Abstract: Adequate analgesia following caesarean section
decreases morbidity, hastens ambulation, improves patient outcome
and facilitates care of the newborn. Intrathecal magnesium, an
NMDA antagonist, has been shown to prolong analgesia without
significant side effects in healthy parturients. The aim of this study
was to evaluate the onset and duration of sensory and motor block,
hemodynamic effect, postoperative analgesia, and adverse effects of
magnesium or fentanyl given intrathecally with hyperbaric 0.5%
bupivacaine in patients with mild preeclampsia undergoing caesarean
section. Sixty women with mild preeclampsia undergoing elective
caesarean section were included in a prospective, double blind,
controlled trial. Patients were randomly assigned to receive spinal
anesthesia with 2 mL 0.5% hyperbaric bupivacaine with 12.5 μg
fentanyl (group F) or 0.1 ml of 50% magnesium sulphate (50 mg)
(group M) with 0.15ml preservative free distilled water. Onset,
duration and recovery of sensory and motor block, time to maximum
sensory block, duration of spinal anaesthesia and postoperative
analgesic requirements were studied. Statistical comparison was
carried out using the Chi-square or Fisher’s exact tests and
Independent Student’s t-test where appropriate. The onset of both
sensory and motor block was slower in the magnesium group. The
duration of spinal anaesthesia (246 vs. 284) and motor block (186.3
vs. 210) were significantly longer in the magnesium group. Total
analgesic top up requirement was less in group M. Hemodynamic
parameters were similar in both the groups. Intrathecal magnesium
caused minimal side effects. Since Fentanyl and other opioid
congeners are not available throughout the country easily,
magnesium with its easy availability and less side effect profile can
be a cost effective alternative to fentanyl in managing pregnancy
induced hypertension (PIH) patients given along with Bupivacaine
intrathecally in caesarean section.
Abstract: The purpose of this study is the discrimination of 28
postmenopausal with osteoporotic femoral fractures from an agematched
control group of 28 women using texture analysis based on
fractals. Two pre-processing approaches are applied on radiographic
images; these techniques are compared to highlight the choice of the
pre-processing method. Furthermore, the values of the fractal
dimension are compared to those of the fractal signature in terms of
the classification of the two populations. In a second analysis, the
BMD measure at proximal femur was compared to the fractal
analysis, the latter, which is a non-invasive technique, allowed a
better discrimination; the results confirm that the fractal analysis of
texture on calcaneus radiographs is able to discriminate osteoporotic
patients with femoral fracture from controls. This discrimination was
efficient compared to that obtained by BMD alone. It was also
present in comparing subgroups with overlapping values of BMD.
Abstract: This paper presents results of the survey regarding the
awareness about HIV/AIDS among HIV-infected individuals. A
questionnaire covering various aspects of HIV-infection was
conducted among 110 HIV-infected individuals who attended the
G.A. Zaharyan Moscow Tuberculosis Clinic, Department for
treatment of TB patients with HIV. The questionnaire included
questions about modes of HIV transmission and preventive measures
against HIV/AIDS, as well as questions about age, gender, education
and employment status. The survey revealed that the respondents in
the whole had a good knowledge regarding modes of HIV
transmission and preventive measures against HIV/AIDS: about
83,6% male respondents and 85,7% female respondents gave an
accurate answers regarding the HIV-infection. However, the
overwhelming majority of the study participants, that is, 88,5% men
and 98% women, was quite ignorant about the risk of acquiring HIV
through saliva and toothbrush of HIV-infected individual. Though
that risk is rather insignificant, it is still biologically possible. And
this gap in knowledge needs to be filled. As the study showed another
point of concern was the fact, that despite the knowledge of HIV
transmission risk through unprotected sex about 40% percent of HIVpositive
men and 25% of HIV-positive women did not insist on using
condoms with their sexual partners. These findings indicate that there
are still some aspects about HIV-infection which needed to be
clarified and explained through more detailed and specific
educational programs.
Abstract: This paper is based on a large questionnaire study. The
paper presents how all participants and subgroups (upper- and
lower-level white-collar workers) answered the question, “Have you
had an ache, pain, or numbness, which you associate with desktop
computer use, in the different body parts during the last 12 months?’
14.6% of participants (19.4% of women and 8.2% of men) reported
that they had often or very often physical symptoms in the neck. Even
if our results cannot prove a causal relation of symptoms with
computer use, show that workers believe that computer use can
influence their wellbeing: this is important when devising treatment
modalities to decrease these physical symptoms.
Abstract: Breast cancer is in the top rate of cancer. We analyzed
the prevalence of obesity and its association with breast cancer and
finally we reviewed 25 article that 320 patient and 320 control which
enrolled to our study. The distribution of breast cancer patients and
controls with respect to their anthropometric indices in patients with
higher weight, which was statistically significant (60.2 ± 10.2 kg)
compared with control group (56.1 ± 11.3 kg). The body mass index
of patients was (26.06+/-3.42) and significantly higher than the
control group (24.1+/-1.7). Obesity leads to increased levels of
adipose tissue in the body that can be stored toxins and carcinogens
to produce a continuous supply. Due to the high level of fat and the
role of estrogen in a woman which is endogenous estrogen of the
tumor and regulates the activities of growth steroids, obesity has
confirmed as a risk factor for breast cancer. Our study and other
studies have shown that obesity is a risk factor for breast cancer. And
it can be prevented with a weight loss intervention for breast cancer
in the future.
Abstract: The notion of power and gender domination is one of
the inseparable aspects of themes in postmodern literature. The
reason of its importance has been discussed frequently since the rise
of Michel Foucault and his insight into the circulation of power and
the transgression of forces. Language and society operate as the basic
grounds for the study, as all human beings are bound to the set of
rules and norms which shape them in the acceptable way in the
macrocosm. How different genders in different positions behave and
show reactions to the provocation of social forces and superiority of
one another is of great interest to writers and literary critics. Mamet’s
works are noticeable for their controversial but timely themes which
illustrate human conflicts with the society and greed for power. Many
critics like Christopher Bigsby and Harold Bloom have discussed
Mamet and his ideas in recent years. This paper is the study of
Oleanna, Mamet’s masterpiece about the teacher-student relationship
and the circulation of power between a man and woman. He shows
the very breakable boundaries in the domination of a gender and the
downfall of speech as the consequence of transgression and freedom.
The failure of the language the teacher uses and the abuse of his own
words by a student who seeks superiority and knowledge are the
main subjects of the discussion. Supported by the ideas of Foucault,
the language Mamet uses to present his characters becomes the
fundamental premise in this study. As a result, language becomes
both the means of achievement and downfall.
Abstract: Obesity and osteoporosis are the two diseases whose
increasing prevalence and high impact on the global morbidity and
mortality, during the two recent decades, have gained a status of
major health threats worldwide. Obesity purports to affect the bone
metabolism through complex mechanisms. Debated data on the
connection between the bone mineral density and fracture prevalence
in the obese patients are widely presented in literature. There is
evidence that the correlation of weight and fracture risk is sitespecific.
This study is aimed at determining the connection between
the bone mineral density (BMD) and trabecular bone score (TBS)
parameters in Ukrainian women suffering from obesity. We
examined 1025 40-89-year-old women, divided them into the groups
according to their body mass index: Group A included 360 women
with obesity whose BMI was ≥30 kg/m2, and Group B – 665 women
with no obesity and BMI of
Abstract: Quick adoption of e-business and emerging influence
of “Electronic Word of Mouth e-WOM” communication on guests
made leading hotel brands successful examples of electronic guest
relationship management. Main reasons behind such success are well
established procedures in collection, analysis and usage of highly
valuable data available on the Internet, generated through some form
of e-GRM programme. E-GRM is more than just a technology
solution. It’s a system which balance respective guest demands, hotel
technological capabilities and organizational culture of employees,
discharging the universal approach in guest relations “same for all”.
The purpose of this research derives from the necessity of
determining the importance of monitoring and applying e-WOM
communication as one of the methods used in managing guest
relations. This paper analyses and compares different hotelier’s
opinions on e-WOM communication.
Abstract: Structural Equation Modeling (SEM) was used to test
a hypothesized model explaining Malaysian hypermarket customers’
perceptions of brand trust (BT), customer perceived value (CPV) and
perceived service quality (PSQ) on building their brand loyalty
(CBL) and generating positive word-of-mouth communication
(WOM). Self-administered questionnaires were used to collect data
from 374 Malaysian hypermarket customers from Mydin, Tesco,
Aeon Big and Giant in Kuala Lumpur, a metropolitan city of
Malaysia. The data strongly supported the model exhibiting that BT,
CPV and PSQ are prerequisite factors in building customer brand
loyalty, while PSQ has the strongest effect on prediction of customer
brand loyalty compared to other factors. Besides, the present study
suggests the effect of the aforementioned factors via customer brand
loyalty strongly contributes to generate positive word of mouth
communication.
Abstract: Introduction: There are multiple social, individual and
cultural factors that influence an individual’s decision to adopt family
planning methods especially among non-users in patriarchal societies
like Pakistan. Non-users, if targeted efficiently, can contribute
significantly to country’s CPR. A research study showed that nonusers
if convinced to adopt lactational amenorrhea method can shift
to long term methods in future. Research shows that if non users are
targeted efficiently a 59% reduction in unintended pregnancies in
Saharan Africa and South-Central and South-East Asia is anticipated.
Methods: We did secondary data analysis on Pakistan
Demographic Heath Survey (2012-13) dataset. Use of contraception
(never-use/ever-use) was the outcome variable. At univariate level
Chi-square/Fisher Exact test was used to assess relationship of
baseline covariates with contraception use. Then variables to be
incorporated in the model were checked for multicollinearity,
confounding and interaction. Then binary logistic regression (with an
urban-rural stratification) was done to find relationship between
contraception use and baseline demographic and social variables.
Results: The multivariate analyses of the study showed that
younger women (≤ 29 years)were more prone to be never users as
compared to those who were >30 years and this trend was seen in
urban areas (AOR 1.92, CI 1.453-2.536) as well as rural areas (AOR
1.809, CI 1.421-2.303). While looking at regional variation, women
from urban Sindh (AOR 1.548, CI 1.142-2.099) and urban
Balochistan (AOR 2.403, CI 1.504-3.839) had more never users as
compared to other urban regions. Women in the rich wealth quintile
were more never users and this was seen both in urban and rural
localities (urban (AOR 1.106 CI .753-1.624); rural areas (AOR 1.162,
CI .887-1.524)) even though these were not statistically significant.
Women idealizing more children (>4) are more never users as
compared to those idealizing less children in both urban (AOR 1.854,
CI 1.275-2.697) and rural areas (AOR 2.101, CI 1.514-2.916).
Women who never lost a pregnancy were more inclined to be nonusers
in rural areas (AOR 1.394, CI 1.127-1.723) .Women familiar
with only traditional or no method had more never users in rural areas
(AOR 1.717, CI 1.127-1.723) but in urban areas it wasn’t significant.
Women unaware of Lady Health Worker’s presence in their area
were more never users especially in rural areas (AOR 1.276, CI
1.014-1.607). Women who did not visit any care provider were more
never users (urban (AOR 11.738, CI 9.112-15.121) rural areas (AOR
7.832, CI 6.243-9.826)).
Discussion/Conclusion: This study concluded that government,
policy makers and private sector family planning programs should
focus on the untapped pool of never users (younger women from underserved provinces, in higher wealth quintiles, who desire more
children.). We need to make sure to cover catchment areas where
there are less LHWs and less providers as ignorance to modern
methods and never been visited by an LHW are important
determinants of never use. This all is in sync with previous literate
from similar developing countries.
Abstract: This study attempts to identify the factors influencing
on women empowerment of rural area in Sri Lanka through micro
finance services. Data were collected from one hundred (100) rural
women involving self-employment activities through a questionnaire
using direct personal interviews. Judgment and Convenience Random
sampling technique was used to select the sample size from three
Divisional Secretariat divisions of Kandawalai, Poonakari and
Karachchi in Kilinochchi District. The factor analysis was performed
on fourteen (14) variables for screening and reducing the variables to
identify the influencing factors on empowerment. Multiple regression
analysis was used to identify the relationship between the three
empowerment factors and the impact of micro finance on overall
empowerment of rural women. The result of this study summarized
the variables into three factors namely decision making, freedom to
mobility and family support and which are positively associated with
empowerment. In addition to this the value of adjusted R2 is 0.248
indicates that all the variables extracted can be explained 24.8% of
the variation in the women empowerment through microfinance.
Independent variables of these three factors have positive correlation
with women empowerment as well as significant values at 5 percent
level.
Abstract: Breast cancer is considered as a substantial health
concern and practicing mammography screening [MS] is important in
minimizing its related morbidity. So it is essential to have a better
understanding of breast cancer screening behaviors of women and
factors that influence utilization of them. The aim of this study is to
identify the factors that are linked to MS behaviors among the
Egyptian women. A cross-sectional descriptive design was carried
out to provide a snapshot of the factors that are linked to MS
behaviors. A convenience sample of 311 women was utilized and all
eligible participants admitted to the Women Imaging Unit who are 40
years of age or above, coming for mammography assessment, not
pregnant or breast feeding and who accepted to participate in the
study were included. A structured questionnaire was developed by
the researchers and contains three parts; Socio-demographic data;
Motivating factors associated with MS; and association between MS
and model of behavior change. The analyzed data indicated that most
of the participated women (66.6%) belonged to the age group of 40-
49.A high proportion of participants (58.1%) of group having
previous MS influenced by their neighbors to practice MS, whereas
32.7 % in group not having previous MS were influenced by family
members which indicated significant differences (P
Abstract: Turkish migrants constitute the largest group among
people with migration background living in Germany. Turkish
women’s labor market participation is of significant importance for
their social and economic integration to the German society. This
paper thus aims to investigate their labor market positions. Turkish
migrant women participate less in the labor market compared to men,
and are responsible for most of the housework, child care, and elderly
care. This is due to their traditional roles in the family, educational
level, insufficient knowledge of German language, and insufficient
professional experience. We strongly recommend that wide-reaching
integration policies for women are formulated, so as to encourage
participation of not only migrant women but also their husbands,
fathers and/or brothers, and natives.
Abstract: Introduction: Researchers globally have strived to explore diverse factors that augment the continuation and uptake of family planning methods. Clients’ satisfaction is one of the core determinants facilitating continuation of family planning methods. There is a major debate yet scanty evidence to contrast public and private sectors with respect to client satisfaction. The objective of this study is to compare quality-of-care provided by public and private sectors of Pakistan through a client satisfaction lens. Methods: We used Pakistan Demographic Heath Survey 2012-13 dataset on 3133 women. Ten different multivariate models were made. to explore the relationship between client satisfaction and dependent outcome after adjusting for all known confounding factors and results are presented as OR and AOR (95% CI). Results: Multivariate analyses showed that clients were less satisfied in contraceptive provision from private sector as compared to public sector (AOR 0.92, 95% CI 0.63-1.68) even though the result was not statistically significant. Clients were more satisfied from private sector as compared to the public sector with respect to other determinants of quality-of-care follow-up care (AOR 3.29, 95% CI 1.95-5.55), infection prevention (AOR 2.41, 95% CI 1.60-3.62), counseling services (AOR 2.01, 95% CI 1.27-3.18, timely treatment (AOR 3.37, 95% CI 2.20-5.15), attitude of staff (AOR 2.23, 95% CI 1.50-3.33), punctuality of staff (AOR 2.28, 95% CI 1.92-4.13), timely referring (AOR 2.34, 95% CI 1.63-3.35), staff cooperation (AOR 1.75, 95% CI 1.22-2.51) and complications handling (AOR 2.27, 95% CI 1.56-3.29). Discussion: Public sector has successfully attained substantial satisfaction levels with respect to provision of contraceptives, but it contrasts previous literature from a multi country studies. Our study though in is concordance with a study from Tanzania where public sector was more likely to offer family planning services to clients as compared to private facilities. Conclusion: In majority of the developing countries, public sector is more involved in FP service provision; however, in Pakistan clients’ satisfaction in private sector is more, which opens doors for public-private partnerships and collaboration in the near future.
Abstract: Background - The TrendCare Patient Dependency
System is currently used by a large number of maternity Services
across Australia, New Zealand and Singapore. In 2012, 2013 and
2014 validation studies were initiated in all three countries to validate
the acuity tools used for women in labour, and postnatal mothers and
babies. This paper will present the findings of the validation study.
Aim - The aim of this study was to; identify if the care hours
provided by the TrendCare acuity system was an accurate reflection
of the care required by women and babies; obtain evidence of
changes required to acuity indicators and/or category timings to
ensure the TrendCare acuity system remains reliable and valid across
a range of maternity care models in three countries.
Method - A non-experimental action research methodology was
used across maternity services in four District Health Boards in New
Zealand, a large tertiary and a large secondary maternity service in
Singapore and a large public maternity service in Australia.
Standardised data collection forms and timing devices were used to
collect midwife contact times, with women and babies included in the
study. Rejection processes excluded samples when care was not
completed/rationed, and contact timing forms were incomplete. The
variances between actual timed midwife/mother/baby contact and the
TrendCare acuity category times were identified and investigated.
Results - Thirty two (88.9%) of the 36 TrendCare acuity category
timings, fell within the variance tolerance levels when compared to
the actual timings recorded for midwifery care. Four (11.1%)
TrendCare categories provided less minutes of care than the actual
timings and exceeded the variance tolerance level. These were all
night shift category timings. Nine postnatal categories were not able
to be compared as the sample size for these categories was
statistically insignificant. 100% of labour ward TrendCare categories
matched actual timings for midwifery care, all falling within the
variance tolerance levels.
The actual time provided by core midwifery staff to assist lead
maternity carer (LMC) midwives in New Zealand labour wards
showed a significant deviation to previous studies. The findings of
the study demonstrated the need for additional time allocations in
TrendCare to accommodate an increased level of assistance given to
LMC midwives.
Conclusion - The results demonstrated the importance of regularly
validating the TrendCare category timings with actual timings of the
care hours provided. It was evident from the findings that variances
to models of care and length of stay in maternity units have increased
midwifery workloads on the night shift. The level of assistance
provided by the core labour ward staff to the LMC midwife has
increased substantially.
Outcomes - As a consequence of this study, changes were made to
the night duty TrendCare maternity categories, additional acuity
indicators were developed and times for assisting LMC midwives in
labour ward increased. The updated TrendCare version was delivered
to maternity services in 2014.
Abstract: Electronic Word-Of-Mouth (eWOM) communities
represent today an important source of information in which more
and more customers base their purchasing decisions. They include
thousands of reviews concerning very different products and services
posted by many individuals geographically distributed all over the
world. Due to their massive audience, eWOM communities can help
users to find the product they are looking for even if they are less
popular or rare. This is known as the long tail effect, which leads to a
larger number of lower-selling niche products. This paper analyzes
the long tail effect in a well-known eWOM community and defines a
tool for finding niche products unavailable through conventional
channels.
Abstract: The objectives of study are the following: To study
the way of life in terms of one hundred years co-existence of the
Muslim and local community in this area 2) To analyze factors affect
to this community with happy co-existence. The study requires
quantitative research to study a history together with the study of
humanity. The result of this study showed that the area of Petchburi
7 community is an ancient area which has owned by the Muslim for
almost 100 years. There is a sanctuary as & center of unity. Later
Bangkok becomes developed and provides more infrastructures like
motorway and other transportation: however, the owners of lands in
this community still keep their lands and build many buildings to run
business. With this purpose, there are many non-Muslim people come
to live here with co-existence. Not only are they convenient to work
but also easy to transport by sky train. There are factors that make
them live harmonious as following: 1) All Muslims in this area are
strict to follow their rules and allocate their community for business.
2) All people, who come and live here, are middle-aged and working
men and women. They, rent rooms closed to their work. 3) There are
Muslim food and desserts, especially Roti, the popular fried flour,
and local Chachak, tea originated from the south of Thailand. All
these food and desserts are famous for working men and women to
home and join after work 4) All Muslim in this area are independent
to lead their own lives although a society changes rapidly.
Abstract: This review emphasizes the effectiveness of men’s
participation in preventing domestic violence, and whether nonviolent
(NV) boys’ and men’s perceptions of intimate partner
violence (IPV) prevention programs affect their involvement. The
main goals of this assessment were to investigate (1) how NV men
engaged in anti-violence prevention programs that empower women,
(2) what were the possible perceptions of NV men involved in
prevention programs (3) how to identify effective approaches and
strategies that encouraged NV men to become involved in prevention
programs. This critical review also included the overview of
prevention programs such as: The Mentors in Violence Prevention
Programs (MVP), The White Ribbon Campaign (WRC), and
Domestic Violence Prevention Enhancement and Leadership through
Alliances (DELTA). The review suggested that (1) the expanding
prevention programs need to reach more macro settings such as work
place, faith-based and other community based organizations, and (2)
territory prevention programs should expand through addressing the
long-term effects of violence.
Abstract: Early detection of breast cancer saves many thousands
of lives each year via application of mammography and genetic
screening and many more lives could be saved if nurses are involved
in breast care screening practices. So, the aim of the study was to
identify nurse's role in early detection of breast cancer through
mammography and genetic screening and its impact on patient's
outcome. In order to achieve this aim, 400 women above 40 years,
asymptomatic were recruited for mammography and genetic
screening. In addition, 50 nurses and 6 technologists were involved in
the study. A descriptive analytical design was used. Five tools were
utilized: sociodemographic, mammographic examination and risk
factors, women's before, during and after mammography, items
relaying to technologists, and items related to nurses were also
obtained. The study finding revealed that 3% of women detected for
malignancy and 7.25% for fibroadenoma. Statistically significant
differences were found between mammography results and age,
family history, genetic screening, exposure to smoke, and using
contraceptive pills. Nurses have insufficient knowledge about
screening tests. Based on these findings the present study
recommended involvement of nurses in breast care which is very
important to in force population about screening practices.
Abstract: Background: With the perceived pain and poor
function experienced following knee arthroplasty, patients usually
feel un-satisfied. Yet, a controversy still persists on the appropriate
operative technique that doesn’t affect proprioception much.
Purpose: This study compared the effects of Cruciate Retaining
(CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA on
dynamic balance, pain and functional performance following
rehabilitation.
Methods: Thirty patients with CRTKA (group I), thirty with
PSTKA (group II) and fifteen indicated for arthroplasty but weren’t
operated on yet (group III) participated in the study. The mean age
was 54.53±3.44, 55.13±3.48 and 55.33±2.32 years and BMI
35.7±3.03, 35.7±1.99 and 35.73±1.03 kg/m2 for groups I, II and III
respectively. The Berg Balance Scale (BBS), WOMAC pain subscale
and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were
used for assessment. Assessments were conducted four weeks preand
post-operatively, three, six and twelve months post-operatively
with the control group being assessed at the same time intervals. The
post-operative rehabilitation involved hospitalization (1st week),
home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks)
programs, follow-up to all groups for twelve months.
Results: The Mixed design MANOVA revealed that group I had
significantly lower pain scores and SC time compared with group II
three, six and twelve months post-operatively. Moreover, the BBS
scores increased significantly and the pain scores and TUG and SC
time decreased significantly six months post-operatively compared
with four weeks pre- and post-operatively and three months postoperatively
in groups I and II with the opposite being true four weeks
post-operatively. But no significant differences in BBS scores, pain
scores and TUG and SC time between six and twelve months postoperatively
in groups I and II.
Interpretation/Conclusion: CRTKA is preferable to PSTKA,
possibly due to the preserved human proprioceptors in the un-excised
PCL.