RESUMO
This study aims to investigate the characteristics of students who switch versus those who do not switch when they transition from upper secondary to higher education. The data from 1338 students randomly selected from 21 HEIs in Cambodia in 2020 found that upper secondary school students are more likely than not to switch academic majors when they enter higher education. The tendency to switch is more common for female students in science-track, most of whom chose non-STEM majors such as business, management, accounting and finance. Probit analysis revealed that the decision to switch is influenced by individual academic performance and interest in science and mathematics at upper secondary school, household's socioeconomic status, higher education institution (HEI)'s location and type. However, students whose like mathematics and physics and who have a higher technology readiness index score and those who were awarded scholarships are less likely to switch from science to non-STEM majors. Teaching approaches that create opportunities for students to engage in practical classroom activities and stimulate their curiosity in science and mathematics should be considered. Efforts to optimise learning experiences should therefore focus on creating a highly interactive teaching-learning environment as a cognitive-activation strategy for promoting students' interest and enjoyment of the subjects they are studying. Scholarship can also be an alternative to address the switching issue.
RESUMO
BACKGROUND: Antimicrobial-resistant Gram-negative infections are a significant cause of mortality in young infants. We aimed to determine characteristics of, and risk factors for, colonization and invasive infection caused by 3rd generation cephalosporin (3GC) or carbapenem-resistant organisms in outborn infants admitted to a neonatal unit (NU) in Cambodia. METHODS: During the first year of operation, patients admitted to the Angkor Hospital for Children NU, Siem Reap, Cambodia, underwent rectal swabbing on admission and twice weekly until discharge. Swabs were taken also from 7 environmental sites. Swabs were cultured to identify 3GC or carbapenem-resistant Acinetobacter sp., Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. RESULTS: The study included 333 infants with a median age at NU admission of 10 days (range, 0-43). Colonization by ≥1 3GC-resistant organism was detected in 85.9% (286/333). Admission swabs were collected in 289 infants: 61.9% were colonized by a 3GC-resistant organism at the time of admission, and a further 23.2% were colonized during hospitalization, at a median of 4 days [95% confidence interval: 3-5]. Probiotic treatment (hazard ratio: 0.58; 95% confidence interval: 0.35-0.98) was associated with delayed colonization. Colonization by a carbapenem-resistant organism occurred in 25 (7.5%) infants. Six infants had NU-associated K. pneumoniae bacteremia; phenotypically identical colonizing strains were found in 3 infants. Environmental colonization occurred early. CONCLUSIONS: Colonization by antimicrobial-resistant Gram-negative organisms occurred early in hospitalized Cambodian infants and was associated with subsequent invasive infection. Trials of potential interventions such as probiotics are needed.
