Cost effectiveness analysis of using different monitoring modalities in treating severe traumatic brain injury (CESTBI) in neuro-ICU, HUSM, Kelantan

Introduction: There are two schools of thought in practicing neurotrauma monitoring for patients with severe traumatic brain injury (TBI); the application of the baseline neuro-monitoring (BNM) and the use of multiple modalities neurotrauma monitoring (M3) which is very expensive. The answer of which of the two monitoring systems is more eflicient and worth doing should be sought. Objective: To determine the cost effectiveness analysis between BNM and M3 monitoring modalities in the management of severe TBI. Methodology: Sixty-two patients with severe TBI admitted to Neuro-ICU, USM who fulfilled the predetermined criteria were selected using systematic random sampling. The macro and micro costing were performed on each of patient. Barthel Index was used to measure physical performance as an outcome six months after discharge. The analyses used were the Independent t- test, ANCOVA, and Repeated Measure ANOVA. Results: The mean total equipment cost of M3 was significantly higher at p = 0.049 (mean difference of RM23.74) after controlling other variables. The mean difference in Barthel Index after six months was significance between the two groups (p = 0.031), patients that were treated with M3 had higher score 163.7 (SD 30.03)J compared to those who were treated with BNM 146.83 (SD 30.36)]. However, the cost-effectiveness ratio of using M3 was significantly lowered (p=O.031) with a mean of RM476.29 was needed to increase a unit improvement in mean Barthel Index compared to RM629.12 if we used BNM. Conclusion: Although M3 is more costly, the outcome of patients treated with M3 was better than that of BNM. Therefore we can conclude that the used of multiple neuro-monitoring was more cost effective than the use of only baseline neuro-monitoring in treating severe traumatic brain injury

Palm oil fuel ash as the future supplementary cementitious material in concrete

The use of Palm Oil Fuel Ash (POFA) as a pozzolanic material for partial cement replacement in concrete reduces the cost of concrete as well as cuts down the number of landfill area required for disposing the ash. This paper presents a comprehensive review of the engineering properties and durability aspects of blended cement concrete incorporating POFA as a partial replacement of ordinary Portland cement (OPC). An Ordinary Portland Cement concrete mix termed P0 and two POFA concrete mixes with different fineness termed (POFA 45 and POFA 10) at 20% replacement level by weight of cement were considered in the study. Acid solution was found to be the most destructive under the applied exposure conditions on P0. The loss of mass and the resistance to chloride penetration were found to be depended on the degree of fineness of POFA to which the specimens were exposed. As for the values obtained from compressive strength test, P0 specimens were found to be the lowest compared with specimen consisting POFA. On the other hand, POFA 10 exhibited better resistance against acid than POFA 45. Conclusively, integration of POFA as partial cement replacement, especially very fine POFA increases the resistance of high strength POFA concrete towards both chloride attack and acid attack

Financial Constraints and Islamic Finance: Lesson Learned From External Financing Perspective

This study examines the presence of financial constraints and explores the role of profit-loss sharing (PLS) in mitigating the problem of the financial constraints stemmed from the capital market imperfections. Using Malaysian listed companies' data, this study finds that the financial constraints are present in the capital market. This finding implies the imperfect capital market. In Islamic PLS framework, there are two options of financing contracts that may be enforced in the capital market as financing mechanisms, i.e. al-musharakah and al-mudharabah. These schemes promote sharing of information and mutual trust between financiers and ‘borrowers'. In these contracts, there are strict terms and conditions to be adhered to by both parties so that the contracts pursue to be valid. Besides, PLS mechanism may reduce the cost of capital since the profit and loss are shared rather than be burdened only on one shoulder. In this regard, the imperfect market problems namely asymmetric information, agency problem and transaction cost can be reduced if not be overcome

Ethical Ideology and Ethical Judgments of Accounting Practitioners in Malaysia

Abstract: The paper intends to explore the ethical ideology and ethical judgments of accounting practitioners in Malaysia. The objectives of this study are twofold. First, the paper intends to examine the factors that contribute to the different ethical ideology among Malaysian accounting practitioners. Second, it aims to investigate the influence of demographic factors and ethical ideology on ethical judgments of accounting practitioners. The study used Forsyths (1980) Ethics Position Questionnaire instrument to examine the ethical ideology of the accountants and adopted ethics vignettes used by Emerson et al. (2007) to assess the ethical judgments of the respondents. From the statistical analysis, this study found that age and gender have a significant impact on ethical judgment but not on ethical ideology. In addition, idealism and relativism have a significant influence on ethical judgment, especially in a legally unethical situation. Abstrak: Penelitian ini bertujuan untuk mengeksplorasi ideologi dan pertimbangan etik dari para praktisi akuntansi di Malaysia. Tujuan dari penelitian ini terbagi menjadi dua. Pertama, bertujuan untuk meneliti faktor-faktor yang berkontribusi terhadap perbedaan ideologi etik diantara para praktisi akuntansi di Malaysia. Kedua, bertujuan untuk mengetahui pengaruh faktor demografi dan ideologi etik terhadap pertimbangan etik di antara praktisi akuntansi. Penelitian ini menggunakan instrument kuesioner Ethics Position Questionnaire Instrument (Forsyths 1980) untuk menguji ideologi etik para akuntan dan mengadopsi sketsa etik yang digunakan (dalam Emerson dkk. 2007) untuk menguji pertimbangan etik dari para responden. Dari analisis statistik, penelitian ini menemukan bahwa usia dan gender memiliki dampak yang signifikan terhadap pertimbangan etik namun tidak pada ideologi etik. Selain itu, idealisme dan relativisme memiliki pengaruh signifikan terhadap pertimbangan etik, terutama pada situasi dimana tidak ada etika hukum

Mangrove mapping using Landsat imagery and aerial photographs: Kemaman District, Terengganu, Malaysia

Classification and distribution of mangrove vegetation are vital information for the proper development of a mangrove management plan. In this study, classification for the mangroves of the district of Kemaman were done using both 1 : 5000 aerial photographs and Landsat TM imageries. The coverage by aerial photographs is limited to the coastal and estuarine areas only. Thus, for areas further upstream of the aerial photo coverage, Landsat TM imageries were used. Analysis of aerial photographs and remote sensing images revealed that the mangroves of Kemaman could be classified into 14 different classes of vegetation. All the 14 classes were identified from areas covered by the aerial photographs. For areas covered by the Landsat images only 7 classes of vegetation were identified. The accuracy for aerial photograph and Landsat images are 91.2% and 87.8%, respectively. It can be concluded that although both techniques are useful in determining the mangrove vegetation classes, the large 1 : 5000 aerial photographs are more accurate and provided more detailed information comparatively

Air pollution modelling to predict maximum ground level concentration for dust from a palm oil mill stack

The study is to model emission from a stack to estimate ground level concentration from a palm oil mill. The case study is a mill located in Kuala Langat, Selangor. Emission source is from boilers stacks. The exercise determines the estimate the ground level concentrations for dust to the surrounding areas through the utilization of modelling software. The surround area is relatively flat, an industrial area surrounded by factories and with palm oil plantations in the outskirts. The model utilized in the study was to gauge the worst-case scenario. Ambient air concentrations were garnered calculate the increase to localized conditions

Physico-mechanical properties of polymer concrete containing micro-filler of palm oil fuel ash

Objective of this study is to present a research conducted on ground (fine) and unground (coarse) POFA in polymer concrete (PC) followed by determination on the physico-mechanical properties of PC. Physical properties of micro-fillers and mechanical properties of produced PCs were characterized. Calcium carbonate and silica sand were also used as micro-fillers for comparison purpose. The samples were subjected to compression and flexural. Morphology images of the particles were captured under morphology test to support the findings. Results showed that fine POFA micro-filler has a highly promising potential in becoming PC filler compared to coarse micro-filler. Additionally, its produced PC had comparable strength to PC with calcium carbonate. From the strength development and sustainability stand point, fine POFA has demonstrated its capability to produce quality and sustainable P

Wasatiyyah Values Appreciation in the Syariah Governance as Consumer Understanding Education Mechanisme Towards Islamic Banking System

The concept and values of wasatiyyah are fundamental in Islamic banking practice as the syariahlaw has delineated basic muamalat principles as an operation guideline for the banking industry.So that, all kind of extreme characteristics may be prevented. The principles of wasatiyyah prohibitany element which overlooks the permitted limit namely gambling, uncertainty (gharar), usury,fraud and so on. These elements have to be avoided in life because they were clearly prohibited byAllah SWT due to their oppressive nature especially towards the unfortunate such as the poor orlow-income group. This prohibition is also attached with the heavy intimidation in the hereafter.The Islamic banking system upholds the concept of wasatiyyah through the values of fairness,trust, transparency and accountability which are instilled through the syariah governance system.The appreciation of these values is proposed to be a part of the new curriculum for the financialawareness subject has been presented by the Malaysia government in the 13th Parliamentarysession. It is important to educate and enhance the understanding of the public especially the youngabout the Islamic banking system as an alternative to avoid the prohibited conventional bankingsystem

Determining and mapping of vegetation using GIS and phytosociological approach in Mount Tahan, Malaysia.

The study on lowland tropical forest plants is complicated by the extreme species diversity, very complex plant mosaic and time constraints. These impediments however do not occur in mountain forest, where habitat diversity is clearly distinguished by small homogenous plants types. Plant association and composition study were presented in this work from two locations of Mount Tahan, Malaysia the relatively untrampled and the trampled site. In each site, plant species number, vegetation cover, plant height, and species cover and frequency in untrampled and trampled areas were counted or measured. The analysis included a field survey following the relevance method of Braun-Blanquet and mapping using a GIS. The study focused on altitudinal distribution of specific plants communities located between 1900 m and 2140 m altitude. The data from field survey were mapped and analyzed in GIS. The phytosociological classification revealed that untrampled areas in Botak and Puncak sites were high in species more diversified communities compared to the trampled areas. The results showed that Leptospermum flavescens was the dominant species most in both sites (Botak and Puncak), with 48%, specifically at the untrampled site. The abundance class and sociability value are also high for this species with score 4.5 out of 5, respectively. A total number of trees in the area probably play an important role in quantifying the species richness and diversity parameters. From the study it can be concluded that GIS technique useful in developing a tree mapping system and creating a geo-database for spatial analysis. Further studies are recommended to integrate more data into the system for better evaluation

Preparation and characterisation of inexpensive porous kaolin hollow fibre as ceramic membrane supports for gas separation application

Low-cost, porous ceramic kaolin-based hollow fibre membrane support (HFMS) for gas separation application was developed via phase inversion technique. The ceramic suspensions with various ratios of kaolin to polyethersulfone (PESf) binder (5:1 to 9:1) were extruded and then sintered at 1200 to 1500 °C. The HFMSs were characterised by several analyses to investigate the effects of kaolin/PESf ratio and sintering temperature on the sample properties. The results showed that the kaolin/PES ratio and sintering temperature affected the considerable structure and physical properties of the kaolin membrane. It is observed that with increasing sintering temperature, the porosity and gas permeation of the HFMS decreased, while the bending strength and density of the HFMS increased. As a result, a porous HFMS with sufficient mechanical strength and high gas permeation characteristics is achievable if the appropriate kaolin/PESf ratio and sintering temperature are chosen