Search results for: hypertension exercise

Authors: Angelis P. Barlampas

Abstract:

The purpose of this study is to inform the reader, about the various applications of artificial intelligence (AI), in cardiac imaging. AI grows fast and its role is crucial in medical specialties, which use large amounts of digital data, that are very difficult or even impossible to be managed by human beings and especially doctors.Artificial intelligence (AI) refers to the ability of computers to mimic human cognitive function, performing tasks such as learning, problem-solving, and autonomous decision making based on digital data. Whereas AI describes the concept of using computers to mimic human cognitive tasks, machine learning (ML) describes the category of algorithms that enable most current applications described as AI. Some of the current applications of AI in cardiac imaging are the follows: Ultrasound: Automated segmentation of cardiac chambers across five common views and consequently quantify chamber volumes/mass, ascertain ejection fraction and determine longitudinal strain through speckle tracking. Determine the severity of mitral regurgitation (accuracy > 99% for every degree of severity). Identify myocardial infarction. Distinguish between Athlete’s heart and hypertrophic cardiomyopathy, as well as restrictive cardiomyopathy and constrictive pericarditis. Predict all-cause mortality. CT Reduce radiation doses. Calculate the calcium score. Diagnose coronary artery disease (CAD). Predict all-cause 5-year mortality. Predict major cardiovascular events in patients with suspected CAD. MRI Segment of cardiac structures and infarct tissue. Calculate cardiac mass and function parameters. Distinguish between patients with myocardial infarction and control subjects. It could potentially reduce costs since it would preclude the need for gadolinium-enhanced CMR. Predict 4-year survival in patients with pulmonary hypertension. Nuclear Imaging Classify normal and abnormal myocardium in CAD. Detect locations with abnormal myocardium. Predict cardiac death. ML was comparable to or better than two experienced readers in predicting the need for revascularization. AI emerge as a helpful tool in cardiac imaging and for the doctors who can not manage the overall increasing demand, in examinations such as ultrasound, computed tomography, MRI, or nuclear imaging studies.

Keywords: artificial intelligence, cardiac imaging, ultrasound, MRI, CT, nuclear medicine

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Authors: Aijing Luo, Zirui Xin, Yifeng Yuan

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Background: With the rapid development of the online health community, more and more patients or families are seeking health information on the Internet. Objective: This study aimed to discuss how to fully reveal the health information needs expressed by hypertensive patients in their questions in the online environment. Methods: This study randomly selected 1,000 text records from the question data of hypertensive patients from 2008 to 2018 collected from the website www.haodf.com and constructed a classification system through literature research and content analysis. This paper identified the background characteristics and questioning the intention of each hypertensive patient based on the patient’s question and used co-occurrence network analysis to explore the features of the health information needs of hypertensive patients. Results: The classification system for health information needs of patients with hypertension is composed of 9 parts: 355 kinds of drugs, 395 kinds of symptoms and signs, 545 kinds of tests and examinations , 526 kinds of demographic data, 80 kinds of diseases, 37 kinds of risk factors, 43 kinds of emotions, 6 kinds of lifestyles, 49 kinds of questions. The characteristics of the explored online health information needs of the hypertensive patients include: i)more than 49% of patients describe the features such as drugs, symptoms and signs, tests and examinations, demographic data, diseases, etc. ii) these groups are most concerned about treatment (77.8%), followed by diagnosis (32.3%); iii) 65.8% of hypertensive patients will ask doctors online several questions at the same time. 28.3% of the patients are very concerned about how to adjust the medication, and they will ask other treatment-related questions at the same time, including drug side effects, whether to take drugs, how to treat a disease, etc.; secondly, 17.6% of the patients will consult the doctors online about the causes of the clinical findings, including the relationship between the clinical findings and a disease, the treatment of a disease, medication, and examinations. Conclusion: In the online environment, the health information needs expressed by Chinese hypertensive patients to doctors are personalized; that is, patients with different background features express their questioning intentions to doctors. The classification system constructed in this study can guide health information service providers in the construction of online health resources, to help solve the problem of information asymmetry in communication between doctors and patients.

Keywords: online health community, health information needs, hypertensive patients, doctor-patient communication

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Authors: Mahdi Eskandarlou, Mehrdad Taghipour

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Background: Partial-thickness skin graft is the cornerstone for scalp defect repair. Routine donor sites include abdomen, thighs, and buttocks. Given the potential side effects following harvesting from these sites and the potential advantages of harvesting from scalp (broad surface, rapid healing, and better cosmetics results), this study is trying to compare the outcomes of graft harvesting from scalp and lower limb. Methods: This clinical trial is conducted among a sample number of 40 partial thickness graft candidates (20 case and 20 control group) with scalp defect presenting to plastic surgery clinic at Besat Hospital during the time period between 2018 and 2019. Sampling was done by simple randomization using random digit table. Data gathering was performed using a designated checklist. The donor site in case group and control group was scalp and lower limb, respectively. The resultant data were analyzed using chi-squared and t-test and SPPS version 21 (SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp). Results: Of the total 40 patients participating in this study, 28 patients (70%) were male, and 12 (30%) were female with and mean age of 63.62 ± 09.73 years. Hypertension and diabetes mellitus were the most common comorbidities among patients with basal cell carcinoma (BCC) and trauma being the most common etiology for the defects. There was a statistically meaningful relationship between two groups regarding the etiology of defect (P=0.02). The most common anatomic location of defect for case and control groups was temporal and parietal, respectively. Most of the defects were deep to galea zone. The mean diameter of defect was 24.28 ± 45.37 mm for all of the patients. The difference between diameter of defect in both groups was statistically meaningful, while no such difference between graft diameter was seen. The graft 'Take' was completely successful in both groups according to evaluations. The level of postoperative pain was lower in the case group compared to the control according to VAS scale, and the satisfaction was higher in them per Likert scale. Conclusion: Scalp can safely be used as donor site for skin graft to be used for scalp defects, which is associated with better results and lower complication rates compared to other donor sites.

Keywords: donor site, leg, partial-thickness graft, scalp

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Authors: Nixon Kuruvila, H. V. Ravindra

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Wire-cut Electro Discharge Machining (WEDM) is a special form of conventional EDM process in which electrode is a continuously moving conductive wire. The present study aims at determining parametric influence and optimum process parameters of Wire-EDM using Taguchi’s Technique and Genetic algorithm. The variation of the performance parameters with machining parameters was mathematically modeled by Regression analysis method. The objective functions are Dimensional Accuracy (DA) and Material Removal Rate (MRR). Experiments were designed as per Taguchi’s L16 Orthogonal Array (OA) where in Pulse-on duration, Pulse-off duration, Current, Bed-speed and Flushing rate have been considered as the important input parameters. The matrix experiments were conducted for the material Oil Hardened Non Shrinking Steel (OHNS) having the thickness of 40 mm. The results of the study reveals that among the machining parameters it is preferable to go in for lower pulse-off duration for achieving over all good performance. Regarding MRR, OHNS is to be eroded with medium pulse-off duration and higher flush rate. Finally, the validation exercise performed with the optimum levels of the process parameters. The results confirm the efficiency of the approach employed for optimization of process parameters in this study.

Keywords: dimensional accuracy (DA), regression analysis (RA), Taguchi method (TM), volumetric material removal rate (VMRR)

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Authors: H. Alabed, K. Abuzayan. L. Fgie, K. Zarug

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Ramadan requires individuals to abstain from food and fluid intake between sunrise and sunset; physiological considerations predict that poorer mood, physical performance and mental performance will result. In addition, any difficulties will be worsened because preparations for fasting and recovery from it often mean that nocturnal sleep is decreased in length, and this independently affects mood and performance. A difficulty of interpretation in many studies is that the observed changes could be due to fasting but also to the decreased length of sleep and altered food and fluid intakes before and after the daytime fasting. These factors were separated in this study, which took place over three separate days and compared the effects of different durations of fasting (4, 8 or 16h) upon a wide variety of measures (including subjective and objective assessments of performance, body composition, dehydration and responses to a short bout of exercise) - but with an unchanged amount of nocturnal sleep, controlled supper the previous evening, controlled intakes at breakfast and daytime naps not being allowed. Many of the negative effects of fasting observed in previous studies were present in this experiment also. These findings indicate that fasting was responsible for many of the changes previously observed, though some effect of sleep loss, particularly if occurring on successive days (as would occur in Ramadan) cannot be excluded.

Keywords: drinking, eating, mental performance, physical performance, social activity, blood, sleepiness

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Authors: Paulino V. Tavares, Ana L. Romao

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Public governance represents an articulated arrangement, dynamic and interactive, present in the exercise of authority aimed at strengthening the decision-making procedure in public administration with transparency, accountability, responsiveness and capable of to emerge control and social empowerment, to pursue and achieve the objectives efficiently and with the effectiveness desired by the collective, respecting laws and providing social, institutional and economic equility in society. With this, using a multidimensional approach with the application of three questionnaires to a universe of twenty Counselors of the Courts of Auditors (Brazil), twenty professionals of public administration (Brazil), twenty Government/Provincial Counselors (South Africa), and twenty South African professionals of public administration, the present work aims to capture what is the perception about the efficiency and equility of public policies in Brazil and South Africa. With this, up until now, 30 responses have been obtained, and the results indicate that, in Brazil, 65% affirm due to the inefficiency of public policies, 70% point out that they do not believe in the equility of these same policies. In South Africa, the results indicate that 45% believe in government efficiency, and, with regard to the equility of public policies, 65% do not believe. In Brazil, the research reveals at least three reasons for this result, that is, lack of planning, lack of clear objectives of public policies, and lack of information on the part of society, while in South Africa, so far, research has not identified a specific reason for this result.

Keywords: efficiency, equility, governance, public policy

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Authors: Mary S. Ruppert-Stroescu, Minh Pham, Bruce Benjamin

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Sleep apnea is a condition where a person stops breathing and can lead to cardiovascular disease, hypertension, and stroke. In the United States, approximately forty percent of overnight sleep apnea detection tests are cancelled. The purpose of this study was to develop a textile-based sensing system that acquires biometric signals relevant to cardiovascular health, to transmit them wirelessly to a computer, and to quantitatively assess the signals for sleep apnea detection. Patient interviews, literature review and market analysis defined a need for a device that ubiquitously integrated into the patient’s lifestyle. A multi-disciplinary research team of biomedical scientists, apparel designers, and computer engineers collaborated to design a textile-based sensing system that gathers EKG, Sp02, and respiration, then wirelessly transmits the signals to a computer in real time. The electronic components were assembled from existing hardware, the Health Kit which came pre-set with EKG and Sp02 sensors. The respiration belt was purchased separately and its electronics were built and integrated into the Health Kit mother board. Analog ECG signals were amplified and transmitted to the Arduino™ board where the signal was converted from analog into digital. By using textile electrodes, ECG lead-II was collected, and it reflected the electrical activity of the heart. Signals were collected when the subject was in sitting position and at sampling rate of 250 Hz. Because sleep apnea most often occurs in people with obese body types, prototypes were developed for a man’s size medium, XL, and XXL. To test user acceptance and comfort, wear tests were performed on 12 subjects. Results of the wear tests indicate that the knit fabric and t-shirt-like design were acceptable from both lifestyle and comfort perspectives. The airflow signal and respiration signal sensors return good signals regardless of movement intensity. Future study includes reconfiguring the hardware to a smaller size, developing the same type of garment for the female body, and further enhancing the signal quality.

Keywords: sleep apnea, sensors, electronic textiles, wearables

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Authors: Mauricio Filho, Carina Castro

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The object of this project is to analyze long-time public agents that passed through several governments and see themselves in the position of having to deliberate with new agents, recently settled in the public administration. For theoretical ends, internal deliberation is understood as the one practiced on the public administration agencies, without any direct participation from the general public in the process. The assumption is: agents with longer periods of public service tend to step away from momentary political discussions that guide the current administration and seek to concentrate on institutionalized routines and procedures, making the most politically aligned individuals with the current government deliberate with less "passion" and more exchanging of knowledge and information. The theoretical framework of this research is institutionalism, which is guided by a more pragmatic view, facing the fluidity of reality in ways showing the multiple relations between agents and their respective institutions. The critical aspirations of this project rest on the works of professors Cass Sunstein, Adrian Vermeule, Philipp Pettit and in literature from both institutional theory and economic analysis of law, greatly influenced by the Chicago Law School. Methodologically, the paper is a theoretical review and pretends to be unfolded, in a future moment, in empirical tests for verification. This work has as its main analytical tool the appeal to theoretical and doctrinaire areas from the Juridical Sciences, by adopting the deductive and analytical method.

Keywords: institutions, state, law, agencies

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Authors: Asriana Issa Sofia, Retno Hendrowati, Dewi Kurniaty

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This study aims at analyzing the role of Corruption Eradication Commission in combating corruption cases including punishing high-profile corruptors and changing the culture of corruption in Indonesia by strengthening the relations with other agencies. Corruption Eradicating Commission was created in 2002 as Indonesia’s most trusted government institution as the anti-corruption agency that will exercise investigatory and prosecutorial power independently from the executive, legislature, and judiciary. The analysis of partnership addressed the role of collaboration with other institutions including Non-Government Organization, Youth Organization, Governmental Institution and Society. The collaboration is needed due to the limitations of Corruption Eradication Commission in preventing corruption. The collaboration focuses on the intensive communication, strengthening leadership, commitment, and creating trust. The research method used the qualitative study by employing the literature study and having a semi-structured interview with the key informant in Corruption Eradication Commission and its partners. The analysis found that intensive communication, leadership, communication, and creating trust were the important pillars in assisting Corruption Eradication Commission to prevent the incoming seed of corruption. The pillars will support the Indonesian Government to deliver better services for society.

Keywords: corruption, corruption eradicating commission, partnership, preventing actions

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Authors: H. Alabed, K. Abuzayan, J. Ezarrugh, S. Ali, M. Touba

Abstract:

Ramadan requires individuals to abstain from food and fluid intake between sunrise and sunset, Physiological considerations predict that poorer mood, Physical performance and mental performance will result. In addition, Any difficulties will be worsened because preparations for fasting and recovery from it often mean that nocturnal sleep is decreased in length and this independently affects mood and performance. A difficulty of interpretation in many studies is that the observed changes could be due to fasting but also to the decreased length of sleep and altered food and fluid intakes before and after the daytime fasting. These factors were separated in this study, Which took place over three separate days and compared the effects of different durations of fasting (4, 8 or 16 h) upon a wide variety of measures (including subjective and objective assessments of performance, body composition, Dehydration and responses to a short bout of exercise) but with an unchanged amount of nocturnal sleep, Controlled supper the previous evening, Controlled intakes at breakfast and daytime naps not being allowed. Many of the negative effects of fasting observed in previous studies were present in this experiment also. These findings indicate that fasting was responsible for many of the changes previously observed, Though some effect of sleep loss, Particularly if occurring on successive days (as would occur in Ramadan) cannot be excluded.

Keywords: Drinking, eating, mental performance, physical performance, social activity, blood, sleepiness

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Authors: Porntip Ruengtam

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This article is an extension of previous research presenting the relevant factors related to environmental perceptions, residential community, and the design of a healing environment, which have effects on the well-being and requirements of Thai elderly. Research methodology began with observations and interviews in three case studies in terms of the management processes and environment design of similar existing projects in Thailand. The interview results were taken to summarize with related theories and literature. A questionnaire survey was designed for data collection to confirm the factors of requirements in a residential community intended for the Thai elderly. A structural equation model (SEM) was formulated to explain the cause-effect factors for the requirements of a residential community for Thai elderly. The research revealed that the requirements of a residential community for Thai elderly were classified into three groups when utilizing a technique for exploratory factor analysis. The factors were comprised of (1) requirements for general facilities and activities, (2) requirements for facilities related to health and security, and (3) requirements for facilities related to physical exercise in the residential community. The results from the SEM showed the background of elderly people had a direct effect on their requirements for a residential community from various aspects. The results should lead to the formulation of policies for design and management of residential communities for the elderly in order to enhance quality of life as well as both the physical and mental health of the Thai elderly.

Keywords: elderly, environmental design, residential community, structural equation modeling

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Authors: Phan Hong, David Lishner, Matthew Hanson

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Sixty-five children across four school research sites participated in the present experiment, which was designed to examine whether mindfulness promotes eating enjoyment and diverse eating behaviors in preschool- and early elementary-age children. Children, ages 3-9 years old, were randomly assigned to a 4-week mindfulness intervention condition or a 4-week exposure, control condition. Each week for four days, children received one of four different foods (celery, cauliflower, kidney beans, or garbanzo beans). Children either received instructions to mindfully engage with the food or were given the food and allowed to eat without mindfulness prompts from the researchers. Following the eating exercise, they recorded the amount eaten and rated their enjoyment level. Across all sessions, researchers modeled eating behaviors for the children by eating all the offered food. Results suggested that a brief mindfulness intervention promoted more diverse eating behaviors and more overall food consumption of typically not preferred and unfamiliar foods (celery, cauliflower, and garbanzo beans), compared with an exposure, control condition in preschool children and elementary-age children. However, food enjoyment ratings did not significantly differ between the two conditions for any of the foods. Implications of the finding for addressing eating behavior of young children are considered.

Keywords: children, control trial, eating behavior, eating enjoyment, mindfulness, schools

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Authors: K. Thawichai, R. Pornthep

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This study examined the effects of ten basic exercises of Muay Thai Chaiya training for balance and strength in male older adults. Thirty male older adult volunteer from Thayang elderly clubs, Thayang, Petchaburi, Thailand. All participants were randomly assigned to two groups a training group and a control group. The training group (n=15) participated in eight week training program of ten basic exercises of Muay Thai Chaiya training and not to change or increase another exercise during of the study. In the control group, (n=15) did not participate in ten basic exercises of Muay Thai Chaiya training. Both groups were tested before and after eight weeks of the study period on balance in terms of single leg stance with eyes closed and strength in terms of the thirty second chair stand. The data of the study show that the participants of the training group perform significantly different higher scores in single leg stance with eyes closed and thirty second chair stand than the participants in the control group. The results of this study suggested that ten basic exercises of Muay Thai Chaiya training can use to improve balance and strength in male older adults.

Keywords: balance, strength, Muay Thai Chaiya, older adults

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Authors: Basma Hassabo, Sarah Ahmed, Aisha Hameed

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Aims and Objectives: To determine the incidence of maternal mortality amongst pregnant women with sickle cell disease (SCD) in the United Kingdom and to determine exact cause of death in these women. Background: SCD is caused by the ‘sickle’ gene and is characterized by episodes of severe bone pain and other complications like acute chest syndrome, chronic pulmonary hypertension, stroke, retinopathy, chronic renal failure, hepato-splenic crises, avascular bone necrosis, sepsis and leg ulcers. SCD is a continual cause of maternal mortality and fetal complications, and it comprises 1.5% of all Direct and Indirect deaths in the UK. Sepsis following premature rupture of membranes with ascending infection, post-partum infection and pre-labour overwhelming septic shock is one of its leading causes of death. Over the last fifty years of maternal mortality reports in UK, between 1 to 4 pregnant women died in each triennium. Material and Method: This is a retrospective study that involves pregnant women who died from SCD complications in the UK between 1952-2012. Data were collected from the UK Confidential Enquiries into Maternal Death and its causes between 1952–2012. Prior to 1985, exact cause of death in this cohort was not recorded. Results: 33 deaths reported between 1964 and 1984. 17 deaths were reported due to sickle cell disease between 1985 and 2012. Five women in this group died of sickle cell crisis, one woman had liver sequestration crisis, two women died of venous thromboembolism, two had myocardial fibrosis and three died of sepsis. Remaining women died of amniotic fluid embolism, SUDEP, myocardial ischemia and intracranial haemorrhage. Conclusion: The leading causes of death in sickle cell sick pregnant women are sickle cell crises, sepsis, venous thrombosis and thromboembolism. Prenatal care for women with SCD should be managed by a multidisciplinary team that includes an obstetrician, nutritionist, primary care physician, and haematologist. In every sick Sickle Cell woman Sickle Cell crises should be on the top of the list of differential diagnosis. Aggressive treatment of complications with low threshold to commence broad-spectrum antibiotics and LMWH contribute to better outcomes.

Keywords: incidence, maternal mortality, sickle cell disease (SCD), uk

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Authors: Wipakon Sonsnam, Kanya Napapongsa

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The quantitative aim of the study; 1) health conditions, to examine the state of health of the aging, 2) perceived of self-efficacy, self-care of aging ,3) perceived of social support of the aging, 4) to examine factors associated with self-efficacy in enhancing the health and self-care when illness. 100 samples selected from communities in Dusit, Bangkok, 2014 by random sampling. The questionnaires were used to collect data have 5-point rating scale, consisting of strongly agree, agree, undecided, disagree, and strongly disagree; approved content valid by 3 experts, reliability coefficients alpha was .784 for perceived of self-efficacy, self-care of aging and .827 for perceived of social support of the aging. ST-5, 2Q used for collect mental health. The ability to engage in a daily routine was collected by Barthel ADL index. Founding, the sample group were female (68%). (33%) of them were in the age of 60-65. Most of them were married and still live with their spouse (55%) and do not work (38%). The average annual income was less than 10,000 baht supported by child. Most people think that income was adequate (49.0%) and Satisfaction (61.0%). Most of aging caring them-self, followed by them spouse (26%). Welfare of the public had supported, living for the aging (100%), followed by Join and health volunteers in communities (23%). In terms of health, (53%) of the sample group feels health was fair, hypertension was the most common health condition among sample group (68%), following by diabetes (55%). About eyesight, (42%) have visual acuity. (59.0%) do not need hearing aids. 84% have more than 20 teeth remaining, and have no problem with chewing (61%). In terms of Ability to engage in a daily routine, most of people (84%) in sample group are in type 1. (91%) of the participants don’t have bladder incontinence. For mental condition, (82%) do not have insomnia. (87%) do not have anxiety. (96%) do not have depression. However, (77%) of the sample group is facing stress. In terms of environment in home, bathroom in the home (90.0%) and floor of bathroom was slippery (91.0%). (48%) of the sample group has the skills of how to look after themselves while being sick, and how to keep up healthy lifestyle. Besides, some other factors, such as gender, age and educational background are related to the health perception. The statistical significance was <0.05. Suggestion: The instruments available to national standards such as ST-5, 2Q and Barthel ADL index. Reliability coefficients alpha was .784 for perceived of self-efficacy, self-care of aging and .827 for perceived of social support of the aging. The instrument used to collect perceived of social support must be further developed to study level of influence of social support that affect the health of elderly.

Keywords: ้health status, perception of aging, self-efficacy, social support

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Authors: Prakash Singh

Abstract:

The focus of this paper is on the impact of internal organizational factors on the inappropriate job performance and behaviour of employees. The Buffalo City Metropolitan Municipality (BCMM) in South Africa has been experiencing inappropriate job behaviour and performance of some of its workers. They include misappropriation of resources, maladministration, mismanagement, lack of service delivery, fraud, and corruption. Since many workers in this organization have various levels of formal education, such practices are not expected, because the structural-functionalist assumption is that formal education is a solution to societal challenges. Since inappropriate job behaviour and performance continue to be reported in spite of the formal education of BCMM workers, this study seeks to investigate how the two phenomena co-exist. It thus seeks to put into perspective the paradoxical co-existence of formal education with inappropriate job behaviour and performance, by focusing on the BCMM as a case-study. For data collection, this study used the mixed method approach; that is, a combination of qualitative and quantitative methods. The findings revealed structural, systemic and human impediments to labour productivity in the organization. By and large, the unquestioning acceptance of the assumption that the skills shortage is responsible for inappropriate workers’ job performance and behaviour is discredited by the evidence of skilled personnel who exercise their responsibilities in a manner that undermines their occupational requirements. Therefore, this exploratory study affirms that the narrow conception of skills, that privileges job-specific capabilities, is not enough for cultivating a workforce with appropriate job behaviour and performance practices.

Keywords: inappropriate job behaviour, labour productivity, mismanagement, skills shortage

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Authors: Cherrie Mae S. Sia, Noel J. Belonguel, Jarungchai Anton S. Vatanagul

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Background: Parkinson’s disease (PD) is a chronic progressive, neurodegenerative disorder known for its motor symptoms such as bradykinesia, resting tremor, muscle rigidity, and postural instability. Patients with PD also experience non-motor symptoms (NMS) such as depression, fatigue, and sleep disturbances that are most of the time unrecognized by clinicians. This may be due to the lack of spontaneous reports from the patients or partly because of the lack of systematic questioning from the healthcare professional. There is limited data with regards to these NMS especially that of Filipino patients with PD. Objectives: This study aims to determine the non-motor symptoms of Filipino patients with Parkinson’s disease. Materials and Methods: This is a prospective, cohort study involving thirty-four patients of Filipino-descent diagnosed with PD in three out-patient clinics in Cebu City from April to September 2014. Each patient was interviewed using the Non-Motor Symptom Scale (NMSS). A Cebuano version of the NMSS was also provided for the non-English speaking patients. Interview time was approximately ten to fifteen minutes for each respondent. Results: Of the thirty-four patients with Parkinson’s disease, majority was noted to be males (N=19) and the disease was noted to be more prevalent in patients with a mean age of 62 (SD±9) years old. Hypertension (59%) and diabetes mellitus (29%) were the common co-morbidities in the study population. All patients presented more than one NMS, with insomnia (41.2%), poor memory (23.5%) and depression (14.7%) being the first non-motor symptoms to occur. Symptoms involving mood/cognition (mean=2.21), and attention/memory (mean=2.05) were noted to be the most frequent and of moderate severity. Based on the NMSS, the symptoms that were noted to be mild and often to occur were those that involved the mood/cognition (score=3.84), attention/memory (score=3.50), and sleep/fatigue (score=3.00) domains. Levodopa-Carbidopa, Ropinirole, and Pramipexole were the most frequently used medications in the study population. Conclusion: Non-motor symptoms (NMS) are common in patients with Parkinson’s disease (PD). They appear at the time of diagnosis of PD or even before the motor symptoms manifest. The earliest non-motor symptoms to occur are insomnia, poor memory, and depression. Those pertaining to mood/cognition and attention/memory are the most frequent NMS and they are of moderate severity. Identifying these NMS by doing a questionnaire-guided interview such as the Non-Motor Symptom Scale (NMSS) before they can become more severe and affect the patient’s quality of life is a must for every clinician caring for a PD patient. Early treatment and control of these NMS can then be given, hence, improving the patient’s outcome and prognosis.

Keywords: non motor symptoms, Parkinson's Disease, insomnia, depression

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Authors: Sherly Ferro Lensun, Donal Matheos Ratu, Elni Jeini Usoh, Helena M. L. Pandi, Mayske Rinny Liando

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This study aims to gain a deep understanding of the process and the increase resulting in mastery of Kanji with a Language Learning Strategies through multimedia. This research aims to gain scientific data on process and the result of improving kanji mastery by using Chokusetsu strategy in Kanji learning. The method used in this research is Action Research developed by Kemmis and Mc. Taggart is known as Spiral Model. This model consists of following stages: planning, implementation, observation, and reflection. The research results in following findings: (1) Kanji mastery comprises 4 major aspects, those are reading, writing, the use in sentence, and memorizing, and those aspects show gradual improvement from time to time. (2) Students have more participation in learning activities which can be identified from some positive behaviours such giving respond in finishing exercise in class. (3) Students’ better attention to the lesson shown by active behaviour in giving more questions or asking for more explanation to the lecturers, memorizing Kanji card, finishing the task of making Kanji card/house, doing the exercises more seriously, and finishing homework assignment punctually. (4) More attractive learning activities and tasks in the forms of more engaging colour and pictures enables students to conduct self-evaluation on their learning process.

Keywords: Kanji, action research, language learning strategies, multimedia

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Authors: Omaima E. S. Mohammed, Amira A. A. Abdallah, Amal A. M. El Borady

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Background: Core stability training has recently attracted attention for improving muscle performance. Purpose: This study investigated the effect of beginners' core stability exercises on trunk active repositioning error at 30° and 60° trunk flexion. Methods: Forty healthy males participated in the study. They were divided into two equal groups; experimental “group I” and control “group II”. Their mean age, weight and height were 19.35±1.11 vs 20.45±1.64 years, 70.15±6.44 vs 72.45±6.91 kg and 174.7±7.02 vs 176.3±7.24 cm for group I vs group II. Data were collected using the Biodex Isokinetic system at an angular velocity of 60º/s. The participants were tested twice; before and after a 6-week period during which group I performed a core stability training program. Results: The Mixed 3-way ANOVA revealed significant increases (p<0.05) in the absolute error (AE) at 30˚ compared with 60˚ flexion in the pre-test condition of group I and II and the post-test condition of group II. Moreover, there were significant decreases (p<0.05) in the AE in the post-test condition compared with the pre-test in group I at both 30˚ and 60˚ flexion with no significant differences for group II. Finally, there were significant decreases (p<0.05) in the AE in group I compared with group II in the post-test condition at 30˚ and 60˚ flexion with no significant differences for the pre-test condition Interpretation/Conclusion: The improvement in trunk proprioception indicated by the decrease in the active repositioning error in the experimental group recommends including core stability training in the exercise programs that aim to improve trunk proprioception.

Keywords: core stability, isokinetic, trunk proprioception, biomechanics

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Authors: Sarvada Nand

Abstract:

Teacher quality is directly proportional to the achievement level of students. Recent researches reveal that the teacher learning communities enhance the quality of teacher. It is a proven fact that community does help in enhancing teachers’ self-esteem as professionals, their teaching skills and enhancing classroom transaction that results in the higher achievement of students. The purpose of this study is to develop TLC and provide them platform where they share their views and ideas on various academic issues. The study examines how teachers conceptualize TLCs, up to what extent TLC help in developing professionalism among teachers and how they prepare themselves for the days to come. In this study, pre-test in five subjects, Hindi, English, Mathematics, Science and Social Studies was conducted and a questionnaire was designed to judge the teachers' attitude towards teaching practice. After completion of the project duration of three and a half-month, an exercise of post-test was conducted in all the above subjects. The post tests show tremendous improvements in achievement level of those students who were regular in their classes and were attended through this new method. A visible shift in teacher’s attitude is seen for the better. They were able to realize their own potentials. There was a group of Facilitators formed to perform continuously supervision and monitor in regular intervals so that they could easily handle the challenges, and factors much important for the attainment towards the fulfillment of the objectives.

Keywords: teacher learning communities, best practice, teacher professionalism, student achievement

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Authors: Esther Matthews

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This paper looks at ways of translating new metaphors: those conceived and created by authors, which are often called ‘original’ metaphors in the world of Translation Studies. An original metaphor is the most extreme form of figurative language, often dramatic and shocking in effect. It displays unexpected juxtapositions of language, suggesting there could be as many different translations as there are translators. However, some theorists say original metaphors should be translated ‘literally’ or ‘word for word’ as far as possible, suggesting a similarity between translators’ solutions. How do literary translators approach this challenge? This study focuses on Spanish-English translations of a novel full of original metaphors: Nada by Carmen Laforet (1921 – 2004). Original metaphors from the text were compared to the four published English translations by Inez Muñoz, Charles Franklin Payne, Glafyra Ennis, and Edith Grossman. These four translators employed a variety of translation methods, but they translated ‘literally’ in well over half of the original metaphors studied. In a two-part translation exercise and questionnaire, professional literary translators were asked to translate a number of these metaphors. Many different methods were employed, but again, over half of the original metaphors were translated literally. Although this investigation was limited to one author and language pair, it gives a clear indication that, although literary translators’ solutions vary, on the whole, they prefer to translate original metaphors as literally as possible within the confines of English grammar and syntax. It also reveals literary translators’ desire to reproduce the distinctive character of an author’s work as accurately as possible for the target reader.

Keywords: translation, original metaphor, literature, translator training

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Authors: Mmamapudi Kubjane, Natacha Berkowitz, Rene Goliath, Naomi S. Levitt, Robert J. Wilkinson, Tolu Oni

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Background: South Africa remains a high tuberculosis (TB) burden country globally and the burden of diabetes – a TB risk factor is growing rapidly. As an infectious disease, TB also induces transient hyperglycaemia. Therefore, screening for diabetes in newly diagnosed tuberculosis patients may result in misclassification of transient hyperglycaemia as diabetes. Objective: The objective of this study was to determine and compare the prevalence of hyperglycaemia (diabetes and impaired glucose regulation (IGR)) in TB patients and to assess the cross-sectional association between TB and hyperglycaemia at enrolment and after three months of follow-up. Methods: Consecutive adult TB and non-TB participants presenting at a TB clinic in Cape Town were enrolled in this cross-sectional study and follow-up between July 2013 and August 2015. Diabetes was defined as self-reported diabetes, fasting plasma glucose (FPG) ≥ 7.0 mmol·L⁻¹ or glycated haemoglobin (HbA1c) ≥ 6.5%. IGR was defined as FPG 5.5– < 7.0 mmol·L⁻¹ or HbA1c 5.7– < 6.5%. TB patients initiated treatment. After three months, all participants were followed up and screened for diabetes again. The association between TB and hyperglycaemia was assessed using logistic regression adjusting for potential confounders including sex, age, income, hypertension, waist circumference, previous prisoner, marital status, work status, HIV status. Results: Diabetes screening was performed in 852 participants (414 TB and 438 non-TB) at enrolment and in 639 (304 TB and 335 non-TB) at three-month follow-up. The prevalence of HIV-1 infection was 69.6% (95% confidence interval (CI), 64.9–73.8 %) among TB patients, and 58.2% (95% CI, 53.5–62.8 %) among the non-TB participants. Glycaemic levels were much higher in TB patients than in the non-TB participants but decreased over time. Among TB patients, the prevalence of IGR was 65.2% (95% CI 60.1 - 69.9) at enrollment and 21.5% (95% CI 17.2-26.5) at follow-up; and was 50% (45.1 - 54.94) and 32% (95% CI 27.9 - 38.0) respectively, among non-TB participants. The prevalence of diabetes in TB patients was 12.5% (95% CI 9.69 – 16.12%) at enrolment and 9.2% (95% CI, 6.43–13.03%) at follow-up; and was 10.04% (95% CI, 7.55–13.24%) and 8.06% (95% CI, 5.58–11.51) respectively, among non-TB participants. The association between TB and IGT was significant at enrolment (adjusted odds ratio (OR) 2.26 (95% CI, 1.55-3.31) but disappeared at follow-up 0.84 (0.53 - 1.36). However, the TB-diabetes association remained positive and significant both at enrolment (2.41 (95% CI, 1.3-4.34)) and follow-up (OR 3.31 (95% CI, 1.5 - 7.25)). Conclusion: Transient hyperglycaemia exists during tuberculosis. This has implications on diabetes screening in TB patients and suggests a need for diabetes confirmation tests during or after TB treatment. Nonetheless, the association between TB and diabetes noted at enrolment persists at 3 months highlighting the importance of diabetes control and prevention for TB control. Further research is required to investigate the impact of hyperglycaemia (transient or otherwise) on TB outcomes to ascertain the clinical significance of hyperglycemia at enrolment.

Keywords: diabetes, impaired glucose regulation, transient hyperglycaemia, tuberculosis

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Authors: Rajae Tahri, Omar Chokairi, Asmae Saadi, Souad Chaouir

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Background: The factors motivating students to choose a medical career is a long-standing topic of publication and discussion. To our knowledge, no national study on the motivation for choosing medical studies has been published to date. Population and methods: This is an observational, descriptive, and cross-sectional study of first-year medical students at the Faculty of Medicine and Pharmacy of Rabat. An anonymous questionnaire comprising 16 questions was developed and distributed to students during Embryology tutorials. The students were free to fill it in or not. The number of students who consented to participate in the survey was 266. The variables studied are the socio-demographic variables of the students and the reasons for choosing medical studies. Results: The most strongly and frequently chosen reasons for choice by our students were saving lives (64.9%), helping others (62.1%), love of medicine (57%), and reducing suffering (56.5%). The comparison of the results according to gender showed a significant difference between the degree of self-motivation of girls compared to that of boys (p <0.001). The reason that stood out the most for them was teamwork. The presence of a health professional in the family was associated with strong extrinsic motivation (p = 0.005). Conclusion: Understanding medical student career choices would improve our knowledge of the factors that influence medical student learning and performance. This knowledge will make it possible to adapt the educational strategies to maintain the motivation of the students throughout their course as well as during their exercise.

Keywords: motivation, motivational profiles, medical studies, Morocco

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Authors: Chen-Yu Chien, Shiow-Fang Shieh

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Tattoos are the most intimate form of body art. Unlike other art forms, tattoos emphasize breaking through tradition, innovation, and creativity. The designs created by tattoo artists are often regarded as true works of art. In recent years, there has been a notable increase in athletes with tattoos, thereby amplifying the beliefs and psychological expressions conveyed by tattoos on athletes compared to the past. The primary objectives of this study are 1. to explore and understand the presence and significance of tattoos for athletes and 2. to examine the impact of tattoos on athletes' performance. This study employs a semi-structured, in-depth interview method utilizing purposive sampling. The participants are athletes who have engaged in regular exercise for more than three years and have tattoos. A total of 10 athletes were interviewed, including 9 males and 1 female, aged between 24 and 43 years, each with different sports specializations. The sample was collected using snowball sampling. Results and Discussion: 1. For athletes, tattoos are not merely body decorations but serve to reinforce their inner beliefs, thereby enhancing their athletic performance. 2. Tattoos have a positive impact on the appearance of athletes. 3. The influence of tattoos on athletic performance extends beyond physical appearance, serving as a psychological motivation and support. 4. Individuals with tattoos tend to be more outgoing and extroverted, with higher impulsivity and adventurousness in their athletic endeavors. Conclusion: I. For athletes, tattoos not only have a positive impact on their appearance but also strengthen their internal beliefs. II. Athletes with tattoos exhibit not only greater extroversion and openness but also heightened impulsivity and adventurousness in their athletic performance.

Keywords: tattoo, athletes, athletic performance, psychological impact, body art

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Authors: Deike Janssen

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In the scenery of the Tyrolean mountains, at an altitude of 1300 meters, stands a building. Residents and activists call it a prison. However, it is not a prison -according to authorities, it is a 'Return Counseling Facility' where migrants and refugees should be "motivated" to return "voluntary" to their countries of origin. This paper argues that the geographical location of the camp functions as a site of exclusion, isolation, and coercion where no one can decide “voluntary” to return, but where people are brought to despair to leave Austria. Through a qualitative case study, this paper documents the heavy impact of offshore detention on the mental, physical and social state of the residents and a variety of human rights problems in the centre. Different developments at the Return Counselling Facility and the law that back up the centre uncover a worrying dynamic that deliberately accepts human rights problems in order to enforce borders, a policy that disregards humanitarian, legal, and ethical stands in order to deport people at all hazards. It, therefore, can be seen as a creative and ultimate exercise of state power, which uses isolated locations to control migration. While the analysis revises the micro and macro implications of the facility and, therefore, the legal and political facets, it also sheds light on the role of the civil society, which tries to increase through constant and collective efforts the human rights efforts of the government.

Keywords: deportation, human rights, migration, refugee detention, voluntary return

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Authors: Amal Abo El-Maaty, Amira Mohamed, Nashwa Abu-Aita, Hisham Morgan

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For estimating markers of overweight or obesity of brood mares used for riding and training, 17 mares of different body conditions were subjected to blood sampling and ultrasound examination to measure rump fat thickness and monitor ovulation for six consecutive weeks. Also length (L), heart girth (G) and withers height (H) were measured to estimate body weight (BW), body fat %, body fat mass (BFM) and body mass index (BMI). Mares were classified into three groups according to both body condition score (BCS) and rump back fat (BF). Overweight mares (O) were having BCS > 7 and BF thickness >7mm, moderate body condition (M) mares were having BCS >3and ≤7and BF <3and <7mm, and emaciated mares (E) were having BCS ≤3 and BF ≤3mm. glucose, triglycerides, nitric oxide, ovarian, thyroid, insulin, insulin like growth factor-I (IGF-1), and leptin hormones were measured. Results revealed that BCS, G, L, L*G*H, BW, BF, fat %, BFM were significantly (P<0.0001) decreasing linearly from O to E. T4 concentrations of E were significantly high (P=0.04) compared to M and O but T3 concentrations tended to decrease in E (P>0.05). Insulin and IGF-1 concentrations tended to be high in O (P>0.05) and decrease with the decrease of body condition. M had (P=0.007) the highest leptin, but E mares had the lowest P4 concentrations (P=0.01). Concentrations of glucose and NO decreased with the decrease of BCS and BF but triglycerides of O were insignificantly high. In conclusion, exercise could prevent the development of metabolic syndrome in horses and back fat and morphometric measurements were the easiest and simple assessment of overweight and deviation to obesity.

Keywords: body condition score, insulin, leptin, mares, rump fat

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Authors: Gabriel Cucato, Marilia Correia, Wagner Domingues, Aline Palmeira, Paulo Longano, Nelson Wolosker, Raphael Ritti-Dias

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Women with peripheral arterial disease (PAD) present lower walking capacity in comparison with men. However, whether cardiovascular regulation is also different between genders is unknown. Thus, the aim of this study was to compare walking capacity and cardiovascular regulation between men and women with PAD. A total of 23 women (66±7 yrs) and 31 men (64±9 yrs) were recruited. Patients performed a 6-minute test and the onset claudication distance and total walking distance were measured. Additionally, cardiovascular regulation was assessed by arterial stiffness (pulse wave velocity and augmentation index) and heart rate variability (frequency domain). Independent T test or Mann-Whitney U test were performed. In comparison with men, women present lower onset claudication distance (108±66m vs. 143±50m; P=0.032) and total walking distance (286±83m vs. 361±91 m, P=0.007). Regarding cardiovascular regulation, there were no differences in heart rate variability SDNN (72±160ms vs. 32±22ms, P=0.587); RMSSD (75±209 vs. 25±22ms, P=0.726); pNN50 (11±17ms vs. 8±14ms, P=0.836) in women and men, respectively. Moreover, there were no difference in augmentation index (39±10% vs. 34±11%, P=0.103); pulse pressure (59±17mmHg vs. 56±19mmHg, P=0.593) and pulse wave velocity (8.6±2.6m\s vs. 9.0±2.7m/s, P=0.580). In conclusion, women have impaired walking capacity compared to men. However, sex differences were not observed on cardiovascular regulation in patients with PAD.

Keywords: exercise, intermittent claudication, cardiovascular load, arterial stiffness

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Authors: John Yahng, Hansraj Riteesh Bookun

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Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

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Authors: Thanura Randula Abeywardena

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This study recognized the effectiveness of cold-water immersion recovery post exhaustive short-term exercise. The purpose of this study was to understand if 16- 20°C of cold-water immersion would be beneficial in a tropical environment to achieve optimal recovery in sprint swim performance in comparison to 10-15°C of water immersion. Two 100m-sprint swim performance times were measured along with blood lactate (BLa), heart rate (HR) and rate of perceived exertion (RPE) in a 25m swimming pool with full body head out horizontal water immersions of 10-15°C, 16-20°C and 29-32°C (pool temperature) for 10 minutes followed by 5 minutes of seated passive rest outside; in between the two swim performances. Twelve well-trained adult swimmers (5 male and 5 female) within the top twenty in the Sri Lankan national swimming championships in 100m Butterfly and Freestyle in the years 2020 & 2021 volunteered for this study. One-way ANOVA analysis (p<0.05) suggested performance time, Bla and HR had no significant differences between the 3 conditions after the second sprint; however, RPE was significantly different with p=0.034 between 10-15°C and 16-20°C immersion conditions. The study suggested that the recovery post the two cold-water immersion conditions were similar in terms of performance and physiological factors; however, the 16-20°C temperature had a better “feel good” factor post sprint 2. Further study is recommended as there was participant bias with the swimmers not reaching optimal levels in sprint 1. Therefore, they might have possibly fully recovered before sprint 2, invalidating the physiological effect of recovery.

Keywords: hydrotherapy, blood lactate, fatigue, recovery, sprint-performance, sprint-swimming

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Authors: Ling-Lang Huang

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Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.

Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care

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