Application of rasch model in measuring the quality of health and wellness final exam questions

The assessment of the Health and Wellness module includes two components, 60% for the continuous examination and 40% for the final examination paper. In this paper we discussed the performance of students in the final examination paper which comprises 40 MCQs (MCQ). The 40 MCQ were constructed based on the Table of Test Specification developed by the subject matter experts at the faculty. The difficulty level of the questions was based on the 5:3:2 proportions. This ratio produces 20 MCQ at lower difficulty level, 12 MCQ at moderately difficult and 8 MCQ at higher difficulty. Results of 764 students were analysed based on their ability and item difficulty of the 40 MCQ using RaschWinsteps 4.01 software. Person Item Map Distribution (PIDM) showed that the item measure is between -3.62 to +4.97 logits and the person measure is between -1.28 to +4.09 logits. This finding indicated that while person ability exceeded item difficulty at the lower logit continuum of the Rasch model, at the upper logit continuum, some items are at higher difficulty level compared to students’ ability. Item difficulty and separation indices statistics for both person and item are also of concern in this study. To ensure and enhance reliability and validity of the questions, it is highly recommended that the subject matter experts review the questions before applying it again in another exam or depositing it in the item bank system

Performance of Lightweight Foamed Concrete with Waste Clay Brick as Coarse Aggregate

AbstractPerformances of lightweight foamed concretes that are made from partial substitution of waste clay brick as coarse aggregate has been investigated in this study. The research aims were to identify the properties and characteristic of lightweight foamed concrete using waste clay brick as alternative materials to reduce the depletion of normal coarse aggregate from granite. Four different percentages of concrete mixtures using new coarse aggregate have been prepared that consist of 25%, 50%, 75%, and 100% waste clay brick. Foamed were injected into concrete mixture to produce lightweight concrete with appropriate proportions. The samples have undergone several testing including compression test, water absorption test, workability test and density test. From the results obtained, lightweight concrete that were produced with 25% substitution of waste clay brick showed the highest compressive strength of 25MPa with density of 1647kg/m3

Flexural Behaviour Of High Performance Slurry Infiltrated Fiber Reinforced Concerete With Different Curing Method.

In the conventional steel fiber reinforced concrete, the structure is fabricated by combining steel fiber to the concrete mix. By using this method, the volume fraction of fiber is limited. So in order to improve the properties of fiber reinforced concrete, slurry infiltrated fiber concrete was introduced. In this study, concrete slurry grades 80 is 3%, 4%, 5% and also the control sample without fiber. Sizes of prism used in this study are 100 x 100 x 500 mm. In order to determine the effect of the curing method, each sample with different volume friction were prepared for two types of curing method. Water curing and steam curing at temperatures of 80° Celsius and cured for 24 hours were applied. The prisms were tested by two-point load test until failure. The behaviors of the prisms were observed and the load-deflection was recorded. Based on the result, it was concluded that the optimum steel fiber content in this report was 5 % by volume friction which provided the highest flexural strength and deflection. The prisms with steam curing obtained lower flexural strength compared to the water curing prisms except for the control specimen

A Properties of Municipal Solid Waste Incineration Fly Ash (IFA) And Cement Used in The Manufacturing of New Inventive Blended Cement

Municipal solid waste incinerator fly (IFA) ash is prone to accumulate high concentration heavy metals. Due to the increasing costs to treat remaining fly ash at the landfill, a lot of research has been done to recycle IFA. This study was focusing on the properties of IFA and cement as main raw materials in new inventive blended cement. The properties of blended cement were also being investigated. Properties of IFA and cement were examined through several test which includes density, specific gravity, X-Ray Fluorescence (XRF), Loss of Ignition (LOI) and through Toxicity Characteristic Leaching Procedure (TCLP) test. The density test and LOI test were also being done for the blended cement. From the tests for IFA and cement, it can be found that density the density of fly ash and cement that has been used for this study were found to be 0.76 g/cm3 and 3.67 g/cm3 respectively. Then, the specific gravity of fly ash and cement were 1.69 and 2.98, accordingly. XRF results shows that both materials have highest content of aluminium, silica and iron, as expected. LOI of fly ash and cement were found to be 17.33 % and 12.33 %, respectively. In terms of the leaching rates of heavy metals (Mn, Ni, Cd, Cr, Cu), only Cd leached at rate 2.39 mg/L, which is above the USEPA's regulatory level, 1.0 mg/L. 5 %, 10 % and 15 % of IFA was mixed with cement to produced blended cement. As the density of blended cement, it was found to be 1.12 g/cm3, 1.08 g/cm3 and 1.09 g/cm3 for each of 5 %, 10 % and 15 % of fly ash in blended cement

A Properties of Municipal Solid Waste Incineration Fly Ash (IFA) And Cement Used in The Manufacturing of New Inventive Blended Cement

Municipal solid waste incinerator fly (IFA) ash is prone to accumulate high concentration heavy metals. Due to the increasing costs to treat remaining fly ash at the landfill, a lot of research has been done to recycle IFA. This study was focusing on the properties of IFA and cement as main raw materials in new inventive blended cement. The properties of blended cement were also being investigated. Properties of IFA and cement were examined through several test which includes density, specific gravity, X-Ray Fluorescence (XRF), Loss of Ignition (LOI) and through Toxicity Characteristic Leaching Procedure (TCLP) test. The density test and LOI test were also being done for the blended cement. From the tests for IFA and cement, it can be found that density the density of fly ash and cement that has been used for this study were found to be 0.76 g/cm3 and 3.67 g/cm3 respectively. Then, the specific gravity of fly ash and cement were 1.69 and 2.98, accordingly. XRF results shows that both materials have highest content of aluminium, silica and iron, as expected. LOI of fly ash and cement were found to be 17.33 % and 12.33 %, respectively. In terms of the leaching rates of heavy metals (Mn, Ni, Cd, Cr, Cu), only Cd leached at rate 2.39 mg/L, which is above the USEPA's regulatory level, 1.0 mg/L. 5 %, 10 % and 15 % of IFA was mixed with cement to produced blended cement. As the density of blended cement, it was found to be 1.12 g/cm3, 1.08 g/cm3 and 1.09 g/cm3 for each of 5 %, 10 % and 15 % of fly ash in blended cement

The Stiffness of Steel-Wood-Steel Connection Loaded Parallel to the Grain

In Eurocode 5, the stiffness equation for bolted steel-wood-steel is stated as a function of wood density and fastener diameter only. In this research, an experimental study on various configurations of tested bolted steel-wood-steel (SWS) connections has been undertaken to predict the initial stiffness of each connection. In order to validate the Eurocode 5 stiffness equation, tests on 50 timber specimens (40 glued laminated timbers and 10 laminated veneer lumbers (LVL)) with steel plates were undertaken. The number of bolts was kept similar and the connector diameter, timber thickness, and wood density were varied. The results obtained in the experimental tests are compared with those obtained from the Eurocode 5 stiffness equation. From the analysis, it is signified that the stiffness equation specified in Eurocode 5 for bolted SWS connections does not adequately predict the initial stiffness. The results from Eurocode 5 stiffness equation are very far from the experimental values. The ratio of stiffness equation to experimental results ranges from 3.48 to 4.20, with the average at 3.77, where the equation overpredicted the experimental stiffness value for the connection. There is a need to consider or incorporated other parameters such as geometric configurations in Eurocode 5 stiffness equation to improve the ratio with the experimental data

Reclamation and Reutilization of Incinerator Ash in Artificial Lightweight Aggregate

This study focused on the reclamation of ash from incineration process and development of new artificial lightweight aggregate (LWA) that have comparable properties with existing natural coarse aggregate. The main objective of this study is to examine potential use of recycled municipal solid waste incineration (MSWI) ash as raw material in LWA production with a method of cold-bonded pelletization. Two types of incineration ash which is bottom ash (BA) and fly ash (FA) were collected from Cameron Highland Incineration Plant, Malaysia. The properties of BA and FA are studied by means of X-Ray Fluorescence (XRF) and microstructure of these ashes were inspected using Scanning Electron Microscope (SEM). The properties of BALA and FALA produced in this study is examined including loose bulk density, water absorption and aggregate impact value (AIV). From the results of both types of artificial LWA, the lowest loose bulk density of BALA is BALA50 with 564.14 kg/m3 and highest is at 831.19 kg/m3. For FALA50, lowest loose bulk density is 573.64 kg/m3 and highest is 703.35 kg/m3. Water absorption of BALA and FALA is quite similar with one another in with the value of 23.8% and 22.6%, respectively. Generally, FALA have better qualities of LWA comparing with BALA with lower bulk density and water absorption and can be categorized as strong aggregate. In summary, reclamation and reutilization of incinerator ash has generated acceptable qualities for artificial LWA. Both types of BA and FA shown a great potential to be recycled as additional materials in artificial aggregate production

Presentation of Breast Cancer and Impact of Patient Navigation on Timeliness of Diagnosis and Treatment and on Adherence to Treatment Recommendations in a Multicenter Network in Malaysia

PURPOSEBreast cancer deaths disproportionately affect women living in low- and middle-income countries (LMICs). Patient navigation has emerged as a cost-effective and impactful approach to enable women with symptoms or suspicious mammogram findings to access timely diagnosis and patients with breast cancer to access timely and appropriate multimodality treatment. However, few studies have systematically evaluated the impact of patient navigation on timeliness of diagnosis and treatment in LMICs.METHODSWe established a nurse- and community-navigator-led navigation program in breast clinics of four public hospitals located in Peninsular and East Malaysia and evaluated the impact of navigation on timeliness of diagnosis and treatment.RESULTSPatients with breast cancer treated at public hospitals reported facing barriers to accessing care, including having a poor recognition of breast cancer symptoms and low awareness of screening methods, and facing financial and logistics challenges. Compared with patients diagnosed in the previous year, patients receiving navigation experienced timely ultrasound (84.0% v 65.0%; P < .001), biopsy (84.0% v 78.0%; P = .012), communication of news (63.0% v 40.0%; P < .001), surgery (46% v 36%; P = .008), and neoadjuvant therapy (59% v 42%, P = .030). Treatment adherence improved significantly (98.0% v 87.0%, P < .001), and this was consistent across the network of four breast clinics.CONCLUSIONPatient navigation improves access to timely diagnosis and treatment for women presenting at secondary and tertiary hospitals in Malaysia