SEP−OCT 2015 Changi General H o spi t al Magazine

中文由第26页起

A H E A LT H I E R , H A P P I E R L I F E

DRUGS, FOOD AND DRINK How various medicines interact with food and drink

HEALTHY ACTIVE AGEING Empowering seniors to stay stronger and happier

LAUNCHING CHART The future of robotic technology in healthcare

A day in the life of a CGH geriatric pharmacist

DISPENSING CARE, PRESCRIBING

HEART

A Note fr om the Editor In conjunction with the 25th Singapore Pharmacists Congress happening in

September, read about Wendy Ang and her professional journey with CGH as a Geriatric Pharmacist (page 8), as well as how different foods and drugs can

interact together for the better or ill of the patient under Health Notes (page 2).Speaking about working for the betterment of our patients, healthcare robotic

technologies today serve a higher calling than simply beaming messages from distressed princesses a la Star Wars. As you will about to read in this issue, CGH is the first local hospital to establish CHART – or the Centre for Healthcare Assistive and Robotics Technology – through Economic Development Board funding (page 14).

Rounding off our issue, we give recognition to a group of professionals without whom healthcare would never be the same – our nurses. Every year on 1st August, CGH celebrates Nurses’ Day, which is an important platform to give our dear ladies and men in white their due accolades and a day to just be merry (page 20).

EDITOR’S NOTE

Jason Woo Editor

Supervising EditorLim Ee GuanEditor Jason WooContributorsElizabeth Soh Elena OwyongTranslators Yip Laimei Elena Owyong Madeline HuangPhotographer Bobby OhDesign & Production Publicitas PublishingEmail: pp.asia@publicitas.comMedia Specialist: Merlyn Hor Email: merlyn.hor@publicitas.com Materials: Doreen Lau Email: doreen.lau@publicitas.com

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CONTENTSISSUE 138

SEP – OCT 2015

02 OF DRUGS, FOOD AND DRINK

How medicines interact with certain food and drink

04 HEALTHY ACTIVE AGEING Empower yourself to stay healthier, stronger and happier

08 DISPENSING CARE, PRESCRIBING HEART

Meet CGH Principal Clinical Pharmacist Wendy Ang Swee Tee

14 “THESE ARE THE DROIDS WE ARE LOOKING FOR!” The future of robotic technology in healthcare

20 A CALLING TO LOVE AND SERVE

CGH celebrates Nurses Day 2015

22 YOUR SAY

23 SUBSCRIBE TO CARING

25 HEALTHY EATS Pomelo salad

26 食物和饮料与药物的相互作用

饮食如何影响药物的作用

28 健康活跃的黄金岁月 让自己活得更健康、更强壮、

更快乐

32 包含爱与关怀的处方 首席临床药剂师，汪瑞蒂——

一位智慧与爱心并存，置身于照料年长病患的天使

36 “这就是我们要找的人形机器人！”

这些叫好又叫座的影片说的都是人与机械人之间的关系

40 吃出健康 柚子沙律

Feedback 1800 850 2823

14 36

08 32

25 4004 28

2 S E P – O C T 2 01 5 C A R I N G

Not every drug and tasty tidbit go together like

kaya and toast!

The next time you try to take your medicine with anything other than water, stop: you might be doing more

harm than good (besides making your medicine ineffective).

The fundamental step to take with all medication is to follow usage instructions on the label and advice given to you by your doctor or pharmacist. Having a proper understanding about drug-food interactions – how various medicines are affected by different kinds of food and drink – will help you avoid common pitfalls and ensure your medicine works effectively.

Drug-food interactions can occur with both prescription medication as well as over-the-counter medication. Let us now explore some common interactions between drugs, food and drink.

Food-Drug Interactions Drugs to be consumed without food When taken together at about the same time, some foods can affect the absorption rate of some medicines by your body. Such medicines should be consumed on an empty stomach, between 30 minutes to one hour before – or two hours after – a meal. Examples of these medications include:

8 Antibiotics such as cloxacillin, penicillin V and rifampicin

8 Thyroid replacement medication such as levothyroxine

8 Medication to treat osteoporosis such as alendronate and risedronate

Drugs to be consumed with food On the other hand, certain medicines can lead to an upset stomach if taken without food. These medicines should therefore be taken with or shortly after food intake. Examples of these medications include:

8 Those that reduce the risk of clotting or stroke, such as aspirin and clopidogrel

8 Oral steroids such as prednisolone, hydrocortisone and dexamethasone

8 Painkillers such as ibuprofen, diclofenac and tramadol

Drugs not to be taken with dairy products Some medicines should not be taken at the same time as dairy products such as milk, cheese and yoghurt.

One should also pay close attention to food containing calcium, magnesium and/or iron as well since they can affect the efficacy of such medicine. These medicines should be taken at least two hours after consuming dairy products or food containing the above mentioned minerals. Examples of these include:

8 Antibiotics such as ciprofloxacin and doxycycline

8 Thyroid replacement medication such as levothyroxine

8 Medication to treat osteoporosis such as alendronate and risedronate

2 S E P – O C T 2 01 5 C A R I N G

DRUGS, FOOD DRINK

OF

AND

Tyramine and antidepressants Food products rich in tyramine such as alcohol, avocados and soy sauce should be avoided if you are taking certain antidepressants such as moclobemide or linezolid (a form of antibiotic). This is because generally, antidepressants block an enzyme called monoamine oxidase, which breaks down excess tyramine in the body. Blocking this enzyme helps relieve depression. However, tyramine can quickly reach dangerous levels if you eat foods high in tyramine, which may cause a spike in blood pressure and require emergency treatment.

Fluid-Drug Interactions It is common knowledge that oral medicines should be taken with a full glass of water. But what if water is not available? We clue you in on which fluids are a definite no-no when taking with medication. Alcohol Generally, please avoid alcohol when under medication, because alcohol may increase the sedative effect of medicines. So, there is a good reason to avoid alcohol for your own personal safety! Caffeine Found commonly in tea, coffee and chocolate, high-caffeine intake (more than five cups of coffee in a day) can affect some medicines. Do try to limit caffeine consumption when taking the following medicines:

8 Medicines that treat respiratory conditions such as salbutamol, fenoterol and theophylline

8 Relaxants or medicines that induce sleep such as diazepam, lorazepam and zolpidem

Grapefruit juiceWhile other fruit juices are safe to consume alongside medicines, please pay careful, special attention to grapefruit juice, as it can affect how certain medicines are cleared from the body.

For example, if you drink a lot of grapefruit juice while taking certain statin drugs to lower cholesterol, too much

of the drug may stay in your body, increasing your risk for liver damage and muscle breakdown that can lead

to kidney failure.Medicines that you should not

consume with grapefruit juice include:

8 Cholesterol-lowering medications such as simvastatin, atorvastatin and lovastatin

8 Medicines that treat heart conditions such as nifedipine, amlodipine, verapamil and diltiazem

8 Medications for the nervous system such as ciclosporin and tacrolimus

Traditional Chinese Medicine (TCM) with Prescribed Drugs In general, it is good practice to check with your doctor or pharmacist if it is ok to take particular TCM along with drugs that you have been prescribed, as some interactions between TCM and western drugs can lead to certain, unexpected interactions that could be harmful. Always consult your doctor if you are taking TCM. This article is adapted from the CGH brochure, “Drug-Food Interactions”. Do ask for a copy from your doctor or pharmacist.

AVOID ALCOHOL WHEN UNDER MEDICATION AS IT MAY INCREASE THE SEDATIVE EFFECT OF MEDICINES

FEATUREHEALTH NOTES

4 S E P – O C T 2 01 5 C A R I N G

Growing older is a normal part of life and ageing will affect you physically and mentally. As you age,

it is important to keep practising healthy lifestyle habits that will help reduce stress and maintain physical and mental health. Although you cannot control everything that affects your health, keep in mind that many things are within your hands. There are things you can do to enhance your self-care that cost next to nothing and can be done alone or with friends. Ways to minimise the effects of ageing include staying mentally alert, intellectually curious and physically active. Here are some tips on how to stay healthier, stronger and happier in your golden years.

4 S E P – O C T 2 0 1 5 C A R I N G

Text by Dr Vanessa Mok, Registrar, Psychiatry

HEALTHYEmpower yourself to stay healthier, stronger and happier

ACTIVE AGEING

➊Make healthy lifestyle choices

8 Eat a balanced, healthy diet – it has been said often enough, but as you get older, you must get smarter about eating better. Dietary requirements can change as your energy needs decrease, while your need for nutrients, such as proteins, vitamins and minerals, may stay the same or even increase with age. Some ways to eat better include consuming more fruit and vegetables, lean meat, fish and poultry, some dairy products such as milk or yoghurt, and to reduce fat where possible as well as drinking plenty of water.

8 Make sure you get enough sleep. Waking up feeling refreshed will allow you to use that energy to get out into the daylight and do active things. You will be able to engage better in activities and sleep better the next night. Overall, your daily energy levels will increase. Dreams and deep sleep are also important for your brain to form memories and links, so quality sleep plays a vital part in helping you remember and process things better. Sleep is also the time your body repairs and restores itself.

8 Moderate your consumption of alcohol and smoking. If possible, eliminate

them altogether.

➋ Stay as active as possible

8 Physical activity improves balance, coordination, breathing, circulation and mental acuity. Increase in physical stamina aids in maintaining healthy bones, muscles and joints. Exercise helps control body weight, lowers your blood pressure and strengthens your muscles, which helps you avoid injuries by reducing your chances of falling.

HEALTH NOTES MENTAL WELLNESS

6 S E P – O C T 2 01 5 C A R I N G

8 Regular exercise need not be strenuous to achieve

health benefits. Older adults can gain significant health benefits with

a moderate amount of physical activity, preferably daily. A moderate amount of activity can be achieved in longer sessions of moderately intense activities (such as walking) or in shorter sessions of more vigorous activities (such as brisk walking or climbing stairs).

8 A variety of sports and activities worth considering include walking, jogging, yoga, cycling, swimming and tai chi. These activities can be done alone or with others, as part of an exercise regime adaptable to your lifestyle.

➌Keep your mind active

8 An environment that is cognitively and even socially challenging facilitates and enhances cognitive performance as opposed to one providing little stimulation, which results in boredom and cognitive decline.

8 Basically, do not be afraid of new experiences, and make use of opportunities to learn new things. The science is clear – active engagement in cognitively stimulating leisure activities is associated with better memory function, decreased depression and increased life satisfaction, and a reduced risk of dementia.

8 Social interaction and social networks challenge you to keep in touch with society. Your children may grow up and move away or you may lose your spouse. Get to know your neighbours and other residents in the area by visiting and getting involved with a senior activity centre or community centre.

8 Cultivating a variety of leisure, social, cultural and spiritual activities can be done alone, with family members or in the community. Things to consider include cooking, gardening, painting, rearing a pet, doing volunteer work or even taking up a part-time job.

➍Have a positive outlook

8 Your attitude shapes the way you perceive, understand or interact with the world. A positive attitude helps you better deal with stress or negative feelings.

8 In older adults, stress is thought to play a bigger role in triggering depression than in other age groups. But as you grow older, do realise that it is normal to have some feelings of insecurity and fear. Acknowledge your feelings and do not be afraid to share your emotions and worries. Be willing to talk to family, friends or even a healthcare professional so that they can give you the support you need.

8 Recognise that there are some things that are out of your control in life, and direct your attention toward the things that you can control or influence. Focus on being thankful, being appreciative and enjoying your life.

8 Try to keep a sense of humour and put some fun back into your life by doing something you really enjoy every day.

➎ See your doctor regularly

Do go for your routine check-ups and follow your doctor’s recommendations for screening and preventative measures. Early detection and treatment may prevent health conditions from getting worse.

As you get older, you may find it difficult to cope with certain changes in your life. The most common challenges older adults face include:

8 Death and loss of family, friends and loved ones

8 Relationships and family problems8 Loneliness and feelings of isolation8 Adjustments to new roles such as life

as a retiree8 Memory difficulties8 Physical health problems

Some of these challenges can in turn result in mental health problems. It is beneficial to detect them early, so you can seek help promptly and learn to cope with these difficulties.

Dr Vanessa Mok is a Registrar in Psychiatry at CGH. She received her MBBS from Imperial College London. Dr Mok is a member of the Royal College of Psychiatrists.

YOU'RE NOT

ALONEIf you experience bouts of depression or grief, or know someone who suffers from dementia, know that help is at hand. Learn to recognise the early signs of these mental conditions and ways to manage them.

HEALTH NOTES MENTAL WELLNESS

Depression It is normal to feel sad or down once in a while. However, take note if you feel an intense sadness that lasts longer than usual (over several weeks, for example). Depression is not a natural part of ageing, but it is a common problem and medical help may be needed. It can be triggered by a significant life event such as retirement, loss of a loved one, chronic illness or physical disability. Sometimes, depression can also occur without any obvious triggers.

If you are experiencing more than half of these symptoms, you may be suffering from depression: 8 Feelings of sadness and frequent

tearfulness8 Feelings of worthlessness8 Excessive tiredness, where even the

simplest of tasks seem strenuous8 Sleep disturbances that include difficulty

sleeping or an excessive amount of sleep8 Significant decrease or increase in appetite8 Poor concentration8 Little or no interest and enjoyment in life8 Recurring thoughts of life not worth living

or suicide

For most people, depression can be treated successfully, so see a doctor early as there is no reason to suffer silently.

Grief It is normal to grieve for the loss of health, a loved one, or your status or role. It is a natural response to help accept your loss and adjust to life after significant changes. Everybody grieves in their own way, and sometimes it can take six months to one year

to restore a sense of balance in one’s life. However, it is worrying if you are unable to cope with the difficulty and cannot resume daily activities.

When grieving, common experiences include: 8 Excessive tiredness8 Loss of appetite8 Forgetfulness or poor concentration8 Disturbed sleep8 Constant thoughts about

the loss8 Neglect of self-care, including personal

appearance or hygiene8 Social withdrawal from friends or usual activities

If you experience any of the above situations for a prolonged period of time or feel them intensely only many months after the loss, you may be suffering from complicated grief. Support and understanding from family and friends can help you cope with normal grief, but if you suffer from complicated grief, consult a doctor or healthcare professional for help.

Dementia Some degree of forgetfulness is normal with age, but significant memory loss or cognitive decline is not an inevitable part of normal ageing. Dementia is a disease of the brain that can be due to many causes, with the most common being Alzheimer’s dementia. Typical characteristics of dementia include:

8 Gradually worsening memory8 Decline in ability to perform routine tasks8 Disorientation8 Difficulty in learning new things8 Loss in language skills8 Impaired judgment and ability to plan8 Personality and behaviour changes

These symptoms are usually noticed when they interfere with daily life and they intensify as the condition worsens. It is important to recognise these symptoms early, so do not brush off forgetfulness as a natural process of ageing. See a doctor as early as possible, because dementia does not only affect

the older adult; family members also need support or counselling to cope with this change.

Emotional, mental and physical health are all connected. A healthy mind is as important as a healthy body and should be given the

same attention. Successful ageing is defined as maximising your potential and minimising negative effects of getting older. It is never too late to start, and there is a lot you can do to improve your health and longevity, and reduce your risk for physical and mental disability as you get older.

Text by Jason Woo, Editor

Meet Principal Clinical Pharmacist Wendy Ang Swee Tee, a lady with both head and heart for her elderly patients. We catch up with her for some “bedside tales”

DISPENSING CARE, PRESCRIBING HEART

8 S E P – O C T 2 01 5 C A R I N G 8 S E P – O C T 2 0 1 5 C A R I N G

FEATURE

Feeling at home amidst the rows of medication, Wendy goes about her duties with professionalism and care

COVER STORY

ABOVE: Wendy outside one of her regular work locations – the Pharmacy at the IB

RIGHT: Wendy and her team of dedicated pharmacists. Clockwise from Wendy: Nashirah Binte Kamal Mustapa; Tay Xin Yong; Lim Li San; Helen Lee Hoi Lun; Lin Huimin

1 0 S E P – O C T 2 01 5 C A R I N G

help the doctors, nurses, patients and their families make more appropriate, informed decisions about medication. After a period of time, my work evolved into what I am doing today.”

Today, as a principal clinical pharmacist with a specialisation in geriatric pharmacy, Wendy’s work duties are quite varied. They range from mentoring resident pharmacists in geriatrics – part of a national programme to train pharmacists in various specialities – to reviewing inpatient medication-related

Meet Wendy Ang Swee Tee, Geriatric Pharmacist. Her job is focused on the medication care needs of the

mainly elderly patients across the Integrated Building's (IB) various wards. Ward 57 at the IB is Wendy’s base of operations. A typical work day begins with making rounds with doctors and the care teams in the wards, checking on her patients, then clearing a plethora of ever-present emails, followed by working at the handful of dispensaries scattered across CGH, which includes mentoring young pharmacy undergraduates attached to CGH who aspire to be just like her. When she described her typical day to me, I wondered if she had a secret stash of “Wendy clones” stepping in for her at times or whether she even tires at all!

But the truth is, Wendy is intensely focused and energised by her work and cares for patients with a passion that is profoundly striking. To Wendy, her work is more than a profession; it is a labour of love from which she draws meaning, contentment and satisfaction. She has been a clinical pharmacist for close to 17 years.

STEPPING INTO GERIATRIC PHARMACYWendy graduated from the NUS Faculty of Science and was attached to CGH as a pre-registered pharmacist for a year from 1997 to 1998, en route to being trained as a full-fledged pharmacist.

“Looking back, I realised that like every young person, I only had a vague idea of what I wanted to pursue as a professional career," she muses. "I only knew that I was interested in laboratory work, but you know what they say about life and the curveballs it throws at you – somehow I ended up in the pharmacy line, which is pretty far from being engaged in lab work!”

The faith that her tutors placed in her paid off as she did well in her training at CGH and earned her stripes. But as Wendy continued work at CGH, it became gradually apparent to her that her chief interest was in geriatric pharmacy.

“As I worked as a pharmacist, I noticed that the care teams working with geriatric patients had many questions about medications, including those coming from elderly patients and their families,” she says. “These questions were mainly about supply, access, cost, and how patients and families were instructed about their medications. I realised these were issues directly pertaining to a pharmacist’s work, and this is where I could come in with my expert advice to

To Wendy, her work is more than a profession; for almost 17 years, it has been a labour of love from which she draws meaning, contentment and satisfaction

COVER STORY

1 2 S E P – O C T 2 01 5 C A R I N G

LEFT: Wendy with the nurses of Ward 57

BELOW: As part of her daily work, Wendy helps out at the pharmacy by ensuring the correct dosages and the proper handling of prescriptions

been one of my chief driving forces,” Wendy shares.

For her, working with the elderly over the years has created in her a yearning to speak for a group of people who are often painted in a stereotypical fashion.

“A lot of people associate the elderly with being troublesome, crotchety and belligerent, but that is only one segment of the elderly population,” Wendy says. “I have had healthcare professional students coming to me saying that it’s normal for old people not to be able to walk properly, that it’s normal for them to require a walking sick. I want to say that that is not normal at all! Admittedly it is common, but by no means should this be taken as a normal part of ageing. Throughout my career I have seen patients who are chronologically old but still extremely independent.

“They also do not definitively require more medications as a normal young person; this is a false impression. What is true is that older people may be functionally deficit – meaning that they might not be able to see very clearly or retain memories very well, but beyond that, they should not be treated or seen any differently,” she adds. It’s clear Wendy is keen to erase the kind of negative press that the elderly tend to get in mainstream culture. “It is pretty interesting to hear such views often from young people, who will eventually become the elderly of tomorrow!”

“Sometimes if you ask any of the geriatricians around, you will find that we can have a hard time convincing people why we are constantly trying so hard to educate people about the things we do,” Wendy says. “Seemingly simple things like making medicine labels more readable can be very important to the elderly. We need to change old thinking!”

PARTING WAYSIt is not an exaggeration to say that after my interview with Wendy, I have come away changed – not just in my appreciation for the high level of professionalism, love and grace that healthcare professionals are required to give, but also in the amount of respect I have for the individuals who choose to dedicate years of their lives to caring for others.

In Wendy’s case, there’s no question that she has spent a considerable amount of time looking after many elderly patients, and I also greatly respect the fact that she retains the avid fire and interest in her work, and who recognises that her work is ultimately bigger than herself.

issues; working with nursing and welfare homes regarding medication management matters; and participating in various projects and committees that deal with national medical agendas, such as the Pharmacy Specialisation and Accreditation Board.

“It sounds so natural now, but back in the day, it was not really common for pharmacists to do their rounds in the wards, much less actively exchanging information with other healthcare professionals,” Wendy says. “Everyone tended to work within their own professional specialities, which made it hard to streamline and dovetail processes. The fact that I was gradually able to share my expertise and knowledge with my teammates and colleagues allowed me to participate as a team member instead of simply acting on instructions. This was, and continues to be, huge to me and contributed greatly to why I went into geriatrics, besides having the heart for the discipline needed for the job.

“On hindsight, the pharmacy course was a challenge to get into, and that’s still true today. First you have to get into the Faculty of Science in NUS and then be selected for pharmacy school! I guess they deemed me suitable,” Wendy laughs. “The intake and ultimately the number of graduates back in my time numbered no more than 100, but I hear now it has increased, which can only be good for the sector.”

A HEART FOR HER PATIENTSIn the medical line, having head knowledge may be a given, but the real factor for anyone to do well and prosper in the sector is ultimately heart – an aspect many start with but may lose after years of being in the healthcare industry. Wendy reminds us that having a keen heart for one’s patients and work really does go a long way.

“I think taking an active interest in your work and having a heart for your patients go a long way to sustain your performance and instill in you the will to improve. People always say this, but I guess for me this passion for my work and patients has truly

Having a keen heart for one's patients and work goes a long way to sustain your performance

COVER STORY

“THESE ARE THE DROIDS WE ARE LOOKING FOR!”Terminator, Star Wars, WALL-E, Avengers: Age of Ultron. Great movies, each a commentary on the relationship between Man and Machine

CHARTING THE FUTURE OF ROBOTIC TECHNOLOGY IN HEALTHCARE

1 4 S E P – O C T 2 01 5 C A R I N G

Text by Jason Woo, Editor

“THESE ARE THE DROIDS WE ARE LOOKING FOR!”

Be sure to look out for HOSPI, CGH’s new robotic assistant that will help transport files and other

documents within the hospital

Snap back to reality, and many of those movies’ themes are playing out in society. Technology is becoming

increasingly sophisticated. Today, machines perform tasks that are increasingly demanding and call for absolute precision and untiring consistency. Consider how the automotive and high-precision manufacturing industries have evolved over the past few

decades to incorporate a lot of robotic and assistive technology into their processes. You would not think of assembling a car or building a silicon chip without the use of machines.

In healthcare, robotics and assistive technology are touted to be the next frontier as Singapore’s population is ageing rapidly, and the workforce will consequently be older.

But there are other key considerations as well, as CGH CEO Dr Lee Chien

Earn describes: “With a growing, ageing population we need to also be able to effectively harness technology to augment clinical care, enable people to live more independently, enhance staff safety and improve productivity.”

As a hospital that has continually pushed the boundaries of innovation in healthcare delivery, CGH has, with the support of the Singapore Economic

Development Board (EDB), set up the Centre for Healthcare Assistive and Robotics Technology, or

CHART for short. CHART was launched by

President Tony Tan at the official opening

of The Integrated Building (IB) on 23 July 2015.

Assistive technology can enable people to live more independently

FEATURE

ABOVE: Opening address at the official IB and CHART launch by President Tony Tan

RIGHT (Above): CHART is now launched! (Below): Impressing President Tan with our latest tools in healthcare

1 6 S E P – O C T 2 01 5 C A R I N G

CHART provides a collaborative platform that will enable healthcare professionals to work closely with academc, industrial and research institutions to develop impactful healthcare solutions leveraging on robotics and assistive technology. Sited at CGH, CHART is equipped with a Design Lab for ideation and collaboration, and a mock- up hospital with wards, clinics and minor surgery rooms that will enable solutions to be prototyped.

Key to the projects and solutions that CHART will help convene, coordinate and develop are how innovative, practical and effective they will be to help achieve the national healthcare vision to provide accessible, affordable and high-quality care while managing the challenges of an ageing

population and workforce. At the launch, President Tan shared that

“At CHART, companies, research institutes and healthcare practitioners can come together to harness the promise of robotics and assistive technologies to introduce impactful healthcare delivery solutions. Equally important, CHART will also help to develop new skill sets among our healthcare practitioners through modalities such as simulation training to ensure that they are well-equipped to meet evolving future healthcare needs.”

To this end, CHART will seek to drive the development of robotics and assistive technology solutions in five key healthcare domains – developing virtual hospitals, transforming aged care, optimising rehabilitation, automating processes and enhancing medical training.

Mr Lim Kok Kiang, EDB�s Assistant Managing Director, said, “We see significant opportunities for advances in robotics to be applied as part of the solution. CHART provides a platform for end-users, technologists and companies to co-innovate new robotics applications for healthcare and eldercare, thus enabling technology to be

CHART can help us achieve our vision of providing affordable, high-quality care

FEATURE

1 8 S E P – O C T 2 01 5 C A R I N G

BOTS ‘R’ US!Caring takes a quick look inside CHART to bring you a glimpse of some of the robotic technology being tested to help enhance patient care at CGH.

Robotic Doctor Assistant (NAO) NAO are humanoid robots equipped with sensors that enable interaction with humans, sense their environment and react accordingly – making them ideal doctor’s assistants. They can welcome and entertain patients who are waiting for their appointments at the clinic. More significantly, they can talk to patients, conduct initial interviews and take their medical history. The robots can also provide a pleasant distraction for patients, especially children, while they are receiving treatment.

As doctor assistants, these robot assistants can pull up patient records from various databases and have them ready by the time the patient sees the doctor. These robots can also prepare initial diagnoses, if properly trained, based on patient interviews.

Continuous Passive Motion Machines (CPMMs) A CPMM is a post-surgical robot that aids patient recovery in muscle coordination and strength, as well as encourages an increase in the range of motion, after a stroke for example. This can possibly reduce hospital stays and speed recovery times, according to NTU.

The CPMM measures the performance of patients while exercising. Depending on their effort and performance, the machine will vary the difficulty of the exercise. An interactive interface can also let patients play games during their exercises to keep them engaged, while providing valuable feedback on their performance. To date, CPMMs have been designed for use in multiple configurations and postures such as standing, sitting, on horizontal or vertical planes, and for body regions such as the upper or lower extremities.

For patient convenience, these robots can also be connected to online networks, so as to provide tele-rehabilitation to patients to enable them to do their exercises in the comfort of home.

Leg Rehabil itation RobotThe LR2 or Leg Rehabilitation Robot by Yaskawa includes functions to help in the rehabilitation of the lower parts of the body by offering six exercise patterns that control hip, knee and ankle joints simultaneously and independently.

LR2 can be used to treat a wide range of conditions ranging from

orthopaedic diseases and central nerve diseases, to improving flexibility. Caregivers can easily perform rehabilitation therapy by following pre-set angle movements customised to an individual’s particular condition.

As a result, LR2 can save time and improve rehabilitation efficiency.

Cleaning RobotRemember the cute, fastidious cleaner bot in the WALL-E movie? That character seems to come to life in the form of the Cleaning Robot, which can be programmed to clean efficiently and consistently.

The Cleaning Robot by Muratec is able to construct a map of areas to be cleaned and is fully capable of memorising speed,

water amount, pad pressure and even a cleaning squeegee tool’s

up-and-down movement along different routes, depending on cleaning needs (up to a maximum of 64 routes!).

As a safety feature, Cleaning Robot can operate around obstacles by detecting them with built-in sensors. Cleaning Robot is equipped with voice guidance and a driving recorder to support it should it be working unattended.

Robotic Pickers for Logistics ApplicationsThe Robotic Picker designed by NTU can pick items from shelves or boxes and put them in bins for further transportation. Accurate and consistent item picking is a critical performance requirement in logistics. In the hospital, Robotic Picker can be adapted to sort and deliver surgical and medical items, food and medicine. It can also be used in the cleaning of surgical items to ensure sterility.

Robotic pickers are composed of several modules including vision (to identify and register objects) and grasping (to determine how to pick particular items). Robotic Picker has even been tested with various grocery items and books during May 2015�s inaugural Amazon Picking Challenge held in Seattle, Washington in the US.

ABOVE: NAO meets the president and the other dignitaries during the tour of CHART

brought to market faster. All these go toward supporting Singapore’s vision to be a hub for the development of new robotic solutions.”

At the official opening of the Integrated Building on the same occasion, President Tan also shared an observation about how these two facilities could work together: “CHART and the IB can work in synergy to shape the delivery of healthcare for the future. The IB serves as a living laboratory for prototypes developed by CHART, enabling new solutions developed in the test environment to be applied in real-life environments. Patients will benefit from early access to these innovative solutions that expedite functional restoration and facilitate an early return to the community.”

CHART – STRETCHING A COLLABORATIVE ARM The launch of CHART is significant – it creates a ready platform for national healthcare institutions to engage various healthcare clusters and aged-care providers for new healthcare solutions to be developed and tested, under the guidance of a central Ministry of Health robotics implementation committee. In addition, CHART will also

serve as a launch pad for an upcoming National Robotics Programme, a multi-agency initiative that will coordinate and support the end-to-end development of robotics technologies for Singapore.

CGH has also signed a Memorandum of Understanding (MOU) with two key organisations, the Nanyang Technological University College of Engineering (CoE) and the Singapore University of Technology and Design (SUTD), in the areas of knowledge sharing and capability development. CHART has also started collaborative projects with various local and foreign companies and welcomes more partners from healthcare, academia, research and industry, including local small and medium enterprises (SMEs), to jointly develop and test solutions.

Patients will benefit from quicker recovery periods and an early return to the community

FEATURE

2 0 S E P – O C T 2 01 5 C A R I N G

A CALLING TO LOVE AND SERVECGH CELEBRATES NURSES DAY 2015!

FEATUREFEATURE

They soothe those in pain with their touch, console the grieving with their words, and minister to their patients

with utmost grace and patience. Our nurses play a vital role in making the experience and stay of our patients and their caregivers as pleasant as possible.

Some see it as a calling, others a profession with dignity, but regardless, nurses form an important part of a patient’s experience while they are being cared for in hospital.

This is why Singapore has, since the 1980s, designated 1 August every year as Nurses Day. This date marks the beginning of the development of nursing in Singapore, and healthcare organisations of all stripes find ways to celebrate and acknowledge our nurses and their contributions.

Adopting a simple yet meaningful approach this year, CGH, with help from the Ministry of Health Holdings (MOHH), put up a visually vibrant display of colourful 60cm-tall pinwheels that resemble garden blooms in the central koi pond near the Kopitiam food court in CGH. Members of the public were encouraged to pen their well wishes to nurses over a period of two weeks. The pinwheels with the dedications were then added daily to the ones already at the pond, creating a colourful landscape in motion with the regular breeze blowing through this central open space in CGH!

In addition, a special party was held in honour of our nurses on 1 August itself. CGH’s tradition is to celebrate Nurses Day on 1 August, no matter what day of the week it is. This year, it fell on a Saturday, but this did not deter our staff, who thronged the CGH Training Centre/Auditorium area. Our women and men in white, and other invited staff, came together to let their hair down and celebrate the best of nursing in CGH. Besides a sumptuous feast provided by our CGH food services and other catering partners, our nurses were also treated to an entertaining programme in the CGH Auditorium, made more special this year as the female nurses got to root for their male counterparts in an inaugural “Mr CGH” pageant, with our six finalists coming from the ranks of the not-small contingent of male nurses in CGH. Nurses and other attending CGH staff were treated to a wonderful show, where our six finalists strutted their stuff,

dancing, singing, acting and showcasing their “presence”! It was especially wonderful to see our six finalists take their final bows and catwalk in their sparkling white nursing uniforms, a reminder of their frontline identity as nurses who provide excellent care.

The programme culminated in the always eagerly anticipated lucky draw with prizes kindly sponsored by other staff – frontline and management – in CGH.

“We often say, ‘Nurses never fail to deliver any task at hand’ and ‘We can trust that Nursing will do it!’ I am sure the management will agree with me that our nurses are truly cooperative and wonderful people in healthcare,” said Ms Paulin Koh, Chief Nurse of CGH during her Nurses Day event opening remarks. “In my short year of work here, I have come to realise that our nurses are very committed individuals who always quietly do their best for their patients and the organisation.”

Well done, nurses of CGH. Thank you for all that you do, day in and day out. Here’s to another fulfilling year ahead delivering the best patient care with passion and empathy!

Did you know that in January 1974, International Nurses Day was designated on 12 May, the

birthday of Florence Nightingale, widely considered the founder of modern nursing?

However, Singapore sets its Nurses Day on 1 August.

Find out more here: eresources.nlb.gov.sg/infopedia/articles/SIP_499_2004-12-30.html

NURSES DAY FUN FACT!

2 2 S E P – O C T 2 01 5 C A R I N G

Y our feature “Just a Pinch of Salt” was

a very informative read as it taught me about the sodium levels found in many of the foods my family and I eat every day, and how we can opt for healthier versions while eating out or preparing our meals.

Thank you for the great reads and keep them coming! In the meantime, I wil l be sure to pass Caring around so that more of my fr iends wil l know about this wonderful publication.

Zhou WeiyuanJalan Tenteram

I am a new retiree and was quite lost in trying to

understand the details with regards to making a wil l unti l I stumbled upon your article, “Planning for the Future”. The

feature was very well written and easy for me to fol low. The FAQ in the story al lowed me to understand the differences between a wil l and the lasting power of attorney as well as where I could make one. Thank you, Caring!

Catherine Chew Ang Mo Kio

WE WANT TO HEAR FROM YOUIf your letter is published in the next issue, you’ll get a free Sebamed Shampoo, which is soap-free and alkaline-free for healthier scalp and hair! Send your letter by 9 October 2015 to: 5 Tampines Central 1, Tampines Plaza #08-01/05, Singapore 529541

YOUR SAY

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Caring Jul–Aug 2015

ONLINEVisit www.cgh.com.sg/ caring to read past issues of Caring – your guide to a better, healthier life!

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YOUR TRUSTED GUIDE TO A HEALTHIER, HAPPIER LIFE 《关怀》季刊助您迈向健康美好生活

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C A R I N G S E P – O C T 2 01 5 2 3

It’s free! Subscribe now. 完全免费！请立即订阅。

(surname in block letters) (Prof/Dr/Mr/Mrs/Ms) (姓氏以正楷书写) (教授/博士/先生/女士/小姐)

Full Name 全名

NRIC/Passport No. 身份证/护照号码

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Email 电邮 Date of Birth 出生日期 (DD/MM/YY)

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Are you currently a patient of CGH? 您目前是不是樟宜综合医院的病人？ Your particulars will be used strictly for mailing and/or notification of CGH’s upcoming events and public forums. They will be kept confidential. 您的资料只供邮寄之用及/或通知您樟宜综合医院所主办的活动和讲座。您的资料将获得保密。

I want to be mailed to me! 我希望通过邮寄方式收到《关怀》！

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C A R I N G S E P – O C T 2 01 5 2 5

HEALTHY EATS

This refreshing salad can be served as an appetiser

PREPARATION TIME45 minutes

SERVES

WHAT YOU’LL NEED Dried prawns, soaked to soften, then drained and pat-dried (45g)

Pomelo (1/2, small) Kaffir lime leaf, finely shredded (1) Bird’s eye chillies, thinly sliced (3) Onion, peeled and thinly sliced (1/2, small) Shallots, peeled and thinly sliced (20g) Unsalted, roasted cashew nuts, coarsely chopped (55g)

Coriander leaves, finely chopped (85g) Garlic, peeled and finely chopped (2 cloves) Fresh lime juice (4 Tbsp) Fish sauce (2 Tbsp)

METHOD Preheat oven to 160°C. Bake dried prawns for 10 minutes or until brown and crisp. Remove from heat and set aside.

Separate pomelo into segments. Peel off membranes and discard pips. Place pomelo sacs in a mixing bowl, add remaining ingredients and toss lightly to mix well.

Transfer to a serving dish and top with dried prawns. Serve immediately.

NUTRITIONAL INFO (PER SERVING)Energy 97kcalCarbohydrates 8.6gFat 4.5gCholesterol 33.7mgFibre 0.7g

This recipe was first published in A Cookbook for Diabetics by a Dietitian and a Chef.

POMELO SALAD

C A R I N G S E P – O C T 2 01 5 2 5

2 6 S E P – O C T 2 01 5 C A R I N G

如果您下次吃药时想用清水以外的食物或饮料来服下药物，请您停止。这样做可能对您有害无益，或更糟的是导致药

物失去效用。服用药物的基本规则是遵照标签上的使用

说明及医生或药剂师的吩咐。拥有正确的药物与食物相互作用的知识将能够防止您犯下常见的错误，并且让您的药物更好的发挥作用，让您及早恢复健康。

药物与食物的相互作用可发生在处方药和非处方药上。我们现在就来探讨一些常见的食物和饮料与药物的相互作用吧！

食物与药物的相互作用 不可和食物一起吃的药物 当两者在差不多同一个时间吃进肚子里时，某些食物会影响药物被身体吸收的速度。因此，这些药物必须空腹服用。空腹的定义是进食前30分钟到1小时或进食后2小时。这些药物包括了：

8 抗生素如氯洒西林 (cloxacillin)、青霉素V (penicillin V)及利福平（rifampicin）

8 甲状腺替代药物如左旋甲状腺素（levothyroxine）

8 治疗骨质疏松症的药物如阿仑膦酸钠(alendronate) 及利塞膦酸盐（risedronate)

须和食物一起吃的药物 相反的，有些药物如果空腹服用会导致肠胃不适。因此，这些药物应当在进食时服用或在进食后的短时间内服用。这些药物包括了:

8 减低血管阻塞及中风风险的药物如阿司匹林(aspirin)及氯吡格雷（clopidrogel)

8 口服类固醇如泼尼松龙（prednisolone)、氢化可的松(hydrocortisone) 及地塞米松（dexamethasone）

8 止痛药如布洛芬（ibuprofen）、双氯芬酸（diclofenac）及盐酸曲马多（tramadol）

不可和奶制品一起服用的药物 有些药物不可以和奶制品，如牛奶、乳酪及酸奶，一起服用。您也应当注意含有钙、镁及铁质的食物，因为这些食品有可能影响药物的效力。因此，以下几种药物必须在吃奶制品或含有以上所述矿物质的食物最少2小时后才可服用。这些药物包括了：

8 抗生素如环丙沙星（ciprofloxacin)、多西环素(doxycycline)

8 甲状腺替代药物如左旋甲状腺素（levothyroxine）

8 治疗骨质疏松症的药物如阿仑膦酸钠(alendronate) 及利塞膦酸盐 (risedronate)

2 6 S E P – O C T 2 01 5 C A R I N G

食物和

饮料与药物的相互作用

不是任何的美食和药物的配对都像咖椰酱和吐司一

样是绝配！

保健小笔记

酪胺与抗抑郁药物 如果您正在服用抗抑郁药物如吗氯贝胺（moclobemide）或利奈唑胺（linezolid），那您最好是避开含有高量酪胺的食品如酒精、鳄梨及酱油。这是由于抗抑郁药物阻挡一种叫单胺氧化的酶，而这种酶的作用是催化体内多 余的酪胺。阻挡单胺氧化酶有助于缓解抑郁症。但是如果您在服用抗抑郁药物期间吃下酪胺 含量高的食物将可导致血压上涨并且需要急诊治疗。

液体与药物的相互作用总所周知一杯清水是服药时的最佳良伴，但如果偏偏就在这个时候您找不到一杯清水呢? 那可怎么办? 我们在这里提示您哪些饮料是绝对不可以用来搭配药物的。

酒精 在服用药物期间最好是滴酒不沾。这是由于酒精有可能会加强药物的催眠作用，因此危害到自身和他人的安全。

咖啡因 此物质是茶、咖啡及巧克力的常见成分。高量的咖啡因摄取(每天超过5杯)可能会影响到药物的效力。如果您正在服用以下几种药物，请注意咖啡因的摄取量:

8 治疗 呼吸疾病的药物如舒喘灵 (salbutamol)、非诺特罗 (fenoterol) 及茶碱 (theophylline)

8 安眠或驰缓药物如安定 (diazepam)、劳拉西泮(lorazepam) 及唑吡旦 (zolpidem)

葡萄柚汁 大多数的果汁都可以用来搭配药物，唯独葡萄柚汁需特别注意。因为当它和某些药物一起吃下时会影响到药物排出体外的过程。

举例说明，如果您正在服用降低胆固醇的抑制素类型药物，喝下大量的葡萄柚汁将导致大量的药物滞留在体内，从而提高肝脏受损和肌肉损坏所导致肾衰竭的风险。不可和葡萄柚汁一起服用的药物包括了:

8 降低胆固醇的药物如辛伐他汀 (simvastatin)、阿活他汀 (atorvastatin) 及洛伐他汀 (lovastatin)

8 治疗心脏疾病的药物如弥新平 (nifedipine)、 氨氯地平 (amlodipine)、维拉帕米 (verapamil) 及地尔硫卓 (diltiazem)

8 治疗神经系统的药物如环孢素 (ciclosporin) 及他克莫司 tacrolimus)

传统中药和处方药 我们建议您最好还是咨询医生或药剂师的意见能否在服用处方药期间也服用中药，因为当两者在同一时期被服用时可能会导致一些意想不到的相互作用，从而对健康造成伤害。

本文取材于樟宜综合医院“药物与食物的相互作用”资讯手册。您可向医生或药剂师索取一份。

您也应当注意含有钙、镁及铁质的食物，因为这些食品有可能影响药物的效力

FEATURE保健小笔记

2 8 S E P – O C T 2 01 5 C A R I N G 2 8 S E P – O C T 2 0 1 5 C A R I N G

健康活跃的黄金岁月

老化乃人生必经过程，这将会影响您的身

心健康。在老化的过程中，拥有健康的

生活习惯，将有助于减轻压力，以保持身心健

康。虽然我们无法控制影响我们健康的每一

个因素，但我们能做的也有很多。许多无需花

费的自我保健活动，可单独进行也可拉拢好友

参与。有效缓解老化的方法包括保持头脑灵

活、增强求知欲望以及保持体力充沛。以下的

小贴士能让黄金年华的您生活

得更健康、更强壮、更快乐。

让自己活得更健康、 更强壮、更快乐

原文莫煒翎,心理学专科住院医师

➊选择健康 的生活方式

8 饮食要均衡。这是一句老话。但随着年龄的增长，您必须更加注意您的饮食习惯。随着能量需求的减少，您的饮食需求也会随之而变。但您对营养素，如蛋白质、维他命及矿物质的需求可能保持不变也可能会增加。良好的饮食习惯包括了：多吃蔬果；选择瘦肉、鱼及家禽；在饮食里加入奶制品如牛奶或酸奶；尽量减少脂肪的摄取及多喝水。

8 睡眠要充足。足够的睡眠让您精神百倍，并有精力从事白天的活动，这也有助于提高您的睡眠质量。总之，充足的睡眠将让您精力充沛。梦境和深睡眠是大脑增强记忆和联想的重要阶段，因此良好的睡眠质量有助加深记忆和提高思考能力。睡眠也是身体修复与生长的黄金时刻。

8 适量摄取酒精及减少吸烟，最好烟酒不沾。

➋保持身 体活跃

8 体力活动可改善平衡感、协调能力、呼吸、血液循环及心智

的敏锐度。增强耐力有助于保持健康的骨骼、肌肉及关节。做运动有助于控制体重、减低血压及增强肌肉组织，从而减低跌倒和受伤的机率。

8 日常运动不宜激烈。年长者可通过适量的日常体力活动来获得可观的健康益处。适量的运动包括时间较长的中度运动如步行，又或是时间较短的稍微剧烈的运动如快走和爬楼梯。

HEALTH NOTES 精神保健

3 0 S E P – O C T 2 01 5 C A R I N G

8 做多样化的运动和活动，如步行、跑步、瑜伽、骑脚车、游泳及打太极拳。这些运动可以单独进行或和他人一起做，使之成为您日常生活的一部分。

➌保持心 智活跃

8 一个能够刺激认知和社交能力的环境有助于促进和增强认知功能。相反的，一个没有刺激的环境使人感到无聊，从而导致认知功能的衰退。

8 您无需害怕体验新事物，反而应该利用机会学习新的东西。这个说法是有科学性的——积极参与刺激认知力的休闲活动有助增强记忆力、缓解抑郁症及增加生活满足感，并且减少患上老人痴呆症的风险。

8 社会交往和人际关系网使得您必须和社会保持联系。您的孩子长大后或许会搬出去 自己住，又或者您会失去您的配偶。通过参与老人活动中心或民众联络所的活动，您可促进邻里关系，也能结识区里的其他居民。

8 您可单独或与家人或在社区里开展多种休闲、社交、文化及精神上的活动，其中包括了烹饪、园艺、绘画、饲养宠物、做义工或找一份兼职工。

➍保持心 境开朗

8 您的生活态度影响您对外界的理解和沟通方式。持有积极的态度有助于您更好的面对压力或消极的想法。

8 与其他年龄层相比，压力是导致年长者患上忧郁症的重要因素。随着年龄的增长，您或许会感到焦虑不安，但这是正常的现象。正视您的感受，不要害怕与他人分享您的情绪与不安。敞开胸怀和家人、朋友甚至是专业的医疗人员分享您的问题，让他们给予您所需的支持。

8 您必须意识到有些事情是您无法掌控的。与其钻牛角尖，不如将您的注意力转向在您控制范围内的事务。怀着一个

感恩、感激的态度，并且学习享受人生。

8 尽量保持幽默感，并且在日常生活中从事自己喜欢做的事，把乐趣注入生活中。

➎定期看 医生

记得定期做检查，并且遵照医生的建议做适当的筛查和预防措施。及早发现和治疗将能够预防健康状况继续恶化。当您的年龄渐长时，您或许难以接受生活中所发生

的一些变化。年长者最常遇到的挑战包括了：

8 家人、朋友及至亲死亡8 家庭问题及与他人的关系出现问题8 感到孤寂8 适应新生活，如退休生活8 记忆力衰退8 健康问题

其中一些挑战可能会导致精神上出现问题。因此及早发现有助于您及时寻求帮助并且学习应对这些困难。

您并非

孤军作战如果您感到抑郁或悲伤，或认识患有痴呆症的人士，请及早求助。学习如何发现心理病症的早期征兆，从而更好地应对病症。

HEALTH NOTES 精神保健

抑郁症

偶尔感到沮丧是正常的。但如果您有较长一段时间（如几个星期）感到极度沮丧，那您必须多加注意。抑郁症并不是老化所必然带来的的后果，但它确实是一个常见的现象并且患者可能需要接受治疗。人生的重大事件如退休、失去至亲、患上疾病或行动不便，都可能诱发抑郁症的发生。抑郁症也可以随机发作，没有任何的明显导因。

如果您有超过半数以下的症状，那您有可能是患上了抑郁症：

8 感到难过并且经常哭泣8 觉得自己很没用8 感到过度疲倦，就连很简单的任务都觉得吃力8 睡眠出现问题，其中包括无法熟睡或需要大量

睡眠8 胃口显著的减少或增加8 集中力差8 对于享受生活不感兴趣8 经常觉得活的没有意思或有自杀的念头

悲伤

因为失去至亲或身份地位，或是因为健康衰退而感到悲伤都是正常的。这是身体的自然反应来帮助您面对您失去的痛苦并且在经历了人生的重大改变后重新适应生活。每个人表现悲痛的方式都不一样，有时候疗伤的时间可长达半年至一年，之后才能再次在生活中找到平衡。然而，如果您无法应付失去的悲伤并且无法恢复正常的日常生活，这是值得关注的。

在悲伤的过程中，您会觉得：

8 非常疲倦8 胃口不好8 记忆力差或无法集中精神8 睡眠不好8 脑子里一直想着失去了的人和事8 忽略照顾自己，如自己的外表或个人卫生8 疏远朋友或避开社交活动

如果您长时间有以上所述感受，或者在事后的多个月出现以上感受，那您可能患有复杂性悲伤。家人和朋友的支持与关爱能够助您克服普通悲伤。但如果您患的是复杂性悲伤,那您应当寻求医生或专业医护人员的帮助。

痴呆症

记性变差是老化过程中的常见现象，但大量的记忆流失或认知能力显著减弱则并非是正常的。痴呆症是一种脑部疾病而它的病发因素有很多，但其中最常见的是阿尔茨海默痴呆症(Alzheimer’s dementia)。

典型的痴呆症症状包括了 ：8 记忆力逐渐减弱8 打理日常事务的能力减弱 8 有方向感障碍 8 学习新事物有困难 8 语言能力变差 8 失去判断和策划能力 8 行为和个性出现变化

当日常生活受到影响时，这些症状也开始变得明显并且会随着病情的恶化而加深。及早正视这些症状是非常重要的，因此不要视健忘为老化过程中的自然现象。及早求医，因为老人痴呆症影响的不仅是病人本身，他的家人也需要支持或辅导来应对这个病症所带来的变化。

心理、生理及精神健康环环相扣。心理上的健康和生理上的健康具有同等

重要性，因此都不可忽视。成功变老指的是在充分发挥所长的同时尽可能的把负面影响减到最低。从今天起以实际行动改善

您的健康以减低老化所可能带来的生理和心理功能的衰退。一切为时未晚 。

莫煒翎是樟宜综合医院的心理学专科住院医生，于伦敦帝国学院获得医学学士及外科学士。莫煒翎也是皇家精神科医学院的成员之一。

3 2 S E P – O C T 2 01 5 C A R I N G 3 2 S E P – O C T 2 0 1 5 C A R I N G

为您介绍汪瑞蒂, 她是我们的首席临床药剂师。她擅长于年长病人的药物需要, 并且是一个全心全意去照顾病人的医护人员。《关怀》有幸听她讲述她的从医经历

原文 Jason Woo，编辑

包含

爱与关怀的处方

FEATURE

置身于医药的海洋也同样有家的感觉，瑞蒂用专业及关怀的心完成每一项工作

封面故事

3 4 S E P – O C T 2 01 5 C A R I N G

作还包括了复查住院病人的药物问题，与养老院和疗养院的医护团队合作有关药物管理方面的事宜，以及参与各种针对全国性医疗议程，如药学专业认证委员会 (Pharmacy Specialisation and Accreditation Board)所开展的项目和工作小组。"现在看起来理所当然，但是以前药剂师很少在病房

出没，更别说是和其他的医护人员有密切的沟通了!大家都是在自己的专业领域范围内工作，因此很难简化及配合各部门的流程。后来我逐渐能够和我的队友及同事分享我的经验和知识，这让我以一个队友的身份来参与病人的治疗过程而并非只是单纯的遵照指示来办事。这曾经是，现在仍然还是，给予我推动力的源泉。除了个人兴趣之外，它也是促使我选择专修老年药学的其中一个原因。"瑞蒂分享道。

"现在回想起当年读书的时候，选修药学科对我来说还真是一项挑战。因为你必须得先进入国大的科学院才有机会被选入药学院! 我想他们应该是觉得我适合这种工作吧! (瑞蒂笑着说)。当年的入学和毕业人数不超过100位，不过我听说现在的人数已经不只这个了。这对整个行业来说无疑是好消息。" 用心对待病人 在医疗行业里，掌握好医药知识是必然的，但最终能够让一个医护人员成为常胜军靠的不是脑子，而是一颗执热的心。许多人在刚开始是都是热诚满腔，但是在工作几年后，这股热诚便逐渐消减。

瑞蒂提醒了我们拥有一颗对病人及工作的热心才是持久的推动力。

“我认为对于自己的工作持有积极的兴趣和对于病人持有一颗真诚的心是推动你维持工作表现及积极进取的力量。我知道这是老话，但这些因素确实是我的主要推动力。”瑞蒂分享道。

对于瑞蒂而言，在这些年里照料老年病人使她渴望为这群被定式的群体说句公道话。

“许多人把老年人与麻烦、反复无常及爱找人吵架联想在一起。但这只是老年人群体当中的一部分。我还曾经碰过实习生跟我说老年人行动不便是很正常的、他们需要拐杖走路也是很正常的。这完全是错误的观念！我承认他们所说的现象相当普遍，但这并不表示这是老化的正常现象。我经常说我曾经看过年级虽大但仍然非常独立的老年病人。”

“与一个正常的年轻人相比较，他们也未必就一定需要服用更多的药物。这绝对是

她身穿一件笔挺的白色医生袍，站在宽敞的病房走廊时看来格外显眼。为您介绍汪瑞蒂, 她是我们的首席临床药

剂师。她擅长于年长病人的药物需要, 并且是一个全心全意去照顾病人的医护人员。《关怀》有幸听她讲述她的从医经历。

如果您刚好身处综合大楼的57号病房，不妨留意一下是否有一位戴眼镜、身材娇小、穿着洁白医生袍的女医护人员正在巡房。她查看病人、在他们的档案里做记录、并且和病房的医生和护士谈话。

她就是我们的老年学药剂师，汪瑞蒂。她的工作范主要集中在照料综合大楼病房的老年病人的药物需要。但57号病房可说是瑞蒂的工作基地，她几乎每天都从这里开始她一天的工作。首先她和医生们及其他医护人员一起巡房， 跟进病人的病况，然后查看永远都看不完的邮件，再来是到分布在医院的药房做配药的工作，这其中还包括了指导在医院实习的年轻药剂师。他们都以瑞蒂做为学习的榜样。听完瑞蒂说完她一天的工作流程后，我不禁惊叹她是如何分身来完成所有的这些工作。听她说话的语气一点疲倦的感觉都没有！

事实上，瑞蒂非常专注和投入于她的工作，她对病人的关爱让我觉得非常的感动。对瑞蒂而言，她的工作不仅仅是一个专业，那也是她辛苦经营的事业，带给她意义、成就感和满足感。她从事这个职业已经快17年了(从1998年开始)。 选择老年药学 瑞蒂毕业于新加坡国立大学科学系并且在1997至1998年期间在樟宜综合医院实习，通过职业培训从预注册药剂师成为一名执业药剂师。

"回头看，我和大多数的年轻人一样，对于自己的职业前程只有一个模糊的概念。" 她回忆道。"我只知道我非常喜欢实验室的工作。但有句话说的很对，人生就是充满曲折离奇，峰回路转。我最后进入了药剂师这个行业，那是和研究室完全不相干的工作!"

导师们对她的栽培最终没有白费，她在樟宜综合医院培训期间表现优异，最后获得通过。之后瑞蒂继续留在樟宜综合医院工作。经过一段时间后她发现自己最终的兴趣是老年药学。

"我在工作时发现照顾老年病人的医护团队对于药物有很多疑问，其实就连病人本身及他们的家属在这方面也有许多的疑问。这些疑问包括了药物的供应、分销的渠道、价格、以及病人和家属对于药物的管理。我意识到这些疑问和药剂师的工作有直接的关连，而我可以在这方面给予医护人员、病人及他们的家属专业意见，从而增进他们对老年药物的认知。经过一段时间后，我的工作逐渐转变成我今天所做的工作。”

做为首席临床药剂师同时具备老年药学的专长，瑞蒂的工作职责相当多元化。其中包括了为住院药剂师提供老年药学方面的指导，这是一个全国性药剂师培训项目的一部分, 目的是培育出具备专科特长的药剂师。此外，她的工

对瑞蒂而言，她的工作不仅仅是一个专业，那也是她辛苦经营的事业，带给她意义、成就感和满足感

图左下：瑞蒂的日常工作，帮助药房确保正确的剂量 及药方的处理图中下：瑞蒂与57号病房 的护士图右下：瑞蒂和敬业的药 剂师团队。从瑞蒂开始顺时针分别为：Nashirah Binte Kamal Mustapa; Tay Xin Yong; Lim Li San; Helen Lee Hoi Lun; Lin Huimin

图上：摄于瑞蒂的其中一 个日常工作地点外——Pharmacy @ IB

一个错误的印象。虽然老年人在功能上确实有衰退——我指的是他们的视力减弱或记性变差——但除此以外他们应该获得和正常人一样平等的待遇。”瑞蒂补充道。她希望能够抹去主流文化给老年人所刻下的负面刻板影像。“当我听到年轻人这么说时，我觉得挺有意思的，因为他们终究是未来的老年人！”瑞蒂说道。

“如过你有机会和老年学医生谈话，您会发现我们很难说服他人我们其实已经非常努力的在让人们了解我们的工作，例如简单的把药物上的说明印的大一些对于老年人来说其

实是相当重要的。我们需要改变陈旧的思 维方式！” 作者感想 要说我在访问完瑞蒂之后改变了我的人生观一点都不夸张。我不仅更加欣赏医护专业人士所须具备的专业精神、爱心及慈悲，也同时更加佩服他们用自己的生命来关怀他人的献身精神。就像接受我访问的瑞蒂，她用了一段相当长的时间来照料许多老年病人，但依然保留最初对这个专业的狂热和兴趣。她也意识到她的工作其实比她自己更伟大。

封面故事

“这就是我们要找的人形机器人！”《终结者》、《星球大战》、《机械人总动员》、《复仇者联盟之奥创纪元》——这些叫好又叫座的影片说的都是人与机械人之间的关系

绘出机械科技在保健行业的未来

3 6 S E P – O C T 2 01 5 C A R I N G

原文 Jason Woo，编辑

“这就是我们要找的人形机器人！”

樟宜综合医院的新机械帮手HOSPI能于医院内

递送物件

回到现实，我们会发现有许多电影题材正被实现到生活当中。在科技日新月异的时代里，机械化逐渐取代人力。现在有

许多高难度、要求精准及一致性的工作都是由机器代劳。回想一下自动化和高精准工业在过去几十年里的变化，它们在生产过程中融入了大量的机械和辅助技术。若汽车业和晶片制造业不使用机器，那是完全不可能的。

新加坡正面临人口迅速老化、劳动力老化的趋势，机械与辅助技术因此被视为保健行业的新新领域。但这当中也有其他的考量，就如樟宜综合医院总裁李建恩医生所说:“在人口不断老化的趋势下，我们必须有效的利用科技来加强临床护理、帮助人们更好的独立生活、改善员工安全及提高生产力。”

做为一个力求在医疗保健方面不断挑战创意界限的医疗机构，樟宜综合医院在

经济发展局的支持下创建了医疗辅助机械研发中心（Centre for

Healthcare Assistive and Robotics Technology），简称CHART。CHART是由我国总统陈庆炎博士在2015年7月23日综合大楼正式开幕当天一同启动的。

CHART提供一个合作平台让医疗保健专业人士能够与学术、工业及研究界紧密合作，借助机械和辅助技术共同创造有效的医疗保健方案。位于樟宜综合医院的CHART具备一个设计研究室做为构思和集思广益之用；还有一个生活研究室，

里面有模拟病房、诊所及迷你手术室，以便将设想的构思做成原型。

CHART所召集、协调及策划的项目和方案的核心是它们必须

具创意性、实践性及有效性，目的是在人口老化和劳动

力萎缩的同时提供方便、价格合理及高素

质的医疗护理。这是我国的医疗保健远景。

陈总统在启

我们必须有效的利用科技来加强临床护理，帮助 人们更好的独立生活

特写

图左：陈庆炎总统在综合大楼和CHART的开幕仪式上致词图右上：CHART正式启动！图右下：向陈总统展示最新医疗护理器具

3 8 S E P – O C T 2 01 5 C A R I N G

动仪式上分享道:“在CHART，企业、研究机构及医疗从业员可聚在一起，利用机械与辅助技术来研发出有效的医疗护理方案。同样重要的是CHART将通过模拟训练的方式获让医疗从业员获取新技能，以确保他们具备应对未来医疗护理的需求。”

为了达到这个目标，CHART将在5项主要保健领域里推动及发展机械与辅助技术方案。这5项领域分别是发展虚拟医院、改善老人护理、优化复建护理、程序自动化及改善医疗培训。

经济发展局助理局长林瑞年说：“我们预见机械科技的发展被应用在医疗护理方面有非常大的潜能。CHART为最终用户、技术专家及企业提供一个平台，让他们针对医疗保健护理和老人护理共同创造全新的机械应用程序，从而更快的把科技带到市场上。我们所做的工作是帮助新加坡发展成为开发新机械技术的聚集地。”

在综合大楼的开幕仪式上，陈总统也分享了自己的意见，评论综合大楼与CHART如何可以合作：“CHART与综合大楼可携手合作塑造未来的医疗护理模式。综合大楼可做为CHART所研发的原型的生活实验室，把在实验环境里研发的方案应用到真实的环境里。病人能够及早使用这些创新的方案，从而加快康复过程并且帮助他们及早回到社区里生活。这对病人是有益处的。”

CHART － 伸出合作之手 CHART的启动深具意义——在卫生部机械 推行委员会的指导下，它提供一个平台让公立的医疗保健机构能够和其他的医疗保健群体和老人护理供应商紧密合作研发和测试全新的医疗护理方案。此外，CHART也将做为即将推出的全国机械项目的启动平台。这是一个多机构项目，目的是为协调和支持机械科技的发展。

樟宜综合医院也与两家关键机构在知识分享和技能发展方面签署了备忘录。这两家机构是南洋理工大学的工程学院及新加坡科技设计大学。CHART也与多家本地和外国企业开展合作项目，并且欢迎更多医疗保健、学术、研究及工业合作伙伴，包括本地中小型企业的加入，共同开发和测试新方案。

在CHART，企业、研究机构及医疗从业员可聚在一起，利用机械与辅助技术来研发出有效的医疗护理方案

机械反斗城！《关怀》在CHART游览了一圈，窥探中心正在测试的机械科技。说不定这些研究室里的新技术最终会被应用在樟宜综合医院的病房或诊所里，帮助我们的病人和医护人员！

医生的机器助手由南洋理工大学所设计的医生机器助手是备有感应器的人形机器人，它们能够和人沟通、感觉周遭的环境及做出适当的反应。这些特质使得他们非常适合成为医生的助手。它们能够在门口欢迎病人并且和在休息室里招待他们。更具意义的是，机器助手也可以与病人说话、进行初步会诊及记录下病人的医药历史。它们也是令人愉悦的调剂，儿童尤其喜欢它们，这让病人在接受治疗时也能够娱乐一下。

同时做为医生助手的机器人也能够从多个档案库里取出病人记录，把这些事情在病人看医生前就预先准备好。若接受适当的训练，它们也能够根据与病人做的面试做初步诊断。

持续被动活动仪持续被动活动仪器是一个手术后的机器，用于帮助如中风病人，恢复肌肉协调能力、体力及增加他们的关节活动度。南洋理工大学说这有助于缩短住院时间并且加快康复的速度。

持续被动活动仪在病人做运动时测量他们的身体性能。仪器会根据病人所投入的力气和身体性能调节运动的难度。仪器上有一个互动的显示屏，让病人在做运动时可以玩游戏，同时对病人的身体性能做出评估。到目前为止，持续被动活动仪被应用在许多不同的结构和姿势上，如站立、坐立、水平面和垂直面及人体部位如上肢和下肢。

为了方便病人，这些机器也能够被连接上网提供视频复建指导，让病人能够

舒服的在自己家里做运动。 脚步复建机器人脚步复建机器人，又叫做LR2，是由安川电机所制造，它提供6种帮助下半身肢体复建的运动模式。它能够同时和独立的控制臀部、膝盖及脚踝关节。LR2适用于治疗多种病症如骨骼疾病、中枢神经疾病及改善肢体的灵活度。机器人可以根据病人的个别情况预先设定好活动的

角度，看护着只需要按照设置，便可以轻松的为病人进行复建疗程。

因此，LR2既节省时间又改善复建的效率。

保洁机器人您还记得在影片《机器人总动员》里那个既可爱又挑剔的保洁机器人吗？这个荧幕上的人物现在可是

活生生的被带入现实生活里，它是一个可按照编程有

效率和保持一致水准来

从事清洁工作的保洁机器

人。由村田机械

所研发的保洁机器人能够规划出一个需要清理的面积蓝图，它能够记住根据不同路线的清洁需要所设

定的清洁速度、水量、衬垫的压力及橡胶扫帚器的上下动作。它能够记住高达64个路线！

为安全起见，保洁机器人备有感应器，它能够感应到周围的障碍物并且避开它们。机器人也具备声音指导功能和一个行驶录制器，在无人操作的情况下为它提供支持。

用于物流的采摘机由南洋理工大学设计的采摘机可以从架子上或盒子里采集物品，然后把它们放入相应的箱子里准备发货。准确和一致的物品采摘是物流的一个关键表现指标。在医院里，采摘机

可适用于分类和运送手术和医疗物品、食物及药物。它也可用于清洗和消毒手术用品。

采摘机是由多种模块所组成，其中包括了视力（识别和记住物件）和抓拿力（以决定如何采摘某些物件）。在2015年5月间所举行的首度亚马逊采摘挑战赛里，采摘

机甚至被测试用来可采摘多种超市物品和书本。

特写

4 0 S E P – O C T 2 01 5 C A R I N G

吃出健康

这个令人耳目一新的沙拉可做为前菜。柚子、泰国柠檬叶及青柠檬汁的新鲜组合绝对会刺激您的味觉，让您胃口大开!

准备时间 45分钟

供 份

所需材料 虾仁干45公克(1½盎司) 浸泡在水里直到软化，从水中 取出后稍微擦干

柚子½个（小） 泰国柠檬叶1片 撕碎 小红辣椒3条切细条 洋葱½个(小)去皮后切细条 小葱头20公克(2/3盎司)去皮后切细条 不加盐的干烧腰豆55公克(2盎司)切粗块 香菜85公克(3盎司)切碎 大蒜2瓣去皮后切碎 新鲜的青柠檬汁4汤匙 鱼露2汤匙

做法 把烤箱加热至160摄氏度(325华氏度)。把虾仁干放入烤箱干烧10分钟或直到呈棕色、香脆为止。从烤箱取出，备用。

把柚子的皮剥掉后将它一瓣一瓣的分开。把柚子果肉从薄膜里挖出来，将果核丢弃。将果肉放入搅拌碗里，再将其他材料倒入，捞均匀。

将捞好的沙拉转放到餐盘里，撒上干烧过的虾仁干。立即上桌。

营养成分（每份）卡路里 97大卡碳水化合物 8.6公克脂肪 4.5公克胆固醇 33.7毫克纤维 0.7公克

该食谱首次出版于 《A Cookbook for Diabetics by a Dietitian and a Chef》。

柚子沙律

4 0 S E P – O C T 2 01 5 C A R I N G

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