Evaluation of free i-applications for tertiary level gross anatomy education

Directory of Open Access Journals (Sweden)

Matthew F. Pollard

2012-04-01

Full Text Available BackgroundThe use of electronic resources in education, including i-applications used on portable handheld devices, is increasing. Apple® handheld devices are popular, with free applications the most prevalent download form. Many gross anatomy i-applications are available, however no information on the quality of free anatomy products is available. Rating such products could therefore guide product recommendations.AimTo evaluate the quality and range of free iPod® applications that are applicable for tertiary level gross anatomy education.MethodsA search of the iTunes® Application Store with keywords anatomy, free, medical, functional, clinical, gross, and human was performed, with inclusion based on free applications containing human gross anatomy usable for tertiary education purposes. Application specification was noted; each was trialled independently and rated for usability, specification, academic level, and quality (image and programme.ResultsSixty-three applications were identified and eleven met inclusion criteria. Two provided gross anatomy of the entire body, nine examined specific regions or systems. Five were judged introductory in academic level, five intermediate, and one advanced. One application was rated low quality, and four excellent. None were considered difficult to use (six easy, five medium. Application size ranged between 1.2MB and 229MB (mean 27MB.ConclusionsThere are few free i-applications for learning gross anatomy and most concentrate on individual body systems, with the academic level and usability of all products well rated. Results suggest some free I-applications could be suitable adjuncts for gross anatomy education at both an undergraduate and graduate level.

Tertiary Education and the Crisis of Public Finance

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Milos Maryska

2012-04-01

Full Text Available Turbulent economic environment after overwhelming the last crisis period is typical for present days as well as permanent increasing dependability of all our activities on information and communication technology (ICT. Although the global economic crisis was the reason for disinvestment into ICT in 2009 there is expected that ICT will generate almost 5.8 million new jobs in Europe till year 2013 and they have to be saturated also by adequately qualified ICT specialists.This contribution presents the research in the progress focused on the tertiary education system in the Czech Republic. We are predicting trends in education and especially in ICT education in Europe and in the Czech Republic as well for next ten years. We can expect that future ten years period will be critical not only for the Czech tertiary education system, but also for the Czech Republic because number of ICT students will be decreasing and number of ICT specialist demanded by labor market will be increasing. From macroeconomic point of view we can expect that also state subventions into state governed tertiary education system will decrease in the whole Europe.Some recommendations, proposals and forecasts for further development of education system are presented at the end of this contribution.

An Integrated Skills Approach Using Feature Movies in EFL at Tertiary Level

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Tuncay, Hidayet

2014-01-01

This paper presents the results of a case study based on an integrated skills approach using feature movies (DVDs) in EFL syllabi at the tertiary level. 100 students took part in the study and the data was collected through a three - section survey questionnaire: demographic items, 18 likert scale questions and an open-ended question. The data…

Entrepreneurship Education at Tertiary Education Level: Implication to Historical Studies

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Salahu Mohammed Lawal

2012-07-01

Full Text Available Nigeria is richly endowed with both human and material resources that when well utilized can make her one of the richest and developed nation in the world.  But poor utilization of the resources, corruption and dwindling fortune in her education system made her among the first twenty five poorest nations in the world.  Similarly, report shows that 26% of the employable population remained unemployed.  This called for the need for entrepreneurship education most especially at tertiary level where high level manpower is supposed to be trained.  It is on this premise that the paper attempts to examine entrepreneurship education and its implication to history students and graduates.

Analysis of Management Practices in Lagos State Tertiary Institutions through Total Quality Management Structural Framework

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AbdulAzeez, Abbas Tunde

2016-01-01

This research investigated total quality management practices and quality teacher education in public tertiary institutions in Lagos State. The study was therefore designed to analyse management practices in Lagos state tertiary institutions through total quality management structural framework. The selected public tertiary institutions in Lagos…

Anthropometric Indicators in Children Referred to a Tertiary-level Public Health Care Institution from Buenos Aires, Argentina

International Nuclear Information System (INIS)

Janjetic, Mariana Andrea; Mantero, Paula; Zubillaga, Marcela Beatriz; Boccio, José; Goldman, Cinthia

2014-01-01

Full text: Introduction: Stunting is a multifactorial phenomenon with a high prevalence in developing countries. Helicobacter pylori, a bacterium that colonizes the gastric mucosa, has been related to growth impairment due to micronutrient malabsorption. However this hypothesis remains controversial. Objective: The aim of our work was to determine anthropometric indicators in children referred to a Tertiary-level Public Health Care Institution from Buenos Aires, Argentina, for upper gastrointestinal symptoms evaluation. Methods: 525 children (4-16 y) assisting to the Gastroenterology Unit of the Hospital de Niños “Sor María Ludovica”, La Plata, Argentina, were diagnosed for H. pylori infection by the 13C-Urea Breath Test. Weight and height were measured for calculation of anthropometric indicators height for age (HAZ), weight for age (WAZ) and Body Mass Index for age (BMI) using the Anthro Plus 2007 software of the World Health Organization. Statistical analysis was performed by Student’s t Test, Mann-Whitney Test and lineal regression. Results: Prevalence of H. pylori infection was 25.1% (95% CI, 21.5-29.5), with a mean age of the children similar in both groups, 10.1y (95% CI, 9.8-10.3y). Mean HAZ and WAZ were -0.40 (95% CI, -0.57-[-0.22]) and -0.31 (95% CI, -0.51-[-0.11]) in the positive group, and -0.18 (95% CI, -0.28-[-0.09]) and -0.10 (95% CI, -0.21-0.01) in the negative group. HAZ was significantly lower in the positive group (p = 0.04), while no significant differences were found for WAZ (p = 0.07) and BMI for age (p = 0.20) between both groups. However, after adjusting for confounding factors these differences were no longer significant. Stunting was found in 4.5% (95% CI, 2.1-9.6) and 3.3% (95% CI, 1.9-5.6) of the H. pylori positive and negative children respectively, while underweight was observed in 5.3% (95% CI, 2.6-10.5) and 6.7% (95% CI, 4.6-9.6) of the above mentioned groups. Conclusions: Prevalence of stunting and underweight were low in

Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study.

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Sun, Jing; Lin, Qian; Zhao, Pengyu; Zhang, Qiongyao; Xu, Kai; Chen, Huiying; Hu, Cecile Jia; Stuntz, Mark; Li, Hong; Liu, Yuanli

2017-08-22

It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients' satisfaction. However, few were well-documented, and the effects were rarely measured with robust methods. We conducted a longitudinal study of the length of waiting times in a public tertiary hospital in Southern China which developed comprehensive data collection systems. Around an average of 60,000 outpatients and 70,000 prescribed outpatients per month were targeted for the study during Oct 2014-February 2017. We analyzed longitudinal time series data using a segmented linear regression model to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was conducted to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0.05. The monthly average length of waiting time decreased 3.49 min (P = 0.003) for consultations and 8.70 min (P = 0.02) for filling prescriptions in the corresponding month when respective interventions were introduced. The trend shifted from baseline slight increasing to afterwards significant decreasing for filling prescriptions (P =0.003). There was a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services (r = -0.71, P = 0.004). The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction effect on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives implemented by a taskforce authorized by the hospital managers. This

Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study

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Jing Sun

2017-08-01

Full Text Available Abstract Background It is globally agreed that a well-designed health system deliver timely and convenient access to health services for all patients. Many interventions aiming to reduce waiting times have been implemented in Chinese public tertiary hospitals to improve patients’ satisfaction. However, few were well-documented, and the effects were rarely measured with robust methods. Methods We conducted a longitudinal study of the length of waiting times in a public tertiary hospital in Southern China which developed comprehensive data collection systems. Around an average of 60,000 outpatients and 70,000 prescribed outpatients per month were targeted for the study during Oct 2014-February 2017. We analyzed longitudinal time series data using a segmented linear regression model to assess changes in levels and trends of waiting times before and after the introduction of waiting time reduction interventions. Pearson correlation analysis was conducted to indicate the strength of association between waiting times and patient satisfactions. The statistical significance level was set at 0.05. Results The monthly average length of waiting time decreased 3.49 min (P = 0.003 for consultations and 8.70 min (P = 0.02 for filling prescriptions in the corresponding month when respective interventions were introduced. The trend shifted from baseline slight increasing to afterwards significant decreasing for filling prescriptions (P =0.003. There was a significant negative correlation between waiting time of filling prescriptions and outpatient satisfaction towards pharmacy services (r = −0.71, P = 0.004. Conclusions The interventions aimed at reducing waiting time and raising patient satisfaction in Fujian Provincial Hospital are effective. A long-lasting reduction effect on waiting time for filling prescriptions was observed because of carefully designed continuous efforts, rather than a one-time campaign, and with appropriate incentives

Secondary and tertiary hyperparathyroidism.

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Jamal, Sophie A; Miller, Paul D

2013-01-01

We reviewed the etiology and management of secondary and tertiary hyperparathyroidism. Secondary hyperparathyroidism is characterized by an increase in parathyroid hormone (PTH) that is appropriate and in response to a stimulus, most commonly low serum calcium. In secondary hyperparathyroidism, the serum calcium is normal and the PTH level is elevated. Tertiary hyperparathyroidism is characterized by excessive secretion of PTH after longstanding secondary hyperparathyroidism, in which hypercalcemia has ensued. Tertiary hyperparathyroidism typically occurs in men and women with chronic kidney disease usually after kidney transplant. The etiology and treatment of secondary hyperparathyroidism is relatively straightforward whereas data on the management of tertiary hyperparathyroidism is limited to a few small trials with short follow-up. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Examination of factors predicting secondary students' interest in tertiary STEM education

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Chachashvili-Bolotin, Svetlana; Milner-Bolotin, Marina; Lissitsa, Sabina

2016-02-01

Based on the Social Cognitive Career Theory (SCCT), the study aims to investigate factors that predict students' interest in pursuing science, technology, engineering, and mathematics (STEM) fields in tertiary education both in general and in relation to their gender and socio-economic background. The results of the analysis of survey responses of 2458 secondary public school students in the fifth-largest Israeli city indicate that STEM learning experience positively associates with students' interest in pursuing STEM fields in tertiary education as opposed to non-STEM fields. Moreover, studying advanced science courses at the secondary school level decreases (but does not eliminate) the gender gap and eliminates the effect of family background on students' interest in pursuing STEM fields in the future. Findings regarding outcome expectations and self-efficacy beliefs only partially support the SCCT model. Outcome expectations and self-efficacy beliefs positively correlate with students' entering tertiary education but did not differentiate between their interests in the fields of study.

Screening of HBsAg and anti HCV from tertiary care, private and public sector hospitals

International Nuclear Information System (INIS)

Khan, R.A.W.; Ahmed, W.; Alam, S.E.; Arif, A

2011-01-01

Objectives: To find out the frequency of hepatitis B surface antigen and hepatitis C antibodies in patients referred from a tertiary care public sector hospital, other public sector and private hospitals of Karachi. Settings and duration: Pakistan Medical Research Council's Specialized Research Centre for Gastroenterology and Hepatology, at Jinnah Postgraduate Medical Centre Karachi from January to December 2009. Patients and Methods: A cross sectional study was conducted where patients were referred from different departments of Jinnah Postgraduate Medical Centre (tertiary care public sector hospital), other public sector hospitals, private hospitals and clinics for the screening of hepatitis B and C virus infection. Three ml blood was collected from each patient, serum separated and tested for HBsAg and Anti HCV using Abbott Murex fourth Generation ELISA kits. Results: A total of 2965 cases were referred in a year. Overall sero prevalence of HBsAg and Anti-HCV was 5.9% and 12.8% respectively. HBsAg positivity in patient referred from public sector hospitals was 5.8%, those from private hospitals/clinics were 7.2%, and self-referred patients was 5.6%. Anti HCV positivity rates amongst these cases were 12.5%, 16.7% and 8.5% respectively. Co-infection of hepatitis B virus and hepatitis C virus was seen in 0.9, 2.5 and 1.4% cases respectively. Breakdown of viral positivity within different departments of Jinnah Postgraduate Medical Centre Karachi showed HBsAg positivity of 7.1% in Medical department, 5.2% in Surgical department, 5.0% in Gynaecology department, 6.6% in other departments of Jinnah Postgraduate Medical Centre while, only 1.7% were positive from Pakistan Railway, hospital Anti HCV positivity was maximally (20.3%) seen in medical department followed by 14% in other departments, 10.9% in surgical department, 7.9% in gynaecology and 5.1% in railway hospital. Co-infection of HBV and HCV was seen in 2% cases referred from medical department, while rest of the

Ambient Noise Levels in Acute Neonatal Intensive Care Unit of a Tertiary Referral Hospital

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Sonia R. B D'Souza

2017-10-01

Full Text Available Background: Advances in neonatal care have resulted in improved survival of neonates admitted to the intensive care of the Neonatal Intensive Care Unit (NICU. However, the NCU may be an inappropriate milieu, with presence of overwhelming stimuli, most potent being the continuous presence of noise in the ambience of the NICU. Aim and Objectives: To determine and describe the ambient noise levels in the acute NICU of a tertiary referral hospital. Material and Methods: The ambient noise, in this study was the background sound existing in the environment of the acute NICU of a tertiary referral hospital in South India. The ambient noise levels were analyzed by an audiologist and acoustical engineer using a standardized and calibrated Sound Level Meter (SLM i.e., the Hand Held Analyzer type 2250, Brüel and Kjær, Denmark on a weighted frequency A and reported as dB (A. Results: The ambient noise levels were timed measurements yielded by the SLM in terms of L eq, L as well as L exceeded the standard A 10 Aeqmax levels (Leq< 45 dB, L ≤ 50 dB, and Lmax ≤ 65 10 dB.The L eq ranged from 59.4 to 62.12 dB A. A Ventilators with alarms caused the maximum amount of ambient noise yielding a L Sound Pressure Level AF (SPL of 82.14 dB A. Conclusion: The study has found high levels of ambient noise in the acute NICU. Though there are several measures to reduce the ambient noise levels in the NICU, it is essential to raise awareness among health care personnel regarding the observed ambient noise levels and its effects on neonates admitted to the NICU.

Factors predicting quality of work life among nurses in tertiary-level hospitals, Bangladesh.

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Akter, N; Akkadechanunt, T; Chontawan, R; Klunklin, A

2018-06-01

This study examined the level of quality of work life and predictability of years of education, monthly income, years of experience, job stress, organizational commitment and work environment on quality of work life among nurses in tertiary-level hospitals in the People's Republic of Bangladesh. There is an acute shortage of nurses worldwide including Bangladesh. Quality of work life is important for quality of patient care and nurse retention. Nurses in Bangladesh are fighting to provide quality care for emerging health problems for the achievement of sustainable development goals. We collected data from 288 randomly selected registered nurses, from six tertiary-level hospitals. All nurses were requested to fill questionnaire consisted of Demographic Data Sheet, Quality of Nursing Work Life Survey, Expanded Nursing Stress Scale, Questionnaire of Organizational Commitment and Practice Environment Scale of the Nursing Work Index. Data were analysed by descriptive statistics and multiple regression. The quality of work life as perceived by nurses in Bangladesh was at moderate level. Monthly income was found as the best predictor followed by work environment, organizational commitment and job stress. A higher monthly income helps nurses to fulfil their personal needs; positive work environment helps to provide quality care to the patients. Quality of work life and predictors measured by self-report only may not reflect the original picture of the quality of work life among nurses. Findings provide information for nursing and health policymakers to develop policies to improve quality of work life among nurses that can contribute to quality of nursing care. This includes the working environment, commitment to the organization and measures to reduce job stress. © 2017 International Council of Nurses.

Job satisfaction, work environment and intention to leave among migrant nurses working in a publicly funded tertiary hospital.

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Goh, Yong-Shian; Lopez, Violeta

2016-10-01

This study sought to explore the job satisfaction level of migrant nurses working in a multicultural society and, more specifically, the relationship between their job satisfaction levels, work environment, their intentions to leave and the predictors of their intentions to leave. Nursing shortages have led to the increasing trend of employing migrant nurses, which necessitated studies examining nurses' migration. A cross-sectional, correlational design using a stratified random sample was conducted on 495 migrant nurses working in a tertiary public-funded hospital in Singapore. The results showed that migrant nurses were satisfied with their jobs; with job satisfaction negatively correlated with work environment. Interestingly, pre-existing groups of Chinese migrant nurses did not help newly arrived Chinese migrant nurses to assimilate better. Predictors of migrant nurses' intentions to leave included having supportive nurse managers and nursing practice environment. The presence of a supportive work environment is essential to retain migrant nurses. Health administrators need to empower nursing managers with skills to implement career development plans as part of hospitals' retention strategies for migrant nurses. Information should also be provided during recruitment campaigns to enable migrant nurses to make informed choices. © 2016 John Wiley & Sons Ltd.

Challenges and Perspectives for Tertiary Level Hospitals in Bolivia: The case of Santa Cruz de La Sierra Department.

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Medici, André

2015-01-01

Current legislation transferred public tertiary hospitals in Bolivia from the Municipalities to the Regional Level. However, the Regional Governments are experiencing technical and financial constraints to reform infrastructure, modernize equipment and introduce reforms to allow better governance, management and sustainability of these hospitals. This articles summarizes the recent experience of the Government of Santa Cruz de la Sierra in Bolivia where five tertiary hospitals and blood bank (most of them in precarious working conditions) has been transferred in 2012 from the Municipal Government of Santa Cruz (the capital) to the Regional Government of Santa Cruz. To face the challenges, the Regional Government of Santa Cruz implement several improvements, such as contract new clinical and administrative personal, increases hospital budgetary autonomy, outsource hospitals' auxiliary services, take measures to eliminate waiting lists and make several new investments to modernize and equip the hospitals. The World Bank was contracted to evaluated the future financial sustainability of these investments and to advice the Government to propose changes to increase the hospitals' management performance. The article describes the remaining challenges in these hospitals and the proposals from the World Bank Study. In the area of quality of care, the main challenge is to improve client satisfaction and continuous outcomes monitoring and evaluation according quality standards. In the area of financing, the challenge is how to assure the sustainability of these hospitals with the current level of health financing and the insufficient financial transfers from the National Government. In the area of Governance, reforms to streamline and simplify internal processes need to be introduced in order to establish mechanisms to increase transparency and accountability, allowing the hospital to have a good administration and adequate participation of the main actors in the guidance of

Medical tourism in India: perceptions of physicians in tertiary care hospitals.

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Qadeer, Imrana; Reddy, Sunita

2013-12-17

Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians' however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical

Medical tourism in india: perceptions of physicians in tertiary care hospitals

Science.gov (United States)

2013-01-01

Senior physicians of modern medicine in India play a key role in shaping policies and public opinion and institutional management. This paper explores their perceptions of medical tourism (MT) within India which is a complex process involving international demands and policy shifts from service to commercialisation of health care for trade, gross domestic profit, and foreign exchange. Through interviews of 91 physicians in tertiary care hospitals in three cities of India, this paper explores four areas of concern: their understanding of MT, their views of the hospitals they work in, perceptions of the value and place of MT in their hospital and their views on the implications of MT for medical care in the country. An overwhelming majority (90%) of physicians in the private tertiary sector and 74.3 percent in the public tertiary sector see huge scope for MT in the private tertiary sector in India. The private tertiary sector physicians were concerned about their patients alone and felt that health of the poor was the responsibility of the state. The public tertiary sector physicians’ however, were sensitive to the problems of the common man and felt responsible. Even though the glamour of hi-tech associated with MT dazzled them, only 35.8 percent wanted MT in their hospitals and a total of 56 percent of them said MT cannot be a public sector priority. 10 percent in the private sector expressed reservations towards MT while the rest demanded state subsidies for MT. The disconnect between their concern for the common man and professionals views on MT was due to the lack of appreciation of the continuum between commercialisation, the denial of resources to public hospitals and shift of subsidies to the private sector. The paper highlights the differences and similarities in the perceptions and context of the two sets of physicians, presents evidence, that questions the support for MT and finally analyzes some key implications of MT on Indian health services, ethical

A Study of the Transition Pathways of School Level Scholarship Recipients into Work and Tertiary Education

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Hobden, Sally; Hobden, Paul

2015-01-01

School-level educational interventions targeting learners from low socioeconomic backgrounds often have the long-term goal of enabling access to, and successful completion of tertiary studies. This study tracked the progress of alumni of an educational intervention two or three years post school, in order to investigate their pathways to their…

A Changing Paradigm in Language Planning: English-Medium Instruction Policy at the Tertiary Level in Malaysia

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Ali, Nor Liza

2013-01-01

The literature shows that English-medium instruction (EMI) programmes at the tertiary level in various parts of the world have positioned EMI as a language-planning tool to promote students' mastery of English. English proficiency is believed to be intertwined with the overall economic development of a country. In addition to internationalising…

Ambient Noise Levels in Acute Neonatal Intensive Care Unit of a Tertiary Referral Hospital

OpenAIRE

Sonia R. B D'Souza; Leslie Edward Lewis; Vijay Kumar; Ramesh Bhat Y; Jayashree Purkayastha; Hari Prakash

2017-01-01

Background: Advances in neonatal care have resulted in improved survival of neonates admitted to the intensive care of the Neonatal Intensive Care Unit (NICU). However, the NCU may be an inappropriate milieu, with presence of overwhelming stimuli, most potent being the continuous presence of noise in the ambience of the NICU. Aim and Objectives: To determine and describe the ambient noise levels in the acute NICU of a tertiary referral hospital. Material and Methods...

Improving listening skills of tertiary level students for effective ...

African Journals Online (AJOL)

Listening is essential to the leaming process. Students in tertiary institutions of learning need to acquire effective listening and note-taking skiils in order to benefit from lectures. This paper focused on factors militating against effective listening during lectures such as poor rate of presentation, poor communication skills, ...

Interactions to the fifth trophic level: secondary and tertiary parasitoid wasps show extraordinary efficiency in utilizing host resources

NARCIS (Netherlands)

Harvey, J.A.; Wagenaar, R.; Bezemer, T.M.

2009-01-01

1. Parasitoid wasps are highly efficient organisms at utilizing and assimilating limited resources from their hosts. This study explores interactions over three trophic levels, from the third (primary parasitoid) to the fourth (secondary parasitoid) and terminating in the fifth (tertiary

A retrospective review of snake bite victims admitted in a tertiary ...

African Journals Online (AJOL)

Objective: Snake bite remains major public health problem worldwide. We present our experience with cases of snake bites managed in our tertiary care teaching center of South India. Materials and Methods: The details of all patients with snake bite admitted to a tertiary teaching care hospital from 2010 to 2012 were ...

Framework of Assessment for the Evaluation of Thinking Skills of Tertiary Level Students

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Heng, Chan Swee; Ziguang, Yan

2015-01-01

In the 21st century, students are required to master thinking skills in order to deal with many situations that arise in the tertiary environment which later would translate into the workplace. Nowadays, thinking skills play a vital role in tertiary education. To provide an approach for teachers, this paper identifies a 4-step model that can be…

e-Learning for expanding distance education in tertiary level in Bangladesh: Problems and progress

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Md. Abdullah Al-Masum

2013-11-01

Full Text Available E-learning has broadly become an important enabler to promote distance education (DE and lifelong learning in most of the developed countries, but in Bangladesh it is still a new successful progressive system for the learning communities. Distance education is thought to be introduced as an effective way of educating people of all sections in Bangladesh. Bangladesh Open University (BOU, the only distance education provider in Bangladesh, has been trying to adopt the use of various e-learning materials for its distance delivery. This paper has tried to describe the current progress of quality e-learning for expanding distance education, identifying the major problems of e-learning in distance education at tertiary level in Bangladesh, with special reference to BOU, and finally to put forward some valuable recommendations for solving the problems. The study is based on both primary and secondary sources. It is observed from the research that e-learning is going to ensure its bright prospect as an alternative mode of education at the tertiary level in Bangladesh. There are several problems that are identified and can be mitigated and solved through Information and Communication Technology (ICT development, greater acceptance by learners, and much research in this sector in Bangladesh to face globalization.   DOI: 10.18870/hlrc.v3i4.171

Staff perception of relative importance of quality dimensions for patients at tertiary public services in oman.

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Alrashdi, Ismail; Al Qasmi, Ahmed

2012-09-01

This research attempted to explore the public healthcare providers understanding the quality dimensions and patient priorities in Oman. It also addresses the issue of risks confronting health professionals in management without "a customer focused" approach. A descriptive study was carried out using a self-administered questionnaire distributed around two tertiary public hospitals. A total of 838 respondents from several specialties and levels of hierarchy participated in the study. The data was analyzed to compare the perception of two groups; the group of junior and frontline staff, as well as of managers and senior staff involved in management. The results showed that 61% of the junior and frontline staff, and 68.3% of the senior staff and managers think that cure or improvement in overall health is the single most important quality dimension in healthcare. Both groups perceive that technical dimensions have greater importance (to patients) over interpersonal aspects such as communication with the exception of dignity and respect. There was no significant difference between the perception of the managers and senior staff vis-à-vis the perception of junior and frontline staff on the importance of technical dimensions and the interpersonal aspects of service quality. Despite the proven contribution of empathy to patient satisfaction, it was ranked by both groups as the least important among the dimensions examined. The findings of this research are therefore informative of the need to implement strategies that deal effectively with such attitudes and create the platform and programs that reinforce the culture of good quality service amongst healthcare providers, managers in particular, and to improve patient satisfaction.

Customer satisfaction survey with clinical laboratory and phlebotomy services at a tertiary care unit level.

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Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi

2014-09-01

We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level.

Associations between Psychosocial Aspects of English Classroom Environments and Motivation Types of Chinese Tertiary-Level English Majors

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Bi, Xuefei

2015-01-01

This study involved whether psychosocial aspects of English classroom environments had associations with the English learning motivation types of Chinese tertiary-level English majors based on a case study of approximate 1,000 English majors in their first 2 years at one of the key universities located in South China. Canonical correlation…

Smoke-Free Policies in New Zealand Public Tertiary Education Institutions

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Robertson, Lindsay A.; Marsh, L.

2015-01-01

The Framework Convention on Tobacco Control mandates the creation of smoke-free environments to protect non-smokers from second-hand smoke and reduce demand for tobacco. We aimed to examine the extent and nature of smoke-free campus policies at tertiary education institutions throughout New Zealand, and examine the policy development process.…

A Collaborative Governance Approach to Improving Tertiary Education in Papua New Guinea

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Eldridge, Kaye; Larry, Lisa; Baird, Jeanette; Kavanamur, David

2018-01-01

Tertiary education in Papua New Guinea (PNG) is in a critical state, as the sector struggles to address increased demand for student places with severely curtailed capacity. Recent thinking about improving public services in PNG has emphasized "whole of sector" or collaborative governance. Such an approach in tertiary education has the…

"Digitize Me": Generating E-Learning Profiles for Media and Communication Students in a Jamaican Tertiary-Level Institution

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Stewart-McKoy, Michelle A.

2014-01-01

The purpose of this project was to develop an e-learning profile for a group of media and communication students enrolled in a Jamaican tertiary-level institution in order to make informed decisions most the appropriate [online] learning complement for these students. The objectives sought to determine the e-learning profile of media and…

Role of Starting School Age in the Academic Performance at the Tertiary Level

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Mahwish Ali Baber

2017-11-01

Full Text Available The purpose of this research was to find out whether starting school earlier than four years of age gave any academic benefit to the students in the long run. This research aimed to find out whether the students who started schooling earlier than four years of age are able to achieve better grades and are better at self-regulation at the tertiary level. For this purpose, a sample of 108 students from a private business school comprising both early and late school starters were made to fill in questionnaires reporting their school starting age, their CGPA and answering questions that showed their level of self-regulation. The findings of this study suggest that there is no difference in the academic performance of the two groups, both in terms of their CGPA and their self-regulation skills.

Parathyroid carcinoma in tertiary hyperparathyroidism.

Science.gov (United States)

Kim, Byung Seup; Ryu, Han Suk; Kang, Kyung Ho; Park, Sung Jun

2016-10-01

Parathyroid carcinoma is a rare disease of unknown etiology. This study presents a case of parathyroid carcinoma in a patient with tertiary hyperparathyroidism. Despite a successful kidney transplantation, the intact parathyroid hormone (iPTH) level of the patient was elevated consistently and could not be controlled by medical therapy. Due to the development of tertiary hyperparathyroidism with bone pain and osteoporosis, subtotal parathyroidectomy was performed 4 months after the kidney transplantation. Histological evaluation revealed that one of four parathyroid lesions was a parathyroid carcinoma, while the others were diffuse hyperplasia. Postoperative laboratory studies indicated a decreased level of iPTH. A positron emission tomography-computed tomography performed 6 months after the operation revealed no evidence of local recurrence or distant metastasis. Copyright © 2013. Published by Elsevier Taiwan.

Sexual harassment in tertiary institutions: A comparative perspective

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Joseph Janice

2015-01-01

Full Text Available Sexual harassment is not a new phenomenon in tertiary institutions. It has been receiving considerable attention in research and the media and public awareness has increased dramatically. However, the term sexual harassment is not used uniformly across the globe because countries have defined it differently. Consequently, prevalence of sexual harassment in education varies across cultures. This paper examines sexual harassment from a comparative perspective. It specifically focuses on the definition of sexual harassment, incidence of sexual harassment of students in tertiary institutions, effects of sexual harassment on victims; and victims’ responses to sexual harassment. It also offers suggestions for curtailing sexual harassment in these institutions.

Assessment of motivation levels and associated factors among the nursing staff of tertiary-level government hospitals.

Science.gov (United States)

Pandey, Rahul; Goel, Sonu; Koushal, Vipin

2018-04-15

The present study assessed the motivation level of nurses working in 3 highly decorated tertiary-level government hospitals of India and also underpins the factors attributing to motivation levels. A sequential mixed-method design was used in this study wherein 400 nurses working in 5 units of nursing care in the hospitals were enrolled based upon proportionate random stratified sampling techniques. A self-administered questionnaire with Likert scale was developed based upon scale used by Mbindyo et al. The attributes of motivation were then categorized into external and internal attributes. For the qualitative component, participants with varied responses in quantitative data were selected and interviewed. Overall mean motivation score of the nursing staff was found 3.57 ± 0.93, which was higher for extrinsic motivational attributes (3.67 ± 0.88) as compared with intrinsic attributes (3.47 ± 0.98). The intrinsic motivational attribute of organizational commitment was rated highest followed by general motivation, conscientiousness, and self-efficacy. Personal issues, timeliness, and burnout were prime discouraging attributes among study participants. Sociodemographic characteristics and work profile characteristics showed significant relationship with the attributes of motivation. This study underscores the significance of different attributes of motivation which needs to be considered while framing administrative strategies and policy guidelines by authorities. Copyright © 2018 John Wiley & Sons, Ltd.

IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) (Public Comment Draft)

Science.gov (United States)

In September 2016, the U.S. Environmental Protection Agency's (USEPA) released the draft Integrated Risk Information System (IRIS) Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE). Consistent with the 2013 IRIS Enhancements, draft IRIS assessments are released prior to e...

An Overview of Teaching Listening in Islamic Tertiary Level of Education

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Andang Saehu

2016-12-01

Full Text Available The ultimate aim of this paper is to depict listening activities in teaching Basic Listening designed by lecturers in an EFL classroom observation of Islamic tertiary level of education in Indonesia. Qualitative methods, used to collect and analyze data gained from observation and interview. The result showed that the lecturer designed various activities in teaching Basic Listening in the EFL class, which they were set up in three stages: pre-listening, while-listening, and post-listening. The activities in the pre-listening were aimed at generating students’ interest, activating student’s prior knowledge, and trying to anticipate any difficult vocabularies.  The while-listening stage is to invite students to be involved at listening through various physical movements, such as story telling, dialogue, listening to songs, and drama. The post-listening stage is to internalize what they have heard with other language skills and to check students’ comprehension. 

Public Healthcare Services - Component of Tertiary Economy

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Mircea Bunaciu

2016-05-01

Full Text Available The field of public health care is a major social objective in all countries of the world. The public health care assistance reflects an effort organised to protect and promote the health of population, being achievable through political-legislative measures, programs and strategies addressed to the forums in the field of public health, as well as by establishing an organisational framework that would favour the provision of medical services requested by the population. The implementation of the objectives of health policy and strategy is done by the Ministry of Public Health as central authority in the field of public health, and local actions of public health are developed and implemented by the county authorities of public health. Public health authorities in the ascribed territory operate under the subordination of the public health authorities. Also, the county public health authorities coordinate locally the implementation of the activities arising from obligations assumed under the Treaty of Accession of Romania to the European Union and the plans for implementing the Community instruments relating to health.

Pregnancy outcome of women with gestational diabetes in a tertiary level hospital of North India

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Pikee Saxena

2011-01-01

Full Text Available Background: Women with gestational diabetes mellitus (GDM pose an important public health problem because diabetes not only affects the maternal and fetal outcome, but these women and their fetuses are also at an increased risk of developing diabetes and related complications later in their life. Objectives: The study was conducted to determine the maternal and fetal outcomes of 50 diabetic vs 50 normoglycemic pregnancies. Materials and Methods: This was a retrospective analytical record-based study conducted in a tertiary level hospital. Detailed information regarding maternal, fetal, and labor outcome parameters was recorded in a prestructured proforma and compared in normoglycemic and diabetic pregnancies. Results: Patients with obesity, history of diabetes in the family, spontaneous abortions, and gestational diabetes in previous pregnancies had a greater incidence of GDM in current pregnancy (P<0.05 for all. Hypertension, polyhydramnios, macrosomia, fetopelvic disproportion, and cesarean sections were more (P<0.001 among diabetic pregnancies. Congenital anomalies, polycythemia, hypocalcemia, and hyperbilirubinemia were also observed to be more (P<0.05 in neonates born to diabetics, suggesting an adverse effect of hyperglycemia in utero. Conclusion: Diabetes during pregnancy is associated with higher maternal and fetal morbidity. Therefore, early screening, detection, close monitoring, and intervention is essential to reduce maternal and fetal short- and long-term adverse effects, especially in high-risk groups. Pregnancy provides an opportunity to the clinician to control the disease process and inculcate healthy lifestyle practices in these patients.

IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) (Interagency Science Consultation Draft)

Science.gov (United States)

In September 2016, EPA released the draft IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) for public comment and discussion. The draft assessment was reviewed internally by EPA and by other federal agencies and White House Offices before public release. Consistent ...

TERRITORIAL DISPARITIES REGARDING THE DISTRIBUTION OF HEALTH SERVICE PROVIDERS IN ROMANIA AFTER JOINING THE EUROPEAN UNION STUDY CASE: MEDICAL STAFF WITH TERTIARY LEVEL OF EDUCATION

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Babucea Ana-Gabriela

2017-02-01

Full Text Available In Romania 90ˈs, there was a relatively low level of regional disparities compared with western economies in all fields, but inequalities have emerged and widened rapidly because only certain areas, especially urban areas have benefited from inflows of capital and specialized human resources. Currently, Romania has a low level of development between EU countries, five of the eight NUTS 2 regions being the most underdeveloped in Europe. The aim of this research is a comparative analysis of developments and trends manifested in the public health system in terms of distribution of health services providers at the regional level in Romania. For the analysis of regional disparities, the research seeks to highlight a comprehensive image of the level and dynamics of the Romania territorial inequalities regarding the personnel with tertiary education, which includes physicians, dentists, and pharmaceutical chemists, as professional providers of the health services. Were took into account statistical indicators that describe the distribution of such as healthcare providers, at level of the eight Romanian NUTS2 regions, highlighting inequalities in access to health services for the population. We used available data, accessed from National Institute of Statistics of Romania, regarding Romania, and itˊs eight regions. We appeal also to statistical publications at the national and European level, other data analysis, and experts' opinions expressed in recent articles in the field. In order to identify the factors that can reduce the disparities, and ensure the equity for disadvantaged population, in terms of ensuring the health system of medical services in parallel with a homogeneous distribution of resources and services in this area, we apply specific statistics for territorial analysis and comparisons.

[Level of job satisfaction among employees working at healthcare facilities in Nisava and Toplica district].

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Marković, Roberta Teofilo; Ilić, Marina Deljanin; Milosević, Zoran; Vasić, Milena; Bogdanović, Dragan; Sagrić, Cedomir

2013-01-01

The product of health system and its employees is health service whose quality is related to the satisfaction and motivation of people working in health system. The objective of this study was to assess and compare satisfaction with different aspects of work among different categories of employees in healthcare facilities on primary, secondary and tertiary level of health care in Nisava and Toplica districts. The study was conducted as a one-day study in 15 healthcare facilities on primary level, in two public hospitals and 27 clinics of Clinical Centre of Nis, using anonymous questionnaire. Out of 3,892 employees, who took part in this study, 2,227 were from primary and 1,665 were from secondary and tertiary level. All employees on primary level are more satisfied with the majority of aspects of job comparing with employees on secondary and tertiary level of health care. Administrative staff is in general more satisfied with all aspects of job comparing with other categories of employees. All employees on secondary and tertiary level are more physically and psychically exhausted than employees on primary level of health care. Health workers on secondary and tertiary level are most psychically exhausted. There is a difference in satisfaction with different aspects ofjob in different categories of employees, and on different levels of health, in healthcare facilities in Nisava and Toplica districts. Employees of healthcare facilities on primary level of health care are in general more satisfied than employees on se-condary and tertiary level of health care.

Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India.

OpenAIRE

Sendhilkumar, M; Tripathy, JP; Harries, AD; Dongre, AR; Deepa, M; Vidyulatha, A; Poongothai, S; Venkatesan, U; Anjana, RM; Mohan, V

2017-01-01

Objective: We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM) in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. Methods: A mixed-methods (triangulation design) study with quantitative methodology (survey) and qualitative methodology (interviews) was carried out. Stress levels w...

Quality Computer Assisted Mobile Learning (CAML and Distance Education Leadership in Managing Technology Enhanced Learning Management System (TELMS in the Malaysian Public Tertiary Education

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Lee Tan Luck

2009-07-01

Full Text Available Abstract - The success in the implementation of a quality computer assisted mobile learning and distance education in a Technology Enhanced Learning Management System is highly rely on the academic leadership in managing and application of Information and Communication Technology (ICT in the tertiary level. The effectiveness of its leadership, knowledge, application and management of ICT and learning management system is of utmost important. Successful application and management includes quality and cost effectiveness of universities administration, CAML and distance education leadership development, organizational culture, academic staffs and students’ attitude and their commitment towards teaching and learning process, support towards the usage of state of the art techno-educational facilities, availability of ICT resources, maintenance and funding of a Learning Management System. This paper will discuss the above factors, which present a comprehensive framework for the implementation of a quality CAML and distance education environment in ICT application and management in the Malaysian public universities. Selected Fifty-two respondents from two Malaysian public universities which offer e Learning and distance education with Learning Management System were acquired. A survey questionnaire is used to determine the effectiveness of ICT and mobile learning application management. Data from the questionnaires were analyzed by using non-parametric and parametric statistics testing. Results of this study show there is significant different in the CAML and distance education leadership in TELMS and the application of ICT and its management in the Malaysian public universities. The study will also address the implementation elements necessary for transforming the public universities and its CAML and distance education teaching and learning process into an effective and result oriented computer assisted mobile learning management model in public

[Environmental noise levels in 2 intensive care units in a tertiary care centre].

Science.gov (United States)

Ornelas-Aguirre, José Manuel; Zárate-Coronado, Olivia; Gaxiola-González, Fabiola; Neyoy-Sombra, Venigna

2017-04-03

The World Health Organisation (WHO) has established a maximum noise level of 40 decibels (dB) for an intensive care unit. The aim of this study was to compare the noise levels in 2 different intensive care units at a tertiary care centre. Using a cross-sectional design study, an analysis was made of the maximum noise level was within the intensive coronary care unit and intensive care unit using a digital meter. A measurement was made in 4 different points of each room, with 5minute intervals, for a period of 60minutes 7:30, 14:30, and 20:30. The means of the observations were compared with descriptive statistics and Mann-Whitney U. An analysis with Kruskal-Wallis test was performed to the mean noise level. The noise observed in the intensive care unit had a mean of 64.77±3.33dB (P=.08), which was similar to that in the intensive coronary care unit, with a mean of 60.20±1.58dB (P=.129). Around 25% or more of the measurements exceeded the level recommended by the WHO by up to 20 points. Noise levels measured in intensive care wards exceed the maximum recommended level for a hospital. It is necessary to design and implement actions for greater participation of health personnel in the reduction of environmental noise. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

Predictive value of Borrelia burgdorferi IgG antibody levels in patients referred to a tertiary Lyme centre.

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Zwerink, M; Zomer, T P; van Kooten, B; Blaauw, G; van Bemmel, T; van Hees, B C; Vermeeren, Y M; Landman, G W

2018-03-01

A two-step testing strategy is recommended in serological testing for Lyme borreliosis; positive and indeterminate enzyme-linked immunosorbent assay (ELISA) results are confirmed with immunoblots. Several ELISAs quantify the concentration of antibodies tested, however, no recommendation exists for an upper cut-off value at which an IgG ELISA is sufficient and the immunoblot can be omitted. The study objective was to determine at which IgG antibody level an immunoblot does not have any additional predictive value compared to ELISA results. Data of adult patients who visited a tertiary Lyme centre between 2008 and 2014 were analysed. Both an ELISA (Enzygnost Lyme link VlsE IgG) and immunoblot (recomLine blot Borrelia) were performed. Clinical data were extracted from the patient's digital medical record. Positive predictive values (PPVs) for either previous or active infection with Borrelia burgdorferi s.l. were calculated for different cut-off ELISA IgG antibody levels where the immunoblot was regarded as reference test. In total, 1454 patients were included. According to the two-step test strategy, 486 (33%), 69 (5%) and 899 (62%) patients had positive, indeterminate and negative Borrelia IgG serology, respectively. At IgG levels of 500 IU/ml and higher, all immunoblots were positive, resulting in a 100% PPV (95% CI: 97.0-100). At IgG levels of 200 IU/ml and higher, the PPV was 99.3% (95% CI: 97.4-99.8). In conclusion, at IgG levels of 200 IU/ml and higher, an ELISA was sufficient to detect antibodies to Borrelia burgdorferi s.l. At those IgG levels, a confirmatory immunoblot may be omitted in patients referred to a tertiary Lyme centre. Before these results can be implemented in routine diagnosis of Lyme borreliosis, confirmation of the results is necessary in other patient populations and using other quantitative ELISAs and immunoblots. Copyright © 2017 Elsevier GmbH. All rights reserved.

Ten years of energy consumption in the tertiary sector

International Nuclear Information System (INIS)

Rabai, Yacine

2012-11-01

This document presents and comments data regarding electricity consumption by the tertiary sector over the last ten years in France. It notably outlines its strong increase compared to the other sectors (housing, industry, transport, agriculture). It comments the evolution of the energy mix of the tertiary sector (electricity with 47%, gas with 25% and oil with 19% are prevailing). It briefly comments the evolution of energy efficiency within this sector. It indicates and comments the shares of energy consumption, of high voltage electricity and gas consumption by the different sub-sectors (retail, automobile and motorcycle repair, public administration, health and social activity, real estate, specialised, scientific and technical activities, education, and so on)

An assessment on the trustworthiness of engineers in higher tertiary institutions

Science.gov (United States)

Ooi Kuan, Tan; Lloyd, Ling; Mou Chuan, Cheng

2017-10-01

In Malaysian higher education history, the evolution from public funded to private funded and now to private non profit oriented model has been taking place since 80s. The evolution also demarcated higher learning institution into academic or research based university. As such, postgraduate studies became increasingly competitive in students intake. The evolution also created doubt to the public in term of the quality of postgraduate education offered by different classifications. This study investigates the gender specific perception and trustworthiness of engineering postgraduate students in private non profit oriented higher tertiary institution. An equally divided gender groups of 118 respondents were chosen for the study. Non-parametric statistics were used and the result showed that there was no difference and no correlation of genders in perception on teaching role and trustworthiness among the future engineers in private non profit oriented higher tertiary institution.

Rethinking the Tertiary Mathematics Curriculum

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Petocz, Peter; Reid, Anna

2005-01-01

Mathematics curriculum at the tertiary level is located within a range of social and cultural theories, and is often constructed by academics seeking to promulgate a particular view of mathematics. We argue that such a curriculum should incorporate a real acknowledgement of the different ways in which students understand the nature of mathematics…

Framework of Assessment for the Evaluation of Thinking Skills of Tertiary Level Students

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Chan Swee Heng

2015-10-01

Full Text Available In the 21st century, students are required to master thinking skills in order to deal with many situations that arise in the tertiary environment which later would translate into the workplace. Nowadays, thinking skills play a vital role in tertiary education. To provide an approach for teachers, this paper identifies a 4-step model that can be implemented in test design with reference to Bloom’s Taxonomy for thinking skills. This model illustrates a feasible procedure of test construction built upon existing resource. The procedures can easily be applied to different fields of study. It provides an appropriate way for teachers who may want to add more ideas to their repertoire skills in addressing the learning of HOT (higher-order thinking skills. Keywords: thinking skills, Bloom’s Taxonomy, 4-step model

Use of English Vocabulary Learning Strategies by Thai Tertiary-Level Students in Relation to Fields of Study and Language-Learning Experiences

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Boonkongsaen, Nathaya; Intaraprasert, Channarong

2014-01-01

The present study was intended to examine the effects of 1) fields of study (arts, business and science-oriented); and 2) language-learning experiences (whether limited or non-limited to formal classroom instructions) on the use of VLSs among Thai tertiary-level students. The participants were 905 Thai EFL students studying in the Northeast of…

Smoke-free policies in New Zealand public tertiary education institutions.

Science.gov (United States)

Robertson, Lindsay A; Marsh, L

2015-04-01

The Framework Convention on Tobacco Control mandates the creation of smoke-free environments to protect non-smokers from second-hand smoke and reduce demand for tobacco. We aimed to examine the extent and nature of smoke-free campus policies at tertiary education institutions throughout New Zealand, and examine the policy development process. Stage one comprised an audit and content analysis of smoke-free policies. In stage two, semi-structured telephone interviews were conducted to investigate the process of developing and implementing policies. Qualitative content analysis was undertaken on interview notes. Policies were identified for most institutions (n = 26/29), though varied widely in nature. Only nine mandated 100% smoke-free campuses without exceptions and few prohibited the sale of tobacco on campus, or connections with the tobacco industry. During interviews (n = 22/29), cited barriers to developing a 100% smoke-free policy included enforcement challenges and anticipated opposition from staff and students. However, participants from institutions with 100% smoke-free policies reported having encountered few challenges. Varying levels of compliance with 100% smoke-free policies were reported yet, overall, these policies were viewed as being effective. Smoke-free campus policies could be strengthened to better reflect a completely tobacco-free organization. Other institutions and workplaces could use these findings to develop 100% smoke-free policies. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Job satisfaction and Job stress among various employees of tertiary care level hospital in central Uttar Pradesh, India

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Ruchi Yadav

2017-03-01

Full Text Available Introduction: Job satisfaction defined as the end state of feeling, the feeling that is experienced after a task is accomplished. Job stress can be defined as the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or need of the worker. Objectives: To study the relationship between job satisfaction and job stress among various employees of tertiary care level hospital and to find the co-relates of job stress and job satisfaction. Materials & Methods: A cross sectional study carried out for a period of 2 month among various employees working in Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, a tertiary care level hospital. A total 225 Participants 75 from each medical, paramedical and office staff were selected by purposive sampling technique. The study was conducted using pretested structured questionnaire regarding socio-demographic profile, job satisfaction and job stress. Data was analyzed using chi square test. Result: A total of 225 participants,75 from each medical, paramedical and office staff were interviewed. On doing analysis of questionnaire regarding job satisfaction and job stress it was found that majority believe that their job was well recognized and working in a good institute and were not satisfied with the management and salary and were coping well with their job stress and were having average level of satisfaction. Conclusion: The present study conclude that majority of the participants felt they are well recognized with their job, working in a good institute but not satisfied with the management and salary.

A decentralised model of psychiatric care: Profile, length of stay and outcome of mental healthcare users admitted to a district-level public hospital in the Western Cape

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Eileen Thomas

2015-02-01

Full Text Available Background. There is a lack of studies assessing the profile and outcome of psychiatric patients at entry-level public hospitals that are prescribed by the Mental Health Care Act to provide a decentralised model of psychiatric care. Objective. To assess the demographic and clinical profile as well as length of stay and outcomes of mental healthcare users admitted to a district-level public hospital in the Western Cape.  Method. Demographic data, clinical diagnosis, length of stay, referral profile and outcomes of patients (N=487 admitted to Helderberg Hospital during the period 1 January 2011 - 31 December 2011 were collected.  Results. Psychotic disorders were the most prevalent (n=287, 59% diagnoses, while 228 (47% of admission episodes had comorbid/secondary diagnoses. Substance use disorders were present in 184 (38% of admission episodes, 37 (57% of readmissions and 19 (61% of abscondments. Most admission episodes (n=372, 76% were discharged without referral to specialist/tertiary care.  Conclusion. Methamphetamine use places a significant burden on the provision of mental healthcare services at entry-level care. Recommendations for improving service delivery at this district-level public hospital are provided.

Publications | Page 316 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 3151 - 3160 of 6374 ... Through books, articles, research publications, and studies, we aim to widen the impact of our investment and advance development research. ... in tertiary education, Educational Contents of Compulsory ICT Training in Tertiary Education of Mongolia and Evaluation ON ICT education contents.

Sexual harassment in tertiary institutions: A comparative perspective

OpenAIRE

Joseph Janice

2015-01-01

Sexual harassment is not a new phenomenon in tertiary institutions. It has been receiving considerable attention in research and the media and public awareness has increased dramatically. However, the term sexual harassment is not used uniformly across the globe because countries have defined it differently. Consequently, prevalence of sexual harassment in education varies across cultures. This paper examines sexual harassment from a comparative perspective...

The Perception of Malaysian ESL Tertiary Level Students on the IELTS Test

Science.gov (United States)

Zahari, Dhiya Amalina; Dhayaalan, Jeremiah Dhayaalan Jackson

2016-01-01

Currently, the most acknowledged test to qualify for overseas universities is the IELTS test which is referred to as the International English Language Testing System. It is implemented as an accreditation tool and is believed to be a reputable and trustworthy tool of language competence by tertiary institutions which employ its use. Regardless of…

Tertiary Journalism Education: Its Value in Cadet Selection at Metropolitan Media.

Science.gov (United States)

Alysen, Barbara

2001-01-01

Notes tertiary study in journalism has been a feature of the education of Australian journalists for decades, yet many industry representatives remain skeptical of its value. Finds applicants for entry-level jobs with a tertiary journalism qualification can expect to secure, on average, at least half the available positions in any cadet or trainee…

Risk factors predicting mortality in patients with lung abscess in a public tertiary care center in Karachi, Pakistan.

Science.gov (United States)

Ghazal, Shaista; Kumar, Ashok; Shrestha, Binav; Sajid, Sana; Malik, Maria; Rizvi, Nadeen

2013-01-01

Lung abscess is a commonly encountered entity in South-East Asia but not much data regarding its outcome is available. The objective of this study was to identify the factors associated with increased mortality in patients diagnosed with lung abscess in a tertiary care center of Karachi, Pakistan. A retrospective case analysis was performed via hospital records, on patients admitted with lung abscess between January 2009 and January 2011 at the largest state-owned tertiary care centre in Karachi, Pakistan. Out of the 41 patients hospitalized, 17 could not survive and were evaluated for clinical, radiological and microbiological factors to determine association with heightened mortality. Mortality due to lung abscess stood at 41.4% (17 of 41 cases). Adult male patients were found to have higher mortality with 13 out of 17 (43%) dead patients being male. A majority (21/41, 51.2%) of the cases belonged to the 41-60 year old age group. Highest mortality was seen in patients200 mg/dL (56%) succumb to disease. Patients with a positive history of smoking, diabetes mellitus, and alcohol intake expressed mortality rates of 44%, 56%, and 50% respectively; while 29.4% of the mortalities were positive for Pseudomonas aeruginosa on sputum culture. A significant association was found with elevated mortality and low haemoglobin levels at time of admission; mortality was 58% (p=0.005) in patients with Hb less than or equal to 10 mg/dL. The risk factors involved with heightened mortality included male gender and history of smoking, diabetes and alcohol intake. High blood sugar levels and detection of Pseudomonas aeruginosa on sputum cultures were also implicated. Anemia (Hb level less than or equal to 10 mg/dl) was statistically significant predictive factor for increased mortality.

Relationship between Vocabulary Size and Reading Comprehension Levels of Malaysian Tertiary Students

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Angelina Wan Lin Tan

2018-01-01

Full Text Available This study investigated the relationship between vocabulary size and reading comprehension performance among students in a tertiary institution in a Malaysian context and examined the vocabulary size required for students to achieve reading comprehension at various levels of proficiency. The research questions that guided this study were: 1 What is the vocabulary size of second year diploma students studying Mass Communication?; 2 What is the reading comprehension proficiency of second year diploma students studying Mass Communication?; and 3 What vocabulary size is required for different levels of reading comprehension proficiency? This study used the quantitative approach. The participants were 53 Malaysian second-year students at a private university college in Malaysia who were reading for their Diploma in Mass Communication. The instruments used were the Vocabulary Size Test and the IELTS Reading Test (Academic Module. The findings showed that the average vocabulary size of the students was just over 6000 word families and this vocabulary size was generally insufficient for adequate reading comprehension. Students needed an average vocabulary size of about 8000 word families to achieve adequate reading comprehension and about 10000 word families to achieve proficient reading comprehension. Based on the individual student’s performance, this study did not find a linear relationship between vocabulary size and reading comprehension performance, nor was there a threshold vocabulary size for adequate reading comprehension.

Hospital-associated methicillin-resistant Staphylococcus aureus: A cross-sectional analysis of risk factors in South African tertiary public hospitals.

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Liliwe L Shuping

Full Text Available Hospital-associated methicillin-resistant S. aureus (HA-MRSA remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa.We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture. Multivariable logistic regression modelling was used to determine risk factors for HA-MRSA.Of the 9971 patients with positive blood cultures, 7.7% (772 had S. aureus bacteraemia (SAB. The overall prevalence of MRSA among those with SAB was 30.9% (231/747; 95% confidence interval [CI] 27.6%- 34.3%. HA-MRSA infections accounted for 28.3% of patients with SAB (207/731; 95% CI 25.1%- 31.7%. Burns (adjusted odds ratio [aOR] 12.7; 95% CI 4.7-34.4, age ≤1 month (aOR 8.7; 95% CI 3.0-24.6, residency at a long-term care facility (aOR 5.2; 95% CI, 1.5-17.4, antibiotic use within two months of the current SAB episode (aOR 5.1; 95% CI 2.8-9.1, hospital stay of 13 days or more (aOR 2.8; 95% CI 1.3-5.6 and mechanical ventilation (aOR 2.2; 95% CI 1.07-4.6, were independent risk factors for HA-MRSA infection.The prevalence of MRSA remains high in South African tertiary public hospitals. Several identified risk factors of HA-MRSA infections should be considered when instituting infection and prevention strategies in public-sector hospitals, including intensifying the implementation of antimicrobial stewardship programmes. There is an urgent need to strengthen infection prevention and control in burn wards, neonatal wards, and intensive care units which house mechanically ventilated patients.

Expanding the Range of the First Step to Success Intervention: Tertiary-Level Support for Children, Teachers, and Families

Science.gov (United States)

Frey, Andy J.; Small, Jason W.; Lee, Jon; Walker, Hill M.; Seeley, John R.; Feil, Edward G.; Golly, Annemeike

2015-01-01

This study presents the findings of a quasi-experimental feasibility study examining the Tertiary First Step intervention, an enhanced version of the First Step to Success early intervention program. Tertiary FirstStep was developed to engage families more effectively and influence and improve parenting practices for children having challenging…

Job satisfaction and Job stress among various employees of tertiary care level hospital in central Uttar Pradesh, India

Directory of Open Access Journals (Sweden)

Ruchi Yadav

2017-03-01

Full Text Available Introduction: Job satisfaction defined as the end state of feeling, the feeling that is experienced after a task is accomplished. Job stress can be defined as the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or need of the worker. Objectives: To study the relationship between job satisfaction and job stress among various employees of tertiary care level hospital and to find the co-relates of job stress and job satisfaction. Materials & Methods: A cross sectional study carried out for a period of 2 month among various employees working in Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, a tertiary care level hospital. A total 225 Participants 75 from each medical, paramedical and office staff were selected by purposive sampling technique. The study was conducted using pretested structured questionnaire regarding socio-demographic profile, job satisfaction and job stress. Data was analyzed using chi square test. Result: A total of 225 participants,75 from each medical, paramedical and office staff were interviewed. On doing analysis of questionnaire regarding job satisfaction and job stress it was found that majority believe that their job was well recognized and working in a good institute and were not satisfied with the management and salary and were coping well with their job stress and were having average level of satisfaction. Conclusion: The present study conclude that majority of the participants felt they are well recognized with their job, working in a good institute but not satisfied with the management and salary.

Stereoinversion of tertiary alcohols to tertiary-alkyl isonitriles and amines.

Science.gov (United States)

Pronin, Sergey V; Reiher, Christopher A; Shenvi, Ryan A

2013-09-12

The SN2 reaction (bimolecular nucleophilic substitution) is a well-known chemical transformation that can be used to join two smaller molecules together into a larger molecule or to exchange one functional group for another. The SN2 reaction proceeds in a very predictable manner: substitution occurs with inversion of stereochemistry, resulting from the 'backside attack' of the electrophilic carbon by the nucleophile. A significant limitation of the SN2 reaction is its intolerance for tertiary carbon atoms: whereas primary and secondary alcohols are viable precursor substrates, tertiary alcohols and their derivatives usually either fail to react or produce stereochemical mixtures of products. Here we report the stereochemical inversion of chiral tertiary alcohols with a nitrogenous nucleophile facilitated by a Lewis-acid-catalysed solvolysis. The method is chemoselective against secondary and primary alcohols, thereby complementing the selectivity of the SN2 reaction. Furthermore, this method for carbon-nitrogen bond formation mimics a putative biosynthetic step in the synthesis of marine terpenoids and enables their preparation from the corresponding terrestrial terpenes. We expect that the general attributes of the methodology will allow chiral tertiary alcohols to be considered viable substrates for stereoinversion reactions.

PHENOMENOLOGICAL APPROACHES TO STUDY LEARNING IN THE TERTIARY LEVEL CHEMISTRY LABORATORY

Directory of Open Access Journals (Sweden)

Santiago Sandi-Urena

Full Text Available Despite the widespread notion amongst chemistry educators that the laboratory is essential to learn chemistry, it is often a neglected area of teaching and, arguably, of educational research. Research has typically focused on secondary education, single institutions, and isolated interventions that are mostly assessed quantitatively. It has also honed in on compartmentalised features instead of searching understanding of broader aspects of learning through experimentation. This paper contends there is a gap in subject specific, tertiary level research that is comprehensive and learning-centred instead of fragmented and instruction-based. A shift in focus requires consideration of methodological approaches that can effectively tackle the challenges of researching complex learning environments. This paper reckons qualitative approaches, specifically phenomenology, are better suited for this purpose. To illustrate this potential, it summarises an exemplar phenomenological study that investigated students’ experience of change in instructional style from an expository (traditional laboratory program to one that was cooperative and project-based (reformed. The study suggests the experience was characterised by a transition from a learning environment that promoted mindless behaviour to one in which students were mindfully engaged in their learning. Thus, this work puts forth the use of Mindfulness Theory to investigate and support design of laboratory experiences.

A study on the utilization of serial resources in selected tertiary ...

African Journals Online (AJOL)

A study on the utilization of serial resources in selected tertiary institutions in Ogun State. ... Lagos Journal of Library and Information Science ... Serial resources are publications either in printed form or electronic format issued in successive parts usually having numerical or chronological designations and intended to be ...

Ocular disorders in stroke patients in a tertiary hospital in Nigeria

African Journals Online (AJOL)

2015-08-06

Aug 6, 2015 ... Abstract. Background: Stroke is a medical emergency of public health ... Aim: To determine the prevalence of ocular disorders in patients with stroke in a Tertiary Hospital in Nigeria. ... Risk factors include old age, high blood pressure, previous .... such as cataract, refractive errors, and age‑related changes.

The public sector nursing workforce in Kenya: a county-level analysis.

Science.gov (United States)

Wakaba, Mabel; Mbindyo, Patrick; Ochieng, Jacob; Kiriinya, Rose; Todd, Jim; Waudo, Agnes; Noor, Abdisalan; Rakuom, Chris; Rogers, Martha; English, Mike

2014-01-27

Kenya's human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations. This work describes the public sector nursing workforce likely to be inherited by the counties, and examines the relationships between nursing workforce density and key indicators. National nursing deployment data linked to nursing supply data were used and analyzed using statistical and geographical analysis software. Data on nurses deployed in national referral hospitals and on nurses deployed in non-public sector facilities were excluded from main analyses. The densities and characteristics of the public sector nurses across the counties were obtained and examined against an index of county remoteness, and the nursing densities were correlated with five key indicators. Of the 16,371 nurses in the public non-tertiary sector, 76% are women and 53% are registered nurses, with 35% of the nurses aged 40 to 49 years. The nursing densities across counties range from 1.2 to 0.08 per 1,000 population. There are statistically significant associations of the nursing densities with a measure of health spending per capita (P value = 0.0028) and immunization rates (P value = 0.0018). A higher county remoteness index is associated with explaining lower female to male ratio of public sector nurses across counties (P value public sector countrywide is complicated by mal-distribution and varying workforce characteristics (for example, age profile) across counties. All stakeholders should support improvements in human resources information systems and help address personnel shortages and mal-distribution if equitable, quality health-care delivery in the counties is to be achieved.

A web-based survey of attitudes toward epilepsy in secondary and tertiary students in Malaysia, using the Public Attitudes Toward Epilepsy (PATE) scale.

Science.gov (United States)

Lim, Kheng Seang; Hills, Michael D; Choo, Wan Yuen; Wong, Mee Hoo; Wu, Cathie; Tan, Chong Tin

2013-02-01

Students' attitudes toward epilepsy have been studied in several countries, but none of the studies used a quantitative scale. We aimed to determine the validity and reliability of the Public Attitudes Toward Epilepsy (PATE) scale in a homogenous population consisting of secondary and tertiary students in Malaysia and to quantify their attitudes toward epilepsy, using a web-based survey. A total of 227 respondents with a mean age of 19.6±2.07 years, predominantly Chinese (85%), female (62%), and in a pre-university education level (71%) completed the web-based survey. Psychometric testing showed that the PATE is a valid and reliable scale to be applied in a homogenous population. The mean score in the personal domain was significantly higher than that in the general domain (2.73±0.61 vs. 2.12±0.60, respectively, ppopulation (Lim et al., 2012 [10]), the mean score in the general domain was significantly lower (pstudents are more positive than those of the general population in the general domain but not in the personal domain. Copyright © 2012 Elsevier Inc. All rights reserved.

KNOWLEDGE AND ATTITUDE TOWARDS HUMAN PAPILLOMA VIRUS AND ITS VACCINE AMONG PHARMACY STUDENTS OF TERTIARY TEACHING UNIVERSITY HOSPITAL IN SOUTH INDIA

OpenAIRE

Raghupathi Mahitha; T. S. Arunprasath

2016-01-01

BACKGROUND Cervical cancer in women can be effectively prevented by HPV vaccine. Healthcare professionals including pharmacists have a role in creating awareness about this vaccine to public. In this context, it was decided to study awareness level about HPV among pharmacy students. The aim of the study is to study the knowledge and attitude towards human papilloma virus and it’s vaccine among pharmacy students of tertiary teaching university hospital in South India. MATERIA...

IRIS Toxicological Review of Ethyl Tertiary Butyl Ether (ETBE) (External Review Draft, 2009)

Science.gov (United States)

EPA is conducting a peer review and public comment of the scientific basis supporting the human health hazard and dose-response assessment of ethyl tertiary butyl ether (ETBE) that when finalized will appear on the Integrated Risk Information System (IRIS) database.

Hospital-associated methicillin-resistant Staphylococcus aureus: A cross-sectional analysis of risk factors in South African tertiary public hospitals

Science.gov (United States)

Kuonza, Lazarus; Musekiwa, Alfred; Iyaloo, Samantha; Perovic, Olga

2017-01-01

Introduction Hospital-associated methicillin-resistant S. aureus (HA-MRSA) remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa. Methods We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture. Multivariable logistic regression modelling was used to determine risk factors for HA-MRSA. Results Of the 9971 patients with positive blood cultures, 7.7% (772) had S. aureus bacteraemia (SAB). The overall prevalence of MRSA among those with SAB was 30.9% (231/747; 95% confidence interval [CI] 27.6%– 34.3%). HA-MRSA infections accounted for 28.3% of patients with SAB (207/731; 95% CI 25.1%– 31.7%). Burns (adjusted odds ratio [aOR] 12.7; 95% CI 4.7–34.4), age ≤1 month (aOR 8.7; 95% CI 3.0–24.6), residency at a long-term care facility (aOR 5.2; 95% CI, 1.5–17.4), antibiotic use within two months of the current SAB episode (aOR 5.1; 95% CI 2.8–9.1), hospital stay of 13 days or more (aOR 2.8; 95% CI 1.3–5.6) and mechanical ventilation (aOR 2.2; 95% CI 1.07–4.6), were independent risk factors for HA-MRSA infection. Conclusion The prevalence of MRSA remains high in South African tertiary public hospitals. Several identified risk factors of HA-MRSA infections should be considered when instituting infection and prevention strategies in public-sector hospitals, including intensifying the implementation of antimicrobial stewardship programmes. There is an urgent need to strengthen infection prevention and control in burn wards, neonatal wards, and intensive care units which house mechanically ventilated patients. PMID:29145465

Section Level Public Land Survey - polygons

Data.gov (United States)

Minnesota Department of Natural Resources — Public Land Survey line delineations to the section level. Data are derived primarily from Section corner locations captured from paper USGS seven and one-half...

Section Level Public Land Survey - lines

Data.gov (United States)

Minnesota Department of Natural Resources — Public Land Survey line delineations to the section level. Developed from manually digitized section corners captured from paper USGS seven and one-half map sources.

League tables as policy instruments: the political economy of accountability in tertiary education

OpenAIRE

Salmi, Jamil; Saroyan, Alenoush

2007-01-01

The main objective of this article is to examine the role and usefulness of public information mechanisms, such as the rankings and similar classification instruments that are increasingly relied upon to measure and compare the performance of tertiary education institutions. The article begins with a typology of ranking instruments used for public accountability purposes, followed by a discussion of the political economy of the ranking phenomenon. It then attempts to assess their respective ...

'The public is too subjective': public involvement at different levels of health-care decision making.

Science.gov (United States)

Litva, Andrea; Coast, Joanna; Donovan, Jenny; Eyles, John; Shepherd, Michael; Tacchi, Jo; Abelson, Julia; Morgan, Kieran

2002-06-01

There are a number of impulses towards public participation in health care decision making including instrumentalist, communitarian, educative and expressive impulses and the desire for increased accountability. There has, however, been little research looking systematically at the public's preferences for being involved in particular types of rationing decisions, nor indeed, has there been a critical examination of the degree of involvement desired by the public. The research reported here uses findings from focus groups and in-depth interviews to explore these questions. Eight focus groups were conducted with a total of 57 informants, four amongst randomly selected members of the public and four with informants from health and non-health related organisations. Nineteen interviews were conducted to allow the elaboration of focus group comments, to probe views more deeply and to pursue emerging themes. The findings show variations in the willingness of members of the public to be involved in health care decisions and consistency across the different forms of the public as represented by the focus groups with randomly selected citizens and pre-existing organisations. There was a strong desire in all the groups for the public to be involved both at the system and programme levels, with much less willingness to be involved at the individual level. At the system and programme levels informants generally favoured consultation, without responsibility for decisions, but with the guarantee that their contribution would be heard and that decisions taken following consultation would be explained. At the patient level informants felt that the public should participate only by setting criteria for deciding between potential beneficiaries of treatment. The public has much to contribute, particularly at the system and programme levels, to supplement the inputs of health care professionals.

Do pregnant women know about danger signs of pregnancy and childbirth? – A study of the level of knowledge and its associated factors from a tertiary care hospital in Southern India

OpenAIRE

R Nithya; Gowri Dorairajan; Palanivel Chinnakali

2017-01-01

Background: Awareness about danger signs during pregnancy is essential for a woman to seek prompt care. This can avert long-term morbidity and mortality. This study was aimed to find the level of knowledge and its related factors about danger signs of pregnancy and childbirth among pregnant women attending a tertiary care hospital in southern India. Patients and Methods: We conducted a cross-sectional survey of pregnant women attending a tertiary care hospital in South India. Systematic rando...

Tertiary Students' ICT Self-Efficacy Beliefs and the Factors Affecting Their ICT-Use

Science.gov (United States)

Turel, Vehbi; Calik, Sinan; Doganer, Adem

2015-01-01

This study looked at tertiary (i.e. undergraduate /a four-year degree) students' information and communication technology (ICT) self-efficacy beliefs and their level in use of certain common programmes at a newly established (i.e. 2007) university in Turkey in the spring of 2012. The study examined the tertiary students' (a) demographic…

Incidence of dog bite injuries and clinical rabies in a tertiary health ...

African Journals Online (AJOL)

Background: It is widely recognized that rabies is grossly under-reported even though it is a notifiable disease and a lack of accurate figures has rendered rabies a low public health and veterinary priority. This study aimed at determining the incidence of dog bite injuries and clinical rabies in a tertiary health care centre.

Rajiv Aarogyasri Community Health Insurance Scheme in Andhra Pradesh, India: a comprehensive analytic view of private public partnership model.

Science.gov (United States)

Reddy, Sunita; Mary, Immaculate

2013-01-01

The Rajiv Aarogyasri Community Health Insurance (RACHI) in Andhra Pradesh (AP) has been very popular social insurance scheme with a private public partnership model to deal with the problems of catastrophic medical expenditures at tertiary level care for the poor households. A brief analysis of the RACHI scheme based on officially available data and media reports has been undertaken from a public health perspective to understand the nature and financing of partnership and the lessons it provides. The analysis of the annual budget spent on the surgeries in private hospitals compared to tertiary public hospitals shows that the current scheme is not sustainable and pose huge burden on the state exchequers. The private hospital association's in AP, further acts as pressure groups to increase the budget or threaten to withdraw services. Thus, profits are privatized and losses are socialized.

Risk factors for syphilis and hiv infection in pregnant women attending a tertiary care public sector hospital

International Nuclear Information System (INIS)

Batool, K.; Bano, K.A.; Sherwani, M.I.K.

2010-01-01

Background: Syphilis, a sexually transmitted disease which seemed to have disappeared or had been controlled over the years, has now been re-emerged as a major public health problem in many communities. It can complicate the pregnancies with serious consequences. Appropriate treatment of pregnant women often prevents such complications. Aims: To study the frequency of syphilis in pregnant women attending a tertiary care public sector hospital, and see the positivity for HIV/AIDS among syphilis positive women. Patients and Methods: This cross sectional and interventional study was conducted among pregnant women attending Sir Ganga Ram hospital for antenatal care at PMRC Research Centre, Fatima Jinnah Medical College, Lahore. Blood samples from 2000 women were collected after taking consent. The blood was tested for syphilis by Treponema Pallidum Haemagglutination. History of the subjects for risks factors was also taken. Syphilis positive women were further screened for human immunodeficiency virus positivity. Results: The treponemal antibodies were detected in less than one percent (9) pregnant women. The highest positivity was observed among age group of 21-26 years. Women in third trimester were significantly more infected with syphilis. Risk factors included husband's history with frequent traveling and drug abuse. All husbands of syphilis positive women were also positive. All syphilis positive women and their husbands were negative for Human immunodeficiency virus /Acquired immune deficiency syndrome. Conclusions: Less than 1% of pregnant women were infected with syphilis, and most of the spouses of these positive women were either travelers or drug addicts.(author)

Approach to mathematics in textbooks at tertiary level - exploring authors' views about their texts

Science.gov (United States)

Randahl, Mira

2012-10-01

The aim of this article is to present and discuss some results from an inquiry into mathematics textbooks authors' visions about their texts and approaches they choose when new concepts are introduced. Authors' responses are discussed in relation to results about students' difficulties with approaching calculus reported by previous research. A questionnaire has been designed and sent to seven authors of the most used calculus textbooks in Norway and four authors have responded. The responses show that the authors mainly view teaching in terms of transmission so they focus mainly on getting the mathematical content correct and 'clear'. The dominant view is that the textbook is intended to help the students to learn by explaining and clarifying. The authors prefer the approach to introduce new concepts based on the traditional way of perceiving mathematics as a system of definitions, examples and exercises. The results of this study may enhance our understanding of the role of the textbook at tertiary level. They may also form a foundation for further research.

Public health preparedness in Alberta: a systems-level study.

Science.gov (United States)

Moore, Douglas; Shiell, Alan; Noseworthy, Tom; Russell, Margaret; Predy, Gerald

2006-12-28

Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

Comparison of two public sector tertiary care hospitals' management in reducing direct medical cost burden on breast carcinoma patients in Lahore, Pakistan.

Science.gov (United States)

Hameed Khaliq, Imran; Zahid Mahmood, Hafiz; Akhter, Naveed; Danish Sarfraz, Muhammad; Asim, Khadija; Masood Gondal, Khalid

2018-01-01

Breast cancer is one of the major causes of death incurring highest morbidity and mortality amongst women of Pakistan. The purpose of this study was to assess and compare the role of two public sector tertiary care hospitals' management in reducing out of pocket (OOP) expenses on direct medical costs borne by breast carcinoma patients' household from diagnosis through treatment. Moreover, the study intended to explore the reasons of opting private diagnostic facilities by the said patients during the services taken from the foresaid tertiary care centers. A purposive sample of 164 primary breast carcinoma patients was recruited for data collection of this cross-sectional study. Face to face interviews and semistructured questionnaires were adopted as method of data gathering tools. Major cost components of direct medical costs were used to compare the financial strain on the patients' households of both targeted hospitals. In addition, information was collected regarding the reasons of opting private diagnostic centers for investigations. Frequency, percentages, median and inter quartile range (IQR) were calculated for the data. Non-parametric variables were compared using the Mann-Whitney U test. It was observed that overall direct medical cost borne by the breast carcinoma patients' households in Jinnah hospital (median US$1153.93 / Rs. 118,589) was significantly higher than Mayo hospital (median US$427.93 /Rs. 43,978), pprivately opted investigations procedures was the common issue of the patients under treatment in both hospitals.

Usability of cerebrospinal fluid biomarkers in a tertiary memory clinic

DEFF Research Database (Denmark)

Brandt, C.; Bahl, J.C.; Heegaard, N.H.

2008-01-01

AIM: Assays for cerebrospinal fluid (CSF) levels of total tau, phospho-tau protein and beta-amyloid 1-42 have been available for some years. The aim of the study was to assess the usability of these biomarkers in a mixed population of tertiary dementia referral patients in a university-based memory......, the sensitivity of a single abnormal value was between 33 and 66%. The specificity was high except when discriminating AD from amnestic mild cognitive impairment. Two or more abnormal markers further increased the specificity and decreased the sensitivity. CONCLUSION: In a tertiary setting, abnormal CSF biomarker...

Tertiary climatic fluctuations and methods of analysis of tertiary floras

Science.gov (United States)

Wolfe, J.A.

1971-01-01

On theoretical grounds, an analysis of the physiognomy of a Tertiary leaf assemblage is more direct and reliable than a circuitous floristic analysis in assigning thermal regimes to fossil assemblages. Using primarily foliar physiognomy and secondarily floristic composition, it can be shown that: (1) some middle latitude Tertiary assemblages probably lived under meteoroligically tropical climates; (2) a major and rapid climatic deterioration occurred in the Oligocene; and (3) a major climatic fluctuation probably occurred in the Late Eocene. These analyses thus substantiate the conclusions of several other paleobotanists regarding climatic fluctuations. Recent criticisms of these analyses are shown to be invalid and to be based largely on misinterpretations. ?? 1971.

Halitosis amongst students in tertiary institutions in Lagos state.

Science.gov (United States)

Arinola, J E; Olukoju, O O

2012-12-01

Halitosis is defined as a noticeable unpleasant odor from the mouth. It is a medico-social problem that affects a significant number of people around the world. Research reveals that nearly 50% of the adult population has halitosis. To determine level of awareness of halitosis and prevalence of the condition amongst students in tertiary institutions as a baseline survey. For this project, 100 students from three tertiary institutions in Lagos state were chosen: University of Lagos, Lagos State University, Ojo campus and Yaba College of Technology. A semi-structured questionnaire and practical testing/diagnostic tool were utilized. Data collected was collated and analyzed using Microsoft Excel 2007 and SPSS statistical software. Most of the respondents were single and Christian. Level of awareness of halitosis was high. Results showed that 15%, 2% and 22% from UNILAG, LASU and YCT respectively said they had halitosis. Using the diagnostic tool, 6%, 8% and 2% respectively were positive for halitosis. There is high level of awareness of halitosis among the respondents. The prevalence of the disorder is low, however, it is recommended that enlightenment campaigns be mounted in schools to improve level of awareness and treatment seeking.

Public health preparedness in Alberta: a systems-level study

Directory of Open Access Journals (Sweden)

Noseworthy Tom

2006-12-01

Full Text Available Abstract Background Recent international and national events have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. This article describes the study design and methods being used to conduct a systems-level analysis of public health preparedness in the province of Alberta, Canada. The project is being funded under the Health Research Fund, Alberta Heritage Foundation for Medical Research. Methods/Design We use an embedded, multiple-case study design, integrating qualitative and quantitative methods to measure empirically the degree of inter-organizational coordination existing among public health agencies in Alberta, Canada. We situate our measures of inter-organizational network ties within a systems-level framework to assess the relative influence of inter-organizational ties, individual organizational attributes, and institutional environmental features on public health preparedness. The relative contribution of each component is examined for two potential public health threats: pandemic influenza and West Nile virus. Discussion The organizational dimensions of public health preparedness depend on a complex mix of individual organizational characteristics, inter-agency relationships, and institutional environmental factors. Our study is designed to discriminate among these different system components and assess the independent influence of each on the other, as well as the overall level of public health preparedness in Alberta. While all agree that competent organizations and functioning networks are important components of public health preparedness, this study is one of the first to use formal network analysis to study the role of inter-agency networks in the development of prepared public health systems.

The development of the tertiary sector in the economy and the reduction in CO2 emissions

International Nuclear Information System (INIS)

Morvan, R.; Hubert, M.; Gregoire, P.; Lowezanin, Ch.

2004-09-01

The development of the tertiary sector appears to support sustainable development since it now accounts for almost two thirds of the national economy and is responsible for low CO 2 emission levels. Between 1980 and 1997, CO 2 emissions from the tertiary sector increased by 20 % compared with a 48 % rise in the sector value added. In terms of production, CO 2 levels in the tertiary sector are low, compared with 55 % for the secondary sector (industry). However, when trade between economic activities is taken into account, there is cause to qualify the assessment. This makes it possible to ascertain emissions from the point of view of satisfying final demand for products, and to identify direct and indirect emissions in each branch of activity. Thus, when emissions from certain industrial and agricultural activities are redistributed specifically to branches of activity in the tertiary sector, CO 2 emissions in this sector account for almost one-third of total emissions. (A.L.B.)

Determinants of the direct cost of heart failure hospitalization in a public tertiary hospital.

Science.gov (United States)

Parissis, John; Athanasakis, Kostas; Farmakis, Dimitrios; Boubouchairopoulou, Nadia; Mareti, Christina; Bistola, Vasiliki; Ikonomidis, Ignatios; Kyriopoulos, John; Filippatos, Gerasimos; Lekakis, John

2015-02-01

Heart failure (HF) is the first reason for hospital admission in the elderly and represents a major financial burden, the greatest part of which results from hospitalization costs. We sought to analyze current HF hospitalization-related expenditure and identify predictors of cost in a public tertiary hospital in Europe. We performed a retrospective chart review of 197 consecutive patients, aged 56±16years, 80% male, with left ventricular ejection fraction (LVEF) of 30±10%, hospitalized for HF in a major university hospital in Athens, Greece. The survey involved the number of hospitalization days, laboratory investigations and medical therapies. Patients who were hospitalized in CCU/ICU or underwent interventional procedures or device implantations were excluded from analysis. Costs were estimated based on the Greek healthcare system perspective in 2013. Patients were hospitalized for a median of 7 days with a total direct cost of €3198±3260/patient. The largest part of the expenses (79%) was attributed to hospitalization (ward), while laboratory investigations and medical treatment accounted for 17% and 4%, respectively. In multivariate analysis, pre-admission New York Heart Association NYHA class (p=0.001), serum creatinine (p=0.003) and NT-proBNP (p=0.004) were significant independent predictors of hospitalization cost. Direct cost of HF hospitalization is high particularly in patients with more severe symptoms, profound neurohormonal activation and renal dysfunction. Strategies to lower hospitalization rates are warranted in the current setting of financial constraints faced by many European countries. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Distinguishing between tertiary and secondary facilities: a case study of cardiac diagnostic-related groups (DRGs).

Science.gov (United States)

Rouse, Paul; Arulambalam, Ajit; Correa, Ralph; Ullman, Cornelia

2010-05-14

To develop a classification of tertiary cardiac DRGs in order to investigate differences in tertiary/secondary product mix across New Zealand district health boards (DHBs). 67 DRGs from 85,442 cardiac cases were analysed using cost weights and patient comorbidity complexity levels, which were used as a proxy for complexity. The research found high variability of severity within some DRGs. 5 DHBs are the main providers of 27 DRGs which are high cost and identified as tertiary by several ADHB clinicians; the same 5 DHBs have on average higher severity by DRG than the other DHBs. NZ tertiary hospitals have a product mix of DRGs with higher complexity than secondary hospitals. Funding based on case weights needs to recognise the additional resource requirements for this higher complexity.

"Digitize Me": Generating E-Learning Profiles for Media and Communication Students in a Jamaican Tertiary-Level Institution

Directory of Open Access Journals (Sweden)

Michelle A. Stewart-McKoy

2014-01-01

Full Text Available The purpose of this project was to develop an e-learning profile for a group of media and communication students enrolled in a Jamaican tertiary-level institution in order to make informed decisions most the appropriate [online] learning complement for these students. The objectives sought to determine the e-learning profile of media and communication students but more specifically, the profile examined students’ demographic data, their technology access, usage, proficiency and comfort levels as well as their learning styles, preferences, behaviours, strategies and their preferences for specific teaching styles. The research utilised a survey research design and the participants involved in the research were ninety-eight students from all year groups in the programme. Findings reveal that the “typical” media and communication student is a young Jamaican adult with limited technology access, usage and proficiency, who stays connected with others largely by phone texts, phone calls, emails, instant messages and posts via the Facebook social network, who has a visual-learning orientation, is a sequential learner who is extrinsically motivated and who readily employs surface learning strategies.

Present-day dilemmas and challenges of the South African tertiary system

OpenAIRE

Mouton, N.; Louw, G.P.; Strydom, G.L.

2013-01-01

The Education White Paper 3 on Higher Education aimed to transform the higher education system. Change within tertiary education included adjusting the size and shape of institutions, the meaning of autonomy and accountability, the nature of higher education, the character of student demographic distribution, management and governance, roles of student politics, models of delivery, the notion of higher education in terms of the relationship between free trade and public good, p...

Teaching Design in Adolescent Environments: Twinning Secondary and Tertiary Learning Experiences

Directory of Open Access Journals (Sweden)

David Jones

2004-06-01

Full Text Available Increasingly our landscape architecture teaching and educational pedagogies are facing an internationalisation in approach and expectation. We are positioned within a tertiary learning layer in a tripartite educational system for which each layer assumes certain expectations and outcomes. But their vertical linkages are unclear, and we incorrectly assume continuity of knowledge and skill learning strategies. It is a horizontally stratified teaching setting that we have to work within and while we can think of internationalisation as occurring within our level we need to appreciate that internationalisation is also occurring at the secondary level. This paper discusses the educational environment within which globalisation is occurring, and reviews a project model that builds bridges vertically between secondary and tertiary learning environments. The project displays possibilities in both secondary and tertiary educational sectors, but especially in enhancing and improving the design fluency of our annual incoming cohorts who often possess a naive understanding of built environmental design. Commencing in 1998 as an experimental project, it has been recognised at the South Australian state level as a forward-thinking initiative that has radically transformed secondary school Design teacher's perspectives as to educational possibilities, and substantially matured attitudes to landscape design by both suites of participants. As a consequence, it is an educational project that has experienced requests from numerous secondary schools around the State to participate.

Differentiation and Articulation in Tertiary Education Systems : A Study of Twelve African Countries

OpenAIRE

Ng'ethe, Njuguna; Subotzky, George; Afeti, George

2008-01-01

This study strives to sketch an initial map of the extent and nature of institutional and program differentiation within African systems of tertiary education. In doing so, it also seeks to chart the patterns of articulation that have emerged or been consciously put in place between the different institutional types (such as public universities, private universities, polytechnics, training...

A theoretical analysis of procurement auctions for tertiary control in Germany

International Nuclear Information System (INIS)

Mueller, Gernot; Rammerstorfer, Margarethe

2008-01-01

As far as energy policy is concerned, the design of the regulatory framework for energy transmission and distribution is a key issue. Consequently, also the embodiment of balancing power markets drives mainly the effectiveness of political implications for the energy sector. Initially, tertiary control in Germany was solely offered by transmission system operators of the respective power control areas and their associated power plant. The recast of the Energy Industry Act of 2005 led in last consequence to a common procurement auction for the supply of tertiary control, which starts on December 1, 2006. Admittedly, the reform has fallen short of expectations so far, first concerning the intensification of market entry of tertiary control providers as well as the desired decline of the price level. Hence, this article examines the effects of the changeover on observable demand charges. In order to identify attributes of the common procurement auction for tertiary control hampering market entry of providers, giving stimuli to collusion and strategic behavior, reducing intensity of competition and encouraging an upswing of prices, we analyze the design under an auction theoretical approach and deduce empirically whether structural components of the auction design have to be touched up again

Utilization of Antihypertensive Drugs: A Comparison of Tertiary and ...

African Journals Online (AJOL)

To compare the quality of antihypertensive prescriptions at 2 different health care levels in a hypertensive Nigerian population.We carried out a retrospective comparative analysis of the quality and pattern of antihypertensive and low-dose aspirin prescription in a tertiary and two secondary health care institutions providing ...

Cryptosporidium and Giardia removal by secondary and tertiary wastewater treatment.

Science.gov (United States)

Taran-Benshoshan, Marina; Ofer, Naomi; Dalit, Vaizel-Ohayon; Aharoni, Avi; Revhun, Menahem; Nitzan, Yeshayahu; Nasser, Abidelfatah M

2015-01-01

Wastewater disposal may be a source of environmental contamination by Cryptosporidium and Giardia. This study was conducted to evaluate the prevalence of Cryptosporidium oocysts and Giardia cysts in raw and treated wastewater effluents. A prevalence of 100% was demonstrated for Giardia cysts in raw wastewater, at a concentration range of 10 to 12,225 cysts L(-1), whereas the concentration of Cryptosporidium oocysts in raw wastewater was 4 to 125 oocysts L(-1). The removal of Giardia cysts by secondary and tertiary treatment processes was greater than those observed for Cryptosporidium oocysts and turbidity. Cryptosporidium and Giardia were present in 68.5% and 76% of the tertiary effluent samples, respectively, at an average concentration of 0.93 cysts L(-1) and 9.94 oocysts L(-1). A higher detection limit of Cryptosporidium oocysts in wastewater was observed for nested PCR as compared to immune fluorescent assay (IFA). C. hominis was found to be the dominant genotype in wastewater effluents followed by C. parvum and C. andersoni or C. muris. Giardia was more prevalent than Cryptosporidium in the studied community and treatment processes were more efficient for the removal of Giardia than Cryptosporidium. Zoonotic genotypes of Cryptosporidium were also present in the human community. To assess the public health significance of Cryptosporidium oocysts present in tertiary effluent, viability (infectivity) needs to be assessed.

Short-Run Distributional Effects of Public Education Transfers to Tertiary Education Students in Seven European Countries

Science.gov (United States)

Callan, Tim; Smeeding, Tim; Tsakloglou, Panos

2008-01-01

Direct provision of public services can alter the balance of resources across income groups. We focus on the issues arising when taking account of the impact of publicly provided education services across the income distribution. We combine OECD information on spending per student in particular levels of the education system with micro data from…

Prevalence of carbapenem resistant Enterobacteriaceae from a tertiary care hospital in Mumbai, India

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Pravin K. Nair

2013-12-01

Full Text Available Objective: The emergence of Carbapenem Resistant Enterobacteriaceae (CRE in recent times has become a serious threat to public health due to the high mortality, potential dissemination rates and limited treatment options associated with these organisms. Thus, the present study was conducted in our tertiary care hospital in Mumbai, to retrospectively analyze the prevalence of CRE in the hospital. Methods: The study was carried out in the microbiology department of the tertiary care hospital over a period of 12 months. The samples tested were clinical samples from hospitalized and Out-Patient Department (OPD patients sent to the department for microbiological testing. CRE isolates were identified using the Vitek 2- Compact system (BioMérieux, France. Results: A CRE prevalence rate of 12.26% was obtained from the study, from which the majority of the isolates were detected in urine samples (46%. Although most of the CRE isolates were detected in patient samples from the wards (42% and the ICU (26%, a significant number of isolates was also detected from the OPD patients (19%. Conclusion:Thus, the study shows a significant rate of carbapenem resistance among Enterobacteriaceae isolated from hospitalized and OPD patients. This emphasizes the urgent need for CRE control at the hospital and community level, and to rationalize the use of antibiotics. J Microbiol Infect Dis 2013;3(4: 207-210

Palynological and iridium anomalies at Cretaceous-Tertiary boundary, south-central Saskatchewan

Science.gov (United States)

Nichols, D.J.; Jarzen, D.M.; Orth, C.J.; Oliver, P.Q.

1986-01-01

The Cretaceous-Tertiary boundary in south-central Saskatchewan is marked by coincident anomalies in abundance of iridium and fern spores at the extinction level of a suite of Cretaceous pollen taxa. Evidence of disruption of the terrestrial flora includes the fern-spore abundance anomaly and local extinction of as much as 30 percent of angiosperm species. The reorganized earliest Tertiary flora is made up largely of surviving species that assumed new roles of dominance. Persistence of climatically sensitive taxa across the boundary indicates that if paleoclimate was altered by the terminal Cretaceous event, it returned quickly to the pre-event condition.

Embedded and Direct Metacognitive Strategy Instruction and its Effects on the Metacognitive Awareness of Tertiary Level Malaysian ESL Listeners

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Siew Ean Lye

2018-01-01

Full Text Available This small-scale quasi-experimental study compared the effects of metacognitive strategy instruction using two pedagogical approaches on the metacognitive awareness of Malaysian ESL listeners. Embedded and direct strategy instruction was delivered using the Metacognitive Pedagogical Sequence and Cognitive Academic Language Learning Approach instructional models respectively. 45 tertiary level students were randomly selected and assigned to two treatment groups to receive metacognitive instruction over a training period of five weeks. Paired-samples t-test results on participants‟ metacognitive awareness, as measured using the Metacognitive Awareness Listening Questionnaire (MALQ were inclusive despite significant improvements in their IELTS listening scores. No significant development was recorded in the overall MALQ scores but there were significant changes in three out of the five metacognitive awareness factors. Results further layered according to participants‟ listening proficiency levels (low, intermediate and high to examine if differences existed among the listening levels similarly showed no significant difference. These results suggest that ESL listeners‟ metacognitive awareness may not be easily developed with strategy instruction, regardless of the instructional approaches.

Present-Day Dillemas And Challenges Of The South African Tertiary System

OpenAIRE

N. Mouton; G. P. Louw; G. L. Strydom

2013-01-01

The Education White Paper 3 on Higher Education aimed to transform the higher education system. Change within tertiary education included adjusting the size and shape of institutions, the meaning of autonomy and accountability, the nature of higher education, the character of student demographic distribution, management and governance, roles of student politics, models of delivery, the notion of higher education in terms of the relationship between free trade and public good, programme change...

Defining English Language Proficiency for Malaysian Tertiary Education: Past, Present and Future Efforts

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Chan Swee Heng

2012-07-01

Full Text Available Any attempt to define English language proficiency can never be divorced from the theories that describe the nature of language, language acquisition and human cognition. By virtue of such theories being socially constructed, the descriptions are necessarily value-laden. Thus, a definition of language proficiency can only, at best, be described as developmental, following changes that are linguistic, pragmatic, cultural and political. In defining English proficiency for tertiary education, the context is naturally also linked to the focus on university education. The argument has been that an ‘acceptable’ level of language competence of a university applicant is anything but constant. Tremendous social changes have seen traditional values of elitism in university education giving way to the ‘massification’ of education. As Kaplan and Baldauf (1997:257 affirms, “The principal problem in tertiary education is not declining literacy standards but rather it is about meeting changed societal, cultural and informational requirements and circumstances”. In the light of these changes, this paper attempts to trace influencing factors that help define an ‘acceptable’ level of English proficiency for Malaysian tertiary education. The paper examines past and present efforts of establishing an English language policy and assessment practice for tertiary education, and concludes with some views on future development that could evolve from the current indicative pursuits of establishing language learning and ability.

Evaluating public involvement in the National Low-Level Radioactive Waste Management Program

International Nuclear Information System (INIS)

1982-09-01

The Department of Energy contracted with the Keystone Center to evaluate the effectiveness of the National Low-Level Radioactive Waste Management Program's public-involvement efforts. The Center chose six evaluators with diverse training and experience related to low-level waste management and public-participation programs. Keystone's evaluation was based on (a) observations by the evaluators who attended the National Program-sponsored strategy review meetings and fairs; (b) interviews with low-level waste generators, local government officials, state legislators, public-interest groups, and members of the general public; and (c) observations of the final National Program strategy task force meeting. The evaluators concluded that, overall, the public-participation processes yielded some very positive results - for policy development and for DOE and the EG and G staff. They judged the strategy document to be complete, concise, and helpful to public dialogue on low-level waste issues. They also made specific recommendations for improvements to the public-participation program

Tertiary Institutions, Entrepreneurship Education and Youth Empowerment in Nigeria

Science.gov (United States)

Olasunkanmi, Abari Ayodeji; Olufunke, Oyetola Idowu; Adetayo, Okunuga Adedapo

2013-01-01

Entrepreneurship Education has recently become a global phenomenon in the development of world youths for self employment and self-reliance. The Nigerian nation cannot afford to be left out and left behind in this new trend in education both at the secondary and tertiary levels. However, while the Universal Basic Education (UBE) curriculum has…

Treatment of self-poisoning at a tertiary level hospital in Bangladesh

DEFF Research Database (Denmark)

Verma, Vasundhara; Paul, Sujat; Ghose, Aniruddha

2017-01-01

OBJECTIVES: Approximately 10,000 people die from suicide annually in Bangladesh, many from pesticide poisoning. We aimed to estimate financial costs to patients and health services of treating patients with self-poisoning. METHODS: Data on direct costs to families, sources of funds for treatment...... and family wealth were collected prospectively over a one-month period in 2016 at the tertiary Chittagong Medical College Hospital, Bangladesh. Aggregate operational costs to the government were calculated using annual budget, bed occupancy and length-of-stay data. RESULTS: Agrochemicals were the most common...... as organophosphorus poisoning in 17(.) 0% of agrochemical cases resulted in increased cost to patients. Only 51(.) 9% of patients had indicators of wealth; 78(.) 1% borrowed money to cover costs. Conservatively estimated median healthcare costs (US$ 21(.) 30 per patient) were markedly lower than costs to patients...

Measuring case-mix complexity of tertiary care hospitals using DRGs.

Science.gov (United States)

Park, Hayoung; Shin, Youngsoo

2004-02-01

The objectives of the study were to develop a model that measures and evaluates case-mix complexity of tertiary care hospitals, and to examine the characteristics of such a model. Physician panels defined three classes of case complexity and assigned disease categories represented by Adjacent Diagnosis Related Groups (ADRGs) to one of three case complexity classes. Three types of scores, indicating proportions of inpatients in each case complexity class standardized by the proportions at the national level, were defined to measure the case-mix complexity of a hospital. Discharge information for about 10% of inpatient episodes at 85 hospitals with bed size larger than 400 and their input structure and research and education activity were used to evaluate the case-mix complexity model. Results show its power to predict hospitals with the expected functions of tertiary care hospitals, i.e. resource intensive care, expensive input structure, and high levels of research and education activities.

Bahrain’s tertiary education reform : a step towards sustainable economic development

OpenAIRE

Karolak, Magdalena

2012-01-01

Bahrain has been experiencing along with other Gulf Council Cooperation countries a rapid development of its tertiary sector of education. The 2000's were marked by a boom in education with the opening of twelve private universities in this country of roughly 1 million inhabitants. Some institutions were locally based, while others worked in affiliation with foreign based universities. It is in sharp contrast with the 1990's, when only three public universities served as centers of higher edu...

76 FR 9004 - Public Comment on Setting Achievement Levels in Writing

Science.gov (United States)

2011-02-16

... DEPARTMENT OF EDUCATION Public Comment on Setting Achievement Levels in Writing AGENCY: U.S... Achievement Levels in Writing. SUMMARY: The National Assessment Governing Board (Governing Board) is... for NAEP in writing. This notice provides opportunity for public comment and submitting...

A third of patients treated at a tertiary-level surgical service could be ...

African Journals Online (AJOL)

primary healthcare.[3,4]. The public healthcare sector in SA is overburdened at all levels of care.[5] Healthcare funding has not kept pace with inflation and the burden of disease.[6] Data are .... An example would be a skin laceration requiring sutures .... care pyramid. If skills and resources are limited, the trend is to refer to.

Counselling for Sustainable Peace in Tertiary Institutions in Nigeria

Science.gov (United States)

Nduka-Ozo, Stella Ngozi

2016-01-01

This study reviewed the nature of peace in Tertiary Institutions in Nigeria using Ebonyi State University as a case study. The purpose of the study was to review the various factors responsible for lack of peace. The sample was drawn from the three hundred level students of the Faculty of Education. Thirty students were selected from each of the…

Some aspects of public associations’ participation in implementing public control at municipal level

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Roman V. Gornev

2016-03-01

Full Text Available Objective to clarify the status of public associations as subjects of public control and to analyze the problems of participation of citizens 39 associations in conducting public expertise and public audits. Methods the methodology of research includes general scientific methods such as dialectic method. Specific jurisprudence methods of scientific cognition have also been used. Systematic method was used for the analysis of forms of public control by citizens39 associations at the municipal level. The principle of scientific objectivity has allowed for a comprehensive and objective analysis of the factual material the totality of factors affecting the interaction of public associations with local authorities in the implementation of public control. The formallegal method allowed to analyze the normativelegal acts to reveal the signs of fixing of such public control forms as public expertise and public audit. In the present study other research methods were also applied allowing to study the theme in detail. Results the study identified the lack of legal regulation of the legal status of public associations as subjects of public control as well as some forms of public control. The additions to the list of subjects of public control by public associations were proposed as well as improvements in the implementation of public expertise and public audit by the citizens39 associations as forms of social control. Scientific novelty the author found a lack of regulation of public associationsrsquo participation in some forms of social control and justified proposals for their improvement from a scientific point of view. Practical significance the possibility to apply the research results in legislative activity aimed at improving the provisions of the Federal Laws quotOn fundamentals of public control in the Russian Federationquot and quotOn the general principles of local selfgovernment organization in the Russian Federationquot. In addition the

Time Management and Administrative Effectiveness of Kwara State Tertiary Institutions, Nigeria

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Olasunkanmi Muftau AFOLABI

2015-02-01

Full Text Available This study investigated the relationship between time management and administrative effectiveness of Kwara State owned tertiary institutions. The study adopted a descriptive survey of correlational type. Stratified random sampling technique was adopted to select 600 respondents from the sampled institutions. The respondents selected are deans, directors, head of departments, senior lecturers, lecturers, head of the units, class representatives and student’s government executives and the Associations Presidents, secretaries and treasurers. Four research questions and four research hypotheses were generated to guide the study. The instruments staged Time Management for Administrative Effectiveness Questionnaire (TMADEQ was researcher’s self designed instrument. The instrument was validated by the experts in Educational management and psychology. Reliability index of .65 was obtained after subjecting to test-retest method, and using Spearman Ranking order Statistics at .05 significance level. All the research questions were answered using percentages while, Pearson product moment correlation statistics was used to test all the research hypotheses formulated also at .05 significance level. The findings however showed that time allocation, utilization commitment and lapses have high positive significant relationship with the indicators of the administrative effectiveness of Kwara State tertiary institutions. Recommendations was however made that time management skills should be taught as a course in the higher institutions so as to enhance administrative effectiveness in the tertiary institutions and that adequate time should be allocated to every institutional programmes.

Secondary and tertiary hyperparathyroidism in chronic kidney disease

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Lilit V. Egshatyan

2017-12-01

Full Text Available In the treatment of secondary hyperparathyroidism of end-stage chronic kidney disease, vitamin D receptor activation and allosteric modulators of the calcium-sensing receptor – inhibit glandular hyperplasia, reduce parathyroid hormone levels, impact on bone turnover and mineral density. But the use of calcimimetic and vitamin D analogs or mimetics did not reduce the need for parathyroidectomy for refractory hyperparathyroidism. The enlarged parathyroid gland and gland nodular transformation became refractory to medical therapy and patient need for parathyroidectomy. Tertiary hyperparathyroidism is a state of excessive secretion of parathyroid hormone after a long period of secondary hyperparathyroidism and renal transplantation. In this article, we present the case of a Caucasian male with chronic kidney disease (end-stage on chronic hemodialysis and after kidney transplantation and different forms of hyperparathyroidism (secondary and tertiary. Our case study shows that only a multi-interventional strategy is likely to be more effective treatment in cases of severe and refractory to medical therapy hyperparathyroidism.

Medical treatment of primary, secondary, and tertiary hyperparathyroidism.

Science.gov (United States)

Vestergaard, Peter; Thomsen, Susanna vid Strym

2011-04-01

Hyperparathyroidism is a condition with elevated parathyroid hormone (PTH). The increase may be due to a) primary hyperparathyroidism which is caused by adenoma of one or more parathyroid glands or hyperplasia of all four glands, b) secondary hyperparathyroidism, which may be caused by deficiency in vitamin D or uremia, and 3) tertiary hyperparathyroidism, which most often is the result of a long-standing, severe secondary hyperparathyroidism, which has turned autonomous once the cause of the secondary hyperparathyroidism has been removed. Many new treatment options have been introduced in recent years. Cinacalcet is calcium sensing receptor agonist, which by stimulating the receptor decreases PTH and calcium levels. It may be used in primary hyperparathyroidism, secondary hyperparathyroidism caused by uremia, which may not be controlled with calcium and activated vitamin D. It may also be used in tertiary hyperparathyroidism. Newer analogues of vitamin D such as paricalcitol have also been introduced, which may have an advantage over traditional compounds such as alphacalcidol and calcitriol.

An Examination of Tertiary Students' Desire to Found an Enterprise

Science.gov (United States)

Birdthistle, Naomi

2008-01-01

Purpose: The purpose of this paper is twofold. First, the paper aims to identify and explain the behaviour and intentions of students in their decision to start entrepreneurial activities and establish an enterprise. Second, the paper aims to identify whether students in tertiary level institutions in Ireland display the personality traits of an…

Seepage characteristics of the second tertiary combined model

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Huan ZHAO

2015-08-01

Full Text Available The second tertiary combined model experiment zone has been developed in Block B, Field L. The percolation feature of the second tertiary combined develop model shows great importance to rational and efficient development of the reservoir. In order to clearly illuminate its percolation feature, the typical reservoir numerical model is built by Eclipse, which is a reservoir numerical simulation software. The percolation features of original and added perforation interval under the second tertiary combined model are studied, and the variation features of general water-cut, recovery percentage, wellbore pressure, reservoir pressure and water saturation on condition of higher injection rate under the second tertiary combined model are analyzed. The research indicates that the second tertiary combined enhances the recovery of remaining oil on top of thick reservoir by developing and enhancing original perforation interval under water drive, then improves development results by polymer flooding, and gains higher recovery rate by synthetic action of water driver and polymer flooding.

Leveling up? An inter-neighborhood experiment on parochialism and the efficiency of multi-level public goods provision

OpenAIRE

Gallier, Carlo; Goeschl, Timo; Kesternich, Martin; Lohse, Johannes; Reif, Christiane; Römer, Daniel

2017-01-01

Many public goods can be provided at different spatial levels. Evidence from social identity theory and in-group favoritism raises the possibility that where higher-level provision is more efficient, subjects’ narrow concern for local outcomes (parochialism) could harm efficiency. Building on the experimental paradigm of multi-level public good games and the ‘neighborhood attachment’ concept, we conduct an artefactual field experiment with 600 participants in a setting conducive to parochial...

Public perception of low-level waste technologies: Demands on research and public education programs

International Nuclear Information System (INIS)

Witzig, W.F.; Bord, R.J.; Vincenti, J.R.

1986-01-01

The complexities of our political and legal systems, along with both insufficient information and misinformation, has resulted in significant problems in the disposal of radioactive waste. Distrust of the industry and regulators by the public, along with insufficient understanding of public fear by those responsible for waste disposal, has created a delay which shows few signs of early resolution. In light of these problems, this paper will specifically cover low-level radioactive waste disposal and management issues in the Appalachian Compact state of Pennsylvania. It will focus on the public's perception of waste technologies, and related policy issues, and the necessity of research and public education to create a bridge of understanding between those responsible for disposing of this material, those who benefit (the general public) from the creation of the waste, and those who are asked to live near disposal sites

EXPLORING THE TERTIARY EFL STUDENTS' ACADEMIC WRITING COMPETENCIES

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Aunurrahman Aunurrahman

2017-05-01

Full Text Available For tertiary English as a Foreign Language (EFL students, academic writing is not an easy task. It requires knowledge of the academic writing genres with their particular linguistic features. Moreover, academic writing demands good critical thinking. This research aims to explore the students' academic writing competencies that also focus on critical thinking. The research involved thirty-six first-year tertiary EFL students from a regular class of a private university in Pontianak, West Kalimantan, Indonesia. The source for data collection was the students’ texts. Three texts were selected and the students were categorized into low, medium, and high levels of writing achievement. The text analysis utilized functional grammar rooted in systemic functional linguistics (Emilia, 2014. The analysis shows that the students, regardless of their levels of writing achievement, have little control over the schematic structure and linguistic features of an argumentative writing. The text analysis also shows that the students’ texts have some limitations as regards their critical thinking capacity. Still, a few examples of academic language were detected in the texts. The findings suggest that the lecturer should incorporate explicit teaching and cooperative learning activities to alleviate the students' difficulties and develop their academic writing and critical thinking capacity.

Tertiary education and its association with mental health indicators and educational factors among Arctic young adults: the NAAHS cohort study

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Elisabeth Valmyr Bania

2016-09-01

Full Text Available Background: Completed tertiary education is closely associated with employment and influences income, health and personal well-being. Objective: The purpose of the study is to explore predictors for completed tertiary education among indigenous Sami and non-indigenous young people in relation to mental health indicators and educational factors in sociocultural rural and urban contexts across the Arctic part of Norway. Design: The Norwegian Arctic Adolescent Health Study (NAAHS is a cross-sectional, school-based survey that was conducted in 2003–2005. Of all 5,877 10th graders (aged 15–16 years in north Norway, 83% from all 87 municipalities participated; 450 (9.2% reported indigenous Sami ethnicity, and 304 (6.2% reported Laestadian affiliation. Data from NAAHS were merged with registry data from the National Education Database and Norwegian Patient Register for 3,987 adolescents who gave their consent for follow-up studies. Results: Completion of upper secondary school is the only common predictor of a completed tertiary education degree for both genders. Among females, conduct problems was a significant predictor of lower level education, typically vocational professions, while among males severe mental health problems requiring treatment by the specialist health care system reduced the opportunity to complete tertiary education at intermediate and higher level. Parental higher educational level was associated with less lower education among females and less higher education among males. Men residing in the northernmost and remote areas were less likely to complete education on higher level. Males’ completion of higher level education was strongly but not significantly associated (p=0.057 with higher average marks in lower secondary school. Conclusions: The gender differences found in this study emphasize the need for gender-specific interventions to encourage, support and empower young people to attend and complete tertiary education

Tertiary education and its association with mental health indicators and educational factors among Arctic young adults: the NAAHS cohort study.

Science.gov (United States)

Bania, Elisabeth Valmyr; Kvernmo, Siv Eli

2016-01-01

Background Completed tertiary education is closely associated with employment and influences income, health and personal well-being. Objective The purpose of the study is to explore predictors for completed tertiary education among indigenous Sami and non-indigenous young people in relation to mental health indicators and educational factors in sociocultural rural and urban contexts across the Arctic part of Norway. Design The Norwegian Arctic Adolescent Health Study (NAAHS) is a cross-sectional, school-based survey that was conducted in 2003-2005. Of all 5,877 10th graders (aged 15-16 years) in north Norway, 83% from all 87 municipalities participated; 450 (9.2%) reported indigenous Sami ethnicity, and 304 (6.2%) reported Laestadian affiliation. Data from NAAHS were merged with registry data from the National Education Database and Norwegian Patient Register for 3,987 adolescents who gave their consent for follow-up studies. Results Completion of upper secondary school is the only common predictor of a completed tertiary education degree for both genders. Among females, conduct problems was a significant predictor of lower level education, typically vocational professions, while among males severe mental health problems requiring treatment by the specialist health care system reduced the opportunity to complete tertiary education at intermediate and higher level. Parental higher educational level was associated with less lower education among females and less higher education among males. Men residing in the northernmost and remote areas were less likely to complete education on higher level. Males' completion of higher level education was strongly but not significantly associated (p=0.057) with higher average marks in lower secondary school. Conclusions The gender differences found in this study emphasize the need for gender-specific interventions to encourage, support and empower young people to attend and complete tertiary education. Young females with conduct

Tertiary education and its association with mental health indicators and educational factors among Arctic young adults: the NAAHS cohort study

Science.gov (United States)

Bania, Elisabeth Valmyr; Kvernmo, Siv Eli

2016-01-01

Background Completed tertiary education is closely associated with employment and influences income, health and personal well-being. Objective The purpose of the study is to explore predictors for completed tertiary education among indigenous Sami and non-indigenous young people in relation to mental health indicators and educational factors in sociocultural rural and urban contexts across the Arctic part of Norway. Design The Norwegian Arctic Adolescent Health Study (NAAHS) is a cross-sectional, school-based survey that was conducted in 2003–2005. Of all 5,877 10th graders (aged 15–16 years) in north Norway, 83% from all 87 municipalities participated; 450 (9.2%) reported indigenous Sami ethnicity, and 304 (6.2%) reported Laestadian affiliation. Data from NAAHS were merged with registry data from the National Education Database and Norwegian Patient Register for 3,987 adolescents who gave their consent for follow-up studies. Results Completion of upper secondary school is the only common predictor of a completed tertiary education degree for both genders. Among females, conduct problems was a significant predictor of lower level education, typically vocational professions, while among males severe mental health problems requiring treatment by the specialist health care system reduced the opportunity to complete tertiary education at intermediate and higher level. Parental higher educational level was associated with less lower education among females and less higher education among males. Men residing in the northernmost and remote areas were less likely to complete education on higher level. Males’ completion of higher level education was strongly but not significantly associated (p=0.057) with higher average marks in lower secondary school. Conclusions The gender differences found in this study emphasize the need for gender-specific interventions to encourage, support and empower young people to attend and complete tertiary education. Young females with

Regionalised tertiary psychiatric residential facilities.

Science.gov (United States)

Lesage, Alain; Groden, David; Goldner, Elliot M; Gelinas, Daniel; Arnold, Leslie M

2008-01-01

Psychiatric hospitals remain the main venue for long-term mental health care and, despite widespread closures and downsizing, no country that built asylums in the last century has done away with them entirely--with the recent exception of Italy. Differentiated community-based residential alternatives have been developed over the past decades, with staffing levels that range from full-time professional, to daytime only, to part-time/on-call. This paper reviews the characteristics of community-based psychiatric residential care facilities as an alternative to long-term care in psychiatric hospitals. It describes five factors decision makers should consider: 1. number of residential places needed; 2. staffing levels; 3. physical setting; 4. programming; and 5. governance and financing. In Italy, facilities with full-time professional staff have been developed since the mid-1990s to accommodate the last cohorts of patients discharged from psychiatric hospitals. In the United Kingdom, experiments with hostel wards since the 1980s have shown that home-like, small-scale facilities with intensive treatment and rehabilitation programming can be effective for the most difficult-to-place patients. More recently in Australia, Community Care Units (CCUs) have been applying this concept. In the Canadian province of British Columbia (BC), Tertiary Psychiatric Residential Facilities (TPRFs) have been developed as part of an effort to regionalise health and social services and downsize and ultimately close its only psychiatric hospital. This type of service must be further developed in addition to the need for forensic, acute-care and intermediate-level beds, as well as for community-based care such as assertive community treatment and intensive case management. All these types of services, together with long-term community-based residential care, constitute the elements of a balanced mental health care system. As part of a region's balanced mental health care plan, these Tertiary

Who benefits from public health financing in Zimbabwe? Towards universal health coverage.

Science.gov (United States)

Shamu, Shepherd; January, James; Rusakaniko, Simbarashe

2017-09-01

Zimbabwe's public health financing model is mostly hospital-based. Financing generally follows the bigger and higher-level hospitals at the expense of smaller, lower-level ones. While this has tended to perpetuate inequalities, the pattern of healthcare services utilisation and benefits on different levels of care and across different socioeconomic groups remains unclear. The purpose of this study was therefore to assess the utilisation of healthcare services and benefits at different levels of care by different socioeconomic groups. We conducted secondary data analysis of the 2010 National Health Accounts survey, which had 7084 households made up of 26,392 individual observations. Results showed significant utilisation of health services by poorer households at the district level (concentration index of -0.13 [CI:-0.2 to -0.06; p < .05]), but with mission hospitals showing equitable utilisation by both groups. Provincial and higher levels showed greater utilisation by richer households (0.19; CI: 0.1-0.29; p < .05). The overall results showed that richer households benefited significantly more from public health funds than poorer households (0.26; CI: 0.2-0.4; p < .05). Richer households disproportionately benefited from public health subsidies overall, particularly at secondary and tertiary levels, which receive more funding and provide a higher level of care.

Co-existing institutional logics and agency among top-level public servants

DEFF Research Database (Denmark)

Bjerregaard, Toke

2011-01-01

to address parts of this void. This study examines the agency exerted by top-level public servants through their everyday strategy and policy work in face of co-existing logics of public administration. The findings illustrate how their action strategies span from more passive strategies of coping...... with coexisting logics of administration to more skilled agency of combining logics aimed at enhancing their opportunity and action space. The study suggests that the interplay between co-existing institutional logics, action strategies and the practical skills of top-level public servants provides the basis...... for both coping and more proactive strategies in pluralistic public administrations. Findings illustrate the role of public servants' practical sense of realizable opportunities that inform such strategies of handling co-existing institutional logics. Implications for institutional studies of organizations...

SECTORAL ANALYSIS: GROWTH ACCOUNTING OF TERTIARY INDUSTRIES

Directory of Open Access Journals (Sweden)

Yahya Z. ALSHEHHI

2017-08-01

Full Text Available The tertiary sector is one of the modern styles of economic systems in view of the share it occupies in the field of production as well as employment occupied share. Hence, just like other lands, the UAE, witnessed an economic structural change similar to developed and developing nations, where the tertiary industries contributed 55.4% in 2015 to total country’s income. The empirical study aimed to analyze the contribution portion of growth in the tertiary industries through using the growth accounting framework in time-series from 1990 to 2015. The empirical study found that most of the industries contributed significantly to the growth of the tertiary sector. The contribution shares of growth due to labor and capital varied among industries. The main observed results show that there was a vice versa relationship between TFP performance and the size of labor, where the TFP positively corresponded with the decline in the size of labor specifically from 2010-2015.

Energy Management Systems and tertiary regulation in hierarchical control architectures for islanded micro-grids

DEFF Research Database (Denmark)

Sanseverino, Eleonora Riva; Di Silvestre, Maria Luisa; Quang, Ninh Nguyen

2015-01-01

In this paper, the structure of the highest level of a hierarchical control architecture for micro-grids is proposed. Such structure includes two sub-levels: the Energy Management System, EMS, and the tertiary regulation. The first devoted to energy resources allocation in each time slot based...

77 FR 75491 - Entry-Level Driver Training; Public Listening Session

Science.gov (United States)

2012-12-20

... identified are supported by research and data analyses, including cost/benefit considerations. The session...-27748] Entry-Level Driver Training; Public Listening Session AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of public listening session. SUMMARY: FMCSA announces that it will...

Grade-Level Retention in Texas Public Schools, 2015-16

Science.gov (United States)

Texas Education Agency, 2017

2017-01-01

This annual report provides information for the 2015-16 school year on grade-level retention in the Texas public school system. Data on retention are provided by student characteristics, including grade level; race/ethnicity; gender; degree of English proficiency; and economic, at-risk, immigrant, migrant, and overage statuses. Data also are…

Is the low level of physical activity a public policy issue?

Directory of Open Access Journals (Sweden)

Kalman Michal

2013-03-01

Full Text Available BACKGROUND: Many studies and scientific evidence confirm a positive effect of physical activity on the quality of life and human health. Physical activity, which is also one of the key factors preventing mass non-communicable diseases, is decreasing in Europe, including the Czech Republic, both in children and adults. Serious health consequences for the population and economy of the countries are a reason for a discussion about including the low level of physical activity among public policy issues and a higher allocation of public sources into the area of physical activity promotion. OBJECTIVES: The main objective of the paper is to determine whether the low level of physical activity is a public policy issue. An issue that should by systematically addressed by national, regional as well as local policy. METHODS: Through the policy analysis approach we conducted a content analysis of 25 systematically selected foreign national strategies aimed at the issue of physical activity promotion. The data source was an internal database of the World Health Organization - the International Inventory of Documents on Physical Activity Promotion. The content analysis of the strategies was performed using the Atlas.ti software tool. RESULTS: During a content analysis of 25 foreign strategies a total of 411 text segments (quotations relating to the low level of physical activity were selected. These text segments showed five basic features of a public policy issue according to a conceptual framework developed by Bardach (2000 and Patton and Sawicky (1993 - 1 affects the lives of a significant number of people of a society; 2 is analysable; 3 can be solved through public policy tools; 4 the primary cause or problem can be defined; 5 cannot be solved easily and quickly. CONCLUSIONS: The results indicate that the low level of physical activity is a public policy issue that must be systematically addressed at national level.

Benign Prostatic Hyperplasia: Health Seeking Behaviour of patients at a tertiary care hospital.

Directory of Open Access Journals (Sweden)

Aman Deep

2010-03-01

Full Text Available BackgroundBenign Prostatic Hyperplasia is a widely prevalent conditionaffecting elderly men throughout the world. With increasinglife expectancy, there has been a rise in the percentage ofelderly men and so for this disease across the globe. There islack of information about health seeking behaviour of patientswith Benign Prostatic Hyperplasia. Therefore the study wasdesigned with the objectives of assessing health-seekingbehaviour and the effect of literacy on it among adult andolder subjects suffering from Benign Prostatic Hyperplasiaattending a tertiary care hospital.MethodA series of 81 patients suffering from Benign ProstaticHyperplasia above the age of 50 years, attending surgical OutPatient Department of a tertiary care hospital in Delhi, wereassessed for their health seeking behaviour using a pre-testedand a modified questionnaire designed for assessing healthseeking behaviour.ResultsPositive health seeking behaviour of patients was observed in44%, who reported to a doctor within a month of noticingtheir problem. A greater proportion of the literates was awareabout the symptoms suggestive of enlarged prostate andconsulted a qualified health care practitioner as their firstaction. More literates approached the higher level of healthcare facility on being referred and had maximum faith inallopathic system of medicine. Also, lesser number of literateshad performed pooja (Hindi word for worship or othertraditional rituals for relief of their problems.ConclusionWe concluded that majority of subjects suffering fromBenign Prostatic Hypertrophy were not aware of theirdisease and their health-seeking behaviour was poor andcould be related to literacy. Our data highlights the needfor public awareness program targeting the younger malepopulation so that early detection and treatment can beoffered.

Evaluation of prevalence of low and high level mupirocin resistance in methicillin resistant staphylococcus aureus isolates at a tertiary care hospital

International Nuclear Information System (INIS)

Nizamuddin, S.; Irfan, S.; Zafar, A.

2011-01-01

To evaluate the trend of mupirocin resistance in MRSA, isolated at the Clinical Microbiology Laboratory of a tertiary care hospital. Methods: A total of 200 MRSA strains recovered over a 2 year period from various body sites were tested using the 5 and 200 mu g discs of mupirocin to detect its resistance. Results: High level and low level mupirocin resistance were detected in zero and 1 % of MRSA strains, respectively. Resistance to other non beta lactam antibiotics was also high. No MRSA strains were found to be resistant to vancomycin and tegicycline. Conclusion: Mupirocin resistance was found to be very low among local clinical isolates of MRSA. Its judicious use to decolonize nasal carriers should be promoted among hospitalized patients to avoid further transmission and infections due to prevalent endemic MRSA strains in any health care setting. Concomitantly, regular surveillance and effective infection control initiatives are desirable to reduce the incidence of health care associated infections due to MRSA and also of mupirocin resistance. (author)

Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India

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Muthappan Sendhilkumar

2017-01-01

Full Text Available Objective: We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. Methods: A mixed-methods (triangulation design study with quantitative methodology (survey and qualitative methodology (interviews was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. Results: The prevalence of high/very high stress was 35% among DM patients. Age 30–40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. Conclusions: This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity.

Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India.

Science.gov (United States)

Sendhilkumar, Muthappan; Tripathy, Jaya Prasad; Harries, Anthony D; Dongre, Amol R; Deepa, Mohan; Vidyulatha, Ashok; Poongothai, Subramanian; Venkatesan, Ulaganathan; Anjana, Ranjit Mohan; Mohan, Viswanathan

2017-01-01

We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM) in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. A mixed-methods (triangulation design) study with quantitative methodology (survey) and qualitative methodology (interviews) was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. The prevalence of high/very high stress was 35% among DM patients. Age 30-40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity.

Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India

Science.gov (United States)

Sendhilkumar, Muthappan; Tripathy, Jaya Prasad; Harries, Anthony D.; Dongre, Amol R.; Deepa, Mohan; Vidyulatha, Ashok; Poongothai, Subramanian; Venkatesan, Ulaganathan; Anjana, Ranjit Mohan; Mohan, Viswanathan

2017-01-01

Objective: We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM) in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. Methods: A mixed-methods (triangulation design) study with quantitative methodology (survey) and qualitative methodology (interviews) was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. Results: The prevalence of high/very high stress was 35% among DM patients. Age 30–40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. Conclusions: This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity. PMID:28217499

45 CFR 400.66 - Eligibility and payment levels in a publicly-administered RCA program.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Eligibility and payment levels in a publicly... REFUGEE RESETTLEMENT PROGRAM Refugee Cash Assistance § 400.66 Eligibility and payment levels in a publicly-administered RCA program. (a) In administering a publicly-administered refugee cash assistance program, the...

Older Australian's Motivation for University Enrollment and Their Perception of the Role of Tertiary Education in Promoting Healthy Aging: A National Cross-Sectional Study

Science.gov (United States)

Brownie, Sonya

2014-01-01

The aims of this study were to describe the characteristics of older Australian university students (aged 60+ years); to identify the factors that motivate late-life, tertiary-level learning; and to capture older students' views about the role of tertiary-level learning in promoting healthy aging. In 2012, an invitation to participate in the study…

Sepsis is a preventable public health problem.

Science.gov (United States)

Kempker, Jordan A; Wang, Henry E; Martin, Greg S

2018-05-06

There is a paradigm shift happening for sepsis. Sepsis is no longer solely conceptualized as problem of individual patients treated in emergency departments and intensive care units but also as one that is addressed as public health issue with population- and systems-based solutions. We offer a conceptual framework for sepsis as a public health problem by adapting the traditional model of primary, secondary, and tertiary prevention.

Low-level radioactive waste disposal technology development through a public process

International Nuclear Information System (INIS)

Murphy, M.P.; Hysong, R.J.; Edwards, C.W.

1989-01-01

When Pennsylvania's legislature ratified the Appalachian States Low-Level Radioactive Waste Compact in 1985, the Commonwealth of Pennsylvania became the host state designee for the compact's low-level radioactive waste (LLWR) disposal facility. Programs necessary for the establishment of this facility became the responsibility of the Department of Environmental Resources' (DER), Bureau of Radiation Protection's, Division of Nuclear Safety (DNS). It was realized early in the process that the technical aspects of this program, while challenging, probably were not the largest obstacle to completing the facility on schedule. The largest obstacle was likely to be public acceptance. Recognizing this, the DNS set out to develop a program that would maximize public involvement in all aspects of site and facility development. To facilitate public involvement in the process, the DNS established a LLRW advisory committee and a strategy for holding public meetings throughout Pennsylvania. As a result of the significant public involvement generated by these efforts, Pennsylvania passed, in February of 1988, one of the most stringent and technically demanding LLRW disposal laws in the nation. Hopefully, increased public confidence will reduce to a minimum public opposition to the facility

Tertiary Education in the Czech Republic: The Pathway to Change

Science.gov (United States)

Pesik, Richard; Gounko, Tatiana

2011-01-01

This article analyzes recent policy proposals to reform Czech tertiary education. A brief overview of the evolution of Czech tertiary education presents the background against which emerging policy trends in education are examined. We relate the changes in tertiary education to the policy framework and recommendations of the OECD, underpinned by…

A Case Study Analysis of Clt Methods to Develop Grammar Competency for Academic Writing Purposes at Tertiary Level

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Almodad Biduk Asmani

2013-10-01

Full Text Available The purpose of the research project is to find out how effective grammar teaching and learning using the Principled CLT method can improve the ability of freshman Binus University students to understand and use grammar knowledge for academic writing purposes. The research project is expected to result in computer-animated format which can be used as one of the main tools in teaching and learning grammar at tertiary level. The research project applies the descriptive quantitative approach, and thus uses numeric data. The research project involves two subject groups, which are experimental and control. The two groups are pre-tested so as to find out their level of grammar competency by their academic writing works. The experimental group receives the treatment of grammar learning by using the Principled CLT approach, while the control group receives the standard CLT approach. Then, the two groups have the post-test, and the results are compared. Through statistics, the numerical data show that there is no significant difference between the two methods’ results, and as a result, either method has its own strength and weaknesses. If one is to be implemented, it must be linked to the specific goals and purposes that each entails.  

Which type of leader do I support in step-level public good dilemmas? The roles of level of threshold and trust.

Science.gov (United States)

De Cremer, David

2007-02-01

The present research examined the moderating effect of the level of threshold on people's preferences for different leader types in step-level public good dilemmas. It was assumed that the primary focus of people in step-level public good dilemmas is to make sure that the group surpasses the threshold. Consequently, when the level of threshold is difficult to reach people are expected to provide more support for and cooperate with a leader that monitors and controls the contributions made toward the public good. However, if the threshold is easy to surpass people will focus more on whether the obtained public good or bonus will be distributed according to agreements, suggesting that people will provide more support to and cooperate with a leader that monitors and controls the distribution of the bonus. These predictions were confirmed across two experiments using a step-level public good paradigm with a dichotomous (Study 1) and a continuous (Study 2) contribution choice. Moreover, the results also revealed that perceptions of trust accounted, in part, for the effect of level of threshold on people's leadership preferences.

Adapting the Academic Motivation Scale for Use in Pre-Tertiary Mathematics Classrooms

Science.gov (United States)

Lim, Siew Yee; Chapman, Elaine

2015-01-01

The Academic Motivation Scale (AMS) is a comprehensive and widely used instrument for assessing motivation based on the self-determination theory. Currently, no such comprehensive instrument exists to assess the different domains of motivation (stipulated by the self-determination theory) in mathematics education at the pre-tertiary level (grades…

2. Tertiary Foraminifera

NARCIS (Netherlands)

Umbgrove, J.H.F.

1931-01-01

In his review of the palaeozoology of Java, K. Martin could in 1919, record 49 foraminifera from tertiary strata of Java, on the strength of a critical study of the existant literature, and especially on the strength of his own studies and knowledge of the above mentioned fossils (Bibl. 49). In

Limits and opportunities of marketeering tertiary education in post-colonial Zimbabwe

OpenAIRE

Patrick Sibanda

2016-01-01

This paper intended to assess the impact of marketeering tertiary education in Zimbabwe. The paper revealed that marketeering of tertiary education in Zimbabwe has drastically impacted on access to higher education and training. Poor and vulnerable students have found it difficult to access tertiary education due to escalating commercialized fees. Literature indicates that, even in developed countries like UK, marketeering tertiary education has led to decreased enrolments, diminishing prospe...

Mixed La-Li heterobimetallic complexes for tertiary nitroaldol resolution.

Science.gov (United States)

Tosaki, Shin-ya; Hara, Keiichi; Gnanadesikan, Vijay; Morimoto, Hiroyuki; Harada, Shinji; Sugita, Mari; Yamagiwa, Noriyuki; Matsunaga, Shigeki; Shibasaki, Masakatsu

2006-09-13

A kinetic resolution of tertiary nitroaldols derived from simple ketones is described. Mixed BINOL/biphenol La-Li heterobimetallic complexes gave the best selectivity in retro-nitroaldol reactions of racemic tertiary nitroaldols. By using a mixture of La-Li3-(1a)3 complex (LLB 2a) and La-Li3-(1b)3 (LLB* 2b) complex in a ratio of 2/1, chiral tertiary nitroaldols were obtained in 80-97% ee and 30-47% recovery yield.

Massification and Quality Assurance in Tertiary Education: The ...

African Journals Online (AJOL)

The study sets out to examine massification and its impact on quality assurance in tertiary education and the extent to which lecturer–student ratio, adequacy of infrastructure and pedagogical resources affect quality in tertiary institutions. Two research questions and one hypothesis were posed to guide the investigation.

Evaluation of health literacy status among patients in a tertiary care hospital in coastal karnataka, India.

Science.gov (United States)

U P, Rathnakar; Belman, Madhuri; Kamath, Ashwin; B, Unnikrishnan; Shenoy K, Ashok; A L, Udupa

2013-11-01

People with limited health literacy are more likely to make medication errors, and they have less health knowledge, worse health status, more hospitalizations, and higher healthcare costs than people with adequate literacy. The objective of this study is to assess the health literacy status among patients who are able to read and understand English attending a tertiary care hospital by using Rapid Estimate of Adult Literacy in Medicine [REALM] technique and to compare the health literacy levels to educational status and other baseline characteristics. A widely used word recognition method [REALM] was used to assess the HL status of 200 patients attending a tertiary care hospital in Southern India. The number of correctly pronounced words was used to assign a grade-equivalent reading level. Scores 0 to 44 indicate reading skills at or below the 6th grade level, scores from 45 to 60 represent skills at the 7th or 8th grade level, and scores above 60 indicate skills at the high-school level or higher. HL status was found below adequate level in more than 50% of the patients. Younger age group showed better HL scores compared to those aged more than 25 years. General education level or the medium of education does not truly reflect HL levels as brought out in the study. Even those with postgraduate qualification had poor HL skills. The study was carried out to find out the HL levels among patients attending a tertiary care hospital. It was assumed that the general education levels may not reflect true HL status. In view of the results of this study it can be concluded that patient's HL skills should not be taken for granted and adequate attention should be paid in educating and briefing patients whenever patients are required to interpret and understand health care related documents.

Chinese Tertiary English Educators' Perceptions of Foreign Teacher Involvement in Their Professional Development

Science.gov (United States)

Bleistein, Tasha Maria

2013-01-01

China continues to invite expatriate tertiary-level English language educators to teach. Foreign English language teachers and local Chinese English educators who wish to develop professionally have an ever-increasing body of research regarding Chinese culture, education, professional development, and intercultural communication; however, research…

Assessment of safety levels in operation rooms at two major tertiary care public hospitals of Karachi. Safe surgery saves life

International Nuclear Information System (INIS)

Minhas, M.S.; Muzzammil, M.; Effendi, J.

2017-01-01

The objectives of this study are to determine the knowledge and attitude towards surgical safety among the health care professionals including surgeons, anaesthetist, hospital administrators, and operation room personnel and raise awareness towards the importance of safe surgery. Method: A pilot cross- sectional study of 543 healthcare providers working in the operating rooms and the surgical intensive care units was conducted in two tertiary care hospitals, within a study period of one month. A structured questionnaire was constructed and an informed verbal consent was taken. The questionnaire was then distributed; data collected and analysed on SPSS 20.0. Results: A total of 543 respondents participated in the study out of which there were 375 (69%) men and 168 (31%) women. The ages ranged between 23-58 years, mean 40.5+-24.74. There were 110 (20.25%) surgeons, 58 (10.68%) anaesthetist, 132 (24.30%) trainees, 125 (23.02%) technicians, and were 118 (21.73%) nurses. The question regarding briefing operation room personnel is important for patient safety was agreed by 532 (98%) respondents. Amongst the respondents, 239 (44%) did not feel safe to be operated in their own setup. Team communication improvement through the check list implementation was agreed by 483 (89%) respondents. 514 (94.7%) opted for the checklist to be used while they are being operated. That operation room personnel frequently disregard established protocols was agreed by 374 (69%) respondents. 193 (35.54%) of the respondents stated that it is difficult for them to speak up in the or if they perceive a problem with patient care. Conclusion: Operation room personnel were not aware of several important areas related to briefing, communication, safety attitude, following standard protocols and use of WHO Surgical Safety check list. A pre-post intervention study should be conducted after formal introduction of the Checklist. Successful implementation will require taking all stake holders on board

FUNDING PUBLIC INSTITUTIONS IN ROMANIA

Directory of Open Access Journals (Sweden)

Florin-Constantin, DIMA

2014-11-01

Full Text Available The development of this article started from the fact that in the field of public institutions accounting there have been many changes and it aims to capture the essential aspects of their financing. Thus the article covers a series of issues related to the credit officers, to employment, to settlement and payment of public institutions expenditure, to the budgeting and budgetary credits accounting. It also presents a brief classification of the public institutions according to several criteria, as well as their financing sources. The paper also practically presents the accounting of the budgetary credits and their sharing mechanism between the principal, secondary and tertiary budgetary credits officers.

A public health framework to translate risk factors related to political violence and war into multi-level preventive interventions.

Science.gov (United States)

De Jong, Joop T V M

2010-01-01

Political violence, armed conflicts and human rights violations are produced by a variety of political, economic and socio-cultural factors. Conflicts can be analyzed with an interdisciplinary approach to obtain a global understanding of the relative contribution of risk and protective factors. A public health framework was designed to address these risk factors and protective factors. The framework resulted in a matrix that combined primary, secondary and tertiary interventions with their implementation on the levels of the society-at-large, the community, and the family and individual. Subsequently, the risk and protective factors were translated into multi-sectoral, multi-modal and multi-level preventive interventions involving the economy, governance, diplomacy, the military, human rights, agriculture, health, and education. Then the interventions were slotted in their appropriate place in the matrix. The interventions can be applied in an integrative form by international agencies, governments and non-governmental organizations, and molded to meet the requirements of the historic, political-economic and socio-cultural context. The framework maps the complementary fit among the different actors while engaging themselves in preventive, rehabilitative and reconstructive interventions. The framework shows how the economic, diplomatic, political, criminal justice, human rights, military, health and rural development sectors can collaborate to promote peace or prevent the aggravation or continuation of violence. A deeper understanding of the association between risk and protective factors and the developmental pathways of generic, country-specific and culture-specific factors leading to political violence is needed.

[Association between occupational stress and presenteeism among medical staff at grade A tertiary hospitals in Shanghai, China].

Science.gov (United States)

Dai, Junming; Hua, Yujie; Zhang, Hao; Huang, Li; Fu, Hua

2015-10-01

To investigate the current status of occupational stress and presenteeism among medical staff at grade A tertiary hospitals in Shanghai, China, and to analyze the association between occupational stress and presenteeism. A total of 2356 healthcare workers from eight grade A tertiary hospitals in Shanghai were investigated by stratified random sampling. All the subjects were asked to complete self-administered questionnaires with informed consent. The occupational stress was assessed by the occupational stress core questionnaire. The presenteeism was evaluated by the Stanford Presenteeism Scale. In all subjects, the average score of presenteeism was 15.23 ± 3.89, and 72.5% felt occupational stress in self-evaluation. There were significant differences in the score of presenteeism between subjects with different ages, education levels, occupations, lengths of service, job titles, and shifts (all Poccupational stress, including job demand, control, social support, and demand-control ratio (Poccupational stress in medical staff from grade A tertiary hospitals is positively correlated with the level of presenteeism. It is important to promote social support to reduce the loss of work efficiency due to presenteeism.

Crime and Crime Management in Nigeria Tertiary Institutions

Science.gov (United States)

Adebanjo, Margaret Adewunmi

2014-01-01

This paper examines crime and its management in Nigerian tertiary institutions. Tertiary institutions today have become arenas for crime activities such as rape, cultism, murder, theft, internet fraud, drug abuse, and examination malpractices. This paper delves into what crime is, and its causes; and the positions of the law on crime management.…

10 CFR 212.78 - Tertiary incentive crude oil.

Science.gov (United States)

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Tertiary incentive crude oil. 212.78 Section 212.78 Energy DEPARTMENT OF ENERGY OIL MANDATORY PETROLEUM PRICE REGULATIONS Producers of Crude Oil § 212.78 Tertiary incentive crude oil. Annual prepaid expenses report. By January 31 of each year after 1980, the project...

Costing of severe pneumonia in hospitalized infants and children aged 2-36 months, at a secondary and tertiary level hospital of a not-for-profit organization

DEFF Research Database (Denmark)

Madsen, Helle Ostergaard; Hanehøj, Malin; Das, Ashima Rani

2009-01-01

OBJECTIVES: To determine health care provider cost and household cost of the treatment of severe pneumonia in infants and young children admitted to secondary and tertiary level health care facilities. METHODS: The study was done in a private, not-for-profit medical college hospital, in Vellore...... comprised travel, accommodation and special food during the period of illness, and indirect costs of productivity loss for family members. Patient specific resource consumption and related charges were recorded from charts, nursing records, pharmacy lists and hospital bills, and the providers view point...

Population and colony-level determinants of tertiary sex ratio in the declining barn swallow.

Directory of Open Access Journals (Sweden)

Nicola Saino

Full Text Available Sex ratio of adults (tertiary sex ratio, TSR is a major feature of animal populations with consequences for their behaviour, genetic structure and viability. Spatial and temporal variation in TSR occurs within species but the mechanisms behind it are poorly understood. In this long-term study of a declining population of a socially monogamous, colonial, migratory bird, the barn swallow (Hirundo rustica, we first analyzed population-level variation in TSR ( =  proportion of males of yearlings at sexual maturation in relation to ecological conditions as gauged by annual survival rate of adults. TSR was male-biased both among yearlings and older individuals, but male bias of yearlings was more pronounced after years with larger decline in adult survival. Thus, male offspring were less susceptible to the adverse ecological conditions that cause increased mortality. Dispersal and settling site decisions can have major consequences on fitness via the effects of local TSR on mating and sperm competition. Breeding barn swallows are highly philopatric while natal dispersal is high and, together with mortality, is the main determinant of colony TSR. We thus also investigated the mechanisms of breeding colony choice by yearlings and found that TSR of new-settlers in a given colony and year was negatively predicted by TSR of returning, early arriving older individuals in that year, but not by overall TSR at the colony in the previous year. This suggests that in our male-biased population new-settler males respond to local TSR upon arrival to choose the sites with larger breeding opportunities. Hence, variation in ecological conditions as reflected by adult survival can shift the TSR of individuals recruiting into a local population, with potentially various demographic consequences. However, breeding site choice based on TSR tends to homogenize TSR at a population level likely by facilitating settling of dispersing males in colonies with less male

Echocardiographic evaluation of simple versus complex congenital heart disease in a tertiary care Paediatrics Hospital

OpenAIRE

Uttam Kumar Sarkar; Anish Chatterjee; Suprit Basu; Atanu Pan; Sumit Periwal

2017-01-01

Background & Objectives:Congenital heart diseases are treatable either by catheter based intervention or open heart surgery according to their quality. In our study we aim to analyze congenital heart disease echocardiographically into simple versus complex heart disease at a tertiary care centre with a public health planning and policy making perspective.Materials & Methods:This hospital based study was done on 1010 patients, both from in-patient and out-patient, who were clinically s...

Tertiary Technical Education and Youth Integration in Brazil, Colombia and Mexico

Directory of Open Access Journals (Sweden)

Claudia Jacinto

2014-11-01

Full Text Available Vocational training versus a traditional university education. This chapter seeks to answer the question of whether ‘tertiary technical education’ has contributed to increasing economic and social opportunity for young people in Latin America, using three case studies from Brazil, Colombia and Mexico. It examines the extent to which tertiary technical education has contributed towards democratising access to education through institutional diversification, expanded enrolment and, at least theoretically, improved access to quality employment. The analysis shows that tertiary technical education has contributed to widening of opportunities by offering an alternative form of education to new generations of young people. Tertiary technical education is more accessible, shorter in duration, has a vocational orientation, and tends to be cheaper than a university education. However, the case studies also reveal that while a tertiary technical education diploma is an asset for young people seeking employment, it nonetheless does not have the same perceived value as a traditional university education. Available data appear to indicate that graduates of tertiary technical education earn less on average than university graduates and face several challenges in the labour market. Furthermore, the studies reveal that despite the presence of highly regarded tertiary technical education institutions in all three countries, these carry less prestige and status than universities.

Statutory compliance in assets disposal practices in the public sector: Evidence from Ghana

Directory of Open Access Journals (Sweden)

Oswald Atiga

2015-03-01

Full Text Available Background: This article examined the unserviceable assets disposal practices of five polytechnics (tertiary educational institutions in Ghana. Objectives: The aim was to determine the extent of statutory compliance, and the degree to which value for money was achieved in actual disposal. Method: A survey was conducted using interviewer-administered questionnaires containing five-point likert scale test items. Descriptive statistics and a one-way analysis of variance (ANOVA were employed to analyse the data. Results: The study results showed that a limited number of polytechnics had internal policies to operationalise statutory procurement legislation. Top management demonstrated very clear understanding of procurement legislation whilst senior-level managers displayed mixed levels of understanding. The section of the legislation dealing with disposals and the procedures pertaining thereto is perceived to be difficult to implement and does not promote value for money. Top management’s interference in auctions was the toughest challenge in the process, whilst public auction was the predominant method used in assets disposal. Research limitations: The research was carried out in only five polytechnics. This study could be replicated in other tertiary institutions or in other sectors outside higher education.

Low and intermediate level waste repositories: public involvement aspects

International Nuclear Information System (INIS)

Ferreira, Vinicius V.M.; Mourao, Rogerio P.; Fleming, Peter M.; Soares, Wellington A.; Braga, Leticia T.P.; Santos, Rosana A.M.

2009-01-01

The nuclear energy acceptance creates several problems, and one of the most important is the disposal of the radioactive waste. International experiences show that not only environmental, radiological and technical questions have to be analyzed, but the public opinion about the project must be considered. The objective of this article is to summarize some public involvement aspects associated with low and intermediate level waste repositories. Experiences from USA, Canada, South Africa, Ukraine and other countries are studied and show the importance of the population in the site selection process for a repository. (author)

Tertiary recovery and tritide injection equipment

International Nuclear Information System (INIS)

Li Lin

1989-01-01

The exploitation of an oil field is a continously developing process, undergoing seveal stages, such as the low production, the high production, the stable production and the decline. The tertiary recovery is an important means of the enhanced oil recovery. Since the object of the tertiary recovery is to treat the oil in micropores which is difficult to be produced, it is more necessary to know further the reservoir. Tritide can be used as a tracer and is an ideal marker of knowing the reservoir and the state of the fluid movement. The paper presents the tritide injection equipment

[A case-series analysis of tuberculosis in pediatric patients treated in a tertiary level hospital].

Science.gov (United States)

Vázquez Rosales, José Guillermo; Acosta Gallegos, Cynthia; Miranda Novales, María Guadalupe; Fuentes Pacheco, Yazmín Del Carmen; Labra Zamora, María Guadalupe; Pacheco Rosas, Daniel Octavio; Solórzano Santos, Fortino

Tuberculosis (TB) remains a challenge because severe forms occur most frequently in children under 5 years of age and the diagnosis is complex. The objective of this paper was to describe the clinical presentation, frequency, diagnostic methods used and response to treatment in children with TB treated at a tertiary level hospital. The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2010 to December 2013. Ninety-three medical records of children diagnosed with TB according to the definition of the NOM-006-SSA2-2013 were reviewed. Descriptive statistics were used for the analysis. From 93 children, 58% were male (mean age of 7 years), 97% with a history of BCG vaccination, and 6% had contact with a TB case. The most frequent clinical forms were pulmonary (30.1%), lymph node (24.7%), miliary/disseminated (16.1%), meningeal (13%), and osteal TB (7.5%). The most common symptoms were fever and weight loss (50% and 40%, respectively). BAAR and culture were positive in 26% and 7% of all cases, respectively. The histopathological study was conclusive in 90% of the cases. The treatment was successful in 94.6%, with not associated mortality. The association of clinical symptoms with alterations in chest radiography and positive PPD are useful in establishing the presumptive diagnosis and an early and appropriate treatment. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Risk Factors Predicting Mortality in Patients with Lung Abscess in a Public Tertiary Care Center in Karachi, Pakistan

OpenAIRE

Shaista Ghazal; Ashok Kumar; Binav Shrestha; Sana Sajid; Maria Malik; Nadeen Rizvi

2013-01-01

Introduction: Lung abscess is a commonly encountered entity in South-East Asia but not much data regarding its outcome is available. The objective of this study was to identify the factors associated with increased mortality in patients diagnosed with lung abscess in a tertiary care center of Karachi, Pakistan. Methods: A retrospective case analysis was performed via hospital records, on patients admitted with lung abscess between January 2009 and January 2011 at the largest state...

Job satisfaction among nurses working in the private and public sectors: a qualitative study in tertiary care hospitals in Pakistan

Directory of Open Access Journals (Sweden)

Hamid S

2014-01-01

Full Text Available Saima Hamid,1 Asmat Ullah Malik,2 Irum Kamran,3 Musarat Ramzan41Health Services Academy, Islamabad, Pakistan; 2Integrated Health Services, Islamabad, Pakistan; 3GIZ, Islamabad, Pakistan; 4Wah Medical College, Wah Cantt, University of Health Sciences, Wah, PakistanBackground: Many low and middle income countries lack the human resources needed to deliver essential health interventions. A health care system with a limited number of nurses cannot function effectively. Although the recommended nurse to doctor ratio is 4:1, the ratio in Pakistan is reversed, with 2.7 doctors to one nurse.Methods: A qualitative study using narrative analysis was undertaken in public and private tertiary care hospitals in Pakistan to examine and compare job satisfaction among nurses and understand the factors affecting their work climate. Interactive interviews were conducted with nurses working with inpatients and outpatients.Results: All of the respondents had joined the profession by choice and were supported by their families in their decision to pursue their career, but now indicated that they were dissatisfied with their jobs. Three types of narratives were identified, namely, “Working in the spirit of serving humanity”, “Working against all odds”, and “Working in a functional system and facing pressures of increased accountability”. Nurses working in a public sector hospital are represented in the first two narrative types, whereas the third represents those working in a private sector hospital. The first narrative represents nurses who were new in the profession and despite hard working conditions were performing their duties. The second narrative represents nurses working in the public sector with limited resources, and the third narrative is a representation of nurses who were working hard and stressed out despite a well functioning system.Conclusion: The study shows that the presence of a well trained health workforce is vital, and that certain

Efficacy, Beliefs, and Investment in Step-Level Public Goods

NARCIS (Netherlands)

Dijkstra, Jacob; Mulders, Jaap Oude

2014-01-01

A central concept for understanding social dilemma behavior is the efficacy of an actor's cooperative behavior in terms of increasing group well-being. We report a decision and game theoretical analysis of efficacy in step-level public goods (SPGs). Previous research shows a positive relation

Public acceptance for centralized storage and repositories of low-level waste session (Panel)

Energy Technology Data Exchange (ETDEWEB)

Lutz, H.R.

1995-12-31

Participants from various parts of the world will provide a summary of their particular country`s approach to low-level waste management and the cost of public acceptance for low-level waste management facilities. Participants will discuss the number, geographic location, and type of low-level waste repositories and centralized storage facilities located in their countries. Each will discuss the amount, distribution, and duration of funds to gain public acceptance of these facilities. Participants will provide an estimated $/meter for centralized storage facilities and repositories. The panel will include a brief discussion about the ethical aspects of public acceptance costs, approaches for negotiating acceptance, and lessons learned in each country. The audience is invited to participate in the discussion.

Solvent effects on the magnetic shielding of tertiary butyl alcohol

African Journals Online (AJOL)

)4 and tetramethyl ammonium cation N(CH3)4(+) have also been presented. KEY WORDS: Solvent effects, Magnetic shielding, Tertiary butyl alcohol, Tertiary butyl amine, Continuum solvation calculations, Chemical shift estimation methods

Ensuring Effective Mentoring in Tertiary Institutions in Anambra State ...

African Journals Online (AJOL)

This paper concerns itself only with ascertaining the strategies that could ensure effective mentoring in tertiary institutions. The survey method was employed. The study population comprised 78 teacher educators in tertiary institutions in Anambra State. One research question guided the study while one null hypothesis was ...

Extraterrestrial cause for the Cretaceous-Tertiary extinction

International Nuclear Information System (INIS)

Alvarez, L.W.; Alvarez, W.; Asaro, F.; Michel, H.V.

1980-01-01

Platinum metals are depleted in the earth's crust relative to their cosmic abundance; concentrations of these elements in deep-sea sediments may thus indicate influxes of extraterrestrial material. Deep-sea limestones exposed in Italy, Denmark, and New Zealand show iridium increases of about 30, 160, and 20 times, respectively, above the background level at precisely the time of the Cretaceous-Tertiary extinctions, 65 million years ago. Reasons are given to indicate that this iridium is of extraterrestrial origin, but did not come from a nearby supernova. A hypothesis is suggested which accounts for the extinctions and the iridium observations. Impact of a large earth-crossing asteroid would inject about 60 times the object's mass into the atmosphere as pulverized rock; a fraction of this dust would stay in the stratosphere for several years and be distributed worldwide. The resulting darkness would suppress photosynthesis, and the expected biological consequences match quite closely the extinctions observed in the paleontological record. One prediction of this hypothesis has been verified: the chemical composition of the boundary clay, which is thought to come from the stratospheric dust, is markedly different from that of clay mixed with the Cretaceous and Tertiary limestones, which are chemically similar to each other. Four different independent estimates of the diameter of the asteroid give values that lie in the range 10 +- 4 kilometers

The effect of the development of an emergency transfer system on the travel time to tertiary care centres in Japan

Directory of Open Access Journals (Sweden)

Arima Hideaki

2006-06-01

Full Text Available Abstract Background In Japan, the emergency medical system is categorized into three levels: primary, secondary, and tertiary, depending on the severity of the condition of the patient. Tertiary care centres accept patients who require 24-h monitoring. In this research, the average travel times (minutes from the centroids of all municipalities in Japan to the nearest tertiary care centre were estimated, using the geographic information system. The systems affecting travel time to tertiary care centres were also examined. Regression analysis was performed to determine the factors affecting the travel time to tertiary care centres, using selected variables representing road conditions and the emergency transfer system. Linear regression analysis was performed to identify specific benchmarks that would be effective in reducing the average travel time to tertiary care centres in prefectures with travel times longer than the average 57 min. Results The mean travel time was 57 min, the range was 83 min, and the standard deviation was 20.4. As a result of multiple regression analysis, average coverage area per tertiary care centre, kilometres of highway road per square kilometre, and population were selected as variables with impact on the average travel time. Based on results from linear regression analysis, benchmarks for the emergency transfer system that would effectively reduce travel time to the mean value of 57 min were identified: 26% pavement ratio of roads (percentage of paved road to general roads, and three tertiary care centres and 108 ambulances. Conclusion Regional gaps in the travel time to tertiary care centres were identified in Japan. The systems we should focus on to reducing travel time were identified. Further reduction of travel time to tertiary care centres can be effectively achieved by improving these specific systems. Linear regression analysis showed that a 26% pavement ratio and three tertiary care centres are beneficial to

Efficacy, Beliefs, and Investment in Step-Level Public Goods

NARCIS (Netherlands)

Dijkstra, J.; Oude Mulders, J.

2014-01-01

behavior in terms of increasing group well-being. We report a decision and game theoretical analysis of efficacy in step-level public goods (SPGs). Previous research shows a positive relation between efficacy and contributions to SPGs and explains this relation by a purely motivational account. We

How to integrate street-level bureaucracies into public management?

DEFF Research Database (Denmark)

Aagaard, Peter; Pedersen, John Storm

the professionals in the public sector at the street-level such as social-workers, teachers, doctors, and other professionals have maintained autonomy regarding the provision, production and delivery of the specific core welfare services to the citizens as end users. By definition hard budget constraint...... and professionals´ autonomy do not fit well. To explore both theoretically and empirically the conflicts between hard budget constraint and professionals´ autonomy, the professionals´ provision, production and delivery of the services to the citizens with disability and socially disadvantaged people and the public...... management of the public spending on the services in Denmark is used as a case. Surprisingly, we find that the managers have been able to resolve the conflicts between the hard budget constraint and the professionals´ autonomy to a rather high degree. The managers have integrated the street...

Intense acidic volcanism at the Cretaceous-Tertiary boundary

International Nuclear Information System (INIS)

Javoy, M.; Courtillot, V.

1989-01-01

A 87 Sr/ 86 Sr spike in seawater strontium with amplitude 2 x 10 -4 and duration of order 2 Ma is superimposed on longer-term variations at the Cretaceous-Tertiary boundary. The anomaly has been attributed to increased continental runoff due either to meteorite impact-related acid rain or sea-level regression. We speculate here that the spike could have resulted from intense, explosive acid volcanism preceding the development of the Deccan traps. A good model, both in tectonic position and geochemical characteristics, for these as yet elusive acidic products is provided by granites in the Seychelles Islands and particularly Mahe. (orig.)

Spatio-temporal observations of the tertiary ozone maximum

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V. F. Sofieva

2009-07-01

Full Text Available We present spatio-temporal distributions of the tertiary ozone maximum (TOM, based on GOMOS (Global Ozone Monitoring by Occultation of Stars ozone measurements in 2002–2006. The tertiary ozone maximum is typically observed in the high-latitude winter mesosphere at an altitude of ~72 km. Although the explanation for this phenomenon has been found recently – low concentrations of odd-hydrogen cause the subsequent decrease in odd-oxygen losses – models have had significant deviations from existing observations until recently. Good coverage of polar night regions by GOMOS data has allowed for the first time to obtain spatial and temporal observational distributions of night-time ozone mixing ratio in the mesosphere.

The distributions obtained from GOMOS data have specific features, which are variable from year to year. In particular, due to a long lifetime of ozone in polar night conditions, the downward transport of polar air by the meridional circulation is clearly observed in the tertiary ozone maximum time series. Although the maximum tertiary ozone mixing ratio is achieved close to the polar night terminator (as predicted by the theory, TOM can be observed also at very high latitudes, not only in the beginning and at the end, but also in the middle of winter. We have compared the observational spatio-temporal distributions of the tertiary ozone maximum with that obtained using WACCM (Whole Atmosphere Community Climate Model and found that the specific features are reproduced satisfactorily by the model.

Since ozone in the mesosphere is very sensitive to HO_x concentrations, energetic particle precipitation can significantly modify the shape of the ozone profiles. In particular, GOMOS observations have shown that the tertiary ozone maximum was temporarily destroyed during the January 2005 and December 2006 solar proton events as a result of the HO_x enhancement from the increased ionization.

Growth of Business English and the Need to Teach Memo-Writing Skills to Indian Tertiary-Level Learners

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Aruna Arputhamalar

2015-05-01

Full Text Available English has become an inevitable means of communication. Due to globalization and rapid growth in business communication, the need to learn the English language has also gained momentum. Employers are looking for employees who are skilled in the language skills. In India, English has become an important means of communication and learning in the education and professional setup. Though English is being taught in schools and colleges, Indian students miserably fail to produce a good quality lengthy composition. In this respect, this paper aims to focus on the need to teach memo-writing skills to tertiary students. To this end, a group of second year Indian BCA students was taken as samples for the study. The students were given a pre-test on memo writing. They lacked the essential skills in writing a memo. In order to improve their memo writing skills the students had to undergo four tasks. At the end of the tasks, they were able to write a good memo. The corporate world demands accurate business writings and our students have to be trained to meet the demands of the business world. This paper studies the growth of business English, the components of effective business writing and the need to teach business writing to tertiary students, which will enable them to be successful in the business world.

Determinants of propensity of tertiary agricultural students in Ghana ...

African Journals Online (AJOL)

The study aimed to identify factors that affect the decision of tertiary agricultural students in Ghana to enter agribusiness as a self-employment venture after graduation. The results showed that tertiary agricultural students in Ghana were predominantly males with little or no farming background. They had a rather moderate ...

Inpatient dermatology: Characteristics of patients and admissions in a tertiary level hospital in Eastern India

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Arpita Sen

2016-01-01

Full Text Available Introduction: Dermatology is primarily a non-acute, outpatient-centered clinical specialty, but substantial number of patients need indoor admission for adequate management. Over the years, the need for inpatient facilities in Dermatology has grown manifold; however, these facilities are available only in some tertiary centers. Aims and Objectives: To analyze the characteristics of the diseases and outcomes of patients admitted in the dermatology inpatient Department of a tertiary care facility in eastern India. Materials and Methods: We undertook a retrospective analysis of the admission and discharge records of all patients, collected from the medical records department, admitted to our indoor facility from 2011 to 2014. The data thus obtained was statistically analyzed with special emphasis on the patient's demographic profile, clinical diagnosis, final outcome, and duration of stay. Results and Analysis: A total of 375 patients were admitted to our indoor facility during the period. Males outnumbered females, with the median age in the 5th decade. Immunobullous disorders (91 patients, 24.27% were the most frequent reason for admissions, followed by various causes of erythroderma (80 patients, 21.33% and infective disorders (73 patients, 19.47%. Other notable causes included cutaneous adverse drug reactions, psoriasis, vasculitis, and connective tissue diseases. The mean duration of hospital stay was 22.2±15.7 days; ranging from 1 to 164 days. Majority of patients (312, 83.2% improved after hospitalization; while 29 (7.73% patients died from their illness. About 133 patients (35.64% required referral services during their stay, while 8 patients (2.13% were transferred to other departments for suitable management. Conclusion: Many dermatoses require inpatient care for their optimum management. Dermatology inpatient services should be expanded in India to cater for the large number of cases with potentially highly severe dermatoses.

Assessing the Influence of Advertising on Student Enrolment in Private Tertiary Institutions in Ghana

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Bede Akorige Atarah

2014-03-01

Full Text Available Abstract Private tertiary institutions have increasingly advertised their products in recent years to the general public in Ghana through various media. The desire to find out whether these institutions just copy other business entities blindly or that advertising actually helps in increasing their enrolments led to this study. The main aim of the study was to find out if advertising had an influence on students’ enrolment decision in private tertiary institutions. Two private universities were selected and all the students along with the admission/marketing officers of the institutions were targeted. Structured questionnaires were used to collect data from the students and unstructured interviews were organised to gather data from the admission/marketing officers. Statistical package for social sciences (SPSS was used to analyse the data. The results showed that advertising in addition to serving as a source of information to students also influenced the enrolment decision of some students. There were however other factors that influenced the enrolment decision of students such as family, friends, current students, etc that could be exploited by these institutions to their advantage.

American Tertiary mollusks of the genus Clementia

Science.gov (United States)

Woodring, W.P.

1927-01-01

Aside from its value as an aid in determining the age of Tertiary beds, the chief interest of the genus Clementia lies in the anomalous features of its present and former distribution. An attempt is made in this paper to trace its geologic history, to point out its paleobiologic significance, and to describe all the known American Tertiary species. The fossils from Colombia used in preparing this report were collected during explorations made under the direction of Dr. 0. B. Hopkins, chief geologist of the Imperial Oil Co. (Ltd.), who kindly donated them to the United States National Museum. Dr. T. Wayland Vaughan, of the Scripps Institution of Oceanography, furnished information relating to specimens collected by him in Mexico. Dr. Bruce L. Clark, of the University of California; Dr. G. Dallas Hanna, of the California Academy of Sciences; Dr. H. A. Pilsbry, of the Philadelphia Academy of Natural Sciences; and Dr. W. D. Matthew, of the American Museum of Natural History, generously loaned type specimens and other material. Doctor Clark and Doctor Hanna also gave information concerning the Tertiary species from California. Mr. Ralph B. Stewart, of the University of California, read the manuscript, and I have taken advantage of his suggestions. I am also indebted to Mr. L. R. Cox, of the British Museum, for information relating to the fossil species from Persia, Zanzibar, and Burma, and to Dr. Axel A. Olsson, of the International Petroleum Co., for data concerning undescribed Tertiary species from Peru.

Use of Treated Municipal Wastewater as Power Plant Cooling System Makeup Water: Tertiary Treatment versus Expanded Chemical Regimen for Recirculating Water Quality Management

Energy Technology Data Exchange (ETDEWEB)

David Dzombak; Radisav Vidic; Amy Landis

2012-06-30

nitrification helped to reduce the corrosivity and biocide demand. Also, the lower pH and alkalinity resulting from nitrification reduced the scaling to an acceptable level, without the addition of anti-scalant chemicals. Additional GAC adsorption treatment, MWW_NFG, yielded no net benefit. Removal of organic matter resulted in pitting corrosion in copper and cupronickel alloys. Negligible improvement was observed in scaling control and biofouling control. For all of the tertiary treatments, biofouling control was achievable, and most effectively with pre-formed monochloramine (2-3 ppm) in comparison with NaOCl and ClO2. Life cycle cost (LCC) analyses were performed for the tertiary treatment systems studied experimentally and for several other treatment options. A public domain conceptual costing tool (LC3 model) was developed for this purpose. MWW_SF (lime softening and sand filtration) and MWW_NF were the most cost-effective treatment options among the tertiary treatment alternatives considered because of the higher effluent quality with moderate infrastructure costs and the relatively low doses of conditioning chemicals required. Life cycle inventory (LCI) analysis along with integration of external costs of emissions with direct costs was performed to evaluate relative emissions to the environment and external costs associated with construction and operation of tertiary treatment alternatives. Integrated LCI and LCC analysis indicated that three-tiered treatment alternatives such as MWW_NSF and MWW_NFG, with regular chemical addition for treatment and conditioning and/or regeneration, tend to increase the impact costs and in turn the overall costs of tertiary treatment. River water supply and MWW_F alternatives with a single step of tertiary treatment were associated with lower impact costs, but the contribution of impact costs to overall annual costs was higher than all other treatment alternatives. MWW_NF and MWW_SF alternatives exhibited moderate external impact costs

[Development of an index system for the comprehensive evaluation on public health emergency events surveillance system in China].

Science.gov (United States)

Hong, Zhiheng; Ni, Daxin; Cao, Yang; Meng, Ling; Tu, Wenxiao; Li, Leilei; Li, Qun; Jin, Lianmei

2015-06-01

To establish a comprehensive evaluation index system for the China Public Health Emergency Events Surveillance System (CPHEESS). A draft index system was built through literature review and under the consideration of the characteristics on CPHEESS. Delphi method was adapted to determine the final index system. The index system was divided into primary, secondary and tertiary levels. There were 4 primary indicators: System structure, Network platform, Surveillance implementation reports with Data analysis and utilization. There were 16 secondary and 70 tertiary indicators being set, with System structure including 14 tertiary indicators (accounted for 20.00%), 21 Network platforms (accounted for 30.00%). Twenty-four Surveillance implementation reports (accounted for 34.29%), 11 Data analysis and utilization (accounted for 15.71%). The average score of importance of each indicators was 4.29 (3.77-4.94), with an average coefficient variation as 0.14 (0.12-0.16). The mean Chronbach's α index was 0.84 (0.81-0.89). The adaptability of each related facilities indicator was specified. The primary indicators were set in accordance with the characteristics and goals of the surveillance systems. Secondary indicators provided key elements in the management and control of the system while the tertiary indicators were available and operative. The agreement rate of experts was high with good validity and reliability. This index system could be used for CPHEESS in future.

Patient knowledge and intention to use the intrauterine contraceptive device IUCD at a tertiary level hospital

Directory of Open Access Journals (Sweden)

Nadia van der Westhuizen

2016-12-01

Full Text Available Background:  The intrauterine device (IUCD is a highly effective and safe method of contraception.  Prevention of unwanted pregnancies has made its use a matter of national priority in certain countries.Despite numerous advantages and suitability the uptake of the IUCD is poor. Patients in South Africa seem to lack knowledge regarding this contraceptive.Objectives:  The aim of this study was to determine the quantity and quality of knowledge of the IUCD, and to evaluate its acceptability for future use.Methods:  A prospective cross-sectional study was conducted at Pelonomi Tertiary Hospital.  201 consecutive patients were interviewed using structured questionnaires.Results:  Awareness of the IUCD was found in almost half (49%, n=95 of our patients. Its use was very low, with only one patient having used it before. Overall qualitative knowledge was poor, even among those that were aware of the IUCD. There was a significant association between level of education and knowledge, with patients having passed Grade 12 or higher significantly more likely to have knowledge of the IUCD than those at lower levels (RR 1.57, 95% CI 1.18-2.08. Forty-five percent (n=86 of patients indicated a desire for future IUCD use.Conclusion:  Despite the availability of the IUCD in South African clinics and hospitals, its uptake is still poor. Awareness of this method seemed to have improved over the past few years, but the qualitative knowledge still lacks considerably.  Education plays a major role in the knowledge of contraception and better educational aids in all facilities will increase its use and reduce unwanted pregnancies. 

Effect of a 5-Month Worksite Physical Activity Program on Tertiary Employees Overall Health and Fitness.

Science.gov (United States)

Genin, Pauline Manon; Degoutte, Fabrice; Finaud, Julien; Pereira, Bruno; Thivel, David; Duclos, Martine

2017-02-01

This pilot study questions the effects of a worksite physical activity program on health and fitness in tertiary employees. Ninety-five employees were randomly assigned to Control (CON); Novice (NOV); Experienced group (EXP). The NOV and EXP groups followed a 5-month worksite physical activity program (at least two sessions/week). Body composition, physical activity level and physical fitness, eating habits, health perception, sleep quality, pain, and quality of life were assessed. Fat mass decreased in NOV and EXP; the distance covered during the 6-minute walking test, push-ups, squat jump increased for NOV and EXP group. Physical activity level, health perception, quality of sleep, and eating habits were improved in NOV. This study underlines for the first time the beneficial effects of such worksite programs among tertiary employees on overall health and the feasibility of its design.

Theoretical Aspects of Optimizing the Allocation of Public Financial Resources at Local Level

OpenAIRE

Eugen DOGARIU

2010-01-01

The allocation of financial resources at local, but also at central level, is an issue especially since in times of crisis, finding the optimum way to spend public funds concerns all authorities. This paper aims to identify the ways in which, by leaving from the division of powers based on the allocation of resources and tools available, the local authorities can identify an optimal level of public expenditure so as to achieve a maximum level of using them. Also, the paper seeks to identify t...

Welfare, wellness, and job satisfaction of Chinese physicians: A national survey of public tertiary hospitals in China.

Science.gov (United States)

Sun, Jing; Ma, Jing; Hu, Guangyu; Zhao, Qi; Yuan, Changzheng; Si, Wen; Zhang, Xinqing; Liu, Yuanli

2017-07-01

Little national data are available on Chinese physicians' welfare, wellness, and job satisfaction. We conducted a self-administered smartphone-based national survey in early 2016 of 17 945 physicians from 136 tertiary hospitals across 31 provinces in China. In addition to collecting the physicians' basic information, we also measured 5 domains (the ethical and working environments, welfare, wellness, and job satisfaction). Half of the physicians reported a hospital-based annual income of less than RMB 72 000 ($10 300), and 60.31% of them did not think that the current medical pricing system reflects physicians' value. More than half (58.64%) of them did not have or did not know about medical malpractice insurance. These physicians worked long hours (an average of 10 h) and slept short hours (average 6 h). Only 35.78% of them thought that they were in good health, and 51.03% were in good mental health. Approximately, a quarter of them had helped to pay medical bills for patients who could not afford care, and 1 in 7 has been penalised for seeing patients who generated bad debts. Only 33.42% of them thought that their occupation receives social recognition and respect, and 70.98% would not encourage their children to pursue a medical career. The top 3 factors that may influence physician job satisfaction as chosen by the physicians were as follows: (1) the income distribution policy (45.92%), (2) working environment safety (25.86%), and (3) public trust and respect for their job (16.10%). In conclusion, we found that Chinese physicians bear heavy physical, mental, and financial stress, and many of them lack confidence that they receive trust and respect from society. Copyright © 2017 John Wiley & Sons, Ltd.

Emotions or Science? Pre-Tertiary Males' Accounts of Psychology as a Subject Choice

Science.gov (United States)

Mercer, Jenny; Sander, Paul; Williams, Stella; Jones, Tim

2013-01-01

It is well established that the number of males studying psychology in the UK, both at A-level and on degree courses, is disproportionately low compared to females. There is a paucity of research, however, which discusses how psychology is viewed by this group. The present study employed focus groups with 35 pre-tertiary males (some of whom were…

Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India

Directory of Open Access Journals (Sweden)

Yogesh Tiwari

2014-01-01

Full Text Available Background: Emergency Department (ED of tertiary health care institute in India is mostly overcrowded, over utilized and inappropriately staffed. The challenges of overcrowded EDs and ill-managed patient flow and admission processes result in excessively long waits for patients. Aim: The objective of the present study was to analyze the patient flow system by assessing the arrival and waiting time distribution of patients in an Emergency out Patient Department (EOPD. Materials and Methods: This short cross-sectional descriptive study was conducted in the EOPD of a Tertiary level health care Institution in North India in the month of May, 2011. The data was obtained from 591 patients, who were present in the EOPD during the month of May, 2011. The waiting time, inter arrival time between two consecutive patients were calculated in addition to the daily census data (discharge rate, admission rate and transfer out rates etc. of the emergency. Results: Arrival time pattern of patients in the EOPD was highly stochastic with the peak arrival hours to be "9.00-12.00 h" in which around 26.3% patients arrived in the EOPD. The primary waiting areas of patients included patients "under observation" (29.6%; "waiting for routine diagnostic tests" (16.4% and "waiting for discharge" (14.6%. Around 71% patients were waiting due to reasons within emergency complex. Conclusion: The patient flow of the ED could only be addressed by multifaceted, multidisciplinary and hospital wide approach.

Yb(OTf){sub 3}-catalyzed one-pot three component synthesis for tertiary amines

Energy Technology Data Exchange (ETDEWEB)

Lee, Bum Seok; Kim, Ji Hye; Nam, Tae Kyu; Jang, Doo Ok [Dept. of Chemistry, Yonsei University, Wonju (Korea, Republic of)

2015-07-15

Tertiary amine functionality is found in many natural bioactive products such as alkaloids, amino acids, nucleic acids, pharmaceuticals, and agrochemicals. Tertiary amines have also been used as building blocks for nitrogen-containing organic compounds and synthetic polymers. A one-pot method for direct reductive amination of aldehydes has been developed to synthesize tertiary amines using HMDS as a nitrogen source in the presence of Yb(OTf ){sub 3}. With a stoichiometric amount of HMDS, the reaction afforded the desired tertiary amines without competitive reduction of the parent carbonyl compounds. This reaction offers a convenient and efficient protocol for synthesizing aromatic and aliphatic tertiary amines under mild reaction conditions.

Anxiety Level in Students of Public Speaking: Causes and Remedies

Directory of Open Access Journals (Sweden)

Farhan Uddin Raja

2017-06-01

Full Text Available Despite being competent in their field of work, professional’s worldwide struggle due to lack of good public speaking skills. Their assessments and appraisals are often not depictive of their professional competitiveness; therefore, it is important for students to overcome public speaking anxiety before they transit from academic life to professional life. The purpose of this study is to analyze the reasons behind the anxiety level in undergraduate students of a public speaking class and recommend strategies to overcome this fear. This study was entailed quantitative research paradigm on a sample of 50 students using convenience sampling technique from a reputable private sector business school in Karachi. The findings showed that students who fear public speaking can perform well if they use certain strategies to fight their fears. 75% participants admitted their fear of public speaking and 95% participants agreed that if proper counseling, instruction and coaching is provided, this fear can be overcome. Research revealed that exposure to virtual environment can facilitate student confidence and enables themto face audience irrespective of the size.

Gender differences in public and private drinking contexts: a multi-level GENACIS analysis.

Science.gov (United States)

Bond, Jason C; Roberts, Sarah C M; Greenfield, Thomas K; Korcha, Rachael; Ye, Yu; Nayak, Madhabika B

2010-05-01

This multi-national study hypothesized that higher levels of country-level gender equality would predict smaller differences in the frequency of women's compared to men's drinking in public (like bars and restaurants) settings and possibly private (home or party) settings. GENACIS project survey data with drinking contexts included 22 countries in Europe (8); the Americas (7); Asia (3); Australasia (2), and Africa (2), analyzed using hierarchical linear models (individuals nested within country). Age, gender and marital status were individual predictors; country-level gender equality as well as equality in economic participation, education, and political participation, and reproductive autonomy and context of violence against women measures were country-level variables. In separate models, more reproductive autonomy, economic participation, and educational attainment and less violence against women predicted smaller differences in drinking in public settings. Once controlling for country-level economic status, only equality in economic participation predicted the size of the gender difference. Most country-level variables did not explain the gender difference in frequency of drinking in private settings. Where gender equality predicted this difference, the direction of the findings was opposite from the direction in public settings, with more equality predicting a larger gender difference, although this relationship was no longer significant after controlling for country-level economic status. Findings suggest that country-level gender equality may influence gender differences in drinking. However, the effects of gender equality on drinking may depend on the specific alcohol measure, in this case drinking context, as well as on the aspect of gender equality considered. Similar studies that use only global measures of gender equality may miss key relationships. We consider potential implications for alcohol related consequences, policy and public health.

Intentional injury against children in Sub-Saharan Africa: A tertiary trauma centre experience.

Science.gov (United States)

Gallaher, Jared R; Wildfire, Benjamin; Mabedi, Charles; Cairns, Bruce A; Charles, Anthony G

2016-04-01

Intentional injuries are the result of violence. This is an important public health issue, particularly in children, and is an unaddressed problem in sub-Saharan Africa. This study sought to describe the characteristics of intentional injury, particularly physical abuse, in children presenting to our tertiary trauma centre in Lilongwe, Malawi and how they compare to children with unintentional injuries. A retrospective analysis of children (in Lilongwe, Malawi from 2009 to 2013 was performed. Children with intentional and unintentional injuries were compared with bivariate analysis and multivariate logistic regression modelling. 67,672 patients with traumatic injuries presented to KCH of which 24,365 were children. 1976 (8.1%) patients presented with intentional injury. Intentional injury patients had a higher mean age (11.1 ± 5.0 vs. 7.1 ± 4.6, pin intentional injury patients (80.5 vs. 45.4%, pin both groups (89.2 vs 80.9%, pin both groups. Sub-Saharan African tertiary hospitals are uniquely positioned to play a pivotal role in the identification, clinical management, and alleviation of intentional injuries to children by facilitating access to social services and through prevention efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

THE FACTORS AFFECTING SATISFACTION LEVELS IN HOSPITALIZED PATIENTS: AN APPLICATION IN PUBLIC HOSPITAL

Directory of Open Access Journals (Sweden)

Neşe ACAR

2017-09-01

Full Text Available This study was conducted to determine the factors that affect the level of satisfaction of services provided by public hospitals. Patients' satisfaction levels were measured by interviewing 156 patients in a public hospital. Factor analysis of the data obtained from the research resulted in five factors called nurses 'behaviors, physical conditions, doctors' behavior, technical staff behaviors, food and beverage. MANOVA analysis was conducted to determine the differences in the perception of factors with respect to the demographic characteristics of the patients and differences were found in terms of profession. It has been seen that it is important that public hospitals have specialist doctors and modern equipment and that they have qualities such as the quality of the health personnel in preferring patients to public hospitals.

Characterisation of Teacher Professional Knowledge and Skill through Content Representations from Tertiary Chemistry Educators

Science.gov (United States)

Schultz, M.; Lawrie, G. A.; Bailey, C. H.; Dargaville, B. L.

2018-01-01

An established tool for collating secondary teachers' pedagogical content knowledge (Loughran's CoRe) has been adapted for use by tertiary educators. Chemistry lecturers with a range of levels of experience were invited to participate in workshops through which the tool was piloted, refined and applied. We now present this refined tool for the…

Literacy Skills Development for Tertiary Institutions: A Case Study of ...

African Journals Online (AJOL)

Literacy Skills Development for Tertiary Institutions: A Case Study of the University of Calabar. ... These were drawn from five faculties, namely Education, Social Sciences, Law, Arts and Agriculture. The study observed that there is a ... more literacy skills. Key Words: Literacy skills, university, Nigeria, tertiary institution ...

Gender Differences in Public and Private Drinking Contexts: A Multi-Level GENACIS Analysis

Directory of Open Access Journals (Sweden)

Jason C. Bond

2010-05-01

Full Text Available This multi-national study hypothesized that higher levels of country-level gender equality would predict smaller differences in the frequency of women’s compared to men’s drinking in public (like bars and restaurants settings and possibly private (home or party settings. GENACIS project survey data with drinking contexts included 22 countries in Europe (8; the Americas (7; Asia (3; Australasia (2, and Africa (2, analyzed using hierarchical linear models (individuals nested within country. Age, gender and marital status were individual predictors; country-level gender equality as well as equality in economic participation, education, and political participation, and reproductive autonomy and context of violence against women measures were country-level variables. In separate models, more reproductive autonomy, economic participation, and educational attainment and less violence against women predicted smaller differences in drinking in public settings. Once controlling for country-level economic status, only equality in economic participation predicted the size of the gender difference. Most country-level variables did not explain the gender difference in frequency of drinking in private settings. Where gender equality predicted this difference, the direction of the findings was opposite from the direction in public settings, with more equality predicting a larger gender difference, although this relationship was no longer significant after controlling for country-level economic status. Findings suggest that country-level gender equality may influence gender differences in drinking. However, the effects of gender equality on drinking may depend on the specific alcohol measure, in this case drinking context, as well as on the aspect of gender equality considered. Similar studies that use only global measures of gender equality may miss key relationships. We consider potential implications for alcohol related consequences, policy and public

Corot 310266512: A Light Curve With Primary, Secondary And Tertiary Eclipses

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Fernández Fernández Javier

2015-01-01

Full Text Available We present the photometric study of an interesting target in the CoRoT exoplanet database: CoRoT 310266512. Its light curve shows primary, secondary and tertiary eclipses that suggests the presence of at least three celestial bodies. The primary and secondary eclipses have the same orbital period, 7.42 days, and the tertiary eclipse has an orbital period of 3.27 days. Two of the tertiary eclipses fall within a primary eclipse and a secondary eclipse. The properties of the light curve indicate the presence of two physically separated systems. The primary and secondary eclipses corresponds to a binary system (System I. The tertiary eclipses correspond to a star-planet system or a star-dwarf system (System II. Some parameters of these two systems are obtained from JKTEBOP [1] program.

Awareness of Breast Cancer among Female Care Givers in Tertiary Cancer Hospital, China

Science.gov (United States)

Dinegde, Negalign Getahun; Xuying, Li

2017-01-01

Objective: Breast cancer is a worldwide public health issue and most common cancer diagnosed among women including China, where advanced stages at diagnosis appears to be increasing and an ever-rising incidence twice as fast as global rates. The study was conducted to describe the awareness of breast cancer and associated factors among care giver women in tertiary Cancer Hospital, China. Methods: Institutional based cross-sectional study was conducted among 261 women selected by systematic random sampling. Information provided by the participants was converted into awareness scores for analysis using SPSS version 23. Awareness scores were dichotomized in to ‘good awareness and ‘poor awareness’ taking median score=11 as the cut-off point. Data analysis was performed using the binary logistic regression. A p-value of awareness. Breast lump was the most commonly known symptom of cancer by 61.7% of the respondents. Slightly more than half of the study participants acknowledged having a past history of breast cancer, drinking alcohol and having close relative with breast cancer as potential risk factors for breast cancer (63.6%, 58.6%, and 55.6% respectively). Nevertheless, a vast majority of the study participants were unable to appreciate modifiable risk factors of the disease. More than half of the participants had never/rarely checked their breasts and all of the participants wrongly answered breast cancer knowledge age related risk. Awareness level was significantly associated with entertainment preference (OR=3.57; 95%CI=1.71, 7.44) and residence setting areas (OR=2.4; 95%CI=1.04, 5.69). Conclusion: The study indicated suboptimal awareness while entertainment preference and residence setting were significantly associated with awareness level. Public awareness campaigns should be made by dissemination of information about breast cancer through health education and printed Medias with great emphases on women living in rural areas. PMID:28749635

Effects of Primary, Secondary and Tertiary Education on Conflict Intensity in Africa

Directory of Open Access Journals (Sweden)

Julius A. Agbor

2015-10-01

Full Text Available This study investigates the impact of different schooling dimensions (primary, secondary and tertiary on the intensity of intra-state conflicts in 25 African states during the period 1989–2008. It uses fixed-effects and Generalized Methods of Moments (GMM estimators in an annualized panel data framework. Parameter estimates suggest the following (1 primary schooling broadly mitigates conflicts in Africa. However, in environments with high natural resource rents, it could ignite conflicts; (2 there is evidence, although not overwhelming, that secondary schooling potentially drives conflicts in Africa. There is also evidence that urbanization potentially drives conflicts in Africa. However, although secondary schooling and urbanization potentially drives conflicts, in environments where secondary schooling (urbanization is high, urbanization (secondary schooling mitigates conflicts; (3 there is no evidence of a strong direct positive impact of tertiary education on conflicts and conditioning on tertiary schooling, income inequality potentially drives conflicts in African states. However, in contexts where income inequality (tertiary schooling is high, tertiary schooling (inequality mitigates conflict. Two important policy implications follow from this study. First, in contexts where income inequality is high (for instance, in South Africa, governments should strive to foster tertiary education in order to reduce conflict. Second, where urbanization rates are high, they should foster both secondary and tertiary education. This study contributes to existing knowledge by clearly demonstrating the utility of distinguishing between different educational dimensions and the contexts wherein they matter for conflict mitigation in Africa.

Public Acceptance of Low-Level Waste Disposal Critical to the Nuclear Renaissance

International Nuclear Information System (INIS)

Sonny Goldston, W.T.

2009-01-01

The disposal of various Low-Level Waste (LLW) forms projected to result from the operation of a pilot or large scale Advanced Fuel Cycle Initiative Programs' (formally known as Global Nuclear Energy Partnership (GNEP)) reprocessing and vitrification plants requires the DOE LLW program and regulatory structure to be utilized in its present form due to the limited availability of Nuclear Regulatory Commission licensed commercial LLW disposal facilities to handle wastes with radionuclide concentrations that are greater than Nuclear Regulatory Commission (NRC) Class A limits. This paper will describe the LLW forms and the regulatory structures and facilities available to dispose of this waste. Then the paper discusses the necessity of an excellent public involvement program to ensure the success of an effective technical solution. All of the decisions associated with the management of these wastes are of interest to the public and successful program implementation would be impossible without including the public up-front in the program formulation. Serious problems can result if program decisions are made without public involvement, and if the public is informed after key decisions are made. This paper will describe the regulatory and public involvement program and their effects on the decisions concerning the disposal of Low-Level Radioactive Waste (LLW) at the Savannah River Site (SRS). An extensive public communications effort resulted in endorsement of changes in disposal practices by the SRS Citizens Advisory Board that was critical to the success of the program. A recommendation will be made to install a public involvement program that is similar to the SRS Citizens Advisory Board in order to ensure the success of the AFCI programs in view of the limited availability to handle the wastes from the program and the public acceptance of change that will be required. (authors)

Current Trends of Using Antimicrobial Drugs in the ICU at a Tertiary Level Teaching Hospital in Mymensingh.

Science.gov (United States)

Saha, S K; Shaha, K C; Haque, M F; Khatun, S; Akhter, S M; Akhter, H

2016-10-01

The aim of the present study was to investigate the current trends of using antimicrobial drugs in the ICU at a tertiary level teaching hospital in Mymensingh. The study of prescribing patterns seeks to monitor, evaluate and suggest modifications in clinicians prescribing habits so as to make medical care rational. It was an observational type of descriptive study, conducted in the Mymensingh medical college hospital, Mymensingh, during the study period of June 2016 to September 2016.The study was approved by the institutional ethical committee. Most patients in the ICU belonged to the older age group >60 years. Male patients were more than the female patients in ICU. Average duration of stay in ICU was 4.35 days. Admissions in ICU were common due to respiratory system related diseases and the present study showed that 31.68% of the reported cases belong to the respiratory system. Average number of drugs per prescription was 6.46. Average number of anti-microbial drugs per prescription was 1.38. Cephalosporin group and individually ceftriaxone was the most frequently prescribed antimicrobial group and agent respectively in the ICU. Most commonly used antimicrobial combination was Cephalosporin and Metronidazole (43.33%) followed by Carbapenem (Meropenem) and Metronidazole (13.33%). Most antimicrobial agents were prescribed without bacteriological culture and sensivity testing evidence. There is a need for motivating the physicians to prescribe antimicrobial agents with supportive bacteriological evidences.

State-level public policy as a predictor of individual and family well-being.

Science.gov (United States)

Zimmerman, S L

1987-01-01

This exploratory study examines the relationship between state-level public policy and individual and family well-being and factors that affect it. The inquiry, based on exchange and choice theories, assumes that state-level public policy reflects states' awareness of the needs of individuals and families, their ability to predict the future in failing to meet them, and the extent to which the norm of reciprocity prevails in the 50 states. Measures of states' collective choices were states' per capita expenditures for public welfare, education, and health, and per capita taxes in 1980; measures of states' individual and well- or ill-being, or social malaise, were states' teenage birthrates, infant death rates, and suicide rates. Taken into account as antecedent and intervening variables were age, gender, and racial composition, income distribution, marital, socioeconomic, and employment status of states' populations, and attitudes toward public spending. The findings show that higher state expenditures for public welfare and for education indeed contribute to individual and family well-being as measured by lower state rates of suicide and teenage births. States per capita spending for education, which together with state per capita spending for public welfare was a positive predictor of school completion rates and positively associated with states' income level, accounted for almost all of the variance in states' per capita taxes. State spending for public welfare was not a predictor of state per capita taxes. These findings are cause for considerable concern given the reduced role of the federal government in human affairs, particularly in states whose choices violate the assumptions underlying exchange and choice theories and the norm of reciprocity which says that people should help, not hurt, others.

Level of Motivation Amongst Health Personnel Working in A Tertiary Care Government Hospital of New Delhi, India

Science.gov (United States)

Jaiswal, Poonam; Singhal, Ashok K.; Gadpayle, Adesh K.; Sachdeva, Sandeep; Padaria, Rabindra

2014-01-01

Aims: To assess the level and factors of motivation amongst permanent government employees working in a tertiary health care institution. Material and Methods: A sample of 200 health personnel (50 in each category) i.e. doctors, nurses, technician, and support staff were contacted through face to face interview. Motivation was measured as the degree to which an individual possessed various identified motivation domains like Drive, Control, Challenge, Relationship and Rewards. Each domain was represented by 4 dimensions- accordingly a closed-ended statement represented each of these dimensions and responses were assessed on a Likert based scale. Data management was done using SPSS, ver. 19. Results: The average age for different health personnel were: Doctors 48.68 (±8.53), nurses 40.72 (±7.76), technician 38.4 (±10.65) and support staff 43.24 (±9.52) years. The average year of work experience was: Doctor 19.09 (±9.77), nurses 17.2 (±8.420), technician 14.84 (±10.45), support staff 18.24 (±10.28). A comparison of overall motivation index (mean score) revealed that nurse had highest level (3.47), followed by support staff (3.46), doctor (3.45) and technician (3.43). Based on their individual mean scores, the healthcare providers were categorised into three different levels of motivation and it was found that majority of the health personnel i.e.70% of support staff, 62% nurse, 56% doctor and technician, had high to very high level of motivation index. The mean scores for all the five factors as well as their respective ranks were also found out and it was deduced that “relationship” assumed first rank for doctors (mean score: 3.71) and technician (mean score: 3.75), whereas “control” assumed greatest significance for nurses (mean score, 3.62) and support staff (mean scores, 3.61). Based upon the mean scores, “reward” assumed third rank among all the four categories. Kruskal-Wallis test was applied to test if the different categories of health

Academic mentoring and the future of tertiary education in Nigeria ...

African Journals Online (AJOL)

Tertiary education is a major outlet for the provision of high manpower for national development. This paper therefore highlighted the challenges of tertiary education in Nigeria, early perspectives of mentoring undergraduates, the rationale for academic mentoring, the role of a mentor, and the role of library as catalyst in the ...

Risk of malignancy index used as a diagnostic tool in a tertiary centre for patients with a pelvic mass

DEFF Research Database (Denmark)

Håkansson, Fanny; Høgdall, Estrid V S; Nedergaard, Lotte

2012-01-01

Abstract Objective. Risk of malignancy index (RMI), based on a serum cancer antigen 125 level, ultrasound findings and menopausal status, is used to discriminate ovarian cancer from benign pelvic mass. In Denmark, patients with pelvic mass and RMI =200 are referred to tertiary gynecologic oncology...... the use of RMI =200 as a tool for preoperative identification of ovarian cancer at a tertiary center. Design. Prospective observational study. Setting. A tertiary center in Copenhagen, Denmark. Population. One thousand one hundred and fifty-nine women with pelvic mass. Methods. The RMI was calculated...... pelvic mass. Results. There were 778 women diagnosed with benign pelvic mass, while 251 had ovarian cancer and 74 had borderline ovarian tumor. Fifty-six women were diagnosed with other forms of cancer. Sensitivity and specificity for ovarian cancer vs. benign pelvic mass for RMI =200 were 92 and 82...

West Hackberry Tertiary Project. Annual report, September 3, 1997--September 2, 1998

Energy Technology Data Exchange (ETDEWEB)

Gillham, T.H.

1997-09-10

The following report is the Project Management Plan for the fifth year of the West Hackberry Tertiary Project. The West Hackberry Tertiary Project is one of four mid-term projects selected by the United States Department of Energy (DOE) as part of the DOE`s Class 1 Program for the development of advance recovery technologies in fluvial dominated deltaic reservoirs. The West Hackberry Tertiary Project is a field test of the idea that air injection can be combined with the Double Displacement Process to produce a low cost tertiary recovery process which is economic at current oil prices. The Double Displacement Process is the gas displacement of a water invaded oil column for the purpose of recovering tertiary oil by gravity drainage. The Double Displacement Process is based upon the concept that in fields such as West Hackberry waterdrive recoveries are typically 50%-60% of the original oil in place while gravity drainage recoveries average 80%-90% of the original oil in place. Therefore, by injecting a gas into a watered out reservoir, a gas cap will form an additional oil can be recovered due to gravity drainage. Although the Double Displacement Process has been shown to be successful in recovering tertiary oil in other fields, this project will be the first to utilize air injection in the Double Displacement Process. The use of air injection in this process combines the benefits of air`s low cost and universal accessibility with the potential for accelerated oil recovery due to the combustion process. If successful, this project will demonstrate that the use of air injection in the Double Displacement Process will result in an economically viable tertiary process in reservoirs where tertiary oil recovery is presently uneconomical.

Tertiary-amine-containing thermo- and pH-sensitive hydrophilic ABA triblock copolymers: effect of different tertiary amines on thermally induced sol-gel transitions.

Science.gov (United States)

Henn, Daniel M; Wright, Roger A E; Woodcock, Jeremiah W; Hu, Bin; Zhao, Bin

2014-03-11

This Article reports on the synthesis of a series of well-defined, tertiary-amine-containing ABA triblock copolymers, composed of a poly(ethylene oxide) (PEO) central block and thermo- and pH-sensitive outer blocks, and the study of the effect of different tertiary amines on thermally induced sol-gel transition temperatures (T(sol-gel)) of their 10 wt % aqueous solutions. The doubly responsive ABA triblock copolymers were prepared from a difunctional PEO macroinitiator by atom transfer radical polymerization of methoxydi(ethylene glycol) methacrylate and ethoxydi(ethylene glycol) methacrylate at a feed molar ratio of 30:70 with ∼5 mol % of either N,N-diethylaminoethyl methacrylate (DEAEMA), N,N-diisopropylaminoethyl methacrylate, or N,N-di(n-butyl)aminoethyl methacrylate. The chain lengths of thermosensitive outer blocks and the molar contents of tertiary amines were very similar for all copolymers. Using rheological measurements, we determined the pH dependences of T(sol-gel) of 10 wt % aqueous solutions of these copolymers in a phosphate buffer. The T(sol-gel) versus pH curves of all polymers exhibited a sigmoidal shape. The T(sol-gel) increased with decreasing pH; the changes were small on both high and low pH sides. At a specific pH, the T(sol-gel) decreased with increasing the hydrophobicity of the tertiary amine, and upon decreasing pH the onset pH value for the T(sol-gel) to begin to increase noticeably was lower for the more hydrophobic tertiary amine-containing copolymer. In addition, we studied the effect of different tertiary amines on the release behavior of FITC-dextran from 10 wt % micellar gels in an acidic medium at 37 and 27 °C. The release profiles for three studied hydrogels at 37 °C were essentially the same, suggesting that the release was dominated by the diffusion of FITC-dextran. At 27 °C, the release was significantly faster for the DEAEMA-containing copolymer, indicating that both diffusion and gel dissolution contributed to the

Hospital-acquired infections in a Nigerian tertiary health facility: An ...

African Journals Online (AJOL)

Hospital-acquired infections in a Nigerian tertiary health facility: An audit of surveillance reports. ... This study evaluated the occurrence of HAI in a foremost tertiary health facility over a 5-year period for the purpose of reinforcing control efforts. Materials and Methods: A retrospective survey of records from the infection control ...

76 FR 10810 - Public Workshop to Discuss Low-Level Radioactive Waste Management

Science.gov (United States)

2011-02-28

... Radioactive Waste Management AGENCY: Nuclear Regulatory Commission. ACTION: Public Workshop and Request for... regulatory framework for the management of commercial low-level radioactive waste (LLW). The purpose of this...-level radioactive wastes that did not exist at the time part 61 was promulgated. The developments...

Interactive Intranet Portal for effective Management in Tertiary Institution

OpenAIRE

Idogho O. Philipa; Akpado Kenneth; James Agajo

2011-01-01

Interactive Intranet Portal for effective management in Tertiary Institution is an enhanced and interactive method of managing and processing key issues in Tertiary Institution, Problems of result processing, tuition fee payment, library resources management are analyzed in this work. An interface was generated to handle this problem; the software is an interactive one. Several modules are involved in the paper, like: LIBRARY CONSOLE, ADMIN, STAFF, COURSE REGISTRATION, CHECKING OF RESULTS and...

Assessment Quality in Tertiary Education: An Integrative Literature Review

OpenAIRE

Gerritsen-van Leeuwenkamp, Karin; Joosten-ten Brinke, Desirée; Kester, Liesbeth

2018-01-01

In tertiary education, inferior assessment quality is a problem that has serious consequences for students, teachers, government, and society. A lack of a clear and overarching conceptualization of assessment quality can cause difficulties in guaranteeing assessment quality in practice. Thus, the aim of this study is to conceptualize assessment quality in tertiary education by providing an overview of the assessment quality criteria, their influences, the evaluation of the assessment quality ...

Tertiary Treatment Process of Preserved Wastewater

Directory of Open Access Journals (Sweden)

Wang Qingyu

2016-01-01

Full Text Available The effects of the composite coagulants on coagulation sedimentation for the preserved wastewater was investigated by changing the composite coagulant dosages, and the coagulant was composed of polymeric ferric sulfate (PFS, polyaluminium chloride (PAC, and polyaluminum ferric silicate (PAFSC, while the effect of the tertiary treatment process on the preserved wastewater was tested, which was exceeded the standard seriously. The results showed that 400 mg/L was the optimum composite coagulant dosage. The removal rates of salt and sugar were as high as 99.1% and 99.5% respectively, and the removal rates of CODCr and SS were 99.3% and 96.0%, respectively after the preserved wastewater was treated by the tertiary treatment technology, which both reached the primary standard of “The Integrated Wastewater Discharge Standard” (GB8978-1996.

Text mining analysis of public comments regarding high-level radioactive waste disposal

International Nuclear Information System (INIS)

Kugo, Akihide; Yoshikawa, Hidekazu; Shimoda, Hiroshi; Wakabayashi, Yasunaga

2005-01-01

In order to narrow the risk perception gap as seen in social investigations between the general public and people who are involved in nuclear industry, public comments on high-level radioactive waste (HLW) disposal have been conducted to find the significant talking points with the general public for constructing an effective risk communication model of social risk information regarding HLW disposal. Text mining was introduced to examine public comments to identify the core public interest underlying the comments. The utilized test mining method is to cluster specific groups of words with negative meanings and then to analyze public understanding by employing text structural analysis to extract words from subjective expressions. Using these procedures, it was found that the public does not trust the nuclear fuel cycle promotion policy and shows signs of anxiety about the long-lasting technological reliability of waste storage. To develop effective social risk communication of HLW issues, these findings are expected to help experts in the nuclear industry to communicate with the general public more effectively to obtain their trust. (author)

Hydrogeology, groundwater levels, and generalized potentiometric-surface map of the Green River Basin lower Tertiary aquifer system, 2010–14, in the northern Green River structural basin

Science.gov (United States)

Bartos, Timothy T.; Hallberg, Laura L.; Eddy-Miller, Cheryl

2015-07-14

In cooperation with the Bureau of Land Management, groundwater levels in wells located in the northern Green River Basin in Wyoming, an area of ongoing energy development, were measured by the U.S. Geological Survey from 2010 to 2014. The wells were completed in the uppermost aquifers of the Green River Basin lower Tertiary aquifer system, which is a complex regional aquifer system that provides water to most wells in the area. Except for near perennial streams, groundwater-level altitudes in most aquifers generally decreased with increasing depth, indicating a general downward potential for groundwater movement in the study area. Drilled depth of the wells was observed as a useful indicator of depth to groundwater such that deeper wells typically had a greater depth to groundwater. Comparison of a subset of wells included in this study that had historical groundwater levels that were measured during the 1960s and 1970s and again between 2012 and 2014 indicated that, overall, most of the wells showed a net decline in groundwater levels.

Favorability for uranium in tertiary sedimentary rocks, southwestern Montana

International Nuclear Information System (INIS)

Wopat, M.A.; Curry, W.E.; Robins, J.W.; Marjaniemi, D.K.

1977-10-01

Tertiary sedimentary rocks in the basins of southwestern Montana were studied to determine their favorability for potential uranium resources. Uranium in the Tertiary sedimentary rocks was probably derived from the Boulder batholith and from silicic volcanic material. The batholith contains numerous uranium occurrences and is the most favorable plutonic source for uranium in the study area. Subjective favorability categories of good, moderate, and poor, based on the number and type of favorable criteria present, were used to classify the rock sequences studied. Rocks judged to have good favorability for uranium deposits are (1) Eocene and Oligocene strata and undifferentiated Tertiary rocks in the western Three Forks basin and (2) Oligocene rocks in the Helena basin. Rocks having moderate favorability consist of (1) Eocene and Oligocene strata in the Jefferson River, Beaverhead River, and lower Ruby River basins, (2) Oligocene rocks in the Townsend and Clarkston basins, (3) Miocene and Pliocene rocks in the Upper Ruby River basin, and (4) all Tertiary sedimentary formations in the eastern Three Forks basin, and in the Grasshopper Creek, Horse Prairie, Medicine Lodge Creek, Big Sheep Creek, Deer Lodge, Big Hole River, and Bull Creek basins. The following have poor favorability: (1) the Beaverhead Conglomerate in the Red Rock and Centennial basins, (2) Eocene and Oligocene rocks in the Upper Ruby River basin, (3) Miocene and Pliocene rocks in the Townsend, Clarkston, Smith River, and Divide Creek basins, (4) Miocene through Pleistocene rocks in the Jefferson River, Beaverhead River, and Lower Ruby River basins, and (5) all Tertiary sedimentary rocks in the Boulder River, Sage Creek, Muddy Creek, Madison River, Flint Creek, Gold Creek, and Bitterroot basins

Tertiary syphilis in the lumbar spine: a case report.

Science.gov (United States)

Bai, Yang; Niu, Feng; Liu, Lidi; Sha, Hui; Wang, Yimei; Zhao, Song

2017-07-24

The incidence of tertiary syphilis involvement in the spinal column with destructive bone lesions is very rare. It is difficult to establish the correct diagnosis from radiographs and histological examination alone. Limited data are available on surgical treatment to tertiary syphilitic spinal lesions. In this article, we report a case of tertiary syphilis in the lumbar spine with osteolytic lesions causing cauda equina compression. A 44-year-old man who suffered with low back pain for 6 months and progressive radiating pain at lower extremity for 1 week. Radiologic findings showed osteolytic lesion and new bone formation in the parts of the bodies of L4 and L5. Serum treponema pallidum hemagglutination (TPHA) test was positive. A surgery of posterior debridement, interbody and posterolateral allograft bone fusion with instrumentation from L3 to S1 was performed. The low back pain and numbness abated after operation. But the follow-up radiographs showed absorption of the bone grafts and failure of instrumentation. A Charcot's arthropathy was formed between L4 and L5. It is challenging to diagnose the tertiary syphilis in the spine. Surgery is a reasonable auxiliary method to antibiotic therapy for patients who suffered with neuropathy. Charcot's arthropathy should be considered as an operative complication.

Analysis of colonoscopic perforations at a local clinic and a tertiary hospital.

Science.gov (United States)

Sagawa, Toshihiko; Kakizaki, Satoru; Iizuka, Haruhisa; Onozato, Yasuhiro; Sohara, Naondo; Okamura, Shinichi; Mori, Masatomo

2012-09-21

To define the clinical characteristics, and to assess the management of colonoscopic complications at a local clinic. A retrospective review of the medical records was performed for the patients with iatrogenic colon perforations after endoscopy at a local clinic between April 2006 and December 2010. Data obtained from a tertiary hospital in the same region were also analyzed. The underlying conditions, clinical presentations, perforation locations, treatment types (operative or conservative) and outcome data for patients at the local clinic and the tertiary hospital were compared. A total of 10  826 colonoscopies, and 2625 therapeutic procedures were performed at a local clinic and 32  148 colonoscopies, and 7787 therapeutic procedures were performed at the tertiary hospital. The clinic had no perforations during diagnostic colonoscopy and 8 (0.3%) perforations were determined to be related to therapeutic procedures. The perforation rates in each therapeutic procedure were 0.06% (1/1609) in polypectomy, 0.2% (2/885) in endoscopic mucosal resection (EMR), and 3.8% (5/131) in endoscopic submucosal dissection (ESD). Perforation rates for ESD were significantly higher than those for polypectomy or EMR (P hospital. Six perforations occurred with therapeutic endoscopy (perforation rate, 0.08%; 1 per 1298 procedures). Perforation rates for specific procedure types were 0.02% (1 per 5500) for polypectomy, 0.17% (1 per 561) for EMR, 2.3% (1 per 43) for ESD in the tertiary hospital. There were no differences in the perforation rates for each therapeutic procedure between the clinic and the tertiary hospital. The incidence of iatrogenic perforation requiring surgical treatment was quite low in both the clinic and the tertiary hospital. No procedure-related mortalities occurred. Performing closure with endoscopic clipping reduced the C-reactive protein (CRP) titers. The mean maximum CRP titer was 2.9 ± 1.6 mg/dL with clipping and 9.7 ± 6.2 mg/dL without clipping

Pushing the frontiers of atomic models for protein tertiary structure ...

Indian Academy of Sciences (India)

as an NP complete or NP hard problem.4,5 This notwith- standing, the dire need for tertiary structures of proteins in drug discovery and other areas6–8 has propelled the development of a multitude of computational recipes. In this article, we focus on ab initio/de novo strategies,. Bhageerath in particular, for protein tertiary ...

Tertiary colleges: a study of perspectives on organizational innovation

OpenAIRE

Preedy, Margaret

1998-01-01

The purpose of this research study was to explore organisational innovation in education with reference to one particular type of organisation - the tertiary college. The research sought to examine the extent to which the intended objectives for new educational organisations are realised in practice, and how far the goals and ethos which organisational leaders seek to promote are shared by organisational members. The study focused on eleven tertiary colleges, comparing the 'official' view of ...

STUDY ON KAP OF OCULAR COMPLICATIONS DUE TO DIABETES AMONG TYPE II DIABETICS VISITING A TERTIARY TEACHING HOSPITAL

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Jacob Koshy

2012-03-01

Full Text Available Introduction: Diabetes mellitus is a major public health problem worldwide. Diabetic patients are at risk of developing blindness from diabetic retinopathy. While occurrence of diabetic retinopathy cannot be prevented, its complications can be minimized. This requires awareness of the sight-threatening potential of diabetes and the need for regular eye examinations. Aim: To study the knowledge of ocular complications of diabetes, among type II diabetics visiting a tertiary level hospital. Settings and Design: This was a prospective study in a tertiary care teaching hospital. Methods and Material: This was a questionnaire based study on 350 type II diabetics. All patients were interviewed by the same investigator. Statistical analysis used: The data was analysed using chi square test. Results: With increase in the duration of illness, the awareness about diabetic retinopathy is more. Even though the awareness of the disease increased with increasing duration of the disease, 51.4% of the diabetics did not know how diabetes can affect the eye, 49.7% of diabetics did not know if diabetic retinopathy can be treated and 67.4% had not heard of any treatment modality for diabetic retinopathy. This shows that lack of knowledge about the disease was significant. Conclusions: Prevention of non-communicable disease through increased awareness needs to be the thrust of the effort in resource poor contexts, where the treatment can be prohibitively costly. These measures would help to bring about more awareness and understanding about the disease among the patients and therefore prevent sight-threatening complications by timely intervention and management.

Evaluation of a Public Child Eye Health Tertiary Facility for Pediatric Cataract in Southern Nigeria I: Visual Acuity Outcome

Science.gov (United States)

Duke, Roseline E.; Adio, Adedayo; Oparah, Sidney K.; Odey, Friday; Eyo, Okon A.

2016-01-01

Purpose: A retrospective study of the outcome of congenital and developmental cataract surgery was conducted in a public child eye health tertiary facility in children <16 years of age in Southern Nigeria, as part of an evaluation. Materials and Method: Manual Small Incision Cataract Surgery with or without anterior vitrectomy was performed. The outcome measures were visual acuity (VA) and change (gain) in visual acuity. The age of the child at onset, duration of delay in presentation, ocular co-morbidity, non ocular co-morbidity, gender, and pre operative visual acuity were matched with postoperative visual acuity. A total of 66 children were studied for a period of six weeks following surgery. Results: Forty eight (72.7%) children had bilateral congenital cataracts and 18 (27.3%) children had bilateral developmental cataracts. There were 38(57.6%) males and 28 (42.4%) females in the study. Thirty Five (53%) children had good visual outcome (normal vision range 6/6/ -6/18) post-operatively. The number of children with blindness (vision <3/60) decreased from 61 (92.4%) pre-operatively to 4 (6.1%) post-operatively. Post operative complication occurred in 6.8% of cases six week after surgery. Delayed presentation had an inverse relationship with change (gain) in visual acuity (r = - 0.342; p-value = 0.005). Pre-operative visual acuity had a positive relationship with post operative change (gain) in visual acuity (r = 0.618; p-value = 0.000). Conclusion: Predictors of change in visual acuity in our study were; delayed presentation and pre-operative VA. Cataract surgery in children showed clinical benefit. PMID:27347247

Level of satisfaction and issues with procurement systems used in the Malaysian public sector

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Mastura Jaafar

2013-03-01

Full Text Available Since the declaration of Malaysian independence, the public sector has significantly contributed to the country’s development. In the 1990s, a new procurement system was developed due to CIBD various changes in the construction industry. Since that period, the poor quality of public sector projects has started to attract public attention. This paper describes a study that was conducted to identify the dominant public procurement systems in place, the problems associated with these systems, and the satisfaction level of the industry players in the Malaysian construction industry. The results were drawn from 84 survey responses and interviews with industry players. The public sector is using a traditional system inherited from the British, with an intention to adopt new procurement systems. Aside from the disputes that are present in most systems, the public sector seems to encounter particular problems in relation to capabilities, time, and cost of the major procurement systems used. Traditional work culture and the industry environment influence public sector practice, which accounts for the modifications of each procurement system used. Thus, the full advantages of using an alternative procurement system may not be realised in public sector organizations. This produces an average level of satisfaction gained from the procurement system adopted. As a developing country, Malaysia needs to exert significant efforts to improve the public procurement system. 

Level of satisfaction and issues with procurement systems used in the Malaysian public sector

Directory of Open Access Journals (Sweden)

Mastura Jaafar

2013-03-01

Full Text Available Since the declaration of Malaysian independence, the public sector has significantly contributed to the country’s development. In the 1990s, a new procurement system was developed due to CIBD various changes in the construction industry. Since that period, the poor quality of public sector projects has started to attract public attention. This paper describes a study that was conducted to identify the dominant public procurement systems in place, the problems associated with these systems, and the satisfaction level of the industry players in the Malaysian construction industry. The results were drawn from 84 survey responses and interviews with industry players. The public sector is using a traditional system inherited from the British, with an intention to adopt new procurement systems. Aside from the disputes that are present in most systems, the public sector seems to encounter particular problems in relation to capabilities, time, and cost of the major procurement systems used. Traditional work culture and the industry environment influence public sector practice, which accounts for the modifications of each procurement system used. Thus, the full advantages of using an alternative procurement system may not be realised in public sector organizations. This produces an average level of satisfaction gained from the procurement system adopted. As a developing country, Malaysia needs to exert significant efforts to improve the public procurement system.

Nuclear Accidents Intervention Levels for Protection of the Public

International Nuclear Information System (INIS)

1989-01-01

The impact of the 1986 Chernobyl accident called attention to the need to improve international harmonization of the principles and criteria for the protection of the public in the event of a nuclear accident. This report provides observations and guidance related to the harmonization of radiological protection criteria, and is intended to be of use to national authorities and international organizations examining the issue of emergency response planning and intervention levels

Challenges and opportunities for primary, secondary, and tertiary prevention of Chagas' disease.

Science.gov (United States)

Rassi, A; Dias, J C P; Marin-Neto, J A; Rassi, A

2009-04-01

A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of imported Chagas' disease have now been detected in non-endemic areas, such as North America and some European countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.

General Allylic C–H Alkylation with Tertiary Nucleophiles

Science.gov (United States)

2015-01-01

A general method for intermolecular allylic C–H alkylation of terminal olefins with tertiary nucleophiles has been accomplished employing palladium(II)/bis(sulfoxide) catalysis. Allylic C–H alkylation furnishes products in good yields (avg. 64%) with excellent regio- and stereoselectivity (>20:1 linear:branched, >20:1 E:Z). For the first time, the olefin scope encompasses unactivated aliphatic olefins as well as activated aromatic/heteroaromatic olefins and 1,4-dienes. The ease of appending allyl moieties onto complex scaffolds is leveraged to enable this mild and selective allylic C–H alkylation to rapidly diversify phenolic natural products. The tertiary nucleophile scope is broad and includes latent functionality for further elaboration (e.g., aliphatic alcohols, α,β-unsaturated esters). The opportunities to effect synthetic streamlining with such general C–H reactivity are illustrated in an allylic C–H alkylation/Diels–Alder reaction cascade: a reactive diene is generated via intermolecular allylic C–H alkylation and approximated to a dienophile contained within the tertiary nucleophile to furnish a common tricyclic core found in the class I galbulimima alkaloids. PMID:24641574

General allylic C-H alkylation with tertiary nucleophiles.

Science.gov (United States)

Howell, Jennifer M; Liu, Wei; Young, Andrew J; White, M Christina

2014-04-16

A general method for intermolecular allylic C-H alkylation of terminal olefins with tertiary nucleophiles has been accomplished employing palladium(II)/bis(sulfoxide) catalysis. Allylic C-H alkylation furnishes products in good yields (avg. 64%) with excellent regio- and stereoselectivity (>20:1 linear:branched, >20:1 E:Z). For the first time, the olefin scope encompasses unactivated aliphatic olefins as well as activated aromatic/heteroaromatic olefins and 1,4-dienes. The ease of appending allyl moieties onto complex scaffolds is leveraged to enable this mild and selective allylic C-H alkylation to rapidly diversify phenolic natural products. The tertiary nucleophile scope is broad and includes latent functionality for further elaboration (e.g., aliphatic alcohols, α,β-unsaturated esters). The opportunities to effect synthetic streamlining with such general C-H reactivity are illustrated in an allylic C-H alkylation/Diels-Alder reaction cascade: a reactive diene is generated via intermolecular allylic C-H alkylation and approximated to a dienophile contained within the tertiary nucleophile to furnish a common tricyclic core found in the class I galbulimima alkaloids.

Performance of the Public Expenditure Management at Local Level in Romania

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Ani MATEI

2008-06-01

Full Text Available The current paper aims to analyze the performance of the public expenditure management based on the decrease of the administrative costs. The paper is grounded on the following premises: (1 Romania as an EU Member State is under a continuous process to harmonize its legislation with the EU legislation. (2 The integration of Romania in EU in 2007 has determined a significant change in the administrative expenditure amount. (3 Strengthening local autonomy through the decentralization and the devolution processes emphasizes clearer the need for improving the performance of the expenditure management at local level. (4 Internal order, flows of communication and transfer, synergy of the governance system assume administrative expenditure that can be determined. (5 The performance of public organizations in managing local governance issues depends directly also on the administrative expenditure level**. [** Paper accepted to be presented at the Fourth TransAtlantic Dialogue “The Status of Inter-Governmental Relations and Multi-Level Governance in Europe and the US”, Workshop 5: “Performance measurement and accountability in IGR-MLG”.

Outbreak of carbapenem-resistant Providencia rettgeri in a tertiary hospital

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V S Tshisevhe

2017-01-01

Full Text Available The emergence of resistance to multiple antimicrobial agents in pathogenic bacteria is a significant public health threat, as there are limited effective antimicrobial agents for infections caused by multidrug-resistant (MDR bacteria. Several MDR bacteria are now frequently detected. Carbapenem resistance in Enterobacteriaceae is often plasmid mediated, necessitating stringent infection control practices. We describe an outbreak of carbapenem-resistant Providencia rettgeri involving 4 patients admitted to intensive care and high-care units at a tertiary hospital. Clinical and demographic characteristics of 4 patients with carbapenem-resistant P. rettgeri were documented. All P. rettgeri isolated in these cases had a carbapenem-resistant antibiogram, with resistance to imipenem, ertapenem and meropenem. These cases could be epidemiologically linked. A multiprong approach, simultaneously targeting antibiotic stewardship, universal precautions and appropriate transmission-based precaution practices, is integral to prevention and control of nosocomial infections.

Lessons learned from infertility investigations in the public sector ...

African Journals Online (AJOL)

Objectives. To determine the main factors causing infertility in an urban, tertiary hospital population. To establish if any such major causal factor could be used to rationalise and improve the service for infertile couples in the public sector. Design. A retrospective analysis of the hospital records of 206 women who had a tubal ...

[Decomposition model of energy-related carbon emissions in tertiary industry for China].

Science.gov (United States)

Lu, Yuan-Qing; Shi, Jun

2012-07-01

Tertiary industry has been developed in recent years. And it is very important to find the factors influenced the energy-related carbon emissions in tertiary industry. A decomposition model of energy-related carbon emissions for China is set up by adopting logarithmic mean weight Divisia method based on the identity of carbon emissions. The model is adopted to analyze the influence of energy structure, energy efficiency, tertiary industry structure and economic output to energy-related carbon emissions in China from 2000 to 2009. Results show that the contribution rate of economic output and energy structure to energy-related carbon emissions increases year by year. Either is the contribution rate of energy efficiency or the tertiary industry restraining to energy-related carbon emissions. However, the restrain effect is weakening.

bilingualism in the english of tertiary students: a sine-qua-non

African Journals Online (AJOL)

REV YOUNG EZENWA OBIOHA

questions were used to investigate the effects of Bilingualism on the English of tertiary students. A total of three hundred students from two tertiary institutions were used. ... thoughts, inner feelings, personal psychological ... Chinese migration to the U.S.A (Akindele & ... child is taught Mathematical multiplication and division ...

Auditing surgical service provision at a South African tertiary institution: Implications for the development of district services.

Science.gov (United States)

Laing, G L; Skinner, D L; Bruce, J L; Aldous, C; Govindasamy, V; Thomson, S R; Clarke, D L

2017-11-01

The optimal management of resources within South African state hospitals has been hampered by a paucity of data due to a lack of robust auditing information systems. This study reviews the use of a Hybrid Electronic Medical Record (HEMR) system to capture and aggregate data pertaining to the inpatient service demands on a South African tertiary surgical service. This dataset was used to analyse the appropriateness of tertiary surgical resource utilisation. The HEMR system was implemented at Greys Hospital, in the city of Pietermaritzburg, Kwa-Zulu Natal, South Africa on 1 January 2013. Inpatient data pertaining to surgical admissions and operative interventions were captured prospectively. Following an 18-month study period, the data were extracted, aggregated and analysed. The district referral hospitals were mapped, and district surgical procedures performed within the tertiary center were identified and quantified. Results: 7314 patients were admitted and managed by the tertiary surgical service during the study period. The median patient age was 33 years (IQR 6.5-42.4 years). 59.7% were male and 40.3% were female. General, trauma and paediatric surgical admissions constituted 54.8%, 28.6% and 16.6% respectively. Emergency admissions constituted 62.4% and elective admissions 37.6%. Referral sources were captured for 6653 (91%) of the cohort. 4338 (65.2%) patients were referred from district hospitals. The district hospital (Northdale) closest to Greys Hospital was responsible for 1675 (25.2%) of surgical referrals. 4174 operative procedures were performed during the study period, 54.7% performed as an emergency, 34.1% electively and 11.2% semi-electively. The median waiting time for emergency operative intervention was 535 minutes (IQR 130-663). A total of 1272 (30.5%) operative procedures performed were assessed as district-level operations. The time intervals of 07:00-07:59 and 17:00-17:59 were identified as the time periods during which the least number of

Epilepsy in Ireland: towards the primary-tertiary care continuum.

Science.gov (United States)

Varley, Jarlath; Delanty, Norman; Normand, Charles; Coyne, Imelda; McQuaid, Louise; Collins, Claire; Boland, Michael; Grimson, Jane; Fitzsimons, Mary

2010-01-01

Epilepsy is a chronic neurological disease affecting people of every age, gender, race and socio-economic background. The diagnosis and optimal management relies on contribution from a number of healthcare disciplines in a variety of healthcare settings. To explore the interface between primary care and specialist epilepsy services in Ireland. Using appreciative inquiry, focus groups were held with healthcare professionals (n=33) from both primary and tertiary epilepsy specialist services in Ireland. There are significant challenges to delivering a consistent high standard of epilepsy care in Ireland. The barriers that were identified are: the stigma of epilepsy, unequal access to care services, insufficient human resources, unclear communication between primary-tertiary services and lack of knowledge. Improving the management of people with epilepsy requires reconfiguration of the primary-tertiary interface and establishing clearly defined roles and formalised clinical pathways. Such initiatives require resources in the form of further education and training and increased usage of information communication technology (ICT). Epilepsy services across the primary-tertiary interface can be significantly enhanced through the implementation of a shared model of care underpinned by an electronic patient record (EPR) system and information communication technology (ICT). Better chronic disease management has the potential to halt the progression of epilepsy with ensuing benefits for patients and the healthcare system. Copyright 2009 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Clinicians and their cameras: policy, ethics and practice in an Australian tertiary hospital.

Science.gov (United States)

Burns, Kara; Belton, Suzanne

2013-09-01

Medical photography illustrates what people would prefer to keep private, is practiced when people are vulnerable, and has the power to freeze a moment in time. Given it is a sensitive area of health, lawful and ethical practice is paramount. This paper recognises and seeks to clarify the possibility of widespread clinician-taken medical photography in a tertiary hospital in northern Australia, examining the legal and ethical implications of this practice. A framework of Northern Territory law, state Department of Health policy and human rights theory were used to argue the thesis. Clinicians from 13 purposively chosen wards were asked to participate in an anonymous survey and confidential in-depth interviews. Questions were generated from the literature and local knowledge on the topics of 'occurrence', 'image use', 'quality of consent', 'cameras and technology', 'confidentiality', 'data storage and security', 'hospital policy and law' and 'cultural issues'. One hundred and seventy surveys and eights interviews were analysed using descriptive statistics and theme and content analysis, then triangulated for similarity, difference and unique responses. Forty-eight percent of clinicians surveyed take medical photographs, with the majority using hospital-owned cameras. However, one-fifth of clinicians reported photographing with personal mobile phones. Non-compliance with written consent requirements articulated in policy was endemic, with most clinicians surveyed obtaining only verbal consent. Labeling, storage, copyright and cultural issues were generally misunderstood, with a significant number of clinicians risking the security of patient information by storing images on personal devices. If this tertiary hospital does not develop a clinical photography action plan to address staff lack of knowledge, and noncompliance with policy and mobile phone use, patients' data is at risk of being distributed into the public domain where unauthorised publication may cause

Cervical cancer screening: knowledge, attitude and practices among nursing staff in a tertiary level teaching institution of rural India.

Science.gov (United States)

Shekhar, Shashank; Sharma, Chanderdeep; Thakur, Sita; Raina, Nidhi

2013-01-01

Assessment of the nursing staff knowledge, attitude and practices about cervical cancer screening in a tertiary care teaching institute of rural India. A cross sectional, descriptive, interview- based survey was conducted with a pretested questionnaire among 262 staff nurses of a tertiary care teaching and research institute. In this study 77% respondents knew that Pap smear is used for detection of cervical cancer, but less than half knew that Pap smear can detect even precancerous lesions of cervix. Only 23.4% knew human papilloma virus infection as a risk factor. Only 26.7% of the respondents were judged as having adequate knowledge based on scores allotted for questions evaluating knowledge about cervical cancer and screening. Only 17 (7%) of the staff nurses had themselves been screened by Pap smear, while 85% had never taken a Pap smear of a patient. Adequate knowledge of cervical cancer and screening, higher parity and age >30 years were significantly associated with self screening for cervical cancer. Most nurses held a view that Pap test is a doctor procedure, and nearly 90% of nurses had never referred a patient for Pap testing. The majority of nursing staff in rural India may have inadequate knowledge about cervical cancer screening, and their attitude and practices towards cervical cancer screening could not be termed positive.

KNOWLEDGE AND ATTITUDE TOWARDS HUMAN PAPILLOMA VIRUS AND ITS VACCINE AMONG PHARMACY STUDENTS OF TERTIARY TEACHING UNIVERSITY HOSPITAL IN SOUTH INDIA

Directory of Open Access Journals (Sweden)

Raghupathi Mahitha

2016-10-01

Full Text Available BACKGROUND Cervical cancer in women can be effectively prevented by HPV vaccine. Healthcare professionals including pharmacists have a role in creating awareness about this vaccine to public. In this context, it was decided to study awareness level about HPV among pharmacy students. The aim of the study is to study the knowledge and attitude towards human papilloma virus and it’s vaccine among pharmacy students of tertiary teaching university hospital in South India. MATERIALS AND METHODS Cross sectional, questionnaire-based study among pharmacy students. RESULTS 229 pharmacy students participated in the study. The mean total knowledge score among participants was 2.69 (SD=2.260 out of the possible maximum of 11 and the mean total attitude score was 2.67 (SD=2.437 out of the possible maximum of 10. Lack of knowledge about vaccine was the main reason for not taking the vaccine. Knowledge about the vaccines improves the attitude towards it (p<0.0001. CONCLUSION There is a need to design education program for pharmacy students to increase awareness about HPV, which in turn will increase the awareness among public positively.

Recruitment Of International Students Into Cameroon Tertiary ...

African Journals Online (AJOL)

Recruitment Of International Students Into Cameroon Tertiary Institutions In The Absence Of International Offices. ... The present system of recruiting international students is haphazardly been handled by ... AJOL African Journals Online.

[Triage evaluation making in a pediatric emergency department of a tertiary hospital].

Science.gov (United States)

Pascual-Fernández, Ma Cristina; Ignacio-Cerro, Ma Carmen; Jiménez-Carrascosa, Ma Amalia

2014-03-01

Evaluation triage level assignments depending level of the professionals' education and experience in the unit. This was a retrospective and observational study to triages making from January to March 2012 in Pediatric Emergency Department of tertiary hospital in Madrid. The collection data included variables from Pediatric Canadian Triage with five levels, triage tool using in the unit. 6443 triages were evaluated. The most common mistakes was: not to register pain level, 1445 (22.4%); not to register hydration level, 377 (5.9%); principal symptoms inappropriate, 232 (3.6%). Didn't indicate pain level 140 (5.6%) nurses with 12 hour formal training on triage; 492 (14.5%) with training in the unit, and 92 (16.3%) without training in the last year (p hydration level 296 (7.7%). The triage education favors better adaptation in the triage assignment. The most common errors are: not to register level pain and hydration when it's needed for the principal symptoms.

Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists.

Science.gov (United States)

Abdul Aziz, Aznida F; Mohd Nordin, Nor Azlin; Abd Aziz, Noor; Abdullah, Suhazeli; Sulong, Saperi; Aljunid, Syed M

2014-03-02

Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services. A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached. Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on 'as needed' basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS' perceived 4 important 'needs' in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family and caregiver support. Post discharge

Public administration of quality of education at the local level on the foundation of the competence approach

Directory of Open Access Journals (Sweden)

O. I. Popova

2014-04-01

Full Text Available The article deals with the essence of the phenomenon of management, reveals the meaning of science categories of public administration, of public administration of education and public administration of quality of education at the local level. Personnel factor identifies priority in improving of public administration of quality of education at the local level, the importance of the implementation of the competence approach to management education sector as a necessary condition to ensure the quality of education.

Characteristics and risk factors of preterm births in a tertiary center in ...

African Journals Online (AJOL)

Characteristics and risk factors of preterm births in a tertiary center in Lagos, Nigeria. ... Introduction: preterm birth is a dire complication of pregnancy that poses ... to a tertiary center for prenatal care in order to significantly reduce adverse birth ...

Frozen Chirality of Tertiary Aromatic Amides: Access to Enantioenriched Tertiary α-Amino Acid or Amino Alcohol without Chiral Reagent.

Science.gov (United States)

Mai, Thi Thoa; Viswambharan, Baby; Gori, Didier; Guillot, Régis; Naubron, Jean-Valère; Kouklovsky, Cyrille; Alezra, Valérie

2017-04-27

One of the fundamental and intriguing aspects of life is the homochirality of the essential molecules. In this field, the absolute asymmetric synthesis of α-amino acids is a major challenge. Herein, we report access, by chemical means, to tertiary α-amino acid derivatives in up to 96 % ee without using any chiral reagent. In our strategy, the dynamic axial chirality of tertiary aromatic amides is frozen in a crystal and is responsible for the stereoselectivity of the subsequent steps. Furthermore, we could control the configuration of the final product by manually sorting and selecting the initial crystals. Based on vibrational circular dichroism studies, we could rationalize the observed stereoselectivity. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Tertiary classes–after Chern-Simons theory

Indian Academy of Sciences (India)

J.N. Iyer Institute of Mathematical Sciences Chennai, India

2013-11-08

Nov 8, 2013 ... Euler characteristic class. In early twentieth century, the notion of local product structure, i.e. fiber spaces and their generalizations appeared, in the study of topological spaces (with additional structures). J.N. Iyer. IMSc, Chennai. Tertiary classes–after Chern-Simons theory ...

Transition and Tertiary Education: A Case Study of Mzuzu University, Malawi

Science.gov (United States)

Zozie, Paxton Andrew; Kayira, Peter Benwell

2012-01-01

This article reviews the role of guidance and counselling in Malawi in reducing dropout and easing the transition of students to tertiary education, as well as in helping them during their time in tertiary education. It begins by identifying key success factors in guidance and counselling services for learners in both developed and developing…

Awareness about basic life support and emergency medical services and its associated factors among students in a tertiary care hospital in South India.

Science.gov (United States)

Aroor, Akshatha Rao; Saya, Rama Prakash; Attar, Nazir Rahim; Saya, Ganesh Kumar; Ravinanthanan, Manikandan

2014-07-01

The knowledge and skills about the basic life support (BLS) and the advanced life support are the most important determining factors of the cardiopulmonary resuscitation (CPR) success rates. To determine the level of awareness on BLS and skills among undergraduate and postgraduate students of medical and dental profession, as well as nursing students and interns in a tertiary care hospital. This descriptive cross-sectional study was conducted in a tertiary care hospital in South India. The awareness level on BLS and factors associated which include age, sex, level of training (undergraduate, internship, and postgraduate groups), course of study (nursing, dental, and medical groups), and previous exposure to BLS were assessed by using a structured questionnaire. The association of these variables with awareness level was assessed by independent t test, analysis of variance, and linear regression analysis. Among 520 study subjects, 229 were students, 171 were interns, and 120 were postgraduate students. The overall mean score of awareness was 4.16 ± 1.40 (score range: 0-10). Age, sex, level of training, course of study, and previous exposure to BLS were significantly associated with awareness level in univariate analysis (P < 0.05). Linear regression model also showed that all the above variables were significantly associated with awareness level (P < 0.05). About 322 (61.9%) subjects attributed lack of awareness about BLS to lack of available professional training. About 479 (92.1%) responded that BLS training should be a part of medical curriculum. Awareness level on BLS is below average indicating the importance of professional training at all levels in a tertiary care health institution.

Awareness about basic life support and emergency medical services and its associated factors among students in a tertiary care hospital in South India

Directory of Open Access Journals (Sweden)

Akshatha Rao Aroor

2014-01-01

Full Text Available Background: The knowledge and skills about the basic life support (BLS and the advanced life support are the most important determining factors of the cardiopulmonary resuscitation (CPR success rates. Objectives: To determine the level of awareness on BLS and skills among undergraduate and postgraduate students of medical and dental profession, as well as nursing students and interns in a tertiary care hospital. Materials and Methods: This descriptive cross-sectional study was conducted in a tertiary care hospital in South India. The awareness level on BLS and factors associated which include age, sex, level of training (undergraduate, internship, and postgraduate groups, course of study (nursing, dental, and medical groups, and previous exposure to BLS were assessed by using a structured questionnaire. The association of these variables with awareness level was assessed by independent t test, analysis of variance, and linear regression analysis. Results: Among 520 study subjects, 229 were students, 171 were interns, and 120 were postgraduate students. The overall mean score of awareness was 4.16 ± 1.40 (score range: 0-10. Age, sex, level of training, course of study, and previous exposure to BLS were significantly associated with awareness level in univariate analysis (P < 0.05. Linear regression model also showed that all the above variables were significantly associated with awareness level (P < 0.05. About 322 (61.9% subjects attributed lack of awareness about BLS to lack of available professional training. About 479 (92.1% responded that BLS training should be a part of medical curriculum. Conclusion: Awareness level on BLS is below average indicating the importance of professional training at all levels in a tertiary care health institution.

The equity imperative in tertiary education: Promoting fairness and efficiency

Science.gov (United States)

Salmi, Jamil; Bassett, Roberta Malee

2014-06-01

While the share of the tertiary education age cohort (19-25) which is being given the opportunity to study has increased worldwide over the past two decades, this does not in fact translate into reduced inequality. For many young people, especially in the developing world, major obstacles such as disparities in terms of gender, minority population membership or disabilities as well as academic and financial barriers are still standing in their way. The authors of this article propose a conceptual framework to analyse equity issues in tertiary education and document the scope, significance and consequences of disparities in tertiary education opportunities. They throw some light on the main determinants of these inequalities and offer suggestions about effective equity promotion policies directed towards widening participation and improving the chances of success of underprivileged youths in order to create societies which uphold humanistic values.

Dietary habits and physical activity levels in Jordanian adolescents attending private versus public schools.

Science.gov (United States)

Tayyem, R F; Al-Hazzaa, H M; Abu-Mweis, S S; Bawadi, H A; Hammad, S S; Musaiger, A O

2014-07-08

The present study examined differences in dietary habits and physical activity levels between students attending private and public high schools in Jordan. A total of 386 secondary-school males and 349 females aged 14-18 years were randomly recruited using a multistage, stratified, cluster sampling technique. Dietary habits and physical activity level were self-reported in a validated questionnaire. The prevalence of obesity was significantly higher among adolescents in private (26.0%) than in public schools (16.7%). The frequency of breakfast intake was significantly higher among adolescents in private schools, whereas French fries and sweets intake was significantly higher in public schools. Television viewing showed a significant interaction with school type by sex. A higher rate of inactivity was found among students attending private schools. Despite a slightly better overall dietary profile for students in private schools, they had a higher rate of overweight and obesity compared with those in public schools.

Smoking trends amongst young doctors of a tertiary care hospital - Mayo Hospital, Lahore - Pakistan

International Nuclear Information System (INIS)

Chudhary, M.K.; Younis, M.; Bukhari, M.H.

2011-01-01

The World Health Organization cites tobacco use as one of the biggest public health threats the world has ever faced. Tobacco is the number one preventable cause of disability and death. Tobacco has many negative health effects which many of the smokers know them well. In Pakistan tobacco use is common in general public and the health professionals don't lack behind this habit. To study the smoking trends amongst young doctors of Mayo Hospital. Questionnaire based descriptive study. This study was conducted at the Institute of Chest Medicine, Mayo Hospital - A tertiary care hospital affiliated with King Edward Medical University, Lahore. Out of 250 doctors, 180 (72%) were males and 70 (28%) were female. Amongst 180 male doctors 97 (53.88%) were smokers and 83 (46.21%) were non smokers. Amongst 70 female doctors 8 (11.43%) were smokers and 62 (88.57%) were non smokers. Smoking is common among male young doctors but it is less common in female doctors. (author)

Species distribution and antifungal susceptibility patterns of Candida isolates from a public tertiary teaching hospital in the Eastern Cape Province, South Africa.

Science.gov (United States)

Mnge, P; Okeleye, B I; Vasaikar, S D; Apalata, T

2017-05-15

Candida species are the leading cause of invasive fungal infections, and over the past decade there has been an increased isolation of drug resistant Candida species. This study aimed to identify the species distribution of Candida isolates and to determine their unique antifungal susceptibility and resistance patterns. During a cross-sectional study, 209 Candida isolates (recovered from 206 clinical samples) were collected and their species distribution was determined using ChromAgar Candida. The Vitek-2 system (Biomerieux, South Africa) was used to determine minimum inhibitory concentrations (MICs) to azoles (fluconazole, voriconazole), echinocandins (caspofungin, micafungin), polyenes (amphotericin B) and flucytosine. Four species of Candida were isolated, of which C. albicans was the most frequent, isolated in 45.4% (95/209) of the isolates, followed by C. glabrata: 31.1% (65/209). The MICs of the different antifungal drugs varied amongst the species of Candida. From the 130 isolates tested for MICs, 90.77% (112/130) were susceptible to all antifungal drugs and 6.9% (9/130) of the isolates were multi-drug resistant. C. dubliniensis (n=2) isolates were susceptible to all the above mentioned antifungal drugs. There was no significant difference in species distribution amongst clinical specimens and between patients' genders (P>0.05). An increase in MIC values for fluconazole and flucytosine towards the resistance range was observed. To our knowledge, this is the first report on surveillance of Candida species distribution and antifungal susceptibility at a public tertiary teaching hospital in Eastern Cape, South Africa.

Stakeholder Groups of Public and Private Universities in the Czech Republic – Identification, Categorization and Prioritization

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Slabá Marie

2015-09-01

Full Text Available With regard to changes in the environment of tertiary education and tertiary educational systems, universities are now unlikely to succeed as ‘separated closed’ institutions that are unresponsive to their environment and stakeholders. Stakeholder analysis is considered as an important part of university management and marketing and universities have to take care of key stakeholder groups and build long term relationships with them. This paper focuses on the stakeholder analysis and adopts the stake-holder theory and analysis for the needs of the Czech market of tertiary education. This paper analyses results of the author’s online questionnaire that provided the input for data analysis deploying basic descriptive analysis and first steps of stakeholder analysis – identification, categorization and prioritization. Results of author’s research show that there are only slight differences between public and private universities and their perspective concerning generic stakeholder groups of universities. However the research revealed two controversial stakeholder groups – donors and competitors. In comparison with other stakeholder groups perception of these two stakeholder groups by public and private universities is very different. Stakeholder groups of public and private universities were categorized into four basic groups - primary internal stakeholder groups, primary external stakeholder groups, secondary internal stakeholder groups, and secondary external stakeholder groups. Primary internal and external stakeholder groups which are crucial for survival of universities are the most important stakeholder groups for universities. The author identified ten most important stakeholder groups for public and private universities separately, based on assigned priorities that will be used for further research.

Equalization of opportunities in the tertiary level of education of students with special needs in the Czech Republic – innovation programme of services at the University of Hradec Kralove

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Ruzickova Kamila

2016-01-01

Full Text Available The specialized text describes the standard rules of the equalization of opportunities at the tertiary level of the education of students with special needs in the Czech Republic. National standard recommendations for support services at Czech universities and colleges are presented in the first part of the article. The next part concentrates specifically on the innovative programme of services for students with special needs at the University of Hradec Kralove. The final part of the article provides the selected results of research study into the level of support services at the University of Hradec Kralove. Data were obtained from 52 respondents - kye workers for equalization of opportunities for students with special needs. A set of questionnaire was analysed using descriptive statistic. The first selected data demonstrate the status of readiness the innovated service system at the University of Hradec Kralove

Evaluating public involvement in the national low-level radioactive-waste-management program. Final report

International Nuclear Information System (INIS)

1982-01-01

An extensive public involvement approach has been developed to obtain the views and assistance of state and local governments, citizen groups, industry, professional societies and other organizations in the preparation and review of a national strategy document on low-level radioactive wastes. Six evaluators who have a wide diversity of backgrounds were selected to evaluate the effectiveness of this approach. This final report presents findings discussed under the headings: Introduction to the Recent History of Low-level Waste Policy Development (LLWMP) and the Role of Public Participation; Public Participation Mechanisms Employed in Preparing the National Strategy Document; the Keystone's Evaluation Process; and Findings. The overall evaluation of the process was very positive. It was clear that the LLWMP staff was seriously committed to building a credible public participation process. The evaluation team was provided rough cost figures for the various components of the LLWMP effort and concluded that, in its opinion, the public participation process provided benefits to the federal government that exceeded its costs. Moreover, the costs of the individual components were not out of line with each one's usefulness and contribution to the overall effort

Innovations in Tertiary Education Financing: A Comparative Evaluation of Allocation Mechanisms. Education Working Paper Series. Number 4

Science.gov (United States)

Salmi, Jamil; Hauptman, Arthur M.

2006-01-01

In recent decades, a growing number of countries have sought innovative solutions to the substantial challenges they face in financing tertiary education. One of the principal challenges is that the demand for education beyond the secondary level in most countries around the world is growing far faster than the ability or willingness of…

Beyond Expectations: Autonomy and the Iranian Postgraduate Students in Malaysian Public Universities

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Sina Neissi

2017-10-01

Full Text Available Iranian learners at all levels of education (primary, secondary and tertiary face a number of constraints in their studies due to restriction of educational system, cultures, upbringing and expectations of society. Based on this premise the researchers would like to explore the degrees of autonomy as practiced by selected Iranian postgraduate students studying at three premier public universities in Malaysia. Data were gathered using the Learner Autonomy Profile (LAP developed by Confessore & Confessore (1992.  The findings reveal that these Iranian postgraduate students do practice autonomy and know how to apply positive coping strategies in their studies; thus indicating positive contradiction from the normal expectations of Iranian learners’ performance in relation to autonomy. The paper concludes with the impacts and implications of the findings.

Prognostic Implications of Level-of-Care at Tertiary Heart Centers Compared With Other Hospitals After Resuscitation From Out-of-Hospital Cardiac Arrest

DEFF Research Database (Denmark)

Søholm, Helle; Kjaergaard, Jesper; Bro-Jeppesen, John

2015-01-01

(OR, 10 [5.3-22] and 3.8 [2.5-5.7]), neurophysiological examination (OR, 1.8 [1.3-2.6]), and brain computed tomography (OR, 1.9 [1.4-2.6]), whereas no difference in therapeutic hypothermia was noted. Patients at tertiary centers were more often consulted by a cardiologist (OR, 8.6 [5.0-15]), had...

PROFILE OF SYPHILIS PATIENTS ATTENDING THE DERMATOLOGY VENEREOLOGY OPD AT A GOVERNMENT TERTIARY HOSPITAL

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Vasuki Shanmugam

2017-08-01

Full Text Available BACKGROUND Syphilis is one of the major sexually transmitted infections, which is showing a raising trend across the globe. The aim of the study is to study the prevalence of syphilis among Sexually Transmitted Infection (STI clinic attendees of a tertiary care hospital of south India. MATERIALS AND METHODS This was a cross-sectional study of one year duration conducted at STI clinic of a government tertiary hospital in South India. Patients who have been diagnosed to have syphilis were analysed with respect to demographic profile and their sexual behaviour pattern. RESULTS 40 were persons diagnosed to have syphilis among a total of 1790 STI clinic attendees. The mean age of patients with syphilis found to be 31 years. Male-to-female ratio is 7:1. 80% of patients with syphilis had higher school level and college level education. Homosexual behaviour pattern was predominant and it was found among 60% of them (p value 0.011. 62.5% of them were alcoholic. Safe sex practices were minimal in spite of knowledge about condom. CONCLUSION There was a raising trend of syphilis among STI clinic attendees during 2016. Early infectious stage of disease is more and was found more commonly among Men Having Sex with Men (MSM.

Learning Enhancement in Tertiary Institutions Using Mobile ...

African Journals Online (AJOL)

2012-12-01

Dec 1, 2012 ... model that is still by far the dominant mode of education and learning in tertiary institutions. In addition to identifying ... education has there been a technology that ..... Determinant of Mobile Learning Acceptance: An Empirical.

Influence Factor of Tertiary Students’ Employability Awareness Adjust Industry 4.0

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Chun-Mei Chou

2017-09-01

Full Text Available This study aims to analyze the correlation (N=621 among tertiary students’ career planning, erecruiting adoption acceptance, and employability awareness in Taiwan. Tertiary students’ perceived career planning includes four factors, namely, self-appraisal, job expectancy, goal selection, and problem solving. E-recruiting adoption acceptance includes four factors, namely, playfulness, ease of use, effectiveness, and usefulness. Employability awareness includes four factors, namely, personal adaptability, employability ambition, career identity, and labour market. Participants responded to a 5-point Likert-type scale for each factor. Analysis was conducted using the structural equation modeling (SEM, and a good model fit was found for both the measurement and structural models. Research findings demonstrate that tertiary students’ career planning significantly and directly influences employability awareness. Career planning significantly and indirectly influences employability awareness by e-recruiting adoption acceptance. Tertiary students’ career planning and e-recruiting adoption acceptance fit the influence model and empirical data of employability awareness. Implications of this study, including the value of student self-assessment of their skills and utility of the e-recruiting to underpin personal career development planning and inform graduate recruitment processes, are discussed and recommendations made.

Do pregnant women know about danger signs of pregnancy and childbirth? – A study of the level of knowledge and its associated factors from a tertiary care hospital in Southern India

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R Nithya

2017-01-01

Full Text Available Background: Awareness about danger signs during pregnancy is essential for a woman to seek prompt care. This can avert long-term morbidity and mortality. This study was aimed to find the level of knowledge and its related factors about danger signs of pregnancy and childbirth among pregnant women attending a tertiary care hospital in southern India. Patients and Methods: We conducted a cross-sectional survey of pregnant women attending a tertiary care hospital in South India. Systematic random sampling of every 10th woman exiting the antenatal clinic was done. Results: We studied 382 pregnant women. Of them, 188 (49.2% [95% confidence interval (CI: 44%–54%], 104 (27.2% [95% CI: 23%–32%], and 81 (21.2% [95% CI: 17%–26%] women had sufficient knowledge about danger signs during pregnancy, labor, and childbirth, respectively. On multivariable analysis, lack of exposure to formal awareness raising health counseling classes was the only factor found to be significantly associated with a lack of knowledge about danger signs of pregnancy (adjusted prevalence ratio, 95% CI: 1.8 [1.2–2.7] and after childbirth (1.4 [1.1–1.7]. Lower education level was significantly associated with a lack of knowledge about danger signs of labor (1.2 [1.1–1.4]. Conclusion: We found that lack of exposure to formal awareness raising health counseling classes is a modifiable risk factor to improve knowledge about danger signs. We recommend structured mandatory health awareness sessions addressing the danger signs of pregnancy and child health to all pregnant women.

Chemical Properties, Decomposition, and Methane Production of Tertiary Relict Plant Litters: Implications for Atmospheric Trace Gas Production in the Early Tertiary

Science.gov (United States)

Yavitt, J. B.; Bartella, T. M.; Williams, C. J.

2006-12-01

Throughout the early Tertiary (ca. 65-38 Ma) Taxodiaceae-dominated (redwood) wetland forests occupied the high latitudes and were circumpolar in their distribution. Many of these forests had high standing biomass with moderate primary productivity. The geographic extent and amount of Tertiary coals and fossil forests throughout Arctic Canada suggests large areas of wetland forests that may have cycled substantial quantities of carbon, particularly methane until they were replaced by cold tolerant Pinus, Picea, and Larix following climatic cooling associated with the Terminal Eocene Event. To test this hypothesis we compared physiochemical properties, decomposition, and trace gas production of litter from extant Metasequoia, Pinus, Picea, and Larix. Initial results from plantation-grown trees indicate Metasequoia litter is a better source of labile organic substrate than pinaceous litter. Metasequoia litter contained the least lignin and highest amounts of water-soluble compounds of the four litter types studied. Analysis of the lignin structure using cupric oxide oxidation indicates that Metasequoia lignin is enriched in 4'-hydroxyacetophenone and 4'- Hydroxy-3'-methoxyacetophenone relative to the pinaceous litter. In a 12-month decomposition study using litterbags, average litter mass loss was greater for Metasequoia litter (62%) compared to the pinaceous species (50%). Moreover, Metasequoia litter incubated under anoxic conditions produced nearly twice as much CO2 (ca. 4.2 umol/g.day) and CH4 (2.1 umol/g.day) as the pinaceous litter (2.4 umol/g.day for CO2; 1.2 umol/g.day for CH4). Our results support the idea of greater decomposability and palatability of Metasequoia litter as compared to Larix, Picea, or Pinus. Provided that the biochemical properties of Metasequoia have remained relatively stable through geologic time, it appears that early Tertiary Metasequoia-dominated wetland forests may have had higher microbial driven trace gas production than the

Tutorial Continuing Education: Innovative Strategy in a Tertiary Specialized Health Unit

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Flaviana Maciel

2017-06-01

Full Text Available Hospital Pelopidas Silveira-IMIP/SES/SUS is a tertiary-unit, specialized in cardiology, neurology, neurosurgery and interventional radiology. It is the only hospital of Brazilian Public-Health-System (SUS with this profile and a 24h-acute-cardio/neurovascular facility. Challenges of Continuing-Education include a guaranteeing appropriate level of basic knowledge, b empowering clinical staff to remain up to date in current knowledge. HPS Continuing-Education Program is based on three branches: a Classroom-Tutorials (CT, b Online-Tutorials at "Pelopidas Digital" Virtual-Teaching-Platform (PD-VTP and c Daily-Practice Evaluation (DPE. This paper presents logistic details of HPS Continuing-Education Program. Training team coordinates tutorial meetings and performs continuous statistical analysis. Evaluation team visit hospital departments daily, observing in practice the incorporation of information provided, and retraining individuals in their work scenarios. Both teams perform curriculum development, meeting planning and creation of digital-training-modules. Tutorial meetings have pre/post-tests, allowing monitoring of attendance, topic significance and short-term retention. Tutorial groups are formed by 6-12 employees sharing similarities in training needs. CT is offered to 4 groups-of-interest: a nurses, b nursing assistants, c administrative staff, porters, drivers, d cleaning, laundry and security staff. Problematization and active strategies have resulted into an attractive, structured educational program customized to produce short-term results. The strategy is of interest to institutions sharing similar challenges.

Life Cycle Assessment of urban wastewater reuse with ozonation as tertiary treatment

International Nuclear Information System (INIS)

Munoz, Ivan; Rodriguez, Antonio; Rosal, Roberto; Fernandez-Alba, Amadeo R.

2009-01-01

Life Cycle Assessment has been used to compare different scenarios involving wastewater reuse, with special focus on toxicity-related impact categories. The study is based on bench-scale experiments applying ozone and ozone in combination with hydrogen peroxide to a wastewater effluent from a Spanish sewage treatment plant. Two alternative characterisation models have been used to account for toxicity of chemical substances, namely USES-LCA and EDIP97. Four alternative scenarios have been assessed: wastewater discharge plus desalination supply, wastewater reuse without tertiary treatment, wastewater reuse after applying a tertiary treatment consisting on ozonation, and wastewater reuse after applying ozonation in combination with hydrogen peroxide. The results highlight the importance of including wastewater pollutants in LCA of wastewater systems assessing toxicity, since the contribution of wastewater pollutants to the overall toxicity scores in this case study can be above 90%. Key pollutants here are not only heavy metals and other priority pollutants, but also non-regulated pollutants such as pharmaceuticals and personal care products. Wastewater reuse after applying any of the tertiary treatments considered appears as the best choice from an ecotoxicity perspective. As for human toxicity, differences between scenarios are smaller, and taking into account the experimental and modelling uncertainty, the benefits of tertiary treatment are not so clear. From a global warming potential perspective, tertiary treatments involve a potential 85% reduction of greenhouse gas emissions when compared with desalination

Noise and room acoustic conditions in a tertiary referral hospital in Seoul, Korea

DEFF Research Database (Denmark)

Jeong, Cheol-Ho; Cho, Wan-Ho; Chang, Ji-ho

2018-01-01

Noise levels and room acoustic parameters at a tertiary referral hospital, Seoul National University Hospital in Korea, are investigated. Through a questionnaire, acoustically problematic rooms are identified. Noise levels in emergency rooms (ERs) and intensive care units (ICUs) are measured over...... level for the first night was 66 dBA, which came down to 56 dBA for the next day. The reason for the higher noise level for the first night in the ICU was frequent alarm sound and treatment noise related to a critical patient. The noise level in the measured ERs is about 10 dB lower than those measured...... about three days. Acoustically critical and problematic rooms in the otolaryngology department are measured: examination rooms, operating rooms, nurse stations, patient rooms, and audiometric rooms. The equivalent A-weighted noise level, LAeq, ranges from 54 to 56 dBA in two ERs. In an ICU, the noise...

Wildfires and animal extinctions at the Cretaceous/Tertiary boundary

Science.gov (United States)

Adair, Robert K.

2010-06-01

Persuasive models of the ejection of material at high velocities from the Chicxulub asteroid impact marking the Cretaceous/Tertiary boundary have led to the conclusion that upon return, that material, heated in passage through the upper atmosphere, generated a high level of infrared energy density over the Earth's surface. That radiant energy has been considered to be a direct source of universal wildfires, which were presumed to be a major cause of plant and animal species extinctions. The extinction of many animal species, especially the dinosaurs, has also been attributed to the immediate lethal effects of the radiation. I find that the absorption of the radiation by the atmosphere, by cloud formations, and by ejecta drifting in the lower atmosphere reduced the radiation at the surface to a level that cannot be expected to have generated universal fires. Although the reduced radiation will have likely caused severe injuries to many animals, such insults alone seem unlikely to have generated the overall species extinctions that have been deduced.

Neonatal Outcomes of Rh-Negative Pregnancies in a Tertiary Level Neonatal Intensive Care Unit: A Prospective Study

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Chacham

2016-07-01

Full Text Available Background Rhesus incompatibility is a preventable cause for severe neonatal hyperbilirubinemia, hydrops fetalis and still births. The prevalence of the Rh-negative blood group among Indian woman varies from 2% - 10%. Despite declining the incidence of Rhesus incompatibility, due to availability of anti-D immunoglobulin, and improved antenatal care of the Rh-negative pregnant woman, it still accounts for a significant proportion of neonatal hyperbilirubinemia and neuro-morbidity. The prevalence of Rh-negative women having Rh-positive neonates is 60%. Objectives This study aimed to estimate the incidence of Rh iso-immunization and evaluate the outcomes of Rh iso-immunized neonates. Methods This prospective observational study was conducted in a tertiary level neonatal intensive care unit, Princess Esra hospital, Deccan college of medical sciences, Hyderabad, Telangana, India. Consecutive intramural and extramural neonates admitted to neonatal intensive care unit with the Rh-negative mother’s blood group and hyperbilirubinemia were enrolled. Neonates born to Rh+ve mothers were excluded. Neonatal gestational age, birth weight, age at admission, duration of phototherapy, duration of hospitalization, neonatal examination and investigations were recorded in a predesigned, pretested performa. Results A total of 90 neonates were born to Rh-negative mothers, of which 70% (63 had the Rh-positive blood group and 30% had the Rh-negative blood group. Of these 63 neonates, 48 (76.2% had hyperbilirubinemia and 43 neonates (68.3% had significant hyperbilirubinemia (total serum bilirubin > 15mg/dL. Among them, 2%, 75% and 23% were born to primi, multi and grandmutli, respectively. Also, 14.5% of the neonates were large for dates (LFD, 75% appropriate for dates (AFD and 10.5% were small for dates (SFD. Premature and SFD neonates had higher incidence of hyperbilirubinemia. Significantly higher incidence of jaundice occurred within 72 hours of life. The mean

Hospitalized Patients' Awareness Of Their Rights-A Cross Sectional Survey In A Public And Private Tertiary Care Hospitals Of Punjab, Pakistan.

Science.gov (United States)

Tabassum, Tahirah; Ashraf, Mariam; Thaver, Inayat

2016-01-01

The awareness of patient's rights is negligible in developing countries where no legal framework is present to protect these rights and Pakistan is no exception. Not only is there an absence of legal structure for protection of patients' rights, but the enforcement and implementation for existing law is also questionable. Pakistan has an Islamic Charter of Medical and Health Ethics which includes the medical behaviour and physician's rights and duties towards the patients. Despite all these charters on patients' rights, there is little to no awareness regarding these rights and their practice remains low in healthcare system of Pakistan. This assessment of awareness among patients about their rights will guide in formulating recommendations to improve the existing system of healthcare delivery in the country. This descriptive cross-sectional comparative study was conducted in two hospitals in Lahore, each belonging to public and private sector. A structured questionnaire was used to collect data from patients. A total of 220 patients were selected to participate in the study, 110 belonging to each private and public hospital. The findings indicate that most of the patients (64%) were not aware of their rights. The awareness level was better in patients seeking care from private hospital than those from public hospital. Education, monthly income and type of hospital utilized were found to be positively associated with the level of awareness. Most of the patients were not satisfied with the practices of their rights, especially in public hospitals. The lack of awareness regarding the rights of a patient was more common in patients of public/government hospitals compared to private hospitals. A nation-wide healthcare education program is needed to increase awareness and practice of patients' rights in the country.

Geology of drill hole UE25p No. 1: A test hole into pre-Tertiary rocks near Yucca Mountain, southern Nevada

International Nuclear Information System (INIS)

Carr, M.D.; Waddell, S.J.; Vick, G.S.; Stock, J.M.; Monsen, S.A.; Harris, A.G.; Cork, B.W.; Byers, F.M. Jr.

1986-01-01

Yucca Mountain in southern Nye County, Nevada, has been proposed as a potential site for the underground disposal of high-level nuclear waste. An exploratory drill hole designated UE25p No. 1 was drilled 3 km east of the proposed repository site to investigate the geology and hydrology of the rocks that underlie the Tertiary volcanic and sedimentary rock sequence forming Yucca Mountain. Silurian dolomite assigned to the Roberts Mountain and Lone Mountain Formations was intersected below the Tertiary section between a depth of approximately 1244 m (4080 ft) and the bottom of the drill hole at 1807 m (5923 ft). These formations are part of an important regional carbonate aquifer in the deep ground-water system. Tertiary units deeper than 1139 m (3733 ft) in drill hole UE25p No. 1 are stratigraphically older than any units previously penetrated by drill holes at Yucca Mountain. These units are, in ascending order, the tuff of Yucca Flat, an unnamed calcified ash-flow tuff, and a sequence of clastic deposits. The upper part of the Tertiary sequence in drill hole UE25p No. 1 is similar to that found in other drill holes at Yucca Mountain. The Tertiary sequence is in fault contact with the Silurian rocks. This fault between Tertiary and Paleozoic rocks may correlate with the Fran Ridge fault, a steeply westward-dipping fault exposed approximately 0.5 km east of the drill hole. Another fault intersects UE25p No. 1 at 873 m (2863 ft), but its surface trace is concealed beneath the valley west of the Fran Ridge fault. The Paintbrush Canyon fault, the trace of which passes less than 100 m (330 ft) east of the drilling site, intersects drill hole UE25p No. 1 at a depth of approximately 78 m (255 ft). The drill hole apparently intersected the west flank of a structural high of pre-Tertiary rocks, near the eastern edge of the Crater Flat structural depression

Examining public open spaces by neighborhood-level walkability and deprivation.

Science.gov (United States)

Badland, Hannah M; Keam, Rosanna; Witten, Karen; Kearns, Robin

2010-11-01

Public open spaces (POS) are recognized as important to promote physical activity engagement. However, it is unclear how POS attributes, such as activities available, environmental quality, amenities present, and safety, are associated with neighborhood-level walkability and deprivation. Twelve neighborhoods were selected within 1 constituent city of Auckland, New Zealand based on higher (n = 6) or lower (n = 6) walkability characteristics. Neighborhoods were dichotomized as more (n = 7) or less (n = 5) socioeconomically deprived. POS (n = 69) were identified within these neighborhoods and audited using the New Zealand-Public Open Space Tool. Unpaired 1-way analysis of variance tests were applied to compare differences in attributes and overall score of POS by neighborhood walkability and deprivation. POS located in more walkable neighborhoods have significantly higher overall scores when compared with less walkable neighborhoods. Deprivation comparisons identified POS located in less deprived communities have better quality environments, but fewer activities and safety features present when compared with more deprived neighborhoods. A positive relationship existed between presence of POS attributes and neighborhood walkability, but the relationship between POS and neighborhood-level deprivation was less clear. Variation in neighborhood POS quality alone is unlikely to explain poorer health outcomes for residents in more deprived areas.

Evolution of global contribution in multi-level threshold public goods games with insurance compensation

Science.gov (United States)

Du, Jinming; Tang, Lixin

2018-01-01

Understanding voluntary contribution in threshold public goods games has important practical implications. To improve contributions and provision frequency, free-rider problem and assurance problem should be solved. Insurance could play a significant, but largely unrecognized, role in facilitating a contribution to provision of public goods through providing insurance compensation against the losses. In this paper, we study how insurance compensation mechanism affects individuals’ decision-making under risk environments. We propose a multi-level threshold public goods game model where two kinds of public goods games (local and global) are considered. Particularly, the global public goods game involves a threshold, which is related to the safety of all the players. We theoretically probe the evolution of contributions of different levels and free-riders, and focus on the influence of the insurance on the global contribution. We explore, in both the cases, the scenarios that only global contributors could buy insurance and all the players could. It is found that with greater insurance compensation, especially under high collective risks, players are more likely to contribute globally when only global contributors are insured. On the other hand, global contribution could be promoted if a premium discount is given to global contributors when everyone buys insurance.

Tertiary instability of zonal flows within the Wigner-Moyal formulation of drift turbulence

Science.gov (United States)

Zhu, Hongxuan; Ruiz, D. E.; Dodin, I. Y.

2017-10-01

The stability of zonal flows (ZFs) is analyzed within the generalized-Hasegawa-Mima model. The necessary and sufficient condition for a ZF instability, which is also known as the tertiary instability, is identified. The qualitative physics behind the tertiary instability is explained using the recently developed Wigner-Moyal formulation and the corresponding wave kinetic equation (WKE) in the geometrical-optics (GO) limit. By analyzing the drifton phase space trajectories, we find that the corrections proposed in Ref. to the WKE are critical for capturing the spatial scales characteristic for the tertiary instability. That said, we also find that this instability itself cannot be adequately described within a GO formulation in principle. Using the Wigner-Moyal equations, which capture diffraction, we analytically derive the tertiary-instability growth rate and compare it with numerical simulations. The research was sponsored by the U.S. Department of Energy.

Understanding Australian Aboriginal Tertiary Student Needs

Science.gov (United States)

Oliver, Rhonda; Rochecouste, Judith; Bennell, Debra; Anderson, Roz; Cooper, Inala; Forrest, Simon; Exell, Mike

2013-01-01

Drawing from a study of the experiences of Australian Aboriginal and Torres Strait Islander university students, this paper presents an overview of the specific needs of these students as they enter and progress through their tertiary education. Extracts from a set of case studies developed from both staff and student interviews and an online…

Public health approach to birth defects: the Argentine experience.

Science.gov (United States)

Bidondo, María Paz; Groisman, Boris; Barbero, Pablo; Liascovich, Rosa

2015-04-01

Birth defects are a global problem, but their impact is particularly severe in low and middle income countries, where the conditions for prevention, treatment, and rehabilitation are more critical. The epidemiological transition in the infant mortality causes, and the concern of the community and the mass media about the teratogenic risk of environmental pollutants, has made health authorities aware of the importance of birth defects in Argentina. The objective of this paper is to outline those actions specifically taken in Argentina aimed at the prevention of birth defects at a national level. Firstly, we focus on birth defects in Argentina on a general basis, and then we present different laws and actions taken in terms of surveillance and public health programs, primary, secondary, and tertiary prevention. Finally, we present the Teratology Information Service "Fetal Health Line", and the genetic services organization and health professionals training by the National Center of Medical Genetics and the National Program of Genetics Network. In conclusion, in the country, several programs focus on different approaches to the problem, and the challenge is to coordinate the teamwork between them. Finally, we list tips to address birth defects from the public health perspective.

Derivation of Intervention levels for Protection of the Public in a Radiological Emergency in Korea

International Nuclear Information System (INIS)

Lee, Jong Tai; Lee, Goan Yup; Khang, Byung Oui; Oh, Ki Hoon; Kim, Chang Kyu

2001-01-01

Intervention levels for protection of the public in a radiological emergency are theoretically derived by the cost-benefit approach with the concept of justification and optimization. Intervention levels on the sheltering, evacuation, temporary relocation and permanent resettlement for protection of the public are estimated with the cost to protective countermeasures and the value from dose averted which are the site specific parameters. As a result, it is confirmed that IAEA guidelines for intervention levels are applicable to the radiological emergency in Korea. Optimum ranges of 5 - 10 mSv/2days for sheltering, 25 - 130 mSv/week for evacuation, 15 - 90 mSv/month for temporary relocation and 600 - 3,500 mSv/lifetime for permanent resettlement for intervention levels are also provided. The result can be applied as useful data to update intervention levels under the theoretical background in Korea

On Progress of Mass Tertiary Education: Case of Lebanon, Kenya and Oman

Science.gov (United States)

Liu, Zhimin; Mutinda, Gladys

2016-01-01

Mass higher education is a huge force to be reckoned with and its existence, already in the expansion of tertiary institutions is undeniable. This study will focus on three countries: Lebanon, Kenya and Oman. The purpose of this study is to evaluate mass tertiary education progress in these countries. It will synthesize data results of gross…

Water levels in the Yucca Mountain area, Nevada, 1993

International Nuclear Information System (INIS)

Tucci, P.; Goemaat, R.L.; Burkhardt, D.J.

1996-01-01

Water levels were monitored in 28 wells in the Yucca Mountain area, Nevada, during 1993. Seventeen wells were monitored periodically, generally on a monthly basis, and 11 wells representing 18 intervals were monitored hourly. All wells monitor water levels in Tertiary volcanic rocks, except one that monitors water levels in Paleozoic carbonate rocks. Water levels were measured using calibrated steel tapes and pressure transducers; steel-tape measurements were corrected for mechanical stretch, thermal expansion, and borehole deviation to obtain precise water-level altitudes. Water-level altitudes in the Tertiary volcanic rocks ranged from about 728 meters above sea level east of Yucca Mountain to about 1,034 meters above sea level north of Yucca Mountain. Water-level altitudes in the well monitoring the Paleozoic carbonate rocks varied between 752 and 753 meters above sea level during 1993. Water levels were an average of about 0.04 meter lower than 1992 water levels. All data were acquired in accordance with a quality-assurance program to support the reliability of the data

First report of tertiary syphilis presenting as lipoatrophic panniculitis in an immunocompetent patient.

Science.gov (United States)

Drago, Francesco; Ciccarese, Giulia; Tomasini, Carlo F; Calamaro, Paola; Boggio, Maurizio; Rebora, Alfredo; Parodi, Aurora

2017-03-01

We describe herein a woman who developed subcutaneous gummas in her trochanteric regions, bilaterally, although she had been treated for syphilis two decades earlier. Evidence of Treponema pallidum latent late infection was the presence of IgG antibodies against T. pallidum and the positive non-treponemal and treponemal tests. Moreover, immunohistochemical staining for T. pallidum detected some spirochetes close to the atrophic adipocytes allowing the diagnosis of lypo-atrophic panniculitis tertiary syphilis. This is the first case of tertiary syphilis presenting as panniculitis in an immunocompetent patient, demonstrating that subcutaneous fat may be another organ infected in tertiary syphilis.

Enhancing learning in tertiary institutions through multimedia based ...

African Journals Online (AJOL)

Enhancing learning in tertiary institutions through multimedia based ... convenient and cost-effective courseware reengineering methodology of our age. ... Also discussed are the reasons for converting classroom courses to e-learning format.

Lithium levels in the public drinking water supply and risk of suicide: A pilot study.

Science.gov (United States)

Liaugaudaite, Vilma; Mickuviene, Narseta; Raskauskiene, Nijole; Naginiene, Rima; Sher, Leo

2017-09-01

Suicide is a major public health concern affecting both the society and family life. There are data indicating that higher level lithium intake with drinking water is associated with lower suicide rate. This pilot study examined the relationship between lithium levels in drinking water and suicide rates in Lithuania. Twenty-two samples from public drinking water systems were taken in 9 cities of Lithuania. The lithium concentration in these samples was determined by inductively coupled plasma mass spectrometry (ICP-MS). The suicide data were obtained from the Lithuania Database of Health Indicators, and comprised all registered suicides across all ages and gender within the 5-year period from 2009 to 2013. The study demonstrated an inverse correlation between levels of lithium (log natural transformed), number of women for 1000 men and standardized mortality rate for suicide among total study population. After adjusting for confounder (the number of women for 1000 men), the lithium level remained statistically significant in men, but not in women. Our study suggested that higher levels of lithium in public drinking water are associated with lower suicide rates in men. It might have a protective effect on the risk of suicide in men. Copyright © 2017 The Authors. Published by Elsevier GmbH.. All rights reserved.

Maternal and reproductive health financing in Burundi: public-sector contribution levels and trends from 2010 to 2012.

Science.gov (United States)

Chaumont, Claire; Muhorane, Carmen; Moreira-Burgos, Isabelle; Juma, Ndereye; Avila-Burgos, Leticia

2015-10-01

An understanding of public financial flows to reproductive health (RH) at the country level is key to assessing the extent to which they correspond to political commitments. This is especially relevant for low-income countries facing important challenges in the area of RH. To this end, the present study analyzes public expenditure levels and trends with regards to RH in Burundi between the years 2010 to 2012, looking specifically at financing agents, health providers, and health functions. The analysis was performed using standard RH sub-account methodology. Information regarding public expenditures was gathered from national budgets, the Burundi Ministry of Public Health information system, and from other relevant public institutions. Public RH expenditures in Burundi accounted for $41.163 million international dollars in 2012, which represents an increase of 16 % from 2010. In 2012, this sum represented 0.57 % of the national GDP. The share of total public health spending allocated to RH increased from 15 % in 2010 to 19 % in 2012. In terms of public agents involved in RH financing, the Ministry of Public Health proved to play the most important role. Half of all public RH spending went to primary health care clinics, while more than 70 % of this money was used for maternal health; average public RH spending per woman of childbearing age stagnated during the study period. The flow patterns and levels of public funds to RH in Burundi suggest that RH funding correctly reflects governmental priorities for the period between 2010 and 2012. In a context of general shrinking donor commitment, local governments have come to play a key role in ensuring the efficient use of available resources and the mobilizing of additional domestic funding. A strong and transparent financial tracking system is key to carrying out this role and making progress towards the MDG Goals and development beyond 2015.

Challenges Faced by Key Stakeholders Using Educational Online Technologies in Blended Tertiary Environments

Science.gov (United States)

Tuapawa, Kimberley

2016-01-01

Traditional learning spaces have evolved into dynamic blended tertiary environments (BTEs), providing a modern means through which tertiary education institutes (TEIs) can augment delivery to meet stakeholder needs. Despite the significant demand for web-enabled learning, there are obstacles concerning the use of EOTs, which challenge the…

Submarine fans and associated deposits in the Lower Tertiary of Guipuzcoa (Northern Spain)

NARCIS (Netherlands)

Vliet, van A.

1982-01-01

The Lower Tertiary outcrop along the coast of Guipuzcoa, northern Spain, consists exclusively of deep-marine sediments, deposited in a narrow elongated (ESE-WNW) basin. The early Tertiary sedimentary history of this basin can be described in terms of three main phases:

- a phase of

Cost effectiveness of screening of all newly recruited employees for diabetes at a tertiary care hospital.

Science.gov (United States)

Ali, Niloufer Sultan; Khuwaja, Ali Khan

2007-01-01

Diabetes Mellitus is a disease which remains asymptomatic for long duration of time and usually diagnosed either when gets complicated or by routine or opportunistic screening. The practice of universal screening is not recommended, particularly in constraint resources. However, we embarked with a study to assess the yield of recommended screening for Type 2 diabetes in all the newly recruited employees at a tertiary care hospital in Karachi. All the information required for this study was collected from medical records of all newly recruited employees of nursing services department of a tertiary care hospital of Karachi, Pakistan, over a period of 5 months (August 2004 to December 2004). Out of 360 subjects, 326, whose information was found to be complete, were included for final analysis. Mean age of the study subjects was 25.3 +/- 4.7 years and their mean casual plasma glucose level was 99.1 +/- 16.3 mg/dl. 315 (96.6%) study subjects had casual plasma glucose level of 139 mg/dl or less. Only 10 (3.1%) study subjects had casual plasma glucose levels between 140 to 199 mg/dl. Just one employee, 41 years old, was found to have casual plasma glucose level of 213 mg/dl. In this study, screening of all individuals for diabetes had a very low yield. Recommendation of universal screening for diabetes does not represent a good use of resources and perhaps not cost-effective. However, periodic screening of high risk individuals should be warranted.

Sexual harassment of students on public transport: An exploratory study in Lucknow, India

OpenAIRE

Tripathi, K.; Borrion, H.; Belur, J.

2017-01-01

Studies suggest that incidents of sexual harassment are common occurrence on public transport in India, but there is little reliable data to understand and tackle the problem. This research explores actual and witnessed victimisations as well as perceptions of the risk by a sample of 200 tertiary female students in Lucknow, India. Consistent with literature, sexual harassment victimisation appears to be most prevalent in buses and increases with the frequency of use of public transport. We fo...

Structural Biology for A-Level Students

Science.gov (United States)

Philip, Judith

2013-01-01

The relationship between the structure and function of proteins is an important area in biochemistry. Pupils studying A-level Biology are introduced to the four levels of protein structure (primary, secondary, tertiary and quaternary) and how these can be used to describe the progressive folding of a chain of amino acid residues to a final,…

Indigenous Students in the Tertiary Education Sector

Science.gov (United States)

Bandias, Susan; Fuller, Don; Larkin, Steven

2014-01-01

Important recent objectives of indigenous education policy in Australia have been aimed at redressing indigenous economic and social disadvantage through increasing student retention, progression and completion rates in both compulsory and post-compulsory education. The two sectors of the tertiary education system, vocational education and…

Integrated marketing communication and the role of public relations therein : a case study of RAU

OpenAIRE

2012-01-01

M.A. This study determines the role of public relations as a marketing communication function in RAU's integrated marketing communication approach. The research topic was selected for numerous reasons. Firstly, dramatic changes have occurred in the tertiary educational domain, which causes universities to adapt their marketing communication approaches. Based on these environmental changes, the Public Relations Division at RAU commissioned the study on the research topic, which is the secon...

Comparison of stress and burnout among anesthesia and surgical residents in a tertiary care teaching hospital in North India.

Science.gov (United States)

Gandhi, K; Sahni, N; Padhy, S K; Mathew, P J

2017-10-23

The residents undergoing training at hospitals in our country face challenges in terms of infrastructure and high workload with undefined working hours. The aim of the study was to compare the stress and burnout levels in trainee doctors doing residency in surgical fields and anesthesia at a tertiary care academic center in North India. A comparative, observational study was conducted in a tertiary care teaching hospital in North India. After Ethics Committee approval, 200 residents (100 each from surgical branches and anesthesia) were required to fill a questionnaire with information about age, sex, year of residency, marital status, and the Perceived Stress Scale-10, and Burnout Clinical Subtype Questionnaire-12. Burnout and perceived stress were compared between residents of anesthesia and surgical specialties. Residents of both surgical and anesthesia branches scored high in perceived stress, namely 21 and 18, respectively. The score was significantly higher in surgical residents (P = 0.03) and increased progressively with the year of residency. The majority of residents (90% surgical, 80% anesthesia) felt that they were being overloaded with work. However, only 20%-30% of respondents felt that there was lack of development of individual skills and still fewer (<10%) reported giving up in view of difficulties. There is high level of stress and overload dimension of burnout among the residents of anesthesia and surgical branches at our tertiary care academic institution and the surgical residents score marginally higher than anesthesia residents.

Integrated Identity and Access Management System for Tertiary ...

African Journals Online (AJOL)

Nigerian Journal of Technology ... identity management and access control and the unavailability of actionable information on pattern of ... This Tertiary Identity and Access Management System (T-IAMS) is a fingerprint biometric database that ...

Sexism and Sexual Harassment in Tertiary Institutions | Akpotor ...

African Journals Online (AJOL)

Gender and Behaviour ... Sexual harassment is a recurring decimal in tertiary institutions. The paper therefore investigates the effects of sexual harassment on the academic performance of female students, using Delta State University, Abraka, ...

Formation mechanism of NDMA from ranitidine, trimethylamine, and other tertiary amines during chloramination: a computational study.

Science.gov (United States)

Liu, Yong Dong; Selbes, Meric; Zeng, Chengchu; Zhong, Rugang; Karanfil, Tanju

2014-01-01

Chloramination of drinking waters has been associated with N-nitrosodimethylamine (NDMA) formation as a disinfection byproduct. NDMA is classified as a probable carcinogen and thus its formation during chloramination has recently become the focus of considerable research interest. In this study, the formation mechanisms of NDMA from ranitidine and trimethylamine (TMA), as models of tertiary amines, during chloramination were investigated by using density functional theory (DFT). A new four-step formation pathway of NDMA was proposed involving nucleophilic substitution by chloramine, oxidation, and dehydration followed by nitrosation. The results suggested that nitrosation reaction is the rate-limiting step and determines the NDMA yield for tertiary amines. When 45 other tertiary amines were examined, the proposed mechanism was found to be more applicable to aromatic tertiary amines, and there may be still some additional factors or pathways that need to be considered for aliphatic tertiary amines. The heterolytic ONN(Me)2-R(+) bond dissociation energy to release NDMA and carbocation R(+) was found to be a criterion for evaluating the reactivity of aromatic tertiary amines. A structure-activity study indicates that tertiary amines with benzyl, aromatic heterocyclic ring, and diene-substituted methenyl adjacent to the DMA moiety are potentially significant NDMA precursors. The findings of this study are helpful for understanding NDMA formation mechanism and predicting NDMA yield of a precursor.

Public health and health promotion capacity at national and regional level: a review of conceptual frameworks

Directory of Open Access Journals (Sweden)

Christoph Aluttis

2014-04-01

Full Text Available The concept of capacity building for public health has gained much attention during the last decade. National as well as international organizations increasingly focus their efforts on capacity building to improve performance in the health sector. During the past two decades, a variety of conceptual frameworks have been developed which describe relevant dimensions for public health capacity. Notably, these frameworks differ in design and conceptualization. This paper therefore reviews the existing conceptual frameworks and integrates them into one framework, which contains the most relevant dimensions for public health capacity at the country or regional level. A comprehensive literature search was performed to identify frameworks addressing public health capacity building at the national or regional level. We content-analysed these frameworks to identify the core dimensions of public health capacity. The dimensions were subsequently synthesized into a set of thematic areas to construct a conceptual framework which describes the most relevant dimensions for capacities at the national or regional level. The systematic review resulted in the identification of seven core domains for public health capacity: resources, organizational structures, workforce, partnerships, leadership and governance, knowledge development and country specific context. Accordingly, these dimensions were used to construct a framework, which describes these core domains more in detail. Our research shows that although there is no generally agreed upon model of public health capacity, a number of key domains for public health and health promotion capacity are consistently recurring in existing frameworks, regardless of their geographical location or thematic area. As only little work on the core concepts of public health capacities has yet taken place, this study adds value to the discourse by identifying these consistencies across existing frameworks and by synthesising

Misconception of emergency contraception among tertiary school ...

African Journals Online (AJOL)

Objective: To assess the degree of awareness and use of emergency contraception among tertiary school students in Akwa Ibom State, Nigeria. Design: A self-administered questionnaire survey. Setting: The Akwa Ibom State Polytechnic, Ikot Osurua, located on the outskirts of Ikot Ekpene local government area between ...

"Community of Practice" as a Framework for Supporting Tertiary Teachers' Informal Workplace Learning

Science.gov (United States)

Viskovic, Alison R.

2005-01-01

This article discusses aspects of the informal learning of tertiary teachers in a polytechnic, a wananga (Maori tertiary institution) and a university in New Zealand. Case studies showed that they gained their teaching knowledge and skills mainly on the job, through informal, experiential learning, and much less through formal courses,…

Public funding of health at the district level in Indonesia after decentralization-sources, flows and contradictions.

Science.gov (United States)

Heywood, Peter; Harahap, Nida P

2009-04-16

During the Suharto era public funding of health in Indonesia was low and the health services were tightly controlled by the central government; district health staff had practically no discretion over expenditure. Following the downfall of President Suharto there was a radical political, administrative and fiscal decentralization with delivery of services becoming the responsibility of district governments. In addition, public funding for health services more than doubled between 2001 and 2006. It was widely expected that services would improve as district governments now had both more adequate funds and the responsibility for services. To date there has been little improvement in services. Understanding why services have not improved requires careful study of what is happening at the district level. We collected information on public expenditure on health services for the fiscal year 2006 in 15 districts in Java, Indonesia from the district health offices and district hospitals. Data obtained in the districts were collected by three teams, one for each province. Information on district government revenues were obtained from district public expenditure databases maintained by the World Bank using data from the Ministry of Finance. The public expenditure information collected in 15 districts as part of this study indicates district governments are reliant on the central government for as much as 90% of their revenue; that approximately half public expenditure on health is at the district level; that at least 40% of district level public expenditure on health is for personnel, almost all of them permanent civil servants; and that districts may have discretion over less than one-third of district public expenditure on health; the extent of discretion over spending is much higher in district hospitals than in the district health office and health centers. There is considerable variation between districts. In contrast to the promise of decentralization there has been

Technological, Pedagogical, and Content Knowledge (TPACK): An Educational Landscape for Tertiary Science Faculty

Science.gov (United States)

Lavadia, Linda

Earlier studies concluded that technology's strength is in supporting student learning rather than as an instrument for content delivery (Angeli & Valanides, 2014). Current research espouses the merits of the Technological Pedagogical Content Knowledge (TPACK) framework as a guide for educators' reflections about technology integration within the context of content and instructional practice. Grounded by two theoretical frameworks, TPACK (Mishra & Koehler, 2006; 2008) and Rogers' (1983, 1995) theory of diffusion of innovation, the purpose of this mixed-methods research was two-fold: to explore the perceived competencies of tertiary science faculty at higher education institutions with respect to their integration of technology within the constructs of pedagogical practice and content learning and to analyze whether these perceived competencies may serve as predictive factors for technology adoption level. The literature review included past research that served as models for the Sci-TPACK instrument. Twenty-nine professors of tertiary science courses participated in an online Likert survey, and four professors provided in-depth interviews on their TPACK practices. Quantitative analysis of data consisted of descriptive and reliability statistics, calculations of means for each of the seven scales or domains of TPACK, and regression analysis. Open-ended questions on the Likert survey and individual interviews provided recurrent themes of the qualitative data. Final results revealed that the participants integrate technology into pedagogy and content through a myriad of TPACK practices. Regression analysis supported perceived TPACK competencies as predictive factors for technology adoption level.

Study of tertiary creep instability in several elevated-temperature structural materials

International Nuclear Information System (INIS)

Booker, M.K.; Sikka, V.K.

1978-01-01

Data for a number of common elevated temperature structural materials have been analyzed to yield mathematical predictions for the time and strain to tertiary creep at various rupture lives and temperatures. Materials examined include types 304 and 316 stainless steel, 2 1/4 Cr-1 Mo steel, alloy 800H, alloy 718, Hastelloy alloy X, and ERNiCr--3 weld metal. Data were typically examined over a range of creep temperatures for rupture lives ranging from less than 100 to greater than 10,000 hours. Within a given material, trends in these quantities can be consistently described, but it is difficult to directly relate the onset of tertiary creep to failure-inducing instabilities. A series of discontinued tests for alloy 718 at 649 and 620 0 C showed that the material fails by intergranular cracking but that no significant intergranular cracking occurs until well after the onset of tertiary creep

System for radiation emergency medicine. Activities of tertiary radiation emergency hospitals

International Nuclear Information System (INIS)

Kamiya, Kenji; Tanigawa, Koichi; Hosoi, Yoshio

2011-01-01

Japanese system for radiation emergency medicine is primarily built up by Cabinet Nuclear Safety Commission in 2001 based on previous Tokai JCO Accident (1999) and is composed from the primary, secondary and tertiary medical organizations. This paper describes mainly about roles and actions of the tertiary facilities at Fukushima Nuclear Power Plant Accident and tasks to be improved in future. The primary and secondary organizations in the system above are set up in the prefectures with or neighboring the nuclear facility, and tertiary ones, in two parts of western and eastern Japan. The western organization is in Hiroshima University having its cooperating 7 hospitals, and is responsible for such patients as exposed to high dose external radiation, having serious complication, and difficult to treat in the primary/secondary hospitals. The eastern is in National Institute of Radiological Sciences (NIRS) with 6 cooperating hospitals and responsible for patients with internal radiation exposure difficult to treat, with contaminated body surface with difficulty in decontamination and/or with causable of secondary contamination, and difficult to treat in the secondary hospitals. The tertiary organizations have made efforts for the education and training of medical staff, for network construction among the primary, secondary and other medicare facilities, for establishment of transferring system of patients, and for participation to the international network by global organizations like Response Assistance Network (RANET) in International Atomic Energy Agency (IAEA), and Radiation Emergency Preparedness and Network (REMPAN) in World Health Organization (WHO). At the Fukushima Accident, staffs of the two tertiary hospitals began to conduct medicare on site (Mar. 12-) and learned following tasks to be improved in future: the early definition of medicare and its network system, and Emergency Planning Zone (EPZ); urgent evacuation of residents weak to disaster like elderly

The dark sides of public service motivation: A multi-level theoretical framework

NARCIS (Netherlands)

Schott, C.; Ritz, Adrian

2017-01-01

Over the past decade, research on public service motivation (PSM) has made substantial progress in terms of explaining the desired work outcomes of the concept such as individual performance and satisfaction. In light of Perry and Wise’s warning, already voiced in 1990, that high levels of PSM may

Emerging trends of nosocomial pneumonia in intensive care unit of a tertiary care public teaching hospital in Western India.

Science.gov (United States)

Bhadade, Rakesh; Harde, Minal; deSouza, Rosemarie; More, Ashwini; Bharmal, Ramesh

2017-01-01

Nosocomial pneumonia poses great challenge to an intensivist. Detailed information about hospital-acquired pneumonia (HAP) and ventilator-acquired pneumonia (VAP) is crucial for prevention and optimal management, thus improving quality Intensive Care Unit (ICU) care. Hence, we aimed to study the current trend of nosocomial pneumonia in ICU. It was a prospective observational cohort study, conducted in the ICU of a tertiary care teaching public hospital over a period of 18 months. We studied clinical profile and outcome of 120 adult patients who developed VAP/HAP during the study period. We also analyzed the causative organisms, antibiotic sensitivity, and resistance pattern in these patients. Out of 120 patients, 29 patients were HAP and 91 patients were VAP. Mortality was 60% (72), and development of VAP and requirement of mechanical ventilation showed significant association with mortality (P antibiotiques et le modèle de résistance chez ces patients. Résultats: Sur 120 patients, 29 patients étaient HAP et 91 patients étaient VAP. La mortalité était de 60% (72), et le développement du VAP et l'exigence de ventilation mécanique ont montré une association significative avec la mortalité (P antibiotique maximale a été observée chez la pipéracilline + tazobactam (58,8%), suivie de l'imipénème (49,5%) et du méropénem (41,8%), alors que la résistance antibiotique maximale a été observée à cefépime (95,1%), suivie de ceftazidime et de l'amoxicilline (91,2%) . la pneumonie nosocomiale a montré une incidence élevée (17,44%) et la mortalité (60%). Les organismes communs identifiés étaient S. aureus et K. pneumoniae. La résistance était élevée pour les antibiotiques couramment utilisés et une forte sensibilité aux antibiotiques pour la pipéracilline + le tazobactam et le carbapénème.

Goal oriented Mathematics Survey at Preparatory Level- Revised set ...

African Journals Online (AJOL)

This cross sectional study design on mathematical syllabi at preparatory levels of the high schools was to investigate the efficiency of the subject at preparatory level education serving as a basis for several streams, like Natural science, Technology, Computer Science, Health Science and Agriculture found at tertiary levels.

[The ALANAM statement on public health policy].

Science.gov (United States)

Goic, Alejando; Armas, Rodolfo

2010-12-01

The ALANAM (Association of Latin American National Academies of Medicine) statement on public health policy, issued following its 19th Congress, held October 28–30, 2010, in Santiago, Chile, declares that cardiovascular diseases, cancer, accidents and violence are the leading causes of death in the region, while in several of its member nations, emergent and re-emergent infectious diseases, malnutrition, and mother-child illnesses remain prevalent. The statement calls attention to the lack of functioning water supply and sewage systems in many villages and rural areas. After describing the social causes of the present state of public health in Latin America (poverty levels reaching upwards of 44% of the total population, or some 110 million people), it calls on governments, first, to spare no efforts in the task of eradicating extreme poverty in the short-term, and poverty in the long-term. Second, considering that about 15 million 3-to-6 year-olds have no access to education, it recommends extending educational services to these children, and to improve the quality of existing pre-school and primary education. Third, the statement calls for universal health care coverage and for equal access to good quality medical care for everyone, and for programs aimed at promoting healthy personal habits and self-care. In this regard, it also recommends that disease prevention programs be sustained over time, that national sanitary objectives be defined, and that its results be periodically reviewed. Fourth, it recommends that primary health care be extended to everyone, and that it be enhanced by improving coverage and coordination with secondary and tertiary level health care institutions. The statement lays special stress on the need for adopting public health policies aimed at lowering the cost of medicines; to this end, it calls for the creation of an official list of generic drugs. The statement ends by calling on governments to support public health research as a

Assessing the Readability of College Textbooks in Public Speaking: Attending to Entry Level Instruction

Science.gov (United States)

Schneider, David E.

2011-01-01

More research is needed that examines textbooks intended for the entry level college classroom. This study offers valuable information to academics that adopt a public speaking textbook for instruction as well as objective feedback to the collective authors. Readability levels of 22 nationally published textbooks, based on McGlaughlin's (1969)…

Evaluation of a tertiary teledermatology service between peripheral and academic dermatologists in the Netherlands

NARCIS (Netherlands)

van der Heijden, Job P.; de Keizer, Nicolette F.; Witkamp, Leonard; Spuls, Phyllis I.

2014-01-01

Tertiary teledermatology (TTD)-secondary-care to tertiary-care teleconsultation-is applied rarely compared with the frequently applied secondary teledermatology (primary to secondary care). The objective of this study was to determine the effect of TTD on referrals from peripheral dermatologists to

Policing low-level disorder:police use of section 5 of the Public Order Act 1986

OpenAIRE

Brown, David; Ellis, Tom

1996-01-01

Following a Government review of public disorder law, the Public Order act 1986 introduced a structured series of offences to deal with disorder at all levels. At the lower end of the range, section 5 covers various forms of offensive conduct likely to cause harassment, alarm, or distress to vulnerable members of society.

Nationwide study of factors associated with public's willingness to use home self-test kit for dengue fever in Malaysia.

Science.gov (United States)

Wong, Li Ping; Atefi, Narges; AbuBakar, Sazaly

2016-08-12

As there is no specific treatment for dengue, early detection and access to proper treatment may lower dengue fatality. Therefore, having new techniques for the early detection of dengue fever, such as the use of dengue test kit, is vitally important. The aims of the study were: 1) identify factors associated with acceptance of a home self-test kit for dengue fever if the dengue test is available to the public and 2) find out the characteristics of the test kits that influence the use of the dengue test kit. A national telephone survey was carried out with 2,512 individuals of the Malaysian public aged 18-60 years old. Individuals were contacted by random digit dialling covering the whole of Malaysia from February 2012 to June 2013. From 2,512 participants, 6.1 % reported to have heard of the availability of the dengue home test kit and of these, 44.8 % expressed their intention to use the test kit if it was available. Multivariate logistic regressions indicated that participants with primary (OR: 0.65; 95 % CI: 0.43-0.89; p = 0.02, vs. tertiary educational level) and secondary educational levels (OR: 0.73; 95 % CI: 0.57-0.90; p = 0.01, vs. tertiary educational level) were less likely than participants with a tertiary educational level to use a home self-testing dengue kit for dengue if the kit was available. Participants with lower perceived barriers to dengue prevention (level of barriers 0-5) were less likely (OR: 0.67, 95 % CI: 0.53-0.85, p dengue kit for dengue if the kit was available compared to those with higher perceived barriers to dengue prevention (level of barriers 6-10). Participants with a lower total dengue fever knowledge score (range 0-22) were also less likely to use a home self-testing dengue kit for dengue if the kit was available (OR: 0.75; 95 % CI: 0.61-0.91, p = 0.001, vs. higher total dengue fever knowledge score) compared to those with a higher total dengue fever knowledge score (range 23-44). With response to

The effectiveness of the Danish Organic Action Plan 2020 to increase the level of organic public procurement in Danish public kitchens

DEFF Research Database (Denmark)

Sørensen, Nina Nørgaard; Tetens, Inge; Løje, Hanne

2016-01-01

and after kitchen employees participated in conversion projects. Public kitchens participating in the nine organic food conversion projects under the Danish Organic Action Plan 2020, initiated during autumn 2012 and spring 2013 and completed in summer 2015. A total of 622 public kitchens. The average...... (median) increase in organic food percentage from baseline to follow-up was 24 percentage points (Pincrease remained significant for seven out of eight kitchens. Furthermore......’, ‘menu planning’, ‘network’ and ‘Organic Cuisine Label method’ to ensure successful implementation. The study reports significant increases in the level of organic food procurement among public kitchens participating in the Danish Organic Action Plan 2020. Recommendations for future organic conversion...

Public support for government regulatory interventions for overweight and obesity in Australia.

Science.gov (United States)

Sainsbury, Emma; Hendy, Chelsea; Magnusson, Roger; Colagiuri, Stephen

2018-04-18

There is growing recognition among public health circles of the need for regulatory action for overweight and obesity, but there has been limited research into whether the Australian public supports government intervention. This study aimed to determine the level of public support for food-related regulations for obesity, and to assess the determinants of support. A nationally representative sample of Australian adults (n = 2011) was recruited by market research company Online Research Unit to complete an online survey. The survey measured respondents' perception of the obesity problem in Australia, and level of agreement on a 5-point Likert scale (strongly disagree to strongly agree) with proposed regulations in three domains; advertising, sponsorship of children's sport, and taxation. Binary logistic regression models were run to examine the association between demographic variables and support for regulation. The majority of respondents (92.5%) considered overweight and obesity to be a somewhat or very serious problem in Australia, and almost 90% felt there should be at least some government regulation to protect the public. Respondents agreed that the government should regulate food and beverage advertising (69.5%), with strongest support for restricting unhealthy food advertising to children (78.9%). There was lower support for prohibiting unhealthy food and beverage company sponsorship of children's sport (63.4% agreement), and for taxing sugar-sweetened beverages (54.5%), although the majority were still in favour. Support for fiscal policies slightly increased if revenue was to be used for health purposes. Females and tertiary educated respondents showed stronger agreement with proposed regulations (p < 0.05). The survey findings suggest the majority of the Australian population recognises obesity to be a serious health problem, and support government regulation of the food environment as a population-level preventative strategy.

Oxidation of tertiary homoallylic alcohols by thallium trinitrate: fragmentation versus ring contraction

International Nuclear Information System (INIS)

Silva Junior, Luiz F.; Quintiliano, Samir A.P.; Ferraz, Helena M.C.; Santos, Leonardo S.; Eberlin, Marcos N.

2006-01-01

The oxidation of tertiary homoallylic alcohols with thallium trinitrate (TTN) was investigated. The alcohols bearing an allylic methyl group lose a molecule of acetone via a fragmentation reaction that leads to isomeric secondary allylic alcohols as major products, together with their corresponding acetylated derivatives. On the other hand, treating analogous tertiary alcohols without the allylic methyl group with TTN gives indans, through a ring contraction reaction. (author)

Positive effects of tertiary centres for amyotrophic lateral sclerosis on outcome and use of hospital facilities.

Science.gov (United States)

Chiò, A; Bottacchi, E; Buffa, C; Mutani, R; Mora, G

2006-08-01

To evaluate the effects of tertiary centres for amyotrophic lateral sclerosis (ALS) on ALS outcome and the use of hospital facilities. The study was based on the data of an epidemiological, prospective, population-based register on ALS (Piemonte and Valle d'Aosta Register for amyotrophic lateral sclerosis, PARALS). The 221 patients recruited between 1995 and 1996 were prospectively followed up for outcome and use of hospital-based services. In all, 97 patients were followed up by tertiary ALS centres and 124 by general neurological clinics. Patients followed up by tertiary ALS centres were found to be 4 years younger and underwent percutaneous endoscopic gastronomy and non-invasive positive-pressure ventilation more often. Patients followed up by tertiary ALS centres were found to have a considerably longer median survival time (1080 v 775 days), even when stratifying by age, site of onset and respiratory function at diagnosis. In Cox multivariate analysis, attending a tertiary ALS centre was observed to be an independent positive prognostic factor. Moreover, patients attending a tertiary ALS centre were admitted to hospital less often (1.2 v 3.3) and were more frequently admitted for planned interventions. Conversely, patients followed up by general neurological clinics were more frequently admitted for acute events. Also, the hospital stay was considerably shorter for patients attending tertiary ALS centres (5.8 v 12.4 days). Improved survival was seen in patients with ALS attending tertiary ALS centres, independently from all other known prognostic factors, possibly through a better implementation of supportive treatments. Moreover, because of these centres, the hospitalisation rate was markedly reduced, thus offering a cost-effective service to patients with ALS and to the community as a whole.

New Zealand Summer of Code/Summer of Technology: an industry, student and tertiary engagement

OpenAIRE

Komisarczuk, Peter; Clegg, John; McDavitt, Ruth; Linton, Andy

2011-01-01

In 2006 the Wellington Summer of Code was brought to life engaging ICT undergraduates with innovative Wellington employers, it has developed into a thriving talent pipeline engaging all levels of tertiary students and industry in the Wellington region. Summer of Code engages students during term time through industry led learning and a summer seminar and workshop series that are open to all. It has worked with the NZCS to integrate the Evening with Industry where undergraduates see young IT p...

Drug utilization study from a government sponsored pharmacy in a tertiary care teaching hospital of rural West Bengal: A cross-sectional study

OpenAIRE

Tanmoy Gangopadhyay; Ananya Mandal; Sonai Mandal; Bishan Basu; Tamoghna Maiti; Abhijit Das; Soumitra Mandal; Sekhar Mandal

2016-01-01

Context: Newly started government sponsored pharmacies providing discounts have been available to the public at the medical college hospitals in West Bengal. Aims: The present study was undertaken to evaluate the drug prescribing trends from the prescriptions at such a pharmacy at a tertiary care hospital. Methods: The study was a prospective cross-sectional study that spanned for a period of 1-month from 1 to 31 August 2015. Prescriptions were reviewed and analyzed using the World Health Org...

Effect of public transport strikes on air pollution levels in Barcelona (Spain).

Science.gov (United States)

Basagaña, Xavier; Triguero-Mas, Margarita; Agis, David; Pérez, Noemí; Reche, Cristina; Alastuey, Andrés; Querol, Xavier

2018-01-01

Public transport strikes can lead to an increase of the number of private vehicle trips, which in turn can increase air pollution levels. We aimed to estimate the change in air pollution concentrations during public transport strikes in the city of Barcelona (Spain). Data on strikes of the metro, train or bus systems were collected from government records (2005-2016). We collected daily concentrations of NOx; particulate matter with an aerodynamic diameter smaller than 10μm (PM10), 2.5μm (PM2.5), and 1μm (PM1); particle number concentration (N); black carbon (BC) and CO from research and official monitoring stations. We fitted linear regression models for each pollutant with the strike indicator as an independent variable, and models were adjusted for day of the week, month, year, and holiday periods. During the study period, there were 208days affected by a strike of the metro (28), train (106) or bus (91) systems. Half of the strikes were partial, most of them were single-day strikes, there was little overlap between strikes of the different transport systems, and all strikes had to comply with mandatory minimal services. When pooling all types of strikes, NOx and BC showed higher levels during strike days in comparison with non-strike days (increase between 4.1% and 7.7%, with higher increases for NO). The increases in these concentrations were more evident during full day and multiday metro strikes. In conclusion, alterations in public transport have consequences on air quality. This highlights the importance of public transport in reducing air pollution concentrations in cities. Copyright © 2017 Elsevier B.V. All rights reserved.

Modelling the harmonized tertiary Institutions Salary Structure ...

African Journals Online (AJOL)

This paper analyses the Harmonized Tertiary Institution Salary Structure (HATISS IV) used in Nigeria. The irregularities in the structure are highlighted. A model that assumes a polynomial trend for the zero step salary, and exponential trend for the incremental rates, is suggested for the regularization of the structure.

Public relations work at a regional level

Energy Technology Data Exchange (ETDEWEB)

Kirchhoff, H.R.

1982-04-01

With 'Elektrizitaets-AG Mitteldeutschland (EAM)' (power corporation central Germany) - head office in Kassel and five works maintained in Kassel, Goettingen, Marburg, Dillenburg and Hanau - public relations work has a tradition. It is seen as conscious, planned and continued effort to build up the public understanding: Public relations work is intended to present the enterprise as a community with a multitude of technical, economic and social tasks, which can be carried out with optimal success only if supported by the confidence of society.

managing tertiary institutions for the promotion of lifelong learning

African Journals Online (AJOL)

Global Journal

KEYWORDS: Managing, tertiary institutions, promotion, lifelong learning. INTRODUCTION ... science, medicine and technology towards the ... different environments, whether formal, informal ... schools considering that each day gives birth to.

Tertiary paediatric emergency department use in children and young people with cerebral palsy.

Science.gov (United States)

Meehan, Elaine; Reid, Susan M; Williams, Katrina; Freed, Gary L; Babl, Franz E; Sewell, Jillian R; Rawicki, Barry; Reddihough, Dinah S

2015-10-01

The aim of this study was to describe the pattern of tertiary paediatric emergency department (ED) use in children and young people with cerebral palsy (CP). A retrospective analysis of ED data routinely collected at the two tertiary paediatric hospitals in Victoria, Australia, cross-matched with the Victorian Cerebral Palsy Register. Data pertaining to the ED presentations of 2183 registered individuals born 1993-2008 were obtained. Between 2008 and 2012, 37% (n = 814) of the CP cohort had 3631 tertiary paediatric ED presentations. Overall, 40% (n = 332) of presenters were residing in inner metropolitan Melbourne; 44% (n = 356) in outer Melbourne; and 13% (n = 108) in regional Victoria. Presenters were more likely than non-presenters to be younger, non-ambulant and have epilepsy. In total, 71% of presentations were triaged as Australasian Triage Scale 1-3 (urgent), and 44% resulted in a hospital admission. Disorders of the respiratory, neurological and gastrointestinal systems, and medical device problems were responsible for 72% of presentations. Many of the tertiary paediatric ED presentations in this group were appropriate based on the high admission rate and the large proportion triaged as urgent. However, there is evidence that some families are bypassing local services and travelling long distances to attend the tertiary paediatric ED, even for less urgent complaints that do not require hospital admission. Alternative pathways of care delivery, and strategies to promote the management of common problems experienced by children and young people with CP in non-paediatric EDs or primary care settings, may go some way towards reducing unnecessary tertiary paediatric ED use in this group. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Profile of catering staff at a tertiary care hospital in Mumbai.

Science.gov (United States)

Bobhate, Prateek S; R Shrivastava, Saurabh; Gupta, Pankaj

2011-01-01

Food borne illnesses, even today, continue to be a major public health problem in both developing and developed nations. Food handlers play an important role in ensuring food safety throughout the chain of production, processing, storage and preparation.Health of food handlers is of great importance for maintaining hygienic quality of food prepared and served by them. Thus, the present study was conducted to study socio-demographic characteristics, morbidity pattern and immunization status of catering staff at a tertiary care hospital in Mumbai A cross sectional study was conducted from August 2010 to November 2010. Out of the total of 162 food handlers working in 11 food service establishments, 137 were interviewed face to face using a semi-structured questionnaire, while remaining 25 food handlers were excluded because of either their absence or not giving consent. The food handlers were assessed clinically for personal hygiene and investigated for hemoglobin, stool routine and sputum AFB examination. 82 (59.8%) food handlers were from the age group 10 - 29 years, 113 (82.5%) male, 95 (69%) married, 59 (43.1%) educated up to primary level. Only 7 (5.1%) had ever received a dose of typhoid vaccine. 103 (75.2%) had an addiction, majority consuming gutkha 59 (57.3%). Dental caries 32 (23.4%) was the most common morbidity identified. Entamoeba histolytica was isolated in 13 (9.5%) subjects. This study has confirmed an association between educational status and personal hygiene suggesting the need for greater personal hygiene in this group. Preemployment and periodical medical examination should be encouraged.

Discovery of tertiary sulfonamides as potent liver X receptor antagonists.

Science.gov (United States)

Zuercher, William J; Buckholz, Richard G; Campobasso, Nino; Collins, Jon L; Galardi, Cristin M; Gampe, Robert T; Hyatt, Stephen M; Merrihew, Susan L; Moore, John T; Oplinger, Jeffrey A; Reid, Paul R; Spearing, Paul K; Stanley, Thomas B; Stewart, Eugene L; Willson, Timothy M

2010-04-22

Tertiary sulfonamides were identified in a HTS as dual liver X receptor (LXR, NR1H2, and NR1H3) ligands, and the binding affinity of the series was increased through iterative analogue synthesis. A ligand-bound cocrystal structure was determined which elucidated key interactions for high binding affinity. Further characterization of the tertiary sulfonamide series led to the identification of high affinity LXR antagonists. GSK2033 (17) is the first potent cell-active LXR antagonist described to date. 17 may be a useful chemical probe to explore the cell biology of this orphan nuclear receptor.

Water-quality characteristics of quaternary unconsolidated-deposit aquifers and lower tertiary aquifers of the Bighorn Basin, Wyoming and Montana, 1999-2001

Science.gov (United States)

Bartos, Timothy T.; Eddy-Miller, Cheryl A.; Norris, Jody R.; Gamper, Merry E.; Hallberg, Laura L.

2004-01-01

As part of the Yellowstone River Basin National Water Quality Assessment study, ground-water samples were collected from Quaternary unconsolidated-deposit and lower Tertiary aquifers in the Bighorn Basin of Wyoming and Montana from 1999 to 2001. Samples from 54 wells were analyzed for physical characteristics, major ions, trace elements, nutrients, dissolved organic carbon, radionuclides, pesticide compounds, and volatile organic compounds (VOCs) to evaluate current water-quality conditions in both aquifers. Water-quality samples indicated that waters generally were suitable for most uses, and that natural conditions, rather than the effects of human activities, were more likely to limit uses of the waters. Waters in both types of aquifers generally were highly mineralized, and total dissolved-solids concentrations frequently exceeded the U.S. Environmental Protection Agency (USEPA) Secondary Maximum Contaminant Level (SMCL) of 500 milligrams per liter (mg/L). Because of generally high mineralization, waters from nearly one-half of the samples from Quaternary aquifers and more than one-half of the samples from lower Tertiary aquifers were not classified as fresh (dissolved-solids concentration were not less than 1,000 mg/L). The anions sulfate, fluoride, and chloride were measured in some ground-water samples at concentrations greater than SMCLs. Most waters from the Quaternary aquifers were classified as very hard (hardness greater than 180 mg/L), but hardness varied much more in waters from the lower Tertiary aquifers and ranged from soft (less than 60 mg/L) to very hard (greater than 180 mg/L). Major-ion chemistry varied with dissolved-solids concentrations. In both types of aquifers, the predominant anion changes from bicarbonate to sulfate with increasing dissolved-solids concentrations. Samples from Quaternary aquifers with fresh waters generally were calcium-bicarbonate, calcium-sodium-bicarbonate, and calcium-sodium-sulfate-bicarbonate type waters, whereas

Tertiary work-up of apparent treatment-resistant hypertension.

Science.gov (United States)

Heimark, Sondre; Eskås, Per Anders; Mariampillai, Julian Eek; Larstorp, Anne Cecilie K; Høieggen, Aud; Fadl Elmula, Fadl Elmula M

2016-10-01

Treatment-resistant hypertension (TRH) has regained attention with development of new methods for treatment. However, the prevalence of TRH varies considerably from primary to secondary and tertiary care. We aimed to assess the prevalence of true TRH in a population of patients with apparent TRH in a university hospital setting of tertiary work-up and also investigate reasons for poor BP control and evaluate how work-up can be performed in general practice and secondary care. In this cohort study, we characterize a study population from Oslo Renal Denervation (RDN) Study. Patients (n = 83) were referred for RDN from secondary care. All patients underwent thorough medical investigation and 24-h ambulatory blood pressure measurements (24ABPM) after directly observed therapy (DOT). We then assessed reasons for lack of BP control. Fifty-three of 83 patients did not have true TRH. Main reasons for non-TRH were poor drug adherence (32%), secondary hypertension (30%) and white coat hypertension (15%). Forty-seven percent achieved blood pressure control after DOT with subsequent 24ABPM. There were otherwise no statistically significant differences in patient characteristics between the true TRH and the non-TRH group. Despite being a highly selected cohort referred for tertiary work-up of apparent TRH, BP control was achieved or secondary causes were identified in almost two thirds of the patients. Thorough investigation according to guidelines and DOT with subsequent 24ABPM is needed in work-up of apparent TRH.

Clinical Presentation and Outcomes among Children with Sepsis Presenting to a Public Tertiary Hospital in Tanzania

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Teresa Bleakly Kortz

2017-12-01

Full Text Available BackgroundPediatric sepsis causes significant global morbidity and mortality and low- and middle-income countries (LMICs bear the bulk of the burden. International sepsis guidelines may not be relevant in LMICs, especially in sub-Saharan Africa (SSA, due to resource constraints and population differences. There is a critical lack of pediatric sepsis data from SSA, without which accurate risk stratification tools and context-appropriate, evidence-based protocols cannot be developed. The study’s objectives were to characterize pediatric sepsis presentations, interventions, and outcomes in a public Emergency Medicine Department (EMD in Tanzania.MethodsProspective descriptive study of children (28 days to 14 years with sepsis [suspected infection with ≥2 clinical systemic inflammatory response syndrome (SIRS criteria] presenting to a tertiary EMD in Dar es Salaam, Tanzania (July 1 to September 30, 2016. Outcomes included: in-hospital mortality (primary, EMD mortality, and hospital length of stay. We report descriptive statistics using means and SDs, medians and interquartile ranges, and counts and percentages as appropriate. Predictive abilities of SIRS criteria, the Alert-Verbal-Painful-Unresponsive (AVPU score and the Lambaréné Organ Dysfunction Score (LODS for in-hospital, early and late mortality were tested.ResultsOf the 2,232 children screened, 433 (19.4% met inclusion criteria, and 405 were enrolled. There were 247 (61% subjects referred from an outside facility. Approximately half (54.1% received antibiotics in the EMD, and some form of microbiologic culture was collected in 35.8% (n = 145 of subjects. In-hospital and EMD mortality were 14.2 and 1.5%, respectively, median time to death was 3 days (IQR 1–6, and median length of stay was 6 days (IQR 1–12. SIRS criteria, the AVPU score, and the LODS had low positive (17–27.1, 33.3–43.9, 18.3–55.6%, respectively and high negative predictive values (88.6–89.8, 86.5�

Knowledge and perception of plastic surgery among tertiary ...

African Journals Online (AJOL)

2015-10-16

Oct 16, 2015 ... tertiary education students in Enugu, South‑East. Nigeria. CM Isiguzo ..... This finding should be a motivation for plastic surgeons who have private ... population of this country some of whom travel abroad to source for these ...

Drug adherence behavior among hypertensive out-patients at a tertiary health institution in Manicaland province, Zimbabwe, 2011

OpenAIRE

Mukora-Mutseyekwa, Fadzai NN; Chadambuka, Elizabeth M

2013-01-01

Fadzai NN Mukora-Mutseyekwa, Elizabeth M ChadambukaFaculty of Health Sciences, Africa University, Mutare, ZimbabweObjectives: This study investigated the level of drug adherence among hypertensive outpatients at a tertiary hospital in Zimbabwe. Specific objectives included measurement of blood pressure (BP) control achievement, estimating prevalence of drug adherence behavior, and establishing the association between drug adherence behavior and achievement of BP control.Methods and materials:...

Analysis of haloforms in wastewater. Removal of haloforms during secondary and tertiary treatment and formation during disinfection

Energy Technology Data Exchange (ETDEWEB)

de Leer, E W.B.

1980-01-01

The removal of haloforms during secondary and tertiary treatment and formation during disinfection was determined with a pentane extraction method followed by gas chromatographic separation with quantification by electron capture detection, which showed good results. High chloroform and trichloroethane levels in domestic sewage were reduced in activated-sludge tanks to 0 to 2 ..mu..g/l, one order of magnitude lower than Rotterdam drinking water.

Phenotypic and genotypic characteristics of carbapenem-resistant Enterobacteriaceae in a tertiary-level reference hospital in Turkey.

Science.gov (United States)

Baran, Irmak; Aksu, Neriman

2016-04-06

Enterobacteriaceae are among the most common pathogens that are responsible for serious community-acquired, hospital-acquired, and health-care associated infections. The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) have become an increasing concern for healthcare services worldwide. Infections caused by these bacteria have been associated with significant morbidity and mortality and treatment options have been limited. The rapid and accurate detection of carbapenem resistance in these bacteria is important for infection control. The aim of this study was to investigate the phenotypic and genotypic features of CRE strains isolated in a tertiary-level reference hospital in Turkey. A total of 181 CRE strains were included in the study. Antimicrobial susceptibility rates were tested using Vitek 2 system. Modified Hodge test (MHT) was performed using meropenem and ertapenem discs. Metallo-β-lactamase antimicrobial gradient test (E-test MBL strips) were used for evaluation of metallo-β-lactamase production. A multiplex PCR was used for detection of carbapenems resistance genes (IMP, VIM, KPC, NDM-1 and OXA-48). The OXA-48 gene was detected in 86 strains, NDM-1 gene in six strains, VIM gene in one strain. IMP and KPC genes were not identified. Three strains produced both OXA-48 and NDM-1 and one strain produced both OXA-48 and VIM. In two patients more than one genus of OXA-48 positive CREs was isolated. Ninety-two of the isolates were multidrug-resistant. One hundred and ten isolates were MHT with meropenem (MEM-MHT) positive and 109 isolates were MHT with ertapenem (ERT-MHT) positive. Nine of the isolates were positive with E-test MBL strips. The sensitivity of MEM-MHT and ERT-MHT for detection of OXA-48 was 70.9 and 70.6 %, respectively. MEM-MHT was found highly discriminative for OXA-48 Escherichia coli (p Enterobacteriaceae in the hospital environment. While OXA-48 is still the most common source of carbapenem resistance in

Peracetic acid (PAA) disinfection of primary, secondary and tertiary treated municipal wastewaters.

Science.gov (United States)

Koivunen, J; Heinonen-Tanski, H

2005-11-01

The efficiency of peracetic acid (PAA) disinfection against enteric bacteria and viruses in municipal wastewaters was studied in pilot-scale. Disinfection pilot-plant was fed with the primary or secondary effluent of Kuopio municipal wastewater treatment plant or tertiary effluent from the pilot-scale dissolved air flotation (DAF) unit. Disinfectant doses ranged from 2 to 7 mg/l PAA in the secondary and tertiary effluents, and from 5 to 15 mg/l PAA in the primary effluents. Disinfection contact times were 4-27 min. Disinfection of secondary and tertiary effluents with 2-7 mg/l PAA and 27 min contact time achieved around 3 log reductions of total coliforms (TC) and enterococci (EC). PAA disinfection also significantly improved the hygienic quality of the primary effluents: 10-15 mg/l PAA achieved 3-4 log reductions of TC and EC, 5 mg/l PAA resulting in below 2 log reductions. F-RNA coliphages were more resistant against the PAA disinfection and around 1 log reductions of these enteric viruses were typically achieved in the disinfection treatments of the primary, secondary and tertiary effluents. Most of the microbial reductions occurred during the first 4-18 min of contact time, depending on the PAA dose and microorganism. The PAA disinfection efficiency remained relatively constant in the secondary and tertiary effluents, despite of small changes of wastewater quality (COD, SS, turbidity, 253.7 nm transmittance) or temperature. The disinfection efficiency clearly decreased in the primary effluents with substantially higher microbial, organic matter and suspended solids concentrations. The results demonstrated that PAA could be a good alternative disinfection method for elimination of enteric microbes from different wastewaters.

Binge drinking among young adults in an urban tertiary care emergency department in Israel.

Science.gov (United States)

Levinson, Daphna; Rosca, Paola; Vilner, Doron; Brimberg, Idit; Stall, Yael; Rimon, Ayelet

2017-07-01

Alcohol use is a major preventable public health problem with serious health and social consequences especially among youth. In Israel, alcohol use has become an emerging problem during the last decade, and its use has increased among adolescents and young adults. Binge drinking is the common pattern of alcohol consumption among young adults who drink for recreational purposes. The present survey was conducted among 16-35 years old visitors to the ED. The aim was specifically to identify binge drinkers in order to assess the scope of the need for a brief counseling intervention among young people who arrive intoxicated to a large tertiary care urban ED in Israel. The survey was conducted throughout a 1 week period (24 h per day) at the general EDs in a large, tertiary care center, situated in Tel Aviv. During the survey week, 946 individuals, aged 16-35, visited the ED and 573 (63%) of them were approached for an interview. 89% of those approached agreed to be interviewed. Consenting patients [N = 348] were asked whether they drink any alcohol, how often they drink and how much. About one fifth of those interviewed were in the habit of consuming more than four units of alcohol per occasion. Drinking several times a week or every day was reported by 19% of the males and 26% of the females. Frequency of the drinking episodes was highly correlated with the number of units of drink per occasion. The study found a very high rate of binge drinking among ED visitors, and this suggests a need for large scale ED-based interventions. As binge drinkers are at elevated risk for accidents, violence and related problems, effective ED-based interventions could make an important contribution to public health. Accordingly, Israel is in the process of assessing the effectiveness of a large-scale ED-based counseling intervention. Trial registration number 0230-13-TLV.

The development of hospitalbased palliative care services in public hospitals in the Western Cape South Africa

Directory of Open Access Journals (Sweden)

L Gwyther

2018-02-01

Full Text Available With the recent approval of a South African (SA National Policy Framework and Strategy for Palliative Care by the National Health Council, it is pertinent to reflect on initiatives to develop palliative care services in public hospitals. This article reviews the development of hospital-based palliative care services in the Western Cape, SA. Palliative care services in SA started in the non-governmental sector in the 1980s. The first SA hospital-based palliative care team was established in Charlotte Maxeke Johannesburg Academic Hospital in 2001. The awareness of the benefit of palliative care in the hospital setting led to the development of isolated pockets of excellence providing palliative care in the public health sector in SA. This article describes models for palliative care at tertiary, provincial and district hospital level, which could inform development of hospital-based palliative care as the national policy for palliative care is implemented in SA.

Forensic analysis of tertiary-butyl alcohol (TBA) detections in a hydrocarbon-rich groundwater basin.

Science.gov (United States)

Quast, Konrad W; Levine, Audrey D; Kester, Janet E; Fordham, Carolyn L

2016-04-01

Tertiary-butyl alcohol (TBA), a high-production volume (HPV) chemical, was sporadically detected in groundwater and coalbed methane (CBM) wells in southeastern Colorado's hydrocarbon-rich Raton Basin. TBA concentrations in shallow water wells averaged 75.1 μg/L, while detections in deeper CBM wells averaged 14.4 μg/L. The detection of TBA prompted a forensic investigation to try to identify potential sources. Historic and recent data were reviewed to determine if there was a discernable pattern of TBA occurrence. Supplemental samples from domestic water wells, monitor wells, CBM wells, surface waters, and hydraulic fracturing (HF) fluids were analyzed for TBA in conjunction with methyl tertiary-butyl ether (MTBE) and ethyl tertiary-butyl ether (ETBE), proxies for evidence of contamination from reformulated gasoline or associated oxygenates. Exploratory microbiological sampling was conducted to determine if methanotrophic organisms co-occurred with TBA in individual wells. Meaningful comparisons of historic TBA data were limited due to widely varying reporting limits. Mapping of TBA occurrence did not reveal any spatial patterns or physical associations with CBM operations or contamination plumes. Additionally, TBA was not detected in HF fluids or surface water samples. Given the widespread use of TBA in industrial and consumer products, including water well completion materials, it is likely that multiple diffuse sources exist. Exploratory data on stable isotopes, dissolved gases, and microbial profiling provide preliminary evidence that methanotrophic activity may be producing TBA from naturally occurring isobutane. Reported TBA concentrations were significantly below a conservative risk-based drinking water screening level of 8000 μg/L derived from animal toxicity data.

Ascertainment bias in dementias: a secondary to tertiary centre analysis in Central Italy and conceptual review.

Science.gov (United States)

Bonanni, L; Bontempo, G; Borrelli, I; Bifolchetti, S; Buongarzone, M P; Carlesi, N; Carolei, A; Ciccocioppo, F; Colangelo, U; Colonna, G; Desiderio, M; Ferretti, S; Fiorelli, L; D'Alessio, O; D'Amico, A; D'Amico, M C; De Lucia, R; Del Re, L; Di Blasio, F; Di Giacomo, R; Di Iorio, A; Di Santo, E; Di Giuseppe, M; Felice, N; Litterio, P; Gabriele, A; Mancino, E; Manzoli, L; Maruotti, V; Mearelli, S; Molino, G; Monaco, D; Nuccetelli, F; Onofrj, M; Perfetti, B; Sacchet, C; Sensi, F; Sensi, S; Sucapane, P; Taylor, J P; Thomas, A; Viola, P; Viola, S; Zito, M; Zhuzhuni, H

2013-06-01

Ascertainment bias (AB) indicates a bias of an evaluation centre in estimating the prevalence/incidence of a disease due to the specific expertise of the centre. The aim of our study was to evaluate classification of different types of dementia in new cases appearing in secondary and tertiary centres, in order to evidence possible occurrence of AB in the various (secondary to tertiary) dementia centres. To assess the mechanism of AB, the rates of new cases of the different forms of dementia reported by different centres were compared. The centres involved in the study were 11 hospital-based centres including a tertiary centre, located in the University Department of Clinical Neurology. The tertiary centre is endowed with state-of-the-art diagnostic facilities and its scientific production is prominently focused on dementia with Lewy bodies (DLB) thus suggesting the possible occurrence of a bias. Four main categories of dementia were identified: Alzheimer's disease (AD), DLB, fronto-temporal dementia (FTD), vascular dementia (VaD), with other forms in a category apart. The classification rate of new cases of dementia in the tertiary centre was compared with rates reported by secondary centres and rates of recoding were calculated during a follow-up of 2 years. The study classified 2,042 newly diagnosed cases of dementia in a population of 1,370,000 inhabitants of which 315,000 were older than 65. AD was categorized in 48-52 % of cases, DLB in 25-28 %, FTD in 2-4 % and VaD in 17-28 %. During the 2-year follow-up the diagnosis was re-classified in 40 patients (3 %). The rate of recoding was 5 % in the tertiary centre, 2-8 % in referrals from secondary to tertiary centre, 2-10 % in recodings performed in secondary centres and addressed to tertiary centre. Recoding or percentages of new cases of AD or DLB were not different in the comparison between secondary or between secondary and tertiary centres. FTD and VaD were instead significantly recoded. The results

Descriptive Analysis on the Impacts of Universal Zero-Markup Drug Policy on a Chinese Urban Tertiary Hospital.

Directory of Open Access Journals (Sweden)

Wei Tian

Full Text Available Universal Zero-Markup Drug Policy (UZMDP mandates no price mark-ups on any drug dispensed by a healthcare institution, and covers the medicines not included in the China's National Essential Medicine System. Five tertiary hospitals in Beijing, China implemented UZMDP in 2012. Its impacts on these hospitals are unknown. We described the effects of UZMDP on a participating hospital, Jishuitan Hospital, Beijing, China (JST.This retrospective longitudinal study examined the hospital-level data of JST and city-level data of tertiary hospitals of Beijing, China (BJT 2009-2015. Rank-sum tests and join-point regression analyses were used to assess absolute changes and differences in trends, respectively.In absolute terms, after the UZDMP implementation, there were increased annual patient-visits and decreased ratios of medicine-to-healthcare-charges (RMOH in JST outpatient and inpatient services; however, in outpatient service, physician work-days decreased and physician-workload and inflation-adjusted per-visit healthcare charges increased, while the inpatient physician work-days increased and inpatient mortality-rate reduced. Interestingly, the decreasing trend in inpatient mortality-rate was neutralized after UZDMP implementation. Compared with BJT and under influence of UZDMP, JST outpatient and inpatient services both had increasing trends in annual patient-visits (annual percentage changes[APC] = 8.1% and 6.5%, respectively and decreasing trends in RMOH (APC = -4.3% and -5.4%, respectively, while JST outpatient services had increasing trend in inflation-adjusted per-visit healthcare charges (APC = 3.4% and JST inpatient service had decreasing trend in inflation-adjusted per-visit medicine-charges (APC = -5.2%.Implementation of UZMDP seems to increase annual patient-visits, reduce RMOH and have different impacts on outpatient and inpatient services in a Chinese urban tertiary hospital.

Descriptive Analysis on the Impacts of Universal Zero-Markup Drug Policy on a Chinese Urban Tertiary Hospital.

Science.gov (United States)

Tian, Wei; Yuan, Jiangfan; Yang, Dong; Zhang, Lanjing

2016-01-01

Universal Zero-Markup Drug Policy (UZMDP) mandates no price mark-ups on any drug dispensed by a healthcare institution, and covers the medicines not included in the China's National Essential Medicine System. Five tertiary hospitals in Beijing, China implemented UZMDP in 2012. Its impacts on these hospitals are unknown. We described the effects of UZMDP on a participating hospital, Jishuitan Hospital, Beijing, China (JST). This retrospective longitudinal study examined the hospital-level data of JST and city-level data of tertiary hospitals of Beijing, China (BJT) 2009-2015. Rank-sum tests and join-point regression analyses were used to assess absolute changes and differences in trends, respectively. In absolute terms, after the UZDMP implementation, there were increased annual patient-visits and decreased ratios of medicine-to-healthcare-charges (RMOH) in JST outpatient and inpatient services; however, in outpatient service, physician work-days decreased and physician-workload and inflation-adjusted per-visit healthcare charges increased, while the inpatient physician work-days increased and inpatient mortality-rate reduced. Interestingly, the decreasing trend in inpatient mortality-rate was neutralized after UZDMP implementation. Compared with BJT and under influence of UZDMP, JST outpatient and inpatient services both had increasing trends in annual patient-visits (annual percentage changes[APC] = 8.1% and 6.5%, respectively) and decreasing trends in RMOH (APC = -4.3% and -5.4%, respectively), while JST outpatient services had increasing trend in inflation-adjusted per-visit healthcare charges (APC = 3.4%) and JST inpatient service had decreasing trend in inflation-adjusted per-visit medicine-charges (APC = -5.2%). Implementation of UZMDP seems to increase annual patient-visits, reduce RMOH and have different impacts on outpatient and inpatient services in a Chinese urban tertiary hospital.

Student Expectations of Tertiary Institutions: A Case Study of the Fiji National University (FNU)

Science.gov (United States)

Khan, Shana Nigar

2012-01-01

Education is a human right and Fiji's tertiary education board recently declared that all tertiary institutions in Fiji must abide by the framework in order to meet student-customers' needs. The Fiji National University's (FNU's) destiny to be Fiji's leading higher education provider could be a reality if students and staff's expectations are…

Disease patterns and clinical outcomes of patients admitted in intensive care units of tertiary referral hospitals of Tanzania.

Science.gov (United States)

Sawe, Hendry R; Mfinanga, Juma A; Lidenge, Salum J; Mpondo, Boniventura C T; Msangi, Silas; Lugazia, Edwin; Mwafongo, Victor; Runyon, Michael S; Reynolds, Teri A

2014-09-23

In sub-Saharan Africa the availability of intensive care unit (ICU) services is limited by a variety of factors, including lack of financial resources, lack of available technology and well-trained staff. Tanzania has four main referral hospitals, located in zones so as to serve as tertiary level referral centers. All the referral hospitals have some ICU services, operating at varying levels of equipment and qualified staff. We analyzed and describe the disease patterns and clinical outcomes of patients admitted in ICUs of the tertiary referral hospitals of Tanzania. This was a retrospective analysis of ICU patient records, for three years (2009 to 2011) from all tertiary referral hospitals of Tanzania, namely Muhimbili National Hospital (MNH), Kilimanjaro Christian Medical Centre (KCMC), Mbeya Referral Hospital (MRH) and Bugando Medical Centre (BMC). MNH is the largest of the four referral hospitals with 1300 beds, and MRH is the smallest with 480 beds. The ratio of hospital beds to ICU beds is 217:1 at MNH, 54:1 at BMC, 39:1 at KCMC, and 80:1 at MRH. KCMC had no infusion pumps. None of the ICUs had a point-of-care (POC) arterial blood gas (ABG) analyzer. None of the ICUs had an Intensive Care specialist or a nutritionist. A masters-trained critical care nurse was available only at MNH. From 2009-2011, the total number of patients admitted to the four ICUs was 5627, male to female ratio 1.4:1, median age of 34 years. Overall, Trauma (22.2%) was the main disease category followed by infectious disease (19.7%). Intracranial injury (12.5%) was the leading diagnosis in all age groups, while pneumonia (11.7%) was the leading diagnosis in pediatric patients (<18 years). Patients with tetanus (2.4%) had the longest median length ICU stay: 8 (5,13) days. The overall in-ICU mortality rate was 41.4%. The ICUs in tertiary referral hospitals of Tanzania are severely limited in infrastructure, personnel, and resources, making it difficult or impossible to provide optimum care

A study of structure–activity relationships of commercial tertiary amines for post-combustion CO_2 capture

International Nuclear Information System (INIS)

Xiao, Min; Liu, Helei; Idem, Raphael; Tontiwachwuthikul, Paitoon; Liang, Zhiwu

2016-01-01

Highlights: • Ethyl group is beneficial for tertiary amines of CO_2 absorption. • The existence of side carbon chain may promote the activity of tertiary amine. • Hydroxyl group reduces the equilibrium CO_2 solubility, k_2 and pKa. • Heterocyclic structure decrease the equilibrium CO_2 solubility, k_2 and pKa. • Hydroxyl group results in higher CO_2 absorption heat. - Abstract: This work examined the relationship between the structure of various commercial tertiary amines and their activity in CO_2 absorption/desorption in terms of rate of CO_2 absorption, equilibrium CO_2 loading, pKa and heat of CO_2 absorption in order to establish possible guidelines for selection of tertiary amine components for amine blends. Results show that any electron donating group linked directly to the nitrogen atom increases their reactivity with CO_2. In addition, the presence of steric hindrance effect and good water solubility also show enhancements in activity. In contrast, the existence of a hydroxyl group leads to a decrease in all the activity of the tertiary amine. The heat of CO_2 absorption of tertiary amines, which is closely related to the regeneration energy, can be reduced by decreasing the number of hydroxyethyl groups or by positing the hydroxyl group at the proper carbon relative to the nitrogen atom.

Clinical unity and community empowerment: the use of smartphone technology to empower community management of chronic venous ulcers through the support of a tertiary unit.

Directory of Open Access Journals (Sweden)

Edel Marie Quinn

Full Text Available BACKGROUND: Chronic ulcers affect roughly 60,000 Irish people, at a total cost of €600,000,000, or €10,000 per patient annually. By virtue of their chronicity, these ulcers also contribute a significant burden to tertiary outpatient vascular clinics. OBJECTIVE: We propose utilizing mobile phone technology to decentralise care from tertiary centres to the community, improving efficiency and patient satisfaction, while maintaining patient safety. METHODS: Bespoke mobile software was developed for Apples iPhone 4 platform. This allowed for the remote collection of patient images prospectively and their transmission with clinical queries, from the primary healthcare team to the tertiary centre. Training and iPhones were provided to five public health nurses in geographically remote areas of the region. Data were uploaded securely and user end software was developed allowing the review and manipulation of images, along with two way communication between the teams. Establishing reliability, patients were reviewed clinically as well as remotely, and concordance analysed. Qualitative data were collected through focus group discussion. RESULTS: From October to December 2011 eight patients (61-83 yrs, mean 75.3 yrs with chronic venous ulceration and their five public health nurses were recruited. Data were transmitted using 3 G, Edge, GPRS and WiFi, at a mean speed of 69.03 kps. Concordance was 100% for wound bed assessment, 80% for skin integrity/colour and 60% for exudate assessment. Focus group analysis explored the concept, practicalities and future applications of the system. CONCLUSIONS: With an evolving national data network, the secure transmission of clinical images is a safe alternative to regular clinic appointments for patients with chronic venous ulceration. With further development, and packaged as a freely downloadable application, this has the potential to support the community care of chronic wounds.

Clinical unity and community empowerment: the use of smartphone technology to empower community management of chronic venous ulcers through the support of a tertiary unit.

Science.gov (United States)

Quinn, Edel Marie; Corrigan, Mark A; O'Mullane, John; Murphy, David; Lehane, Elaine A; Leahy-Warren, Patricia; Coffey, Alice; McCluskey, Patricia; Redmond, Henry Paul; Fulton, Greg J

2013-01-01

Chronic ulcers affect roughly 60,000 Irish people, at a total cost of €600,000,000, or €10,000 per patient annually. By virtue of their chronicity, these ulcers also contribute a significant burden to tertiary outpatient vascular clinics. We propose utilizing mobile phone technology to decentralise care from tertiary centres to the community, improving efficiency and patient satisfaction, while maintaining patient safety. Bespoke mobile software was developed for Apples iPhone 4 platform. This allowed for the remote collection of patient images prospectively and their transmission with clinical queries, from the primary healthcare team to the tertiary centre. Training and iPhones were provided to five public health nurses in geographically remote areas of the region. Data were uploaded securely and user end software was developed allowing the review and manipulation of images, along with two way communication between the teams. Establishing reliability, patients were reviewed clinically as well as remotely, and concordance analysed. Qualitative data were collected through focus group discussion. From October to December 2011 eight patients (61-83 yrs, mean 75.3 yrs) with chronic venous ulceration and their five public health nurses were recruited. Data were transmitted using 3 G, Edge, GPRS and WiFi, at a mean speed of 69.03 kps. Concordance was 100% for wound bed assessment, 80% for skin integrity/colour and 60% for exudate assessment. Focus group analysis explored the concept, practicalities and future applications of the system. With an evolving national data network, the secure transmission of clinical images is a safe alternative to regular clinic appointments for patients with chronic venous ulceration. With further development, and packaged as a freely downloadable application, this has the potential to support the community care of chronic wounds.

REE in some tertiary volcanic complexes in the Republic of Macedonia

International Nuclear Information System (INIS)

Tasev, Goran; Serafimovski, Todor

2009-01-01

Petrological and geochemical features of the Tertiary magmatic rocks from the Republic of Macedonia were subject of study in this paper. The latest K-Ar, 87 Sr/ 86 Sr, and REE data for samples from Kratovo- Zletovo, Sasa-Toranica and Damjan-Buchim ore districts are presented. Whole rock XRF analyses confirmed host rock composition as dacites, quartz-latites, trachyandesites, rhyolites and rhyodacites. Absolute age determinations by the K-Ar dating method have shown ages range from 31 to 14 Ma confirming Oligocene-Miocene age as previously determined by relative methods. Determinations of 87 Sr/ 86 Sr ratios (0.70504 to 0.71126) suggest material is sourced from the contact zone between the lower crust and upper mantle where contamination of primary melt occurred. New REE data including negative Eu anomalies along with previously determined La/Yb ratios ranging from 13.3 to 43.0 (Serafimovski 1990) confirm inferred material source. These new data reconfirm previous results, provide insight into the Tertiary magmatic history of the district, and suggest the exact origin of the material that produced the Tertiary magmatic rocks.

Siting a low-level radioactive waste incinerator in North Carolina: the impacts of public opposition

International Nuclear Information System (INIS)

Miller, E.M.

1987-01-01

Establishing low-level radioactive waste (LLRW) facilities has become increasingly difficult due to public opposition to siting proposals. Widespread opposition to siting new waste management facilities of all types has focused sharp attention on the technical, political, and socioeconomic problems associated with siting controversial, but necessary facilities. This paper reviews a recent private sector initiative to site a LLRW incinerator in Bladen County, NC. Public reactions to the proposed facility are documents, as well as reasons for public opposition to the facility. The impacts of public opposition on the siting process, regulatory agencies, the media, industry, the general public, and elected officials are examined. The paper points out how public opposition to proposed waste management facilities may have both positive and negative impacts on the long-term management of LLRW. In doing so, the paper addresses policy questions, processes, and perceptions that will shape the debate over the development and location of new treatment and disposal facilities for managing LLRW. 14 references

The consumption of electric power on the tertiary sector - an instrument for economical and social analysis and market studies

International Nuclear Information System (INIS)

Villela, L.E.

1991-04-01

The main subjective of this thesis is to analyse the effects of the growth of the tertiary sector on the electric power demand. In order to accomplish this goal an economical and social, analysis of the tertiary sector is made to identify its dynamic, its relations with the other sectors of the economy and to describe the methodologies for measuring the overall tertiary production. Afterwards it is made an analysis of the electric power consumption evolution in the tertiary sector, in order to identify the consumption per region of the country, per consumers and tertiary subsectors. It is also analysed the product power intensify and, finally its described the present tariff system. (author)

Characteristics of patients presenting to the vascular emergency department of a tertiary care hospital: a 2-year study

Directory of Open Access Journals (Sweden)

Kotsikoris Ioannis

2011-11-01

Full Text Available Abstract Background The structure of health care in Greece is receiving increased attention to improve its cost-effectiveness. We sought to examine the epidemiological characteristics of patients presenting to the vascular emergency department of a Greek tertiary care hospital during a 2-year period. We studied all patients presenting to the emergency department of vascular surgery at Red Cross Hospital, Athens, Greece between 1st January 2009 and 31st December 2010. Results Overall, 2452 (49.4% out of 4961 patients suffered from pathologies that should have been treated in primary health care. Only 2509 (50.6% needed vascular surgical intervention. Conclusions The emergency department of vascular surgery in a Greek tertiary care hospital has to treat a remarkably high percentage of patients suitable for the primary health care level. These results suggest that an improvement in the structure of health care is needed in Greece.

41 CFR 102-79.65 - May Executive agencies outlease space on major public access levels, courtyards and rooftops of...

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false May Executive agencies outlease space on major public access levels, courtyards and rooftops of public buildings? 102-79.65... Utilization of Space Outleasing § 102-79.65 May Executive agencies outlease space on major public access...

Patient satisfaction with care in an urban tertiary referral academic glaucoma clinic in the US

Directory of Open Access Journals (Sweden)

Peterson KM

2018-05-01

Full Text Available Kristen M Peterson, Carrie E Huisingh, Christopher Girkin, Cynthia Owsley, Lindsay A Rhodes Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA Background: The purpose of this study was to determine the factors associated with glaucoma patients’ satisfaction with their medical care by fellowship-trained glaucoma specialists in an urban tertiary referral clinic in the US.Methods: A total of 110 established patients aged ≥60 years with a diagnosis of either primary open angle glaucoma, glaucoma suspect, or ocular hypertension monitored by an ophthalmologist with fellowship training in glaucoma were enrolled at an academic, urban, tertiary referral eye clinic. Enrolled patients were administered a general demographics questionnaire along with a Patient Satisfaction Questionnaire-18 (PSQ-18, a Likert scale validated tool. The seven dimensions of patient satisfaction from the PSQ-18 were summarized for the sample overall and by the patients’ age, race, employment status, education level, distance travelled from home address to clinic, and glaucoma therapy type. Two-sample t-tests were used to compare group means. Spearman correlation coefficients were used to correlate satisfaction scores with peripheral vision and visual acuity function.Results: Overall, the general satisfaction scores were high (mean 4.62. Patients ≥70 years of age had lower general satisfaction with their care (mean 4.5 vs 4.8, p=0.03, the interpersonal manner of their appointment (mean 4.7 vs 4.9, p=0.009, and with their time spent with their doctor (mean 4.4 vs 4.7, p=0.03 than patients aged 60–69 years. Non-European descent patients (47% African descent and 1% other of sample were more satisfied with the time they spent with the doctor (mean 4.7 vs 4.4, p=0.04 and with the communication during the appointment (mean 4.8 vs 4.6, p=0.04 than European descent patients (52% of sample. Patients with a higher level of

Most Common Publication Types in Radiology Journals:: What is the Level of Evidence?

Science.gov (United States)

Rosenkrantz, Andrew B; Pinnamaneni, Niveditha; Babb, James S; Doshi, Ankur M

2016-05-01

This study aimed to assess the most common publication types in radiology journals, as well as temporal trends and association with citation frequency. PubMed was searched to extract all published articles having the following "Publication Type" indices: "validation studies," "meta-analysis," "clinical trial," "comparative study," "evaluation study," "guideline," "multicenter study," "randomized study," "review," "editorial," "case report," and "technical report." The percentage of articles within each category published within clinical radiology journals was computed. Normalized percentages for each category were also computed on an annual basis. Citation counts within a 2-year window following publication were obtained using Web of Science. Overall trends were assessed. Publication types with the highest fraction in radiology journals were technical reports, evaluation studies, and case reports (4.8% to 5.8%). Publication types with the lowest fraction in radiology journals were randomized trials, multicenter studies, and meta-analyses (0.8% to 1.5%). Case reports showed a significant decrease since 1999, with accelerating decline since 2007 (P = 0.002). Publication types with highest citation counts were meta-analyses, guidelines, and multicenter studies (8.1 ± 10.7 to 12.9 ± 5.1). Publication types with lowest citation counts were case reports, editorials, and technical reports (1.4 ± 2.4 to 2.9 ± 4.3). The representation in radiology journals and citation frequency of the publication types showed weak inverse correlation (r = -0.372). Radiology journals have historically had relatively greater representation of less frequently cited publication types. Various strategies, including methodological training, multidisciplinary collaboration, national support networks, as well as encouragement of higher level of evidence by funding agencies and radiology journals themselves, are warranted to improve the impact of radiological research

Factors affecting public prejudice and social distance on mental illness: analysis of contextual effect by multi-level analysis.

Science.gov (United States)

Jang, Hyeongap; Lim, Jun-Tae; Oh, Juhwan; Lee, Seon-Young; Kim, Yong-Ik; Lee, Jin-Seok

2012-03-01

While there have been many quantitative studies on the public's attitude towards mental illnesses, it is hard to find quantitative study which focused on the contextual effect on the public's attitude. The purpose of this study was to identify factors that affect the public's beliefs and attitudes including contextual effects. We analyzed survey on the public's beliefs and attitudes towards mental illness in Korea with multi-level analysis. We analyzed the public's beliefs and attitudes in terms of prejudice as an intermediate outcome and social distance as a final outcome. Then, we focused on the associations of factors, which were individual and regional socio-economic factors, familiarity, and knowledge based on the comparison of the intermediate and final outcomes. Prejudice was not explained by regional variables but was only correlated with individual factors. Prejudice increased with age and decreased by high education level. However, social distance controlling for prejudice increased in females, in people with a high education level, and in regions with a high education level and a high proportion of the old. Therefore, social distance without controlling for prejudice increased in females, in the elderly, in highly educated people, and in regions with a high education and aged community. The result of the multi-level analysis for the regional variables suggests that social distance for mental illness are not only determined by individual factors but also influenced by the surroundings so that it could be tackled sufficiently with appropriate considering of the relevant regional context with individual characteristics.

Early Tertiary magmatism and probable Mesozoic fabrics in the Black Mountains, Death Valley, California

Science.gov (United States)

Miller, Martin G.; Friedman, Richard M.

1999-01-01

We report two early Tertiary U-Pb zircon ages for pegmatite from the Black Mountains of Death Valley, California. These ages, 54.7 ± 0.6 Ma and 56 ± 3 Ma, are unique for much of southeastern California. The samples belong to a pegmatite suite that occupies part of the footwall of the Badwater turtleback, a late Tertiary extensional feature; similar but undated pegmatite intrudes the footwalls of the Copper Canyon and Mormon Point turtlebacks farther south. The pegmatite suite demonstrates that fabric development on the turtlebacks was at least a two-stage process. Fabrics cut by these pegmatites likely formed during the Mesozoic, whereas those that involve them formed during late Tertiary extension.

Barriers and Facilitators to Career Advancement by Top-Level, Entry-Level and Non-Administrative Women in Public School Districts: A Mixed Methods Study

Science.gov (United States)

Ahmed, Eman Ibrahim El-Desouki

2011-01-01

The purpose of this study was to investigate the barriers and facilitators to career advancement among women administrators occupying top-level positions, those occupying entry-level positions and those in non-administrative positions in both rural and urban public school districts in central Pennsylvania. The need to increase the awareness of the…

Montane pollen from the Tertiary of NW. Borneo

NARCIS (Netherlands)

Muller, J.

1966-01-01

In NW. Borneo thick series of Tertiary sediments occur which are rich in fossil pollen and spores. The majority of these plant microfossils were derived from the various types of tropical lowland vegetation such as mangrove (Muller, 1964), mixed peat swamp forest and mixed Dipterocarp forest. Some

Mainstreaming Climate Change Into Geosciences Curriculum of Tertiary Educational Systems in Ghana

Science.gov (United States)

Nyarko, B. K.

2015-12-01

The impact of Climate Change has a far-reaching implication for economies and people living in the fragile Regions of Africa analysts project that by 2020, between 75 million and 250 million people will be exposed various forms of Climate Change Stresses. Education as a key strategy identified under Agenda 21 has been incorporated into the efforts of various educational institutions as a means of mitigating climate change and enhancing sustainability. Climate Change education offers many opportunities and benefits for educators, researchers, learners, and for wider society, but there are also many challenges, which can hinder the successful mainstreaming of climate change education. The study aims at understanding barriers for Climate Change Education in selected tertiary institutions in Ghana. The study was conducted among Geoscience Departments of the 7 main public universities of Ghana and also juxtapose with the WASCAL graduate school curriculum. The transcript analysis identified issues that hinders the mainstreaming of Climate Change, these includes existing levels of knowledge and understanding of the concept of climate change, appreciating the threshold concepts, ineffective teaching of Climate Change and some Departments are slow in embracing Climate Change as a discipline. Hence to develop strategies to mainstream climate change education it is important to recognize that increasing the efficiency and delivery of Climate Change education requires greater attention and coordination of activities and updating the educators knowledge and skill's. Institutions and Educator should be encouraged to undertake co-curricula activities and finding ways to make Climate Change education practical.

The use of tribromoisocyanuric acid to distinguish among primary, secondary and tertiary alcohols

Energy Technology Data Exchange (ETDEWEB)

Crespo, Livia T.C., E-mail: livia.vilela@ifrj.edu.br [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto de Quimica. Departamento de Quimica Organica; Instituto Federal de Educacao, Ciencia e Tecnologia do Rio de Janeiro (IF-RJ), Duque de Caxias, RJ (Brazil); Mattos, Marcio C.S. de; Esteves, Pierre M. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Instituto de Quimica. Departamento de Quimica Organica

2013-09-01

Primary, secondary and tertiary alcohols can be easily distinguished due to their reactivity towards tribromoisocyanuric acid (TBCA). The test is performed by adding TBCA to the alcohol in a test tube heated in a boiling water bath. Orange color develops in the tube containing the primary alcohol, light yellow is observed in the tube containing the secondary alcohol while the tertiary alcohol results in a colorless mixture. (author)

The use of tribromoisocyanuric acid to distinguish among primary, secondary and tertiary alcohols

International Nuclear Information System (INIS)

Crespo, Livia T.C.; Mattos, Marcio C.S. de; Esteves, Pierre M.

2013-01-01

Primary, secondary and tertiary alcohols can be easily distinguished due to their reactivity towards tribromoisocyanuric acid (TBCA). The test is performed by adding TBCA to the alcohol in a test tube heated in a boiling water bath. Orange color develops in the tube containing the primary alcohol, light yellow is observed in the tube containing the secondary alcohol while the tertiary alcohol results in a colorless mixture. (author)

The use of tribromoisocyanuric acid to distinguish among primary, secondary and tertiary alcohols

Directory of Open Access Journals (Sweden)

Lívia T. C. Crespo

2013-01-01

Full Text Available Primary, secondary and tertiary alcohols can be easily distinguished due to their reactivity towards tribromoisocyanuric acid (TBCA. The test is performed by adding TBCA to the alcohol in a test tube heated in a boiling water bath. Orange color develops in the tube containing the primary alcohol, light yellow is observed in the tube containing the secondary alcohol while the tertiary alcohol results in a colorless mixture.

Innovating in the Real World: Exploring Institutional Effects on Tertiary Teacher Innovations in New Zealand

Science.gov (United States)

Lawrence, Belinda

2018-01-01

Innovation is a key goal of many tertiary education and distance learning providers. This research explores how teachers and educational designers across three New Zealand tertiary institutions worked to innovatively achieve teaching goals. A longitudinal design using the Cultural Historical Activity Theory (CHAT) framework explored the influence…

Public health leadership competency level among health professionals in a South Eastern European country

NARCIS (Netherlands)

Pampuri, O.; Czabanowska, K.; Hysa, B.; Roshi, E.; Burazeri, G.

2015-01-01

Pampuri O, Czabanowska K, Hysa B, Roshi E, Burazeri G. Public health leadership competency level among health professionals in a South Eastern European country (Original research). SEEJPH 2015, posted: 10 February 2015. DOI 10.12908/SEEJPH-2014-40

Mainstreaming of Climate Change into the Ghanaian Tertiary Educational System

Science.gov (United States)

Nyarko, B. K.

2013-12-01

The impact of Climate Change has a far-reaching implication for economies and people living in the fragile Regions of Africa analysts project that by 2020, between 75 million and 250 million people will be exposed various forms of Climate Change Stresses. Education as a key strategy identified under Agenda 21 has been incorporated into the efforts of various educational institutions as a means of mitigating climate change and enhancing sustainability. Climate Change education offers many opportunities and benefits for educators, researchers, learners, and for wider society, but there are also many challenges, which can hinder the successful mainstreaming of climate change education. The study aims at understanding barriers for Climate Change Education in selected tertiary institutions in Ghana. The study was conducted among Geoscience Departments of the 7 main public universities of Ghana. The transcript analysis identified issues that hinders the mainstreaming of Climate Change, these includes existing levels of knowledge and understanding of the concept of climate change, appreciating the threshold concepts, ineffective teaching of Climate Change and some Departments are slow in embracing Climate Change as a discipline. Hence to develop strategies to mainstream climate change education it is important to recognise that increasing the efficiency and delivery of Climate Change education requires greater attention and coordination of activities and updating the educators knowledge and skill's. Various Ministries should be challenged to develop and integrate climate change into education policies. In the design of curriculum, there is a need to integrate Climate Change Education into curricula without compromising already overstretched programmes of study. There is a need to encourage and enhance innovative teaching approaches such as Problem-based learning (PBL) is an approach that challenges students to learn through engagement in a real problem. Institutions and

Social Activities and Manifest Anxiety among Freshmen in Tertiary ...

African Journals Online (AJOL)

) in tertiary institutions in Lagos state of Nigeria were analysed to determine the relationship between social activities and manifest anxiety. Social activities in the study were measured in terms of freshmen adjustment to religious activities and ...

Sociology, Street-Level Bureaucracy, and the Management of the Public Sector

OpenAIRE

Piore, Michael J.

2011-01-01

This article extends the concept of street-level bureaucracy to address the problem of the inflexibility and rigidity of governmental rules and regulations, a problem at the heart of the standard economic argument against an active government role in the management of the economy. In so doing, it seeks to create a conceptual bridge over which a range of social science disciplines can be drawn into the debate about public sector management and thereby expand the repertoire of policy tools. The...

Screening-Level Safety Assessment of Personal Care Product Constituents Using Publicly Available Data

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Ernest S. Fung

2018-06-01

Full Text Available Organizations recommend evaluating individual ingredients when assessing the safety of personal care or cosmetic products. The goal of this study was to present a screening-level safety assessment methodology to evaluate the safety of a product by identifying individual ingredients, determining their frequency of use in on-market products, and examining published safe-level-of-use information for each ingredient. As a case study, we evaluated WEN by Chaz Dean (WCD cleansing conditioners since there have been claims of adverse health effects associated with product use. We evaluated 30 ingredients in three on-market WCD cleansing conditioners. We then analyzed the National Library of Medicine’s Household Products Database and the Environmental Working Group’s (EWG Skin Deep Cosmetic Database, two of the largest publicly available databases, for other on-market personal care and cosmetic products that contained these ingredients. Safe-level-of-use information for each ingredient was obtained by reviewing peer-reviewed literature, the Food and Drug Administration’s (FDA generally recognized as safe (GRAS database, available Cosmetic Ingredient Review (CIR publications, and available product safety publications. The results of this analysis showed that more than 20,000 personal care and cosmetic products contained one or more of the evaluated ingredients used in WCD cleaning conditioners. Published safety information was available for 21 of the 30 evaluated ingredients: seven identified ingredients were designated as GRAS by the FDA and 16 ingredients had safe-level-of-use information available from the CIR. This study presents a screening-level safety assessment methodology that can serve as an initial screening tool to evaluate the safety of an ingredient intended for use in personal care and cosmetic products before a product is launched onto the market. This study provides evidence that the evaluated WCD cleansing conditioner ingredients

Tertiary lymphoid organs in Takayasu Arteritis

OpenAIRE

Marc eClement; Marc eClement; Adrien eGaly; Patrick eBruneval; Marion eMorvan; Fabien eHyafil; Fabien eHyafil; Khadija eBenali; Nicoletta ePasi; Lydia eDeschamps; Quentin ePellenc; Quentin ePellenc; Thomas ePapo; Antonino eNicoletti; Antonino eNicoletti

2016-01-01

Objective: The role of B cells in the pathogenesis of Takayasu arteritis (TA) is controversial. We aimed to study the presence of tertiary lymphoid organs (TLOs) in the aortic wall of TA patients.Methods: Hematoxylin and eosin–stained sections from aorta specimens from patients with TA were screened for TLOs. The presence of B cell aggregates (CD20), follicular dendritic cells (FDCs, CD21), and high endothelial venules (HEVs, PNAd) was investigated by immunohistochemistry. Immune cells from t...

Tertiary Lymphoid Organs in Takayasu Arteritis

OpenAIRE

Clement, Marc; Galy, Adrien; Bruneval, Patrick; Morvan, Marion; Hyafil, Fabien; Benali, Khadija; Pasi, Nicoletta; Deschamps, Lydia; Pellenc, Quentin; Papo, Thomas; Nicoletti, Antonino; Sacre, Karim

2016-01-01

Objective The role of B cells in the pathogenesis of Takayasu arteritis (TA) is controversial. We aimed to study the presence of tertiary lymphoid organs (TLOs) in the aortic wall of TA patients. Methods Hematoxylin and eosin-stained sections from aorta specimens from patients with TA were screened for TLOs. The presence of B cell aggregates (CD20), follicular dendritic cells (FDCs, CD21), and high endothelial venules (HEVs, PNAd) was investigated by immunohistochemistry. Immune ce...

Inactive Publics: The Forgotten Publics in Public Relations.

Science.gov (United States)

Hallahan, Kirk

2000-01-01

Notes that recent public relations theory has largely ignored inactive publics, stakeholder groups that demonstrate low levels of knowledge and involvement in the organization or its products, services, candidates, or causes, but are important to an organization. Examines the nature of inactive publics and proposes a model that locates inactive…

Comparing Canadian and American cybersecurity awareness levels: Educational strategies to increase public awareness

Science.gov (United States)

Hoggard, Amy

Cybersecurity awareness is an important issue that affects everyone who uses a computer or a mobile device. Canada and the United States both recognize the value of mitigating cybersecurity risks in terms of national safety, economic stability and protection of their citizens. The research performed compared the levels of cybersecurity awareness in Canadian and American Internet users. Canadian and American users were equally aware of cybersecurity measures, but were not implementing best practices to keep themselves safe. The research suggested users needed to understand why a cybersecurity measure was important before being motivated to implement it. Educational strategies were reviewed in both Canada and the United States and it was determined that although there were significant resources available, they were not being utilized by both the educators and the public. In order to increase cybersecurity awareness levels, nations should focus on increasing the public's awareness by using various types of messaging, such as cartoons, in media. One possible consideration is a compulsory awareness model before accessing the Internet. Cybersecurity topics should be included in the curriculum for students at all levels of education and a focus on providing training and resources to teachers will help increase the cybersecurity knowledge of children and youth.

Helpless patients' perception of bed-bath in tertiary health ...

African Journals Online (AJOL)

Helpless patients' perception of bed-bath in tertiary health institutions in Enugu, Southeast Nigeria. ... Journal Home > Vol 10, No 2 (2005) > ... patients to bed bathing by nurses is a very important aspect of quality assurance in nursing care.

STUDY OF GASTROINTESTINAL CANCERS IN A TERTIARY CARE HOSPITAL

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Rema Nair Sarkar

2017-11-01

Full Text Available BACKGROUND Cancer is one of the leading cause of death both in developed and developing countries. In India, it accounts for 0.3 million deaths per year. Cancers of lung, GIT and oral cancers dominated among men while breast, cervix, ovary and oral cavity were commonest cancer seen in women. Among the gastrointestinal cancers, cancers of the oesophagus, stomach, colon, rectum and liver cancers were commonest. The aim of the study is to evaluate the incidence of the various GIT cancers in a tertiary hospital of Coastal Andhra when compared to other studies. MATERIALS AND METHODS In this retrospective study, a total of 509 health records of patients affected by cancers were studied and relevant details noted. RESULTS A total of 509 cancer cases were reported in this period of 18 months (January 2016 - June 2017 of which 85 cases (16.3% were of Gastrointestinal (GIT cancers. The age group between 40 and 60 recorded the maximum incidence of 47 cancers (55.1%. The incidence of gastrointestinal cancers were significantly higher in the men (56 cases (65.8% than the women (29 cases (34.11%. The commonest site of GIT cancers was the colorectal region (30 cases (35.7%. The most common type of cancer seen was adenocarcinoma seen in 73 cases (85.8%. CONCLUSION Public education and awareness for the warning symptoms should be increased to prevent reduction of the life span and health caused by the gastrointestinal cancers with intense awareness drive using various means including social media undertaken to educate the public regarding the warning symptoms and screening of such group for GIT cancers.

Water levels in the Yucca Mountain area, Nevada, 1995

International Nuclear Information System (INIS)

Graves, R.P.; Goemaat, R.L.

1998-01-01

Water levels were monitored in 28 wells in the Yucca Mountain area, Nevada, during 1995. Seventeen wells representing 18 depth intervals were monitored periodically, generally on a monthly basis, 2 wells representing 3 depth intervals were monitored hourly, and 9 wells representing 15 depth intervals were monitored both periodically and hourly. All wells monitor water levels in Tertiary volcanic rocks except one that monitors water levels in Paleozoic carbonate rocks. Water levels were measured using calibrated steel tapes, a multiconductor cable unit, and/or pressure transducers. Mean water-level altitudes in the Tertiary volcanic rocks ranged from about 728 to about 1,034 meters above sea level during 1995. The mean water-level altitude in the well monitoring the Paleozoic carbonate rocks was about 753 meters above sea level during 1995. Mean water level altitudes were only an average of about 0.01 meters higher than 1994 mean water level altitudes. A single-well aquifer test was conducted on well UE-25 WT number-sign 12 during August and September 1995. Well USW 0-2 was also pumped during October and November 1995, in preparation for single-well aquifer test at that well. All data were acquired in accordance with a quality-assurance program to support the reliability of the data

Levels of violence among nurses in Cape Town public hospitals.

Science.gov (United States)

Khalil, Doris

2009-01-01

The paper presents findings from a study examining violence in nursing. A combined ethno-phenomenology was identified as the most appropriate approach. Ethnography is to understand the culture of nursing that permits violence to occur within the profession. Phenomenology is to explore and capture nurse-on-nurse experiences of violence. The population is all nurses registered with the South African Nursing Council. The research participants are nurses employed in eight public hospitals in Cape Town during 2005. METHOD OF DATA COLLECTION: The first stage of data collection was the distributions of confidential questionnaires to nurses employed in eight hospitals and willing to participate in the study. Responses to close-ended questions were analyzed using Microsoft Excel. Responses to open-ended questions were grouped per question. The qualitative data were then compared for similarities and differences in information provided. Six levels of violence exist among nurses. The highest forms of violence among nurses occurred at the psychological level, with the least at the physical level of interaction. The other four levels of violence among nurses were vertical, horizontal, covert, and overt. All categories of nurses in the study had resorted to one or more levels of violence against other nurses during their nursing career. Professional nurses and senior nurse managers were identified as the main category of nurses that frequently resort to mistreating other nurses. However, auxiliary nurses were identified as the main perpetrators of physical violence against other nurses.

Source of sulphur in the Ebro Basin (Northern Spain). Tertiary nonmarine evaporite deposits as evidenced by sulphur isotopes

International Nuclear Information System (INIS)

Birnbaum, S.J.; Coleman, D.

1979-01-01

The Ebro Basin is an intermontane basin, located in northern Spain, filled with Tertiary (largely Oligocene and Miocene) elastic and chemical deposits. Sulphur isotopes are utilized to determine the source of sulphur in the sulphate deposits (predominantly gypsum with accessory thenardite, mirabolite and epsomite). Data obtained from Tertiary gypsum rocks produce a range of delta 34 S values from +9.16% to + 14.02% with a mean of +13.61%. Data obtained from Triassic gypsum rocks (in source area) produce a range from +13.73% to +15.14%, with a mean of +14.66%. Values for Tertiary marine water range from +18% to +24%. These data indicate a nonmarine origin for sulpur within the Tertiary sulphate rocks. The contribution of Triassic sulphur to the groundwater system, plus varying degrees of dilution by isotopically lighter (atmospheric and sulphide) sulphur, best explains the isotopic ratios observed in the Tertiary Basin deposits. (Auth.)

Efficiency and Productivity of County-level Public Hospitals Based on the Data Envelopment Analysis Model and Malmquist Index in Anhui, China

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Nian-Nian Li

2017-01-01

Conclusions: In 2010–2015, the relative service efficiency of 12 county-level public hospitals in Anhui Province showed a decreasing trend, and the service efficiency of each hospital changed. In the past 6 years, although some hospitals have been effective, the efficiency of the county-level public hospitals in Anhui Province has not improved significantly, and the total factor productivity has not been effectively improved. County-level public hospitals need to combine their own reality to find their own deficiencies.

DO PUBLIC AND PRIVATE DEBT LEVELS AFFECT THE SIZE OF FISCAL MULTIPLIERS?

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Chairul Adi

2017-09-01

Full Text Available This paper investigates the effectiveness of fiscal policies – as measured by the impact and cumulative multipliers – and how they interact with public and private debt. Harnessing the moderated panel regression approach, based on the yearly data set of several economies during the period from 1996 to 2012, the analysis is focused on the impact of spending-and-revenue-based fiscal policies on economic growth and how these fiscal instruments interact with public and private indebtedness. The result of spending stimuli advocates the basic Keynesian theory. An increase in public expenditures contemporaneously generates a positive multiplier, of around 0.29 – 0.44 and around 0.45 – 0.58 during two years. Decomposing the expenditures into their elements, this paper documents a stronger impact from public investment than that from government purchases. On the other hand, the revenue stimuli seem to follow the Ricardian Equivalence Hypothesis (REH, arguing that current tax cuts are inconsequential. The impact and cumulative multipliers for this fiscal instrument have mixed results, ranging from -0.21 to 0.05 and -0.26 to 0.06, respectively. Moreover, no robust evidence is found to support the argument that government debt moderates the effectiveness of fiscal policies. The size of the multipliers for both spending and revenue policies remain constant with the level of public debt. On the other hand, private debt appears to show a statistically significant moderating effect on spending stimuli. Its impact on spending multipliers, however, is economically insignificant. The moderation effect of private debt on the revenue stimuli does not seem to exist. Finally, this paper documents that both public and private debt exhibit a negative and statistically significant estimation for economic output.

Relevance of Donation to Special Federal Tertiary Institution ...

African Journals Online (AJOL)

While structured and open-ended interview and relevant documents, including gift and donation files, acquisition records and library accession registers were used to collect data for the study. The population of the study consisted of the Special Federal Tertiary Institution Libraries under study while the subjects of the study ...

Emotional Intelligence and the Conflict Resolution Repertoire of Couples in Tertiary Institutions in Imo State

Science.gov (United States)

Nnodum, B. I.; Ugwuegbulam, C. N.; Agbaenyi, I. G.

2016-01-01

This study is a descriptive survey that investigated the relationship between emotional intelligence and conflict resolution repertoire of couples in tertiary institutions. A sample of 250 married people were drawn from the population of couples in tertiary institutions in Imo State. Two researcher made and validated instruments were used in…

Bahrain’s tertiary education reform : a step towards sustainable economic development

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Magdalena Karolak

2012-07-01

Full Text Available Bahrain has been experiencing along with other Gulf Council Cooperation countries a rapid development of its tertiary sector of education. The 2000's were marked by a boom in education with the opening of twelve private universities in this country of roughly 1 million inhabitants. Some institutions were locally based, while others worked in affiliation with foreign based universities. It is in sharp contrast with the 1990's, when only three public universities served as centers of higher education. The reasons behind this large-scale expansion of higher education include the growth of local and expatriate population, the planned transition from oil industry to a knowledge-based economy as well as the growing role of women in the workforce. All of these factors need to be addressed in order to assure a stable social and economic development, and education is the backbone of both. This paper examines the recent initiatives undertaken in Bahrain to monitor and ensure the quality of education of cross-border educational institutions as well as that of local education providers.

Microbial Carriage of Cockroaches at a Tertiary Care Hospital in Ghana

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Patience B. Tetteh-Quarcoo

2013-01-01

Full Text Available Cockroaches are common in the environment of many hospitals in Ghana; however, little is known about their public health risks. To evaluate potential risks, we investigated the external and internal microbial flora of 61 cockroaches from a tertiary hospital in Ghana and evaluated the antibiotic resistance profiles of the common bacterial species. Standard methods were used in all the microbiological investigations and antibiotic susceptibility testing. A rotavirus carriage rate of 19.7% was observed among the cockroaches. Four types of intestinal parasites were carried externally by the cockroaches, and the most prevalent was Hookworm (4.9%. Eight nosocomial bacteria were isolated from the cockroaches, and the most prevalent was Klebsiella pneumoniae , which occurred internally in 29.5% of the cockroaches and 26.2% externally. Multiple drug resistance among common bacteria isolated from the cockroaches ranged from 13.8% ( Escherichia coli to 41.1% ( Klebsiella pneumoniae . Cockroaches constitute an important reservoir for pathogenic microorganisms, and may be important vectors of multiple resistant nosocomial pathogens in the studied hospital.

Distribution of 16S rRNA Methylases Among Different Species of Aminoglycoside-Resistant Enterobacteriaceae in a Tertiary Care Hospital in Poland.

Science.gov (United States)

Piekarska, Katarzyna; Zacharczuk, Katarzyna; Wołkowicz, Tomasz; Rzeczkowska, Magdalena; Bareja, Elżbieta; Olak, Monika; Gierczyński, Rafał

2016-01-01

Aminoglycosides are a group of antimicrobial agents still the most commonly used in the treatment of life-threatening bacterial infections in human and animals. The emergence and spread of 16S rRNA methylases, which confer high-level resistance to the majority of clinically relevant aminoglycosides, constitute a major public health concern. Our goal was to evaluate the distribution of 16S rRNA methylases among different species of Enterobacteriaceae during a five month-long survey in a tertiary hospital in Warszawa, Poland. In the survey, a total of 1770 non-duplicate clinical isolates were collected from all hospital wards in a tertiary hospital in Warszawa, Poland. The survey was conducted between 19 April and 19 September 2010. The ability to produce 16S rRNA methylase was examined by determining MICs for gentamicin, kanamycin, amikacin by means of the agar dilution method. The isolates resistant to high concentration of aminoglycosides were PCR tested for genes: armA, rmtA, rmtB and rmtC. PCR products were subjected to DNA sequencing by the Sanger method. The genetic similarity of the ArmA-producing isolates was analysed by pulsed-filed gel electrophoresis (PFGE). ArmA was the only 16S rRNA methylase detected in 20 of 1770 tested isolates. The overall prevalence rate of ArmA was 1.13%. In K. pneumoniae (n = 742), P. mirabilis (n = 130), and E. cloacae (n = 253) collected in the survey, the prevalence of ArmA was 0.4%, 0.8% and 5.9%, respectively. The PFGE revealed both horizontal and clonal spread of the armA gene in the hospital. The prevalence of 16S rRNA methylase ArmA reported in this study is significantly higher than observed in other countries in Europe.

Obesity and associated factors in young adults attending tertiary ...

African Journals Online (AJOL)

Obesity and associated factors in young adults attending tertiary institutions ... and associated factors in a group of university undergraduates in south-east Nigeria. ... being a female (X2 = 47.91), first year student (X2 = 41.82), and having high ...

Assessment Quality in Tertiary Education: An Integrative Literature Review

NARCIS (Netherlands)

Gerritsen-van Leeuwenkamp, Karin; Joosten-ten Brinke, Desirée; Kester, Liesbeth

2018-01-01

In tertiary education, inferior assessment quality is a problem that has serious consequences for students, teachers, government, and society. A lack of a clear and overarching conceptualization of assessment quality can cause difficulties in guaranteeing assessment quality in practice. Thus, the

Optimising Tertiary Student Accommodation within University Neighbourhoods

OpenAIRE

Ike, Nnenna; Baldwin, Claudia; Lathouras, Athena

2017-01-01

Tertiary students’ activities within neighbourhoods adjacent to universities engender positive and negative impacts that have consequences for neighbourhood sustainability. This might lead to studentification, a process that triggers physical, economic and socio-cultural transformation of university towns. Where non-student residents perceive negative impacts, it can lead to conflict and resentment towards the student population, mistrust between student and local resident groups and a decrea...

Evaluation of the onset of tertiary creep for types 304 and 316 stainless steels

International Nuclear Information System (INIS)

Staerk, E.; Picker, C.; Felsen, M.F.

1989-01-01

Austenitic stainless steels Types 304 and 316 are used for LMFBR components. Although at high temperature many codes base the allowable stress on the stress rupture strength, some recent codes eg ASME Code Case N47 and RCC-MR also take account of the onset of tertiary creep. In order to examine this latter aspect creep deformation data on Type 304 and Type 316 steel have been collected and analysed. The ratio time to onset of tertiary creep against the time to rupture has been analysed as a function of temperature. At temperatures below 750 0 C the ratio is found to decrease slightly with increasing temperature. Monkman Grant and Lambda relationships have also been investigated. In relation to the ASME S t allowable stress criteria it is shown that below 600 0 C the allowable stress is likely to be governed by the stress rupture strength rather than the onset of tertiary creep criterion. Recommendations are given concerning the determination of the onset of tertiary creep, the fitting of the Leyda/Rowe relationship and a method to compute the maximum allowable stress S t from equation describing the time-temperature dependency of the three constituents of S t

Tandem catalytic allylic amination and [2,3]-Stevens rearrangement of tertiary amines.

Science.gov (United States)

Soheili, Arash; Tambar, Uttam K

2011-08-24

We have developed a catalytic allylic amination involving tertiary aminoesters and allylcarbonates, which is the first example of the use of tertiary amines as intermolecular nucleophiles in metal-catalyzed allylic substitution chemistry. This process is employed in a tandem ammonium ylide generation/[2,3]-rearrangement reaction, which formally represents a palladium-catalyzed Stevens rearrangement. Low catalyst loadings and mild reaction conditions are compatible with an unprecedented substrate scope for the ammonium ylide functionality, and products are generated in high yields and diastereoselectivities. Mechanistic studies suggested the reversible formation of an ammonium intermediate.

Constructing Knowledge Societies: New Challenges for Tertiary Education.

Science.gov (United States)

Salmi, Jamil

2003-01-01

The principal set of challenges facing tertiary education today is that set which links it to the construction of knowledge societies. Governments, the private sector, and the World Bank have specific tasks to perform in meeting these challenges. Countries--depending upon whether or not they are transition economies, low-income countries, or small…

Tertiary Educational Institutions for Teaching, Research and Development

Science.gov (United States)

Amoo, Sikiru A.

2014-01-01

This paper examines the quality of teaching and research in developing human resources to facilitate the development of tertiary education in the nation. It discusses the challenges and the roles of research in higher education. The author argues that the combination of content and pedagogical knowledge could help to develop human resources for…

Geochemical characteristics of Tertiary saline lacustrine oils in the Western Qaidam Basin, northwest China

International Nuclear Information System (INIS)

Zhu Yangming; Weng Huanxin; Su Aiguo; Liang Digang; Peng Dehua

2005-01-01

Based on the systematic analyses of light hydrocarbon, saturate, aromatic fractions and C isotopes of over 40 oil samples along with related Tertiary source rocks collected from the western Qaidam basin, the geochemical characteristics of the Tertiary saline lacustrine oils in this region was investigated. The oils are characterized by bimodal n-alkane distributions with odd-to-even (C 11 -C 17 ) and even-to-odd (C 18 -C 28 ) predominance, low Pr/Ph (mostly lower than 0.6), high concentration of gammacerane, C 35 hopane and methylated MTTCs, reflecting the high salinity and anoxic setting typical of a saline lacustrine depositional environment. Mango's K 1 values in the saline oils are highly variable (0.99-1.63), and could be associated with the facies-dependent parameters such as Pr/Ph and gammacerane indexes. Compared with other Tertiary oils, the studied Tertiary saline oils are marked by enhanced C 28 sterane abundance (30% or more of C 27 -C 29 homologues), possibly derived from halophilic algae. It is noted that the geochemical parameters of the oils in various oilfields exhibit regular spatial changes, which are consistent with the depositional phase variations of the source rocks. The oils have uncommon heavy C isotopic ratios (-24%o to -26%o) and a flat shape of the individual n-alkane isotope profile, and show isotopic characteristics similar to marine organic matter. The appearance of oleanane and high 24/(24 + 27)-norcholestane ratios (0.57-0.87) in the saline oils and source rocks confirm a Tertiary organic source

Low and Intermediate Level Waste Repository: Radiation and Public

International Nuclear Information System (INIS)

Cerskov Klika, M.

1998-01-01

Some of basic elements related to public participation in radioactive waste management in Croatia are underlined in the paper. Most of them are created or led by the APO-Hazardous Waste Management Agency. Present efforts in improvement of public participation in the field radioactive waste management are important in particular due to negligible role of public in environmentally related issues during former Yugoslav political system. For this reason it is possible to understand the public fearing to be deceived or neglected again. Special attention is paid to the current APO editions related to public information and education in the field of radioactive waste management. It is important because only the well-informed public can present an active and respectful factor in hazardous and radioactive waste management process. (author)

A structural model analysis of public opposition to a high-level radioactive waste facility

International Nuclear Information System (INIS)

Flynn, J.; Mertz, C.K.; Slovic, P.; Burns, W.

1991-09-01

Studies show that most Nevada residents and almost all state officials oppose the proposed high-level radioactive waste repository project at Yucca Mountain. Surveys of the public show that individual citizens view the Yucca Mountain repository as having high risk; nuclear experts, in contrast, believe the risks are very low. Policy analysts have suggested that public risk perceptions may be reduced by better program management, increased trust in the federal government, and increased economic benefits for accepting a repository. The model developed in this study is designed to examine the relationship between public perceptions of risk, trust in risk management, and potential economic impacts of the current repository program using a confirmatory multivariate method known as covariance structure analysis. The results indicate that perceptions of potential economic gains have little relationship to opposition to the repository. On the other hand, risk perceptions and the level of trust in repository management are closely related to each other and to opposition. The impacts of risk perception and trust in management on opposition to the repository result from a combination of their direct influences as well as their indirect influences operating through perceptions that the repository would have serious negative impacts on the state's economy due to stigmatization and reduced tourism

Management for the children with otitis media with effusion in the tertiary hospital.

Science.gov (United States)

Choung, Yun-Hoon; Shin, You Ree; Choi, Seong Jun; Park, Keehyun; Park, Hun Yi; Lee, Jong Bin; Han, Dong Hee; Kahng, Hison

2008-12-01

Recently, new evidence-based recommendations have been introduced for diagnosing and managing otitis media with effusion (OME) in children. However, there are some difficulties to follow the general guidelines in the tertiary hospitals. The purpose is to evaluate the efficiency of antibiotics or antihistamines for treatment of children with OME in the tertiary hospital with a randomized prospective clinical study. Eighty-four children with OME who had been diagnosed in the tertiary hospital were randomized to receive 5 different medications for 2 weeks. We prescribed antibiotics (amoxicillin-clavulanate syrup) in Group I (n=16), antibiotics/steroids (prednisolone) in Group II (n=18), antibiotics/antihistamines (ebastine) in Group III (n=15), antibiotics/steroids/antihistamines in Group IV (n=17), and mucolytics (ivy leaf extract) in Group V (n=17) for control. We followed-up children every 2 weeks and evaluated the state of OME at 3 months. Thirty six (42.9%) of 84 children were resolved within average 6.9 weeks after the treatments. Thirty-six (42.9%) were treated with ventilation tube insertion and 12 patients (14.3%) were observed. There was no difference in the resolution rates of OME among the five different protocols (P>0.05). There was no difference in the resolution rates among groups who used steroids, antihistamines, steroids and antihistamines, or other medications to manage 42 children with allergies (P>0.05). In the tertiary hospital, the cure rate of children with OME was not as high as well-known, and antibiotics or anti-allergic medications were not more effective than control. We may, therefore, need any other guidelines which are different from the previous evidence-based recommendations, including early operation in the tertiary hospitals.

Assessment of pediatric residents burnout in a tertiary academic centre

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Roaa S. Jamjoom

2018-03-01

Full Text Available Objectives: To study burnout among pediatric residents at King Abdulazaiz University Hospital in Jeddah, Saudi Arabia. Methods: This is a cross-sectional survey that was administered to all pediatric residents enrolled in the Saudi Paediatric Board program (PGY1-PGY4 in a large tertiary academic hospital in the Western region of Saudi Arabia (King Abdulaziz University Hospital. The survey were sent via E-mail to 50 registered general pediatric residents. Results: Seventy percent of the pediatric residents completed the survey. More than 70% of residents experiencing severe burnout. Forty-three percent suffering emotional exhaustion, 71.8% experiencing depersonalization and 40.6% suffering from low accomplishment. Conclusion: Burnout syndrome appear to be a serious threat to resident well-being in our program. Moreover, pediatric residents in our institute experienced higher levels of depersonalization than their peers nationally and internationally.

Outbreak of carbapenem-resistant Providencia rettgeri in a tertiary ...

African Journals Online (AJOL)

Carbapenem resistance in Enterobacteriaceae is often plasmid mediated, necessitating stringent infection control practices. We describe an outbreak of carbapenem-resistant Providencia rettgeri involving 4 patients admitted to intensive care and high-care units at a tertiary hospital. Clinical and demographic characteristics ...

What evidence and support do state-level public health practitioners need to address obesity prevention.

Science.gov (United States)

Leeman, Jennifer; Teal, Randall; Jernigan, Jan; Reed, Jenica Huddleston; Farris, Rosanne; Ammerman, Alice

2014-01-01

Obesity has reached epidemic proportions. Public health practitioners are distinctly positioned to promote the environmental changes essential to addressing obesity. The Centers for Disease Control and Prevention (CDC) and other entities provide evidence and technical assistance to support this work, yet little is known about how practitioners use evidence and support as they intervene to prevent obesity. The study's purpose was to describe how practitioners and CDC project officers characterized the obesity prevention task, where practitioners accessed support and evidence, and what approaches to support and evidence they found most useful. APPROACH OR DESIGN: Mixed-methods, cross-sectional interviews, and survey. State-level public health obesity prevention programs. Public health practitioners and CDC project officers. We conducted 10 in-depth interviews with public health practitioners (n = 7) and project officers (n = 3) followed by an online survey completed by 62 practitioners (50% response rate). We applied content analysis to interview data and descriptive statistics to survey data. Practitioners characterized obesity prevention as uncertain and complex, involving interdependence among actors, multiple levels of activity, an excess of information, and a paucity of evidence. Survey findings provide further detail on the types of evidence and support practitioners used and valued. We recommend approaches to tailoring evidence and support to the needs of practitioners working on obesity prevention and other complex health problems.

Trophic assimilation efficiency markedly increases at higher trophic levels in four-level host-parasitoid food chain.

Science.gov (United States)

Sanders, Dirk; Moser, Andrea; Newton, Jason; van Veen, F J Frank

2016-03-16

Trophic assimilation efficiency (conversion of resource biomass into consumer biomass) is thought to be a limiting factor for food chain length in natural communities. In host-parasitoid systems, which account for the majority of terrestrial consumer interactions, a high trophic assimilation efficiency may be expected at higher trophic levels because of the close match of resource composition of host tissue and the consumer's resource requirements, which would allow for longer food chains. We measured efficiency of biomass transfer along an aphid-primary-secondary-tertiary parasitoid food chain and used stable isotope analysis to confirm trophic levels. We show high efficiency in biomass transfer along the food chain. From the third to the fourth trophic level, the proportion of host biomass transferred was 45%, 65% and 73%, respectively, for three secondary parasitoid species. For two parasitoid species that can act at the fourth and fifth trophic levels, we show markedly increased trophic assimilation efficiencies at the higher trophic level, which increased from 45 to 63% and 73 to 93%, respectively. In common with other food chains, δ(15)N increased with trophic level, with trophic discrimination factors (Δ(15)N) 1.34 and 1.49‰ from primary parasitoids to endoparasitic and ectoparasitic secondary parasitoids, respectively, and 0.78‰ from secondary to tertiary parasitoids. Owing to the extraordinarily high efficiency of hyperparasitoids, cryptic higher trophic levels may exist in host-parasitoid communities, which could alter our understanding of the dynamics and drivers of community structure of these important systems. © 2016 The Authors.

Uncovering High-Level Corruption: Cross-National Objective Corruption Risk Indicators Using Public Procurement Data

OpenAIRE

Fazekas, Mihaly; Kocsis, G

2017-01-01

Measuring high-level corruption is subject to extensive scholarly and policy interest, which has achieved moderate progress in the last decade. This article develops two objective proxy measures of high-level corruption in public procurement: single bidding in competitive markets and a composite score of tendering ‘red flags’. Using official government data on 2.8 million contracts in twenty-eight European countries in 2009–14, we directly operationalize a common definition of corruption: unj...

Adults Studying Pure Mathematics in Adult Tertiary Preparation.

Science.gov (United States)

Bennison, Anne

2002-01-01

Investigated the experiences of a group of adults enrolled in the Pure Mathematics module of the Certificate IV in Adult Tertiary Preparation in 2000 at one of the Institutes of TAFE in Brisbane, Australia. Classroom learning experiences, exposure to technology, and the impact of returning to study on other facets of students' lives were…

Hydrochemical synthesis Northern Switzerland: tertiary- and Malm-aquifers

International Nuclear Information System (INIS)

Schmassmann, H.; Kullin, M.; Wexsteen, P.

1990-05-01

This Tertiary-Malm synthesis represents the first part of an overall hydrochemical synthesis of deep groundwaters in Northern Switzerland and adjacent areas. The investigation is mainly based on data from Nagra deep boreholes, from Nagra regional programme as well as from external sources. The first part provides a hydrogeological overview including a brief description of the aquifer rocks. A compilation of all existing hydraulic potential data is given and discussed for Northern Switzerland, Bodensee area and western Swabian Alb. In the Molasse Basin, hydrochemical and isotope analyses allowed a distinction of three main water types positioned one upon another: calcium-magnesium-bicarbonate groundwaters, sodium-bicarbonate and sodium-chloride deep groundwaters. Hydrochemical and isotopegeochemical details of these three water types comprise the major part of this report. Unlike the other two water types, the calcium-magnesium-bicarbonate groundwaters also include shallow waters with considerable tritium activities, indicating a mean residence time of less than 35 years. The spacial distribution of these three water types are demonstrated and different secular flow models in the Tertiary-Malm Aquifer group are discussed. (author) figs., tabs., 194 refs

Pedagogical Study into Tertiary Learning Styles in Vietnam

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Barry Ramsay

2016-07-01

Full Text Available Pedagogical studies for tertiary students in Vietnam are limited and no comparative benchmarking studies with other Asian tertiary students found. As a means to fill this gap and provide a better understanding the following study using Biggs (1987c Study Process Questionnaire (SPQ, a 42-item self-report survey consisting of ratings on a 5-point scale to questions relating to respondents' study motivations and their usual study patterns was conducted with 355 respondents. Findings were consistent with Hong Kong students and supports studies carried out in other countries by Kemper et al. (1989, Kemper and Gow (1991, Niles (1995, Volet and Renshaw (1996, Ramburuth (2001 and Hua, Williams and Hoi (2007. Despite learning in a “rote” manner during their formative years, students have adapted to deeper learning approaches although there is a still a slight but insignificant bias to surface learning. They desire to achieve and get good marks although strategy is limiting their progress. According to Biggs, this is commonly caused by a language problem.

RAISING ESP STUDENTS’ AWARENESS OF THE GENERIC STRUCTURES AND LINGUISTIC FEATURES OF JOB APPLICATION LETTERS THROUGH THE APPLICATION OF GENRE-BASED INSTRUCTION AT THE TERTIARY LEVEL: THE CASE OF 3 rd YEAR MANAGEMENT STUDENTS DJILLALI LIABES UNIVERSITY, SIDI BEL ABBES

OpenAIRE

SEKKAL, Faiza

2012-01-01

The current study is an attempt to investigate the genre of job application letter using genre-based analysis as a powerful educational tool, in order to improve the teaching of business writing at the tertiary level with reference to third- year management students by raising their awareness of the generic structures and linguistic features of the target genre. In this regard, this research work is based on the theory of genre analysis in ESP; it aims to help future graduates ...

English Textbooks in Parallel-Language Tertiary Education

OpenAIRE

Pecorari, D.; Shaw, P.; Irvine, Aileen; Malmstrom, H.

2011-01-01

Tertiary education in many countries is increasingly bilingual, with English used in parallel with the national language, particularly as a reading language. This article describes the results of a survey of student attitudes toward, and reading practices regarding, English language textbooks. Over 1,000 students at three Swedish universities responded to a questionnaire asking about their experiences with English textbooks. Textbooks written in English were generally unpopular, and the perce...

Assessment of job satisfaction among health workers in a tertiary ...

African Journals Online (AJOL)

Assessment of job satisfaction among health workers in a tertiary hospital in Zaria ... factors affecting job satisfaction and retention of health professionals working in ... help the hospital management to increase their employee's job satisfaction.

Oro-Dental and Maxillofacial Trauma in Epilepsy at a Tertiary ...

African Journals Online (AJOL)

Oro-Dental and Maxillofacial Trauma in Epilepsy at a Tertiary Hospital in Lagos. ... Information sought included patient's sociodemographics, type of seizure, ... bones were not so common, all such cases received surgical treatment in hospital.

The effects of media on the level of accountability of public organization

Directory of Open Access Journals (Sweden)

Mehrdad Matani

2014-09-01

Full Text Available One of the features of democratic political systems is the accountability against their own performances. Media, one of the powerful elements of civil society and effectual on public thought, plays an important role in making the government responsive. To achieve this goal, the present study tries to investigate the effect of media on the improvement of the accountability level of the government agencies. The statistical society of this research includes all male students of Azad Ghaemshahr University where 320 students were selected through purposive sampling method based on Kerjesy and Morgan table. Applied research method is used in this survey. A researcher-made questionnaire was used to collect the required data. In order to validate the instrument, appropriate questions related to each variable were extracted from valid sources and finally approved by authorities. In order to calculate the reliability of the questionnaire, Cronbach’s alpha was calculated to be 89. Since the distribution of the data was normal, parametric statistical tests were used to testify the hypotheses. The findings of the study show that the media could be effective in terms of making public organizations responsive, through leading and training the public, unifying demands, and monitoring and broadcasting. However, the findings reveal that if the media were free and independent, they would better perform their responsibilities. Finally, the study at hand concludes that in comparison to other media, television is much more powerful in terms of pushing the public sector to be responsive.

Assessment of maternal risk factors associated with low birth weight neonates at a tertiary hospital, Nanded, Maharashtra.

Science.gov (United States)

Domple, Vijay Kishanrao; Doibale, Mohan K; Nair, Abhilasha; Rajput, Pinkesh S

2016-01-01

To assess the maternal risk factors associated with low birth weight (LBW) neonates at a tertiary hospital, Nanded, Maharashtra. This study was carried out in a tertiary care hospital in Nanded city of Maharashtra between January 2014 and July 2014 among 160 cases (LBW-birth weight ≤2499 g) and 160 controls (normal birth weight-birth weight >2499. Data collection was done by using predesigned questionnaire and also related health documents were checked and collected the expected information during the interview after obtaining informed consent from mothers. The data were analyzed by Epi Info 7 Version. The present study found the significant association among gestational age, sex of baby, type of delivery, maternal age, religion, education of mother and husband, occupation of mother and husband, type of family, maternal height, weight gain, hemoglobin level, planned/unplanned delivery, bad obstetric history, interval between pregnancies, previous history of LBW, underlying disease, tobacco chewing, timing of first antenatal care (ANC) visit, total number of ANC visit, and iron and folic acid (IFA) tablets consumption with LBW. No significant association was found among maternal age, residence, caste, consanguinity of marriage, socioeconomic status, gravida, birth order, multiple pregnancy, and smoking with LBW in our study. It was concluded that hemoglobin level, weight gain during pregnancy, gestational age, planned/unplanned delivery, bad obstetric history, and IFA tablets consumption during pregnancy were independent risk factors for LBW.

Thermodynamics and kinetics of RNA tertiary structure formation in the junctionless hairpin ribozyme.

Science.gov (United States)

White, Neil A; Hoogstraten, Charles G

2017-09-01

The hairpin ribozyme consists of two RNA internal loops that interact to form the catalytically active structure. This docking transition is a rare example of intermolecular formation of RNA tertiary structure without coupling to helix annealing. We have used temperature-dependent surface plasmon resonance (SPR) to characterize the thermodynamics and kinetics of RNA tertiary structure formation for the junctionless form of the ribozyme, in which loops A and B reside on separate molecules. We find docking to be strongly enthalpy-driven and to be accompanied by substantial activation barriers for association and dissociation, consistent with the structural reorganization of both internal loops upon complex formation. Comparisons with the parallel analysis of a ribozyme variant carrying a 2'-O-methyl modification at the self-cleavage site and with published data in other systems reveal a surprising diversity of thermodynamic signatures, emphasizing the delicate balance of contributions to the free energy of formation of RNA tertiary structure. Copyright © 2017 Elsevier B.V. All rights reserved.

THE EFFECTIVENESS OF ONLINE AND OFF LINE WORD OF MOUTH MESSAGES ON TRADITIONAL COURSE CHOICE AT TERTIARY LEVEL

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N. Serdar SEVER

2009-01-01

Full Text Available This study aims to explain how bachelor of communications students who are enrolled to various courses at Anadolu University value word-of-mouth messages in making a course decision. Use of WOM as a marketing tool in tertiary teaching is not a common practice. As elective course numbers increase, students look for alternative avenues and types of information to be sure of making the best possible course selection. The findings of this study indicate that instructors’ previous experiences are not as important as their in-class performances. Another interesting finding of the study is although participants are prone to use internet resources as sources of information; they value the use of computer-mediated and enhanced technologies in teaching. Perhaps the most peculiar finding of the study is senior students are perceived as the most common source of information, and their experiences often seen as a point of reference in choosing a course.

Antibiotic use in acute pancreatitis: An audit of current practice in a tertiary centre.

Science.gov (United States)

Baltatzis, Minas; Mason, J M; Chandrabalan, Vishnu; Stathakis, Panagiotis; McIntyre, Ben; Jegatheeswaran, Santhalingam; Jamdar, Saurabh; O'Reilly, Derek A; Siriwardena, Ajith K

Intravenous antibiotic prophylaxis is not recommended in acute pancreatitis. According to current international guidelines antibiotics together with further intervention should be considered in the setting of infected necrosis. Appropriate antibiotic therapy particularly avoiding over-prescription is important. This study examines antibiotic use in acute pancreatitis in a tertiary centre using the current IAP/APA guidelines for reference. Data were collected on a consecutive series of patients admitted with acute pancreatitis over a 12 month period. Data were dichotomized by patients admitted directly to the centre and tertiary transfers. Information was collected on clinical course with specific reference to antibiotic use, episode severity, intervention and outcome. 111 consecutive episodes of acute pancreatitis constitute the reported population. 31 (28%) were tertiary transfers. Overall 65 (58.5%) patients received antibiotics. Significantly more tertiary transfer patients received antibiotics. Mean person-days of antibiotic use was 23.9 (sd 29.7) days in the overall study group but there was significantly more use in the tertiary transfer group as compared to patients having their index admission to the centre (40.9 sd 37.1 vs 10.2 sd 8.9; P < 0.005). Thirty four (44%) of patients with clinically mild acute pancreatitis received antibiotics. There is substantial use of antibiotics in acute pancreatitis, in particular in patients with severe disease. Over-use is seen in mild acute pancreatitis. Better consideration must be given to identification of prophylaxis or therapy as indication. In relation to repeated courses of antibiotics in severe disease there must be clear indications for use. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Generic versus specific competencies of entry-level public health graduates: employers' perceptions in Poland, the UK, and the Netherlands.

Science.gov (United States)

Biesma, Regien G; Pavlova, Milena; Vaatstra, Rina; van Merode, Godefridus G; Czabanowska, Katarzyna; Smith, Tony; Groot, Wim

2008-08-01

Constant changes in society and the public health domain force public health professionals into new roles and the development of new competencies. Public health professionals will need to be trained to respond to this challenge. The aim of this comparative study among Poland, the UK and the Netherlands is to identify competence needs for Master of Public Health graduates entering the labour market from a European perspective. A self-administered questionnaire was sent to employers in the three countries, rating the importance of competency in public health on a master's level. In all three countries, interpersonal competencies, like team working and communication skills, are rated as highly important. However, employers in the UK and Poland generally rate public health specific competencies as much more important than their Dutch colleagues. It is concluded that while public health specific knowledge is providing a useful starting point for entry-level public health professionals, employers increasingly recognise the value of generic competencies such as communication and team working skills. The results suggest a stronger emphasis on teaching methods that encourage active learning and the integration of skills, which is crucial for enhancing graduates' employability, and foster an open attitude to multidisciplinary working, which is essential in modern health care.

Drug Production in Tertiary Health Institutions – Needs, Constraints ...

African Journals Online (AJOL)

The use of questionnaires was employed in the study covering all pharmacists in the pharmaceutical services department, pharmacy technicians and quality control technologist in the drug production unit of the hospital. It was unanimously agreed by the respondents that local drug production was necessary in tertiary ...

Sexual behaviours of undergraduates of tertiary institutions in Kwara ...

African Journals Online (AJOL)

The study also examined whether or not variables of gender and school type had significant influence on the sexual behaviours of undergraduates of tertiary ... the school counsellors and teachers should provide guidance to students on developmental challenges and help youths to abstain from risky sexual behaviours.

Patient satisfaction in neurological second opinions and tertiary referrals

NARCIS (Netherlands)

Wijers, D.; Wieske, L.; Vergouwen, M. D. I.; Richard, E.; Stam, J.; Smets, E. M. A.

2010-01-01

Although the number of neurological second opinions (SOs) and tertiary referrals (TRs) is increasing, only little is known about expectations and patient satisfaction in this group of patients. Therefore, the purpose of this study was to explore expectations of patients who get a neurological SO or

Factors affecting utilization of University health services in a tertiary ...

African Journals Online (AJOL)

2013-01-16

Jan 16, 2013 ... Objective: To determine students' perception of health care services provided in a tertiary institution and ... evaluation of health services utilization among students in the .... African culture and health. ... Asian Am Pac Isl J.

Melanoma screening: Informing public health policy with quantitative modelling.

Directory of Open Access Journals (Sweden)

Stephen Gilmore

Full Text Available Australia and New Zealand share the highest incidence rates of melanoma worldwide. Despite the substantial increase in public and physician awareness of melanoma in Australia over the last 30 years-as a result of the introduction of publicly funded mass media campaigns that began in the early 1980s -mortality has steadily increased during this period. This increased mortality has led investigators to question the relative merits of primary versus secondary prevention; that is, sensible sun exposure practices versus early detection. Increased melanoma vigilance on the part of the public and among physicians has resulted in large increases in public health expenditure, primarily from screening costs and increased rates of office surgery. Has this attempt at secondary prevention been effective? Unfortunately epidemiologic studies addressing the causal relationship between the level of secondary prevention and mortality are prohibitively difficult to implement-it is currently unknown whether increased melanoma surveillance reduces mortality, and if so, whether such an approach is cost-effective. Here I address the issue of secondary prevention of melanoma with respect to incidence and mortality (and cost per life saved by developing a Markov model of melanoma epidemiology based on Australian incidence and mortality data. The advantages of developing a methodology that can determine constraint-based surveillance outcomes are twofold: first, it can address the issue of effectiveness; and second, it can quantify the trade-off between cost and utilisation of medical resources on one hand, and reduced morbidity and lives saved on the other. With respect to melanoma, implementing the model facilitates the quantitative determination of the relative effectiveness and trade-offs associated with different levels of secondary and tertiary prevention, both retrospectively and prospectively. For example, I show that the surveillance enhancement that began in

Driven to Support: Individual- and County-Level Factors Associated With Public Support for Active Transportation Policies.

Science.gov (United States)

Cradock, Angie L; Barrett, Jessica L; Chriqui, Jamie F; Evenson, Kelly R; Goins, Karin Valentine; Gustat, Jeanette; Heinrich, Katie M; Perry, Cynthia K; Scanze, Michele; Schmid, Thomas L; Tabak, Rachel G; Umstattd Meyer, M Renee; Valko, Cheryl

2018-03-01

To assess predictors of stated support for policies promoting physically active transportation. Cross-sectional. US counties selected on county-level physical activity and obesity health status. Participants completing random-digit dialed telephone survey (n = 906). Survey measures assessed stated support for 5 policies to promote physically active transportation, access to active transportation facilities, and time spent in a car. County-level estimates included household car dependence and funding for bicycle-pedestrian projects. Multivariable generalized linear mixed models using binary distribution and logit link, accounting for clustering within county. Respondents supported policies for accommodating bicyclists and pedestrians through street improvements (89%), school active transportation programs (75%), employer-funded active commuting incentives (67%), and allocation of public funding (68%) and tax support (56%) for building and maintaining public transit. Residents spending >2 h/d (vs public transit (OR: 1.85; CI: 1.24-2.77) improvements. Residents in counties investing >$1.6 million in bicycle and pedestrian improvements expressed greater support for funding (OR: 1.71; CI: 1.04-2.83) and tax increases (OR: 1.73; CI: 1.08-2.75) for transit improvements compared to those with lower prior investments (transportation is higher where relevant investments in active transportation infrastructure are large (>$1.6 M), public transit is nearby, and respondents drive >2 h/d.

Effect of health education on knowledge and attitude of tertiary ...

African Journals Online (AJOL)

Background: In order to make good decisions about their sexual and ... of health education on the knowledge and attitude of tertiary school students towards sexually ... Methods: The study employed a quasi-experimental study design in which ...

Effectiveness of secondary and tertiary prevention for violence against women in low and low-middle income countries: a systematic review.

Science.gov (United States)

Kirk, Lucy; Terry, Samantha; Lokuge, Kamalini; Watterson, Jessica L

2017-07-04

Violence against women (VAW) is a major problem worldwide, with one in three women experiencing violence in their lifetime. While interventions to prevent violence (primary prevention) are extremely important, they can take many years. This review focuses on secondary and tertiary prevention interventions that address the needs of survivors of violence and aim to prevent recurrence. This review also focuses on studies taking place in low and low-middle income countries, where rates of VAW are highest. Searches of peer-reviewed and grey literature took place from March-June 2016 through databases (Embase, CINAHL, WHO Global Index Medicus, Medline, PsychINFO, Web of Science, Cochrane Library, Applied Social Sciences Index and Abstracts and Sociological Abstracts) and by consulting experts in the field. Only primary research was eligible for inclusion and studies had to focus on secondary or tertiary prevention for survivors of VAW in low or low-middle income countries. All study designs were eligible, as long as the study examined client-related outcome measures (e.g., incidence of violence, health outcomes or client satisfaction). Data were extracted and quality of the studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies and a qualitative quality assessment tool developed by Mays and Pope. Due to the low number of results and heterogeneity of the study populations and outcomes, a narrative synthesis was conducted and evidence was summarized. One thousand two hundred fifteen studies were identified through the search strategy and 22 of these met the eligibility criteria. Overall, the evidence for interventions is weak and study limitations prevent definitive conclusions on what works. There is some evidence that interventions targeting alcohol use, both among perpetrators and survivors, may be effective at reducing VAW through secondary prevention, and that psychotherapy might be effective for

Public relations effectiveness in public health institutions.

Science.gov (United States)

Springston, Jeffrey K; Weaver Lariscy, Ruth Ann

2005-01-01

This article explores public relations effectiveness in public health institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.

Why Do Tertiary Education Graduates Regret Their Study Program? A Comparison between Spain and the Netherlands

Science.gov (United States)

Kucel, Aleksander; Vilalta-Bufi, Montserrat

2013-01-01

In this paper we investigate the determinants of regret of study program for tertiary education graduates in Spain and the Netherlands. These two countries differ in their educational system in terms of the tracking structure in their secondary education and the strength of their education-labor market linkages in tertiary education. Therefore, by…

Radiological safety for the public during nuclear emergencies: application of intervention levels and derived intervention levels

International Nuclear Information System (INIS)

Thomas, G.; Kumar, K.S.

2006-01-01

Control of radiation exposures to the public following a major nuclear accident can be achieved through intervention by implementing countermeasures such as sheltering, iodine prophylaxis, evacuation, control of foodstuff, etc. Intervention levels (I.L.) are formulated such that exposure to individuals from all exposure pathways is well below the thresholds for deterministic effects, and risk of stochastic health effects to individuals and overall incidence of stochastic effects in the exposed population are minimized. It is also necessary to translate such I.L. into quantities, called derived intervention levels (D.I.L.) that can be measured. The I.L. followed in various countries for the recommended countermeasures cater to the exposure range of 1-50 mSv for sheltering, 10-500 mSv for evacuation, 30- 1000 mSv for iodine prophylaxis and 1-10 mSv for food control. The models used for these are based on conservative estimations assuming maximum dose delivered to the critical group for the pathway assumed. While the concept of upper dose level above which countermeasures is always justified to avoid deterministic effects, the lower range of dose levels have to be optimised based on various parameters as discussed in this paper. While arriving at the I.L., the question to be addressed is: How much (dose) risk should be averted by the intervention planned? Implementation of any countermeasure will result in some inconvenience/ limitation of resource/ disruption and consequently, a positive net benefit will justify the intervention. Sheltering may result in substantially less disruption than evacuation, but if the type of sheltering is not offering enough radiation shielding or ventilation protection, this may not result in significant reduction of exposure. It is to be ensured that deterministic effects are totally avoided and it is possible to define a safe threshold exposure and above which balancing risks and benefits is not applicable. While the dose limit for the

A sequence of events across the Cretaceous-Tertiary boundary

NARCIS (Netherlands)

Smit, J.; Romein, A.J.T.

1985-01-01

The lithological and biological sequence of events across the Cretaceous-Tertiary (K/T), as developed in thick and complete landbased sections and termed the standard K/T event sequence, is also found in many DSDP cores from all over the globe. Microtektite-like spherules have been found in

Factors driving public tolerance levels and information-seeking behaviour concerning insects in the household environment

NARCIS (Netherlands)

Schoelitsz, Bruce; Poortvliet, P.M.; Takken, Willem

2018-01-01

BACKGROUND: The public's negative attitudes towards household insects drive tolerance for these insects and their control. Tolerance levels are important in integrated pest management (IPM), as are pest knowledge and information. The risk information seeking and processing (RISP) model describes the

Mudflow utilization for construction materials of tertiary irrigation canal lining

Science.gov (United States)

Azis, Subandiyah; Kustamar

2017-11-01

Mudflow in Siring Village, Sidoarjo Regency, Indonesia, has been in eruption since May 29, 2006. It still shows irregular large bursts which loaded in a sludge reservoir with capacity of 59 million m3. From 2007 until 2015, there were more than 20 studies which concluded that the mudflow could be used as a mixture of building materials. However, the studies were not detailed and needed further research. This research aims to investigate the use of mudflow as tertiary irrigation canal lining material. This research comes with several laboratory tests to obtain a mixture that is solid and water-resistant. The methods that were used are descriptive methods as follows: 1). Sampling of mudflow, to be analyzed in Material Testing Laboratory. 2). Sampling of soil at research site, to be analyzed in Soil Mechanics Laboratory 3). Mixing of materials which are consist of mudflow and other materials and doing strength test in the laboratory. 4). Installation of tertiary irrigation canal lining using materials that have been tested. 5). Observation of lining's strength inactive soil pressure-bearing and its impermeability. It is expected that the results of this research will be applied extensively throughout the tertiary irrigation canals, so mudflow can be utilized as raw materials that are environmentally friendly, which are able to help preserving the environment, also to reduce the removal of sand / rock in the river, which has been used for lining materials, that benefits in preventing damage to the river ecosystem.

Employees' Assessment Of Customer Focus In A Tertiary Hospital In ...

African Journals Online (AJOL)

Employees' Assessment Of Customer Focus In A Tertiary Hospital In ... tool 'Are we making progress?' were used by respondents to rate customer focus. ... that they were allowed to take decisions to solve problems for customers (p < 0.001).

The roles of tertiary amine structure, background organic matter and chloramine species on NDMA formation.

Science.gov (United States)

Selbes, Meric; Kim, Daekyun; Ates, Nuray; Karanfil, Tanju

2013-02-01

N-nitrosodimethylamine (NDMA), a probable human carcinogen, is a disinfection by-product that has been detected in chloraminated and chlorinated drinking waters and wastewaters. Formation mechanisms and precursors of NDMA are still not well understood. The main objectives of this study were to systematically investigate (i) the effect of tertiary amine structure, (ii) the effect of background natural organic matter (NOM), and (iii) the roles of mono vs. dichloramine species on the NDMA formation. Dimethylamine (DMA) and 20 different tertiary aliphatic and aromatic amines were carefully examined based on their functional groups attached to the basic DMA structure. The wide range (0.02-83.9%) of observed NDMA yields indicated the importance of the structure of tertiary amines, and both stability and electron distribution of the leaving group of tertiary amines on NDMA formation. DMA associated with branched alkyl groups or benzyl like structures having only one carbon between the ring and DMA structure consistently gave higher NDMA yields. Compounds with electron withdrawing groups (EWG) reacted preferentially with monochloramine, whereas compounds with electron donating group (EDG) showed tendency to react with dichloramine to form NDMA. When the selected amines were present in NOM solutions, NDMA formation increased for compounds with EWG while decreased for compounds with EDG. This impact was attributed to the competitions between NOM and amines for chloramine species. The results provided additional information to the commonly accepted mechanism for NDMA formation including chloramine species reacting with tertiary amines and the role of the leaving group on overall NDMA conversion. Copyright © 2012 Elsevier Ltd. All rights reserved.

Study on tertiary in-situ leachable uranium mineralization conditions in South Songliao basin

International Nuclear Information System (INIS)

Zhang Zhenqiang; Li Guokuan; Zhao Zonghua; Zhang Jingxun

2001-01-01

Tertiary in-situ leachable mineralization in Songliao Basin was analyzed in theory in the past. Since 1998, regional investigation at 1:200000 scale has been done with about 120 holes drilled. Based on drill holes recording, section compiling and sample analysis, the authors investigate into the Tertiary in-situ leachable conditions including rock character, sedimentary facies, rock chemistry, organic substances, uranium content, sandstone porosity, sandstone bodies, interlayer oxidation, and hydro-dynamic value. The study would play important role in prospecting for in-situ leachable uranium in South Songliao basin

The University of Illinois at Chicago School of Public Health Doctor of Public Health program: an innovative approach to doctoral-level practice leadership development.

Science.gov (United States)

Lenihan, Patrick; Welter, Christina; Brandt-Rauf, Paul; Neuberger, Babette; Pinsker, Eve; Petros, Michael; Risley, Kristine

2015-03-01

The University of Illinois at Chicago, School of Public Health, Doctor of Public Health degree is designed to build leadership skills and an ability to contribute to the evidence base of practice. The competency-based, distance-format, doctoral-level program for midcareer professionals features an action learning approach in which students apply leadership principles from the virtual classroom to real-world problems at their work sites. Students demonstrate mastery of the competencies and readiness to advance to the dissertation stage through completing a portfolio by using a process of systematic reflection. The practice-oriented dissertation demonstrates the ability to contribute to the evidence base of public health practice in an area of emphasis. Preliminary evaluation data indicate that the program is meeting its intended purposes.

Entrepreneurship Education in Delta State Tertiary Institution as a Means of Achieving National Growth and Development

Science.gov (United States)

Osakwe, Regina N.

2015-01-01

This study examined entrepreneurship education in Delta Sate tertiary institutions as a means of national growth and development. Two research questions were asked to guide the study. The population comprised all the 1,898 academic staff in eight tertiary institutions in the state. A sample of 800 lecturers was drawn through the multi stage and…

A Comparison of Teacher and Lecturer Perspectives on the Transition from Secondary to Tertiary Mathematics Education

Science.gov (United States)

Hong, Ye Yoon; Kerr, Suzanne; Klymchuk, Sergiy; McHardy, Johanna; Murphy, Priscilla; Spencer, Sue; Thomas, Michael O. J.; Watson, Peter

2009-01-01

The transition from school to tertiary study of mathematics comes under increasing scrutiny in research. This article reports on some findings from a project analysing the transition from secondary to tertiary education in mathematics. One key variable in this transition is the teacher or lecturer. This article deals with a small part of the data…

Service quality of diagnostic fine needle aspiration cytology in a tertiary care hospital of lahore

International Nuclear Information System (INIS)

Rizvi, Z.; Usmani, R.A.; Zahra, T.; Rasool, H.; Rizvi, A.

2017-01-01

Quality of any service is the most important aspect for the manufacturer as well as the consumer. The primary objective of any nation's health system is to provide supreme quality health care services to its patients. The objective of this study was to assess the quality of diagnostic fine needle aspiration cytology service in a tertiary care hospital. As Patient's perspectives provide valuable information on quality of process, therefore, patient's perception in terms of satisfaction with the service was measured. Methods: In this cross sectional analytical study, 291 patients undergoing fine needle aspiration cytology in Mayo Hospital were selected by systematic sampling technique. Information regarding satisfaction of patients with four dimensions of service quality process, namely procedure, sterilization, conduct and competency of doctor was collected through interview on questionnaire. The questionnaire was developed on SERVQUAL model, a measurement tool, for quality assessment of services provided to patients. All items were assessed on 2- point likert scale (0=dissatisfied, 1=satisfied). Frequencies and percentages of satisfied and dissatisfied patients were recorded for each item and all items in each dimension were scored. If the percentage of sum of all item scores of a dimension was =60, the dimension was 'good quality'. Whereas <60% was 'poor quality' dimension. Data was analysed using epi-info-3.5.1. Fisher test was applied to check statistical significance. (p-value <0.05) Results: Out of the 4 dimensions of service quality process, Procedure (48.8%), Sterilization (51.5%) and practitioner conduct (50.9%) were perceived as 'poor' by the patients. Only practitioner competency (67.4%) was perceived as 'good'. Comparison of dimensions of service quality scoring with overall level of patient satisfaction revealed that all 4 dimensions were significantly related to patient dissatisfaction (p<.05) Conclusion: The study suggests that service quality of

Food formulation and not processing level: Conceptual divergences between public health and food science and technology sectors.

Science.gov (United States)

Botelho, R; Araújo, W; Pineli, L

2018-03-04

Observed changes in eating and drinking behaviors in economically developing countries are associated with increase of obesity and related chronic diseases. Researchers from field of public health (PH) have attributed this problem to food processing and have created new food classification systems to support their thesis. These classifications conceptually differ from processing level concepts in food science, and state to people that food processing is directly related to nutritional impact of food. Our work aims to compare the concept of food processing from the standpoint of food science and technology (FST) and public health and to discuss differences related to formulation or level of processing of products and their impact on nutritional quality. There is a misconception between food processing/unit operation/food technology and formulation or recipes. For the public health approach, classification is based on food products selection and the use of ingredients that results in higher consumption of sugar, sodium, fat, and additives, whereas in FST, processing level is based on the intensity and amount of unit operations to enhance shelf life, food safety, food quality, and availability of edible parts of raw materials. Nutritional quality of a product or preparation is associated with formulation/recipe and not with the level of processing, with few exceptions. The impact of these recommendations on the actual comprehension of food processing and quality must be considered by the population.

FINANCING PUBLIC INSTITUTIONS OF ACADEMIC EDUCATION IN SPAIN

Directory of Open Access Journals (Sweden)

DRĂGUŞIN CRISTINA-PETRINA

2015-04-01

Full Text Available Currently, Spanish universities meet the educational needs of the students with a wide offer of courses and the opportunity to study at all levels. They appear as an attractive option in the context of the relatively low cost of living compared to other countries in the EU area and under conditions of a tax system controlled by the Government. Starting from the assumption that the financing model of the academic education public institutions represents the foundation of their modernization in the current society based on changes and evolution, in this paper we propose to bring into the light of the concerns of those who are interested, through a persuasive exhibit, the Spanish model and its specific features. To this end, our debate will begin with a description of the Spanish system of academic education under the decentralized model of financing imprint, continuing with the presentation of specific skills in terms of funding on the triptych template: state - autonomous communities - universities. Subsequently, our investigative approach will focus on detailing the tertiary education financing sources: public resources, private and patrimonial revenues. The end of our presentation will be intended for conclusions, through which we aim to advance our vision regarding the investigated problems. In fact, the paper is intended to be a precursor step in carrying out a comparative study between the academic education funding mechanism in Romania and the Spanish one.

Dynamic response of tertiary systems in structures subjected to base excitation

International Nuclear Information System (INIS)

Hernried, A.G.; Kai-sing Lau

1988-01-01

The dynamic response of very lightweight equipment (tertiary subsystem) attached to light equipment (secondary subsystem) which in turn is attached to a heavier structure (primary subsystem) that is subjected to ground shock or earthquake excitation is investigated. Both the single-degree-of-freedom and multi-degree-of-freedom subsystem models are considered. The systems are damped as well as undamped, completely detuned (all natural frequencies of the subsystems well spaced), singly tuned (one natural frequency of each subsystem equal or close to one another), or multiply tuned (more than one natural frequency of the subsystems close to each other). Efficient techniques for the determination of the tertiary subsystem response that avoid a computationally intensive numerical integration of the combined system equations are presented. (author)

Sexual Harassment in Tertiary Science: Implications for Gender Equity

African Journals Online (AJOL)

The paper focuses on the incidence of sexual harassment in tertiary science education and its attendant effects on students and academics. Data from a survey of six higher institutions comprising two universities, two colleges of education and two polytechnics was used. Results indicate high rate of sexual harassment of ...

Automated Stock Control System for Bookshops in Tertiary Institutions

African Journals Online (AJOL)

The recent need for automated stock control system for bookshops in tertiary institutions was generated by unequal availability of books and stiff scarcity of books in some areas while in ... This approach provides for faster response times for users because the database is local to each business unit within the organization.

CLINICAL PROFILE OF ANAEMIA IN A TERTIARY CARE HOSPITAL

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Ather Akhtar

2016-04-01

Full Text Available BACKGROUND Anaemia causes a reduction in the oxygen carrying capacity of the blood resulting in tissue hypoxia. Cardiac output at rest is not usually increased in most chronic anaemia until haemoglobin levels fall below 7 g/dL, but abnormal rise in output with exercise may occur with levels as high as 10 g/dL. The increase in cardiac output has been observed to correlate well with the degree of anaemia. Other compensatory mechanisms to chronic anaemia available to the body include decreased circulation time and increased tissue oxygen uptake. The latter is facilitated by a shift to the right of the oxygen haemoglobin dissociation curve. Cardiomegaly may also be as a result of the increased workload on the heart from the increased viscosity of blood in anaemia patients. Anaemia in the elderly is an extremely common problem that is associated with increased mortality and poorer health-related quality of life, regardless of the underlying cause of the low haemoglobin. A study of anaemia in elderly patients found a wide variation in prevalence, ranging from 2.9% to 61% in men and 3.3% to 41% in women. Higher rates were found in hospitalised patients than in community dwellers. It is easy to overlook anaemia in the elderly, since such symptoms as fatigue, weakness, or shortness of breath may be attributed to the ageing process itself. Our objective is to show the prevalence of anaemia even in a tertiary health care centre. METHODS One hundred patients were identified who were admitted in the Department of Medicine, Deccan College of Medical Sciences. Among the 100 patients, 38 were male and 62 were female. The study was conducted from Jan 2014 To Jan 2015. Patients having haemoglobin less than 10 g% in the medical wards were enrolled in the study. RESULTS Among the 100 patients, 38 were male and 62 were female. The average haemoglobin was 6.4 g%, the lowest being 2.8 g%. Peripheral blood smear showed hypochromic picture in 58, macrocytic picture in

Accuracy of MRI diagnosis of internal derangement of the knee in a non-specialized tertiary level referral teaching hospital

International Nuclear Information System (INIS)

Challen, J.; Tang, Y. M.; Stuckey, S.; Hazratwala, K.

2007-01-01

Full text: This study was designed to assess the accuracy of knee MRl examinations carried out in a general tertiary referral hospital without a musculoskeletal fellowship trained radiologist. The study included all patients who had undergone a knee arthroscopy carried out within a 2-year period and who had had a prior MRl knee examination, where both were carried out at this institution. The accuracy of the MRl knee examination was determined by correlation to the arthroscopy report. The accuracy for diagnosis of meniscal and cartilage injuries, in this setting, was found to be similar to a published meta-analysis of previous studies correlating knee MRl and arthroscopy. The overall accuracy of this study was better than the previous similar study. However, the accuracy for diagnosing ACL injuries was lower than in the meta-analysis. The potential reasons for this and other sources of error are discussed

New public diplomacy and its effects on international level

OpenAIRE

Elena Gurgu; Aristide Dumitru Cociuban

2016-01-01

Abstract. The purpose of this article is to make known the new type of public diplomacy and the effects this new diplomacy can have internationally. The objectives of our article refer to the context of change, the role of the media in public diplomacy, new approaches and elements of public diplomacy, current diplomacy in scientific and technical way and the use of scientific cooperation to improve bilateral relations between countries.

PROSPECTIVE ANALYTICAL STUDY ON THE MEDICAL TERMINATION OF PREGNANCIES IN A TERTIARY CARE CENTRE

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S. Gayathriedevi Sellathamby

2017-06-01

Full Text Available BACKGROUND This study is carried out to estimate incidence of medical termination of pregnancies in a tertiary care centre, to analyse the causes of medical termination of pregnancies, to analyse the success of the methods of abortion and adoption family planning procedures in a tertiary care centre (Government Rajaji Hospital, Madurai. This may provide the baseline measures for safe abortion practices and to increase the awareness among men and women of reproductive age, the availability of safe abortion services at locality. The aim of the study is to know the incidence of medical termination of pregnancies in a tertiary level hospital, to study the causes for seeking MTP, to analyse the success of the methods of abortion and adoption of family planning methods. MATERIALS AND METHODS This study was carried out in Government Rajaji Hospital, Madurai, during the period of 12 months from September 2011- August 2012. Of 3516 patients attending the family planning OP, 496 women seek MTP. Among them, every 5 th women were selected and thus 100 cases were included in this study. Social parameters like age, education, residence, marital status, family pattern, number of living children, sex of the living children, obstetric parameters like parity, trimester of abortion, methods of abortion, causes for MTP, adoption of family planning methods, basic investigation like Hb%, BT, CT, urine albumin, RFT, blood sugar, blood grouping and typing and VCTC were included. RESULTS Induced abortions were common in women in 20-29-year age group, more in third gravid, Hindus, from rural areas, living in nuclear family, married and educated. Most of the women seek 1 st trimester abortion with underlying social cause. Majority had surgical abortion. Majority adopted transabdominal tubectomy as the concurrent family planning method. Second trimester abortions common in unmarried, uneducated women. CONCLUSION The variables analysed in this study bring into light the

Delivering tertiary centre specialty care to ALS patients via telemedicine: a retrospective cohort analysis.

Science.gov (United States)

Selkirk, Stephen M; Washington, Monique O; McClellan, Frances; Flynn, Broderick; Seton, Jacinta M; Strozewski, Richard

2017-08-01

This study was undertaken to determine if ALS patients evaluated via telemedicine received the same quality of care as patients evaluated by traditional face-to-face encounters. A retrospective cohort study design was used. Participants were patients diagnosed with ALS that received multidisciplinary care at the tertiary Cleveland VA ALS Centre between 1 March 2008- and 31 anuary 2015. Participants were not randomised, but chose telemedicine based on preference, disability level or distance from the clinic. Telemedicine in this study consisted of a video conferencing platform enabling remote rather than face-to-face encounters with participants. There was no significant association between receiving quality ALS care and the mode of care. There was a trend for telemedicine patients to utilise home health care less often than those that received clinic care (AOR 0.50; 95% CI 0.16-1.59). There was no significant difference in survival time between the two groups (log-rank test χ 2  = 3.62, df = 1, p = 0.05). Patients receiving telemedicine had a higher probability of remaining stable or having telemedicine (HR = 0.39, 95% CI = 0.16-0.93). Patients managed by telemedicine received the same quality of care and had similar outcomes to those patients seen via traditional face-to-face encounters. Telemedicine is an effective platform for delivering high quality tertiary ALS care.

Contraceptive Awareness and Practice Among Antenatal Attendees in a Tertiary Hospital in South-South Nigeria

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Aniekan Monday Abasiattai

2011-02-01

Full Text Available Background: Use of effective contraceptive methods has been shown to improve health, sexual life and partner relations and also significantly reduce maternal and infant mortality by protecting against unplanned pregnancy, high fertility and high parity. The aim of this study is to determine the degree of awareness and practice of contraception by women in Uyo, Nigeria. Materials and Methods: Semi-structured questionnaires were administered to three hundred and seventy women in the antenatal clinic of the University of Uyo Teaching Hospital. Results: Majority of the respondents were 21-30 years old (64.1%, 53.8% were multiparous and 66.5% had tertiary level education. Three hundred and twenty women (87.6% had heard about contraception (OR=49.6, P< 0.001, while only 49.5% of the respondents had practiced contraception previously (OR=0.96, P=0.76 of which the male condom (40.0% and the safe period/calendar method (31.1% were the most commonly practiced methods. Majority of the respondents (66.8% preferred to have 3 to 4 children and 78.4% of the respondents would want to used a method of contraception to either space their family or limit child bearing (OR=13.14, P< 0.001. Fear of side effects (20.0% and previous bad experience (8.8% were the most common reasons given by those respondents who would not want to practice contraception. Conclusion: This study reveals a high level of awareness of contraception but a significant unmet need among the respondents. There is need to intensify public enlightenment campaigns in our environment emphasizing the benefits and safety of modern contraceptive methods. Community leaders and heads of social groups and women organisations should be co-opted in the dissemination of accurate information on contraception. [TAF Prev Med Bull 2011; 10(1.000: 29-34

Assessing Readiness for Integration of Electronic Learning into Business Education Programmes in Tertiary Institutions in Ebonyi State

Science.gov (United States)

Nwagwu, Lazarus; Azih, Nonye

2015-01-01

The study was conducted to assess readiness for integration of electronic learning into business education programmes in tertiary institutions in Ebonyi State. Two research questions and two hypotheses guided the study. The population was 37 business education lecturers and 748 Business Education Students in tertiary institutions that offer…

Study on generic intervention levels for protecting the public in a nuclear accident or radiological emergency

International Nuclear Information System (INIS)

Suzuki, Fabio Fumio

2003-01-01

After a nuclear accident or radiological emergency, several social and economical factors shall be considered for the actions to protect the public and to recover the environment. The application of the radiological protection principles on practices in intervention situations may lead to adoption of protective measures disproportional to the involved risk, compromising the resources available to more effective actions. This causes a negative impact on the population and may conduct to discredit about the protective measures and the lost of confidence on the authorities. In this context, the principles of radiological protection for interventions should be studied and analyzed for being adequately applied in accident situations or radiological emergencies that involves the country. These principles are constantly improved and the concept of generic intervention level plays an important role in the decision-making to protect the public. The costs involved to the protective measures for the public in Brazil were studied and cost benefit analysis techniques were applied to estimate the generic intervention levels for public protection applicable in the country. These results were compared to those values internationally recommended, as well to values obtained in a similar study accomplished for Japan. It was also performed a sensibility analysis of the results regarding a value and a simple analysis of the results considering the costs of the several protective measures. (author)

Tentorial and dural calcification with tertiary hyperparathyroidism: a rare entity in chronic renal failure

International Nuclear Information System (INIS)

Dorenbeck, U.; Bretschneider, T.; Feuerbach, S.; Leingaertner, T.; Kraemer, B.K.

2002-01-01

A case of rare calcification of the tentorium cerebelli, the thoracal dura mater of the spine, and the sclera in an adult male patient with tertiary hyperparathyroidism is presented. The often reported feature in the skull is that of a combination of osteopenia and osteosclerosis giving a granular bone texture. Extensive dura calcification with this condition has very rarely been reported. It is the aim of this paper to document the latter in a patient with chronic renal failure and tertiary hyperparathyroidism. (orig.)

Food Insecurity: Is It an Issue among Tertiary Students?

Science.gov (United States)

Gallegos, Danielle; Ramsey, Rebecca; Ong, Kai Wen

2014-01-01

Insufficient access to food is known to compromise tertiary studies. Students often belong to groups known to have poor food security such as those renting or relying on government payments. The present study administered a cross-sectional survey incorporating the USDA food security survey module (FSSM) to 810 students at a metropolitan university…

Motivation in vocational education: a reform issue in tertiary ...

African Journals Online (AJOL)

Working in a non-motivating environment is a nagging issue in various tertiary institutions in Cross River State .This dampens staff morale a great deal. However, the provision of motivation in work places will be a great boost to staff morale especially in Vocational Education. This paper discusses the meaning of motivation, ...

New public diplomacy and its effects on international level

Directory of Open Access Journals (Sweden)

Elena Gurgu

2016-09-01

Full Text Available Abstract. The purpose of this article is to make known the new type of public diplomacy and the effects this new diplomacy can have internationally. The objectives of our article refer to the context of change, the role of the media in public diplomacy, new approaches and elements of public diplomacy, current diplomacy in scientific and technical way and the use of scientific cooperation to improve bilateral relations between countries.

Financial impact of tertiary care in an academic medical center.

Science.gov (United States)

Huber, T S; Carlton, L M; O'Hern, D G; Hardt, N S; Keith Ozaki, C; Flynn, T C; Seeger, J M

2000-06-01

To analyze the financial impact of three complex vascular surgical procedures to both an academic hospital and a department of surgery and to examine the potential impact of decreased reimbursements. The cost of providing tertiary care has been implicated as one potential cause of the financial difficulties affecting academic medical centers. Patients undergoing revascularization for chronic mesenteric ischemia, elective thoracoabdominal aortic aneurysm repair, and treatment of infected aortic grafts at the University of Florida were compared with those undergoing elective infrarenal aortic reconstruction and carotid endarterectomy. Hospital costs and profit summaries were obtained from the Clinical Resource Management Office. Departmental costs and profit summary were estimated based on the procedural relative value units (RVUs), the average clinical cost per RVU ($33.12), surgeon charges, and the collection rate for the vascular surgery division (30.2%) obtained from the Faculty Group Practice. Surgeon work effort was analyzed using the procedural work RVUs and the estimated total care time. The analyses were performed for all payors and the subset of Medicare patients, and the potential impact of a 15% reduction in hospital and physician reimbursement was analyzed. Net hospital income was positive for all but one of the tertiary care procedures, but net losses were sustained by the hospital for the mesenteric ischemia and infected aortic graft groups among the Medicare patients. In contrast, the estimated reimbursement to the department of surgery for all payors was insufficient to offset the clinical cost of providing the RVUs for all procedures, and the estimated losses were greater for the Medicare patients alone. The surgeon work effort was dramatically higher for the tertiary care procedures, whereas the reimbursement per work effort was lower. A 15% reduction in reimbursement would result in an estimated net loss to the hospital for each of the tertiary

Public opposition to the siting of the high-level nuclear waste repository: The importance of trust

International Nuclear Information System (INIS)

Pijawka, K.D.; Mushkatel, A.H.

1991-01-01

This paper examines several dimensions of public opposition to the proposed siting of the high-level nuclear waste repository at Yucca Mountain. In order to provide a context for the public's views of the repository in metropolitan Clark County, both governmental studies of the repository siting process are analyzed, as well as elements of the Nuclear Waste Policy Act. This analysis suggests that one potentially key component of the public's opposition to the siting, as well as their perceptions of risk of the facility, may be the result of a lack of trust in the Department of Energy. Empirical analysis of survey data collected in Nevada in 1988 confirms the strong relationship between political trust and repository risk perceptions

Mapping of radio frequency electromagnetic field exposure levels in outdoor environment and comparing with reference levels for general public health.

Science.gov (United States)

Cansiz, Mustafa; Abbasov, Teymuraz; Kurt, M Bahattin; Celik, A Recai

2018-03-01

In this study, radio frequency electromagnetic field exposure levels were measured on the main streets in the city center of Diyarbakır, Turkey. Measured electric field levels were plotted on satellite imagery of Diyarbakır and were compared with exposure guidelines published by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Exposure measurements were performed in dense urban, urban and suburban areas each day for 7 consecutive days. The measurement system consisted of high precision and portable spectrum analyzer, three-axis electric field antenna, connection cable and a laptop which was used to record the measurement samples as a data logger. The highest exposure levels were detected for two places, which are called Diclekent and Batıkent. It was observed that the highest instantaneous electric field strength value for Batıkent was 7.18 V/m and for Diclekent was 5.81 V/m. It was statistically determined that the main contributor band to the total exposure levels was Universal Mobile Telecommunications System band. Finally, it was concluded that all measured exposure levels were lower than the reference levels recommended by ICNIRP for general public health.

Risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in a tertiary armed force referral and teaching hospital, Ethiopia.

Science.gov (United States)

Demile, Biresaw; Zenebu, Amare; Shewaye, Haile; Xia, Siqing; Guadie, Awoke

2018-05-31

Ethiopia is one of the world health organization defined higher tuberculosis (TB) burden countries where the disease remains a massive public health threat. This study aimed to identify the prevalence and associated factors of multidrug-resistant tuberculosis (MDR-TB) using all armed force and civilian TB attendants in a tertiary level armed force hospital, where data for MDR-TB are previously unpublished. Cross-sectional study was conducted from September 2014 to August 2015 in a tertiary level Armed Force Referral and Teaching Hospital (AFRTH), Ethiopia. Armed force members (n = 251) and civilians (n = 130) which has been undergone TB diagnosis at AFRTH were included. All the specimens collected were subjected to microscopic smear observation, culture growth and drug susceptibility testing. Data were analyzed using statistical package for social sciences following binary logistic regression and Chi-square. P-values < 0.05 were considered statistically significant. Among 381 TB patients, 355 (93.2%) new and 26 (6.8%) retreatment cases were identified. Culture and smear positive TB cases were identified in 297 (77.9%) and 252 (66.1%) patients, respectively. The overall prevalence of MDR-TB in AFRTH was found 1.8% (1.3% for armed force members and 0.5% for civilian patients) all of which were previously TB treated cases. The entire treatment success rates were 92.6% achieved highest in the armed force (active and pension) than the civilian patients. The failure and dead cases were also found 2.5 and 4.6%, respectively. Using bivariate analysis, category of attendants and TB contact history were strong predictors of MDR-TB in armed force and civilian patients. Moreover, human immunodeficiency virus (HIV) infection also identified a significant (OR = 14.6; 95% CI = 2.3-92.1; p = 0.004) predicting factor for MDR-TB in armed force members. However, sex, age and body mass index were not associated factor for MDR-TB. In AFRTH, lower prevalence of

The association between estimated average glucose levels and fasting plasma glucose levels in a rural tertiary care centre

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Raja Reddy P

2013-01-01

Full Text Available The level of hemoglobin A1c (HbA1c, also known as glycated hemoglobin, determines how well a patient’s blood glucose level has been controlled over the previous 8-12 weeks. HbA1c levels help patients and doctors understand whether a particular diabetes treatment is working and whether adjustments need to be made to the treatment. Because the HbA1c level is a marker of blood glucose for the previous 60- 90 days, average blood glucose levels can be estimated using HbA1c levels. Aim in the present study was to investigate the relationship between estimated average glucose levels, as calculated by HbA1c levels, and fasting plasma glucose levels. Methods: Type 2 diabetes patients attending medicine outpatient department of RL Jalappa hospital, Kolar between March 2010 and July 2012 were taken. The estimated glucose levels (mg/dl were calculated using the following formula: 28.7 x HbA1c-46.7. Glucose levels were determined using the hexokinase method. HbA1c levels were determined using an HPLC method. Correlation and independent t- test was the test of significance for quantitative data. Results: A strong positive correlation between fasting plasma glucose level and estimated average blood glucose levels (r=0.54, p=0.0001 was observed. The difference was statistically significant. Conclusion: Reporting the estimated average glucose level together with the HbA1c level is believed to assist patients and doctors determine the effectiveness of blood glucose control measures.

An analysis of orthopaedic theses in Turkey: Evidence levels and publication rates.

Science.gov (United States)

Koca, Kenan; Ekinci, Safak; Akpancar, Serkan; Gemci, Muhammed Hanifi; Erşen, Ömer; Akyıldız, Faruk

2016-10-01

The aim of this study was to present characteristics and publication patterns of studies arise from orthopedic theses obtained from National Thesis Center; database in terms of publication years, study types, topics, level of evidence between 1974 and 2014. Firstly, National Thesis Center database was searched for orthopedics and Traumatology theses. The theses, which their summary or full text were available were included in the study. The topics, study types and quality of study designs were reviewed. Then theses were searched in the PubMed database. Journals of published theses were classified according to category, scope and impact factors of the year 2014. 1508 theses were included into the study. Clinical studies comprised 71,7% of the theses, while 25,6% of the theses were non-clinical experimental and 2,7% of the theses were observational studies. Clinical studies were Level I in 8,6% (n = 93) and Level II in 5,8% of the theses (n = 63). A total of 224 theses (14,9%) were published in the journals indexed in PubMed database from 1974 to 2012. Fifty-two (23,2%) were published in SCI; 136 theses (60,7%) were published in SCI-E journals and 36 theses (16%) were published in other Journals indexed in PubMed. The quantity and quality of published theses need to be improved and effective measures should be taken to promote quality of theses. Theses from universities and Training hospitals which did not allow open access, and; incomplete records of the National Thesis Center database were major limitations of this study. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Accessibility of tertiary hospitals in Finland: A comparison of administrative and normative catchment areas.

Science.gov (United States)

Huotari, Tiina; Antikainen, Harri; Keistinen, Timo; Rusanen, Jarmo

2017-06-01

The determination of an appropriate catchment area for a hospital providing highly specialized (i.e. tertiary) health care is typically a trade-off between ensuring adequate client volumes and maintaining reasonable accessibility for all potential clients. This may pose considerable challenges, especially in sparsely inhabited regions. In Finland, tertiary health care is concentrated in five university hospitals, which provide services in their dedicated catchment areas. This study utilizes Geographic Information Systems (GIS), together with grid-based population data and travel-time estimates, to assess the spatial accessibility of these hospitals. The current geographical configuration of the hospitals is compared to a normative assignment, with and without capacity constraints. The aim is to define optimal catchment areas for tertiary hospitals so that their spatial accessibility is as equal as possible. The results indicate that relatively modest improvements can be achieved in accessibility by using normative assignment to determine catchment areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

Epidemiology of paediatric poisoning reporting to a tertiary hospital ...

African Journals Online (AJOL)

Methods. We conducted a retrospective study from January 2007 to January 2012 at the Komfo Anokye Teaching Hospital, a tertiary hospital in Ghana. Results. Poisoning is a significant health problem in the study area. A total of 253 children reported to the hospital with poisoning over the 61month period, with an average ...

Rethinking Materiality In Pre-Tertiary Studio Art Education In Ghana

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Kwame Opoku-Bonsu

2017-12-01

Full Text Available This paper explores the conventional artist and environment connections, and argues that, environment that produce the Senior High School student do so with peculiar material affinities and competences ripe for 21st century art. The culture of obliging student to a few institutionalised media like clay, dyes and paints in the studio based art disciplines inhibit the numerous possibilities available, and confines art education to limited aptitudes and few institutionally expected expressions in pre-tertiary art education in Ghana. Using content analysis, the paper examines the Art Curricula and WAEC examination questions for Art Students at the SHS level. It recommends that, curricula and examination item reviews, as well as the incorporation of visual and material culture into artistic processes through democratization and participations of candidates’ cultural backgrounds, will usher in an art education premised on meaning making and conception, and institutionally groomed cultural ambassadors with significant material and visual diversities and competences.

COMPARATIVE STUDY OF TERTIARY WASTEWATER TREATMENT BY COMPUTER SIMULATION

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Stefania Iordache

2010-01-01

Full Text Available The aim of this work is to asses conditions for implementation of a Biological Nutrient Removal (BNR process in theWastewater Treatment Plant (WWTP of Moreni city (Romania. In order to meet the more increased environmentalregulations, the wastewater treatment plant that was studied, must update the actual treatment process and have tomodernize it. A comparative study was undertaken of the quality of effluents that could be obtained by implementationof biological nutrient removal process like A2/O (Anaerobic/Anoxic/Oxic and VIP (Virginia Plant Initiative aswastewater tertiary treatments. In order to asses the efficiency of the proposed treatment schemata based on the datamonitored at the studied WWTP, it were realized computer models of biological nutrient removal configurations basedon A2/O and VIP process. Computer simulation was realized using a well-known simulator, BioWin by EnviroSimAssociates Ltd. The simulation process allowed to obtain some data that can be used in design of a tertiary treatmentstage at Moreni WWTP, in order to increase the efficiency in operation.

Conflict and coordination in the provision of public goods: a conceptual analysis of continuous and step-level games.

Science.gov (United States)

Abele, Susanne; Stasser, Garold; Chartier, Christopher

2010-11-01

Conflicts between individual and collective interests are ubiquitous in social life. Experimental studies have investigated the resolution of such conflicts using public goods games with either continuous or step-level payoff functions. Game theory and social interdependence theory identify consequential differences between these two types of games. Continuous function games are prime examples of social dilemmas because they always contain a conflict between individual and collective interests, whereas step-level games can be construed as social coordination games. Step-level games often provide opportunities for coordinated solutions that benefit both the collective and the individuals. For this and other reasons, the authors conclude that one cannot safely generalize results obtained from step-level to continuous-form games (or vice versa). Finally, the authors identify specific characteristics of the payoff function in public goods games that conceptually mark the transition from a pure dilemma to a coordination problem nested within a dilemma.

Ectopic pregnancy experience in a tertiary health facility in South ...

African Journals Online (AJOL)

Background: Ectopic pregnancy is a life-threatening gynecological emergency, and a significant cause of maternal morbidity and mortality in Nigeria. Objective: To determine the incidence, clinical presentation, risk factors and management outcomes of ectopic pregnancies in a tertiary health facility. Methods: A retrospective ...

26 CFR 1.193-1 - Deduction for tertiary injectant expenses.

Science.gov (United States)

2010-04-01

... in which the expenses are paid or incurred. (b) Definitions—(1) Qualified tertiary injectant expenses... Chief Counsel (Technical) for purposes of section 193. (c) Special rules for hydrocarbons—(1) In general. If an injectant contains more than an insignificant amount of recoverable hydrocarbons, the amount...

Induction of secondary and tertiary lymphoid structures in the skin.

NARCIS (Netherlands)

Cupedo, T.; Jansen, W.; Kraal, G.; Mebius, R.E.

2004-01-01

During embryogenesis a developmental program leading to the formation of lymph nodes and Peyer's patches is initiated. We now show that lymph node-like structures as well as tertiary lymphoid structures can ectopically be induced by intradermal injection of newborn lymph node-derived cells.

Chronic Carcinogenicity Study of Gasoline Vapor Condensate (GVC) and GVC Containing Methyl Tertiary-Butyl Ether in F344 Rats

OpenAIRE

Benson, Janet M.; Gigliotti, Andrew P.; March, Thomas H.; Barr, Edward B.; Tibbetts, Brad M.; Skipper, Betty J.; Clark, Charles R.; Twerdok, Lorraine

2011-01-01

Chronic inhalation studies were conducted to compare the toxicity and potential carcinogenicity of evaporative emissions from unleaded gasoline (GVC) and gasoline containing the oxygenate methyl tertiary-butyl ether (MTBE; GMVC). The test materials were manufactured to mimic vapors people would be exposed to during refueling at gas stations. Fifty F344 rats per gender per exposure level per test article were exposed 6 h/d, 5 d/wk for 104 wk in whole body chambers. Target total vapor concentra...

Differences between users of six public parks in Barcelona depending on the level of perceived safety in the neighborhood

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Félix Pérez Tejera

2012-03-01

Full Text Available Research on the relation between fear of crime and public space has been often limited to psychosocial processes (place attachment, social cohesion, collective efficacy and the effect of environmental variables (brightness, graffitis, cleaness. Most of the behavioral aspects involved, however, have been neglected. In this work we carried out a systematic observational study of the types of users (gender, age, ethnicity, signs of poverty of six public parks in Barcelona. We examined whether there would be differences between users of three parks in the neighbourhood with the highest level of fear of crime and the users of three public parks in the neighbourhoods with the highest levels of perceived safety. The analysis showed significant differences in the spatial occupancy patterns between the two neighbourhoods. The differences highlighted processes of avoidance of public space by women, children and the elderly, and processes of spatial segregation depending on ethnicity and the presence of signs of poverty.

Employing the EPEC Hierarchy of Conditions (Version II) to Evaluate the Effectiveness of Using Synchronous Technologies with Multi-Location Student Cohorts in the Tertiary Education Setting

Science.gov (United States)

Eady, Michelle J.; Woodcock, Stuart; Sisco, Ashley

2017-01-01

As e-learning maintains its popularity worldwide, and university enrolments continue to rise, online tertiary level coursework is increasingly being designed for groups of distributed learners, as opposed to individual students. Many institutions struggle with incorporating all facets of online learning and teaching capabilities with the range and…

Noble metals in cretaceous/tertiary sediments from El Kef

International Nuclear Information System (INIS)

Kuslys, M.; Kraehenbuehl, U.

1983-01-01

Sediments from El Kef, Tunisia, were analysed by RNAA for Au, Ir and Os. All three elements show a 10-20 fold enrichment at the Cretaceous/Tertiary boundary. This enrichment must be the result of the addition of material with a high concentration of noble metals. It is plausible that this exotic material has an extra-terrestrial origin. (orig.)

Noble metals in Cretaceous/Tertiary sediments from El Kef

International Nuclear Information System (INIS)

Kuslys, M.; Kraehenbuehl, U.

1983-01-01

Sediments from El Kef, Tunisia, were analysed by RNAA for Au, Ir and Os. All three elements show a 10-20 fold enrichment at the Cretaceous/Tertiary boundary. This enrichment must be the result of the addition of material with a high concentration of noble metals. It is plausible that this exotic material has an extraterrestrial origin. (orig.)

Knowledge, attitude, and infection control practices of two tertiary ...

African Journals Online (AJOL)

2014-04-02

Apr 2, 2014 ... This study assessed the effects of the implementation of the policy in a tertiary hospital in Port Harcourt, ... malpractice suit in developing countries, not only for the ... Infection control policy has however been shown to reduce the burden of ..... SSIs‑activities that mirror the plan‑do‑check‑act that is applied in ...

The Incidence and Management of Conflicts in Secular and Non-Secular Tertiary Institutions in South West Nigeria

Science.gov (United States)

Ayodele, Joseph Babatola; Adewumi, Joseph Olukayode

2007-01-01

This paper compared the incidence and management of conflicts in secular and non-secular tertiary institutions in Nigeria. The sample of this study was made of sixty staff, and two hundred and forty students randomly selected each from two secular and two non-secular tertiary institutions in south western Nigeria. A validated questionnaire was…