Hypertension Management Through Patient Education

Hypertension serves as a common diagnosis among Americans, and its management to prevent further cardiovascular complications remains as an organizational goal. To prevent complications, the goal of a Primary Care Provider’s patient panel maintaining a blood pressure less than 140/90 has been established on the organization’s national office. In the Primary Care Clinic, an interdisciplinary team consisting of a Registered Nurse, Clinical Psychologist, and Cardiologist implemented a group education class aimed at a Hypertensive Veteran cohort. The purpose of this project is to improve self-management behaviors in the Veteran population, and to help increase the hypertension performance metric by 2% one month after class implementation. Blood pressure readings were measured before and after the class, as well as the percentage of well-controlled hypertensive patients on the Primary Care Dashboard. Data collection revealed a 2.2% performance increase one month after the class implementation; this reflects an improvement in the Primary Care Provider’s ability to manage his hypertensive cohort, while also indicating an overall increase in the number of hypertensive patients whose systolic blood pressure was lower than 140 mmHg, and diastolic blood pressure lower than 90 mmHg

Effectiveness of Sleep Intervention strategies on Sleep Quality and Daytime Sleepiness among the Elderly

No matter what the age is, sleeping well is essential for physical health and emotional wellbeing. For the elderly good night sleep is especially important because it helps improve concentration and memory formation, allows the body to repair any cell damage that occurred during the day and refreshes the immune system which in turn helps to prevent disease. So the present study was undertaken to evaluate the effectiveness of sleep intervention statergies on sleep quality and daytime sleepiness of the elderly people residing in oldage homes.Quasi experimental design with non equivalent pretest and posttest control group design was adopted for this study.Samples were the elderly people in the age group of 60 – 80 years who fit the inclusion criteria. Samples size was 60. Tools used were Epworth Daytime Sleepiness scale to assess the daytime sleepiness and Pittsburgh Sleep Quality to assess the sleep quality of the elderly. The sleep intervention strategies which included were structured teaching program on sleep hygiene, aerobic exercises and aromatherapy were administered for 5 weeks to the experimental group. Both descriptive and inferential statistics were used and the study findings were as follows: In the pre-test all the elderly in the experimental group and control group had poor sleep quality.Among the elderly, in the experimental group 86.6% had borderline daytime sleepiness and 13.3% had abnormal daytime sleepiness, whereas in the control group 83.3% had border time daytime sleepiness and 16.6% had abnormal daytime sleepiness.Elderly who underwent intervention had good quality sleep. [the mean pretest sleep quality score 6.5 (experimental group) and 12.3 ( control group); ‘t’ value 13.10; ‘p’ value (0.01) and the [mean posttest daytime sleepiness score 2.76 (experimental group) and 9.76 (control group); “t” value 20.27; p (0.01)] were highly significant and the elderly remained alert during day time than their counterparts in the control group which was evident in the posttest score. Sleep intervention statergies is an effective non – pharmacological intervention in the treatment of sleep problems in the elderly

Of tales changed to other forms : an analysis of the traditions and future of Ovidian adaptations

Not only does the publication of Ovidian adaptations online increase public awareness of Ovid, but it also offers new material for research and pedagogical purposes. Consequently, in this thesis, I explore both the historical tradition of Ovidian adaptations, specifically adaptations of Ovid's Orpheus tale, and the modern presentation of Ovidian Adaptations online. In the first half of the thesis, I trace the thematic connections between historical and modern adaptations of Ovid's Orpheus myth. My analysis reveals that despite changes in form and medium, from printed poems to Internet video games, Ovidian adaptations return to Ovid's distinct thematic emphasis on exploring human passions and expressing an individual's emotional tensions through art. In the second half of the thesis, I focus on the pedagogical implications of locating Ovidian adaptations on the public space of the Internet. I contend that online adaptations offer educators the possibility of showing students interpretive models and of making student knowledge and experience central to learning in the classroom

Freshmen program withdrawal: types and recommendations

University program dropout is a problem that has important consequences not only for the student that leaves but also for the institution in which the withdrawal occurs. Therefore, higher education institutions must study the problem in greater depth to establish appropriate prevention measures in the future. However, most research papers currently focus primarily on the characteristics of students who leave university, rather than on those who choose to pursue alternative courses of study and therefore fail to take into account the different kinds of abandonment. The aim of this paper is to identify the different types of dropout to define their characteristics and propose some recommendations. Thus, an ex post facto study was carried out on a sample of 1,311 freshmen from a university in the north of Spain using data gathered using an ad-hoc designed questionnaire, applied by telephone or an online survey, and completed with data available in the university data warehouse. A descriptive analysis was performed to characterize the sample and identify five different groups, including 1. Students persisting in their initiated degree 2. Students who change of program (within the same university) 3. Students transferring to a different university 4. Students enrolling in non-higher- education studies 5. Students that quit studying. Also, data mining techniques (decision trees) were applied to classify the cases and generate predictive models to aid in the design of differentiated intervention strategies for each of the corresponding groups.Alfaguia Project was funded by the European Union (DCIALA/ 2010/94). Additionally, our research team is granted by the European Regional Development Funds (The European Union and Principality of Asturias) in the frame of the Science, Technology and Innovation Plan (GROUPIN14-100 and GROUPIN14-053). Also, Ph.D. students were granted: ME was granted by the Spanish Ministry of Economy, Industry and Competitiviness (BES-2015-072470), AC recibe support of Asturias Regional Department of Education and Culture (BP16014) and JC received funding from the Portuguese Foundation for Science and Technology (SFRH/BD/117902/2016).info:eu-repo/semantics/publishedVersio

Pilot assessment of Novel Membrane Bioreactor Processes - Improvements in Biological Nutrient Removal and Membrane Operation

With increasing water reuse applications and upcoming stringent regulations for treated wastewater effluent discharge, wastewater plants need to consider alternative technologies beyond conventional treatment processes. The new regulations, Numeric Nutrient Criteria (NNC), may regulate discharge nitrogen and phosphorus concentrations to as low as 0.5 mg/L as N and 10 μg/L as P respectively. To meet these target requirements, system retrofitting to incorporate chemical or advanced nutrient removal systems possibly with membrane technology will most likely be required. Although microfiltration/ultrafiltration membranes coupled with biological processes, otherwise known as membrane bioreactors (MBR), remove contaminants and suspended solids, nutrient removal is minimal to none. This emphasizes the importance of the biological process in MBRs. This study evaluated and tested the improvement of biological nutrient removal (BNR) in an MBR system which can meet NNC regulations along with the optimization of membrane operation for the reduction of fouling and energy consumption. A pilot study was conducted at the City of Tampa wastewater treatment plant and was divided into four phases of experimentation using two submerged MBR membranes operated with modified biological configurations. Laboratory analyses and data collection were conducted during the experiments and the performance evaluated for each configuration. System configurations were also optimized throughout each phase of testing for nutrient removal. Important factors used in the development of an appropriate configuration included isolation of the membrane tank from the biological reactors in the design, control of the dissolved oxygen (DO) concentrations or specifically the oxidation reduction potential (ORP) during operation and appropriate internal recirculation rates between the reactors. The results of this study provided information relevant for the assessment of both the BNR process and membrane performance. Membrane performance data indicated the importance and effect of air scouring (despite energy consumption) on membrane fouling for long-term stable flux operation as well as the cleaning frequency whether chemical enhanced backwash (CEB) or clean-in-place (CIP). This assessment also discussed how BNR systems can be enhanced through the incorporation of important design factors to eliminate the inhibiting factors of nitrogen and phosphorus removal such as dissolved oxygen. One of the biological processes tested in this study achieved effluent nitrogen and phosphorus concentrations below 5 mg/L and 1 mg/L respectively. Although the process tested did not meet NNC criteria, it can be applied with chemical precipitation. This, in turn, can reduce the operating and maintenance (O&M) costs associated with the chemical precipitation of phosphorus

Antibacterial activities of selected marine fungi from Peninsular Malaysia / Audra Shaleena A/P Paliany

Over the past few decades, scientists have come to acknowledge the growing importance of marine and marine-related resources for new drugs, pesticides and anti-fouling substances, with over 10,000 metabolites isolated from marine organisms to date. In an effort to tap into the pharmaceutical potential of marine fungi in Malaysia, selected marine derived endophytic and manglicolous fungi from the coastlines of Peninsular Malaysia were investigated for their antibacterial potential. The endophytic fungi in this study were isolated from two marine associated plants; Vitex rotundifolia L.f. and Ipomoea pes-caprae (L.) R.Br., from the east and west coast of Peninsular Malaysia respectively. A total of 13 and 21 endophytic fungi were isolated from V. rotundifolia and I. pes-caprae, respectively. The eleven manglicolous fungi strains used in this study were of mangrove origin and were obtained from the Institute of Biological Sciences (ISB) culture collection. In preliminary experiments, a mycelial plug assay was employed to study the antibacterial activities of both endophytic and manglicolous fungi. Almost 38.5% of the fungal strains from V. rotundifolia and 47.6% of the fungal strains from I. pes-caprae exhibited antibacterial activity against at least one test bacteria. Ten or 91% of the manglicolous fungi exhibited antibacterial activity against at least one test bacteria. Endophytic fungi from I. pes-caprae displayed higher potential for antibacterial activity in comparison to endophytic fungi from V. rotundifolia. Minimidochium sp. and Bipolaris sp. displayed antibacterial activity towards five or more of the test bacteria. Ten or 91% of the eleven manglicolous fungi displayed antibacterial activity. Saccardoella rhizophorae, Henningsomyces sp., Dactylospora haliotrepha (ISB003) and MF 28 exhibited promising antibacterial potential. Based on the results from the mycelial plug assay, five endophytic and ten manglicolous fungi were further investigated using the broth microdilution assay to obtain quantitative antibacterial parameters. Saccardoella rhizophorae was chosen for complete chemical analysis of its secondary metabolite profile. Bioactivity-guided fractionation of S. rhizophorae crude extract resulted in the isolation and characterization of two fatty acids namely palmitic acid and linoleic acid from the n-hexane fraction. Both isolated fatty acids exhibited antibacterial activity against gram positive bacteria. Certain fatty acids are important constituents of essential oils and fatty acids, such as linoleic acid, are important as nutritional supplements. Fatty acids are also essential in the field of biodiesel which is fast becoming the preferred alternate to conventional fuel with research being performed to identify sustainable sources of biodiesel feedstock. The isolation of fatty acids from S. rhizophorae indicates its potential application in the field of food technology and biodiesel. Although Malaysia hosts a great diversity of fungi, there are very few studies on metabolites of fungal origin, thus this study may prove crucial in paving the way towards commercial application of fungal metabolites and possibly lead to further discovery of new or novel fungal metabolites with pharmacological values

Engineering Biomimetic Gelatin Based Nanostructures as Synthetic Substrates for Cell Culture

There is a need for synthetic substrates that replicate the natural environment for in vitro intestinal models. Electrospinning is one of the most versatile and cost-effective techniques to produce nanofibrous scaffolds mimicking the basement membrane topography. In this study, three different novel electrospun nanofibrous scaffolds made of a polycaprolactone (PCL), gelatin, and poloxamer 188 (P188) blend were produced and compared with PCL and PCL/gelatin fibers produced using the same solvent system and electrospinning parameters. Each polymer solution used in this experiment was electrospun at four different voltages to study its influence on fiber diameter. The morphology and physical characteristics of the fibers were studied using scanning electron microscopy and atomic force microscopy. The average fiber diameter of all scaffolds was within 200–600 nm and no significant decrease in diameter with an increase in voltage was observed. Attenuated total reflection Fourier transform infrared spectroscopy was used to determine the chemical characteristics of the nanofibrous scaffold. The conductivity of the polymer solutions was also analyzed. Biocompatibility of the scaffolds was determined by a cell proliferation study performed using colorectal carcinoma (Caco-2) cells. PCL/gelatin/P188 scaffolds exhibited higher cell proliferation compared to PCL, PCL/gelatin scaffolds, and the control (tissue culture multi-well plate) with PCL/gelatin/P188 80:10:10 sample showing the highest cell proliferation

Electrospun Nanometer to Micrometer Scale Biomimetic Synthetic Membrane Scaffolds in Drug Delivery and Tissue Engineering: A Review

The scaffold technology research utilizes biomimicry to produce efficient scaffolds that mimic the natural cell growth environment including the basement membrane for tissue engineering. Because the natural basement membrane is composed of fibrillar protein networks of nanoscale diameter, the scaffold produced should efficiently mimic the nanoscale topography at a low production cost. Electrospinning is a technique that can achieve that. This review discusses the physical and chemical characteristics of the basement membrane and its significance on cell growth and overall focuses on nanoscale biomimetic synthetic membrane scaffolds primarily generated using electrospinning and their application in drug delivery and tissue engineering

A REVIEW OF SOFT COMPUTING TECHNIQUES IN MATERIALS ENGINEERING IJARET © I A E M E

ABSTRACT Within the last three decades, a solid and real amount of research efforts has been directed at the application of soft computing (SC) techniques in engineering. This paper provides a systematic review of the literature originating from these efforts which focus on materials engineering (ME) particularly sheet metals. The primary aim is to provide background information, motivation for application and an exposition to the methodologies employed in the development of soft computing technologies in engineering. Our review shows that all the works on the application of SC to sheet metal have reported excellent, good, positive or at least encouraging results. Our appraisal of the literature suggest that the interface between material engineering and intellectual systems engineering techniques, such as soft computing, is still blur. The need to formalize the computational and intelligent system engineering methodology used in sheet material, therefore, arises. We also provide a brief exposition to our on-going efforts in this direction. Although our study focuses on materials engineering in particular, we think that our findings applies to other areas of engineering as well

Examining if a gap exists between accounting education and accounting practice in Metro Manila: Perceptions from academicians and practitioners

Accounting is the language of business and in meeting the demands of the accounting profession, it is important for students to have a strong foundation of the necessary knowledge and skills which are acquired through education. Accordingly, the primary purpose of this study is to examine if a gap exists between accounting education and accounting practice in Metro Manila. Past studies in other countries have concluded that there is a gap and this is due to the curriculum being too technical rather than practical. The researchers used exploratory and descriptive designs to gather insights and characteristics of the population. Perceptions of academicians from the top performing schools and practitioners from four audit firms were gathered through a survey instrument. The survey instrument sought to determine if the accounting knowledge and skills supplied by the schools are aligned with the demands of the workplace. Correspondingly, the results of the study showed that there are no significant differences between the perceptions of academicians and practitioners regarding the relevance of skills and importance of courses and off-school learning activities acquired through education with the development of an accounting professional. Overall, results indicated that a gap does not exist between accounting education and accounting practice in Metro Manila. Differences in results of past studies could be attributed to the time when the researches were conducted or the difference in cultures