Comparison for ease of insertion for laryngeal mask airway between trendelenburg and supine position for elective orthopaedic, surgical and gynecology surgery

The purpose of this study is to assess the ease of insertion of the Laryngeal Mask Airway (LMA) between supine and trendelenburg position in the elective Gynecology, Orthopedic and General surgery patient. We measured easiness of insertion, incidence of adverse respiratory complication and hemodynamic response to LMA insertion. A randomized single blinded prospective study was conducted involving a total of 92 premedicated, ASA 1 or 11 patients, aged 18 to 65 years and were divided into 2 groups either insertion in supine or trendelenburg position. After a standardized induction of anesthesia with Fentanyl 1.5 meg/kg and propofol 2 mg/kg, a size 3 or 4 Laryngeal mask airway was inserted and the patient breathe spontaneously through the surgery with no muscle relaxant given. Anesthesia was maintained with nitrous oxide, oxygen and servoflurance. The LMA was removed at the end of surgery with the patient fully awake. The speed and ease of insertion and the number of attempts needed to successfully secure airway were recorded. The incidence of adverse respiratory complications like sore throat, presence of blood on LMA, laryngospasm, coughing, vomiting and desaturation was recorded. Hemodynamic changes such as systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate at the different time interval were recorded. We found that there was no statistically significant difference in time required for successful insertion and number of attempts for both group. We were able to insert LMA at frrst attempt in 73.9% within 20.20 seconds in trendelenburg position. There were no differences in incidence of adverse airway complication both in supine and trendelenburg position. Both groups had no statistical differences in hemodynamic parameters during spontaneous ventilation under anesthesia except systolic blood pressure and mean arterial pressure just after LMA insertio~ which had statistically significant. We conclude that, insertion of the LMA in trendelenburg position is appropriate provided with a good experience and proper patients selection and strongly indicated in the scenario of fail intubation and ventilation as an alternative to the conventional method of LMA insertion

PSYCHOSOCIAL DEVELOPMENT PORTRAYED IN JANE AUSTEN’S EMMA

This paper investigates the bildungsroman phenomenon as depicted in Jane Austen’s Emma (1817) by consulting Erik Erikson’s theory of psychosocial development as a framework of analysis. The most two conflicting readings in this regard could be best seen in Buckley’s (1974) claim which excluded Emma from the bildungsroman, for the genre has always been associated with the protagonist’s physical quest seeking maturity and social integration. However, Kohn (1995) read Emma as a domestic bildungsroman when he argued that Emma did not have to travel physical distances to achieve her maturity. For Kohn, Emma matured within her social sphere. This paper particularly traced Emma’s psychological and social development since this type of development is the basic ingredient of any bildungsroman novel. This paper argued that Emma cannot be read as bildungsroman not because the protagonist did set on a quest, as Buckley claimed, but mainly because Emma did not develop a sense of psychological or social maturation. After placing Emma in Erikson’s developmental stages, the study revealed that she did not really mature neither she realized her own identity. This paper proposed that Emma should not be classified as bildungsroman because the heroine distorted the real meaning of maturity and social integrity.

Laminated Veneer Lumber (LVL) sengon: an innovative sustainable building material in Indonesia

Laminated Veneer Lumber (LVL) is recently available in Indonesian markets. The veneers are majority from Sengon wood (Paraserianthes falcataria), which is a fast-growing timber species native to Indonesia. Their use in practice is limited to non-structural components since Sengon wood species has low engineering properties and less resistance to termite attacks. The LVL production introduced few years ago has significantly improved both mechanical properties and durability as well as has expanded its utilization into various structural components. This remarkable improvement has made LVL Sengon wood as an innovative sustainable building materials in Indonesia. This paper summarized a series of authors’ work conducted since couple years ago to initiate the utilization of LVL Sengon in structural components such as shear walls and floor systems as parts of a project to develop its design standard. In addition, creep behavior of this LVL is also highlihgted here as this phenomenon is essential for designers and engineers to anticipate their designs within their service life. In particular, the test results showed that addition of diagonal members increased both racking resistance and equivalent viscous damping ratio of the developed LVL shear walls. And the LVL floor model which is composed of built-up box joists and plywood sheathing remained liniear-elastic under bearing load up to 18.75 kN/2

An Analysis of the Institutional Framework of the Commercial Vehicle Rebuilt Industry in Malaysia

Rebuilt industry, also known as remanufacturing, is the practice of taking end-of-life goods and reengineering them back to as new or better condition. In Malaysia, one of significant remanufacturing activities is the automotive remanufacturing or rebuilt commercial vehicle industry. The industry has begun since 1970s, the time when the construction sector was booming. Despite of its importance in bringing to a sustainable development of a country, no studies have been conducted on the effectiveness of the practice in Malaysia. However, the recent problematic issue surrounding the industry has led to the call for this research. The purpose of this study is to explore the effectiveness of the institutional framework of the commercial vehicle rebuilt industry in Malaysia. The results obtained were based on seventeen interviews. All interviews were transcribed and the data were analysed using the content analysis method. The results demonstrated that with the present practice of the institutional framework allows some loopholes within the industry. These loopholes have led to the production of false document and thus excessive number of rebuilt commercial vehicles registered, far greater than the quota given by the Ministry. This issue arose due to unavailability of effective communication mechanisms among the relevant government authorities. This study provides insights into the strengths and weaknesses of the present governance in dealing with the rebuilt commercial vehicle industry in Malaysia. It is important as it opens up various issues that have been lingering within the implementation of the industry.rebuilt industry, automotive remanufacturing, interviews, governance

End-of-life: old age in contemporary society, self-perception of aging and ‘An’ Islamic perspective

Population aging is a global phenomenon which has important and far-reaching implications for many facets of human life. Although it is an achievement of public health policies and socioeconomic development; it is generally greeted with alarm as it is assumed that elderly will be ill and dependant due to age-related chronic diseases which will require long term care. Despite the fact that many older adults continue to work and contribute to the society, they are seen as a burden and a drain on resources, rather than as a resource in themselves. Ageism and discrimination towards elderly is prevalent at individual and institutional levels that affect their physical and mental health, putting them at risk of depression and social isolation. According to the World Health Organization’s (WHO) combatting ageism has great potential for achieving healthy ageing for all people as they age. Individual health and longevity is influenced by biological, environmental, and psychosocial factors, however modifiable risk factors are especially relevant as they are amenable to intervention. There is enough evidence that religiosity and spirituality (R/S) are among such factors which allow older adults to age in a more positive way. Further R/S activities are prevalent globally and elderly tend to have high rates of involvement in religious activities. Health benefits that may stem from R/S involvement could be important for the future of global health which suggests that they could be incorporated into the idea of positive ageing. Islamic perspective on old age is deeply rooted in the very texts of revelation and as such is divinely based. This review article intends to create awareness of the elderly on the ageing process, their status in the contemporary society and how by adopting positive attitude toward ageing they can enjoy better functional health, self-esteem and satisfaction in life

Tree induced suction on slope stabilization analysis

This research explores the effect of active root zone related to slope stabilization. The matric suction produced by mature tree was determined with high and moderated intensity of rainfall event condition. The increasing of soil moisture and pour water pressure can significantly reduce shear strength of soil, which leads to shallow slope failure. This exploration is concentrate at active root zone of the tree at toe of the slope. The effect only focused on hydrological aspect with soil suction pattern within vicinity of the tree. The monitoring result show a substantially increase in soil suction at slope with tree at toe. The effect of tree water uptake on soil suction distribution is applied for slope stability analysis that significantly changes stability of the slope. The rainfall events also lead to variation on soil suction and factor of safety of the slope. The influence of water uptake from root activity at the toe of slope created a dry condition and substantially increased the factor of safety against slope failure up to 63

Characterisation of osteomyelitis microbiome using specific growth media

Osteomyelitis is an inflammation of the bone caused by microbial infection. The objective of the study is to characterise the microbiome from osteomyelitis with the hypothesis that osteomyelitis is induced by polymicrobial infection. To identify the microbiome, sample was initially isolated from pin site of ortophaedic patients with osteomyelitis using sterile swab. Following that, the sample was inoculated into nutrient broth and incubated at 37° C for 24 h aerobically. Later, the sample was cultured on CHROMagar, mitis salivarius agar (MSA) and lactobacillus specific agar (LSA) for identification of Candida species, Streptococcus species and Lactobacillus species, respectively. Gram-staining was conducted to identify its phenotype under light microscope. Finally, disc diffusion test was conducted on each isolate to assess its sensitivity towards nystatin, amphotericin B, gentamicin and tetracycline. Based on the study, only Candida albicans and Streptococcus species were identified. Candida albicans and Streptococcus species were isolated from the sample with C. albicans exhibited resistance to amphotericin B, gentamicin and tetracycline while Streptococcus species were resistance to nystatin, amphotericin B and tetracyclin. In conclusion, osteomyelitis is induced by polymicrobial infection, with the microbial isolates possess various susceptibility towards common antimicrobial agents

Eksplorasi adaptasi antarabudaya pelajar Melayu di Australia dan United Kingdom

Kajian ini dijalankan bertujuan untuk menganalisis proses adaptasi antarabudaya pelajar Melayu di Australia dan United Kingdom sewaktu melanjutkan pengajian mereka ke peringkat Ijazah Sarjana (Master) dan Ijazah Kedoktoran (Phd). Fokus kajian ini tertumpu kepada perbezaan budaya dan cara hidup pelajar di luar negara. Model Lekuk-U (Lysgaard, 1955) telah digunakan sebagai asas kepada penyelidikan) yang bermula dari peringkat bulan madu (honeymoon stage), peringkat kejutan budaya (culture shock stage), peringkat pelarasan (adjustment stage) dan akhir sekali peringkat penguasaan (mastery stage). Empat kumpulan fokus telah dijalankan membabitkan pelajar-pelajar sarjana Melayu yang telah belajar di Australia dan United Kingdom. Hasil analisis dapatan kajian mendapati bahawa peringkat berbulan madu (honeymoon stage) tidak dilalui oleh pelajar ini kerana peringkat awal di negara baru lebih tertumpu untuk menyesuaikan diri dan mempelajari bagaimana untuk beradaptasi. Mereka kurang mempunyai masa untuk bersuka-ria. Walaupun terdapat cabaran sebagai seorang Muslim di luar negara, pelajar mampu menjalani hidup dengan baik kerana negara luar telah mula mendapat pendedahan tentang cara hidup orang Islam

Investigating the perception and acceptance towards smartphone and its application as learning tool among Universiti Teknologi MARA dental students / Nor Faharina Abdul Hamid, Nur Saiyidah Hanisah Ali and Nadia Syahirah Mohd Nazri.

The development of smartphones throughout the years had made it a very valuable tool in teaching and learning activities. The purpose of this study was to investigate the perception and acceptance towards the use of smartphones as additional learning tool among Universiti Teknologi MARA (UiTM) dental students. Methods: All undergraduate dental students were invited to participate in a self‐ administered questionnaire (content validated, pre-tested) survey, conducted online, involving students across all academic years. Results: Of the 215 respondents, (99.1%) owned a smartphone, with majority of them were iPhone and Android user. 94%, n=202 of the respondent had access to internet data via a third generation (3G) mobile carrier and WiFi connection. Most of the respondents gave positive remarks of all ten statements in regards the perception and acceptance towards smartphone and its application as learning tool. 96.7%, n=208 of respondents agreed that smart phone help them in finding resources related to their study while 74%, n= 159 of them stated that smartphone can help them to manage their study. Conclusion: In conclusion, the results of this study suggested that UiTM undergraduate dental students have positive perception and acceptance towards use smartphones in teaching and learning activities