Background knowledge, attitude and practice of contraception among Pahang women

Objectives: 1. To study the knowledge awareness regarding contraception among women from Pahang.. 2. To identify the most popular method of contraception in use. 3. To find out the common reasons for the less frequent use of contraception. 4. To asses factors impacting knowledge in the use of contraception. METHOD This cross sectional study included 200 women from Pahang state from the first of September to 31st of December 2012. Any women with history of sexual exposure and consented were included to this study. Questioner was given in malay language to each female who asked to answer it on the spot and without assistant unless for the indication of reading for those who cannot read and write(just three illiterate women required the assistant). RESULT Out of 200 participants who were included in this study, the majority 87%(174) were in the reproductive age between 20- 40 year old, 11.5%(23) age more than 40 and 1.5%(2) less than 20. Ninety five percent are married(190) and 5% (10) are unmarried. A 53% (106) have tertiary education, 41.5(83) participants with secondary level. Four percent(8) and 1.5%(three) responder were from primary and no education background respectively. Majority of the responder were Malay 185(92.5%), Indian 2.5%(five),Chinese 1.5 %(3) and 3.5% (7) others. There is positive correlation between the educational status and the knowledge of contraception, being higher among ladies with tertiary education about 54.2% and lowest 1.1% in among women without education background. The practice of contraception followed the same pattern. Almost 50%(97/200) of respondents were aware of modern contraception,only the minority (4/200) only aware of tradisional contraception and the other 50%(99/200) were know both type of contraception. Among the respondents 76%( 152/200) were believed that contraception were effective. and 12.5%(25/200) were not effective and a nonnegligible proportion 11.5%(23/200) were not sure. A large number of women 70%(140/200) stated that no contraception side effects, 15.5%(31/200) talking about that and 14.5%( 29/200) were unsure. Educational level had broadly positive impact on the mentioned attitude. The method known to the greatest degree were contaceptives pills 27.7%(46),condom 15%(25) and combinations method. Among all the women 22.5%(38) choosed other method of contraception. A total of hundred respondents were not using any contraception method in this study, 52%(52) due to inconvenience side effects 12%(12) related to medical problems and 36%(36) because of other reasons. Among 190 married women, 88.9% of them had a discussion with husband regarding contraception and 87.1%(148) had gained support from husband. Out of these 70.5%(134) agreed to practise contraception in future. CONCLUSION Educational level had significant impact on the knowledge ,attitude and practice of contraception among Pahang Women with majority of them gained husband support

Breathing exercise for hypertensive patients: A scoping review

Background: Non-pharmacological management of hypertension includes weight loss, alcohol and sodium restriction, regular exercise, and relaxation. In people with overweight hypertension, systolic blood pressure (SBP) and diastolic blood pressure (DBP) can be decreased via exercise and weight loss together. Breathing exercises are one method of relaxing.Objectives: The aim of this scoping review is to map the information that is currently available about the advantages of breathing exercises in decreasing blood pressure in hypertension patients.Methods: This scoping review adheres to Arksey and O’Malley’s framework, which entails identifying review questions, seeking pertinent evidence, choosing pertinent studies, mapping data, and discussing, concluding, and reporting the findings. The PRISMA flowchart is used to show how the evidence search process works.Results: As a result, 339 articles in total were retrieved from the three databases. 20 papers total were included in this review after screening. In 14 of the 20 investigations, participants with stage 1 and stage 2 essential hypertension, two with pre-hypertension, and four with Isolated Systolic Hypertension (ISH) were studied. The respondents’ ages ranged from 18 to 75. The systolic blood pressure declined by 4–54.22 mmHg, while the diastolic blood pressure dropped by 3–17 mmHg.Conclusion: Slow breathing can be used as an alternate, non-pharmacological therapy for hypertension individuals to reduce blood pressure.Systematic Review Registration: (https://osf.io/ta9u6/)

Quantum key distribution in terms of the Greenberger-Horne-Zeilinger state: multi-key generation

In this paper, we develop a quantum key distribution protocol based on the Greenberger-Horne-Zeilinger states (GHZs). The particles are exchanged among the users in blocks through two steps. In this protocol, for three-particle GHZs three keys can be simultaneously generated. The advantage of this is that the users can select the most suitable key for communication. The protocol can be generalized to $N$ users to provide $N$ keys. The protocol has two levels for checking the eavesdroppers. Moreover, we discuss the security of the protocol against different attacks.Comment: 10 Page, no figures. Comments are most welcom

Strength and chloride penetration performance of concrete using coal bottom ash as coarse and fine aggregate replacement

Since 1987, Malaysia had used coal as a product to generate electricity. One of the main or the largest power plant in Malaysia is Tanjung Bin power plant at kukup, Johor. As a coal-based power plant, tonnes of coal bottom ash had been burned every day and the waste is wasted without specific economic benefit. Other than that, the waste generated are dangerous as it involved in environmental risk such as landfill ash reservoir. Therefore, this paper presents one of the alternative ways to manage the coal waste by cooperative it into concrete. This research study focuses on strength and durability performance of the concrete containing coal bottom ash as a coarse and fine aggregates replacement. The tests conducted was workability on fresh concrete, compressive strength test and chloride penetration test in 5% sodium chloride. The results show that the concrete containing coal bottom ash has low workability compare with normal concrete without coal bottom ash. Compressive strength test with coal bottom ash resulted higher than normal concrete. In chloride solution, the concrete containing coal bottom ash replacement shows better performance compare to normal concrete. Thus, it can be concluded that by using coal bottom ash in concrete as fine and coarse aggregates replacement, the performance in term of strength and chloride resistance are better compare to normal concrete. On the other hand, by using it in concrete, the waste generated dump in landfill can be reduced

Protocol and statistical analysis plan for the mega randomised registry trial comparing conservative vs. liberal oxygenation targets in adults with nonhypoxic ischaemic acute brain injuries and conditions in the intensive care unit (Mega-ROX Brains)

Background: The effect of conservative vs. liberal oxygen therapy on 90-day in-hospital mortality in adults who have nonhypoxic ischaemic encephalopathy acute brain injuries and conditions and are receiving invasive mechanical ventilation in the intensive care unit (ICU) is uncertain. Objective: The objective of this study was to summarise the protocol and statistical analysis plan for the Mega-ROX Brains trial. Design, setting, and participants: Mega-ROX Brains is an international randomised clinical trial, which will be conducted within an overarching 40,000-participant, registry-embedded clinical trial comparing conservative and liberal ICU oxygen therapy regimens. We expect to enrol between 7500 and 9500 participants with nonhypoxic ischaemic encephalopathy acute brain injuries and conditions who are receiving unplanned invasive mechanical ventilation in the ICU. Main outcome measures: The primary outcome is in-hospital all-cause mortality up to 90 d from the date of randomisation. Secondary outcomes include duration of survival, duration of mechanical ventilation, ICU length of stay, hospital length of stay, and the proportion of participants discharged home. Results and conclusions: Mega-ROX Brains will compare the effect of conservative vs. liberal oxygen therapy regimens on 90-day in-hospital mortality in adults in the ICU with acute brain injuries and conditions. The protocol and planned analyses are reported here to mitigate analysis bias. Trial Registration: Australian and New Zealand Clinical Trials Registry (ACTRN 12620000391976)

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42\ub74% vs 44\ub72%; absolute difference \u20131\ub769 [\u20139\ub758 to 6\ub711] p=0\ub767; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5\u20138] vs 6 [5\u20138] cm H2O; p=0\ub70011). ICU mortality was higher in MICs than in HICs (30\ub75% vs 19\ub79%; p=0\ub70004; adjusted effect 16\ub741% [95% CI 9\ub752\u201323\ub752]; p<0\ub70001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0\ub780 [95% CI 0\ub775\u20130\ub786]; p<0\ub70001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status. Funding: No funding

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

Small Scale Hydro-Power as a Source of Renewable Energy in Malaysia: A Review

Small scale hydropower is one of the technology options to generate and supply electricity to grid off and rural applications with almost zero emission. Malaysia is blessed with abundance of water sources and receives high rain volume per year which can be used to generate power. This paper is carried out to present the potential of small scale hydropower in Malaysia and its current status at low head location and rural electrification. Moreover, the relevant research literatures for small scale hydropower technology and the challenges facing by small renewable energy power in Malaysia are also reviewed. The review of available works display that the estimated hydropower resources in Malaysia are registered to be 29,000 MW, of which 500 MW is from small (mini)-hydro power. For this, a total of 149 sites for small hydropower potential have been identified in the country and the expected potential by 2020 is 490 MW. Despite hydro-power technologies are preferable choices for energy generation in Malaysia, they have not been fully exploited yet due to some technical, economical, and institutional challenges. Therefore, this paper can provide information for further investigations on the application of small scale hydropower for rural electrification in Malaysia

Фінансові показники та ефективні зміни малазійських банківських установ під час злиття та поглинання

The purpose of this paper is twofold. First, it intends to analyse the financial performance changes of commercial banks on stand alone basis and compare it with 'post merger' basis on the consolidation program initiated by the central bank following the recent 1997-1998 Asian financial crisis. This paper also tries to analyse and explore the efficiency of the banks resulted from this consolidation. The findings suggest that based on the actual accounting data of the anchor banks and DEA analysis, the consolidation program initiated by the central bank does not show any significant difference to the level of efficiency and the financial performance of the banking institutions in Malaysia. The total number of banking institutions as of 20th October 1999 was 55, which consisted of 20 commercial banks, 23 finance companies and 12 merchant banks. They have been given a dateline by end of January 2000 to forward their comprehensive proposal to the Central Bank. Initially the Central Bank, Bank Negara Malaysia (BNM) has approved 6 anchor banks i.e. Maybank, Multi-Purpose, Public, Southern, Perwira Affin and Bumiputra Commerce. Consequently, the number has been increased to 10 with the additional EON, Hong Leong, RHB and Arab Malaysian joining the elite group.Мета даної статті – проаналізувати фінансові показники змін комерційних банків на незалежній основі та порівняти їх з показниками після поглинання, базованого на програмі консолідації, розпочатій центральним банком після Азіатської фінансової кризи 1997-1998 рр. В цій статті також зроблена спроба проаналізувати та дослідити ефективність банків після консолідації. На основі отриманої інформації, яка базується на фактичних бухгалтерських даних “якорних” банків та DEA аналізі, можна стверджувати, що для програми консолідації немає суттєвої різниці рівня ефективності та фінансових показників банківських установ в Малайзії. The purpose of this paper is twofold. First, it intends to analyse the financial performance changes of commercial banks on stand alone basis and compare it with 'post merger' basis on the consolidation program initiated by the central bank following the recent 1997-1998 Asian financial crisis. This paper also tries to analyse and explore the efficiency of the banks resulted from this consolidation. The findings suggest that based on the actual accounting data of the anchor banks and DEA analysis, the consolidation program initiated by the central bank does not show any significant difference to the level of efficiency and the financial performance of the banking institutions in Malaysi

The influence of SS316l foam fabrication parameter using powder metallurgy route

Metal foams are widely produced by using different techniques such as compaction and replication method. In this study, slurry method also known as replication method has been used to produce SS316L foams. SS316L powders (50wt% and 60wt%) were mixed with the binders and distilled water by using mechanical stirrer. Polyethylene Glycol (PEG) and Carboxyl Methyl Cellulose (CMC) were used as binders. Polyurethane (PU) foam was used as scaffold and dipped into SS316L slurry then dried in room temperature for 24 hours. Sintering process has been done in two different temperatures which were 1200oC and 1300oC in vacuum furnace. The morphological study was performed using Scanning Electron Microscopy (SEM) and Energy Dispersive X-Ray (EDX). The SEM micrograph showed that the cells were interconnected and the structures become denser as the sintering temperature increase. The average pores size is ranging from 252.8 μm-353.8 μm, while strut size ranging from 50.2 μm -79.9 μm based on SEM micrograph analysis. The elemental analysis from EDX showed the element presence in the SS316L foam remain from SS316L powder which are Chromium (Cr), Nickel (Ni), Molybdenum (Mo), Cooper (Cu), Nitrogen (N2), Sulphur (S) and Silicon (Si). Higher sintering temperature contributes better grain growth between particles where the point-contact between the particles expanded and disappear the small pores