The effect of multiple deformations on the formation of ultrafine grained steels

A C-Mn-Nb-Ti steel was deformed by hot torsion to study ultrafine ferrite formation through dynamic strain-induced transformation (DSIT) in conjunction with air cooling. A systematic study was carried out first to evaluate the effect of deformation temperature and prior austenite grain size on the critical strain for ultrafine ferrite formation (&epsilon; C,UFF) through single-pass deformation. Then, multiple deformations in the nonrecrystallization region were used to study the effect of thermomechanical parameters (i.e., strain, deformation temperature, etc.) on &epsilon; C,UFF. The multiple deformations in the nonrecrystallization region significantly reduced &epsilon; C,UFF, although the total equivalent strain for a given thermomechanical condition was higher than that required in single-pass deformation. The current study on a Ni-30Fe austenitic model alloy revealed that laminar microband structures were the key intragranular defects in the austenite for nucleation of ferrite during the hot torsion test. The microbands were refined and overall misorientation angle distribution increased with a decrease in the deformation temperature for a given thermomechanical processing condition. For nonisothermal multipass deformation, there was some contribution to the formation of high-angle microband boundaries from strains at higher temperature, although the strains were not completely additive.<br /

The role of general practitioners in the management of erectile dysfunction - a qualitative study

The objective of this study was to explore the roles and perceptions of general practitioners (GPs) in the management of erectile dysfunction (ED). This qualitative study used focus group discussions and in-depth interviews. This study was conducted based on 28 GPs from an urban area in Malaysia who had managed patients with ED and prescribed anti-ED drugs. Main outcome measures included the roles of GPs in managing patients with ED ( active or passive), perceptions regarding ED and the treatment, and factors influencing their decision to prescribe. Majority of the GPs assumed a passive role when managing patients with ED. This was partly due to their perception of the disease being nonserious. Some also perceived ED as mainly psychological in nature. The anti-ED drugs were often viewed as a lifestyle drug with potentially serious side effects. The fear of being perceived by patients as 'pushing' for the drug and being blamed if the patients were to develop serious side effects also hampered the management of this disease. GPs who participated in this study remained passive in identifying and treating patients with ED and this was attributed to their perception of the disease, drug treatment and patient's background

How do men perceive erectile dysfunction and its treatment? A qualitative study on opinions of men

Introduction. Erectile dysfunction (ED) is a common medical disorder affecting the aging male. A man's perception of a disease affects his health seeking behaviour. This study aimed to explore perceptions of ED among men with ED and how these perceptions came about. Methods. This qualitative study utilized in-depth interviews involving 17 urban men aged between 40 and 75 years old. Results. Misconceptions existed regarding the definitions of ED. Most men perceived impotence to be more serious than ED. Although most were aware of the medical causes of ED, 'overuse of penis' and black magic were mentioned as culturally-related causes. ED was perceived as a serious problem associated with loss of manhood and it had a significant impact on relationships with their partners. However, some adopted an 'accepting' view and attributed it to aging and fate. Most men were only familiar with PDE-5 inhibitors and traditional therapies. PDE-5 inhibitors were perceived to be effective but they were concerned about side effects and costs. Conclusions. Identifying men's perceptions of ED and its treatment would help doctors in their consultation, and inform health policy makers in planning appropriate public education and services

The role of general practitioners in the management of erectile dysfunction - a qualitative study

The objective of this study was to explore the roles and perceptions of general practitioners (GPs) in the management of erectile dysfunction (ED). This qualitative study used focus group discussions and in-depth interviews. This study was conducted based on 28 GPs from an urban area in Malaysia who had managed patients with ED and prescribed anti-ED drugs. Main outcome measures included the roles of GPs in managing patients with ED ( active or passive), perceptions regarding ED and the treatment, and factors influencing their decision to prescribe. Majority of the GPs assumed a passive role when managing patients with ED. This was partly due to their perception of the disease being nonserious. Some also perceived ED as mainly psychological in nature. The anti-ED drugs were often viewed as a lifestyle drug with potentially serious side effects. The fear of being perceived by patients as 'pushing' for the drug and being blamed if the patients were to develop serious side effects also hampered the management of this disease. GPs who participated in this study remained passive in identifying and treating patients with ED and this was attributed to their perception of the disease, drug treatment and patient's background

Management of erectile dysfunction: barriers faced by general practitioners

Aim: To explore the barriers faced by general practitioners (GPs) in the management of patients with erectile dysfunction (ED). Methods: This was a qualitative analysis of focus group discussions and in-depth interviews involving 28 Malaysian GPs. Results: GPs' perception of ED being not a serious condition was a major determinant of their prescribing practice. Doctor's age (younger), gender (female), short consultation time and lack of experience were cited as barriers. The GPs' prescribing habits were heavily influenced by the feedback from the first few patients under treatment, the uncertainty of etiology of ED without proper assessment and the profit margin with bulk purchase. Other barriers include Patients' coexisting medical conditions, older age, lower socio-economic status, unrealistic expectations and inappropriate use of the anti-impoteneet drugs. Cardiovascular side effects and cost were two most important drug barriers. Conclusion: The factors influencing the management of ED among the general practitioners were multiple and complex. An adequate understanding of how these factors (doctors, patients and drugs) interact can assist in the formulation and implementation of strategies that encourage GPs to identify and manage ED patients

Complications from the Gardner-Wells tongs

10.1016/0020-1383(96)00058-7Injury277512-513INJU

Feeling Unsafe a photovoice analysis of factors influencing physical activity behavior among Malaysian adolescents

Understanding the factors influencing physical activity (PA) in the Asia-Pacific region is critical, given the high prevalence of inactivity in this area. The photovoice technique explores the types of PA and factors influencing PA among adolescents in Kuching, Sarawak. A total of 160 photographs were collected from participants (adolescents, n = 22, mean age = 14.27 ± 0.7 years, and parents, n = 8, mean age = 48 ± 6.8 years). Data analysis used constant comparison methods of a grounded theory. The Analysis Grid for Environments Linked to Obesity was used to categorize PA factors. Study findings were centered on the concept of safety, facilities, parental restriction, friends, cultural traits, media, community cohesiveness, and weather. The central theme was �feeling unsafe� when being outdoors. To promote PA behavior, provision of PA facilities needs to be supported by other programs that build on peer support, crime prevention, and traffic safety, together with other educational campaigns

Prevalence of falls among community-dwelling elderly and its associated factors: A cross-sectional study in Perak, Malaysia

Introduction: Fall is a major cause of injuries and can increase the risk of early mortality among elderly. The objective of this study was to determine the prevalence of falls among community-dwelling elderly in rural Malaysia and its associated factors. Methods: Data were obtained from a cross-sectional survey in five randomly selected districts in the state of Perak, Malaysia. A total of 250 households were randomly selected. A total of 811 individuals aged 60 years or more were recruited and interviewed using a structured questionnaire. Information about socio-demographic, history of falls in the past 1 year, medical history, drug history and physical activity level were enquired. Results: The prevalence of falls in the past 1 year among community-dwelling elderly was reported to be 4.07%. Indigenous elderly (Adjusted odd ratio, AOR = 6.06, 95% CI = 1.10-33.55, p = 0.039) and living alone (AOR = 2.60, 95% CI = 1.04-6.50, p = 0.042) were shown to be factors associated with falls. Physical activity level, number of co-morbidities and number of medications used were not associated with falls. Conclusion: Elderly of indigenous ethnicity and living alone are the main factors associated with falls in this population. Indigenous people may be at higher risk, which warrant further investigation with a larger sample to improve the precision of estimates

Employability among people with uncontrolled seizures: An interpretative phenomenological approach

Purpose: This study aimed to explore positive and negative factors affecting the employability in patients with uncontrolled seizures. Method: Semistructured interviews with 21 patients with uncontrolled seizures were analyzed using interpretative phenomenological analysis. Result: Eleven (52.4%) of the participants interviewed were employed; 7 were holding full-time position with more than 4. years of working experience. The mean age was 34.6. years, 71.4% were female, 38% were married, 71.4% had at least 11. years of education, 38% had a driving license, 19% received government monetary aid, 66.7% had seizure onset before reaching 17. years of age, 66.7% experienced monthly seizures, and 76% were on polytherapy. A total of 6 main themes were found to be affecting the employability among people with uncontrolled seizures: (a) ability to work; (b) intention to work; (c) support and stigma at workplace; (d) family support, overdependence, and protection; (e) life event; and (f) government and welfare support. Subthemes under the main theme ability to work included education, cognitive and physical functions, ability to continue working after seizures, ability to travel to work, self-perceived ability to work, and ability to cope with stress. Many shared the same idea that employment is important, but their intention to work varied. The employed group tended to work for a future goal and self-satisfaction, and the unemployed group tended to have no or lack intention to work. Positive factors were noted in the following themes: ability to work; intention to work; support and stigma at workplace; and family support, overdependence, and protection. Conclusion: There were internal and external factors affecting the employability among people with uncontrolled seizures both positively and negatively. Positive internal factors such as ability and intention to work require further exploration