Search results for: nine-square exercise

Authors: Svetlana Petrikova, Alexander Yu Kostinskiy

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Management of research evaluation in the Higher School of Economics (HSE) originates from the HSE Academic Fund created in 2004 to facilitate and support academic research and presents its results to international academic community. As the means to inspire the applicants, science projects went through competitive selection process evaluated by the group of experts. Drastic development of HSE, quantity of applied projects for each Academic Fund competition and the need to coordinate the conduct of expert evaluation resulted in founding of the Office for Research Evaluation in 2013. The Office’s primary objective is management of research evaluation of science projects. The standards to conduct the evaluation are defined as follows: - The exercise of the process approach, the unification of the functioning of department. - The uniformity of regulatory, organizational and methodological framework. - The development of proper on-line evaluation system. - The broad involvement of external Russian and international experts, the renouncement of the usage of own employees. - The development of an algorithm to make a correspondence between experts and science projects. - The methodical usage of opened/closed international and Russian databases to extend the expert database. - The transparency of evaluation results – free access to assessment while keeping experts confidentiality. The management of research evaluation of projects is based on the sole standard, organization and financing. The standard way of conducting research evaluation at HSE is based upon Regulations on basic principles for research evaluation at HSE. These Regulations have been developed from the moment of establishment of the Office for Research Evaluation and are based on conventional corporate standards for regulatory document management. The management system of research evaluation is implemented on the process approach basis. Process approach means deployment of work as a process, which is the aggregation of interrelated and interacting activities processing inputs into outputs. Inputs are firstly client asking for the assessment to be conducted, defining the conditions for organizing and carrying of the assessment and secondly the applicant with proper for the competition application; output is assessment given to the client. While exercising process approach to clarify interrelation and interacting main parties or subjects of the assessment are determined and the way for interaction between them forms up. Parties to expert assessment are: - Ordering Party – The department of the university taking the decision to subject a project to expert assessment; - Providing Party – The department of the university authorized to provide such assessment by the Ordering Party; - Performing Party – The legal and natural entities that have expertise in the area of research evaluation. Experts assess projects in accordance with criteria and states of expert opinions approved by the Ordering Party. Objects of assessment generally are applications or HSE competition project reports. Mainly assessments are deployed for internal needs, i.e. the most ordering parties are HSE branches and departments, but assessment can also be conducted for external clients. The financing of research evaluation at HSE is based on the established corporate culture and traditions of HSE.

Keywords: expert assessment, management of research evaluation, process approach, research evaluation

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Authors: Janet Ige, Paul Pilkington, Selena Gray, Jane Powell

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Older adults from socially disadvantaged groups and Black and Minority Ethnic (BME) groups experience a higher burden of physical inactivity. Physical inactivity among BME groups is associated with the disproportionately higher level of health inequalities. People from minority ethnic groups encounter more barriers to physical activity. However, this is not often reported. There is very limited review-level evidence on the barriers and facilitators of physical activity among older adults from BME groups in the UK. This study aims to answer the following research question: what are the barriers and facilitators of physical activity participation among adults and older adults from BME background in the UK? To address this, we conducted a review of qualitative studies investigating the barriers and opportunities for physical activity among of BME adults and older adults in the UK. Method: This study is nested in an interpretive paradigm of meta-ethnography. A structured search for published literature was conducted on 6 electronic databases (MEDLINE, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Applied Social Sciences Index and Abstracts, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine) from January 2007 to July 2017. Hand searching of the reference list of publications was performed in addition to a search conducted on Google Scholar to identify grey literature. Studies were eligible provided they employed any qualitative method and included participants identified as being BME, aged 50 and above, living in any community within the UK. In total, 1036 studies were identified from the structured search for literature, 718 studies were screened by titles after duplicates were removed. On applying the inclusion and exclusion criteria, a final selection of 10 studies was considered eligible for synthesis. Quality assessment was performed using the Critical Appraisal Skills Programme tool. Logic maps were used to show the relationship between factors that impact on physical activity participation among adults and older adults Result: Six key themes emerged from the data: awareness of the links between physical activity and health, interaction, and engagement with health professionals, cultural expectations and social responsibilities, appropriate environment, religious fatalism and practical challenges. Findings also showed that the barriers and facilitators of physical activity exist at the individual, community, and socio-economic, cultural and environmental level. There was a substantial gap in research among Black African groups. Findings from the review also informed the design of an ongoing survey investigating the experience and attitude of adults from Somali backgrounds towards physical activity in the UK. Conclusion: Identifying the barriers and facilitators of physical activity among BME groups is a crucial step in addressing the widening inequality gap. Findings from this study highlight the importance of engaging local BME residents in the design of exercise facilities within the community. This will ensure that cultural and social concerns are recognized and properly addressed.

Keywords: BME, UK, meta-ethnographic, adults

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Authors: Laura E. Hall, Joel Monárrez-Espino, Luz María Tejada Tayabas

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College students are at risk of weight gain and poor dietary habits, and health behaviours established during this period have been shown to track into midlife. They may therefore be an important target group for health promotion strategies, yet there is a lack of literature regarding dietary intakes and associated factors in this group, particularly in middle-income countries such as Mexico. The aim of this exploratory research was to describe and compare reported dietary intakes among nursing and nutrition college students at two public universities in Mexico, and to explore the relationship between demographic, behavioural and other health-related factors and the risk of low diet quality. Mexican college students (n=444) majoring in nutrition or nursing at two urban universities completed questionnaires regarding dietary and health-related behaviours and risks. Dietary intake was assessed via 24-hour recall. Weight, height and abdominal circumference were measured. Descriptive statistics were reported and nutrient intakes were compared between colleges and study tracks using Student’s t tests, odds ratios and Pearson chi square tests. Two dietary quality scores were constructed to explore the relationship between demographic, behavioural and other health-related factors and the diet quality scores using binary logistic regression. Analysis was performed using SPSS statistics, with differences considered statistically significant at p<0.05. The response rate to the survey was 91%. When macronutrients were considered as a percentage of total energy, the majority of students had protein intakes within recommended ranges, however one quarter of students had carbohydrate and fat intakes exceeding recommended levels. Three quarters had fibre intakes that were below recommendations. More than half of the students reported intakes of magnesium, zinc, vitamin A, folate and vitamin E that were below estimated average requirements. Students studying nutrition reported macronutrient and micronutrient intakes that were more compliant with recommendations compared to nursing students, and students studying in central-north Mexico were more compliant than those studying in southeast Mexico. Breakfast skipping (Adjusted Odds Ratio (OR) = 5.3; 95% Confidence Interval (CI) = 1.2-22.7), risk of anxiety (OR = 2.3; CI = 1.3-4.4), and university location (OR = 1.6; CI = 1.03-2.6) were associated with a greater risk of having a low macronutrient score. Caloric intakes <1800kcal (OR = 5.8; CI = 3.5-9.7), breakfast skipping (OR = 3.7; CI = 1.4-10.3), vigorous exercise ≤1h/week (OR = 2.6; CI = 1.3-5.2), soda consumption >250mls/day (OR = 2.0; CI = 1.2-3.3), unhealthy diet perception (OR = 1.9; CI = 1.2-3.0), and university location (OR = 1.8; CI = 1.1-2.8) were significantly associated with greater odds of having a low micronutrient score. College students studying nursing and nutrition did not report ideal diets, and these students should not be overlooked in public health interventions. Differences in dietary intakes between universities and study tracks were evident, with more favourable profiles evident in nutrition compared to nursing, and North-central compared to Southeast students. Further, demographic, behavioural and other health-related factors were associated with diet quality scores, warranting further research.

Keywords: college student, diet quality, nutrient intake, young adult

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Authors: Amy Heaps, Amy Burns, Una McMahon-Beattie

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Shock and fear tactics have been used to encourage consumer behaviour change within the UK regarding lifestyle choices such as smoking and alcohol abuse, yet such measures have not been applied to food labels to encourage healthier purchasing decisions. Obesity levels are continuing to rise within the UK, despite efforts made by government and charitable bodies to encourage consumer behavioural changes, which will have a positive influence on their fat, salt, and sugar intake. We know that taking extreme measures to shock consumers into behavioural changes has worked previously; for example, the anti-smoking television adverts and new standardised cigarette and tobacco packaging have reduced the numbers of the UK adult population who smoke or encouraged those who are currently trying to quit. The USA has also introduced new front-of-pack labelling, which is clear, easy to read, and includes concise health warnings on products high in fat, salt, or sugar. This model has been successful, with consumers reducing purchases of products with these warning labels present. Therefore, investigating if shock labels would have an impact on UK consumer behaviour and purchasing decisions would help to fill the gap within this research field. This study aims to develop an understanding of consumer’s initial responses to shock advertising with an interest in the perceived impact of long-term effect shock advertising on consumer food purchasing decisions, behaviour, and attitudes and will achieve this through a mixed methodological approach taken with a sample size of 25 participants ages ranging from 22 and 60. Within this research, shock mock labels were developed, including a graphic image, health warning, and get-help information. These labels were made for products (available within the UK) with large market shares which were high in either fat, salt, or sugar. The use of online focus groups and mouse-tracking experiments results helped to develop an understanding of consumer’s initial responses to shock advertising with interest in the perceived impact of long-term effect shock advertising on consumer food purchasing decisions, behaviour, and attitudes. Preliminary results have shown that consumers believe that the use of graphic images, combined with a health warning, would encourage consumer behaviour change and influence their purchasing decisions regarding those products which are high in fat, salt and sugar. Preliminary main findings show that graphic mock shock labels may have an impact on consumer behaviour and purchasing decisions, which will, in turn, encourage healthier lifestyles. Focus group results show that 72% of participants indicated that these shock labels would have an impact on their purchasing decisions. During the mouse tracking trials, this increased to 80% of participants, showing that more exposure to shock labels may have a bigger impact on potential consumer behaviour and purchasing decision change. In conclusion, preliminary results indicate that graphic shock labels will impact consumer purchasing decisions. Findings allow for a deeper understanding of initial emotional responses to these graphic labels. However, more research is needed to test the longevity of these labels on consumer purchasing decisions, but this research exercise is demonstrably the foundation for future detailed work.

Keywords: consumer behavior, decision making, labelling legislation, purchasing decisions, shock advertising, shock labelling

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Authors: Mathilde Pavis

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From Schumann to Van Gogh, Frida Kahlo, and Ray Charles, the stories narrating the careers of artists with physical or mental disabilities are becoming increasingly popular. From the emergence of ‘pathography’ at the end of 18th century to cinematographic portrayals, the work and lives of differently-abled creative individuals continue to fascinate readers, spectators and researchers. The achievements of those artists form the tip of the iceberg composed of complex politico-cultural movements which continue to advocate for wider recognition of disabled artists’ contribution to western culture. This paper envisages copyright law as a potential tool to such end. It investigates the array of rights available to artists with intellectual disabilities to assert their position as authors of their artwork in the twenty-first-century looking at international and national copyright laws (UK and US). Put simply, this paper questions whether an artist’s intellectual disability could be a barrier to assert their intellectual property rights over their creation. From a legal perspective, basic principles of non-discrimination would contradict the representation of artists’ disability as an obstacle to authorship as granted by intellectual property laws. Yet empirical studies reveal that artists with intellectual disabilities are often denied the opportunity to exercise their intellectual property rights or any form of agency over their work. In practice, it appears that, unlike other non-disabled artists, the prospect for differently-abled creators to make use of their right is contingent to the context in which the creative process takes place. Often will the management of such rights rest with the institution, art therapist or mediator involved in the artists’ work as the latter will have necessitated greater support than their non-disabled peers for a variety of reasons, either medical or practical. Moreover, the financial setbacks suffered by medical institutions and private therapy practices have renewed administrators’ and physicians’ interest in monetising the artworks produced under their supervision. Adding to those economic incentives, the rise of criminal and civil litigation in psychiatric cases has also encouraged the retention of patients’ work by therapists who feel compelled to keep comprehensive medical records to shield themselves from liability in the event of a lawsuit. Unspoken transactions, contracts, implied agreements and consent forms have thus progressively made their way into the relationship between those artists and their therapists or assistants, disregarding any notions of copyright. The question of artists’ authorship finds itself caught in an unusually multi-faceted web of issues formed by tightening purse strings, ethical concerns and the fear of civil or criminal liability. Whilst those issues are playing out behind closed doors, the popularity of what was once called the ‘Art of the Insane’ continues to grow and open new commercial avenues. This socio-economic context exacerbates the need to devise a legal framework able to help practitioners, artists and their advocates navigate through those issues in such a way that neither this minority nor our cultural heritage suffers from the fragmentation of the legal protection available to them.

Keywords: authorship, copyright law, intellectual disabilities, art therapy and mediation

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Authors: Marina Gold, Yves Jackson, David Parrat

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The high predominance of Latin American migrants in Geneva from countries where Chagas disease is endemic (Bolivia, Brazil, Argentina, Colombia) is increasing the incidence of chronic Chagas-related problems, especially cardiovascular complications. The precarious migratory status of what are mostly undocumented migrants complicates access to health and affects patients’ and doctors’ health perceptions regarding screening, treatment and monitoring of Chagas-related health concerns. This project results from a 3 year collaboration between the Geneva University Hospital and the NGO Mundo Sano to understand the following questions: 1) how do Latin American migrants perceive their health? 2) What do they understand from Chagas disease? 3) Are patients’ and doctors’ health perceptions similar or do they have competing agendas? This paper aims to present the results of a long-term study that interrogates health perceptions among Latin American migrants in Geneva. The first phase consisted in completing surveys at three community screening events (2016, 2017. 2018), and the results of these surveys reveal the subordination of the importance of health to that of having met economic family obligation. That is, health is important only when it becomes an impediment to economic gain. The contradictory result emerged that people are aware of the importance of health prevention in order to ensure long-term health, but they do not always have agency over their life-style habits (healthy food, regular exercise, emotional stability). The second phase of the research collected open-ended interviews with selected participants, in order to explore in more detail how Latin American migrants deal with Chagas in a different socio-political and economic context to that of endemic countries. These interviews (5 in total) reveal mixed methods of managing health: social networks, access to health care transnationally (in Geneva, Spain and back in their home country), and different valuations of health problems in each situation. The third phase consisted in observations of doctor-patient consultations and further extended interviews with patients to determine doctor/patient health perceptions around Chagas disease. This phase is ongoing, but it has yielded preliminarily observations regarding the expectations that patients’ have of doctors, and the understanding of doctors’ to patients’ complex situations. Positive and complementary health perceptions include patients’ feeling that doctors in Geneva are more understanding, more knowledgeable and less racist than those in their home country, who do not provide detailed information about Chagas or its treatment and discriminate against them for being indigenous or from poor rural areas, enabling a better communication between doctors and patients. Possible conflicting health perceptions include patients addressing their health concerns more holistically and encountering the specialist’s limitations to only treating one health concern, given time limitations and lack of competition with their colleagues (the general practitioner that referred the patient, for example). The implications of this study extend the case of Chagas disease in Geneva and is relevant for all chronic concerns and migratory contexts of precarity.

Keywords: chagas disease, health perceptions, Latin American Migrants, non-endemic countries

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Authors: Li Jiuen Ong, Magdalin Cheong, Sri Rahayu, Lek Alexander, Pei Ting Tan

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Background: Previous programme evaluations from the diabetes training programme conducted in Changi General Hospital revealed that healthcare professionals (HCPs) are keen to receive advance diabetes training and education, specifically in medical, nutritional therapy. HCPs also expressed a preference for interactive activities over didactic teaching methods to enhance their learning. Since the War on Diabetes was initiated by MOH in 2016, HCPs are challenged to be actively involved in continuous education to be better equipped to reduce the growing burden of diabetes. Hence, streamlining training to incorporate an element of fun is of utmost importance. Aim: The nutrition programme incorporates game play using an interactive board game that aims to provide a more conducive and less stressful environment for learning. The board game could be adapted for training of community HCPs, health ambassadors or caregivers to cope with the increasing demand of diabetes care in the hospital and community setting. Methodology: Stages for game’s conception (Jaffe, 2001) were adopted in the development of the interactive board game ‘Sweet Score™ ’ Nutrition concepts and topics in diabetes self-management are embedded into the game elements of varying levels of difficulty (‘Easy,’ ‘Medium,’ ‘Hard’) including activities such as a) Drawing/ sculpting (Pictionary-like) b)Facts/ Knowledge (MCQs/ True or False) Word definition) c) Performing/ Charades To study the effects of game play on knowledge acquisition and perceived experiences, participants were randomised into two groups, i.e., lecture group (control) and game group (intervention), to test the difference. Results: Participants in both groups (control group, n= 14; intervention group, n= 13) attempted a pre and post workshop quiz to assess the effectiveness of knowledge acquisition. The scores were analysed using paired T-test. There was an improvement of quiz scores after attending the game play (mean difference: 4.3, SD: 2.0, P<0.001) and the lecture (mean difference: 3.4, SD: 2.1, P<0.001). However, there was no significance difference in the improvement of quiz scores between gameplay and lecture (mean difference: 0.9, 95%CI: -0.8 to 2.5, P=0.280). This suggests that gameplay may be as effective as a lecture in terms of knowledge transfer. All the13 HCPs who participated in the game rated 4 out of 5 on the likert scale for the favourable learning experience and relevance of learning to their job, whereas only 8 out of 14 HCPs in the lecture reported a high rating in both aspects. 16. Conclusion: There is no known board game currently designed for diabetes training for HCPs.Evaluative data from future training can provide insights and direction to improve the game format and cover other aspects of diabetes management such as self-care, exercise, medications and insulin management. Further testing of the board game to ensure learning objectives are met is important and can assist in the development of awell-designed digital game as an alternative training approach during the COVID-19 pandemic. Learning through gameplay increases opportunities for HCPs to bond, interact and learn through games in a relaxed social setting and potentially brings more joy to the workplace.

Keywords: active learning, game, diabetes, nutrition

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Authors: Guilherme Oliveira

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The assimilation of images and their potential symbolism into lived experiences is inherent. It is through this exercise of recognition via imagistic records that the questioning of the origins of a constant narrative stimulated by the media arises. The construction of the "Man" archetype and the reflections of active masculine imagery in the 21st century, when conveyed through media channels, could potentially have detrimental effects. Addressing this systematic behavioral chronology of virile cisgender, permeated imagistically through these means, involves exploring potential resolutions. Thus, an investigation process is initiated into the potential representation of the 'hero' in this media emulation through idols contextualized in the political sphere, with the purpose of elucidating the processes of simulation and emulation of narratives based on mythical, historical, and sacred accounts. In this process of sharing, the narratives contained in the imagistic structuring offered by information dissemination channels seek validation through a process of public acceptance. To achieve this consensus, a visual set adorned with mythological and sacred symbolisms adapted to the intended environment is promoted, thus utilizing sociocultural characteristics in favor of political marketing. Visual recognition, therefore, becomes a direct reflection of a cultural heritage acquired through lived human experience, stimulated by continuous representations throughout history. Echoes of imagery and narratives undergo a constant process of resignification of their concepts, sharpened by their premises, and adapted to the environment in which they seek to establish themselves. Political figures analyzed in this article employ the practice of taking possession of symbolisms, mythological stories, and heroisms and adapt their visual construction through a continuous praxis of emulation. Thus, they utilize iconic mythological narratives to gain credibility through belief. Utilizing iconic mythological narratives for credibility through belief, the idol becomes the very act of release of trauma, offering believers liberation from preconceived concepts and allowing for the attribution of new meanings. To dissolve this issue and highlight the subjectivities within the intention of the image, a linguistic, semiotic, and anthropological methodology is created. Linguistics uses expressions like 'Blaming the Image' to create a mechanism of expressive action in questioning why to blame a construction or visual composition and thus seek answers in the first act. Semiotics and anthropology develop an imagistic atlas of graphic analysis, seeking to make connections, comparisons, and relations between modern and sacred/mystical narratives, emphasizing the different subjective layers of embedded symbolism. Thus, it constitutes a performative act of disarming the image. It creates a disenchantment of the superficial gaze under the constant reproduction of visual content stimulated by virtual networks, enabling a discussion about the acceptance of caricatures characterized by past fables.

Keywords: image, heroic narrative, media heroism, virile politics, political, myth, sacred performance, visual mythmaking, characterization dynamics

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Authors: Natàlia Garcia Soler, Timothy Moss

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Despite the multiple benefits of sustainable urban drainage, as demonstrated in numerous case studies across the world, urban rainwater harvesting techniques are generally restricted to isolated model projects. The leap from niche to mainstream has, in most cities, proved an elusive goal. Why policies promoting rainwater harvesting are limited in their widespread implementation has seldom been subjected to systematic analysis. Much of the literature on the policy, planning and institutional contexts of these techniques focus either on their potential benefits or on project design, but very rarely on a critical-constructive analysis of past experiences of implementation. Moreover, the vast majority of these contributions are restricted to single-case studies. There is a dearth of knowledge with respect to, firstly, policy implementation processes and, secondly, multi-case analysis. Insights from both, the authors argue, are essential to inform more effective rainwater harvesting in cities in the future. This paper presents preliminary findings from a research project on rainwater harvesting in cities from a social science perspective that is funded by the Swedish Research Foundation (Formas). This project – UrbanRain – is examining the challenges and opportunities of mainstreaming rainwater harvesting in three European cities. The paper addresses two research questions: firstly, what lessons can be learned on suitable policy incentives and planning instruments for rainwater harvesting from a meta-analysis of the relevant international literature and, secondly, how far these lessons are reflected in a study of past and ongoing rainwater harvesting projects in a European forerunner city. This two-tier approach frames the structure of the paper. We present, first, the results of the literature analysis on policy and planning issues of urban rainwater harvesting. Here, we analyze quantitatively and qualitatively the literature of the past 15 years on this topic in terms of thematic focus, issues addressed and key findings and draw conclusions on research gaps, highlighting the need for more studies on implementation factors, actor interests, institutional adaptation and multi-level governance. In a second step we focus in on the experiences of rainwater harvesting in Berlin and present the results of a mapping exercise on a wide variety of projects implemented there over the last 30 years. Here, we develop a typology to characterize the rainwater harvesting projects in terms of policy issues (what problems and goals are targeted), project design (which kind of solutions are envisaged), project implementation (how and when they were implemented), location (whether they are in new or existing urban developments) and actors (which stakeholders are involved and how), paying particular attention to the shifting institutional framework in Berlin. Mapping and categorizing these projects is based on a combination of document analysis and expert interviews. The paper concludes by synthesizing the findings, identifying how far the goals, governance structures and instruments applied in the Berlin projects studied reflect the findings emerging from the meta-analysis of the international literature on policy and planning issues of rainwater harvesting and what implications these findings have for mainstreaming such techniques in future practice.

Keywords: institutional framework, planning, policy, project implementation, urban rainwater management

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Authors: Ojochenemi J. Onubi, Debbi Marais, Lorna Aucott, Friday Okonofua, Amudha Poobalan

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Background: Obesity is a worldwide epidemic with major health and economic consequences. Pregnancy is a trigger point for the development of obesity, and maternal obesity is associated with significant adverse effects in the mother and child. Nigeria is experiencing a double burden of under- and over-nutrition with rising levels of obesity particularly in women. However, there is scarcity of data on maternal obesity in Nigeria and other African countries. Aims and Objectives: This project aimed at identifying crucial components of potential interventions for maternal obesity in Nigeria. The objectives were to assess the prevalence, effects, and distribution of maternal obesity; knowledge, attitude and practice (KAP) of pregnant women and maternal healthcare providers; and identify existing interventions for maternal obesity in Nigeria. Methodology: A systematic review and meta-analysis were initially conducted to appraise the existing literature on maternal obesity in Africa. Following this, a quantitative questionnaire survey of the KAP of pregnant women and a qualitative interview study of the KAP of Health Care Workers (HCW) were conducted in seven secondary and tertiary hospitals across Nigeria. Quantitative data was analysed using SPSS statistical software, while thematic analysis was conducted for qualitative data. Results: Twenty-nine studies included in the systematic review showed significant prevalence, socio-demographic associations, and adverse effects of maternal obesity on labour, maternal, and child outcomes in Africa. The questionnaire survey of 435 mothers revealed a maternal obesity prevalence of 17.9% among mothers who registered for antenatal care in the first trimester. The mothers received nutrition information from different sources and had insufficient knowledge of their own weight category or recommended Gestational Weight Gain (GWG), causes, complications, and safe ways to manage maternal obesity. However, majority of the mothers were of the opinion that excess GWG is avoided in pregnancy and some practiced weight management (diet and exercise) during pregnancy. For the qualitative study, four main themes were identified: ‘Concerns about obesity in pregnancy’, ‘Barriers to care for obese pregnant women’, ‘Practice of care for obese pregnant women’, and ‘Improving care for obese pregnant women’. HCW expressed concerns about rising levels of maternal obesity, lack of guidelines for the management of obese pregnant women and worries about unintended consequences of antenatal interventions. ‘Barriers’ included lack of contact with obese women before pregnancy, late registration for antenatal care, and perceived maternal barriers such as socio-cultural beliefs of mothers and poverty. ‘Practice’ included anticipatory care and screening for possible complications, general nutrition education during antenatal care and interdisciplinary care for mothers with complications. HCW offered suggestions on improving care for obese women including timing, type, and settings of interventions; and the need for involvement of other stake holders in caring for obese pregnant women. Conclusions: Culturally adaptable/sensitive interventions should be developed for the management of obese pregnant women in Africa. Education and training of mothers and health care workers, and provision of guidelines are some of the components of potential interventions in Nigeria.

Keywords: Africa, maternal, obesity, pregnancy

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Authors: O. O. Oku, K. S. Jerry-Alagbaoso

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It is universally acknowledged that the primary function of universities is the generation and dissemination of knowledge. This mission is pursued through the research component of the university programme especially at the post-graduate level. The senior academic staff teach, supervise and provide general academic leadership to post-graduate students who are expected to carry out research leading to the presentation of dissertation as requirement for the award of doctoral degree in their various disciplines. Carrying out the research enterprises involves a lot of corroboration among individuals and communities. The need to safeguard the interest of everyone involved in the enterprise makes the development of ethical standard in research imperative. Ensuring the development and effective application of such ethical standard falls within the leadership role of the vice –chancellors, Deans of post-graduate schools/ faculties, Heads of Departments and supervisors. It is the relevance and application of such ethical standard in Nigerian university research efforts that this study discussed. The study adopted the descriptive research design. A researcher-made 4 point rating scale was used to elicit information from the post-graduate dissertation supervisors sampled from one university each from the six geo-political zones in Nigeria using the purposive sampling technique. The data collected was analysed using the mean score and standard deviation. The findings of the study include among others that there are several cases of unethical practices by Ph.D dissertation students in Nigerian universities. Prominent among these include duplicating research topics, making unauthorized copies of data paper or computer programme, failing to acknowledge contributions of relevant people and authors, rigging an experiment to prempt the result among others. Some of the causes of the unethical practices according to the respondents include inadequate funding of universities resulting in inadequate remuneration for university teachers, inadequacy of equipment and infrastructures, poor supervision of Ph.D students,’ poverty on the side of the student researchers and non-application of sanctions on violators. Improved funding of the Nigerian universities system with emphasis on both staff and student research efforts, admitting academic oriented students into the Ph.D programme and ensuring the application of appropriate sanctions in cases of unethical conduct in research featured prominently in the needed leadership imperatives. Based on the findings of the study, the researchers recommend the development of university research policies that is closely tied to each university’s strategic plan. Such plan should explain the research focus that will attract more funding and direct students interest towards it without violating the principle of academic freedom. The plan should also incorporate the establishment of a research administration office to provide the necessary link between the students and funding agencies and also organise training for supervisors on leadership activities expected of them while educating students on the processes involved in carrying out a qualitative and acceptable research study. Such exercise should include the ethical principles and guidelines that comprise all parts of research from research topic through the literature review to the design and the truthful reporting of results.

Keywords: academic leadership, ethical standards, research stakeholders, research enterprise

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Authors: Jorge Cortés, Alejandra Martínez, Carlos Pérez, Anaid Simón

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The presence of government, news media, and general citizenry in social media allows considering interactions between them as a form of political communication (i.e. the public exchange of contradictory discourses about politics). Twitter’s asymmetrical following model (users can follow, mention or reply to other users that do not follow them) could foster alternative democratic practices and have an impact on Mexican political culture, which has been marked by a lack of direct communication channels between these actors. The research aim is to assess Twitter’s role in political communication practices through the analysis of interaction dynamics between government, news media, and citizens by extracting and visualizing data from Twitter’s API to observe general behavior patterns. The hypothesis is that regardless the fact that Twitter’s features enable direct and horizontal interactions between actors, users repeat traditional dynamics of interaction, without taking full advantage of the possibilities of this medium. Through an interdisciplinary team including Communication Strategies, Information Design, and Interaction Systems, the activity on Twitter generated by the controversy over the presence of Uber in Mexico City was analysed; an issue of public interest, involving aspects such as public opinion, economic interests and a legal dimension. This research includes techniques from social network analysis (SNA), a methodological approach focused on the comprehension of the relationships between actors through the visual representation and measurement of network characteristics. The analysis of the Uber event comprised data extraction, data categorization, corpus construction, corpus visualization and analysis. On the recovery stage TAGS, a Google Sheet template, was used to extract tweets that included the hashtags #UberSeQueda and #UberSeVa, posts containing the string Uber and tweets directed to @uber_mx. Using scripts written in Python, the data was filtered, discarding tweets with no interaction (replies, retweets or mentions) and locations outside of México. Considerations regarding bots and the omission of anecdotal posts were also taken into account. The utility of graphs to observe interactions of political communication in general was confirmed by the analysis of visualizations generated with programs such as Gephi and NodeXL. However, some aspects require improvements to obtain more useful visual representations for this type of research. For example, link¬crossings complicates following the direction of an interaction forcing users to manipulate the graph to see it clearly. It was concluded that some practices prevalent in political communication in Mexico are replicated in Twitter. Media actors tend to group together instead of interact with others. The political system tends to tweet as an advertising strategy rather than to generate dialogue. However, some actors were identified as bridges establishing communication between the three spheres, generating a more democratic exercise and taking advantage of Twitter’s possibilities. Although interactions in Twitter could become an alternative to political communication, this potential depends on the intentions of the participants and to what extent they are aiming for collaborative and direct communications. Further research is needed to get a deeper understanding on the political behavior of Twitter users and the possibilities of SNA for its analysis.

Keywords: interaction, political communication, social network analysis, Twitter

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Authors: Ciaran Friel, Jerry Suls, Mark Butler, Patrick Robles, Samantha Gordon, Frank Vicari, Karina W. Davidson

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Physical activity guidelines focus on increasing moderate-intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence supports that any increase in physical activity is positively correlated with health benefits. Behavior change techniques (BCTs) have demonstrated effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a Personalized Trials (N-of-1) design to evaluate the efficacy of using four BCTs to promote an increase in low-intensity physical activity (2,000 steps of walking per day) in adults aged 45-75 years old. The 4 BCTs tested were goal setting, action planning, feedback, and self-monitoring. BCTs were tested in random order and delivered by text message prompts requiring participant engagement. The study recruited health system employees in the target age range, without mobility restrictions and demonstrating interest in increasing their daily activity by a minimum of 2,000 steps per day for a minimum of five days per week. Participants were sent a Fitbit® fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7 but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by Fitbit for two weeks. In the 8-week intervention phase of the study, participants received each of the four BCTs, in random order, for a two-week period. Text message prompts were delivered daily each morning at a consistent time. All prompts required participant engagement to acknowledge receipt of the BCT message. Engagement is dependent upon the BCT message and may have included recording that a detailed plan for walking has been made or confirmed a daily step goal (action planning, goal setting). Additionally, participants may have been directed to a study dashboard to view their step counts or compare themselves to their baseline average step count (self-monitoring, feedback). At the end of each two-week testing interval, participants were asked to complete the Self-Efficacy for Walking Scale (SEW_Dur), a validated measure that assesses the participant’s confidence in walking incremental distances, and a survey measuring their satisfaction with the individual BCT that they tested. At the end of their trial, participants received a personalized summary of their step data in response to each individual BCT. The analysis will examine the novel individual-level heterogeneity of treatment effect made possible by N-of-1 design and pool results across participants to efficiently estimate the overall efficacy of the selected behavioral change techniques in increasing low-intensity walking by 2,000 steps, five days per week. Self-efficacy will be explored as the likely mechanism of action prompting behavior change. This study will inform the providers and demonstrate the feasibility of an N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

Procedia PDF Downloads 92

Authors: K. Rhea Devaiah, B. S. Premalatha

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Background: Tonsillar Lingual sulcus is the area between the tonsils and the base of the tongue. The surgical resection of the lesions in the head and neck results in changes in speech and swallowing functions. The severity of the speech and swallowing problem depends upon the site and extent of the lesion, types and extent of surgery and also the flexibility of the remaining structures. Need of the study: This paper focuses on the importance of speech and swallowing rehabilitation in an individual with the lesion in the Tonsillar Lingual Sulcus and post-operative functions. Aim: Evaluating the speech and swallow functions post-intensive speech and swallowing rehabilitation. The objectives are to evaluate the speech intelligibility and swallowing functions after intensive therapy and assess the quality of life. Method: The present study describes a report of an individual aged 47years male, with the diagnosis of basaloid squamous cell carcinoma, left tonsillar lingual sulcus (pT2n2M0) and underwent wide local excision with left radical neck dissection with PMMC flap reconstruction. Post-surgery the patient came with a complaint of reduced speech intelligibility, and difficulty in opening the mouth and swallowing. Detailed evaluation of the speech and swallowing functions were carried out such as OPME, articulation test, speech intelligibility, different phases of swallowing and trismus evaluation. Self-reported questionnaires such as SHI-E(Speech handicap Index- Indian English), DHI (Dysphagia handicap Index) and SESEQ -K (Self Evaluation of Swallowing Efficiency in Kannada) were also administered to know what the patient feels about his problem. Based on the evaluation, the patient was diagnosed with pharyngeal phase dysphagia associated with trismus and reduced speech intelligibility. Intensive speech and swallowing therapy was advised weekly twice for the duration of 1 hour. Results: Totally the patient attended 10 intensive speech and swallowing therapy sessions. Results indicated misarticulation of speech sounds such as lingua-palatal sounds. Mouth opening was restricted to one finger width with difficulty chewing, masticating, and swallowing the bolus. Intervention strategies included Oro motor exercise, Indirect swallowing therapy, usage of a trismus device to facilitate mouth opening, and change in the food consistency to help to swallow. A practice session was held with articulation drills to improve the production of speech sounds and also improve speech intelligibility. Significant changes in articulatory production and speech intelligibility and swallowing abilities were observed. The self-rated quality of life measures such as DHI, SHI and SESE Q-K revealed no speech handicap and near-normal swallowing ability indicating the improved QOL after the intensive speech and swallowing therapy. Conclusion: Speech and swallowing therapy post carcinoma in the tonsillar lingual sulcus is crucial as the tongue plays an important role in both speech and swallowing. The role of Speech-language and swallowing therapists in oral cancer should be highlighted in treating these patients and improving the overall quality of life. With intensive speech-language and swallowing therapy post-surgery for oral cancer, there can be a significant change in the speech outcome and swallowing functions depending on the site and extent of lesions which will thereby improve the individual’s QOL.

Keywords: oral cancer, speech and swallowing therapy, speech intelligibility, trismus, quality of life

Procedia PDF Downloads 112

Authors: Vinti Davar

Abstract:

Introduction: Childhood overweight increases the risk for certain medical and psychological conditions. Millions of school-age children worldwide are affected by serious yet easily treatable and preventable illnesses that inhibit their ability to learn. Healthier children stay in school longer, attend more regularly, learn more and become healthier and more productive adults. Schools are an important setting for nutrition education because one can reach most children, teachers and parents. These years offer a key window for shaping their lifetime habits, which have an impact on their health throughout life. Against this background, an attempt was made to impart nutrition education to school children in Haryana state of India to promote healthy food choices and assess the effectiveness of this program. Methodology: This study was completed in two phases. During the first phase, pre-intervention anthropometric and dietary survey was conducted; the teaching materials for nutrition intervention program were developed and tested; and the questionnaire was validated. In the second phase, an intervention was implemented in two schools of Kurukshetra, Haryana for six months by personal visits once a week. A total of 350 children in the age group of 6-12 years were selected. Out of these, 279 children, 153 boys and 126 girls completed the study. The subjects were divided into four groups namely: underweight, normal, overweight and obese based on body mass index-for-age categories. A power point colorful presentation to improve the quality of tiffin, snacks and meals emphasizing inclusion of all food groups especially vegetables every day and fruits at least 3-4 days per week was used. An extra 20 minutes of aerobic exercise daily was likewise organized and a healthy school environment created. Provision of clean drinking water by school authorities was ensured. Selling of soft drinks and energy-dense snacks in the school canteen as well as advertisements about soft drink and snacks on the school walls were banned. Post intervention, anthropometric indices and food selections were reassessed. Results: The results of this study reiterate the critical role of nutrition education and promotion in improving the healthier food choices by school children. It was observed that normal, overweight and obese children participating in nutrition education intervention program significantly (p≤0.05) increased their daily seasonal fruit and vegetable consumption. Fat and oil consumption was significantly reduced by overweight and obese subjects. Fast food intake was controlled by obese children. The nutrition knowledge of school children significantly improved (p≤0.05) from pre to post intervention. A highly significant increase (p≤0.00) was noted in the nutrition attitude score after intervention in all four groups. Conclusion: This study has shown that a well-planned nutrition education program could improve nutrition knowledge and promote positive changes in healthy food choices. A nutrition program inculcates wholesome eating and active life style habits in children and adolescents that could not only prevent them from chronic diseases and early death but also reduce healthcare cost and enhance the quality of life of citizens and thereby nations.

Keywords: children, eating habits healthy food, obesity, school going, fast foods

Procedia PDF Downloads 204

Authors: Andrea Bertocchi, Alessio Barnaba Di Fonzo, Davide Talarico, Simone Rivaroli, Jeff Konin

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The patient is a 89 years old male (180cm/85kg) retired notary former golfer with no past medical history. He describes a progressive ideomotor slowdown for 14 months. The disorder is characterized by short-term memory deficits and, for some months, also by unstable walking with a broad base with skidding and risk of falling at directional changes and urinary urgency. There were also episodes of aggression towards his wife and staff. At the time, the patient takes no prescribed medications. He has difficulty eating, dressing, and some problems with personal hygiene. In the initial visit, the patient was alert, cooperating, and performed simple tasks; however, he has a hearing impairment, slowed spontaneous speech, and amnestic deficit to the short story. Ideomotor apraxia is not present. He scored 20 points in the MMSE. From a motor function, he has deficits using Medical Research Council (MRC) 3-/5 in bilateral lower limbs and requires maximum assistance from sit to stand with existing premature fatigue. He’s unable to walk for about 1 month. Tremors and hypertonia are absent. BERG was unable to be administered, and BARTHEL was obtained 45/100. An Amyloid Angiopathy is suspected and then confirmed at the neurological examination. Therehabilitation objectives were the recovery of mobility and reinforcement of the UE/LE, especially legs, for recovery of standing and walking. The cognitive aspect was also an essential factor for the patient's recovery. The literature doesn’t demonstrate any particular studies regarding motor and cognitive rehabilitation on this pathology. Failing to manage his attention on exercise and tending to be disinterested and falling asleep constantly, we used golf-specific gestures to stimulate his mind to work and get results because the patient has memory recall of golf related movement. We worked for 4 months with a frequency of 3 sessions per week. Every session lasted for 45 minutes. After 4 months of work, the patient walked independently with the use of a stick for about 120 meters without stopping. MRC 4/5 AI bilaterally andpostural steps performed independently with supervision. BERG 36/56. BARTHEL 65/100. 6 Minutes Walking Test (6MWT), at the beginning, it wasn’t measurable, now, he performs 151,5m with Numeric Rating Scale 4 at the beginning and 7 at the end. Cognitively, he no longer has episodes of aggression, although the short-term memory and concentration deficit remains. Amyloid Angiopathy is a mix of motor and cognitive disorder. It is worth the thought that cerebral amyloid angiopathy manifests with functional deficits due to strokes and bleedings and, as such, has an important rehabilitation indication, as classical stroke is not associated with amyloidosis. Exploring the motor patterns learned at a young age and remained in the implicit and explicit memory of the patient allowed us to set up effective work and to obtain significant results in the short-middle term. Surely many studies will still be done regarding this pathology and its rehabilitation, but the importance of the cognitive sphere applied to the motor sphere could represent an important starting point.

Keywords: amyloid angiopathy, cognitive rehabilitation, golf, motor disorder

Procedia PDF Downloads 137

Authors: Ahmad Ali, Muhammad Imran Ghani, Haiyan Ding, Zhihui Cheng, Muhammad Iqbal

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Background and Aims: In recent years, protected cultivation trend, especially in the northern parts of China, spread dynamically where production area, structure, and crops diversity have expanded gradually under plastic greenhouse vegetable cropping (PGVC) system. Under this growing system, continuous monoculture with excessive synthetic fertilizers inputs are common cultivation practices frequently adopted by commercial producers. Such long-term cumulative wild exercise year after year sponsor the continuous cropping obstacles in PGVC soil, which have greatly threatened the regional soil eco-sustainability and further impose the continuous assault on soil ecological diversity leading to the exhaustion of agriculture productivity. The aim of this study was to develop new allelopathic insights by exploiting available biological resources in the favor of sustainable PGVC to illuminate the continuous obstacle factors in plastic greenhouse. Method: A greenhouse study was executed under plastic tunnel located at the Horticulture Experimental Station of the College of Horticulture, Northwest A&F University, Yangling, Shaanxi Province, one of the prominent regions for intensive commercial PGVC in China. Post-harvest garlic residues (stalk, leaves) mechanically smashed, homogenized into powder size and incorporated at the ratio of 1:100; 3:100; 5:100 as a soil amendment in a replanted soil that have been used for continuous cucumber monoculture for 7 years (annually double cropping system in a greenhouse). Results: Incorporated C-rich garlic stalk significantly influenced the soil condition through various ways; organic matter decomposition and mineralization, moderately adjusted the soil pH, enhanced the soil nutrient availability, increased enzymatic activities, and promoted 20% more cucumber yield in short-time. Using Illumina MiSeq sequencing analysis of bacterial 16S rRNA and fungal 18S rDNA genes, the current study revealed that addition of garlic stalk/residue could also improve the microbial abundance and community composition in extensively exploited soil, and contributed in soil functionality, caused prosper changes in soil characteristics, reinforced to good crop yield. Conclusion: Our study provided evidence that addition of garlic stalk as soil fertility amendment is a feasible, cost-effective and efficient resource utilization way for renovation of degraded soil health, ameliorate soil quality components and improve ecological environment in short duration. Our study may provide a better scientific understanding for efficient crop residue management typically from allelopathic source.

Keywords: garlic stalk, microbial community dynamics, plant growth, soil amendment, soil-plant system

Procedia PDF Downloads 134

Authors: Diana Reckien

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Vulnerability assessments are increasingly used to support policy-making in complex environments, like urban areas. Usually, vulnerability studies include the construction of aggregate (sub-) indices and the subsequent mapping of indices across an area of interest. Vulnerability studies show a couple of advantages: they are great communication tools, can inform a wider general debate about environmental issues, and can help allocating and efficiently targeting scarce resources for adaptation policy and planning. However, they also have a number of challenges: Vulnerability assessments are constructed on the basis of a wide range of methodologies and there is no single framework or methodology that has proven to serve best in certain environments, indicators vary highly according to the spatial scale used, different variables and metrics produce different results, and aggregate or composite vulnerability indicators that are mapped easily distort or bias the picture of vulnerability as they hide the underlying causes of vulnerability and level out conflicting reasons of vulnerability in space. So, there is urgent need to further develop the methodology of vulnerability studies towards a common framework, which is one reason of the paper. We introduce a social vulnerability approach, which is compared with other approaches of bio-physical or sectoral vulnerability studies relatively developed in terms of a common methodology for index construction, guidelines for mapping, assessment of sensitivity, and verification of variables. Two approaches are commonly pursued in the literature. The first one is an additive approach, in which all potentially influential variables are weighted according to their importance for the vulnerability aspect, and then added to form a composite vulnerability index per unit area. The second approach includes variable reduction, mostly Principal Component Analysis (PCA) that reduces the number of variables that are interrelated into a smaller number of less correlating components, which are also added to form a composite index. We test these two approaches of constructing indices on the area of New York City as well as two different metrics of variables used as input and compare the outcome for the 5 boroughs of NY. Our analysis yields that the mapping exercise yields particularly different results in the outer regions and parts of the boroughs, such as Outer Queens and Staten Island. However, some of these parts, particularly the coastal areas receive the highest attention in the current adaptation policy. We imply from this that the current adaptation policy and practice in NY might need to be discussed, as these outer urban areas show relatively low social vulnerability as compared with the more central parts, i.e. the high dense areas of Manhattan, Central Brooklyn, Central Queens and the Southern Bronx. The inner urban parts receive lesser adaptation attention, but bear a higher risk of damage in case of hazards in those areas. This is conceivable, e.g., during large heatwaves, which would more affect more the inner and poorer parts of the city as compared with the outer urban areas. In light of the recent planning practice of NY one needs to question and discuss who in NY makes adaptation policy for whom, but the presented analyses points towards an under representation of the needs of the socially vulnerable population, such as the poor, the elderly, and ethnic minorities, in the current adaptation practice in New York City.

Keywords: vulnerability mapping, social vulnerability, additive approach, Principal Component Analysis (PCA), New York City, United States, adaptation, social sensitivity

Procedia PDF Downloads 395

Authors: Yael Rieder, Yael Gilboa, S. O. Adva, Efrat Halevi, Ronnie Tepper

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Background: Operation of ultrasound equipment is a core skill for many clinical specialties. As part of the training program at -Simultech- a simulation center for Ob\Gyn at the Meir Medical Center, Israel, teaching how to operate ultrasound equipment requires dealing with misunderstandings of spatial and 3D orientation, failure of the operator to hold a transducer correctly, and limited ability to evaluate the data on the screen. We have developed a platform intended to endow physicians and sonographers with clinical and operational skills of obstetric ultrasound. Simultech's simulations are focused on medical knowledge, risk management, technology operations and physician-patient communication. The simulations encompass extreme work conditions. Setup: Between eight and ten of the eight hundred and fifty physicians and sonographers of the Clalit health services from seven hospitals and eight community centers across Israel, participate in individual Ob/Gyn training sessions each week. These include Ob/Gyn specialists, experts, interns, and sonographers. Innovative teaching and training methodologies: The six-hour training program includes: (1) An educational computer program that challenges trainees to deal with medical questions based upon ultrasound pictures and films. (2) Sophisticated hands-on simulators that challenge the trainees to practice correct grip of the transducer, elucidate pathology, and practice daily tasks such as biometric measurements and analysis of sonographic data. (3) Participation in a video-taped simulation which focuses on physician-patient communications. In the simulation, the physician is required to diagnose the clinical condition of a hired actress based on the data she provides and by evaluating the assigned ultrasound films accordingly. Giving ‘bad news’ to the patient may put the physician in a stressful situation that must be properly managed. (4) Feedback at the end of each phase is provided by a designated trainer, not a physician, who is specially qualified by Ob\Gyn senior specialists. (5) A group exercise in which the trainer presents a medico-legal case in order to encourage the participants to use their own experience and knowledge to conduct a productive ‘brainstorming’ session. Medical cases are presented and analyzed by the participants together with the trainer's feedback. Findings: (1) The training methods and content that Simultech provides allows trainees to review their medical and communications skills. (2) Simultech training sessions expose physicians to both basic and new, up-to-date cases, refreshing and expanding the trainee's knowledge. (3) Practicing on advanced simulators enables trainees to understand the sonographic space and to implement the basic principles of ultrasound. (4) Communications simulations were found to be beneficial for trainees who were unaware of their interpersonal skills. The trainer feedback, supported by the recorded simulation, allows the trainee to draw conclusions about his performance. Conclusion: Simultech was found to contribute to physicians at all levels of clinical expertise who deal with ultrasound. A break in daily routine together with attendance at a neutral educational center can vastly improve performance and outlook.

Keywords: medical training, simulations, ultrasound, Simultech

Procedia PDF Downloads 279

Authors: Lei Ye, Min Liu, Yong-Li Gao, Jun Zhang

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Purpose: The aims of the study are to investigate the status of health-promoting lifestyle and to compare the healthy lifestyle of emergency nurses in different levels of hospitals in Sichuan province, China. The investigation is mainly about the health-promoting lifestyle, including spiritual growth, health responsibility, physical activity, nutrition, interpersonal relations, stress management. Then the factors were analyzed influencing the health-promoting lifestyle of emergency nurses in hospitals of Sichuan province in order to find the relevant models to provide reference evidence for intervention. Study Design: A cross-sectional research method was adopted. Stratified cluster sampling, based on geographical location, was used to select the health facilities of 1389 emergency nurses in 54 hospitals from Sichuan province in China. Method: The 52-item, six-factor structure Health-Promoting Lifestyle Profile II (HPLP- II) instrument was used to explore participants’ self-reported health-promoting behaviors and measure the dimensions of health responsibility, physical activity, nutrition, interpersonal relations, spiritual growth, and stress management. Demographic characteristics, education, work duration, emergency nursing work duration and self-rated health status were documented. Analysis: Data were analyzed through SPSS software ver. 17.0. Frequency, percentage, mean ± standard deviation were used to describe the general information, while the Nonparametric Test was used to compare the constituent ratio of general data of different hospitals. One-way ANOVA was used to compare the scores of health-promoting lifestyle in different levels hospital. A multiple linear regression model was established. P values which were less than 0.05 determined statistical significance in all analyses. Result: The survey showed that the total score of health-promoting lifestyle of nurses at emergency departments in Sichuan Province was 120.49 ± 21.280. The relevant dimensions are ranked by scores in descending order: interpersonal relations, nutrition, health responsibility, physical activity, stress management, spiritual growth. The total scores of the three-A hospital were the highest (121.63 ± 0.724), followed by the senior class hospital (119.7 ± 1.362) and three-B hospital (117.80 ± 1.255). The difference was statistically significant (P=0.024). The general data of nurses was used as the independent variable which includes age, gender, marital status, living conditions, nursing income, hospital level, Length of Service in nursing, Length of Service in emergency, Professional Title, education background, and the average number of night shifts. The total score of health-promoting lifestyle was used as dependent variable; Multiple linear regression analysis method was adopted to establish the regression model. The regression equation F = 20.728, R2 = 0.061, P < 0.05, the age, gender, nursing income, turnover intention and status of coping stress affect the health-promoting lifestyle of nurses in emergency department, the result was statistically significant (P < 0.05 ). Conclusion: The results of the investigation indicate that it will help to develop health promoting interventions for emergency nurses in all levels of hospital in Sichuan Province through further research. Managers need to pay more attention to emergency nurses’ exercise, stress management, self-realization, and conduct intervention in nurse training programs.

Keywords: emergency nurse, health-promoting lifestyle profile II, health behaviors, lifestyle

Procedia PDF Downloads 282

Authors: Bensaid A., Mostephaoui T., Nedjai R.

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Nowadays, wetlands are the subject of contradictory debates opposing scientific, political and administrative meanings. Indeed, given their multiple services (drinking water, irrigation, hydrological regulation, mineral, plant and animal resources...), wetlands concentrate many socio-economic and biodiversity issues. In some regions, they can cover vast areas (>100 thousand ha) of the landscape, such as the Camargue area in the south of France, inside the Rhone delta. The high biological productivity of wetlands, the strong natural selection pressures and the diversity of aquatic environments have produced many species of plants and animals that are found nowhere else. These environments are tremendous carbon sinks and biodiversity reserves depending on their age, composition and surrounding environmental conditions, wetlands play an important role in global climate projections. Covering more than 3% of the earth's surface, wetlands have experienced since the beginning of the 1990s a tremendous revival of interest, which has resulted in the multiplication of inventories, scientific studies and management experiments. The geographical and physical characteristics of the wetlands of the central region conceal a large number of natural habitats that harbour a great biological diversity. These wetlands, one of the natural habitats, are still influenced by human activities, especially agriculture, which affects its layout and functioning. In this perspective, decision-makers need to delimit spatial objects (natural habitats) in a certain way to be able to take action. Thus, wetlands are no exception to this rule even if it seems to be a difficult exercise to delimit a type of environment as whose main characteristic is often to occupy the transition between aquatic and terrestrial environment. However, it is possible to map wetlands with databases, derived from the interpretation of photos and satellite images, such as the European database Corine Land cover, which allows quantifying and characterizing for each place the characteristic wetland types. Scientific studies have shown limitations when using high spatial resolution images (SPOT, Landsat, ASTER) for the identification and characterization of small wetlands (1 hectare). To address this limitation, it is important to note that these wetlands generally represent spatially complex features. Indeed, the use of very high spatial resolution images (>3m) is necessary to map small and large areas. However, with the recent evolution of artificial intelligence (AI) and deep learning methods for satellite image processing have shown a much better performance compared to traditional processing based only on pixel structures. Our research work is also based on spectral and textural analysis on THR images (Spot and IRC orthoimage) using two object-oriented approaches, the nearest neighbour approach (k-NN) and the Super Vector Machine approach (SVM). The k-NN approach gave good results for the delineation of wetlands (wet marshes and moors, ponds, artificial wetlands water body edges, ponds, mountain wetlands, river edges and brackish marshes) with a kappa index higher than 85%.

Keywords: land development, GIS, sand dunes, segmentation, remote sensing

Procedia PDF Downloads 72

Authors: M. Velana, G. Rinkenauer

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Nowadays, nurses are facing unprecedented amounts of pressure due to the ongoing global health demands. Work-related stress can cause a high physical and psychological workload, which can lead, in turn, to burnout. On the physiological level, stress triggers an initial activation of the sympathetic nervous and adrenomedullary systems resulting in increases in cardiac activity. Furthermore, activation of the hypothalamus-pituitary-adrenal axis provokes endocrine and immune changes leading to the release of cortisol and cytokines in an effort to re-establish body balance. Based on the current state of the literature, it has been identified that resilience and mindfulness exercises among nurses can effectively decrease stress and improve mood. However, it is still unknown what relaxation techniques would be suitable for and to what extent would be effective to decrease psychophysiological arousal deriving from either a physiological or a psychological stressor. Moreover, although cardiac activity and cortisol are promising candidates to examine the effectiveness of relaxation to reduce stress, it still remains to shed light on the role of cytokines in this process so as to thoroughly understand the body’s response to stress and to relaxation. Therefore, the main aim of the present study is to develop a comprehensive experimental paradigm and assess different relaxation techniques, namely progressive muscle relaxation and a mindfulness exercise originating from cognitive therapy by means of biofeedback, under highly controlled laboratory conditions. An experimental between-subject design will be employed, where 120 participants will be randomized either to a physiological or a psychological stress-related experiment. Particularly, the cold pressor test refers to a procedure in which the participants have to immerse their non-dominant hands into ice water (2-3 °C) for 3 min. The participants are requested to keep their hands in the water throughout the whole duration. However, they can immediately terminate the test in case it would be barely tolerable. A pre-test anticipation phase and a post-stress period of 3 min, respectively, are planned. The Trier Social Stress Test will be employed to induce psychological stress. During this laboratory stressor, the participants are instructed to give a 5-min speech in front of a committee of communication specialists. Before the main task, there is a 10-min anticipation period. Subsequently, participants are requested to perform an unexpected arithmetic task. After stress exposure, the participants will perform one of the relaxation exercises (treatment condition) or watch a neutral video (control condition). Electrocardiography, salivary samples, and self-report will be collected at different time points. The preliminary results deriving from the pilot study showed that the aforementioned paradigm could effectively induce stress reactions and that relaxation might decrease the impact of stress exposure. It is of utmost importance to assess how the human body responds under different stressors and relaxation exercises so that an evidence-based intervention could be transferred in a clinical setting to improve nurses’ general health. Based on suggestive future laboratory findings, the research group plans to conduct a pilot-level randomized study to decrease stress and promote well-being among nurses who work in the stress-riddled environment of a hospital located in Northern Germany.

Keywords: nurses, psychophysiology, relaxation, stress

Procedia PDF Downloads 110

Authors: Ciaran Friel, Jerry Suls, Patrick Robles, Frank Vicari, Joan Duer-Hefele, Karina W. Davidson

Abstract:

Physical activity guidelines focus on increasing moderate intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence supports that any increase in physical activity is positively correlated with health benefits. Behavior change techniques (BCTs) have demonstrated effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a Personalized Trials (N-of-1) design to evaluate the efficacy of using four BCTs to promote an increase in low-intensity physical activity (2,000 steps of walking per day) in adults aged 45-75 years old. The 4 BCTs tested were goal setting, action planning, feedback, and self-monitoring. BCTs were tested in random order and delivered by text message prompts requiring participant response. The study recruited health system employees in the target age range, without mobility restrictions and demonstrating interest in increasing their daily activity by a minimum of 2,000 steps per day for a minimum of five days per week. Participants were sent a Fitbit Charge 4 fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7, but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by the Fitbit for two weeks. Participants then engaged with a clinical research coordinator to review comprehension of the text message content and required actions for each of the BCTs to be tested. Participants then selected a consistent daily time in which they would receive their text message prompt. In the 8 week intervention phase of the study, participants received each of the four BCTs, in random order, for a two week period. Text message prompts were delivered daily at a time selected by the participant. All prompts required an interactive response from participants and may have included recording their detailed plan for walking or daily step goal (action planning, goal setting). Additionally, participants may have been directed to a study dashboard to view their step counts or compare themselves with peers (self-monitoring, feedback). At the end of each two week testing interval, participants were asked to complete the Self-Efficacy for Walking Scale (SEW_Dur), a validated measure that assesses the participant’s confidence in walking incremental distances and a survey measuring their satisfaction with the individual BCT that they tested. At the end of their trial, participants received a personalized summary of their step data in response to each individual BCT. Analysis will examine the novel individual-level heterogeneity of treatment effect made possible by N-of-1 design, and pool results across participants to efficiently estimate the overall efficacy of the selected behavioral change techniques in increasing low-intensity walking by 2,000 steps, 5 days per week. Self-efficacy will be explored as the likely mechanism of action prompting behavior change. This study will inform the providers and demonstrate the feasibility of N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

Procedia PDF Downloads 129

Authors: Sweta Rout-Hoolash

Abstract:

Each year, selected students from around 20 countries begin their degrees at Middlesex University with the International Foundation Program (IFP), developing the skills required for academic study at a UK university. The IFP runs for 30 learning/teaching weeks at Middlesex University Mauritius Branch Campus, which is an international campus of UK’s Middlesex University. Successful IFP students join their degree courses already settled into life at their chosen campus (London, Dubai, Mauritius or Malta) and confident that they understand what is required for degree study. Although part of the School of Science and Technology, in Mauritius it prepares students for undergraduate level across all Schools represented on campus – including disciplines such as Accounting, Business, Computing, Law, Media and Psychology. The researcher has critically reviewed the framework and resources in the curriculum for a particular six week period of IFP study (dedicated group work phase). Despite working together closely for 24 weeks, IFP students approach the final 6 week small group work project phase with mainly inhibitive feelings. It was observed that students did not engage effectively in the group work exercise. Additionally, groups who seemed to be working well did not necessarily produce results reflecting effective collaboration, nor individual members’ results which were better than prior efforts. The researcher identified scope for change and innovation in the IFP curriculum and how group work is introduced and facilitated. The study explores the challenges of groupwork in the context of the Mauritius campus, though it is clear that the implications of the project are not restricted to one campus only. The presentation offers a reflective review on the previous structure put in place for the management of small group assessed projects on the programme from both the student and tutor perspective. The focus of the research perspective is the student voice, by taking into consideration past and present IFP students’ experiences as written in their learning journals. Further, it proposes the introduction of a revised framework to help students take greater ownership of the group work process in order to engage more effectively with the learning outcomes of this crucial phase of the programme. The study has critically reviewed recent and seminal literature on how to achieve greater student ownership during this phase especially under an environment of assessed multicultural group work. The presentation proposes several new approaches for encouraging students to take more control of the collaboration process. Detailed consideration is given to how the proposed changes impact on the work of other stakeholders, or partners to student learning. Clear proposals are laid out for evaluation of the different approaches intended to be implemented during the upcoming academic year (student voice through their own submitted reflections, focus group interviews and through the assessment results). The proposals presented are all realistic and have the potential to transform students’ learning. Furthermore, the study has engaged with the UK Professional Standards Framework for teaching and supporting learning in higher education, and demonstrates practice at the level of ‘fellow’ of the Higher Education Academy (HEA).

Keywords: collaborative peer learning, enhancing learning experiences, group work assessment, learning communities, multicultural diverse classrooms, studying abroad

Procedia PDF Downloads 327

Authors: Joanne DiFrancisco-Donoghue, Seth E. Jenny, Peter C. Douris, Sophia Ahmad, Kyle Yuen, Hillary Gan, Kenney Abraham, Amber Sousa

Abstract:

Background: Guidelines for the maintenance of health of esports players and the cognitive changes that accompany competitive gaming are understudied. Executive functioning is an important cognitive skill for an esports player. The relationship between executive functions and physical exercise has been well established. However, the effects of prolonged sitting regardless of physical activity level have not been established. Prolonged uninterrupted sitting reduces cerebral blood flow. Reduced cerebral blood flow is associated with lower cognitive function and fatigue. This decrease in cerebral blood flow has been shown to be offset by frequent and short walking breaks. These short breaks can be as little as 2 minutes at the 30-minute mark and 6 minutes following 60 minutes of prolonged sitting. The rationale is the increase in blood flow and the positive effects this has on metabolic responses. The primary purpose of this study was to evaluate executive function changes following 6-minute bouts of walking and complete rest mid-session, compared to no break, during prolonged gameplay in competitive first-person shooter (FPS) esports players. Methods: This study was conducted virtually due to the Covid-19 pandemic and was approved by the New York Institute of Technology IRB. Twelve competitive FPS participants signed written consent to participate in this randomized pilot study. All participants held a gold ranking or higher. Participants were asked to play for 2 hours on three separate days. Outcome measures to test executive function included the Color Stroop and the Tower of London tests which were administered online each day prior to gaming and at the completion of gaming. All participants completed the tests prior to testing for familiarization. One day of testing consisted of a 6-minute walk break after 60-75 minutes of play. The Rate of Perceived Exertion (RPE) was recorded. The participant continued to play for another 60-75 minutes and completed the tests again. Another day the participants repeated the same methods replacing the 6-minute walk with lying down and resting for 6 minutes. On the last day, the participant played continuously with no break for 2 hours and repeated the outcome tests pre and post-play. A Latin square was used to randomize the treatment order. Results: Using descriptive statistics, the largest change in mean reaction time incorrect congruent pre to post play was seen following the 6-minute walk (662.0 (609.6) ms pre to 602.8 (539.2) ms post), followed by the 6-minute rest group (681.7(618.1) ms pre to 666.3 (607.9) ms post), and with minimal change in the continuous group (594.0(534.1) ms pre to 589.6(552.9) ms post). The mean solution time was fastest in the resting condition (7774.6(6302.8)ms), followed by the walk condition (7929.4 (5992.8)ms), with the continuous condition being slowest (9337.3(7228.7)ms). the continuous group 9337.3(7228.7) ms; 7929.4 (5992.8 ) ms 774.6(6302.8) ms. Conclusion: Short walking breaks improve blood flow and reduce the risk of venous thromboembolism during prolonged sitting. This pilot study demonstrated that a low intensity 6 -minute walk break, following 60 minutes of play, may also improve executive function in FPS gamers.

Keywords: executive function, FPS, physical activity, prolonged sitting

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Authors: Annette Louise Dupont

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Background and Introduction: Broadly defined, hybridity is a condition of racial and cultural ‘cross-pollination’ which arises as a result of contact between colonized and colonizer. It remains a highly contested concept in postcolonial studies as it is implicitly underpinned by colonial notions of ‘racial purity.’ While some postcolonial scholars argue that individuals exercise significant agency in the construction of their hybrid subjectivities, others underscore associated experiences of exclusion, marginalization, and alienation. Kuwait and the Philippines are among the most disparate of contemporary postcolonial states. While oil resources transformed the former British Mandate of Kuwait into one of the world’s richest countries, enduring poverty in the former US colony of the Philippines drives a global diaspora which produces multiple Filipino hybridities. Although more Filipinos work in the Arabian Gulf than in any other region of the world, scholarly and literary accounts of their experiences of hybridization in this region are relatively scarce when compared to those set in North America, Australia, Asia, and Europe. Study Aims and Significance: This paper aims to address this existing lacuna by investigating hybridity and other postcolonial themes in a novel by a Kuwaiti author which vividly portrays the lives of immigrants and citizens in Kuwait and which gives a rare voice and insight into the struggles of an Arab-Filipino and European-Filipina. Specifically, this paper explores the relationships between colonial discourses of ‘black’ and ‘white’ and postcolonial discourses pertaining to ‘brown’ Filipinos and ‘brown’ Arabs, in order to assess their impacts on the protagonists’ hybrid subjectivities. Methodology: Foucault’s notions of discourse not only provide a conceptual basis for analyzing the colonial ideology of Orientalism, but his theories related to the social exclusion of the ‘mad’ also elucidate the mechanisms by which power can operate to marginalize, alienate and subjectify the Other, therefore a Foucauldian lens is applied to the analysis of postcolonial themes and hybrid subjectivities portrayed in the novel. Findings: The study finds that Kuwaiti and Filipino discursive practices mirror those of former white colonialists and colonized black laborers and that these discursive practices combine with a former British colonial system of foreign labor sponsorship to create a form of governmentality in Kuwait which is based on exclusion and control. The novel’s rich social description and the reflections of the key protagonist and narrator suggest that such fiction has a significant role to play in highlighting the historical and cultural specificities of experiences of postcolonial hybridity in under-researched geographic, economic, social, and political settings. Whereas hybridity can appear abstract in scholarly accounts, the significance of literary accounts in which the lived experiences of hybrid protagonists are anchored to specific historical periods, places and discourses, is that contextual particularities are neither obscured nor dehistoricized. Conclusions: The application of Foucauldian theorizations of discourse, disciplinary, and biopower to the analysis of this Kuwaiti literary text serves to extend an understanding of the effects of contextually-specific discourses on hybrid Filipino subjectivities, as well as a knowledge of prevailing social dynamics in a little-researched postcolonial Arabian Gulf state.

Keywords: Filipino, Foucault, hybridity, Kuwait

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Authors: A. C. Facin, M. C. Maronezi , M. P. Menezes, G. L. Montanhim, L. Pavan, M. A. R. Feliciano, R. P. Nociti, R. A. R. Uscategui, P. C. Moraes

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The incidence of brachycephalic syndrome (BS) in the clinical routine of small animals has increased significantly giving the higher proportion of brachycephalic pets in the last years and has been considered as an animal welfare problem. The treatment of BS is surgical and the clinical signs related can be considerably attenuated. Nevertheless, the systemic effects of the BS are still poorly reported and little is known about these when the surgical correction is not performed early. Affected dogs are more likely to develop cardiopulmonary, gastrointestinal and sleep disorders in which the chronic hypoxemia plays a major role. This syndrome is compared with the obstructive sleep apnea (OSA) in humans, both considered as causes of systemic and metabolic dysfunction. Among the several consequences of the BS little is known if the syndrome also affects the hepatic tissue of brachycephalic patients. Elastography is a promising ultrasound technique that evaluates tissue elasticity and has been recently used with the purpose of diagnosis of liver fibrosis. In medicine, it is a growing concern regarding the hepatic injury of patients affected by OSA. This prospective study hypothesizes if there is any consequence of BS in the hepatic parenchyma of brachycephalic dogs that don’t receive any surgical treatment. This study was conducted following the approval of the Animal Ethics and Welfare Committee of the Faculdade de Ciências Agrárias e Veterinárias, UNESP, Campus Jaboticabal, Brazil (protocol no 17944/2017) and funded by Sao Paulo Research Foundation (FAPESP, process no 2017/24809-4). The methodology was based in ARFI elastography using the ACUSON S2000/SIEMENS device, with convex multifrequential transducer and specific software as well as clinical evaluation of the syndrome, in order to determine if they can be used as a prognostic non-invasive tool. On quantitative elastography, it was collected three measures of shear wave velocity (meters per second) and depth in centimeters in the left lateral, left medial, right lateral, right medial and caudate lobe of the liver. The brachycephalic patients, 16 pugs and 30 french bulldogs, were classified using a previously established 4-point functional grading system based on clinical evaluation before and after a 3-minute exercise tolerance test already established and validated. The control group was based on the same features collected in 22 beagles. The software R version 3.3.0 was used for the analysis and the significance level was set at 0.05. The data were analysed for normality of residuals and homogeneity of variances by Shapiro-Wilks test. Comparisons of parametric continuous variables between breeds were performed by using ANOVA with a post hoc test for pair wise comparison. The preliminary results show significant statistic differences between the brachycephalic groups and the control group in all lobes analysed (p ≤ 0,05), with higher values of shear wave velocities in the hepatic tissue of brachycephalic dogs. In this context, the results obtained in this study contributes to the understanding of BS as well as its consequences in our patients, reflecting in evidence that one more systemic consequence of the syndrome may occur in brachycephalic patients, which was not related in the veterinary literature yet.

Keywords: airway obstruction, brachycephalic airway obstructive syndrome, hepatic injury, obstructive sleep apnea

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Authors: Karlee J. Hall, Mark Laylor, Jessy Varghese, Paula Polastri, Karen Van Ooteghem, William McIlroy

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Balance training is a common part of physiotherapy treatment and often involves a set of proprioceptive exercises which the patient carries out in the clinic and as part of their exercise program. Understanding all contributing factors to altered balance is of utmost importance to the clinical success of treatment of balance dysfunctions. A critical role for the autonomic nervous system (ANS) in the control of balance reactions has been proposed previously, with evidence for potential involvement being inferred from the observation of phasic galvanic skin responses (GSR) evoked by external balance perturbations. The current study explored whether the coupling between ANS reactivity and balance reactions would be observed during spontaneously occurring instability while standing, including standard positions typical of physiotherapy balance assessments. It was hypothesized that time-varying changes in GSR (ANS reactivity) would be associated with time-varying changes in the mediolateral center of pressure (ML-COP) (somatomotor reactivity). Nine individuals (5 females, 4 males, aged 19-37 years) were recruited. To induce varying balance demands during standing, the study compared ML-COP and GSR data across different task conditions varying the availability of vision and width of the base of support. Subjects completed 3, 30-second trials for each of the following stance conditions: standard, narrow, and tandem eyes closed, tandem eyes open, tandem eyes open with dome to shield visual input, and restricted peripheral visual field. ANS activity was evaluated by measures of GSR recorded from Ag-AgCl electrodes on the middle phalanges of digits 2 and 4 on the left hand; balance measures include ML-COP excursion frequency and amplitude recorded from two force plates embedded in the floor underneath each foot. Subjects were instructed to stand as still as possible with arms crossed in front of their chest. When comparing mean task differences across subjects, there was an expected increase in postural sway from tasks with a wide stance and no sensory restrictions (least challenging) to those with a narrow stance and no vision (most challenging). The correlation analysis revealed a significant positive relationship between ML-COP variability and GSR variability when comparing across tasks (r=0.94, df=5, p < 0.05). In addition, correlations coincided within each subject and revealed a significant positive correlation in 7 participants (r= 0.47, 0.57, 0.62, 0.62, 0.81, 0.64, 0.69 respectively, df=19, p < 0.05) and no significant relationship in 2 participants (r=0.36, 0.29 respectively, df=19, p > 0.05). The current study revealed a significant relationship between ML-COP and GSR during balance tasks, revealing the ANS reactivity associated with naturally occurring instability when standing still, which is proportional to the degree of instability. Understanding the link between ANS activity and control of COP is an important step forward in the enhancement of assessment of contributing factors to poor balance and treatment of balance dysfunctions. The next steps will explore the temporal association between the time-varying changes in COP and GSR to establish if the ANS reactivity phase leads or lags the evoked motor reactions, as well as exploration of potential biomarkers for use in screening of ANS activity as a contributing factor to altered balance control clinically.

Keywords: autonomic nervous system, balance control, center of pressure, somatic nervous system

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Authors: Yasmin A. M. Ferreira, Ana C. K. Pelissari, Sofia De C. F. Vicente, Raquel M. Da S. Campos, Deborah C. L. Masquio, Lian Tock, Lila M. Oyama, Flavia C. Corgosinho, Valter T. Boldarine, Ana R. Dâmaso

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The prevalence of overweight and obesity is growing around the world and currently considered a global epidemic. Food and nutrition are essential requirements for promoting health and protecting non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate the inflammation and oxidative stress in obese individuals. Few studies have investigated the dietary Inflammation Factor Rating (IFR) in obese adolescents. The IFR was developed to characterize an individual´s diet on anti- to pro-inflammatory score. This evaluation contributes to investigate the effects of inflammatory diet in metabolic profile in several individual conditions. Objectives: The present study aims to investigate the effects of a multidisciplinary weight loss therapy on inflammation factor rating and cardiometabolic risk in obese adolescents. Methods: A total of 26 volunteers (14-19 y.o) were recruited and submitted to 20 weeks interdisciplinary therapy allied to health education website- Ciclo do Emagrecimento®, including clinical, nutritional, psychological counseling and exercise training. The body weight was monitored weekly by self-report and photo. The adolescents answered a test to evaluate the knowledge of the topics covered in the videos. A 24h dietary record was applied at the baseline and after 20 weeks to assess the food intake and to calculate IFR. A negative IFR suggests that diet may have inflammatory effects and a positive IFR indicates an anti-inflammatory effect. Statistical analysis was performed using the program STATISTICA version 12.5 for Windows. The adopted significant value was α ≤ 5 %. Data normality was verified with the Kolmogorov Smirnov test. Data were expressed as mean±SD values. To analyze the effects of intervention it was applied test t. Pearson´s correlations test was performed. Results: After 20 weeks of treatment, body mass index (BMI), body weight, body fat (kg and %), abdominal and waist circumferences decreased significantly. The mean of high-density lipoprotein cholesterol (HDL-c) increased after the therapy. Moreover, it was found an improvement of inflammation factor rating from -427,27±322,47 to -297,15±240,01, suggesting beneficial effects of nutritional counselling. Considering the correlations analysis, it was found that pro-inflammatory diet is associated with increase in the BMI, very low-density lipoprotein cholesterol (VLDL), triglycerides, insulin and insulin resistance index (HOMA-IR); while an anti-inflammatory diet is associated with improvement of HDL-c and insulin sensitivity Check index (QUICKI). Conclusion: The 20-week blended multidisciplinary therapy was effective to reduce body weight, anthropometric circumferences and improve inflammatory markers in obese adolescents. In addition, our results showed that an increase in inflammatory profile diet is associated with cardiometabolic parameters, suggesting the relevance to stimulate anti-inflammatory diet habits as an effective strategy to treat and control of obesity and related comorbidities. Financial Support: FAPESP (2017/07372-1) and CNPq (409943/2016-9)

Keywords: cardiometabolic risk, inflammatory diet, multidisciplinary therapy, obesity

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Authors: Rufina C. Abul, Dylan Kyle D. Apostol, Darius Rex G. Binuya, Alyanah Mae F. Cauilan, Darren A. Diaz, Angelica Jones A. Gallang, Charisse G. Kiwang, Alyanna Nicole G. Mactal, Nadine Beatrize V. Nerona, Janella Nicole R. Posadas, Charisse Purie C. Toledo

Abstract:

Background: Dramatic physical development, socioemotional adjustment, and cognitive changes highlight adolescent development. Adolescent brains are susceptible to emotional reactivity, making them likely to engage in risk-taking and impulsive behaviors. The family is crucial in laying the foundations of good health. Aims: This study determined the degree of family cohesion, quality of father-child and mother-child relationships, and degree of academic pressure across cultures, age groups, and sexual orientations. Further, it sought the prevalence of adolescent health concerns, including suicide risks, risk-taking behaviors, social media engagement, and self-care deviations. Finally, the correlations between health risk behaviors and the elements of family dynamics were unraveled. Methods: The descriptive-correlational design served as the blueprint for this study. Data were collected from 1095 adolescents aged 12-21 in two high schools and two universities in Baguio City using self-report questionnaires. Data was analyzed using Microsoft Excel Toolpak and IBM SPSS Statistics to identify significant differences and relationships among variables through descriptive statistics (frequency, %, means and figures) and inferential statistics (ANOVA and logistic regression). Results and Discussion: Adolescents generally have strong family cohesion (FC), high-quality father-child relationships (F-CR), very high-quality mother-child relationships(M-CR), and experience high academic pressure (AP). Cultural affiliation does not influence the 4 elements of family dynamics; the higher the age, the stronger the family cohesion; males score significantly higher on family cohesion and mother-child relationship while significantly lower in perceived academic pressure compared to their female and LGBT counterparts. Suicide risk is prevalent among 29-63% of the population, safety issues have the lowest prevalence for having an abusive relationship (8.22%) and the highest for encountering major family changes (53.52%). Substance use was highest for vaping (22.74%), sexual engagement occurs in 14.61% of the population, while 63% are engaged in social media for >5 hours/day. The self-care deviation is highest for weight concerns (63.39%), lack of visits to health care professionals (64.65%) and lack of exercise (49.94%). All 4 elements of family dynamic (FC, F-CR, M-CR and AP) are significantly associated with safety concerns, suicide risks and social media engagement, while M-CR significantly influences cigarette smoking, alcohol drinking, rugby use and engagement in sex. Conclusion and Recommendations: Strong family cohesion and quality parent-child interactions improve emotional and behavioral outcomes. Sexual orientation has a significant impact on academic pressure and social media use, demanding targeted treatments. The link between family dynamics and health-risk behaviors emphasizes the importance of promoting positive family relationships and encouraging safer behaviors, which are critical for increasing adolescents' well-being.

Keywords: adolescent health, family cohesion, health risk behaviors, suicide risk

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