Search results for: nutrition intervention

Authors: A. Zecchin, E. Vallicella, I. Alberi, A. Dalle Carbonare, A. Festi, F. Galeone, S. Garzon, R. Raffaelli, P. Pomini, M. Franchi

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Introduction: Severe endometriosis is a multiorgan disease, that involves bowel in 31% of cases. Disabling symptoms and deep infiltration can lead to bowel obstruction: surgical bowel treatment may be needed. In these cases, colorectal segment resection is usually performed by inferior mesenteric artery ligature, as radically as for oncological surgery. This study was made on surgery based on intestinal vascular axis’ preservation. It was assessed postoperative complications risks (mainly rate of dehiscence of intestinal anastomoses), and results were compared with the ones found in literature about classical colorectal resection. Materials and methods: This was a retrospective study based on 62 patients with deep infiltrating endometriosis of the bowel, which undergo segmental resection with intestinal vascular axis preservation, between 2013 and 2016. It was assessed complications related to the intervention both during hospitalization and 30-60 days after resection. Particular attention was paid to the presence of anastomotic dehiscence. 52 patients were finally telephonically interviewed in order to investigate the presence or absence of intestinal constipation. Results and Conclusion: Segmental intestinal resection performed in this study ensured a more conservative vascular approach, with lower rate of anastomotic dehiscence (1.6%) compared to classical literature data (10.0% to 11.4% ). No complications were observed regarding spontaneous recovery of intestinal motility and bladder emptying. Constipation in some patients, even after years of intervention, is not assessable in the absence of a preoperative constipation state assessment.

Keywords: anastomotic dehiscence, deep infiltrating endometriosis, colorectal resection, vascular axis preservation

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Authors: Bereket Amare Mulu

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Ethiopia is one of the countries that consists of a huge variety of botanical resources as compared to the world. The agroclimatic is suitable for a variety of plants to grow effectively throughout the year. Sources of food plants are basic items for people in the world. Production of food items is a prior activity and needs more resources and attention to produce a huge amount of production. The local food is rich in nutrition and healthful foods. The local food is fresh and not exposed to infections easily. The community can easily get the food items in their surroundings. The local food sources are not expensive when it is compared to the other proceed food items, and it is affordable to the community purchasing power. The food is very tasty and palatable capacity by the whole community categories. The basic problems in Ethiopia are the community experiences some of the common food source items. On the contrary, inefficient food production, low economic growth, and climate variability affected food production. This leads to serious food shortages and acute health problems. The objective of the study is to identify local food sources and analyze the advantage and benefits of local food sources. Casava is one of the root crop plants in Ethiopia and easily adapts to any type of agroecology in every place in the country. 50 community members have been identified to prepare casava in different forms of food items. They have prepared in the forms of Bread, Injera, Porridge, Boiled casava, fried chips Casava, and Cocktails. The prepared food items have been exposed to the community as a food festival to eat and taste how much interesting Even though there is a cultural barrier to eating the food items, the community had the food and tasted it the food. The result showed that community awareness is still not addressed the benefits of local food sources yet. The local food has high nutritional value and healthful foods. The local food sources are fresh and easily produced in every place of the country.

Keywords: bread, cassava, injera, nutrition

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Authors: Vicent Lwanga

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Issue: Communication between parent and child is important and necessary. Poor parenting and lack of openness and communication between parents and their children contribute to the increasing rate of HIV infection among young persons between the ages of 10-25. The young person, when left on their own are at the risk of misinformation from peers and from other sources. Description: Parent-Child Communication (PCC) was designed as a key component of a community-based HIV and AIDS intervention focused on young persons by Elderly Widows Orphans Family Support Organisation. Findings from the preliminary community-level process indicated that the lack of parent-child communication militates against young persons adopting and maintaining healthier sexual behaviors. An integrated youth strategy consisting of youth Peer Education/Facilitation and PCC was used to bridge this gap. The process involved an interactive parent-child forum, which allowed parents and children to meet and have open and frank discussions on the needs of young persons and the role of parents. This forum addressed all emerging issues from all parties and created better cordiality amongst them. Lessons Learnt: When young people feel unconnected to their parents, family, or home, they may become involved in activities that put their health at risk. Equally, when parents affirm the value of their children through open interaction, children are more likely to develop positive and healthy attitudes about themselves. Creating the opportunity for this interactive forum is paramount in any intervention program focused on young persons. Conclusion: HIV and AIDS-related programmes, especially those focusing on youth, should have PCC as an integral, essential component. Parents should be vehicles for information dissemination and need to be equipped with the capacity and skills to take on the onerous task of talking sexual reproductive health and sexuality with their children and wards.

Keywords: aids, communication, HIV, youth

Procedia PDF Downloads 101

Authors: Rahm Sibylle

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The core element in most European teacher training concepts consists in practical periods where teacher students may review the chosen profession before going on to their theoretical studies. In Germany, teacher students learn in practical studies about everyday teaching and learning in schools. Teacher students appreciate opportunities to explore school practice and to feel responsible for students’ learning. In practical studies, teacher students often idealize their teacher mentors (and consequently tend to imitate their teaching style) or contrarily feel disappointed about school practice. Concepts of empowerment through practical experience in school-based academic teacher training have to be developed. Our Swiss-German research project COPRA (Coaching in practical periods; funded by the Swiss National Science Foundation (SNF) and the German Research Foundation (DFG), aims at gaining resilient results about the effectiveness of (peer) coaching in practical school periods. To explore innovative ways of accompanying novice teachers in practical periods we consider different cultures of teacher training institutions. School cultures, including teachers’ beliefs and teaching traditions involve different training cultures as starting positions for our intervention study. In our qualitative study, we describe typologies of teacher training institutions by analyzing group discussions with teacher students, mentor teachers and university lecturers concerning participation, cooperation, and relationships. In our paper, we present the design of our intervention study, our coaching concept as well as typologies of teacher training cultures. We discuss opportunities for teacher students to learn through domain-specific (peer) coaching on the background of these typologies.

Keywords: teacher training (practical periods), teacher students' coaching, training cultures (typologies), COPRA (coaching in practical periods)

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Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos

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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.

Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation

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Authors: Muzaffer Topgül, Ersi̇n Yilmaz

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One of the unknown aspects of Çanakkale Battles is that the importance and contributions of Mobile Gendarmarie Battalion have not been fully understood. It was because the battles of the troops which were deployed more in interior parts of Gallipoli Peninsula, and the contributions of battle on level tactical troops were not considered as much as the studies on strategical or operative level troops. When the operation field and battle plans are examined, instead of deploying along the coast to put the forces with a power at zero level landing on the coast out of action, the main battle components are seen to have deployed as strong reserves in the more inner areas. The negative effect of the field on the great trop operation reveals the need for time in order to use the intervention forces. ‘Time’ emerged as the main factor in victory as a result of giving intervention opportunity to the troops. While ordering his soldiers in Conkbayırı to die rather than fight, Liutenant Colonel Mustafa Kemal, the Commander of the 19th division, also emphasized the significance of time. In this respect, the contribution of Mobile Gendarmarie Battalion which saved time for the troops to intervene can be clearly seen. During the study, the memoirs and the works written by military institutions based on the record sources under the light of the notes taken during the trips to the region were used. By preventing the enemies from capturing the area, Mobile Gendarmerie Battalions had an important role in Battles of Kerevizdere, Kireçtepe and Alçıtepe which were of great importance among the battles. The success of these battalions was expressed with compliment by both Turkish and foreign commanders that participated in the war. During the battles the losses of armed forces commissioned to keep the security and order brought about the formation of the regions deficient in state authority.

Keywords: Canakkale battles, mustafa kemal, mobile gerdarmarie, Ottoman empire, time

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Authors: Elif Cakir, Görkem Özülkü, Hatice Bekiroğlu, Muhammet Arici, Osman Sağdic

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It is important to be able to formulate cakes with a wide consumption mass with gluten-free and high nutritional value ingredients to increase the consumption possibilities of people with limited nutrition opportunities. Although people do not prefer Prunus spinosa (PS)because of its sour taste and its use in the food industry is limited on a local scale, the potential of using PS, which is a naturally rich source of many micronutrients and bioactive compounds, in glutenfree cake production has been investigated. In this study, the potential of using PS, a natural wild fruit, in the production of functional gluten-free cakes was investigated. It was aimed to evaluate the effects of freeze-dried and powdered PS-enriched rice flour cakes on tech functionality, nutrition and eating quality. In terms of physicochemical properties, PS raises increased the ash, protein, and moisture values of the cakes. PS with high phenolic content, phenolic component content, and radical reducing power made by ABTS, FRAP, and DPPH techniques were higher in all samples than control, and the highest 4% PS was determined in cakes. In terms of the glycemic index (GI), which is an important feature of diet products, it was determined that the GI in cakes decreased by 86.30±1.04.75.05±1.16 and 69.38±1.21, respectively, with the increase in PS ratio. Except for the 1%, PS added sample, the increase in PS caused a decrease in specific volume, % porosity and increase in hardness, including 4 days of storage. PS increase decreased the L* and b* values and increased a* value and redness of the cake. Sensory liking of the cake samples containing PS was scored significantly (p<0.05) higher of control.

Keywords: Prunus spinosa, gluten-free cake, antioxidant, phenolic, glycemic index

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Authors: Chandrakala Varatharajoo, Adelina Binti Asmawi, Nabeel Abdallah Mohammad Abedalaziz

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This study investigated the impact of inflectional and derivational morphemic analysis awareness on ESL secondary school students’ vocabulary learning strategy. The quasi-experimental study was conducted with 106 low proficiency secondary school students in two experimental groups (inflectional and derivational) and one control group. The students’ vocabulary acquisition was assessed through two measures: Morphemic Analysis Test and Vocabulary- Morphemic Test in the pretest and posttest before and after an intervention programme. Results of ANCOVA revealed that both the experimental groups achieved a significant score in Morphemic Analysis Test and Vocabulary-Morphemic Test. However, the inflectional group obtained a fairly higher score than the derivational group. Thus, the results indicated that ESL low proficiency secondary school students performed better on inflectional morphemic awareness as compared to derivatives. The results also showed that the awareness of inflectional morphology contributed more on the vocabulary acquisition. Importantly, learning inflectional morphology can help ESL low proficiency secondary school students to develop both morphemic awareness and vocabulary gain. Theoretically, these findings show that not all morphemes are equally useful to students for their language development. Practically, these findings indicate that morphological instruction should at least be included in remediation and instructional efforts with struggling learners across all grade levels, allowing them to focus on meaning within the word before they attempt the text in large for better comprehension. Also, by methodologically, by conducting individualized intervention and assessment this study provided fresh empirical evidence to support the existing literature on morphemic analysis awareness and vocabulary learning strategy. Thus, a major pedagogical implication of the study is that morphemic analysis awareness strategy is a definite boon for ESL secondary school students in learning English vocabulary.

Keywords: ESL, instruction, morphemic analysis, vocabulary

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Authors: Tatiana A. Kuznetsova, Maxim V. Vechersky, Natalia V. Kostina, Marat M. Umarov, Elena I. Naumova

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One of the main problems of nutrition of phytophagous animals is the insufficiency of protein in their forage. Usually, symbiotic microorganisms highly contribute both to carbohydrates and nitrogen compounds of the food. But it is not easy to utilize microbial biomass in the large intestine and caecum for the animals with hindgut fermentation. So that, some animals, as well hares, developed special mechanism of contribution of such biomass - obligate autocoprophagy, or reingestion. Hares have two types of feces - the hard and the soft. Hard feces are excreted at night, while hares are vigilance ("foraging period"), and the soft ones (caecotrophs) are produced and reingested in the day-time during hares "resting-period". We examine the role of microbial digestion in providing nitrogen nutrition of hare (Lepus europaeus). We determine the ability of nitrogen fixation in fornix and stomach body, small intestine, caecum and colon of hares' gastro-intestinal tract in two main period of hares activity - "resting-period" (day time) and "foraging period" (late-evening and very-early-morning). We use gas chromatography to measure levels of nitrogen fixing activity (acetylene reduction). Nitrogen fixing activity was detected in the contents of all analyzed parts of the gastrointestinal tract. Maximum values were recorded in the large intestine. Also daily dynamics of the process was detected. Thus, during hare “resting-period” (caecotrophs formation) N2-fixing activity was significantly higher than during “foraging period”, reaching 0,3 nmol C2H4/g*h. N2-fixing activity in the gastrointestinal tract can allocate to significant contribution of nitrogen fixers to microbial digestion in hare and confirms the importance of coprophagy as a nitrogen source in lagomorphs.

Keywords: coprophagy, gastrointestinal tract, lagomorphs, nitrogen fixation

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Authors: Kyngäs Helvi, Patala-Pudas, Kaakinen Pirjo

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It has been reported that COPD -patients may experience much emotional distress, which can compromise positive health outcomes. The aim of this study was to explore disease-related uncertainty as reported by Chronic Obstructive Pulmonary Disease (COPD) patients. Uncertainty was defined as a lack of confidence; negative feelings; a sense of confidence; and awareness of the sources of uncertainty. Research design was a non-experimental cross-sectional survey. The data (n=141) was collected by validated questionnaire during COPD -patients’ visits or admissions to a tertiary hospital. The response rate was 62%. The data was analyzed by statistical methods. Around 70% of the participants were male with COPD diagnosed many years ago. Fifty-four percent were under 65 years and used an electronic respiratory aid apparatus (52%) (oxygen concentrator, ventilator or electronic inhalation device). Forty-one percent of the participants smoked. Disease-related uncertainty was widely reported. Seventy-three percent of the participants had uncertainty about their knowledge of the disease, the pulmonary medication and nutrition. One-quarter (25%) did not feel sure about managing COPD exacerbation. About forty percent (43%) reported that they did not have a written exacerbation decision aid indicating how to act in relation to COPD symptoms. Over half of the respondents were uncertain about self-management behavior related to health habits such as exercise and nutrition. Over a third of the participants (37%) felt uncertain about self-management skills related to giving up smoking. Support from the care providers was correlated significantly with the patients’ sense of confidence. COPD -patients who felt no confidence stated that they received significantly less support in care. Disease-related uncertainty should be considered more closely and broadly in the patient care context, and those strategies within patient education that enhance adherence should be strengthened and incorporated into standard practice.

Keywords: adherence, COPD, disease-management, uncertainty

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Authors: Dana Zelicha

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The objective of this paper is to present innovative mindfulness tools specifically designed by OWBA—The Well Being Agency for organisations and corporate wellness programmes. The OWBA Mindfulness Tools (OWBA-MT) consist of practical mindfulness exercises to educate and train employees and business leaders to think, feel, and act more mindfully. Among these cutting-edge interventions are Mindful Meetings, Mindful Decision Making and Unitasking activities, intended to cultivate mindful communication and compassion in the workplace and transform organisational culture. In addition to targeting CEO’s and leaders within large corporations, OWBA-MT is also directed at the needs of specific populations such as entrepreneurs’ resilience and women empowerment. The goals of the OWBA-MT are threefold: to inform, inspire and implement. The first goal is to inform participants about the relationship between workplace stress, distractibility and miscommunication in the framework of mindfulness. The second goal is for the audience to be inspired to share those practices with other members of their organisation. The final objective is to equip participants with the tools to foster a compassionate, mindful and well-balanced work environment. To assess these tools, a 6-week case study was conducted as part of an employee wellness programme for a large international corporation. The OWBA-MT were introduced in a workshop forum once-a-week, with participants practicing these tools both in the office and at home. The workshops occurred 1 day a week (2 hours each), with themes and exercises varying weekly. To reinforce practice at home, participants received reflection forms and guided meditations online. Materials were sent via-email at the same time each day to ensure consistency and participation. To evaluate the effectiveness of the mindfulness intervention, improvements in four categories were measured: listening skills, mindfulness levels, prioritising skills and happiness levels. These factors were assessed using online self-reported questionnaires administered at the start of the intervention, and then again 4-weeks following completion. The measures included the Mindfulness Attention Awareness Scale (MAAS), Listening Skills Inventory (LSI), Time Management Behaviour Scale (TMBS) and a modified version of the Oxford Happiness Questionnaire (OHQ). All four parameters showed significant improvements from the start of the programme to the 4-week follow-up. Participant testimonials exhibited high levels of satisfaction and the overall results indicate that the OWBA-MT intervention substantially impacted the corporation in a positive way. The implications of these results suggest that OWBA-MT can improve employees’ capacities to listen and work well with others, to manage time effectively, and to experience enhanced satisfaction both at work and in life. Although corporate mindfulness programmes have proven to be effective, the challenge remains the low engagement levels at home in between training sessions and to implement the tools beyond the scope of the intervention. OWBA-MT has offered an innovative approach to enforce engagement levels at home by sending daily online materials outside the workshop forum with a personalised response. The limitations also noteworthy to consider for future research include the afterglow effect and lack of generalisability, as this study was conducted on a small and fairly homogenous sample.

Keywords: corporate mindfulness, listening skills, mindful leadership, mindfulness tools, organisational well being

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Authors: Hatice Akbıyık, Hülya Gökmen Özel, Nagehan Emiralioğlu, Elmas Ebru Güneş Yalçın, Deniz Doğru Ersöz, Hayriye Uğur Özçelik, Nural Kiper

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Background: Dietary recommendations in cystic fibrosis (CF) are based on the need to compensate for the increased energy needs of infection, the increased energy cost of breathing and the losses, incurred from malabsorption. Studies in CF indicate that dietary recommendations for CF patients can be difficult to achieve Aim: The aim of this study was to evaluate the energy and nutrient intakes and to compare in accordance with CF dietary guidelines in CF. Methods: One-hundred sixty patients with CF, aged between 2 to 20 years (mean±SD= 7.4±4.8 years) attending Hacettepe University, Faculty of Medicine, Department of Pediatric Pulmonary Diseases were included. Energy and nutrient intakes from foods and enteral products were calculated using a-24-hour dietary recall method with BEBIS 7.2 programme. Percentages of energy and nutrient intakes were compared in accordance with CF dietary guidelines. Patients or/and parents completed a questionnaire showing mealtime problems, usage of alternative therapies and type of nutrition. Statistical analyses were done using SPSS 16.0 programme. Results: It was obtained that 14.5% and 46.9% of the total energy intake were from proteins and carbohydrates, respectively. The actual contribution of total, saturated, monounsaturated and polyunsaturated fats to the total caloric intake was 37.5%, 14.3%, 14.9%, 9.9%, respectively. It was found that 87.7% of energy, 85% of protein 91.7% of carbohydrate, 81.1% of fat intakes were met, when compared CF recommended intakes of 120% RDA. Additionally 67%, 69.5%, 68.2% and 68.9% of the subjects did not achieve CF recommended intakes of 120% RDA for energy, protein, carbohydrate and fat, respectively. Patients with CF had low intakes for age for almost all vitamins and minerals, although supplementation was given. Especially most patients did not achieve the minimum recommended vitamin K intake of 120% RDA. The percentage meeting 120% RDA was 75.9% for vitamin K. It was shown that 41% of the patients had mealtime problems and they skipped the breakfast. Moreover 25.4% of the patients used alternative products outside the standard treatment (such as omega-3, ginger, turmeric, local honey). It was also showed that 60.8% of patients were using enteral products in addition to normal foods, the remaining patients were on only normal foods. Conclusion: The aims of improving nutritional status in children are to achieve normal weight gain and growth; optimize vitamin and mineral status; and slow the rate of clinical decline. In this study although enteral products were used in patients with CF, it was found that energy and nutrient requirements were unable to meet. Because dietary assessment is essential to identify the need for earlier nutritional intervention, in each visit patients need to be referred to CF specialist dietitian.

Keywords: cystic fibrosis, energy and nutrient intakes, mealtime problems, malabsorbtion

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Authors: Ragy Raafat Gaber Attaalla

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For cardiovascular illness, oral P2Y12 inhibitors including clopidogrel, prasugrel, and ticagrelor are frequently recommended. Each of these medications has advantages and disadvantages. In the absence of genotyping, it has been demonstrated that the stronger platelet aggregation inhibitors prasugrel and ticagrelor are superior than clopidogrel at preventing significant adverse cardiovascular events following an acute coronary syndrome and percutaneous coronary intervention (PCI). Both, nevertheless, come with a higher risk of bleeding unrelated to a coronary artery bypass. As a prodrug, clopidogrel needs to be bioactivated, principally by the CYP2C19 enzyme. A CYP2C19 no function allele and diminished or absent CYP2C19 enzyme activity are present in about 30% of people. The reduced exposure to the active metabolite of clopidogrel and reduced inhibition of platelet aggregation among clopidogrel-treated carriers of a CYP2C19 no function allele likely contributed to the reduced efficacy of clopidogrel in clinical trials. Clopidogrel's pharmacogenetic results are strongest when used in conjunction with PCI, but evidence for other indications is growing. One of the most typical examples of clinical pharmacogenetic application is CYP2C19 genotype-guided antiplatelet medication following PCI. Guidance is available from expert consensus groups and regulatory bodies to assist with incorporating genetic information into P2Y12 inhibitor prescribing decisions. Here, we examine the data supporting genotype-guided P2Y12 inhibitor selection's effects on clopidogrel response and outcomes and discuss tips for pharmacogenetic implementation. We also discuss procedures for using genotype data to choose P2Y12 inhibitor therapies as well as any unmet research needs. Finally, choosing a P2Y12 inhibitor medication that optimally balances the atherothrombotic and bleeding risks may be influenced by both clinical and genetic factors.

Keywords: inhibitors, cardiovascular events, coronary intervention, pharmacogenetic implementation

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Authors: Paula M. Lantz

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In the United States, significant socioeconomic and racial inequalities exist in many population-based indicators of health and social welfare. Although a number of effective prevention programs and interventions are available, local and state governments often do not pursue prevention in the face of budgetary constraints and more acute problems. There is growing interest in and excitement about Pay for Success” (PFS) strategies, also referred to as social impact bonds, as an approach to financing and implementing promising prevention programs and services that help the public sector either save money or achieve greater value for an investment. The PFS finance model implements evidence-based interventions using capital from investors who only receive a return on their investment from the government if agreed-upon, measurable outcomes are achieved. This paper discusses the current landscape regarding social impact bonds in the U.S., and their potential and challenges in addressing serious health and social problems. The paper presents an analysis of a number of social science issues that are fundamental to the potential for social impact bonds to successfully address social inequalities in health and social welfare. This includes: a) the economics of the intervention and a potential public payout; b) organizational and management issues in intervention implementation; c) evaluation research design and methods; d) legal/regulatory issues in public payouts to investors; e) ethical issues in the design of social impact bond deals and their evaluation; and f) political issues. Despite significant challenges in the U.S. context, there is great potential for social impact bonds as a type of social impact investing to encourage private investments in evidence-based interventions that address important public health and social problems in underserved populations and provide a return on investment.

Keywords: pay for success, public/private partnerships, social impact bonds, social impact investing

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Authors: Cho Achidi

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Tomato is a crucial food crop significantly contributes to global food and nutrition security. However, postharvest losses severely limit its role. Therefore, it is necessary to develop sustainable strategies to minimize these losses and improve the shelf-life of tomato fruits. One of the major concerns is bacterial infections, particularly by faecal coliform bacteria, which can cause food poisoning and illnesses like diarrhoea and dysentery. This study seeks to identify the presence of coliform bacteria on tomato fruits in fields and markets in Muea, Buea Municipality. The study also evaluated different management strategies to reduce the bacterial incidence and load on tomato fruits. A total of 200 fruits were sampled for both the coliform survey and shelf-life analysis. Ten farmers and traders provided samples, including asymptomatic and symptomatic tomato fruits. The samples designated for shelf-life analysis were treated with Aquatab, warm water, lemon, and onion. The results indicated that out of the 80 symptomatic samples collected, 12.5% contained faecal and total coliform species. Among the ten farms sampled, 14% were infected with coliform bacteria, with the highest infestation rate of 60% recorded in field 4. Furthermore, 15% of the asymptomatic tomato fruits were found to be infected by coliform bacteria. Regarding the management strategies, Aquatabs exhibited the highest efficacy in reducing the incidence of coliform bacteria on tomato fruits, followed by onion and lemon extracts. Although hot water treatment effectively removed bacteria from the fruits, damaging the cell wall negatively affected their shelf-life. Overall, this study emphasizes the severity of coliform bacterial pathogens in the Muea area, particularly their occurrence on asymptomatic tomatoes, which poses a significant concern for plant quarantine services. It also demonstrates potential options for mitigating this bacterial challenge.

Keywords: tomato, shelf-life analysis, food and nutrition security, coliform bbacteria

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Authors: Caroline Smith, Professor Debi Bhattacharya, Sion Scott

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Introduction: Oropharyngeal Dysphagia (OD) effects around 15% of older people, however it is often unrecognised and under diagnosed until they are hospitalised. There is a need for primary care healthcare practitioners (HCPs) to assume a proactive role in identifying and managing OD to prevent adverse outcomes such as aspiration pneumonia. Understanding the determinants of primary care HCPs undertaking this new behaviour provides the intervention targets for addressing. This realist review, underpinned by the Theoretical Domains Framework (TDF), aims to synthesise relevant literature and develop programme theories to understand what interventions work, how they work and under what circumstances to facilitate HCPs to prevent harm from OD. Combining realist methodology with behavioural science will permit conceptualisation of intervention components as theoretical behavioural constructs, thus informing the design of a future behaviour change intervention. Furthermore, through the TDF’s linkage to a taxonomy of behaviour change techniques, we will identify corresponding behaviour change techniques to include in this intervention. Methods & analysis: We are following the five steps for undertaking a realist review: 1) clarify the scope 2) Literature search 3) appraise and extract data 4) evidence synthesis 5) evaluation. We have searched Medline, Google scholar, PubMed, EMBASE, CINAHL, AMED, Scopus and PsycINFO databases. We are obtaining additional evidence through grey literature, snowball sampling, lateral searching and consulting the stakeholder group. Literature is being screened, evaluated and synthesised in Excel and Nvivo. We will appraise evidence in relation to its relevance and rigour. Data will be extracted and synthesised according to its relation to Initial programme theories (IPTs). IPTs were constructed after the preliminary literature search, informed by the TDF and with input from a stakeholder group of patient and public involvement advisors, general practitioners, speech and language therapists, geriatricians and pharmacists. We will follow the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) quality and publication standards to report study results. Results: In this ongoing review our search has identified 1417 manuscripts with approximately 20% progressing to full text screening. We inductively generated 10 IPTs that hypothesise practitioners require: the knowledge to spot the signs and symptoms of OD; the skills to provide initial advice and support; and access to resources in their working environment to support them conducting these new behaviours. We mapped the 10 IPTs to 8 TDF domains and then generated a further 12 IPTs deductively using domain definitions to fulfil the remaining 6 TDF domains. Deductively generated IPTs broadened our thinking to consider domains such as ‘Emotion,’ ‘Optimism’ and ‘Social Influence’, e.g. If practitioners perceive that patients, carers and relatives expect initial advice and support, then they will be more likely to provide this, because they will feel obligated to do so. After prioritisation with stakeholders using a modified nominal group technique approach, a maximum of 10 IPTs will progress to test against the literature.

Keywords: behaviour change, deglutition disorders, primary healthcare, realist review

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Authors: Cristina Hotoleanu

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Introduction: The recent Covid-19 pandemic accelerated the development of e-health, including telemedicine, smartphone applications, and medical wearable devices. Providing remote teleconsultations supposes challenges which may require further face-to-face medical interactions. The aim of this study was to assess the correlation between the types of teleconsultations and the need of onsite medical services (investigations and medical visits) for the diagnosis and treatment. Methods: a retrospective study including all the teleconsultations using the platform offered by a telehealth provider in Romania (Telios Care SA) between May 1, 2021- April 30, 2022, was performed. Binary data were analysed using the chi-square test with a significance level of p < 0.05. Results: out of 7163 consultations, 3961 were phone calls, 1981 were online messages, and 1221 were video calls. Onsite medical services were indicated in 3327 (46.44%) cases; the onsite investigations or the onsite visits were recommended for 2908 patients as follows: 2326 in case of phone calls, 582 in case of online messages, none in case of video calls. Both onsite investigations and visits were indicated for 419 patients. The need for onsite additional medical services was significantly higher in the case of phone calls than in the other 2 types of teleconsultations (Chi square= 1207.06, p= 0.00001). The indication for onsite services was done mainly after teleconsultations covering medical specialties (87.34%), significantly higher than the other specialties (Chi square=914.59, p=0.00001). Teleconsultations in surgical specialties and other fields (pharmacy, dentistry, psychology, wellbeing- nutrition, fitness) resulted in 12.13%, respective less than 1%, indication for onsite investigations or visits, explained by using of video calls in most of the cases. Conclusion: a further onsite medical service was necessary in less than a half of the teleconsultations. This indication was done mainly after phone calls and teleconsultations in medical specialties. Video calls were used mostly in psychology, nutrition, and fitness teleconsultations and did not require a further onsite medical service. Other studies are necessary to assess better the types of teleconsultations and the specialties bringing the biggest benefit for the patients.

Keywords: onsite medical services, phone calls, teleconsultations, telemedicine

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Authors: T. Poppendieker, H. Maurer, C. Segieth

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Over the past ten years, foam rolling has become a new trend in the fitness and health market. It is also a frequently used technique for self-massage. However, the scope of effects from foam rolling has only recently started to be researched and understood. The focus of this study is to examine the effects of prolonged foam rolling on muscle performance. Isometric muscle force was used as a parameter to determine an improving impact of the myofascial roller in two different application volumes. Besides the maximal muscle force, data were also collected on muscle activation during all tests. Twenty-four (17 females, 7 males) healthy students with an average age of 23.4 ± 2.8 years were recruited. The study followed a cross-over pre-/post design in which the order of conditions was counterbalanced. The subjects performed a one-minute and three-minute foam rolling application set on two separate days. Isometric maximal muscle force of the dominant calf was tested before and after the self-myofascial release application. The statistic software program SPSS 22 was used to analyze the data of the maximal isometric force of the calf muscle by a 2 x 2 (time of measurement x intervention) analysis of variance with repeated measures. The statistic significance level was set at p ≤ 0.05. Neither for the main effect of time of measurement (F(1,23) = .93, p = .36, f = .20) nor for the interaction of time of measurement x intervention (F(1,23) = 1.99, p = .17, f = 0.29) significant p-values were found. However, the effect size indicates a mean interaction effect with a tendency of greater pre-post improvements under the three-minute foam rolling condition. Changes in maximal force did not correlate with changes in EMG-activity (r = .02, p = .95 in the short and r = -.11, p = .65 in the long rolling condition). Results support findings of previous studies and suggest a positive potential for use of the foam roll as a means for keeping muscle force at least at the same performance level while leading to an increase in flexibility.

Keywords: application volume differences, foam rolling, isometric maximal force, self-myofascial release

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Authors: Ayman Bani Salameh

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Background: Obesity in children is in increasing in developed and developing countries, which leads to morbidity and premature mortality. Lifestyle behaviors are an important issue in minimizing this problem and subsequent complications. Thus, this study purposed to assess lifestyle behaviors, including dietary habits and physical activity, among Jordanian obese children aged 6-9 years. Methods: A cross-sectional study was conducted on 324 children aged 6-9 years using a questionnaire consisting of items measuring dietary habits (7 items) and physical activity (8 items). Results: Findings showed that obese children had bad dietary habits involved in the number of meals eaten day (M= 5.06, SD=1.14), number of snacks of sweet/ chocolates daily (M= 3. 61, SD=0.82), and number of glasses of sweet fizzy drinks/day (M= 3.39, SD=0.96). Moreover, they had poor physical activity represented in the number of playing or training in an activity like dancing, swimming, and walking in the past week (M= 0.06, SD=1.01), number of days in participating in moderate physical activity last week (M= 0.06, SD=1.01), time spending in using a computer, watching TV, watching videos or using the internet as a part of study or homework in the last week (M= 16.88, SD=2.37), and ), time spending in using a computer, watching TV, watching videos or using the internet for fun or recreation in the past week (M= 14.44, SD=2.37). Conclusion: Obese children aged 6-9 had unhealthy lifestyle behaviors, which could expose them to a high risk of increasing comorbidities associated with obesity. Therefore, this preliminary study helps develop an intervention program based on modifying unhealthy behaviors, including bad dietary habits and a sedentary lifestyle. The results provide baseline data about the strategies for developing intervention programs for weight reduction.

Keywords: obesity, children, behaviors, lifestyle

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Authors: Huang Chiung Chiu

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This article is about the nursing experience of assisting an outpatient with premature menopause, osteoporosis and sarcopenia through a multi-discipline care model. The nursing period is from September 22nd, 2020, to December 7th, 2020, collecting data through interviews with the patient, observation, and physical assessment. It was found that the main health problems were insufficient nutrition, less physical need, insomnia, and potentially dangerous falls. As an outpatient nurse, the author observed that in recent years, the age group of women with premature menopause, osteoporosis and sarcopenia had shifted downward. Integrated multi-disciplinary interventions were provided upon the initial diagnosis of osteoporosis and sarcopenia. Under the outpatient care setting, the collaborative team works between the doctors, nutritionists, osteoporosis educators, rehabilitates, physical therapists and other specialized teams were applied to provide individualized, integrated multi-disciplinary care. Through empathy and the establishment of attentive care, companionship and trust, we discussed care plans and treatment guidelines with the case, providing accurate, complete disease information and feedback education to strengthen the patient’s knowledge and motivation for exercise. Nursing guidance regarding the dietary nutrition and adjustment of daily routine was provided to increase the self-care ability, improve the health problems of muscle weakness and insomnia, and prevent falls. For patients with postmenopausal osteoporosis and sarcopenia, it is recommended that the nurses coordinate the multi-discipline integrated care model, adjust patients’ lifestyle and diet, and establish a regular exercise plan so that the cases can be evaluated holistically to improve the quality of care and physical and mental comfort.

Keywords: multi-discipline care model, premature menopause, osteoporosis, sarcopenia, insomnia

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Authors: Julius Adebayo John

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The objective of this study is to compare the use of medicinal plants and Conventional medicine intervention in the management of HBV among Ibadan populace. A purposive sampling technique was used to administer questionnaires at 2 places, namely, the University College Hospital and Total Healthcare Diagnostic Centre, Ibadan, where viral loads are carried out. A EuroQol (EQ – 5D) was adopted to collect data. Descriptive and inferential analyses were performed. Also, ANOVA, Correlation, charts, and tables were used. Findings revealed a high prevalence of HBV among female respondents and sample between ages 26years to 50years. Results showed that the majority discovered their health status through free HBV tests. Analysis indicated that the use of medicinal plant extract is cost-effective in 73% of cases. Rank order utility derived from medicinal plants is higher than other interventions. Correlation analysis performed for the current health status of respondents were significant at P<0.01 against the intervention management adopted (0.046), cost of treatment (0.549), utility (0.407) at P<0.00, duration of the treatment (0.604) at P<0.01; viral load before treatment (-0.142) not significant at P<0.01, the R2 (72.2%) showed the statistical variance in respondents current health status as explained by the independent variables. Respondents gained quality-adjusted life-years (QALYs) of between 1year to 3years. Suggestions were made for a public-private partnership effort against HBV with emphasis on periodic screening, viral load test subsidy, and free vaccination of people with –HBV status. Promoting phytomedicine through intensive research with strong regulation of herbal practitioners will go a long way in alleviating the burdens of the disease in society.

Keywords: medicinal plant, HBV management interventions, utility, QALYs, ibadan metropolis

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Authors: Shaista Meghani, Rozina Karmaliani, Khairulnissa Ajani, Shireen Shahzad, Nadeem Ullah Khan

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Background: The concept of Family Presence During Resuscitation (FPDR) is gradually gaining recognition in western countries, however, it is rarely considered in South Asian countries including Pakistan. Over time, patients’ and families’ rights have gained recognition and healthcare has progressed to become more patient-family centered. Objectives: The objective of this study was to evaluate the impact of an educational program on the Knowledge, Attitude, and Practices (KAP) of healthcare professionals (HCPs) towards FPDR in Emergency Department (ED), at a tertiary care setting, in Karachi, Pakistan. Methods: This was a Pre-test and Post-test study design. A convenient universal sampling was done, and all ED nurses and physicians with more than one year of experience were eligible. The intervention included one-hour training sessions for physicians (three sessions) and nurses (eight sessions), The KAP of nurses and physicians were assessed immediately after (post-test I), and two weeks(post-test II) after the intervention using a pretested questionnaire. Results: The findings of the study revealed that the mean scores of knowledge and attitude of HCPs at both time points were statistically significant (p-value=<0.001), however, an insignificant difference was found on practice of FPDR (p-value=>0.05). Conclusion: The study findings recommend that the educational program on FPDR for HCPs needs to be offered on an ongoing basis. Moreover, training modules need to be developed for the staff, and formal guidelines need to be proposed for FPDR, through a multidisciplinary team approach.

Keywords: family presence, cardiopulmonary resuscitation, attitude, education, practices, health care professionals

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Authors: Geraldine Macdonald, Oliver Perra, Nina O’Neill, Laura Neeson, Kathryn Higgins

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Background: Despite improvements in recent years, almost one in six children in Northern Ireland (NI) leaves primary school without achieving the expected level in English and Maths. By early adolescence, this ratio is one in five. In 2010-11, around 9000 pupils in NI had failed to achieve the required standard in literacy and numeracy by the time they left full-time education. This paper reports the findings of an experimental evaluation of a programmed designed to improve educational outcomes of a cohort of children starting primary school in areas of high social disadvantage in Northern Ireland. The intervention: ‘Ready to Learn’ comprised two key components: a literacy-rich After School programme (one hour after school, three days per week), and a range of activities and support to promote the engagement of parents with their children’s learning, in school and at home. The intervention was delivered between September 2010 and August 2013. Study aims and objectives: The primary aim was to assess whether, and to what extent, ‘Ready to Learn’ improved the literacy of socially disadvantaged children entering primary schools compared with children in schools without access to the programme. Secondary aims included assessing the programme’s impact on children’s social, emotional and behavioural regulation, and parents’ engagement with their children’s learning. In total, 505 children (almost all) participated in the baseline assessment for the study, with good retention over seven sweeps of data collection. Study design: The intervention was evaluated by means of a cluster randomized trial, with schools as the unit of randomization and analysis. It included a qualitative component designed to examine process and implementation, and to explore the concept of parental engagement. Sixteen schools participated, with nine randomized to the experimental group. As well as outcome data relating to children, 134 semi-structured interviews were conducted with parents over the three years of the study, together with 88 interviews with school staff. Results: Given the children’s ages, not all measures used were direct measures of reading. Findings point to a positive impact of “Ready to Learn” on children’s reading achievement (comprehension and fluency), as assessed by the York Assessment of Reading Comprehension (YARC) and decoding, assessed using the Word Recognition and Phonic Skills (WRaPS3). Effects were not large, but evidence suggests that it is unusual for an after school programme to clearly to demonstrate effects on reading skills. No differences were found on three other measures of literacy-related skills: British Picture Vocabulary Scale (BPVS-II), Naming Speed and Non-word Reading Tests from the Phonological Assessment Battery (PhAB) or Concepts about Print (CAP) – the last due to an age-related ceiling effect). No differences were found between the two groups on measures of social, emotional and behavioural regulation, and due to low levels of participation, it was not possible directly to assess the contribution of the parent component to children’s outcomes. The qualitative data highlighted conflicting concepts of engagement between parents and school staff. Ready to Learn is a promising intervention that merits further support and evaluation.

Keywords: after-school, education, literacy, parental engagement

Procedia PDF Downloads 342

Authors: Norsuhana Omar, Amilia Aminuddina Zaiton Zakaria, Raifana Rosa Mohamad Sattar, Kalaivani Chellappan, Mohd Alauddin Mohd Ali, Norizam Salamt, Zanariyah Asmawi, Norliza Saari, Aini Farzana Zulkefli, Nor Anita Megat Mohd. Nordin

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Inflammation plays an important role in the pathogenesis of vascular dysfunction leading to arterial stiffness. Pulse wave velocity (PWV) and augmentation index (AS), as tools for the assessment of vascular damages are widely used and have been shown to predict cardiovascular disease (CVD). C-reactive protein (CRP) is a marker of inflammation. Several studies noted that regular exercise is associated with reduced arterial stiffness. The lack of exercise among Malaysians and the increasing CVD morbidity and mortality among young men are of concern. In Malaysia data on the workplace exercise intervention is scarce. A programme was designed to enable subjects to increase their level of walking as part of their daily work routine and self-monitored by using pedometers. The aim of this study to evaluate the reducing of inflammation by measuring CRP and improvement arterial stiffness measured by carotid femoral PWV (PWVCF) and AI. A total of 70 young men (20 - 40 years) who were sedentary, achieving less than 5,000 steps/day in casual walking with 2 or more cardiovascular risk factors were recruited in Institute of Vocational Skills for Youth (IKBN Hulu Langat). Subjects were randomly assigned to a control (CG) (n=34; no change in walking) and pedometer group (PG) (n=36; minimum target: 8,000 steps/day). The CRP was measured by using immunological method while PWVCF and AI were measured using Vicorder. All parameters were measured at baseline and after 12 weeks. Data for analysis was conducted using Statistical Package of Social Sciences Version 22 (SPSS Inc., Chicago, IL, USA). At post intervention, the CG step counts were similar (4983 ± 366vs 5697 ± 407steps/day). The PG increased step count from 4996 ± 805 to 10,128 ±511 steps/day (P<0.001). The PG showed significant improvement in anthropometric variables and lipid (time and group effect p<0.001). For vascular assessment, the PG showed significantly decreased for time and effect (p<0.001) for PWV (7.21± 0.83 to 6.42 ± 0.89) m/s; AI (11.88± 6.25 to 8.83 ± 3.7) % and CRP (pre= 2.28 ± 3.09, post=1.08± 1.37mg/L). However, no changes were seen in CG. As a conclusion, a pedometer-based walking programme may be an effective strategy for promoting increased daily physical activity which reduces cardiovascular risk markers and thus improve cardiovascular health in terms of inflammation and arterial stiffness. The community intervention for health maintenance has potential to adopt walking as an exercise and adopting vascular fitness index as the performance measuring tools.

Keywords: arterial stiffness, exercise, inflammation, pedometer

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Authors: Olusola Joseph Adesina, Sunmaila Oyetunji Raimi, Olufemi Akinloye Bolaji, Abiodun Ezekiel Adesina

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The quality of education and the standard of a nation cannot rise above the quality of the teacher (NPE, 2004). Efforts at improving the falling standard of education in the country call for the need-based assessment of the primary tier of education in Nigeria. It was revealed that the teachers’ standard of performance and pupils’ achievement was below average. Teachers’ cluster meeting intervention was therefore recommended as a step towards enhancing the teachers’ professional competency, efficient and effective proactive and interactive lesson presentation. The study thus determined the impact of the intervention on teachers’ professional performance (lesson note preparation and teaching performance) in Oyo State, Nigeria. The main and interaction effects of the gender of the teachers as moderator variable were also determined. Three null hypotheses guided the study. Pre-test, posttest control group quazi experimental design was adopted for the study. Three hundred intact classes from three hundred different schools were randomly selected into treatment and control groups. Two response instruments-Classroom Lesson Note Preparation Checklist (CLNPC; r = 0.89) Cluster Lesson Observation Checklist (CLOC; r = 0.86) were used for data collection. Mean, Standard deviation and Analysis of Covariance (ANCOVA) were used to analyse the collected data. The results showed that the teachers’ cluster meeting have significant impact on teachers’ lesson note preparation (F(1,295) = 31.607; p < 0.05; η2 = .097) and teaching performance (F(1,295) = 20.849; p < 0.05; η2 = .066) in the core subjects of primary schools in Oyo State, Nigeria. The study therefore recommended among others that teachers’ cluster meeting should be sustained for teachers’ professional development in the State.

Keywords: teachers’ cluster meeting, teacher lesson note preparation, teaching performance, teachers’ gender, primary schools in Oyo state

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Authors: Caiwei Zhu, Remke Klapwijk

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Spatial thinking, a way of thinking based on the understanding and reasoning of spatial concepts and representations, is embedded in science, technology, engineering, arts, and mathematics (STEAM) learning. Aside from many studies that successfully used targeted training to improve students’ spatial thinking skills, few have closely examined how spatial thinking can be trained in classroom settings. Design and technology education, which receives increasing attention towards its integration into formal curriculums, inherently encompasses a wide range of spatial activities, such as constructing mental representations of design ideas, mentally transforming objects and materials to form designs, visually communicating design plans through annotated drawings, and creating 2D and 3D design artifacts. Among different design topics, biomimicry offers a unique avenue for students to recognize and analyze the shapes and structures in nature. By mapping the forms of plants and animals onto functions, students gain inspiration to solve human design challenges. This study is one of the first to highlight opportunities for training spatial thinking in a biomimicry design project for primary school students. Embracing methodological principles of educational design-based research, this case study is conducted along with iterations in the design of the intervention and collaboration with teachers. Data are harvested from small groups of 10- to 12-year-olds at an international school in the Netherlands. Classroom videos, semi-structured interviews with students, design drawings and artifacts, formative assessment, and the pre- and post-intervention spatial test triangulate evidence for students' spatial thinking. In addition to contributing to a theory of integrating spatial thinking in the primary curriculum, mechanisms underlying such improvement in spatial thinking are explored and discussed.

Keywords: biomimicry, design and technology education, primary education, spatial thinking

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Authors: Hannah Patricia S., Louise Margarrette R., Josking Oliver L., Denisse Katrina C., Justine Kali O.

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Aims: In the Philippines, there has been an astronomical increase in the population of elderly sent to nursing home facilities which has been studied to induce despair and loss of self-worth. Nurses in institutionalized facilities generally care for the elderly. Although supportive group therapy has been explored to mend this psychological disparity, nursing research has limited published studies about this in the institutionalized setting. Hence, the study determined the effectiveness of supportive group therapy in depression, self-esteem and quality of life among institutionalized elderly. Methodology: A one-group pre-test-post-test design was conducted among 20-purposively selected institutionalized elderly after the Ethics Research Board approval. All eligible participants underwent the supportive group therapy after being subdivided into session groups. The Geriatric Depression Scale, which has a Cronbach’s alpha coefficient of 0.90; the Rosenberg Self-Esteem, which has a Cronbach’s alpha coefficient = 0.84; and the Older People Quality of Life, which has a Cronbach’s alpha coefficient =0.88, were utilized to measure depression, self-esteem, and quality of life, respectively. Descriptive statistics and Repeated Measures-Multivariate Analysis of Variance (RM-MANOVA) analyzed gathered data. Results: Results showed that the supportive group therapy significantly decreased post-test depression scores (F(1,19)=78.69,p=0.0001,partial η2=0.805), significantly improved post-test self-esteem score (F(1,19)=28.07,p=0.0001,partial η2=0.596), and significantly increased the post-test quality of life (F(1,19)=79.73,p=0.0001,partial η2=0.808) after the intervention has been rendered. Conclusion: Supportive group therapy is effective in alleviating depression and in improving self-esteem and quality of life among institutionalized elderly and can be utilized by nursing homes as an intervention to improve the over-all psychosocial status of elderly patients.

Keywords: supportive group therapy, institutionalized elderly, depression, self-esteem, quality of life

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Authors: Zyrah Lou R. Samar, Genecarlo Liwanag

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Type 2 Diabetes Mellitus is the more prevalent type, caused by a combination of insulin resistance and inadequate insulin response to hyperglycemia1. Aside from pharmacologic interventions, medical nutrition therapy is an integral part of the management of patients with Type 2 Diabetes Mellitus. Whey protein, which is one of the best protein sources, has been investigated for its applicability in improving glycemic control in patients with Type 2 Diabetes Mellitus. This systematic review and meta-analysis was conducted to measure the magnitude of the effect of whey protein on glycemic control in type 2 diabetes mellitus. The aim of this review is to evaluate the efficacy and safety of whey protein in patients with type 2 diabetes mellitus. Methods: A systematic electronic search for studies in the PubMed and Cochrane Collaboration database was done. Included in this review were randomized controlled trials of whey protein enrolling patients with type 2 diabetes mellitus. Three reviewers independently searched, assessed, and extracted data from the individual studies. Results: A systematic literature search on online databases such as Cochrane Central Registry, PubMed, and Herdin Plus was conducted in April to September 2021 to identify eligible studies. The search yielded 21 randomized controlled trials after removing duplicates. Only 5 articles were included after reviewing the full text, which met the criteria for selection. Conclusion: Whey protein supplementation significantly reduced fasting blood glucose. However, it did not reduce post-prandial blood glucose, HbA1c level, and weight when compared with the placebo. There has been a considerate heterogeneity across all studies, which may have contributed/confounded its effects. A larger sample size and better inclusion, and a more specific study may be included in the future reviews.

Keywords: whey protein, diabetes, nutrition, fasting blood sugar, postprandial glucose, HbA1c, weight reduction

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Authors: S. A. N. Rashani, S. Pigera, P. N. J. Fernando, S. Jayawickema, M. A. Niriella, A. P. De Silva

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Dietary supplement (DS) consumption is drastically trending among the young athlete generation in developing countries. Many athletes try to fulfill their nutrition requirements using dietary supplements without knowing their effects on health and performance. This study aimed to assess the DS usage patterns of university athletes in Sri Lanka. A self-administered questionnaire was employed to collect data from state university students representing a university team, and a sample of 200 respondents was selected based on a stratified random sampling technique. Incomplete questionnaires were omitted from the analysis. The data were analyzed using IBM SPSS statistics for Windows version 25. The level of significance was set at p<0.05 in the data analysis. The prevalence of DS was 48.2% (n= 94), with no significant association between gender and DS intake. Protein (15.9%), vitamin (14.9%), sports drinks (12.8%), and creatine (8.2%) were the most consumed DS by students. Weightlifting (85.0%), football (62.5%), rugby (57.7%), and wrestling (40.9%) players showed higher DS usage among other sports. Coaches were reported as the most frequent person who was advised to use DS (43.0%). Students who won interuniversity games showed significantly low DS intake (p = 0.002) compared to others. Interestingly, DS use was significantly affected by the season of use (p = 0.000), pointing out that during competition and training seasons (62.4%) was the most frequent use. The pharmacy (27.0%) was the commonest place to buy DS. Students who used nutrient-dense meal plans during the training and competition period still showed a 61.0% tendency to consume DS. Most claimed reason to use DS was to increase energy and strength (29.0%). A majority reported that they used DS for less than one month (35.5%), while the second-highest duration was over three years (17.2%). Considering body mass index (BMI), healthy weight students showed 71.0% DS prevalence. DS prevalence was moderate among Sri Lankan university students, highlighting that the highest DS use was during competition and training seasons. Moreover, it emphasizes the need for nutrition and anti-doping counseling in the Sri Lankan university system.

Keywords: athlete, dietary, supplements, university

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Authors: Sohni Siddiqui, Anja Schultze-Krumbholz

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Our lives now revolve more around online-related tasks, as the internet has become a necessity. One of the disturbance concerns with high internet usage is the multiplication of cyber-associated risky behaviors such as cyber aggression and/or cyberbullying. Cyber Bullying is an emerging issue that needs immediate attention from many stakeholders such as parents, doctors, school administrators, policymakers, researchers, and others, especially in the COVID-19 pandemic when online learning has been adopted as an instructional strategy, and there is a continuous rise in cyberbullying cases. The aim of the article is to review existing successful and emerging interventions designed to control bullying and cyberbullying by engaging individuals through teachers’ professional development and adopting a whole-school approach. The study identified the strengths and limitations of the programs and suggested improvements to existing interventions. Preparing interventions with a strong theoretical framework, integrating applications of emerging theories in interventions, promoting proactive and reactive strategies in combination, beginning with the baseline needs assessment surveys, reducing digital time and digital divide among parents and children, promoting the concept of lead trainer, peer trainer, and hot spots, focusing on physical activities, use of landmarks are some of the recommendations proposed by authors. In addition to face-to-face intervention, the researchers recommend updating and improving previous intervention programs with games and apps. Especially in the time of pandemic crises, when face-to-face interactions are limited and cyberbullying is triggered, the use of apps, web-based interventions, and games can be an effective way to control electronic perpetration and victimization.

Keywords: anti bullying programs, cyber bullying, individualized trainings, teachers’ professional development, whole school interventions

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