7 results
Development of a youth version of the Here and Now Aboriginal Assessment (HANAA-Y) tool
- A. Janca, Z. Lyons
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S153-S154
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Introduction
Assessment of social and emotional wellbeing (SEWB) of Aboriginal people is challenging. A The culturally appropriate screening instrument for SEWB in Aboriginal adults entitled Here and Now Aboriginal Assessment (HANAA), has been developed and evaluated. The HANAA explores ten key domains and adopts a yarning process to initiate a semi-structured interview that covers each domain. This is recorded in narrative form and each domain rated as ‘problem’ or ‘no problem’ and a ‘recommended action’ is determined. The HANAA is widely used by Aboriginal mental health service providers around Australia.
ObjectivesThere have been multiple requests by service providers for a similar instrument to be developed for young Aboriginal people. This study aims to develop a youth version of the instrument abbreviated as HANAA-Y.
MethodsA Working Group comprised of Aboriginal and non-Aboriginal psychiatrists and mental health professionals with expertise of SEWB in Aboriginal youth was established and a draft version of the HANAA-Y has been produced. Evaluation od cultural applicability, reliability and validity of HANAA-Y is underway in metropolitan, rural and remote locations across Australia.
ResultsThe original HANAA structure, yarning style, and rating has been retained. However, new domains and probe words relevant to young people have been selected. The new domains are as follows: somatic complaints; emotional issues; suicide risk and self-harm; alcohol and drug use; cognition and activity; behavioural and legal issues; strange thoughts and unusual experiences; functioning; stressful life events; and resilience and healing. The HANAA-Y administration guidelines have also been amended to be of relevance to Aboriginal youth.
ConclusionsIt is expected that HANAA-Y will be a culturally appropriate and useful instrument which can be used by a range of service providers with differing levels of mental health training to screen for SEWB among young Aboriginal people.
Disclosure of InterestNone Declared
Assessing mental health in Aboriginal youth
- A. Janca, Z. Lyons
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S138
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Introduction
The assessment of social and emotional wellbeing (SEWB) among Aboriginal people in Australia and elsewhere is complex and challenging task. A culturally appropriate tool for screening SEWB among Aboriginal adults known as the Here and Now Aboriginal Assessment (HANAA) has been developed and evaluated. The HANAA is based on exploring key domains of Aboriginal concept of SEWB and is based on a yarning process aimed to initiate a semi-structured interview that covers each domain. Over the last ten years the HANAA has been widely used by Aboriginal mental health service providers around Australia and elsewhere.
ObjectivesThere have been multiple requests by service providers for a similar tool to be developed for young Aboriginal people. The aim of this study was to develop a youth version of the HANAA.
MethodsA Working Group was established to guide the development of the youth HANAA. This work included discussion of assessment domains, prompt words and other adolescent specific considerations that were needed. The evlauation process was also discussed.
ResultsThe adult version of HANAA was well accepted by participants. Reliability was good with kappa agreements between Aboriginal and non-Aboriginal interviewers ranging from 0.5 to 1.0. Agreement between interviewers and treating clinicians on ecommended course of action was good.
ConclusionsBased on the previous field test results, it is expected that the youth HANAA will also be a culturally appropriate and useful tool which can be used by a range of service providers with differing levels of mental health training to assess SEWB among young Aboriginal people.
DisclosureNo significant relationships.
The CODATwins Project: The Current Status and Recent Findings of COllaborative Project of Development of Anthropometrical Measures in Twins
- K. Silventoinen, A. Jelenkovic, Y. Yokoyama, R. Sund, M. Sugawara, M. Tanaka, S. Matsumoto, L. H. Bogl, D. L. Freitas, J. A. Maia, J. v. B. Hjelmborg, S. Aaltonen, M. Piirtola, A. Latvala, L. Calais-Ferreira, V. C. Oliveira, P. H. Ferreira, F. Ji, F. Ning, Z. Pang, J. R. Ordoñana, J. F. Sánchez-Romera, L. Colodro-Conde, S. A. Burt, K. L. Klump, N. G. Martin, S. E. Medland, G. W. Montgomery, C. Kandler, T. A. McAdams, T. C. Eley, A. M. Gregory, K. J. Saudino, L. Dubois, M. Boivin, M. Brendgen, G. Dionne, F. Vitaro, A. D. Tarnoki, D. L. Tarnoki, C. M. A. Haworth, R. Plomin, S. Y. Öncel, F. Aliev, E. Medda, L. Nisticò, V. Toccaceli, J. M. Craig, R. Saffery, S. H. Siribaddana, M. Hotopf, A. Sumathipala, F. Rijsdijk, H.-U. Jeong, T. Spector, M. Mangino, G. Lachance, M. Gatz, D. A. Butler, W. Gao, C. Yu, L. Li, G. Bayasgalan, D. Narandalai, K. P. Harden, E. M. Tucker-Drob, K. Christensen, A. Skytthe, K. O. Kyvik, C. A. Derom, R. F. Vlietinck, R. J. F. Loos, W. Cozen, A. E. Hwang, T. M. Mack, M. He, X. Ding, J. L. Silberg, H. H. Maes, T. L. Cutler, J. L. Hopper, P. K. E. Magnusson, N. L. Pedersen, A. K. Dahl Aslan, L. A. Baker, C. Tuvblad, M. Bjerregaard-Andersen, H. Beck-Nielsen, M. Sodemann, V. Ullemar, C. Almqvist, Q. Tan, D. Zhang, G. E. Swan, R. Krasnow, K. L. Jang, A. Knafo-Noam, D. Mankuta, L. Abramson, P. Lichtenstein, R. F. Krueger, M. McGue, S. Pahlen, P. Tynelius, F. Rasmussen, G. E. Duncan, D. Buchwald, R. P. Corley, B. M. Huibregtse, T. L. Nelson, K. E. Whitfield, C. E. Franz, W. S. Kremen, M. J. Lyons, S. Ooki, I. Brandt, T. S. Nilsen, J. R. Harris, J. Sung, H. A. Park, J. Lee, S. J. Lee, G. Willemsen, M. Bartels, C. E. M. van Beijsterveldt, C. H. Llewellyn, A. Fisher, E. Rebato, A. Busjahn, R. Tomizawa, F. Inui, M. Watanabe, C. Honda, N. Sakai, Y.-M. Hur, T. I. A. Sørensen, D. I. Boomsma, J. Kaprio
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- Journal:
- Twin Research and Human Genetics / Volume 22 / Issue 6 / December 2019
- Published online by Cambridge University Press:
- 31 July 2019, pp. 800-808
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The COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) project is a large international collaborative effort to analyze individual-level phenotype data from twins in multiple cohorts from different environments. The main objective is to study factors that modify genetic and environmental variation of height, body mass index (BMI, kg/m2) and size at birth, and additionally to address other research questions such as long-term consequences of birth size. The project started in 2013 and is open to all twin projects in the world having height and weight measures on twins with information on zygosity. Thus far, 54 twin projects from 24 countries have provided individual-level data. The CODATwins database includes 489,981 twin individuals (228,635 complete twin pairs). Since many twin cohorts have collected longitudinal data, there is a total of 1,049,785 height and weight observations. For many cohorts, we also have information on birth weight and length, own smoking behavior and own or parental education. We found that the heritability estimates of height and BMI systematically changed from infancy to old age. Remarkably, only minor differences in the heritability estimates were found across cultural–geographic regions, measurement time and birth cohort for height and BMI. In addition to genetic epidemiological studies, we looked at associations of height and BMI with education, birth weight and smoking status. Within-family analyses examined differences within same-sex and opposite-sex dizygotic twins in birth size and later development. The CODATwins project demonstrates the feasibility and value of international collaboration to address gene-by-exposure interactions that require large sample sizes and address the effects of different exposures across time, geographical regions and socioeconomic status.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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Tri-axial accelerometers tease apart discrete behaviours in the common cuttlefish Sepia officinalis
- G.N. Lyons, E.C. Pope, B. Kostka, R.P. Wilson, Z. Dobrajc, J.D.R. Houghton
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- Journal:
- Journal of the Marine Biological Association of the United Kingdom / Volume 93 / Issue 5 / August 2013
- Published online by Cambridge University Press:
- 26 November 2012, pp. 1389-1392
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Acceleration data loggers can be used to construct time–energy budgets or identify specific behaviours in free living animals. Within a marine context such devices have been largely deployed on vertebrates with comparatively little attention paid to commercially important invertebrates such as cephalopod molluscs. Here we tested the utility of tri-axial accelerometers to tease apart six discrete behaviours in the common cuttlefish Sepia officinalis. By considering depth profiles in conjunction with body pitch and roll and overall dynamic body acceleration we were able to make distinctions between resting at the seabed, active swimming, mating, post-coital panting and active manoeuvring along the seabed.
Contributors
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- By Mona Aboulghar, Mostafa Abuzeid, Valentine Akande, Carolyn J. Alexander, Gautam N. Allahbadia, Vicki Arguello, Nabil Aziz, Osama M. Azmy, Shawky Z. A. Badawy, Susan L. Baker, Tony Bazi, Nicole Brooks, Robin Brown, William W. Brown, Maria Cerrillo, Rebecca Chilvers, Angela Clough, Willie Cotten, Alan H. DeCherney, Aygul Demirol, Richard Palmer Dickey, Essam S. Dimitry, Maria Dimitry, Tiffany Driver, Alaa El-Ebrashy, Kareem El-Nahhas, Amr Etman, Aimee Eyvazzadeh, Juan A. Garcia-Velasco, Tarek A. Gelbaya, Seth Granberg, Timur Gurgan, Gurkan Levent, Suleyman Guven, Lars Hamberger, Andrew C. Harbin, Wayne J. G. Hellstrom, Micah J. Hill, James Hole, Yakoub Khalaf, John C. LaFleur, Deborah Levine, Iwan Lewis-Jones, Edward A. Lyons, Diana M. Marcus, Samuel F. Marcus, Mohamed F. M. Mitwally, Hany F. Moustafa, Manubai Nagamani, Luciano G. Nardo, Mary G. Nawar, Moshood Olatinwo, Lia Ornat, Sheri Owens, Kathy B. Porter, Jose M. Puente, Puscheck Elizabeth, Rizk Botros, Christine B. Rizk, Christopher B. Rizk, Hassan N. Sallam, Dimitrios Siassakos, Youssef Simaika, Stuart J. Singer, Brad Steffler, Annika Strandell, Sherri K. Taylor, Antoine Watrelot, Matts Wikland, Tony G. Zreik
- Edited by Botros R. M. B. Rizk, University of South Alabama
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- Book:
- Ultrasonography in Reproductive Medicine and Infertility
- Published online:
- 07 September 2011
- Print publication:
- 25 March 2010, pp ix-xii
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Combined epidural/spinal anaesthesia: needle-through-needle or separate spaces?
- S. K. Backe, Z. Sheikh, R. Wilson, G. R. Lyons
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- Journal:
- European Journal of Anaesthesiology / Volume 21 / Issue 11 / November 2004
- Published online by Cambridge University Press:
- 28 January 2005, pp. 854-857
- Print publication:
- November 2004
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Summary
Background and objective: This prospective, randomized and blinded study compared the performance of a new needle-through-needle (NTN) kit (Epistar®; Medimex, Germany) with the double-space technique for providing combined spinal epidural anaesthesia during Caesarean section.
Methods: Following local Ethics Committee approval and patient consent, 200 females were randomized to receive combined spinal epidural anaesthesia by the double-space (n = 100) or NTN (n = 100) technique. The frequency with which the intrathecal component could achieve a T5 block to touch for Caesarean section without the need for epidural augmentation or an alternative technique was determined. The time from start of procedure to achieving a block height to T5 was recorded. Pain and backache at insertion, and at 24 h follow-up were recorded using a visual analogue scale. To remove any bias due to posture, 50% of each group were further randomized to receive their block in the sitting or in the left lateral position. To evaluate improvement of performance over time the success in the first 100 study patients were compared to the success in the second 100.
Results: A successful block to T5 with the double-space and NTN techniques were 80 vs. 54, odds ratio 0.29. Failure to enter the intrathecal space once the epidural space had been located occurred in 29 patients in the NTN group. Time to readiness for surgery was 15 min (95% confidence interval (CI): 12.7–17.4) and 12.9 min (95% CI: 11.5–14.3) for the double-space and NTN techniques, respectively. The median (interquartile range) visual analogue scores for discomfort at insertion were 30 (12.5–51.5) and 32 (12.75–60) and for postoperative backache 0 (0–10) and 0 (0–10.75) in the double-space and NTN groups, respectively. The number of epidural augmentations was similar in both the groups and posture made no difference. There was a tendency to increased success in the second half of the study.
Conclusion: The double-space technique had a greater success rate than the NTN technique.
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