Search results for: Alice Joan Ferrer

Authors: Alice W. Theuri, Anselimo O. Makokha, Florence M. Kyallo

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Type 2 diabetes mellitus (T2DM) is a serious metabolic disorder whose prevalence among adults has been increasing in the last decade. It is estimated that by 2030, the number of cases in Africa will almost double. Diet and lifestyle modifications are considered the cornerstone for the treatment and management of T2DM. Despite this, there is minimum literature assessing the dietary practices and glycemic control in a semi arid region context in Kenya. The objective of this study was to determine the dietary practices of adult T2DM patients attending Kitui out patient clinic in Kitui County. This was a cross sectional study design where every consenting second patient attending diabetic clinic was interviewed. A total of 138 T2DM patients were interviewed using a structured interview guide on socio-economic and dietary practices administered. The study was carried out in April and May 2017. There were more female (64%) than male (36%) in this study with majority being unemployed (38.4%). Forty seven percent (47.6%) had elevated HbA1c. Majority took three meals per day while DDS was 4.3 ± 1.09. The mean energy intake for men and women was 2823.8 ± 82.45 and 2766.3.30 ± 76.74 respectively. There was a non significant positive relationship (r= 131; P value = 0.124) between amount energy consumed and glycemic control. There were suboptimal dietary practices leading to poor glycemic control among T2DM patients attending diabetic clinic at Kitui District Hospital.

Keywords: adults, dietary practices, semi arid region, T2DM

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Authors: Alice Schittek, Isabelle Roskam, Moira Mikolajczak

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Background: Perfectionistic strivings (PS) and perfectionistic concerns (PC) are associated with an increase in parental burnout (PB), and PB causally increases violence towards the offspring. Objective: To our best knowledge, no study has ever investigated whether perfectionism (PS and PC) predicts violence towards the offspring and whether PB could explain this link. We hypothesized that an increase in PS and PC would lead to an increase in violence via an increase in PB. Method: 228 participants responded to an online survey, with three measurement occasions spaced two months apart. Results: Contrary to expectations, cross-lagged path models revealed that violence towards the offspring prospectively predicts an increase in PS and PC. Mediation models showed that PB is not a significant mediator. The results of all models did not change when controlling for social desirability. Conclusion: The present study shows that violence towards the offspring increases the risk of PS and PC in parents, which highlights the importance of understanding the effect of child maltreatment on the whole family system and not just on children. Results are discussed in light of the feeling of guilt experienced by parents. Considering the insignificant mediation effect, PB research should slowly shift towards more (quasi) causal designs, allowing to identify which significant correlations translate into causal effects. Implications: Clinicians should focus on preventing child maltreatment as well as treating parental perfectionism. Researchers should unravel the effects of child maltreatment on the family system.

Keywords: maltreatment, parental burnout, perfectionistic strivings, perfectionistic concerns, perfectionism, violence

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Authors: Aadiv Shah, Hari Nair, Vedant Mittal, Alice Cheeran

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Present-day agricultural practices such as blanket spraying not only lead to excessive usage of pesticides but also harm the overall crop yield. This paper introduces an algorithm to optimize the traversal of an unmanned aerial vehicle (UAV) in constrained environments. The proposed system focuses on the agricultural application of targeted spraying for locust elimination. Given a satellite image of a farm, target zones that are prone to locust swarm formation are detected through the calculation of the normalized difference vegetation index (NDVI). This is followed by determining the optimal path for traversal of a UAV through these target zones using the proposed algorithm in order to perform pesticide spraying in the most efficient manner possible. Unlike the classic travelling salesman problem involving point-to-point optimization, the proposed algorithm determines an optimal path for multiple regions, independent of its geometry. Finally, the paper explores the idea of implementing reinforcement learning to model complex environmental behaviour and make the path planning mechanism for UAVs agnostic to external environment changes. This system not only presents a solution to the enormous losses incurred due to locust attacks but also an efficient way to automate agricultural practices across the globe in order to improve farmer ergonomics.

Keywords: locust, NDVI, optimization, path planning, reinforcement learning, UAV

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Authors: Yuchen Chen, Dehong Li, Bin Li, Denis Rodrigue, Xiaodong (Alice) Wang

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When selecting insulation materials, not only should their thermal efficiency be considered, but also their impact on the environment. Compared to conventional insulation materials, bio-based materials not only have comparable thermal performance, but they also have a lower embodied energy. Sheep wool has the advantages of low negative health impact, high fire resistance, eco-friendliness, and high moisture resistance. However, studies on applying sheep wool insulation in cold and humid climates are still insufficient. The purpose of this study is to simulate the hygrothermal performance of sheep wool insulation for the Quebec City climate, as well as analyze the mold growth risks. The results show that a sheep wool wall has better thermal performance than a reference wall and that both meet the minimum requirements of the Quebec Code for the thermal performance of above-ground walls. The total water content indicates that the sheep wool wall can reach dynamic equilibrium in the Quebec climate and can dry out. At the same time, a delay of almost four months in the maximum total water content indicates that the sheep wool wall has high moisture absorption compared to the reference wall. The hygrothermal profiles show that the sheathing-insulation interface of both walls is at the highest risk for condensation. When the interior surface gypsum was replaced by stucco, the mold index significantly dropped.

Keywords: sheep wool, water content, hygrothermal performance, mould growth risk

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Authors: Justin Lee, Siraj Shaikh, Alice Chu MD

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Children with cerebral palsy (CP) commonly present with upper extremity impairment, affecting one or both extremities, and are classified using the Manual Ability Classification Scale (MACS). The MACS defines bimanual hand abilities for children ages 4-18 years in everyday tasks and is a gradient scale, with I being nearly normal and V requiring total assistance. Children with more severe upper extremity impairment (MACS III-V) are often underrepresented, and relatively few effective therapies have been identified for these patients. Current orthoses are static and are only meant to prevent the progression of contractures in these patients. Other limitations include cost, comfort, accessibility, and longevity of the orthoses. Taking advantage of advances in 3D printing technology, we have created a highly customizable upper extremity orthotic that can be produced at a low cost. Iterations in our design have resulted in an orthotic that is custom fit to the patient based on scans of their arm, made of rigid polymer when needed to provide support, flexible material where appropriate to allow for comfort, and designed with a mechanical pulley system to allow for some functional use of the arm while in the orthotic. Preliminary data has shown that our orthotic can be built at a fraction of the cost of current orthoses and provide clinically significant improvement in assisting hand assessment (AHA) and pediatric quality of life scores (PedsQL).

Keywords: upper extremity orthosis, upper extremity, orthosis, 3-D printing, cerebral palsy, occupational therapy, spasticity, customizable

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Authors: Dilek Saritas Atalar, Cansu Alsancak Akbulut, İrem Metin Orta, Feyza Yön, Zeynep Yenen, Joan Grusec

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Objective: The aim of this study was to develop semi-structured Domains of Socialization Interview and its coding manual and to test their psychometric properties. Domains of Socialization Interview was designed to assess maternal awareness regarding effective parenting in five socialization domains (protection, mutual reciprocity, control, guided learning, and group participation) within the framework of the domains-of-socialization approach. Method: A series of two studies were conducted to develop and validate the interview and its coding manual. The pilot study, sampled 13 mothers of preschool-aged children, was conducted to develop the assessment tools and to test their function and clarity. Participants of the main study were 82 Turkish mothers (Xage = 34.25, SD = 3.53) who have children aged between 35-76 months (Xage = 50.75, SD = 11.24). Mothers filled in a questionnaire package including Coping with Children’s Negative Emotions Questionnaire, Social Competence and Behavior Evaluation-30, Child Rearing Questionnaire, and Two Dimensional Social Desirability Questionnaire. Afterward, interviews were conducted online by a single interviewer. Interviews were rated independently by two graduate students based on the coding manual. Results: The relationships of the awareness of effective parenting scores to the other measures demonstrate convergent, discriminant, and predictive validity of the coding manual. Intra-class correlation coefficient estimates were ranged between 0.82 and 0.90, showing high interrater reliability of the coding manual. Conclusion: Taken as a whole, the results of these studies demonstrate the validity and reliability of a new and useful interview to measure maternal awareness regarding effective parenting within the framework of the domains-of-socialization approach.

Keywords: domains of socialization, parenting, interview, assessment

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Authors: Masita Mokeira, Kimani Rita, Obonyo Brian, Kwenda Kennedy, Mugambi Purity, Kirui Joan, Chomba Eric, Orwa Daniel, Waiganjo Peter

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Rugby is a highly intense and physical game requiring speed and strength. The need for physical fitness therefore cannot be over-emphasized. Sports are no longer about lifting weights so as to build muscle. Most professional teams are investing much more in the sport in terms of time, equipment and other resources. To play competitively, Kenyan players may therefore need to complement their ‘home-grown’ and sometimes ad-hoc training and nutrition regimes with carefully measured strength and conditioning, diet, nutrition, and supplementation. Nokia Research Center and University of Nairobi conducted an exploratory study on needs and behaviours surrounding sports in Africa. Rugby being one sport that is gaining ground in Kenya was selected as the main focus. The end goal of the research was to identify areas where mobile technology could be used to address gaps, challenges and/or unmet needs. Themes such as information gap, social culture, growth, and development, revenue flow, and technology adoption among others emerged about the sport. From the growth and development theme, it was clear that as rugby continues to grow in the country, teams, coaches, and players are employing interesting techniques both in training and playing. Though some of these techniques are indeed scientific, those employing them are sometimes not fully aware of their scientific basis. A further case study on sports science in rugby in Kenya focusing on physical fitness and nutrition revealed interesting findings. This paper discusses findings on emerging adoption of techniques in managing physiological and nutritional needs of rugby players across different levels of rugby in Kenya namely high school, club and national levels.

Keywords: rugby, nutrition, physiological needs, sports science

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Authors: Osagbai Joshua Eriki, Ngozi Agunwamba, Alice Hill, Lorna Almond, Maniya Duffy, Devashini Naidoo, David Ho, Raman Deo

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Aims: To evaluate the baseline eating pattern in a psychiatric hospital through quantifying purchases of food and drink items at the hospital shop and to implement a traffic light healthy eating labeling system. Method: A electronic till with reporting capabilities was purchased. A two-week period of baseline data collection was conducted. Thereafter, a system for labeling items based on the nutritional value of the food items at the hospital shop was implemented. Green labeling represented the items with the lowest calories and red the most. Further data was collated on the number and types of items purchased by patients according to the category, and the initial effectiveness of the system was evaluated. Result: Despite the implementation of the traffic light system, the red category had the highest number of items purchased by patients, highlighting the importance of promoting healthy eating choices. However, the study also showed that the system was effective in promoting healthy options, as the number of items purchased from the green category increased during the study period. Conclusion: The implementation of a traffic light labeling system for items sold at the hospital shop offers a promising approach to promoting healthy eating habits and choices. This is likely to contribute to a toolkit of measures when considering the multifactorial challenges that obesity and weight issues pose for long-stay psychiatric inpatients

Keywords: mental health, nutrition, food, healthy

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Authors: M. A. Hernández-Ceballos, M. Marín-Ferrer, G. Cinelli, L. De Felice, T. Tollefsen, E. Nweke, P. V. Tognoli, S. Vanzo, M. De Cort

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This study analyses the latitudinal impact of the spatial and temporal distribution on the cosmogenic isotope 7Be in surface air along Europe. The long-term database of the 6 sampling sites (Ivalo, Helsinki, Berlin, Freiburg, Sevilla and La Laguna), that regularly provide data to the Radioactivity Environmental Monitoring (REM) network managed by the Joint Research Centre (JRC) in Ispra, were used. The selection of the stations was performed attending to different factors, such as 1) heterogeneity in terms of latitude and altitude, and 2) long database coverage. The combination of these two parameters ensures a high degree of representativeness of the results. In the later, the temporal coverage varies between stations, being used in the present study sampling stations with a database more or less continuously from 1984 to 2011. The mean values of 7Be activity concentration presented a spatial distribution value ranging from 2.0 ± 0.9 mBq/m3 (Ivalo, north) to 4.8 ± 1.5 mBq/m3 (La Laguna, south). An increasing gradient with latitude was observed from the north to the south, 0.06 mBq/m3. However, there was no correlation with altitude, since all stations are sited within the atmospheric boundary layer. The analyses of the data indicated a dynamic range of 7Be activity for solar cycle and phase (maximum or minimum), having been observed different impact on stations according to their location. The results indicated a significant seasonal behavior, with the maximum concentrations occurring in the summer and minimum in the winter, although with differences in the values reached and in the month registered. Due to the large heterogeneity in the temporal pattern with which the individual radionuclide analyses were performed in each station, the 7Be monthly index was calculated to normalize the measurements and perform the direct comparison of monthly evolution among stations. Different intensity and evolution of the mean monthly index were observed. The knowledge of the spatial and temporal distribution of this natural radionuclide in the atmosphere is a key parameter for modeling studies of atmospheric processes, which are important phenomena to be taken into account in the case of a nuclear accident.

Keywords: Berilium-7, latitudinal impact in Europe, seasonal and monthly variability, solar cycle

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Authors: Joan Esper Kuhnly, Jess Holden, Lynn Shelley, Nicole Kuhnly

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Empathy serves as a foundational nursing principle inherent in the nurse’s ability to form those relationships from which to care for patients. Evidence supports, including empathy in nursing and healthcare education, but there is limited data on what methods are effective to do so. Building evidence supports experiential and interactive learning methods to be effective for students to gain insight and perspective from a personalized experience. The purpose of this project is to evaluate learning activities designed to promote the attainment of empathic behaviors across 5 levels of the nursing curriculum. Quantitative analysis will be conducted on data from pre and post-learning activities using the Toronto Empathy Questionnaire. The main hypothesis, that simulation learning activities will increase empathy, will be examined using a repeated measures Analysis of Variance (ANOVA) on Pre and Post Toronto Empathy Questionnaire scores for three simulation activities (Stroke, Poverty, Dementia). Pearson product-moment correlations will be conducted to examine the relationships between continuous demographic variables, such as age, credits earned, and years practicing, with the dependent variable of interest, Post Test Toronto Empathy Scores. Krippendorff’s method of content analysis will be conducted to identify the quantitative incidence of empathic responses. The researchers will use Colaizzi’s descriptive phenomenological method to describe the students’ simulation experience and understand its impact on caring and empathy behaviors employing bracketing to maintain objectivity. The results will be presented, answering multiple research questions. The discussion will be relevant to results and educational pedagogy in the nursing curriculum as they relate to the attainment of empathic behaviors.

Keywords: curriculum, empathy, nursing, simulation

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Authors: Olga Muries-Cantan, Alice Schippers, Climent Gine, Noelle van den Heuvel

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A systematic review of the literature about the quality of life perceptions of siblings of people with intellectual and developmental disabilities (ID/DD) has shown differences and similarities among siblings’ perceptions around the world. Some of these differences might be explained by the influence of cultural and religious backgrounds on siblings’ quality of life through values, beliefs, and perceptions of ‘normalcy’ and stigma. The main goal of the multiple case study that we present, is to explore the quality of life perceptions of two adolescent siblings of individuals with ID/DD in order to identify the role cultural influence has played in their perceptions of quality of life. Two siblings from different European regions will participate in the study: one from a Southern European country (Spain) and the other one from a Western European country (The Netherlands). Taking a cross-cultural perspective, concepts such as values, cultural beliefs regarding disability, expectations, identity, supports, desires, and sibling relationships, will be discussed in a semi-structured interview with each sibling. Data will be analysed following an interpretative phenomenological analysis (IPA). It is expected that findings will show the particularities of the experience of having a brother or a sister with ID/DD and the singular influence of the culture on siblings’ perceptions of quality of life. The results of this study will help to spread awareness around the necessity that researchers, practitioners, and policymakers take into account the cultural background of the individuals in order to provide them with better services and support. In this line, more culturally situated research is required to enlarge the knowledge in this field.

Keywords: culture, intellectual disability, quality of life, siblings

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Authors: Mannan Mridha, Usama Gazay, Kosovare V. Aslani, Hugo Linder, Alice Ravizza, Carmelo de Maria

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In most developing countries, although the vast majority of the people are living in the rural areas, the qualified medical doctors are not available there. Health care workers and paramedics, called village doctors, informal healthcare providers, are largely responsible for the rural medical care. Mishaps due to wrong diagnosis and inappropriate medication have been causing serious suffering that is preventable. While innovators have created many devices, the vast majority of these technologies do not find applications to address the needs and conditions in low-resource settings. The primary motive is to address the acute lack of affordable medical technologies for the poor people in low-resource settings. A low cost smart medical device that is portable, battery operated and can be used at any point of care has been developed to detect breathing rate, electrocardiogram (ECG) and arterial pulse rate to improve diagnosis and monitoring of patients and thus improve care and safety. This simple and easy to use smart medical device can be used, managed and maintained effectively and safely by any health worker with some training. In order to empower the health workers and village doctors, our device is being further developed to integrate with ICT tools like smart phones and connect to the medical experts wherever available, to manage the serious health problems.

Keywords: e-health for low resources settings, health awareness education, improve patient care and safety, smart and affordable medical device

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Authors: Abiodun Ezekiel Adesina, Alice M. Olagunju

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This study determined the effects of Computer Assisted Instructions (CAI) and Academic Self-Concepts (ASC) on pre-service teachers’ achievement in AE concepts in CoE in Southwest, Nigeria. The study adopted pretest-posttest, control group, quasi-experimental design. Six CoE with e-library facilities were purposively selected. Two hundred and thirty-two intact 200 level Agricultural education students offering introduction to AE course across the six CoE were participants. The participants were assigned to three groups (D&PM, 77, TM, 73 and control, 82). Treatment lasted eight weeks. The AE achievement test (r=0.76), pre-service teachers’ ASC Scale (r=0.81); instructional guides for tutorial (r=0.76), drill and practice (r=0.81) and conventional lecture modes (r=0.83), and teacher performance assessment sheet were used for data collection. Data were analysed using analysis of covariance and Scheffe post-hoc at 0.05 level of significance. The participants were 55.6% female with mean age of 20.8 years. Treatment had significant main effects on pre-service teachers’ achievement (F(2,207)=60.52; η²=0.21; p < 0.05). Participants in D&PM (x̄ =27.83) had the best achievement compared to those in TM (x̄ =25.41) and control (x̄ =18.64) groups. ASC had significant main effect on pre-service teachers’ achievement (F(1,207)=22.011; η²=0.166; p < 0.05). Participants with high ASC (x̄ =27.52) had better achievement compared to those with low ASC (x̄ =22.37). The drill and practice and tutorial instructional modes enhanced students’ achievement in Agricultural Economics concepts. Therefore, the two instructional modes should be adopted for improved learning outcomes in agricultural economics concepts among pre-service teachers.

Keywords: achievement in agricultural economics concepts, colleges of education in southwestern Nigeria, computer-assisted instruction, drill and practice instructional mode, tutorial instructional mode

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Authors: Joselyne Rugema, Innocent Twagirayezu, Aimable Nkurunziza, Alice Nyirazigama, Vedaste Bagweneza, Belancilla Nikuze

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Introduction: Burn injuries among children are associated with major complications. Early health care seeking and appropriate management are crucial in saving lives and preventing complications. Objective: To assess home-based management practices and health seeking behaviors among caregivers of children admitted with burn injuries at selected hospitals in Rwanda. Methods: A cross-sectional descriptive study was conducted among caregivers of children admitted with burn injuries at three hospitals in Kigali. A semi-structured questionnaire was used to collect the data that were analyzed using SPSS version 25. Statistical software Results: Most of the children with burn injuries had median age of 36 months, and 89.9% had second-degree burns. 92.4% of burns happened at home and 63.3% were scalds. Only 18% of the caregivers seek care immediately after children’s burn injuries. About 2.5% reported not seeking any care after burn injuries and 3.8% sought care from traditional healers. 65.9% of the participants used wrong practices before seeking care such as applying honey, cooking oil and urine to the burn injuries. Transportation difficulties before consulting health facilities were the main reported faced barriers to success health care (86.1%). Conclusion: Immediate health seeking behavior was low. Wrong practices including application of harmful products to burn injuries are common in the community. There is a need for community based interventions to prevent burn injuries at home and to empower the community with appropriate actions to take after injuries.

Keywords: adolescent pregnancy, qualitative design, childbearing, teenage mothers

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Authors: Tony Jehi, Sujatha Rajaram, Nader majzoub, Joan Sabate

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Aging significantly increases the incidence of various cardiometabolic diseases, including cardiovascular disease (CVD). To combat CVD and its associated risk factors, it is imperative to adopt a healthy dietary pattern that is rife with beneficial nutrient and non-nutrient compounds. Unsaturated fats, specifically n-3 polyunsaturated fatty acids (n-3 PUFA), have cardio-protective effects; the opposite is true for saturated fatty acids. What role, if any, does the biomarker of fatty acid intake (specific fatty acids in the erythrocyte) play in predicting cardiometabolic risk among the elderly, a population highly susceptible to increased mortality and morbidity from CVD risk factors, remains unclear. This was a secondary analysis of the Walnuts and Healthy Aging Study. Briefly, elderly (n=192, mean age 69 y) participants followed their usual diet and were randomized into two groups to either eat walnuts daily or abstain from eating walnuts for a period of 2 years. The purpose was to identify potential associations between erythrocyte membrane fatty acids and cardiometabolic risk factors (body weight, blood pressure, blood lipids, and fasting glucose). Erythrocyte n-3 PUFA were inversely associated with total cholesterol (ß = -3.83; p= 0.02), triglycerides (ß = -7.66; p= <0.01), and fasting glucose (ß = -0.19; p=0.03). Specifically, erythrocyte ALA (ß= -1.59; P = 0.04) and DPA (ß= -0.62; P=0.04) were inversely associated with diastolic blood pressure and fasting glucose, respectively. N-6 PUFAs were positively associated with systolic blood pressure (ß=1.10; P=0.02). Mono-unsaturated fatty acids were positively associated with TAG (ß = 4.16; P=0.03). Total saturated fatty acids were not associated with any cardiometabolic risk factors. No association was found between any erythrocyte fatty acid and body weight. In conclusion, erythrocyte n-3 PUFA may be used as a biomarker to predict the cardiometabolic risk among healthy elders, providing support for the American Heart Association guidelines for including n-3 PUFA for preventing CVD.

Keywords: cardiometabolic diseases, erythrocyte fatty acids, elderly, n-3 PUFA

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Authors: Alice Morenike Olagunju, Olufemi A. Fakolade, Abiodun Ezekiel Adesina, Olufemi Akinloye Bolaji, Oriyomi Rabiu

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The use of computer-assisted instruction(CAI) has been suggested as a way out of the problem of Colleges of Education (CoE) in Southwest, Nigeria persistent high failure rate in and negative attitude towards Agricultural Economics (AE).The impacts of this are yet unascertained on high-flyers. This study, therefore, determined the impacts of CAI onhigh-flyers pre-service teachers’ attitude towards AE concepts in Southwest, Nigeria. The study adopted pretest-posttest, control group, quasi-experimental design. Six CoE with e-library facilities were purposively selected. Fourty-nine 200 level Agricultural education students offering introduction to AE course across the six CoE were participants. The participants were assigned to two groups (CAI, 22 and control, 27). Treatment lasted eight weeks. The AE Attitude Scale(r=0.80), Instructional guides and Teacher Performance Assessment Sheets were used for data collection. Data were analysed using t-test. The participants were 62.8% male with mean age of 22 years. Treatment had significant effects on high-flyers pre-service teachers’ attitude (t = 17.44; df = 47, p < .5). Participants in CAI ( =71.03) had higher post attitude mean score compared to those in control ( = 64.92) groups. Gender had no significant effect on attitude (t= 3.06; df= 47, p > .5). The computer assisted instructional mode enhanced students’ attitude towards Agricultural Economics concepts. Therefore, CAI should be adopted for improved attitude towards agricultural economics concepts among high-flyers pre-service teachers.

Keywords: attitude towards agricultural economics concepts, colleges of education in southwest Nigeria, computer-assisted instruction, high-flyers pre-service teachers

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Authors: Bhogendra Mishra, Andy Nelson, Mirco Boschetti, Lorenzo Busetto, Alice Laborte

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Rice is grown on over 100 million hectares in almost every country of Asia. It is the most important staple crop for food security and has high economic and cultural importance in Asian societies. The combination of genetic diversity and management options, coupled with the large geographic extent means that there is a large variation in seasonality (when it is grown) and cropping intensity (how often it is grown per year on the same plot of land), even over relatively small distances. Seasonality and intensity can and do change over time depending on climatic, environmental and economic factors. Detecting where and when these changes happen can provide information to better understand trends in regional and even global rice production. Remote sensing offers a unique opportunity to estimate these trends. We apply the recently published PhenoRice algorithm to 14 years of moderate resolution remote sensing (MODIS) data (utilizing 250m resolution 16 day composites from Terra and Aqua) to estimate seasonality and cropping intensity per year and changes over time. We compare the results to the surveyed data collected by International Rice Research Institute (IRRI). The study results in a unique and validated dataset on the extent and change of extent, the seasonality and change in seasonality and the cropping intensity and change in cropping intensity between 2003 and 2016 for the Philippines. Observed trends and their implications for food security and trade policies are also discussed.

Keywords: rice, cropping intensity, moderate resolution remote sensing (MODIS), phenology, seasonality

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Authors: Ariadna Manresa, Ines Ferrer

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Introduction: Ultrasonic moulding process (USM) is a recent injection technology used to manufacture micro components. It is able to melt small amounts of material so the waste of material is certainly reduced comparing to microinjection molding. This is an important advantage when the materials are expensive like medical biopolymers. Micro-scaled components are involved in a variety of uses, such as biomedical applications. It is required replication fidelity so it is important to stabilize the process and minimize the variability of the responses. The aim of this research is to investigate the influence of the main process parameters on the filling behaviour, the dimensional accuracy and the cavity pressure when a micro-plate is manufactured by biomaterials such as PLA and PCL. Methodology or Experimental Procedure: The specimens are manufactured using a Sonorus 1G Ultrasound Micro Molding Machine. The used geometry is a rectangular micro-plate of 15x5mm and 1mm of thickness. The materials used for the investigation are PLA and PCL due to biocompatible and degradation properties. The experimentation is divided into two phases. Firstly, the influence of process parameters (vibration amplitude, sonotrodo velocity, ultrasound time and compaction force) on filling behavior is analysed, in Phase 1. Next, when filling cavity is assured, the influence of both cooling time and force compaction on the cavity pressure, part temperature and dimensional accuracy is instigated, which is done in Phase. Results and Discussion: Filling behavior depends on sonotrodo velocity and vibration amplitude. When the ultrasonic time is higher, more ultrasonic energy is applied and the polymer temperature increases. Depending on the cooling time, it is possible that when mold is opened, the micro-plate temperature is too warm. Consequently, the polymer relieve its stored internal energy (ultrasonic and thermal) expanding through the easier direction. This fact is reflected on dimensional accuracy, causing micro-plates thicker than the mold. It has also been observed the most important fact that affects cavity pressure is the compaction configuration during the manufacturing cycle. Conclusions: This research demonstrated the influence of process parameters on the final micro-plated manufactured. Future works will be focused in manufacturing other geometries and analysing the mechanical properties of the specimens.

Keywords: biomaterial, biopolymer, micro injection molding, ultrasound

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Authors: Medagedara Kaushalya Sewwandi Supun Gunarathne

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This research explores the underlying motivations and consequences of individuals changing their sexual orientation as a response to sexual violence. The primary objective of the study is to unravel the psychological, emotional, and social factors that drive individuals, akin to Celie in Alice Walker’s ‘The Color Purple’, to contemplate and undergo changes in their sexual orientation following the trauma of sexual violence. Through an analytical and qualitative approach, the study employs in-depth textual and thematic analyses to scrutinize the complex interplay between sexual orientation and violence within the selected text. Through a close examination of Celie’s journey and experiences, the study reveals that her decision to switch sexual orientation arises from a desire for a more favorable and benevolent relationship driven by the absence of safety and refuge in her previous relationships. By establishing this bond between sexual orientation and violence, the research underscores how sexual violence can lead individuals to opt for a change in their sexual orientation. The findings highlight Celie’s transformation as a means to seek solace and security, thus concluding that sexual violence can prompt individuals to alter their sexual orientation. The ensuing discussion explores the implications of these findings, encompassing psychological, emotional, and social consequences, as well as the societal and cultural factors influencing the perception of sexual orientation. Additionally, it sheds light on the challenges and stigma faced by those who undergo such transformations. By comprehending the complex relationship between sexual violence and the decision to change sexual orientation, as exemplified by Celie in ‘The Color Purple’, a deeper understanding of the experiences of survivors who seek a safe haven through altering their sexual orientation can be attained.

Keywords: sexual violence, sexual orientation, refuge, transition

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Authors: Joan Edwards, J. Lawlor

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Technological innovation is frequently defined in terms of bringing a new invention to market through a relatively straightforward process of diffusion. In reality, this process is complex and non-linear in nature, and includes social and cognitive factors that influence the development of an emerging technology and its related market or environment. As recent studies contend technological trajectory is part of technological paradigms, which arise from the expectations and desires of industry agents and results in co-evolution, it may be realised that social factors play a major role in the development of a technology. It is conjectured that collective social behaviour is fuelled by individual motivations and expectations, which inform the possibilities and uses for a new technology. The individual outlook highlights the issues present at the micro-level of developing a technology. Accordingly, this may be zoomed out to realise how these embedded social structures, influence activities and expectations at a macro level and can ultimately strategically shape the development and use of a technology. These social factors rely on communication to foster the innovation process. As innovation may be defined as the implementation of inventions, technological change results from the complex interactions and feedback occurring within an extended environment. The framework presented in this paper, recognises that social mechanisms provide the basis for an iterative dialogue between an innovator, a new technology, and an environment - within which social and cognitive ‘identity-shaping’ elements of the innovation process occur. Identity-shaping characteristics indicate that an emerging technology has a performative nature that transforms, alters, and ultimately configures the environment to which it joins. This identity–shaping quality is termed as ‘performative’. This paper examines how technologies evolve within a socio-technological sphere and how 'performativity' facilitates the process. A framework is proposed that incorporates the performative elements which are identified as feedback, iteration, routine, expectations, and motivations. Additionally, the concept of affordances is employed to determine how the role of the innovator and technology change over time - constituting a more conducive environment for successful innovation.

Keywords: affordances, framework, performativity, strategic innovation

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Authors: Steeve Mercier, Joan Netten, Olivier Massé

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The traditional lack of success of most Canadian students in the regular French program in attaining the ability to communicate spontaneously led to the conceptualization of a modified program. This program, called Intensive French, introduced and evaluated as an experiment in several school districts, formed the basis for the creation of a more effective approach for the development of skills in a second/foreign language and literacy: the Neurolinguistic Approach (NLA).The NLA expresses the major change in the understanding of how communication skills are developed: learning to communicate spontaneously in a second language depends on the reuse of structures in a variety of cognitive situations to express authentic messages rather than on knowledge of the way a language functions. Put differently, it prioritises the acquisition of implicit competence over the learning of grammatical knowledge. This is achieved by the adoption of a literacy-based approach and an increase in intensity of instruction.Besides having strong support empirically from numerous experiments, the NLA has sound theoretical foundation, as it conforms to research in neurolinguistics. The five pedagogical principles that define the approach will be explained, as well as the differences between the NLA and the paradigm on which most current resources and teaching strategies are based. It is now 25 years since the original research occurred. The use of the NLA, as it will be shown, has expanded widely. With some adaptations, it is used for other languages and in other milieus. In Canada, classes are offered in mandarin, Ukrainian, Spanish and Arabic, amongst others. It has also been used in several indigenous communities, such as to restore the use of Mohawk, Cri and Dene. Its use has expanded throughout the world, as in China, Japan, France, Germany, Belgium, Poland, Russia, as well as Mexico. The Intensive French program originally focussed on students in grades 5 or 6 (ages 10 -12); nowadays, the programs based on the approach include adults, particularly immigrants entering new countries. With the increasing interest in inclusion and cultural diversity, there is a demand for language learning amongst pre-school and primary children that can be successfully addressed by the NLA. Other current experiments target trilingual schools and work with Inuit communities of Nunavik in the province of Quebec.

Keywords: neuroeducation, neurolinguistic approach, literacy, second language acquisition, plurilingualism, foreign language teaching and learning

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Authors: V. Samulionis, J. Banys, A. Sánchez-Ferrer

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Inorganic nanoparticles are used for fabrication of various composites based on polymer materials because they exhibit a good homogeneity and solubility of the composite material. Multifunctional materials based on composites of a polymer containing inorganic nanotubes are expected to have a great impact on industrial applications in the future. An emerging family of such composites are polyurea elastomers with inorganic MoS2 nanotubes or MoSI nanowires. Polyurea elastomers are a new kind of materials with higher performance than polyurethanes. The improvement of mechanical, chemical and thermal properties is due to the presence of hydrogen bonds between the urea motives which can be erased at high temperature softening the elastomeric network. Such materials are the combination of amorphous polymers above glass transition and crosslinkers which keep the chains into a single macromolecule. Polyurea exhibits a phase separated structure with rigid urea domains (hard domains) embedded in a matrix of flexible polymer chains (soft domains). The elastic properties of polyurea can be tuned over a broad range by varying the molecular weight of the components, the relative amount of hard and soft domains, and concentration of nanoparticles. Ultrasonic methods as non-destructive techniques can be used for elastomer composites characterization. In this manner, we have studied the temperature dependencies of the longitudinal ultrasonic velocity and ultrasonic attenuation of these new polyurea elastomers and composites with inorganic nanoparticles. It was shown that in these polyurea elastomers large ultrasonic attenuation peak and corresponding velocity dispersion exists at 10 MHz frequency below room temperature and this behaviour is related to glass transition Tg of the soft segments in the polymer matrix. The relaxation parameters and Tg depend on the segmental molecular weight of the polymer chains between crosslinking points, the nature of the crosslinkers in the network and content of MoS2 nanotubes or MoSI nanowires. The increase of ultrasonic velocity in composites modified by nanoparticles has been observed, showing the reinforcement of the elastomer. In semicrystalline polyurea elastomer matrices, above glass transition, the first order phase transition from quasi-crystalline to the amorphous state has been observed. In this case, the sharp ultrasonic velocity and attenuation anomalies were observed near the transition temperature TC. Ultrasonic attenuation maximum related to glass transition was reduced in quasicrystalline polyureas indicating less influence of soft domains below TC. The first order phase transition in semicrystalline polyurea elastomer samples has large temperature hysteresis (> 10 K). The impact of inorganic MoS2 nanotubes resulted in the decrease of the first order phase transition temperature in semicrystalline composites.

Keywords: inorganic nanotubes, polyurea elastomer composites, ultrasonic velocity, ultrasonic attenuation

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Authors: Yu-Tzu Hsu, Alice Wu, Hsiang-Kuang Tseng

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Introduction: Hepatitis A virus causes acute hepatitis and is usually transmitted by a fecal-oral route of food contamination, which is more prevalent in areas with poor hygienic practices. However, we described a hepatitis A outbreak associated with a fecal-oral route of sexual behavior in men who has sex with men (MSM) in Northern Taiwan. Methods: We retrospectively collected patients with acute HAV infection in MacKay Memorial Hospital, Taipei, Taiwan between July 2015 and November 2016. Demographic data (age, gender, onset time and infection risk), laboratory data (GOT, GPT, bilirubin, HIV status, HBsAg, HCV antibody and syphilis), clinical symptoms and travel history with a foreign tour were analyzed. We compared variables between HIV and non-HIV group. Unless otherwise stated, continuous variables were expressed as mean ± SD, and categorical variables were expressed as number (percentage) for each item. The t test for continuous variables was applied for the comparison between two groups and chi-square for categorical variables were applied for measures of association. Results: We collected 80 cases during the study period. Among them, 54 (67.5%) cases were MSM and 43 (53.8%) cases were HIV positive. The average age was 32.6±7.59 years-old. The average value of initial liver function was 1324 IU/L for AST (GOT), 2100 IU/L for ALT (GPT), and 5.82 mg/dL for bilirubin. We found seven (8.6%) cases were in the status of HBV carrier, five (6.3%) cases were positive for HCV antibody, and 15 (18.6%) cases were co-infected with syphilis. With regards to associated symptoms, 32 (40%) had fever, 46 (57.5%) had nausea, 34 (42.5%) had abdominal discomfort and 46 (57.5%) had general malaise. To compare the non-HIV patients with HIV patients, HIV patients were more likely to be male (p=0.008), MSM (p=0.000), co-infected syphilis (p=0.000) and slowly improving liver function of transaminases (p=0.033, 0.027). Conclusion: The HAV outbreak in Northern Taiwan was mainly occurred in MSM population. Hereafter, our cohort data support a policy in Taiwan to provide one dose of free HAV vaccine shot in this population. Hopefully, the outbreak could be stop by the free vaccine policy and public education.

Keywords: acute hepatitis A, men who has sex with men, human immunodeficiency virus, vaccine

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Authors: Jackie Oakley, Alice V. Brown

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Those experiencing homelessness are regularly excluded from the development of policies and services that impact their lives. This is particularly true for Aboriginal and Torres Strait Islander people experiencing homelessness in Australia, who tend to have differing needs, cultural obligations, and views of what equates to a ‘home’ and ‘homelessness’ than non-Aboriginal Australians. Aboriginal people are the traditional owners of Australia yet have had to survive within colonial housing customs, housing and homelessness policies, and markets that often conflict with their culture. Recognising this, in 2022, we commenced community-led research into the needs of Aboriginal people experiencing homelessness in Perth. Historically, research has often been done on Aboriginal people rather than with them. As such, a Participatory Action Research methodology was chosen, which recognises that those being researched are the experts of their circumstances rather than the research team, and facilitates their driving of the research, its questions, and how their community can directly benefit. A Community Ownership Group (COG) was formed to guide this process and negotiate the best ways that the Aboriginal community can be fairly and adequately involved. The COG approved a process developed by an Aboriginal Elder called Ngala Kadidjiny (Knowledge Vault), which outlines who and when various groups should be consulted throughout the research to ensure adequate involvement of the Aboriginal community at all stages. The process includes many markers of research integrity, including ensuring a Community Ownership Group is formed with diversity and recruiting its members through votes taking place within Elders groups across the metropolitan area. The process also demands that the community have the chance to review research findings before any findings are published. Additionally, the process asks that draft reports and findings are delivered to the broader community and Community Ownership Groups before being finalised, published, and shared officially with stakeholders and the government. This paper details how Ngala Kadidjiny’s process impacted the research, how it was explained and agreed upon by the Aboriginal community, the benefits and challenges of such a process, and its implications for other community-led research for and with Aboriginal people experiencing homelessness.

Keywords: Aboriginal and Torres Strait Islander peoples, Aboriginal elders, homelessness, community-led research, community consultation

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Authors: Pierluigi Tosi, Ed de Jong, Gerard van Klink, Luc Vincent, Alice Mija

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During the last decades renewable and low-cost resources have attracted increasingly interest. Carbohydrates can be derived by lignocellulosic biomasses, which is an attractive option since they represent the most abundant carbon source available in nature. Carbohydrates can be converted in a plethora of industrially relevant compounds, such as 5-hydroxymethylfurfural (HMF) and levulinic acid (LA), within acid catalyzed dehydration of sugars with mineral acids. Unfortunately, these acid catalyzed conversions suffer of the unavoidable formation of highly viscous heterogeneous poly-disperse carbon based materials known as humins. This black colored low value by-product is made by a complex mixture of macromolecules built by covalent random condensations of the several compounds present during the acid catalyzed conversion. Humins molecular structure is still under investigation but seems based on furanic rings network linked by aliphatic chains and decorated by several reactive moieties (ketones, aldehydes, hydroxyls, …). Despite decades of research, currently there is no way to avoid humins formation. The key parameter for enhance the economic viability of carbohydrate conversion processes is, therefore, increasing the economic value of the humins by-product. Herein are presented new humins based polymeric materials that can be prepared starting from the raw by-product by thermal treatment, without any step of purification or pretreatment. Humins foams can be produced with the control of reaction key parameters, obtaining polymeric porous materials with designed porosity, density, thermal and electrical conductivity, chemical and electrical stability, carbon amount and mechanical properties. Physico chemical properties can be enhanced by modifications on the starting raw material or adding different species during the polymerization. A comparisons on the properties of different compositions will be presented, along with tested applications. The authors gratefully acknowledge the European Community for financial support through Marie-Curie H2020-MSCA-ITN-2015 "HUGS" Project.

Keywords: by-product, humins, polymers, valorization

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Authors: Xiao Chen, Alice Ho, Mabel Tie, Xiaoheng Xu

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Background and Significance of the Study: School-enterprise cooperation has been the cornerstone of vocational education in China and many other countries. Researchers and policymakers have paid much attention to ensuring the implementation and improving the quality of school-enterprise cooperation. However, many problems still exist on the implementation level of the cooperation. On the one hand, the enterprises lack the motivation to participate in the cooperation. On the other hand, there is a lack of effective guidance and management during the cooperation. Furthermore, the current literature focuses greatly on policy recommendations on the national level while failing to provide a detailed practical understanding of how school-enterprise cooperation is carried out on the ground level. With emerging social problems, such as the aging population in China, there is an increasing need for diverse nursing services and better nursing quality. Methodology: To gain a deeper understanding of the influencing factors of the implementation of school-enterprise cooperation, this work conducted 37 exploratory interviews in four Chinese cities spanning first-tier to fourth-tier cities with hospital department directors, vocational school deans, nurses, and vocational students. Multiple critical policy documents that founded the current vocational education system in China were analyzed, along with the data collected from the interviews. Major Findings: Based on the policy and interview analyses, this work reveals a set of influencing factors for school-enterprise cooperation implementation. Findings from each region contribute to an overall model of influencing factors for implementing school-enterprise cooperation in vocational nursing education in China, which leads to practical insights for policy recommendation. The key influencing factors are found based on the policy, hospital, school, and social levels. Following practical policy recommendations were presented. Moving forward, further research on the implementation of school-enterprise cooperation in specific industries will become increasingly critical to improving the effectiveness of educational policies and the quality of vocational education.

Keywords: nursing, policy recommendation, school-enterprise cooperation, vocational education

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Authors: Alexi Colleen F. Lim, Inna Felicia I. Agoncillo, Quenniejoy T. Dizon, Jennifer Joyce T. Eti, Carlota Aileen H. Monares, Neil Roy B. Rosales, Joshua F. Santillan, Alyssa Francesca D. S. Tanchuling, Josefina A. Tuazon, Mary Joan Therese C. Valera-Kourdache

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Majority of leading causes of mortality in the Philippines are NCDs, which are preventable through control of known risk factors such as smoking, obesity, physical inactivity, and alcohol. Sugar-sweetened beverages such as soda and energy drinks also contribute to NCD risk and are of concern particularly for youth. This study provides baseline data on beverage consumption of university students in Manila with the focus on alcohol and soda. It further aims to identify factors affecting consumption. Specific objectives include: (1) to describe beverage consumption practices of university students in Manila; and (2) to determine factors promoting excessive consumption of alcohol and soda including demographic characteristics, attitude, interpersonal and environmental variables. Methods: The study employed correlational design with randomly selected students from two universities in Manila. Students 18 years or older who agreed to participate were included after obtaining ethical clearance. The study had two instruments: (1) World Health Organization’s Alcohol Use Disorders Identification Test (AUDIT) was used with permission, to determine excessive alcohol consumption; and (2) a questionnaire to obtain information regarding soda and energy drink consumption. Results: Out of 400 students surveyed, 70% were female and 78.75% were 18-20 years old (mean=19.79; SD=3.76). Among them, 51.50% consumed alcohol, with 30.10% excessive drinkers. Soda consumption is 91.50% with 37.70% excessive consumers. For energy drinks, 36.75% consume this and only 4.76% drink excessively. Using logistic regression, students who were more likely to be excessive alcohol drinkers belonged to non-health courses (OR=2.21) and purchased alcohol from bars (OR=7.84). Less likely to drink excessively are students who do not drink due to stress (OR=0.05) and drink when it is accessible (OR=0.02). Excessive soda consumption was less likely for female students (OR=0.28), those who drink when it is accessible (OR=0.14), do not drink soda during stressful situations (OR=0.19), and do not use soda as hangover treatment (OR=0.15). Conclusion: Excessive alcohol consumption was greater among students in Manila (30.10%) than in US (20%). Drinking alcohol with friends was not related to excessive consumption but availability in bars was. It is expected that health sciences students are less likely to engage in excessive alcohol as they are more aware of its ill effects. Prevalence of soda consumption in Manila (91.50%) is markedly higher compared to 24.5% in the US. These findings can inform schools in developing appropriate health education interventions and policies. For greater understanding of these behaviors and factors, further studies are recommended to explore knowledge and other factors that may promote excessive consumption.

Keywords: alcohol consumption, beverage consumption, energy drinks consumption, soda consumption, university students

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Authors: Lingling Li, Peng Zhao, Runze Guan, Alice Jones, Tao Yu

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Background: Shoulder pain and weakness are associated with complex pathologies and often precludes weightlifters from participation in training. The role and mode of exercise training in weightlifters with shoulder pathology remains unclear. Objectives: This case report described an exercise program in management of an elite weightlifter with primary complaint of right shoulder pain and weakness. Methods: A 22-year-old weightlifter presented with 2-year duration of right shoulder pain and weakness which was worsened by routine weightlifting training, and symptoms were not relieved with steroid injection, manual therapy nor usual physiotherapy. There was a limitation in all active range of motion especially horizontal extension (13ᵒ) and external rotation (41ᵒ) with pain intensity at 4/10 and 10/10 (numeric pain rating score) respectively. Muscle weakness was most significant at supraspinatus and teres minor, 38% and 27% respectively compared to his left shoulder (hand-held dynamometry, Micro FET2). An exercise training program focusing on improving mobility was designed for this athlete following a comprehensive physical assessment. Exercises included specific stretching, muscle activating and scapular stability training; once per day, and for 60 minutes each session. All exercises were completed under instruction as pain allowed. Quantitative assessment was conducted at the end of each week for 3 weeks. Outcomes: After the program, the athlete was pain-free in all movements except the O’Brien active compression internal rotation test, the pain was however reduced from 10/10 to 3/10. The horizontal extension and external rotation range increased to 79ᵒ to 120ᵒ respectively, and strength of all rotator cuff muscles returned to normal. At 1-month follow up, the athlete was totally pain-free and had returned to normal function and weightlifting training activities. The outcomes sustained through 6-month and one year. Conclusion: This case report supports the use of a mobility-focused exercise program for management of shoulder pain and weakness in an elite weightlifter athlete.

Keywords: exercise training, mobility, rehabilitation, shoulder pain, weightlifting

Procedia PDF Downloads 155

Authors: Einat Waizbard, Emilio Ferrer, Meghan Miller, Brianna Heath, Derek S. Andrews, Sally J. Rogers, Christine Wu Nordahl, Marjorie Solomon, David G. Amaral

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Background: Autism symptoms are comprised of social-communication deficits and restricted/repetitive behaviors (RRB). The severity of these symptoms can change during childhood, with differences between boys and girls. From the literature, it was found that young autistic girls show a stronger tendency to decrease and a weaker tendency to increase their overall autism symptom severity levels compared to young autistic boys. It is not clear, however, which symptoms are driving these sex differences across childhood. In the current study, we evaluated the trajectories of independent autism symptoms across childhood and compared the patterns of change in such symptoms between boys and girls. Method: The study included 183 children diagnosed with autism (55 girls) evaluated three times across childhood, at ages 3, 6 and 11. We analyzed 22 independent items from the Autism Diagnostic Observation Scheudule-2 (ADOS-2), the gold-standard assessment tool for autism symptoms, each item representing a specific autism symptom. First, we used latent growth curve models to estimate the trajectories for the 22 ADOS-2 items for each child in the study. Second, we extracted the factor scores representing the individual slopes for each ADOS-2 item (i.e., slope representing that child’s change in that specific item). Third, we used factor analysis to identify common patterns of change among the ADOS-2 items, separately for boys and girls, i.e., which autism symptoms tend to change together and which change independently across childhood. Results: The best-emerging patterns for both boys and girls identified four common factors: three factors representative of changes in social-communication symptoms and one factor describing changes in RRB. Boys and girls showed the same pattern of change in RRB, with four items (e.g., speech abnormalities) changing together across childhood and three items (e.g., mannerisms) changing independently of other items. For social-communication deficits in boys, three factors were identified: the first factor included six items representing initiating and engaging in social-communication (e.g., quality of social overtures, conversation), the second factor included five items describing responsive social-communication (e.g., response to name) and the third factor included three items related to different aspects of social-communication (e.g., level of language). Girls’ social-communications deficits also loaded onto three factors: the first factor included five items (e.g., unusual eye contact), the second factor included six items (e.g., quality of social response), and the third factor included four items (e.g., showing). Some items showed similar patterns of change for both sexes (e.g., responsive joint attention), while other items showed differences (e.g., shared enjoyment). Conclusions: Girls and boys had different patterns of change in autism symptom severity across childhood. For RRB, both sexes showed similar patterns. For social-communication symptoms, however, there were both similarities and differences between boys and girls in the way symptoms changed over time. The strongest patterns of change were identified for initiating and engaging in social communication for boys and responsive social communication for girls.

Keywords: autism spectrum disorder, autism symptom severity, symptom trajectories, sex differences

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Authors: Turki J. Alharbi, Jencia Wong, Dennis Yue, Tania P. Markovic, Julie Hetherington, Ted Wu, Belinda Brooks, Radhika Seimon, Alice Gibson, Stephanie L. Silviera, Amanda Sainsbury, Tanya J. Little

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Fasting has been practiced for centuries and is incorporated into the practices of different religions including Islam, whose followers intermittently fast throughout the month of Ramadan. Thus, Ramadan presents a unique model of prolonged intermittent fasting (IF). Despite a growing body of evidence for a cardio-metabolic and endocrine benefit of IF, detailed studies of the effects of IF on these indices in type 2 diabetes are scarce. We studied 5 subjects with type 2 diabetes (T2DM) and 7 healthy controls (C) at baseline (pre), and in the last week of Ramadan (post). Fasting circulating levels of glucose, HbA1c and lipids, as well as body composition (with DXA) and resting energy expenditure (REE) were measured. Plasma gut hormone levels and appetite responses to a mixed meal were also studied. Data are means±SEM. Ramadan decreased total fat mass (-907±92 g, p=0.001) and trunk fat (-778±190 g, p=0.014) in T2DM but not in controls, without any reductions in lean mass or REE. There was a trend towards a decline in plasma FFA in both groups. Ramadan had no effect on body weight, glycemia, blood pressure, or plasma lipids in either group. In T2DM only, the area under the curve for post-meal plasma ghrelin concentrations increased after Ramadan (pre:6632±1737 vs. post:9025±2518 pg/ml.min-1, p=0.045). Despite this increase in orexigenic ghrelin, subjective appetite scores were not altered by Ramadan. Meal-induced plasma concentrations of the satiety hormone pancreatic polypeptide did not change during Ramadan, but were higher in T2DM compared to controls (post: C: 23486±6677 vs. T2DM: 62193±6880 pg/ml.min-1, p=0.003. In conclusion, Ramadan, as a model for IF appears to have more favourable effects on body composition in T2DM, without adverse effects on metabolic control or subjective appetite. These data suggest that IF may be particularly beneficial in T2DM as a nutritional intervention. Larger studies are warranted.

Keywords: type 2 diabetes, obesity, intermittent fasting, appetite regulating hormones

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