Search results for: regional block

Authors: Fedili Benamar, Beloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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 Background and aims: Peripheral regional anesthesia has been integrated into most analgesia protocols for total knee arthroplasty which considered among the most painful surgeries with a huge potential for chronicization. The adductor canal block (ACB) has gained popularity. Similarly, the IPACK block has been described to provide analgesia of the posterior knee capsule. This study aimed to evaluate the analgesic efficacy of this block in patients undergoing primary PTG. Methods: 90 patients were randomized to receive either an IPACK, an anterior sciatic block, or a sham block (30 patients in each group + multimodal analgesia and a catheter in the KCA adductor canal). GROUP 1 KCA GROUP 2 KCA+BSA GROUP 3 KCA+IPACK The analgesic blocks were done under echo-guidance preoperatively respecting the safety rules, the dose administered was 20 cc of ropivacaine 0.25% was used. We were to assess posterior knee pain 6 hours after surgery. Other endpoints included quality of recovery after surgery, pain scores, opioid requirements (PCA morphine)(EPI info 7.2 analysis). Results: -groups were matched -A predominance of women (4F/1H). -average age: 68 +/-7 years -the average BMI =31.75 kg/m2 +/- 4. -70% of patients ASA2 ,20% ASA3. -The average duration of the intervention: 89 +/- 19 minutes. -Morphine consumption (PCA) significantly higher in group 1 (16mg) & group 2 (8mg) group 3 (4mg) - The groups were matched . -There was a correlation between the use of the ipack block and postoperative pain Conclusions :In a multimodal analgesic protocol, the addition of IPACK block decreased pain scores and morphine consumption ,

Keywords: regional anesthesia, analgesia, total knee arthroplasty, the adductor canal block (acb), the ipack block, pain

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Authors: A. Duncan, A. Blake, A. O'Gara, J. Fitzgerald

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Introduction: Acute traumatic rib fractures have significant morbidity and mortality and are a commonly seen injury in trauma patients. Rib fracture pain can often be acute and can prove challenging to manage. We performed an audit on patients with acute traumatic rib fractures with the aim of composing a referral and treatment pathway for such patients. Methods: From January 2021 to January 2022, the pain medicine service encouraged early referral of all traumatic rib fractures to the pain service for a multi-modal management approach. A retrospective audit of analgesic management was performed on a select cohort of 24 patients, with a mean age of 67, of which 19 had unilateral rib fractures. Results: 17 of 24 patients (71%) underwent local, regional block as part of a multi-modal analgesia regime. Only one regional complication was observed, seen with hypotension occurring in one patient with a thoracic epidural. The group who did not undergo regional block had a length of stay (LOS) 17 days longer than those who did (27 vs. 10) and higher rates of pneumonia (29% vs. 18%). Conclusion: Early referral to pain specialists is an important component of the effective management of acute traumatic rib fractures. From our audit, it is evident that regional blocks can be effectively used in these cases as part of a multi-modal analgesia regime and may confer benefits in terms of respiratory complications and length of stay.

Keywords: rib fractures, regional blocks, thoracic epidural, erector spina block

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Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

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Authors: Nazia Nazir

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Background: The benefits of regional anesthetic techniques are well established. Use of additives to local anesthetics can prolong these benefits. The aim of this study was to observe the effect of adding dexmedetomidine to bupivacaine for the supraclavicular block. Methods (Design): In this randomized, double-blind study, seventy ASA I & II patients of either sex undergoing elective surgeries on the upper limb were given supraclavicular block under ultrasound guidance. Group C (n=35), received 38 mL 0.25% bupivacaine + 2mL normal saline and group D received 38 mL 0.25% bupivacaine + 1 µg/kg dexmedetomidine (2mL). Patients were observed for onset, duration of motor and sensory block, duration of analgesia, sedation score, hemodynamic changes and any adverse events. Results: In group D the onset was faster (P < 0.001), duration of sensory and motor block, as well as duration of analgesia, was prolonged as compared to group C (P < 0.0001). There was significant drop in heart rate (HR) from the baseline in group D (P < 0.05) at 30, 60, 90 and 120 min, however, none of the patients dropped HR below 50/min. Mean arterial Pressure (MAP) remained unaffected. The patients in group D were effectively sedated than those in group C (P < 0.05). No adverse event was reported in either group. Conclusion: Dexmedetomidine as adjuvant to bupivacaine in supraclavicular block resulted in faster action, prolonged motor and sensory block, prolonged analgesia with hemodynamic stability and adequate sedation.

Keywords: Analgesia, bupivacaine, dexmedetomidine, supraclavicular block

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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

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Authors: Darshana Rathod, Kirtikumar Rathod, Kamlesh Kumari, Abhilasha Motghare

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Background and Aims: Hypospadias is one of the common congenital anomalies in males. Various modalities are used for pain management, including caudal, penile, pudendal, ring blocks, and systemic analgesics. There has yet to be a consensus regarding the most effective and safe analgesic method for controlling pain in these children. We planned this study to determine our institute's pain management practices for hypospadias surgeries. Material and Methods: This retrospective cohort study reviewed 150 children with hypospadias undergoing surgery from January 2020 to December 2023. Data regarding the mode of pain management, postoperative opioid requirement, PACU discharge, and complications was collected from the records. Results: For postoperative pain, 33 (22%) children received caudal block, 60 (40%) penile block, and 57 (38%) were managed by intravenous analgesics. A significant difference was found in the three groups, with the IV analgesic group requiring significantly higher opioid boluses in PACU [43 (75.4%) required two boluses (p < 0.05)]. The difference in PACU discharge time among the three groups was statistically significant (p< 0.05), with IV analgesics groups having the highest (55 mins [47, 60]), the Caudal group at 35mins (30, 40), and the dorsal penile block group at 35mins (25, 40). There was no significant difference in complications like edema, meatal stenosis, urethra-cutaneous fistula, or wound dehiscence among all three groups. Conclusion: Intravenous analgesics and regional blocks like caudal and penile blocks are the common pain management modalities in our institute. The regional blocks are effective in managing pain in the postoperative period and are not significantly associated with complications.

Keywords: caudal block, hypospadias, pain management, penile block

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Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

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Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

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Authors: Maciej Major, Izabela Major

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The aim of this paper is a numerical analysis of three-layered block design to walls construction subjected to the dynamic load. The block consists of the layers: concrete with rubber pads in shape of crosses, space filled with air and concrete with I-shape rubber pads. The main purpose of rubber inserts embedded during the production process is additional protection against the transversal dynamic load. For the analysis, as rubber, the Zahorski hyperelastic incompressible material model was assumed. A concentrated force as dynamic load applied to the external block surface was investigated. The results for the considered block observed as the stress distribution plot were compared to the results obtained for the solid concrete block. In order to estimate the percentage damping of proposed composite, rubber-concrete block in relation to the solid block the numerical analysis with the use of finite element method based on ADINA software was performed.

Keywords: dynamics, composite, rubber, Zahorski

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Authors: Hae-Yeoun Lee

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Mosaic refers to a technique that makes image by gathering lots of small materials in various colours. This paper presents an automatic algorithm that makes the photomosaic image using photos. The algorithm is composed of four steps: Partition and feature extraction, block matching, redundancy removal and colour adjustment. The input image is partitioned in the small block to extract feature. Each block is matched to find similar photo in database by comparing similarity with Euclidean difference between blocks. The intensity of the block is adjusted to enhance the similarity of image by replacing the value of light and darkness with that of relevant block. Further, the quality of image is improved by minimizing the redundancy of tiles in the adjacent blocks. Experimental results support that the proposed algorithm is excellent in quantitative analysis and qualitative analysis.

Keywords: photomosaic, Euclidean distance, block matching, intensity adjustment

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Authors: H. Starzyczna, M. Stoklasa, K. Matusinska

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This article deals with the benefits of regional brands for companies in the Czech Republic. Research was focused on finding out the expected and actual benefits of regional brands for companies. The data were obtained by questionnaire survey and analysed by IBM SPSS. Representative sample of 204 companies was created. The research analysis disclosed the expected benefits that the regional brand should bring to companies. But the actual benefits are much worse. The statistical testing of hypotheses revealed that the benefits depend on the region of origin, which surprised both us and the regional coordinators.

Keywords: Brand, regional brands, product protective branding programs, brand benefits

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Authors: Young-Hun Ko, Seung-Jun Kim, Khaqan Baluch, Hyung- Sik Yang

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In this study, the polymer gel was used as coupling material in a blasting hole and its comparison was made with other coupling materials like sand, water, and air. Trazul lead block test and AUTODYN numerical analysis were conducted to analyze the effects of the coupling materials on the intensity of the explosion, as well as the verification tests were conducted by using concrete block test. The emulsion explosives were used in decoupling conditions, sand, water, and polymer gel were used as the coupling materials. The lead block test and the numerical analysis showed that the expansion of the blast hole in the lead block was similar to that of the water and gelatin and followed by sand and air conditions. The validation of concrete block test result showed the similar result as Trazul lead block test and the explosion strength was measured at 0.8 for polymer gel, 0.7 for sand, and 0.6 for no coupling material, in comparison to the full charge (1.0) case.

Keywords: Trazul lead block test, AUTODYN numerical analysis, coupling material, polymer gel, soil covering concrete block explosion test

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Authors: Khairil I. Othman, Mahfuzah Mahayaddin, Zarina Bibi Ibrahim

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We develop and demonstrate a computationally efficient numerical technique to solve first order stiff differential equations. This technique is based on block method whereby three approximate points are calculated. The Cholistani of varied step sizes are presented in divided difference form. Stability regions of the formulae are briefly discussed in this paper. Numerical results show that this block method perform very well compared to existing methods.

Keywords: block method, divided difference, stiff, computational

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Authors: Khairil Iskandar Othman, Nadhirah Kamal, Zarina Bibi Ibrahim

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Block methods for solving stiff systems of ordinary differential equations (ODEs) are based on backward differential formulas (BDF) with PE(CE)2 and Newton method. In this paper, we introduce Modified Newton as a new strategy to get more efficient result. The derivation of BBDF using modified block Newton method is presented. This new block method with predictor-corrector gives more accurate result when compared to the existing BBDF.

Keywords: modified Newton, stiff, BBDF, Jacobian matrix

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Authors: A. M. Sagir

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The aim of this paper is to investigate the performance of the developed linear multistep block method for solving first order initial value problem of Ordinary Differential Equations (ODEs). The method calculates the numerical solution at three points simultaneously and produces three new equally spaced solution values within a block. The continuous formulations enable us to differentiate and evaluate at some selected points to obtain three discrete schemes, which were used in block form for parallel or sequential solutions of the problems. A stability analysis and efficiency of the block method are tested on ordinary differential equations involving practical applications, and the results obtained compared favorably with the exact solution. Furthermore, comparison of error analysis has been developed with the help of computer software.

Keywords: block method, first order ordinary differential equations, linear multistep, self-starting

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Authors: Malika Yaici, Kamel Hariche

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In control engineering, systems described by matrix fractions are studied through properties of block roots, also called solvents. These solvents are usually dealt with in a block Vandermonde matrix form. Inverses and determinants of Vandermonde matrices and block Vandermonde matrices are used in solving problems of numerical analysis in many domains but require costly computations. Even though Vandermonde matrices are well known and method to compute inverse and determinants are many and, generally, based on interpolation techniques, methods to compute the inverse and determinant of a block Vandermonde matrix have not been well studied. In this paper, some properties of these matrices and iterative algorithms to compute the determinant and the inverse of a block Vandermonde matrix are given. These methods are deducted from the partitioned matrix inversion and determinant computing methods. Due to their great size, parallelization may be a solution to reduce the computations cost, so a parallelization of these algorithms is proposed and validated by a comparison using algorithmic complexity.

Keywords: block vandermonde matrix, solvents, matrix polynomial, matrix inverse, matrix determinant, parallelization

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Authors: Thomas Roche, Erica Wilson, Elizabeth Goode

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Universities across the globe are considering how to effect meaningful change in their higher education (HE) delivery in the face of increasingly diverse student cohorts and shifting student learning preferences. This paper reports on a descriptive case study of whole-of-institution curriculum reform at one regional Australian university, where more traditional 13-week semesters were replaced with a 6-week immersive block model drawing on active learning pedagogy. Based on a synthesis of literature in best practice HE pedagogy and principles, the case study draws on student performance data and senior management staff interviews (N = 5) to outline the key changes necessary for successful HE transformation to deliver increased student pass rates and retention. The findings from this case study indicate that an institutional transformation to an immersive block model requires both a considered change in institutional policy and process as well as the appropriate resourcing of roles, governance committees, technical solutions, and, importantly, communities of practice. Implications for practice at higher education institutions considering reforming their curriculum model are also discussed.

Keywords: student retention, immersive scheduling, block model, curriculum reform, active learning, higher education pedagogy, higher education policy

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Authors: B. Saripah, A. Alias

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Cocoa Theobroma cacao (Linnaeus) (Malvales: Sterculiaceae) is subjected to be infested by various numbers of insect pests, and Conopomorpha cramerella Snellen (Lepidoptera: Gracillariidae) is the most serious pest of cocoa in Malaysia. The pest was indigenous to the South East Asia. Several control measures have been implemented and the chemicals have been a major approach if not unilateral, in the management of CPB. Despite extensive use of insecticides, CPB continues to cause an unacceptable level of damage; thus, the combination of several control approaches should be sought. The study was commenced for 12 months at three blocks; Block 18C with complete management practices which include insecticide application, pruning, fertilization and frequent harvesting, Block 17C was treated with frequent harvesting at intervals of 7-8 days, and Block 19C was served as control block. The results showed that the mean numbers of CPB eggs were recorded higher in Block 17C compared with Block 18C in all sampling occasions. Block 18C shows the lowest mean number of CPB eggs in both sampling plots, outside and core plots and it was found significantly different (p ≤ 0. 05) compared to the other blocks. The mean number of CPB eggs was fluctuated throughout sampling occasions, the lowest mean number of eggs was recorded in January (17C) and November (18C), while the highest was recorded in April (17C) and December 2012 (18C). Frequent spraying with insecticides at the adjacent block (18C) helps in reducing CPB eggs in the control block (Block 19C), although there was no spraying was implemented Block 19C. In summary, the combination of complete management practices at Block 18C seems to have some effect on the CPB population at Blocks 17 and 19C because all blocks are adjacent to each other.

Keywords: cocoa, theobroma cacao, cocoa pod borer, conopomorpha cramerella

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Authors: A. M. Sagir

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Discrete linear multistep block method of uniform order for the solution of first order Initial Value Problems (IVPs) in Ordinary Differential Equations (ODEs) is presented in this paper. The approach of interpolation and collocation approximation are adopted in the derivation of the method which is then applied to first order ordinary differential equations with associated initial conditions. The continuous hybrid formulations enable us to differentiate and evaluate at some grids and off – grid points to obtain four discrete schemes, which were used in block form for parallel or sequential solutions of the problems. Furthermore, a stability analysis and efficiency of the block method are tested on ordinary differential equations, and the results obtained compared favorably with the exact solution.

Keywords: block method, first order ordinary differential equations, hybrid, self-starting

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Authors: Wang Ye, Wei Wei

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Residential block construction of big cities in China began in the 1950s, and four models had far-reaching influence on modern residential block in its development process, including unit compound and residential district in 1950s to 1980s, and gated community and open community in 1990s to now. Based on analysis of the four models’ fabric, the article takes residential blocks in Hangzhou west area as an example and carries on the studies from urban structure level and block special level, mainly including urban road network, land use, community function, road organization, public space and building fabric. At last, the article puts forward semi-open sub-community strategy to improve the current fabric.

Keywords: Hangzhou west area, residential block model, residential block fabric, semi-open sub-community strategy

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Authors: J. C. Cheng, Y. L. Tsay, Z. D. Chan, C. H. Yang

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In this study the physical system under consideration is a three-dimensional (3-D) cabinet with arrays of block heat sources mounted on one of the walls of the cabinet. The block heat sources dissipate heat to the cabinet surrounding through the conjugate conduction and natural convection. The results illustrate that the difference in hot spot temperatures of the system (θH) for the situations with and without consideration of thermal interaction is higher for smaller Rayleigh number (Ra), and can be up to 94.73% as Ra=10^5. In addition, the heat transfer characteristics depends strongly on the dimensionless heat conductivity of cabinet wall (Kwf), heat conductivity of block (Kpf) and length of cabinet (Ax). The maximum reduction in θH is 70.01% when Kwf varies from 10 to 1000, and it is 30.07% for Ax from 0.5 to 1. While the hot spot temperature of system is not sensitive to the cabinet angle (Φ).

Keywords: block heat sources, 3-D cabinet, thermal interaction, heat transfer

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Authors: Amit Bhattacharyya

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The economic scenario of any region does not show the real picture for the measurement of overall development. Therefore, economic development must be accompanied by social development to be able to make an assessment to measure the level of development. The spatial variation with respect to social development has been discussed taking into account the quality of functioning of a social system in a specific area. In this paper, an attempt has been made to study the spatial distribution of social infrastructural facilities and analyze the magnitude of regional disparities at inter- block level in Barddhman district. It starts with the detailed account of the selection process of social infrastructure indicators and describes the methodology employed in the empirical analysis. Analyzing the block level data, this paper tries to identify the disparity among the blocks in the levels of social development. The results have been subsequently explained using both statistical analysis and geo spatial technique. The paper reveals that the social development is not going on at the same rate in every part of the district. Health facilities and educational facilities are concentrated at some selected point. So overall development activities come to be concentrated in a few centres and the disparity is seen over the blocks.

Keywords: disparity, inter-block, social development, spatial variation

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Authors: Presto Tri Sambodo, Suharjana, Galih Yoga Santiko

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Having an ideal body shape healthy body are the desire of everyone, both young and old. The purpose of this study was to determine: (1) the effect of block circuit training on aerobic fitness and body fat percentage, (2) the effect of non-block circuit training on aerobic fitness and body fat percentage, and (3) differences in the effect of exercise on block and non-circuit training block against aerobic fitness and body fat percentage. This research is an experimental research with the prestest posttest design Two groups design. The population in this study were 57 members of fat loss at GOR UNY Fitness Center. The retrieval technique uses purposive random sampling with a sample of 20 people. The instruments with rockport test (1.6 KM) and body fat percentage with a scale of bioelectrical impedance analysis omron (BIA). So it can be concluded the circuit training between block and non-block has a significant effect on aerobic fitness and body fat percentage. And for differences in the effect of circuit training between blocks and non-blocks, it is more influential on aerobic fitness than the percentage of body fat.

Keywords: circuit training, aerobic fitness, body fat percentage, healthy body

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Authors: Anne Gibbons

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Both inside and outside of academia, people have sought to understand the “sense of place” of various regions, many times over and for many different reasons. The concept of regional identity is highly complex and surrounded by considerable contention. There are multiple bodies of research on regional identity theory in many different disciplines and even across sub-disciplinary classifications. Each discipline takes a slightly different angle or perspective on regional identity, resulting in a fragmented body of work on this topic overall. There is a need to consolidate this body of increasingly fragmented theory through interdisciplinary integration. For the purpose of this study, the province of Saskatchewan will serve as an exemplar for exploring regional identity in a concrete context. Saskatchewan can be thought of as a ‘functional region,’ with clear boundaries and clear residency, from which regional identity can be studied. This thesis shares the outcomes of a qualitative study grounded in a series of group interviews with askatchewan residents, from which it is concluded that the use of interdisciplinary theory is an appropriate approach to the study of regional identity. Regional identity cannot be compartmentalized; it is a web of characteristics, attributes, and feelings that are inextricably linked. The thesis thus concludes by offering lessons learned about how we might better understand regional identity, as illuminated through both interdisciplinary theory and the lived experiences and imaginations of people living in the region of Saskatchewan.

Keywords: interdisciplinary, regional identity, Saskatchewan, tourism studies

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Authors: Mrudula Kudtarkar, Rajesh Mane

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Introduction: Cleft lip repair is one of the common surgeries performed in India and the usual method used for post-operative analgesia is perioperative opioids and NSAIDs. There has been an increase in use of regional techniques and Opioids are the common adjuvants but their efficacy and safety have not been studied extensively in children. Aim: A prospective, randomized, double-blind study was done to compare the efficacy, duration and safety of intraoral infraorbital nerve block on post-operative pain relief using bupivacaine alone or in combination with fentanyl or pethidine in paediatric cleft lip repair. Methodology: 45 children between the age group 5 – 60 months undergoing cleft lip surgery randomly allocated into 3 groups of 15 each received bilateral intraoral infraorbital nerve block with 0.75ml of solution. Group B received 0.25% bupivacaine; group P received 0.25% bupivacaine with 0.25mg/kg pethidine, group F received 0.25% bupivacaine with 0.25microgm/kg fentanyl. Sedation after recovery, post-operative pain intensity and duration of post-operative analgesia were assessed using Modified Hannallah Pain Score. Results: The mean duration of analgesia was 17.8 hrs in Group B, 23.53 hrs in Group F and 35.13 hrs in Group P. There was statistically significant difference between the means of the three groups- ANOVA (p < 0.05). Conclusion: Thus we conclude that addition of fentanyl or pethidine to bupivacaine for Bilateral Intraoral Infraorbital Nerve Block prolong the duration of analgesia with no complications and can be used safely in paediatric patients.

Keywords: cleft lip, infraorbital block, NSAIDS, Opiods

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Authors: M. Panahian

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A global challenge which is of paramount significance today is the issue of devising innovative solutions to tackle the environmental issues, as well as more intelligent and foresightful consumption of and management of natural resources. Changes in global climate resulting from the burning of fossil fuel and the rise in the level of energy consumption are a few examples of environmental issues detrimental to any form of life on earth, which are aggravated year by year. Overall, energy-efficient designs and construction strategies can be studied at three scales: building, block, and city. Nevertheless, as the available literature suggests, the greatest emphasis has been on building and city scales, and little has been done as to the energy-efficient designs at block scale. Therefore, the aim of the current research is to investigate the influences of residential block scale envelope on the energy consumption in buildings. To this end, a case study of residential block scale has been selected in the city of Isfahan, in Iran, situated in a hot and dry climate with cold winters. Eventually, the most effective variables in energy consumption, concerning the block scale envelope, will be concluded.

Keywords: sustainability, passive energy saving solutions, residential block scale, energy efficiency

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Authors: Kamonwat Suksumek, Seeronk Prichanont

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Access block refers to the situation where Emergency Department (ED) patients requiring hospital admission spend an unreasonable holding time in an ED because their access to a ward is blocked by the full utilization of the ward’s beds. Not only it delays the proper treatments required by the patients, but access block is also the cause of ED’s overcrowding. Clearly, access block is an inter-departmental problem that needs to be brought to management’s attention. This paper focuses on the analysis of strategies to address the access block problem, both in the operational and intermediate levels. These strategies were analyzed through a simulation model with a real data set from a university hospital in Thailand. The paper suggests suitable variable levels for each strategy so that the management will make the final decisions.

Keywords: access block, emergency department, health system analysis, simulation

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Authors: Jungeun Cho

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Social finance has received increasing attention as a means to promote the growth of regional economies. Despite the plenty of research discussed their critical role and functions in regional economic development such as the financing and promotion of co-operatives or social enterprises and the offering credit to the financially excluded in the region, however, rarely are efforts made to measure the contribution of social finance in the regional economy. It is essential to establish an evaluation model in order to encourage social finance institutions to perform their supposed role and functions on regional economic development. The objective of this paper is to formulate an evaluation model of the contribution of social finance to the regional economy through an analytic hierarchy process (AHP) approach. This study is expected to provide useful guidelines for social finance institutions’ strategies and the policies of local or central government regarding social finance.

Keywords: social finance, regional economy, social economy, policies of local or central government

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Authors: К. Lisinchuk

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An effective approach to the management of international educational mobility in regional universities with the purpose of increasing tourist activity in the region is considered.

Keywords: export and import of tourist and educational services, international academic mobility, regional tourist activities

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Authors: Dodi Ikhsanshaleh

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When subjected to dynamic load, foundation oscillates in the way that depends on the soil behaviour, the geometry and inertia of the foundation and the dynamic exctation. The practical guideline to analysis block-type foundation excitated by dynamic load from vibrating machine is presented. The analysis use Lumped Mass Parameter Method to express dynamic properties such as stiffness and damping of soil. The numerical examples are performed on design block-type foundation supporting gas turbine compressor which is important equipment package in gas processing plant

Keywords: block foundation, dynamic load, lumped mass parameter

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Authors: Luís Farinha, João J. Ferreira

Abstract:

Nowadays innovation represents a challenge crucial to remaining globally competitive. This study seeks to develop a conceptual model aimed at measuring the dynamic interactions of the triple/quadruple helix, balancing innovation and entrepreneurship initiatives as pillars of regional competitiveness – the Regional Helix Scoreboard (RHS). To this aim, different strands of literature are identified according to their focus on specific regional competitiveness governance mechanisms. We put forward an overview of the state-of-the-art of research and is duly assessed in order to develop and propose a framework of analysis that enables an integrated approach in the context of collaborative dynamics. We conclude by presenting the RHS for the study of regional competitiveness dynamics, which integrates and associates different backgrounds and identifies a number of key performance indicators for research challenges.

Keywords: entrepreneurship, KPIs, innovation, performance measurement, regional competitiveness, regional helix scoreboard

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