Patient’s Knowledge and Use of Sublingual Glyceryl Trinitrate Therapy in Taiping Hospital, Malaysia

Background: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self-administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Evaluation of Medication Administration Process in a Paediatric Ward

Children are more susceptible to medication errors than adults. Medication administration process is the last stage in the medication treatment process and most of the errors detected in this stage. Little research has been undertaken about medication errors in children in the Middle East countries. This study was aimed to evaluate how the paediatric nurses adhere to the medication administration policy and also to identify any medication preparation and administration errors or any risk factors. An observational, prospective study of medication administration process from when the nurses preparing patient medication until administration stage (May to August 2014) was conducted in Saudi Arabia. Twelve paediatric nurses serving 90 paediatric patients were observed. 456 drug administered doses were evaluated. Adherence rate was variable in 7 steps out of 16 steps. Patient allergy information, dose calculation, drug expiry date were the steps in medication administration with lowest adherence rates. 63 medication preparation and administration errors were identified with error rate 13.8% of medication administrations. No potentially life-threating errors were witnessed. Few logistic and administrative factors were reported. The results showed that the medication administration policy and procedure need an urgent revision to be more sensible for nurses in practice. Nurses’ knowledge and skills regarding to the medication administration process should be improved.

Educators’ Adherence to Learning Theories and Their Perceptions on the Advantages and Disadvantages of e-Learning

Information and Communication Technologies (ICTs) are pervasive nowadays, including in education where they are expected to improve the performance of learners. However, the hope placed in ICTs to find viable solutions to the problem of poor academic performance in schools in the developing world has not yet yielded the expected benefits. This problem serves as a motivation to this study whose aim is to examine the perceptions of educators on the advantages and disadvantages of e-learning. This aim will be subdivided into two types of research objectives. Objectives on the identification and design of theories and models will be achieved using content analysis and literature review. However, the objective on the empirical testing of such theories and models will be achieved through the survey of educators from different schools in the Pinetown District of the South African Kwazulu-Natal province. SPSS is used to quantitatively analyse the data collected by the questionnaire of this survey using descriptive statistics and Pearson correlations after assessing the validity and the reliability of the data. The main hypothesis driving this study is that there is a relationship between the demographics of educators’ and their adherence to learning theories on one side, and their perceptions on the advantages and disadvantages of e-learning on the other side, as argued by existing research; but this research views these learning theories under three perspectives: educators’ adherence to self-regulated learning, to constructivism, and to progressivism. This hypothesis was fully confirmed by the empirical study except for the demographic factor where teachers’ level of education was found to be the only demographic factor affecting the perceptions of educators on the advantages and disadvantages of e-learning.

Predictor Factors for Treatment Failure among Patients on Second Line Antiretroviral Therapy

Second line antiretroviral therapy (ART) regimen is used when patients fail their first line regimen. There are many factors such as non-adherence, drug resistance as well as virological and immunological failure that lead to second line highly active antiretroviral therapy (HAART) regimen treatment failure. This study was aimed at determining predictor factors to treatment failure with second line HAART and analyzing median survival time. An observational, retrospective study was conducted in Sungai Buloh Hospital (HSB) to assess current status of HIV patients treated with second line HAART regimen. Convenience sampling was used and 104 patients were included based on the study’s inclusion and exclusion criteria. Data was collected for six months i.e. from July until December 2013. Data was then analysed using SPSS version 18. Kaplan-Meier and Cox regression analyses were used to measure median survival times and predictor factors for treatment failure. The study population consisted mainly of male subjects, aged 30- 45 years, who were heterosexual, and had HIV infection for less than 6 years. The most common second line HAART regimen given was lopinavir/ritonavir (LPV/r)-based combination. Kaplan-Meier analysis showed that patients on LPV/r demonstrated longer median survival times than patients on indinavir/ritonavir (IDV/r) based combination (p

Impact of Behavioral Aspects of Autism on Cognitive Abilities in Children with Autism Spectrum Disorder

Cognitive symptoms and behavioral symptoms may, in fact, overlap and be related to the level of the general cognitive function. We have measured the behavioral aspects of autism and its correlation to the cognitive ability in 30 children with ASD. We used a neuropsychological Battery CANTAB eclipse to evaluate the ASD children's cognitive ability. Individuals with ASD and challenging behaviors showed significant correlation between some cognitive abilities and Motor aspects. Based on these findings, we can conclude that the motor behavioral problems in autism affect specific cognitive abilities in ASDs such as comprehension, learning, reversal, acquisition, attention set shifting, and speed of reaction to one stimulus. Future researches should also focus on the relationship between motor stereotypes and other subtypes of repetitive behaviors, such as verbal stereotypes, ritual routine adherence, and the use of different types of CANTAB tests.

Generation of Catalytic Films of Zeolite Y and ZSM-5 on FeCrAlloy Metal

This work details the generation of thin films of structured zeolite catalysts (ZSM–5 and Y) onto the surface of a metal substrate (FeCrAlloy) using in-situ hydrothermal synthesis. In addition, the zeolite Y is post-synthetically modified by acidified ammonium ion exchange to generate US-Y. Finally the catalytic activity of the structured ZSM-5 catalyst films (Si/Al = 11, thickness 146 0m) and structured US–Y catalyst film (Si/Al = 8, thickness 230m) were compared with the pelleted powder form of ZSM–5 and USY catalysts of similar Si/Al ratios. The structured catalyst films have been characterised using a range of techniques, including X-ray diffraction (XRD), Electron microscopy (SEM), Energy Dispersive X–ray analysis (EDX) and Thermogravimetric Analysis (TGA). The transition from oxide-onalloy wires to hydrothermally synthesised uniformly zeolite coated surfaces was followed using SEM and XRD. In addition, the robustness of the prepared coating was confirmed by subjecting these to thermal cycling (ambient to 550oC). The cracking of n–heptane over the pellets and structured catalysts for both ZSM–5 and Y zeolite showed very similar product selectivities for similar amounts of catalyst with an apparent activation energy of around 60 kJ mol-1. This paper demonstrates that structured catalysts can be manufactured with excellent zeolite adherence and when suitably activated/modified give comparable cracking results to the pelleted powder forms. These structured catalysts will improve temperature distribution in highly exothermic and endothermic catalysed processes.

Importance of Mobile Technology in Successful Adoption and Sustainability of a Chronic Disease Support System

Self-management is becoming a new emphasis for healthcare systems around the world. But there are many different problems with adoption of new health-related intervention systems. The situation is even more complicated for chronically ill patients with disabilities, illiteracy, and impairment in judgment in addition to their conditions, or having multiple co-morbidities. Providing online decision support to manage patient health and to provide better support for chronically ill patients is a new way of dealing with chronic disease management. In this study, the importance of mobile technology through an m-Health system that supports self-management interventions including the care provider, family and social support, education and training, decision support, recreation, and ongoing patient motivation to promote adherence and sustainability of the intervention are discussed. A proposed theoretical model for adoption and sustainability of system use is developed, based on UTAUT2 and IS Continuance of Use models, both of which have been pre-validated through longitudinal studies. The objective of this paper is to show the importance of using mobile technology in adoption and sustainability of use of an m-Health system which will result in commercially sustainable self-management support for chronically ill patients.

Hepatitis B Virus Infection among Egyptian Children Vaccinated during Infancy

This is a national community based project to evaluate effectiveness of HBV vaccination program in prevention of infection. HBV markers were tested in the sera of 3600 vaccinated children. Infected children were followed up for 1 year. Prevalence of HBV infection was 0.39 % (0.28% positive for anti-HBc, 0.03% positive for HBsAg and 0.08% positive for both). One year later, 50% of positive anti-HBc children turned negative with sustained positivity for positive HBsAg cases. HBV infection was significantly higher at age above 9 years (0.6%) compared to 0.2% at age 3-9 years and 0% at younger age (P

Improved Body Mass Index Classification for Football Code Masters Athletes, A Comparison to the Australian National Population

Thousands of masters athletes participate quadrennially in the World Masters Games (WMG), yet this cohort of athletes remains proportionately under-investigated. Due to a growing global obesity pandemic in context of benefits of physical activity across the lifespan, the prevalence of obesity in this unique population was of particular interest. Data gathered on a sub-sample of 535 football code athletes, aged 31-72 yrs ( =47.4, s =±7.1), competing at the Sydney World Masters Games (2009) demonstrated a significantly (p

Adherence of Alveolar Fibroblasts and Microorganisms on Titanium Implants

An implant elicits a biological response in the surrounding tissue which determines the acceptance and long-term function of the implant. Dental implants have become one of the main therapy methods in clinic after teeth lose. A successful implant is in contact with bone and soft tissue represent by fibroblasts. In our study we focused on the interaction between six different chemically and physically modified titanium implants (Tis-MALP, Tis-O, Tis- OA, Tis-OPAAE, Tis-OZ, Tis-OPAE) with alveolar fibroblasts as well as with five type of microorganisms (S. epidermis, S.mutans, S. gordonii, S. intermedius, C.albicans). The analysis of microorganism adhesion was determined by CFU (colony forming unite) and biofilm formation. The presence of α3β1 and vinculin expression on alveolar fibroblasts was demonstrated using phospho specific cell based ELISA (PACE). Alveolar fibroblasts have the highest expression of these proteins on Tis-OPAAE and Tis-OPAE. It corresponds with results from bacterial adhesion and biofilm formation and it was related to the lowest production of collagen I by alveolar fibroblasts on Tis-OPAAE titanium disc.

The Loess Regression Relationship Between Age and BMI for both Sydney World Masters Games Athletes and the Australian National Population

Thousands of masters athletes participate quadrennially in the World Masters Games (WMG), yet this cohort of athletes remains proportionately under-investigated. Due to a growing global obesity pandemic in context of benefits of physical activity across the lifespan, the BMI trends for this unique population was of particular interest. The nexus between health, physical activity and aging is complex and has raised much interest in recent times due to the realization that a multifaceted approach is necessary in order to counteract the obesity pandemic. By investigating age based trends within a population adhering to competitive sport at older ages, further insight might be gleaned to assist in understanding one of many factors influencing this relationship.BMI was derived using data gathered on a total of 6,071 masters athletes (51.9% male, 48.1% female) aged 25 to 91 years ( =51.5, s =±9.7), competing at the Sydney World Masters Games (2009). Using linear and loess regression it was demonstrated that the usual tendency for prevalence of higher BMI increasing with age was reversed in the sample. This trend in reversal was repeated for both male and female only sub-sets of the sample participants, indicating the possibility of improved prevalence of BMI with increasing age for both the sample as a whole and these individual sub-groups.This evidence of improved classification in one index of health (reduced BMI) for masters athletes (when compared to the general population) implies there are either improved levels of this index of health with aging due to adherence to sport or possibly the reduced BMI is advantageous and contributes to this cohort adhering (or being attracted) to masters sport at older ages.

Tension Stiffening Parameter in Composite Concrete Reinforced with Inoxydable Steel: Laboratory and Finite Element Analysis

In the present work, behavior of inoxydable steel as reinforcement bar in composite concrete is being investigated. The bar-concrete adherence in reinforced concrete (RC) beam is studied and focus is made on the tension stiffening parameter. This study highlighted an approach to observe this interaction behavior in bending test instead of direct tension as per reported in many references. The approach resembles actual loading condition of the structural RC beam. The tension stiffening properties are then applied to numerical finite element analysis (FEA) to verify their correlation with laboratory results. Comparison with laboratory shows a good correlation between the two. The experimental settings is able to determine tension stiffening parameters in RC beam and the modeling strategies made in ABAQUS can closely represent the actual condition. Tension stiffening model used can represent the interaction properties between inoxydable steel and concrete.

Free Convection Boundary Layer Flow of a Viscoelastic Fluid in the Presence of Heat Generation

The present paper considers the steady free convection boundary layer flow of a viscoelastics fluid with constant temperature in the presence of heat generation. The boundary layer equations are an order higher than those for the Newtonian (viscous) fluid and the adherence boundary conditions are insufficient to determine the solution of these equations completely. The governing boundary layer equations are first transformed into non-dimensional form by using special dimensionless group. Computations are performed numerically by using Keller-box method by augmenting an extra boundary condition at infinity and the results are displayed graphically to illustrate the influence of viscoelastic K, heat generation γ , and Prandtl Number, Pr parameters on the velocity and temperature profiles. The results of the surface shear stress in terms of the local skin friction and the surface rate of heat transfer in terms of the local Nusselt number for a selection of the heat generation parameterγ (=0.0, 0.2, 0.5, 0.8, 1.0) are obtained and presented in both tabular and graphical formats. Without effect of the internal heat generation inside the fluid domain for which we take γ = 0.0, the present numerical results show an excellent agreement with previous publication.

Body Mass Index for Australian Athletes Participating in Rugby Union, Soccer and Touch Football at the World Masters Games

Whilst there is growing evidence that activity across the lifespan is beneficial for improved health, there are also many changes involved with the aging process and subsequently the potential for reduced indices of health. Data gathered on a subsample of 535 football code athletes, aged 31-72 yrs ( = 47.4, s = ±7.1), competing at the Sydney World Masters Games (2009) demonstrated a significantly (p < 0.001), reduced classification of obesity using Body Mass Index (BMI) when compared to the general Australian population. This evidence of improved classification in one index of health (BMI < 30) for master athletes (when compared to the general population) implies there are either improved levels of this index of health due to adherence to sport or possibly the reduced BMI is advantageous and contributes to this cohort adhering (or being attracted) to masters sport. Demonstration of this proportionately under-investigated World Masters Games population having improved health over the general population is of particular interest.

Natural Convection Boundary Layer Flow of a Viscoelastic Fluid on Solid Sphere with Newtonian Heating

The present paper considers the steady free convection boundary layer flow of a viscoelastic fluid on solid sphere with Newtonian heating. The boundary layer equations are an order higher than those for the Newtonian (viscous) fluid and the adherence boundary conditions are insufficient to determine the solution of these equations completely. Thus, the augmentation an extra boundary condition is needed to perform the numerical computational. The governing boundary layer equations are first transformed into non-dimensional form by using special dimensionless group and then solved by using an implicit finite difference scheme. The results are displayed graphically to illustrate the influence of viscoelastic K and Prandtl Number Pr parameters on skin friction, heat transfer, velocity profiles and temperature profiles. Present results are compared with the published papers and are found to concur very well.

Contributory Factors to Diabetes Dietary Regimen Non Adherence in Adults with Diabetes

A cross sectional survey design was used to collect data from 370 diabetic patients. Two instruments were used in obtaining data; in-depth interview guide and researchers- developed questionnaire. Fisher's exact test was used to investigate association between the identified factors and nonadherence. Factors identified were: socio-demographic factors such as: gender, age, marital status, educational level and occupation; psychosocial obstacles such as: non-affordability of prescribed diet, frustration due to the restriction, limited spousal support, feelings of deprivation, feeling that temptation is inevitable, difficulty in adhering in social gatherings and difficulty in revealing to host that one is diabetic; health care providers obstacles were: poor attitude of health workers, irregular diabetes education in clinics , limited number of nutrition education sessions/ inability of the patients to estimate the desired quantity of food, no reminder post cards or phone calls about upcoming patient appointments and delayed start of appointment / time wasting in clinics.

Variations of Body Mass Index with Age in Masters Athletes (World Masters Games)

Whilst there is growing evidence that activity across the lifespan is beneficial for improved health, there are also many changes involved with the aging process and subsequently the potential for reduced indices of health. The nexus between health, physical activity and aging is complex and has raised much interest in recent times due to the realization that a multifaceted approached is necessary in order to counteract a growing obesity epidemic. By investigating age based trends within a population adhering to competitive sport at older ages, further insight might be gleaned to assist in understanding one of many factors influencing this relationship. BMI was derived using data gathered on a total of 6,071 masters athletes (51.9% male, 48.1% female) aged 25 to 91 years ( =51.5, s =±9.7), competing at the Sydney World Masters Games (2009). Using linear and loess regression it was demonstrated that the usual tendency for prevalence of higher BMI increasing with age was reversed in the sample. This trend in reversal was repeated for both male and female only sub-sets of the sample participants, indicating the possibility of improved prevalence of BMI with increasing age for both the sample as a whole and these individual subgroups. This evidence of improved classification in one index of health (reduced BMI) for masters athletes (when compared to the general population) implies there are either improved levels of this index of health with aging due to adherence to sport or possibly the reduced BMI is advantageous and contributes to this cohort adhering (or being attracted) to masters sport at older ages. Demonstration of this proportionately under-investigated World Masters Games population having an improved relationship between BMI and increasing age over the general population is of particular interest in the context of the measures being taken globally to curb an obesity epidemic.