Search results for: tertiary
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 675

Search results for: tertiary

615 Use of Geosynthetics as Reinforcement Elements in Unpaved Tertiary Roads

Authors: Vivian A. Galindo, Maria C. Galvis, Jaime R. Obando, Alvaro Guarin

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In Colombia, most of the roads of the national tertiary road network are unpaved roads with granular rolling surface. These are very important ways of guaranteeing the mobility of people, products, and inputs from the agricultural sector from the most remote areas to urban centers; however, it has not paid much attention to the search for alternatives to avoid the occurrence of deteriorations that occur shortly after its commissioning. In recent years, geosynthetics have been used satisfactorily to reinforce unpaved roads on soft soils, with geotextiles and geogrids being the most widely used. The interaction of the geogrid and the aggregate minimizes the lateral movement of the aggregate particles and increases the load capacity of the material, which leads to a better distribution of the vertical stresses, consequently reducing the vertical deformations in the subgrade. Taking into account the above, the research aimed at the mechanical behavior of the granular material, used in unpaved roads with and without the presence of geogrids, from the development of laboratory tests through the loaded wheel tester (LWT). For comparison purposes, the reinforced conditions and traffic conditions to which this type of material can be accessed in practice were simulated. In total four types of geogrids, were tested with granular material; this means that five test sets, the reinforced material and the non-reinforced control sample were evaluated. The results of the numbers of load cycles and depth rutting supported by each test body showed the influence of the properties of the reinforcement on the mechanical behavior of the assembly and the significant increases in the number of load cycles of the reinforced specimens in relation to those without reinforcement.

Keywords: geosynthetics, load wheel tester LWT, tertiary roads, unpaved road, vertical deformation

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614 A Discrete Logit Survival Model with a Smooth Baseline Hazard for Age at First Alcohol Intake among Students at Tertiary Institutions in Thohoyandou, South Africa

Authors: A. Bere, H. G. Sithuba, K. Kyei, C. Sigauke

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We employ a discrete logit survival model to investigate the risk factors for early alcohol intake among students at two tertiary institutions in Thohoyandou, South Africa. Data were collected from a sample of 744 students using a self-administered questionnaire. Significant covariates were arrived at through a regularization algorithm implemented using the glmmLasso package. The tuning parameter was determined using a five-fold cross-validation algorithm. The baseline hazard was modelled as a smooth function of time through the use of spline functions. The results show that the hazard of initial alcohol intake peaks at the age of about 16 years and that at any given time, being of a male gender, prior use of other drugs, having drinking peers, having experienced negative life events and physical abuse are associated with a higher risk of alcohol intake debut.

Keywords: cross-validation, discrete hazard model, LASSO, smooth baseline hazard

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613 Education 5.0 and the Proliferation of Social Entrepreneurs in Zimbabwe: Challenges and Opportunities for the Nation

Authors: Tsuu Faith Machingura, Doreen Nkala, Daniel Madzanire

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Higher and tertiary Education in Zimbabwe is driven by is a five-pillar Education 5.0 model, which thrusts upon teaching, community engagement, research, innovation and industrialisation. Migration from the previous three-pillar model, the focus of which was on teaching, research and community engagement, to the current one saw universities churning out prolific social entrepreneurs. Apart from examining challenges social entrepreneurs face, the study aimed to identify opportunities that are available for the country as a corollary of the proliferation of social entrepreneurs. A sample of 20 participants comprising 15 social entrepreneurs and five lecturers was purposively drawn. Focus group and face to face interviews were used to gather data. The study revealed that the current higher and tertiary education model in Zimbabwe has stimulated proliferation of social entrepreneurs. It was recommended that a sound financial support system was needed to support new entrepreneurs.

Keywords: social entrepreneurs, education 5.0, innovation, industrialisation

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612 Nexus Between Library and Information Science Education Training and Practice in Nigeria: A Critical Assessment of the Synergy

Authors: Adebayo Emmanuel Layi

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Library and Information Science Education is about six (6) decades old in Nigeria. The first Library School was established in 1962 at the University of Ibadan, and since then, several institutions have been running the programme under various certifications, providing the manpower needs of professionals for libraries. As at June 2023, Nigeria has close to a thousand (1000) tertiary institutions and all needing the services of librarians. Apart from the tertiary institutions, several libraries exit in various establishments, both government, private and non-governmental organisations. These has underscored the enormous need for trained librarians for the libraries in these places. The Nexus between LIS Education training and Practice is like a puzzle of egg and chick, which one came first and against this background, this paper examined the roles of the colonial masters in educational development in Africa and vis-à-vis the influence of great library educators such as Melvil Dewey and other educators and the journey through Nigeria institutions. Despite the sound footing of LIS Education, Noise which seems to be a major obstacle on the practice as well as mending the broken link were all examined in the paper. Strategies and the way forward for overall development are suggested.

Keywords: nexus, education, training, synergy

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611 The Relationship between Class Attendance and Performance of Industrial Engineering Students Enrolled for a Statistics Subject at the University of Technology

Authors: Tshaudi Motsima

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Class attendance is key at all levels of education. At tertiary level many students develop a tendency of not attending all classes without being aware of the repercussions of not attending all classes. It is important for all students to attend all classes as they can receive first-hand information and they can benefit more. The student who attends classes is likely to perform better academically than the student who does not. The aim of this paper is to assess the relationship between class attendance and academic performance of industrial engineering students. The data for this study were collected through the attendance register of students and the other data were accessed from the Integrated Tertiary Software and the Higher Education Data Analyzer Portal. Data analysis was conducted on a sample of 93 students. The results revealed that students with medium predicate scores (OR = 3.8; p = 0.027) and students with low predicate scores (OR = 21.4, p < 0.001) were significantly likely to attend less than 80% of the classes as compared to students with high predicate scores. Students with examination performance of less than 50% were likely to attend less than 80% of classes than students with examination performance of 50% and above, but the differences were not statistically significant (OR = 1.3; p = 0.750).

Keywords: class attendance, examination performance, final outcome, logistic regression

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610 Survey on Awareness, Knowledge and Practices: Managing Osteoporosis among Practitioners in a Tertiary Hospital, Malaysia

Authors: P. H. Tee, S. M. Zamri, K. M. Kasim, S. K. Tiew

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This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

Keywords: awareness, knowledge, osteoporosis, practices

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609 The Effects of Subsidised Irrigation Service Fees on Irrigation Performance in Vietnam

Authors: Trang Pham

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Approximately 70% of the Vietnamese population lives in rural areas where the main livelihood is farming. For many years, the Vietnamese Government has been working towards improving farmers’ quality of life. In 2008, the Government issued the decree 115/2008/ND-CP to subsidize farmers’ water fees. The subsidy covers operation and management costs of major water infrastructure. Water users have only to pay for the operation and management of minor or tertiary canal systems. But the “subsidized water fee” has become contentious; there are two opposing schools of thought. One view is that the subsidy lessens the burden on farmers in terms of reducing their production costs, at the same time generating a sufficient budget for Irrigation Management Companies (IMCs) and Water User Association (WUAs). The alternate point of view is that the subsidy negatively effects irrigation performance, especially in tertiary canals. The aim of this study was to gain clear awareness of the perceptions of farmers, WUA members, and IMC staffs in regard to irrigation performance and management since the introduction of subsidies and local water fees. In order to find out how the government intervention has affected local farming communities, a series of questionnaires and interviews were administered in 2013. Four case studies were chosen which represent four different agricultural areas and four different irrigation systems in Vietnam. Interviews were conducted with IMC staffs and WUA members and questionnaires were used to gather information from farmers. The study compares the difference in operation and management costs across the four case studies both before and after the implementation of the decree. The results disclose factors behind the subsidized water fee that either allow or hinder improved irrigation performance and better irrigation management.

Keywords: water fee, irrigation performance, local farming, tertiary canal systems

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608 Feminine Gender Identity in Nigerian Music Education: Trends, Challenges and Prospects

Authors: Julius Oluwayomi Oluwadamilare, Michael Olutayo Olatunji

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In the African traditional societies, women have always played the role of a teacher, albeit informally. This is evident in the upbringing of their babies. As mothers, they also serve as the first teachers to teach their wards lessons through day-to-day activities. Furthermore, women always play the role of a musician during naming ceremonies, in the singing of lullabies, during initiation rites of adolescent boys and girls into adulthood, and in preparing their children especially daughters (and sons) for marriage. They also perform this role during religious and cultural activities, chieftaincy title/coronation ceremonies, singing of dirges during funeral ceremonies, and so forth. This traditional role of the African/Nigerian women puts them at a vantage point to contribute maximally to the teaching and learning of music at every level of education. The need for more women in the field of music education in Nigeria cannot be overemphasized. Today, gender equality is a major discourse in most countries of the world, Nigeria inclusive. Statistical data in the field of education and music education reveal the high ratio of male teachers/lecturers over their female counterparts in Nigerian tertiary institutions. The percentage is put at 80% Male and a distant 20% Female! This paper, therefore, examines feminine gender in Nigerian music education by tracing the involvement of women in musical practice from the pre-colonial to the post-colonial periods. The study employed both primary and secondary sources of data collection. The primary source included interviews conducted with 19 music lecturers from 8 purposively selected tertiary institutions from 4 geo-political zones of Nigeria. In addition, observation method was employed in the selected institutions. The results show, inter alia, that though there is a remarkable improvement in the rate of admission of female students into the music programme of Nigerian tertiary institutions, there is still an imbalance in the job placement in these institutions especially in the Colleges of Education which is the main focus of this research. Religious and socio-cultural factors are highly traceable to this development. This paper recommends the need for more female music teachers to be employed in the Nigerian tertiary institutions in line with the provisions stated in the Millennium Development Goals (MDGs) of the Federal Republic of Nigeria.

Keywords: gender, education, music, women

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607 Clinical Characteristics of Children Presenting with History of Child Sexual Abuse to a Tertiary Care Centre in India

Authors: T. S. Sowmya Bhaskaran, Shekhar Seshadri

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This study aims to study the clinical features of with a history of Child Sexual Abuse (CSA). A chart review of 40 children (<16 years) with history of CSA evaluated at the Department of Child and Adolescent Psychiatry of NIMHANS during a two year period was performed. Results:The most common form of abuse was contact penetrative abuse (65%) followed by non-contact penetrative abuse (32.5%). 75% (N=30) had a psychiatric diagnosis at baseline. 50% of these children had one or more psychiatric comorbidities. Anxiety disorder was the most common diagnosis (27.5%) which included PTSD (11%) followed by Depressive disorder (25.2%). Children abused by multiple perpetrators were found to be more likely to have depression, to having a comorbid psychiatric disorder and more prone to exhibit sexualized behaviour. Children who also experienced physical violence at home were more likely to develop psychiatric illness following child sexual abuse. Psychiatric morbidity is high in clinic population of children with history of CSA. It is important to increase the awareness regarding the consequences of CSA in order to increase help seeking.

Keywords: child sexual abuse, India, tertiary care centre, clinical characteristics

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606 INNPT Nano Particles Material Technology as Enhancement Technology for Biological WWTP Performance and Capacity

Authors: Medhat Gad

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Wastewater treatment became a big issue in this decade due to shortage of water resources, growth of population and modern live requirements. Reuse of treated wastewater in industrial and agriculture sectors has a big demand to substitute the shortage of clean water supply as well as to save the eco system from dangerous pollutants in insufficient treated wastewater In last decades, most of wastewater treatment plants are built using primary or secondary biological treatment technology which almost does not provide enough treatment and removal of phosphorus and nitrogen. those plants which built ten to 15 years ago also now suffering from overflow which decrease the treatment efficiency of the plant. Discharging treated wastewater which contains phosphorus and nitrogen to water reservoirs and irrigation canals destroy ecosystem and aquatic life. Using chemical material to enhance treatment efficiency for domestic wastewater but it leads to huge amount of sludge which cost a lot of money. To enhance wastewater treatment, we used INNPT nano material which consists of calcium, aluminum and iron oxides and compounds plus silica, sodium and magnesium. INNPT nano material used with a dose of 100 mg/l to upgrade SBR treatment plant in Cairo Egypt -which has three treatment tanks each with a capacity of 2500 cubic meters per day - to tertiary treatment level by removing Phosphorus, Nitrogen and increase dissolved oxygen in final effluent. The results showed that the treatment retention time decreased from 9 hours in SBR system to one hour using INNPT nano material with improvement in effluent quality while increasing plant capacity to 20 k cubic meters per day. Nitrogen removal efficiency achieved 77%, while phosphorus removal efficiency achieved 90% and COD removal efficiency was 93% which all comply with tertiary treatment limits according to Egyptian law.

Keywords: INNPT technology, nanomaterial, tertiary wastewater treatment, capacity extending

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605 Headache Masquerading as Common Psychiatric Disorders in Patients of Low Economic Class in a Tertiary Care Setting

Authors: Seema Singh Parmar, Shweta Chauhan

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Aims & Objectives: To evaluate the presence of various psychiatric disorders in patients reporting with a headache as the only symptom. Methodology: 200 patients with the chief complain of a headache who visited the psychiatric OPD of a tertiary care were investigated. Out of them 50 who had pure psychiatric illness without any other neurological disease were investigated, and their diagnosis was made. Independent sample t-tests were applied to generate results. Results: The most common psychiatric diagnosis seen in the sample was Depression (64%) out of which 47% showed features of Depression with anxious distress. Other psychiatric disorders seen were Generalized Anxiety Disorder, Panic Attacks, Somatic Symptom Disorder and Obsessive Compulsive Disorder. For pure psychiatry, headache related illnesses female to male ratio was 1.64. Conclusion: The increasing frequency of psychiatric disorders among patients who only visit the doctor seeking treat a headache shows the need for better identification of psychiatric disorders because proper diagnosis and target of psychiatric treatment shall give complete relief to the patient’s symptomatology.

Keywords: anxiety disorders, depression, headache, panic attacks

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604 Stabilization of y-Sterilized Food, Packaging Materials by Synergistic Mixtures of Food-Contact Approval Stabilizers

Authors: Sameh A. S. Thabit Alariqi

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Food is widely packaged with plastic materials to prevent microbial contamination and spoilage. Ionizing radiation is widely used to sterilize the food-packaging materials. Sterilization by γ-radiation causes degradation for the plastic packaging materials such as embrittlement, stiffening, softening, discoloration, odour generation, and decrease in molecular weight. Many antioxidants can prevent γ-degradation but most of them are toxic. The migration of antioxidants to its environment gives rise to major concerns in case of food packaging plastics. In this attempt, we have aimed to utilize synergistic mixtures of stabilizers which are approved for food-contact applications. Ethylene-propylene-diene terpolymer (EPDM) have been melt-mixed with hindered amine stabilizers (HAS), phenolic antioxidants and organo-phosphites (hydroperoxide decomposer). Results were discussed by comparing the stabilizing efficiency of mixtures with and without phenol system. Among phenol containing systems where we mostly observed discoloration due to the oxidation of hindered phenol, the combination of secondary HAS, tertiary HAS, organo-phosphite and hindered phenol exhibited improved stabilization efficiency than single or binary additive systems. The mixture of secondary HAS and tertiary HAS, has shown antagonistic effect of stabilization. However, the combination of organo-phosphite with secondary HAS, tertiary HAS and phenol antioxidants have been found to give synergistic even at higher doses of -sterilization. The effects have been explained through the interaction between the stabilizers. After γ-irradiation, the consumption of oligomeric stabilizer significantly depends on the components of stabilization mixture. The effect of the organo-phosphite antioxidant on the overall stability has been discussed.

Keywords: ethylene-propylene-diene terpolymer, synergistic mixtures, gamma sterilization, gamma stabilization

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603 Study of Reporting System for Adverse Events Related to Common Medical Devices at a Tertiary Care Public Sector Hospital in India

Authors: S. Kurian, S. Satpathy, S. K. Gupta, S. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: adverse events, health care technology, medical devices, public sector hospital, reporting systems

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602 Sectoral Energy Consumption in South Africa and Its Implication for Economic Growth

Authors: Kehinde Damilola Ilesanmi, Dev Datt Tewari

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South Africa is in its post-industrial era moving from the primary and secondary sector to the tertiary sector. The study investigated the impact of the disaggregated energy consumption (coal, oil, and electricity) on the primary, secondary and tertiary sectors of the economy between 1980 and 2012 in South Africa. Using vector error correction model, it was established that South Africa is an energy dependent economy, and that energy (especially electricity and oil) is a limiting factor of growth. This implies that implementation of energy conservation policies may hamper economic growth. Output growth is significantly outpacing energy supply, which has necessitated load shedding. To meet up the excess energy demand, there is a need to increase the generating capacity which will necessitate increased investment in the electricity sector as well as strategic steps to increase oil production. There is also need to explore more renewable energy sources, in order to meet the growing energy demand without compromising growth and environmental sustainability. Policy makers should also pursue energy efficiency policies especially at sectoral level of the economy.

Keywords: causality, economic growth, energy consumption, hypothesis, sectoral output

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601 Frequency of Refractive Errors in Squinting Eyes of Children from 4 to 16 Years Presenting at Tertiary Care Hospital

Authors: Maryum Nawaz

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Purpose: To determine the frequency of refractive errors in squinting eyes of children from 4 to 16 years presenting at tertiary care hospital. Study Design: A descriptive cross-sectional study was done. Place and Duration: The study was conducted in Pediatric Ophthalmology, Hayatabad Medical Complex, Peshawar. Materials and Methods: The sample size was 146 keeping 41.45%5 proportion of refractive errors in children with squinting eyes, 95% confidence interval and 8% margin of error under WHO sample size calculations. Non-probability consecutive sampling was done. Result: Mean age was 8.57±2.66 years. Male were 89 (61.0%) and female were 57 (39.0%). Refractive error was present in 56 (38.4%) and was not present in 90 (61.6%) of patients. There was no association of gender, age, parent refractive errors, or early usage of electric equipment with the refractive errors. Conclusion: There is a high prevalence of refractive errors in a patient with strabismus. There is no association of age, gender, parent refractive errors, or early usage of electric equipment in the occurrence of refractive errors. Further studies are recommended for confirmation of these.

Keywords: strabismus, refractive error, myopia, hypermetropia, astigmatism

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600 Tertiary Training of Future Health Educators and Health Professionals Involved in Childhood Obesity Prevention and Treatment Strategies

Authors: Thea Werkhoven, Wayne Cotton

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Adult and childhood rates of obesity in Australia are health concerns of high national priority, retaining epidemic status in the populations affected. Attempts to prevent further increases in prevalence of childhood obesity in the population aged below eighteen years have had varied success. A multidisciplinary approach has been used, employing strategies in schools, through established health care system usage and public health campaigns. Over the last decade a plateau in prevalence has been reached in the youth population afflicted by obesity and interest has peaked in school based strategies to prevent and treat overweight and obesity. Of interest to this study is the importance of the tertiary training of future health educators or health professionals destined to be involved in obesity prevention and treatment strategies. Health educators and health professionals are considered instrumental to the success of prevention and treatment strategies, required to possess sufficient and accurate knowledge in order to be effective in their positions. A common influence on the success of school based health promoting activities are the weight based attitudes possessed by health educators, known to be negative and biased towards overweight or obese children during training and practice. Whilst the tertiary training of future health professionals includes minimal nutrition education, there is no mandatory training in health education or nutrition for pre-service health educators in Australian tertiary institutions. This study aimed to assess the impact of a pedagogical intervention on pre-service health educators and health professionals enrolled in a health and wellbeing elective. The intervention aimed to increase nutrition knowledge and decrease weight bias and was embedded in the twelve week elective. Participants (n=98) were tertiary students at a major Australian University who were enrolled in health (47%) and non-health related degrees (53%). A quantitative survey using four valid and reliable instruments was conducted to measured nutrition knowledge, antifat attitudes and weight stereotyping attitudes at baseline and post-intervention. Scores on each instrument were compared between time points to check if they had significantly changed and to determine the effect of the intervention on attitudes and knowledge. Antifat attitudes at baseline were considered low and decreased further over the course of the intervention. Scores representing weight bias did decrease but the change was not significant. Fat stereotyping attitudes became stronger over the course of the intervention and this change was significant. Nutrition knowledge significantly improved from baseline to post-intervention. The design of the nutrition knowledge and attitude amelioration content of the intervention was semi-successful in achieving its outcomes. While the level of nutrition knowledge was improved over the course of the intervention, an unintentional increase was observed in weight based prejudice which is known to occur in interventions that employ stigma reduction methodologies. Further research is required into a structured methodology that increases level of nutrition knowledge and ameliorates weight bias at the tertiary level. In this way training provided would help prepare future health educators with the knowledge, skills and attitudes required to be effective and bias free in their practice.

Keywords: education, intervention, nutrition, obesity

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599 Assessment of Digital Literacy Skills of Librarians in Tertiary Institutions Inniger State

Authors: Mustapha Abdulkadir Gana, Jibrin Attahiru Alhassan, Adamu Musa Baba

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The exponential growth of information sources, resources and the continued Communication Technology (ICT) sophistication of libraries all over the world call for capable and ICT compliant librarians in Nigeria, this article assesses the digital literacy skills of librarians in tertiary institutions in Niger state. The survey research method was applied in the study using a random sampling technique to draw the sample. Fifty-eight copies of the questionnaire were administered while forty-nine copies were completed, returned, and used in the study, which represents 84% of the response rate. Two research questions were answered, and data were analyzed using Statistical Package for the Social Sciences (SPSS). The finding uncovered that the librarians lack the requisite digital literacy skills to access the wealth of digital information resources available. The study recommends some steps to turn around the situations amongst; librarians must be empowered with all necessary digital literacy skills, embark on rigorous training and retraining programs, workshops, conferences, and seminars, there should also be a coherent training policy for the librarians on a sustainable basis to increase their requisite digital literacy skills.

Keywords: digital, information, literacy, skills

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598 Play in College: Shifting Perspectives and Creative Problem-Based Play

Authors: Agni Stylianou-Georgiou, Eliza Pitri

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This study is a design narrative that discusses researchers’ new learning based on changes made in pedagogies and learning opportunities in the context of a Cognitive Psychology and an Art History undergraduate course. The purpose of this study was to investigate how to encourage creative problem-based play in tertiary education engaging instructors and student-teachers in designing educational games. Course instructors modified content to encourage flexible thinking during game design problem-solving. Qualitative analyses of data sources indicated that Thinking Birds’ questions could encourage flexible thinking as instructors engaged in creative problem-based play. However, student-teachers demonstrated weakness in adopting flexible thinking during game design problem solving. Further studies of student-teachers’ shifting perspectives during different instructional design tasks would provide insights for developing the Thinking Birds’ questions as tools for creative problem solving.

Keywords: creative problem-based play, educational games, flexible thinking, tertiary education

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597 Absolute Lymphocyte Count as Predictor of Pneumocystis Pneumonia in Patients With Unknown HIV Status at a Private Tertiary Hospital

Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura

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Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.

Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP

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596 A Simulation of Patient Queuing System on Radiology Department at Tertiary Specialized Referral Hospital in Indonesia

Authors: Yonathan Audhitya Suthihono, Ratih Dyah Kusumastuti

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The radiology department in a tertiary referral hospital faces service operation challenges such as huge and various patient arrival, which can increase the probability of patient queuing. During the COVID-19 pandemic, it is mandatory to apply social distancing protocol in the radiology department. A strategy to prevent the accumulation of patients at one spot would be required. The aim of this study is to identify an alternative solution which can reduce the patient’s waiting time in radiology department. Discrete event simulation (DES) is used for this study by constructing several improvement scenarios with Arena simulation software. Statistical analysis is used to test the validity of the base case scenario model and to investigate the performance of the improvement scenarios. The result of this study shows that the selected scenario is able to reduce patient waiting time significantly, which leads to more efficient services in a radiology department, be able to serve patients more effectively, and thus increase patient satisfaction. The result of the simulation can be used by the hospital management to improve the operational performance of the radiology department.

Keywords: discrete event simulation, hospital management patient queuing model, radiology department services

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595 Systemic Factors, Intraocular Lens, and Ocular Abnormalities in Patients with Intraocular Lens Glistening at a Tertiary Hospital in Semarang

Authors: Azmi Ilmi Aziz, Wisnu Sadasih, Rizal Fanany

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Purpose: This study describes systemic factors, intraocular lens (IOL), and ocular abnormalities in patients with IOL glistening at a tertiary hospital in Semarang. Methods: A retrospective, with a descriptive approach on patients with IOL glistening who visited the eye clinic between August 2019 to June 2023. Results: Twenty-five patients were examined; 11 patients (44%) had IOL glistening in their right eye, 4 patients (16%) in their left eye, and 10 patients (40%) in both eyes. The gender of patients consisted of 12 male patients (48%) and 13 female patients (52%). The median age of the patients was 68 years. The mean onset was 4.44 years after the first cataract surgery. Hypertension was found in 13 patients (52%), and diabetes was found in 9 patients (36%). Nine patients (36%) were identified with a foldable IOL with a closed loop design, and 1 patient (4%) with a PMMA IOL with an iris-fixated IOL design, while 15 other patients’ IOL were unrecorded. Glaucoma was found in 3 patients (12%). Conclusions: The result of this study showed that more than half of the patients were hypertensive, and some were glaucomatous, which had been discussed relevant in previous studies. Most IOL that could be identified was foldable IOL with a closed loop design. To our knowledge, the design of an IOL to glistening had never been explored. A longer study involving larger subjects is needed to better describe the systemic factors, IOL, and ocular abnormalities in patients with IOL glistening.

Keywords: glistening, intraocular lens, foldable IOL, PMMA IOL

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594 Recycling of Polymers in the Presence of Nanocatalysts: A Green Approach towards Sustainable Environment

Authors: Beena Sethi

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This work involves the degradation of plastic waste in the presence of three different nanocatalysts. A thin film of LLDPE was formed with all three nanocatalysts separately in the solvent. Thermo Gravimetric Analysis (TGA) and Differential Scanning Calorimetric (DSC) analysis of polymers suggest that the presence of these catalysts lowers the degradation temperature and the change mechanism of degradation. Gas chromatographic analysis was carried out for two films. In gas chromatography (GC) analysis, it was found that degradation of pure polymer produces only 32% C3/C4 hydrocarbons and 67.6% C5/C9 hydrocarbons. In the presence of these catalysts, more than 80% of polymer by weight was converted into either liquid or gaseous hydrocarbons. Change in the mechanism of degradation of polymer was observed therefore more C3/C4 hydrocarbons along with valuable feedstock are produced. Adjustment of dose of nanocatalyst, use of nano-admixtures and recycling of catalyst can make this catalytic feedstock recycling method a good tool to get sustainable environment. The obtained products can be utilized as fuel or can be transformed into other useful products. In accordance with the principles of sustainable development, chemical recycling i.e. tertiary recycling of polymers along with the reuse (zero order recycling) of plastics can be the most appropriate and promising method in this direction. The tertiary recycling is attracting much attention from the viewpoint of the energy resource.

Keywords: degradation, differential scanning calorimetry, feedstock recycling, gas chromatography, thermogravimetric analysis

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593 ARCS Model for Enhancing Intrinsic Motivation in Learning Biodiversity Subjects: A Case Study of Tertiary Level Students in Malaysia

Authors: Nadia Nisha Musa, Nur Atirah Hasmi, Hasnun Nita Ismail, Zulfadli Mahfodz

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In Malaysian Education System, subject related to biodiversity has started in the curriculum from Foundation Study until tertiary education. Biodiversity become the focus of attention due to awareness on global warming which potentially leads to a loss of biodiversity. A loss in biodiversity means a loss in medicinal discoveries and reduces food supply. It is of great important to ensure that young generations become aware of biodiversity conservation. The more interactive approaches are needed to build society with a high awareness for biodiversity conservation. To address this challenge, the goal of this study is to enhance intrinsic motivation of biological students via ARCS model of instruction. Self-access learning materials such as tutorial, module and fieldwork were designed with ARCS elements to a sample size of 70 university students from the beginning of the semester. Both paper and online surveys were used to collect data from the respondents. The results showed that elements of attention, relevance, confidence and satisfaction have a positive impact on intrinsic motivation of students and their academic performance.

Keywords: intrinsic motivation, ARCS model of instruction, biodiversity, self-access learning

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592 Skin Manifestations in Children With Inborn Errors of Immunity in a Tertiary Care Hospital in Iran

Authors: Zahra Salehi Shahrbabaki, Zahra Chavoshzadeh, Fahimeh Abdollahimajd, Samin Sharafian, Tolue Mahdavi, Mahnaz Jamee

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Background: Inborn errors of immunity (IEIs) are monogenic diseases of the immune the system with broad clinical manifestations. Despite the increasing genetic advancements, the diagnosis of IEIs still leans on clinical diagnosis. Dermatologic manifestations are observed in a large number of IEI patients and can lead to proper approach, prompt intervention and improved prognosis. Methods: This cross-sectional study was carried out between 2018 and 2020 on IEIs at a Children's tertiary care center in Tehran, Iran. Demographic details (including age, sex, and parental consanguinity), age at onset of symptoms and family history of IEI with were recorded. Results :212 patients were included. Cutaneous findings were reported in (95 ,44.8%) patients. and 61 of 95 (64.2%) reported skin lesions as the first clinical presentation. Skin infection (69, 72.6%) was the most frequent cutaneous manifestation, followed by an eczematous rash (24, 25 %). Conclusions: Skin manifestations are common feature in IEI patients and can be readily recognizable by healthcare providers. This study tried to provide information on prognostic consequences.

Keywords: primary immuno deficiency, inborn errror of metabolism, skin manifestation, skin infection

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591 Valuation of Entrepreneurship Education (EE) Curriculum and Self-Employment Generation among Graduates of Tertiary Institutions in Edo State, Nigeria

Authors: Angela Obose Oriazowanlan

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Despite the introduction of Entrepreneurship education into the Nigerian University curriculum to prepare graduates for self-employment roles in order to abate employment challenges, their unemployment rate still soars high. The study, therefore, examined the relevance of the curriculum contents and its delivery mechanism to equip graduates with appropriate entrepreneurial skills prior to graduation. Four research questions and two hypotheses guided the study. The survey research design was adopted for the study. An infinite population of graduates of a period of five years with 200 sample representatives using the simple random sampling technique was adopted. A 45-item structured questionnaire was used for data gathering. The gathered data thereof was anlysed using the descriptive statistics of mean and standard deviation, while the formulated hypotheses were tested with Z-score at 0.5 level of significance. The findings revealed, among others, that graduates acquisition of appropriate entrepreneurial skills for self-employment generation is low due to curriculum deficiencies, insufficient time allotment, and the delivery mechanism. It was recommended, among others, that the curriculum should be reviewed to improve its relevancy and that sufficient time should be allotted to enable adequate teaching and learning process.

Keywords: evaluation of entrepreneurship education (EE) curriculum, self-employment generation, graduates of tertiary institutions, Edo state, Nigeria

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590 The Use of English Quantifiers in Writing: A Case Study of the NCE I Students of the Federal College of Education, Kano, Nigeria

Authors: Hadiza Lawan Ismail

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Academic writing in Nigeria is fraught with a lot of grammatical errors which brings backward to education specifically at the tertiary institution level. This paper deals with the use of English quantifiers in academic writing, with particular emphasis on the use of ‘MANY.’ NCEI students of the Federal College of Education, Kano were used as the case study. The paper attempts to highlight the problems that arise due to incorrect use of quantifiers as well as identifying the causes of difficulties in the use of English quantifiers by some NCE1 students. To achieve this objective, the data was collected through sentence writing test by testing the students’ use of quantifiers, using only one quantifier as the variable of the study, which is MANY. In analyzing the data, the sentence writing tests are analyzed item by item and the scores of the correct responses as well as the wrong responses are converted into percentage forms. The findings revealed that students have difficulty in remembering and grasping the grammatical restrictions that control the use of English quantifiers specifically MANY; mother tongue also affects the use of quantifiers by some NCE1 students to the extent that they use one word to represent about three or four English quantifiers. The causes of difficulty in the use of English quantifiers by the students are attributed to poor background and inadequate use of English language and quantifiers, because we cannot use quantifiers alone and get the desired meaning without putting them in a sentence.

Keywords: academic writing, English quantifiers, grammatical restrictions, tertiary institution students

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589 Estimation of Adult Patient Doses for Chest X-Ray Diagnostic Examinations in a Tertiary Institution Health Centre

Authors: G. E. Okungbowa, H. O. Adams, S. E. Eze

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This study is on the estimation of adult patient doses for Chest X-ray diagnostic examinations of new admitted undergraduate students attending a tertiary institution health centre as part of their routine clearance and check up on admitted into the institution. A total of 531 newly admitted undergraduate students were recruited for this survey in the first quarter of 2016 (January to March, 2016). CALDOSE_X 5.0 software was used to compute the Entrance Surface Dose (ESD) and Effective Dose (ED); while the Statistical Package for Social Sciences (SPSS) version 21.0 was used to carry out the statistical analyses. The basic patients' data and exposure parameters required for the software are age, sex, examination type, projection posture, tube potential and current-time product. The mean Entrance Surface Dose and Effective Doses of the undergraduate students were calculated using the software, and the values were compared with existing literature and internationally established diagnostic reference levels. The mean ESD calculated is 0.29 mGy, and the mean effective dose is 0.04 mSv. The values of ESD and ED obtained are below the internationally established diagnostic reference levels, which could be attributed to good radiographic techniques employed during the chest X-ray procedure for these students.

Keywords: x-ray, dose, examination, chest

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588 Comparison of Patient Satisfaction and Observer Rating of Outpatient Care among Public Hospitals in Shanghai

Authors: Tian Yi Du, Guan Rong Fan, Dong Dong Zou, Di Xue

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Background: The patient satisfaction survey is becoming of increasing importance for hospitals or other providers to get more reimbursement and/or more governmental subsidies. However, when the results of patient satisfaction survey are compared among medical institutions, there are some concerns. The primary objectives of this study were to evaluate patient satisfaction in tertiary hospitals of Shanghai and to compare the satisfaction rating on physician services between patients and observers. Methods: Two hundred outpatients were randomly selected for patient satisfaction survey in each of 28 public tertiary hospitals of Shanghai. Four or five volunteers were selected to observe 5 physicians’ practice in each of above hospitals and rated observed physicians’ practice. The outpatients that the volunteers observed their physician practice also filled in the satisfaction questionnaires. The rating scale for outpatient survey and volunteers’ observation was: 1 (very dissatisfied) to 6 (very satisfied). If the rating was equal to or greater than 5, we considered the outpatients and volunteers were satisfied with the services. The validity and reliability of the measure were assessed. Multivariate regressions for each of the 4 dimensions and overall of patient satisfaction were used in analyses. Paired t tests were applied to analyze the rating agreement on physician services between outpatients and volunteers. Results: Overall, 90% of surveyed outpatients were satisfied with outpatient care in the tertiary public hospitals of Shanghai. The lowest three satisfaction rates were seen in the items of ‘Restrooms were sanitary and not crowded’ (81%), ‘It was convenient for the patient to pay medical bills’ (82%), and ‘Medical cost in the hospital was reasonable’ (84%). After adjusting the characteristics of patients, the patient satisfaction in general hospitals was higher than that in specialty hospitals. In addition, after controlling the patient characteristics and number of hospital visits, the hospitals with higher outpatient cost per visit had lower patient satisfaction. Paired t tests showed that the rating on 6 items in the dimension of physician services (total 14 items) was significantly different between outpatients and observers, in which 5 were rated lower by the observers than by the outpatients. Conclusions: The hospital managers and physicians should use patient satisfaction and observers’ evaluation to detect the room for improvement in areas such as social skills cost control, and medical ethics.

Keywords: patient satisfaction, observation, quality, hospital

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587 The Development of the Geological Structure of the Bengkulu Fore Arc Basin, Western Edge of Sundaland, Sumatra, and Its Relationship to Hydrocarbon Trapping Mechanism

Authors: Lauti Dwita Santy, Hermes Panggabean, Syahrir Andi Mangga

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The Bengkulu Basin is part of the Sunda Arc system, which is a classic convergent type margin that occur around the southern rim of the Eurasian continental (Sundaland) plate. The basin is located between deep sea trench (Mentawai Outer Arc high) and the volvanic/ magmatic Arc of the Barisan Mountains Range. To the northwest it is bounded by Padang High, to the northest by Barisan Mountains (Sumatra Fault Zone) to the southwest by Mentawai Fault Zone and to the southeast by Semangko High/ Sunda Strait. The stratigraphic succession and tectonic development can be broadly divided into four stage/ periods, i.e Late Jurassic- Early Cretaceous, Late Eocene-Early Oligocene, Late Oligocene-Early Miocene, Middle Miocene-Late Miocene and Pliocene-Plistocene, which are mainly controlled by the development of subduction activities. The Pre Tertiary Basement consist of sedimentary and shallow water limestone, calcareous mudstone, cherts and tholeiitic volcanic rocks, with Late Jurassic to Early Cretaceous in age. The sedimentation in this basin is depend on the relief of the Pre Tertiary Basement (Woyla Terrane) and occured into two stages, i.e. transgressive stage during the Latest Oligocene-Early Middle Miocene Seblat Formation, and the regressive stage during the Latest Middle Miocene-Pleistocene (Lemau, Simpangaur and Bintunan Formations). The Pre-Tertiary Faults were more intensive than the overlying cover, The Tertiary Rocks. There are two main fault trends can be distinguished, Northwest–Southwest Faults and Northeast-Southwest Faults. The NW-SE fault (Ketaun) are commonly laterally persistent, are interpreted to the part of Sumatran Fault Systems. They commonly form the boundaries to the Pre Tertiary basement highs and therefore are one of the faults elements controlling the geometry and development of the Tertiary sedimentary basins.The Northeast-Southwest faults was formed a conjugate set to the Northwest–Southeast Faults. In the earliest Tertiary and reactivated during the Plio-Pleistocene in a compressive mode with subsequent dextral displacement. The Block Faulting accross these two sets of faults related to approximate North–South compression in Paleogene time and produced a series of elongate basins separated by basement highs in the backarc and forearc region. The Bengkulu basin is interpreted having evolved from pull apart feature in the area southwest of the main Sumatra Fault System related to NW-SE trending in dextral shear.Based on Pyrolysis Yield (PY) vs Total Organic Carbon (TOC) diagram show that Seblat and Lemau Formation belongs to oil and Gas Prone with the quality of the source rocks includes into excellent and good (Lemau Formation), Fair and Poor (Seblat Formation). The fine-grained carbonaceous sediment of the Seblat dan Lemau Formations as source rocks, the coarse grained and carbonate sediments of the Seblat and Lemau Formations as reservoir rocks, claystone bed in Seblat and Lemau Formation as caprock. The source rocks maturation are late immature to early mature, with kerogen type II and III (Seblat Formation), and late immature to post mature with kerogen type I and III (Lemau Formation). The burial history show to 2500 m in depthh with paleo temperature reached 80oC. Trapping mechanism occur during Oligo–Miocene and Middle Miocene, mainly in block faulting system.

Keywords: fore arc, bengkulu, sumatra, sundaland, hydrocarbon, trapping mechanism

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586 Additional Usage of Remdesivir with the Standard of Care in Patients with Moderate And Severe COVID-19: A Tertiary Hospital’s Experience

Authors: Pugazhenthan Thangaraju

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Background: Since the pandemic began, more than millions of people have become infected with COVID-19. Globally, researchers are working for safe and effective treatments for this disease. Remdesivir is a drug that has been approved for the treatment of COVID-19. Many aspects are still being considered that may influence the future use of remdesivir. Aim: To assess the safety and efficacy of Remdesivir in hospitalized adult patients diagnosed with moderate and severe COVID-19. Methods: It was a record-based retrospective cohort study conducted between April 1st, 2020 and June 30th, 2021 at the tertiary care teaching hospital All India Institutes of Medical Sciences (AIIMS), Raipur Results: There were a total of 10,559 medical records of COVID-19 patients of which 1034 records were included in this study. Overall, irrespective of the survival status, there was statistical significant difference observed between the WHO score at the time of admission and discharge. Clinical improvement among the survivors was found to be statistically significant. Conclusion: Remdesivir's potential efficacy against coronaviruses has so far been limited to in vitro studies and animal models. However, information about COVID-19 is rapidly expanding. Several clinical trials for the treatment of COVID-19 with remdesivir are now underway. However, the findings of this study support remdesivir as a promising agent in the fight against SARS-CoV-2.

Keywords: Remdesivir, COVID-19, SARS-CoV-2, antiviral, RNA-dependent RNA polymerase, viral pneumonia

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