bluuebunny/crossref_metadata_2025 huggingface dataset:
Yerel Halkın Turizme Olan Desteği: Türkiye’deki Sakin Şehirler Üzerine Bir Araştırma
Authors: Çiçek Dönüş , Sarı Yaşar
Published: November 2018

Bu makalede, Türkiye’deki sakin şehirlerde yerel halkın turizme ve sakin şehir hareketine yönelik algı ve tutumları ile turizme olan desteği arasındaki ilişkinin araştırılması amaçlanmaktadır. Çalışma, sakin şehir uygulamalarındaki aksaklıkların giderilmesinde yerel halkın daha fazla destek olmasına yönelik öneriler geliştirmesi açısından önemlidir. Çalışmanın kapsamını Vize, Taraklı, Yenipazar, Gökçeada, Seferihisar ve Akyaka sakin şehirleri oluşturmaktadır. Araştırma verileri anket tekniği ile toplanmıştır. Anketler, Mart-Temmuz 2017 tarihleri arasında kolayda örnekleme yöntemiyle seçilen 1143 kişiye uygulanmış, 1116 anket analiz edilmiştir. Analiz sonuçlarına göre; yerel halkın sakin şehir algısı ile turizme olan desteği; yaşam kalitesi memnuniyeti ile turizme olan desteği arasında olumlu ilişki olduğu saptanmıştır. Turizmden sağlanan kişisel fayda ile turizmin algılanan olumlu etkileri arasında istatistiksel açıdan anlamlı bir ilişki bulunamamıştır.
İklim Değişikliği ve Turizm İlişkisinin Türkiye İç Turizmi Açısından İncelenmesi
Authors: BAYAZIT Sema
Published: November 2018

Atmosferde biriken seragazlarının yol açtığı küresel ısınma sadece çevre ve doğal hayat üzerinde bir tehdit olmaktan çıkmış; sıcaklık seviyelerindeki değişimler, beklenmeyen hava olayları günlük hayatı, tarım, enerji, turizm gibi ekonomik faaliyetleri etkilemeye başlamıştır. Mevsim normalleri dışındaki hava olaylarından kaynaklanan olumsuzlukların yakın gelecekte göç hareketlerine, iş kayıplarına, sağlık sorunlarına, bazı türlerin yok olmasına yol açması beklenmektedir. Tüm bunlarla mücadelede tehditlere karşı önlem alınması-uyum, seragazlarının azaltılması ve seragazlarını tutan (yutak) orman, mera ve sucul alanların korunması ve yaygınlaştırılması temel başlıklardır. Turizm, iklim olaylarıyla bağlantısı yüksek bir faaliyet alanı olup iklim değişikliğinden de etkilenebilecektir. Turizm politikaları ve projeleri geliştirilirken hava olaylarından etkilenebilme ihtimalinin dikkate alınması gerekmektedir. Turizm sektörü faaliyetlerinin yol açtığı seragazlarının kontrolü ve azami düzeyde azaltılması; yutak alanlar üzerinde oluşturduğu tehdit ve tahribatların önlenmesi önem arz etmektedir. Bu makalede, iklim değişikliği-turizm etkileşimi Türkiye iç turizmi açısından tartışmaya açılmış, mevcut verilerden geliştirilen tahmin yöntemleriyle turizm-iklim değişikliği etkileşimi ortaya konulmuştur. Türkiye’de turizm faaliyetleri ve gelirleri artarken seragazı salımlarının da artması iklim değişikliği-turizm ilişkisindeki riskleri ve fırsatları göstermektedir. Bu çerçevede politika ve çalışma önerileri geliştirilmiştir.
Uncertainties in the South African wind load design formulation
Authors: Botha J , Retief J , Viljoen C
Published: November 2018

This paper presents an investigation of the uncertainties inherent in the South African formulation of design wind loads on structures, as stipulated by SANS 10160-3:2011. The investigation follows from the identification of anomalous values in the existing South African probabilistic wind load models during a reliability assessment of SANS 10160. The primary wind load components which have the greatest effect on the total wind load uncertainty are identified as the time variant free-field wind pressure, followed by the time invariant pressure coefficients and terrain roughness factors. A rational and transparent reliability framework for the quantification of the uncertainties inherent in the formulation of these components is then presented. Probabilistic models of these components were developed following independent investigations of each component. The results from these investigations show that the existing probabilistic wind load models underestimate the uncertainty of the wind load components, particularly when considering the time invariant components.
The influence of health and safety practices on health and safety performance outcomes in small and medium enterprise projects in the South African construction industry
Authors: Agumba J , Haupt T
Published: November 2018

Health and safety (H&S) management is imperative for construction projects owing to the high level of fatalities and accident rates experienced. However, very few studies have used mixed-method research to examine H&S practices that are tailored towards small and medium constructio n enterprises (SMEs) to establish whether they influenced overall H&S performance. A Delphi study involving 16 H&S experts produced a refined H&S conceptual model comprising five H&S practices and one H&S performance outcome which were tested on 216 construction SMEs. Exploratory factor analysis and confirmatory factor analysis confirmed that the H&S practices and performance were valid, reliable and acceptable variables. Structural equation modelling (SEM) produced a good-fit model. Upper management commitment and involvement in H&S influenced overall H&S performance indirectly through the mediating variables of project supervision and H&S resources and training. These three H&S practices are essential in influencing H&S performance at project level of construction SMEs, and are viewed as catalysts for H&S culture. However, to ensure that H&S performance by construction SMEs is improved, upper management personnel should be committed and involved in H&S at project level
Perverse incentives and the political economy of South African academic journal publishing
Authors: Tomaselli Keyan G.
Published: November 2018

Academic publishing in South Africa attracts a state research incentive for the universities to which the authors are affiliated. The aim of this study was twofold: (1) to examine the composition of the research value chain and (2) to identify the effects of broken links within the chain. The methodology selected was a lived cultural economy study, which was constructed through incorporating dialogue with editors, authors and researchers in terms of my own experience as a journal editor, read through a political economy framework. The prime effect is to exclude journals, especially independent titles, from directly earning publishing incentives. The behaviour of universities in attracting this variable income is discussed in terms of rent-seeking which occurs when organisations and/or individuals leverage resources from state institutions. Firstly, this process commodifies research and its product, publication. Secondly, the value chain is incomplete as it is the journals that are funding publication rather than – in many cases – the research economy funding the journals. Thirdly, authors are seeking the rewards enabled by the incentive attached to measurement systems, rather than the incentive of impacting the discipline/s which they are addressing. Fourthly, the paper discuses some policyand institutional matters which impact the above and the relative costs between open access and subscription models. Editors, journals and publishers are the un- or underfunded conduits that enable the transfer of massive research subsidies to universities and authors, and, in the case of journals, editors’ voluntary work is the concealed link in the value chain enabling the national research economy.Significance:

The South African scientific publishing economy is built on a foundation of clay: this economy distorts research impact and encourages universities and academics to commoditise output.
appropriateness of a realist review for evaluating the South African Housing Subsidy Programme
Authors: Amisi Matodzi M. , Marais Lochner , Cloete Jan S.
Published: November 2018

Conducting meta-reviews of government programmes has become common practice. In South Africa, the national Department of Human Settlements and the national Department of Performance Monitoring and Evaluation recently commissioned a team to review the extent to which the Housing Subsidy Programme had provided assets to municipalities and the poor and whether these assets had helped poor households escape from poverty. A realist approach was employed to conduct the review. We argue that, given thecomplex nature of housing programmes, the realist review methodology was an appropriate approach to follow in answering the review questions. We explored how the realist review method allowed us to work with the uneven and contested nature of the housing literature and how the review nonetheless enabled elucidation of the factors that had contributed to the expected outcomes. Because this case was the first time that this method was used in a government-commissioned evaluation of housing, there were some practical challenges involved in its use. Some of the challenges were related to the nature of the questions that were asked. At the time of the review, the Department of Human Settlements was in the process of reviewing the 1996 White Paper and, to inform this process, the Housing Subsidy Programme review included a copious number of questions set by the Department of Human Settlements and Department of Performance Monitoring and Evaluation, which made the review rather large and, in some cases, complicated the analysis. In some cases, because the Departments wanted clear-cut answers, the commissioners perceived the theoretical strength of the method, such as offering explanatory instead of conclusive judgement, as a weakness. The paper reveals some limitations of the realist review method for evaluating the multifaceted outcomes of a complex programme, particularly the practical difficulty of dealing with large quantities of data. We do however consider this method to have potential for further reviews.Significance:

Housing research in South Africa is uneven which makes any review process difficult.
The review was unable to offer judgement on the effect that the Housing Subsidy Programme has had on the asset base of the poor.
The review was useful for making clear which factors will help the Programme to achieve the intended outcomes and also for pointing out on what government should focus to build assets for the urban poor.
Students’ ability to correctly apply differentiation rules to structurally different functions
Authors: Maharaj Aneshkumar , Ntuli Mthobisi
Published: November 2018

The derivative concept is studied in first-year university mathematics. In this study, we focused on students’ ability to correctly apply the rules for derivatives of functions with the different structures that they encounter in their university studies. This was done by investigating the online responses of first-year students at the University of KwaZulu-Natal to online quizzes that contributed to their assessment. Based on this investigation, we then interviewed eight students to gain an insight into the thinking behind their responses. We report on the analysis of students’ responses to five items on the online quizzes based on the derivative concept. The categories in which those items were based are: condition for existence of derivative at a point; rules for derivatives of standard functions; application of chain rule to different function structures; the application of multiple rules; and application of derivatives to optimise a function. Our findings indicate that students had difficulty in detecting that multiple rules for derivatives were required to differentiate certain types of functions represented in symbolic form. Furthermore, students had difficulty in finding the derivative of a function when more than one application of the chain rule was required. However, there were students who had the ability to apply the rules for derivatives of functions without difficulty. In particular, most of the students were able to correctly recall the differentiation rules for functions with standard structures f(x)=xn, h(x)=ekx and y=[g(x)]n, n ≠ 0 and k is a non-zero constant. Students were also able to correctly apply the chain rule to an exponential function with base e, raised to 4x. The majority of students were able to correctly apply the chain rule together with differentiation rules for logarithmic and exponential (with bases a >1) function structures, and function structures that required the application of the product rule together with the chain rule. Most of the students were able to apply derivatives to optimise a function.Significance:

A significant percentage of students who took online quizzes experienced difficulties with applying multiple differentiation rules in the context of a single function. The difficulties stemmed from their inability to detect from the structure of the function which rules should be applied and also the order in which those relevant rules should be applied.
Applying the water-energy-food nexus to farm profitability in the Middle Breede Catchment, South Africa
Authors: Seeliger Leanne , De Clercq Willem P. , Hoffman Willem , Cullis James D.S. , Horn Annabel M. , De Witt Marlene
Published: November 2018

The water-energy-food nexus has emerged as a useful concept to understand the multiple interdependencies that exist between the water, energy and food sectors. The nexus is an ambitious attempt to work across disciplines and scales to understand the workings of these complex systems. It is, however, criticised for being more of a general framework than a practical methodology because of the vast amount of data it would need to make real-life contributions to sustainable development. We show how the nexus approach, when used within a farm budget model, can transform the problem focus in water governance. By changing the relationship among water, energy and food production of a farm, profitability is significantly changed. The water-energy-food nexus debate is discussed within the context of the South African water sector, particularly the Breede River Catchment. Working from within the farm budget model, we demonstrate the impact of moving from an irrigation canal system that requires electricity for pumping, to a gravity-fed piped irrigation system in the Middle Breede River. The finding is that the water-energy-food nexus has the potential to unlock groundbreaking solutions to complex problems in agricultural water management when used in appropriate modelling systems.Significance:

The water-energy-food nexus approach can lead to an entirely new framing of water governance problems and therefore solutions to these problems.
The water-energy-food nexus when used in farm budget models can identify ways of altering farm profitability.
By addressing the energy cost of farming through an irrigation pipeline system in parts of the Breede Catchment Area, farm profitability could significantly increase.
A gravity-fed closed pipeline system in parts of the Breede River can improve water availability and reduce farm and management costs.
Hominin cranial fragments from Milner Hall, Sterkfontein, South Africa
Authors: Beaudet Amélie , Heaton Jason L. , L’Abbé Ericka N. , Pickering Travis R. , Stratford Dominic
Published: November 2018

The Sterkfontein Caves site is one of the richest early hominin localities in Africa. In addition to significant fossil assemblages from Members 2 and 4 of the Sterkfontein Formation, recent excavations have revealed hominin-bearing sedimentary deposits in the lesser-known Milner Hall. We describe two hominin cranial fragments excavated from the Milner Hall in 2015 and present the results of a high-resolution microtomographic-based approach to diagnosing the anatomical and taxonomical origin of these specimens. Based on external morphology, StW 671 and StW 672 are tentatively identified as frontal and occipital fragments, respectively. Our non-invasive bi-dimensional quantitative investigation of the two cranial fragments reveals a mean cranial thickness of 8.8 mm and 5.6 mm for StW 671 and StW 672 respectively and a contribution of the diploic layer to the cumulative cranial thickness that is less than 50%. While the mean cranial thickness of StW 671 falls within the range of Homo, the relative proportion of the diploë in both StW 671 and StW 672 is lower than in Australopithecus (>60%) and extant humans (>50%). Accordingly, in terms of both cranial thickness and inner structural organization, the Milner Hall hominins combine derived and unique traits, consistent with the condition of other postcranial and dental material already described from the deposit. Moreover, our study opens interesting perspectives in terms of analysis of isolated cranial fragments, which are abundant in the hominin fossil record.
Significance:

The Sterkfontein Caves have widely contributed to our understanding of human evolution.
Besides the well-known Members 4 and 2, where the iconic ‘Mrs Ples’ and ‘Little Foot’ have been found, in this study we suggest that the Milner Hall locality represents an additional, stratigraphically associated source of not only fossil hominins, but also Oldowan stone tools.
In particular, we describe for the first time two cranial fragments, StW 671 and StW 672, identified as frontal and occipital bones, respectively.
Our microtomographic-based analysis of these materials reveals some affinities with Homo combined with unique characters.
In this context, our study suggests an intriguing mosaicism consistent with the description of the two fossil hominins found in the Milner Hall.
PHOTODYNAMIC THERAPY OF RAT SARCOMA M-1 WITH PHOTOSENSITIZER AMIDOAMINCHLORINE
Authors: Kaplan M. A. , Malygina A. I. , Ponomareva G. V. , Mikhailovskaya A. A. , Drozhzhina V. V. , Arkhipova L. M. , Osipchuk J. S.
Published: November 2018

Efficacy of photodynamic therapy with intraperitoneal introduction photosensitizer Amidoaminchlorine on rat sarcoma M1 model was studied. The aim of this study was to determine minimum effective dose of photosensitizer and parameters of laser radiation for achievement of tumor full regress. Dynamics of photosensitizer accumulation in tumor and healthy tissues was studied to definite the time of photodynamic therapy. Antitumor efficacy different doses of photosensitizer and various parameters of laser radiation were investigated. As a result, optimal term of photodynamic therapy, photosensitizer minimum effective dose and parameters of laser irradiation were established.
A NEW PARADIGM OF SUSTAINABLE DEVELOPMENT DIMENSIONS
Authors: Amantova-Salmane Liene
Published: November 2018

Sustainable development has become an universal phrase and the area of many policy initiatives, especially those regarding environmental organizations. The revision of the dimensions of sustainable development gives vital support to develop and implement indicators for them. The dimensions of sustainable development are inseparable and mutually reinforcing. Sustainable development actions depend on complexity and working with different interests of environment and development. It is impossible to predict what needs future generations will have. The obligation of the current generation is both to use and protect the world resources in ways that meet human development opportunities more justifiably today, but which do not exclude choices for such actions tomorrow. The aim of the research is to analyse the dimensions of sustainable development. More deeply, the research tasks are to outline the hierarchical organization of sustainable development criteria and indicators and to create a new paradigm of sustainable development dimensions. The methods of research are monographic, quantitative, deductive, and inductive. The key result: a new paradigm of sustainable development dimensions is created. Sustainable development is a concept, possibly surrounding closely every aspect of human society. The meaning of the dimensions of sustainable development is all the time in progress. There is a new approach to the dimensions given in the research. Sustainability could be understood better in terms of “here and now”, “later” and “elsewhere”. The existence of sustainability criteria guarantees sustainability in the long perspective. It can be suggested that the sustainability criteria analysis and their practical use could be further developed.
RESEARCH OF SOME ASPECTS ABOUT THE ELDERLY EMPLOYED IN THE LATVIAN LABOUR MARKET
Authors: Silinevica Irena
Published: November 2018

The seniors are among the resources to reduce tension in certain labour market areas and promote further economic development. Taking into account the aging population trends, the role of seniors will increase in Latvia’s labour market. The aim of this research study is to explore the self-assessment of the elderly employed about their abilities to work competitively at pre-retirement age and go on to work at pension age. The research has verified some theoretical findings about the elderly people in the labour market by using content analysis, comparative analysis, synthesis, and the abstract and logical construction methods. The self-assessment of the employed aged above 50 about their abilities to compete in labour market is analysed in the research. A survey of the pre-retirement and pension-aged employees is carried out in the research. The main findings of the research are as follows: the development of technologies and the raising standard of living in Latvia creates new social opportunities for pre-retirement and retirement-age people to go on to work. The stereotypes in society on the preretirement and retirement-age employees are out of date and need to be changed. There are recommendations for improvement of competitiveness of the elderly employed in the labour market developed in the paper.
Тезаурусный подход и молодежная тематика в гуманитарных науках
Authors: Луков Валерий Андреевич
Published: November 2018

В статье изложены основы теории, методологии и практики применения в современной гуманитаристике тезаурусного подхода, а также пути развития тезаурусной теории. Они показаны через становление тезаурусной социологии и ее ориентации на молодежные исследования.
Итоги I Всероссийской конференции «Кристофер Марло и его творчество в русской и мировой культуре: междисциплинарный взгляд»
Authors: Захаров Николай Владимирович
Published: November 2018

В статье представлен обзор результатов I Всероссийской научной конференция «Кристофер Марло и его творчество в русской и мировой культуре: междисциплинарный взгляд», которая проходила в Москве с 22 по 23 июня 2018 г. Итоги конференции рассмотрены с позиций тезаурусного подхода.
Universidad e investigación para el bien común: la función social de la Universidad
Authors: Díez Gutiérrez Enrique Javier
Published: November 2018

RESUMENEn un Estado Social y Democrático la universidad ha de orientarse a la prestación de un servicio público de generación de conocimiento en el que se contemplen los intereses generales de la ciudadanía, el bien común, funcionando como un agente de cambio y mejora social. Pero nuestras instituciones de  ducación superior, siguiendo lógicas globales neoliberales, promovidas por  organizaciones económicas internacionales, se están transformando  progresivamente en “universidades corporativas o emprendedoras” dominadas por una cultura empresarial interesada sobre todo en lograr posiciones sobresalientes en rankings internacionales. Es hora de defender un modelo de universidad pública al servicio de las necesidades sociales reales y prioritarias y no solo las demandas del mercado. Pero también es necesario profundizar y priorizar la función social de la universidad, consiguiendo un contrato con la sociedad en su conjunto, que entienda la universidad no solo como institución académica de prestigio, sino como un bien público y un agente dinamizador para la transformación social. Este modelo social de Universidad debería basarse en el refuerzo del compromiso y la responsabilidad social de las universidades públicas, la vinculación con los sectores sociales más desfavorecidos y el  compromiso mutuo en pos de la justicia social.Palabras Clave: Educación Superior, Capitalismo académico, Función social de la Universidad, Bien Común, Servicio Público.ABSTRACTIn a social and democratic state, universities must strive to provide a public service, generating knowledge of general interest to citizens for the common good and working as agents of social change and improvement. However, in line with the global neoliberal logic promoted by international economic organisations, universities are increasingly metamorphosing into “corporate or entrepreneurial institutions” dominated by a business culture primarily nterested in achieving a high international ranking. It is time to defend the model of a public university in the service of real, pressing social needs rather than market demands. It is also necessary to prioritise and expand the social function of universities, establishing a contract with society as a whole that considers the university not only as a prestigious academic institution but also as a common good and a dynamic agent for social change. This social model of the university should be based on strengthening public universities’ social responsibility and commitment, ties with the most disadvantaged sectors of society and a mutual commitment to social justice.Keywords: Higher education, Academic capitalism, Social function of universities, Common good, Public service.
Jóvenes universitarios y pre-universitarios y actitudes cívico-políticas hacia una Europa social
Authors: Viejo Almanzor Carmen , Gómez-López Mercedes , Ortega-Ruiz Rosario
Published: November 2018

RESUMENLa Universidad se ocupa de dotar a las nuevas generaciones de la capacidad para comprender ideas y procesos complejos, pero también de formar la personalidad de los y las jóvenes para ser capaces de identificar los retos para avanzar hacia un futuro mejor. Con el objetivo de describir el análisis crítico que la juventud española hace de la Europa actual y futura, y determinar el valor que otorga a la educación, se analizaron las prioridades y preocupaciones con respecto al futuro, las visiones sobre el futuro de Europa, los valores y las actitudes de 268 jóvenes de entre 16 y 25 años (64.6% chicas, 35.1% chicos, 0.4% otro), con una edad media de 20.72 años. Los resultados señalaron el desempleo como una de las principales inquietudes, sólo superada por el terrorismo. Sin embargo, su visión sobre la Europa del futuro está marcada por la atribución de valor a la Educación, junto a valores democráticos, de atención y derechos a la diversidad, equidad y la justicia. Se discuten estos resultados con relación al valor que la Educación Superior tiene para la formación de un pensamiento crítico y la construcción de la Europa social que algunos de ellos deberán liderar.Palabras Clave: Juventud, Universidad, Educación, Europa.ABSTRACTThe University is the institution responsible for providing new generations with the skills to understand and analyze complex ideas and processes. But it must also shape the personality of young people to be able to identify the potentialities of different realities and visualize the possible challenges to move towards a better future. This study aims to describe the critical analysis that Spanish youth make of current and future Europe, and to determine the value that they give to Higher Education as a tool for improvement and advancement of society. This study analyses the priorities, visions and worries about future, and the values and attitudes of 268 young people; they were aged between 16 and 25 years old (64.6% females, 35.1% males, 0.4% other denomination). The results indicated unemployment as one of the main concerns, only overpassed by terrorism. However, the expectations and motivations profile of Spanish youth regarding their future Europe is positive. Their vision is marked by the attribution of value to Education, together with democratic values, attention and rights to diversity, equity and justice. These results are discussed in relation to the value that Higher Education has for the formation of critical thinking and the construction of the social Europe that some of those youngers should lead.Keywords: Youth, University, Higher Education, Europe.
Entrepreneurship and regional economic growth in Antioquia: An empirical analysis
Authors: Aparicio Sebastian , Urbano David , Gomez Diego
Published: November 2018

Drawing on the concept of entrepreneurship capital, which links collective entrepreneurial action with growth, this paper aims to explore the effect that entrepreneurship has had on the economic growth of Antioquia (Colombia). We estimate a growth model using unbalanced panel data with fixed effects for the period 2001-2012. In this study, entrepreneurship is measured as the number of new businesses and the ratio of new and discontinued companies, which have a positive impact on the economic growth of Antioquia. These results motivate a discussion about the importance of public policy in creating an environment that stimulates entrepreneurship and productive expansion; this should be maintained over time under the same social and economic purposes.
The Substitution Effect from the Profit Function in Consumption: Expressions from the Marshallian, Hicksian, and Frischian demand functions
Authors: Gimenez-Nadal José Ignacio
Published: November 2018

In the context of the optimizing behaviour assumption of individuals (Becker, 1976), three types of demand functions appear: Marshallian, Hicksian, and Frischian functions (Sproule, 2013). The Substitution Effect (SE) is a relevant concept, with our short paper developing two alternative theoretical expressions, specifically focusing on the Profit Function in Consumption and the Frischian functions. I address the fact that these demand functions with constant marginal utility of income play a very relevant role in the inter-temporal context.
Introduction - Gambling economics and management: some insights into recent developments in gambling-related research
Authors: Perez Levi
Published: November 2018

There are several arguments why the economic and management analysis of gambling seems to be very interesting. Gambling is a relevant worldwide market from which either local or national governments obtain resources due to some sort of fiscal imposition on gambling participation. On the other hand, gambling is also a social phenomenon with potential risks to society and the consumption of gambling seems to violate the premises of economic theory (risk aversion, maximizing and rational conduct). The aim of this special issue is to provide an outlet for recent developments in gambling-related research encompassing topics on sports betting, responsible gambling, lottery markets and online gambling, among others.
A prospective analysis of the risk factors and the perinatal outcome of preterm labour
Authors: Mathew Sunitha Mary , Kumar Ajay
Published: November 2018

Background: Preterm labour is a challenging complication encountered by obstetricians. The dictum prevention is better than cure well applies for preterm labour also, hence the importance of knowing the risk factors. Infection is one treatable, thus preventable risk factor.Methods: Prospective cohort study involving 75 antenatals at gestational age from 28 to 36+6 weeks.  After getting clearance from institutional ethical committee detailed history including history of UTI, excessive vaginal discharge, previous abortions and previous preterm labour and medical complications were collected. Two doses of injection Betamethasone 12 mg 24 hours apart were given for all patients. High vaginal swab was taken from all subjects and results analysed. Neonates are then followed up till discharge.Results: The incidences were higher in primigravidas compared to multiparas. Late preterms (34-36+6 weeks) were the majority in the group. PPROM was the major cause for late preterm births, this was followed by UTI and vaginal infections. Among the high vaginal swab 30.7% were culture positive. E Coli was the most common organism isolated followed by Staphylococcus Aureus, Klebsiella, and MRSA. Hyperbilirubinemia was the most common neonatal complication. Out of 7 neonatal deaths 6 were due to RDS and one was extremely preterm newborn. Women who delivered at least 24 hours after initiation of steroid were considered steroid covered group. Steroid covered group had lesser incidence of RDS with P value of 0.001which was statistically significant.Conclusions: UTI and vaginal infections were major risk factors for preterm labour and should be tackled antenatally. High vaginal swab should be taken for threatened preterm labour especially early preterm. Betamethasone administration causes a definite reduction in the incidence of RDS. Induce PPROM after 36 weeks to reduce late preterm complications provided there is no chorioamnionitis.
Low dose unfractionated heparin with low dose aspirin in treatment of thrombo prophylaxis in utero placental insufficiency: a new vision in heparinization during pregnancy
Authors: Madhubala M. , Kasthuri C. , Shukul Mansi , Ali J. Mohamed
Published: November 2018

Background: The use of heparin and aspirin in obstetric care has grown considerably since their introduction into clinical practice. Because of the physiological changes of pregnancy, the usage of heparin and optimal dosage of heparin remains uncertain. Here our institute designed low dose Unfractionated Heparin (5000 IU s/c daily) as thrombo Prophylaxis regimen. To study the outcome of low dose UFH (5000 IU sc /daily) + Low dose aspirin (75 mg oral per day) for thrombo prophylaxis in utero placental insufficiency, in patient with 2 or more abortions.Methods: This retrospective study was conducted in 135 patients with 2 or more abortions as obstetric history. Prophylactic low dose of UFH (5000 IU s/c daily) + LDA 75 mg oral was initiated.  The Primary outcome is live birth, and secondary outcomes is Reduced incidence of early onset of gestational hypertension (HT), Intrauterine Growth Retardation (IUGR).Results: Out of 135 women 131 gave live birth, 2 had first trimester abortion and 2 had intrauterine death by 5 to 6 months. PIH was higher in patients with more than 30 years of age.Conclusions: In our Retrospective, data combination of low dose UFH (5000IU s/c) + LDA (75mg oral) is as safe as routine thrombo prophylaxis with good compliance.
Effect of maternal body mass index on pregnancy outcomes
Authors: Bhuyar Sonal , Dharmale Neha
Published: November 2018

Background: BMI is widely accepted as a better measure of underweight or overweight than weight alone. The developing countries including India are facing a dual burden of undernutrition and obesity. Extremes of BMI in pregnancy have been associated with multiple complications affecting maternal and perinatal outcome. The objectives of the present study was to observe distribution of antenatal patients in underweight, normal, overweight and obese categories according to booking BMI and to examine the association of BMI with obstetric and perinatal outcomes in singleton pregnancies.Methods: This was an observational prospective study with a sample size of 610 patients carried out during the period Dec 2016 to Nov 2017 in Dr PDMMC, Amravati. The antenatal patients were categorized into four categories of BMI according to WHO classification and pregnancy outcomes were compared.Results: Depending on booking BMI, 73.8% patients enrolled in the study had normal booking BMI and 16.7%, 8.5% and 1% were underweight, overweight and obese respectively. Postdatism, preterm births, induction of labour, LSCS and prolonged hospital stay were commoner in overweight patients while IUGR, oligohydramnios and BOH were seen more in underweight group. Neonatal resuscitation and neonatal complications were common in both underweight and overweight patients as compared to normal BMI patients.Conclusions: Based on this study, we conclude that majority of antenatal patients being catered in our hospital have normal BMI. Adverse maternal and perinatal outcomes are seen more commonly with the extremes of BMI.
Vitamin D status in pregnant women and their newborns in a tertiary care hospital
Authors: Kour Harleen , Gupta Shashi , Gupta Swarn K. , Bhagat Bawa Ram , Singh Gagan
Published: November 2018

Background: In the recent years there has been an increased understanding of the role that vitamin D plays in regulation of cell growth, calcium absorption and immunity and its impact on the developing fetus and maternal health is of significant concern. This study aims at evaluating the Vitamin D status in pregnant women and their newborns.Methods: A cross sectional study was done on 100 pregnant females according to inclusion and exclusion criteria. At the time of delivery, maternal blood was collected, and newborn samples were taken from newborn side of umbilical cord and sent for analysis.Results: The prevalence of Vitamin D deficiency has been found to be 85% of pregnant females and 91% of the newborns. Only 5% of pregnant females and 1% of the newborns showed Vitamin D sufficiency. Maternal and newborn vitamin D levels show a positive correlation. Mean maternal and newborn Vitamin D levels were found to be 16.78±7.04 ng/mL and 11.29±5.75 ng/ml.Conclusions: Vitamin D deficiency is highly prevalent among pregnant women in north India. Low maternal vitamin D levels lead to vitamin D deficiency in the newborns also.
Acute renal failure in preeclampsia and eclampsia
Authors: Mulik Jayshree , Gaikwad Varsha
Published: November 2018

Background: Incidence of acute renal failure (ARF) in preeclampsia and eclampsia is reported to be alarmingly high. Present study was conducted to evaluate the incidence of acute renal failure (ARF) in our institute, to study ARF associated risk factors and its complications along with pregnancy outcome evaluation.Methods: All 812 patients of preeclampsia and eclampsia admitted in the department of obstetrics and gynecology during the study period at our institute were studied. Out of them, the 44 patients diagnosed with ARF were analyzed in detail in terms of maternal age, gravida, booked/unbooked, gestational age, associated complications, management and outcome of pregnancy.Results: ARF was found to occur in 0.4% (2/501) cases of mild preeclampsia, in 16.76% (28/167) cases of severe preeclampsia and in 9.72% (14/144) cases of eclampsia. Intrauterine death (14, 31.82%) was the commonest complication followed by HELLP syndrome (11, 25.0%), post-partum hemorrhage (8, 18.18%) and maternal death (7, 15.9%). Out of 44 cases, 14 (31.82%) had intrauterine death and 8 (18.18%) had fresh stillbirth. Sixteen (36.36%) had low birth weight babies. Total neonatal mortality in present study was observed in 5 (11.36%) cases, 3 in severe preeclampsia group and 2 in eclampsia group.Conclusions: Acute renal failure is seen frequently in patients of severe preeclampsia and eclampsia with associated complications. Maternal and perinatal mortality and morbidity can be prevented in them with earlier detection and management of complications.
Quality of life of post-menopausal women residing in rural and urban areas of Sikkim, India
Authors: Devi Barkha , Karki Prerna , Chhetry Rajnee , Sharma Neelam , Niroula Manisha , Lepcha Pema Chuki , Pradhan Shobna , Sherpa Yanchen , Sherpa Anjali , Sharma Priya , Sharma Beenu , Thapa Khushboo , Sharma Bhawana , Bhutia Tshring Y. , Chib Anney Singh
Published: November 2018

Background: Menopause is an inevitable reproductive phase during midlife when various physical and mental changes may impair the quality of life of women. The presence and severity of symptoms vary tremendously from woman to woman and can last from months to years during this transitional period. This study was conducted to assess the quality of life and menopause related problems among post-menopausal women residing rural and urban areas of Sikkim.Methods: Descriptive explorative study was done in East Sikkim among 120 rural and urban post-menopausal women who were in the age group of 45 years and above, had attained natural menopause and didn’t have menstruation from last one year, were selected through purposive sampling technique. Women with induced menopause, hysterectomy, receiving hormonal treatment were excluded. Along with collection of socio-demographic data, the Menopause Specific Quality of Life Questionnaire was used to assess the Quality of life based on experience of the symptoms through interview technique.Results: The mean menopausal age was 48±3.649 years in rural area and 47±3.831 years for urban area. The mean scores in quality of life between post-menopausal women in rural areas (M=136.6, SD=28.78) were found significantly impaired and the difference was found statistically significant (t=5.75 p<0.001) which shows that rural women were having impaired quality of life as compared to urban women during post-menopausal period. The findings also revealed that factors affecting the quality of life of postmenopausal women were the history of menopause, occupation of women, in urban women and time of attending menopause, in rural women.Conclusions: The present study shows that menopause related symptoms had a negative effect on the quality of life of the post-menopausal women. Such studies can help in creating awareness and in educating women on the early identification of the common menopausal symptoms.
Vaginal cuff dehiscence after total laparoscopic hysterectomy a case report and brief review of the literature
Authors: Kalogeropoulos Sotirios , Chronopoulou Elpiniki , Iliopoulos Evangelos , Decavalas Georgios
Published: November 2018

Vaginal cuff dehiscence (VCD) is a serious complication of total laparoscopic hysterectomy (TLH) or trachelectomy with high morbidity, as it can potentially lead to evisceration/bowel ischemia and sepsis. Authors present a case report of vaginal cuff dehiscence after laparoscopic trachelectomy. The patient reported post-coital onset of symptoms. She presented with acute abdomen and required urgent surgical intervention. In this case surgical management was dictated by the clinical manifestation. However, authors argue that conservative management is also an option for some of these patients and the decision regarding the management plan should be personalized according to the clinical presentation and the patient’s expectations. Emphasis should be given to avoid early onset of sexual activity during the immediate recovery period. Compared to women who underwent an abdominal or vaginal hysterectomy, those who had a laparoscopic procedure have less post-operative pain, shorter recovery period and often they are advised to return early to their normal habits and their work place.  It is expected that this group of patients feel well enough to resume sexual activity soon after their procedure. Therefore, our counselling is of paramount importance as it should be highlighted that sexual intercourse is possibly the most common triggering event for VCD which a serious complication with severe morbidity is. The resumption should, therefore, follow medical consultation and be individualized according to co-morbidities which could affect healing, intraoperative findings and evaluation of the whole recovery progress.
Evaluation of correlation between myocardial performance index and left ventricular ejection fraction in patients with acute ST-elevation myocardial infarction
Authors: Benjamin Bino
Published: November 2018

Background: In the diagnosis of patients with ST-elevation myocardial infarction (STEMI), prediction of left ventricular systolic function is one of the vital elements. Traditionally, assessment of left ventricular function is focused on measurement of left ventricular ejection fraction (LVEF). But it is load dependent and sensitive to the alterations in preload and after-load. However, myocardial performance index (MPI) demonstrates supremacy over older established indexes. Hence, the purpose of the study is to estimate the correlation between MPI and LVEF in patients with acute STEMI.Methods: A total of 105 consecutive patients underwent conventional estimation of ejection fraction and LV end-systolic volume by a Teichholz method. All patients received 325mg dispersible aspirin, 300mg clopidogrel at the time of admission and streptokinase. Doppler echocardiographic evaluations were performed at presentation, immediately after thrombolysis (90 minutes) and before discharge on 3rd to 5th days.Results: The mean patient age was 56.36years and 89 (84.76%) patients were male. A low LVEF of <40%, significantly correlated with higher (worse) MPI at the time of presentation (P= 0.04). LVEF showed improvement after thrombolysis, moreover it was significantly higher at 0' (P= <0.03) and 3rd day (P= 0.05) in patients with MPI <0.5.Conclusions: A significant correlation was found between left ventricular ejection fraction and myocardial performance index; lesser the left ventricular ejection fraction, higher the myocardial performance index. However, myocardial performance index could not predict adverse cardiac events during the hospital stay.
Role of multidetector computed tomography in evaluation of retroperitoneal masses
Authors: Chinwan Diksha , Vohra Poonam
Published: November 2018

Background: Diagnostic imaging plays an important role in the evaluation of abdominal masses. Many imaging modalities are available ranging from conventional modalities to the cross-sectional modalities like USG, CT and MRI. The main principles of imaging are to determine the origin of mass, its measurement, extent, characterisation and assessment of its effect on contiguous organs. In the past, the mainstay was conventional imaging modalities like plain radiograph, Gastrointestinal contrast studies and I.V.U. Modern imaging modalities allow an early and accurate pre-operative diagnosis resulting in a higher rate of surgical resection and improvement of survival.Methods: A Cross-sectional observational study was done in 30 patients. Patients of either sex of any age group who had presented with involvement of retroperitoneal organs detected by routine ultrasound and postoperative patients with recurrence were included in our study.Results: Ultrasound is the initial imaging modality of choice since it is inexpensive, easy to perform and no radiation exposure. On USG, the retroperitoneal masses are classified as solid or cystic or mixed. Since most of the retroperitoneal masses have hetroechoic/mixed pattern, they cannot be characterized by ultrasound alone and hence need further evaluation.Conclusions: Multidetector computed tomography is the imaging modality of choice for further evaluation and characterization. CT protocol for evaluation of the retroperitoneum consisted of both non-enhanced and contrast-enhanced scans for localisation and characterisation of the masses. Multiplanar reconstructions allowed the images to be viewed in any plane chosen including a curved plane thus helping in defining the exact location and extent of the lesion. With MIP and volume rendered images, the relationship of the vessels with the mass lesions was clearly visualized.
Characteristics, indications and complications in patients undergoing permanent pacemaker implantation: a single centre study
Authors: Bhat Sanjeev , Kumar Dharminder , Parimoo Aditi
Published: November 2018

Background: To determine the demographic details, indications, type of pacemakers and complications in patients undergoing the permanent pacemaker implantation.Methods: This was a single-center, retrospective study conducted in at a tertiary-care center in India. The records of 200 patients who had undergone implantation of permanent pacemakers in the period of May 2016 to April 2018 were reviewed.Results: Total 200 patients with mean age of 67 years were paced. Of these 120 (60%) were males. The mean duration of hospital stay was 6.5 days. Sinus node disease (105 patients, 52.5%) was the most common indication for permanent pacemaker insertion. Single chamber (VVIR) pacing mode (125 patients, 62.5%) was found to be the most common pacing mode used for pacemaker insertion. Among the 200 patients complications were observed in 8 patients (4%). Of these 8 patients, pneumothorax (4 patients, 2%) was found to be the most common complication for permanent pacemaker implantation followed by local site infection (1 patient, 0.5%). Only 1 patient (0.5%) died during the observation period of the study.Conclusions: Geriatric population with male predominance have observed to commonly undergo permanent pacemaker implantation. Sinus node disease in the elderly patients is the most common indication for cardiac pacing followed by atrioventricular block. Single chamber (VVIR) pacing mode is commonly used followed by dual chamber (DDDR) due to economic reasons in India. Pacemaker implantation is a relatively safe procedure with a low complication rate.