Making gastrointestinal endoscopy safer

University of Technology, Sydney. Faculty of Science.Endoscopic procedures have become the ‘gold standard’ of diagnosis and therapy in the alimentary tract and are frequently delivered in high volume centres. Given that the generic term endoscopy is broad, in this thesis, panendoscopy will refer to “upper gastrointestinal” procedure and colonoscopy will refer to “lower gastrointestinal” procedure. In such procedures, complications can be attributed to the bowel preparation, the procedure itself and/or the effects of the sedative/anaesthesia. This thesis reports on an anonymous postal survey of Australian practice of endoscopic procedures and identifies system issues in the delivery of sedation. In particular, there is an unacceptable morbidity and mortality rate seen in some public endoscopy units. Therefore, there is scope to improve levels of safety in gastrointestinal endoscopy. The first half of this thesis focuses on sedation-associated cardio respiratory embarrassment, a common cause of morbidity and mortality. This thesis examines the changes in cardio- respiratory parameters associated with sedation. Expanding on this knowledge the thesis describes the development of a novel oxygenating bite-block with capacity to sample carbon dioxide. The device, when tested against conventional delivery systems in a comparative clinical study shows, superiority in monitoring of ventilation. The second half of this thesis focuses on the complications associated with bowel preparations relating to their palatability, their purgative effect and dehydration. Effective purgation is essential to reduce the missed pathology rate. The development of a novel bowel preparation to improve safety was trialled in a comparative clinical study against three other methods. Lessons learnt from this study led to the process of further enhancement to the development to formulate a capsule bowel preparation. Improvements in oxygen delivery, ventilation monitoring and bowel preparation described in this thesis will significantly increase the safety of gastrointestinal endoscop

Morphofunctional Characteristics of the Umbilical Vessels from Newborns Delivered by Mothers Experiencing an Exacerbation of Chronic Cytomegalovirus Infection during Gestation

The characteristic features of the cord blood and endothelium of the umbilical vessels from newborns delivered by mothers experiencing an exacerbation of chronic cytomegalovirus (CMV) infection during gestation has been studied. Exacerbation of the chronic CMV infection was found to increase during pregnancy and sharply affect the function of gas transport in both the maternal and fetal blood. Lipid peroxidation in the maternal blood as well as in the fetal blood was seen to increase, which was reflected in the characteristic endothelial structure and enzymatic activity in the umbilical vessels of the newborns

“I\u27ll do whatever as long as you keep telling me that I’m important”: A case study illustrating the link between adolescent dating violence and sex trafficking victimization

Background: Approximately 10% of U.S. high school-attending youth are physically abused by a dating partner each year. Many sequelae of dating violence have been documented, but the dating violence literature is lacking information about commercial sexual exploitation as a possible outcome of an abusive dating relationship. Conversely, scholarship on sex trafficking victimization has documented that some girls are enticed into sex work by exploitative partners who initially pretend to be dating partners, but the research lacks specificity about why and how the girls become vulnerable to these destructive relationships. This case series chronicles the experiences of four women who were commercially sexually exploited in the U.S. as minors, identifies common themes cross their narratives, and organizes these themes into a proposed framework for understanding a possible pathway from safety to unsafe dating to sex trafficking victimization. Methods: We conducted in-depth qualitative interviews with four adult women who had firsthand experience as victims of domestic minor sex trafficking. Participants were recruited through an organization that serves sex trafficking survivors. A constructivist grounded approach was used for data analysis. Participants’ narratives are presented, as well as illustrative quotes that typify each of the primary themes identified. Results: There were six primary themes that emerged from the cases’ narratives. Factors that made girls vulnerable to entering into abusive dating relationships and subsequently to experiences as sex trafficked minors included: (1) feeling physically unattractive and unimportant; (2) lacking examples of healthy relationships; (3) experiencing sexual abuse that caused subsequent dissociation and emotional debilitation; (4) being flattered by romantic gestures early in an abusive dating relationship and becoming emotionally attached; (5) gaining confidence from dating someone with higher social status; and (6) experiencing short-term satisfaction from out-earning other sex workers. Secondary themes that merit further investigation included having conflicts with guardians, engaging in criminal behavior at the request of their dating partner, and developing substance dependence that made it difficult to exit sex work. Discussion: Findings support the conclusions that one pathway into commercial sexual exploitation for minors is via dating partners, and that some minors are motivated to engage in sex work out of devotion to their dating partners rather than fear of violent retribution. A proposed framework for understanding how youth become vulnerable to sexual exploitation by a dating partner includes pre-dating, early phase dating, and late phase dating factors. Some pre-dating factors, for example, include feeling insecure, being bullied by peers, and having conflict with a guardian. Early phase dating factors include being impressed by the high social status of a new love interest and romantic gestures. Late phase dating factors include engaging in criminal activity to please the dating partner, and being physically, sexually, financially and emotionally abused. Additional empirical research that replicates and expands the proposed framework is encouraged, with the long-term objective of improving both dating violence and sexual exploitation prevention initiative

Finishing the Job Best Practices for a Diverse Workforce in the Construction Industry v.8 Sept 2018

This manual is a work in progress. It is produced by the Policy Group on Tradeswomen’s Issues (PGTI), a regional collaboration of researchers, government agencies, unions, community-based organizations, developers and contractors committed to increasing access for women and people of color to good paying careers in the construction trades. Our goal is to make our shared efforts and experiences helpful to industry leaders who share our commitment. It is based on best practices developed on major projects that came close, met, or exceeded workforce hiring goals. This manual and additional resources are available online at on the PGTI website at www.policygroupontradeswomen.org . There is also a comment section. We look forward to receiving feedback from users that will help us improve the tools contained here. The Policy Group on Tradeswomen’s Issues (PGTI) is a regional collaboration of stakeholders working together since 2008 to crush the barriers to women’s access to good paying careers in the construction trades. Participants include tradeswomen, regional and local political leaders, representatives from state and federal government agencies, union and contractor representatives, staff from pre-apprentice programs, community-based organizations (CBOs) and other interested parties. Participants meet every other month to build relationships and share information across silos of expertise, to identify points of intervention that will get women into training and jobs and support high retention rates for women in the trades. Our focus on women explicitly supports efforts to increase all forms of diversity in the construction industry. In urban areas, as many as half of the women entering the trades are women of color. This demographic fact means that bringing more women into the trades addresses economic inequalities of both gender and race. As the industry opens up to women and people of color, the culture of workplaces is improving for all

Natriuretic Peptide in Patients with Metabolic Syndrome

The present research aimed at studying the atrial and brain natriuretic peptide (NUP) levels in the blood plasma of patients with Metabolic Syndrome (MS). The research includes 52 patients in total, of which 40 patients with MS constitute the observation group while 12 conventionally healthy people comprise the control group. An increase in the NT-proBNP at 20% (p<0.05) and proANP at 67.8% (p<0.05) was observed in the blood plasma of the patients with MS. We observed a strong correlation between the atrium and brain NUP in the plasma and insulin and the insulin resistance index (IRI) that allows us to consider the NUP levels as the markers of early diagnosis of MS

BUILDING BRIDGES: A COMPARATIVE STUDY OF WOMEN WORKING IN THE CONSTRUCTION INDUSTRY IN INDIA AND THE US

In January 2017, a delegation of women construction workers and advocates from the United States will visit India to meet with labour and civic leaders and share stories and experiences with women working in India’s construction industry. The goal of the delegation is to lay a foundation for an international network by and for women construction workers. This article describes the history and background of the delegation and its purpose

Effect of Age on the Hemostatic Function in Patients with Degenerative Diseases of the Large Joints

Background: Aging is associated with an increased hypercoagulable state. Degenerative diseases of the large joints are also accompanied by increased coagulation activity. We investigated the effect of age on the hemostatic function in patients with osteoarthritis. Material and Methods: The study included 192 patients with osteoarthritis admitted to the clinic for primary hip or knee arthroplasty. The patients were categorized into 5 age groups: the age group under 40 years, the 41–to-50 -year age group, the 51–to-60-year age group, the 61-to-70- year age group, and the age group over 70 years. The general blood clotting tests, platelet number, fibrinogen, antithrombin, protein C, TAT, D-dimer, vonWillebrand factor (vWF), PAI-1, ß-thromboglobulin were determined. Results: Among patients with osteoarthritis, the antithrombin III level significantly decreased by the age of 50; however, above the age of 60 there was a distinct decrease in platelet count, and over the age of 70 the activity of the extrinsic coagulation pathway and the plasminogen level dropped significantly. TAT and D-dimer levels were elevated in most of the patients. Conclusion: The decrease in platelet count coupled with the activity of the extrinsic coagulation pathway in elderly osteoarthritic patients may increase blood loss during total arthroplasty; also, the drop in the anticoagulant and fibrinolytic potential may play a negative role in strengthening the prothrombotic state during the postoperative period

Uroflowmetric Monitoring and its Role in Evaluating the Results of Surgical Treatment in Children with Urethral Valves

This paper presents the results of research and treatments in 41 children (from two months to 15 years of age) with urethral valves. In all, 16 patients were treated using the endoscopic method, 7 patients by employing the polyethylene urethrotome and 18 patients treated by the proposed method, using a metallic urethrotome. Diagnosis of the urethral valves was done using ultrasonography, voiding cystourethrogram, urethrocystoscopy, uroflowmetry and cystomanometry. Mathematical modeling was applied to assess the treatment methods. The proposed method, using the metallic urethrotome, was preferable to the endoscopic method

Constitution of the Lymphatic System

The lymphatic system consists of two types segments – general (systemic or periarterial) and special (own, intervalvular). The segments organize all the system’s reactions in response to its environmental influences. This paper presents the results of the research the common structure of all the sections of the lymphatic bed

DESIGNING A PRE-APPRENTICESHIP MODEL FOR WOMEN ENTERING AND SUCCEEDING IN THE CONSTRUCTION TRADES

It has been over a quarter century since the Carter administration set a goal of increasing the number of women working in the construction industry to 6.9% of the workforce. It is often overlooked that the stated intent of this policy initiative was for women to make up 25% of construction workers by the year 2000 (Eisenberg, 1999). While some isolated projects have met or exceeded the 6.9% target, the number of women working in the construction trades nationally increased in the first few years after 1979, but leveled off at under 3% in the early 1980’s and has stayed at that level for over two decades (Bureau of Labor Statistics, 2003). In fact, recent reports show that while the number of women moving into management and ownership positions in the construction industry has gone up sharply in the past few years, the number of tradeswomen has gone down