Search results for: tertiary

Authors: Rahaf Mandura, Fatmah Abusharkh, Layan Kurdi, Rahaf Shigdar, Khadijah Alattas

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Introduction: Age-related macular degeneration (AMD) in older individuals are serious health issues that severely impact the quality of life of millions globally. In 2020, the fourth leading cause of blindness worldwide was AMD. The global prevalence of AMD is estimated to be around 8.7%. AMD is a progressive disease involving the macular region of the retina, and it has a complex pathophysiology. RPE cell dysfunction plays a crucial step in the pathway leading to irreversible degeneration of photoreceptors with yellowish lipid-rich, protein-containing drusen deposits accumulating between Bruch's membrane and the RPE. Furthermore, lipofuscinogenesis, drusogenesis, inflammation, and neovascularization are four main processes responsible for the formation of the two types of AMD: the wet (exudative, neovascular) and dry (non-exudative, geographic atrophy) types. We retrospectively evaluated the prevalence of AMD among patients visiting the retina clinic at King Abdulaziz University Hospital (Jeddah, Makkah Province, Saudi Arabia) to identify the commonly associated risk factors of AMD. Methods: The records of 3,067 individuals from 2017 to 2021 were reviewed. Of these, 1,935 satisfied the inclusion criteria and were included in this study. We excluded all patient below 18 years, and those who did not undergo fundus imaging or attend their booked appointments, follow-ups, treatments, and referrals were excluded. Results: The prevalence of AMD among the patients was 4%. The age of patients with AMD was significantly greater than those without AMD (72.4 ± 9.8 years vs. 57.2 ± 15.5 years; p < 0.001). Participants with a family history of AMD tended to have the disease more than those without such a history (85.7% vs. 45%; p = 0.043). Ex- and current smokers were more likely to have AMD than non-smokers (34% and 18.6% vs. 7.2%; p < 0.001). Patients with hypertension and those without type 1 diabetes were at a higher risk of developing AMD than those without hypertension (5.5% vs. 2.8%; p = 0.002) and those with type 1 diabetes (4.2% vs. 0.8%; p = 0.040). In contrast, sex, nationality, type 2 diabetes, and abnormal lipid profile were not significantly associated with AMD. Regarding the clinical characteristics of AMD cases, most cases (70.4%) were of the dry type and affected both eyes (77.2%). The disease duration was ≥5 years in 43.1% of the patients. The most frequent chronic diseases associated with AMD were type 2 diabetes (69.1%), hypertension (61.7%), and dyslipidemia (18.5%). Conclusion: In summary, our single tertiary center study showed that AMD is widely prevalent in Jeddah, Saudi Arabia (4%) and linked to a wide range of risk factors. Some of these are modifiable risk factors that can be adjusted to help reduce AMD occurrence. Furthermore, this study has shown the importance of screening and follow-up of family members of patients with AMD to promote early detection and intervention of AMD. We recommend conducting further research on AMD in Saudi Arabia. Concerning the study design, a community-based cross-sectional study would be more helpful for assessing the disease's prevalence. Finally, recruiting a larger sample size is required for more accurate estimation.

Keywords: age related macular degeneration, prevelence, risk factor, dry AMD

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Authors: Nwobu Obiamaka, Samuel O. Faboyede

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This study examines the factors influencing career choice of undergraduate accounting students in selected Nigerian universities. The manner in which students of accounting perceive the factors that drive them into pursuing a career in accounting is important to the profession. The study made use of primary data collected from undergraduate accounting students in their final year in selected Nigerian universities. The data was collected using a survey instrument (questionnaire), copies of which were made and administered to the respondents (undergraduate accounting students in selected Nigerian universities). The finding suggests that the major factors influencing undergraduate accounting students to opt for a career in accounting include pressure from peers and monetary reward. The findings from the study have crucial policy implications for admission officers in tertiary institutions as well as the accounting profession in Nigeria.

Keywords: accounting, career, choice, undergraduate

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Authors: Sunday Ose Ugadu

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Unemployment, especially graduate unemployment is, for now, the greatest problem facing Nigeria as a nation. It is responsible for most of the other ills of the country, including kidnapping, armed robbery, youth restiveness, thuggery, to mention but a few. More and more people in Nigeria are now losing confidence in the prospect of tertiary education as an instrument par excellence for effecting national development. This paper, therefore, critically examined the problem of graduate unemployment in Nigeria. It briefly traced the history of university education in Nigeria. The rate and causes of graduate unemployment in Nigeria were also discussed. Previous attempts made by the government to solve the problem of unemployment were highlighted. The paper also harped on the prospect of entrepreneurship education as an instrument for fighting graduate unemployment identifying obstacles to entrepreneurship education in Nigeria. The paper drew conclusion, and major recommendation made was a call for converting the National Youth Service Corps Scheme in Nigeria to entrepreneurship and skills acquisition scheme as soon as possible.

Keywords: graduate, unemployment, entrepreneurship education, national development

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Authors: Silpa Mariyam John, S. Baburaj, Prajit Geevarghese

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Diabetes accelerates pregnancy and can cause adverse effects on the fetus. Studies have shown that fetal abdominal circumference measured in ultrasound is an early parameter for the assessment of macrosomia. The objective of the study is to compare the fetal abdominal circumferences between diabetes and non-diabetic mothers. It was a comparative cross-sectional study conducted in a tertiary care hospital in Trivandrum, Kerala, with a sample size calculated as 95 for each group. All mothers taking antenatal care and delivering at the hospital were included after obtaining consent. The mothers and their newborns were divided into 2 groups (diabetic and non-diabetic). Relevant fetal biometry values were collected from medical records, and birth weight was measured by a calibrated electronic weighing machine after birth. The data were entered in MS EXCEL and analyzed. It was found that there is a significant relationship between the fetal abdominal circumference and birthweight in diabetic mothers during the first and third trimesters.

Keywords: newborn, diabetes, abdominal circumference, ultrasound

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Authors: Stephany Inalegwu

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Museums play a very critical role in understanding the cultural values and the history of any given society in Nigeria and the world at large. The role of Museums as an avenue through which artefacts are collected, preserved and exhibited cannot be over emphasized as they are now seen as not only with the above stated aims but also as a creator of employment and revenue generation if properly harnessed. Interestingly, despite its importance, museum studies have been limited to University curriculum alone causing a dearth of information for the younger generation up until they attain the University age. It is against this background that this paper carefully analyses the definitions of museums, the state of museums and museum studies in Nigeria today and the need to include its studies at all the levels of Education in Nigeria from the primary, to secondary and tertiary levels. It should reflect a study of all ages, as this is vital in the development of individuals. It concludes by harping on the need for a better appreciation of the Nigerian culture ranging from the famous Nok Terracotta, Benin Bronze works etc and its importance of museums as an avenue to display the rich Nigerian cultural heritage.

Keywords: culture, curriculum, education, museum

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Authors: Shilpa K. Nandwani, Mousumi Chakraborty, Smita Gupta

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When selecting surfactants for surfactant flooding during enhanced oil recovery, the most important criteria is that the surfactant system should reduce the interfacial tension between water and oil to ultralow values. In the present study, a mixture of ionic liquid surfactant and commercially available binding agent sodium tosylate has been used as a surfactant mixture. Presence of wormlike micelles indicates the possibility of achieving ultralow interfacial tension. Surface tension measurements of the mixed surfactant system have been studied. The emulsion size distribution of the mixed surfactant system at varying salinities has been studied. It has been found that at high salinities the viscoelastic surfactant system loses their efficacy and degenerate. Hence the given system may find application in low salinity reservoirs, providing good mobility to the flood during tertiary oil recovery process.

Keywords: ionic liquis, interfacial tension, Na-tosylate, viscoelastic surfactants

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Authors: Lauren Dhugga, Meena Parameswaran, David Blundell, Abbas Khushnood

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Context: A multidisciplinary weekly safety briefing was implemented at the Paediatric Cardiothoracic Unit at the Freeman Hospital in Newcastle-upon-Tyne. It is a tertiary referral centre with a quarternary cardiac paediatric intensive care unit and provides complexed care including heart and lung transplants, mechanical support and advanced heart failure assessment. Aim: The aim of this briefing is to provide a structured platform of communication, in an effort to improve efficiency, safety, and patient care. Problem: The paediatric cardiothoracic unit is made up of a vast multidisciplinary team including doctors, intensivists, anaesthetists, surgeons, specialist nurses, echocardiogram technicians, physiotherapists, psychologists, dentists, and dietitians. It provides care for children with congenital and acquired cardiac disease and is one of only two units in the UK to offer paediatric heart transplant. The complexity of cases means that there can be many teams involved in providing care to each patient, and frequent movement of children between ward, high dependency, and intensive care areas. Currently, there is no structured forum for communicating important information across the department, for example, staffing shortages, prescribing errors and significant events. Strategy: An initial survey questioning the need for better communication found 90% of respondents agreed that they could think of an incident that had occurred due to ineffective communication, and 85% felt that incident could have been avoided had there been a better form of communication. Lastly, 80% of respondents felt that a weekly 60 second safety briefing would be beneficial to improve communication within our multidisciplinary team. Based on those promising results, a weekly 60 second safety briefing was implemented to be conducted on a Monday morning. The safety briefing covered four key areas (SAFE): staffing, awareness, fix and events. This was to highlight any staffing gaps, any incident reports to be learned from, any issues that required fixing and any events including teachings for the week ahead. The teams were encouraged to email suggestions or issues to be raised for the week or to approach in person with information to add. The safety briefing was implemented using change theory. Effect: The safety briefing has been trialled over 6 weeks and has received a good buy in from staff across specialties. The aim is to embed this safety briefing into a weekly meeting using the PDSA cycle. There will be a second survey in one month to assess the efficacy of the safety briefing and to continue to improve the delivery of information. The project will be presented at the next clinical governance briefing to attract wider feedback and input from across the trust. Lessons: The briefing displays promise as a tool to improve vigilance and communication in a busy multi-disciplinary unit. We have learned about how to implement quality improvement and about the culture of our hospital - how hierarchy influences change. We demonstrate how to implement change through a grassroots process, using a junior led briefing to improve the efficiency, safety, and communication in the workplace.

Keywords: briefing, communication, safety, team

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Authors: Wiyanti Fransisca Simanullang, Shinya Yamanaka

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Grinding method was used to control the active site and to improve the specific surface area (SSA) of calcium oxide (CaO) derived from scallop shell as a sustainable resource. The dry grinding of CaO with acetone and tertiary butanol as a liquid additive was carried out using a planetary ball mill with a laboratory scale. The experiments were operated by stepwise addition with time variations to determine the grinding limit. The active site of CaO was measured by X-Ray Diffraction and FT-IR. The SSA variations of products with grinding time were measured by BET method. The morphology structure of CaO was observed by SEM. The use of liquid additive was effective for increasing the SSA and controlling the active site of CaO. SSA of CaO was increased in proportion to the amount of the liquid additive and the grinding time. The performance of CaO as a solid base catalyst for biodiesel production was tested in the transesterification reaction of used cooking oil to produce fatty acid methyl ester (FAME).

Keywords: active site, calcium oxide, grinding, specific surface area

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Authors: Peter Okpamen

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The issue of environmental degradation in Nigeria is of serious concern. The colonial period brought a major change in environmental awareness and relationship with the environment. This period introduced a model of development, the major thrust of which was the exploration and transformation of natural and human resources for the benefit of the colonial masters. There is abundant evidence in the literature that there are various manifestations of environmental degradation in Nigeria, which have resulted in the various problems found throughout the Nigeria national space. The idea of the environment acting as a constraint to the growth of human activity has given way to the contrary. Environmental education, going by the literature, exists at the primary, secondary and tertiary institutions. In short, the 1st National conference on environmental education gave several suggestions on how it could be realised. Thus, to realise sustainable environmental development we need to accelerate the process of providing basic education for both the old and young. Environmental education should cover the whole federation, and resources should be made available for the training of environmental education teachers and research into environmental education for the development of appropriate learning resources.

Keywords: degradation, development, education, environment, sustainable

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Authors: Stanley Fore, Gaetan Ngabonziza

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In spite of the need for skilled labour in South Africa, tertiary education graduates are increasingly faced with unemployment, which poses a serious obstacle to the economic growth of the country. This paper is an outcome of the study that investigated students’ perceptions on the role of entrepreneurship education in enhancing graduates’ self-employment. The study was descriptive in nature and used a survey questionnaire to answer questions pertaining to the extent to which entrepreneurship education is important in enhancing self-employment endeavours. Collected data were analysed using of the statistical software for social science (SPSS) for descriptive statistics in the form of tables and charts. The study found that entrepreneurship education is critical in providing knowledge and skills that are required to succeed in self-employment. As one module of entrepreneurship does not ensure self-employment orientation or more positive expectations about entrepreneurial abilities and careers, this study suggests that students, irrespective of their field of study, should be given entrepreneurship modules in every academic year. This will help in reminding them that their success does not solely rely on their ability to find a better-paying employment but also on their ability to employ themselves.

Keywords: entrepreneurship, education, self-employment, students

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Authors: Md. Samsuddin Ansari, Ashish Arora

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Every year 10 million people fall ill with one of the oldest diseases known as tuberculosis, caused by Mycobacterium tuberculosis. The success of M. tuberculosis as a pathogen is because of its ability to persist in host tissues. Multidrug resistance (MDR) mycobacteria cases increase every day, which is associated with efflux pumps controlled at the level of transcription. The transcription regulators of MDR transporters in bacteria belong to one of the following four regulatory protein families: AraC, MarR, MerR, and TetR. Phenolic acid decarboxylase repressor (PadR), like a family of transcription regulators, is closely related to the MarR family. Phenolic acid decarboxylase repressor (PadR) was first identified as a transcription factor involved in the regulation of phenolic acid stress response in various microorganisms (including Mycobacterium tuberculosis H37Rv). Recently research has shown that the PadR family transcription factors are global, multifunction transcription regulators. Rv0047c is a PadR subfamily-1 protein. We are exploring the biophysical and structural characterization of Rv0047c. The Rv0047 gene was amplified by PCR using the primers containing EcoRI and HindIII restriction enzyme sites cloned in pET-NH6 vector and overexpressed in DH5α and BL21 (λDE3) cells of E. coli following purification with Ni2+-NTA column and size exclusion chromatography. We did DSC to know the thermal stability; the Tm (transition temperature) of protein is 55.29ºC, and ΔH (enthalpy change) of 6.92 kcal/mol. Circular dichroism to know the secondary structure and conformation and fluorescence spectroscopy for tertiary structure study of protein. To understand the effect of pH on the structure, function, and stability of Rv0047c we employed spectroscopy techniques such as circular dichroism, fluorescence, and absorbance measurements in a wide range of pH (from pH-2.0 to pH-12). At low and high pH, it shows drastic changes in the secondary and tertiary structure of the protein. EMSA studies showed the specific binding of Rv0047c with its own 30-bp promoter region. To determine the effect of complex formation on the secondary structure of Rv0047c, we examined the CD spectra of the complex of Rv0047c with promoter DNA of rv0047. The functional role of Rv0047c was characterized by over-expressing the Rv0047c gene under the control of hsp60 promoter in Mycobacterium tuberculosis H37Rv. We have predicted the three-dimensional structure of Rv0047c using the Swiss Model and Modeller, with validity checked by the Ramachandra plot. We did molecular docking of Rv0047c with dnaA, through PatchDock following refinement through FireDock. Through this, it is possible to easily identify the binding hot-stop of the receptor molecule with that of the ligand, the nature of the interface itself, and the conformational change undergone by the protein pattern. We are using X-crystallography to unravel the structure of Rv0047c. Overall the studies show that Rv0047c may have transcription regulation along with providing an insight into the activity of Rv0047c in the pH range of subcellular environment and helps to understand the protein-protein interaction, a novel target to kill dormant bacteria and potential strategy for tuberculosis control.

Keywords: mycobacterium tuberculosis, phenolic acid decarboxylase repressor, Rv0047c, Circular dichroism, fluorescence spectroscopy, docking, protein-protein interaction

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Authors: U. P. Rathnakar, Medha Urval, K. Ashok Shenoy

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Introduction: There are many tools available for the measurement of health literacy. REALM (Rapid Estimate of Adult Literacy in Medicine) is a very commonly used tool in advanced countries. It comes in two forms-one with 66 words and shorter version (REALM-SF) with seven words. We decided to test the applicability of shorter version of the REALM test among our patients. Methodology: REALM (SF) was tested among 200 patients in a tertiary hospital. Discussion and conclusion: From the analysis of results, when the results of pronunciation indicate adequate levels of HL skills, analysis of comprehension shows that mere reading skills is likely to be misleading. So it is proposed that in Indian population who have adequate reading skills without adequate comprehension the REALM-SF test tool in its present form may not be an ideal testing tool for assessing HL.

Keywords: health literacy, REALM, short form, India

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Authors: David J. Thomson, Joshua C. J. Chew

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Background: Syndrome of Irreversible Lithium-Effectuated Neurotoxicity (SILENT) is a rare complication of lithium toxicity that typically causes irreversible cerebellar dysfunction. These patients may require hemodialysis and extensive supports in the intensive care. Methods: A review was performed on the available literature of SILENT with a focus on current pathophysiological hypotheses and advances in treatment. Articles were restricted to the English language. Results: Although the exact mechanism is unclear, CNS demyelination, especially in the cerebellum, was seen on the brain biopsies of a proportion of patients. There is no definitive management of SILENT but instead current management is focused on primary and tertiary prevention – detection of those at risk, and rehabilitation post onset of neurological deficits. Conclusions: This review draws conclusions from a limited amount of available literature, most of which are isolated case reports. Greater awareness of SILENT and further investigation into the risk factors and pathogenesis are required so this serious and irreversible syndrome may be avoided.

Keywords: lithium toxicity, pathogenesis, SILENT, syndrome of irreversible lithium-effectuated neurotoxicity

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Authors: Kira Merigan

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BACKGROUND- Fertility preservation (FP) measures are increasingly recognised as an important consideration for children and adolescents planned to undergo potentially damaging gonadotoxic therapy. Worldwide, there are very few documented cases of FP in young females by way of ovarian stimulation and oocyte cryopreservation.AIM – To report a case series of mature oocyte cryopreservation in 5post-pubertal adolescents aged 14-17 years old, with varied medical conditions requiring gonadotoxic treatment. SETTING-These cases took place via a multidisciplinary team approach at The Royal Children’s Hospital, a large tertiary centre in Melbourne, Australia. INTERVENTION– Ovarian stimulation and oocyte collection was performed as detailed in each case. RESULTS –Across the 5 patients, 3-28 oocytes were retrieved. We report pre-treatment workup, complications, and delays to treatment. CONCLUSION- Oocyte cryopreservation may be a safe alternative to ovarian tissue cryopreservation (OTC) in the adolescent population

Keywords: fertility preservation, adolescent, ovarian stimulation, oocyte cryopreservation

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Authors: Kaliammah Kumaran, Thilaagheswary Thangadurai

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This study examined the relationship between anxious attachment and avoidant attachment among young adult romantic relationship quality. Our survey was administered to 300 young adult participants (126 males and 174 females) aged 18-24 years old (M= 20.85, SD=1.89), accomplished the English version of the Revised Adult Attachment Scale (RAAS) used to measure adult attachment and Revised Dyadic Adjustment Scale (RDAS). All the participants were tertiary level students. Findings of our study indicated that young adults experienced anxious attachment style is negatively correlated with romantic relationship quality as well as young adult from avoidant attachment also negatively correlated with romantic relationship quality among young adults. The results showed that insecure adult attachment styles which are anxious and avoidance adult attachment styles links with reduced quality of romantic relationship.

Keywords: adult attachment style, anxious attachment style, avoidant attachment style, romantic relationship quality

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Authors: Kanokrat Makkwao, Tassanee Prueksasit

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This study aimed to investigate PM₁₀ emitted from different limestone mines in Saraburi province, Thailand. The blasting and crushing were the main processes selected for PM₁₀ sampling. PM₁₀ was collected in two mines including, a limestone mine for cement manufacturing (mine A) and a limestone mine for construction (mine B). The IMPACT samplers were used to collect PM₁₀. At blasting, the points aligning with the upwind and downwind direction were assigned for the sampling. The ranges of PM₁₀ concentrations at mine A and B were 0.267-5.592 and 0.130-0.325 mg/m³, respectively, and the concentration at blasting from mine A was significantly higher than mine B (p < 0.05). During crushing at mine A, the PM₁₀ concentration with the range of 1.153-3.716 and 0.085-1.724 mg/m³ at crusher and piles in respectively were observed whereas the PM₁₀ concentration measured at four sampling points in mine B, including secondary crusher, tertiary crusher, screening point, and piles, were ranged 1.032-16.529, 10.957-74.057, 0.655-4.956, and 0.169-1.699 mg/m³, respectively. The emission of PM₁₀ concentration at the crushing units was different in the ranges depending on types of machine, its operation, dust collection and control system, and environmental conditions.

Keywords: PM₁₀ concentration, limestone mines, blasting, crushing

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Authors: Budi Annisa Sidi

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Present-day Indonesia maintains a narrative of a culturally plural but unified nation. At the same time, multicultural policies extend different degrees of recognition, accommodation, toleration and even discrimination towards different socio-cultural groups. In conjunction with different ethnographic landscapes across regions in Indonesia, this approach leads to a varied experience and understanding of national identity and multiculturalism among people. As a result, governments seeking to maintain national unity while practicing multiculturalism have to juggle different expectations. This situation is examined through the microcosms of university students using questionnaires followed up by focus group discussions and personal interviews. A comparison between university students across four different provinces in Indonesia (Aceh, Jakarta, West Java and the Moluccas) highlights the influence of one’s surroundings on their perception of multiculturalism. Students in the more heterogeneous areas generally show more acceptance towards diversity compared to students in primarily homogenous areas who have little actual experience in dealing with diversity. Regardless of their environment, students claim to have positive feelings and a strong sense of attachment to Indonesia but hold different ideas of what constitutes an ideal Indonesian national identity.

Keywords: Indonesia, multiculturalism, national identity, nationalism

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Authors: Krishnamoorthy Shanmugaraj, Malaichamy Ilanchelian

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Ascorbic acid is an essential component in the diet of humans, and also is a typical long used pharmaceutical agent. In the present contribution, we have carried out a detailed study on the binding interaction of ascorbic acid (AA) with bovine hemoglobin (BHb) using steady state emission, time resolved fluorescence, UV-Vis absorption, circular dichroism (CD), Fourier transform infra-red (FT-IR) and three dimensional emission (3D) spectral studies. The results from the emission spectral studies unveiled that the quenching of BHb emission by AA is attributed to the formation of a complex in the ground state (static in nature) after correcting for inner filter effect. The binding parameters calculated from corrected emission quenching data revealed that BHb exhibited a significant binding affinity towards AA. Moreover, AA induced tertiary and secondary conformational changes of BHb were monitored by UV-Vis absorption, CD, FT-IR and 3D emission spectral studies. The results presented here will help to further understand the credible mechanism of BHb-AA system which is expected to provide insights into conformational and microenvironmental changes of BHb.

Keywords: ascorbic acid, bovine hemoglobin, circular dichroism, three dimensional emission spectral studies

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Authors: Cheng Shuk Ling

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This paper examines the English syntactic errors and their patterns in the written assignments of a General Education course at City University of Hong Kong. Subjects are 60 local and non-local (exchange) undergraduate students who are all EFL learners and L2 users with diversified education and disciplinary background (i.e. their major of study), which are unrelated to English language studies. The objective of this paper brings to the foreground a broad discussion of EFL/L2 undergraduate learners’ average syntactic ability in terms of written assessment. This paper is an attempt in classifying the patterns and categories of syntactic errors committed by students who were brought up and educated in non-native English-speaking countries. Thus, pedagogical recommendations are offered for both EFL/L2 learners and educators in tertiary education settings in such ways as to calibrate how and in what manner English language as the medium of instruction can lead to more enduring effects in learners within non-native English-speaking countries.

Keywords: syntactic errors, english as a foreign language, second language users, pedagogy

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Authors: Marilyn U. Balagtas, Maria Ruth M. Regalado, Carmelina E. Barrera, Ramer V. Oxiño, Rosarito T. Suatengco, Josephine E. Tondo

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This study presents the perceptions of the students and teachers from kindergarten to tertiary level of the image of the 21st century teacher to provide basis in designing teacher development programs in Teacher Education Institutions (TEIs) in the Philippines. The highlights of the report are the personal, psychosocial, and professional images of the 21st century teacher in basic education and the teacher educators based on a survey done to 612 internal stakeholders of nine member institutions of the National Network of Normal Schools (3NS). Data were obtained through the use of a validated researcher-made instrument which allowed generation of both quantitative and qualitative descriptions of the teacher image. Through the use of descriptive statistics, the common images of the teacher were drawn, which were validated and enriched by the information drawn from the qualitative data. The study recommends a repertoire of teacher development programs to create the good image of the 21st century teachers for a better Philippines.

Keywords: teacher image, 21st century teacher, teacher education, development program

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Authors: Sireethorn Nimitvilai, Ussanee Poolvivatchaikarn, Nuchanart Tomeun

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Objective: To determine the simple laboratory parameters to predict disease severity among COVID-19 patients in resource-limited settings. Material and methods: A retrospective cohort study was conducted at Nakhonpathom Hospital, a 722-bed tertiary care hospital, with an average of 50,000 admissions per year, during April 15 and May 15, 2021. Eligible patients were adults aged ≥ 15 years who were hospitalized with COVID-19. Baseline characteristics, comorbid conditions ad laboratory findings at admission were collected. Predictive factors for severe COVID-19 infection were analyzed. Result: There were 207 patients (79 male and 128 female) and the mean age was 46.7 (16.8) years. Of these, 39 cases (18.8%) were severe and 168 (81.2%) cases were non-severe. Factors associated with severe COVID-19 were neutrophil to lymphocyte ratio ≥ 4 (OR 8.1, 95%CI 2.3-20.3, P < 0.001) and C-reactive protein to albumin ratio ≥ 10 (OR 3.49, 95%CI 1.3-9.1, p 0.01). Conclusions: Complete blood counts, C-reactive protein and albumin are simple, inexpensive, widely available tests and can be used to predict severe COVID-19 in resource-limited settings.

Keywords: COVID-19, predictor of severity, resource-limiting settings, simple laboratory parameters

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Authors: Onyebueke Godwin, Okwarafor Friday

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Introduction: Persons with HIV/AIDS disease are predisposed to mental health disorders such as depression and suicide. HIV/AIDS, being a chronic medical illness with antecedent stigmatization ostracization, leads to low mood, low self-esteem, and a tendency to kill oneself due to the burden of the disease in terms of cost and disability. The aim of one study was to examine the prevalence of depression and risk of suicide among HIV/AIDS patients compared to negative persons. Instruments: The Major Depressive Episode and Suicidality modules of the MINI-Neuropsychiatric inventory were used to screen the attendees. Report: The prevalence of depression and risk of suicide were 27.8% and 7.8%, respectively, for the HIV positive subjects, but 1208% and 2.2%, respectively, for negative subjects. Conclusion and Significance: Persons with HIV/AIDS usually present with mental health symptoms, but the attending physicians usually pay attention to physical symptoms. The symptoms of the disease or the side effects of the medication may mask the mental health disease. Recommendation: There is need to screen HIV/AIDS patents for mental health disorders during clinic visits.

Keywords: depression, HIV/AIDS, suicidality

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Authors: Rita Darmayanti

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This study aims at investigating the discourse pattern and structure of research article abstracts. The characteristics of the language used in abstracts written by non-native English-speaking (NNES) novice researchers are mainly examined in terms of rhetorical moves and the degree of variability of the rhetorical features as indicated by the structure of clauses and the linguistic features of the text. To this end, 20 abstracts written by undergraduate students of the accounting department at the State Polytechnic of Malang in 2018-2019 were employed as the data of this study. Findings showed that the most frequently used pattern of the rhetorical move is I(Introduction)-P(Purpose)-M(Method)-Pr(Product or Result)-C(Conclusion) with the significant use of active sentence and present and past tense. The findings of the study are projected to be utilized for evaluating the quality of students’ abstracts and generating a pedagogical proposal of ESP writing course or at least providing a critical review of current practices in ESP program intended for non-native English students at tertiary level.

Keywords: rhetorical features, rhetorical moves, non-native English-speaking novice researchers, research abstract

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Authors: Azza Mohsin Al-Hashami, Reginald Victor

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Treatment of wastewater involves physical, chemical, and biological processes to remove the pollutants from wastewater. This study evaluates of the effectiveness of sewage treatment plants (STP) in Samail, Oman. Samail STP has tertiary treatment using conventional activated sludge with surface aeration. The collection of wastewater is through a network with a total length of about 60 km and also by tankers for the areas outside the network. Treated wastewater from this STP is used for the irrigation of vegetation in the STP premises and as a backwash for sand filters. Some treated water is supplied to the Samail municipality, which uses it for the landscaping, road construction, and 'the Million Date Palms' project. In this study, homogenous samples were taken from eight different treatment stages along the treatment continuum for one year, at a frequency of once a month, to evaluate the physical, chemical, and biological parameters. All samples were analyzed using the standard methods for the examination of water and wastewater. The spatial variations in water quality along the continuum are discussed. Despite these variations, the treated wastewater from Samail STP was of good quality, and most of the parameters are within class A category in Oman Standards for wastewater reuse and discharge.

Keywords: wastewater, STP, treatment, processes

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Authors: K. Adu Michael, K. Alese Boniface

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Developing a reliable and sustainable software products is today a big challenge among up–coming software developers in Nigeria. The inability to develop a comprehensive problem statement needed to execute proper requirements engineering process is missing. The need to describe the ‘what’ of a system in one document, written in a natural language is a major step in the overall process of Software Engineering. Requirements Engineering is a process use to discover, analyze and validate system requirements. This process is needed in reducing software errors at the early stage of the development of software. The importance of each of the steps in Requirements Engineering is clearly explained in the context of using detailed problem statement from client/customer to get an overview of an existing system along with expectations from the new system. This paper elicits inadequate Requirements Engineering principle as the major cause of poor software development in developing nations using a case study of final year computer science students of a tertiary-education institution in Nigeria.

Keywords: client/customer, problem statement, requirements engineering, software developers

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Authors: Eldah Ephraim Buba

Abstract:

This paper evaluated the quality of tourism education in Nigeria higher education. The problem of poor quality of tourism education in Nigeria’s higher institutions prompted the study. Archival research was used with evaluation reports as secondary data, twenty evaluation reports for different polytechnics from the National board for technical education (NBTE) from 1995-2012 were assessed. The evidence from the documents shows that the quality of teaching and evaluation is fair. The programmes resources are fairly good, and most of the teachers do not have a postgraduate qualification in tourism related courses. It is therefore recommended that the institutions running tourism programmes in Nigeria need to introduce self -assessment of programmes and not rely on the NBTE accreditation which comes up in three years. Also there is need for a staff development policy that will encourage Tourism educators to further their education; The Tertiary Educational Trust Fund (TETFUND) should focus on developing staff of tourism education because it is an area of study in Nigeria that lacks qualified personnel. With the way higher institution in Nigeria are finding interest in tourism programmes, having good quality programmes will not only produce better professionals but it will help in offering better services in the industry and maximizing the impacts of the business.

Keywords: education, evaluation, tourism quality, self-assessment

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Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo N. Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: While delays to care exist in resource rich settings, greater delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of traumatic brain injury (TBI) in Sub Saharan Africa (SSA). While many LMICs have government subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold. First, due to a lack of a functional CT scanner at the tertiary hospital, patients need to arrange their own transportation to the nearby private facility for CT scans. Second, self-financing for the private CT scans ranges from $80 - $130, which is near the average monthly income in Kampala. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified ‘three delays’ framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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Authors: Wincharles Coker

Abstract:

This study troubles the role the state as the chief sponsor of higher education plays in shaping communication training in Ghana. Using a public university as a case study, it explores how the government of Ghana, through its regimes of control, exercises its authority over the means of production in the academy. Based on Wenger’s community of practice theory and critical theory, the research analyzes the political economy within which higher education in the country operates, focusing on the mandates of two of its bodies: the National Council for Tertiary Education (NCTE) and the National Accreditation Board (NAB). Results show that communication training in Ghana is shaped by three basic strategies of control: developmentalism, bureaucratization, and corporatization. This governmentality, the research reveals nonetheless, largely constrains the agency and practices of the community of communication faculty and administrators, and thus presents a major challenge to the exercise of intellectual freedom, and the self-critical nature of the academy. The study bears implications for further research in the political economy of communication studies, the administration of higher education, and critical/cultural studies in education.

Keywords: communication, developmentalism, educattion, governmentality

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Authors: Delly C. Lestari, Linosefa, Ardiana Kusumaningrum, Andi Yasmon, Anis Karuniawati

Abstract:

The objective of this study is to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mecA genes from screening isolates among intensive care unit (ICU) patients. All MRSA screening isolates from ICU’s patients of Cipto Mangunkusumo Hospital during 2011 and 2014 were included in this study. Identification and susceptibility test was performed using Vitek2 system (Biomereux®). PCR was conducted to characterize the SCCmec of S. aureus harboring the mecA gene on each isolate. Patient’s history of illness was traced through medical record. 24 isolates from 327 screening isolates were MRSA positive (7.3%). From PCR, we found 17 (70.8%) isolates carrying SCCmec type I, 3 (12.5%) isolates carrying SCCmec type III, and 2 (8.3%) isolates carrying SCCmec type IV. In conclusion, SCCmec type I is the most prevalent MRSA colonization among ICU patients in Cipto Mangunkusumo Hospital.

Keywords: MRSA, mecA genes, ICU, colonization

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Authors: B. Unnikrishnan, Tanuj Kanchan, Ramesh Holla, Nithin Kumar

Abstract:

Euthanasia has been debated for the ethical, legal, social, and religious implications associated with it. The present research was conducted to study the perceptions of doctors and nurses about ethical and legal aspects of Euthanasia in Indian scenario. The study was carried out at three tertiary care hospitals of Kasturba Medical College (KMC), Mangalore, India. Practicing doctors and nurses working in the hospitals associated with KMC were included in the study after taking written informed consent from the participants. The data was analyzed using SPSS version 11.5. Mann-Whitney U test was used to compare the responses of doctors and nurses. P-value of <0.05 was taken as statistically significant. A total of 144 doctors and nurses participated in the study. Both doctors and nurses agreed that if a terminally ill patient wishes to die, the wish cannot be honored ethically and legally. A significantly larger number of nurses agreed that patient’s wish for euthanasia cannot be honored ethically and legally when compared to the doctors. Though the doctors and nurses were broadly in agreement with the existing legal and ethical views on the issue, their knowledge on the issue with regard to the legal status of euthanasia in India and ethical aspects relating to it needs to be strengthened.

Keywords: euthanasia, ethical aspects, legal aspects, India

Procedia PDF Downloads 281