophrenia spectrum disorders.

Sustainable facilities

PurposeThe Sino‐Singapore Tianjin Eco‐city Project, the agreement of which was signed in 2007, is an important milestone that would further cement ties between Singapore and the People's Republic of China (PRC). The Eco‐city Project will be used to showcase the latest green technologies adopted in buildings with a view to reducing the adverse effects of global warming, carbon emissions, and climate change; leading in the process to sustainable facilities. The purpose of this paper is to examine the institutional compliance framework for transferring environmental sustainability regulations from Singapore to China.Design/methodology/approachThe paper examines the current environmental sustainability regulations that are already in place in Singapore, with a view to possibly transfer these regulations as well as the supporting green technologies, codes and practices to the joint Sino‐Singapore Eco‐city Project in the PRC. The study proposes an understanding of the institutional compliance framework to facilitate this transfer.FindingsThere are existing statutory provisions within the Ministry of Environmental Protection (MEP) in the PRC that encourage the use of solar and renewable energy with a view to fostering sustainable construction, including provisions dealing with water pollution. However, beyond these generic areas, it appears that statutory provisions within the MEP do not institutionalize the same level of details that can be found in Singapore relating to the conceptualization, design and construction of sustainable facilities. Hence, transfer of such provisions from Singapore to the Tianjin Eco‐city Project can be facilitated through an understanding of the institutional compliance framework from the Chinese side.Research limitations/implicationsThe environmental sustainability regulations that are already in place in Singapore will be examined in the paper. The study explains the reasons why these regulations were implemented in Singapore, and the framework within which such provisions may be transferred to the Tianjin Eco‐city Project.Practical implicationsThe paper observes that while the legal systems in both Singapore and the PRC may be different, it would be strategic and expedient for the Chinese partners in the Eco‐city joint project to familiarize themselves with the environmental sustainability regulations within Singapore's jurisdiction with a view to possibly adopting them in the PRC through the institutional compliance framework.Originality/valueSingapore is probably the first and only country in the world to enact building regulations pertaining to environmental sustainability with attendant inputs from an appropriate Code for Environmental Sustainability of Buildings and the Green Mark Scheme. The successful completion of the Tianjin Eco‐city Project could provide a role model for further development of Eco‐cities in the world, leading to greater emphasis to be placed on sustainable facilities anchored on the institutional compliance framework.

The Neighbourhood in the Creative Economy: Policy, Practice and Place in Singapore

This paper examines the wild and unruly side of the creative economy and how work-styles associated with this form of production are closely tied to particular types of urban environment. In the case of Singapore, the policy to grow creative industry as a key competitive strategy has focused on building infrastructure, manpower and alliances without space provision for a range of activities. State policies, especially in the education of creative workers and artists, are broad in their impacts and these tend to have unanticipated effects in growing a wider array of activities than imagined. As a result, new start-ups take root in ungentrified portions of Singapore's inner city where low rents and centrality provide the functional basis for growth, but equally important, the diversity and vitality create an atmosphere which fits the work-styles of new economy firms.

Renal Transplantation in Singapore

Renal transplantation is the best treatment for kidney failure. As the demand far exceeds the supply, various legislative measures have been put into place in Singapore to increase kidney transplant rates. This paper evaluates the impact of these measures and reports on the outcomes for kidney transplant recipients in Singapore. Patient demographics, recipient and donor characteristics, and co-morbidities occurring in incident transplant patients were extracted from Singapore Renal Registry (SRR) Reports from 1997 to 2006, tabulated and summarised. Graft and patient survivals data, which were calculated by Kaplan-Meier analysis until return to dialysis/pre-emptive renal re-transplant or patient death respectively, were extracted from SRR Reports. Published data from the United States Renal Data System (USRDS) and Organ Procurement and Transplantation Network (OPTN) were used for comparisons with data from the SRR. The introduction of the Human Organ Transplant Act increased the rate of deceased donor (DD) kidney transplants from 4.7 per year from 1970 to 1988, to 41.4 per year from 1988 to 2004. In 2006, the overall DD and living donor (LD) rate for kidney transplants performed locally for Singaporeans and permanent residents of Singapore was 22.6 per million population (pmp); taking into account overseas kidney transplants, the kidney transplant rate was 33.0 pmp. One and 5-year graft survivals for local LD and DD transplanted between 1999 and 2006, as reported by the SRR, were 98.1% and 95.3% versus 88.9% and 81.3%, respectively (P <0.001). Patient survivals at 1 and 5 years were likewise significantly better for LD versus DD (99.4% and 96.6% vs. 96% and 89.1%, respectively; P = 0.005). The local kidney transplant rates were lower than those reported by the USRDS for the USA, Spain, Norway and Australia but higher than other Asian countries. While 1-year outcomes for transplants reported to the SRR were similar to that reported by the OPTN, 5-year survivals were significantly higher, possibly due to the selection of patients with fewer comorbidities for kidney transplantation in Singapore. These results suggest that while outcomes are excellent, there is much more to be done to increase kidney transplantation rates in Singapore so as to meet the needs of end-stage renal failure patients in the country.

Genomic Epidemiology of a Dengue Virus Epidemic in Urban Singapore

Dengue is one of the most important emerging diseases of humans, with no preventative vaccines or antiviral cures available at present. Although one-third of the world's population live at risk of infection, little is known about the pattern and dynamics of dengue virus (DENV) within outbreak situations. By exploiting genomic data from an intensively studied major outbreak, we are able to describe the molecular epidemiology of DENV at a uniquely fine-scaled temporal and spatial resolution. Two DENV serotypes (DENV-1 and DENV-3), and multiple component genotypes, spread concurrently and with similar epidemiological and evolutionary profiles during the initial outbreak phase of a major dengue epidemic that took place in Singapore during 2005. Although DENV-1 and DENV-3 differed in viremia and clinical outcome, there was no evidence for adaptive evolution before, during, or after the outbreak, indicating that ecological or immunological rather than virological factors were the key determinants of epidemic dynamics.

The role of store environmental stimulation and social factors on impulse purchasing

PurposeThis study aims to examine the role of environmentally induced stimulation in influencing impulse buying. In addition, the authors seek to investigate the impact of two social factors (perceived crowding and employee friendliness) on unplanned purchases.Design/methodology/approachA wide variety of retail outlets in Singapore were selected as the context for this field study, ranging from small cosmetics shops (e.g. Body Shop) to mega furniture outlets (i.e. IKEA).FindingsThe results of this study indicate that perceived over‐stimulation (higher than desired) has a positive impact on impulse buying. Moreover, the two social factors jointly influence consumers' unplanned purchases.Research limitations/implicationsThe sample size was relatively small (n=138) and data collection took place in Singapore. Thus, future research with a bigger sample and tested in other cultures is needed to enhance the generalizability of the findings.Practical implicationsThe study findings suggest that over‐stimulation has a positive impact on impulse purchases. Store managers can look at a number of environmental design variables to increase stimulation in their shops. The findings further indicate that perceived crowding and employee friendliness jointly influence impulse buying, and hence these two factors need to be considered together in store design.Originality/valueRetailers are fully aware of the power of impulse buying in enhancing their revenues, yet little is known about how the store environment influences unplanned purchases. This study addresses that gap in the services literature.