Search results for: group intervention

Authors: Kumaran Narayanan, Andrew N. Osahor

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E. coli has been engineered by our group and by others as a vector to deliver DNA into cultured human and animal cells. However, so far conditions to improve gene delivery using this vector have not been investigated, resulting in a major gap in our understanding of the requirements for this vector to function optimally. Our group recently published novel data showing that simple addition of the DNA transfection reagent Lipofectamine increased the efficiency of the E. coli vector by almost 3-fold, providing the first strong evidence that further optimization of bactofection is possible. This presentation will discuss advances that demonstrate the effects of several intracellular strategies that improve the efficiency of this vector. Conditions that promote endosomal escape of internalized bacteria to evade lysosomal destruction after entry in the cell, a known obstacle limiting this vector, are elucidated. Further, treatments that increase bacterial lysis so that the vector can release its transgene into the mammalian environment for expression will be discussed. These experiments will provide valuable new insight to advance this E. coli system as an important class of vector technology for genetic correction of human disease models in cells and whole animals.

Keywords: DNA, E. coli, gene expression, vector

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Authors: Rose Mini Agoes Salim, Shahnaz Safitri

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The aim of this study is to test the effectiveness of teaching kindness in preschool children by using several techniques. Kindness is a physical act or emotional support aimed to build or maintain relationships with others. Kindness is known to be essential in the development of moral reasoning to distinguish between the good and bad things. In this study, kindness is operationalized as several acts including helping friends, comforting sad friends, inviting friends to play, protecting others, sharing, saying hello, saying thank you, encouraging others, and apologizing. It is mentioned that kindness is crucial to be developed in preschool children because this is the time the children begin to interact with their social environment through play. Furthermore, preschool children's cognitive development makes them begin to represent the world with words, which then allows them to interact with others. On the other hand, preschool children egocentric thinking makes them still need to learn to consider another person's perspective. In relation to social interaction, preschool children need to be stimulated and assisted by adult to be able to pay attention to other and act with kindness toward them. On teaching kindness to children, the quality of interaction between children and their significant others is the key factor. It is known that preschool children learn about kindness by imitating adults on their two way interaction. Specifically, this study examines two types of teaching techniques that can be done by parents as a way to teach kindness, namely the picture-storybook reading and hand-puppet storytelling. These techniques were examined because both activities are easy to do and both also provide a model of behavior for the child based on the character in the story. To specifically examine those techniques effectiveness in teaching kindness, two studies were conducted. Study I involves 31 children aged 5-6 years old with picture-storybook reading technique, where the intervention is done by reading 8 picture books for 8 days. In study II, hand-puppet storytelling technique is examined to 32 children aged 3-5 years old. The treatments effectiveness are measured using an instrument in the form of nine colored cards that describe the behavior of kindness. Data analysis using Wilcoxon Signed-rank test shows a significant difference on the average score of kindness (p < 0.05) before and after the intervention has been held. For daily observation, a ‘kindness tree’ and observation sheets are used which are filled out by the teacher. Two weeks after interventions, an improvement on all kindness behaviors measured is intact. The same result is also gained from both ‘kindness tree’ and observational sheets.

Keywords: kindness, moral teaching, storytelling, hand puppet

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Authors: Martina Grdiša, Filip Varga, Nina Jeran, Ante Turudić, Zlatko Šatović

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Dalmatian pyrethrum (Tanacetum cinerariifolium (Trevir.) Sch. Bip.) is a plant species that occurs naturally in the eastern Mediterranean. It is of immense economic importance as it synthesizes and accumulates the phytochemical compound pyrethrin. Pyrethrin consists of several monoterpene esters (pyrethrin I and II, cinerin I and II and jasmolin I and II), which have insecticidal and repellent activity through their synergistic action. In this study, 15 natural Dalmatian pyrethrum populations were sampled along their natural range in Croatia, Bosnia and Herzegovina and Montenegro to characterize and compare their pyrethrin profiles and to define the bioclimatic factors associated with the accumulation of each pyrethrin compound. Pyrethrins were extracted from the dried flower heads of Dalmatian pyrethrum using ultrasound-assisted extraction and the amount of each compound was quantified using high-performance liquid chromatography coupled to DAD-UV /VIS. The biochemical data were subjected to analysis of variance, correlation analysis and multivariate analysis. Quantitative variability within and among populations was found, with population P15 Vranjske Njive, Podgorica having the significantly highest pyrethrin I content (66.47% of total pyrethrin content), while the highest levels of total pyrethrin were found in P14 Budva (1.27% of dry flower weight; DW), followed by P08 Korčula (1.15% DW). Based on the environmental conditions at the sampling sites of the populations, five bioclimatic groups were distinguished, referred to as A, B, C, D, and E, each with rare chemical profile. The first group (A) consisted of the northern Adriatic population P01 Vrbnik, Krk and the population P06 Sevid - the coastal population of the central Adriatic, and generally differed significantly from the other bioclimatic groups by higher average jasmolin II values (2.13% of total pyrethrin). The second group (B) consisted of two central Adriatic island populations (P02 Telašćica, Dugi otok and P03 Žman, Dugi otok), while the remaining central Adriatic island populations were grouped in bioclimatic group C, which was characterized by the significantly highest average pyrethrin II (48.52% of total pyrethrin) and cinerin II (5.31% DW) content. The South Adriatic inland populations P10 Srđ and P11 Trebinje (Bosnia and Herzegovina), and the populations from Montenegro (P12 Grahovo, P13 Lovćen, P14 Budva and P15 Vranjske Njive, Podgorica) formed bioclimatic group E. This bioclimatic group was characterized by the highest average values for pyrethrin I (53.07 % of total pyrethrin), total pyrethrin content (1.06 % DW) and the ratio of pyrethrin I and II (1.85). Slightly lower values (although not significant) for the latter traits were detected in bioclimatic group D (southern Adriatic island populations P07 Vis, P08 Korčula and P09 Mljet). A weak but significant correlation was found between the levels of some pyrethrin compounds and bioclimatic variables (e.g., BIO03 Isothermality and BIO04 Temperature Seasonality), which explains part of the variability observed in the populations studied. This suggests the interconnection between bioclimatic variables and biochemical profiles either through the selection of adapted genotypes or through the ability of species to alter the expression of biochemical traits in response to environmental changes.

Keywords: biopesticides, biochemical variability, pyrethrin, Tanacetum cinerariifolium

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Authors: João Coutinho-Rodrigues, Nuno Sousa, Luís Alçada-Almeida

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Transportation infrastructure systems are fundamental in modern society and economy. However, they need modernizing, maintaining, and reinforcing interventions which require large investments. In many countries, accumulated intervention delays arise from aging and intense use, being magnified by financial constraints of the past. The decision problem of managing the renewal of large backlogs is common to several types of important transportation infrastructures (e.g., railways, roads). This problem requires considering financial aspects as well as operational constraints under a multidimensional framework. The present research introduces a linear programming multiobjective model for managing railway infrastructure asset renewal. The model aims at minimizing three objectives: (i) yearly investment peak, by evenly spreading investment throughout multiple years; (ii) total cost, which includes extra maintenance costs incurred from renewal backlogs; (iii) priority delays related to work start postponements on the higher priority railway sections. Operational constraints ensure that passenger and freight services are not excessively delayed from having railway line sections under intervention. Achieving a balanced annual investment plan, without compromising the total financial effort or excessively postponing the execution of the priority works, was the motivation for pursuing the research which is now presented. The methodology, inspired by a real case study and tested with real data, reflects aspects of the practice of an infrastructure management company and is generalizable to different types of infrastructure (e.g., railways, highways). It was conceived for treating renewal interventions in infrastructure assets, which is a railway network may be rails, ballasts, sleepers, etc.; while a section is under intervention, trains must run at reduced speed, causing delays in services. The model cannot, therefore, allow for an accumulation of works on the same line, which may cause excessively large delays. Similarly, the lines do not all have the same socio-economic importance or service intensity, making it is necessary to prioritize the sections to be renewed. The model takes these issues into account, and its output is an optimized works schedule for the renewal project translatable in Gantt charts The infrastructure management company provided all the data for the first test case study and validated the parameterization. This case consists of several sections to be renewed, over 5 years and belonging to 17 lines. A large instance was also generated, reflecting a problem of a size similar to the USA railway network (considered the largest one in the world), so it is not expected that considerably larger problems appear in real life; an average of 25 years backlog and ten years of project horizon was considered. Despite the very large increase in the number of decision variables (200 times as large), the computational time cost did not increase very significantly. It is thus expectable that just about any real-life problem can be treated in a modern computer, regardless of size. The trade-off analysis shows that if the decision maker allows some increase in max yearly investment (i.e., degradation of objective ii), solutions improve considerably in the remaining two objectives.

Keywords: transport infrastructure, asset renewal, railway maintenance, multiobjective modeling

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Authors: Olivia Rachel Hwang, Yu-Hsuan Joni Shao

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Androgen Deprivation Therapy (ADT) has been a primary treatment for patients with advanced prostate cancer. However, it is associated with numerous adverse effects related to Metabolic Syndrome (MetS), including hypertension, diabetes, hyperlipidaemia, heart diseases and ischemic strokes. However, complications associated with ADT for prostate cancer in Taiwan is not well documented. The purpose of this study is to utilize the data from NHIRD (National Health Insurance Research Database) to examine the trajectory changes of MetS-related complications in men receiving ADT. The risks of developing complications after the treatment were analyzed with multivariate Cox regression model. Covariates including in the model were the complications before the diagnosis of prostate cancer, the age, and the year at cancer diagnosis. A total number of 17268 patients from 1997-2013 were included in this study. The exclusion criteria were patients with any other types of cancer or with the existing MetS-related complications. Changes in MetS-related complications were observed among two treatment groups: 1) ADT (n=9042), and 2) non-ADT (n=8226). The ADT group appeared to have an increased risk in hypertension (hazard ratio 1.08, 95% confidence interval 1.03-1.13, P = 0.001) and hyperlipidemia (hazard ratio 1.09, 95% confidence interval 1.01-1.17, P = 0.02) when compared with non-ADT group in the multivariate Cox regression analyses. In the risk of diabetes, heart diseases, and ischemic strokes, ADT group appeared to have an increased but not significant hazard ratio. In conclusion, ADT was associated with an increased risk in hypertension and hyperlipidemia in prostate cancer patients in Taiwan. The risk of hypertension and hyperlipidemia should be considered while deciding on ADT, especially those with the known history of hypertension and hyperlipidemia.

Keywords: androgen deprivation therapy, ADT, complications, metabolic syndrome, MetS, prostate cancer

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Authors: Bouzidi Abdelouahab, Ghadjati Nadhra, Bettihi Sara, Mahdeb Nadia, Daamouche Z. El Youm

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The effects of acute administration of TOTAL alkaloids, the main active principle of Datura stramonium, with toxic properties, were studied in female Albino-Wistar rats. After acute intraperitoneal administration of dose 120 mg kg-1 (≈1/3 DL50) of total alkaloids to the seeds of D. stramonium, there were no remarkable changes in general appearance and no deaths occurred in any experimental group. After 5 days a significant reduction was observed in total alkaloids of seeds. The Red Blood Cells (RBC), Hematocrit (HCT) and Hemoglobin (HGB) show significant changes in the treated groups. There were no statistical differences in Glutamic-pyruvic Transaminase (GPT), Alkaline Phosphatase (ALP), urea, glucose and total protein observed between groups. After 24 h Glutamic-Oxaloacetic Transaminase (GOT) and creatinine were significantly higher in the treated male rats than the control group histological examination of liver showed no histopathological changes.

Keywords: datura stramonium, rat, liver, kidney, alkaloids, toxicity

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Authors: Vilma Sasyte, Vilma Viliene, Asta Raceviciute-Stupeliene, Agila Dauksiene, Romas Gruzauskas, Virginijus Slausgalvis, Jamal Al-Saifi

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The aim of the present study was to investigate the effect of butyrate, acids, medium-chain fatty acids and plant extract mixture on performance, blood and gastrointestinal tract characteristics of laying hens’. For the period of 8 weeks, 24 Hisex Brown laying hens were randomly assigned to 2 dietary treatments: 1) control wheat-corn-soybean meal based diet (Control group), 2) control diet supplemented with the mixture of butyrate, acids, medium chain fatty acids and plant extract (Lumance®) at the level of 1.5 g/kg of feed (Experimental group). Hens were fed with a crumbled diet at 125 g per day. Housing and feeding conditions were the same for all groups and met the requirements of growth for laying hens of Hisex Brown strain. In the blood serum total protein, bilirubin, cholesterol, DTL- and MTL- cholesterol, triglycerides, glucose, GGT, GOT, GPT, alkaline phosphatase, alpha amylase, contents of c-reactive protein, uric acid, and lipase were analyzed. Development of intestines and internal organs (intestinal length, intestinal weight, the weight of glandular and muscular stomach, pancreas, heart, and liver) were determined. The concentration of short chain fatty acids in caecal content was measured using the method of HPLC. The results of the present study showed that 1.5 g/kg supplementation of feed additive affected egg production and feed conversion ratio for the production of 1 kg of egg mass. Dietary supplementation of analyzed additive in the diets increased the concentration of triglycerides, GOT, alkaline phosphatase and decreased uric acid content compared with the control group (P<0.05). No significant difference for others blood indices in comparison to the control was observed. The addition of feed additives in laying hens’ diets increased intestinal weight by 11% and liver weight by 14% compared with the control group (P<0.05). The short chain fatty acids (propionic, acetic and butyric acids) in the caecum of laying hens in experimental groups decreased compared with the control group. The supplementation of the mixture of butyrate, acids, medium-chain fatty acids and plant extract at the level of 1.5 g/kg in the laying hens’ diets had the effect on the performance, some gastrointestinal tract function and blood parameters of laying hens.

Keywords: acids, butyrate, laying hens, MCFA, performance, plant extract, psysiological state

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Authors: Leonard Simoni, Ilir Alimehmeti, Ervina Shirka, Endri Hasimi, Ndricim Kallashi, Verona Beka, Suerta Kabili, Artan Goda

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Background: Diabetes Mellitus type 2, small vessel calibre, stented length of vessel, complex lesion morphology, and prior bypass surgery have resulted risk factors for In-Stent Restenosis (ISR). However, there are some contradictory results about body mass index (BMI) as a risk factor for ISR. Purpose: We want to identify clinical, lesional and procedural factors that can predict clinical ISR in our patients. Methods: Were enrolled 759 patients who underwent first-time elective PCI with Bare Metal Stents (BMS) from September 2011 to December 2013 in our Department of Cardiology and followed them for at least 1.5 years with a median of 862 days (2 years and 4 months). Only the patients re-admitted with ischemic heart disease underwent control coronary angiography but no routine angiographic control was performed. Patients were categorized in ISR and non-ISR groups and compared between them. Multivariate analysis - Binary Logistic Regression: Forward Conditional Method was used to identify independent predictive risk factors. P was considered statistically significant when <0.05. Results: ISR compared to non-ISR individuals had a significantly lower BMI (25.7±3.3 vs. 26.9±3.7, p=0.004), higher risk anatomy (LM + 3-vessel CAD) (23% vs. 14%, p=0.03), higher number of stents/person used (2.1±1.1 vs. 1.75±0.96, p=0.004), greater length of stents/person used (39.3±21.6 vs. 33.3±18.5, p=0.01), and a lower use of clopidogrel and ASA (together) (95% vs. 99%, p=0.012). They also had a higher, although not statistically significant, prevalence of Diabetes Mellitus (42% vs. 32%, p=0.072) and a greater number of treated vessels (1.36±0.5 vs. 1.26±0.5, p=0.08). In the multivariate analysis, Diabetes Mellitus type 2 and multiple stents used were independent predictors risk factors for In-Stent Restenosis, OR 1.66 [1.03-2.68], p=0.039, and OR 1.44 [1.16-1.78,] p=0.001, respectively. On the other side higher BMI and use of clopidogrel and ASA together resulted protective factors OR 0.88 [0.81-0.95], p=0.001 and OR 0.2 [0.06-0.72] p=0.013, respectively. Conclusion: Diabetes Mellitus and multiple stents are strong predictive risk factors, whereas the use of clopidogrel and ASA together are protective factors for clinical In-Stent Restenosis. Paradoxically High BMI is a protective factor for In-stent Restenosis, probably related to a larger diameter of vessels and consequently a larger diameter of stents implanted in these patients. Further studies are needed to clarify this finding.

Keywords: body mass index, diabetes mellitus, in-stent restenosis, percutaneous coronary intervention

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Authors: Valentine Seymour

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Environmental volunteering organisations use questionnaires to explore the relationship between environmental volunteers and their health. To the author’s best knowledge, no one has explored volunteers’ health perception, which could be considered when designing a health impact measurement tool used to increase effective communication. This paper examines environmental volunteers' perceptions of health, knowledge which can be used to design a health impact measurement tool. This study uses focus group interviews, content analysis, and a general inductive approach to explore the health perceptions of volunteers who engage in environmental volunteering activities from the perspective of UK charity The Conservation Volunteers. Findings showed that volunteer groups presented were relatively similar in how they defined the term health, with their overall conceptual model closely resembling that of the World Health Organization 1948 definition. This suggests that future health impact measurement tools in the environmental volunteering sector could base their design around the World Health Organization’s definition.

Keywords: health perception, impact measurement, mental models, tool development

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Authors: Konrad Steyn, Jacques Laubscher

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South African urban design solutions are mostly aligned with European and North American models that are often not appropriate in addressing some of this country’s challenges such as multiculturalism and decaying urban areas. Sustainable urban redevelopment in South Africa should be comprehensive in nature, sensitive in its manifestation, and should be robust and inclusive in order to achieve social relevance. This paper argues that the success of an urban design intervention is largely dependent on the public’s perceptions and expectations, and the way people participate in shaping their environments. The concept of sustainable urbanism is thus more comprehensive than – yet should undoubtedly include – methods of construction, material usage and climate control principles. The case study is a central element of this research paper. 725 Arcadia Street in Pretoria, was originally commissioned as a food market structure. A starkly contrasting existing modernist adjacent building forms the morphological background. Built in 1969, it is a valuable part of Pretoria’s modernist fabric. It was realised early on that the project should not be a mere localised architectural intervention, but rather an occasion to revitalise the neighbourhood through urban regeneration. Because of the complex and comprehensive nature of the site and rich cultural diversity of the area, a multi-faceted approach seemed the most appropriate response. The methodology for collating data consisted of a combination of literature reviews (regarding the historic original fauna and flora and current plants, observation (frequent site visits) and physical surveying on the neighbourhood level (physical location, connectivity to surrounding landmarks as well as movement systems and pedestrian flows). This was followed by an exploratory design phase, culminating in the present redevelopment proposal. Since built environment interventions are increasingly based on generalised normative guidelines, an approach focusing of urban acupuncture could serve as an alternative. Celebrating the specific urban condition, urban acupuncture offers an opportunity to influence the surrounding urban fabric and achieve urban renewal through physical, social and cultural mediation.

Keywords: neighbourhood, urban renewal, South African urban design solutions, sustainable urban redevelopment

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Authors: Hugo Reis, Isabel Rabiais

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The main purpose of the present study is to understand the nurse’s responsibility in preventing the septic shock in an oncological patient with febrile neutropenia submitted to chemotherapy. In order to do it, an integrative review of literature has been conducted. In the research done in many databases, it was concluded that only 7 out of 5202 articles compiled the entire inclusion standard present in the strict protocol of research, being this made up by all different methodologies. On the research done in the 7 articles it has resulted 8 text macro-units associated to different nursing interventions: ‘Health Education’; ‘Prophylactic Therapy Administration’; ‘Scales Utilization’; ‘Patient Evaluation’; ‘Environment Control’; ‘Performance of Diagnostic Auxiliary Exams’; ‘Protocol Enforcement/Procedure Guidelines’; ‘Antibiotic Therapy Administration’. Concerning the prevalence/result’s division there can be identified many conclusions: the macro-units ‘Patient Evaluation’, ‘Performance of Diagnostic Auxiliary Exams’, and ‘Antibiotic Therapy Administration’ present themselves to be the most prevalent in the research – 6 in 7 occurrences (approximately 85.7%). Next, the macro-unit ‘Protocol Enforcement/Procedure Guidelines’ presents itself as an important expression unit – being part of 5 out of the 7 analyzed studies (approximately 71.4%). The macro-unit ‘Health Education’, seems to be in the same way, an important expression unit – 4 out of the 7 (or approximately 57%). The macro-unit ‘Scales Utilization’, represents a minor part in the research done – it’s in only 2 out of the 7 cases (approximately 28.6%). On the other hand, the macro-units ‘Prophylactic Therapy Administration’ and ‘Environment Control’ are the two categories with fewer results in the research - 1 out of the 7 cases, the same as approximately 14.3% of the research results. Every research done to the macro-unit ‘Antibiotic Therapy Administration’ agreed to refer that the intervention should be strictly done, in a period of time less than one hour after diagnosing the fever, with the purpose of controlling the quick spread of infection – minimizing its seriousness. Identifying these interventions contributes, concluding that, to adopt strategies in order to prevent the phenomenon that represents a daily scenario responsible for the cost´s increase in health institutions, being at the same time responsible for the high morbidity rates and mortality increase associated with this specific group of patients.

Keywords: febrile neutropenia, oncology nursing, patient, septic shock

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Authors: Jayanta Bora, Sukhvinder Kaur, Ashok Agarwal, Sangeeta Kaul

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Background: It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility and literacy for effective human immunodeficiency virus (HIV) prevention. This paper examines the association between vulnerability and behavioural outcomes among FSWs in Thane district, Maharashtra under USAID PHFI-PIPPSE project. Methods: Data were used from the Behavioural Tracking Survey, a cross-sectional behavioural study conducted in 2015 with 503 FSWs randomly selected from 12 TI-NGOs which were functioning and providing services to FSWs in Thane district prior to April 2014 in Thane district of Maharashtra. We have created the “vulnerability index”, a composite index of literacy, factors of dependence (alternative livelihood options, current debt), and aspects of sex work (mobility and duration in sex work) as a dependent variable. The key independent measures used were program exposure to intervention, service uptake, self-confidence, and self-identity. Bi-variate and multivariate logistic regressions were used to examine the study objectives. Results: A higher proportion of FSWs who were in the age-group 18–25 years from brothel/street /home/ lodge-based were categorized as highly vulnerable to HIV risk as compared to bar-based sex worker (74.1% versus 59.8%, P,0.002); regression analysis highlighted lower odds of vulnerability among FSWs who were aware of services and visited NGO clinic for medical check-up and counselling for STI [AOR= 0.092, 95% CI 0.018-0.460; P,0.004], However, lower odds of vulnerability on confident in supporting fellow sex worker in crisis [AOR= 0.601, 95% CI 0.476-0.758; P, 0.000] and were able to turn away clients when they refused to use a condom during sex [AOR= 0.524, 95% CI 0.342-0.802; P, 0.003]. Conclusion: The results highlight that FSWs associated with TIs and getting services are less vulnerable and highly empowered. As a result of behavioural change communication and other services provided by TIs, FSWs were able to successfully negotiate about condom use with their clients and manage solidarity in the crisis situation for fellow FSWs. Therefore, it is evident from study paper that TI prevention programs may transform the lives of masses considerably and may open a window of opportunity to infuse the information and awareness about HIV risk.

Keywords: female sex worker, HIV prevention, HIV service uptake, vulnerability

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Authors: Dana Cassandra Winkler, Delia Leiding, Rene Bergs, Franziska Kaiser, Ramona Kirchhart, Ute Habel

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Background: Violence is a multidimensional phenomenon, affecting people of every age, socio-economic status and gender. Nevertheless, most studies primarily focus on men perpetrating women. Aim of the present study is to identify the likelihood of mental and somatic disorders and risk-taking behavior in male violence affected. In addition, the relationship between age of violence experience and the risk for health-related problems was analyzed. Method: On the basis of current evidence, a questionnaire was developed focusing on demographic background, health status, risk-taking behavior, and active and passive violence exposure. In total, 5221 males (Mean: 56,1 years, SD: 17,6) were consulted. To account for the time of violence experience in an efficient way, age clusters ‘0-12 years’, ‘13-20 years’, ‘21-35 years’, ‘36-65 years’ and ‘over 65 years’ were defined. A binary logistic regression was calculated to reveal differences in violence-affected and non-violence affected males regarding health and risk-taking factors. Males who experienced violence on a daily/ almost daily basis vs. males who reported violence occurrence once/ several times a month/ year were compared with respect to health factors and risk-taking behavior. Data of males, who indicated active and passive violence exposure, were analyzed by a chi²-analysis, to investigate a possible relation between the age of victimization and violence perpetration. Findings: Results imply that general violence experience, independent of active and passive violence exposure increases the likelihood in favor of somatic-, psychosomatic- and mental disorders as well as risk-taking behavior in males. Experiencing violence on a daily or almost daily basis in childhood and adolescence may serve as a predictor for increased health problems and risk-taking behavior. Furthermore, the violence experience and perpetration occur significantly within the same age cluster. This underlines the importance of a near-term intervention to minimize the risk, that victims become perpetrators later. Conclusion: The present study reveals predictors concerning health risk factors as well as risk-taking behavior in males with violence exposure. The results of this study may underscore the benefit of intervention and regular health care approaches in violence-affected males and underline the importance of acknowledging the overlap of violence experience and perpetration for further research.

Keywords: health disease, male, mental health, prevalence, risk-taking behavior, violence

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Authors: Yu Liang, Wei Wei

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Spatial representation of numbers and numerical magnitude are important for preschoolers’ mathematical ability. Mental number line, a typical index to measure numbers spatial representation, and numerical comparison are both related to arithmetic obviously. However, they seem to rely on different mechanisms and probably influence arithmetic through different mechanisms. In line with this idea, preschool children were trained with two tasks to investigate which one is more important for approximate arithmetic. The training of numerical processing and number line estimation were proved to be effective. They both improved the ability of approximate arithmetic. When the difficulty of approximate arithmetic was taken into account, the performance in number line training group was not significantly different among three levels. However, two harder levels achieved significance in numerical comparison training group. Thus, comparing spatial representation ability, symbolic approximation arithmetic relies more on numerical magnitude. Educational implications of the study were discussed.

Keywords: approximate arithmetic, mental number line, numerical magnitude, preschooler

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Authors: Sarwat un Nisa

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One of the remarkable gifts that a human being is blessed with is the ability to speak using a combination of sounds. Different combinations of sounds combine to form a word which in turn make a sentence and therefore give birth to a language. A person can either be a monolingual, i.e., can speak one language or bilingual, i.e., can speak more than one language. Whether a person speaks one language or multiple languages or in whatever language a person speaks, the main aim is to communicate, express ideas, feelings or thoughts. Sometimes the choice of a language is deliberate and sometimes it is a habitual act. The language which is used to put our ideas across speaks many things about our cultural, linguistic and ethnic identities. It can never be claimed that bilinguals are better than monolinguals in terms of linguistic skills, bilinguals or multilinguals have more than one language at their disposal. Therefore, how effectively two languages are used by the same person keeps linguists always intrigued. The most prominent and common features found in the speech of bilingual speakers are code switching and code mixing. The aim of the present paper is to explore these features among the adolescent speakers of Kashmir. The reason for studying the linguistics behavior of adolescents is the age when a person is neither an adult nor a child. They want to drift away from the norms and make a new norm for themselves. Therefore, how their linguistics skills are influenced by their age is of great interest because it can set the trend for the future generation. Kashmir is a multilingual society where three languages, i.e., Kashmiri, Urdu, and English are regularly used by the speakers, especially the educated ones. Kashmiri is widely used at home or mostly among adults. Urdu is the official language, and English is used in schools and for most of the written official correspondences. Thus, it is not uncommon to find these three languages coming in contact with each other quite frequently. The language contact results in the code switching and code mixing. In this paper different aspects of code switching and code mixing are discussed. Research Method: The data were collected from the different districts of Kashmir. The informants did not have prior knowledge of the survey. The situation was spontaneous and natural. The topics were introduced by the interviewer to the group of informants which comprised of three participants. They were asked to discuss the topic, most of the times without any intervention of the interviewer. Along with conversations, the informants also filled in written questionnaires comprising sociolinguistic questions. Questionnaires were analysed to get an idea about the sociolinguistic attitude of the informants. Percentage, frequency, and average were used as statistical tools to analyse the data. Conclusions were drawn taking into consideration of interpretations of both speech samples and questionnaires.

Keywords: code mixing, code switching, Kashmir, bilingualism

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Authors: Sedigheh Abbasnasab Sardareh

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The current study investigates ESL teachers' voices in order to formulate further research on the effectiveness of the SBOA practices. It is an attempt to find out (1) what are ESL experienced teachers’ perceptions, experiences, attitudes, and beliefs of SBOA; (2) what teaching and learning aspects of SBOA needs focus to enhance its effectiveness; (3) external issues related to the implementation of SBOA; (4) internal issues related to the implementation of SBOA; and also (5) perceived recommendations on SBOA. The study utilized focus group discussion sessions. 9 experienced ESL (5 females and 4 males) teachers were selected based on the consent letters sent to them. These teachers had over 20 years experience in both traditional and SBOA-type assessment and the train-the-trainer experts recommended by the Ministry of Education. Respondents were guided with open-ended questions to extracts their perceived experiences implementing SBOA guided structurally by the author as the moderator. Data were first discussed with the respondents for further clarifications and then only analyzed and re-confirmed with some recommendations before the final presentation of this preliminary results were presented here. The focus group discussions yielded some important perceived views on the SBOA implementation. Some of the themes were discussed and some recommendations were proposed for further in-depth study by the Ministry of Education. Some of the future directions based on the results were also put forward. Some external and internal variables were important in order for successful implementation of SBOA. Mere implementing a policy should be taken into consideration because this might impede some of the teaching and learning processes both by the classroom stakeholders such as teachers and student. More research methods such as the use of questionnaires could be utilized to further investigate to large populations of teacher educators in Malaysia.

Keywords: school based oral assessment, Malaysia, ESL, focus group discussion

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Authors: Shivani Thakur, Jasmin Dominguez Cervantes, Ahmed Zabiba, Fatima Zabiba, Sandhini Agarwal, Kamalpreet Kaur, Hussein Maatouk, Shae Chand, Omar Madriz, Tiffany Huang, Saloni Bansal

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The prevalence of lymphedema in women in rural communities highlights the importance of developing effective treatment and prevention methods. Subjects with secondary lymphedema in California’s Central Valley were surveyed at 6 surgical clinics to assess demographics and symptoms of lymphedema. Additionally, subjects on semaglutide treatment for obesity and/or T2DM were monitored for their diabetes management, weight loss progress, and lymphedema symptoms compared to subjects who were not treated with semaglutide. The subjects were followed for 12 months. Subjects who were treated with semaglutide completed pre-treatment questionnaires and follow-up post-treatment questionnaires at 3, 6, 9, 12 months, along with medical assessment. The untreated subjects completed similar questionnaires. The questionnaires investigated subjective feelings regarding lymphedema symptoms and management using a Likert-scale; quantitative leg measurements were collected, and blood work reviewed at these appointments. Paired difference t-tests, chi-squared tests, and independent sample t-tests were performed. 50 subjects, aged 18-75 years, completed the surveys evaluating secondary lymphedema: 90% female, 69% Hispanic, 45% Spanish speaking, 42% disabled, 57 % employed, 54% income range below 30 thousand dollars, and average BMI of 40. Both treatment and non-treatment groups noted the most common symptoms were leg swelling (x̄=3.2, ▁d= 1.3), leg pain (x̄=3.2, ▁d=1.6 ), loss of daily function (x̄=3, ▁d=1.4 ), and negative body image (x̄=4.4, ▁d=0.54). Subjects in the semaglutide treatment group >3 months of treatment compared to the untreated group demonstrated: 55% subject in the treated group had a 10% weight loss vs 3% in the untreated group (average BMI reduction by 11% vs untreated by 2.5%, p<0.05) and improved subjective feelings about their lymphedema symptoms: leg swelling (x̄=2.4, ▁d=0.45 vs x̄=3.2, ▁d=1.3, p<0.05), leg pain (x̄=2.2, ▁d=0.45 vs x̄= 3.2, ▁d= 1.6, p<0.05), and heaviness (x̄=2.2, ▁d=0.45 vs x̄=3, ▁d=1.56, p<0.05). Improvement in diabetes management was demonstrated by an average of 0.9 % decrease in A1C values compared to untreated 0.1 %, p<0.05. In comparison to untreated subjects, treatment subjects on semaglutide noted 6 cm decrease in the circumference of the leg, knee, calf, and ankle compared to 2 cm in untreated subjects, p<0.05. Semaglutide was shown to significantly improve weight loss, T2DM management, leg circumference, and secondary lymphedema functional, physical and psychosocial symptoms.

Keywords: diabetes, secondary lymphedema, semaglutide, obesity

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Authors: Masoumeh Hosseini

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Obesity is known to be associated with cardiovascular diseases and metabolic syndrome. This study aimed to assess the effect of a long term aerobic training program on serum ghrelin in obese men. For this purpose, twenty four sedentary adult obese men aged 30-40 years and body mass index 30-36 kg/m2 were participated in this study and divided randomly into exercise (3 months aerobic training, 3 times/weekly) or control (no training) groups. Serum ghrelin and cardiovascular risk factor (TG, TC, LDL, and HDL) were measured before and after treatment. Anthropometrical markers were measured at two occasions. Data were analyzed by independent-paired T-test. Significance was accepted at P < 0.05. Aerobic training resulted in significant decrease in serum ghrelin and TG in exercise group. All anthropometrical markers decreased significantly in exercise group but not in control subjects. Based on these data, it is concluded that weight loss by aerobic training can be affect serum ghrelin in obese subject, although some cardiovascular risk factor remained without changed.

Keywords: aerobic training, homeostasis, lipid profile, obesity

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Authors: Hala O. El-Mesallamy, Salwa M. Suwailem, Mae M. Seleem

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Visfatin and apelin are two new adipokines that recently gained a special interest in diabetes research. This study was conducted to study the interplay between these two adipokines and their correlation with other inflammatory and biochemical parameters in type 2 diabetic (T2D) postmenopausal women with CAD. Visfatin and apelin were measured by enzyme-linked immunoassay (ELISA). Visfatin was found to be significantly higher in the following groups: T2D patients without CAD, non-obese and obese T2D patients with CAD when compared to control group. Apelin was found to be significantly lower in non-obese and obese T2D patients with CAD when compared to control group. Visfatin and apelin were found to be significantly associated with each other and with other biochemical parameters. The current study provides evidence for the interplay between visfatin and apelin through the inflammatory milieu characteristic of T2D and their possible role in the pathogenesis of CAD complication of T2D.

Keywords: apelin, coronary artery disease, inflammation, type 2 diabetes, visfatin

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Authors: Hasan Coruk, Recep Cakir

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This study aimed at investigating the effect of multimedia containing ‘the structure and properties of matter’ unit on students’ academic achievement level and self-efficacy relating to science and technology course. The study used an experimental design with pre-test and post-test groups. The data collection tools were ‘Science and Technology Course Achievement Test’ and ‘Science and Technology Self-Efficacy Scale’. The sample of the study consisted of 8th grade students at a primary school in Tokat Province. The study was carried out with 42 students from two classes, 21 (8 males, 13 females) from experimental group and 21 (13 males and 8 females) from control group. The data were analyzed in SPSS.18 software. The findings of the study indicated that the use of multimedia increased the students’ academic achievement in science and technology course in comparison with traditional teaching methods. It was also determined that there was not a significant difference in students’ course-oriented self-efficacy levels regarding the two methods. Necessary and feasible suggestions were put forward for whom it concerns.

Keywords: multimedia learning, science and technology, the structure-properties of matter, self-efficacy, academic achievement

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Authors: Mitra Ghiasi, Roghayeh Ghorbani Bousari

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Nowadays, the aim of the organizations is to gain sustainable competitive. So, developing their intellectual capital, encouraging innovation, increasing suitable performance can be done by knowledge management. Knowledge turns into science if knowledge is used to improve decision making, decision quality and make effective decisions. The current research intends to investigate the relationship between cybernetics and knowledge management from the perspective of users who are members of electronic discussion groups (ALA, ALIA). The research methodology is survey method, and it is a type of correlation research. Cybernetics and knowledge management questionnaires used for collecting data. The questionnaire that was designed in electronic format, distributed among two electronic discussion groups during 30 days and completed by 100 members of each electronic discussion groups. The finding of this research showed that although cybernetics has an impact on knowledge management, there is no significant difference between the ALA and ALIA user's view regard to effect of cybernetics on knowledge management. The results also indicated that this conceptual model is consistent with the data collected from the sample.

Keywords: ALA discussion group, ALIA discussion group, cybernetics, knowledge management

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Authors: Roman Graf, Sergiu Gordea, Heather M. Ryan

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This paper presents an approach for easy creation and classification of institutional risk profiles supporting endangerment analysis of file formats. The main contribution of this work is the employment of data mining techniques to support set up of the most important risk factors. Subsequently, risk profiles employ risk factors classifier and associated configurations to support digital preservation experts with a semi-automatic estimation of endangerment group for file format risk profiles. Our goal is to make use of an expert knowledge base, accuired through a digital preservation survey in order to detect preservation risks for a particular institution. Another contribution is support for visualisation of risk factors for a requried dimension for analysis. Using the naive Bayes method, the decision support system recommends to an expert the matching risk profile group for the previously selected institutional risk profile. The proposed methods improve the visibility of risk factor values and the quality of a digital preservation process. The presented approach is designed to facilitate decision making for the preservation of digital content in libraries and archives using domain expert knowledge and values of file format risk profiles. To facilitate decision-making, the aggregated information about the risk factors is presented as a multidimensional vector. The goal is to visualise particular dimensions of this vector for analysis by an expert and to define its profile group. The sample risk profile calculation and the visualisation of some risk factor dimensions is presented in the evaluation section.

Keywords: linked open data, information integration, digital libraries, data mining

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Authors: Nichole Haag, Kimberly Velk, Tyler McCune, Chun Wu

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Methicillin/multiple-resistant Staphylococcus aureus (MRSA) are infectious bacteria that are resistant to common antibiotics. A previous in silico study in our group has identified a hypothetical protein SAV1226 as one of the potential drug targets. In this study, we reported the bioinformatics characterization, as well as cloning, expression, purification and kinetic assays of hypothetical protein SAV1226 from methicillin/vancomycin-resistant Staphylococcus aureus Mu50 strain. MALDI-TOF/MS analysis revealed a low degree of structural similarity with known proteins. Kinetic assays demonstrated that hypothetical protein SAV1226 is neither a domain of an ATP dependent dihydroxyacetone kinase nor of a phosphotransferase system (PTS) dihydroxyacetone kinase, suggesting that the function of hypothetical protein SAV1226 might be misannotated on public databases such as UniProt and InterProScan 5.

Keywords: Methicillin-resistant Staphylococcus aureus, dihydroxyacetone kinase, essential genes, drug target, phosphoryl group donor

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Authors: Taurino S. R. Neto, Epitácio D. S. Neto, Flávio Signorelli, Gustavo G. M. Balbi, Alex H. Higashi, Mário Luiz R. Monteiro, Eloisa Bonfá, Danieli C. O. Andrade, Leandro C. Zacharias

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Purpose: To perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with primary antiphospholipid syndrome (PAPS) without ocular complaints and to compare them with healthy individuals. Methods: A complete structural and functional ophthalmological evaluation using OCTA and microperimetry (MP) exam in patients with PAPS, followed at a tertiary rheumatology outpatient clinic, was performed. All ophthalmologic manifestations were recorded and then statistical analysis was performed for comparative purposes; p <0.05 was considered statistically significant. Results: 104 eyes of 52 subjects (26 patients with PAPS without ocular complaints and 26 healthy individuals) were included. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. Thrombotic PAPS was the main clinical criteria manifestation (100%); 65.4% had venous and 34.6% had arterial thrombosis. Obstetrical criteria were present in 34.6% of all thrombotic PAPS patients. Lupus anticoagulant was present in all patients. 19.2% of PAPS patients presented ophthalmologic findings against none of the healthy individuals. The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen-like deposits (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (1 patient, 1 eye). Systemic hypertension and hyperlipidaemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together. In the quantitative OCTA evaluation, we found significant differences between PAPS patients and controls in both the superficial vascular complex (SVC) and deep vascular complex (DVC) in the high-speed protocol, as well as in the SVC in the high-resolution protocol. In the analysis of the foveal avascular zone (FAZ) parameters, the PAPS group had a larger area of FAZ in the DVC using the high-speed method compared to the control group (p=0.047). In the quantitative analysis of the MP, the PAPS group had lower central (p=0.041) and global (p<0.001) retinal sensitivity compared to the control group, as well as in the sector analysis, with the exception of the inferior sector. In the quantitative evaluation of fixation stability, there was a trend towards worse stability in the PAPS subgroup with PAMM in both studied methods. Conclusions: PAMM was observed in 11.5% of PAPS patients with no previous ocular complaints. Systemic hypertension concomitant with hyperlipidemia was the most commonly associated risk factor for PAMM in patients with PAPS. PAPS patients present lower vascular density and retinal sensitivity compared to the control group, even in patients without PAMM.

Keywords: antiphospholipid syndrome, optical coherence angio tomography, optical coherence tomography, retina

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Authors: M. Khajezadeh, M. Saied Fallah Niasar, S. Ali Asli, D. Davani Davari, M. Godarzi, Y. Asgari

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This study aims to explore the joint application of both Boston and Ansoff matrices in the operational development of the product. We conduct deep analysis, by utilizing the Artificial Neural Network, to predict the position of the product in the market while the company is interested in increasing its share. The data are gathered from two industries, called hygiene and detergent. In doing so, the effort is being made by investigating the behavior of top player companies and, recommend strategic orientations. In conclusion, this combination analysis is appropriate for operational development; as well, it plays an important role in providing the position of the product in the market for both hygiene and detergent industries. More importantly, it will elaborate on the company’s strategies to increase its market share related to a combination of the Boston Consulting Group (BCG) Matrix and Ansoff Matrix.

Keywords: artificial neural network, portfolio analysis, BCG matrix, Ansoff matrix

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Authors: Faizan Rathore, Naveed Sultan, Humphrey O. Connor

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This study was carried out from Jan '12-Dec'12 to assess current practice in Kerry General Hospital against the age-related indicators for colonoscopies. A total of 1474 colonoscopies were performed,1177(79.9%) were diagnostic and 297 (20.1%) were therapeutic, patients were divided into 4 age groups under 75, 75-80, 81-85, 86+. The trend analysis revealed an increase in diagnostic colonoscopies and decrease in therapeutic colonoscopies with age. 664(45.04%) of colonoscopies were reported normal which made up the majority of the total diagnoses, 1330 (90.2%) of colonoscopies occurred without any complications. Main complications were patient discomfort being the highest, present in 112(7.6%) of patients, and lowest being urticaria around the IV site present in 1 (0.1%) of the cases. Patient discomfort was higher in younger patients as evidenced by 98 cases aged <75 , followed by 11 cases aged 75-80, 2 cases aged 81-85 and 1 case aged >86. Highest percentage of poor tolerance was found in 14 (1.1%) of total patients <75, 1 (0.8%) of total patients aged 75-80, 1(1.7%) of total patients in age group 81-85 and none (0%) in age group >86. We have established the safety of colonoscopy, low rate of complications and a better tolerance in the elderly from this study, however, its utility, especially in the presence of other comorbidities in elderly is questionable.

Keywords: colonoscopy, elderly patients, utility, tolerance

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Authors: Fulufhelo Oscar Maphiri-Makananise

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The main purpose of this paper is to explore and provide substantiated evidence based on the usage patterns of Information and Communication Technologies (ICTs) by females in the Vhembe District in Limpopo-Province, South Africa. The study presents a broader picture and understanding about the usage of ICTs from female’s perspective. The significance of this study stems from the need to discover the role, relevance and usage patterns of ICTs such as smartphones, computers, laptops, and iPods, internet and social networking sites among females following the trends of new media technologies in the society. The main objective of the study was to investigate the usability and accessibility of ICTs to empower the Vhembe District females in South Africa. The study used quantitative research method together with elements of qualitative research to determine the major ideas, perceptions and usage patterns of ICTs by females in the District. Data collection involved structured and self-administered questionnaire with both closed-ended and open-ended questions. Two groups of respondents participated in this study. Media Studies female students (n=50) at the University of Venda provided their ideas and perceptions about the usefulness and usage patterns of ICTs such as smartphones, internet and computers at the university level, while the second group were (n=50) Makhado comprehensive school learners who also provided their perceptions and ideas about the use of ICTs at the high school level. Also, the study provides a more balanced, accurate and rational results on the pertinent issues that concern the use of ICTs by females in the Vhembe District. The researcher also believes that the findings of the study are useful as a guideline and model for ICT intervention that work as an empowerment to women in South Africa. The study showed that the main purpose of using ICTs by females was to search information for writing assignments, conducting research, dating, exchanging ideas and networking with friends and relatives that are also members of social networking sites and maintaining existing friends in real life. The study further revealed that most females were using ICTs for social purposes and accessing the internet than entertaining themselves. The finding also indicated a high number of females that used ICTs for e-learning (62%) and social purposes (85%). Moreover, the study centred on providing strong insightful information on the females’ usage patterns and their perceptions of ICTs in the Vhembe district of Limpopo province.

Keywords: female users, information and communication technologies, internet, usage patterns

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Authors: Leila Karshenas, Hamidreza Khodaei, Behnaz Mahdavi

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Ovulation is a physiologic process with an inflammatory response that depends on a coordinated activity of gonadotropins and steroid hormones, as well as inflammatory mediators such as cytokines, prostaglandins, leptin, nitric oxide (NO), etc. Conjugated linoleic acid (CLA) is composed of polyunsaturated fatty acids (PUFA) found in dairy products, beef and lamb. There is strong evidence that dietary CLA affects mediators involved in ovulation. The aim of this study was to determine the effects of different doses of dietary CLA on systemic and local hormones and factors involved in ovulation. In this case-control study, 80 (50±2-day old) female mice were randomly divided into four groups (C as the controls and T1, T2 and T3 as the treatment groups). There were four replicates in each group and there were five mice in every replicate (20 mice, in total). The mice in the control group were fed with no CLA in their diet but the ones in the treatment group received 0.1, 0.3 and 0.5g/kg of CLA (replacing corn oil in the diet), respectively for 120 days. Later on, blood samples were obtained from the tails of animals that displayed estrus signs and estradiol (E2), progesterone (P4), LH, FSH, NO, leptin and TNFα were measured. Furthermore, the effects of CLA on the ovarian production of prostaglandins (PGs) and NO were investigated. The data were analyzed by SAS software.CLA significantly decreased serum levels of FSH (p<0.05), LH, estradiol, NO, leptin and TNFα (p<0.01). In addition, CLA decreased progesterone levels but this effect was statistically insignificant. The significantly negative effects of CLA were seen on the ovarian production of PGE2 and PGF2α (p<0.01).It seems that CLA may play an effective role in reducing the ovulation rate in mice as CLA adversely affected female reproduction and it had negative effects on systemic and local hormones involved in ovulation.

Keywords: conjugated linoleic acid, nitric oxide, ovary, ovulation, prostaglandin, gonadotropin

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Authors: Heroda Gebru, Berhanu Seyoum, Melake Damena, Gezahegn Tesfaye

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Background: In Ethiopia there is a population policy aimed at reducing fertility and increasing contraceptive prevalence. Objective: To assess the fertility preference and contraceptive use status of married women who were living in Dire Dawa administrative city. Methods: Cross sectional study which included a sample size of 421 married women of reproductive age were performed. Data was collected using structured questionnaire during house to house survey and semi-structured questionnaire during in-depth interview. Data was processed and analyzed using SPSS version 16 computer software. Univariate, bi variate and multi variate analysis was employed. Results: A total of 421 married women of reproductive age group were interviewed having a response rate of 100 percent. More than half (58.2%) of the respondent have desire of more children. While 41.8% want no more children. Regarding contraceptive use 52.5% of the respondents were using contraceptive at the time of survey. Fertility preference and contraceptive use were significantly associated with age of the respondent, history of child death, number of living children, religion and age at first birth. Conclusions: Those women with younger age group, who had no child death history and women with lesser number of surviving children were more likely desire additional children. Women with older age at first birth and protestant in religion were more likely practiced contraceptive use. Strong information and education regarding contraceptive for younger age group should be provided, advocacy at level of religious leader is important, comprehensive family planning counselling and education should be available for the community, husbands, and religious leaders and the aim for increasing contraceptive use should focus on the practical aspect.

Keywords: fertility preference, contraceptive use, univariate analysis, family planning

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Authors: Nermeen Elbeltagy, Sara Hassan, Tamer Hosny, Mostafa Abdelaziz

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Introduction: Adequate postoperative analgesia after caesarean section (CS) is crucial as it impacts the distinct surgical recovery needs of the parturient. Over recent years, there has been increased interest in regional nerve block techniques with promising results on efficacy. These techniques reduce the need for additional analgesia, thereby lowering the incidence of drug-related side effects. As postoperative pain after cesarean is mainly due to abdominal incision, the transverses abdomenis plane ( TAP ) block is a relatively new abdominal nerve block with excellent efficacy after different abdominal surgeries, including cesarean section. Objective: The main objective is to compare ultrasound-guided TAP block provided by the anesthesiologist with TAP provided by the surgeon through a caesarean incision regarding the duration of postoperative analgesia, intensity of analgesia, timing of mobilization, and easiness of the procedure. Method: Ninety pregnant females at term who were scheduled for delivery by elective cesarean section were randomly distributed into two groups. The first group (45) received spinal anesthesia and postoperative ultrasound guided TAP block using 20ml on each side of 0.25% bupivacaine which was provided by the anesthesiologist. The second group (45) received spinal anesthesia plus a TAP block using 20ml on each side of 0.25% bupivacaine, which was provided by the surgeon through the cesarean incision. Visual Analogue Scale (VAS) was used for the comparison between the two groups. Results: VAS score after four hours was higher among the TAP block group provided by the surgeon through the surgical incision than the postoperative analgesic profile using ultrasound-guided TAP block provided by the anesthesiologist (P=0.011). On the contrary, there was no statistical difference in the patient’s dose of analgesia after four hours of the TAP block (P=0.228). Conclusion: TAP block provided through the surgical incision is safe and enhances early patient’s mobilization.

Keywords: TAP block, CS, VAS, analgesia

Procedia PDF Downloads 49