晨光聚焦：什么是抗微生物药物耐药性？(Morning Spotlight: What is antimicrobial resistance?)

​18 to 24 November 2023 is World Antimicrobial Resistance Awareness Week. Antimicrobial resistance (AMR) is on the rise – in 2019, an estimated 1.3 million people worldwide died due to AMR, and this number is expected to increase to 10 million by 2050. Dr Sky Koh, Family Physician and Associate Consultant at National University Polyclinics, discussed some of the factors that contribute to AMR, including overuse of antibiotics; slow development of new medicines; and poor hygiene habits. Dr Koh said that AMR will result in prolonged and more severe bacterial infections that increases the risk of complications.

To combat AMR, hospitals have launched antimicrobial stewardship programmes to better guide doctors and pharmacists in prescribing antibiotics to patients. Ms Chin Min Hui, Alexandra Hospital Pharmacist, said that broad-spectrum antibiotics are typically given the option to be switched to narrow-spectrum antibiotics, when tests are completed to identify more effective antibiotics for the patient. Ms Doris Hung, Nurse Clinician at National University Polyclinics, shared a patient's journey to overcome AMR.

• 8world, 13 November 2023, 本地耐药性问题有所加剧 部分病患须改服其他抗生素才能康复 (Antibiotic resistance in Singapore has intensified, requiring some patients to switch to different antibiotics for recovery)
  

Screening for nose cancer extended to 3 more polyclinics

National University Health System (NUHS) is expanding a five-year study to more polyclinics under National University Polyclinics (NUP) to evaluate tools for the early diagnosis of nasopharyngeal cancer (NPC). Launched in November 2022 and initially conducted at Jurong and Pioneer Polyclinics, this study has been extended to Bukit Batok, Choa Chu Kang, and Clementi Polyclinics. The study is part of an integrated research programme involving National University Cancer Institute, Singapore, and other institutions to enhance early detection of NPC and improve patient survival rates. The objective is to recruit 20,000 participants aged 35 to 60. The screening is provided free of charge and includes a serology test, saliva self-collection, and a questionnaire.

Dr Joshua Tay, Consultant, Department of Otolaryngology – Head and Neck Surgery, National University Hospital (NUH), shared that the study will use an early antigen serology marker to pick up the presence of the Epstein-Barr virus (EBV) in the nose, as EBV has been found in nearly all nose cancer cells. Those identified to be high risk will be referred to specialists at NUH for further evaluation.

A/Prof Thomas Loh, Group Chairman of NUHS Medical Board and Senior Consultant at NUH’s Department of Otolaryngology – Head and Neck Surgery, shared that the study will allow the team to reach out to the at-risk population in the community, to identify and effectively treat early-stage disease. It is also hoped that the study can help to develop a cost-effective and practical screening model to dramatically increase the early diagnosis of NPC. 

NUHS launches Singapore's large-scale nose cancer screening research study in the community

958新闻聊开来： 乳癌意识月：乳癌预防与筛查知多少？(Capital 958 News: Breast Cancer Awareness Month: How much do you know about breast cancer prevention and screening?)

​Assist Prof Samuel Ow, Chairman, Breast Cancer Awareness Month (BCAM) 2023 Organising Committee, and Senior Consultant, Department of Haematology-Oncology, National University Cancer Institute, Singapore, explained why family physicians are roped in for this year’s campaign. Dr Zhou Qian, Resident Physician, Queenstown Polyclinic, explained when she would broach the topic of breast cancer screening to her patients and how she addresses misconceptions about mammograms.

亚历山大医院外展计划；药剂师做家访支援 两年339病患受惠 (Alexandra Hospital’s pharmacist outreach programme benefitted 339 patients in over two years)

​Alexandra Hospital, a hospital within the National University Health System, has put in place a Pharmacy Outreach Programme since 2018 with the primary objective of providing ongoing support to discharged patients. This support is extended through means such as home visits and virtual consultations, with the aim of assisting patients who may face challenges adhering to their medication regimen. From 2021 to date, this programme has positively impacted 339 patients. Joyce Ho, a senior pharmacist at Alexandra Hospital, has been actively involved in this initiative for two years and emphasised the vital role that pharmacists play in aiding patients with intricate medication instructions, especially in cases where familial support is lacking.

In addition, National University Polyclinics, also part of the National University Health System, introduced a pharmacist-led assessment service in all its polyclinics since June this year. This service allows eligible patients with minor ailments, following a preliminary screening, to directly consult with a pharmacist at the counter for the purchase of over-the-counter (OTC) medications, bypassing the need to see a doctor. Since its introduction in June, there has been a 16% increase in the number of patients opting for this service across all Nationaly University Polyclinics polyclinics. 

Kadar wanita Melayu jalani ujian barah buah dada kekal terendah (Proportion of Malay women undergoing breast cancer screening remains the lowest)

Assist Prof Samuel Ow, Chairman, Breast Cancer Awareness Month (BCAM) 2023 Organising Committee, and Senior Consultant, Department of Haematology-Oncology, National University Cancer Institute, Singapore, cited a study by National University Hospital, Breast Surgery and NUS Saw Swee Hock School of Public Health in 2022, which showed some barriers to breast cancer screening in the Malay community, such as a perceived low risk.

A two-page spread on BCAM mentioned this year's theme of "Keeping Her In The Picture" and roping in family physicians to promote screening. Dr Grace Lau, Senior Resident Physician, Queenstown Polyclinic, talked about her role to remind patients to rescreen at appropriate intervals.

National University Cancer Institute, Singapore patient, Madam Nuritah Abdul Rahim, was diagnosed with stage 2 breast cancer in 2020 when she was 34 weeks pregnant with her fourth child. Her mother, Madam Zubaidah Jalil, also had breast cancer in 2015. A sidebar listed the upcoming BCAM activities.

• Berita Minggu, 15 October 2023, Page 6, Kaum Adam, ajaklah wanita tersayang jalani pemeriksaan barah buah dada (Dear men, invite your beloved women to undergo breast cancer screening)
  
• Berita Minggu, 15 October 2023, Page 7, Hadapi Barah buah dada semasa hamil, namun enggan menyerah kalah (She faced breast cancer during pregnancy, but refused to give up)
  

Peranan doktor keluarga penting galak wanita jalani mamogram (Role of family doctor important in encouraging women to undergo mammograms)

​Breast Cancer Awareness Month (BCAM) was launched with this year’s theme “Keeping Her In The Picture”. Miss Lee Kim Hua, Senior Nurse Clinician at National University Cancer Institute, Singapore (NCIS), shared how she detected her early breast cancer through a routine check-up. Assist Professor Samuel Ow, Chairman of BCAM 2023 Organising Committee and Senior Consultant, Department of Haematology-Oncology, NCIS, as well as Dr Grace Lau, Senior Resident Physician, Queenstown Polyclinic, explained the significance of roping in family physicians in the campaign.

• Berita Mediacorp, 5 October 2023, Peranan doktor keluarga penting galak wanita jalani mamogram (Role of family doctor important in encouraging women to undergo mammograms)
  

NUH turns to AI to track wait times for emergency patients

​National University Health System launched two new artificial intelligence (AI) projects that are hosted on the Endeavour AI platform. Pathfinder provides real-time insights into waiting time at the Emergency Department (ED) and bed occupancy rates, while CalSense flags hypercalcaemia to doctors in real time.

A/Prof Ngiam Kee Yuan, Group Chief Technology Officer, National University Health System; Dr Ian Mathews, Deputy Group Chief Technology Officer, National University Health System; and Dr James Lee, Assistant Group Chief Technology Officer, National University Health System were quoted on the significance of these AI projects to streamline processes and improve patient care. Dr Mathews, who is Senior Consultant in National University Hospital's Emergency Department, said that AI "does not take over" even as it helps to streamline processes and reduce inefficiencies.

Reports also featured National University Hospital patient Mr Poh Chin Sheng, who received earlier intervention after CalSense detected the high amount of calcium in his blood.  

• Shin Min Daily News, 20 September 2023, Page 6, AI测出高血钙症 阿叔及早接受治疗 (AI tool flags hypercalcaemia, uncle receives early treatment)
  
• 8world, 20 September 2023, 国大医学组织开展两项试点计划 采用人工智能工具更好照顾病患 (NUHS launches two pilot projects, uses AI tools to improve patient care)
  
• Red Hot Singapore, 20 September 2023, NUH turns to AI to shorten waiting times for emergency patients
  

Mobile hearing clinics to bring hearing loss testing to the community

National University Hospital (NUH) has expanded its community audiology services to enhance greater accessibility to hearing health services, especially for residents in the western region of Singapore. A new satellite hearing clinic has been introduced at Jurong Medical Centre, and mobile audiology clinics have been established at three National University Polyclinics: Bukit Batok, Choa Chu Kang, and Queenstown. This expansion is an initiative led by the audiology team from NUH's Department of Otolaryngology – Head and Neck Surgery, and it primarily aims to cater to the hearing care needs of older people. 

In a live interview on Channel 8, Associate Professor Loh Woei Shyang, Head and Senior Consultant, Department of Otolaryngology - Head & Neck Surgery, NUH, and Dr Jenny Loo, Senior Principal Audiologist, Department of Otolaryngology - Head & Neck Surgery, NUH, explained the significance of accurate hearing assessments, diagnoses, and appropriate treatment in minimising the risk of other health issues.

Dr Loo, who leads NUH's audiology team, highlighted a previous study revealing that 73% of seniors in Singapore were reluctant to visit a hospital for hearing tests, and only approximately 5% of those who would benefit from hearing aids actually obtained them. She emphasised that the expansion of audiology services aims to enhance convenience and raise awareness about the importance of hearing care within the community.

• Lianhe Zaobao, 13 September 2023, 全新流动听力诊所 开进西部受益居民增倍 (Number of residents benefitting from brand new mobile hearing clinics doubled following expansion into western region) 
  

• ZB Online, 12 September 2023, 流动听力诊所开进社区 排期更快受惠病患倍增 (Mobile audiology clinics open in the community to help more patients)
  

• Shin Min Daily News, 12 September 2023, 国大医院 推新流动听力诊所 应对年长病患需求 (NUH launches new mobile audiology clinics to address the needs of elderly patients)
  

• 8world, 12 September 2023, 国大医院推新款流动听力诊所 西部居民有更多地点接受检测 (NUH launches new Mobile Audiology Clinics, more locations for Western residents to receive testing)
  

• 8world, 12 September 2023, 狮城有约 | 十分访谈：年长者听力问题 (Hello Singapore | 10mins Interview: Hearing issues among elderly)
  

• Capital 95.8FM news, 12 September 2023
  

• Medical Channel Asia, 13 September 2023, NUH bolsters hearing health in the singapore heartlands
  

• Red Hot Singapore, 12 September 2023, Mobile hearing clinics to bring hearing loss testing to the community
  

• SG News, 12 September 2023 国大医院推新款流动听力诊所 西部居民有更多地点接受检测 (NUH launches new Mobile Audiology Clinics, more locations for Western residents to receive testing)
  

• Shi Cheng news, 13 September 2023, 国大医院推新款流动听力诊所 西部居民有更多地点接受检测 (NUH launches new Mobile Audiology Clinics, more locations for Western residents to receive testing)
  

• Tamil Murasu, 14 September 2023, Page 4, Mobile hearing clinics to bring hearing loss testing to the community
  

A healthy start for care providers

​Over 1,000 National University Health System nurses gathered to celebrate Nurses' Day on 22 July. During the event, Minister for Health Ong Ye Kung's reiteration of a sign-on bonus for fresh nurses and a retention incentive for current nurses drew loud applause from the audience. National University Health System also announced a new Nurse Researcher Career Framework to provide nurses with more diverse career opportunities.

Dr Catherine Koh, Group Chief Nurse, National University Health System, said that the nursing role has come a long way, evolving into a dynamic profession that undertakes teaching, research, and clinical care. National University Health System has been redesigning the nursing profession to support its diverse nursing talent and create more opportunities for National University Health System nurses.

Media featured various nurses across National University Health System, including Ms Sophia Saw, Assistant Nurse Clinician, National University Hospital, who pursued a graduate certificate in innovation and is involved in the development of Missi, a cloud-based nurse companion robot designed to perform basic tasks such as fetching items, monitoring of vital signs and falls prevention. Ms Liau Wei Fong, Advanced Practice Nurse, National University Polyclinics, shared how the role of nursing has expanded over the years. Mdm Loke Wai Chan, Deputy Director, Ng Teng Fong General Hospital, and Ms Fatimah Binte Abdul Rahman, Principal Enrolled Nurse, National University Hospital, shared more about their decades of experience in nursing.

• Lianhe Zaobao, 23 July 2023, Page 6, 国大医院护士工作七年进修 职业发展更多元 (NUH nurse worked seven years before furthering studies for greater career development)
  
• Zaobao Online, 22 July 2023, 护理研究者职业框架推出 提供护士更多元职业发展 (Career framework for nurse researcherslaunched to offer greater career diversity for nurses)
  
• Shin Min Daily News, 22 July 2023, Page 4, 庆护士节 国立大学医学组织 今早办健康嘉年华 (NUHS holds health carnival this morning to celebrate Nurses Day)
  
• 8world, 23 July 2023, 国大医学组织推新框架 提供护士更多元职业发展机会 (NUHS launches new framework to provide nurses with more diverse career opportunities)
  

Medical students being taught how to communicate effectively with PWDs

Around 300 medical students from NUS Yong Loo Lin School of Medicine have been taught how to communicate effectively with persons with disabilities (PWDs). The module currently covers audio, visual and mobility impairments, but it could soon be expanded to include intellectual disabilities.

Launched last July, the curriculum was co-designed by doctors from National University Polyclinics and National University Health System together with PWDs.

• Lianhe Zaobao, 19 May 2023, 工坊模拟问诊 提升医科生与残障者沟通技巧 (Curriculum with simulated consultations to enhance medical students’ communication skills with people with disabilities)
  

• 8world, 19 May 2023, 国大医学组织制定课程 教医科学生如何与残障病人沟通 (NUHS develops curriculum to teach medical students how to communicate with patients with disabilities) 
  

• Berita Mediacorp, 19 May 2023, Latihan khas bantu 300 siswa NUS berkomunikasi lebih berkesan dengan golongan kurang upaya (A special curriculum helped 300 NUS students communicate more effectively with disabled community)
  

NUHS and NUP family doctors mark World Family Doctor Day with impactful research and inclusive clinical care curriculum

Eye-care kiosks for glaucoma, cataract tests to be rolled out at more polyclinics

The new Centre for Innovation and Precision Eye Health at National University Health System (NUHS) and NUS Yong Loo Lin School of Medicine (NUS Medicine) was launched to focus on the detection and treatment of eye diseases, including genetic degenerative eye diseases, with the aim of making diagnosis and treatment more accessible and affordable. The centre would also develop new technologies, including AI software, to bring specialist diagnoses to the community.

Speaking at the centre opening, Prof Yeoh Khay Guan, CE of NUHS, stated that the new research centre is a significant step forward in improving the public's eye health. About 180,000 people above 60 have some kind of visual impairment, said Prof Cheng Ching-Yu, NUS Medicine. A/Prof Victor Koh, Head, Department of Ophthalmology, National University Hospital and NUS Medicine, said that one of the challenges of bringing specialist diagnosis to the community is the cost involved and the space an eye centre requires.

The new centre's initiatives include eye-care kiosks at Pioneer Polyclinic that were piloted to collect data about a patient's eyesight before sending it off-site to an ophthalmologist for diagnosis, in an effort to make diagnosis and treatment of eye diseases more accessible and affordable.

• Lianhe Zaobao, 26 March 2023, Page 7,本地研发便携式仪器方便公众检验眼睛 (Singapore develops portable devices to facilitate the public to have their eyes examined)
  

• 8world, 25 March 2023, 社区提供眼科护理服务 可直接转介眼疾病患到医院 (Community provides eye care service with direct referral to hospital for eye diseases)
  

• Tamil Murasu, 26 March 2023, Page 2, பலதுறை மருந்தகங்களில் கண் பராமரிப்புக் கூடங்கள் திட்டம் (Eye-care kiosks for glaucoma, cataract tests to be rolled out at more polyclinics)
  

• 8world, 25 March 2023, 国大杨潞龄医学院设立创新与精准眼科研究中心 (NUS Yong Loo Lin School of Medicine sets up Centre for Innovation and Precision Eye Health)
  

• Berita Mediacorp, 25 March 2023, Pusat kesihatan mata manfaatkan AI dan sains data (Eye health centers leverage AI and data science)
  

• Berita Harian Online, 25 March 2023, Kios jagaan mata bagi ujian glaukoma, katarak dirancang bagi lebih banyak poliklinik (Eye care kiosks for glaucoma, cataract tests are planned for more polyclinics)
  

• Tamil Murasu Online, 26 March 2023, பலதுறை மருந்தகங்களில் கண் பராமரிப்புக் கூடங்கள் திட்டம் (Eye-care kiosks for glaucoma, cataract tests to be rolled out at more polyclinics)
  

• Channel NewsAsia, 25 March 2023, Improving eye care – new centre will harness artificial intelligence to treat eye diseases
  

• Channel 8 news, 25 March 2023, Improving eye care – new centre will harness artificial intelligence to treat eye diseases
  

• Red Hot Singapore, 25 March 2023, Glaucoma tests at polyclinics, gene therapy research, announced at launch of new eye health centre
  

• SGNews, 25 March 2023, 国大杨潞龄医学院设立创新与精准眼科研究中心 (NUS Yong Loo Lin School of Medicine sets up Centre for Innovation and Precision Eye Health)
  

• Shin Min Daily News, Page 4, 本地研发 便携式仪器验眼 缩短看诊时间 (Locally invented portable optometry device helps shorten consultation time)
  

Infections at Nanyang Primary not a sign of flu outbreak here

​While doctors are seeing more flu cases, numbers are still very much lower than in pre-COVID-19 days. Prof Dale Fisher, Senior Consultant, Division of Infectious Diseases, National University Hospital, and A/Prof Hsu Li Yang, Vice Dean of Global Health, NUS Saw Swee Hock School of Public Health, explained that this showed that the community was more sensitised to identifying and managing clusters of infectious disease, particularly respiratory infections.

A spokesman from National University Polyclinics said that there were many bugs that can cause respiratory infections similar to influenza. The National University Polyclinics spokesman urged people with chronic medical conditions or those who are on immune-suppressing medication, and at risk of developing severe symptoms and complications, to wear masks and avoid crowded places.

Over 100,000 to get awards for helping S’pore fight COVID-19

The Prime Minister’s Office announced the COVID-19 National Awards, which recognise individuals for their outstanding efforts and contributions in Singapore’s fight against COVID-19. Mr Tan Chong Meng, Group CEO of PSA International, who is Deputy Chairman, NUHS Board, was named as one of three recipients of the top award, the Meritorious Service Medal (COVID-19). 

A side story listed award winners in the different categories, with several recipients from National University Health System, National University Hospital, Ng Teng Fong General Hospital, Alexandra Hospital, National University Polyclinics, NUS Yong Loo Lin School of Medicine and NUS Saw Swee Hock School of Public Health.