Audrey Chia

Suicide Methods in Singapore (2000-2004): Types and Associations

The choice of suicide methods varies between countries. Common methods used in Singapore between 2000 and 2004 were jumping (72.4%), hanging (16.6%), and poisoning (5.9%). Those who jumped were more likely to be young, single, female, and to have had a major mental illness. By comparison, those who hung themselves were more likely to be older (OR 2.68), Indian (OR 2.32), and to leave a suicide note (OR 1.53). Those who used poison were more likely to be married (OR 2.33), to be on antidepressants (OR 2.40), to have previously attempted suicide (OR 2.13), and to leave a letter (OR 2.30). The choice was determined by accessibility, acceptability, generational, gender, and racial factors.

Suicide Letters in Singapore

The contents of suicide letters provide insight into the reasons for suicide and the mental states of victims. Coroner court records of 1,721 Singaporean suicides occurring between 2000 and 2004 were reviewed, 398 (23%) of whom left suicide letters. Letter writers tended to be younger, single, and less likely to have mental or physical illness. A reason for suicide was evident in 58%. Major reasons included school and relationship problems in the young, financial and marital problems in adults and physical illnesses in the elderly. Positive sentiment (care/concern) was expressed in 59%. Negative emotions in 45% of which despondency/agony (60%) was the most common, followed by emptiness (25%), guilt/shame (15%), hopelessness (10%), and anger (3%). The study of these letters suggests that there are combinations of social, psychological and physical factors that influence a person to suicide, all of which are important in the prevention, assessment, and management of suicide.

Suicide in young Singaporeans aged 10-24 years between 2000 to 2004.

The objective of this study was to understand the features of young suicide in order to contribute to suicide prevention efforts. In this article, the demographic, clinical, and suicide-related features of all cases of young suicide (aged 10–24 years) in Singapore for the years 2000–2004 are described. We also compared those who sought mental health services to those who did not. Overall, the suicide rate was 5.7 per 100, 000, with gender ratio of 1:1 and higher rates among ethnic Indians. Psychosocial stressors and suicide by jumping from height were common. Mental health service use was associated with unemployment, previous suicide attempts, family history of suicide, more use of lethal methods, lack of identifiable stressor, and less suicide notes. Suicide prevention efforts should promote awareness of suicide risks and access to mental health services.

Suicide Trends in Singapore: 1955–2004

The objective of this study was to investigate suicide trends in Singapore between 1955 and 2004. Suicide cases were identified from the Registry of Birth and Death, Singapore, and analyzed using Poisson regression. Overall, suicide rates in Singapore remained stable between 9.8–13.0/100,000 over the last 5 decades. Rates remain highest in elderly males, despite declines among the elderly and middle-aged males in recent years. Rates in ethnic Chinese and Indians were consistently higher than in Malays. While the rates among female Indians and Chinese have declined significantly between 1995 and 2004, some increase was noted in female Malays. Although there was no increase in overall suicide rates, risk within certain population segments has changed over time.

Age of onset of myopia predicts risk of high myopia in later childhood in myopic Singapore children

To investigate the effect of age of myopia onset on the severity of myopia later in life among myopic children.

Assessing and understanding sedentary behaviour in office-based working adults: a mixed-method approach

BackgroundSedentary behaviours (SB) can be characterized by low energy expenditure in a reclining position (e.g., sitting) often associated with work and transport. Prolonged SB is associated with increased risk for chronic conditions, and due to technological advances, the working population is in office settings with high occupational exposure to SB. This study aims to assess SB among office workers, as well as barriers and strategies towards reducing SB in the work setting.MethodsUsing a mixed-methods approach guided by the socio-ecological framework, non-academic office workers from a professional school in a large public university were recruited. Of 180 eligible office workers, 40 enrolled and completed all assessments. Self-reported and objectively measured SB and activity levels were captured. Focus group discussion (FGD) were conducted to further understand perceptions, barriers, and strategies to reducing workplace SB. Environmental factors were systematically evaluated by trained research staff using an adapted version of the Checklist for Health Promotion Environments at Worksites (CHEW). Thematic analysis of FGD was conducted and descriptive analysis of quantitative data was performed.ResultsThe sample was mostly Chinese (nu2009=u200933, 80xa0%) with a total of 24 (60xa0%) female participants. Most participants worked five days a week for about 9.5(0.5) hrs/day. Accelerometer data show that participants spend the majority of their days in sedentary activities both on workdays (76.9xa0%) and non-workdays (69.5xa0%). Self-report data confirm these findings with median sitting time of 420(180) minutes at work. From qualitative analyses, major barriers to reducing SB emerged, including the following themes: workplace social and cultural norms, personal factors, job scope, and physical building/office infrastructure. CHEW results confirm a lack of support from the physical infrastructure and information environment to reducing SB.ConclusionsThere is high SB among office workers in this sample. We identified multiple levels of influence for prolonged occupational SB, with a particular emphasis on workplace norms and infrastructure as important barriers to reducing SB and increasing PA. A larger, representative sample of the Singaporean population is needed to confirm our findings but it seems that any intervention aimed at reducing SB in the workplace should target individual, environmental, and organizational levels.

Analysis of Changes in Refraction and Biometry of Atropine- and Placebo-Treated Eyes

PURPOSEnTo analyze changes in refraction and associated biometric changes in atropine- and placebo-treated eyes in the Atropine for Treatment of Myopia study (ATOM1).nnnMETHODSnA total of 400 myopic children, aged 6 to 12 years, were assigned randomly to receive 1% atropine or a placebo agent in one eye daily for 2 years, after which drops were stopped and children monitored for another year. Cycloplegic autorefraction, A-scan biometry, and automated keratometry were performed at the initial visit, 2 weeks (baseline), and at 4, 8, 12, 16, 20, 24, 30, and 36 months.nnnRESULTSnA total of 313 children (78.3%) completed the study. In placebo-treated eyes, there was myopic progression of -1.55 diopters (D), between baseline and 36 months, associated with reductions in corneal curvature (K; -0.13 D) and anterior chamber depth (ACD; -0.17 mm) and increases in lens thickness (LT; 0.05 mm), vitreous chamber depth (VCD; 0.65 mm), and axial length (AL; 0.53 mm). Multivariate analysis of change in spherical equivalent demonstrated that the hyperopic shift (0.20 D) noted in atropine-treated eyes between baseline and 4 months, and the myopic rebound (-0.74 D) noted between 24 to 30 months when atropine was stopped, were associated with a reduction and increase in VCD and AL, respectively, after adjusting for age and sex. Changes in K, ACD, and LT were less relevant. Between 4 and 24 months, atropine-treated eyes demonstrated gradual myopic progression (-0.40 D), accompanied by reduction in K (-0.06 D) and ACD (-0.07 mm) and increase in VCD (0.13 mm) and AL (0.06 mm).nnnCONCLUSIONSnAtropine appeared to slow myopia progression mainly by reducing or slowing the growth in VCD, and thereby AL. (ClinicalTrials.gov number, NCT00371124.)

Topical Atropine in the Control of Myopia

AbstractEfforts to reduce myopia progression in childhood are driven by the increasing incidence of high myopia and its attendant health risks. Interventional approaches to reduce myopia progression in childhood have included the use of spectacles, contact lens, and pharmacological methods, of which the latter appear to be most promising. We review the use of topical atropine eye drops in the retardation of myopia progression in children and discuss the efficacy and safety profiles when used at different concentrations (1.0%, 0.5%, 0.1%, and 0.01%). Topical atropine reduces myopia progression and axial elongation in children in a dose-related manner, but a rebound phenomenon occurs with higher doses. Its use has been shown to be safe, but higher doses cause pupil dilation, loss of accommodation and near vision. Atropine 0.01% has the best therapeutic index, with clinically insignificant amounts of pupil dilation, near vision, and accommodation loss but remains as effective as higher doses.

Effect of topical atropine on astigmatism

Aim: The aim of this study was to determine if topical atropine, used to retard axial length elongation and myopia progression, had any effect on ocular astigmatism. Methods: Data collected from subjects enrolled in the Atropine in the Treatment of Myopia (ATOM) study were analysed. In this study, 400 myopic children (aged 6–12 years) were randomly assigned to administer atropine 1% or a placebo daily to a randomly selected eye for 2 years. Cycloplegic autorefraction and keratomy readings were measured using a Canon RK5 autorefractor. The refractive error was then split into its power vector components: J0 and J45. Results: Astigmatism increased by 0.12–0.16 D per year in both treated and placebo groups. There was no difference between groups (pu200a=u200a0.182). The increase was mirrored by an increase in corneal astigmatism of 0.10–0.13 D per year, suggesting that most of the change was corneal in nature. There was an increase in J0 vector (with-the-rule astigmatism) with no change in the J45 (oblique) vector over time. The change in the J0 vector was significantly larger in the atropine-treated versus atropine-untreated eyes during the 2-year treatment period (pu200a=u200a0.011), but this difference disappeared after atropine was stopped. Conclusion: The use of atropine on a daily basis over 2 years did not have any clinically significant effect on astigmatism.

Social Entrepreneurship: Improving Global Health.

This Viewpoint describes the efforts of social enterpreneurs, individuals and organizations who develop self-sustaining business models to deliver cost-effective health care and social services to poor and underserved communities around the world.