Protocol for Preparation and Administration of Chemotherapy

The patient and the health care personnel who are preparing and administering the chemotherapeutic drugs are at the risk of teratogenic, mutagenic and carcinogenic effect. The chemotherapy drug should be prepared by loading nurses who are trained specially in preparation and administration of chemotherapy. While preparing and administering the chemotherapeutic drugs, care must be taken to protect patients as well as the health care personnel

Can infant CPR performance be improved through the provision of 'real time' feedback?

Cardiac arrest (CA) is a significant health issue Worldwide. Paediatric sufferers have particu-larly poor outcomes, with high-rates of associated mortality and morbidity. Early cardiopulmonary-resuscitation (CPR), an emergency procedure which combines external chest-compressions with artificial-ventilations (rescue breaths), has been shown to improve CA outcomes. Researchers have, however, demonstrated CPR, even when delivered by highly-trained-rescuers is not currently being performed optimally. International guidelines have suggested the potential contribution of feedback systems (assistance), in improving the delivery of chest-compressions and rescue breaths to improve survival rates. Thus, the main focus of this research was to design and develop a real-time CPR-performance-feedback-system, to monitor and assist rescuers in producing high-quality infant-CPR (iCPR). This was conducted as follows: assessment of current compressions by Basic Life Support (BLS) and ‘lay’ rescuers, design and development of a real-time feedback and performance system and the study of its effects during iCPR. All performances were compared against benchmarked quality standards. During unassisted iCPR, BLS and ‘lay’ rescuer overall compression quality, that is those con-comitantly achieving all four iCPR quality targets, was 61.4% and >24.6%, respectively. Assistance delivered more breaths, 5-32%, more quickly, 30-84%, complying with recommendations. As-sisted compression count, after each ventilation, was 53% less than unassisted, complying with recommendations. There were no differences in the guideline compression duty cycle (DC), provided that compression time and peak depth were the same. Thesis summary iv Unassisted compressions failed to show compliance with quality targets. Assistance produced significant improvements in the overall quality of compressions, reduced the time for breaths and regulated the compression counts after each ventilation. However, lay rescuers require additional training with the feedback system and iCPR simulation. Overall the real-time feed-back system significantly improved iCPR performance, such that it could now be trialled to investigate possible improvements in clinical outcomes

Self-Adaptive Trust Based ABR Protocol for MANETs Using Q

Mobile ad hoc networks (MANETs) are a collection of mobile nodes with a dynamic topology. MANETs work under scalable conditions for many applications and pose different security challenges. Due to the nomadic nature of nodes, detecting misbehaviour is a complex problem. Nodes also share routing information among the neighbours in order to find the route to the destination. This requires nodes to trust each other. Thus we can state that trust is a key concept in secure routing mechanisms. A number of cryptographic protection techniques based on trust have been proposed. Q-learning is a recently used technique, to achieve adaptive trust in MANETs. In comparison to other machine learning computational intelligence techniques, Q-learning achieves optimal results. Our work focuses on computing a score using Q-learning to weigh the trust of a particular node over associativity based routing (ABR) protocol. Thus secure and stable route is calculated as a weighted average of the trust value of the nodes in the route and associativity ticks ensure the stability of the route. Simulation results show that Q-learning based trust ABR protocol improves packet delivery ratio by 27% and reduces the route selection time by 40% over ABR protocol without trust calculation

TSH Receptor Gene and Autoimmune Thyroid Diseases

The primary regulators of thyroid activity are the thyroid-stimulating hormone (TSH) and its receptor (TSH-R). Studies have shown that genetic variants in the TSHR gene can increase susceptibility to autoimmune thyroid diseases (AITD). The TSHR gene is located on chromosome 14q31 and encodes a membrane-bound receptor that interacts with TSH to regulate thyroid hormone synthesis and secretion. AITD including Graves' disease (GD) and Hashimoto's thyroiditis (HT), are the most common thyroid disorders, affecting millions of people worldwide. In AITD, autoantibodies can bind to and activate the TSHR, leading to increased thyroid hormone production and secretion in GD, or thyroid destruction and hypothyroidism in HT. In addition to its role in thyroid hormone synthesis and secretion, some studies also revealed that the TSHR has also been implicated in a variety of other physiological processes, including bone metabolism, reproduction, and immune regulation. Genetic variation in the TSHR region may affect the expression, post-translational processing, and/or protein structure, which in turn may cause or worsen the autoimmune response. The TSHR gene and its products are widely used in diagnostic testing for AITD. Understanding the molecular mechanisms underlying the interaction between the TSHR and autoantibodies is critical for developing new diagnostic and therapeutic strategies for AITD

Can real-time feedback improve the simulated infant cardiopulmonary resuscitation performance of basic life support and lay rescuers?

Background Performing high-quality chest compressions during cardiopulmonary resuscitation (CPR) requires achieving of a target depth, release force, rate and duty cycle. Objective This study evaluates whether ‘real time’ feedback could improve infant CPR performance in basic life support-trained (BLS) and lay rescuers. It also investigates whether delivering rescue breaths hinders performing high-quality chest compressions. Also, this study reports raw data from the two methods used to calculate duty cycle performance. Methodology BLS (n=28) and lay (n=38) rescuers were randomly allocated to respective ‘feedback’ or ‘no-feedback’ groups, to perform two-thumb chest compressions on an instrumented infant manikin. Chest compression performance was then investigated across three compression algorithms (compression only; five rescue breaths then compression only; five rescue breaths then 15:2 compressions). Two different routes to calculate duty cycle were also investigated, due to conflicting instruction in the literature. Results No-feedback BLS and lay groups demonstrated 60% and >25% of all chest compressions, across all three algorithms. Performing rescue breaths did not impede chest compression quality. Conclusions A feedback system has great potential to improve infant CPR performance, especially in cohorts that have an underlying understanding of the technique. The addition of rescue breaths—a potential distraction—did not negatively influence chest compression quality. Duty cycle performance depended on the calculation method, meaning there is an urgent requirement to agree a single measure

Apolipoprotein E Polymorphism And It’s Lifestyle Impact

The Apolipoprotein E Polymorphism, with its three main allelic variants (APOE2, APOE3, and APOE4), has gained prominence in genetic research due to its critical implications for human health. This review article offers a concise introduction to the APOE protein polymorphism and its influence on individual’s way of life. The APOE gene encodes apolipoprotein E, a critical component of lipid metabolism that is essential for both cholesterol transport and neuron repair in the central nervous system. APOE ℇ4 raises Alzheimer's risk, ℇ2 protects, and ℇ3 is neutral. Lifestyle choices, such as diet, exercise, and cognitive engagement, predict susceptibility to chronic illnesses like Alzheimer's and cardiovascular disease (CVD). For APOE ℇ4 carriers, a heart-healthy lifestyle can reduce elevated risk, while ℇ2 carriers, being less vulnerable, may need less intervention

Invisible bodies and disembodied voices? Identity work, the body and embodiment in transnational service work

This article explores the linkages between identity work, the body and embodiment in transnational call centres. Identity work, defined as the masking of national identity to imply proximity to the western client, provides an opportunity for the analyst to examine workplace embodiment in a global context. Qualitative data from an ethnographic study of two global outsourcing firms in India (2010-2012) explicated these processes. Narrative accounts suggest that call centre workers are routinely made aware of the body as a target of discipline, for instance in training; by working on their own bodies (including posture, dress, voice modulation and other forms of body regulation); by working on the bodies of others (through voice-based interactions) and by using embodied images of Americans to contextualize the service provided. In this way, the western client is visualized by the Indian call worker through corporeal imaginaries that concomitantly construct, subvert and resist the West-Rest dichotomy in service relations. Far from being disembodied, this study demonstrates that the body is central to global service work

Development of a novel indentation device suitable for arthroscopic evaluation of articular cartilage

Background: The size of lesions on articular cartilage are difficult to estimate using conventional preoperative imaging techniques, which may prevent the use of conservative procedures in the restoration of joint function following osteoarthritis (OA). Arthroscopic probes have been designed to be used intraopertively which can assess the mechanical integrity of the cartilage surface. These devices may not have the sensitivity to detect early OA. Therefore, there exists the need for a low load indentation system which can determine both static and time-dependent properties of the tissue and thereby improve the likelihood of early OA detection. Such a probe also has the potential for mounting on a robotic arm for precise excision of tissue. In order to determine the early signs of OA, it is important to characterise the repeatability, variation and mechanical response of the articular cartilage surface to being indented with respect to different experimental parameters. Objective: To design, build and evaluate a bench top indentation system to assess the viscoelastic properties of articular cartilage, which has the potential to be converted to a device that could be used arthroscopically and intraopertively. In particular, it was the aim to: - investigate the difference between a spherically headed indenter and a flat headed indenter in assessing the cartilage mechanical properties in vitro; - evaluate articular cartilage's preconditioning properties by cyclic indentation testing; - and to evaluate the recovery of articular cartilage subsequent to the preconditioning. Methods: A bench top materials testing device was designed and built using a high resolution linear actuator and a spring-loaded Linear Variable Differential Transducer (LVDT). The actuator drove the tip of the LVDT, with either a flat or spherical tip, into the cartilage surface and the spring of the LVDT provided a known force and displacement. The surface deformation of the cartilage could then be determined from such a device. Healthy osteochondral plugs were harvested from the bovine tibial plateau articulating surface using an osteochondral coring tool. Plugs were mounted in plaster of paris with the cartilage surface normal to the indenter. All test procedures were identical: an actuator displacement of 5mm, a ramp speed of 5mm/second and a holding time of 30 seconds. An initial experiment was performed on a metal plug to ensure that any recorded deformation was that of the cartilage surface and not of the underlying environment. Subsequently the indentation mechanics of two indenter tips was evaluated: a spherical head indenter of diameter 4.8 mm and a flat ended indenter with a diameter of 5.1 mm. Then the cartilage preconditioning properties were evaluated using the flat-ended indenter. Each plug was tested 10 times in exactly the same place on the cartilage surface with a time interval of 20 seconds between each test. Finally, to test how long the cartilage takes to recover from its preconditioned state, each plug was indented 5 times in exactly the same place on the cartilage surface with a time interval of 20 seconds between each test and a further 6th indentation was also done in the same place on the cartilage surface but after either 1, 5, 10, 20 or 30 minutes interval. This 6th result was compared to the initial indentation. If the properties determined from the 6th indentation were the same as those of the first indentation, one could say that the sample had recovered. Results: Indenting the metal plug did not result in any measurable deformation indicating that subsequent measures are that of the cartilage surface and not of any underlying structures. When indenting with the spherical head indenter the deformation was deeper and quicker than using the flat-ended indenter due to the small contact region on the cartilage surface which means that there was higher stress on the surface compared with the flat-ended indenter. The preconditioning experiment indicated that the indentation depth decreased with each cycle of loading until approximately the 5th cycle after which the cartilage may be assumed to be preconditioned, since successive indentations exhibited similar mechanical behaviour. The time constant describing the surface deformation with time did not undergo any preconditioning which means that only the stiffness is affected by preconditioning, not permeability. Thirty minutes of recovery was sufficient for the surface to fully recover to its original state. Conclusions: A bench top device has been designed and manufactured that can assess the mechanical characteristics of articular cartilage. Furthermore, this device has demonstrated mechanical differences in the surface response between indenter geometries and the preconditioning and recovery characteristics of cartilage. Suggestions and comments have been made regarding the next phase of this research into the development an arthroscopic indentation device.Background: The size of lesions on articular cartilage are difficult to estimate using conventional preoperative imaging techniques, which may prevent the use of conservative procedures in the restoration of joint function following osteoarthritis (OA). Arthroscopic probes have been designed to be used intraopertively which can assess the mechanical integrity of the cartilage surface. These devices may not have the sensitivity to detect early OA. Therefore, there exists the need for a low load indentation system which can determine both static and time-dependent properties of the tissue and thereby improve the likelihood of early OA detection. Such a probe also has the potential for mounting on a robotic arm for precise excision of tissue. In order to determine the early signs of OA, it is important to characterise the repeatability, variation and mechanical response of the articular cartilage surface to being indented with respect to different experimental parameters. Objective: To design, build and evaluate a bench top indentation system to assess the viscoelastic properties of articular cartilage, which has the potential to be converted to a device that could be used arthroscopically and intraopertively. In particular, it was the aim to: - investigate the difference between a spherically headed indenter and a flat headed indenter in assessing the cartilage mechanical properties in vitro; - evaluate articular cartilage's preconditioning properties by cyclic indentation testing; - and to evaluate the recovery of articular cartilage subsequent to the preconditioning. Methods: A bench top materials testing device was designed and built using a high resolution linear actuator and a spring-loaded Linear Variable Differential Transducer (LVDT). The actuator drove the tip of the LVDT, with either a flat or spherical tip, into the cartilage surface and the spring of the LVDT provided a known force and displacement. The surface deformation of the cartilage could then be determined from such a device. Healthy osteochondral plugs were harvested from the bovine tibial plateau articulating surface using an osteochondral coring tool. Plugs were mounted in plaster of paris with the cartilage surface normal to the indenter. All test procedures were identical: an actuator displacement of 5mm, a ramp speed of 5mm/second and a holding time of 30 seconds. An initial experiment was performed on a metal plug to ensure that any recorded deformation was that of the cartilage surface and not of the underlying environment. Subsequently the indentation mechanics of two indenter tips was evaluated: a spherical head indenter of diameter 4.8 mm and a flat ended indenter with a diameter of 5.1 mm. Then the cartilage preconditioning properties were evaluated using the flat-ended indenter. Each plug was tested 10 times in exactly the same place on the cartilage surface with a time interval of 20 seconds between each test. Finally, to test how long the cartilage takes to recover from its preconditioned state, each plug was indented 5 times in exactly the same place on the cartilage surface with a time interval of 20 seconds between each test and a further 6th indentation was also done in the same place on the cartilage surface but after either 1, 5, 10, 20 or 30 minutes interval. This 6th result was compared to the initial indentation. If the properties determined from the 6th indentation were the same as those of the first indentation, one could say that the sample had recovered. Results: Indenting the metal plug did not result in any measurable deformation indicating that subsequent measures are that of the cartilage surface and not of any underlying structures. When indenting with the spherical head indenter the deformation was deeper and quicker than using the flat-ended indenter due to the small contact region on the cartilage surface which means that there was higher stress on the surface compared with the flat-ended indenter. The preconditioning experiment indicated that the indentation depth decreased with each cycle of loading until approximately the 5th cycle after which the cartilage may be assumed to be preconditioned, since successive indentations exhibited similar mechanical behaviour. The time constant describing the surface deformation with time did not undergo any preconditioning which means that only the stiffness is affected by preconditioning, not permeability. Thirty minutes of recovery was sufficient for the surface to fully recover to its original state. Conclusions: A bench top device has been designed and manufactured that can assess the mechanical characteristics of articular cartilage. Furthermore, this device has demonstrated mechanical differences in the surface response between indenter geometries and the preconditioning and recovery characteristics of cartilage. Suggestions and comments have been made regarding the next phase of this research into the development an arthroscopic indentation device

Behind the 2009 Tamil Diaspora Protests in Canada: A Critical Analysis of the Production of Race, Resistance, and Citizenship across Borders

Critical social workers emphasize activism for social justice, and acknowledge that global justice movements can inform the evolution of social work practice. Yet, scholarship on community practice and citizen participation has shown varying levels of attention to the interests and context of racialized populations. This dissertation engages this discussion by developing an understanding of what activism comes to be for migrant communities who experience social injustices across local, national and transnational scales. I draw upon a framework of citizenship, racialization and spatiality to problematize conditions of resistance through the 2009 Tamil diaspora protests in Canada. Through a Critical Discourse Analysis of print media and key informant interviews, I explore the following: (1) What are the ideologies underlying media representations of the movement in Canada? (2) How can social work researchers ethically represent the resistance movements of others? (3) Why and how does race frame the production of suffering and spectacle through protest? (4) How can we unpack representations of racialized local groups who protest an issue unfolding elsewhere? This project highlights the challenges experienced by racialized communities' in their struggles towards citizenship, social justice and decolonization. Chapter 1 presents the context of the 2009 Tamil diaspora protests, the conceptual framework, and methodology guiding this study. In accordance with the Factor-Inwentash Faculty of Social Work's 3-paper dissertation format, Chapter 2, 3 and 4 are stand-alone papers geared towards different peer-review journals. Chapter 2 problematizes how we should represent contested resistance movements in the age of terrorism. Chapter 3 examines how racial logic frames the expression of protesters' suffering, and the construction of the Canadian public's racial apathy. Chapter 4 explores how national media discourses racially and spatially mark protesters as "others," "outlaws," and "outsiders." The findings of this interdisciplinary study demonstrate how resistance by racialized groups in a white settler state is distorted by the indirect and direct representational politics imposed by a hegemonic West. In Chapter 5, I offer implications for social work theory, practice and education to reconsider the boundaries of social justice, incorporate a conceptualization of transnational activism as citizenship, and forefront the politics of protest.Ph.D.2016-11-30 00:00:0