In Malaysia, mineral processing plant is one of the Naturally Occurring Radioactive Material (NORM) processing industries controlled by the Atomic Energy Licensing Board (AELB) through the enforcement of Atomic Energy Licensing Act 1984 (Act 304). The activities generated waste which is called as TENORM wastes. TENORM wastes are mainly found in thorium hydroxide from the processing of xenotime and monazite, and iron oxide and red gypsum from the processing of ilmenite. Other TENORM wastes are scales and sludge from the oil and gas industries, tin slag produced from the smelting of tin, and ilmenite, zircon,
and monazite produced from the processing of tin tailing (amang). The environmental and radiological monitoring program is needed to ensure that the TENORM wastes did not caused any contamination to the environment. The wastes vary in the types of samples, parameters of analysis as well as the frequency of monitoring based on license’s conditions issued by the AELB. The main objective of this study is to assess the suitability of license’s condition and the monitoring program required in oil and gas, and mineral processing
industries. Study was done by assessing the data submitted to the AELB in order to comply with the licensing requirement. This study had found out that there are a few of license’s conditions that need to be reviewed accordingly based on the processing activity.
Muhammad Akmal Asraf Mohamad Sharom, Zainol Abidin Ibrahim, Wan Ahmad Tajuddin Wan Abdullah, Megat Harun Al Rashid Megat Ahmad, Faridah Mohamad Idris, Abdul Aziz Mohamed
Small angle neutron scattering (SANS) is used for probing the microstructure of materials in the range between 1-100 nm in dimension. The scattered neutrons from the target material were detected by a 128 x 128 array area sensitive, Helium gas-filled proportional counter, which is known as Position Sensitive Detector (PSD). The small angle neutron scattering (SANS) facility in Malaysian Nuclear Agency has been developed since 1995. The data acquisition system of this prototype facility consists of the two-dimensional Position Sensitive Detector (2D-PSD) and neutron monitor as a data grabber, TDC Histogram as a memory processing processor, two units of ORTEC 994 as a counter and timer and a computer as a data acquisition controller via GPIB interfacing protocol. This paper will describe on the development of GPIB interface for data acquisition of the SANS instrument on Windows based platform. The GPIB device interface and graphical user interface (GUI) for this data acquisition is developed using WaveMetrics Igor software.
MeSH terms: Computers; Helium; Neutrons; Software; Scattering, Small Angle
Many studies were carried out throughout the world on radon measurement in water especially drinking water for it can cause problem to human health. This study is an attempt to measure the level of radon present in water collect from rivers and lakes. Data gathered from this study provides important information about radiation levels in water at selected sites, because radon gas is the largest contributor to natural radioactive radiation exposure to humans. Exposure to radon gas can cause lung cancer. Liquid scintillation counting (LSC) has been applied to determine the activity concentration of radon ( 222 Rn) in water. Water samples were collected from, ex-mining lake in Perak, Sok River in Kelantan, Tembeling River in Pahang. Water samples were prepared in polyethylene bottles mixed with liquid scintillator and stored for 3 weeks to allow 222 Rn and its progeny to reach the equilibrium, and the activity concentrations ranged from 0.24-1.27 Bq/L, and 0.029 – 0.155 Bq/L for radon and radium respectively.
Neutrino is one of the nuclear particles that are necessary for the correct description of nuclear beta decay. The standard idea is that it is a massless neutral particle and its existence was postulated in order to save the conservation of ener gy principle. This particle was later detected experimentally and it is now known that neutrino has mass. The problem of astrophysical neutrino detection has produced a new phenomenon of neutrino oscillation where the three neutrino flav ours can oscillate between themselves. This paper studies the two component neutrino oscillation problem. We study the neutrino oscillation by using the Lagrangian formulation. In our study, we assume that the neutrinos are produced as n eutrino mass eigenstate and propagate in the vacuum in the superposition of two neutrino flavour state. The Lagrangian for neutrinos with their mass and the oscillation terms were obtained. By using the mass matrix in the Lagrangian, we formulate the time evolution operator in the interaction picture. The neutrino oscillation probability obtained by using the Lagrangian formulation have the same result with the one obtained by using quantum mechanics formulation. This study hopes to gain some deeper understanding into the behaviour of neutrino beyond the Standard Model.
This paper studies the use of gamma irradiation for textile waste water treatment. Prior to irradiation, the raw wastewa ter was diluted using tap water to targeted concentration of COD 400 mg/l. The sample was irradiated at selected dose between the ranges of 2kGy to 100kGy. The results showed that Irradiation was effective in removing the highly colored refractory organic pollutants. The COD removal at lowest dose, 2kGy is about 310 mg/l. Meanwhile, at highest dose, 1 00kGy the COD reduced to 100mg/l. The degree of removal influenced by the dose introduced during the treatment pro cess. As the dose increased, higher removal of organic pollutant was recorded. On the other hand, other properties of t he wastewater such as pH, turbidity, suspended solid, BOD and color shows tremendous changes as the dose increases. This shows the concentration of pollutants and dose of irradiation applied are directly proportional to each other.
MeSH terms: Color; Paper; Textiles; Water; Water Purification; Waste Water
The use of microemulsion in the development of nanoparticle based on acrylated palm oil product is demonstrated. Acr ylated palm oil microemulsions were prepared using ionic surfactant. Combination methods of emulsion polymerization and radiation crosslinking were applied to the microemulsion system for synthesizing nanoparticle. The ionizing radiat ion technique was introduced to generate a crosslinking reaction in the development of nanoparticle. The nanoparticle was evaluated in terms of particle diameter, surface charge, pH and conductance. Their image was captured using Tra nsmission electron microscopy (TEM). Results show that the size, charge and shape of the particles are influenced by c oncentration of surfactants, monomer concentration, radiation dose and time of storage. The study showed a promising method to produced nanoparticle. This nano-sized product has the potential to be utilized as controlled-drug-release-carrier.
MeSH terms: Drug Carriers; Emulsions; Microscopy, Electron; Plant Oils; Surface-Active Agents; Nanoparticles; Polymerization; Drug Liberation
There are many essential and non-essential elements including metals and radionuclides present in vegetables. Howeve r, the accumulation of the several metals and radionuclides might cause the contamination to vegetables itself. Green m ustard (Brasissca rapa var. Parachinesis L.) was selected to represent the vegetable in this study. Objectives of this stud y are to determine the concentration of metals and radionuclides in the samples and to calculate the enrichment factor ( EF) and also to estimate the uptake, base on biological accumulation coefficient (BAC), for the various parts of selecte d vegetables. Three farmlands in the Cameron Highlands were studied namely Bharat, Kg Raja and Bertam area. The g reen mustard and soil samples were collected during the harvest season. Samples were dried, ground and sieved prior t o analysis. Analyses for both samples were done by using X-rays Fluorescence Spectroscopy (XRF) to measure the conc entration of Fe, Zn, Hg, U and Th. The concentration of all elements in the soils is lower than their concentration in the control soil, except for Zn, U and Th. The concentration of all elements in Green Mustard is lower than their concentrat ion in the soil where it was grown. The EF values in the Brasissca rapa var. Parachinesis L are lower than 2 except for U and Th, indicating some degree of contamination due to anthropogenic activities or naturally origin. The BAC values show that Zn and Hg were accumulated in the green mustard, depending on where the plant grows.
For the purpose of teaching statistics, lecturers often rely on data from real studies, text book examples or painstakingly created datasets. The process of creating a dataset can be made easier with the utilization of PASW Statistics to generate random values. The objective of this article is to demonstrate the creation of data which are measured on continuous scale, using PASW Statistics menus and syntax.
The community placement programme was first introduced to our medical students in 2007. The objectives of this community service programme are to enable students to explore and understand the importance of various skills such as leadership, teamwork and interest towards community services, as well as to improve their skills in those areas for becoming better students and future doctors. The first year medical students were tasked to plan, organize and implement activities in selected communities such as disabled people, orphans, neglected elderly, the poor, HIV positive single mothers and children. Amongst the activities conducted were sharing experiences and thoughts, games, donation and ‘gotong-royong’. The objective of this study was to evaluate the students’ perception on the successfulness of the community placement programme in building their professional qualities. A cross-sectional study was conducted among the first year medical students using a self-administered questionnaire. The questionnaire consists of 5 elements of professional qualities such as leadership and team work skills, interest towards community services, volunteerism and empathy. Self-reflection sessions were also held to explore the learning points gained. A total of 147 students answered the questionnaires. The students rated the overall programme as highly useful (80.6%) and as achieving the objectives (80.1%). They perceived that this programme helped them to improve their personal and professional skills such as leadership (70.0%), team work (71.4%), interest towards community services (87.1%), volunteerism (85.0%), and empathy (89.1%). Self-reflection revealed that the programme made them realize the role of doctors in a community, appreciate the spirit of teamwork and helped them to understand the need of vulnerable groups. As a conclusion, this programme was well-accepted and perceived as assisting medical students to build professional qualities to become caring and competent doctors.
MeSH terms: Cross-Sectional Studies; Empathy; Disabled Persons; Leadership; Learning; Malaysia; Mothers; Perception; Physicians; Surveys and Questionnaires; Social Welfare; Students, Medical; Volunteers; HIV Infections; Child, Orphaned
Objective: To determine the construct validity, convergent validity, construct reliability and internal consistency of the Medical Student Stressor Questionnaire (MSSQ) among first-year medical students in Malaysia. Methods: A multicenter cross-sectional study was done on 375 medical students of four medical schools in Malaysia. The confirmatory factor analysis and reliability analysis were applied to measure construct validity, construct reliability and internal consistency of the MSSQ. These analyses were done using Predictive Analytics SoftWare (PASW) version 18 and Analysis of Moment Structure (AMOS) version 19. The Composite Reliability and Average Variance Extracted of the final constructs were calculated manually to determine construct reliability and convergent validity. Results: A total of 359 (95.7%) medical students responded to this study. The confirmatory factor analysis showed the six factor model with 20 items had a good fit with the latent constructs (X2 (df) = 258.02 (155), p < 0.001, RMR = 0.055, GFI = 0.933, AGFI = 0.910, NFI = 0.931, RFI = 0.916, IFI = 0.971, TLI = 0.965, CFI = 0.971, RMSEA = 0.043). The Cronbach’s alpha value of the MSSQ was 0.92. The Cronbach’s alpha values of the six constructs were more than 0.7. Composite Reliability and Average Variance Extracted values of the six constructs were more than 0.6 and 0.5 respectively indicating good construct reliability and adequate convergent validity. Conclusion: This study suggested that the six factor model with 20 items of the MSSQ had a good fit and shown good psychometric values. It is a valid and reliability measurement to identify stressors among medical students across institutions in Malaysia.
Background: In order to achieve the desired performance of graduates a number of traditional evaluation exercises have been practiced to assess their competence as medical students. Many of these assessments are done in a controlled environment and mostly reflect on tests of competence than performance. Mini-CEX or direct observed procedural skills (DOPS) are the real performance-based assessment of clinical skills. Increased opportunity for observation and just-in-time feedback from the role model superiors produce a positive educational impact on students learning. This also provides trainees with formative assessment to monitor their learning objectives. However, to implement assessment strategies with Mini-CEX or DOPS needs to develop institution’s clear policy for a different teaching and learning culture of workplace based assessment. It also needs to develop user friendly rating form, checklist, elaboration of clinical competence and its attributes and procedural guidelines for practice. A precise role of these tools in the assessment of postgraduate program must be established before practicing them to evaluate and monitor trainee’s progress.
Objective: To determine DOPS for its acceptability and feasibility as a method of formative assessment of clinical skills in postgraduate program of Otolaryngology and Head-Neck Surgery.
Method: A total of 25 trainees were assessed for DOPS by 8 supervisors in this 12-weeks pilot study. A faculty development program for faculty members and trainees was run for DOPS. Trainees were advised to undertake at least one DOPS encounter out of 42 shortlisted procedures. Assessors were asked to mark trainees by completing a rating form using a checklist developed for each procedure. Trainees and assessors were asked to endorse their opinion on feasibility and acceptance of DOPS for practice of formative assessment in future. Data was analyzed to determine feasibility and acceptability of DOPS in assessment program. Result: Faculty development and trainees orientation in DOPS were found satisfactory for its acceptance and feasible for its practice. Trainees were mostly assessed in outpatient clinical setting. Majority reported higher rating of satisfaction by assessors and trainees. Among clinical skills higher rating was received in procedural skills performed by the senior trainees. Conclusion: DOPS was found feasible for practice of formative assessment of trainees in postgraduate program of Otolaryngology and Head-Neck Surgery in School of Medical Sciences (SMS) at Universiti Sains Malaysia (USM). It was well accepted by the trainees to help monitor their quality of procedural skills as self-directed learning.
MeSH terms: Clinical Competence; Environment, Controlled; Faculty; Feedback; Malaysia; Otolaryngology; Outpatients; Personal Satisfaction; Pilot Projects; Schools, Medical; Students, Medical; Program Evaluation; Workplace; Checklist
Objective: To determine the internal consistency and construct validity of the Adult Learning Inventory (AL-i) among first year medical students in a Malaysian medical school. Methods: Cross sectional study was done on 196 first year medical student in Universiti Sains Malaysia (USM). The Cronbach’s alpha reliability analysis, exploratory factor analysis and confirmatory factor analysis were applied to measure internal consistency and construct validity of the AL-i respectively. These analyses were done using Predictive Analytics SoftWare (PASW) version 18 and Analysis of Moment Structure (AMOS) version 19. Result: A total of 196 medical students responded to this study. Exploratory factor analysis showed that two potential constructs would be extracted from the inventory. The confirmatory factor analysis showed the two factor model with six items had a good fit with the latent constructs (X2 (df) = 25.63 (8), p = 0.048, RMR = 0.045, GFI = 0.974, AGFI = 0.933, NFI = 0.974, RFI = 0.951, IFI = 0.987, TLI = 0.975, CFI = 0.987, RMSEA = 0.07). Each domain of the final model of the AL-i has three items. The Cronbach’s alpha value of the AL-i was 0.72. The Cronbach’s alpha values of andragogy and pedagogy domains were 0.87 and 0.86 respectively. Composite Reliability and Average Variance Extracted values were more than 0.6 and 0.5 respectively indicating good construct reliability and adequate convergent validity. Conclusion: This study suggested that the two factor model with 6 items of the AL-i has a good fit and shown good psychometric values. It is a valid and reliability measurement to determine types of leaner among first year medical students.
Background: Competence-based curriculum has become the need of medical education to meet the objectives of institutions aiming to produce skilled physicians. To achieve the optimal competence and performance of graduates a number of traditional evaluation exercises have been practiced. Some of these e.g. OSCE although meet the acceptable standard of reliability and validity is the assessment done in a controlled environment. This leaves the room for performance-based assessment in real clinical situation such as mini clinical evaluation exercise (Mini-CEX). To practice and meet the challenges of Mini-CEX it is vital to undertake faculty development program with a comprehensively chalked down Mini-CEX protocol and its objectives to achieve the intended outcome. Objective: To undertake faculty development on Mini-CEX for its feasibility and acceptability as a method of formative assessment to evaluate the clinical competence of trainees in postgraduate program of Otolaryngology and Head-Neck Surgery. Method: 25 trainees from the four classes of master of surgery program of 2009 in Otolaryngology and Head-Neck Surgery (ORL-HNS) undertook Mini-CEX encounters and assessed by 9 supervisors in a 12-week period of study. Faculty development program was carried out through prior lectures deliberating on background, concept and procedure of Mini-CEX followed by demonstrations using video clip of Mini-CEX encounter recorded in own clinical environment. Students were also exposed to similar settings to take up the Mini-CEX encounter without any hesitation. Trainees were assessed in outpatient clinical setting. Program was evaluated for its feasibility and acceptability with respect to patient’s factors, clinical attributes, supervisor and trainee’s performance and their reported level of satisfaction.
Result: Faculty development and trainees orientation in Min-CEX was achieved as feasible and acceptable. Higher rating of satisfaction was reported by majority assessors and trainees as they found Mini-CEX acceptable for formative assessment. Among clinical skills highest rating was received in physical examination and lowest rating in therapeutic skills. Conclusion: A motivated faculty and organized approach towards a comprehensive knowledge on Mini-CEX for its background communication, demonstration of procedure and method to complete the rating forms is the useful guide to adopt Mini-CEX. The faculty and trainees in department of ORL-HNS found Mini-CEX as feasible and acceptable assessment tool to monitor educational activity of postgraduate program through performance-based evaluation in a real clinical situation.
Objective: Missing values is commonly encountered in data analysis in all types of research. Various methods were introduced to handle this matter. This study aims to compare the result of using complete data analysis, missing indicator method, means substitution and single imputation in dealing with this issue. Methods: 202 patients who were discharged from the psychiatric ward, University Malaya Medical Centre (UMMC) from 27th August 2007 to 15th April 2008 were recruited. The general psychopathology was measured with Brief Psychiatric Rating Scale (BPRS-24). The information on age, gender, race, marital status and psychiatric diagnosis were collected. On follow up, the patients who had early readmission (
Background: Faculty’s role as educators is over looked in clinical education, even though the teaching has a direct reflection of performance of clinical competence and professional development of graduating doctors. Two major problems of clinical education are the lack of uniform teaching and learning strategies in postgraduate as well as later years of undergraduate clinical teaching and the professional development of faculty in teaching in medical institutions. Objective: The survey has two major objectives. First objective was to know about the faculty response to a survey on teaching while trying to create awareness for teaching and research in teaching. The second objective was to know the faculty members’ understanding with principles of learning and teaching with strengths and weaknesses of respondents’ performance in clinical teaching on completing The Educator’s Self-Reflective Inventory (ESRI). Method: The ESRI was administered to approach 214 faculty members in SMS at USM. Appraisal of self-reflection inventory as medical teacher and personal development with respect to challenges, opportunities, innovations and need assessment of teaching were explored in response to 35 items grouped in 5 clusters through a questionnaire-based survey utilizing ESRI. Result: Statistical analysis of respondent’s data indicates a mixed response with lab-based disciplines 54.54% followed by surgical-based disciplines 50% and medical-based disciplines 30%. Individual discipline best response is received from Plastic Surgery and ORL-HNS (100%) and Hematology (77.77%). A result of individual item response in each cluster WAS also analyzed. Conclusion: The survey evaluated the faculty’s response to ESRI and concern shown to develop their abilities as teachers and researchers in clinical teaching. However, the initial response suggested the need for more survey to continue creating the awareness for faculty development and research in teaching. Conclusion drawn from analysis of each items in inventory is encouraging for teaching in medical education.
To ensure the reliability of manual blood pressure (BP) readings in a clinical trial, sources of error due to measurement must be reduced as much as possible. Apart from following standard procedure for BP measurement and ensuring good equipments, the measurement errors that come from the assessors themselves should be assessed. Objective: To demonstrate the use of two-way random effects, interactions absent, absolute agreement (Type A), single measures (Type 1) intraclass correlation coefficient (ICC) in the assessment of reliability of manual BP readings among assessors involved in a clinical trial using manual BP measurement, by using an interrater reliability study conducted by the authors as an example study. Methods: The steps involved in obtaining ICC in the study were discussed. Sample size given the number of assessors in the study was calculated. BP was measured using regularly maintained mercury sphygnomanometers, following recommendations by Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) for BP measurement in office setting. The outcomes were systolic and diastolic BP readings. A type of ICC, two-way random effects, interactions absent, absolute agreement (Type A), single measures (Type 1) ICC was chosen for the analysis and specifically discussed. Pre-requisite assumptions for ICC were meticulously checked and described. The interrater reliability for systolic and diastolic BP readings as expressed by ICC (single measure) were presented with confidence interval (CI). The ICCs obtained in the example study were discussed and concluded. The flaws of the study were also criticised. Results: The interrater reliability for systolic and diastolic BP measurements as expressed by ICC (single measure) were 0.87 (95% confidence interval [CI] 0.722, 0.956) and 0.77 (95% CI 0.560, 0.918) respectively. Conclusion: We demonstrated the steps required to obtain ICC. Since the use of manual BP measurement using mercury sphygmomanometer is still considered as gold standard of BP measurement, it is important that studies in which the BP outcome is measured using such method conduct interrater reliability studies properly.
Background: Reflection on the process of learning is an essential ingredient in transforming novice into expert learners. Learning to compile portfolio encourages reflective skills, which help students to work systemically in translating metacognition into self-regulatory control in order to adjust their action and monitor their learning objectives. Introducing to compile portfolio in the early years of postgraduate training is an effective tool to stimulate students’ reflective abilities. Reflective learners are better motivated than the conventional learners to take the responsibilities as researcher in future. Reflective skills achieve both learning in right direction and learning for whole life. However, use of formal methods of reflective portfolio to monitor the learning objectives is an uncommon practice in postgraduate training, primarily due to intensive time and labor required. Challenged with those constraints in Master’s of Surgery Program of Otolaryngology and Head-Neck Surgery in School of Medical Sciences at Universiti Sains Malaysia, a structured self-reflective portfolio was introduced to determine its feasibility and acceptance among supervisors and trainees. Portfolio was practiced as one of the tool for formative assessment and for making recommendations to certify independent thyroid surgery allowed to practice in future. Methodology: A self-reflective structured portfolio was introduced to monitor the learning objectives in trainees of 2007 cohort, using a model as "mentor-system for authentic and structured learning with self-reflective assessment" (MASSRA). Initially a semi-structured portfolio comprising of 12 items and guidelines to compile a portfolio was followed by a structured format in training of thyroid module in sub-specialty of Head and Neck Surgery. Mentoring was organized by putting one-mentor verses 9 students to provide general pastoral guidance to compile portfolio as two entries a year. Mentors held the counseling session with student twice a year after evaluating the portfolios to monitor their progress. Besides, candidates were also observed for their performance in thyroid surgery during a 4-years training program. Those identified with problems for their level of training were referred to "Joint Committee for Surgical Training" comprising of 3 supervisors from Head and Neck Surgery Sub-specialty and a chairman supposedly the head of the department. 7 randomly selected students were also interviewed for direct feedback to evaluate this model. Result: 28 trainees at different level of their training compiled a self-reflection structured portfolio minimum twice a year with instructional feedback from the mentor, which was used as a tract for their personal development plan (produced by each trainee) for training in thyroid surgery. Initial analysis of portfolio revealed interesting feedback from the trainees reflecting on their knowledge, surgical skills and attitude towards thyroid surgery seen in tables 2-4. Conclusion: Self-reflections about each structured items in portfolio-helped trainees to identify their problems, seek mentors guidance and work systemically to help adjust their actions by revising learning objectives. Though time and labor intensive, portfolio was rated as feasible and practical.
MeSH terms: Metacognition; Counseling; Feedback; Learning; Malaysia; Mentors; Motivation; Otolaryngology; Research Personnel; Social Change; Students; Thyroid Gland
Objective: To determine the internal consistency and construct validity of the Learning Approach Inventory (LA-i) among first year medical students in a Malaysian medical school. Methods: Cross sectional study was done on 196 first year medical students in Universiti Sains Malaysia (USM). The items of the LA-i were framed based on characteristics of three learning approaches. The Cronbach’s alpha reliability analysis, exploratory factor analysis and confirmatory factor analysis were applied to measure internal consistency and construct validity. These analyses were done using Predictive Analytics SoftWare (PASW) version 18 and Analysis of Moment Structure (AMOS) version 19. The Composite Reliability (CR) and Average Variance Extracted (AVE) were calculated manually to measure construct reliability and convergent validity. Result: A total of 196 medical students responded to this study. Exploratory factor analysis showed that three potential constructs were extracted from the inventory. The confirmatory factor analysis showed the three factor model with nine items had a good fit with the latent constructs (X2(df) = 26.07 (20), p = 0.163, RMR = 0.04, GFI = 0.969, AGFI = 0.93, NFI = 0.967, RFI = 0.941, IFI = 0.992, TLI = 0.985, CFI = 0.992, RMSEA = 0.04). Each domain of the final model of the LA-i has three items. The Cronbach’s alpha value of the AL-i was 0.86. The Cronbach’s alpha values of surface, strategic and deep approach domains were 0.62, 0.73 and 0.88 respectively. Most of learning approach domains had Composite Reliability and Average Variance Extracted values were more than 0.6 and 0.5 respectively indicating good construct reliability and adequate convergent validity. Conclusion: This study suggested that the three factor model with 9-items of the LA-i has a good fit and shown good psychometric values. It is a valid and reliability measurement to determine learning approaches among first year medical students.
MeSH terms: Cross-Sectional Studies; Factor Analysis, Statistical; Humans; Learning; Malaysia; Personality Inventory; Psychometrics; Schools, Medical; Software; Students, Medical; Reproducibility of Results; Asian Continental Ancestry Group
Background: The weekly held clinical pathologic case conference popularly known as CPC provides an effective and regular educational media of collaborative learning for inter-disciplinary exchange of knowledge among the faculty members of an institution. CPC has been routinely practiced for the last two decades in School of medical Sciences (SMS) at Universiti Sains Malaysia (USM). An hour session primarily involves a case presentation hiding the diagnosis followed by discussion on differential diagnosis and floor interaction on interesting clinical cases. It also gives an opportunity to new teaching staff in the institution to experience an in-house practice of presenting the clinical cases; witch can readily be reproduced as a case report for publication. An effort to follow the original format of CPC is comprehended as an essential outcome of this study to keep up the sanctity of CPC as a case method of learning medicine in future. Methodology: A questionnaire-based survey was recently conducted to evaluate the weekly held CPC in SMS. It was a cross sectional survey in which a questionnaire comprising of 23 items was administered to a targeted population of faculty members of School of Medical Sciences. The items in questionnaire were grouped into 5 clusters. All respondents were adequately briefed through a letter addressing the objectives and importance of survey and its appraisal aiming to revamp the CPC guided by the out-come of study. Questionnaires were administered to 240 academic staff, covering > 80% of the target population of 294 faculty members. 159 (66.2%) members of sample population completed the questionnaires. Total non-responses were 81 (33.7%) and item non-responses were 320 (8.7%) Result: All the items in questionnaire were found significant (p 0.016) except those two items related to, observing a difference in preparing for a case presentation verses a formal CPC presentation and its promotion (p 0.556 and 0.197 respectively). It was also established that the major respondents were unaware of the original format of CPC (p 0.003) in which a presenter select and prepares a case, which is discussed with participating faculty members for its differential diagnoses. 51.6% faculty members did not follow the formal CPC format (p 0.016) in their presentations. A lack of awareness about the format of CPC was shown by (61.0%) faculty members (p 0.003). Conclusion : It was concluded that emphasis to discuss the differential diagnosis by a competent discussant was lacking, as presenters did not follow the formal CPC format. It was critically observed that a number of presentations made in this weekly program deviate from the original format adapted by SMS in USM. However, the out-come appraisal of this survey was the pledge shown by the majority faculty members to adapt the guidelines as a reverence to the formal CPC format.
MeSH terms: Cross-Sectional Studies; Diagnosis, Differential; Faculty; Health Services Needs and Demand; Learning; Malaysia; Surveys and Questionnaires; Schools, Medical
Introduction The purpose of this paper is to demonstrate the effectiveness of using TelePrimary Care (TPC) to monitor immunization programmed in a clinic. Japanese Encephalitis (JE) vaccination was selected as an example because its coverage has not been satisfactory when compared to that of other vaccinations, which generally exceed 90%.
Methods Data for all children who were eligible for JE vaccination (age range from 9 months to 30 months) who attended Sarikei Health Clinic between 1 January 2007 till 31 June 2008, was extracted from the TPC database and analyzed for completeness and timeliness of JE vaccination.
Results The analysis showed that although 1,243 children were eligible to receive their first dose of J vaccine at 9 months of age, only 560 (45%) received it. 15 (3%) received on time, and 545 (97%) received it late (age range from 10 months to 20 months). Out of the 560 who were scheduled to receive their second dose of JE vaccine four weeks after the first, 382 (88%) received it on time, and 55 (12%) received it late. Only 78 (18%) out of 429 children aged between 18 months to 24 months received their booster dose; 52 (67%) received it on time and 26 (33%) received it late.TPC not only enables health staff to monitor immunization coverage and timeliness accurately, but it also helps them to identify defaulters quickly so that these children can be traced and immunized. Doing these tasks manually is time-consuming and tedious, leading to delays in tracing defaulters.
Conclusions TPC provides an effective system for staff to easily access real time child health data to monitor and audit their immunization programme and take remedial action where necessary.
Study site: Klinik Kesihatan Sarikei, Sarawak, Malaysia
MeSH terms: Child Health; Ambulatory Care Facilities; Borneo; Child; Cross-Sectional Studies; Humans; Immunization; Malaysia; Vaccination; Immunization Programs; Electronic Health Records