A study on knowledge and practice on post cardiac arrest care among healthcare providers working in Emergency Department in Kelantan

INTRODUCTION 2010 American Heart Association (AHA) guidelines on CPR and ECC had created the fifth link of the chain of survival which is integrated post cardiac arrest care. Since 2002 two landmark study (HACA et al and Bernard et al) prove that therapeutic hypothermia in resuscitated patient with initial rhythm ventricular fibrillation improve their survival rate with good neurological outcome. (Passali, Pantazopoulos et al. 2011) found that nurses and doctors knowledge of basic and advanced life was suboptimal and practice is varied (Nick Truman et al. 2015). Therapeutic hypothermia implementation is low (Abella, Rhee et al. 2005). OBJECTIVE 1 To determine the level of knowledge of post cardiac arrest care among healthcare personnel in Emergency Department in Kelantan 2. To determine the level of practice of post cardiac arrest care among healthcare personnel in Emergency Department in Kelantan 3. To compare the mean of knowledge and practice of post cardiac arrest care among general, district and university hospital 4. To determine factors associated with the level of knowledge and practice of post cardiac arrest care among healthcare personnel in Emergency Department in Kelantan.METHADOLOGY The questionnaire is created based on 2010 AHA guidelines on CPR and ECC which has 3 domains, demographic, knowledge and practice had been validated. The study was a cross sectional study conducted for six months period from Jun till November 2015 in whole tenth of Emergency Departments in Kelantan. Sample size calculated is 156 and the respond rate was 155, 99%.Data was entered and analyzed via SPSS version 22. RESULT We enrolled 155 people with age range from 24 to 57 years old. Male population (52.9%) are more than female (47.10%).The mean knowledge score is 5.25 , while the mean practice score is 7.5. The median score of knowledge among workplace are different general hospital (6.0,Iqr 3) district hospital (5.0,Iqr 2) and university hospital (7,0 ,Iqr 3). In this study we found that five variables were statistically significant with knowledge score which were ACLS trained, position, workplace, place of practice, and number of patient with ROSC attended before. We also found that median practice score of respondent attended ACLS course and service duration is significantly different.CONCLUSION Healthcare personnel working in emergency department in Kelantan had low knowledge and average practice of post cardiac arrest care. The score of knowledge between districts, university and general hospital are different, however practice score are not. Previously attended ACLS course was found to be a significant factor for better knowledge and practice score. Workplace, place of practice, number of cardiac arrest patient with ROSC attended before and position of healthcare personnel was found to be a significant factor affecting knowledge of post cardiac arrest care. Service duration was found to be a significant factor for practice score

Clinicopathological Changes in Adjuvant Induced Arthritis in Canine Stifle Joint

Osteoarthritis is the most common joint disease ,and cause of physical disability in man and animals. It is a complex disease with unknown etiology. Intra-articular injection of 1 ml. Freund's adjuvant was inoculated into twenty-five adult Mongrel dogs weighing between 10-15kg. Osteoarthritis was induced in the left stifle joint, while the right joint act as a control. The dogs were evaluated for clinical evidence of joint heat, effusion and pain, and gait abnormalities. Radiographs were obtained for soft tissue swelling, osteophytosis and degenerative changes. At the end of each trial period (week 1, 2, 3, 4, 5) the dogs were euthanised. The left stifle joint were opened, examined grossly and the articular cartilage and synovial membrane were harvested and fixed for histopathologic and electron microscopic studies. Clinical signs of joint swelling and pain upon palpation, weight bearing lameness and reduced range of motion were observed within week 1 post-inoculation. These signs were positively correlated with the acute pathological lesions in the synovial membrane and articular cartilage; and in radiograph evaluation. Radiograph study revealed evidences of soft tissue swelling, increased intra-articular space, osteophytes formation; the clinical signs that were suggestive of degenerative changes in osteoarthritis. However, plain radiograph was found to be not informative enough in the early stage of osteoarthritis. Gross changes during post mortem revealed, swelling of the adjacent soft tissue, hypertrophy of the joint capsule and synovial membrane, and joint effusion. These were signs of inflammation of the joint tissues and it was believed that the inflammatory process was one of the major factors in the development of degenerative joint disease. Lameness evaluation was positively correlated with gross examination but negatively correlated with radiograph examination. In histopathology study, there were signs of inflammation in the synovial membrane and formation of synovial pannus, which was thought to be related with the development of degenerative changes on the articular cartilage. Hyperplasia of intima and subintima layer, edema and congestion; flaking and erosion in articular cartilage, were observed as early as week 1 p.i. Under scanning electron microscopy, cartilage fibrillation and erosion, were observed as early as week 1 p.i. Significant positive correlation between the histological changes in articular cartilage with changes in the synovial membrane suggested that changes in the synovium preceded changes in the articular cartilage. The synovial membrane was highly vascularised, causes respond to injury more promptly. In articular cartilage, it took time to heal since healing depending on the depth of lesion. In this study, the pathogenesis of osteoarthritis was divided into three stages: the onset phase, which was observed within one week post-induction; the second phase or the intermediate stage and the end phase. Each structure, cells and tissues was found to have their own role in the production of osteoarthritis . Study on the pathogenesis must emphasize on these structures and cascade of events that occur during the production of osteoarthritis, which will aid in the treatment of osteoarthritis. The clinical, morphological and microstructure changes that occurred in osteoarthritis had been characterised , but the role of each in the aetio-pathogenesis of osteoarthritis, is still not rigidly defined

Dicentrine: The Major Alkaloid of Cyclea laxiflara Miers

The major alkaloid of Cyclea laxiflora Miers. was isolated and identified as dicentrine from its spectral and physical data

Algorithmic approaches in model selection of the air passengers flows data

Algorithm is an important element in any problem solving situation.In statistical modelling strategy, the algorithm provides a step by step process in model building, model testing, choosing the ‘best’ model and even forecasting using the chosen model.Tacit knowledge has contributed to the existence of a huge variability in manual modelling process especially between expert and non-expert modellers.Many algorithms (automated model selection) have been developed to bridge the gap either through single or multiple equation modelling.This study aims to evaluate the forecasting performances of several selected algorithms on air passengers flow data based on Root Mean Square Error (RMSE) and Geometric Root Mean Square Error (GRMSE).The findings show that multiple models selection performed well in one and two step-ahead forecast but was outperformed by single model in three step-ahead forecasts

Assessing the simulation performances of multiple model selection algorithm

The Autometrics is an algorithm for single equation model selection.It is a hybrid method which combines expanding and contracting search techniques.In this study, the algorithm is extended for multiple equations modelling known as SURE-Autometrics.The aim of this paper is to assess the performance of the extended algorithm using various simulation experiment conditions. The capability of the algorithm in finding the true specification of multiple models is measured by the percentage of simulation outcomes.Overall results show that the algorithm has performed well for a model with two equations.The findings also indicated that the number of variables in the true models affect the algorithm performances. Hence, this study suggests improvement on the algorithm development for future research

Governance strategies in sustainable campus using Rasch model

In moving towards sustainability, university needs to establish a good governance strategy which practices to transform a positive sustainable culture toward successful green campus. Howe ver, due to constraint of knowledge and commitment regarding sustainability integration has caused weakness in the implementation of green concept in majority of Malaysian universities. This paper is presents one of the five dimensions of a developed hypot hetical integrated sustainable campus model which is university governance. The university governance dimension consists of 5 constructs and 23 items which are strategies for the university to be complied. These strategies were uncovered using questionnair e survey with 35 selected experts who are currently active in sustainable campus activities and researches. Collected data from this survey was analysed using Rasch method in Winstep software to measure items reliability, separation index, items polarity, item fit and item person map. Results from the analysis indicated that 19 strategies were significant to be implemented. Thus, it provides good information for universities to adopt these sustainable campus strategies in making their campus as a role mode l for a sustainable and conducive living environment

Deterministic and stochastic model for the effect of Chondroitin Sulfate (CS) in cancer cell

Modern medical study show that the new therapeutic strategies known as targeted therapy can help in cancer prognoses. Chondroitin Sulfate (CS) an anticancer drug in targeted therapy has been proved able to reduce cell viability by promoting the activation of the Caspase3 (Casp3) in apoptosis pathway without causing toxicity. To better understand the effect of CS on the cancer cells, deterministic and stochastic model are proposed. The result shows the decreasing trend of the cancer cell in the presence of CS in both models

The Impact of Audit Quality on Firm Performance: the Moderating Role of Ownership Concentration

Purpose: The main objectives of this research were to study the direct relationship between audit quality (AQ) and the performance of non-financial Jordanian companies and to look into how ownership concentration affects this relationship.   Theoretical framework: This research focuses on AQ, FP, and ownership concentration. Ownership concentration moderates the relationship between AQ and FP, according to the framework. Audit fees are used to evaluate AQ and lend credibility to financial reports, protecting shareholders' interests.   Design/methodology/approach: The study was conducted on public companies listed on the Stock Exchange of Amman (ASE) in the services and industry sectors, with a total of 92 firms, from 2014 to 2018. The data analysis method used was partial least squares structural equation modelling (PLS-SEM).   Findings: The study's findings suggest that AQ is positively linked to FP, and ownership concentration has a positive and significant effect on FP. Additionally, the moderating influence of ownership concentration confirms that AQ has a statistically significant impact on FP.   Research, Practical & Social implications: The result of this article helps firm managers, regulatory agencies, and market participants on the ASE, as well as nations with highly concentrated ownership and policymakers, understand governance.   Originality/value: This study is one of the first papers in the Jordanian context to address the role of moderating the effect of ownership concentration between AC and FP