A STUDY OF THE GRAMMATICAL ERRORS IN

ENGLISH-WRITTEN ABSTRACTS OF RESIDENTS

TRAINING IN PEDIATRICS DEPARTMENT

BY

MR. JASSADA BUABOONNAM

AN INDEPENDENT STUDY PAPER SUBMITTED IN

PARTIALFULFILLMENT OF

THE REQUIREMENTS FOR THE DEGREE OF

MASTER OF ARTS IN ENGLISH FOR CAREERS

LANGUAGE INSTITUTE

THAMMASAT UNIVERSITY

ACADEMIC YEAR 2015

COPYRIGHT OF THAMMASAT UNIVERSITY

A STUDY OF THE GRAMMATICAL ERRORS IN

ENGLISH-WRITTEN ABSTRACTS OF RESIDENTS

TRAINING IN PEDIATRICS DEPARTMENT

BY

MR. JASSADA BUABOONNAM

AN INDEPENDENT STUDYPAPER SUBMITTED IN PARTIAL

FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE

OF MASTER OF ARTS IN ENGLISH FOR CAREERS

LANGUAGE INSTITUTE

THAMMASAT UNIVERSITY

ACADEMIC YEAR 2015

COPYRIGHT OF THAMMASAT UNIVERSITY

(1)

Independent Study Paper Title A STUDY OF THE GRAMMATICAL

ERRORS IN ENGLISH-WRITTEN

ABSTRACTS OF RESIDENTS TRAINING IN

PEDIATRICS DEPARTMENT

Author MR. JASSADA BUABOONNAM

Degree Master of Arts

Major Field/Faculty/University English for Careers

Language Institute

Thammasat University

Independent Study Paper Advisor Assistant Professor Supakorn Phoocharoensil,

Ph.D.

Academic Year 2015

ABSTRACT

Introduction

Grammatical errors appear to be one of the most common problems

hindering the international publications of Thai scientists and physicians. This study

regarding such errors in English-written academic writing might benefit Thai authors

who submit their work internationally since they can avoid the errors while writing

English abstracts.

Objectives

The objectives of this study are to explore the common grammatical

errors and investigate the causes of errors.

Methods

Two hundred and six English written abstracts of the third-year pediatric-

residents training in Siriraj Hospital, Mahidol University between 2004 to 2013 were

included and analyzed using 5-step error analysis.

(2)

Results

Of all 206 samples, 25 samples were found to have no errors. The three

most common errors were errors on verb (24.85%), sentence fragment (17.37%) and

errors on article (12.73%), respectively. The other errors included errors on

preposition, errors on word-form, errors on punctuation, errors on voice, misspellings,

errors on parallelism, miscollocation, and errors on plurality, respectively. Both

interlingual errors and intralingual errors accounted for the errors in this study.

Conclusions

Grammatical errors appear to be common in abstract writing written by

Thai pediatricians. This study substantiates the role of English editing to enhance the

qualities of the English abstracts. Further studies might be warranted particularly in

other fields and subspecialties and other parts of original articles i.e., methods and

results.

Keywords:grammatical errors, pediatrician, abstract writing

(3)

ACKNOWLEDGEMENTS

First of all, I would like to thank Assistant Professor Supakorn

Phoocharoensil, Ph.D. for his mentoring and suggestions for bettering my IS. I am

also thankful to Assistant Professor Pattama Sappapan, Ph.D. for her fruitful

comments for improving this work.

I am indebted to Mrs. Pattarapan Sungsukul, the secretary of Hematology

and Oncology Department, Department of Pediatrics, Siriraj Hospital for her

assistance, without her I could not have collected all the samples.

Last, I would like to thank my family and my spouse for their

understanding and great support.

Mr. Jassada Buaboonnam

(4)

TABLE OF CONTENTS Page

ABSTRACT 1 

ACKNOWLEDGEMENTS 3 

TABLE OF CONTENTS 4 

LIST OF TABLES 8 

CHAPTER 1 INTRODUCTION 1 

1.1 Background of the study 1 

1.2 Research questions 2 

1.3 Research objectives 2 

1.4 Definition of terms 2 

1.5 Significance of the study 4 

1.6 Scope of the study 4 

1.7 Limitations of the study 4 

1.8 Organization of the research study 4 

(5)

CHAPTER 2 REVIEW OF LITERATURE 6 

2.1 Errors in second language learning 6 

2.1.1 Definition of errors 6 

2.1.2 Development of error study 6 

2.1.2.1 Contrastive Analysis theory 7 

2.1.2.2 Error Analysis theory 8 

2.1.2.3 Interlanguage theory 9 

2.2 English for physicians and healthcare workers 10 

2.3 English writing skills of medical students and physicians 11 

2.4 Grammatical difficulties for L2 learners 11 

CHAPTER 3 RESEARCH METHODOLOGY 14 

3.1 Abstract selection 14 

3.2 Sampling technique 14 

3.3 Research design and procedures 14 

3.3.1 Collecting samples of learner language 14 

3.3.2 Identifying errors 15 

3.3.3 Describing errors 15 

3.3.4 Explaining errors 15 

3.4 Data analysis 15 

(6)

CHAPTER 4 RESULTS AND DISCUSSION 16 

4.1Error classification 17 

4.1.1 Errors on verb 17 

4.1.1.1 Errors on verb-tense 17 

4.1.1.2 Errors on verb-form 17 

4.1.1.3 Errors on participial phrases 18 

4.1.1.4 Errors on subject-verb agreement 18 

4.1.2 Sentence fragment 18 

4.1.3 Errors on article 19 

4.1.4 Errors on preposition 19 

4.1.5 Errors on word form 19 

4.1.6 Errors on punctuation 19 

4.1.6.1 Comma splice 20 

4.1.6.2 Other errors regarding punctuation 20 

4.1.7 Errors on voice 20 

4.1.8 Misspellings 21 

4.1.9 Errors on parallelism in comparison 21 

4.1.10 Miscollocations 21 

4.1.11 Errors on plurality 22 

4.2 The analysis of interlingual and intralingual errors in abstract writing 22 

4.2.1 Interlingual errors 22 

4.2.1.1 Lexical interference 22 

4.2.1.2 Syntactic interference 23 

4.2.2 Intralingual errors 23 

4.2.2.1 Ignorance of rule restriction 23 

(1) Incorrect use of verb 23 

(2) Incorrect use of adjective 24 

4.2.2.2 Incomplete application of rules 24 

(1) Incorrect use of preposition 24 

(2) Omission of the verb to be in passive form 24 

4.3 The comparison of this study to previous studies 25 

(7)

CHAPTER 5 CONCLUSIONS AND RECOMMENDATIONS 27 

5.1 Conclusions 27 

5.2 Recommendations for future research 27 

REFERENCES 29 

APPENDICES 33 

APPENDIX A Examples of English abstract 34 

BIOGRAPHY 41 

(8)

LIST OF TABLES

Tables Page

Table 4.1 The errors caused by residents in English abstract writing 16 

Table 4.2 The classification of errors on verb 17 

Table 4.3 The classification of errors on punctuation 20 

Table 4.4 The comparison of error studies in Thai students and physicians 25 

1

CHAPTER 1

INTRODUCTION

1.1Background of the study

The field known as English for specific purposes (ESP) began as an

international movement within the field of English language teaching, focusing

mostly on helping international students in English-medium universities with their

academic writing and researchers in non-English speaking countries get published in

English, according to Johns (2013). The field has now expanded to include areas such

as English for occupational purposes, English for vocational purposes, English for

science and technology, English for medical purposes, English for business purposes

and English for community membership etc. (Belcher, 2009).

In the training program of physicians for the Thai Board(residents) and Thai

Subspecialty Board (fellows) of Pediatrics, in-training physicians, no matter whether

they are residents or fellows, have to submit a thesis. Although the theses are written

in Thai, the abstract must be written in English as well as in Thai, and grammatical

errors need correction before submission. As a result, these physicians’ errors are

worth analyzing in detail in order to identify their actual causes and subsequently

provide some solutions to such errors.

Grammatical errors seem to be one of the most common errors made

byEnglish as second language learners worldwide(Thornbury, 2000). These errors

appear to be one of the major obstacles for non-native scientists to publish their

articles; some publishers,e.g.,New England Journal of Medicine, Blood, etc., have

compulsory rules that all research articles written by non-native authors must pass

language proof reading before submission.

The theory of error analysis (EA) in second language learning was first

established by S.P.Corder in the 1970s. EA aims to study the errors produced by

learners. According to Corder (1974), EA consists of two components: the theoretical

objects and applied objects. The theoretical object serves to “elucidate what and how

a learner learns when he studies a second language.” (1974, p.19) And the applied

object serves to enable the learner “to learn more efficiently by exploiting our

2

knowledge of his dialect for pedagogical purposes.” At the same time, the

investigation of errors can serve two purposes, i.e., diagnostic and prognostic.

The present study investigatingerrors in abstract writing by applying the

theory of error analysis might help Thai pediatricians identify their common errors in

writing, thus resulting in improving their academic writing in the future.

The aim of the study is to examine grammatical errors in English-written

abstracts of theses of pediatrics residents and fellows at Siriraj hospital. In this study,

the scope will be focused on three common grammatical errors based on the studies

bySattayatham (2007) and Thep-Ackrapong (2005) namely article, subject-verb-

agreement and passive voice.

1.2 Research questions

What are the common errors in English-written abstracts of theses of residents

training in Pediatrics Department?

What are the principal causes of those errors?

1.3 Research objectives

To explore the common grammatical errors in English writing of Pediatrics

residents

To investigate the major causes of those errors

1.4 Definition of terms

Error analysis refers to the study of the type and quantity of errors occurring in the

field of applied linguistics.

Interlingual error refers to errors occurring as a result of the influence of the native

language.

Intraingual error refers to errors stemming from the negative transfer of language

items within the target language occurring in the rule learning stages of the language.

Resident refers to a physician who is in training after internship in the Department of

Pediatrics at Siriraj hospital.

Abstract refers to the English summary of athesis written by residents and fellows in

Department of Pediatrics at Siriraj hospital.

3

Grammatical error refers to the evidence of faulty, unconventional, or controversial

grammatical usagein the English abstracts written by residents.

Sentence fragment refers to the groups of words that do not express a complete

sentence.

Error on punctuation refers to an error occurring when punctuation is used

incorrectly in sentences, which is classified into 2 categories including comma splice,

and other errors regarding punctuation.

Comma splice refers to the use of a comma to join two independent clauses.

Other errors regarding punctuation refer to errors which cannot be categorized in

comma splice.

Error on verb refers to an error occurring when verb is used incorrectly in sentences

andis classified into 4 categories including subject-verb agreement, verb-form, verb-

tense and participial.

Error on subject verb agreement refers to an error regarding the discordance

between the subject and verb of sentences.

Error on verb-form refers to an error occurring when the verb-form is incorrectly

used in sentences.

Error on verb-tense refers to an error occurring when the verb-tense is incorrectly

used in sentences.

Error on participialrefers to an error occurring when the participial is incorrectly

used in sentences.

Error on voice refers to an error occurring when the passive form or active form is

incorrectly used in sentences.

Error on articlerefers to an error occurring when the article is used incorrectly in

sentences.

Error on prepositionrefers to an error occurring when the preposition is incorrectly

used in sentences.

Error on parallelism in comparison refers to the use of a wrong parallelism when

making a comparison in sentences.

Error on word-form refers to an error occurring when the word-form is incorrectly

used in sentences.

4

Error on singularity and pluralityrefers to an error occurring when the singularity

orplurality isincorrectly used in sentences.

Miscollocation refers to the use of a wrong collocation in sentences.

Misspelling refers to the wrong spelling in sentences.

1.5 Significance of the study

Thisstudy regarding analysis of grammatical errors in in-training physicians

might help the instructors who are preparing ESP lessons targeted at medical students.

It also will assist the pediatricians in identifying their common errors in English

grammar.

1.6 Scope of the study

This study focuses on analyzing errors in English medical-abstract writing

(1) The study was carried out by analyzing English medical abstracts of

residents in the Department of Pediatrics at SirirajHospital during 2004-2013.

(2) The study focuses on grammatical errors occurring in English medical-

abstract writing.

1.7 Limitations of the study

This study may not be generalized or applicable to other physicians outside the

pediatric field. In addition, it may not applicable to other pediatricians who havenot

trained at Siriraj hospital.

1.8 Organization of research study

This study is divided into 5 parts as follows:

Chapter one includes the background statement, research questions, objectives

of the study, definition of terms, scope of the study, significance of the study, and

organization of study.

Chapter two includes the review of literature and the related theories.

Chapter three discusses the research methodology conducted in this study

consisting of the population, materials, procedures and data analysis.

Chapter four provides the research findings.

5

Chapter five includes a summary of the study, discussion, conclusion and

recommendations for further study.

6

CHAPTER 2

REVIEW OF LITERATURE

In our review, we will focus on

2.1 Errors in second language learning

The research in error analysis has evolved over time starting from Contrastive

Analysis theory (Lado, 1957). Further studies were subsequently conducted and

developed to Error Analysis theory by Corder (1973) and Interlanguage theory

(Selinker, 1972, 1992) respectively. Thisstudy regarding error analysis will improve

the English teaching process and contributemore knowledge to furtherthe

theoriesregarding language acquisition.

2.1.1 Definition of Errors

Errors are the use of linguistic items in a way that is unacceptable to native

speakers because of inappropriate use or incomplete learning (Klassen, 1991). In the

linguistic field, errors must be differentiated frommistakes.The former is related to the

deficiency of grammatical knowledge; the latter is the failure to use the knowledge

correctly. Mistakes can occur in both native and non-native speakers but native

speakers can correct the mistakes quickly by themselves. Mistakes can be caused by

performance factors e.g., exhaustion, memory lapses, sleepiness etc. On the other

hand, errors are systematic since they are repeatedly committed and they are usually

unrecognizable (Keshavarz, 1993).

2.1.2 Development of error study

The initial approach to studying L1 interference is Contrastive Analysis (CA),

proposed by Lado (1957). This theory focuses on the differences of linguistic systems

of the two languages in order to remedy the second language instruction problems. It

is based on the hypotheses that the interference from the first language hindersthe

achievement of new language learning and the identification and elimination of

interference effects arethe solution to such problems.

7

Subsequently, in the 1960s, Error Analysis (EA) was developed. This theory

viewed that the influence of the native language on the second language was

complicated and there were many confounding factors influencing the learning

process such as the target language per se, the communication method, and the

categories as well as the qualities of second language instruction (Hashim, 1999). In

addition, different types of errors are categorized (Richard, 1974) for analysis

including:

Overgeneralization: it is the use of form or construction in a context that

cannot be used; for example, he comed instead of he came.

Ignorance of rule restrictions: it occurs when the learner applies rules, which

are not applicable, to context, for example, he made me to go instead of he asked me

to go.

Incomplete application of rules: this error is related to the failure of the use of

the full developed structure (e.g. "You like to have breakfast?" instead of "Do you like

to have breakfast?)

False hypothesis: this errors occur when the learners do not completely

comprehend a distinction in the target language (e.g. the use of "was" as a marker of

past tense in "he was received the awards.”)

In 1970s, the interlanguage theory was first introduced by Selinker. It was

hypothesized that interlanguage is produced during the process of learning a target

language by second or foreign language learners. According to Selinker (1972), inter

language refers to the dynamic linguistic system which has been developed by a

second language learner (L2) who was not proficient. The analysis of interlanguage

involves the linguistic systems of L1 andL2 correlated with the transitional

competence of second language learners (Connor, 1999). Several different factors

such as i) borrowing patterns from the native language, ii) extending patterns from the

target language, e.g. analogy, and iii) expressing meanings using the words and

grammar which are already known (Richards and Schmidt, 2002) involve the learning

process of L2 learners.

2.1.2.1Contrastive Analysis theory

The gist of Contrastive Analysis is to identify the difficulty in foreign

language acquisition by comparing the two languages, i.e., first language (L1) and

8

second language (L2) and cultures. It is believed that if the differences between the

two languages and cultures are few, learning difficulties will not be expected. In

contrast, where the differences are considerable, a much higherdegree of difficulty in

L2 learning will be anticipated. This theory also proposed that teaching materials

could be specified for the needs of language learners. Behavioral psychology is

strongly associated with Contrastive Analysis; it focuses on audio-lingual language

teaching and habit formation. The learning process is thought be achieved by

repeatedly practicing, repeating the correct forms and immediately correcting the

errors (Lado, 1957).

Contrastive Analysis only accounts for errors caused by mother-tongue

interference, while the other types of errors such as intralingual errors cannot be

explained by Contrastive Analysis. Therefore, this theory appears to lose its

pedagogical value (Fisiak, 1981).

2.1.2.2 Error Analysis theory

After the arrival of cognitive psychological study in the 1960s, errors have

been viewed as a major component of the learning process, in oppositionto the

previous theory, i.e., CA.Corder firstly established Error Analysis theory and

highlighted the significance of learners’ errors. This theory proposed that learners

acquired hypotheses and knowledge based on input and subsequently tested the

hypotheses in speech production. Errors are indispensable and inevitable in learning

language. The analyses of errors made by learners are useful in the improvement of

the language learning process. Furthermore, Error Analysis can prognosticate the

progress of language learners and evaluate the effectiveness of the teaching method

and materials.

According to Corder, the following are the steps in any typical EA research:

1. collecting samples of learner language: this step involves collecting samples of

learner language.

2. identifying the errors: the errors in samples will be identified.

3. describing the errors: this step involves comparing the idiosyncratic utterances

to the reconstruction of those in target language

4. explaining the errors: this process relates to the calculation and explanation of

errors

9

5. evaluating/correcting the errors: this process relates to the interpretation and

correction of errors

Albeit superior to Contrastive Analysis in many aspects, several weaknesses

of Error Analysis are noted including:

It cannot effectively demonstrate the learners’ language development because

itinvestigateserrors at a single time-point.

It evaluates only the language production skills, namely speaking and writing,

not their reception: listening and reading (Elis &Barkhuizen, 2005).

2.1.2.3Interlanguage theory

This terminology was firstly introduced by Selinker (1972). He believed that

there is a separate linguistic system emerging from a learner’s attempt toward the

target language. The similar terms include idiosyncratic dialects (Corder, 1971) and

approximative system (Nemser, 1971). It is suggested that Interlanguage (IL) is a

middle position between knowing and not knowing the target language; it might be

demonstrated ina continuum between L1 and L2 where learners move toward the state

of a native speaker, but never achieve it. In addition, it may be shown as

developmental stages of achieving target language proficiency and adaptive strategy

of learners. These L2 learning strategies include simplification, reduction,

overgeneralization, transfer, formulaic language, omissions, substitutions and

restructurings.

Interlanguage completely shifts the pedagogical view from a teaching

perspective to a learning perspective. Nevertheless, this theory is limitedto morpheme

and syntax, not semantic development. Moreover, it cannot account for the

development of effective approaches to facilitate empirical studies (Hamad Al-

khresheh, 2015).

Based on the above three theories concerning errors, it is evident that Error

Analysis and Interlanguage seem to be superior to Contrastive Analysis. However,

both EA and IL should not be considered immaculate theories. As a matter of fact,

they poorly answer several questions concerning second language acquisition. Further

studies are warranted to improve the previous theories.

10

2.2 English for physicians and healthcare workers

English skills are regarded as important skills for communication, particularly

in Thai physicians and other medical personnel, since they have to communicate with

their patients in English, and a large number of Thai medical instructors need to

further their studies abroad. The research by Eggly, Musial and Smulowitz (1999) was

conducted with international in-training physicians at Wayne State University to

evaluate the correlation of the English proficiency scores namely TOEIC (The Test of

English for International Communication) and SPEAK (The Speaking Proficiency in

English Assessment Kit) and patient satisfaction, colleague satisfaction and in-

training general medical knowledge examination. They found that the English

proficiency score well correlated with patient satisfactions but there was no

correlation between English examinations and general medical knowledge. However,

international medical residents who previously had high levels of language

proficiency scores, namely TOEIC (The Test of English for International

Communication) and SPEAK (The Speaking Proficiency in English Assessment Kit)

tests, had poor English proficiency when it was evaluated by faculty and colleagues.

Likewise, the results from a survey study by Chitpakdee (2006) using

questionnaires to collect data from 15 pediatricians at Chonburi hospital showed that,

for pediatricians, reading and writing skills are the most pivotal English skills

followed by listening and speaking respectively. They have to use their writing skills

for writing the medical records or orders and writing journal articles, while, in terms

of reading, they have to read standard textbooks and journals. As for speaking skills,

which are ranked the least important, they used this skill for discussion in medical

conferences and communication with international patients and doctors. The findings

from this studysubstantiate the importance of English language for Thai physicians,

especially medical instructors who have to study abroad.

Another study by Sursattayawong (2006) was conducted on20 professional

nurses working at Rajavithi Hospital. The participants were asked to complete

questionnaires and the results demonstrated that they experienced the following

speaking problems: grammatical errors, word choices and pronunciation. In terms of

grammatical errors, subject verb agreement, and the confusion between active and

passive voice were dominant.

11

2.3 English writing skills of medical students and physicians

Although medical students and in-training physicians were knownto have a

high rankinginnational entrance examination scores with English being tested,

Pleansaisurb (1984) demonstrated that medical students still require the improvement

of reading and writing skills.

Sattayatham and Rattanapinyowong (2008) conducted a research study with

134 first-year medical students from four institutes including Siriraj, Ramathibodi,

Praboromchanok and Bangkok Metropolitan by analyzing errors in paragraph writing.

The errors were categorized into 10 types namely inability to perform the assigned

task because of not understanding the question, no introduction, lack of main ideas, no

topic sentence stating the main points, lack of development of the main ideas (adding

details and facts about the main point), lack of organization, accumulation of errors in

sentence structure and, or usage, no transitional words, incoherence, and no

conclusion. The study showed that the three most common problems in English

writing of the first- year medical students included the lack of cohesion, no

transitional words, and no introductions and conclusions.

Jirapanakorn (2012), in addition, conducted a comparative study of the use of

reporting verbs in Thai and international medical journals using a corpus-based

contrastive analysis. The results showed that a Thai corpus used fewer reporting verbs

than what wasfound in an international corpus; moreover, the grammatical mistakes

concerning reporting verbs including passive voice and subject verb agreement were

observed frequently in the Thai corpus. From these findings, it can be concluded that

most Thai medical students and physicians require the improvement of English

particularly in reading and writing skills.

2.4 Grammatical difficulties for L2 learners

Thep-Ackrapong (2005) showed that grammar is considered the most difficult

part in Thai students’ viewpoints. She classified the influence of the mother tongue

into six main categories: 1) Subject-verb agreement, 2) Topic-comment structure, 3)

Passive voice, 4) Relative clause, 5) Participial phrase, and 6) Subordination. These

results reflect the negative impacts of learners’ mother-tongue on the L2 English

12

grammatical use. Among several grammatical errors, subject-verb agreements, and

word choices appeared to be the most problematic. Sattayatham and Honsa (2007)

investigated the writing and translation errors of first-year Thai medical students at

Mahidol University. Two hundred and thirty seven participants were assigned to

translate sentences and paragraphs from Thai to English and write theiropinion

regarding medical ethics. The errors were analyzed and classified into 10 categories.

The ten most frequent errors were identified namely wrong choice of vocabulary,

articles, wrong plural form, wrong use of “be”, conditional sentences and punctuation,

connectors, fragments, subject-verb agreement, spelling mistake, and omission of

subject, respectively. The findings also demonstrated positive correlation between

sentence-level translation and paragraph-level translation, and between paragraph

level translation and opinion paragraph writing. The author concluded that such errors

occurred because the learners were mainly dependent on the systems of the Thai

language

In another investigation of errors by Jenwitheesuk (2009), L2 writing errors in

college students were mainly caused by a lack of syntactic knowledge. The most

frequent errors concerned determiners, subject and verb agreement, tenses, and

prepositions, respectively. She also points out thatsyntactic errors occur when L2

learners use their mother tongue’s structures in English. Another study was conducted

by using paragraph writing assignments (Watcharapunyawong, 2012) in 40 second-

year Thai EFL students at the Faculty of Humanities and Social Sciences,

ThepsatriRajabhat University. The subjects were assigned to write three paragraphs in

three genres, namely narration, description, and comparison/contrast; the topics were

My Memorable Trip, My Ideal House, and Watching News on Television VS Reading

News from a Paper, corresponding with three genres. The results revealed that the

five most frequent errors in narrative writing were verb- tense, word choice, sentence

structure, preposition, and modal/auxiliary, respectively, while the five most frequent

errors in description and comparison/contrast were article, sentence structure, word

choice, singular/plural form, and subject-verb agreement, respectively.

A recent research in passive voice errors was conducted by Sompong (2013)

on90 students in the South-East Asian Studies Program, Thammasat University. The

participants were asked to write sentences consisting of 25 pairs of nouns and verbs.

13

The results demonstrated that malformed passive sentences, such as“that luxury car is

droven (driven) by the rich” or “the watch was stealen(stolen),”arethe most common

errors. The results indicate that the influences of the students’ mother tongue account

for the errors concerning passive voice and morphological changes.

14

CHAPTER 3

RESEARCH METHODOLOGY

This chapter discusses: (1) participants (2) sampling technique (3) materials

(4) procedures for researching errors in English abstracts (5) data analysis

3.1 Abstract selection

250-word English abstracts were collected from the theses of the third-year

residents in Department of Pediatrics, Siriraj Hospital during 2004-2013. The number

of participants was 206.

3.2 Sampling technique

In this study, purposive sampling method was used since the researcher would

like to focus on the particular characteristics of the population; pediatric residents at

Siriraj hospital. All English abstracts written by Pediatric residents and fellows

training in Siriraj hospital during 2004-2013 were included.

3.3 Research design and procedures

The thesis abstracts were identified and collected from the library in Pediatric

Department, Siriraj Hospital. Then, the 5-step procedure for error analysis (Ellis

1997) was undertaken. However, due to the limitation of time, evaluation of the

errors, the last step for error analysis, was omitted. The initial four steps are described

as follows:

3.3.1 Collecting samples of learner language

The author contacted the librarian at the library in Department of Pediatrics to

gather all theses of residents who were in training between 2004 and 2013. English-

abstracts in the theses were photocopied with the assistance of the librarian and they

were sent to the author.

15

3.3.2 Identifying errors

The English abstracts were examined thoroughly in order to detect errors.

3.3.3Describing errors

The errors will be classified into 11 categories namely 1) sentence fragment 2)

error on punctuation, 3) error on verb, 4) error on voice, 5) error on article, 6) error

on preposition, 7) error on parallelism, 8) error on word form 9) error on plurality 10)

misspelling and 11) miscollocation. The definition of each error was mentioned in the

definition of terms section.

3.3.4Explaining errors

The errors will be classified as either interlingual or intralingual errors;

interlingual errors result from negative transference of mother tongue, while

intralingualerrors are caused by the complexity of the L2 per se.

3.4 Data analysis

The data are analyzed using SPSS program. The percentage, mean and

standard deviation are calculated and subsequently presented. To measure the

consistency and prevent subjectivity of analysis, intercoder reliability will be applied.

Twenty English abstracts wererandomly chosen and the errors were identified by one

English expert. 90% of the analysis must be consistent with the present researcher’s

finding.

16

CHAPTER 4

RESULTS AND DISCUSSION

This chapter is aimed at presenting and discussing the results. Two hundred

and six samples were abstracts from theses of Pediatric residents who were in training

between 2004 and 2013. Of all samples, 25 samples did not have any errors.

There were 495 errors detected in the abstracts; the errors were classified into 11

categories (Table 4.1).

Type of errors Frequency Percentage

1.verb 123 24.85

2. fragment sentence 86 17.37

3.article 63 12.73

4.preposition 48 9.7

5.word form 45 9.1

6.punctuation 44 8.89

7.voice 23 4.65

8.misspelling 18 3.64

9.parallelism 16 3.22

10.miscollocation 16 3.22

11.plurality 13 2.63

total 495 100

Table 4.1 The errors caused by residents in English abstract writing

The three most common errors were errors on verb, sentence fragment and

article, respectively. The other errors included errors on preposition, errors on word-

form, errors on punctuation, errors on voice, misspelling, errors on parallelism,

miscollocation, and errors on plurality, respectively.

17

4.1Error classification

4.1.1 Errors on verb

In terms of errors on verb, the error on verb-tenses was the most common

error followed by the error on verb-form, the error on participial and errors on

subject-verb agreement (Table 4.2). Below are the examples of errors on verb tenses.

Type of errors Frequency Percentage

verb tense 64 52

verb form 26 21

participial 19 16

subject verb agreement 14 11

total 123 100

Table 4.2 The classification of errors on verb

4.1.1.1 Errors on verb-tense

1.“Previously, it has been showed that only 45% of patients under DFP monotherapy

showed a significant reduction of serum ferritin (SF) over one year of treatment.”

2. “Extrapulmonary TB in children is difficult to diagnose and had low rate of

microbiologic confirmation.”

The tense used in sentence 1 should be in the past tense because it discusses a past

event, while sentence 2 should be written in the present simple tense since it discusses

the general knowledge of extrapulmonary TB.

4.1.1.2 Errors on verb-form

3. “PWV non invasive assessments have been use to evaluate sub-clinical

atherosclerosis in adults, but there were limited data in children.”

4. “The median age of patients underwent surgery was 7.7 years (2 months-22

years).”

In sentence 3, the main verb should be “used” as it was written in present perfect

passive form, and sentence in 4 “ undergoing” should be used instead of “underwent”.

18

4.1.1.3 Errors on participial phrases

5. “Rhabdomyosarcoma was the most common subtype of soft tissue sarcoma which

accounted for 49.1%, following by Ewing’s sarcoma (12.7%) and primitive

neuroectodermal tumor (PNET) (10.9%).”

6. “There were 3 of 138 patients (2.1%, 1 boy and 2 girls) present acute transfusion

reactions after received blood products.”

The verb in the present participial form “following” in sentence 5 should be replaced

by “followed” since the full form of the sentence was passive form (which was

followed by), whereas in sentence 6 the verb in the present participial

“receiving”should be used.

4.1.1.4Errors on subject-verb agreement

7. “These high risk infants is always higher than other children in the same age.”

8. “The most common reasons patients listed as the reason for choosing to receive

care at Siriraj hospital was having the physical examination done by a physician ( 49

%), being able to ask advice about child rearing( 25 %) and having confidence in

quality of vaccines being provided ( 24 %).”

The subjects of sentence 7, i.e., “infants” and 8, i.e., “reason”, were plural; the verb,

therefore, should be changed to “are” and “were”, respectively.

4.1.2 Sentence fragment

9. “Prospectively compared/cross sectional study in children 1-15 year-old who were

diagnosed as acute renal failure at Siriraj Hospital from January 2007 to December

2007. To test the hypothesis that FEurea might be more useful in evaluating acute

renal failure in children.”

10. “A cross sectional study between January 2006-December 2007.”

These errors occurred in (9) and (10) since the authors used a full stop after a phrase.

19

4.1.3 Errors on Article

11. “According to complications of biopsy procedure, the 30.8 – percent of events

were pain, but only 12.8 % needed analgesia.”

22. “Most of (the)cases in both groups had stage II hypertension (89% and 75%

respectively).”

In sentence 11, “the” should be omitted, while in sentence 12 “most of” must be

followed by the definite determiner “the”.

4.1.4 Errors on Preposition

13. “Hematuria and anemia were detected approximately 10%, whereas one patient

experienced with hypotension needed blood transfusion.”

14. “Readmission was defined as the patients who had readmitted in the hospital

during one-year period.”

In sentence 13, “experienced” should not have a preposition, while in sentence 14,

readmitted should be followed by “to”.

4.1.5 Errors on word form

15.”The majority of these newborns (94.6%) had sizes appropriately for their

gestational age while preterm delivery were reported 23.4%.”

16. “Clinical course and data were collected and analyzed from medical recordin

patients with PAH which is classification by Dana Point 2008.”

In sentence 15,the word “appropriately” (adv.) should be changed to appropriate (adj)

and placed right after newborn because it modified the size of newborns, while

“classification” (n.) in sentence 16 should be changed to classified (V3).

4.1.6 Errors on punctuation

Regarding punctuation, comma splice was the most common error followed by other

errors regarding punctuation (Table 4.3). Below are the examples of errors in

punctuation.

20

Type of errors Frequency Percentage

comma splice 29 65.9

other punctuation 15 34.1

total 44 100

Table 4.3 The classification of errors on punctuation

4.1.6.1Comma splice

17. “Comparisons of the continuous parameters between control group and

intervention group were performed by independent Student t-test, the Chi-Square test

were used for the categorical variables.”

18. “The median age of the onset of symptom was 6 month,77% was infant and 23%

was school age (5 and 6½ years old).”

These errors were classified as comma splice, since the two sentences in (17) and (18)

were connected by a comma without a conjunction.

4.1.6.2 Other errors regarding punctuation

19. “This study suggests that we cannot predict abnormal DMSA from abnormal

kidney ultrasound and VUR, however (,)this may reflect low number of patients in

the study.”

20. “Fontan completion were performed in 2 patients, but the long term follow up

were not established(.)”

The error which occurred are caused by a wrong use of punctuation. That is

“however” should be put between a semicolon and comma. In (20), the error results

from a lack of afullstop at the end of the sentence.

4.1.7 Errors on voice

21. “The age of these patients at the first diagnosis was ranged from 1 day to 3 years

(median 120 days).”

21

22. “All complete the history of prenatal, perinatal, family, the cause and duration in

Foundation for children and the daily activity of children also recorded.”

Sentence 21 must be written in active voice “range”, while sentence 22 must be

written in passive voice “was recorded”.

4.1.8 Misspellings

23. “Based on our study, the common complications found in children and

adolescents with obesity are dyslipidemia (approximately 60% of all patients),

abnormal liver function test, obstructive sleep apnea, where as abnormal glucose

metabolism and metabolic syndrome were found in 24.8%, 36% respectively.”

24. “We found that fifteen percent of these who were receiving dual NRTI regimen

had NNRTI resistant mutation althought they had never received NNRTI before.”

The correct spellings in sentence 29 and 30 are “whereas” and “although”

respectively.

4.1.9 Errors on parallelism in comparison

25. “The result of this study may be different from (that of)other international studies

and can be used to improve planning of treatment for better outcome in the future.”

26. “The correct achievement of the patients on the first trial of the VDO presentation

group was significantly more than (that of)the oral presentation group (57.5% vs

27.5%; P=0.007).”

Both of the sentences 25 and 26 lacked “that of”.

4.1.10 Miscollocations

27. “A retrospective , descriptive study in children from newborn period to 18 years

old who were diagnosed as having hypertension at Siriraj hospital from 1January

1999 to 31 December 2003”

22

28. “This is a descriptive retrospective study of pediatric patients who were admitted

at Siriraj hospital from January 2005 to December 2007 and were diagnosed as

having definite or probable invasive fungal infection.”

The phrase “diagnose as” should collocate with a disease, not having disease.

4.1.11 Errors on plurality

29. “IgG subclass deficiency is one of primary immune deficiency disease, defined by

deficiency of one or more subclasses.”

30. “Due to small number of patient, the better studies should be performed with the

larger number of patient.”

In sentence 27, “disease” must be changed to diseases, while “patient” in sentence 28

must be made to plural.

4.2 The analysis of interlingual and intralingual errors in abstract writing

4.2.1 Interlingual errors

Native language influence seems to be the most problematic for L2 learners

including Thai physicians who have to write academic papers in English. The results

in this study demonstrate the negative influence of mother-tongue on the errors

occurring. Interlingual errors in this study can be classified into 3 categories as

follows.

4.2.1.1Lexical interference

One of the examples in this study was “admitted in hospital” which must be

correctly written as “admitted to hospital”. This error is prevalent since some Thai

writers probably translated from Thai to English (นอนรักษาตวัในโรงพยาบาล).

The other example included “diagnosed as having (disease)” which should be

changed to “diagnosed as (disease)”, since they probably translated from Thai to

English (ไดรั้บการวินิจฉยัวา่มีภาวะ).

23

4.2.1.2 Syntactic interference

This interference appeared to be the most common cause of errors in this

study. The errors on verb-tenses, comma splice, preposition, parallelism of

comparison etc. are the examples of syntactic interference.

Sentence fragments are common in this study. We found that almost all errors

on sentence fragment presented in the objective part, which was commonly written in

the infinitive pattern, and the authors put the full stop after the infinitive. This finding

may be explained by another cause, i.e., hypercorrection.

Interestingly, the error on parallelism of comparison was not uncommon.

Several Thai authors experienced this problem while making a comparison.

The frequency of errors on subject-verb agreement in our study, in which the

authors used a computer program for their work, is less than that in other studies

(Sattayatham, 2007,Watcharapunyawong 2012) which elicited errors from the

participants writing an assignment. The use of a computer program i.e., Microsoft

word program, which can detect some categories of errors, may result in the

decreased frequencies of some patterns of errors including errors on subject verb

agreement, errors on capitalization, and misspelling.

4.2.2 Intralingual errors

As mentioned in the limitations of the study, the use of a computer program might

reduce the presence of this type of error since several types of errors related to

spelling were detected and corrected before submission of the abstracts. This might

be the reason why overgeneralization appeared to be uncommon in this study.

4.2.2.1 Ignorance of rule restriction

This type of error includes incorrect use of verb, pronoun and adjective. Below

are examples of the incorrect use of them.

(1) Incorrect use of verb

24

“The immediate complication condition been discovered is atrial fibrillation 2.8% ,

arteriovenous fistula 0.8 %, cardiac tamponade 0.6 %, eye embolism 0.3 % , stroke

0.3 %, respectively.”

This sentence must be changed “been discovered” to “discover”.

(2) Incorrect use of adjective

“The relationships between the level of urine metamphetamine in mother and their

newborn infants versus the hours after birth are good correlated but cannot reliably

predict infant outcomes.”

In this sentence “good” (adj.) should be changed to “well” to modify “correlated”.

4.2.2.2Incomplete application of rules

These types of errors include incorrect use of preposition, and omission of the

verb to be in passive voice.

(1) Incorrect use of preposition

“Infection in children is difficult to diagnose because of its nonspecific manifestations

and difficulty to isolate the organism.”

In this sentence, the preposition used with “difficulty” should be “in”, not “to”.

(2) Omission of the verb to be in passive form

“New techniques and a variety of occluding devices will continuously developed to

reduce complications such as residual shunt, device migration, complete heart

block(CHB), aortic regurgitation, tricuspid regurgitation and vascular injury.”

25

This sentence must be written in passive voice “will be continuously developed”

instead of “will continuously developed”.

4.3 The comparison of this study to previous studies

The results show that errors on punctuation are the most common errors

followed by errors on verb and article respectively. These findings differ from

previous findings in the study conducted by Satttayatham (2007), which found that, in

opinion paragraph writing, wrong word choice was the most common followed by

errors on article and plurality respectively.The other studies by Watcharapunyawong,

(2012) found that the 3 most common errors were errors on plurality, word choice and

article respectively (Table 4.4)

Authors Participants/samples Types of writing

Three common errors

Present study (2016)

physicians abstract 1) verb

2) fragment sentence

3) article

Watcharapunyawong(2012)

second year English major students

comparison/contrast paragraph writing

1) plurality 2) word choice 3) article 

Satttayatham(2007)

first year medical students

opinion paragraph

writing

1) word choice 2) article 3) plurality 

Table 4.4 The comparison of error studies in Thai students and physicians

The samples of this study are different from those in many studies conducted

by Thai authors in several aspects. First of all, the abstracts in this research were

written by physicians whereas most of the previous studies were conducted on

students (Sattayatham, 2007, Jenwitheesuk, 2009,Watcharapunyawong 2012).

Secondly, the pattern of abstract writing is more specific i.e., it consists of

introduction, methods, results and conclusion respectively. Thirdly, the samples in

26

this study were typed using a computer program, while the previous studies were hand

written. The distinctions of samples might account for the different results.

The errors on verb and sentence fragment were more common than those in

other studies; this may be caused by the pattern of abstract writing, as was previously

discussed in the syntactic interference section, and the complexities of tenses used in

different parts of abstract writing, in which the backgroundsection and conclusion are

usually written in the present simple tense, whereas methods and results are usually

written in the past simple tense.

27

CHAPTER 5

CONCLUSIONS AND RECOMMENDATIONS

5.1 Conclusions

The results in this study may primarily be helpful to Thai physicians,

particularly those who need to internationally publish their research studies. If they

realize theweaknesses in their academic writing, they might improve the quality of

their work in terms of grammatical concerns. In addition, the errors regarding

parallelism of comparison and errorson preposition are common and have a specific

pattern; Thai authors, therefore, should focus on their work if they use the pattern of

parallelism of comparison. Another point of concern is the pattern to write the

objective sections; most of them were written in infinitive phrase, which must not

have a period. These errors of the use of a period after infinitive clause accounted for

the majority of errors on punctuation. Thai authors who write English abstract should

be aware of this error. These findings will also benefit the English instructors teaching

English for scientific and medical purposes to correct the common errors made by

Thai pediatricians.

This finding also substantiates the role of academic editing by native speakers

before submission since the grammatical errors in academic writing are ubiquitous,

even in the abstract section which contains only a few paragraphs.

5.2 Recommendation for future research

Further studies should be conducted in several aspects as follows.

1) A study regarding errors in large cohort: More research using samples from other

fields of medical specialty such as internal medicine, surgery, etc. should be

conducted so that the results can be generalized to Thai physicians.

2) A study regarding errors in full articles written in English by Thai physicians: a

study conducted on full articles may demonstrate more errors produced by Thai

physicians and may see the specific patterns of errors in English academic writing

28

since most of the authors may pay more attention to abstract writing than other

sections.

29

REFERENCES

Belcher, D. (2006). English for specific purposes: Teaching to perceived needs and

imagined futures in worlds of work, study, and everyday life. TESOL

Quarterly, 40, 133-156

Chitpakdee, A. (2004). A case study of English language skills used by Pediatricians

at Chonbuti Hospital.(Master’s thesis). The University of the Thai Chamber

of Commerce, Bangkok

Corder, S. P. (1971).Idiosyncratic dialects and error analysis.International Review of

Applied Linguistics in Language Teaching, 9, 147–59.

Corder,S.P. (1974). Error Analysis: Perspectives on Second Language Acquisition.

London: Longman.

Eggly, S., Musial, J. &Smulowitz,J (1999). The relationship between English

language proficiency and success as a medical resident.English for Specific

Purposes, 18, 201–208

Ellis, R. (1997). SLA research and language teaching. Oxford: Oxford University

Press.

Ellis, R.&Barkuizen, G. (2005).Analysing learner language. Oxford: Oxford

University Press

Fisiak, J. (ed.) (1981). Contrastive Analysis and the Language Teacher. Oxford: The

PergamonInstitue of English

30

Hamad Al-khresheh, M. (2015).A Review Study of Interlanguage Theory.

International Journal Of Applied Linguistics And English Literature, 4(3),

123-131.

Hashim, A. (1999). Crosslinguistic influence in the written English of Malay

undergraduates. Journal of Modern Languages,12(1), 59-76.

Jenwitheesuk, T. (2009).A study of persisted syntactic errors in writing of the 3rd

year students of English forinternational communication program.Paper

presented at the The Role of Universities in Hands-onEducation

Jirapanakorn, N. (2012). How doctors report: A corpus-based contrastive analysis of

reporting verbs in research article introductions publishedininternational and

Thai medical journals. The Bangkok Medical Journal, 4, 39-46

Johns, A. M. (2013). The history of English for specific purposes research. In B.

Paltridge and S. Starfield (eds). The handbook of English for specific

purposes. Boston: Wiley-Blackwell.

Klassen, J. (1991). “Using Student Errors for Teaching”, FORUM, Vol. XXIX, No. 1,

Jan.

Keshavarz, M.H. (1993). Contrastive Analysis and Error Analysis.Tehran.Rahnama

Press.65-76

Lado, R. (1957).Linguistics across cultures.Applied linguistics for language

teachers.Michigan:University of Michigan Press.

Nemser, W (1971).Approximative Systems of Foreign Language Learners,

International Review of Applied Linguistics in Language Teaching 9, 112–

123.

31

Richards, J.C. (1974).Error Analysis.Perspectives on Second LanguageAcquisition.

London and New York: Longman.

Pleansaisurb, W. (1984).A survey of needs, wants and problems of the medical

students at Mahidol University for the use of the four skills of English.

Master Thesis.Bangkok: Graduate School Mahidol University.

Sattayatham, A., &Honsa, S. (2007). Medical students' most frequent errors at

Mahidol University, Thailand. Asian EFL Journal,9, 170-194

Sattayatham, A. &Rattanapinyowong, P. (2008).Analysis of errors in paragraph

writing in English by first year medical students from the four medical

schools at MahidolUniversity.Silpakorn University International Journal, 8,

17-38.

Selinker, L.(1972).Interlanguage.InternationalReview of Applied Linguistics, 10, 209-

241

Selinker L. (1992). Rediscovering Interlanguage. Longman: London

Somphong, M. (2013).An Analysis of errors in passive sentence structures by Thai

EFL University Students.The Asian Conference on Education 2013 Official

Conference Proceedings.

Sursattayawong, O. (2006).A survey of English speaking problems of

nursesatRajavithihospital.Master Thesis. Bangkok: Graduate School

Srinakarinwirot University.

Thep-Ackrapong, T. (2005).Teaching English in Thailand: An uphill battle.Journal of

Humanities Parithat.Srinakharinwirot University, 27(1), 51-62

Thornbury, S. (2000).How to teach grammar, London: Pearson ESL.

32

Watcharapunyawong S. & Usaha S. (2012). Thai EFL students’ writing errors in

different text types: The interference of the first language. Retrieved March

5, 2015, from http://www.ccsenet.org/journal/index.php/elt/article/

view/23044/14794

33

APPENDICES

34

APPENDIX A

Examples of English abstract

Abstract

Background: Kawashima operation was accepted that was the effective method to treat patients with univentricular physiology with interrupted inferior vena cava, but there were reports shown that pulmonary arteriovenousmalformation(PAVM) that can cause severe desaturation frequently developed after Kawashima operation. Also, venocenousmalformation(VVM) can induced desaturation in patients underwent Kawashima operation. In this study we described the occurrence of PAVM and VVM after Kawashima operation in Siriraj hospital

Objective: To evaluate incidence of PAVM and VVM after Kawashima operation was performed in Sirirajhospital ,timing before PAVM or VVM occur, correction to these complications and follow up after that

Method:This study was a retrospective descriptive study in patients with univentricular physiology with interrupted inferior vena cavapost Kawashima operation in Siriraj Hospital since 1st January 2001 to 31th December 2011. The data of Kawashima operation was collected and analyzed divided in 3 groups: pre, peri and post Kawashima operation

Result: 8 patients with univentricular physiology with interrupted inferior vena cava underwent Kawashima operation. PAVM were found in 3 patients and VVM were found in 4 patients out of 7 survival patients, about 42.8% and 52.7% consecutively. PAVM were diagnosed at the median time of 5 years 1 month(2 years 9 months – 6 years 1 month)Fontan completion were performed in 2 patients, but the long term follow up were not established

Conclusion:PAVM and VVM were the common cause of desaturation in patients post Kawashima operation, So the oxygen saturation should be closely observed. Redirection of

the hepatic venous effluent to the pulmonary arterialcirculation may prevent or lead to regression of pulmonaryarteriovenous malformations. So early Fontan completion before desaturation was detected may be a safe choice in these patients

Abstract

Objectives: The aim of this study was to determine the etiology of children with global developmental delay (GDD) of unclear causes at Special needed child clinic at Siriraj hospital.

Methods: This retrospective study included all patients who were evaluated at Siriraj special-needed child clinic at Siriraj Hospital with GDD from 1 January 2009 to 31 December 2011. Diagnostic studies consisted of history, physical examination, and

35

selected investigations including, screening for metabolic disease, karyotype and FISH testing and neuroimaging.

Results: There were 149 patients during the study period. Among 110 patients were included in the study. There were 66 males (60%) with a mean age of 34.5 ± 30.7 months and median 25.5 months. Etiologic diagnosis was determined in 61.8 percent of the patients and classified under the following categories: Cerebral dysgenesis 29.4 percent, Genetic/Dysmorphic syndromes 19.1 percent, Neurodegenerative diseases (unknown cause) 7.4 percent, Intrauterine infection 7.4 percent, Others 7.4 percent, Neurodegenerative diseases (known cause) 5.9 percent, Chromosomal abnormalities 5.9 percent, Teratogen/toxin 5.9 percent, Brain atrophy (unknown cause) 4.4 percent, Epileptic syndrome 4.4 percent, Brain injury 1.5 percent and Neurocutaneous syndromes 1.5 percent. Etiology was unknown in 38.2 per cent of the patients. Investigations were needed in 90% of these patients. The highest diagnostic yields were FISH and neuroimaging studies.

Conclusion: With the multidisciplinary team approach, etiologic yield in this selected series is found in 62%. These patients need multidisciplinary management including clinical history, examination, and appropriate investigations. Correct diagnosis leads to appropriate management, prognosis, recurrence risk, and genetic counseling in these patients.

Abstract

Introduction

Acute respiratory distress syndrome (ARDS) is a high severity syndrome. Eventhough the incidence of pediatric ARDS is low but required a lot of medical personals and equipments for treatment and it is the important cause of morbidity and mortality in pediatric intensive care units (PICUs).

From previous studies there are very few data available regarding the incidence of pediatric

ARDS, and most of them are performed in adult setting. In contrast, there are many different factors between adult and pediatric patients including underlying diseases, risk factors, treatments and outcomes. So, there is the benefit to study the correlation between severity of pediatric acute respiratory distress syndrome and outcome of treatment to evaluate the efficiency of management in PICU. This study may be used as an initial data to compare our PICU and other PICU in the future when the medical equipments and processes are more developed.

Our teams applied PRISM score to evaluate severity of ARDS and used Murray lung injury score to grading the severity of lung pathology in this study.

Objectives

The purpose of this study was to study in the correlation between severity of pediatric acute respiratory distress syndrome by PRISM score and outcome of treatment in PICU at Siriraj Hospital. Other aims were to find out causes of ARDS, risk factors, treatment, duration of ventilator, complications, and to evaluate severity of ARDS by Murray lung injury score.

36

Methodology

Descriptive retrospective study was carried out through review of the patient medical records. The study focused on the age of 1 month to 15 years old inpatient who were admitted in PICU, Siriraj Hospital between July, 1st 2007 – May, 31st 2012. The different parameters of physical examination, laboratory testing result within 24 hours after diagnosed ARDS were determined by PRISM score and Murray lung injury score to identify the correlation between severity of ARDS and outcome of treatment.

Abstracts

Background :Thalassemia is an inherited disorder of the hemoglobin synthesis which leads to 40% of Thai people have abnormal gene. Severe thalassemia include beta-thalassemia major, beta-thalassemia / Hb E, thalassemia intermedia. Clinical presentations include severe anemia and transfusion dependence. Frequent hemolysis and frequent blood transfusions as well as increased iron absorbtion from the gut result in iron overload of the tissues of various organs and lead to multiple organ dysfunctions. To knowns pulmonary function test and other factors are important to improving patients management.

Objectives: To determine the prevalence and factors associated with abnormal pulmonary function test in children age 5-15 years with severe form of thalassemia in Siriraj hospital.

Methods :A prospective study was conducts in children aged 5-15 years who were diagnosed as transfusion- dependent thalassemia at hematology clinic, pediatric department Siriraj hospital. Data collection from medical records included the demographic data, clinical features and lab investigations. Pulmonary function testing were assessed.

Results :Twenty-eight patients with transfusion- dependent thalassemia. Male:female ratio was 12:17 and mean age was 12:17. Mean onset of age was 1.43+1.4 and mean duration of disease was 10.6+2.8 years old. Patients had neither respiratory symptoms nor hypoxemia. Duration of chelating agents 5.99+2.9 years. Mean hemoglobin was 9.14 + 1.1 g/dl. Pure restrictive defect was found in 12 patients(41%) respectively. Age, duration of disease are associated with those who had abnormal PFT. There was no statistical significant between the degree of impairment in sex, serum ferritin, duration of chelating agents and hemoglobin.

Conclusion :Majority of patients with transfusion-dependent thalassemia have mild degree of abnormal pulmonary function tests, restrictive defect was the common finding. Age, duration of disease were associated with abnormal pulmonary function tests.

Abstract

Objective: Ventricular septal defect (VSD) is the most common congenital heart disease. The complications are congestive heart failure, prolapsed aortic valve and aortic regurgitation, infective endocarditis and pulmonary arterial hypertension. VSD

37

can get smaller and spontaneously close by time. However, the surgical closure is necessary in some patients to prevent long term complications. The operative risk is still there, even though the number is quite low. However, this operation is considered only in the patients who have indications such as failure to thrive, pulmonary hypertension, repeated pneumonia and aortic valve regurgitation (AR). AR is one of the residual lesions which results in quality of life in a long term after operation. The risk factors and prevalence of AR after operation is challenging and these lead to this study.

Method: A retrospective study of VSD type I and II patients who underwent surgical VSD closure and aged 0-18 years old were conducted. This study enrolled all patients during January 1st 2002 until December 31st 2010 of Division of Cardiology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital.

Results: There were 221 patients in this study. The median age at diagnosis was 13 months (0.03-178 months). The prevalence of AR after operation was 26%. There were 50 cases(22.6%) who diagnosed type I VSD and 171 cases (77.4%) who diagnosed type II VSD. After operation, 163 cases (73.8%) did not have AR.

The risk factors of post operative AR were VSD type I (OR = 2.95), small size VSD (OR = 2.71), preoperative prolapsed aortic cusp (OR = 5.38), preoperative AR (OR = 8.74), preoperative RVSP ≤ 52 mmHg(OR = 4.35), age at operation more than 35 months (OR = 2.46), VSD closure with repair aortic valve (OR = 29.68). After excluded confounding factor by logistic regression, the risk factors were only three significant risk factors that were VSD type I (OR = 2.63), preoperative prolapsed aortic cusp (OR = 13.11), and VSD closure with repair aortic valve (OR = 11.52).

Summary: The prevalence of residual AR postoperation VSD closure was 26.2%. The significant risk factors of postoperative AR were VSD type I, preoperative prolapsed aortic cusp and VSD closure with repair aortic valve.

Abstract

Background: School bullying can lead to serious physical and mental sequelae. There are no previous studies about the association between school bullying with depression in Thailand.

Objectives: To study the characteristics of bullying behaviors and their associations with depression among the 7th – 9th grade students in public high school, Bangkok-Noi, Bangkok.

Methods: In a cross-sectional study, 370 students participated in this study during August 2011. Students completed demographic information, the Olweus Bully/Victim questionnaire (Thai version) and Children’s Depression Inventory (Thai version). The data was analyzed by descriptive statistics and Chi-square.

Results: The prevalence of students who were involved in school bullying was 40.2% which were classified as victim 15.3%, bully 9.6% and bully/victim 15.3%. Boys were involved in all bullying behaviors more than girls. The most common type of bullying behaviors was verbal. The significant factors related to bullying problems were gender, education level and GPA (Grade point average) (p<0.05). Of the 370

38

students, the prevalence of depression was 24.6% while the prevalence of depression in students involved in school bullying was 27.9%. There was no correlation between all bullying behaviors/types and depression.

Conclusions: The prevalence of depression in students who were involved in school bullying was slightly higher than general population. These students should be assessed and provided for depression prevention program.

Keywords: bullying, depression

Abstract

Unintentional poisoning is the worldwide major cause of death among children younger than six years of age. The author studied the risk factors of unintentional poisoning in young children admitted in Siriraj hospital in order to create a guideline for injury prevention anticipatory guidance.

Objective: To identify the developmental, behavioral, environmental and social risk factors associated with unintentional poisoning among preschool children and to compare risk factors between study and control groups.

Method: This is a retrospective case-control study. The author categorized the pediatric patient aged 6-60 months who were admitted to Siriraj hospital due to unintentional poisoning from 1st January 2007 to 31st December 2009 as the study case and the children who went to see the doctor at pediatric outpatient department, Siriraj hospital for other problems apart from poison as the control group. We matched age and sex between study and control groups and collected the data by the same questionnaire. The data were analyzed statistically by chi-square and paired t-test with univariate analysis.

Results: Father’s income, mother’s education, number of family member, non-parental primary caregiver, close supervised caregiver, family member’s medication, the type of container of chemical substance, the lid-cover of the container, the label of the container and the height of the storage place were all the risk factors of unintentional poisoning, statistically significant. The developmental skill of the children was not a significant risk factor only.

Conclusion: Doctors should give anticipatory guidance about social, behavioral and environmental risk factors in order to decrease the incidence of unintentional poisoning

Abstract

Background: Bullying is a common and serious problem among school-age children. In Thailand, there have been no previous studies on the association of childhood bullying behaviors and psychosocial health problems.

Objectives: To study the associations between bullying behaviors and psychosocial health problems among primary school students in Bangkok, Thailand

39

Methods: In a cross-sectional study, 368 fourth to sixth-grade students in 3 primary schools participated in August 2011. Parents completed demographic information and Thai Youth Checklist-parent version (TYC). Students completed The Revised Olweus Bully/Victim Questionnaire, Thai version. The data was analyzed by descriptive statistics, chi-square and odds ratio.

Results: The student’s mean age was 10.6 ± 0.95 years, and 53.8% were female. 68.7% of students reported involvement in bullying at school, which was identified as victim 34%, bully 4.3%, bully/victim 30.4%. Bullying was more prevalent among boys than girls and the most common form of bullying was verbal type. The difference of psychosocial health problems among those 4 groups were statistically significant (p=0.003). The highest prevalence of internalizing problems was found in the bully/victim group (25.9%), and the highest prevalence of externalizing problems was found in the bully group (31.3%). Compared with the students who were not involved with school bullying, the bully/victim group had significantly higher risk for internalizing problems (OR:2.16; 95%CI:1.06-4.4) and the bully had significantly higher risk for externalizing problems (OR:4.72; 95%CI:1.1-20.16).

Conclusions: Students who were involved in school bullying had significantly higher risks for psychosocial health problems including internalizing and externalizing problems. Thus, students who are involved in school bulling should be assessed and provided proper management program.

Keywords: bullying, psychosocial health problems, internalizing problems, externalizing problems

Abstract

This is a retrospective study design to determine the incidence of ventilator-associated pneumonia (VAP) among Pediatric Intensive Care Unit (PICU) patients in SIRIRAJ hospital

and to assess the impact of VAP on patient outcomes, including mortality, length of stay, and duration of mechanical ventilation between January 1, 2006 until to December 31, 2010. VAP was identified by SIRIRAJ Infections control department.

Results :During 5 years period, Incidence of ventilator-associated pneumonia in PICU SIRIRAJ hospital is 7.6 per 1000 ventilator days and 6.9 per 100 ventilated patients. There were 34 males and 36 females. The mean age was 3.3 years. Underlying cardiac and respiratory illnesses were the most common disorders associated with VAP but were not significant risk which indicated the outcome of VAP. The most common cause of admission was respiratory failure. The causative organisms of VAP were gram negative bacteria 82.8%, gram positive bacteria 11.4%, and fungus 5.7%. Most common gram negative organism wereAcinetobacterbaumanii45.7%, Pseudomonas aeruginosa28.6% and Stenotrophomonasmaltophillia7.1%. Possible risk factors associated with VAP were blood stream infection (41.1%), reintubation (45.7%) and central line insertion (98.6%). Mortality rate was 45.7% and 8.6% of cases; VAP was the cause of death. Average length of stay in PICU and ventilator day were 89 days (19-860 days) and 65

40

days (5-804 days) respectively. The onset of VAP was ≥ 1 week after mechanical ventilation and the mean was 34 days (3-330 days).

Conclusion: VAP occurs at significant rates among mechanically ventilated patients in PICU. It is associated with high morbidity and mortality. Developing new infectious control interventions and closely monitoring among the high risk patients to make early diagnosis may reduce the incidence and complication of VAP in mechanically ventilated patients.

Abstract

Background : The methods for hematocrit measurement used at Siriraj hospital are manual microhematocrit centrifugation and automated technique. For decades, only the levels obtained by the Centrifuge were acknowledged and set as the standard measurements. However, there has not been any proof that results found using other instruments, such as the Hematology analyzer, were inaccurate.

Objectives : To make comparisons between the results obtained using a centrifuge and a hematology analyzer.

Methods : A prospective design was used. Hematocrit values obtained from microhematocrit centrifugation were compared with automated hematologic analyzer in 150 neonates admitted in division of neonatology, Siriraj hospital. Paired t-test was used to determine differences in hematocrit values for the 2 methods.

Results : The hematocrit levels obtained from the centrifuge and the levels taken from the hematology analyzer shows incoherences. Results from the centrifuge varied from the hematology analyzer, where results were equal (3.33%), lower or even higher than the latter. 83.33% of the results taken from the centrifuge were higher than the results from the hematology analyzer by 0.1% to 9.3%, while 13.34% of the results were lower by -0.1% to -8.4%. 68.7% of the blood samples shows differences ranging from 1% to 9.3%, averaging to 1.97% (standard deviation of 2.51). Where differences are p<0.001.

Conclusion :The study reveals that the level of hematocrit obtained by centrifuge and the hematology analyzer shows differences in the results. Where 68.7% of blood samples show incoherences between the two instruments, differences ranging from 1% to 9.3%, which is not suitable for clinical uses. Therefore, the hematology analyzer should not be used towards medical analysis and care for its inaccuracy. As a conclusion, the centrifuge should continue being used as the gold standard

41

BIOGRAPHY

Name Mr.Jassada Buaboonnam

Date of Birth March 5, 1979

Educational Attainment

2002:Doctor of Medicine (Second class honors),

Faculty of Medicine, Siriraj Hospital, Mahidol

University, Thailand

2005 Diploma of the Thai Board of Pediatrics,

the Thai Medical Council (Royal College of

Pediatrics of Thailand)

2007 Diploma of the Thai Board of Pediatric

Hematology-Oncology, the Thai Medical

Council (Faculty of Medicine, Siriraj Hospital,

Mahidol University), Thailand

2011 Research fellowship in Pediatric Oncology

St.Jude Children Research Hospital, Tennessee

USA

Work Position 2014 – Present: Assistant Professor

Division of Hematology-Oncology, Department

of Pediatrics Faculty of Medicine, Siriraj

Hospital, Mahidol University, Bangkok,

Thailand