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Articles 961 - 990 of 20660
Full-Text Articles in Medicine and Health Sciences
A Novel Approach To Investigate Subcortical And Cortical Sensitivity To Temporal Structure Simultaneously, Sonia Yasmin, David W. Purcell, Sangamanatha A. Veeranna, Ingrid S. Johnsrude, Björn Herrmann
A Novel Approach To Investigate Subcortical And Cortical Sensitivity To Temporal Structure Simultaneously, Sonia Yasmin, David W. Purcell, Sangamanatha A. Veeranna, Ingrid S. Johnsrude, Björn Herrmann
Brain and Mind Institute Researchers' Publications
Hearing loss is associated with changes at the peripheral, subcortical, and cortical auditory stages. Research often focuses on these stages in isolation, but peripheral damage has cascading effects on central processing, and different stages are interconnected through extensive feedforward and feedback projections. Accordingly, assessment of the entire auditory system is needed to understand auditory pathology. Using a novel stimulus paired with electroencephalography in young, normal-hearing adults, we assess neural function at multiple stages of the auditory pathway simultaneously. We employ click trains that repeatedly accelerate then decelerate (3.5 Hz click-rate-modulation) introducing varying inter-click-intervals (4 to 40 ms). We measured the …
Modeling An Auditory Stimulated Brain Under Altered States Of Consciousness Using The Generalized Ising Model, Sivayini Kandeepan, Jorge Rudas, Francisco Gomez, Bobby Stojanoski, Sree Ram Valluri, Adrian Mark Owen, Lorina Naci, Emily Sophia Nichols, Andrea Soddu
Modeling An Auditory Stimulated Brain Under Altered States Of Consciousness Using The Generalized Ising Model, Sivayini Kandeepan, Jorge Rudas, Francisco Gomez, Bobby Stojanoski, Sree Ram Valluri, Adrian Mark Owen, Lorina Naci, Emily Sophia Nichols, Andrea Soddu
Brain and Mind Institute Researchers' Publications
Propofol is a short-acting medication that results in decreased levels of consciousness and is used for general anesthesia. Although it is the most commonly used anesthetic in the world, much remains unknown about the mechanisms by which it induces a loss of consciousness. Characterizing anesthesia-induced alterations to brain network activity might provide a powerful framework for understanding the neural mechanisms of unconsciousness. The aim of this work was to model brain activity in healthy brains during various stages of consciousness, as induced by propofol, in the auditory paradigm. We used the generalized Ising model (GIM) to fit the empirical fMRI …
Regional Disparities In Healthy Eating And Nutritional Status In South Korea: Korea National Health And Nutrition Examination Survey 2017, Jounghee Lee, Jaesin Sa
Regional Disparities In Healthy Eating And Nutritional Status In South Korea: Korea National Health And Nutrition Examination Survey 2017, Jounghee Lee, Jaesin Sa
BACKGROUND/OBJECTIVES: Concerns about regional disparities in heathy eating and nutritional status among South Korean adults are increasing. This study aims to identify the magnitude of regional disparities in diet and nutritional status among Korean adults who completed the 2017 Korea National Health and Nutrition Examination Survey (KNHANES).
SUBJECTS/METHODS: The participants were a nationally representative sample of Korean adults aged 19 years and older from the 2017 KNHANES (n = 6,126). We employed the svy commands in STATA to accommodate the complex survey design. The relative concentration index (RCI), absolute concentration index (ACI) and index of disparity were used to measure …
Apneic Oxygenation: An Adjunctive Therapy For Laryngoscopy During Anesthesia Induction, Yaro Hoffman
Apneic Oxygenation: An Adjunctive Therapy For Laryngoscopy During Anesthesia Induction, Yaro Hoffman
Doctoral Projects
Endotracheal intubation is an essential component within the skill set of anesthesia providers. Rapid arterial desaturation remains a primary risk factor during laryngoscopy and intubation. The risk for hypoxemia exists because during endotracheal intubation, patients are apneic or hypo-ventilating (Wong et al., 2017). Apneic oxygenation (AO) has been advocated to attenuate hypoxemia during endotracheal intubation (Pavlov et al., 2017).
The aim of this project was to assess for any knowledge deficits regarding AO among anesthesia providers and assess the willingness of these providers to include AO into their current practice. The project investigator conducted an education session involving the …
Using Collaborative Objective Simulation Clinical Evaluation With Undergraduate Nursing Students And Nurse Anesthesia Students Labor Epidural Placement In An Active Labor Patient, Chaka K. Jackson, Aisha Pierre
Using Collaborative Objective Simulation Clinical Evaluation With Undergraduate Nursing Students And Nurse Anesthesia Students Labor Epidural Placement In An Active Labor Patient, Chaka K. Jackson, Aisha Pierre
Doctoral Projects
Developing interdisciplinary teamwork and patient communication skills are essential for the student registered nurse anesthetist (SRNA) to provide quality patient care when administering epidural anesthesia. The synthesis of the evidence revealed limited available information on simulation use for SRNA epidural administration and collaboration. This doctoral project examined the effectiveness of learning through traditional simulation to enhance communication and collaboration between the Bachelor of Science in Nursing (BSN) and the Nurse Anesthesia Program (NAP) students. The BSN and NAP students were provided with a simulation environment to care for a laboring patient while improving patient safety and quality outcomes. The project …
Uniform Clinical Evaluation For Video Laryngoscopy In Nurse Anesthesia Training: A Policy Proposal, Kristen Yelverton
Uniform Clinical Evaluation For Video Laryngoscopy In Nurse Anesthesia Training: A Policy Proposal, Kristen Yelverton
Doctoral Projects
At The University of Southern Mississippi’s (USM) Nurse Anesthesia Program (NAP), no standardized clinical evaluation for video laryngoscopy (VL) use exists. To address the gap in standardized evaluation of VL, an evidence-based, objective structured clinical examination (OSCE) will be developed and proposed to the USM NAP. The intervention to this need is the evaluation of the OSCE and supporting documents by the panel of experts. The aim of the OSCE would be to teach SRNAs in a step-by-step process how to properly handle a video laryngoscope and the necessary techniques to ensure both patient and student safety (Wunder et al., …
Evaluating The Effectiveness Of Adverse Childhood Experiences And Trauma Informed Care Training For Mental Health Nurses, Felicia Gathings
Evaluating The Effectiveness Of Adverse Childhood Experiences And Trauma Informed Care Training For Mental Health Nurses, Felicia Gathings
Doctoral Projects
Adverse Childhood Experiences (ACEs) are traumatic events that happened to a person at a young age, and when untreated they have a higher risk of developing a mental illness. ACEs are associated with social problems, illnesses, and physiological issues. ACEs are related to increased health risks and an increase in high-risk behaviors. Despite increase evidence relating ACEs to physical and mental issues, nurses lack training in ACEs and trauma-informed care (TIC). The overall goal of this project was to increase knowledge of ACEs and TIC in mental health nurses when caring for mentally ill patients. Pre-test and Post-test surveys were …
A Best Practice Recommendation: Decreasing Perioperative Fentanyl Used Through The Utilization Of Dexmedetomidine Prior To Surgical Incision, Shelby Harriel, Amy Houck
A Best Practice Recommendation: Decreasing Perioperative Fentanyl Used Through The Utilization Of Dexmedetomidine Prior To Surgical Incision, Shelby Harriel, Amy Houck
Doctoral Projects
Upon anesthesia induction, patients often receive fentanyl, an opioid medication that is linked to addiction, dependence, morbidity, and mortality (Stanley, 2014). The goal of this practice recommendation was to propose an alternative way of managing pain and the increased sympathetic response in the perioperative setting, specifically during the induction phase, through evaluating published research. A possible substitute for fentanyl is a drug called dexmedetomidine (Precedex™). Through a comparison of pharmacology, indications, risks, and benefits, one can conclude that if Precedex™ is given prior to induction, in the place of large doses of fentanyl, it can potentially achieve a smoother intraoperative …
Improving Door To Transfer Times For St Segment Elevation Myocardial Infarction In Small Emergency Departments: A Quality Performance Improvement Project, Amber Ryals
Doctoral Projects
Heart disease is a leading cause of death in the United States (Centers for Disease Control [CDC], 2020). ST-elevation myocardial infarctions are around 38% of all coronary syndrome patients that present to the emergency department (Akbar et al., 2020). Smaller, outlying facilities can be at a disadvantage due to the lack of readily available specialties and services, such as a cardiac catheterization laboratory, which has the potential to cause a delay in inpatient care. With standardized cardiac protocols in place at many facilities, initial identification and treatment of myocardial infarctions are begun long before a patient enters a facility, often …
Educating Student Registered Nurse Anesthetist On Malignant Hyperthermia Using An Objective Structured Clinical Examination, Ednita Street Fountain, Faith Sherman
Educating Student Registered Nurse Anesthetist On Malignant Hyperthermia Using An Objective Structured Clinical Examination, Ednita Street Fountain, Faith Sherman
Doctoral Projects
Malignant hyperthermia (MH) is a low-frequency, high-impact event that many student registered nurse anesthetists (SRNA) may be unprepared to manage due to limited exposure in clinical practice (Hackl et al., 1990). Lack of preparation for dealing with such low frequency, high impact events can lead to unfortunate adverse events resulting in death (Hackl et al., 1990). Thus, students should be are prepared to handle these situations if an event should occur.
An objective structured clinical examination (OSCE) is a structured method used to assess certain skills and underpinning knowledge required for practice (Harden & Gleeson, 1979). Students are allowed to …
Ultrasound-Guided Peripheral Venous Access: An Objective Structured Clinical Examination (Osce), Christopher Smith
Ultrasound-Guided Peripheral Venous Access: An Objective Structured Clinical Examination (Osce), Christopher Smith
Doctoral Projects
Intravenous (IV) access is essential to anesthetic practice as it allows the provider to administer fluids, sedative agents, and resuscitation medications. There is, however, a large subset of patients in which IV access can be difficult to obtain due to confounding factors such as preexisting disease, body habitus, and volume status (Sabado & Pittiruti, 2019). Bedside ultrasonography is an effective tool that can be used to gain IV access in these difficult patient populations. The downside to this technology is that there is a learning curve associated with its use, and proper training in ultrasound-guided venous access techniques is crucial …
Optimizing The Impact Of Quality Healthcare Improvements Within A Federally Qualified Health Clinic (Fqhc), Felicia Keys, Ladonna Phillips, Lashundra Speights
Optimizing The Impact Of Quality Healthcare Improvements Within A Federally Qualified Health Clinic (Fqhc), Felicia Keys, Ladonna Phillips, Lashundra Speights
Doctoral Projects
This doctoral project’s purpose was geared toward strengthening quality healthcare outcomes documentation by constructing an updated policy and procedure manual specific to quality measures identified above, identifying attitudes and barriers to documenting, and assessing administration willingness to change. The project included a retrospective chart review of three populations and seven healthcare topics. Each diagnosis was researched utilizing specific ICD-10 (see Appendix A). A focus group/Pre-Implementation Questionnaire was administered to a panel of experts consisting of three nurse practitioners with one to nine years of experience employed at the FQHC. Afterward, a focus group was held to discuss barriers and attitudes …
Availability And Consumption Of Vitamin A Foods Among Southern Ethiopian And Zambian Primary Students, Trang Vuong
Availability And Consumption Of Vitamin A Foods Among Southern Ethiopian And Zambian Primary Students, Trang Vuong
NUTR/GLST 498b: Global Research Experiences in Nutrition and Health
Purpose: Understand vitamin A food availability in open-air markets (OAM’s), and consumption of those foods by primary school children in southern Ethiopia/Zambia.
Methods: Conducted inventories of all consumable/potable items and interviewed 6-7th grade students about consumption of items with vitamin A.
Results: Students consumed most of the 14 vitamin A foods/items sold in OAM’s. Zambian students ate more liver, pumpkin, squash, watermelon, and wild fruits, while Ethiopian students almost never consumed squash, watermelon or wild fruits.
Conclusions: The availability of Vitamin A foods in Ethiopian and Zambian OAMs are varied; however, Zambian children reportedly eat more vitamin A foods. Nutrition …
Exosomes From Mirna-126-Modified Endothelial Progenitor Cells Alleviate Brain Injury And Promote Functional Recovery After Stroke, Jinju Wang, Shuzhen Chen, Wenfeng Zhang, Yanfang Chen, Ji Chen Bihl
Exosomes From Mirna-126-Modified Endothelial Progenitor Cells Alleviate Brain Injury And Promote Functional Recovery After Stroke, Jinju Wang, Shuzhen Chen, Wenfeng Zhang, Yanfang Chen, Ji Chen Bihl
Pharmacology and Toxicology Faculty Publications
Aims: We previously showed that the protective effects of endothelial progenitor cells (EPCs)-released exosomes (EPC-EXs) on endothelium in diabetes. However, whether EPC-EXs are protective in diabetic ischemic stroke is unknown. Here, we investigated the effects of EPC-EXs on diabetic stroke mice and tested whether miR-126 enriched EPC-EXs (EPC-EXs miR126 ) have enhanced efficacy. Methods: The db/db mice subjected to ischemic stroke were intravenously administrated with EPC-EXs 2 hours after ischemic stroke. The infarct volume, cerebral microvascular density (MVD), cerebral blood flow (CBF), neurological function, angiogenesis and neurogenesis, and levels of cleaved caspase-3, miR-126, and VEGFR2 were measured on day 2 …
The Role Of Prenatal Food Insecurity On Breastfeeding Behaviors: Findings From The United States Pregnancy Risk Assessment Monitoring System, Lauren Dinour, Elizabeth I. Rivera Rodas, Ndidiamaka Amutah-Onukagha, Laurén A. Doamekpor
The Role Of Prenatal Food Insecurity On Breastfeeding Behaviors: Findings From The United States Pregnancy Risk Assessment Monitoring System, Lauren Dinour, Elizabeth I. Rivera Rodas, Ndidiamaka Amutah-Onukagha, Laurén A. Doamekpor
Department of Nutrition and Food Studies Scholarship and Creative Works
Background
In addition to its health and nutritional benefits, breastfeeding can save low-income, food insecure mothers the cost of infant formula so that money can be spent on food and other necessities. Yet breastfeeding may exacerbate food insecurity by negatively affecting maternal employment. The relationship between food insecurity and breastfeeding has been explored previously, with varying results. The purpose of this study was to determine the relationship between prenatal food insecurity and breastfeeding initiation and early cessation (< 10 weeks) among U.S. mothers.
Methods
Data were pooled from 2012 to 2013 (Phase 7) of the Pregnancy Risk Assessment Monitoring System, a population-based cross-sectional survey of …
Technology Aiding In Neonatal Lung Developmental Care, Megan Kirk
Technology Aiding In Neonatal Lung Developmental Care, Megan Kirk
Undergraduate Honors Theses
In this paper, old as well as new technological findings to decrease premature infant mortality are reviewed. This paper discusses fetal development throughout pregnancy from conception to full-term status as well as fetal lung development specifically from conception until full-term status. Several ideas to rapidly develop and mature fetal lungs are discussed such as mothers ingesting artificial surfactant supplements, either independently or coupled with antenatal corticosteroids, as well as intra-amniotic instillation prior to 28 weeks gestational. Drawbacks regarding these two are mentioned as well such as the fetus’s lungs not being mature enough to use the artificial surfactant leading into …
Introduction To Analyzing And Evaluating Medical Terminology, Sowmya Anjur, N. Brennan, S. Saiyed
Introduction To Analyzing And Evaluating Medical Terminology, Sowmya Anjur, N. Brennan, S. Saiyed
Open Access Books and Manuals
Illinois CTE Endorsement Area: Health Science Technology & Human Services
Teacher and Student Editions
Lung Cancer, Ahana Narayanan, Maia Peregrino, Moorea Gay
Lung Cancer, Ahana Narayanan, Maia Peregrino, Moorea Gay
Human Diseases Graphic Novels
No abstract provided.
Celiac Disease, Maia Peregrino, Ahana Narayanan, Moorea Gay
Celiac Disease, Maia Peregrino, Ahana Narayanan, Moorea Gay
Human Diseases Graphic Novels
No abstract provided.
Nervous System: Alzheimer’S Disease, Krisha Patel, Saachi Kumar, Delicia Chen
Nervous System: Alzheimer’S Disease, Krisha Patel, Saachi Kumar, Delicia Chen
Human Diseases Graphic Novels
No abstract provided.
Neuromuscular Response To A Single Session Of Whole-Body Vibration In Children With Cerebral Palsy: A Pilot Study, Huaqing (Virginia) Liang, Gena Henderson, Jianhua Wu
Neuromuscular Response To A Single Session Of Whole-Body Vibration In Children With Cerebral Palsy: A Pilot Study, Huaqing (Virginia) Liang, Gena Henderson, Jianhua Wu
Physical Therapy Faculty Research
Background Whole-body vibration (WBV) is a relative new intervention paradigm that could reduce spasticity and improve motor function in children with cerebral palsy (CP). We investigated neuromuscular response to a single session of side-alternating WBV with different amplitudes in children with CP.
Methods Ten children with spastic CP aged 7–17 years at GMFCS level I-III participated in this pilot study. Participants received two sessions of side-alternating WBV with the same frequency (20 Hz) but different amplitudes (low-amplitude: 1 mm and high-amplitude: 2 mm). Each session included six sets of 90 s of WBV and 90 s of rest. Before and …
Using Empathic Design Principles To Improve Surgical Nursing Efficiency, Roberta Sutton
Using Empathic Design Principles To Improve Surgical Nursing Efficiency, Roberta Sutton
Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects
Improving efficiency to increase operating room utilization, improve turnaround time, and first case on time starts, is a goal of hospitals to increase surgical case volume. Increasing case volumes improves the hospitals bottom line by increasing reimbursement. In addition, improving the utilization will improve patient and caregiver satisfaction, show less wasted time between cases, and allowing for more timely starts. In the hospital that this study was be performed, located in Atlanta, Georgia, there is a need to improve these metrics which will improve the bottom line of the facility. This study addressed inefficiencies in processes, job duties, and preparation …
Developing An Interdisciplinary Team Checklist To Assess Readiness For Appropriate Medical Removal Of Central Venous Catheter (Cvc), Miranda Harper
Developing An Interdisciplinary Team Checklist To Assess Readiness For Appropriate Medical Removal Of Central Venous Catheter (Cvc), Miranda Harper
Doctoral Projects
Healthcare-associated infections are not a new concept in health care. Many different health-care-associated infections have been established over the years including but not limited to healthcare-associated pneumonia, catheter-associated urinary tract infection, and central line-associated bacterial infection. While these infections are common in healthcare facilities, the rates of these infections are still prevalent in hospitals across the United States. This DNP project focused on central line-associated bacterial infections.
An interdisciplinary team checklist to assess readiness for appropriate medical removal of central venous catheter (CVC) was developed to assess intensive care unit patients for early appropriate medical CVC removal. The interdisciplinary team …
Effect Of A Self-Care And Self-Awareness Education Program On Resilience To Burnout And Depression In Clinically Experienced Nursing Students, Andrew Taylor
Undergraduate Honors Theses
The purpose was to examine the effect of a self-care educational intervention on nursing student resilience and thus the potential for compassion fatigue, depersonalization, burnout, depression, and inadequate self-care. A one-group pretest-posttest research design was applied to a convenience sample of 104 nursing students near the end of their last semester in a baccalaureate nursing program. The measurements were demographics, a psychometric resilience scale, program evaluation, and reflection question. The intervention was a standardized, intensive 30 min training program on the high degree of stress and burnout nurses face and the core self-care methods that can promote resilience to these …
Molybdenum Cofactor Deficiency Causing Neonatal Seizures And Global Developmental Delay, Sundal Aziz, Javeria Raza Alvi, Tipu Sultan
Molybdenum Cofactor Deficiency Causing Neonatal Seizures And Global Developmental Delay, Sundal Aziz, Javeria Raza Alvi, Tipu Sultan
Pakistan Journal of Neurological Sciences (PJNS)
ABSTRACT: Molybdenum cofactor deficiency is a rare degenerative brain disorder with autosomal recessive inheritance. It presents early in neonatal life with seizures, feeding difficulty and spasticity, sometimes misdiagnosed as neonatal hypoxic ischemic encephalopathy. Neuroimaging findings are consistent with loss of white matter and volume along with cystic encephalomalacic changes. Most of the patients have mutations in the MOCS1 and MOCS2 genes causing imbalance in the sulfur-containing amino acid metabolism leading to progressive neurological damage and early childhood death in majority of cases. We report a case of a 7 months old child, product of non-consanguineous marriage with history of neonatal …
Burden Of Ileal Perforations Among Surgical Patients Admitted In Tertiary Care Hospitals Of Three Asian Countries: Surveillance Of Enteric Fever In Asia Project (Seap), September 2016-September 2019, Saqib Hamid Qazi, Mohammad Tahir Yousafzai, Irum Fatima Dehraj, Rozina Thobani, Afshan Akhtar, Abdul Momin Kazi, Aneeta Hotwani, Najeeb Rahman, Junaid Mehmood, Farah Naz Qamar
Burden Of Ileal Perforations Among Surgical Patients Admitted In Tertiary Care Hospitals Of Three Asian Countries: Surveillance Of Enteric Fever In Asia Project (Seap), September 2016-September 2019, Saqib Hamid Qazi, Mohammad Tahir Yousafzai, Irum Fatima Dehraj, Rozina Thobani, Afshan Akhtar, Abdul Momin Kazi, Aneeta Hotwani, Najeeb Rahman, Junaid Mehmood, Farah Naz Qamar
Section of Paediatric Surgery
Background: Typhoid fever is caused by Salmonella enterica subspecies enterica serovar Typhi (S. Typhi) and can lead to systemic illness and complications. We aimed to characterize typhoid-related ileal perforation in the context of the population-based Surveillance of Enteric Fever in Asia Project (SEAP) in Bangladesh, Nepal and Pakistan.
Methods: Between September 2016 and September 2019, all cases of nontraumatic ileal perforation with a clinical diagnosis of typhoid were enrolled from 4 tertiary care hospitals in Karachi, 2 pediatric hospitals in Bangladesh, and 2 hospitals in Nepal. Sociodemographic data were collected from patients or their caregivers, and clinical and outcome data …
Response To Comments On Aisha Sheikh Et Al (J Pak Med Assoc. 70: 1477, 2020) Changing Prevalence Of Gestational Diabetes Mellitus During Pregnancy Over More Than A Decade, Aisha Sheikh, Lumaan Sheikh
Response To Comments On Aisha Sheikh Et Al (J Pak Med Assoc. 70: 1477, 2020) Changing Prevalence Of Gestational Diabetes Mellitus During Pregnancy Over More Than A Decade, Aisha Sheikh, Lumaan Sheikh
Section of Diabetes, Endocrinology and Metabolism
No abstract provided.
How Do Pregnant Women Perceive The Role Of The Midwife In Thailand? A Descriptive Study, Sudjit Liblub, Lyn Gum, Maryam Bazargan
How Do Pregnant Women Perceive The Role Of The Midwife In Thailand? A Descriptive Study, Sudjit Liblub, Lyn Gum, Maryam Bazargan
Journal of Asian Midwives (JAM)
Background: Midwives are globally recognised as health professionals who specialise in caring for childbearing women with a vital role in maternal and neonatal health care. Despite the midwifery profession being an autonomous profession, there are many struggles to attain recognition within its formal scope of practice in some countries.
Objective: This study was undertaken to explore the views of pregnant women in Thailand regarding the role of midwifes and their selection of intrapartum care providers in order to understand their perceptions about giving birth with a midwife for normal pregnancies.
Design and setting: An online descriptive survey collected the views …
Spatial Profiling Of Gangliosides In Mouse Brain By Mass Spectrometry Imaging, Douglas A. Andres, Lyndsay E. A. Young, Matthew S. Gentry, Ramon C. Sun
Spatial Profiling Of Gangliosides In Mouse Brain By Mass Spectrometry Imaging, Douglas A. Andres, Lyndsay E. A. Young, Matthew S. Gentry, Ramon C. Sun
Molecular and Cellular Biochemistry Faculty Publications
No abstract provided.
Shelter In Place: Executive Order By The Governor To Ensure A Safe & Healthy Georgia, Preston A. Dunaway, Graham H. Gordon
Shelter In Place: Executive Order By The Governor To Ensure A Safe & Healthy Georgia, Preston A. Dunaway, Graham H. Gordon
Georgia State University Law Review
The Order required all visitors and residents of Georgia to practice social distancing in compliance with the Centers for Disease Control and Prevention guidelines; prohibited businesses in Georgia from allowing groups of more than ten people to gather at any single location; imposed a mandatory shelter-in-place requirement for all visitors and residents of Georgia except for essential workers, as defined within the Order; and laid out guidelines for how businesses would operate during the quarantine. Further, the Order limited restaurant services and closed certain businesses, including gyms and bowling alleys. The Order also superseded all local Orders purporting to regulate …