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Straits Times
a day ago
- Health
- Straits Times
Care model to improve trauma outcome in central S'pore fashioned after ‘bicycle wheel'
During trauma surgery, making life and death decisions are crucial as things often happen badly in trauma care and time is always running out. SINGAPORE - A trauma care model fashioned after the wheel of a bicycle has been launched in the central region of Singapore to improve the outcomes of those who have sustained physical, life-threatening injuries. The hub-and-spoke concept increases the chances of these critically injured patients receiving optimal care at the most appropriate hospital, ultimately leading to faster response times and reduced death rates. Tan Tock Seng Hospital's (TTSH) Trauma Centre serves as the hub, specialising in the most complex and critical trauma cases, while the other hospitals in central Singapore are the spokes, managing moderate to less severe ones. The 'spoke hospitals' comprise Khoo Teck Puat Hospital (KTPH), Woodlands Health (WH), Sengkang General Hospital (SKH), Raffles Hospital and KK Women's and Children's Hospital (KKH), which are from different healthcare clusters. The model also helps to 'maximise resources... since four of the eight specialist trauma surgeons in Singapore are located at TTSH', Dr Teo Li Tserng, director of the TTSH Trauma Centre, told reporters at an interview on July 16 . The rest of the specialist trauma surgeons are based at three other hospitals. Dr Teo said patients requiring care based on a set of tailored secondary transfer criteria are sent to the hub. Top stories Swipe. Select. Stay informed. Singapore Fatal abuse of Myanmar maid in Bishan: Traffic Police officer sentenced to 10 years' jail Singapore HSA launches anti-vaping checks near 5 institutes of higher learning Singapore Kpod vapes, zombie kids: Why it's time to raise the alarm Life 11 new entries on Singapore's Bib Gourmand list, including three re-entries at Old Airport Road Singapore NEA monitoring E. coli at Sentosa beaches after elevated bacteria levels delay World Aquatics events Life First look at the new Singapore Oceanarium at Resorts World Sentosa Opinion The workplace needs to step up on mental health to match Singapore's efforts at the national level Singapore Singapore Zoo celebrates reptile baby boom, including hatchings of endangered species These criteria include patients who require specialised care that is not readily available at the referring hospital, have specific medical conditions, such as severe injuries, require specialised monitoring, or have communication difficulties. The care model was shared at the Singapore Trauma and Acute Care Conference (STACC) 2025, held at Suntec Singapore Convention and Exhibition Centre from July 17 to 18. Trauma is a form of injury caused by an external force . Many such patients suffer multiple injuries or damage in multiple regions, whether from traffic accidents, bad falls or penetrating wounds. It ranks among the top 10 causes of death in Singapore, with falls and road accidents being leading causes of moderate to severe trauma injuries. According to the National Trauma Registry (NTR), there were about eight trauma cases per 100,000 population treated at the public healthcare institutions daily between 2021 and 2023, with almost seven in 10 of the moderate to severe cases involving the elderly aged 65 and above. About one in five patients with severe trauma did not survive and one in 50 with moderate trauma died . Although the hub-and-spoke trauma care model is not a new idea , the one here has a 'bi-directional patient flow', setting it apart from existing ones elsewhere. 'Unlike most uni-directional systems where the hub takes every trauma case first, our model allows for a critically injured victim of, say, of a bad road accident, to be brought the nearest (periphery) hospital to be stabilised before transferring him to TTSH for the complex, life-threatening emergency treatment,' said Dr Teo, who is also the regional director of the Central Region Trauma Services from NHG Health. 'Once emergency treatment is complete and the patient is stabilised, he can be transferred back to the 'spoke' hospital for follow-up rehabilitation, or even to a hospital closer to their residence for ongoing care,' he added. If the patient is not stable enough for transfer , surgeons from the hub can go to the periphery hospitals instead. The bi-directional operation significantly reduces the burden on the main trauma centre at TTSH, making more efficient use of resources and 'reflecting a right-sited, patient-centred approach,' Dr Teo said. Using the analogy of a jar of kaya and several pieces of sliced bread, Dr Teo said: 'The kaya in this case is finite, so how do we adequately spread it around to the increasing slices of bread or even concentrate the kaya to make sure that at least everybody gets enough for taste? That's the challenge. We have to ensure that the patients get adequate care to allow them the chance for survival.' In order for the hub-and-spoke model to work, the Singapore Civil Defence Force (SCDF) plays a crucial role as its first responders decide where to transport patients based on the type and severity of their injuries, Dr Teo said. 'Even with Singapore's small size and short transport times, that extra five minutes taking the critically injured patient to the hub is crucial for him to fare better,' he said. The hub-and-spoke model is still being developed, as some hospitals in the central region are 'at various stages of their maturity', said Dr Teo, who pointed out that Sengkang Hospital and Woodlands Health are the two newest hospitals. In comparison, the TTSH trauma centre has been working with Sengkang Hospital since 2016. 'We are trying to fully roll this (model) out by September this year, and hopefully it will then be the prototype for the rest of the healthcare groups to adopt,' Dr Teo, said.
Straits Times
10-07-2025
- Business
- Straits Times
Brazil has few exit routes from Trump tariff but feels less pain
Sign up now: Get ST's newsletters delivered to your inbox Unlike most countries in the world, Brazil has a trade deficit with the United States. BRASILIA - When US President Donald Trump linked 50 per cent tariffs on Brazil to the trial against his ally, the country's former far-right leader, Washington left Latin America's largest economy with few options to deescalate but may have overestimated the country's vulnerability to the levies. Brazil's President Luiz Inacio Lula da Silva has neither the political will nor the legal authority to interfere in the case against his predecessor Jair Bolsonaro, who faces charges of plotting a coup in the aftermath of a fierce and bitter 2022 election which Mr Lula won. Brazil is in a stronger position than many developing nations given the country's relatively lower trade exposure to the US, even if high tariffs would still be painful. Unlike most countries in the world, Brazil actually has a trade deficit with the US. The US takes in some 12 per cent of Brazil's exports, less than half what China buys, and worth only around 1 per cent of GDP. Mexico - Latin America's second largest economy - sends 80 per cent of its exports to the US. 'We are a long way from having the same vulnerability that other countries have in regards to the US,' said one Brazilian diplomat on condition of anonymity as they are not authorised to speak publicly on the matter. 'We regret this measure has been taken but ... we won't suffer in the short term the brutal impact other economies would.' Top stories Swipe. Select. Stay informed. Business S'pore to launch new grant for companies, expand support for workers amid US tariff uncertainties World Trump to use presidential authority to send weapons to Ukraine, sources say Opinion Whisper it softly, there's a new Japan rising Asia Tariffs overshadow diplomacy as Asean foreign ministers press on with meetings World The $12.8m bag: Original Birkin smashes records at Paris auction Singapore Up to 90% of air-con units can be recycled, including greenhouse gas refrigerant Singapore What 'skills first' really means: Panellists at SkillsFuture Forum talk culture, systems, mindsets Singapore KTPH trials 'smart diapers' for adult patients to prevent skin conditions, relieve burden on nurses The tariffs would also cause pain in the US. Brazilian coffee in particular is a huge US import and a 50 per cent tariff could send coffee prices soaring . Other products like orange juice could also be hit. ARX investment firm said it saw only 'marginal and manageable macroeconomic impact on the Brazilian economy', though others like Goldman Sachs said they expected the tariffs could shave 0.3 per cent to 0.4 per cent off Brazil's GDP if maintained. Political tariffs With the US tariffs more clearly politically motivated than other levies threatened by Mr Trump, Mr Lula is bereft of clear negotiating options. The political motivation behind the tariff threat makes it 'harder to see an off-ramp for Brazil compared with other countries that received tariff letters', wrote William Jackson, chief emerging markets economist at Capital Economics. In Mr Trump's letter outlining the Brazil tariffs he decried what he described as a 'witch hunt' against far-right ally Bolsonaro, saying the levies were imposed due 'in part to Brazil's insidious attacks on Free Elections, and the fundamental Free Speech Rights of Americans'. Mr Lula threatened reciprocal measures in a feisty note posted to social media on July 9, and on July 10 sources said the government could be looking to change tack and exploring how to deescalate the situation. It was unclear what that might look like. But Mr Lula is not a politician to back down from a fight. Forged in the union movement of the 1980s, the 79-year-old lost three presidential elections before finally winning in 2002 and has dominated the country's leftist politics ever since. While many other world leaders have gone out of their way to placate Mr Trump, Mr Lula called him on July 7 an 'emperor' that the world did not want. In his July 9 response, he said: 'Brazil is a sovereign nation with independent institutions and will not accept any form of tutelage.' Another factor is Mr Lula's domestic woes, with polls pointing to a likely defeat in next year's election. Some experts say he could use the scrap with Mr Trump to rally support. Mr Trump stepping in to defend Bolsonaro in such an overt way could also backfire on the Brazilian far right, seen by many as having invited this action that could hurt Brazil's economy. 'The most probable scenario is that this will end up fostering nationalism in Brazil,' said Professor Oliver Stuenkel, who teaches international relations at Fundacao Getulio Vargas, in Sao Paulo. 'If Lula knows how to respond well to this, it could end up strengthening him, just as it also strengthens other leaders of countries that suffer this kind of interference.' REUTERS
Straits Times
10-07-2025
- Sport
- Straits Times
Swiss players revel in historic moment after reaching Euro quarter-finals
Sign up now: Get ST's newsletters delivered to your inbox GENEVA - Switzerland's players were basking in the excitement of making history on Thursday after Riola Xhemaili's 92nd-minute goal against Finland put them through to the Women's Euros quarter-finals for the first time. "It's a historic moment for the whole of Switzerland. We're showing the whole world what Swiss people can do... it's magical," Xhemaili told Reuters after her goal gave the tournaments hosts a 1-1 draw with Finland which was all they needed to progress. Since they first qualified for the Euros in 2017, Switzerland's women's side had never gone past the group stage, nor had they ever seen such a huge level of support at their games. "I think nobody of us expected things to happen in Switzerland -- sold out crowds... Everything is blowing up way bigger than we ever expected," Swiss captain Lia Walti said. "We couldn't even imagine having this when we were little," added defender Viola Calligaris. "And now it's like this for every match. We felt the people cheering — that really gives you strength." The Stade de Geneve saw its biggest attendance of the tournament so far on Thursday, with 26,388 fans watching. "It's so much more fun to coach and play when you have a loud crowd," said Switzerland's coach Pia Sundhage, adding that she hoped the team's performance would inspire the next generation of players. Top stories Swipe. Select. Stay informed. Business S'pore to launch new grant for companies, expand support for workers amid US tariff uncertainties World Trump to use presidential authority to send weapons to Ukraine, sources say Asia Tariffs overshadow diplomacy as Asean foreign ministers press on with meetings Opinion Whisper it softly, there's a new Japan rising Singapore Up to 90% of air-con units can be recycled, including greenhouse gas refrigerant Singapore What 'skills first' really means: Panellists at SkillsFuture Forum talk culture, systems, mindsets Singapore KTPH trials 'smart diapers' for adult patients to prevent skin conditions, relieve burden on nurses Singapore Singaporean fugitive nabbed and charged with drug trafficking, may face death penalty The Swiss hosts are hoping the legacy of the tournament, being played across eight cities with the final on July 27, will bolster female football in the country as Euro 2022 did for champions England. The Swiss FA's stated aim is to double the number of female players from the 40,000 currently registered by 2027. First, though, for Switzerland is a quarter-final next Friday against the winners of Group B which, as things stand, would be World Cup winners Spain. REUTERS
Straits Times
10-07-2025
- Business
- Straits Times
All eyes on Bolsonaro with Lula, Trump locked in trade fight
Sign up now: Get ST's newsletters delivered to your inbox Brazilian President Luiz Inacio Lula da Silva said US President Donald Trump was 'irresponsible for threatening tariffs on social media'. RIO DE JANEIRO – As Brazil's Luiz Inacio Lula da Silva and Donald Trump trade blows, the person they are fighting over has sent mixed signals to investors trying to divine who will blink first. Mr Jair Bolsonaro, Lula's arch-nemesis whose legal woes were the basis of Mr Trump's 50 per cent tariff salvo , is barred from running against a rival who staged the kind of comeback he aspires to now. But all eyes are nevertheless on the right-wing former president who has spent months all but begging for Mr Trump's help ahead of a trial on charges that he attempted a coup. On the surface, Mr Trump's plunge into Brazilian affairs – he called Mr Bolsonaro's case a 'witch hunt' and demanded its dismissal – looks like a shot in the arm from one nationalist to another. But in practice, it has put Mr Bolsonaro and his Maga-like following in a bind. Instead of energising the right, Mr Trump has opened room for similarly charismatic opponent with his own populist base to claim Americans are meddling with a still-young democracy sensitive to the idea of US interference. That is the context in which Mr Bolsonaro is having to weigh in – and 24 hours after the geo-economic bomb dropped, he's struggling. The usually enthusiastic influencer has been busy reposting content from others but little of his own since Mr Trump sent a tariff letter that has markets on tenderhooks. There are, however, a pair of messages referencing two people considered potential heirs. Top stories Swipe. Select. Stay informed. Business S'pore to launch new grant for companies, expand support for workers amid US tariff uncertainties World Trump to use presidential authority to send weapons to Ukraine, sources say Asia Tariffs overshadow diplomacy as Asean foreign ministers press on with meetings Opinion Whisper it softly, there's a new Japan rising Singapore Up to 90% of air-con units can be recycled, including greenhouse gas refrigerant Singapore What 'skills first' really means: Panellists at SkillsFuture Forum talk culture, systems, mindsets Singapore KTPH trials 'smart diapers' for adult patients to prevent skin conditions, relieve burden on nurses Singapore Singaporean fugitive nabbed and charged with drug trafficking, may face death penalty One is his third-eldest son, Mr Eduardo Bolsonaro, a lawmaker who took leave from Brazil's Congress to move to the US in March. From there, he's spearheaded a lobbying push to convince the Trump administration to weigh in on his father's behalf. As chance would have it, the tariffs came on the eve of his birthday. A 41-year-old with close ties to Trump world, Mr Eduardo Bolsonaro praised the tariffs on July 9 night. On July 10 morning, his father wished him a happy birthday, lamenting the fact that they weren't together due to the 'persecution' he says his son has suffered at the hands of the Brazilian justice system. The other is Sao Paulo Governor Tarcisio de Freitas, a former minister in Bolsonaro's government who has begun to emerge as the favorite choice of investors pining for an alternative to Lula in next year's election. Mr Freitas denies he will run, but he is also taken steps to win over Mr Bolsonaro, whose support he would need to earn the backing of Brazil's fervent right. Mr Freitas blamed Lula for the imposition of the tariffs on July 9. By July 10, with business groups in his home state and across Brazil warning that the tariffs would cause major pain, he began calling for negotiations, according to local media. Then, in the afternoon, Mr Bolsonaro posted a video to social media of he and Mr Freitas meeting at a traditional Brazilian barbecue joint in Brasilia, the capital. They hugged and shook hands as if to show all is well. 'Always great to be by your side, president!' Mr Freitas wrote in his post. It demonstrated the right's struggles to find an answer to the suddenly rejuvenated Lula, who has seized on Mr Trump's attacks in a push to boost approval ratings that have been stuck below 50 per cent for months. Some inside right-wing circles want Mr Bolsonaro to intervene to convince Mr Trump to reverse course, CNN Brasil reported on July 10. But others say there's no immediate plan to act. 'We'll eat popcorn and watch for the next 21 days,' Mr Sostenes Cavalcante, the leader of Bolsonaro's party in the lower house, said in a text message on July 10, referencing the Aug 1 date on which the tariffs take effect. 'Let's wait for Lula to solve the problem.' Lula sees little use in negotiating on Mr Trump's terms. There's no economic rationale, Finance Minister Fernando Haddad said on July 10, for tariffs on a country that buys more from the US than it sells – the exact relationship Mr Trump wants. The government also has no power to hand him what he desires: The end of legal proceedings against Mr Bolsonaro. Instead, it plans to blunt the impact on Brazilian exports by moving closer to countries like Indonesia, Canada and Japan via Mercosur, the South American customs union of which it's a member, according to an official with knowledge of the situation who requested anonymity to discuss internal matters. Many of those talks have been ongoing for years, and Lula has pushed to broaden commerce beyond the US and China since Mr Trump sparked a trade war between Brazil's top two trading partners earlier this year. Now the government's position is that it's up to Mr Bolsonaro and Mr Trump to fix the mess they've created. Eventually, Mr Haddad argued, 'even the far right will have to acknowledge that it shot itself in the foot.' BLOOMBERG
Straits Times
10-07-2025
- Business
- Straits Times
Forum: Can historic Istana Woodneuk be preserved?
Sign up now: Get ST's newsletters delivered to your inbox The news last month of the land swop deal between Singapore and the Regent of Johor caught my attention ( Singapore and Johor Regent Tunku Ismail to swop land plots near Botanic Gardens , June 10). It was a welcome reminder of Singapore's intertwined history with the Sultanate, which once ruled the area that we now call home. Within the parcel given to Singapore is the historic Istana Woodneuk, which now lies in ruins after decades of neglect. While on a recent tour of the grounds with heritage expert Sarafian Salleh, it became clear to me that the swop is more than a simple real estate deal. It has given Singapore a unique and precious opportunity to preserve a piece of Singaporean history that would otherwise be lost forever. Heritage sites cannot be manufactured from scratch – they must grow organically out of people's lives, experiences, and memories. Istana Woodneuk is a weathered but enduring testament to Singapore's pre-independence past, and I hope that the Government seizes this unique opportunity to preserve and restore the palace and its surroundings. SG60 would be the perfect occasion to create a new monument that could educate and inspire future generations on the grounds of Istana Woodneuk's many-layered past. Top stories Swipe. Select. Stay informed. Business S'pore to launch new grant for companies, expand support for workers amid US tariff uncertainties Singapore Up to 90% of air-con units can be recycled, including greenhouse gas refrigerant Singapore KTPH trials 'smart diapers' for adult patients to prevent skin conditions, relieve burden on nurses Singapore Singaporean fugitive nabbed and charged with drug trafficking, may face death penalty Sport World Aquatics C'ships Singapore 2025 declared open by President Tharman Shanmugaratnam World 'Do some homework': 6 key exchanges between US Senator Duckworth and S'pore envoy nominee Sinha Multimedia 60 objects to mark SG60: Which is your favourite? Singapore CPF Board uses AI to improve call centre services, prioritise help for less tech-savvy users Christian Jones
