2012

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SAW SWEE HOCK

School of Public Health Turning Discovery into Healthier Communities

ANNUAL REPORT 2011/12

Saw Swee Hock School of Public Health

CONTENTS

VISION

Our Vision, Mission & Values

To be a global leader in Public Health centred in Asia

About the School

/ 01

Dean’s Message

/ 02

Down Memory Lane

/ 04

Benefactions

/ 06

MISSION

Faculty Members

/ 08

To drive knowledge discovery and practice in Public Health

School and Centres Highlights / 12 The School in Numbers

/ 16

Review of Education

/ 18

Faculty and Student Accolades / 20 Knowledge and Research Results Transfer

/ 22

Staff Publications

/ 27

VALUES Altruism • Innovation • Mentorship

ABOUT THE SCHOOL B

uilding on 60 years of experience in research, teaching and practice in epidemiology and public health, the National University of Singapore, Saw Swee Hock School of Public Health was established on 1st October 2011. The founding of The School signifies an important milestone for public health in Singapore. An interdisciplinary approach, augmented by rigorous training, applicable research and regional partnerships places The School at the forefront of public health knowledge discovery and practice in Asia. Moving beyond the traditional domains of chronic disease aetiology and risk factors, The School emphasises integrating diverse disciplines into cutting-edge public health research, new technologies and methods to measure and monitor exposure and disease, as well as new approaches to develop and implement public health programmes and policies. From the use of mathematical and econometric modelling to better inform public health policies, to the development and evaluation of genomic tools to enhance understanding of gene-environment interactions, the underlying motivation is to generate relevant research with practical applications.

Annual Report 2011/12

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DEAN’S MESSAGE T

he founding of The Saw Swee Hock School of Public Health on the 1st of October 2011 signifies an important milestone in public health in Singapore and is the beginning of a new era for us. Building upon over 60 years of experience, The School occupies a unique position in public health research, teaching and practice. Its inter-disciplinary approach augmented by rigorous training, applicable research and regional partnerships places The School at the forefront of public health knowledge discovery and practice in Asia. The last two decades have exposed new challenges in public health ranging from epidemics in chronic diseases like Type 2 diabetes mellitus, cancer and cardiovascular disease to emerging infectious diseases like SARS (severe acute respiratory syndrome) and H1N1. These major threats are compounded in the background of a rapidly ageing population in Singapore and the increasing complexity of health issues such as these often pose seemingly intractable problems to policy makers. Tackling these challenges necessitates an innovative and integrative approach, with various ministries, government agencies, industries and community members an equal part of the solution as researchers and public health leaders. The School, as an institute of higher learning and research, has a vital role to play in turning public health discovery into healthier communities. We aim to expand the boundaries of traditional research by focusing on the application and implementation of science through the formulation of comprehensive policies and programmes to improve health in Singapore and beyond. Our endeavours to improve health must be firmly grounded in scientifically sound evidence and to that effect we are developing ground-breaking areas of research. These include translating genomebased knowledge into public health applications, new methodologies for programme evaluation,

devising systems to better integrate healthcare informatics for the prevention and management of chronic diseases as well as utilising mathematical and econometric modeling for policy decision-making. Emphasising our integrative and multi-disciplinary approach we are also building collaborations and working closely with local and international organisations to help realise our aim to apply research findings to have real world benefits for people. It gives me great pride and pleasure to share with you some of our more significant achievements in the first year since the founding of The School. We signed a Memorandum of Understanding (MOU) with the London School of Hygiene and Tropical Medicine for the exchange of scientific, academic and technical information; to identify opportunities for cooperation in teaching and facilitate exchange of staff and students to develop collaborative projects, and for the organisation of and participation in joint academic and scientific activities. We also have an MOU with the Harvard School of Public Health to conduct research, provide expert training, and establish an evidence-based model for the prevention of Type 2 diabetes in Singapore and Asia. Along with the Health Promotion Board we will be setting up the Health Promotion Academy which will function as a Centre of Excellence for Health Literacy; developing programmes and curricula to train Health Ambassadors in health promotion and disease prevention in Singapore. I would like to highlight The School’s Population Health Metrics and Analytics (PHMA) programme which is a cutting-edge health information system which can monitor and integrate a massive volume of data to help researchers understand health and disease, and provide guidance to policymakers. Going forward, The School will continue to build on its strengths and push to new heights in order to “Turn Discovery into Healthier Communities”

Professor Chia Kee Seng Dean, Saw Swee Hock School of Public Health

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Saw Swee Hock School of Public Health

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DOWN MEMORY LANE

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1 9 5 3

ake a walk down memory lane to over 60 years ago when NUS Saw Swee Hock School of Public Health started as off as the Department of Community, Occupational and Family Medicine (COFM) to an organisation that is today regionally and internationally recognised as a school of excellence in occupational and public health education, training and research.

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1948

1953

1964

1987

1996

The Department of Social Medicine and Public Health was set up to amalgamate the former Raffles College and the King Edward VII College of Medicine, to form the University of Malaya.

The Department was relocated to Nissen Huts in McAlister Road.

Professor Michael J Colbourne served as Head of the Department until 1969.

The Department was renamed the Department of Community, Occupational and Family Medicine after it took on the teaching of family medicine. And it was reorganised into five divisions – Epidemiology, Biostatistics & Health Informatics, Health Care, Occupational Medicine and Family Medicine to allow greater subspecialisation.

The Centre for Environmental and Occupational Health Research was established to focus on and prevent environmental and occupational health problems. The Centre conducted research and provided consultancy in chemical safety, environmental and occupational health, as well as provide training in Environment, Health and Safety.

Combining the Master of Medicine (Public Health) and Master of Medicine (Occupational Medicine), the new Master in Public Health programme was introduced in keeping with the multidisciplinary demands of modern public health.

Professor Lee Hin Peng took over as Head of the Department and served till 2001.

1998

2009

The same year, Dr John J Strahan was appointed as the first professor of the Department and served as Head of the Department until 1953.

1949 A nutrition unit was formed with the transfer of staff from the Department of Biochemistry.

1950 A lecturer in applied nutrition was appointed to the department.

1952 A medical statistician was appointed, enabling the development of a statistical consultative service.

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Saw Swee Hock School of Public Health

Professor Trevor Lloyd-Davies, an industrial physician, was appointed and served as Professor of Social Medicine and Public Health until 1961. Lectures on occupational health were introduced to the curriculum. The postgraduate Diploma of Public Health was introduced with assistance from the World Health Organisation. It was the first diploma course in postgraduate medicine in Singapore and one of the earliest in the region. The course was specially designed to suit the conditions in the Far East.

1957 The Department moved into the Institute of Health in Outram Hill.

1961 Professor Winifred Danaraj served as Head of the Department until 1964.

1970 Professor Phoon Wai On was appointed Head of the Department and was with the Department till 1987. He was the longest serving head in the history of the Department and was instrumental in the development of curriculum and research into occupation medicine.

1973 The Diploma of Public Health course was replaced by the degree of Master of Science (Public Health) course. The degree course for the Master of Science (Occupational Medicine) was introduced – it was the first postgraduate degree course in occupational medicine in this region.

1986 The National University Hospital was completed and the Department together with the rest of the Faculty of Medicine was relocated to the main campus of the National University of Singapore in Kent Ridge.

1992 The Master of Science (Public Health) and Master of Science (Occupational Medicine) were reorganised into the degrees of Master of Medicine (Public Health) and Master of Medicine (Occupational Medicine).

The Department moved into the NUS Biomedical Complex.

2001 Professor David Koh took over as Head, leading the Department into the new millennium with modern challenges in public health.

2002

The Department was designated as a WHO Collaborating Centre in occupational health).

The Centre for Molecular Epidemiology with Professor Chai Kee Seng as its director, was set up to discover gene-environment interactions for the promotion of public health.

1993

2005

The Master of Medicine (Family Medicine) course was introduced.

Centennial Celebration of the School of Medicine.

2007

2008

The Department of Community, Occupational and Family Medicine celebrated 60 years in public health. The Department of Community, Occupational and Family Medicine (COFM) became the Department of Epidemiology and Public Health (EPH). These changes precipitated expansion into new areas of research including the genetic determinants of disease in Asian populations, the mathematical and statistical modelling of infectious disease epidemiology, as well as the role of gene-environment interactions in shaping chronic disease risk factors in the Singapore population.

2011

Formation of Saw Swee Hock School of Public Health to meet new challenges in public health. The School becomes a member of the National University Health System. With its distinctly Asian focus, it has a special role to play in public health research, training and practice. Annual Report 2011/12

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BENEFACTIONS E “It is my wish for the School to

very gift to our School makes a difference. Your gifts are hard at work building the future of public health in Singapore and the region — from scholarships to research to outreach programmes. Your gift gives us the added advantage and confidence in meeting new needs or opportunities and responding to extraordinary challenges as they arise in our mission to become Asia’s global leader in public health.

play a key role in helping to improve the standard of public healthcare in Singapore and the surrounding region in the years ahead.”

 ingapore Exchange •2  6th ICOH2000 Conference • S

Prof Saw Swee Hock

We recognise and would particularly like to extend our deepest appreciation to all our donors — lifetime contributors, friends, individuals, organisations, alumni — listed here and all those who prefer to remain anonymous. Organising Committee •T  he National Kidney

Foundation

•P  fizer Private Limited •P  rof Lee Hin Peng

•L  ee Foundation

•M  r Hsieh Fu Hua

•B  injai Tree

•P  rof Lim Meng Kin

•T  emasek Foundation

•A  msco Healthcare Marketing Private Limited

CLG Limited

Distinguished Benefactor to the NUS Saw Swee Hock School of Public Health, Distinguished NUS Alumnus and member of the NUS Board of Trustees

Limited

•M  s Khoo Kim Geok,

Jacqueline Khoo •S  ingapore Tourism Board •S  incere Watch Limited

•N  ational University Hospital (S) Pte Ltd •S  ingapore Chemical Industry Council Limited

How we use the money Donations to The School will greatly help The School to achieve its vision through mainly two areas — manpower and operating costs. Budget has been allocated to develop and retain existing The School’s academic, research and administrative staff as well as to recruit new staff. It also includes the cost of hiring operations and IT staff involved in the Population Health Metrics and Analytics system.

OUR BENEFACTOR – PROFESSOR SAW SWEE HOCK Professor Saw Swee Hock is a distinguished NUS alumnus whose generous endowed gift of $30 million has enabled the establishment of the Saw Swee Hock School of Public Health, which is specifically designed to play a key role in improving the standard of public health in Singapore and the surrounding region in the years ahead. Professor Saw is President’s Honorary Professor of Statistics in the Department of Statistics and Applied Probability, NUS, and Professorial Fellow in the Institute of Southeast Asian Studies (ISEAS). He serves as a member of the NUS Board of Trustees. Professor Saw was a Senior Lecturer in Statistics in the University of Malaya, Kuala Lumpur, Founding Professor of Statistics in the University of Hong Kong, and subsequently Professor of Statistics in NUS. He is an Honorary Fellow of the London School of Economics (LSE) and an Honorary Professor in both the University of Hong Kong and Xiamen University. His first degree is from NUS and his doctorate in Statistics is from LSE. His publications include many books and articles in learned journals. Professor Saw has provided philanthropic support to many charitable causes, particularly in the area of education in the form of gold medals, bursaries, scholarships, institutes, schools and buildings. Recipients of his donations include ISEAS, NUS, LSE, Xiamen University, University of Hong Kong, Nanyang Technological University and Singapore Management University. In NUS, he has set up an endowed bursary fund which has so far benefited over 100 final year needy students across all faculties and schools.

Best Wishes from WHO It gives me great pride to be associated with The School which has gained regional and international recognition as a centre of exccellence in occupational and public health education, training and research. On a personal level, I have fond memories of my postgraduate days in the School between 1984 and 1985 when I earned my degree in public health. I am confident that the School will continue to grow from strength to strength in its role in the prevention and alleviation of illness, and the protection and promotion of health regionally and internationally. My best wishes to the School in the years ahead! Dr Margaret Chan Prof Saw Swee Hock (second from left) with Prof Lee Hin Peng, Prof Saw Seang Mei, Prof David Koh and Prof Chia Kee Seng (left to right)

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Saw Swee Hock School of Public Health

REPRODUCED WITH KIND PERMISSION FROM NUS DEVELOPMENT OFFICE

Director-General, World health Organization MSc (PH) 1984/1985 Annual Report 2011/12

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FACULTY MEMBERS

5

2

3

1. CHIA Kee Seng Professor, Dean

2. CHIA Sin Eng

Associate Professor, Vice-Dean (Academic Affairs)

3. WONG Chia Siong

Senior Lecturer, Vice-Dean (Education)

1

4. LIM Yee Wei

4

Associate Professor, Vice-Dean (Research); Head, Health Education & Promotion and Health Systems and Policy Domains

5. WONG Mee Lian

8

7

7. TAI E Shyong

Joint Associate Professor

8. Elizabeth Alderman JAHNCKE Joint Lecturer

Associate Professor

6. Gerald KOH Choon Huat Associate Professor

6

4

1. TEO Yik Ying

2

5

1

3

6

4. KOH Woon Puay

7. Agus SALIM

2. Richard James COKER

5. Audrey CHIA Wai Yin

8. LUO Nan

3. LIM Meng Kin

6. Judy SNG Gek Khim

Joint Associate Professor; Head, Biostatistics Domain Visiting Professor; Head, Infectious Disease Programme Associate Professor

Associate Professor

Joint Associate Professor

8

7

Assistant Professor

Assistant Professor

Assistant Professor

OTHER FACULTY MEMBERS Mike PAN An

Leontine ALKEMA

OOI Eng Eong

Gregory CHAN Chung Tsing

Sonia Maria DAVILLA DOMINGUEZ

LEE Chien Earn

Adeline SEOW Ling Hui

Arul EARNEST

Augustus John RUSH

CHEW Ling

GOH Kee Tai

LEE Hock Siang

CHENG Ching-Yu Joint Assistant Professor

GOH Liang Kee

SHEN Han Ming

CHEW Suok Kai

Derrick HENG Mok Kwee

LEE See Muah

Joe SIM Heng Joo

Mohammad Kamran IKRAM

TAN Lai Yong

Angela CHOW Li Ping

Martin Lloyd HIBBERD

Vernon LEE Jian Ming

TAN Kia Tang

KHOR Chiea Chuen

Terri Lois YOUNG

Kenneth David CHOY Kwok Yin

KOH Yang Huang

LEO Yee Sin

Assistant Professor Associate Professor

Joint Associate Professor Joint Associate Professor

Joint Assistant Professor Joint Associate Professor Joint Assistant Professor Joint LKY Postdoctoral Fellow Joint Assistant Professor

Joint Associate Professor Joint Professor

Joint Associate Professor Joint Senior Lecturer Joint Professor

Adjunct Assistant Professor

Adjunct Assistant Professor Adjunct Associate Professor Adjunct Assistant Professor Adjunct Assistant Professor

Adjunct Assistant Professor Adjunct Professor

Adjunct Associate Professor Adjunct Associate Professor Adjunct Assistant Professor

Adjunct Associate Professor Adjunct Associate Professor Adjunct Associate Professor Adjunct Associate Professor Adjunct Associate Professor As on 7 t h September 2012

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FACULTY MEMBERS

6

4

1. LEE Hin Peng

Professor; Head, Epidemiology Domain

2. David KOH Soo Quee Professor

3. TAI Bee Choo

Associate Professor

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2

1

5

3

9

8

6

5

1

4

2

3

7

8

4. Jeannette LEE Jen Mai

7. HSU Li Yang

1. O  NG Choon Nam

4. Rob Martinus van DAM

7. Mikael HARTMAN

5. Eric Andrew FINKELSTEIN

8. Mark CHEN I-Cheng

2. SAW Seang Mei

5. Alex COOK

8. CHOI Hyungwon

6. TAN Chuen Seng

9. LIM Wei Yen

3. WONG Tien Yin

6. Joanne YOONG Su Yin

Christina Misa WONG

Sri Chander s/o TIKAMDAS NEBHRAJ Adjunct Associate Professor

Jeremy LIM Fung Yen

Mahendran s/o A. MALIAPEN

Adjunct Assistant Professor

Eric YAP Peng Huat

Roy CHAN Kum Wah

TAN Min Han

Adjunct Associate Professor

Joint Adjunct Professor

Stefan MA Sze Lok

David Lowell HEYMANN

Associate Professor

Joint Associate Professor

Assistant Professor

Joint Assistant Professor

Assistant Professor

Assistant Professor

Professor

Professor

Joint Professor

Joint Associate Professor

Joint Assistant Professor

Joint Assistant Professor

Assistant Professor

Assistant Professor

OTHER FACULTY MEMBERS LI Yi-Ju

Adjunct Associate Professor

LOW Yen Ling

Adjunct Assistant Professor

Joint Adjunct Assistant Professor

John LIM Chien Wei

NG Wee Tong

LIM Poh Lian

Eugene SHUM Jin-Wen

Mythily SUBRAMANIAM

CHEAH Peh Yean

Adjunct Assistant Professor

Joint Adjunct Associate Professor

TAN Boon Huan

Adjunct Assistant Professor

Annie LING Mei Chuan

Matthias Paul TOH Han Sim

Anbupalam THALAMUTHU

FONG Ngan Phoon

TAN Say Beng

Adjunct Associate Professor Adjunct Associate Professor Adjunct Associate Professor

Adjunct Assistant Professor

Adjunct Assistant Professor

Adjunct Assistant Professor

Joint Adjunct Associate Professor

Joint Adjunct Associate Professor Joint Adjunct Assistant Professor Joint Adjunct Associate Professor

Joint Adjunct Assistant Professor Joint Adjunct Assistant Professor Visiting Professor

Helena Marieke VERKOOIJEN

Visiting Associate Professor

LIU Jianjun

Adjunct Associate Professor As on 7 t h September 2012

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CONFERENCES AND SYMPOSIUMS

SYMPOSIUM ON PREVENTION OF TYPE 2 DIABETES IN ASIA

SCHOOL AND CENTRES HIGHLIGHTS

More than 60 participants from the National University of Singapore (NUS), Duke-NUS, the National University Health System (NUHS), Agency for Science, Technology and Research (A*STAR) Institutes, the Ministry of Health (MOH) and government-restructured hospitals attended the inaugural symposium on the prevention of Type 2 diabetes in Asia in October 2011.

COMBATING CHRONIC DISEASE IN ASIA The second NUS Initiative to Improve Health in Asia (NIHA) forum was held in November 2011. The theme of forum was “Combating Chronic Disease in Asia – Gaps and Innovations.”

UK-SINGAPORE SYMPOSIUM ON OBESITY & DIABETES The NUS Saw Swee Hock School of Public Health together with the British High Commission jointly organised a UKSingapore symposium and workshop in December 2011 on Obesity & Diabetes: Causes, Consequences and Opportunities for Prevention.

CENTRES HIGHLIGHTS SINGAPORE POPULATION HEALTH STUDIES The Singapore Population Health Studies was set up in The School last year to monitor and assess the health of Singaporeans. It serves as a source of health-related information that is useful to health policy makers and other healthcare sector stakeholders, and it will also be the resource centre for the School and the National University of Singapore for population-based health studies.

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Population Studies SINGAPORE CONSORTIUM OF COHORT STUDIES

Recruitment for this cohort of 14,576 community volunteers and 14,074 patients with diabetes has been completed. SINGAPORE HEALTH 2012

From July to November 2012, the unit will be conducting a community survey of the health status, health-related lifestyle behaviours and health-related knowledge and attitudes of a nationally-representative population of 2500 Singaporeans and Permanent Residents between the ages of 18 to 79. H1N1(2009) INFLUENZA STUDIES

Analyses of data obtained from the sero-epidemiology cohort between 2009 and 2010 were further analysed during the year, which resulted in two publications.

Household Cohort Study of Acute Respiratory Infections The unit also embarked on a two-year household cohort study starting in April 2012 involving 800 households.

Demographic Epidemiological Model Of Singapore (DEMOS) The Demographic Epidemiological Model Of Singapore (DEMOS) is a simulation model representation of Singapore. Once completed, it will provide a framework to transform low dimensional summary statistics from national statistics publications into richer, higher dimensional data.

Nutrition, physical activity, and metabolic disorders This research programme is aimed at elucidating the role of nutrition and physical activity in the development of metabolic disorders such as dyslipidemia and hyperglycemia that increase risk of type 2 diabetes and cardiovascular diseases.

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Systematic reviews and meta-analysis A key objective of the unit is to develop the capacity to perform meta-analyses. Systematic reviews and metaanalyses comprehensively summarise relevant data and can allow the identification of potential reasons for differences in study results, and also permit an assessment of the strength of scientific evidence for a particular research hypothesis. We have so far initiated four meta-analyses projects, focusing on diet and health.

Genetic studies Over the last year, the team has utilised the Singapore Genome Variation Project and Hapmap data to explore genetic diversity in Asia, and has also assembled data on both rare and common copy number variation.

International collaborations Multiple collaborations are underway. These collaborations primarily focus on identifying genetic risk factors for common chronic diseases.

nurses, public health inspectors, environmental health officers and other health practitioners who are trained in the delivery of occupational health.

HEALTH PROMOTION RESEARCH

ONGOING PROJECTS

1.STI/HIV/AIDS risks related to heterosexual behaviours of Singapore Men We are collaborating with Health Promotion Board on a study to assess STI/HIV- related sexual behaviours and healthseeking behaviours among heterosexual men who engage in paid sex and/or who have casual sex with women in Singapore and neighbouring countries. This study will provide important findings for the prevention and control of HIV/AIDS and STI among Singapore men who engage in paid sex and/or casual sex. 2. A Qualitative Study of Attitudes and Risk Reduction Behaviors of Women (Non-Sex Workers) With HIV - Positive Partners This AWARE - funded qualitative study is ongoing. The purpose of this study is to explore the attitudes and perceptions about

collaboration with clinicians and agencies in National Univeristy Health System as well as with international partners. The aim is to improve clinical care delivery, generate new knowledge and inform healthcare policy makers.

Research Activities ADHERENCE WITH MEDICATION AND HEALTH RELATED QUALITY OF LIFE AMONG PATIENTS WITH GLAUCOMA AT THE NATIONAL UNIVERSITY HOSPITAL.

The aims of this study are to evaluate the medication adherence rate, to explore the factors relevant to non-adherence, and to evaluate patients’ health related quality of life. EMPIRICAL THERAPY AMONG ADULT FEBRILE NEUTROPENIA PATIENTS AT NUH.

The aim of this study is to monitor and audit the empirical treatment delivered, to monitor the outcomes of using the new treatment guidelines. HOSPITALISATION COSTS FOR FEBRILE NEUTROPENIA PATIENTS AT NUH

Most of the FN cases are managed as inpatients, and the costs for FN are rarely reported in Asian countries. Thus, the aim of this study is to investigate the inpatients’ costs of each febrile neutropenia episode at NUH. RELATIONSHIP BETWEEN APNEA-HYPOPNEA INDEX AND ANGIOGRAPHIC CORONARY DISEASE PHENOTYPES IN PATIENTS PRESENTING WITH ACUTE MYOCARDIAL INFARCTION

Previous studies suggested obstructive sleep apnea was associated with extensive atherosclerosis, but this has not been investigated using coronary angiography. We sought to examine the relationships between apnea-hypopnea index (AHI) and angiographic coronary disease phenotypes. A total of 125 patients presenting with acute myocardial infarction and undergoing a screening sleep study using a level 3 portable diagnostic device were recruited for this study. EXPLORING THE USE OF THE DEMENTIA MANAGEMENT STRATEGIES SCALE IN CAREGIVERS OF PERSONS WITH DEMENTIA IN SINGAPORE

CENTRE FOR ENVIRONMENTAL AND OCCUPATIONAL HEALTH RESEARCH The objective of the Centre for Environmental and Occupational Health Research is to elucidate and prevent environmental and occupational related health problems. It provides support and consultancy in the areas of chemical safety, environmental and occupational health. It also provides training in the area of environmental and occupational health.

WHO COLLABORATING CENTRE FOR OCCUPATIONAL HEALTH The Centre was redesignated as a WHO Collaborating Centre for Occupational Health with effect from 22 June 2010 for another four years. In November 2011, we concluded our training project for a core group of occupational health professionals from the Provincial Health Office of Riau Archipelago Province who will then train their colleagues. An audit was conducted in May 2012 to assess the framework of their training programme. At the end of this project, an estimated workforce of 450,000 in the Riau Archipelaho region will benefit from doctors,

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Saw Swee Hock School of Public Health

HIV, sexual behaviour and safer sexual practices among women whose husbands or partners are infected with HIV so that effective HIV education programmes can be planned for these mainstream women. 3.Randomised Controlled Trial of an STI/HIV/AIDS Prevention Intervention for Adolescents Attending a Public STI Clinic in Singapore This NMRC-funded research project, a collaboration between NUS and the Department of STI Control (DSC), aims to assess the impact of an STI/HIV/AIDS prevention programme on adolescents aged 16 to 19 years attending the Department of STI Control Clinic (DSC). 4. Survey on men having sex with men We collaborated with CDC, Tan Tock Seng Hospital and research staff and clinicians from DSC and AFA in a survey, using respondent-driven sampling, to estimate the prevalence of HIV, syphilis and sexual risk behaviors in men who have sex with men in Singapore.

HEALTH SERVICES RESEARCH

This unit serves to develop and promote Health Services Research through a multidisciplinary and inter-sectoral

The present study expanded on previous research by refining and establishing the scale’s content validity and psychometric properties in the Singapore context. A total of 196 family caregivers completed questionnaires which assessed caregiver and patient characteristics, and dementia management strategies with DMSS.

SALIVARY BIOMARKERS RESEARCH GROUP Our research interests include the use of salivary biomarkers in the study of mental and physical stress, allergic diseases (such as asthma and allergic rhinitis), infectious diseases (such as dengue fever), organophosphate toxicity, and oral immunity. We are also exploring applications in behavioural sciences and health-environment interaction research. In 2012, a new study on the effect of qigong on salivary biomarkers will be initiated, in collaboration with the PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam.

THE SINGAPORE CHINESE HEALTH STUDY The objective of the Singapore Chinese Health Study (SCHS) is to establish a stable cohort for long-term follow-up study of dietary and other environmental determinants of chronic diseases such as cancer, diabetes mellitus, osteoporosis and cardiovascular disease. It will examine potential disease-protective dietary factors that are not present in western populations.

SINGAPORE EPIDEMIOLOGY OF EYE DISEASE (SEED) The Singapore Epidemiology of Eye disease (SEED) serves to initiate, promote and coordinate ophthalmic epidemiologic research in Asia. The programme provides a forum for generating new hypotheses, and the application of epidemiologic. It focuses on epidemiology and biostatistics, and includes research related to clinical epidemiology, genetic and molecular epidemiology research, evidence-based medicine and outcomes research.

CANCER EPIDEMIOLOGY – LUNG AND LYMPHOID MALIGNANCIES

Genes, Environment and Lung Cancer, Singapore (GEL-S) study The Genes, Environment and Lung Cancer, Singapore (GEL-S) study, was completed in April 2011. In total, the team recruited 398 cases and 814 controls from the four major public sector hospitals in Singapore, bringing the combined study population from two lung cancer case-control studies to 701 cases and 1577 controls. Results from this study have been written up and published.

Singapore Lymphoma Study The Singapore Lymphoma Study was completed in February 2011, and preparation of manuscripts is in progress. The collaboration with the Genome Institute of Singapore on a Genome Wide Association Study of genetic determinants of lymphoma risk in Asian populations is still ongoing.

CENTRE FOR INFECTIOUS DISEASE EPIDEMIOLOGY AND RESEARCH (CIDER) The Centre for Infectious Diseases Epidemiology and Research (CIDER) was jointly established by the Ministry of Defence (MINDEF) and Saw Swee Hock School of Public Health, National University of Singapore (SSHSPH, NUS). The aim is to develop the Centre into a professional academic and research centre that can reduce the public health burden caused by infectious diseases locally and in Asia. Annual Report 2011/12

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DOMAINS

STUDENTS TAUGHT BY SCHOOL APPLICATIONS FOR ADMISSION

1,273

POSTGRADUATES

178

RESEARCH AND DEVELOPMENT FUNDING

S$22 126 million

PUBLICATIONS

THE SCHOOL IN NUMBERS

240

DEGREE PROGRAMMES INTERNATIONAL STUDENTS

6 34

Figures from 1 s t October 2011 to 7 t h September 2012

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DEGREES & PROGRAMMES DEVELOPMENT AND GRADUATION STATISTICS Education Programmes

Person-in-charge

Undergraduate (UG)

A/Prof Jeannette Lee

Master of Public Health (MPH)

Dr Wong Chia Siong

Graduate Diploma in Applied Epidemiology (GDAE)

A/Prof Fong Ngan Phoon

Graduate Research Programme (GRP)

A/Prof Rob Martinus van Dam

Preventive Medicine Residency (PMR)

Prof Lee Hin Peng & Dr Judy Sng

Bachelor of Environmental Studies (BES)

Dr Judy Sng

As on 7 t h September 2012

Overview The Education Office at the National University of Singapore (NUS) Saw Swee Hock School of Public Health offers various graduate courses. It is also actively involved in undergraduate medical training at the Yong Loo Lin School of Medicine.

Undergraduate Education The School continues to support the NUS Yong Loo Lin School of Medicine in teaching medical undergraduates. The course is taught in the first to fourth year of the five-year medical course. The curriculum offered by The School aims to impart: • An understanding of the influence and relevance of behavioural, social, cultural, environmental,occupational, and economic factors on health and illness, and apply this understanding to the promotion of health and management of illness; •A  n awareness of the components of healthcare systems, including resource allocation and barriers, and their effects on the population, individuals and patients; skills to gather and critically evaluate information and effectively incorporate it into their knowledge base.

Master in Public Health Programme (MPH)

REVIEW OF EDUCATION

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The present Master in Public Health Programme seeks to provide a rigorous and interdisciplinary approach to learning, with emphasis on finding evidence-based and innovative solutions to Asia’s current and future public health challenges. The annual recruitment exercise draws over 120 applications for 35 places. Approximately one third of our students come from the surrounding countries. Students may choose from any of these areas of study: • General Public Health track • Occupational and • Clinical Epidemiology Environmental Health • Global Health

university graduates with relevant public health experience.  Candidates are required to complete six public health related modules.  Our first GDAE cohort graduated in June 2012.

Graduate Research Programme (MSc/PhD) As a department, we have supervised graduate research students under the auspices of the Yong Loo Lin School of Medicine (YLLSOM). A total of 11 YLLSOM graduate research students with SSHSPH supervisors graduated in AY2011/2012. The School launched its graduate research programmes in August 2012, offering both the Master of Science (M.Sc.) programme and the Doctor of Philosophy (Ph.D.) programme. The emphasis of the programmes is on the acquisition of core knowledge in the area of interest while developing a general understanding of public health, and in the mastery of research skills such as hypothesis formulation and study design, critical appraisal of existing research, data gathering and analysis, research management, and scientific writing.

Preventive Medicine Residency Programme (PMR) Since 2010, public health and occupational medicine training programes are now grouped under the Preventive Medicine Residency - a three- year ACGME-I (Accreditation Council for Graduate Medical Education International) accredited training programme. There are at present 16 residents undergoing the programme.

Bachelor of Environmental Studies (BES) The Bachelor of Environmental Studies (BES) is a 4-year direct Honours degree programme offered jointly by the Faculty of Science, Faculty of Arts since 2011. SSHSPH runs the Environmental and Public Health module, which is a core requirement for students in their second year of study. There are at present 44 enrolled students taking this module. 

Graduate Diploma in Applied Epidemiology (GDAE)

Joint PhD programme in Genetic & Molecular Epidemiology (GAME)

In 2011, The School offered the Graduate Diploma in Applied Epidemiology. This is a 18-month part-time programme for

A student graduated in AY 2011/2012.  The thesis title is “Health outcomes associated with cognitive impairment”. Annual Report 2011/12

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Faculty Professor Lee Hin Peng

• Lee Foundation Lifetime Achievement Award, NUHS Leadership Awards 2011

FACULTY AND STUDENT ACCOLADES

• Chapter of Public Health & Occupational Physicians Achievement Award for his outstanding contributions to public health and occupational medicine in Singapore at the 6th Singapore Public Health & Occupational Medicine Conference in August 2011 A/Prof Gerald Koh

• Award of Promotion and Tenure (1 July 2011) • Awarded Singapore Millennium Foundation Grant in August 2011 for his proposed study entitled “TeleRehabilitation for Newly-Disabled Homebound Older Persons Needing Supervised Physical Therapy” RESEARCH FELLOW

Dr Lim Sin How

• 6th Singapore Public Health and Occupational Medicine Conference Best Oral Presentation Award for the project entitled “Smoking Cessation and Mortality Among Middle-Aged and Elderly Chinese in Singapore – The Singapore Chinese Health Study” in August 2011 A/Prof Teo Yik Ying

• Singapore Youth Award 2011

Students MASTER OF PUBLIC HEALTH

Dr Brian See Cheong Yan

• Tye Cho Yook Gold Medal for Best Performing Student in MPH • Occupational and Environmental Health Society Medal for Best Performing Student in Occupational and Environmental Health Specialisation • Richard Gillis Book Prize for Best Performing Student in CO5305 Industrial Hygiene

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Saw Swee Hock School of Public Health

GRADUATE RESEARCH PROGRAMME DOCTOR OF PHILOSOPHY (PhD)

Astrid Irwanto

• 3rd prize for Poster Award at the 16th Human Genome Meeting 2012 in Sydney Haleh Ghaem Maralani

• Merit award for Oral Presentation and 3rd prize for Poster Presentation at the 6th Singapore Public Health & Occupational Medicine Conference 2011

– A Triple Epidemic Burden on Asia” at the 25th East Asian Medical Students’ Conference in January 2012 Nazirul Hannan Bin Abdul Aziz

• Singapore Medical Association Public Health Research Award at the 2nd Yong Loo Lin School of Medicine Annual Scientific Congress 2012 Wee Liang An

Eugene Ho Wanxing

• Best Abstract Award at the 10th International Scientific Congress of the Royal College of Obstetrics and Gynaecology in Mar 2012

• 2nd runner-up for Oral Presentation Award at the Yong Loo Lin School of Medicine 2nd Annual Graduate Scientific Congress 2012

• Singapore Medical Association Wong Hock Boon Award at the 2nd Yong Loo Lin School of Medicne Annual Scientific Congress 2012

Li Ling Jun

• Best Poster (Quality and Health Services Research) Award at the Singapore Health and Biomedical Congress 2011

• Merit award for Oral Presentation at the 6th Singapore Public Health & Occupational Medicine Conference 2011 • Merit award for Poster Presentation at the 28th Singapore-Malaysia Joint Meeting in Ophthalmology 2012 Mao Hui

• Best Research Publication Award at the Yong Loo Lin School of Medicine 2nd Annual Graduate Scientific Congress 2012 • NMRC (National Medical Research Council) Research Training Fellowship 2012 Sim Xueling

• Best Research Publication Award at the Yong Loo Lin School of Medicine 2nd Annual Graduate Scientific Congress 2012

Kwan Rui

• Merti Award, Allied Health Specialties Category at the 6th KK Women’s and Children’s Hospital Annual Scientific Meeting 2011 Melvin Seng Yi Feng, Kong Wang Yee and their supervisors Prof David Koh, Dr Lim John Wah, Dr Judy Sng

• Won the Best Oral Presentation Award (Occupational Medicine Category) for their paper on “A study of needle stick injuries among medical students” at the 6th Singapore Public Health and Occupational Medicine Conference in August 2011

GRADUATE RESEARCH PROGRAMME MASTER OF SCIENCE (MSc)

Chen Zhaojin

• Best Poster Award at the 2nd Singapore Conference on Statistical Science UNDERGRADUATES MEDICINE

Roderica R.G. Ng, Readon L.H. Teh1, Y.T. Lim1, Jeremy J.Y. Chai

• 2nd runner-up for Best Oral Paper on “Smoking Diabetes and Tuberculosis

As on 7 th September 2012

Annual Report 2011/12

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RETINAL VESSEL CALIBRE, EARLY CHILDHOOD CARDIOVASCULAR RISK FACTORS AND REFRACTIVE ERRORS IN PRESCHOOL CHILDREN This study is to evaluate the relationship of retinal vascular caliber with early cardiovascular predictors such as birth parameters, blood pressure, early childhood lifestyle and maternal factors as well as refractive errors, amblyopia and strabismus in 1,000 children aged 2 to 16 years recruited from the Preschool study of Refractive Error, Amblyopia and Strabismus (STARS) and STARS Family study. The study will provide new information on whether retinal vascular changes occur early in childhood, and whether these are related to birth weight, gestational age, blood pressure, refractive error and other factors.

PLASMA ADIPONECTIN AND ITS ENVIRONMENTAL AND GENETIC DETERMINANTS IN CHINESE, MALAYS AND ASIAN INDIANS Central obesity and insulin resistance are major risk factors for diabetes mellitus and cardiovascular disease. Environmental (diet and physical activity), genetic, gene-environment or gene-gene influences on its levels has still not been fully elucidated in large epidemiological studies. This study is thus an attempt to identify pathways and strategies through which adiponectin concentration may be regulated.

KNOWLEDGE AND RESEARCH RESULTS TRANSFER

ANALYSIS OF MULTIVARIATE FAILURE TIME DATA: A SEMI COMPETING RISKS APPROACH The aim of this research was to develop strategies for modelling covariate effects on the terminal and non-terminal events and account for their possible correlation. Our study suggests that the proposed methods provide an efficient and feasible way of analysing illness-death (or semi-competing risks) models with practical sample sizes.

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Saw Swee Hock School of Public Health

Annual Report 2011/12

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NEW, ONGOING AND COMPLETED RESEARCH PROJECTS AREAS OF RESEARCH

PRINCIPAL INVESTIGATOR

CO-PRINCIPAL INVESTIGATORS/COLLABORATORS

New Projects

PRINCIPAL INVESTIGATOR

CO-PRINCIPAL INVESTIGATORS/COLLABORATORS

Ongoing Projects

NUHS Cross Dept Collaborative Grant

Dr Luo Nan

Dr Titus Lau(NUH), Prof Chia Kee Seng (SPH, NUS), Prof A Vathsala (NUH), A/Prof Evan Lee (NUH)

Development of Statistical Methods for Mass Spectrometry based Proteomics Data Analysis

Dr Choi, Hyung Won

Home Medical Care in Singapore

A/Prof Koh Choon Huat, Gerald

Dr Lydia Seong, Dr Tan Thai Lian (Ren Ci Community Hospital), Dr Tham Weng Yew

Development of Statistical Methods for Mass Spectrometry based Proteomics Data Analysis

Dr Choi, Hyung Won

Influence of Coffee Consumption on Insulin Sensitivity of Overweight and Insulin Resistant Subjects

A/Prof Rob M. Van Dam

Prof Chia Kee Seng(SPH, NUS), Dr. Salome Rebello(SPH, NUS), Dr Eric Khoo

Tele-Rehabilitative Technologies for Home Therapy in Stroke Patients

A/Prof Koh Choon Huat, Gerald

A Novel Multiple-Zone Soft Contact Lens to Slow Myopia Progression

Prof Saw Seang Mei

Dr Liu Kui (Singapore Institute of Manufacturing Technology), Prof Carly Lam(School of Optometry/Hong Kong Polytechnic), Prof Chi-Ho To(School of Optometry/Hong Kong Polytechnic), Asst Prof Inez Wong (Ophthalmology, NUH), Dr Lim Li(Ophthalmology, Singapore National Eye Centre)

Visually Disabling Ocular Complications of High Myopia in Singapore Armed Forces Conscripts - MINDEF

Prof Saw Seang Mei

Visually Disabling Ocular Complications of High Myopia in Singapore Armed Forces Conscripts - NUS

Prof Saw Seang Mei

Prof Yip Cheng Har (University Malaya Medical Centre), Dr Jennifer NW Lim (University of Leeds), Dr Nur Aishah Mohd Taib (University Malaya Medical Centre), Dr Maznah Dahlui (University of Malaya), Dr Hong Ga Sze (KK Women’s and Children’s Hospital), Prof Tar-Ching Aw (United Arab Emirates University), Dr Helena Marieke Verkooijen (University Medical Center Utrecht)

Dietary Fatty Acids, Oxylipins, and Risk of Coronary Heart Disease in Singapore Chinese

A/Prof Rob M. Van Dam

The Health, Social and Financial Effects of Care-Giving among Primary Caregivers of Elderly Stroke Patients in the First Post Stroke Year: A Prospective Cohort Study

A/Prof Koh Choon Huat, Gerald

An Exploratory Randomised Controlled Trial of a Novel FamilyBased Intervention to Increase Outdoor Time for the Prevention of Myopia and Increase Physical Activity among Singapore Youth

Prof Saw Seang Mei

Centre for Infectious Disease Epidemiology and Research

Dr Hsu Li Yang

STI/HIV/AIDS Risk-Related Behaviours of Heterosexual Men in Singapore

A/Prof Wong Mee Lian

Association between Health Behaviors and Intra-ay Work Performance: A Mobile Survey Study of Nurses

Prof Saw Seang Mei

Prospective Studies of Cancer Etiology and Prevention in Shanghai and Singapore

Prof Koh Woon Puay

Identifying T2D Variants by DNA Sequencing in Multiethnic Samples (CME)

A/Prof Tai E Shyong

Identifying Variants Causal for Type 2 Diabetes in Major Human Populations (CME)

Prof Chia Kee Seng

Centre for Infectious Disease Epidemiology and Research (CME)

Assistant Prof Hsu Li Yang

Singapore Gastric Cancer Consortium TCR Flagship Programme – Molecular Epidemiology

Prof Chia Kee Seng (CO PI)

Cancers with High Prevalence or Unique Pathogenesis in Singapore

Prof Chia Kee Seng (CO PI)

Genetic and Environmental Determinants of Type 2 Diabetes in Chinese Singaporeans

Prof Chia Kee Seng (CO PI)

Birth Cohort – Fetal Influences on Epigenetic Factors (GUSTO – Growing Up in Singapore Towards Healthy Outcomes)

Prof Saw Seang Mei

A/Prof Chong Yap Seng, Dr Kenneth Kwek

Retinal Vascular Changes in Children and Its Relationship to Cardiovascular Risk

Prof Saw Seang Mei

Prof Wong Tien Yin

The Singapore Chinese Health Study

A/Prof Koh Woon Puay, Prof Lee Hin Peng

Prof Mimi Yu (Co-PI) (USA), A/Prof Yuan Jian Min (Co-PI) (USA)

Use of Small Aquarium Fish for Biological Monitoring of Water Quality avnd Security

Prof Ong Choon Nam

Prof Gong Zhiyuan (DBS, NUS)vttvt

A Qualitative Study of Women (Non-Sex Workers) With HIV and their Attitudes Towards Safer Sex and Sexual Behaviour of their Partners

A/Prof Wong Mee Lian (SPH), Braema Mathiaparanam

Dr Priya Sen, A/Prof Leo Yee Sin, Adj Prof Roy Chan Kum Wah

Family-Based Genome-Wide Association Study of Early-Onset Myopia

Prof Saw Seang Mei

Prof Terri Young, Duke-NUS GMS

mTOR as the Molecular Target for Modulation of Autophagy, Necrosis and Tumorigenesis

A/Prof Shen Han Ming

Start Up Grant - Mikael Hartman

Dr Mikael Hartman

Estimating and Understanding Social & Biological Factors Contributing to the Burden of Disease due to Breast Cancer in South East Asia

Dr Mikael Hartman

Tele-Rehabilitation for Newly-Disabled Homebound Older Persons Needing Supervised Physical Therapy

A/Prof Koh Choon Huat, Gerald

Assistant Prof Yen Shih-Cheng(Electrical and Computer Engineering, NUS), Associate Prof Arthur Tay (Electrical and Computer Engineering, NUS), Associate Prof Tan Kok Kiong (Electrical and Compquter Engineering, NUS), Ng Yee Sien (SGH, Head of Rehabilitation Medicine), Shekhar Shanker (AMK Thye Hua Kwan Hospital, Head of Rehabilitation), Tim Xu Tian Ma (AMK Thye Hua Kwan Hospital, Head of Rehabilitation), Associate Prof Helen Hoenig (Durham Veterans Administration Medical Centre/Physical Medicine and Rehabilitation, USA and Duke University Medical Centre, Durham USA/Geriatrics), Kevin Caves (Duke School of Medicine, Durham, USA/Department of Surgery), (Pratt School of Engineering Duke University, USA/ Department of Biomedical Engineering)

A Comparison of Trends of Type 2 Diabetes Mellitus Prevalence in Singapore, Mauritius and China

Dr Lim Wei Yen

Prof Li Guang Wei, Prof Paul Zimmet, Prof Li Jinong, A/Prof Rob M. Van Dam (SPH, NUS), Dr Stefan Ma, Dr Elizabeth Barr

Statistical Methods for the Integrative Analysis of Biological Systems using Multiple-Omics Datasets

Dr Choi, Hyung Won

Dr Giulia Rancati (Institute of Medical Biology), Dr Norman Pavelka (Singapore Immunology Network)

Epidermal Growth Factor Receptor Mutation Typing in Lung Cancer Tissue Samples of Cases in the Gene and Environment in Lung Cancer (GEL) Case Control Studies

Dr Lim Wei Yen

A/Prof Adeline Seow Ling Hui(Co-PI), GEL2 Study Clinical (Collaborators)

Organochlorine Exposure and Risk of Prostate Cancer

A/Prof Chia Sin Eng

Developing a Patient Centred Medical Home for Patients with Chronic Diseases

A/Prof Lim Yee Wei

Developing a Patient Centred Medical Home for Patients with Chronic Diseases

A/Prof Lim Yee Wei

Prof Ong Choon Nam NERI/NUS, Dr Barry Kelly Environmental Science and Engineering (ESE)/NUS

Ongoing Projects

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AREAS OF RESEARCH

Improving the Measurement of Vision Specific Quality of Life in Singapore Adults using Item Banking and Computer Adaptive Testing

Prof Saw Seang Mei

Suppression of AMPK as a Novel Cancer Chemotherapeutic Strategy via Inhibition of Autophagy

A/Prof Shen Han Ming

A/Prof Yao Shao-Qin (Dept of Chemistry-FOS), Dr Huang Qin

Tracking Type2 Diabetes Mellitus in Asia: A Multidisciplinary and Multi-Sectoral Initiative

Prof Chia Kee Seng

A/Prof Angelique Chan, A/Prof Eric Finkelstein, A/Prof Tai E Shyong, A/Prof Rob M. Van Dam (SPH, NUS), Prof Jean Yeung

Hospital Location Planning in Singapore

A/Prof Joe Sim Heng Joo, A/Prof Tan Kok Choon

Statistical Methods for Secondary Analysis of Nested CaseControl Data

Dr Agus Salim

Evaluation of the Anti-Cancer Function of Autophagy in a Zebrafish Liver Cancer Model

A/Prof Shen Han Ming

Saw Swee Hock School of Public Health

A/Prof Ecosse Lamoureux

A/Prof Yao Shao-Qin (Dept of Chemistry-FOS), Dr Huang Qing

Asst Prof Yen Shih-Cheng

Prof Chia Kee Seng (SPH, NUS)

Prof Chia Kee Seng (SPH, NUS), A/Prof Chia Sin Eng (SPH, NUS) Annual Report 2011/12

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AREAS OF RESEARCH

PRINCIPAL INVESTIGATOR

CO-PRINCIPAL INVESTIGATORS/COLLABORATORS

A Randomised Controlled Trial of an STI/HIV/AIDS Prevention Intervention for Adolescents Attending A Public STI Clinic in Singapore

A/Prof Wong Mee Lian

Adj Prof Roy Chan Kum Wah, Dr Tan Hiok Hee (NSC), Prof Koh Soo Quee David (SPH, NUS), Dr Martin Chio (NSC), Dr Priya Sen (NSC)

Start Up Grant (Exposure Characterisation and Development of a Health Surveillance Protocol for Persons Handling Engineered Nanomaterials)

Dr Sng Gek Khim, Judy

Prof David Koh Soo Quee (SPH, NUH), A/Prof Liya E. Yu (Environmental Science and Engineering, Faculty of Engineering)

Modeling Complex Interactions in the Genetics and Genomics of Commen Phenotypes and Infectious Diseases

A/Prof Teo Yik Ying

Dietary Intakes, Biomarkers and Genetic Susceptibility in relation to Risk of Coronary Heart Disease in Singapore Chinese

A/Prof Rob M. Van Dam

Role Of Fatty Acids In Colorectal Carcinogenesis - A CaseControl Study Nested Within The Singapore Chinese Health Study

Prof Ong Choon Nam

A/Prof Koh Woon Puay (SPH, NUS), Assistant/Prof Butler Lesley(Colorado State University, USA)

Assessing Impact of Diabetes on Patients’ Health Preferences and Quality of Life

Dr Luo Nam

Prof Chia Kee Seng (SPH, NUS), A/Prof Tai E Shyong (NUHS), Dr Lim Wei Yen (SPH, NUS)

Ongoing Projects

STAFF PUBLICATIONS

Completed Projects Estrogenic Biomarkers in Predicting Breast Cancer Risk: The Singapore Chinese Health Study

A/Prof Koh Woon Puay

Lung Cancer in Singapore Chinese Women: Genetic Determinants of Susceptibility to Inflammation and EstrogenRelated Risk Factors

A/Prof Seow Ling Hui Adeline

Retinal Vessel Caliber, Early Childhood Cardiovascular Risk Factors and Refractive Errors in Preschool Children

Prof Saw Seang Mei

Environmental and Genetic Determinants of Adiponectin in Chinese, Malays and Asian Indians

A/Prof Lee Jen Mai, Jeannette

A/Prof Tai E Shyong (NUHS), Dr Mark Seielstad, Dr Lim Su Chi, Mr Tan Cheung Seng

Genetic Risk Determinants for Asian Type 2 Diabetes Mellitus

Dr Ng Peng Keat, Daniel

A/Prof Tai E Shyong (NUHS), Helen Leong, Prof Chia Kee Seng (SPH, NUS), Prof Koh Soo Quee, David (SPH, NUS), Dr Winston Kon, Dr Stanley Liew

Mitsui Sumitomo Insurance Welfare

A/Prof Koh Choon Huat, Gerald

Dr Steven Graham (Dept of Psychology, NUS)

NMRC/1118/2007 Sensitization of Cancer Cells to Trail-Induced Apoptosis by Andrographolide: Molecular Mechanisms and Potential Clinical Application

A/Prof Shen Han Ming

A/Prof Vinay Tergaonkar, (IMCB), Prof Ong Choon Nam (SPH, NUS)

Analysis of Multivariate Failure Time Data : A Semi-Completing Risks Approach

A/Prof Tai Bee Choo

Dr Xu Jinfeng (Dept of Stats & Applied Probability, NUS), Prof Kalbfleisch (University of Michigan Ann Arbor)

Risk Factors Predicting the Outcomes of Coronary Artery Bypass Graft Surgery (CABG) using a Large Hospital-based Cohort: An Important Pre-requisite for Surgeon Specific Comparisons

Dr Agus Salim

A/Prof Paul Tambyah

POPULATION HEALTH METRICS AND ANALYTICS (PHMA) The Population Health Metrics and Analytics (PHMA) is a cutting-edge health information system that will monitor and integrate a massive volume of data, in order to help researchers understand health and disease; and provide guidance to policymakers. This health information system will consist of three major components: a Population Health Monitor, an Aggregate Data Repository, and a Meta-Analysis Platform. The Population Health Monitor will continuously follow-up a large cohort of Singapore’s population through questionnaires, interviews, health checks and laboratory tests, to understand their health risks and health-seeking behaviour.

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Saw Swee Hock School of Public Health

Two major contributions of the PHMA are expected to be in research and policy. Researchers will have unprecedented access to high-quality demographic, behavioural, clinical, biological and health systems data that can be analysed to generate new scientific understandings of health and disease. The health sector is a complex arena for policymakers who need to understand individual and aggregate national, regional and global indicators of health, economic development and demography. Furthermore they need to be able to evaluate the realistic long-term outcomes of proposed policies and interventions. The PHMA’s monitoring and evaluation systems, mathematical modelling, simulation and decision support tools will greatly help them to do this. Annual Report 2011/12

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Age Conference, Hong Kong (16 17 Nov 2011, ., Hong Kong) 4. Chia, K S, “Ethnicity And Breast Cancer”. 1st Asian Symposium On Breast Density (21 22 Feb 2012, Malaya Medical Centre, University Of Malaya Cancer Research Institute, Kuala Lumpur, Malaysia) 5. Chia, K S, “Future Collaborations And Brainstorming Ideas For Tackling Obesity And Diabetes, Bangkok”. UK Southeast Asia Workshop (13 14 Dec 2011, ., Bangkok, Thailand) 6. Chia, K S, “Genetics In Pre Employment Screening. Is It Ethical?”. 4th Regional Conference On Occupational Health (RCOH) (23 25 Jun 2011, ., Singapore) 7. Chia, K S, “Health For The Community: Meeting The Transition”. Universiti Kuala Lumpur Royal College Of Medicine Perak International Seminar 2011 (20 Dec 2011, ., Ipoh, Perak, Malaysia) 8. Chia, K S, “Prevention Of Type II Diabetes Iin The Post Genomic Era”. Asia Pacific Conference On The Metabolic Syndrome (APCMS) 2011, Sydney ( 4 5 Nov 2011, ., Sydney, Australia) 9. Chia, K S, “Public Health Priorities In Singapore: Strategies In Reducing Risk Of Obesity And Chronic Disease”. 8th Al Invitational Leadership Retreat For Chain Restaurants, Hotels, Supermarkets And Volume Foodservice (18 20 Jan 2012, The Culinary Institute Of America, Eystone, Napa Valley, California, United States) 10. Chia, K S, “Tobacco Control: The Singapore Experience”. 15th World Conference On Tobacco And Health (20 24 Mar 2012, ., Singapore) 11. Chow, P, CH Gerald Koh, C Chen, A Cheong, N P Fong, KM Chan, BY Tan, E Menon, CH Ee, R Petrella, A Thind, D SQ Koh And K S Chia, “Factors Affecting Rehabilitation Effectiveness And Efficiency Among Elderly In Community Hospitals In Singapore.”. 6th Singapore Public Health And Occupational Medicine Conference. (Keynote Paper) (24 26 Aug 2011, ., Singapore) 12. Ghaem MaralanI, H, B C Tai, T Y Wong, J LI, JJ Wang And P Mitchell, “The Impact Of Metabolic Syndrome And Its Components On All Cause And Cause Specific Mortality: The Blue Mountains Eye Study.”. 6th Singapore Public Health And Occupational Medicine Conference (25 26 Aug 2011, Mnn Bn, ., Singapore) 13. Koh, CH Gerald, LE Wee, C Chen, A Cheong, N P Fong, KM Chan, BY Tan, E Menon, CH Ee, KK Lee, R Petrella, A Thind, D SQ Koh And K S Chia, “Caregivers And Their Impact On Inpatient Rehabilitation Efficiency And Effectiveness Amongst Recent Stroke Survivors.”. 2nd Yong Loo Lin School Of Medicine Annual Scientific Congress 2012. (15 Feb 2012, ., Singapore) 14. Koh, CH Gerald, LE Wee, NA Rizvi, C Chen, A Cheong, N P Fong, KM Chan, BY Tan, E Menon, CH Ee, KK Lee, R Petrella, A Thind, D SQ Koh And K S Chia, “Admissions To Community Hospitals In Singapore From 1996 2005 By Sociodemographic And Clinical Profile: A Descriptive Study.”. 1st Singapore Rehabilitation Conference. (10 11 Feb 2012, ., Singapore) 15. Koh, CH Gerald, “Socioeconomic Factors Affecting Gynaecological Cancer Screening In An Asian Urban Low Income Setting At Baseline And Post Intervention: A Mixed Methods Study.”. 10th Royal College Of Obstetricians And Gynaecologists International Scientific Congress. ( 5 8 Jun 2012, ., Kuching, Sarawak, Malaysia) 16. Koh, CH Gerald, “Trade Offs Between Effectiveness And Efficiency In Stroke Rehabilitation. Singapore Health And Biomedical Congress.”. Singapore Health And Biomedical Congress. (11 12 Nov 2011, ., Singapore) 17. Koh, D SQ, “Can We Reduce Workplace Fatalities By Half ?”. 1st Qatar Petroleum Occupational Health Conference (20 21 Mar 2012, ., Qatar, Saudi Arabia) 18. Koh, D SQ, “Can We Reduce Workplace Fatalities By Half?”. International Symposium On Safety And Health At Work 2011. (24 25 Oct 2011, ., Incheon, South Korea) 19. Koh, D SQ, “Exposure Assessment Methods For Vocs And Heavy Metals.”. Invited Lecture At School Of Public Health, Khon Kaen University. ( 6 7 Aug 2011, ., Thailand) 20. Koh, D SQ, “Factors Affecting Rehabilitation Effectiveness And Efficiency Among Elderly In Community Hospitals In Singapore.”. 6th Public Health And Occupational Medicine Conference (25 26 Aug 2011, ., Singapore) 21. Koh, D SQ, “Fatigue Management In The Workplace.”. 6th Singapore Public Health And Occupational Medicine Conference. (24 26 Aug 2011, ., Singapore) 22. Koh, D SQ, “Health Impact Of Vocs And Heavy Metals.”. Invited Lecture At School Of Public Health, Khon Kaen University. ( 6 7 Aug 2011, ., Thailand) 23. Koh, D SQ, “Health Indicators And Biomarkers Of VOC And Heavy Metal Exposure.”. Invited Lecturer. School Of Public Health, Khon Kaen University. ( 6 7

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Saw Swee Hock School of Public Health

Aug 2011, ., Khon Kaen, Thailand) 24. Koh, D SQ, “Hot Topics On Environmental And Occupational Origins Of Cancer.”. 7th Princess Chulaborn International Science Congress On Cancer: From Basic Research To Cure. (13 17 Nov 2011, ., Bangkok, Thailand) 25. Koh, D SQ, “International Collaborative Research.”. University Of Occupational And Environmental Health ( 7 Nov 2011, Kitakyushu, Japan) 26. Koh, D SQ, “Management Of Tinnitus – Lessons From A Counselling Clinic.”. Inaugural Eastern Health Alliance Scientific Meeting “Partners In Healthcare Excellence”. (17 19 Nov 2011, ., Singapore) 27. Koh, D SQ, “Monitoring And Preventive Measures For Vocs And Heavy Metals.”. Invited Lecturer. . School Of Public Health, Khon Kaen University. ( 6 7 Aug 2011, ., Thailand) 28. Koh, D SQ, “Patient Response To Initial Counseling For Tinnitus.”. 2nd Asia Pacific Singapore Otology Neurotology Skull Base Congress. (20 24 Oct 2011, ., Singapore) 29. Koh, D SQ, “Preventive Medicine Education In Singapore.”. 6th Singapore Public Health And Occupational Medicine Conference. (24 26 Aug 2011, ., Singapore) 30. Koh, D SQ, “Release Of Gold Nanoparticles From Commercially Available Nanogold Toothbrushes.”. 6th Public Health And Occupational Medicine Conference (25 26 Aug 2011, ., Singapore) 31. Koh, D SQ, “The Impact Of Caregiver Number And Identity On Post Stroke Rehabilitation Efficiency And Effectiveness Amongst Community Hospital Inpatients In Singapore.”. 6th Public Health And Occupational Medicine Conference (25 26 Aug 2011, ., Singapore) 32. Lee, WW, SC Yen, A Tay, CH Gerald Koh, TT Xu, YS Ng, Z Zhao, P Janani, F Gao, P Zhou, C Png And A Cheong, “Automated Upper Extremity Fugl Meyer Assessment (FMA).”. 1st Singapore Rehabilitation Conference. (10 11 Feb 2012, ., Singapore) 33. Nakul, S, BA Mikael Hartman And HM Verkooijen, “Lymph Node Ratio As A Prognosticator In Breast Cancer Patients Treated With Neoadjuvant Chemotherapy”. Asia Link Closing Conference, Clinical Epidemiology And Evidence Based Medicine (Plenary Paper) (20 Nov 2010 23 Nov 2011, ., Bali, Indonesia) 34. Tan, K K, R Wu And CH Gerald Koh, “Development Of A Portable Tele Rehabilitation System”. Proceedings Of SRC 2012 (2012). Singapore: SRC Committee. (1st Singapore Rehabilitation Conference 2012, 10 11 Feb 2012, Grand Copthorne Waterfront Hotel, Singapore)

ORAL PRESENTATION 35. Raju, A, K M Kyin, H Z Min, Carolina Capistrano Canlas, Mary Hannah Seah, Catherine Serrano, BA Mikael Hartman And P Ho, “Reliability Of Using Ultrasound Duplex For Screening Of Dysfunctional Hemodialysis Access”. 12th Asian Society For Vascular Surgery (ASVS 2011) (Invited Paper) (29 Sep 2 Oct 2011, Taipei International Convention Center, Taipei, Taiwan) (Updated: 10 Oct 2011). POSTER RESENTATION 36. Chen, Z, J Xu, JD Kalbfleisch And B C Tai, “Handling Of Tied First Failures In Competing Risks Analysis”. 2nd Singapore Conference On Statistical Science (19 20 Sep 2011, NUS, ., Singapore) 37. Koh, CH Gerald, N P Fong, D SQ Koh And K S Chia, “Predictors Of Inpatient Rehabilitation Effectiveness And Efficiency Amongst Recent Stroke Survivors In Singapore.”. 1st Singapore Rehabilitation Conference. (10 11 Feb 2012, ., Singapore) 38. Koh, CH Gerald, LE Wee, NA Rizvi, C Chen, A Cheong, N P FONG, KM Chan, BY Tan, E Menon, CH Ee, KK Lee, R Petrella, A Thind, D SQ Koh And K S Chia, “Socio Demographic And Clinical Profile Of All Patients Admitted To Community Hospitals In Singapore From 1996 To 2005: A Descriptive Study.”. 6th Singapore Public Health And Occupational Medicine Conference. (24 26 Aug 2011, ., Singapore) (Proceeding). 39. Koh, D SQ, “Prevention Of Blood Borne Infectious Diseases From Needlestick Injuries Among Medical Students.”. 25th East Asian Medical Students’ Conference (15 19 Jan 2012, ., Singapore) (Awarded Gold Medal). 40. Koh, D SQ, “Sociodemographic And Clinical Profile Of All Patients Admitted To Community Hospitals In Singapore From 1996 2005: A Descriptive Study.”. 6th Public Health And Occupational Medicine Conference (25 26 Aug 2011, ., Singapore) 41. TT, Wang, TG Guo, SKS Sze, BA Mikael Hartman, A B S B Shaik, CWC Chan, PI Iau, LWK Khin, NS Saxena, AW Wong, SHT Tan, BCG Goh And SCL Lee, “Extracellular Matrix Protein Expression Is Associated With Chemotherapy Resistance In Breast Cancer”. Frontiers In Cancer Science 2011 (2011). Singapore: CSI, NUS. (31 Oct 3 Nov 2011, UCC Theatre, NUS, Singapore) 42. Wee, LE And CH Gerald Koh, “Factors Affecting Cardiovascular Health Screening In An Urban Low

Income Setting At Baseline And Post Intervention: A Quasi Experimental Study.”. 6th Singapore Public Health And Occupational Medicine Conference. (24 26 Aug 2011, ., Singapore) 43. Wee, LE, CH Gerald Koh, RT Chin, J Wong And B Seow, “Colorectal, Cervical And Breast Cancer Screening In An Urban Low Income Setting: A Mixed Methods Study.”. 6th Singapore Public Health And Occupational Medicine Conference. (24 26 Aug 2011, ., Singapore)

INTERNATIONAL ORAL PRESENTATION 44. Bishop, G D, X Zhang, F S S Ngau, E S Tai And J J Lee, “Perceived Discrimination And Cardiovascular Responses: Interactions Of Race And Genotype”. 12th International Congress Of Behavioral Medicine (29 Aug 1 Sep 2012, Budapest Hilton, Budapest, Hungary) 45. Bishop, G D, X Zhang, F S S Ngau, E S Tai And J J Lee, “Race And Genotype Moderate The Relationship Between Emotion And Ambulatory Blood Pressure”. 12th International Congress Of Behavioral Medicine (29 Aug 1 Sep 2012, Budapest Hilton, Budapest, Hungary) 46. Chen, Z, J Xu, JD Kalbfleisch And B C Tai, “Handling Of Tied First Failures In Competing Risks Analysis”. 32nd Annual Conference Of The International Society For Clinical Biostatistics (Plenary Paper) (21 25 Aug 2011, Ottawa Convention Centre, Ottawa, Canada) 47. Chong, E, B C Tai, JD Kalbfleisch And JF Xu, “A Frailty Model With Conditional Additive Hazards For Semi Competing Risks”. 32nd Annual Conference Of The International Society For Clinical Biostatistics (Plenary Paper) (21 25 Aug 2011, Ottawa Convention Centre, Ottawa, Canada) 48. Ghaem Maralani, H, B C Tai, T Y Wong, J LI, JJ Wang And P Mitchell, “The Effect Of Baseline Body Mass Index And Its Changes Over 5 Year On All Cause And Cause Specific Mortality In An Elderly Population: The Blue Mountains Eye Study”. 6th Singapore Public Health And Occupational Medicine Conference (25 26 Aug 2011, Furama Riverfront, ., Singapore) 49. Koh, CH Gerald, “The Impact Of Caregiver Number And Identity On Post Stroke Rehabilitation Efficiency And Effectiveness Amongst Community Hospital Inpatients In Singapore.”. 6th Singapore Public Health And Occupational Medicine Conference. (24 26 Aug 2011, ., Singapore) 50. Koh, D SQ, “A Study Of Needle Stick Injuries Among Medical Students.”. 6th Public Health And Occupational Medicine Conference (25 26 Aug 2011, ., Singapore) 51. Koh, D SQ, “Advances In Biological Monitoring For Occupational Exposures.”. 1st Qatar Petroleum Occupational Health Conference (20 21 Mar 2012, ., Qatar, Saudi Arabia) 52. Lee, W W, S Yen, A Tay, CH Gerald Koh, Tim Xu, YS Ng, Z Zhao, S P J , F Gao, P Zhou, Carolina Png And L K Cheong, “Automated Fugl Meyer Assessment For Stroke Rehabilitation”. 1st Singapore Rehabilitation Conference (2012). Singapore: Singapore General Hospital. (1st Singapore Rehabilitation Conference, 10 11 Feb 2012, Grand Copthorne Waterfront Hotel, Singapore) 53. Lim, Y W, “Rapid Evidence Review To Support Innovations In Primary Care”. 4th International Primary Health Care Reform Conference 2012 (Plenary Paper) ( 7 Mar 2012, The Stamford Hotel, Brisbane, Australia) 54. Lim, Y W, “The Development Of A Primary Care Health Services Implementation Research Network In Asia Pacific”. 4th International Primary Health Care Reform Conference 2012 (Plenary Paper) ( 7 Mar 2012, The Stamford Hotel, Brisbane, Australia) 55. Tang, JW, A Nicholle, P Jovan, CH Gerald Koh, LD Wang, M Amin, C Klettner, K W Cheong, S C Sekhar And K W Tham, “Airflow Dynamics Of Coughing And Sneezing In Healthy Human Volunteers From Shadowgraph Imaging: An Aid To Aerosol Infection Control”. Proc Healthy Buildings 2012 (2012). Brisbane: Queensland University Of Technology. (HB 2012, 8 12 Jul 2012, Brisbane Convention Centre, Brisbane, Australia) 56. Xue, L, C Yen, L Chang, B C Tai, H C Chan, HBL Duh And M Choolani, “Mobile Phone Based Health Application For Women”. 4th International Symposium On Applied Sciences In Biomedical And Communication, Sustainable Communication And Biomedical Technologies (2011). New York: ACM Digital Library. (Invited Paper) (4th International Symposium On Applied Sciences In Biomedical And Communication Technologies, 26 29 Oct 2011, Barcelona, Spain, Barcelona, Spain) 57. Xue, L, C Yen, L Chang, H C Chan, B C Tai, HBL DUH And M Choolani, “Journeying Toward Female Focused M Health Applications”. Advances In Human Factors And Ergonomics 2012 14 Volume Set: Proceedings Of The 4th AHFE Conference 21 25 July 2012 Advances In Human Factors And Ergonomics 2012. Advances In Human Factors And Ergonomics 2012 14 Volume

Set: Proceedings Of The 4th AHFE Conference 21 25 July 2012 Advances In Human Factors And Ergonomics 2012 14 Volume Set:, Vol. NA, Ed. Gavriel Salvendy, West Lafayette, Waldemar Karwowski, (2012). Florida: CRC Press. (Invited Paper) (Applied Human Factors And Ergonomics International 2012, 21 25 Jul 2012, San Francisco, California, United States)

POSTER PRESENTATION 58. Bishop, G D, X Zhang, F S S Ngau, E S TAI And J J Lee, “Perceived Discrimination And Ambulatory Blood Pressure: The Roles Of Race, Sex And Genotype”. 33rd Annual Meeting & Scientific Sessions Of The Society Of Behavioral Medicine (11 14 Apr 2012, Hilton Riverside, New Orleans, LA, United States) 59. Chia Chan, A, Y W Lim, H S Khoo, S M Prasad And S E Chia, “Assessing The Integration Of Wellness, Health And Safety In Workplaces: A Study Of Four Industries In Singapore”. American Public Health Association (, Moscone Convention Centre, San Francisco, CA, United States) 60. Hameed, WB, MF Abdul Rahman, LW Sim, SA Rahman, S Sanmugam, HJ Chong, C Hu, Helen Chen, C Chee, Y S Chong, S M Saw, K Kwek, K Godfrey, PD Gluckman, MJ Meaney, MV Fortier, JJ Richmond, A QIU And Anne Rifkin Graboi, “Prenatal Maternal Mood Predicts Infant Hippocampal Structure And Function”. Developmental Origins Of Health And Disease. Developmental Origins Of Health And Disease, Vol. 2 (2011). Cambridge: Cambridge. (Developmental Origins Of Health And Disease, 18 21 Sep 2011, Portland, Oregon, United States) 61. Nakul, S, BA Mikael Hartman, NB Pathy, R Aziz, SE Lim, SC Lee, CH Yip And HM Verkooijen, “Validating The Lymph Node Ratio As A Prognostic Indicator Among South East Asian Breast Cancer Patients.”. 34th Annual San Antonio Breast Cancer Symposium ( 1 Dec 2011, ., San Antonio, United States) 62. Nakul, S, BA Mikael Hartman, NB Pathy, SE Lim, SC Lee, CH Yip And HM Verkooijen, “Breast Cancer In South East Asia: Comparison Of Presentation And Outcome Between A Middle Income And A High Income Country”. 34th Annual San Antonio Breast Cancer Symposium ( 1 Dec 2011, ., San Antonio, United States) 63. Nakul, S, HM Verkooijen, NB Pathy, SE Lim, P Lau, SC Lee, CH Yip And BA Mikael Hartman, “Ethnic Differences In The Association Between Tumor Size And Lymph Node Status Among Breast Cancer Patients In South East Asia.”. 34th Annual San Antonio Breast Cancer Symposium ( 1 Dec 2011, ., San Antonio, Singapore) 64. Nakul, S, HM Verkooijen, SC Lee, SE Lim, P Lau And BA Mikael Hartman, “Avoidable Deaths From Breast Cancer Among Singapore Breast Cancer Patients.”. 34th Annual San Antonio Breast Cancer Symposium ( 1 Dec 2011, ., San Antonio, United States) 65. Tang, Julian W., Andre Nicolle, P Jovan, CH Gerald Koh, Liang De Wang, Amin Muhammad, Christian A. Klettner, K W Cheong, S C Sekhar And K W Tham, “Airflow Dynamics Of Coughing And Sneezing In Healthy Human Volunteers From Shadowgraph Imaging: An Aid To Aerosol Infection Control”. 10th International Conference Healthy Buildings 2012 (2012). Brisbane: Healthy Buildings 2012. (Healthy Buildings 2012, 8 12 Jul 2012, Brisbane Convection And Exhibition Hall, Brisbane, Australia) 66. Wee, LE, CH Gerald Koh, C Chen, A Cheong, N P Fong, KM Chan, BY Tan, E Menon, CH Ee, KK Lee, R Petrella, A Thind, D SQ Koh And K S Chia, “Caregivers And Their Impact On Inpatient Rehabilitation Efficiency And Effectiveness Amongst Recent Stroke Survivors In An Urbanised Asian Society.”. International Stroke Conference 2012 ( 1 3 Feb 2012, ., New Orleans, United States)

PAPER FOR SEMINAR, PUBLIC TALK, LECTURE 1. Lim, Y W, “Diabetes And Obesity Prevention Program In Singapore”. Prevention Of Obesity, Diabetes And CVD: Taking A Whole Of System Approach ( 7 Feb 2012, Deakin University Melbourne City Centre, Melbourne, Australia) 2. Tai, B C, “(1) Biostatistics Considerations For Phase I And Randomized Phase II (2) Phase III Clinical Trial”. IMU Clinical Research Workshop, NUHS (23 24 Nov 2011, NUHS, ., Singapore)

CHAPTER IN BOOK 1. Lubek, I, K Sarath, M L Wong, H Lee, VM Tiny, . Idema, . Roel, . Thamarangsi, . Thaksaphon, . Jakubowicz, . Andrew, . Tolson, . Michelle, . Mccreanor And . Tim, “HIV/AIDS And Alcohol Risks In Cambodia: Confronting Challenges And Policy Making Through Research Guided Actions”. In Global HIV/AIDS Politics, Policy And Activism, Ed. Raymond A. Smith. New York: Praeger Publishers, 2012.

Two eyes good, ‘four’ eyes bad Jeremy, 11, and his sister, Megan, 9, love to go out and play in the park. They like riding around on their bicycles and playing with their friends.

“You mean you didn’t have to do any schoolwork and go for tuition classes?” Jeremy asks his Grandma, incredulously.

“Ah Ma, can we go out and play,” Jeremy asks his Grandma pleadingly, planting a kiss on her cheek.

“I didn’t even go to school! Back then we didn’t have TV, we didn’t have computer games – I don’t remember anyone of my friends wearing spectacles – not like the all the four of you,” says Grandma looking around at her family, lovingly.

“No, your Mummy says not to let you and mei mei play outside. You may fall and hurt yourself, or someone may kidnap the two of you,” says Grandma. Since they can’t go out and play, the children play with the video games their parents had given them for Christmas. It is dinner time. Mummy and Daddy are back from work. The family sits down for dinner. “Mama, you shouldn’t be cooking all these fried foods so often. It’s unhealthy especially for you Mama, because you’re diabetic. You need to lose weight. Also, you and the children shouldn’t be having all that fast food for lunch almost every day,” says Su-Ann, reprimanding her mother gently. Everyone went silent, not knowing if Grandma is offended by the remark about her weight. Then, Megan complains to her parents: “Ah Ma wouldn’t let us go and play in the park.” “When I was young, we lived in the kampung and we played outside all the time. We only went home to eat and sleep,” says Grandma.

“And you know what … we called anyone wearing spectacles four-eyes!” chuckles Grandma, laughing at her own joke. “Ah Ma, that’s not nice – making fun of us!” says Megan. “I have a good idea. From today onwards, every evening after dinner, we shall all go to the park – you can ride your bicycles and Grandma can walk around the park for exercise. According to doctors doing research on myopia, playing outside helps to relax the eyes and prevent your eyesight from getting worse,” says the children’s father, finally speaking up. Since then, every evening, the family heads out to the park after dinner for some fresh air and exercise. And, the children are happy because they get to play in the park with the other children in the neighbourhood.

Saw Swee Hock School of Public Health

www.sph.nus.edu.sg National University of Singapore MD3, 16 Medical Drive Singapore 117597

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2012

SAW SWEE HOCK School of Public Health Turning Discovery into Healthier Communities ANNUAL REPORT 2011/12 Saw Swee Hock School of Public Health CO...

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