Search results for: post prostatectomy histology
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4388

Search results for: post prostatectomy histology

3788 Post Apartheid Language Positionality and Policy: Student Teachers' Narratives from Teaching Practicum

Authors: Thelma Mort

Abstract:

This empirical, qualitative research uses interviews of four intermediate phase English language student teachers at one university in South Africa and is an exploration of student teacher learning on their teaching practicum in their penultimate year of the initial teacher education course. The country’s post-apartheid language in education policy provides a context to this study in that children move from mother tongue language of instruction in foundation phase to English as a language of instruction in Intermediate phase. There is another layer of context informing this study which is the school context; the student teachers’ reflections are from their teaching practicum in resource constrained schools, which make up more than 75% of schools in South Africa. The findings were that in these schools, deep biases existed to local languages, that language was being used as a proxy for social class, and that conditions necessary for language acquisition were absent. The student teachers’ attitudes were in contrast to those found in the schools, namely that they had various pragmatic approaches to overcoming obstacles and that they saw language as enabling interdisciplinary work. This study describes language issues, tensions created by policy in South African schools and also supplies a regional account of learning to teach in resource constrained schools in Cape Town, where such language tensions are more inflated. The central findings in this research illuminate attitudes to language and language education in these teaching practicum schools and the complexity of learning to be a language teacher in these contexts. This study is one of the few local empirical studies regarding language teaching in the classroom and language teacher education; as such it offers some background to the country’s poor performance in both international and national literacy assessments.

Keywords: language teaching, narrative, post apartheid, South Africa, student teacher

Procedia PDF Downloads 147
3787 Effects of Static Stretching Exercises on Flexibility and Sprint Performance in Inactive Healthy Girls

Authors: Gulsun Guven

Abstract:

The aim of this study was to examine the acute effects of static stretching exercises on the flexibility and sprint performance in 10-12 years old inactive healthy girls. A total of 27 girls were randomly divided into control group (n=15) and stretching group (n=12) who performed static stretching. Sit and reach flexibility and 30-meter sprint pre-tests were performed for both groups. Static stretching exercises were performed three times, 30 sec. practice and 15 sec. rest for each leg only on five muscle by stretching group. The post-tests were performed in five minutes after static stretching exercise. Paired t-test was used to analyze differentiations among the group parameters. According to research results, there is a significant difference between pre-test and post-test flexibility (p < 0.05) and sprint test results (p < 0.01). As a conclusion of the study, static stretching exercises improve flexibility but decrease sprint performance in 10-12 years old inactive healthy girls.

Keywords: flexibility, inactive girl, sprint, static stretching

Procedia PDF Downloads 221
3786 The ‘Quartered Head Technique’: A Simple, Reliable Way of Maintaining Leg Length and Offset during Total Hip Arthroplasty

Authors: M. Haruna, O. O. Onafowokan, G. Holt, K. Anderson, R. G. Middleton

Abstract:

Background: Requirements for satisfactory outcomes following total hip arthroplasty (THA) include restoration of femoral offset, version, and leg length. Various techniques have been described for restoring these biomechanical parameters, with leg length restoration being the most predominantly described. We describe a “quartered head technique” (QHT) which uses a stepwise series of femoral head osteotomies to identify and preserve the centre of rotation of the femoral head during THA in order to ensure reconstruction of leg length, offset and stem version, such that hip biomechanics are restored as near to normal as possible. This study aims to identify whether using the QHT during hip arthroplasty effectively restores leg length and femoral offset to within acceptable parameters. Methods: A retrospective review of 206 hips was carried out, leaving 124 hips in the final analysis. Power analysis indicated a minimum of 37 patients required. All operations were performed using an anterolateral approach by a single surgeon. All femoral implants were cemented, collarless, polished double taper CPT® stems (Zimmer, Swindon, UK). Both cemented, and uncemented acetabular components were used (Zimmer, Swindon, UK). Leg length, version, and offset were assessed intra-operatively and reproduced using the QHT. Post-operative leg length and femoral offset were determined and compared with the contralateral native hip, and the difference was then calculated. For the determination of leg length discrepancy (LLD), we used the method described by Williamson & Reckling, which has been shown to be reproducible with a measurement error of ±1mm. As a reference, the inferior margin of the acetabular teardrop and the most prominent point of the lesser trochanter were used. A discrepancy of less than 6mm LLD was chosen as acceptable. All peri-operative radiographs were assessed by two independent observers. Results: The mean absolute post-operative difference in leg length from the contralateral leg was +3.58mm. 84% of patients (104/124) had LLD within ±6mm of the contralateral limb. The mean absolute post-operative difference in offset from contralateral leg was +3.88mm (range -15 to +9mm, median 3mm). 90% of patients (112/124) were within ±6mm offset of the contralateral limb. There was no statistical difference noted between observer measurements. Conclusion: The QHT provides a simple, inexpensive yet effective method of maintaining femoral leg length and offset during total hip arthroplasty. Combining this technique with pre-operative templating or other techniques described may enable surgeons to reduce even further the discrepancies between pre-operative state and post-operative outcome.

Keywords: leg length discrepancy, technical tip, total hip arthroplasty, operative technique

Procedia PDF Downloads 81
3785 Using Metacognitive Strategies in Reading Comprehension by EFL Students

Authors: Simin Sadeghi-Saeb

Abstract:

Metacognitive strategies consistently play important roles in reading comprehension. The metacognitive strategies involve the active monitoring and consequent regulation and orchestration of the cognitive processes in relation to the cognitive objects or data on which they bear. In this paper, the effect of instruction in using metacognitive strategies on reading academic materials, type of metacognitive strategies were mostly used by college university students before and after the instruction and the level they use those strategies before and after the instruction were studied. For these aims, 50 female college students were chosen. Then, they were divided randomly into two groups, experimental and control groups. At first session, students in both groups took the standard TOFEL exam. After the pre-test had been administered, the instruction began. After treatment, a post-test was taken. It is useful to state that after pre-test and post-test the same questionnaire was handed to the students of experimental group. The results of this research show that the instruction of metacognitive strategies has positive effect on the students' scores in reading comprehension tests. Furthermore, it showed that before and after the instruction, the students' usage of metacognitive strategies changed. Also, it demonstrated that the instruction affected the students' level of metacognitive strategies' usage.

Keywords: EFL students, English reading comprehension, instruction, metacognitive strategies

Procedia PDF Downloads 298
3784 Case Report on ‘Primary Adenocarcinoma of Aberrant HER2+ Anogenital Mammary-like Glands in a Male'

Authors: Shivani Kuttuva, James Sampson, Timothy Simmons, Vinayak Thattaruparambil, Holly Burton, Peter Coyne

Abstract:

Anogenital mammary-like glands were established to be embryological remnants of breast tissue due to failed resolution of the ectodermal mammary ridge. However, recent studies are now considering this to represent normal constituents of the anogenital area with histological resemblance to the orthotopic breast tissue with multiple benign and malignant lesions arising from it. The incidence of the above has been predominant in females in the vulval region. Due to the paucity of cases reported in men, this poses a diagnostic and therapeutic challenge resulting in a delay in treatment and, thereby, poor outcomes. Our patient presented to the dermatology clinic with an itchy, purplish lesion in the peri-anal region which, on punch biopsy, was diagnosed to be Extra-mammary Paget’s disease and taken up for Wide local excision. Immunochemically, staining was positive for HER2, ER and Cytokeratin 7, keeping with the presence of actual breast tissue with no primary breast carcinoma. Due to the invasive nature of the disease, he required Abdominoperineal resection with flap reconstruction. Despite complete surgical clearance and adjuvant radiotherapy, the disease progressed to adjacent inguinal and obturator lymph nodes with origin resembling anogenital type mammary glands but histology negative for hormonal receptors of the breast.

Keywords: anogenital mammary-like glands, abdominoperineal resection, ectopic breast tissue, ectopic male breast carcinoma, peri-anal skin lesion

Procedia PDF Downloads 80
3783 Higher Order Thinking Skills Workshop: Faculty Professional Development and Its Effect on Their Teaching Strategies

Authors: Amani Hamdan

Abstract:

A post-workshop of higher-order thinking skills (HOTS), for faculty from diverse academic disciplines, was conducted and the researcher surveyed the participants’ intentions and plans to include HOTS as a goal, as learning and teaching task in their practices. Follow-up interviews with a random sample of participants were used to determine if they fulfilled their intentions three 3 months after the workshop. The degree of planned and enacted HOTS then was analyzed against the post-workshop HOT ability and knowledge. This is one topic that has not been adequately explored in faculty professional development literature where measuring the effect of learning on their ability to use what they learned. This qualitative method study explored a group of male and female faculty members (n=85) enrolled in HOTS 2 day workshop. The results showed that 89% of faculty members although were mostly enthused to apply what they learned after a 3 months period they were caught up with routine presentations and lecturing.

Keywords: higher education, faculty development, Saudi Arabia, higher order thinking skills

Procedia PDF Downloads 457
3782 Recognising and Managing Haematoma Following Thyroid Surgery: Simulation Teaching is Effective

Authors: Emily Moore, Dora Amos, Tracy Ellimah, Natasha Parrott

Abstract:

Postoperative haematoma is a well-recognised complication of thyroid surgery with an incidence of 1-5%. Haematoma formation causes progressive airway obstruction, necessitating emergency bedside haematoma evacuation in up to ¼ of patients. ENT UK, BAETS and DAS have developed consensus guidelines to improve perioperative care, recommending that all healthcare staff interacting with patients undergoing thyroid surgery should be trained in managing post-thyroidectomy haematoma. The aim was to assess the effectiveness of a hybrid simulation model in improving clinician’s confidence in dealing with this surgical emergency. A hybrid simulation was designed, consisting of a standardised patient wearing a part-task trainer to mimic a post-thyroidectomy haematoma in a real patient. The part-task trainer was an adapted C-spine collar with layers of silicone representing the skin and strap muscles and thickened jelly representing the haematoma. Both the skin and strap muscle layers had to be opened in order to evacuate the haematoma. Boxes have been implemented into the appropriate post operative areas (recovery and surgical wards), which contain a printed algorithm designed to assist in remembering a sequence of steps for haematoma evacuation using the ‘SCOOP’ method (skin exposure, cut sutures, open skin, open muscles, pack wound) along with all the necessary equipment to open the front of the neck. Small-group teaching sessions were delivered by ENT and anaesthetic trainees to members of the multidisciplinary team normally involved in perioperative patient care, which included ENT surgeons, anaesthetists, recovery nurses, HCAs and ODPs. The DESATS acronym of signs and symptoms to recognise (difficulty swallowing, EWS score, swelling, anxiety, tachycardia, stridor) was highlighted. Then participants took part in the hybrid simulation in order to practice this ‘SCOOP’ method of haematoma evacuation. Participants were surveyed using a Likert scale to assess their level of confidence pre- and post teaching session. 30 clinicians took part. Confidence (agreed/strongly agreed) in recognition of post thyroidectomy haematoma improved from 58.6% to 96.5%. Confidence in management improved from 27.5% to 89.7%. All participants successfully decompressed the haematoma. All participants agreed/strongly agreed, that the sessions were useful for their learning. Multidisciplinary team simulation teaching is effective at significantly improving confidence in both the recognition and management of postoperative haematoma. Hybrid simulation sessions are useful and should be incorporated into training for clinicians.

Keywords: thyroid surgery, haematoma, teaching, hybrid simulation

Procedia PDF Downloads 96
3781 Exergy Analysis and Evaluation of the Different Flowsheeting Configurations for CO₂ Capture Plant Using 2-Amino-2-Methyl-1-Propanol

Authors: Ebuwa Osagie, Vasilije Manovic

Abstract:

Exergy analysis provides the identification of the location, sources of thermodynamic inefficiencies, and magnitude in a thermal system. Thus, both the qualitative and quantitative assessment can be evaluated with exergy, unlike energy which is based on quantitative assessment only. The main purpose of exergy analysis is to identify where exergy is destroyed. Thus, reduction of the exergy destruction and losses associated with the capture plant systems can improve work potential. Furthermore, thermodynamic analysis of different configurations of the process helps to identify opportunities for reducing the steam requirements for each of the configurations. This paper presents steady-state simulation and exergy analysis of the 2-amino-2-methyl-1-propanol (AMP)-based post-combustion capture (PCC) plant. Exergy analysis performed for the AMP-based plant and the different configurations revealed that the rich split with intercooling configuration gave the highest exergy efficiency of 73.6%, while that of the intercooling and the reference AMP-based plant were 57.3% and 55.8% respectively.

Keywords: 2-amino-2-methyl-1-propanol, modelling, and simulation, post-combustion capture plant, exergy analysis, flowsheeting configurations

Procedia PDF Downloads 164
3780 Free-Standing Pd-Based Metallic Glass Membranes for MEMS Applications

Authors: Wei-Shan Wang, Klaus Vogel, Felix Gabler, Maik Wiemer, Thomas Gessner

Abstract:

Metallic glasses, which are free of grain boundaries, have superior properties including large elastic limits, high strength, and excellent wear and corrosion resistance. Therefore, bulk metallic glasses (BMG) and thin film metallic glasses (TFMG) have been widely developed and investigated. Among various kinds of metallic glasses, Pd-Cu-Si TFMG, which has lower elastic modulus and better resistance of oxidation and corrosions compared to Zr- and Fe-based TFMGs, can be a promising candidate for MEMS applications. However, the study of Pd-TFMG membrane is still limited. This paper presents free-standing Pd-based metallic glass membranes with large area fabricated on wafer level for the first time. Properties of Pd-Cu-Si thin film metallic glass (TFMG) with various deposition parameters are investigated first. When deposited at 25°C, compressive stress occurs in the Pd76Cu6Si18 thin film regardless of Ar pressure. When substrate temperature is increased to 275°C, the stress state changes from compressive to tensile. Thin film stresses are slightly decreased when Ar pressure is higher. To show the influence of temperature on Pd-TFMGs, thin films without and with post annealing below (275°C) and within (370°C) supercooled liquid region are investigated. Results of XRD and TEM analysis indicate that Pd-TFMGs remain amorphous structure with well-controlled parameters. After verification of amorphous structure of the Pd-TFMGs, free-standing Pd-Cu-Si membranes were fabricated by depositing Pd-Cu-Si thin films directly on 200nm-thick silicon nitride membranes, followed by post annealing and dry etching of silicon nitride layer. Post annealing before SiNx removal is used to further release internal stress of Pd-TFMGs. The edge length of the square membrane ranges from 5 to 8mm. The effect of post annealing on Pd-Cu-Si membranes are discussed as well. With annealing at 370°C for 5 min, Pd-MG membranes are fully distortion-free after removal of SiNx layer. Results show that, by introducing annealing process, the stress-relief, distortion-free Pd-TFMG membranes with large area can be a promising candidate for sensing applications such as pressure and gas sensors.

Keywords: amorphous alloy, annealing, metallic glasses, TFMG membrane

Procedia PDF Downloads 352
3779 Sulforaphane Attenuates Fibrosis of Dystrophic Muscle in Mdx Mice via Nrf2-Mediated Inhibition of TGF-β/Smad Signaling

Authors: Chengcao Sun, Cuili Yang, Shujun Li, Ruilin Xue, Yongyong Xi, Liang Wang, Dejia Li

Abstract:

Backgrounds: A few lines of evidence show that Sulforaphane (SFN) has anti-fibrosis effect in liver tissue via Nrf2-mediated inhibition of TGF-β/Smad signaling. However, its effects on muscular dystrophic fibrosis remain unknown. This work was undertaken to evaluate the effects of SFN on fibrosis in dystrophic muscle. Methods: 3-month-old male mdx mice were treated with SFN by gavage (2 mg/kg body weight per day) for 3 months. Gastrocnemius, tibial anterior and triceps brachii muscles were collected for related analysis. Fibrosis in skeletal muscles was analyzed by Sirius red staining. Histology and morphology of skeletal muscles were investigated by H&E staining. Moreover, the expressions of Nrf2, NQO1, HO-1, and TGF-β/Smad signaling pathway were detected by western blot, qRT-PCR, immunohistochemistry and immunofluorescence assays. Results: Our results demonstrated that SFN treatment significantly decreased and improved morphological features in mdx muscles. Moreover, SFN increased the expression of muscle phase II enzymes NQO1 and HO-1 and significantly decreased the expression of TGF-β1,p-smad2, p-smad3, α-SMA, fibronectin, collagen I, PAI-1, and TIMP-1 in Nrf2 dependent manner. Additionally, SFN significantly decreased the expression of CD45 and TNF-α. Conclusions: Collectively, these results show that SFN can ameliorate muscle fibrosis in mdx mice by Nrf2-induced inhibition of TGF-β/Smad signaling pathway, which indicate Nrf2 may be useful for the treatment of muscular dystrophy.

Keywords: sulforaphane, Nrf2, TGF-β/smad signaling, duchenne muscular dystrophy, fibrosis

Procedia PDF Downloads 441
3778 Use of Cobalt Graphene in Place of Platnium in Catalytic Converter

Authors: V. Srinivasan, S. M. Sriram Nandan

Abstract:

Today in the modern world the most important problem faced by the mankind is increasing the pollution in a very high rate. It affects the ecosystem of the environment and also aids to increase the greenhouse effect. The exhaust gases from the automobile is the major cause of a pollution. Automobiles have increased to a large number which has increased the pollution of our world to an alarming rate. There are two methods of controlling the pollution namely, pre-pollution control method and post-pollution control method. This paper is based on controlling the emission by post-pollution control method. The ratio of surface area of nanoparticles to the volume of the nanoparticles is inversely proportional to the radius of the nanoparticles. So decreasing the radius, this ratio is leading resulting in an increased rate of reaction and thus the concentration of the pollution is decreased. To achieve this objective, use of cobalt-graphene element is proposed. The proposed method is mainly to decrease the cost of platinum as it is expensive. This has a longer life than the platinum-based catalysts.

Keywords: automobile emissions, catalytic converter, cobalt-graphene, replacement of platinum

Procedia PDF Downloads 389
3777 2-Dimensional Transition Metal Dichalcogenides for Photodetection and Biosensing Endoscopies After a 5-Year Follow-Up on Central Venous Access Receiving Home (HPN) Patients with Prophylaxis at Tertiary Healthcare Facility

Authors: Michelle Themalil, Celia Bueno, Rulla Al- Araji

Abstract:

Objective and Study: There are no established guidelines for antibiotic prophylaxis in children with central venous catheters (CVCs) on home parenteral nutrition (HPN), leading to varying practices across UK Centres. We hypothesize that children with intestinal failure are at increased risk for bacteraemia due to altered anatomy, dysmotility, inflammation, biofilm formation in long-term CVCs, and the use of central lines during procedures. Given the bacteraemia rates of up to 8% in upper and 25% in lower endoscopy for adults without central lines, we argue that prophylactic antibiotics are reasonable, given the increased risks faced by this high-risk group of children. Methods: We conducted a five-year review of patients with central venous access receiving home parenteral nutrition (HPN) who underwent endoscopies with antibiotic prophylaxis at our center (tertiary). We documented and analyzed post-procedure infections and their associated risk factors. Results: A total of 15 patients on HPN underwent 29 endoscopic procedures, including 4 upper, 9 combined upper and lower, and 16 combined upper, lower, and ileoscopy. Confirmed infection rates remained at 0% up to 28 days post-procedure. The agreed-upon prophylaxis regimen was implemented, with ciprofloxacin and metronidazole administered as the primary antibiotics. Notably, only 51.7% of patients received a peripheral cannula despite recommendations to avoid central line use during anesthesia, and 20.6% had small intestinal bacterial overgrowth. Conclusions: This study is the first to investigate post-endoscopy infection rates in pediatric patients on HPN. Despite a small sample size, we observed a 0% infection rate, significantly lower than reported rates in adults. These findings suggest that further research is warranted to explore the implications of antibiotic prophylaxis in this unique patient cohort and to establish guidelines that may enhance patient safety during endoscopic procedures.

Keywords: post endosopy infections, central venous access, home parenteral nutrition, intestinal failure

Procedia PDF Downloads 6
3776 Effect of Varying Scaffold Architecture and Porosity of Calcium Alkali Orthophosphate Based-Scaffolds for Bone Tissue Engineering

Authors: D. Adel, F. Giacomini, R. Gildenhaar, G. Berger, C. Gomes, U. Linow, M. Hardt, B. Peleskae, J. Günster, A. Houshmand, M. Stiller, A. Rack, K. Ghaffar, A. Gamal, M. El Mofty, C. Knabe

Abstract:

The goal of this study was to develop 3D scaffolds from a silica containing calcium alkali orthophosphate utilizing two different fabrication processes, first a replica technique namely the Schwartzwalder Somers method (SSM), and second 3D printing, i.e. Rapid prototyping (RP). First, the mechanical and physical properties of the scaffolds (porosity, compressive strength, and solubility) was assessed and second their potential to facilitate homogenous colonization with osteogenic cells and extracellular bone matrix formation throughout the porous scaffold architecture. To this end murine and rat calavarie osteoblastic cells were dynamically seeded on both scaffold types under perfusion with concentrations of 3 million cells. The amount of cells and extracellular matrix as well as osteogenic marker expression was evaluated using hard tissue histology, immunohistochemistry, and histomorphometric analysis. Total porosities of both scaffolds were 86.9 % and 50% for SSM and RP respectively, Compressive strength values were 0.46 ± 0.2 MPa for SSM and 6.6± 0.8 MPa for RP. Regarding the cellular behavior, RP scaffolds displayed a higher cell and matrix percentage of 24.45%. Immunoscoring yielded strong osteocalcin expression of cells and matrix in RP scaffolds and a moderate expression in SSM scaffolds. 3D printed RP scaffolds displayed superior mechanical and biological properties compared to SSM. 3D printed scaffolds represent excellent candidates for bone tissue engineering.

Keywords: calcium alkali orthophosphate, extracellular matrix mineralization, osteoblast differentiation, rapid prototyping, scaffold

Procedia PDF Downloads 329
3775 Comparison of Early Post-operative Outcomes of Cardiac Surgery Patients Who Have Had Blood Transfusion Based on Fixed Cut-off Point versus of Change in Percentage of Basic Hematocrit Levels

Authors: Khosro Barkhordari, Fateme Sadr, Mina Pashang

Abstract:

Back ground: Blood transfusion is one of the major issues in cardiac surgery patients. Transfusing patients based on fixed cut-off points of hemoglobin is the current protocol in most institutions. The hemoglobin level of 7- 10 has been suggested for blood transfusion in cardiac surgery patients. We aimed to evaluate if blood transfusion based on change in percentage of hematocrit has different outcomes. Methods: In this retrospective cohort study, we investigated the early postoperative outcome of cardiac surgery patients who received blood transfusions at Tehran Heart Center Hospital, IRAN. We reviewed and analyzed the basic characteristics and clinical data of 700 patients who met our exclusion and inclusion criteria. The two groups of blood transfused patients were compared, those who have 30-50 percent decrease in basal hematocrit versus those with 10 -29 percent decrease. Results: This is ongoing study, and the results would be completed in two weeks after analysis of the date. Conclusion: Early analysis has shown no difference in early post-operative outcomes between the two groups, but final analysis will be completed in two weeks. 1-Department of Anesthesiology and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IRAN 2- Department of Research, Tehran Heart Center, Tehran, IRAN Quantitative variables were compared using the Student t-test or the Mann‐Whitney U test, as appropriate, while categorical variables were compared using the χ2 or the Fisher exact test, as required. Our intention was to compare the early postoperative outcomes between the two groups, which include 30 days mortality, Length of ICU stay, Length of hospital stay, Intubation time, Infection rate, acute kidney injury, and respiratory complications. The main goal was to find if transfusing blood based on changes in hematocrit from a basal level was better than to fixed cut-off point regarding early post-operative outcomes. This has not been studied enough and may need randomized control trials.

Keywords: post-operative, cardiac surgery, outcomes, blood transfusion

Procedia PDF Downloads 86
3774 Umkhonto Wesizwe as the Foundation of Post-Apartheid South Africa’s Foreign Policy and International Relations.

Authors: Bheki R. Mngomezulu

Abstract:

The present paper cogently and systematically traces the history of Umkhonto Wesizwe (MK) and identifies its important role in shaping South Africa’s post-apartheid foreign policy and international relations under black leadership. It provides the political and historical contexts within which we can interpret and better understand South Africa’s controversial ‘Quiet Diplomacy’ approach to Zimbabwe’s endemic political and economic crises, which have dragged for too long. On 16 December 1961, the African National Congress (ANC) officially launched the MK as its military wing. The main aim was to train liberation fighters outside South Africa who would return into the country to topple the apartheid regime. Subsequently, the ANC established links with various countries across Africa and the globe in order to solicit arms, financial resources and military training for its recruits into the MK. Drawing from archival research and empirical data obtained through oral interviews that were conducted with some of the former MK cadres, this paper demonstrates how the ANC forged relations with a number of countries that were like-minded in order to ensure that its dream of removing the apartheid government became a reality. The findings reveal that South Africa’s foreign policy posture and international relations after the demise of apartheid in 1994 built on these relations. As such, even former and current socialist countries that were frowned upon by the Western world became post-apartheid South Africa’s international partners. These include countries such as Cuba and China, among others. Even countries that were not recognized by the Western world as independent states received good reception in post-apartheid South Africa’s foreign policy agenda. One of these countries is Palestine. Within Africa, countries with questionable human rights records such as Nigeria and Zimbabwe were accommodated in South Africa’s foreign policy agenda after 1994. Drawing from this history, the paper concludes that it would be difficult to fully understand and appreciate South Africa’s foreign policy direction and international relations after 1994 without bringing the history and the politics of the MK into the equation. Therefore, the paper proposes that the utilitarian role of history should never be undermined in the analysis of a country’s foreign policy direction and international relations. Umkhonto Wesizwe and South Africa are used as examples to demonstrate how such a link could be drawn through archival and empirical evidence.

Keywords: African National Congress, apartheid, foreign policy, international relations

Procedia PDF Downloads 185
3773 The Role of High Schools in Saudi Arabia in Supporting Young Adults with Intellectual Disabilities with Their Transition to Post-secondary Education

Authors: Sohil I. Alqazlan

Abstract:

Introduction and Objectives: There is limited research focusing on young adults with intellectual disabilities (ID) and their experiences after finishing compulsory education, especially in the Middle Eastern/Arab countries. This paper aims to further understand the lives of young adults with ID in Riyadh [the capital city of Saudi Arabia], particularly as they go on to access Post-Secondary Education [PSE]. As part of this study, it is important to understand the roles of high schools in Riyadh in terms of preparing their students for post-school life. To achieve this, the researcher has asked Saudi Arabia’s Ministry of Education to provide student transition plans (TPs) for post-school opportunities. However, and unfortunately, high schools in Riyadh do not use transition plans for their students. Therefore, the researcher has requested individual education plans (IEPs) for students with ID in their final year at high school to find the type of support the students had regarding both their long- and short-term goals that might help them access PSE or the labour market. Methods: The researcher analysed 10 IEPs of students in their final year at high school. To achieve the aim of the study, the researcher compared these IEPs with expectations set out in the official IEP framework of the MoE in Saudi Arabia, such as collaboration on the IEP sample and the focus on adult life. By analysing the students’ IEPs in terms of various goals, this study attempts to highlight skills that might offer students more independence after finishing compulsory education and going on to PSE. Results: Unfortunately, communication between IEP team members proved persistently absent in the sample. This was clear from the fact that none of the team members, apart from the SEN teachers, had signed any of the IEPs. Thus, none of the daily or weekly goals outlined were sent to parents to review at home. As a result of this, there were no goals in the IEPs that clearly referred to PSE. However, some long-term goals were set which might help those with ID become more independent in their adult life. For example, in the IEPs, which dealt with computer skills, the student had goals related to using Microsoft Word. Finally, just one goal of these IEPs set an important independent skill for the young adults with ID: “the student will learn how to use public transportation”. Conclusions: From analysing the ten IEPs, it was clear that SEN teachers in Riyadh schools were working without any help from other professionals. The students with ID, as well as their families, were not consulted on their views on important goals. Therefore, more work needs to be done with the students regarding their transition to PSE, perhaps by building partnerships between high schools and potential PSE institutions. Finally, more PSE programmes and a higher level of employer awareness could help create a bridge for students transferring from high school to PSE. Schools could also focus their IEP goals towards specific PSE programmes the student might attend, which could increase their chances of success.

Keywords: high school, post-secondary education, PSE, students with intellectual disabilities

Procedia PDF Downloads 169
3772 The Use of Regional Blocks Versus IV Opioid Analgesics for Acute Traumatic Pain Management in the Emergency Department

Authors: Lajeesh Jabbar, Shibu T. Varghese

Abstract:

Being under pain is a very distressing factor that it prolongs the healing of any kind of trauma and add to the post traumatic stressful state. Alleviating the pain from acute traumatic conditions like fracture, degloving injury etc will help in faster recovery and also decrease the incidence of post traumatic stress disorder. Most of the emergency departments in INDIA are using IV opioid analgesics to relieve the patient from pain in cases of acute traumatic injuries. None of the Emergency Departments practice regional blocks in the country. In this study, we are comparing the efficacy of Regional Blocks in relieving the pain in lower limb fractures versus the use of IV analgesics for the same in the emergency department. The site of study is Malabar Institute Of Medical Sciences in Calicut in Kerala in India and is a place which receives approximately 10-20 traumatic fracture cases per day. The fracture sites used for the study purpose are femur fracture and phalangeal fractures.

Keywords: regional blocks, IV analgesia, acute traumatic pain, femur fractures, phalanx fractures

Procedia PDF Downloads 416
3771 Blood Pressure Level, Targeted Blood Pressure Control Rate, and Factors Related to Blood Pressure Control in Post-Acute Ischemic Stroke Patients

Authors: Nannapus Saramad, Rewwadee Petsirasan, Jom Suwanno

Abstract:

Background: This retrospective study design was to describe average blood pressure, blood pressure level, target blood pressure control rate post-stroke BP control in the year following discharge from Sichon hospital, Sichon District, Nakhon Si Thammarat province. The secondary data analysis was employed from the patient’s health records with patient or caregiver interview. A total of 232 eligible post-acute ischemic strokes in the year following discharge (2017-2018) were recruited. Methods: Data analyses were applied to identify the relationship values of single variables were determined through univariate analyses: The Chi-square test, Fisher exact test, the variables found to have a p-value < 0.2 were analyzed by the binary logistic regression Results: Most of the patients in this study were men 61.6%, an average age of 65.4 ± 14.8 years. Systolic blood pressure levels were in the grade 1-2 hypertension and diastolic pressure at optimal and normal at all times during the initial treatment through the present. The results revealed 25% among the groups under the age of 60 achieved BP control; 36.3% for older than 60 years group; and 27.9% for diabetic group. The multivariate analysis revealed the final relationship of four significant variables: 1) receiving calcium-channel blocker (p =.027); 2) medication adherence of antihypertensive (p = .024) 3) medication adherence of antiplatelet ( p = .020); and 4) medication behavior ( p = . 010) . Conclusion: The medical nurse and health care provider should promote their adherence to behavior to improve their blood pressure control.

Keywords: acute ischemic stroke, target blood pressure control, medication adherence, recurrence stroke

Procedia PDF Downloads 122
3770 Contemporary Arabic Novel Probing the Self and the Other: A Contrapuntal Study of Identity, Sexuality, and Fundamentalism

Authors: Jihan Mahmoud

Abstract:

This paper examines the role played by Arabic novelists in revolutionary change in the Arab world, discussing themes of identity, sexuality and fundamentalism as portrayed in a selection of modern and contemporary Arabic novels that are either written in English or translated from Arabic into English. It particularly focuses on the post-Naguib Mahfouz era. Taking my cue from the current political changes in the Arab world, starting with 9/11/ terrorist attacks in the USA and the UK, the ‘Arab Spring’ revolutions, the rise of political Islam and the emergence of Isis, the Islamic state in Iraq and the Levant, the study analyses the differences in the ways contemporary Arab novelists from different Arabic countries represent the interaction between identity, sexual politics and fundamentalist ideas in the Arab world, with a specific focus on the overlap between literature, religion and international politics in the region. It argues that the post-Mahfouz era marked a new phase in the development of the political Arabic novel not only as a force of resistance against political-religious oppression, but as a call for revolution as well. Thus, the Arabic novel reshapes values and prompts future action.

Keywords: Arabic novel, Islam, politics, sexuality

Procedia PDF Downloads 526
3769 Effect of Bactocellon White Leg Shrimp (Litopenaeusvannamei) Growth Performance and the Shrimp Survival to Vibrio paraheamolyticus

Authors: M. Soltani, K. Pakzad, A. Haghigh-Khiyabani, M. Alavi, R. Naderi, M. Castex

Abstract:

Effect of probiotic Bactocell (Pediococcus acidilactici) as a supplementary diet was studied on post-larvae 12-15 of white leg shrimp (Litopenaeus vannamei) (150000 PL/0.5 h pond, average body weight=0.02 g) growth performance under farm condition for 102 days at water quality parameters consisting of temperature at 30.5-36οC, dissolved oxygen 4.1-6.6 mg/l, salinity 40-54 g/l, turbidity 35-110 cm, ammonia 0.1-0.8 mg/l and nitrite 0.1-0.9 mg/l. Also, the resistance level of the treated shrimps was assessed against a virulent strain of Vibrio paraheamolyticus as intramuscular injection route at 1.4 x 106 cells/shrimp. Significantly higher growth rate (11.3±1.54 g) and lower feed conversion ratio (1.1) were obtained in shrimps fed diets supplemented with Bactocell at 350 g/ tone feed compared to other treatments of 250 g Bactocell/ton feed (10.8±2 g, 1.3), 500 g Bactocell/ton feed (10.3±1.7 g, 1.3) and untreated control (10.1±2 g, 1.4). Also, thermal growth coefficient (0.057%) and protein efficiency ratio (2.13) were significantly improved in shrimps fed diets supplemented with Bactocell at 350 g/ton feed compare to other groups. Shrimps fed diet supplemented with Bactocell at 350 g/tone feed showed significantly higher protein content (72.56%) in their carcass composition than treatments of 250 g/ton feed (65.9%), 500 g/ton feed (67.5%) and control group (65.9%), while the carcass contents of moisture, lipid and ash in all shrimp groups were not significantly affected by different concentrations of Bactocell. No mortality occurred in the experimentally infected shrimps fed with Bactocell at 500 g/tone feed after 7 hours post-challenge with V. parahemolyticus. The mortality levels of 100%, 40%, 50% and 70% were obtained in shrimps fed with 0.0, 500 g/tone feed, 350 g/ton feed and 250 g/ton feed, respectively 14 hours post-infection. Also, the cumulative mortalities were achieved in 100%, 92% and 81% in shrimps few with Bactocell at 500 g/ton feed, 250 g/ton feed and 350 g/ton feed, respectively.

Keywords: litopenaeus vannamei, vibrio paraheamolyticus, pediococcus acidilactici, growth performance, bactocell

Procedia PDF Downloads 674
3768 Identifying the Risks on Philippines’ Pre- and Post-Disaster Media Communication on Natural Hazards

Authors: Neyzielle Ronnicque Cadiz

Abstract:

The Philippine is a hotbed of disasters and is a locus of natural hazards. With an average of 20 typhoons entering the Philippine Area of Responsibility (PAR) each year, seven to eight (7-8) of which makes landfall. The country rather inevitably suffers from climate-related calamities. With this vulnerability to natural hazards, the relevant hazard-related issues that come along with the potential threat and occurrence of a disaster oftentimes garners lesser media attention than when a disaster actually occurred. Post-disaster news and events flood the content of news networks primarily focusing on, but not limited to, the efforts of the national government in resolving post-disaster displacement, and all the more on the community leaders’ incompetence in disaster mitigation-- even though the University of the Philippines’ NOAH Center work hand in hand with different stakeholders for disaster mitigation communication efforts. Disaster risk communication is actually a perennial dilemma. There are so many efforts to reach the grassroots level but emergency and disaster preparedness messages inevitably fall short.. The Philippines is very vulnerable to hazards risk and disasters but social media posts and communication efforts mostly go unnoticed, if not argued upon. This study illustrates the outcomes of a research focusing on the print, broadcast, and social media’s role on disaster communication involving the natural catastrophic events that took place in the Philippines from 2009 to present. Considering the country’s state of development, this study looks on the rapid and reliable communication between the government, and the relief/rescue workers in the affected regions; and how the media portrays these efforts effectively. Learning from the disasters that have occurred in the Philippines over the past decade, effective communication can ensure that any efforts to prepare and respond to disasters can make a significant difference. It can potentially either break or save lives. Recognizing the role of communications is not only in improving the coordination of vital services for post disaster; organizations gave priority in reexamining disaster preparedness mechanisms through the Communication with Communities (CwC) programs. This study, however, looks at the CwC efforts of the Philippine media platforms. CwC, if properly utilized by the media, is an essential tool in ensuring accountability and transparency which require effective exchange of information between disasters and survivors and responders. However, in this study, it shows that the perennial dilemma of the Philippine media is that the Disaster Risk Reduction and Management (DRRM) efforts of the country lie in the clouded judgment of political aims. This kind of habit is a multiplier of the country’s risk and insecurity. Sometimes the efforts in urging the public to take action seem useless because the challenge lies on how to achieve social, economic, and political unity using the tri-media platform.

Keywords: Philippines at risk, pre/post disaster communication, tri-media platform, UP NOAH

Procedia PDF Downloads 179
3767 Prevalence Post Partum Depression in NICU

Authors: Ahmad Shahfarhat, Ashraf Mohammadzade, Reza Saeedi, Hadi Hesari

Abstract:

Background: Mothers of infants admitted at NICU are vulnerable to depression (affecting 10 to 20% of mothers during the first year after delivery) As you know, about half of women with prominent postpartum depression (PPD) symptoms are not diagnosed. The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening instrument for PPD. In this study, we checked EPDS score of 12 or more on the second day (D2), discharge, day 28(D28), and day42 (D42) postpartum to determine the risk factors as well as the prevalence of PPD in a sample of mothers of NICU admitted neonates. Methods: A sample of 682 women used the EPDS on admission and at discharge. An assessment for PPD was performed on D28 and D42 by a telephone interview. Results: On admission, the average score on EPDS was 9.72 (SD = 4.4), and 27.4% of women (187) had an EPDS score ≥12. On Discharge, 4weeks and 6weeks postpartum the average score was ordinary 9.34 (SD = 3.8), 9.12 (SD = 3.7), 8.52(SD = 3.36), and (173)25.4 %,( 141)23.3 %,( 88)15.3% of women presented with PPD. a positive correlation was found between scores on EPDS on admission and D42 (P = 0.001). An analysis shows that mothers of twins (P = 0.001) and higher age mothers (P=0.001) are significantly associated with PPD. Conclusion: Women with EPDS score more than 12 and/or older will benefit from a closer follow-up during the rest of the post-partum period, and it is better to be under psychological support.

Keywords: NICU, depression, pregnancy, mothers

Procedia PDF Downloads 104
3766 Formulation and Anticancer Evaluation of Beta-Sitosterol in Henna Methanolic Extract Embedded in Controlled Release Nanocomposite

Authors: Sanjukta Badhai, Durga Barik, Bairagi C. Mallick

Abstract:

In the present study, Beta-Sitosterol in Lawsonia methanolic leaf extract embedded in controlled release nanocomposite was prepared and evaluated for in vivo anticancer efficacy in dimethyl hydrazine (DMH) induced colon cancer. In the present study, colon cancer was induced by s.c injection of DMH (20 mg/kg b.wt) for 15 weeks. The animals were divided into five groups as follows control, DMH alone, DMH and Beta Sitosterol nanocomposite (50mg/kg), DMH and Beta Sitosterol nanocomposite (100 mg/kg) and DMH and Standard Silymarin (100mg/kg) and the treatment was carried out for 15 weeks. At the end of the study period, the blood was withdrawn, and serum was separated for haematological, biochemical analysis and tumor markers. Further, the colonic tissue was removed for the estimation of antioxidants and histopathological analysis. The results of the study displays that DMH intoxication elicits altered haematological parameters (RBC,WBC, and Hb), elevated lipid peroxidation and decreased antioxidants level (SOD, CAT, GPX, GST and GSH), elevated lipid profiles (cholesterol and triglycerides), tumor markers (CEA and AFP) and altered colonic tissue histology. Meanwhile, treatment with Beta Sitosterol nanocomposites significantly restored the altered biochemicals parameters in DMH induced colon cancer mediated by its anticancer efficacy. Further, Beta Sitosterol nanocomposite (100 mg/kg) showed marked efficacy.

Keywords: nanocomposites, herbal formulation, henna, beta sitosterol, colon cancer, dimethyl hydrazine, antioxidant, lipid peroxidation

Procedia PDF Downloads 163
3765 Role of Mismatch Repair Protein Expression in Colorectal Cancer: A Study from North India

Authors: Alka Yadav, Mayank Jain, Rajan Saxena, Niraj Kumari, Narendra Krishnani, Ashok Kumar

Abstract:

Purpose: To study the mismatch repair (MMR) protein expression and its clinicopathological correlation in colorectal cancer patients in North India. Methods: A prospective study was conducted on histologically proven 52 (38 males and 14 females) patients with adenocarcinoma of colorectum. MMR protein loss was determined by using immunohistochemistry for MLH1, MSH2, PMS2 and MSH6. Results: 52 patients (38 males and 14 females) underwent resection for colorectal cancer with the median age of 52 years (16-81 years). 35% of the patients (n=18) were younger than 50 years of the age. 3 patients had associated history of malignancy in the family. 29 (56%) patients had right colon cancer, 9 (17%) left colon cancer and 14 (27%) rectal cancer. 2 patients each had synchronous and metachronous cancer. Histology revealed well-differentiated tumour in 16, moderately differentiated in 10 and poorly differentiated tumour in 26 patients. MMR protein loss was seen in 15 (29%) patients. Seven (46%) of these patients were less than 50 years of age. Combined loss of MSH2 and MSH6 was seen most commonly and it was found in 6 patients. 12 (80%) patients with MMR protein loss had tumour located proximal to the splenic flexure compared to 3 (20%) located distal to the splenic flexure. There was no difference in MMR protein loss based on patients' age, gender, degree of tumour differentiation, stage of the disease and tumour histological characteristics. Conclusions: This study revealed that there was less than 30% MMR protein loss in colorectal cancer patients. The loss was most commonly seen in right sided colon cancer than left. A larger study is further required to validate these findings.

Keywords: colorectal cancer, mismatch repair protein, immunohitochemistry, clinicopathological correlation

Procedia PDF Downloads 233
3764 The Role of Specificity in Mastering the English Article System

Authors: Sugene Kim

Abstract:

The English articles are taught as a binary system based on nominal countability and definiteness. Despite the detailed rules of prescriptive grammar, it has been consistently reported in the literature that their correct usage is extremely difficult to master even for advanced learners of English as a second language (ESL) or a foreign language (EFL). Given that an English sentence (except for an imperative) cannot be constructed without a noun, which is always paired with one of the indefinite, definite, and zero articles; it is essential to understand specifically what causes ESL/EFL learners to misuse them. To that end, this study examined EFL learners’ article use employing a one-group pre–post-test design. Forty-three Korean college students received instruction on correct English article usage for two 75-minute classes employing the binary schema set up for the study. They also practiced in class how to apply the rules as instructed. Then, the participants were assigned a forced-choice elicitation task, which was also used as a pre-test administered three months prior to the instruction. Unlike the pre-test on which they only chose the correct article for each of the 40 items, the post-instruction task additionally asked them to give written accounts of their decision-making procedure to choose the article as they did. The participants’ performance was scored manually by checking whether the answer given is correct or incorrect, and their written comments were first categorized using thematic analysis and then ranked by frequency. The analyses of the performance on the two tasks and the written think-aloud data suggested that EFL learners exhibit fluctuation between specificity and definiteness, overgeneralizing the use of the definite article for almost all cataphoric references. It was apparent that they have trouble distinguishing from the two concepts possibly because the former is almost never introduced in the grammar books or classes designed for ESL/EFL learners. Particularly, most participants were found to be ignorant of the possibility of using nouns as [+specific, –definite]. Not surprisingly, the correct answer rates for such nouns averaged out at 33% and 46% on the pre- and post-tests, respectively, which narrowly reach half the overall mean correct answer rates of 65% on the pre-test and 81% on the post-test. In addition, correct article use for specific indefinites was most impermeable to instruction when compared with nouns used as [–specific, –definite] or [± specific, +definite]. Such findings underline the necessity for expanding the binary schema to a ternary form that incorporates the specificity feature, albeit not morphologically marked in the English language.

Keywords: countability, definiteness, English articles, specificity, ternary system

Procedia PDF Downloads 124
3763 Seismic Behavior of Self-Balancing Post-Tensioned Reinforced Concrete Spatial Structure

Authors: Mircea Pastrav, Horia Constantinescu

Abstract:

The construction industry is currently trying to develop sustainable reinforced concrete structures. In trying to aid in the effort, the research presented in this paper aims to prove the efficiency of modified special hybrid moment frames composed of discretely jointed precast and post-tensioned concrete members. This aim is due to the fact that current design standards do not cover the spatial design of moment frame structures assembled by post-tensioning with special hybrid joints. This lack of standardization is coupled with the fact that previous experimental programs, available in scientific literature, deal mainly with plane structures and offer little information regarding spatial behavior. A spatial model of a modified hybrid moment frame is experimentally analyzed. The experimental results of a natural scale model test of a corner column-beams sub-structure, cut from an actual multilevel building tested to seismic type loading are presented in order to highlight the behavior of this type of structure. The test is performed under alternative cycles of imposed lateral displacements, up to a storey drift ratio of 0.035. Seismic response of the spatial model is discussed considering the acceptance criteria for reinforced concrete frame structures designed based on experimental tests, as well as some of its major sustainability features. The results obtained show an overall excellent behavior of the system. The joint detailing allows for quick and cheap repairs after an accidental event and a self-balancing behavior of the system that ensures it can be used almost immediately after an accidental event it.

Keywords: modified hybrid joint, seismic type loading response, self-balancing structure, acceptance criteria

Procedia PDF Downloads 240
3762 Sanction Influences and Reconstruction Strategies for Iran Oil Market in Post-Sanctions

Authors: Mehrdad HassanZadeh Dugoori, Iman Mohammadali Tajrishi

Abstract:

Since Iran's nuclear program became public in 2002, the International Atomic Energy Agency (IAEA) has been unable to confirm Tehran's assertions that its nuclear activities are exclusively for peaceful purposes and that it has not sought to develop nuclear weapons. The United Nations Security Council has adopted six resolutions since 2006 requiring Iran to stop enriching uranium - which can be used for civilian purposes, but also to build nuclear bombs, which Iran never follow this strategy- and co-operate with the IAEA. Four resolutions have included progressively expansive sanctions to persuade Tehran to comply. The US and EU have imposed additional sanctions on Iranian oil exports and banks since 2012. In this article we reassess the sanction dimensions of Iran and the influences. Then according to the last agreement between P5+1 and Iran in 15 July 2015, we mention reconstruction strategies for oil export markets of Iran and the operational program for one million barrel of crude oil sales per day. These strategies are the conclusion of focus group and brain storming with Iran's oil and gas managers during content analysis.

Keywords: post-sanction, oil market, reconstruction, marketing, strategy

Procedia PDF Downloads 456
3761 Enhancing the Aussie Optimism Positive Thinking Skills Program: Short-term Effects on Anxiety and Depression in Youth aged 9-11 Years Old

Authors: Rosanna M. Rooney, Sharinaz Hassan, Maryanne McDevitt, Jacob D. Peckover, Robert T. Kane

Abstract:

Anxiety and depression are the most common mental health problems experienced by Australian children and adolescents. Research into youth mental health points to the importance of considering emotional competence, parental influence on the child’s emotional development, and the fact that cognitions are still developing in childhood when designing and implementing positive psychology interventions. Additionally, research into such interventions has suggested the inclusion of a coaching component aimed at supporting those implementing the intervention enhances the effects of the intervention itself. In light of these findings and given the burden of anxiety and depression in the longer term, it is necessary to enhance the Aussie Optimism Positive Thinking Skills program and evaluate its efficacy in terms of children’s mental health outcomes. It was expected that the enhancement of the emotional and cognitive aspects of the Aussie Optimism Positive Thinking Skills program, the addition of coaching, and the inclusion of a parent manual would lead to significant prevention effects in internalizing problems at post-test, 6- and 18-months after the completion of the intervention. 502 students (9-11 years old) were randomly assigned to the intervention group (n = 347) or control group (n = 155). At each time point (baseline, post-test, 6-month follow-up, and 18-month follow-up), students completed a battery of self-report measures. The ten intervention sessions making up the enhanced Aussie Optimism Positive Thinking Skills program were run weekly. At post-test and 6-month follow-up, the intervention group reported significantly lower depression than the control group, with no group differences at the 18-month follow-up. The intervention group reported significantly lower anxiety than the control group only at the 6-month follow-up, with no group differences in the post-test or at the 18-month follow-up. Results suggest that the enhanced Aussie Optimism Positive Thinking Skills program can reduce depressive and anxious symptoms in the short term and highlight the importance of universally implemented positive psychology interventions.

Keywords: positive psychology, emotional competence, internalizing symptoms, universal implementation

Procedia PDF Downloads 68
3760 Pre-Operative Psychological Factors Significantly Add to the Predictability of Chronic Narcotic Use: A Two Year Prospective Study

Authors: Dana El-Mughayyar, Neil Manson, Erin Bigney, Eden Richardson, Dean Tripp, Edward Abraham

Abstract:

Use of narcotics to treat pain has increased over the past two decades and is a contributing factor to the current public health crisis. Understanding the pre-operative risks of chronic narcotic use may be aided through investigation of psychological measures. The objective of the reported study is to determine predictors of narcotic use two years post-surgery in a thoracolumbar spine surgery population, including an array of psychological factors. A prospective observational study of 191 consecutively enrolled adult patients having undergone thoracolumbar spine surgery is presented. Baseline measures of interest included the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia, Multidimensional Scale for Perceived Social Support (MSPSS), Chronic Pain Acceptance Questionnaire (CPAQ-8), Oswestry Disability Index (ODI), Numeric Rating Scales for back and leg pain (NRS-B/L), SF-12’s Mental Component Summary (MCS), narcotic use and demographic variables. The post-operative measure of interest is narcotic use at 2-year follow-up. Narcotic use is collapsed into binary categories of use and no use. Descriptive statistics are run. Chi Square analysis is used for categorical variables and an ANOVA for continuous variables. Significant variables are built into a hierarchical logistic regression to determine predictors of post-operative narcotic use. Significance is set at α < 0.05. Results: A total of 27.23% of the sample were using narcotics two years after surgery. The regression model included ODI, NRS-Leg, time with condition, chief complaint, pre-operative drug use, gender, MCS, PCS subscale helplessness, and CPAQ subscale pain willingness and was significant χ² (13, N=191)= 54.99; p = .000. The model accounted for 39.6% of the variance in narcotic use and correctly predicted in 79.7% of cases. Psychological variables accounted for 9.6% of the variance over and above the other predictors. Conclusions: Managing chronic narcotic usage is central to the patient’s overall health and quality of life. Psychological factors in the preoperative period are significant predictors of narcotic use 2 years post-operatively. The psychological variables are malleable, potentially allowing surgeons to direct their patients to preventative resources prior to surgery.

Keywords: narcotics, psychological factors, quality of life, spine surgery

Procedia PDF Downloads 144
3759 Investigating Elastica and Post Buckling Behavior Columns Using the Modified Newmark Method

Authors: Seyed Amin Vakili, Sahar Sadat Vakili, Seyed Ehsan Vakili, Nader Abdoli Yazdi

Abstract:

The purpose of this article is to analyze the finite displacement of Columns by applying the Modified Newmark Method. This research will be performed on Columns subjected to compressive axial load, therefore the non-linearity of the geometry is also considered. If the considered strut is perfect, the governing differential equation contains a branching point in the solution path. Investigation into the Elastica is a part of generalizing the developed method. It presents the ability of the Modified Newmark Method in treating non-linear differential equations Derived from elastic strut stability problems. These include not only an approximate polynomial solution for the Elastica problems, but can also recognize the branching point and the stable solution. However, this investigation deals with the post-buckling response of elastic and pin ended columns subjected to central or equally eccentric axial loads.

Keywords: columns, structural modeling, structures & structural stability, loads

Procedia PDF Downloads 311