Search results for: cardiovascular interventions

Authors: Zinah Jabbar Mohammed Alrubaye

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Objective: The purpose of this study was to compare the efficacy of prophylactic and rescue cervical cerclages for pregnant patients with an incompetent cervix, and to assess the neonatal outcomes of both clinical conditions. Methods: This was a retrospective observational study of all women who had an elective or rescue cerclage between January 2008 and December 2016 in our hospital .Prophylactic cerclage was defined as a cerclage before 16 weeks of gestation, while rescue cerclages were performed between 16 and 23 weeks of gestation. Results: In total, we analyzed the outcomes of 212 cervical interventions; 71% of the recruited patients experienced prophylactic cerclage, while 29% underwent rescue cerclage. Most of the patients delivered vaginally (70%) and were able to leave the hospital with a healthy newborn (78%). The mean pregnancy prolongation time after cerclage in the prophylactic and rescue groups were 21 weeks and 10 weeks, respectively. Conclusion: Prophylactic cerclage interventions are most likely to be associated with a reduction of fetal demise because of the correlation between fetal prognosis and the gestational age at which cerclage is performed. Once the diagnosis of cervical insufficiency is confirmed, cerclage should be recommended as this will help to prolong the pregnancy.

Keywords: cervical, neonate, cerclage, Cervix

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Authors: Naomi Seidu, Edward Poluyi, Chibuikem Ikwuegbuenyi, Eghosa Morgan

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The current poor prognosis of glioblastoma has called for the need for an improvement in treatment methods in order to improve its survival rate. Despite the different interventions currently available for this tumor, the average survival is still only a few months. (12-15). The aim is to create a more favorable prognosis and have a reduction in the resistance to treatment currently being experienced, even with surgical interventions and chemotherapy. From the available literature, there is a relationship between the presence of HOX genes (Homeobox genes) and glioblastoma, which could be attributable to the increasing treatment resistance. Hence silencing these genes can be a key to improving survival rates of glioblastoma. A series of studies have highlighted the role that HOX genes play in glioblastoma prognosis. Promotion of human glioblastoma initiation, aggressiveness, and resistance to Temozolomide has been associated with HOXA9. The role of HOX gene expression in cancer stem cells should be studied as it could provide a means of designing CSC-targeted therapies, as CSCs play a part in the initiation and progression of solid tumors.

Keywords: GBM- glioblastoma, HOXA gene- homeobox genes cluster, signaling pathways, temozolomide

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Authors: Kobus-Cisowska Joanna, Flaczyk Ewa, Gramza-Michalowska Anna, Kmiecik Dominik, Przeor Monika, Marcinkowska Agata

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In recent years, proceed to the attractiveness of typical bakery products. Expanding the education and nutrition knowledge society will develop the production of functional foods, which has a positive impact on human health. Therefore, the aim of the present study was to evaluate the effect of the addition of white mulberry fruit on the content of biologically active compounds in the new designed functional bread premixes designed for selected disease: anemia, diabetes, obesity and cardiovascular disease. For flavonols and phenolic acids content UPLC was conducted, using an NovaPack C18 column and a gradient elution system. It was found that all attempts bread characterized by a high content of biologically active compounds: polyphenols, phenolic acids, and flavonoids. The highest total content of polyphenolic compounds found in the samples of bread for anemia, diabetes and cardiovascular disease both before and after storage. The analyzed sample differed in content of phenolic acids. The highest content of these compounds were found in samples of bread for anemia and diabetes. It was found that the analyzed sample contained phenolic acids that are derivatives of hydroxybenzoic and hydroxycinnamic acid. The new designed bread contained significant amounts of flavonols, of which the dominant was routine.

Keywords: mulberry, antioxidant, polyphenols, phenolic acids, flavonols

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Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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Controlling blood pressure is critical to reducing the risk of cardiovascular disease. However, BP control rates (systolic BP < 140 mm Hg and diastolic BP < 90 mm Hg) have declined since 2013, warranting further analysis to identify contributing factors and potential interventions. This study investigates the factors associated with the decline in blood pressure (BP) control among U.S. adults with hypertension over the past decade. Data from the U.S. National Health and Nutrition Examination Survey (NHANES) were used to assess BP control trends between 2013 and 2020. The analysis included 18,927 U.S. adults with hypertension aged 18 years and older who completed study interviews and examinations. The dataset, obtained from the cardioStatsUSA and RNHANES R packages, was merged based on survey IDs. Key variables analyzed included demographic factors, lifestyle behaviors, hypertension status, BMI, comorbidities, antihypertensive medication use, and cardiovascular disease history. The prevalence of BP control declined from 78.0% in 2013-2014 to 71.6% in 2017-2020. Non-Hispanic Whites had the highest BP control prevalence (33.6% in 2013-2014), but this declined to 26.5% by 2017-2020. In contrast, BP control among Non-Hispanic Blacks increased slightly. Younger adults (aged 18-44) exhibited better BP control, but control rates declined over time. Obesity prevalence increased, contributing to poorer BP control. Antihypertensive medication use rose from 26.1% to 29.2% across the study period. Lifestyle behaviors, such as smoking and diet, also affected BP control, with nonsmokers and those with better diets showing higher control rates. Key findings indicate significant disparities in blood pressure control across racial/ethnic groups. Non-Hispanic Black participants had consistently higher odds (OR ranging from 1.84 to 2.33) of poor blood pressure control compared to Non-Hispanic Whites, while odds among Non-Hispanic Asians varied by cycle. Younger age groups (18-44 and 45-64) showed significantly lower odds of poor blood pressure control compared to those aged 75+, highlighting better control in younger populations. Men had consistently higher odds of poor control compared to women, though this disparity slightly decreased in 2017-2020. Medical comorbidities such as diabetes and chronic kidney disease were associated with significantly higher odds of poor blood pressure control across all cycles. Participants with chronic kidney disease had particularly elevated odds (OR=5.54 in 2015-2016), underscoring the challenge of managing hypertension in these populations. Antihypertensive medication use was also linked with higher odds of poor control, suggesting potential difficulties in achieving target blood pressure despite treatment. Lifestyle factors such as alcohol consumption and physical activity showed no consistent association with blood pressure control. However, dietary quality appeared protective, with those reporting an excellent diet showing lower odds (OR=0.64) of poor control in the overall sample. Increased BMI was associated with higher odds of poor blood pressure control, particularly in the 30-35 and 35+ BMI categories during 2015-2016. The study highlights a significant decline in BP control among U.S. adults with hypertension, particularly among certain demographic groups and those with increasing obesity rates. Lifestyle behaviors, antihypertensive medication use, and socioeconomic factors all played a role in these trends.

Keywords: diabetes, blood pressure, obesity, logistic regression, odd ratio

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Authors: Daniela Salih Khidir, Mohamed G. Al Kuwari, Mercia V. Walt, Izzeldin J. Ibrahim

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Background: University-based physical activity interventions aim to establish durable social patterns during the transition to adulthood. This study is a comprehensive evaluation of a 3-year intervention-based program to increase the culture of physical activity (PA) routine in Qatar campuses community, using a holistic approach. Methodology: General assessment methods: formative evaluation-SIH Campuses logic model design, stakeholders’ identification; process evaluation-members’ step counts analyze and qualitative Appreciative Inquiry session (4-D model); daily steps categorized as: ≤5,000, inactive; 5,000-7,499 low active; ≥7,500, physically active; outcome evaluation - records 3 years interventions. Holistic PA interventions methods: walking interventions - pedometers distributions and walking competitions for students and staff; educational interventions - in campuses implementation of bilingual educational materials, lectures, video related to PA in prevention of non-communicable diseases (NCD); articles published online; monthly emails and sms notifications for pedometer use; mass media campaign - radio advertising, yearly pre/post press releases; community stakeholders interventions-biyearly planning/reporting/achievements rewarding/ qualitative meetings; continuous follow-up communication, biweekly steps reports. Findings: Results formative evaluation - SIH in Campuses logic model identified the need of PA awareness and education within universities, resources, activities, health benefits, program continuity. Results process evaluation: walking interventions: Phase 1: 5 universities recruited, 2352 members, 3 months competition; Phase 2: 6 new universities recruited, 1328 members in addition, 4 months competition; Phase 3: 4 new universities recruited in addition, 1210 members, 6 months competition. Results phase 1 and 2: 1,299 members eligible for analyzes: 800 females (62%), 499 males (38%); 86% non-Qataris, 14% Qatari nationals, daily step count 5,681 steps, age groups 18–24 (n=841; 68%) students, 25–64; (n=458; 35.3%) staff; 38% - low active, 37% physically active and 25% inactive. The AI main themes engaging stakeholders: awareness/education - 5 points (100%); competition, multi levels of involvement in SIH, community-based program/motivation - 4 points each (80%). The AI points represent themes’ repetition within stakeholders’ discussions. Results education interventions: 2 videos implementation, 35 000 educational materials, 3 online articles, 11 walking benefits lectures, 40 emails and sms notifications. Results community stakeholders’ interventions: 6 stakeholders meetings, 3 rewarding gatherings, 1 focus meeting, 40 individual reports, 18 overall reports. Results mass media campaign: 1 radio campaign, 7 press releases, 52 campuses newsletters. Results outcome evaluation: overall 2013-2016, the study used: 1 logic model, 3 PA holistic interventions, partnerships 15 universities, registered 4890 students and staff (aged 18-64 years), engaged 30 campuses stakeholders and 14 internal stakeholders; Total registered population: 61.5% female (2999), 38.5% male (1891), 20.2% (988) Qatari nationals, 79.8% (3902) non-Qataris, 55.5% (2710) students aged 18 – 25 years, 44.5% (2180) staff aged 26 - 64 years. Overall campaign 1,558 members eligible for analyzes: daily step count 7,923; 37% - low active, 43% physically active and 20% inactive. Conclusion: The study outcomes confirm program effectiveness and engagement of young campuses community, specifically female, in PA. The authors recommend implementations of 'holistic PA intervention program approach in Qatar' aiming to impact the community at national level for PA guidelines achievement in support of NCD prevention.

Keywords: campuses, evaluation, Qatar, step-count

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Authors: Nam Sze Cheng, P. C. Janita Chau

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Background: Eczema is a chronic inflammatory disease with high global prevalence rates in many childhood populations. It is also the most common paediatric skin problem. Although eczema education and proper skin care were effective in controlling eczema symptoms, the lack of both sufficient time for patient consultation and structured eczema education programme hindered the transferability of knowledge to patients and their parents. As a result, these young patients and their families suffer from a significant physical disability and psychological distress, which can substantially impair their quality of life. Objectives: This integrative review is to examine the effects of educational interventions for children with eczema and identify the core elements associated with an effective intervention. Methods: This integrative review targeted all articles published in 10 databases between May 2016 and February 2017 that reported the outcomes of disease interventions of any format for children and adolescents with the clinical diagnosis of eczema who were under 18 years of age. Five randomized controlled trials (RCT) and one systematic review of 10 RCTs were identified for review. All these publications had high methodological quality, except one study of web-based eczema education that was limited by selection bias and poor subject blinding. Findings: This review found that most studies adopted nurse-led or multi-disciplinary parental eczema education programme at the outpatient clinic setting. The format of these programmes included individual lectures, demonstration and group sharing, and the educational materials covered basic eczema knowledge and management as well as methods to interrupt itch-scratch cycle. The main outcome measures of these studies included severity of eczema symptoms, treatment adherence and quality of life of both patients and their families. Nine included studies reported statistically significant improvement in the primary outcome of symptom severity of these eczematous children. On the other hand, all these reviews failed to identify an effective dosage of intervention under these educational programmes that was attributed to the heterogeneity of the interventions. One study that was designed based on the social cognitive theory to guide the interventional content yielded statistically significant results. The systematic review recommended the importance of measuring parental self-efficacy. Implication: This integrative review concludes that structured educational programme can help nurses understand the theories behind different health interventions. They can then deliver eczema education to their patients in a consistent manner. These interventions also result in behavioral changes through patient education. Due to the lack of validated educational programmes in Chinese, it is imperative to conduct an RCT of eczema educational programme to investigate its effects on eczema severity, quality of life and treatment adherence in Hong Kong children as well as to promote the importance of parental self-efficacy.

Keywords: children, eczema, education, intervention

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Authors: Lyanne Rodriguez, Eduardo Fuentes, Andrés Trostchansky, Felipe Lagos

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Nutrition is a crucial strategy to combat cardiovascular diseases (CVD), which remain a leading global cause of mortality. Various studies have demonstrated the antiplatelet properties of commonly consumed fruit and vegetable extracts, particularly tomato and bean extracts. Previous research has indicated potent antiplatelet activity in tomato and common bean pomace, attributed to their high fatty acid content (>30%). Notably, fatty acids can undergo nitration during digestion, catalyzed by the reaction of nitrogen dioxide with unsaturated fatty acids. Understanding the mechanisms underlying the formation of nitrated fatty acids from dietary sources is essential to comprehending their antiplatelet action. This research aims to evaluate the formation of nitrated fatty acids (NO₂-FA) from different foods (tomato pulp and common beans). Specifically, tomato pomace and nitrated bean extracts exhibited concentration-dependent antiplatelet effects when platelets were stimulated with TRAP-6 and collagen (1.18±0.04 and 0.7±0.02 mg/mL, respectively). Furthermore, the antiplatelet potential was associated with the modulation of platelet activation markers, as both nitrated extracts suppressed p-selectin expression, CD63 secretion, and fibrinogen modulation. Additionally, a synergistic effect was observed between both nitrated extracts. Our results suggest that NO₂-FA obtained from different food sources has a promising antiplatelet effect for preventing and treating blood clots. This study adds value to these foods in terms of reducing cardiovascular events.

Keywords: foods, nitrated fatty acids, nitration, platelets

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Authors: Ljiljana Stojković, Manja Zec, Maja Zivkovic, Maja Bundalo, Marija Glibetić, Dragan Alavantić, Aleksandra Stankovic

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Cardiovascular disease (CVD) is associated with alterations in DNA methylation, the latter modulated by dietary polyphenols. The present pilot study (part of the original clinical study registered as NCT02800967 at www.clinicaltrials.gov) aimed to investigate the impact of 4-week daily consumption of polyphenol-rich Aronia melanocarpa juice on Long Interspersed Nucleotide Element-1 (LINE-1) methylation in peripheral blood leukocytes, in subjects (n=34, age of 41.1±6.6 years) at moderate CVD risk, including an increased body mass index, central obesity, high normal blood pressure and/or dyslipidemia. The goal was also to examine whether factors known to affect DNA methylation, such as folate intake levels, MTHFR C677T gene variant, as well as the anthropometric and metabolic parameters, modulated the LINE-1 methylation levels upon consumption of polyphenol-rich Aronia juice. The experimental analysis of LINE-1 methylation was done by the MethyLight method. MTHFR C677T genotypes were determined by the polymerase chain reaction-restriction fragment length polymorphism method. Folate intake was assessed by processing the data from the food frequency questionnaire and repeated 24-hour dietary recalls. Serum lipid profile was determined by using Roche Diagnostics kits. The statistical analyses were performed using the Statistica software package. In women, after vs. before the treatment period, a significant decrease in LINE-1 methylation levels was observed (97.54±1.50% vs. 98.39±0.86%, respectively; P=0.01). The change (after vs. before treatment) in LINE-1 methylation correlated directly with MTHFR 677T allele presence, average daily folate intake and the change in serum low-density lipoprotein cholesterol, while inversely with the change in serum triacylglycerols (R=0.72, R2=0.52, adjusted R2=0.36, P=0.03). The current results imply potential cardioprotective effects of habitual polyphenol-rich Aronia juice consumption achieved through the modifications of DNA methylation pattern in subjects at CVD risk, which should be further confirmed. Hence, the precision nutrition-driven modulations of DNA methylation may become targets for new approaches in the prevention and treatment of CVD.

Keywords: Aronia melanocarpa, cardiovascular risk, LINE-1, methylation, peripheral blood leukocytes, polyphenol

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Authors: Prima Khairunisa, Febriana Tri Kusumawati, Endah Luthfiana

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Background: Hypertension in elderly, caused by cardiovascular system cannot work normally, because the valves thickened and inelastic blood vessels. It causes vasoconstriction of the blood vessels. Hypertension exercise, increase cardiovascular function and the elasticity of the blood vessels. While slow deep breathing helps the body and mind feel relax. Combination both of them will decrease the blood pressure. Objective: To know the effect of hypertension exercise and slow deep breathing combination to blood pressure in elderly. Method: The study conducted with one group pre-post test experimental design. The samples were 10 elderly both male and female in a Village in Semarang, Central Java, Indonesia. The tool was manual sphygmomanometer to measure blood pressure. Result: Based on paired t-test between hypertension exercise and slow deep breathing with systole blood pressure showed sig (2-tailed) was 0.045, while paired t-test between hypertension exercise hypertension exercise and slow deep breathing with diastole blood pressure showed sig (2-tailed) was 0,343. The changes of systole blood pressure were 127.5 mmHg, and diastole blood pressure was 80 mmHg. Systole blood pressure decreases significantly because the average of systole blood pressure before implementation was 135-160 mmHg. While diastole blood pressure was not decreased significantly. It was influenced by the average of diastole blood pressure before implementation of hypertension exercise was not too high. It was between 80- 90 mmHg. Conclusion: There was an effect of hypertension exercise and slow deep breathing combination to the blood pressure in elderly after 6 times implementations.

Keywords: hypertension exercise, slow deep breathing, elderly, blood pressure

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Authors: Aziza Al-Sawafi

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Introduction: The evidence of family interventions in schizophrenia is robust primarily in high-income settings. However, they have been adapted to other settings and cultures to improve effectiveness and acceptability. In Oman, there is limited integration of psychosocial interventions in the treatment of schizophrenia. Therefore, the adaptation of family intervention to the Omani culture may facilitate its uptake. Most service users in Oman live with their families outside the healthcare system, and nothing is known about their experience, needs, or resources. Furthermore, understanding caregivers' and mental health professionals' preferences, perceptions, and experience is a fundamental element in the process of intervention development. Therefore, this study aims to develop a culturally sensitive, feasible, and acceptable family intervention for relatives living with schizophrenia in Oman. Method: The Medical Research Council's framework for the evaluation of complex health care interventions provided the conceptual structure for the study. The development phase was carried out, which involved three stages: 1) systematically reviewing the available literature regarding culturally adapted family interventions in the Arab world 2) In-depth interviews with caregivers to explore their experience and perceived needs and preferences regarding intervention 3) A focus group study involving health professionals to explore the acceptability and feasibility of delivering the family intervention in the Omani context. Data synthesis determined the design of the proposed intervention according to the findings obtained from the previous stages. Results: Stage one: The systematic review found limited evidence of culturally-adapted family interventions in the Arab region. However, the cultural adaptation process was comprehensive, and the implementation was reported to be feasible and acceptable. Stage two: The experience of family caregivers illuminated four main themes: burden, stigma, violence, and family needs. Burdens of care included objective and subjective burdens, positive feelings, and coping mechanisms. Caregivers gave their opinion about the content and preference of the intervention from their personal experiences. Stage three: mental health professionals discussed the delivery system of the intervention from a clinical standpoint concerning issues and barriers to implementation. They recommended modifications to the components of the intervention to ensure its acceptability and feasibility in the local setting. Data synthesis was carried out, and the intervention was designed. Conclusion: This study provides evidence of the potential applicability and acceptability of a culturally sensitive family intervention for families of individuals with schizophrenia in Oman. However, more work needs to be done to test the feasibility of the study and overcome the practical challenges.

Keywords: cultural-adaptation, family intervention, Oman, schizophrenia

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Authors: E. H. Walsh, J. McMahon, M. P. Herring

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Post-primary school-based suicide prevention (PSSP) is a valuable avenue to reduce suicidal behaviours in adolescents. The aims of this meta-analysis and meta-regression were 1) to quantify the effect of PSSP interventions on adolescent suicide ideation (SI) and suicide attempts (SA), and 2) to explore how intervention effects may vary based on important contextual and intervention factors. This study provides further support to the benefits of PSSP by demonstrating lower suicide outcomes in over 30,000 adolescents following PSSP and mental health interventions and tentatively suggests that intervention effectiveness may potentially vary based on intervention factors. The protocol for this study is registered on PROSPERO (ID=CRD42020168883). Population, intervention, comparison, outcomes, and study design (PICOs) defined eligible studies as cluster randomised studies (n=12) containing PSSP and measuring suicide outcomes. Aggregate electronic database EBSCO host, Web of Science, and Cochrane Central Register of Controlled Trials databases were searched. Cochrane bias tools for cluster randomised studies demonstrated that half of the studies were rated as low risk of bias. The Egger’s Regression Test adapted for multi-level modelling indicated that publication bias was not an issue (all ps > .05). Crude and corresponding adjusted pooled log odds ratios (OR) were computed using the Metafor package in R, yielding 12 SA and 19 SI effects. Multi-level random-effects models accounting for dependencies of effects from the same study revealed that in crude models, compared to controls, interventions were significantly associated with 13% (OR=0.87, 95% confidence interval (CI), [0.78,0.96], Q18 =15.41, p=0.63) and 34% (OR=0.66, 95%CI [0.47,0.91], Q10=16.31, p=0.13) lower odds of SI and SA, respectively. Adjusted models showed similar odds reductions of 15% (OR=0.85, 95%CI[0.75,0.95], Q18=10.04, p=0.93) and 28% (OR=0.72, 95%CI[0.59,0.87], Q10=10.46, p=0.49) for SI and SA, respectively. Within-cluster heterogeneity ranged from no heterogeneity to low heterogeneity for SA across crude and adjusted models (0-9%). No heterogeneity was identified for SI across crude and adjusted models (0%). Pre-specified univariate moderator analyses were not significant for SA (all ps < 0.05). Variations in average pooled SA odds reductions across categories of various intervention characteristics were observed (all ps < 0.05), which preliminarily suggests that the effectiveness of interventions may potentially vary across intervention factors. These findings have practical implications for researchers, clinicians, educators, and decision-makers. Further investigation of important logical, theoretical, and empirical moderators on PSSP intervention effectiveness is recommended to establish how and when PSSP interventions best reduce adolescent suicidal behaviour.

Keywords: adolescents, contextual factors, post-primary school-based suicide prevention, suicide ideation, suicide attempts

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Authors: Sara atibi, Azzeddine Atibi, Salim Ahmed, Khadija El Kababi

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The emergence of an entrepreneurial culture within academic institutions is increasingly seen as essential for preparing students for contemporary economic challenges. This study examines the effectiveness of educational programs and interventions aimed at promoting entrepreneurial spirit at Al Akhawayn University. The central issue explores the types of programs most efficient in instilling the necessary entrepreneurial skills and attitudes in students. The primary question about the ‘types of educational programs and interventions that are most effective in cultivating and reinforcing the entrepreneurial spirit among students at Al Akhawayn University' is broken down into sub-questions detailing the characteristics of current programs, factors influencing their success, the evolution of students' entrepreneurial skills, the role of teachers and mentors, best practices from other institutions, and the long-term impacts on graduates' entrepreneurial careers. To address this question, a mixed-methods approach, combining quantitative and qualitative methods, was adopted. Quantitative data collection includes questionnaires and surveys designed to evaluate students' attitudes, skills, and perceptions before and after participating in entrepreneurship programs. Simultaneously, semi-structured interviews, focus groups, and participant observations provide in-depth qualitative data on the experiences of students, teachers, and administrators. Quantitative data analysis employs descriptive and inferential statistical techniques, while qualitative analysis uses a thematic approach to identify key perceptions and experiences. This triangulation of data ensures robust and comprehensive results.

Keywords: student entrepreneurship, pedagogical interventions, Al Akhawayn university, entrepreneurial culture, entrepreneurial skills

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Authors: Reza Behmanesh, Mohammad Nasrolahzadeh-Masouleh, Ehsan Khaksar, Saeed Bokaie

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Domestic rabbits (Oryctolagus cuniculus) are an excellent model for cardiovascular research because the size of these animals is more suitable for study and experimentation than smaller animals. One of the most important diagnostic imaging methods is echocardiography, which is used today to evaluate the anatomical and functional cardiovascular system and is one of the most accurate and sensitive non-invasive methods for examining heart disease. Ventricular function indices can be assessed with cardiac imaging techniques. One of these important cardiac parameters is the ejection fraction (EF), which has a valuable place along with other involved parameters. EF is a measure of the percentage of blood that comes out of the heart with each contraction. For this study, 100 adult and young standard domestic rabbits, six months to one year old and of both sexes (50 female and 50 male rabbits) without anesthesia and sedation were used. In this study, the mean EF in domestic rabbits studied in males was 58.753 ± 6.889 and in females, 61.397 ± 6.530, which are comparable to the items mentioned in the valid books and the average size of EF measured in this study; there is no significant difference between this research and other research. There was no significant difference in the percentage of EF between most weight groups, but there was a significant difference (p < 0.05) in weight groups (2161–2320 g and 2481–2640 g). Echocardiographic EF reference values for domestic rabbits (Oryctolagus cuniculus) non-anesthetized are presented, providing reference values for future studies.

Keywords: echocardiography, ejection fraction, rabbit, heart

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Authors: Michael Nolte, Iwona Kasior, Kala Flagg, Spiro Karavatas

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Background: Cryotherapy has been used as a post-exercise recovery modality for decades. Whole-body cryotherapy (WBC) is an intervention which involves brief exposures to extremely cold air in order to induce therapeutic effects. It is currently being investigated for its effectiveness in treating certain exercise-induced impairments. Purpose: The purpose of this systematic review was to determine whether WBC as a recovery intervention is more, less, or equally as effective as other interventions at reducing perceived levels of muscle soreness and promoting recovery of muscle function after exercise-induced muscle damage (EIMD) from running. Methods: A systematic review of the current literature was performed utilizing the following MeSH terms: cryotherapy, whole-body cryotherapy, exercise-induced muscle damage, muscle soreness, muscle recovery, and running. The databases utilized were PubMed, CINAHL, EBSCO Host, and Google Scholar. Articles were included if they were published within the last ten years, had a CEBM level of evidence of IIb or higher, had a PEDro scale score of 5 or higher, studied runners as primary subjects, and utilized both perceived levels of muscle soreness and recovery of muscle function as dependent variables. Articles were excluded if subjects did not include runners, if the interventions included PBC instead of WBC, and if both muscle performance and perceived muscle soreness were not assessed within the study. Results: Two of the four articles revealed that WBC was significantly more effective than treatment interventions such as far-infrared radiation and passive recovery at reducing perceived levels of muscle soreness and restoring muscle power and endurance following simulated trail runs and high-intensity interval running, respectively. One of the four articles revealed no significant difference between WBC and passive recovery in terms of reducing perceived muscle soreness and restoring muscle power following sprint intervals. One of the four articles revealed that WBC had a harmful effect compared to CWI and passive recovery on both perceived muscle soreness and recovery of muscle strength and power following a marathon. Discussion/Conclusion: Though there was no consensus in terms of WBC’s effectiveness at treating exercise-induced muscle damage following running compared to other interventions, it seems as though WBC may at least have a time-dependent positive effect on muscle soreness and recovery following high-intensity interval runs and endurance running, marathons excluded. More research needs to be conducted in order to determine the most effective way to implement WBC as a recovery method for exercise-induced muscle damage, including the optimal temperature, timing, duration, and frequency of treatment.

Keywords: cryotherapy, physical therapy intervention, physical therapy, whole body cryotherapy

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Authors: Zeynep Turhan

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Digital tools can improve knowledge and awareness of strategies and skills for healthy and respectful intimate relationships. The website of the Healthy and Respectful Relationship Program has been developed and included five key videos about how to build healthy intimate relationships. This study examined the perspectives about informative videos by focusing on how individuals learn new information or challenge their preconceptions or attitudes regarding male privilege and women's oppression. Five individuals who received no-contact orders and attended group intervention were the sample of this study. The observation notes were the major methodology examining how participants responded to video tools. The data analysis method was the interpretative phenomenological analysis. The results showed that many participants found the tools useful in learning the types of violence and communication strategies. Nevertheless, obstacles to implementing some techniques were found in their relationships. These digital tools might enhance healthy and respectful relationships despite some limitations.

Keywords: healthy relationship, digital tools, intimate partner violence, perpetrators, video interventions

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Authors: Ashit Syngle, Nidhi Garg, Pawan Krishan

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Background: Endothelial Progenitor Cells (EPCs) are depleted and contribute to increased cardiovascular (CV) risk in rheumatoid arthritis (RA). Statins exert a protective effect in CAD partly by promoting EPC mobilization. This vasculoprotective effect of statin has not yet been investigated in RA. We aimed to investigate the effect of rosuvastatin on EPCs in RA. Methods: 50 RA patients were randomized to receive 6 months of treatment with rosuvastatin (10 mg/day, n=25) and placebo (n=25) as an adjunct to existing stable antirheumatic drugs. EPCs (CD34+/CD133+) were quantified by Flow Cytometry. Inflammatory measures included DAS28, CRP and ESR were measured at baseline and after treatment. Lipids and pro-inflammatory cytokines (TNF-α, IL-6, and IL-1) were estimated at baseline and after treatment. Results: At baseline, inflammatory measures and pro-inflammatory cytokines were elevated and EPCs depleted among both groups. At baseline, EPCs inversely correlated with DAS28 and TNF-α in both groups. EPCs increased significantly (p < 0.01) after treatment with rosuvastatin but did not show significant change with placebo. Rosuvastatin exerted positive effect on lipid spectrum: lowering total cholesterol, LDL, non HDL and elevation of HDL as compared with placebo. At 6 months, DAS28, ESR, CRP, TNF-α and IL-6 improved significantly in rosuvastatin group. Significant negative correlation was observed between EPCs and DAS28, CRP, TNF-α, and IL-6 after treatment with rosuvastatin. Conclusion: First study to show that rosuvastatin improves inflammation and EPC biology in RA possibly through its anti-inflammatory and lipid lowering effect. This beneficial effect of rosuvastatin may provide a novel strategy to prevent cardiovascular events in RA.

Keywords: RA, Endothelial Progenitor Cells, rosuvastatin, cytokines

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Authors: Dinoo Kirthinanda, Sujani Wijeratne

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Pseudohyperkalaemia is a common benign in vitro phenomenon caused by the release of potassium ions (K+) from cells during specimen processing. Analysis of haemolysed blood samples for predominantly intracellular electrolytes may lead to re-investigation and potentially harmful interventions. We report a case of a 52-year male with myeloproliferative disease manifested as Polycythaemia Rubra Vera, Hypertension and hypertensive nephropathy with stage 3 chronic kidney disease admitted to Neuro-intensive care unit (NICU) with an intra-cerebral haemorrhage secondary to hypertensive bleed. His initial blood investigations showed hyperkalemia with serum K+ 6.2 mmol/L yet the bedside arterial blood gas analysis yielded K+ of 4.6 mmol/L. The patient was however given hyperkalemia regime twice based on venous electrolyte analysis. The discrepancy between the bedside electrolyte analysis using arterial blood and venous blood prompted further evaluation. The 12 lead Electrocardiogram showed U waves and sinus bradycardia corresponding to the serum K+ of 2.8 mmol/L on arterial blood gas analysis. Immediate K+ replacement ensured the patient did not develop life-threatening cardiac complications. Pseudohyperkalaemia may pose diagnostic challenges in the absence of detectable haemolysis and should be suspected in susceptible patients with normal Electrocardiogram and Glomerular Filtration Rate to avoid potentially life-threatening interventions. When in doubt, rapid analysis of arterial blood gas may be useful for accurate quantification of potassium.

Keywords: patient safety, pseudohyperkalaemia, haemolysis, myeloproliferative disorder

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Authors: Jakob Renko, Deja Praprotnik, Kristina Martinovič, Igor Karnjuš

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Introduction: Catheter-related bloodstream infections are a major burden for healthcare and patients. Although infections of this type cannot be completely avoided, they can be reduced by taking preventive measures. The aim of this study is to review and analyze the existing literature on preventive interventions to prevent central venous catheters (CVC) infections. Methods: A systematic literature review was carried out. The international databases CINAHL, Medline, PubMed, and Web of Science were searched using the search strategy: "catheter-related infections" AND "intensive care units" AND "prevention" AND "central venous catheter." Articles that met the inclusion and exclusion criteria were included in the study. The literature search flow is illustrated by the PRISMA diagram. The descriptive research method was used to analyze the data. Results: Out of 554 search results, 22 surveys were included in the final analysis. We identified seven relevant preventive measures to prevent CVC infections: washing the whole body with chlorhexidine gluconate (CHG) solution, disinfecting the CVC entry site with CHG solution, use of CHG or silver dressings, alcohol protective caps, CVC care education, selecting appropriate catheter and multicomponent care bundles. Discussion and conclusions: Both single interventions and multicomponent care bundles have been shown to be currently effective measures to prevent CVC infections in adult patients in the ICU. None of the measures identified stood out in terms of their effectiveness. Prevention work to reduce CVC infections in the ICU is a complex process that requires the simultaneous consideration of several factors.

Keywords: central venous access, critically ill patients, hospital-acquired complications, prevention

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Authors: Shalini Rankawat, Mansi Rankawat, Rahul Dubey, Mazad Zaveri

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Physiological signals such as electrocardiogram (ECG) and arterial blood pressure (ABP) in the intensive care unit (ICU) are often seriously corrupted by noise, artifacts, and missing data, which lead to errors in the estimation of heart rate (HR) and incidences of false alarm from ICU monitors. Clinical support in ICU requires most reliable heart rate estimation. Cardiac activity, because of its relatively high electrical energy, may introduce artifacts in Electroencephalogram (EEG), Electrooculogram (EOG), and Electromyogram (EMG) recordings. This paper presents a robust heart rate estimation method by detection of R-peaks of ECG artifacts in EEG, EMG & EOG signals, using energy-based function and a novel Signal Quality Index (SQI) assessment technique. SQIs of physiological signals (EEG, EMG, & EOG) were obtained by correlation of nonlinear energy operator (teager energy) of these signals with either ECG or ABP signal. HR is estimated from ECG, ABP, EEG, EMG, and EOG signals from separate Kalman filter based upon individual SQIs. Data fusion of each HR estimate was then performed by weighing each estimate by the Kalman filters’ SQI modified innovations. The fused signal HR estimate is more accurate and robust than any of the individual HR estimate. This method was evaluated on MIMIC II data base of PhysioNet from bedside monitors of ICU patients. The method provides an accurate HR estimate even in the presence of noise and artifacts.

Keywords: ECG, ABP, EEG, EMG, EOG, ECG artifacts, Teager-Kaiser energy, heart rate, signal quality index, Kalman filter, data fusion

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Authors: Payam Mousavi, Andrew L. Stewart, Huiwen You, Aryeh F. G. Fayerman

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We present a decision-support tool to assist an operator in the detection and tracking of a suspect vehicle traveling to an unknown target destination. Multiple data sources, such as traffic cameras, traffic information, weather, etc., are integrated and processed in real-time to infer a suspect’s intended destination chosen from a list of pre-determined high-value targets. Previously, we presented our work in the detection and tracking of vehicles using traffic and airborne cameras. Here, we focus on the fusion and processing of that information to predict a suspect’s behavior. The network of cameras is represented by a directional graph, where the edges correspond to direct road connections between the nodes and the edge weights are proportional to the average time it takes to travel from one node to another. For our experiments, we construct our graph based on the greater Los Angeles subset of the Caltrans’s “Performance Measurement System” (PeMS) dataset. We propose a Bayesian approach where a posterior probability for each target is continuously updated based on detections of the suspect in the live video feeds. Additionally, we introduce the concept of ‘soft interventions’, inspired by the field of Causal Inference. Soft interventions are herein defined as interventions that do not immediately interfere with the suspect’s movements; rather, a soft intervention may induce the suspect into making a new decision, ultimately making their intent more transparent. For example, a soft intervention could be temporarily closing a road a few blocks from the suspect’s current location, which may require the suspect to change their current course. The objective of these interventions is to gain the maximum amount of information about the suspect’s intent in the shortest possible time. Our system currently operates in a human-on-the-loop mode where at each step, a set of recommendations are presented to the operator to aid in decision-making. In principle, the system could operate autonomously, only prompting the operator for critical decisions, allowing the system to significantly scale up to larger areas and multiple suspects. Once the intended target is identified with sufficient confidence, the vehicle is reported to the authorities to take further action. Other recommendations include a selection of road closures, i.e., soft interventions, or to continue monitoring. We evaluate the performance of the proposed system using simulated scenarios where the suspect, starting at random locations, takes a noisy shortest path to their intended target. In all scenarios, the suspect’s intended target is unknown to our system. The decision thresholds are selected to maximize the chances of determining the suspect’s intended target in the minimum amount of time and with the smallest number of interventions. We conclude by discussing the limitations of our current approach to motivate a machine learning approach, based on reinforcement learning in order to relax some of the current limiting assumptions.

Keywords: autonomous surveillance, Bayesian reasoning, decision support, interventions, patterns of life, predictive analytics, predictive insights

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Authors: Fagner O. Serrano, Danielle R. Bouchard, Todd A. Duhame

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Walking cadence (steps/min) is an effective way to prescribe exercise so an individual can reach a moderate intensity, which is recommended to optimize health benefits. To our knowledge, there is no study on the required walking cadence to reach a moderate intensity for people that present chronic conditions or risk factors for chronic conditions such as Cardiovascular Diseases (CVD). The objectives of this study were: 1- to identify the walking cadence needed for people at risk of CVD to a reach moderate intensity, and 2- to develop and test an equation using clinical variables to help professionals working with individuals at risk of CVD to estimate the walking cadence needed to reach moderate intensity. Ninety-one people presenting a minimum of two risk factors for CVD completed a medically supervised graded exercise test to assess maximum oxygen consumption at the first visit. The last visit consisted of recording walking cadence using a foot pod Garmin FR-60 and a Polar heart rate monitor, aiming to get participants to reach 40% of their maximal oxygen consumption using a portable metabolic cart on an indoor flat surface. The equation to predict the walking cadence needed to reach moderate intensity in this sample was developed as follows: The sample was randomly split in half and the equation was developed with one half of the participants, and validated using the other half. Body mass index, height, stride length, leg height, body weight, fitness level (VO2max), and self-selected cadence (over 200 meters) were measured using objective measured. Mean walking cadence to reach moderate intensity for people age 64.3 ± 10.3 years old at risk of CVD was 115.8  10.3 steps per minute. Body mass index, height, body weight, fitness level, and self-selected cadence were associated with walking cadence at moderate intensity when evaluated in bivariate analyses (r ranging from 0.22 to 0.52; all P values ≤0.05). Using linear regression analysis including all clinical variables associated in the bivariate analyses, body weight was the significant predictor of walking cadence for reaching a moderate intensity (ß=0.24; P=.018) explaining 13% of walking cadence to reach moderate intensity. The regression model created was Y = 134.4-0.24 X body weight (kg).Our findings suggest that people presenting two or more risk factors for CVD are reaching moderate intensity while walking at a cadence above the one officially recommended (116 steps per minute vs. 100 steps per minute) for healthy adults.

Keywords: cardiovascular disease, moderate intensity, older adults, walking cadence

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Authors: Athanasia Kouroupa, Karen Irvine, Sivana Mengoni, Shivani Sharma

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Exploring parents’ preferences towards technology-based interventions for children on the autism spectrum can inform future research and support technology design. The study aimed to provide a comprehensive description of parents’ knowledge and preferences about innovative technology to support children on the autism spectrum. Survey data were collected from parents (n = 267) internationally. The survey included information about the use of conventional (e.g., smartphone, iPod, tablets) and non-conventional (e.g., virtual reality, robot) technologies. Parents appeared to prefer conventional technologies such as tablets and dislike non-conventional ones. They highlighted the positive contribution technology brought to the children’s lives during the pandemic. A few parents were equally concerned that the compulsory introduction of technology during the pandemic was associated with elongated time on devices. The data suggested that technology-based interventions are not widely known, need to be financially approachable and achieve a high standard of design to engage users.

Keywords: autism, intervention, preferences, technology

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Authors: Samereh Abdoli, Amit Vora, Anusha Vora

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Aim: To qualitatively investigate diabetes burnout in parents of children with Type 1 Diabetes (T1D) who shared their experiences through YouTube videos in order to inform future interventions and improve diabetes practice. Methods: A qualitative descriptive approach was used to explore YouTube videos. Of the 568 videos that were identified, only 9 videos met the inclusion criteria of the study. Results: After the videos were transcribed and analyzed using qualitative content analysis, it was revealed that parents shared common concerns and experiences and they translated into three main themes: I do not ever get a break, I am exhausted, I can’t burn out, and I just need a break Conclusion: All in all, the literature revealed that there are negative psychosocial outcomes associated with caring for a child with T1D, but there is a lack of information on diabetes burnout and how parents’ well-being are affected. Reports of self-neglect and sleep deprivation only confirm the need for intervention for parents of children with T1D. The hope with this study is that burnout can be recognized early on and appropriate interventions put in place to help parents cope with the stressors of caring for a child with a chronic disease.

Keywords: Diabetes burnout, type 1 diabetes, qualitative research, parents

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Authors: Hui Fang Huang Su, Leanne Lai, Pei-Fen Li, Mei-Hwei Ho, Yu-Wen Chiu

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This study aimed to provide a practical, systematic, and comprehensive intervention for children with Autism Spectrum Disorder (ASD). A pilot study of quasi-experimental pre-post intervention with control group design was conducted to evaluate if the mathematical intervention (Project MIND - Math Is Not Difficult) increases the math comprehension of children with ASD Children with ASD in the primary grades (K-1, 2) participated in math interventions to enhance their math comprehension and cognitive ability. The Bracken basic concept scale was used to evaluate subjects’ language skills, cognitive development, and school readiness. The study found that our systemic interventions of Project MIND significantly improved the mathematical and cognitive abilities in children with autism. The results of this study may lead to a major change in effective and adequate health care services for children with ASD and their families. All statistical analyses were performed with the IBM SPSS Statistics Version 25 for Windows. The significant level was set at 0.05 P-value.

Keywords: autism, mathematics, technology, family

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Authors: Shakila Singh

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Sexual harassment continues to be a problem both in educational institutions and workplaces with the main victims being women and the main perpetrators being men. The achievement of quality education demands to create safe learning spaces for all students and requires extensive and integrated interventions. This article draws on the data from a broader study that aims to create safer learning environments at university by addressing gender violence. It attempts to understand male students’ perspectives about their role in sexual harassment on the campus. It is a move away from interventions that place the responsibility of prevention of sexual harassment, on women. The study adopts an interpretive paradigm within a qualitative approach. The sample comprises twenty male university students who were purposively selected because they live in the campus residences. The main data generation methods included focus group discussions and individual interviews. Findings show that while many male students agree that victims of sexual harassment are mainly women, they also suggest that men are victims of sexual harassment by women. Male students have varying understandings of what constitutes sexual harassment. They position themselves as victims who feel harassed by women’s dress and behaviour. Male students also felt under pressure by sexual advances made by women that forced them to comply in order to protect their masculinity. This article argues that social norms of masculinity are powerful drivers of behaviour that play a key role in the perpetuation of sexual harassment. Male students who feel strongly against sexual harassment of female students are constrained by their masculinities in their ability to act against it. Effective interventions need to actively engage students in reflecting on and challenging social and cultural norms that contribute to violent expressions and to develop alternatives with them.

Keywords: gender violence, male students, sexual harassment, university students

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Authors: Wing Chi Wong

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Globally, studying parents caring for children with attention deficit/ hyperactivity disorder (ADHD) is valuable in order to design measures in supporting those parents by health care providers and government. Such parents in Hong Kong seem to encounter detrimental stress and enormous difficulties which are exacerbated by the traditional Chinese culture, exclusion from social members and fiercely competitive educational system. However, seldom studies scrutinize this issue in Hong Kong. This article aims to review the literature regarding parents caring offsprings with ADHD in Hong Kong. Criteria were set for searching among published studies listed in various databases, including MEDLINE, CINCAHL, PsycINFO, ProQuest, Embase, Cochrane Library and Springer Link. Articles with words 'Attention Deficit Hyperactivity Disorder', 'parenting', 'parent', 'family', 'father', 'mother', 'care' in titles and abstracts were identified. Articles with all types of research designs and methods, regardless in English or Chinese, were included. They were limited to years between January 2008 and September 2018. Four relevant studies have resulted. Of them, two were exploratory studies, one was a qualitative study, and one was a survey. Samples were recruited from child psychiatric clinic, Child and Adolescent Mental Health Unit, or multiple family group therapy centres. Authors proclaimed that quality of life of those parents was usually low; particularly mothers perceived a higher stress than fathers; parenting barriers existed; conflicts were commonly raised in parent-child relationship resulting in probable maltreatment to children. Previous studies generally suggested the potential negative outcomes of parents caring children with ADHD. The types and effectiveness of interventions to those parents on relieving their tortures under Hong Kong context had not been explored and systematically evaluated. The scanty studies and existing understanding could not give a promising conclusion pertaining to the appropriate family intervention to parents living with children with ADHD. A stringent research design is necessary to establish evidence on the effectiveness of interventions for those families.

Keywords: attention deficit/ hyperactivity disorder, Hong Kong, parents, interventions

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Authors: Mohd Sidek Ahmad, Zainon Mohd Noor, Zaidah Zainal Ariffin

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Fibrin degradation is an important part in prevention or treatment of intravascular thrombosis and cardiovascular diseases. Plasmin like fibrinolytic enzymes has given new hope to patient with cardiovascular diseases by treating fibrin aggregation related diseases with traditional plasminogen activator which have many side effects. Various researches involving wide range of sources for production of fibrinolytic proteases, from bacteria, fungi, insects and fermented foods. But few have looked into endophytic fungi as a potential source. Sixteen (16) endophytic fungi were isolated from Hibiscus sp. leaves from six different locations in Shah Alam, Selangor. Only two endophytic fungi, FH3 and S13 showed positive fibrinolytic protease activities. FH3 produced 5.78cm and S13 produced 4.48cm on Skim Milk Agar after 4 days of incubation at 27°C. Fibrinolytic activity was observed; 3.87cm and 1.82cm diameter clear zone on fibrin plate of FH3 and S13 respectively. 18srRNA was done for identification of the isolated fungi with positive fibrinolytic protease. S13 had the highest similarity (100%) to that of Penicillium citrinum strain TG2 and FH3 had the highest similarity (99%) to that of Fusarium sp. FW2PhC1, Fusarium sp. 13002, Fusarium sp. 08006, Fusarium equiseti strain Salicorn 8 and Fungal sp. FCASAn-2. Media composition variation showed the effects of carbon nitrogen on protein concentration, where the decrement of 50% of media composition caused drastic decrease in protease of FH3 from 1.081 to 0.056 and also S13 from 2.946 to 0.198.

Keywords: isolation, identification, fibrinolytic protease, endophytic fungi, Hibiscus leaves

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Authors: Eman Merza, Stephen Pearson, Glen Lichtwark, Peter Malliaras

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The Achilles tendon (AT) exhibits volume changes related to fluid flow under acute load which may be linked to changes in stiffness. Fluid flow provides a mechanical signal for cellular activity and may be one mechanism that facilitates tendon adaptation. This study aimed to investigate whether isometric intervention involving a high level of load duration and intensity could maximize the immediate reduction in AT volume and stiffness compared to interventions involving a lower level of load duration and intensity. Sixteen healthy participants (12 males, 4 females; age= 24.4 ± 9.4 years; body mass= 70.9 ± 16.1 kg; height= 1.7 ± 0.1 m) performed three isometric interventions of varying levels of load duration (2 s and 8 s) and intensity (35% and 75% maximal voluntary isometric contraction) over a 3 week period. Freehand 3D ultrasound was used to measure free AT volume (at rest) and length (at 35%, 55%, and 75% of maximum plantarflexion force) pre- and post-interventions. The slope of the force-elongation curve over these force levels represented individual stiffness (N/mm). Large reductions in free AT volume and stiffness resulted in response to long-duration high-intensity loading whilst less reduction was produced with a lower load intensity. In contrast, no change in free AT volume and a small increase in AT stiffness occurred with lower load duration. These findings suggest that the applied load on the AT must be heavy and sustained for a long duration to maximize immediate volume reduction, which might be an acute response that enables optimal long-term tendon adaptation via mechanotransduction pathways.

Keywords: Achilles tendon, volume, stiffness, free tendon, 3d ultrasound

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Authors: Chasity O'Connell

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The use of social media and networking sites play a significant role in the lives of adolescents and adults. While research supports that social support and connectedness in general is beneficial; the nature of communication and interaction through social media and its subsequent benefits and impacts could be arguably different. As such, this research aims to explore a specific facet of social media interaction called fear of missing out, or 'FOMO' and investigate its relationship within the context of life stressors, social media usage, anxiety and depressive-symptoms, mindfulness, and psychological well-being. FOMO is the 'uneasy and sometimes all-consuming feeling that you’re missing out—that your peers are doing, in the know about, or in possession of more or something better than you'. Research suggests that FOMO can influence an individual’s level of engagement with friends and social media consumption, drive decisions on participating in various online or offline activities, and ultimately impact mental health. This study hopes to explore the potentially mitigating influence of mindfulness and values-based interventions in reducing the discomfort and distress that can accompany FOMO and increase the sense of psychological well-being in allowing for a more thoughtful and deliberate engagement in life. This study will include an intervention component wherein participants (comprised of university students and adults in the community) will partake in a six-week, group-based intervention focusing on learning practical mindfulness skills and values-exploration exercises (along with a waitlist control group). In doing so, researchers hope to understand if interventions centered on increasing one’s awareness of the present moment and one’s internal values impact decision-making and well-being with regard to social interaction and relationships.

Keywords: FOMO, mindfulness, values, stress, psychological well-being, intervention, distress

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Authors: Babu Shersad, Partha Banerjee

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Reduction in haemoglobin levels has been implicated to be a cause for reduced exercise tolerance and cardiovascular complications of chronic renal diseases. Trends of hemoglobin levels in patients on haemodialysis could be an indicator of efficacy of hemodialysis and an indicator of quality of life in haemodialysis patients. In the UAE, the rate of growth (of patients on dialysis) is 10 to 15 per cent per year. The primary mode of haemodialysis in the region is based on in-patient hospital-based hemodialysis units. The increase in risk of cardiovascular and cerebrovascular morbidity as well as mortality in pre-dialysis Chronic Renal Disease has been reported. However, data on the health burden on haemodialysis in standalone dialysis facilities is very scarce. This is mainly due to the paucity of ambulatory centres for haemodialysis in the region. AMSA is the first center to offer standalone dialysis in the UAE and a study over a one year period was performed. Patient data was analyzed using a questionnaire for 45 patients with an average of 2.5 dialysis sessions per week. All patients were on chronic haemodialysis as outpatients. The trends of haemoglobin levels as an independent variable were evaluated. These trends were interpreted in comparison with other parameters of renal function (creatinine, uric acid, blood pressure and ferritin). Trends indicate an increase in hemoglobin levels with increased supplementation of iron and erythropoietin over time. The adequacy of hemodialysis shows improvement concomitantly. This, in turn, correlates with better patient outcomes and has a direct impact on morbidity and mortality. This study is a pilot study and further studies are indicated so that objective parameters can be studied and validated for hemodialysis in the region.

Keywords: haemodialysis, haemoglobin in haemodialysis, haemodialysis parameters, erythropoietic agents in haemodialysis

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