Search results for: group leader
8327 Effect of Preoperative Single Dose Dexamethasone and Lignocaine on Post-Operative Quality of Recovery and Pain Relief after Laparoscopic Cholecystectomy
Authors: Gurjeet Khurana, Surender Singh, Poonam Arora, Praveendra K. Sachan
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Introduction: Post-operative quality of recovery is the key outcome in the perspective of anesthesiologist. It is directly related to patient satisfaction. This is unsurprising, considering most aspects of a poor quality recovery after surgery will impair satisfaction with care. This study was thus undertaken to evaluate effects of Dexamethasone and Lignocaine on Quality of Recovery using QoR- 40 questionnaire and compare their effects. Material and methods: After obtaining the ethical committee approval and written informed consent, 67 patients of 18-60 years, ASA grade I and II scheduled for elective laparoscopic cholecystectomy were randomly allocated into two groups. Group I of 34 patients received 2mg/kg lignocaine diluted to 10ml with normal saline. Group 2 of 33 patients received 0.1 mg/kg I/V Dexamethasone diluted to 10ml with normal saline. QoR-40 was assessed on pre-operative day, and again QoR-40 was assessed at 24 hr post-operative day-1. Postoperative pain scores, nausea and vomiting and shoulder pain were secondary outcomes. Results: The Global QoR-40 was more than 180 at 24 hr in both the groups. The Dexamethasone group had higher Global QoR-40 than lignocaine group 187.94 v/s 182.85. Amongst dimensions of QoR-40 Dexamethasone had statistically better physical comfort, physical independence, and pain relief as compared to Lignocaine. Positive items had excellent responses in Dexamethasone group. Headache, backache and sore throat were also less severe in Dexamethasone group as compared to Lignocaine group. Dexamethasone group had lower VAS compared to lignocaine group. Similarly, there was less fentanyl consumption in dexamethasone group (364.08 ± 127.31) in postoperative period when compared to the lignocaine group (412.31 ± 147.8). Group receiving dexamethasone had 36% increase in appetite compared to lignocaine group (17.6%), which facilitated early oral feeding. Frequency of PONV was less in group-2 at different time interval as compared to group 1. Total episode of PONV were 18 in group 1 and 7 in group 2. Statistically significant difference was seen among two groups (p value= 0.007). Use of antiemetic was more in group 1 as compared to group 2 at all the times, though it was not statistically significant at different time intervals. Antiemetics were administered to 18 patients in group 1 as compared to 5 patients in group 2 postoperatively. Statistically significant difference (p value= 0.011) was seen in total antiemetic consumption. Conclusion: Our study demonstrated that pre-operative administration of a single dose of dexamethasone enhanced the quality of recovery after laparoscopic cholecystectomy as compared to Lignocaine bolus dose.Keywords: dexamethasone, lignocaine, QoR-40 questionnaire, quality of recovery
Procedia PDF Downloads 1228326 Effect of Erythropoietin Hormone Supplementation on Hypoxia-Inducible Factor1-Alpha in Rat Kidneys with Experimental Diabetic Nephropathy
Authors: Maha Deif, Alaa Eldin Hassan, Eman Shaat, Nesrine Elazhary, Eman Magdy
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Background: Erythropoietin (EPO) is a hematopoietic factor with multiple protective effects. The aim of the present study was to investigate the potential effect of EPO administration on renal functions and hypoxia inducible factor 1-alpha (HIF-1a) in diabetic rat kidneys. Methodology: The current study was carried out on 40 male albino rats divided into four groups (n= 10 in each). Group I served as normal control, group II was the diabetic control, group III rats received EPO on the same day of diagnosis of diabetes mellitus (DM), while group IV received the first dose of EPO 2 weeks after the diagnosis of DM. Results: The results showed that EPO supplementation leads to a significant decrease in serum urea, urinary protein and creatinine clearance as well as a significant increase in renal HIF-1a in group III and IV rats compared to the diabetic control group (group II). However, fasting blood glucose was significantly decreased in group III as compared to the diabetic control group in the third week, but no significant difference was reported in the fourth week among groups II, III and IV. Conclusion: EPO administration leads to the improvement of renal functions and increased levels of HIF-1a in diabetic rats.Keywords: erythropoietin, diabetic nephropathy, hypoxia-inducible factor1-alpha, renal functions
Procedia PDF Downloads 2868325 Impact of Pulmonary Rehabilitation on Respiratory Parameters in Interstitial Lung Disease Patients: A Tertiary Care Hospital Study
Authors: Vivek Ku, A. K. Janmeja, D. Aggarwal, R. Gupta
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Purpose: Pulmonary rehabilitation plays a key role in management of chronic lung diseases. However, pulmonary rehabilitation is an underused modality in the management of interstitial lung disease (ILD). This is because limited information is available in literature and no data is available from India on this issue so far. The study was carried out to evaluate the role of pulmonary rehabilitation on respiratory parameters in ILD patients. Methods: The present study was a prospective randomized non-blind case control study. Total of 40 ILD patients were randomized into 2 groups of 20 patients each viz ‘pulmonary rehabilitation group’ and ‘control group’. Pulmonary rehabilitation group underwent 8 weeks pulmonary rehabilitation (PR) along with medical management as per guidelines and the control group was advised only medical management. Results: Mean age in case group was 59.15 ± 10.39 years and in control group was 62.10 ± 14.54 years. The case and the control groups were matched for age and sex. Mean MRC grading at the end of 8 weeks showed significant improvement in the case group as compared to control group (p= 0.011 vs p = 0.655). Similarly, mean St. George Respiratory Questionnaire (SGRQ) score also showed significant improvement in pulmonary rehabilitation group at the end of the study (p= 0.001 vs p= 0.492). However, FEV1 and FVC had no significant change in the case and control group. Similarly, blood gases also did not show any significant difference in the group. Conclusion: Pulmonary rehabilitation improves breathlessness and thereby improves quality of life in the patients suffering from ILD. However, the pulmonary function values and blood gases are unaffected by pulmonary rehabilitation. Clinical Implications: Further large scale multicentre study is needed to ascertain the association.Keywords: ILD, pulmonary rehabilitation, quality of life, pulmonary functions
Procedia PDF Downloads 2708324 An Empirical Study on the Effect of Physical Exercise and Outdoor Lighting on Pupils’ Eyesight
Authors: Zhang Jun Xiong
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Objective: To explore the effect of physical exercise and outdoor lighting on the improvement of pupils' eyesight. Methods: A total of 208 first grade students in a primary school in Chengdu were enrolled in the study, 104 of whom were nearsighted and 104 had normal vision. They were randomly divided into indoor exercise group, outdoor exercise group, indoor control group and outdoor control group. Indoor and outdoor exercise groups performed moderate and high-intensity aerobic exercise three times a week, 60 minutes each time; The indoor and outdoor control groups had normal study and life during the experiment, without exercise intervention. The experiment lasted for one academic year, and the visual indicators of the subjects were tested before and after the experiment. Results: After the experiment, the visual fatigue index of the subjects with normal vision in the outdoor exercise group, indoor exercise group and outdoor control group decreased by 1.5 ± 2.89, 1.4 ± 3.05, 2.12 ± 2.66 respectively, and the diopter index decreased by 0.30D ± 0.09, 0.41D ± 0.16, 0.40D ± 0.19 respectively, while the visual fatigue score of the subjects with normal vision in the indoor control group increased by 2.3 ± 2.15, and the diopter decreased by 0.53D ± 0.22, There were significant differences in visual fatigue and diopter among the subjects with normal vision in each group (P<0.001). After the experiment, the visual fatigue index of the myopic subjects in the outdoor exercise group, indoor exercise group and outdoor control group decreased by 1.8 ± 1.95, 0.8 ± 1.81, 1.1 ± 1.85 respectively, and the diopter index decreased by 0.35D ± 0.21, 0.52D ± 0.24, 0.52D ± 0.15 respectively, while the visual fatigue score of the myopic subjects in the indoor control group increased by 1.3 ± 2.66, and the diopter decreased by 0.62D ± 0.29. There were significant differences between groups in visual fatigue and diopter (P<0.001). Conclusion: Both physical exercise and outdoor lighting can have a beneficial effect on children's vision, and the superposition effect of the two is better. It is suggested that outdoor physical exercise should be carried out more in primary school.Keywords: physical exercise, outdoor lighting, pupil, vision, myopia
Procedia PDF Downloads 898323 An Exploratory Study on the Difference between Online and Offline Conformity Behavior among Chinese College Students
Authors: Xinyue Ma, Dishen Zhang, Yijun Liu, Yutian Jiang, Huiyan Yu, Chufeng Gu
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Conformity is defined as one in a social group changing his or her behavior to match the others’ behavior in the group. It is used to find that people show a higher level of online conformity behavior than offline. However, as anonymity can decrease the level of online conformity behavior, the difference between online and offline conformity behavior among Chinese college students still needs to be tested. In this study, college students (N = 60) have been randomly assigned into three groups: control group, offline experimental group, and online experimental group. Through comparing the results of offline experimental group and online experimental group with the Mann-Whitney U test, this study verified the results of Asch’s experiment, and found out that people show a lower level of online conformity behavior than offline, which contradicted the previous finding found in China. These results can be used to explain why some people make a lot of vicious remarks and radical ideas on the Internet but perform normally in their real life: the anonymity of the network makes the online group pressure less than offline, so people are less likely to conform to social norms and public opinions on the Internet. What is more, these results support the importance and relevance of online voting, because fewer online group pressures make it easier for people to expose their true ideas, thus gathering more comprehensive and truthful views and opinions.Keywords: anonymity, Asch’s group conformity, Chinese college students, online conformity
Procedia PDF Downloads 1538322 Teacher-Scaffolding vs. Peer-Scaffolding in Task-Based ILP Instruction: Effects on EFL Learners’ Metapragmatic Awareness
Authors: Amir Zand-Moghadam, Mahnaz Alizadeh
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The aim of the present study was to investigate the effect of teacher-scaffolding versus peer-scaffolding on EFL learners’ metapragmatic awareness in the paradigm of task-based language teaching (TBLT). To this end, a number of dialogic information-gap tasks requiring two-way interactant relationship were designed for the five speech acts of request, refusal, apology, suggestion, and compliment following Ellis’s (2003) model. Then, 48 intermediate EFL learners were randomly selected, homogenized, and assigned to two groups: 26 participants in the teacher-scaffolding group (Group One) and 22 in the peer-scaffolding group (Group Two). While going through the three phases of pre-task, while-task, and post-task, the participants in the first group completed the designed tasks by the teacher’s interaction, scaffolding, and feedback. On the other hand, the participants in the second group were required to complete the tasks in expert-novice pairs through peer scaffolding in all the three phases of a task-based syllabus. The findings revealed that the participants in the teacher-scaffolding group developed their L2 metapragmatic awareness more than the peer-scaffolding group. Thus, it can be concluded that teacher-scaffolding is more effective than peer scaffolding in developing metapragmatic awareness among EFL learners. It can also be claimed that the use of tasks can be more influential when they are accompanied by teacher-scaffolding. The findings of the present study have implications for language teachers and researchers.Keywords: ILP, metapragmatic awareness, scaffolding, task-based instruction
Procedia PDF Downloads 5858321 Long-Term Results of Surgical Treatment of Atrial Fibrillation in Patients with Coronary Heart Disease: One Center Experience
Authors: Emil Sakharov, Alex Zotov, Ilkin Osmanov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov
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Objective: Since 2015, our center has been actively implementing methods of surgical correction of atrial fibrillation, in particular, in patients with coronary heart disease. The study presents a comparative analysis of the late postoperative period in patients with coronary artery bypass grafting and atrial fibrillation. Methods: The study included 150 patients with ischemic heart disease and atrial fibrillation for the period from 2015 to 2021. Patients were divided into 2 groups. The first group is represented by patients with ischemic heart disease and atrial fibrillation who underwent coronary bypass surgery and surgical correction of atrial fibrillation (N=50). The second group is represented by patients with ischemic heart disease and atrial fibrillation who underwent only myocardial revascularization (N=100). Patients were comparable in age, gender, and initial severity of the condition. Among the patients in group 1 there were 82% were men, while in the second group, their number was 75%. Among the patients of the first group, there were 36% with persistent atrial fibrillation, 20% with long-term persistent atrial fibrillation. In the second group, 10% with persistent atrial fibrillation and 17% with long-term persistent atrial fibrillation. Results: Average follow-up for groups 1 and 2 amounted to 47 months. There were no complications in group 1, such as bleeding and stroke. There was only 1 patient in group 1, who had died from cardiovascular disease. Freedom of atrial fibrillation was in 82% without AADs therapy. In group 2 there were 8 patients who had died from cardiovascular diseases and total freedom of atrial fibrillation was in 35% of patients, among which 42.8% had additional AADs therapy. Follow-up data are presented in Table 2. Progression of heart failure was observed in 3% in group 1 and 7% in group 2. Combined endpoints (recurrence of AF, stroke, progression of heart failure, myocardial infarction) were achieved in 16% in group 1 and 34% in group 2, respectively. Freedom from atrial fibrillation without antiarrhythmic therapy was 82% for group 1 and 35% for group 2. In the first group, there is a more pronounced decrease in heart failure rates. Deaths from cardiovascular causes were recorded in 2% for group 1 and 7% for group 2. Conclusion: Surgical treatment of atrial fibrillation helps to reduce adverse complications in the late postoperative period and contributes to the regression of heart failure.Keywords: atrial fibrillation, coronary artery bypass grafting, ischaemic heart disease, heart failure
Procedia PDF Downloads 1198320 Eugenol Effects on Metabolic Syndrome Induced Liver Damages
Authors: Fatemeh Kourkinejad Gharaei, Tahereh Safari, Zahra Saebinasab
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Metabolic syndrome (MetS) is a set of risk factors associated with cardiovascular diseases, atherosclerosis, and type 2 diabetes. Nonalcoholic fatty liver disease (NAFLD) is the most important liver disorder in metabolic syndrome. High fructose consumption increases the risk of NAFLD. Eugenol shows anti-thrombotic, insulin-sensitive, fat-reducing effects. This study was designed to investigate the protective role of eugenol in NAFLD caused by metabolic syndrome. Methods: Thirty male Wistar rats were randomly divided into five groups; group 1, drinking water intake animals; group 2, fructose, group 3, fructose+eugenol solvent; group 4, fructose+ eugenol 50mg/kg and group 5, fructose+ eugenol 100mg/kg. At the end of the experiment, after 12 hours of fasting and under anesthesia, blood samples were taken for measurement of fast blood glucose (FBS), SGOT, AGPT, LDL, HDL, cholesterol, triglyceride. Results: FBG significantly increased in group 2 compared to group 1 (p < 0.001); however, it significantly decreased in groups 4 and 5 compared to group 2 (p < 0.05). SGOT and SGPT levels significantly increased in group 2 compared to drinking water alone (p < 0.001). However, SGOT and SGPT levels significantly decreased in groups 4 and 5. MDA and LTDS significantly increased in group 2 compared with drinking water alone (p < 0.01), while MDA and LTDS decreased in 4 and 5 groups compared to group 2 (p < 0.05), which confirms the pathology results related to the liver damage. Conclusion: Eugenol has protective effects on the liver and fat accumulation in liver cells.Keywords: eugenol, fructose, metabolic syndrome, nonalcoholic fatty liver disease
Procedia PDF Downloads 1248319 Exercise and Aging Process Related to Oxidative Stress
Authors: B. Dejanova, S. Petrovska, L. Todorovska, J. Pluncevic, S. Mancevska, V. Antevska, E. Sivevska, I. Karagjozova
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Introduction: Aging process is mainly related to endothelial function which may be impaired by oxidative stress (OS). Exercise is known to be beneficial to aging process, which may improve health and prevent appearance of chronic diseases in elderly. The aim of the study was to investigate the OS markers related to exercise. Methods: A number of 80 subjects (healthy volunteers) were examined (38 male and 32 female), divided in 3 age groups: group I ≤ 30 years (n=24); group II – 31-50 years (n=24); group III - ≥ 51 year (n=32). Each group was divided to subgroups of sedentary subjects (SS) and subjects who exercise (SE). Group I: SS (n=11), SE (n=13); group II: SS (n=13), SE (n=10); group III: SS (n=23) SE (n=9). Lipid peroxidation (LP) as a fluorimetric method with thiobarbituric acid was used to estimate OS. Antioxidative status was determined by cell antioxidants such as enzymes - superoxide dismutase (SOD), glutathione peroxidase (GPx) and glucose 6 phosphate (G-6-PD); and by extra cell antioxidants such as glutathione reductase (GR), nitric oxide (NO) and total antioxidant capacity (TAC). Results: Increased values of LP were noticed along the aging process: group I – 3.30±0.3 µmol/L; group II – 3.91±0.2 µmol/L; group III – 3.94±0.8 µmol/L (p<0.05), while no statistical significance was found between male and female subjects. Statistical significance for OS was not found between SS and SE in group I as it was found in group II (p<0.05) and in group III (p<0.01). No statistical significance was found for all cell antioxidants and GR within the groups, while NO and TAC showed lower values in SS compared to SE in II (p<0.05) and in group III (p<0.05). Discussion and conclusion: Aging process showed increased OS which may be either due to impaired function of scavengers of free radicals or due to their enormous production. Well balanced exercise might be one of the factors that keep the integrity of blood vessel endothelium which slows down the aging process. Possible mechanism of exercise beneficial influence is shear stress by upregulation of genes coding for nitric oxide bioavailability. Thus, due to obtained results we may conclude that OS is found to be diminished in the subject groups who perform exercise.Keywords: oxidative stress, aging process, exercise, endothelial function
Procedia PDF Downloads 3878318 Study on 3D FE Analysis on Normal and Osteoporosis Mouse Models Based on 3-Point Bending Tests
Authors: Tae-min Byun, Chang-soo Chon, Dong-hyun Seo, Han-sung Kim, Bum-mo Ahn, Hui-suk Yun, Cheolwoong Ko
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In this study, a 3-point bending computational analysis of normal and osteoporosis mouse models was performed based on the Micro-CT image information of the femurs. The finite element analysis (FEA) found 1.68 N (normal group) and 1.39 N (osteoporosis group) in the average maximum force, and 4.32 N/mm (normal group) and 3.56 N/mm (osteoporosis group) in the average stiffness. In the comparison of the 3-point bending test results, the maximum force and the stiffness were different about 9.4 times in the normal group and about 11.2 times in the osteoporosis group. The difference between the analysis and the test was greatly significant and this result demonstrated improvement points of the material properties applied to the computational analysis of this study. For the next study, the material properties of the mouse femur will be supplemented through additional computational analysis and test.Keywords: 3-point bending test, mouse, osteoporosis, FEA
Procedia PDF Downloads 3518317 Effects of a Nursing Intervention Program Using a Rehabilitation Self-Management Workbook on Depression, Motivation and Self-Efficacy of Rehabilitation Inpatients
Authors: Young Ae Song, So Yun Kim, Nan Ji Kim, So Young Jang, Yun Mee Park, Mi Jin Lee, Ji Yeon Lee
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Background & Purpose: Many patients have psychological problems such as depression and anxiety during the rehabilitation period. Such psychological instability affects the prognosis of the patient in the long term. We develop a nursing intervention program for rehabilitation inpatients using a rehabilitation self –management note and evaluate the effects of the program on depression, motivation, and self-efficacy. Methods: The study was conducted using a nonequivalent control group non-synchronized design. Participants were rehabilitation inpatients, 27 patients in the control group and 20 in the experimental group. Questionnaires were completed three times (pretest, 5 days, 10 days) Final data for 40 patients were analyzed, 23 patients in the control group and 17 in the experimental group. Data were analyzed using x2-test, t-test, and repeated measure ANOVA. Results: Depression in the experimental group decreased compared to the control group, but it was not significant. The motivation for the experimental group changed significantly (F=3.90, p=.029) and self-efficacy increased, but not significantly (F=0.59, p=.559) Conclusion: Results of this study indicate that nursing intervention programs for rehabilitation inpatients could be useful to decrease depression and to improve motivation and self-efficacy.Keywords: depression, motivation, self-efficacy, rehabilitation inpatient, self-management workbook
Procedia PDF Downloads 1468316 Islamophobia, Years After 9/11: An Assessment of the American Media
Authors: Nasa'i Muhammad Gwadabe
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This study seeks to find the extent to which the old Islamophobic prejudice was tilted towards a more negative direction in the United States following the 9/11 terrorist attacks. It is hypothesized that, the 9/11 attacks in the United States reshaped the old Islamophobic prejudice through the reinforcement of a strong social identity construction of Muslims as “out-group”. The “social identity” and “discourse representation” theories are used as framework for analysis. To test the hypothesis, two categories were created: the prejudice (out-group) and the tolerance (in-group) categories. The Prejudice (out-group) against Muslims category was coded to include six attributes: (Terrorist, Threat, Women's Rights violation, Undemocratic, Backward and Intolerant); while the tolerance (In-group) for Muslims category was also coded to include six attributes: (Peaceful, civilized, educated, partners trustworthy and honest). Data are generated from the archives of three American newspapers: The Los Angeles Times, New York Times and USA Today using specific search terms and specific date range; from 9/11/1996 to 9/11/2006, that is five years before and five years after the 9/11. An aggregate of 20595 articles were generated from the search of the three newspapers throughout the search periods. Conclusively, for both pre and post 9/11 periods, the articles generated under the category of prejudice (out-group) against Muslims revealed a higher frequency, against that of tolerance (in-group) for them, which is lesser. Finally, The comparison between the pre and post 9/11 periods showed that, the increased Prejudice (out-group) against Muslims was most influenced through libeling them as terrorist, which signaled a skyrocketed increase from pre to post 9/11.Keywords: in-group, Islam, Islamophobia, Muslims, out-group, prejudice, terrorism, the 9/11 and tolerance
Procedia PDF Downloads 3068315 Propranalol is Not Effective in Preventing the Progression to Severe Portal Hypertensive Gastropathy in Cirrhotic Patients who Had Undergone Variceal Eradication: A Randomised Controlled Trial
Authors: Jeffey George, Varghese Thomas
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Background and Objectives: PHG is an important source of gastrointestinal bleeding in patients with portal hypertension. Aim: To assess the progression to severe portal hypertensive gastropathy(PHG) in patients with cirrhosis who were treated with maximum tolerated dose of propranalol, after variceal eradication to grade II or below. Methods: Cirrhotic patients(child A and B) presenting with upper gastrointestinal bleeding with endoscopic findings of mild or no PHG were followed up over 6 months after variceal eradication to assess the progression to severe PHG. Included patients were randomised to either maximum tolerated doses of propranalol (group A) or to no treatment (group B). Primary end point of the study were the development of gastrointestinal bleed, evidence of hepatic decompensation and death. Progression to severe PHG were compared between the two groups. Results: 56 patients (49 males) were enrolled (group A = 28, group B = 28). 8 patients were excluded from final analysis (gi bleed=5, encephalopathy=2,HCC=1 including 4 deaths).3 patients were lost to follow-up, and 1 developed intolerance to propranalol. Mean dose of propranalol used was 60 mg per day. Progression to severe PHG in the fundus over 6 months was 23.8% in group A versus 15.8 % in group B (p = 0.52). Severe PHG was noted in body in 14.3% in group A versus 21.1% in group B (p = 0.57). 23.8 % in group A had progression to severe PHG compared with 15.8 % in group B (p =0.52). There was no statistically significant difference in the progression of PHG between the two groups(p=0.43). Conclusion: In this short term study propranalol was found not to prevent the progression to severe portal hypertensive gastropathy in cirrhotic patients who had undergone endotherapy for esophageal varices.Keywords: propranalol, portal hypertensive gastropathy, cirrhotic patients, gastroenterology
Procedia PDF Downloads 3478314 Effects of Probiotics on Specific Immunity in Broiler Chicken in Syria
Authors: Moussa Majed, Omar Yaser
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The main objective of this experiment was to study the impact of Probiotic compound on the specific immunity as the case study of infectious bursal disease. Total of 8000 one-day old Ross 108 broiler were randomly divided into two experimental groups; control group (4500 birds) and experimental group (3500 birds). Birds in two groups were reared under similar environmental conditions. Birds in control group received basal diets without probiotic whereas the birds in experimental one were fed basal diets supplemented with a commercial probiotic mixture) probiotic lacting k, which contains bacteria cells beyond to lactobacillus, Streptococcus and bifidobacterium genus that are isolated from gut microflora in healthy chickens(. The commercial probiotic were used according to the manufacturer instruction. 400 blood samples for each group were collected from wing vein every 5-7 days as interval period till 42 days old. Indirect Enzyme-Linked Immunosorbent Assay (ELISA) test was performed to detect the level of infectious bursal disease virus (IBDV) antibodies. The results clearly showed that the mean of immune titers was significantly (p= 0.03) higher in trail group than control one. The coefficient of variance percentages were 55% and 39% for control and trial groups respectively, this illustrates that homogeneity of immunity titers in the trail group was much better comparing with control group. The values of geometric means of titers in the control group and trial group were reported 3820 and 8133, respectively. The crude mortality rate in the experimental group was two times lower comparing with control group (14% and 28% respectively, p = 0.005Keywords: probiotic, broiler chicken, infectious bursal disease, immunity, ELISA test
Procedia PDF Downloads 708313 Dietary Effect of Probiotic Bacteria, Bacillus amyloliquefaciens JFP-2 Isolate from Jeju Island`s Traditional Fermented Food, on Innate Immune Response of Oplegnathus fasciatus Challenged with Vibrio anguillarum
Authors: Dong Hwi Kim, Dharaneedharan Subramanian, So Hyun Park, Ha-Ri Choi, Ji-Hyung Kim, Dong-Hoon Lee, Moon Soo Heo
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The present study was performed to evaluate the use of Bacillus amyloliquefaciens JFP-2 isolated from a traditional fermented sea food, as probiotic bacteria in the diets for Rock-bream, Oplegnathus faciatus. A total of 180 fish (187.4 ± 2.7 g) were divided into two groups, control (C) and probiotic (P) group (90 fish per group) in triplicate. C group was fed with basal diet without probiotic, while P group was fed with B. amyloliquefaciens spores at concentration of 1.4 x 106 colony forming units per gram (CFU/g) of feed. After two months of feeding experiments, P group fish showed significant improvements in body weight (BW), weight gain (WG), specific growth rate (SGR) and food conversion ratio (FCR) compared with C group. Also, bi-weekly assessment of serum protein, glucose, fatty acid profile showed a significant increase in probiotic fed fish than that of control fish group. Similar increase in serum antioxidant and lysozyme activity was found in probiotic fed fish group. Twenty days challenge experiment shows decrease mortality in probiotic fed fish group when compared with that of control group. Hence, these results indicate that the use of B. amyloliquefaciens JFP-2 as a feed supplement, is beneficial to improve the health status of Oplegnathus fasciatus challenged with Vibrio anguillarum.Keywords: Bacillus amyloliquefaciens, Oplegnathus fasciatus, probiotic feed, rock bream
Procedia PDF Downloads 2598312 Antimicrobial Efficacy of 0.75% Metronidazole and 2% Chlorhexidine Gel Applied in Implant Screw Hole: A Clinical Trial
Authors: Mostafa Solati
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Objectives: Considering the gap of information regarding the optimal antimicrobial efficacy of metronidazole for application in the implant screw hole, this study aimed to compare the antimicrobial efficacy of 0.75% metronidazole and 2% chlorhexidine (CHX) gel applied in the implant screw hole. Materials and Methods: This randomized controlled clinical trial evaluated 60 implants (20 patients, each requiring three implants) in three groups (n=20). In group 1, 0.75% metronidazole gel was applied to the implant screw hole. In group 2, 2% CHX gel was applied, and in group 3, no material was used. Microbial samples were collected from the screw holes after three months, and the microbial colonies were counted. Data were analyzed using ANOVA. Results: The number of bacteria in the control group was significantly higher than that in 0.75% metronidazole gel and 2% CHX groups (P<0.05). The CHX group caused the maximum reduction in colony count with no significant difference from the metronidazole group (P>0.05). Conclusion: The application of 0.75% metronidazole gel and 2% CHX can effectively decrease the colony count in the implant screw hole and can probably play a role in the preservation of peri-implant tissue health.Keywords: dental implant, metronidazole, CHX, screw hole
Procedia PDF Downloads 708311 The Effects of Ellagic Acid on Rat Heart Induced Tobacco Smoke
Authors: Nalan Kaya, D. Ozlem Dabak, Gonca Ozan, Elif Erdem, Enver Ozan
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One of the common causes of cardiovascular disease (CVD) is smoking. Moreover, tobacco smoke decreases the amount of oxygen that the blood can carry and increases the tendency for blood clots. Ellagic acid is a powerful antioxidant found especially in red fruits. It was shown to block atherosclerotic process suppressing oxidative stress and inflammation. The aim of this study was to examine the protective effects of ellagic acid against oxidative damage on heart tissues of rats induced by tobacco smoke. Twenty-four male adult (8 weeks old) Spraque-Dawley rats were divided randomly into 4 equal groups: group I (Control), group II (Tobacco smoke), group III (Tobacco smoke + corn oil) and group IV (Tobacco smoke + ellagic acid). The rats in group II, III and IV, were exposed to tobacco smoke 1 hour twice a day for 12 weeks. In addition to tobacco smoke exposure, 12 mg/kg ellagic acid (dissolved in corn oil), was applied to the rats in group IV by oral gavage. An equal amount of corn oil used in solving ellagic acid was applied to the rats by oral gavage in group III. At the end of the experimental period, rats were decapitated. Heart tissues and blood samples were taken. Histological and biochemical analyzes were performed. Vascular congestion, hyperemic areas, inflammatory cell infiltration and increased connective tissue in the perivascular area were observed in tobacco smoke and tobacco smoke + corn oil groups. Increased connective tissue in the perivascular area, hemorrhage and inflammatory cell infiltration were decreased in tobacco smoke + EA group. Group-II GSH level was not changed (significantly), CAT, SOD, GPx activities were significantly higher than group-I. Compared to group-II, group-IV GSH, SOD, CAT, GPx activities were increased, and MDA level was decreased significantly. Group-II and Group-III levels were similar. The results indicate that ellagic acid could protect the heart tissue from the tobacco smoke harmful effects.Keywords: ellagic acid, heart, rat, tobacco smoke
Procedia PDF Downloads 2258310 Effectiveness of Internet Psychological Counseling in Reducing Social Shyness Symptoms among Students of University of Tabuk
Authors: Khawla Saad Albalawi
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The aim of this research was to explore the effectiveness of the internet counseling in reducing social shyness among the university's students. The sample consisted of 40 students and was divided into two groups: an experimental group and a control group. The social shyness scale (SSS) was administered to both groups before applying the counseling to the experimental group (as a pre-test). After that, the internet counseling was applied to the experimental group. Next, the SSS was administered to both groups (as a post-test). Finally, the SSS was administered to the experimental group (as an iterative application). Results suggest that: 1. There is a significant difference between the two groups in the post-test in all dimensions and the total score of the (SSS) in favor of the experimental group in all cases. 2. There is a significant difference between the pre- and the post-test of the experimental group in all dimensions and the total score of the (SSS) in favor of the post-test in all cases. 3. There is no significant difference between the post-test and the iterative application of the experimental group in all dimensions and the total score of the (SSS). The above results were discussed in light of previous research. Recommendations and future researches were suggested.Keywords: internet psychological clinics, social interaction disorders, shyness, Twitter, Facebook
Procedia PDF Downloads 4978309 Critical Review of the Democracy in Pakistan in Light of Dr. Israr Ahmed and Western Philosophers
Authors: Zoaib Mirza
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Pakistan is an Islamic country that got its partition from India in 1947 so that the people could practice the religion of Islam. The ideology of Pakistan was based on the notion that sovereignty only belonged to God Almighty (in Arabic, God means “Allah”), and Muslims will live in accordance with Islam principles. The Quran (Holy Book) and Sunnah (authentic practices of Prophet Mohammad, Peace Be Upon Him, that explains the application of the Quran) are foundations of the Islamic principles. It has been over 75 years, but unfortunately, Pakistan, due to its own political, social, and economic mistakes, is responsible for not being able to become a true Islamic nation to justify its partition from India. The rationale for writing this paper is to analyze the factors that led to changes in the democratic movements impacting the country's political, social, and economic growth. The methodology to examine the historical and political context of Pakistan’s history is by referencing the scholarly work of Israr Ahmed, a Pakistani Islamic theologian, philosopher, and Islamic scholar. While from a Western perspective, Karl Marx, Mar Weber, Hannah Arendt, Sheldon Wolin, Paulo Freire, and Jacques Ranciere's philosophies specific to totalitarianism, politics, military rule, religion, capitalism, and superpower are used as the framework to analyze Pakistan’s democracy. The study's findings conclude that Pakistan's democracy is unstable and has been impacted by military and civilian governance, which led to political, social, and economic downfall. To improve the current situation, the citizens of Pakistan have to realize that the success of a nation is only dependent on the level of consciousness of the leader and not the political system. Therefore, it is the responsibility of every citizen to be conscious of how they select their leader and take responsibility for the current situation in Pakistan.Keywords: Pakistan, Islam, democracy, totalitarianism, military, religion, capitalism
Procedia PDF Downloads 908308 Growth Performance and Critical Supersaturation of Heterogeneous Condensation for High Concentration of Insoluble Sub-Micron Particles
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Measuring the growth performance and critical supersaturation of particle group have a high reference value for constructing a supersaturated water vapor environment that can improve the removal efficiency of the high-concentration particle group. The critical supersaturation and the variation of the growth performance with supersaturation for high-concentration particles were measured by a flow cloud chamber. Findings suggest that the influence of particle concentration on the growth performance will reduce with the increase of supersaturation. Reducing residence time and increasing particle concentration have similar effects on the growth performance of the high-concentration particle group. Increasing particle concentration and shortening residence time will increase the critical supersaturation of the particle group. The critical supersaturation required to activate a high-concentration particle group is lower than that of the single-particle when the minimum particle size in the particle group is the same as that of a single particle.Keywords: sub-micron particles, heterogeneous condensation, critical supersaturation, nucleation
Procedia PDF Downloads 1578307 IN-SEAN: The Pace of Economic Cooperation between India and ASEAN
Authors: Eumsin Payan
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The article desires the Association of Southeast Asian Nations (ASEAN) to take interest in the policies and give importance to India over other powerful countries in the World, including powerful countries in Asia, comprising of: People’s Republic of China (PRC), Russia, and India countries with the ability to drive the Asian continent, specifically, the ASEAN Economic Community (AEC). (Japan was incapable of stepping up to become the leader of ASEAN due to the fact that Japan has created “wounds” from military history with too many countries in Asia, including wounds from the Greater East Asia War, combining with economic problems Japan is currently facing and also several natural disasters, therefore Japan is not considered a good option of our era.) China appears to be an option that stands out, which could be seen through countless published articles in the general public. However, this article desires to propose India as an option to develop and drive the relationship between ASEAN countries in the future development of Computer Science Technology and allow India to be the leader in driving the Asian Economy in place of China and the United States. As for Russia, its location is distant and apart from South East Asia. Moreover, Russia does not give as much importance to ASEAN. In this light, the author perceives that India already has the “Look East” policy. Therefore, it would be simple for ASEAN to look back at India by simply starting cooperation through policies related to collaboration in the areas of computer science. In effect, this will continuously adjust and improve the relationship towards cooperation in the areas of economics, society, and culture. Referring to the above, the author suggests a word that could be used to call the relationship between India and ASEAN, INSEAN or IN-SEAN. Hereinafter, the author hopes that Thailand, in the position of one in the five founders of ASEAN, could become the leader or be the entity that pushes forward the ASEAN policies that will increase the importance of looking towards India. India is an emerging giant that has the ability to step up in Asia. With the proficient use of English, India is able to pass on the knowledge and drive the ASEAN’s Economic relationship better than China or Russia, as faced with higher language barriers. Moreover, India has cultivated democratic civilization from the colonization of the British Empire, similar to other nations of Southeast Asia, which are familiar with various heritage cultures that the British has brought them. The most important aspect in the author’s perspective is the fact that India is not aggressive and that they have courtesy. Through developing policies of the East through the “Look East” policy, it enabled India to establish a more smooth relationship with Asian countries comparing to China. China has imposed harsh policies towards democracy to the land above the South China Sea, which directly affect the ASEAN countries. From the above reasons, India, therefore, is an appropriate option in the establishment of a closer relationship with ASEAN, as the author has proposed relationship as INSEAN or IN-SEAN.Keywords: IN-SEAN, INSEAN, look west policy, look east policy, ASEAN, India
Procedia PDF Downloads 6478306 Effectiveness of Metacognitive Therapy in Metacognitive Beliefs, Anxiety and Social Phobia of Male High School Students
Authors: Saba Hasanvandi, Molok Khademi Ashkezari, Niloofar Esmaieli
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The research purpose was to assess the effectiveness of metacognitive therapy in metacognitive beliefs, anxiety and social phobia of male students studying in the high schools of Dargaz City. The sample comprised 30 students who were randomly selected and assigned to the experimental and control groups. The kind of this study was experimental study with pre-ops and follow-up stages. Subjects filled out metacognitive beliefs, anxiety and social phobia questionnaires. The experimental group underwent 10 sessions of therapeutic metacognitive sessions. The group therapy was conducted for ten, weekly, 90-minute sessions. Mankova analysis was utilized to analyze the data. Results revealed that metacognitive group therapy decreased metacognitive beliefs (P=0.007), anxiety (P<0.001) and social phobia (P=<0.017) in the experimental group as compared to the control group. Furthermore, the effectiveness of group metacognitive therapy was stable and consistent after one month of time interval. The results of present study can be effective for mental health professional in reaching a better understanding of anxiety and social phobia.Keywords: group metacognitive therapy, metacognitive beliefs, anxiety, social phobia, high school students
Procedia PDF Downloads 5888305 Evaluation of Three Commercially Available Materials in Reducing the White Spot Lesions During Fixed Orthodontic Treatment: A Prospective Randomized Controlled Trial
Authors: Sayeeda Laeque Bangi
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Objectives: Treating white spot lesions (WSL) to create a sound and esthetically pleasing enamel surface is a question yet to be fully answered. The objective of this randomized controlled trial was to measure and compare the degree of regression of WSL during orthodontic treatment achieved by using three commercially available materials. Methods: A single-blinded randomized prospective clinical trial, comprising 80 patients categorized into four groups (one control group and three experimental groups, with 20 subjects per group) using block randomization, was conducted. Group A (control group): Colgate strong toothpaste; and experiments groups were Group B: GC tooth mousse, Group C: Phos-Flur mouthwash and Group D: SHY-NM. Subjects were instructed to use the designated dentifrice/mouthwash and photographs were taken at baseline, third and sixth months, and white spot lesions were reassessed in the maxillomandibular anterior teeth. Results: All the three groups had shown an improvement in WSL. But Group B has shown the greatest difference in mean values of decalcification index (DI) scores. Conclusion: All three commercially available products showed a regression of WSL over a 6-month duration. GC tooth mousse proved to be the most effective means of treating WSL over other regimens.Keywords: white spot lesions, dentifrices, orthodontic therapy, remineralization
Procedia PDF Downloads 1998304 Distributed Leadership and Emergency Response: A Study on Seafarers
Authors: Delna Shroff
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Merchant shipping is an occupation with a high rate of fatal injuries caused by organizational accidents and maritime disasters. In most accident investigations, the leader’s actions are under scrutiny and point out the necessity to investigate the leader’s decisions in critical conditions. While several leadership studies have been carried out in the past, there is a tendency for most research to focus on holders of formal positions. The unit of analysis in most studies has been the ‘individual.’ A need is, therefore, felt to adopt a practice-based perspective of leadership, understand how leadership emerges to affect maritime safety. This paper explores the phenomenon of distributed leadership among seafarers more holistically. It further examines the role of one form of distributed leadership, that is, planfully aligned leadership in the emergency response of the team. A mixed design will be applied. In the first phase, the data gathered by way of semi-structured interviews will be used to explore the seafarer’s implicit understanding of leadership. The data will be used to develop a conceptual framework of distributed leadership, specific to the maritime context. This framework will be used to develop a simulation. Experimental design will be used to examine the relationship between planfully aligned leadership and emergency response of the team members during navigation. Findings show that planfully aligned leadership significantly and positively predicts the emergency response of team members. Planfully aligned leadership leads to a better emergency response of the team members as compared to authoritarian leadership. In the third qualitative phase, additional data will be gathered through semi-structured interviews to further validate the findings to gain a more complete understanding of distributed leadership and its relation to emergency response. Above are the predictive results; the study expects to be a cornerstone of safety leadership research and has important implications for leadership development and training within the maritime industry.Keywords: authoritarian leadership, distributed leadership, emergency response , planfully aligned leadership
Procedia PDF Downloads 1758303 The Effects of High Velocity Low Amplitude Thrust Manipulation versus Low Velocity Low Amplitude Mobilization in Treatment of Chronic Mechanical Low Back Pain
Authors: Ahmed R. Z. Baghdadi, Ibrahim M. I. Hamoda, Mona H. Gamal Eldein, Ibrahim Magdy Elnaggar
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Background: High-velocity low amplitude thrust (HVLAT) manipulation and low-velocity low amplitude (LVLA) mobilization are an effective treatment for low back pain (LBP). Purpose: This study compared the effects of HVLAT versus LVLA on pain, functional deficits and segmental mobility in treatment of chronic mechanical LBP. Methods: Ninety patients suffering from chronic mechanical LBP are classified to three groups; Thirty patients treated by HVLAT (group I), thirty patients treated by LVLA (group II) and thirty patients as control group (group III) participated in the study. The mean age was 28.00±2.92, 27.83±2.28 and 28.07±3.05 years and BMI 27.98±2.60, 28.80±2.40 and 28.70±2.53 kg/m2 for group I, II and III respectively. The Visual Analogue Scale (VAS), the Oswestry low back pain disability questionnaire and modified schoper test were used for assessment. Assessments were conducted two weeks before and after treatment with the control group being assessed at the same time intervals. The treatment program group one was two weeks single session per week, and for group II two sessions per week for two weeks. Results: The One-way ANOVA revealed that group I had significantly lower pain scores and Oswestry score compared with group II two weeks after treatment. Moreover, the mobility in modified schoper increased significantly and the pain scores and Oswestry scores decreased significantly after treatment in group I and II compared with control group. Interpretation/Conclusion: HVLAT is preferable to LVLA mobilization, possibly due to a beneficial neurophysiological effect by Stimulating mechanically sensitive neurons in the lumbar facet joint capsule.Keywords: low back pain, manipulation, mobilization, low velocity
Procedia PDF Downloads 6038302 The Applications of Group Counseling on Self-Concept, Depression, and Resilience of Teenage Pregnancy
Authors: Fauziah Mohd Sa’ad, Mohammad Aziz Shah, B. Mohammad Arip, Norazani Ahmad, Mohd Noor Idris, Hapsah M. Yusof
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This study was carried out to assess the application of person-centred therapy and Cognitive Psychology Ad-Din group counseling on self-concept, depression, and resilience of teenage pregnancy. This study involved 55 teenage pregnancy at three women’s refuge centers which are from KEWAJA, Rhaidatus Sakinah, and Taman Seri Puteri Cheras (JKM). Subjects were classed into two treatment groups and one control group. The Multidimensional Self-Concept Scale (MSCS), Beck Depression inventory (BDI) and Adolescent Resiliency Attitude Scale (ARAS) was administered to assess self-concept, depression, and resilience of teenage pregnancy. The control pre and post test design was used for this study. The research data were analyzed using descriptive analysis, ANOVA, MANCOVA and Tuckey Post Hoc with the significant level of .01 and .05. All treatment group received group counseling sessions for 7 consecutive week, once in each week. The Person-centred group and Cognitive Psychology Ad-Din group counseling showed a significant reduction (pre-test to post-test) on depression, enhancing self-concept and resilience of teenage pregnancy.Keywords: group counseling, person-centred therapy, cognitive psychology Ad-Din, teenage pregnancy
Procedia PDF Downloads 5738301 Effect of Application of Turmeric Extract Powder Solution on the Color Changes of Non-Vital Teeth (An In-vitro study).
Authors: Haidy N. Salem, Nada O. Kamel, Shahinaz N. Hassan, Sherif M. Elhefnawy
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Aim: to assess the effect of using turmeric powder extract on changes of tooth color with extra-coronal and intra-coronal bleaching methods. Methods: Turmeric powder extract was weighted and mixed with two different hydrogen peroxide concentrations (3% and 6%) to be used as a bleaching agent. Thirty teeth were allocated into three groups (n=10): Group A: Bleaching agent (6%) was applied on the labial surface, Group B: Bleaching agent (3%) was applied inside the pulp chamber and Group C: Extra and intra-coronal bleaching techniques were used (6% and 3% respectively). A standardized access cavity was opened in the palatal surface of each tooth in both Groups B and C. Color parameters were measured using a spectrophotometer. Results: A statistically significant difference in color difference values (∆E*) and enamel brightness (∆L*) was found between Group C and each of Groups A and B. There was no statistically significant difference in (∆E*) and (∆L*) between Group A and Group B. The highest mean value of (∆E*) and (∆L*) was found in Group C, while the least mean value was found in Group B. Conclusion: Bleaching the external and internal tooth structure with low concentrations of hydrogen peroxide solution mixed with turmeric extract has a promising effect in color enhancement.Keywords: bleaching, hydrogen peroxide, spectrophotometer, turmeric
Procedia PDF Downloads 1198300 Comparative Effect of Microbial Phytase Supplementation on Layer Chickens Fed Diets with Required or Low Phosphorous Level
Authors: Hamada Ahmed, Mervat A. Abdel-Latif, Alaa. A. Ghoraba, Samah A. Ganna
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An experiment was conducted to determine the effect of microbial phytase (Quantum Blue®) supplementation on layer chickens fed diets with required or low phosphorous level in corn-soybean based diets. One hundred and sixteen 23-week-old Lohman brown laying hens were used in 8-week feeding trial. Hens were randomly allotted into four treatments where the group (1) (control group) was fed basal diet without phytase, group (2) fed basal diet supplemented with phytase, group (3) fed diet supplemented with phytase as a replacement of 25% of monocalcium phosphate and group (4) fed diet supplemented with phytase as a replacement of 50% of monocalcium phosphate. Records on daily egg production, egg mass, egg weight and body weight of hens at the end of experimental period were recorded. Results revealed no significant (p ≥ 0.05) differences were observed among the other dietary treatments in BW, egg production, egg mass, feed intake or feed conversion when these parameters were evaluated over the duration of the experiment while egg weight showed significant (p < 0.05) increase in all phytase supplemented groups. There was no significant (p ≥ 0.05) differences in egg quality including egg length, egg width, egg shape index, yolk height, yolk width, yolk index, yolk weight and yolk albumin ratio while egg albumin was significantly increased (p < 0.05) in group (2) and group (3). Egg shell weight increased significantly (p < 0.05) in all phytase supplemented groups when compared with the control group also shell thickness increased significantly (p < 0.05) in both group (2 &3). No significant (P ≥ 0.05) difference was observed in serum Ca, P level while alkaline phosphatase was significantly (P ˂ 0.05) increased in group (3). Egg shell analysis showed increase in egg shell ash% in all phytase supplemented groups when compared with the control group, egg shell calcium % was higher in group (3) and group (4) than the control group while group (2) showed lower egg shell calcium% than the other experimental groups, egg shell phosphorous% was higher in all phytase supplemented groups than the control group. Phosphorous digestability was significantly (P ˂ 0.05) increased in all phytase supplemented groups than the control group and the highest p digestability was in group (4). Calcium digestability showed significant (P ˂ 0.05) increase in all phytase supplemented groups when compared with the control group and the highest digetability was in group (4).Keywords: layers, microbial phytase, Ca and P availability, egg production, egg characteristics
Procedia PDF Downloads 1878299 Implications of Learning Resource Centre in a Web Environment
Authors: Darshana Lal, Sonu Rana
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Learning Resource Centers (LRC) are acquiring different kinds of documents like books, journals, thesis, dissertations, standard, databases etc. in print and e-form. This article deals with the different types of sources available in LRC. It also discusses the concept of the web, as a tool, as a multimedia system and the different interfaces available on the web. The reasons for establishing LRC are highlighted along with the assignments of LRC. Different features of LRC‘S like self-learning and group learning are described. It also implements a group of activities like reading, learning, educational etc. The use of LRC by students and faculties are given and concluded with the benefits.Keywords: internet, search engine, resource centre, opac, self-learning, group learning
Procedia PDF Downloads 3788298 Nurses’ Views on ‘Effective Nurse Leader’ Characteristics in Iraq
Authors: S. Abed, S. O’Neill
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This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.Keywords: health care, nurse education, nursing in Iraq, nurse leadership
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