Search results for: cognitive dysfunction

Authors: Choi Younshick, Lee Wonseok, Lee Jaemeun, Park Sun-Hyun, Kim Sunwoung, Park Sua, Kim Eun Ho, Kim Jong-Ki

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Iron accumulation in the brain accelerates Alzheimer’s disease progression. To cure iron toxicity, we assessed the therapeutic effects of noncontact transcranial electric field stimulation to the brain on toxic iron deposits in either the Aβ-fibril structure or the Aβ plaque in a mouse model of Alzheimer’s disease (AD). A capacitive electrode-based alternating electric field (AEF) was applied to a suspension of magnetite (Fe₃O₄) to measure the field-sensitized electro-Fenton effect and resultant reactive oxygen species (ROS) generation. The increase in ROS generation compared to the untreated control was both exposure-time and AEF-frequency dependent. The frequency-specific exposure of AEF to 0.7–1.4 V/cm on a magnetite-bound Aβ-fibril or a transgenic Alzheimer’s disease (AD) mouse model revealed the removal of intraplaque ferrous magnetite iron deposit and Aβ-plaque burden together at the same time compared to the untreated control. The results of the behavioral tests show an improvement in impaired cognitive function following AEF treatment on the AD mouse model. Western blot assay found some disease-modifying biological responses, including down-regulating ferroptosis, neuroinflammation and reactive astrocytes that eventually made cognitive improvement feasible. Tissue clearing and 3D-imaging analysis revealed no induced damage to the neuronal structures of normal brain tissue following AEF treatment. In conclusion, our results suggest that the effective degradation of magnetite-bound amyloid fibrils or plaques in the AD brain by the electro-Fenton effect from electric field-sensitized magnetite offers a potential electroceutical treatment option for AD.

Keywords: electroceutical, intraplaque magnetite, alzheimer’s disease, transcranial electric field, electro-fenton effect

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Authors: Gopal Lamichhane, Biswash Sapkota, Grinsun Sharma, Mahendra Adhikari

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Urolithiasis is a condition in which insoluble or less soluble salts like oxalate, phosphate etc. precipitate in urinary tract and causes obstruction in ureter resulting renal colic or sometimes haematuria. It is the third most common disorder of urinary tract affecting nearly 2% of world’s population. Poor urinary drainage, microbial infection, oxalate and calcium containing diet, calciferol, hyperparathyroidism, cysteine in urine, gout, dysfunction of intestine, drought environment, lifestyle, exercise, stress etc. are risk factors for urolithiasis. Wide ranges of treatments are available in allopathic system of medicine but reoccurrence is unpreventable even with the surgical removal of stone or lithotripsy. So, people prefer alternative medicinal systems such as Unani, homeopathic, ayurvedic etc. systems of medicine due to their fewer side effects over allopathic counterpart. Different plants based ethnomedicines are being well established by their continuous effective use in human since long time in treatment of urinary problem. Many studies have scientifically proved those ethnomedicines for antiurolithiatic effect in animal and in vitro model. Plant-based remedies were found to be therapeutically effective for both prevention as well as cure of calcium oxalate urolithiasis. Plants were known to show these effects through a combination of many effects such as antioxidant, diuretic, hypocalciuric, urine alkalinizing effect in them. Berberine, triterpenoids, lupeol are the phytochemicals established for antiurolithiatic effect. Hence, plant-based medicine can be the effective herbal alternative as well as means of discovery of novel drug molecule for curing urolithiatic disorder and should be focused on further research to discover their value in coming future.

Keywords: urolithiasis, herbal medicine, ethnomedicine, kidney stone, calcium oxalate

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Authors: Hanen Bouaziz, Moez Rafrafi, Ghada Ben Salah, Kamel Jamoussi, Tahia Boudawara, Najiba Zeghal

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The present study investigated the protective role of Hyparrhenia hirta against sodium nitrate (NaNO3)-induced nephrotoxicity. A high-performance liquid chromatography coupled with a mass spectrometer (HPLC-MS) method was developed to separate and identify flavonoids in Hyparrhenia hirta. Seven flavonoids were identified as 3-O-methylquercetin, luteolin-7-O-glucoside, luteolin, apigenin-7-O-glucoside, apigenin-8-C-glucoside, luteolin-8-C-glucoside and luteolin-6-C-glucoside. Wistar rats were randomly divided into three groups: a control group and two treated groups during 50 days with NaNO3 administered either alone in drinking water or co-administered with Hyparrhenia hirta. NaNO3 treatment induced a significant increase in plasma levels of creatinine, urea and uric while urinary level decreased significantly. Nephrotoxicity induced by NaNO3 was characterized by significant increase in creatinine clearance. In parallel, a significant increase in malondialdehyde level along with a concomitant decrease in total glutathione content and superoxide dismutase, catalase and glutathione peroxidase activities were observed in the kidney after NaNO3 treatment. The histopathological changes in kidney after NaNO3 administration were shrunken. There were renal tubule cell degeneration and infiltration of mononuclear cells. Most glomeruli revealed shrinkage, a wide capsular space and a peri-glomerular mononuclear cells infiltration. Hyparrhenia hirta supplementation showed a remarkable amelioration of the abnormalities cited above. The results concluded that the treatment with Hyparrhenia hirta had a significant role in protecting the animals from nitrate-induced kidney dysfunction.

Keywords: flavonoids, hyparrhenia hirta, kidney, nitrate toxicity, oxidative stress, rat

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Authors: Sharon Millen, Sarah Miller, Laura Dunne, Clare McGeady, Laura Neeson

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This paper presents the findings from a randomised controlled trial (RCT) and process evaluation of the Lifestart parenting programme. Lifestart is a structured child-centred programme of information and practical activity for parents of children aged from birth to five years of age. It is delivered to parents in their own homes by trained, paid family visitors and it is offered to parents regardless of their social, economic or other circumstances. The RCT evaluated the effectiveness of the programme and the process evaluation documented programme delivery and included a qualitative exploration of parent and child outcomes. 424 parents and children participated in the RCT: 216 in the intervention group and 208 in the control group across the island of Ireland. Parent outcomes included: parental knowledge of child development, parental efficacy, stress, social support, parenting skills and embeddedness in the community. Child outcomes included cognitive, language and motor development and social-emotional and behavioural development. Both groups were tested at baseline (when children were less than 1 year old), mid-point (aged 3) and at post-test (aged 5). Data were collected during a home visit, which took two hours. The process evaluation consisted of interviews with parents (n=16 at baseline and end-point), and focus groups with Lifestart Coordinators (n=9) and Family Visitors (n=24). Quantitative findings from the RCT indicated that, compared to the control group, parents who received the Lifestart programme reported reduced parenting-related stress, increased knowledge of their child’s development, and improved confidence in their parenting role. These changes were statistically significant and consistent with the hypothesised pathway of change depicted in the logic model. There was no evidence of any change in parents’ embeddedness in the community. Although four of the five child outcomes showed small positive change for children who took part in the programme, these were not statistically significant and there is no evidence that the programme improves child cognitive and non-cognitive skills by immediate post-test. The qualitative process evaluation highlighted important challenges related to conducting trials of this magnitude and design in the general population. Parents reported that a key incentive to take part in study was receiving feedback from the developmental assessment, which formed part of the data collection. This highlights the potential importance of appropriate incentives in relation to recruitment and retention of participants. The interviews with intervention parents indicated that one of the first changes they experienced as a result of the Lifestart programme was increased knowledge and confidence in their parenting ability. The outcomes and pathways perceived by parents and described in the interviews are also consistent with the findings of the RCT and the theory of change underpinning the programme. This hypothesises that improvement in parental outcomes, arising as a consequence of the programme, mediate the change in child outcomes. Parents receiving the Lifestart programme reported great satisfaction with and commitment to the programme, with the role of the Family Visitor being identified as one of the key components of the programme.

Keywords: parent-child relationship, parental self-efficacy, parental stress, school readiness

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Authors: Ximena Calle, Plinio Cantero-López, Felipe Muñoz-Córdova, Mayarling-Francisca Troncoso, Sergio Lavandero, Valentina Parra

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MUL1, a mitochondrial E3 ubiquitin ligase anchored to the outer mitochondrial membrane, is highly expressed in the heart. MUL1 is involved in multiple biological pathways associated with mitochondrial dynamics. Increased MUL1 affects the balance between fission and fusion, affecting mitochondrial function, which plays a crucial role in myocardial function. Therefore, it is interesting to evaluate the effect of cardiac-specific overexpression of MUL1 on myocardial function. Aim: To determine heart functionality in a mouse model with cardio-specific overexpression MUL1 protein. Methods and Results: Male C57BL/Tg transgenic mice with cardiomyocyte-specific overexpression of MUL1 (n=10) and control (n=4) were evaluated at 12, 27, and 35 weeks of age. Glucose tolerance curve determination was performed after a 6-hours fast to assess metabolic capacity, treadmill test, and systolic, and diastolic pressure was evaluated by the mouse tail-cuff blood pressure system equipment. The result showed no glucose tolerance curve, and the treadmill test demonstrated no significant changes between groups. However, substantial changes in diastolic function were observed by ultrasound and determination of cardiac hypertrophy proteins by western blot. Conclusions: Cardio-specific overexpression of MUL1 in mice without any treatment affects diastolic cardiac function, thus showing the important role contributed by MUL1 in the heart. Future research should evaluate the effect of cardiomyocyte-specific overexpression of MUL1 in pathological conditions such as a high-fat diet is one of the main risk factors for cardiovascular disease.

Keywords: diastolic dysfunction, hypertrophy cardiac, mitochondrial E3 ubiquitin ligase 1, MUL1

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Authors: Sung-Chun Tsai, Li-Fang Chou, Chun-Jung Tseng

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How relational identity of leader-subordinate relationship affects behavior of both parties is getting more and more attentions in recent years. Different from past studies on leader-subordinate relationship taking viewpoint of self-concept or interaction between categories, we took perspective of social cognitive schema with special focus on the cognition structure and category content of the vertical leader-subordinate relationship. This study firstly clarified the dimensions and contents of cognitive structure of vertical leader-subordinate relationship. By using two dimensions of “equal/unequal” and “close/distant”, the contents of the leader-subordinate relational identity (LSRI) are classified into four categories: communal affection RI (equal and close), instrumental exchange RI (equal but distant), care-repay RI (unequal but close), and authority-obedience RI (unequal and distant). Furthermore, according to the four dimensions of leader-subordinate relational identity, we explored: (1) how a leader’s LSRI leads to paternalistic leadership; and (2) how paternalistic leadership affects subordinate’s LSRI. Using 59 work group as sample (59 leaders and 251 subordinates), the results of HLM and regression analysis showed: (1) leader’s LSRI significantly affects leadership behavior: instrumental exchange RI is positively relates to authoritarian leadership behavior, but significantly has negative relationship with benevolent leadership; care-repay RI has significantly positive relationship with authoritative leadership; authority-obedience RI has significantly positive relationship with authoritarian leadership; (2) paternalistic leadership is significantly related to subordinates’ LSRI: benevolent leadership is positively related to subordinate’s communal affection and care-repay RI; authoritative leadership has significantly positive relationship with care-repay and authority-obedience RI; authoritarian leadership has significantly positive relationship with subordinate’s instrumental exchange RI. Finally, the main findings, contributions and limits, future research directions, and implications were also discussed.

Keywords: relational identity, leader-subordinate relational identity (LSRI), relational schema, paternalistic leadership

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Authors: M. Rodionov, Z. Dedovets

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This article discusses ways to implement a differentiated approach to developing academic motivation for mathematical studies which relies on defining the primary structural characteristics of motivation. The following characteristics are considered: features of realization of cognitive activity, meaning-making characteristics, level of generalization and consistency of knowledge acquired by personal experience. The assessment of the present level of individual student understanding of each component of academic motivation is the basis for defining the relevant educational strategy for its further development.

Keywords: learning activity, mathematics, motivation, student

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Authors: Rashmi Tyagi, Savita Vermani

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Violence against women is the result of long-standing power imbalance between men and women and thus seriously compromises the well-being, productivity and contribution of one half the population. The costs incurred to the family especially children and society at large in terms of physical, psychological, social and financial losses are huge. The communities’ native to the state of Haryana in India is primarily patriarchal, burdened with age old regressive mindset under the socio-cultural and religious structures which discriminates against women. Therefore it was important to bring to light the issues affecting women in this region. Therefore this study focused on studying the consequences of crime on victim women and their families. Two hundred women were randomly selected and out of those one hundred twenty, who were affected with some kind of violence were interviewed. Data was collected and statistically analyzed for physical, psychological, inter-family and societal consequences of violence on these women. Women reported physical injuries, gynecological problems, unwanted pregnancies, frigidity, phobia and sexual dysfunction. 58.9% women felt decreased work efficiency. Psychological problems encountered were anxiety, isolation, depression, suicidal tendencies. 66.7% respondents suffered from anxiety followed by 65.0% faced depression symptoms. At family levels, 40.0% respondents felt the atmosphere was unsuitable for children while 39.2% reported lack of interaction. The societal consequences reported were breakdown of interaction with friends and family (44.2%) and resulting humiliation and demeaning remarks from others (38.3%). The impact of violence on women had an adverse effect on children. 36.7% children felt responsible for abuse and powerless to stop it, 29.2% reported living with fear. Concerted efforts are required to curb violence against women in Haryana.

Keywords: impact of violence against women on children, patriarchal society, physical psychological and societal consequences, violence against women

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Authors: Shilu Deepa Thomas, P. Jayaprakash, Dorota Łazewska, Katarzyna Kieć-Kononowicz, B. Sadek

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A large body of evidence suggests the involvement of cognitive impairment, increased levels of inflammation and oxidative stress in the pathogenesis of autism spectrum disorder (ASD). ASD commonly coexists with psychiatric conditions like anxiety and cognitive challenges, and individuals with ASD exhibit significant levels of inflammation and immune system dysregulation. Previous Studies have identified elevated levels of pro-inflammatory markers such as IL-1β, IL-6, IL-2 and TNF-α, particularly in young children with ASD. The current therapeutic options for ASD show limited effectiveness, signifying the importance of exploring an efficient drugs to address the core symptoms. The role of histamine H3 receptors (H3Rs) in memory and the prospective role of H3R antagonists in pharmacological control of neurodegenerative disorders, e.g., ASD, is well-accepted. Hence, the effects of chronic systemic administration of H3R antagonist E159 on autistic-like repetitive behaviors, social deficits, memory and anxiety parameters, as well as neuroinflammation in Black and Tan BRachyury (BTBR) mice, were evaluated using Y maze, Barnes maze, self-grooming, open field and three chamber social test. E159 (2.5, 5 and 10 mg/kg, i.p.) dose-dependently ameliorated repetitive and compulsive behaviors by reducing the increased time spent in self-grooming and improved reduced spontaneous alternation in BTBR mice. Moreover, treatment with E159 attenuated disturbed anxiety levels and social deficits in tested male BTBR mice. Furthermore, E159 attenuated oxidative stress by significantly increasing GSH, CAT, and SOD and decreasing the increased levels of MDA in the cerebellum as well as the hippocampus. In addition, E159 decreased the elevated levels of proinflammatory cytokines (tumor necrosis factor (TNF-α), interleukin-1β (IL-1β), and IL-6). The observed results show that H3R antagonists like E159 may represent a promising novel pharmacological strategy for the future treatment of ASD.

Keywords: histamine H3 receptors, antagonist E159, autism, behaviors, mice

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Authors: Keroles Akram Saed Ghatas

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The near future will bring significant changes in modern organizations and management due to the growing role of intangible assets and knowledge workers. The area of copyright, intellectual property, digital (intangible) assets and media redistribution appears to be one of the greatest challenges facing business and society in general and management sciences and organizations in particular. The proposed article examines the views and perceptions of fairness in digital media sharing among Harvard Law School's LL.M.s. Students, based on 50 qualitative interviews and 100 surveys. The researcher took an ethnographic approach to her research and entered the Harvard LL.M. in 2016. at, a Face book group that allows people to connect naturally and attend in-person and private events more easily. After listening to numerous students, the researcher conducted a quantitative survey among 100 respondents to assess respondents' perceptions of fairness in digital file sharing in various contexts (based on media price, its availability, regional licenses, copyright holder status, etc.). to understand better . .). Based on the survey results, the researcher conducted long-term, open-ended and loosely structured ethnographic interviews (50 interviews) to further deepen the understanding of the results. The most important finding of the study is that Harvard lawyers generally support digital piracy in certain contexts, despite having the best possible legal and professional knowledge. Interestingly, they are also more accepting of working for the government than the private sector. The results of this study provide a better understanding of how “fairness” is perceived by the younger generation of lawyers and pave the way for a more rational application of licensing laws.

Keywords: cognitive impairments, communication disorders, death penalty, executive function communication disorders, cognitive disorders, capital murder, executive function death penalty, egyptian law absence, justice, political cases piracy, digital sharing, perception of fairness, legal profession

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Authors: Douglas MacCutcheon, Florian Pausch, Robert Ljung, Lorna Halliday, Stuart Rosen

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Contemporary classrooms are increasingly inclusive of children with mild to moderate disabilities and children from different language backgrounds (bilinguals, multilinguals), but classroom environments and standards have not yet been adapted adequately to meet these challenges brought about by this inclusivity. Additionally, classrooms are becoming noisier as a learner-centered as opposed to teacher-centered teaching paradigm is adopted, which prioritizes group work and peer-to-peer learning. Challenging listening conditions with distracting sound sources and background noise are known to have potentially negative effects on children, particularly those that are prone to struggle with speech perception in noise. Therefore, this research investigates two groups vulnerable to these environmental effects, namely children with a mild to moderate hearing loss (MMHLs) and sequential bilinguals learning in their second language. In the MMHL study, this group was assessed on speech-in-noise perception, and a number of receptive language and cognitive measures (auditory working memory, auditory attention) and correlations were evaluated. Speech reception thresholds were found to be predictive of language and cognitive ability, and the nature of correlations is discussed. In the bilinguals study, sequential bilingual children’s listening comprehension, speech-in-noise perception, listening effort and release from masking was evaluated under a number of different ecologically valid acoustic scenarios in order to pinpoint the extent of the ‘native language benefit’ for Swedish children learning in English, their second language. Scene manipulations included target-to-distractor ratios and introducing spatially separated noise. This research will contribute to the body of findings from which educational institutions can draw when designing or adapting educational environments in inclusive schools.

Keywords: sequential bilinguals, classroom acoustics, mild to moderate hearing loss, speech-in-noise, release from masking

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Authors: Blanco T. F., Fernández-López A.

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Nowadays, education, motivated by the new demands of the 21st century, acquires a dimension that converts the skills that new generations may need into a huge and uncertain set of knowledge too broad to be entirety covered. Within this set, and as tools to reach them, we find Learning and Knowledge Technologies (LKT). Thus, in order to prepare students for an everchanging society in which the technological boom involves everything, it is essential to develop digital competence. Nevertheless LKT seems not to have found their place in the educational system. This work is aimed to go a step further in the research of the most appropriate procedures and resources for technological integration in the classroom. The main objective of this exploratory study is to analyze the didactic suitability (epistemic, cognitive, affective, interactional, mediational and ecological) for teaching and learning processes of mathematics with robotics and 3D printing. The analysis carried out is drawn from a STEAM (Science, Technology, Engineering, Art and Mathematics) project that has the Pilgrimage way to Santiago de Compostela as a common thread. The sample is made up of 25 Primary Education students (10 and 11 years old). A qualitative design research methodology has been followed, the sessions have been distributed according to the type of technology applied. Robotics has been focused towards learning two-dimensional mathematical notions while 3D design and printing have been oriented towards three-dimensional concepts. The data collection instruments used are evaluation rubrics, recordings, field notebooks and participant observation. Indicators of didactic suitability proposed by Godino (2013) have been used for the analysis of the data. In general, the results show a medium-high level of didactic suitability. Above these, a high mediational and cognitive suitability stands out, which led to a better understanding of the positions and relationships of three-dimensional bodies in space and the concept of angle. With regard to the other indicators of the didactic suitability, it should be noted that the interactional suitability would require more attention and the affective suitability a deeper study. In conclusion, the research has revealed great expectations around the combination of teaching-learning processes of mathematics and LKT. Although there is still a long way to go in terms of the provision of means and teacher training.

Keywords: 3D printing, didactic suitability, educational design, robotics

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Authors: Panas Gerasimos, Kotidou Varvara, Halkiopoulos Constantinos, Gkintoni Evgenia

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As a result of growing technology and briefing by the internet, users resort to the internet and subsequently to the opinion of an expert. In many cases, they take control of their health in their hand and make a decision without the contribution of a doctor. According to that, this essay intends to analyze the confidence of searching health issues on the internet. For the fulfillment of this study, there has been a survey among doctors in order to find out the reasons a patient uses the internet about their health problems and the consequences that health information could lead by searching on the internet, as well. Specifically, the results regarding the research of the users demonstrate: a) the majority of users make use of the internet about health issues once or twice a month, b) individuals that possess chronic disease make health search on the internet more frequently, c) the most important topics that the majority of users usually search are pathological, dietary issues and the search of issues that are associated with doctors and hospitals. However, it observed that topic search varies depending on the users’ age, d) the most common sources of information concern the direct contact with doctors, as there is a huge preference from the majority of users over the use of the electronic form for their briefing and e) it has been observed that there is large lack of knowledge about e-health services. From the doctor's point of view, the following conclusions occur: a) almost all doctors use the internet as their main source of information, b) the internet has great influence over doctors’ relationship with the patients, c) in many cases a patient first makes a visit to the internet and then to the doctor, d) the internet significantly has a psychological impact on patients in order to for them to reach a decision, e) the most important reason users choose the internet instead of the health professional is economic, f) the negative consequence that emerges is inaccurate information, g) and the positive consequences are about the possibility of online contact with the doctor and contributes to the easy comprehension of the doctor, as well. Generally, it’s observed from both sides that the use of the internet in health issues is intense, which declares that the new means the doctors have at their disposal, produce the conditions for radical changes in the way of providing services and in the doctor-patient relationship.

Keywords: cognitive models, health marketing, e-health, psychological factors, digital marketing, e-health services

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Authors: Arsalan Hassan Pour, Mansoureh Jeihani, Samira Ahangari

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Distracted driving has been one of the most integral concerns surrounding our daily use of vehicles since the invention of the automobile. While much attention has been recently given to cell phones related distraction, commercial billboards along roads are also candidates for drivers' visual and cognitive distractions, as they may take drivers’ eyes from the road and their minds off the driving task to see, perceive and think about the billboard’s content. Using a driving simulator and a head-mounted eye-tracking system, speed change, acceleration, deceleration, throttle response, collision, lane changing, and offset from the center of the lane data along with gaze fixation duration and frequency data were collected in this study. Some 92 participants from a fairly diverse sociodemographic background drove on a simulated freeway in Baltimore, Maryland area and were exposed to three different billboards to investigate the effects of billboards on drivers’ behavior. Participants glanced at the billboards several times with different frequencies, the maximum of which occurred on the billboard with the highest cognitive load. About 74% of the participants didn’t look at billboards for more than two seconds at each glance except for the billboard with a short visible area. Analysis of variance (ANOVA) was performed to find the variations in driving behavior when they are invisible, readable, and post billboards area. The results show a slight difference in speed, throttle, brake, steering velocity, and lane changing, among different areas. Brake force and deviation from the center of the lane increased in the readable area in comparison with the visible area, and speed increased right after each billboard. The results indicated that billboards have a significant effect on driving performance and visual attention based on their content and visibility status. Generalized linear model (GLM) analysis showed no connection between participants’ age and driving experience with gaze duration. However, the visible distance of the billboard, gender, and billboard content had a significant effect on gaze duration.

Keywords: ANOVA, billboards, distracted driving, drivers' behavior, driving simulator, eye-Tracking system, GLM

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Authors: LaRon A. Scott, Donna M. Gibson

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Data indicate that counselor education programs in the United States do not prepare their students adequately to serve students with disabilities nor provide counseling as a related service. There is a need to train more school counselors to provide related services to students with disabilities, for many reasons, but specifically, school counselors are participating in Individualized Education Programs (IEP) and transition planning meetings for students with disabilities where important academic, mental health and post-secondary education decisions are made. While school counselors input is perceived very important to the process, they may not have the knowledge or training in this area to feel confident in offering required input in these meetings. Using a conceptual research design, a model that can be used to prepare school counseling students as related service providers and effective supports to address transition for students with disabilities was developed as a component of this research. The authors developed the Collaborative Model of Preparing School Counseling Students as Related Service Providers to Students with Disabilities, based on a conceptual framework that involves an integration of Social Cognitive Career Theory (SCCT) and evidenced-based practices based on Self-Determination Theory (SDT) to provide related and transition services and planning with students with disabilities. The authors’ conclude that with five overarching competencies, (1) knowledge and understanding of disabilities, (2) knowledge and expertise in group counseling to students with disabilities, (3), knowledge and experience in specific related service components, (4) knowledge and experience in evidence-based counseling interventions, (5) knowledge and experiencing in evidenced-based transition and career planning services, that school counselors can enter the field with the necessary expertise to adequately serve all students. Other examples and strategies are suggested, and recommendations for preparation programs seeking to integrate a model to prepare school counselors to implement evidenced-based transition strategies in supporting students with disabilities are included

Keywords: transition education, social cognitive career theory, self-determination, counseling

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Authors: G. V. Vaniprabha, S. Madhusudhan, S. G. Jadhav

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The purpose of this study was to explore the pattern of alcohol use, mode of suicide and extent of depression among 150 female commercial sex workers (CSWs) in Bangalore, India. After going through a short detoxification programme of two weeks, Karma yoga principles of Shrimad Bhagavad Gita were used as a tool for cognitive behavioural therapy (CBT) for a period of four weeks to maintain abstinence and help with their depression. A six month follow up indicated that they had maintained abstinence over that period and had not attempted suicide, either.

Keywords: alcohol dependence, depression, commercial sex workers, suicide

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Authors: Zahra Kazemi Saleh, Bénédicte Poulin-Charronnat, Annie Vinter

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This study examines the effects of aging on visual statistical learning, using eye-tracking techniques to investigate this cognitive phenomenon. Visual statistical learning is a fundamental brain function that enables the automatic and implicit recognition, processing, and internalization of environmental patterns over time. Some previous research has suggested the robustness of this learning mechanism throughout the aging process, underscoring its importance in the context of education and rehabilitation for the elderly. The study included three distinct groups of participants, including 21 young adults (Mage: 19.73), 20 young-old adults (Mage: 67.22), and 17 old-old adults (Mage: 79.34). Participants were exposed to a series of 12 arbitrary black shapes organized into 6 pairs, each with different spatial configurations and orientations (horizontal, vertical, and oblique). These pairs were not explicitly revealed to the participants, who were instructed to passively observe 144 grids presented sequentially on the screen for a total duration of 7 min. In the subsequent test phase, participants performed a two-alternative forced-choice task in which they had to identify the most familiar pair from 48 trials, each consisting of a base pair and a non-base pair. Behavioral analysis using t-tests revealed notable findings. The mean score for the first group was significantly above chance, indicating the presence of visual statistical learning. Similarly, the second group also performed significantly above chance, confirming the persistence of visual statistical learning in young-old adults. Conversely, the third group, consisting of old-old adults, showed a mean score that was not significantly above chance. This lack of statistical learning in the old-old adult group suggests a decline in this cognitive ability with age. Preliminary eye-tracking results showed a decrease in the number and duration of fixations during the exposure phase for all groups. The main difference was that older participants focused more often on empty cases than younger participants, likely due to a decline in the ability to ignore irrelevant information, resulting in a decrease in statistical learning performance.

Keywords: aging, eye tracking, implicit learning, visual statistical learning

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Authors: Ipek Sensu

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Comorbid Axis I disorders are highly common for suicidal borderline personality disorder (BPD) patients, especially substance use disorder and anxiety disorders. Since interpersonal dysfunction is one of the core symptoms in BPD, the purpose of the current study is to examine perceived criticism and anxiety disorders and also substance abuse disorders (SUD) for women with borderline personality disorder (BPD) who attempt suicide at least once in their lifetime. In the current study, it was suggested that the perceived criticism from others and being upset by criticism differ between suicidal women with BPD with comorbidity of anxiety disorders and SUD (separately) and suicidal women with BPD without anxiety disorders and without SUD (separately). The participants in this study included ninety-nine women who have already been diagnosed with borderline personality disorder and also have had at least two episodes of deliberate self-harm, in other words, suicide attempts and/or non-suicidal self-injury (NSSI) in the last five years and at least one episode in the 8-week period before joining the research study and at least one suicide attempt in the previous year. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and Social History Interview (SHI) were conducted to determine the comorbid axis I disorders and level of perceived criticism. As a result of the independent sample t-tests, the first hypothesis was rejected, in other words, women with BPD and a comorbid anxiety disorder did not show significantly higher levels of ‘criticized by others’, compared to women with BPD alone. However, the levels of ‘upset at criticism’ were significantly different between suicidal women with BPD with or without any anxiety disorders, which is the second hypothesis. In addition, the third hypothesis was also accepted; this means, women with BPD who had any substance use dependence would show significantly higher levels of 'criticized by others' compared to women with BPD alone. Finally, the fourth hypothesis was partly accepted: that is, women with BPD with alcohol dependence had significantly higher levels of ‘how upset when they expose to criticism’, compared to those without alcohol dependence. Limitations, implications, and directions for future research are discussed.

Keywords: anxiety disorders, borderline personality disorders, perceived criticism, substance use disorders

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Authors: Jung Lee, L. G. Pee

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The 'Like' function in social media platforms represents the immediate responses of social media users to postings and other users. A large number of 'likes' is often attributed to fame, agreement, and support from others that many users are proud of and happy with. However, what 'like' implies exactly in social media context is still in discussion. Some argue that it is an accurate parameter of the preferences of social media users, whereas others refute that it is merely an instant reaction that is volatile and vague. To address this gap, this study investigates how social media users perceive the 'like' function and behave differently based on their perceptions. This study posits the following arguments. First, 'like' is interpreted as a quantified form of social capital that resides in social media platforms. This incarnated social capital rationalizes the attraction of people to social media and belief that social media platforms bring benefits to their relationships with others. This social capital is then conceptualized into cognitive and emotive dimensions, where social capital in the cognitive dimension represents the awareness of the 'likes' quantitatively, whereas social capital in the emotive dimension represents the receptions of the 'likes' qualitatively. Finally, the ambivalent perspective of the social media users on 'like' (i.e., social capital) is applied. This view rationalizes why social media users appreciate the reception of 'likes' from others but are aware that those 'likes' can distort the actual responses of other users by sending erroneous signals. The rationale on this ambivalence is based on whether users perceive social media as private or public spheres. When social media is more publicized, the ambivalence is more strongly observed. By combining the ambivalence and dimensionalities of the social capital, four types of social media users with different mechanisms on liking behaviors are identified. To validate this work, a survey with 300 social media users is conducted. The analysis results support most of the hypotheses and confirm that people have ambivalent perceptions on 'like' as a social capital and that perceptions influence behavioral patterns. The implication of the study is clear. First, this study explains why social media users exhibit different behaviors toward 'likes' in social media. Although most of the people believe that the number of 'likes' is the simplest and most frank measure of supports from other social media users, this study introduces the users who do not trust the 'likes' as a stable and reliable parameter of social media. In addition, this study links the concept of social media openness to explain the different behaviors of social media users. Social media openness has theoretical significance because it defines the psychological boundaries of social media from the perspective of users.

Keywords: ambivalent attitude, like function, social capital, social media

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Authors: Soheila Rabiepoor, Elham Sadeghi

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Introduction: Divorce is both a personal and a social issue. Nowadays, due to various factors such as rapid social, economical, and cultural changes, the family structure has undergone many rough changes, out of 3 marriages 2 of them lead to divorce. One of the factors affecting the incidence of divorce and relationship problems between couples is the sexual and marital behaviors. There are several different reasons to suspect that pornography might affect divorce in either a positive or a negative way. Therefore this study evaluated the sexual health of divorce-asking in Urmia, Iran. Methods: This was a cross-sectional descriptive study and was conducted on 71 married women of Urmia, Iran in 2016. Participants were applicants of divorce (referred to divorce center) who were selected by using convenient sampling method. Data gathering tool included the scales for measuring demographic, sexual health (sexual satisfaction and function), and researcher made pornography questions. Data were analyzed based on the SPSS 16 software. P-values less than 0.05 were considered significant. Results: Investigation of demographic features showed that age average of studied samples was 28.98 ± 7.44, with a marriage duration average 8.12 ± 6.53 years (min 1 year/ max 28 years). Most of their education was at diploma (45.1%). 69 % of the women declared their income and expenditure as equal. Nearly 42% of women and 59% of their partner had watched sexual pornography clips. 45.5% of participants reported that they compared own sexual relationship with sexual pornography clips. In the other hand, sexual satisfaction total score was 51.50 ± 17.92. The mean total sexual function score was 16.62 ± 10.58. According to these findings, most of women were experienced sexual dissatisfaction and dysfunction. Conclusions: The results of the study indicated that who had low sexual satisfaction score, had higher rate of watching pornography clips. Based on current study, paying attention to family education and counseling programs especially in the sexual field will be more fruitful.

Keywords: divorce-asking, pornography, sexual satisfaction, sexual function, women

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Authors: Beatriz Delgado

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Although social anxiety is one of the most prevalent disorders in adolescents and causes considerable difficulties and social distress in those with the disorder, to date very few studies have explored the impact of social anxiety on academic adjustment in student populations. The aim of this study was analyze the effect of social anxiety on school functioning in Secondary Education. Specifically, we examined the relationship between social anxiety and self-concept, academic goals, causal attributions, intellectual aptitudes, and learning strategies, personality traits, and academic performance, with the purpose of creating a causal-explanatory model of academic performance. The sample consisted of 2,022 students in the seven to ten grades of Compulsory Secondary Education in Spain (M = 13.18; SD = 1.35; 51.1% boys). We found that: (a) social anxiety has a direct positive effect on internal attributional style, and a direct negative effect on self-concept. Social anxiety also has an indirect negative effect on internal causal attributions; (b) prior performance (first academic trimester) exerts a direct positive effect on intelligence, achievement goals, academic self-concept, and final academic performance (third academic trimester), and a direct negative effect on internal causal attributions. It also has an indirect positive effect on causal attributions (internal and external), learning goals, achievement goals, and study strategies; (c) intelligence has a direct positive effect on learning goals and academic performance (third academic trimester); (d) academic self-concept has a direct positive effect on internal and external attributional style. Also, has an indirect effect on learning goals, achievement goals, and learning strategies; (e) internal attributional style has a direct positive effect on learning strategies and learning goals. Has a positive but indirect effect on achievement goals and learning strategies; (f) external attributional style has a direct negative effect on learning strategies and learning goals and a direct positive effect on internal causal attributions; (g) learning goals have direct positive effect on learning strategies and achievement goals. The structural equation model fit the data well (CFI = .91; RMSEA = .04), explaining 93.8% of the variance in academic performance. Finally, we emphasize that the new causal-explanatory model proposed in the present study represents a significant contribution in that it includes social anxiety as an explanatory variable of cognitive-motivational constructs.

Keywords: academic performance, adolescence, cognitive-motivational variables, social anxiety

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Authors: Ivan Traina, Luigi Sangalli, Fabio Tognon, Angelo Lascioli

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Currently, challenges regarding preschooler children are mainly focused on a sedentary lifestyle. Also, motor activity in infancy is seen as a tool for the separate acquisition of cognitive and socio-emotional skills rather than considering neuromotor development as a tool for improving learning abilities. The paper utilized an observational research method to shed light on the results of practicing neuromotor exercises in preschool children with disability as well as provide implications for practice.

Keywords: children with disability, learning abilities, inclusion, neuromotor development

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Authors: Christine Ysabelle G. Roman, Pauline Torres

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Background: Hypertrophic cardiomyopathy is a disease of marked heterogeneity. It is a genetically determined heart disease characterized by significant myocardium hypertrophy that results in diastolic dysfunction, left ventricular outflow tract obstruction, and an increased risk of arrhythmias. The primary treatment in patients with such conditions is negative inotropic drugs, such as beta-blockers, calcium channel antagonists, and disopyramide. However, for those who remain symptomatic and need septal reduction therapy, surgical septal myectomy or alcohol septal ablation are options. Case Summary: A 19 – year old female presented in the authors’ institution with easy fatigability. The consult was done a year prior, and 2D echocardiography was requested which showed concentric left ventricular hypertrophy, asymmetrically hypertrophied interventricular septum (IVS) with the largest diameter of 3.3cm & subaortic dynamic obstruction with a maximum gradient of 47 mmHg. A repeat echo a year later showed asymmetric septal hypertrophy (IVS measuring at 3cm) with the systolic anterior motion of anterior mitral valve leaflet and left ventricular outflow tract obstruction (peak gradient of 50mmHg). The patient then underwent alcohol septal ablation and was discharged stable after four days of admission. Conclusion: Hypertrophic obstructive cardiomyopathy, a cardiovascular genetic disease, results in various patterns of left ventricular hypertrophy and abnormality of mitral valve apparatus. The patient is managed medically initially. However, despite optimal drug therapy and significant left ventricular outflow tract obstruction, significant heart failure symptoms or syncope require invasive treatment.

Keywords: hypertrophic obstructive cardiomyopathy, left ventricular outflow tract obstruction, alcohol septal ablation, alcohol

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Authors: Djebbar Atmani, Aghiles Karim Aissat, Nadjet Debbache-Benaida, Nassima Chaher-Bazizi, Dina Atmani-Kilani, Meriem Rahmani-Berboucha, Naima Saidene, Malika Benloukil, Lila Azib

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Medicinal plants are believed to be an important source for the discovery of potential antioxidant, anti-inflammatory and anti-diabetic substances. The present study was designed to investigate the neuroprotective, anti-inflammatory, anti-diabetic and anti-hyperuricemic potential of Pistacia lentiscus, as well as the identification of active compounds. The antioxidant potential of plant extracts against known radicals was measured using various standard in vitro methods. Anti-inflammatory activity was determined using the paw edema model in mice and by measuring the secretion of the pro-inflammatory cytokine, whereas the anti-diabetic effect was assessed in vivo on streptozotocin-induced diabetic rats and in vitro by inhibition of alpha-amylase. The anti-hyperuricemic activity was evaluated using the xanthine oxidase assay, whereas neuroprotective activity was investigated using an Aluminum-induced toxicity test. Pistacia lentiscus extracts and fractions exhibited high scavenging capacity against DPPH, NO. and ABTS+ radicals in a dose-dependent manner and restored blood glucose levels, in vivo, to normal values, in agreement with the in vitro anti-diabetic effect. Oral administration of plant extracts significantly decreased carrageenan-induced mice paw oedema, similar to the standard drug, diclofenac, was effective in reducing IL-1β levels in cell culture and induced a significant increase in urinary volume in mice, associated to a promising anti-hyperuricemic activity. Plant extracts showed good neuroprotection and restoration of cognitive functions in mice. HPLC-MS and NMR analyses allowed the identification of known and new phenolic compounds that could be responsible for the observed activities. Therefore, Pistacia lentiscus could be beneficial in the treatment of inflammatory conditions and diabetes complications and the enhancement of cognitive functions.

Keywords: Pistacia lentiscus, anti-inflammatory, antidiabetic, flavanols, neuroprotective

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Authors: Naouel Boussoualim, Hayat Trabsa, Imane Krache, Seddik Khennouf, Noureddine Charef, Lekhmici Arrar, Abderrahmane Baghiani

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Purpose: To evaluate the in-vitro inhibition of xanthine oxidase (purified from bovine milk) by extracts of Lycium arabicum, as well as it is in vivo hypouricemic and renal protective effects. Methods: Four extracts of Lycium arabicum, methanol (CrE), chloroform (ChE), ethyl acetate (EaE) and aqueous (AqE) extracts, were screened for their total phenolics and potential inhibitory effects on purified bovine milk xanthine oxidase (XO) activity by measuring the formation of uric acid or superoxide radical. The mode of inhibition was investigated and compared with the standard drugs, allopurinol, quercitin, and catechin. To evaluate their hypouricemic effect, the extracts were administered to potassium oxonate-induced hyperuricemic mice at a dose of 50 mg/kg body weight. Results: The results showed that EaE had the highest content of phenolic compounds and was the most potent inhibitor of uric acid formation (IC50 = 0.017 ± 0.001 mg/mL) and formation of superoxide (IC50 = 0.035 ± 0.001 mg/ml). Lineweaver-Burk analysis showed that CrE and EaE inhibited XO competitively, whereas the inhibitory activities exerted by ChE and AqE were of a mixed type. Intraperetoneal injection of L. arabicum extracts (50 mg/kg) elicited hypouricemic actions in hyperuricemic mice. Hyperuricemic mice presented a serum uric acid concentration of 4.71 ± 0.29 mg/L but this was reduced to 1.78 ± 0.11 mg/L by EaE, which was the most potent hyporuricemic extract. Conclusion: L. arabicum fractions have a strong inhibitory effect on xanthine oxidase and and also have a significantly lowering effect on serum and liver creatinine and urea levels in hyperuricemic mice.

Keywords: lycium arabicum, uric acid, creatinine, superoxide, phenolic compounds, flavonoids, hyperuricemia

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Authors: Abir Dey, Shams Noman

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Introduction: Offshore Island is the remote and isolated area from the terrestrial mainland. They are deprived of their needs. The children from an offshore island are usually underserved in the case of health care because it is a remote area where the health care systems are quite poor compared to mainland. So, the proper information is required for appropriate planning to reduce underlying causes behind visual deprivation among the surviving children of the Offshore Island. Purpose: The purpose of this study was to determine ocular morbidities, knowledge, and barriers of eye care services among children in an Offshore Island. Methods: The study team visited, and all data were collected from different rural communities at Sandwip Upazila, Chittagong district for screening the children aged 5-16 years old by doing spot examination. The whole study was conducted in both qualitative and quantitative methods. To determine ocular status of children, examinations were done under skilled Ophthalmologists and Optometrists. A focus group discussion was held. The sample size was 490. It was a community based descriptive study and the sampling method was purposive sampling. Results: In total 490 children, about 56.90% were female and 43.10% were male. Among them 456 were school-going children (93.1%) and 34 were non-school going children (6.9%). In this study the most common ocular morbidity was Allergic Conjunctivitis (35.2%). Other mentionable ocular morbidities were Refractive error (27.7%), Blepharitis (13.8%), Meibomian Gland Dysfunction (7.5%), Strabismus (6.3%) and Amblyopia (6.3%). Most of the non-school going children were involved in different types of domestic work like farming, fishing, etc. About 90.04% children who had different ocular abnormalities could not attend to the doctor due to various reasons. Conclusions: The ocular morbidity was high in rate on the offshore island. Eye health care facility was also not well established there. Awareness should be raised about necessity of maintaining hygiene and eye healthcare among the island people. Timely intervention through available eye care facilities and management can reduce the ocular morbidity rate in that area.

Keywords: morbidities, screening, barriers, offshore island, knowledge

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Authors: I. Boroňová, J. Bernasovská, J. Kmec, E. Petrejčíková

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Dilated cardiomyopathy (DCM) is a primary myocardial disease, it is characterized by progressive systolic dysfunction due to cardiac chamber dilatation and inefficient myocardial contractility with estimated prevalence of 37 in 100 000 people. It is the most frequent cause of heart failure and cardiac transplantation in young adults. About one-third of all patients have a suspected familial disease indicating a genetic basis of DCM. Many candidate gene studies in humans have tested the association of single nucleotide polymorphisms (SNPs) in various genes coding for proteins with a known cardiovascular function. In our study we present the results of ZBTB17 gene rs10927875 polymorphism genotyping in relation to dilated cardiomyopathy in Slovak population. The study included 78 individuals, 39 patients with DCM and 39 healthy control persons. The mean age of patients with DCM was 50.7±11.5 years; the mean age of individuals in control group was 51.3±9.8 years. Risk factors detected at baseline in each group included age, sex, body mass index, smoking status, diabetes and blood pressure. Genomic DNA was extracted from leukocytes by a standard methodology and screened for rs10927875 polymorphism in intron of ZBTB17 gene using Real-time PCR method (Step One Applied Biosystems). The distribution of investigated genotypes for rs10927875 polymorphism in the group of patients with DCM was as follows: CC (89.74%), CT (10.26%), TT (0%), and the distribution in the control group: CC (92.31%), CT (5.13%), and TT (2.56%). Using the chi-square (χ2) test we compared genotype and allele frequencies between patients and controls. There was no difference in genotype or allele frequencies in ZBTB17 gene rs10927875 polymorphism between patients and control group (χ2=3.028, p=0.220; χ2=0.264, p=0.608). Our results represent an initial study, it can be considered as preliminary and first of its kind in Slovak population. Further studies of ZBTB17 gene polymorphisms of more numerous files and additional functional investigations are needed to fully understand the role of genetic associations.

Keywords: dilated cardiomyopathy, SNP polymorphism, ZBTB17 gene, bioscience

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Authors: Umi Pudji Astuti, Dedi Sugandi

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The effectiveness of agricultural extension is determined by the component in the agricultural extension system among others are agricultural extension methods. Effective methods should be selected and defined based on the characteristics of the target, the resources, the materials, and the objectives to be achieved. Citrus agribusiness development in Lebong is certainly supported by the role of stakeholders and citrus farmers, as well as the proper dissemination methods. Adoption in the extension process substantially can be interpreted as the changes of behavior process such as knowledge (cognitive), attitudes (affective), and skill (psycho-motoric) in a person after receiving "innovation" from extension submitted by target communities. Knowledge and perception are needed as a first step in adopting a innovation, especially of citrus agribusiness development in Lebong. The process of Specific technology adoption is influenced by internal factors and farmer perceptions of technological innovation. Internal factors such as formal education, experience trying to farm, owned land, production farm goods. The output of this study: 1) to analyze the effectiveness of field trial methods in improving cognitive and affective farmers; 2) Knowing the relationship of adoption level and knowledge of farmers; 3) to analyze the factors that influence farmers' adoption of citrus technology innovation. The method of this study is through the survey to 40 respondents in Rimbo Pengadang Sub District, Lebong District in 2014. Analyzing data is done by descriptive and statistical parametric (multiple linear functions). The results showed that: 1) Field trip method is effective to improve the farmer knowledge (23,17% ) and positively affect the farmer attitude; 2) the knowledge level of PTKJS innovation farmers "positively and very closely related".; 3) the factors that influence the level of farmers' adoption are internal factors (education, knowledge, and the intensity of training), and external factors respondents (distance from the house to the garden and from the house to production facilities shop).

Keywords: affect, adoption technology, citrus gerga, effectiveness dissemination

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Authors: Sharon Harel, Rachel Kizony, Yoram Feldman, Gabi Zeilig, Mordechai Shani

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Multiple Sclerosis (MS) is a neurological disease that may cause restriction in participation in daily activities of young adults. Main symptoms include fatigue, weakness and cognitive decline. The appearance of symptoms, their severity and deterioration rate, change between patients. The challenge of health services is to provide long-term rehabilitation services to people with MS. The objective of this presentation is to describe a course of tele-rehabilitation service of a woman with MS. Methods; R is a 48 years-old woman, diagnosed with MS when she was 22. She started to suffer from weakness of her non-dominant left upper extremity about ten years after the diagnosis. She was referred to the tele-rehabilitation service by her rehabilitation team, 16 years after diagnosis. Her goals were to improve ability to use her affected upper extremity in daily activities. On admission her score in the Mini-Mental State Exam was 30/30. Her Fugl-Meyer Assessment (FMA) score of the left upper extremity was 48/60, indicating mild weakness and she had a limitation of her shoulder abduction (90 degrees). In addition, she reported little use of her arm in daily activities as shown in her responses to the Motor Activity Log (MAL) that were equal to 1.25/5 in amount and 1.37 in quality of use. R. received two 30 minutes on-line sessions per week in the tele-rehabilitation service, with the CogniMotion system. These were complemented by self-practice with the system. The CogniMotion system provides a hybrid (synchronous-asynchronous), the home-based tele-rehabilitation program to improve the motor, cognitive and functional status of people with neurological deficits. The system consists of a computer, large monitor, and the Microsoft’s Kinect 3D sensor. This equipment is located in the client’s home and connected to a clinician’s computer setup in a remote clinic via WiFi. The client sits in front of the monitor and uses his body movements to interact with games and tasks presented on the monitor. The system provides feedback in the form of ‘knowledge of results’ (e.g., the success of a game) and ‘knowledge of performance’ (e.g., alerts for compensatory movements) to enhance motor learning. The games and tasks were adapted for R. motor abilities and level of difficulty was gradually increased according to her abilities. The results of her second assessment (after 35 on-line sessions) showed improvement in her FMA score to 52 and shoulder abduction to 140 degrees. Moreover, her responses to the MAL indicated an increased amount (2.4) and quality (2.2) of use of her left upper extremity in daily activities. She reported high level of enjoyment from the treatments (5/5), specifically the combination of cognitive challenges while moving her body. In addition, she found the system easy to use as reflected by her responses to the System Usability Scale (85/100). To-date, R. continues to receive treatments in the tele-rehabilitation service. To conclude, this case report shows the potential of using tele-rehabilitation for people with MS to provide strategies to enhance the use of the upper extremity in daily activities as well as for maintaining motor function.

Keywords: motor function, multiple-sclerosis, tele-rehabilitation, daily activities

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, John Beatty, Aakash Pai

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Introduction: The development of robotic surgery has accelerated centralisation to tertiary centres, where robotic radical prostatectomy (RP) is offered. The purpose of concentrating treatment in high volume specialist centres is to improve the quality of care and patient outcomes. The aim of this study was to assess the impact on clinical outcomes of centralisation for locally diagnosed patients undergoing RP. Methods: Clinical outcomes for 169 consecutive laparoscopic & open RP pre-centralisation were retrospectively compared with 50 consecutive robotic RP conducted over a similar period post-centralisation. Preoperative risk stratification and time to surgery were collected. Perioperative outcomes, including length of stay (LOS) and complications, were collated. Post-operative outcomes, including erectile dysfunction (ED), biochemical recurrence (BCR), and urinary continence, were assessed. Results: Preoperative risk stratification showed no difference between the two groups. The median time from diagnosis to treatment was similar between the two groups (pre-centralisation, 121 days, post-centralisation, 117 days). The mean length of stay (pre-centralisation, 2.1 days, post-centralisation, 1.6 days) showed no significant difference (p=0.073). Proportion of overall complications (pre-centralisation, 11.4%, post-centralisation, 8.7%) and complications, above Clavien-Dindo 2, were similar between the two groups (pre-centralisation1.2%, post-centralisation 2.2%). Post operative functional parameters, including continence and ED, were comparable. Five-year BCR free rate was 78% for the pre-centralisation group and 79% for the post centralisation group. Conclusion: For our cohort of patients, clinical outcomes have remained static during centralisation. It is imperative that centralisation is accompanied by increased capacity, streamlining of pathways, and training to ensure that improved quality of care is achieved. Our institution has newly acquired a robot, and prospectively studying this data may support the reversal of centralisation for RP surgery.

Keywords: prostate, cancer, prostatectomy, clinical

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