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  • Singapore study to test if pairing wearable devices with health coaches can change lifestyle habits

    Singapore study to test if pairing wearable devices with health coaches can change lifestyle habits

    SINGAPORE – A team from Alexandra Hospital (AH) is testing if using wearable fitness devices alone can change lifestyle habits, or if there is a need for a human health coach to nudge people regularly.

    The pilot programme, called Activation, is a randomised controlled trial of both a wearable technology-based intervention and the presence of a digital health coach for increasing physical activity and reducing sedentary behaviour.

    Gastroenterologist Alexander Yip, who is leading this research initiative, said its focus is on preventive health, or “slowing down the progression of chronic diseases such as diabetes and hypertension, and reducing healthcare expenditure”.

    Activation, which was started in August 2024, aims to recruit 1,700 participants aged between 21 and 75 who are at risk of developing hypertension, diabetes, obesity, and hyperlipidaemia or high cholesterol.

    They will be randomly assigned to three groups – 700 participants will receive only a smartwatch each, 500 will get a smartwatch and a dashboard with a nudging system downloaded onto their smartphones, and the remaining 500 will get a smartwatch and a health coach who assists them digitally via the dashboard and WhatsApp.

    The ConnectedLife dashboard is designed by a Singapore-based health tech company of the same name. It partners Google’s Fitbit to create wearable-based solutions for wellness, condition management and other health-focused applications.

    “Healthcare redesign is a fundamental part of the hospital’s redevelopment, and we look at how we can use technology to enable new kinds of care transformations and workflows or job redesign,” said Dr Yip, who heads the healthcare redesign department at AH. “(This project) is not strictly research because we have to be very practical and pragmatic about our approaches.”

    Participants will be monitored for a year, with follow-up sessions at the three-, six-, nine- and 12-month marks. At the end of the study, the data will be analysed and published so that there is better understanding of the “intrinsic motivations, personalities and readiness for change”, said Dr Yip.

    “Participants get to keep the watch,” he added.

    The Activation initiative is financed by the MOH Health Innovation Fund under the Ministry of Health. The ministry declined to comment on how much of the fund was allocated to the study.

    The new initiative supports the broader Healthier SG strategy, a national game plan on preventive health.

    Healthier SG gets people to be more connected with their primary care physicians who will draw up a health development plan, according to Dr Yip. “It is made up of lifestyle adjustments, vaccinations, and regular health screening and a regular follow-up,” he noted.

    “In six months, when you return for a follow-up, things do not change because there are no lifestyle adjustments on our part,” said Dr Yip. “The primary care physicians cannot leave us alone. Yet, it is too manpower intensive to go out and hand-hold everyone.”

    He added: “With technology, doctors will be able to digitally understand the parameters of our lives and… reach out to us in a low physical touch manner, which is what the healthcare system is today.”

    In the past, users of wearable devices – ranging from smartwatches to wristbands – made positive health changes only in the short term and motivation quickly waned, with many no longer wearing them after six months.

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  • Singapore study to test if pairing wearable devices with health coaches can change lifestyle habits

    Singapore study to test if pairing wearable devices with health coaches can change lifestyle habits

    SINGAPORE – A team from Alexandra Hospital (AH) is testing if using wearable fitness devices alone can change lifestyle habits, or if there is a need for a human health coach to nudge people regularly.

    The pilot programme, called Activation, is a randomised controlled trial of both a wearable technology-based intervention and the presence of a digital health coach for increasing physical activity and reducing sedentary behaviour.

    Gastroenterologist Alexander Yip, who is leading this research initiative, said its focus is on preventive health, or “slowing down the progression of chronic diseases such as diabetes and hypertension, and reducing healthcare expenditure”.

    Activation, which was started in August 2024, aims to recruit 1,700 participants aged between 21 and 75 who are at risk of developing hypertension, diabetes, obesity, and hyperlipidaemia or high cholesterol.

    They will be randomly assigned to three groups – 700 participants will receive only a smartwatch each, 500 will get a smartwatch and a dashboard with a nudging system downloaded onto their smartphones, and the remaining 500 will get a smartwatch and a health coach who assists them digitally via the dashboard and WhatsApp.

    The ConnectedLife dashboard is designed by a Singapore-based health tech company of the same name. It partners Google’s Fitbit to create wearable-based solutions for wellness, condition management and other health-focused applications.

    “Healthcare redesign is a fundamental part of the hospital’s redevelopment, and we look at how we can use technology to enable new kinds of care transformations and workflows or job redesign,” said Dr Yip, who heads the healthcare redesign department at AH. “(This project) is not strictly research because we have to be very practical and pragmatic about our approaches.”

    Participants will be monitored for a year, with follow-up sessions at the three-, six-, nine- and 12-month marks. At the end of the study, the data will be analysed and published so that there is better understanding of the “intrinsic motivations, personalities and readiness for change”, said Dr Yip.

    “Participants get to keep the watch,” he added.

    The Activation initiative is financed by the MOH Health Innovation Fund under the Ministry of Health. The ministry declined to comment on how much of the fund was allocated to the study.

    The new initiative supports the broader Healthier SG strategy, a national game plan on preventive health.

    Healthier SG gets people to be more connected with their primary care physicians who will draw up a health development plan, according to Dr Yip. “It is made up of lifestyle adjustments, vaccinations, and regular health screening and a regular follow-up,” he noted.

    “In six months, when you return for a follow-up, things do not change because there are no lifestyle adjustments on our part,” said Dr Yip. “The primary care physicians cannot leave us alone. Yet, it is too manpower intensive to go out and hand-hold everyone.”

    He added: “With technology, doctors will be able to digitally understand the parameters of our lives and… reach out to us in a low physical touch manner, which is what the healthcare system is today.”

    In the past, users of wearable devices – ranging from smartwatches to wristbands – made positive health changes only in the short term and motivation quickly waned, with many no longer wearing them after six months.

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  • Lebanese doctor races to save the eyes of those hurt by exploding tech devices

    Lebanese doctor races to save the eyes of those hurt by exploding tech devices

    BEIRUT — For almost a week, ophthalmologist Elias Jaradeh has worked around the clock, trying to keep up with the flood of patients whose eyes were injured when pagers and walkie-talkies exploded en masse across Lebanon.

    He has lost track of how many eye operations he has performed in multiple hospitals, surviving on two hours of sleep before starting on the next operation. He has managed to save some patients’ sight, but many will never see again.

    “There is no doubt that what happened was extremely tragic, when you see this overwhelming number of people with eye injures arriving at the same time to the hospital, most of them young men, but also children and young women,” he told The Associated Press at a Beirut hospital this past week, struggling to hold back tears.

    Lebanese hospitals and medics were inundated after thousands of hand-held devices belonging to the Hezbollah militant group detonated simultaneously on Tuesday and Wednesday last week, killing at least 39 people. Around 3,000 more were wounded, some with life-altering disabilities. Israel is widely believed to have been behind the attack, although it has neither confirmed nor denied its involvement.

    Although the explosions appear to have targeted Hezbollah fighters, many of the victims were civilians. And many of those hurt in the attack suffered injuries to their hands, face and eyes because the devices received messages just before they detonated, so they were looking at the devices as they exploded.

    Authorities have not said how many people lost their eyes.

    Veteran and hardened Lebanese eye doctors who have dealt with the aftermath of multiple wars, civil unrest and explosions, said they have never seen anything like it.

    Jaradeh, who is also a lawmaker representing south Lebanon as a reformist, said most of the patients sent to his hospital, which specializes in ophthalmology, were young people who had significant damage to one or both eyes. He said he found plastic and metal shrapnel inside some of their eyes.

    Four years ago, a powerful blast tore through Beirut’s port, killing more than 200 people and wounding more than 6,000. That explosion, caused by the detonation of hundreds of tons of ammonium nitrates that had been stored unsafely at a port warehouse, blew out windows and doors for miles around and sent cascades of glass shards pouring onto the streets, leading to horrific injuries.

    Jaradeh also treated people hurt in the port explosion, but his experience with those wounded by the exploding pagers and walkie-talkies has been so much more intense because of the sheer volume of people with eye injuries.

    “Containing the shock after the Beirut port blast was, I believe, 48 hours while we haven’t reached the period of containing the shock now,” Jaradeh said.

    Jaradeh said he found it hard to dissociate his job as a doctor from his emotions in the operating theater.

    “No matter what they taught you (in medical school) about distancing yourself, I think in a situation like this, it is very hard when you see the sheer numbers of wounded. This is linked to a war on Lebanon and war on humanity,” Jaradeh said.

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  • Thousands of exploding devices in Lebanon trigger a nation that has been on edge for years

    Thousands of exploding devices in Lebanon trigger a nation that has been on edge for years

    BEIRUT — Chris Knayzeh was in a town overlooking Lebanon’s capital when he heard the rumbling aftershock of the 2020 Beirut port blast. Hundreds of tons of haphazardly stored ammonium nitrates had exploded, killing and injuring thousands of people.

    Already struggling with the country’s economic collapse, the sight of the gigantic mushroom cloud unleashed by the blast was the last straw. Like many other Lebanese, he quit his job and booked a one-way ticket out of Lebanon.

    Knayzeh was in Lebanon visiting when news broke Tuesday that hundreds of handheld pagers had exploded across the country, killing 12, injuring thousands and setting off fires. Israel, local news reports said, was targeting the devices of the militant Hezbollah group. Stuck in Beirut traffic, Knayzeh started panicking that drivers around him could potentially be carrying devices that would explode.

    Within minutes, hospitals were flooded with patients, bringing back painful reminders of the port blast four years ago that killed more than 200 people and injured more than 6,000, leaving enduring mental and psychological scars for those who lived through it.

    In total, the explosions of pagers and walkie-talkies over two days killed at least 37 people and injured more than 3,000. Israel is widely believed to be behind the blasts, although it has neither confirmed nor denied responsibility.

    “The country’s state is unreal,” Knayzeh told The Associated Press.

    The port blast was one of the biggest non-nuclear explosions ever recorded, and it came on top of a historic economic meltdown, financial collapse and a feeling of helplessness after nationwide protests against corruption that failed to achieve their goals. It compounded years of crises that have upended the lives of people in this small country.

    Four years after the port catastrophe, an investigation has run aground. The ravaged Mediterranean port remains untouched, its towering silos standing broken and shredded as a symbol of a country in ruins. Political divisions and paralysis have left the country without a president or functioning government for more than two years. Poverty is on the rise.

    On top of that and in parallel with Israel’s war in Gaza, Lebanon has been on the brink of all-out war with Israel for the past year, with Israel and Hezbollah trading fire and Israeli warplanes breaking the sound barrier over Beirut almost daily, terrorizing people in their homes and offices.

    “I can’t believe this is happening again. How many more disasters must we endure?” said Jocelyn Hallak, a mother of three, two of whom now work abroad and the third headed out after graduation next year. “All this pain, when will it end?”

    A full-blown war with Israel could be devastating for Lebanon. The country’s crisis-battered health care system had been preparing for the possibility of conflict with Israel even before hospitals became inundated with the wounded from the latest explosions, many of them in critical condition and requiring extended hospital stays.

    Still, Knayzeh, now a lecturer at a university in France, can’t stay away. He returns regularly to see his girlfriend and family. He flinches whenever he hears construction work and other sudden loud sounds. When in France, surrounded by normalcy, he agonizes over family at home while following the ongoing clashes from afar.

    “It’s the attachment to our country I guess, or at the very least attachment to our loved ones who couldn’t leave with us,” he said.

    This summer, tens of thousands of Lebanese expatriates came to visit family and friends despite the tensions. Their remittances and money they spend during the holidays help keep the country afloat and in some cases are the main source of income for families. Many, however, cut their vacations short in chaotic airport scenes, fearing major escalation after the dual assassinations of Hezbollah and Hamas commanders in Beirut and Tehran last month, blamed on Israel.

    Even in a country that has vaulted from one crisis to another for decades, the level of confusion, insecurity and anger is reaching new heights. Many thought the port blast was the most surreal and frightening thing they would ever experience — until thousands of pagers exploded in people’s hands and pockets across the country this week.

    ’’I saw horrific things that day,” said Mohammad al-Mousawi, who was running an errand in Beirut’s southern suburb, where Hezbollah has a strong presence, when the pagers began blowing up.

    “Suddenly, we started seeing scooters whizzing by carrying defaced men, some without fingers, some with their guts spilling out. Then the ambulances started coming.”

    It reminded him of the 2020 port blast, he said. “The number of injuries and ambulances was unbelievable. “

    “One more horror shaping our collective existence,” wrote Maha Yahya, the Beirut-based director of the Malcolm H. Kerr Carnegie Middle East Center.

    “The shock, the disarray, the trauma is reminiscent of Beirut after the port explosion. Only this time it was not limited to a city but spread across the country,” she said in a social media post.

    In the aftermath of the exploding pagers, fear and paranoia has taken hold. Parents kept their children away from schools and universities, fearing more exploding devices. Organizations including the Lebanese civil defense advised personnel to switch off their devices and remove all batteries until further notice. One woman said she disconnected her baby monitor and other household appliances.

    Lebanon’s civil aviation authorities have banned the transporting of pagers and walkie-talkies on all airplanes departing from Beirut’s Rafik Hariri International Airport “until further notice.” Some residents were sleeping with their phones in another room.

    In the southern city of Tyre, ahead of a speech by Hezbollah leader Hassan Nasrallah, city resident Hassan Hajo acknowledged feeling “a bit depressed” after the pager blasts, a major security breach for a secretive organization like Hezbollah. He was hoping to get a boost from Nasrallah’s speech. “We have been through worse before and we got through it,” he said.

    In his speech, Nasrallah vowed to retaliate against Israel for the attacks on devices, while Israel and Hezbollah traded heavy fire across the border. Israel stepped up warnings of a potential larger military operation targeting the group.

    Another resident, Marwan Mahfouz, said Israeli Prime Minister Benjamin Netanyahu has been threatening Lebanon with war for the past year and he should just do it.

    “If we are going to die, we’ll die. We are already dying. We are already dead,” he said.

    ___

    Karam reported from London. Associated Press writer Hassan Ammar contributed to this report.

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  • Hezbollah leader vows retaliation against Israel for attacks on devices as both sides trade strikes

    Hezbollah leader vows retaliation against Israel for attacks on devices as both sides trade strikes

    BEIRUT — The leader of Hezbollah vowed Thursday to keep up daily strikes on Israel despite this week’s deadly sabotage of its members’ communication devices, and said Israelis displaced from homes near the Lebanon border because of the fighting would not be able to return until the war in Gaza ends.

    Hezbollah and Israel launched fresh attacks across the border as Hassan Nasrallah spoke for the first time since the mass bombing of devices in Lebanon and Syria that he described as a “severe blow” — and for which he promised to retaliate.

    The two days of attacks targeting thousands of Hezbollah pagers and walkie-talkies have been widely blamed on Israel, heightening fears that 11 months of near-daily exchanges of fire between Hezbollah and Israel will escalate into all-out war. Israel has neither confirmed nor denied involvement in the attacks.

    During Nasrallah’s speech, Hezbollah struck at least four times in northern Israel, and two Israeli soldiers were killed in a strike earlier in the day. Israeli warplanes flew low over Beirut while Nasrallah spoke and broke the sound barrier, scattering birds and prompting people in houses and offices to quickly open windows to prevent them from shattering.

    Israel also launched attacks in southern Lebanon on Thursday, saying it struck hundreds of rocket launchers and other Hezbollah infrastructure, though it was not immediately clear if there were any casualties. The army claimed the launchers were about to be used “in the immediate future.”

    At the same time, the army ordered residents in parts of the Golan Heights and northern Israel to avoid public gatherings, minimize movements and stay close to shelters in anticipation of possible rocket fire.

    In recent weeks, Israeli leaders have stepped-up warnings of a potential larger military operation against Hezbollah, saying they are determined to stop the group’s fire to allow tens of thousands of Israelis to return to homes near the border.

    In a Thursday briefing, the Israeli defense minister said Hezbollah would “pay an increasing price” as Israel seeks to make conditions near its border with Lebanon safe enough for residents to return.

    “The sequence of our military actions will continue,” he said.

    The attack on electronic devices appeared to be the culmination of a monthslong operation by Israel to target as many Hezbollah members as possible all at once — but civilians were also hit. At least 37 people were killed, including two children, and some 3,000 wounded in the explosions Tuesday and Wednesday.

    Nasrallah said the group is investigating how the bombings were carried out.

    “Yes, we were subjected to a huge and severe blow,” he said. “The enemy crossed all boundaries and red lines,” he said. Pointing to the number of pagers and walkie-talkies, he accused Israel of intending to kill thousands of people at one time. “The enemy will face a severe and fair punishment from where they expect and don’t expect.”

    He said Hezbollah will continue its barrages into northern Israel as long as the war in Gaza continues, vowing that Israel will not be able to bring its people back to the border region. “The only way is stop the aggression on the people of Gaza and the West Bank,” he said. “Neither strikes, nor assassinations nor an all-out war will achieve that.”

    Earlier Thursday, Hezbollah said it had targeted three Israeli military positions near the border, two of them with drones. Israeli hospitals reported eight people lightly or moderately injured.

    Hezbollah says its near daily fire is a show of support for Hamas. Israel’s 11-month-old war with Hamas in Gaza began after its militants led the Oct. 7 attack on Israel.

    Israel has responded to Hezbollah’s attacks with strikes in southern Lebanon, and has struck senior figures from the group in the capital Beirut. The exchanges have killed hundreds in Lebanon and dozens in Israel and forced the evacuation of tens of thousands of residents on each side of the border.

    Israel and Hezbollah have repeatedly pulled back from an all-out war under heavy pressure from the United States, France and other countries.

    But in their recent warnings, Israeli leaders have said they are determined to change the status quo dramatically.

    Speaking to Israeli troops on Wednesday, Gallant said, “We are at the start of a new phase in the war — it requires courage, determination and perseverance.” He made no mention of the exploding devices but praised the work of Israel’s army and security agencies, saying “the results are very impressive.”

    He said that after months of fighting Hamas in Gaza, “the center of gravity is shifting to the north by diverting resources and forces.”

    Israel began moving more troops to its border with Lebanon on Wednesday as a precautionary measure, Israeli officials said. Israel’s army chief, Lt. Gen. Herzi Halevi, said plans have been drawn up for additional action against Hezbollah, though media reported the government has not yet decided whether to launch a major offensive in Lebanon.

    Lebanon is still reeling from the deadly device attacks of Tuesday and Wednesday.

    The explosions have rattled anxious Lebanese fearing a full-scale war. The Lebanese Army said it has been locating and detonating suspicious pagers and communication devices, while the country’s civil aviation authorities banned pagers and walkie-talkies on all airplanes departing from Beirut’s international airport until further notice.

    The attack was likely to severely disrupt Hezbollah’s internal communication as it scrambles to determine safe means to talk to each other. Hezbollah announced the death of five combatants Thursday, but didn’t specify if they were killed in the explosions or on the front lines.

    The blasts went off wherever the holders of the pagers or walkie-talkies happened to be in multiple parts of Beirut and eastern and southern Lebanon — in homes and cars, grocery stores and cafes and on the street, even at a funeral for some killed in the bombings, often with family and other bystanders nearby.

    Many suffered gaping wounds on their legs, abdomens and faces or were maimed in the hand. Tuesday’s pager blasts killed 12 people, including two children, and wounded some 2,300 others. The following day’s explosion killed 25 and wounded more than 600, Health Minister Firas Abiad said, giving updated figures.

    Abiad told reporters that Wednesday’s injuries were more severe than the previous day as walkie-talkies that exploded were bigger than the pagers. He praised Lebanon’s hospitals, saying they had managed to deal with the flood of wounded within hours. “It was an indiscriminate attack. It was a war crime,” he said.

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