Utilizing video on myocardial infarction as a health educational intervention in patient waiting areas of the developing world: A study at the emergency department of a major tertiary care hospital in India

<p>Abstract</p> <p>Objective</p> <p>To study the effect of health educational video instruction on increasing patients' knowledge in a hospital waiting area of a developing country.</p> <p>Methods</p> <p>An educational video on signs, symptoms, and risk factors of myocardial infarction (MI) was played in an Emergency Department (ED) patient waiting area of an urban tertiary care hospital in India. Participants (n = 217) were randomly assigned to two groups: an intervention group that viewed the MI video (n = 111) and a control group that did not view the video (n = 106). Each group took a standard survey of thirty-seven questions to assess baseline knowledge pertaining to MI (pretest). The intervention group then viewed the video and the initial survey was re-administered to each group (posttest).</p> <p>Results</p> <p>At baseline (pretest) there was no statistically significant difference between the intervention and control group in the mean number of correct (18.1 vs. 19.0, p = 0.19), incorrect (9.4 vs. 8.6, p = 0.27) and unsure (9.6 vs. 9.3, p = 0.78) responses per participant. After viewing the video on MI, the intervention group had a statistically significant improvement in the mean number of correct responses (27.0 vs. 20.0, p < 0.001), and a significant decline in the mean number of unsure responses (1.8 vs. 9.4, p < 0.001) compared to the posttest responses of the control group. There was no significant change in the number of incorrect responses on the posttest between the intervention and control groups, (8.3 vs. 7.7, p = 0.35), respectively.</p> <p>Conclusion</p> <p>A health educational video can serve as an effective tool for increasing patients' short-term knowledge and awareness of health conditions in a hospital waiting area of a developing country.</p> <p>Practice Implications</p> <p>Health educational videos serve as a public health low cost intervention that demonstrates clear short term benefits. Health care workers in developing countries can help educate individuals presenting to hospitals by displaying these videos in hospital waiting areas.</p

Assessment of micrometeorology at selected age stands in a rehabilitated forest of Sarawak, Malaysia

The micrometeorology varies vertically and horizontally from the forest canopy to forest floor. An assessment of the forest micrometeorological is necessary to understand the interaction between the environmental and biological activities, but such information is lacking in rehabilitated forests. The objective of this study was assess the forest floor micrometeorology of selected age stands at a forest rehabilitation project.The study was conducted at a rehabilitated forest in Universiti Putra Malaysia Bintulu Sarawak Campus, Sarawak, Malaysia. Three study plots at(1,10,19-year-old) at the rehabilitated forest sites and a study plot at a natural regenerating secondary forest (± 23-year-old) were established. Davis Vantage Pro2 Weather Station was used to monitor and record micrometeorological variables (i) air temperature (◦C), (ii) relative humidity (%), (iii) heat index (◦C) and (iv) solar radiation (W/m2). Data analyses showed that the micrometeorology inside forests is less extreme and more humid as compared to outside the forests. The micrometeorology among different age stands of rehabilitated forests varies and different which is unique in each study plots as compared to the outside forest. Older rehabilitated forest and natural regenerating secondary forest has less extreme micrometeorological condition as compared to outside forest. The study suggested that the development of the canopy and its layers influence the micrometeorological condition of the forest. The rehabilitated forest has yet to recover in the aspect of the micrometeorology

Assessment of floristic composition in a rehabilitated forest, Sarawak, Malaysia

Assessment of the floristic composition provides information on forest succession stage which is important but only relatively few information are available on the rehabilitated tropical forest. The information can provide an indication of the recovery status of the forest. The objective of this study was to assess the floristic composition of selected age stands at a rehabilitated forest situated in Universiti Putra Malaysia Bintulu Sarawak Campus, Sarawak, Malaysia. A 20 x 20 m plot (0.04 ha) was established each in stands planted in 1991, 1999, 2008 and an adjacent natural regenerating secondary forest (± 23-year-old). All stands were tagged, identified and analyzed for species composition, Importance Value (IV), species diversity and similarity. Floristic analysis showed that in the rehabilitated forest, over 50% of the total family was dominated by the Dipterocarpaceae family but only 14% in natural regenerating secondary forest. Based on the IV Index, stand year 1991 was dominated by Shorea dasyphylla (IV=155.8) while stand year 1999, 2008 and natural regenerating secondary forest were Dryobalanops beccarii (IV=156.2), Sandoricum borneense (IV=144.4) Teijsmanniodendron holophyllum (IV=115.3), respectively. The Simpson’s diversity index at the rehabilitated forest ranged from 0.82 to 0.87 compared to 0.98 at the natural regenerating secondary forest whereas the Shannon-Wiener diversity index ranged from 2.04 to 2.29 compared to 4.23, respectively. Jaccard’s Coefficient of Similarity (Cj) between all combinations of the study plots was generally low (2.2-19.4%). Rehabilitated forest exhibited climax species community despite having lower species diversity. This can promote the conservation of these climax species

Molecular Mechanism of the Inhibition of Phospholipase C β3 by Protein Kinase C

Activation of protein kinase C (PKC) can result from stimulation of the receptor-G protein-phospholipase C (PLCβ) pathway. In turn, phosphorylation of PLCβ by PKC may play a role in the regulation of receptor-mediated phosphatidylinositide (PI) turnover and intracellular Ca2+ release. Activation of endogenous PKC by phorbol 12-myristate 13-acetate inhibited both Gαq-coupled (oxytocin and M1 muscarinic) and Gαi-coupled (formyl-Met-Leu-Phe) receptor-stimulated PI turnover by 50-100% in PHM1, HeLa, COSM6, and RBL-2H3 cells expressing PLCβ3. Activation of conventional PKCs with thymeleatoxin similarly inhibited oxytocin or formyl-Met-Leu-Phe receptor-stimulated PI turnover. The PKC inhibitory effect was also observed when PLCβ3 was stimulated directly by Gαq or Gβγ in overexpression assays. PKC phosphorylated PLCβ3 at the same predominant site in vivo and in vitro. Peptide sequencing of in vitro phosphorylated recombinant PLCβ3 and site-directed mutagenesis identified Ser1105 as the predominant phosphorylation site. Ser1105 is also phosphorylated by protein kinase A (PKA; Yue, C., Dodge, K. L., Weber, G., and Sanborn, B. M. (1998) J. Biol. Chem. 273, 18023-18027). Similar to PKA, the inhibition by PKC of Gαq-stimulated PLCβ3 activity was completely abolished by mutation of Ser1105 to Ala. In contrast, mutation of Ser1105 or Ser26, another putative phosphorylation target, to Ala had no effect on inhibition of Gβγ-stimulated PLCβ 3 activity by PKC or PKA. These data indicate that PKC and PKA act similarly in that they inhibit Gαq-stimulated PLCβ3 as a result of phosphorylation of Ser1105. Moreover, PKC and PKA both inhibit Gβγ-stimulated activity by mechanisms that do not involve Ser1105

Bioprosthetic mitral valve thrombosis less than one year after replacement and an ablative MAZE procedure: a case report

Occurrence of bioprosthetic valve thrombosis less than a year after replacement is very uncommon. Here, we describe a case of a 57 year old male, who presented 10 months after receiving a bioprosthetic mitral valve replacement with a two week history of dyspnea on exertion, worsening orthopnea and decreased exercise tolerance. Echocardiography revealed severe mitral regurgitation (MR), thrombosis of the posterior mitral leaflet, left atrial (LA) mural thrombus and a depressed left ventricular ejection fraction of twenty-five percent. Given severe clot burden and decompensated heart failure (New York Heart Association - NYHA class III) repeat sternotomy was done to replace the bioprosthetic mitral valve and remove LA mural thrombus. MR was resolved postoperatively. This brief report further reviews promoting factors, established guidelines and management strategies of bioprosthetic valve thrombosis

Evaluation of rehabilitated forest stands development using hemispheric photograph

Most tropical rainforest tree species depends on forest gaps for their successful regeneration. Evaluation on the gap or canopy openness provides an indicator on the forest development stages. This paper reported on the canopy openness (CO) of three study plots at (1-, 9-, 18-year old) rehabilitated forest sites and one study plot at natural regenerating secondary forest (± 22-year old) in UPM-Mitsubishi Corporation Forest Rehabilitation Project, Universiti Putra Malaysia Bintulu Sarawak Campus (UPMKB). Plot of 20 x 20 m was established where dendrometric parameters were collected while Delta-T Device HemiView system was used to take the hemispherical photograph and field observation information were used to assess the CO. Qualitative analysis of the photographs suggested there were three stages of forest growth namely gap, building and mature stand development phases. These also helped the interpretation of the quantitative analysis in relation to forest dynamics. Hemispherical photographs were used for quantitative analysis of the CO. CO showed statistical significant differences among study plots which recorded a range of 3-78%. Rapid analysis of CO on the hemispherical photographs with information from the dendrometric measurement had assisted in assessing the forest stand development. The canopy openness was dependent on the age of the rehabilitated forest. Overall, the study plots were in the different stages of stand development

Forest litter assessment in different age stands of rehabilitated forest in Bintulu, Sarawak, Malaysia

Forest degradation caused by mankind disrupts the availability of natural resources of economic, environmental, social and cultural importance. Rehabilitation has the potential to improve degraded sites and restore the ecological processes. Thus, research is needed to enhance the understanding of ecological process development after rehabilitation. The objectives of this study were to estimate the production, decomposition and quality of forest litter in rehabilitated forests at Bintulu, Sarawak. Study plots of 20 m x 20 m were established in seven rehabilitated forest plots, P20 (20 years old, planted in 1991), P18 (18 years old, planted in 1993), P15 (15 years old), P12 (12 years old, planted in 1999), P9 (9 years old, planted in 2002), P6 (6 years old, planted in 2005), P3 (3 years old, planted in 2008), and PSF, an adjacent secondary forest. Litter production and decomposition was monitored in 4 plots, P20, P18, P12 and PSF. Using 1 m x 1 m litter traps placed randomly in the plot, litter fall was collected biweekly for 6 months and weighed after oven-drying. Litter decomposition was determined by using 80 litter bags placed randomly in the plot (2 mm mesh) filled with fresh fallen litter and was retrieved weekly for sorting and weighing. Standing crop litter was sampled from all 8 plots, where litter of 1 m2 area was carefully brushed, oven dried, weighed and then processed for litter quality analysis using standard procedures. The estimated mean annual litter production of P20, P18, P12 and PSF was 6.81 t ha-1 year-1, 3.09 t ha-1 year-1, 2.40 t ha-1 year-1 and 3.57 t ha-1 year-1 respectively. By litter component, leaf was highest followed by branches and others. Litter decomposition monitored revealed the decomposition followed the singleexponential model. The constant value (k) for litter decomposing in PSF has the lowest with 0.208 followed by both P12 and P18 at 0.216 while highest was P20 with 0.224. Standing crop litter of the older rehabilitated plots was significantly different compared to the younger plots. P20 recorded 18.26 t ha-1, P18 with 11.29 t ha-1, PSF with 7.45 t ha-1 and P6 and P3 at 5.25 t ha-1 and 4.52 t ha-1 respectively. However, standing crop litter in P15, P12 and P9 were not significantly different by statistical treatment. Standing crop litter was found to be acidic with pH ranging from 4.4 to 5.1 when measured in water, with significant differences among different stand ages. Concentration of nutrients in litter were categorically in the order of C>N>Ca>K>Mg>P irrespective of plots, generally with older plots having higher concentration of nutrients. Nitrogen ranged from 0.59 mg g-1 to 1.05 mg g-1, phosphorus 0.05 mg g-1 to 0.20 mg g-1, potassium 0.91 mg g-1 to 3.11 mg g-1, calcium 0.31 mg g-1 to 7.92 mg g-1 and magnesium 0.39 mg g-1 to 1.64 mg g-1. The results of production, decomposition and quality of forest litter followed a trend where ecological process rates increase with stand age. Data of rehabilitated forest showed similarity to that of other tropical forests, suggesting that rehabilitation is beneficial importance on ecological processes

Knowledge of modifiable risk factors of Coronary Atherosclerotic Heart Disease (CASHD) among a sample in India

BackgroundThe prevalence of Coronary Atherosclerotic Heart Disease (CASHD) is increasing in India. Several modifiable risk factors contribute directly to this disease burden. Public knowledge of such risk factors among the urban Indian population is largely unknown. This investigation attempts to quantify knowledge of modifiable risk factors of CASHD as sampled among an Indian population at a large metropolitan hospital.MethodsA hospital-based, cross sectional study was conducted at All India Institute of Medical Sciences (AIIMS), a major tertiary care hospital in New Delhi, India. Participants (n = 217) recruited from patient waiting areas in the emergency room were provided with standardized questionnaires to assess their knowledge of modifiable risk factors of CASHD. The risk factors specifically included smoking, hypertension, elevated cholesterol levels, diabetes mellitus and obesity. Identifying 3 or less risk factors was regarded as a poor knowledge level, whereas identifying 4 or more risk factors was regarded as a good knowledge level. A multiple logistic regression model was used to isolate independent demographic markers predictive of a participant's level of knowledge.Results41% of the sample surveyed had a good level of knowledge. 68%, 72%, 73% and 57% of the population identified smoking, obesity, hypertension, and high cholesterol correctly, respectively. 30% identified diabetes mellitus as a modifiable risk factor of CASHD. In multiple logistic regression analysis independent demographic predictors of a good knowledge level with a statistically significant (p &lt; 0.05) adjusted odds ratio (aOR) were: routine exercise of moderate intensity, aOR 8.41 (compared to infrequent or no exercise), no history of smoking, aOR 8.25, and former smokers, aOR 48.28 (compared to current smokers). Although statistically insignificant, a trend towards a good knowledge level was associated with higher levels of education.ConclusionAn Indian population in a hospital setting shows a lack of knowledge pertaining to modifiable risk factors of CASHD. By isolating demographic predictors of poor knowledge, such as current smokers and persons who do not exercise regularly, educational interventions can be effectively targeted and implemented as primary and secondary prevention strategies to reduce the burden of CASHD in India