Why not nursing? Factors influencing healthcare career choice among Singaporean students.

BACKGROUND: Internationally, and particularly in Singapore, health education institutions are facing challenges in attracting school leavers to enter nursing courses. OBJECTIVES: To identify the factors influencing the career choice of Singaporean healthcare students and determine the deterrents in choosing nursing as a career choice. DESIGN: An exploratory descriptive qualitative study design was used. PARTICIPANTS: Fifty-nine healthcare students from three higher education institutions were recruited. METHOD: Four nursing and four non-nursing focus groups discussion were held. Interview transcripts were analysed using thematic analysis. RESULTS: Six themes emerged as follows: 'personal interest'; 'prior healthcare exposure'; 'job prospects'; 'academic performance'; 'perceived nature of work'; and 'social influences'. DISCUSSION: The personal interests to help and care along with prior healthcare exposures were found to influence the students' choice. Job prospects such as the ease of getting a job, job stability, and job salary were considered. Nursing was perceived as a course for students with poor academic ability. Misconceptions about the nature of work and a lack of social recognition were identified as deterring factors in students' choice of nursing as a career. CONCLUSIONS: An understanding of the career decision process among healthcare students enables educational leaders and policy-makers to enhance the focus of nursing recruitment strategies. IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: Strategies for nursing recruitment in Singapore must include creating more opportunities for exposure to nursing in early school years, reviewing the admission policies for nursing programmes to attract academically abled students, ensuring that nursing graduates' salaries are comparable with other healthcare graduates, promoting a better understanding on the role of a registered nurse and its career developments, and providing support for those who are interested in nursing but are faced with career decision-making difficulties due to their families.

Health Promotion Board-Ministry of Health clinical practice guidelines: functional screening for older adults in the community.

The Health Promotion Board (HPB) and the Ministry of Health (MOH) publish clinical practice guidelines to provide doctors and patients in Singapore with evidence-based guidance on managing important medical conditions. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the HPB-MOH clinical practice guidelines on Functional Screening for Older Adults in the Community, for the information of readers of the Singapore Medical Journal. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Health Promotion Board website (http://www.hpb.gov.sg/uploadedFiles/HPB_Online/Publications/CPGFunctionalscreening.pdf). The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

Chemical and microbiological qualities of The East River (Dongjiang) water, with particular reference to drinking water supply in Hong Kong.

Currently, about 80% of drinking water in Hong Kong is abstracted from The East River (Dongjiang) that is located in the mainland side of China. Literature records and monitoring results of 2000-2001 confirmed that the lower section of the Dongjiang had been contaminated by organic and inorganic pollutants. Statistical analyses showed that the increases of total cadmium, copper and zinc in the surface layer of sediment of Hong Kong reservoirs from 1994 to 2001 were positively correlated (significant at p<0.05) with those in the surface layer of sediments of the lower Dongjiang. Recent microbiological survey revealed that pathogens such as Salmonella spp., Vibro spp., Giardia lamblia and Cryptosporidium parvum appeared occasionally in water samples of the Dongjiang and Hong Kong reservoirs. While analytical results found that currently most of the heavy metals, trace organics and microbes were removed by the drinking water treatment plants in Hong Kong, the long-term health risk of drinking water contamination should not be overlooked. The Water Supplies Department of Hong Kong is recommended to intensify its water quality monitoring program to cover pathogenic bacteria and parasites in watercourses and reservoirs.

Nitrosamide carcinogenesis: nitrosation of amide linkages and facile decomposition of resulting nitrosamides.

Nitrite ions interact readily with N-methylacetamide and N-acetylglycine in aqueous buffer solution of pH less than 4 to give the transient nitrosamides, N-nitroso-N-methylacetamide and N-nitroso-N-acetylglycine. These nitrosamides could not be isolated under these conditions because they decompose rapidly, as demonstrated by ultra-violet spectroscopic traces. The gas chromatographic identification of the products indicates that diazo esters and diazoalkanes are the intermediates in these decompositions. The kinetic analysis of the nitrosation in buffered solution shows that the rate constants are proportional to the hydrogen ion concentration in the pH less than 4 range. Evidence in support of the participation of a carboxylate group in the nitrosation of N-acetylglycine is discussed. Possible implications of the presence of nitrite in carcinogenesis in digestive tracts are discussed on the basis of facile formation and decomposition of nitrosamides and the intermediacy of diazo compounds.

Nitrosamides derived from peptide models: their preparations and chemical behavior.

N-Acyl alpha-amino acids have been nitrosated to yield the nitrosamides, which are virtually stable at room temperature, but are thermolysed in refluxing benzene or methanol. The corresponding carboxylates of these nitrosamides rearrange rapidly at room temperature to generate diazoalkane- and/or diazoacylate-type intermediates, which are good alkylating agents. Rate constants for the decomposition of the nitrosamide, N-acetyl-N-nitroso-D,L-phenylalanine, have been determined.

Efficient photolytic degradation of nitrosamines.

The principles and practice of nitrosamine degradation by photochemical means were described. Two types of apparatus were constructed for this purpose. A nitrosamine waste solution containing 10-3-10-1 N in hydrochloric acid and about 10 mole-equivalents of an HNO2 scavenger (i.e., urea, guanidine, or hydrazoic acid) was efficiently and irreversibly degraded to the parent amines and N2 (and/or N2O) by irradiation. Efficiency of the degradation depended on the type of apparatus used. With the use of one apparatus, about 11 g N-nitrosodimethylamine was photolytically converted to dimethylamine, N2, and N2O in 24 hours. Protonated guanidine catalyzed the photohydrolysis processes.