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In vivo antimicrobial activities of natural extracts against oral microorganisms [Doctoral dissertation] 3 arteries of the heart blocked cheap propranolol line. Evaluation of antiplaque activity of Azadirachtaindica leaf extract gel-a 6-week clinical study heart disease cancer and diabetes are examples of discount 80mg propranolol with mastercard. Effects of compounds found in propolis on Streptococcus mutans growth and on glucosyltransferase activity clogged arteries 100 propranolol 80 mg otc. Differences in cariogenicity between fresh isolates of Streptococcus sobrinus and Streptococcus mutans cardiovascular disease mortality rates generic 80mg propranolol otc. Five essential oils from aromatic plants of Cameroon: their antibacterial activity and ability to permeabilize the cytoplasmic membrane of Listeria innocua examined by flow cytometry. Lavender oil as a treatment for agitated behaviour in severe dementia:a placebo controlled study. Tongue-cleansing method: a comparative clinical trial employing a tooth brush and a tongue scraper. Method/Statistical Analysis: the study subjects comprised 175 optometrist, of whom 96 were men (54. They were asked to answer an online questionnaire survey in order to assess their emotional intelligence. Their emotional intelligence was found to differ significantly according to their education, employment type, and salary. All the types of emotional intelligence had statistically significant correlations. Optometrist who were men and older, those who had a higher education level and monthly pay, and those with more experiences of turnover tended to have more emotional intelligence. Introduction Humans have a spirit, a body, and a mind, with the latter divided into reason and sensitivity. Reason is Corresponding Author: Ki-Hun Ye Department of Optometry, Professor, Baekseok University, South Korea e-mail eyelovebaekseok@bu. As opposed to reason, sensitivity is the ability to trigger senses in response to changing stimuli and refers to the human characteristic of reacting to and feeling the influence of external forces. Emotional regulation and expression are essential to maintain and develop human relationships and live a happy life. There have been active studies and surveys on emotional regulation, emotional expression, and emotional labor at work. As medical professionals, optometrist are exposed to many conflicts in their relationships with their seniors (medical doctors), coworkers (nurses, nurse aides, optometrist), and customers, so that they experience emotional labor[2-3]. Customers who visit optical shops and hospitals require a high-quality service and high satisfaction. They have high requirements since they visit these places on account of their physical inconvenience and pain. The emotional labor increased by the emotional distortion can lower their customer service level. Emotional intelligence means the "intelligence of the mind" to regulate self-emotion and have smooth relationships with other people. In addition, optometrist can use their emotions and develop themselves further to plan their life and achieve their goals. The full score for each item was 15 points, and the mean was based on the three questions. All types of emotional intelligence had statistically significant correlations (p<0. In the categories of self-emotion appraisal, regulation of emotion, and use of emotion, men showed somewhat higher emotional intelligence than women.

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Multivariate Survival Analysis for Rates and Correlates of the Child Maltreatment Recurrence cardiovascular medical terms purchase propranolol 80 mg amex. Method/Statistical Analysis: this study is a descriptive survey design using a convenience sampling capillaries 1 cell thick discount 80mg propranolol. Findings: As a result of conducting the stepwise regression analysis cardiovascular system vasodilation order propranolol line, the explanatory power of above 4 variables was appeared to capillaries on my face buy propranolol overnight be 52. Improvements/Applications: this study will be used as basic data for developing nursing intervention programs that can improve well-being of middle age by establishing factors that affect well-being of middle age using variables of multilateral aspects. Keywords: Mid-life, Meaning of life, Depression, Positive thinking, Self-efficacy, Social support. Introduction Mid-life is a kind of transition period from adulthood to old age and is an important and meaningful stage in the life cycle. In recent years, people have shown lots of interests in life satisfaction, happiness and well-being which promote happiness and growth of individuals emphasizing the positive aspects of human beings. Well-being is used in combination with many similar concepts such as quality of life, happiness, life satisfaction, positive emotions and morale[1]. Among them, the subjective well-being is closely related to depression[3] which can be considered as a variable that negatively affects well-being as a factor to reduce the life quality throughout the middle age. Meaning of life is an indicator of psychological health related to happiness, and the effort to find meaning of life is the power to lead the life well by discovering meaning of life in the adversity or suffering experienced in the life[4]. Positive thinking is a factor that allows people to accept and cope positively with their life despite the negative side in the life. Having positive thinking is not only a means of gaining happiness, but also is reported to have a significant effect on the mental health as a factor that can promote health, life quality and well-being[5]. The greater the social support, the less likely they are to experience stress and the potential to develop mental symptoms therefrom[6]. The concept of selfefficacy has been diversely applied in the nursing or health-related fields and acts as a determinant to create behavioral change and motivation for solving problems occurring in the middle age, such that it can be assumed as a factor affecting well-being[7]. Corresponding Author: Hae-Kyung Chang Professor, Department of Nursing, Hanseo University, Republic of Korea e-mail: hkchang@hanseo. In particular, no integrated approach to the factors affecting well-being of middle age has been carried out. Therefore, this study aims to find a nursing intervention plan that can improve well-being of middle age by establishing variables that affect wellbeing of middle age. Data were collected by sampling the middle-aged men and women who visited religious and service organizations and sports centers. In addition, after explaining the purpose of the study, the researcher asked subjects who voluntarily participated in the study to fill out the written consent form and then answer the questionnaire. Ethical Consideration: the researcher explained to subjects the purpose of the study, promised anonymity and confidentiality, and explained in advance that the subject would not have to respond if they were reluctant to reveal personal information. The researcher also explained that subjects can stop or withdraw the answering at any time if they do not want to participate in the study. In addition, multiple regression analysis was conducted to establish the factors affecting well-being of subjects. Subjects: In this study, middle-aged men and women from 40 to 59 years old living in three areas Seoul, Gyeonggi-do, and Chungcheongnam-do, were selected as subjects. The higher the score on the 7-point scale of 10 questions, the more subjective meaning of life they have. General Characteristics and Difference of Well-being according to Characteristics (N = 219) Characteristics Age (Years) Sex Education Spouse Religion Occupation Categories 40-49 50-59 Male Female Below high school Above college Yes No Yes No Yes No Low Economic status Middle High Bada Perceived health status Moderateb Goodc Bada Sleep status Moderate Goodc b n (%) 154(70. Difference of well-being according to general characteristics: the difference of well-being according to general characteristics showed significant difference according to perceived health status (F = 47.

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Alternatively arteries and veins are constructed of buy propranolol 80mg free shipping, angles that exceed 60° produce significant tension on the wound and prevent successful transposition of the triangular flaps kps cardiovascular surgery discount propranolol 80 mg on line. The use of multiple Zplasties reduces lateral tension and more evenly distributes the tension across the entire wound coronary artery wall thickness order propranolol american express. In addition cardiovascular center discount propranolol master card, multiple Z-plasties, in contrast to a single Z-plasty, often produce better cosmesis, particularly in the head and neck region. Four such flaps, the deltopectoral, pectoralis major, trapezius, and sternocleidomastoid muscle flaps are described herein. Deltopectoral Flaps this fasciocutaneous flap is based on the first four perforators of the internal mammary artery with the second and third perforators serving as the primary contributors. The use of this flap in an undelayed fashion requires the continuity of the second perforator. To prevent injury to the perforators, flap elevation should remain lateral to a vertical line approximately 2 cm from the sternal border. The vessels provide an axial blood supply to the proximal two thirds of the flap; the remaining third is random in distribution. The elevation of this flap below the pectoralis fascia protects the subdermal network of vasculature for the random distribution. The donor site of the deltopectoral flap requires a skin graft for a shoulder defect. Primary closure can be completely or partially accomplished for a resulting donor defect of the chest. Pectoralis Major Myocutaneous Flaps the pectoralis major flap has been the workhorse flap in head and neck reconstruction. A secondary contributor that occasionally can be left intact is the lateral thoracic artery. This artery is usually ligated if the flap is to be extended farther superiorly, and the humeral attachment of the muscle is divided for mobilization. The flap is delivered to the neck under a tunnel created by elevating the skin overlying the remaining pectoralis muscle. The flap can successfully be used to reconstruct defects as superior as the lateral temporal bone. Ischemia & Necrosis Apart from fearsome complications, such as a cardiovascular or neurologic event or the death of the patient, the next most serious complications in flap surgery are ischemia and necrosis. Insufficient undermining of the flap or distention of the flap secondary to hematoma or edema can add to the tension at the wound edges. Transposition flaps generate less distal wound tension than rotation or advancement flaps. An inappropriately high length-to-width ratio of the flap increases the risk of necrosis at the tip of the flap. Cigarette smoke affects the cutaneous blood supply by at least two interrelated mechanisms: (1) nicotine in cigarette smoke is a potent vasoconstrictor, and (2) carbon monoxide can cause tissue hypoxemia by competing with oxygen for hemoglobin-binding sites. If the patient can stop smoking for 2 days before and 7 days after surgery, flap reconstruction is much less hazardous. Trapezius Myocutaneous Flaps the trapezius myocutaneous flap can be elevated with an inferior pedicle based on the transverse cervical artery. The superiorly based trapezius flap is a nape of neck flap with the trapezius muscle beneath it.

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Epidem: Incidence has greatly increased over the past 10 years: from 31/100K in 1996 to cardiovascular zones purchase 80mg propranolol free shipping 84/100K in 2005 heart disease by country safe 40 mg propranolol. Some pts can have asymptomatic colonization (probably less than 5%) (J Infect Dis 1985;151:476) coronary artery endarterectomy purchase 40mg propranolol, but may be higher in hospitalized pts (J Hosp Infect 1999;43:317) cardiovascular disease or disorder order discount propranolol online. Crs: Most cases respond to initial abx therapy, but rates of recurrence after abx are quite high: 20% after first episode, 40% after second, 60% after multiple recurrences (Am J Gastroenterol 2002;97:1769); most occur within 2 weeks of stopping abx therapy. In cases of recurrent disease, about 50% are relapses of initial infection not fully treated and about 50% are new exposure to spores; does not generally represent resistance to abx therapy. Mortality low in younger pts (except with more recent, severe strains), but can approach 25% in elderly pts. Cmplc: Ileus and toxic megacolon; protein-wasting enteropathy, leading to hypoalbuminemia. Most samples require loose stool for analysis; do not send formed stool to "screen" for C. Should test initially to confirm dx; if neg test, but high clinical suspicion, would still consider treating until three stool samples can be tested. Do not need to repeat testing once the dx is established or when the treatment is complete; "testing for cure" does not have any bearing on risk of relapse/recurrence. In critically ill pts, consider blood Cx to r/o secondary bacterial infection with sepsis. Noninv: Imaging only if concern for ileus/megacolon or to r/o other diseases or intestinal perforation in severe cases. Endoscopy can be done to look for "pseudo-membranes" caused by colonic wall sloughing, but not necessary in all cases; reserve for pts with resistant disease or high clinical suspicion with neg lab testing. For all hospitals, the most important step is prevention with pt isolation, barrier precautions for all visitors and staff, adequate hand-washing with soap and water (alcohol-based gels do not kill C. Crs: Risk factors for poor prognosis include the following: · Advancing age (Crit Care Med 2006;34:15) · Presence of multiple comorbidities, including cancer (Chest 2006;129:1432) 5. In setting of severe sepsis and shock, elevated serum lactate levels may be further evidence of end-organ damage from hypoperfusion (and assist in facilitating aggressive management). Rx: Improved standardization of therapies due to the Surviving Sepsis Campaign international guidelines, first published in 2004 and updated in 2008 (Crit Care Med 2008;36:296). Not all centers have catheters that can measure continuous ScvO2, but this can be done intermittently with blood gas analysis of blood drawn from the distal port of a central line. Choice usually falls to physician comfort of use and local practice; overall similar effects, except 282 Chapter 5: Infectious Disease norepinephrine induces less tachycardia; combination of the two drugs can be used, but given the similar receptor activations, may not be as helpful as adding another 2nd-line agent (see below). Si: May have erythema, induration, discharge from the catheter site; cardiac murmur may suggest endocarditis. Placement site usually determined by provider and facility choice, but also by potential complications: · Avoid sites of active inflammation/infection. Catheters should be removed as soon as not necessary for pt care; routine catheter changes over a guidewire do not reduce rates of infection and are not recommended by guidelines (Crit Care Med 1997;25:1417), especially if concern for infected catheter (changing over wire will likely infect the new catheter). If catheter removed, can cut and culture the tip, but should only perform if concern for true infection (not with routine catheter removal); otherwise, if pos Cx, unclear if pt requires abx treatment. In setting of infection, imaging only to r/o other sources; echocardiogram if concern for endocarditis.

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