Search results for: outcomes

Authors: Teklay Gebrecherkos, Mahmud Abdulkader, Tobias Rinke De Wit, Britta C. Urban, Feyissa Chala, Yazezew Kebede, Dawit Welday

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Background: C-reactive protein (CRP) levels are a reliable surrogate for interleukin-6 bioactivity that plays a pivotal role in the pathogenesis of cytokine storm associated with severe COVID-19. There is a lack of data on the role of CRP as a determinant of COVID-19 severity status in the African context. Methods: We determined the longitudinal kinetics of CRP levels on 78 RT-PCR-confirmed COVID-19 patients (49 non-severe and 29 severe cases) and 50 PCR-negative controls. Results: COVID-19 patients had overall significantly elevated CRP at baseline when compared to PCR-negative controls [median 11.1 (IQR: 2.0-127.8) mg/L vs. 0.9 (IQR: 0.5-1.9) mg/L; p=0.0004)]. Moreover, severe COVID-19 patients had significantly higher median CRP levels than non-severe cases [166.1 (IQR: 48.6-332.5) mg/L vs. 2.4 (IQR: 1.2-7.6) mg/L; p<0.00001)]. In addition, persistently elevated levels of CRP were exhibited among those with comorbidities and higher age groups. Area under receiver operating characteristic curve (AUC) analysis of CRP levels distinguished PCR-confirmed COVID-19 patients from the ones with PCR-negative non-COVID-19 individuals, with an AUC value of 0.77 (95% CI: 0.68-0.84; p=0.001). Moreover, it clearly distinguished severe from non-severe COVID-19 patients, with an AUC value of 0.83 (95% CI: 0.73-0.91). After adjusting for age and the presence of comorbidities, CRP levels above 30 mg/L were significantly associated with an increased risk of developing severe COVID-19 (adjusted relative risk 3.99 (95%CI: 1.35-11.82; p=0.013). Conclusions: Determining CRP levels in COVID-19 patients in African settings may provide a simple, prompt, and inexpensive assessment of the severity status at baseline and monitoring of treatment outcomes.

Keywords: CRP, COVID-19, SARS-CoV-2, biomarker

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Authors: Keden Montgomery, Kathie Ardzejewska, Alison Casey, Rosemarie Hogan

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Research was undertaken to explore the question “what is known about the experiences of regional, rural and remote Australian women undertaking a Bachelor of Nursing program delivered online?”. The findings will support future research aimed at improving the retention and completion rates of women studying nursing in regional, rural and remote areas.  There is a critical shortage of nurses working in regional, rural and remote (RRR) Australia. It is well supported that this shortage of nurses is most likely to be addressed by nursing students who are completing their studies in RRR areas. Despite this, students from RRR Australia remain an equity group and experience poorer outcomes than their metropolitan counterparts. Completion rates for RRR students who enrol in tertiary education courses are much less than students from metropolitan areas. In addition to this, RRR students are less likely than students from metropolitan areas to gain a tertiary level qualification at all, and even less likely to gain a Bachelor level degree which is required for Registered Nurses. Supporting students to remain in regional, rural and remote areas while they study reduces the need for students to relocate to metropolitan areas and to continue living and working in RRR areas after graduation. This research holds implications for workforce shortages internationally.

Keywords: nurse education, online education, regional, rural, remote, workforce

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Authors: Xiao Luo, Jayashree Arcot, Timothy P. Gill, Jimmy C. Louie, Anna M. Rangan

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Excessive consumption of added sugar is negatively associated with many health outcomes such as lower diet quality, dental diseases and other non-communicable diseases. Sugar-sweetened baked goods are popular discretionary foods that contribute significant amounts of added sugar to people’s diets worldwide. Food reformulation is of the most effective methods to reduce consumption of added sugar without significantly altering individual's diet pattern. However, sucrose, as the major sugar in baked goods, plays several vital functional roles such as providing sweetness and bulking, and suitable substitutes must be able to address these. The review examines the literature on sugar-reduced baked goods to summarise the feasible reformulations of low/no added sugar baked goods, and indicates the future directions for healthier baked goods reformulation. Based on this review, polyols and non-nutritive sweeteners (NNS) are suitable for alternative sweeteners to partially or fully replace sucrose in baked goods. Low-calorie carbohydrates such as oligofructose, polydextrose, maltodextrins are the mostly used bulking agents to compensate the loss of bulk due to the removal of sucrose. This review found that maltitol seems the most suitable sole sucrose substitution at present, while diverse mixtures of NNS( stevia, sucralose, acesulfame-K), other polyols and inulins can also deliver the functionalities of sucrose in baked products.

Keywords: alternative sweeteners, baked goods, reformulation, sugar reduction

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Authors: Emmanuel Osaze Oshoiribhor, Adetokunbo MacGregor John-Otumu

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In recent years, there has been a desire to forecast student academic achievement prior to graduation. This is to help them improve their grades, particularly for individuals with poor performance. The goal of this study is to employ supervised learning techniques to construct a predictive model for student academic achievement. Many academics have already constructed models that predict student academic achievement based on factors such as smoking, demography, culture, social media, parent educational background, parent finances, and family background, to name a few. This feature and the model employed may not have correctly classified the students in terms of their academic performance. This model is built using a logistic regression classifier with basic features such as the previous semester's course score, attendance to class, class participation, and the total number of course materials or resources the student is able to cover per semester as a prerequisite to predict if the student will perform well in future on related courses. The model outperformed other classifiers such as Naive bayes, Support vector machine (SVM), Decision Tree, Random forest, and Adaboost, returning a 96.7% accuracy. This model is available as a desktop application, allowing both instructors and students to benefit from user-friendly interfaces for predicting student academic achievement. As a result, it is recommended that both students and professors use this tool to better forecast outcomes.

Keywords: artificial intelligence, ML, logistic regression, performance, prediction

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Authors: Edo Shonin, William Van Gordon, Mark D. Griffiths

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Due to its potential to concurrently improve Work-Related Wellbeing (WRW) and job performance; occupational stakeholders are becoming increasingly interested in meditation. Despite this, there is a scarcity of methodologically robust research examining the utility of meditation within occupational contexts. This study conducted the first randomized controlled trial to assess the effects of meditation on outcomes relating to both WRW and job performance. Office-based middle-hierarchy managers (n=152) were allocated to either an eight-week meditation intervention (Meditation Awareness Training: MAT) or an active control intervention. MAT participants demonstrated significant improvements (with strong effect-sizes) over control-group participants in levels of work-related stress, job satisfaction, psychological distress, and employer-rated job performance. It is concluded that MAT appears to be effective for improving both WRW and job performance in middle-hierarchy managers. There are a number of novel implications: (i) meditation can effectuate a perceptual shift in how employees experience their work and psychological environment and may thus constitute a cost-effective WRW intervention, (ii) meditation-based (i.e., present-moment-focused) working styles may be more effective than goal-based (i.e., future-orientated) working styles, and (iii) meditation may reduce the separation made by employees between their own interests and those of the organizations they work for.

Keywords: work-related stress, workplace wellbeing, occupational stress, job performance, meditation awareness training, mindfulness

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Authors: Marwa Al-Subhi, Eiman Al-Ajmi, Mallak Al-Maamari, Humood Al-Dhuhli, Srinivasa Rao

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The orbit and its contents are affected by various pathologies and craniofacial anomalies. Sound knowledge of the normal orbital dimensions is clinically essential for successful surgical outcomes and also in the field of forensic anthropology. Racial, ethnic, and regional variations in the orbital dimensions have been reported. This study sought to determine the orbital dimensions of Omani subjects who had been referred for computed tomography (CT) images at a tertiary care hospital. A total of 273 patients’ CT images were evaluated retrospectively by using an electronic medical records database. The orbital dimensions were recorded using both axial and sagittal planes of CT images. The mean orbital index (OI) was found to be 83.25±4.83 and the prevalent orbital type was categorized as mesoseme. The mean orbital index was 83.34±5.05 and 83.16±4.57 in males and females, respectively, with their difference being statistically not significant (p=0.76). A statistically significant association was observed between the right and left orbits with regard to horizontal distance (p<0.05) and vertical distance (p<0.01) of orbit and OI (p<0.05). No significant difference between the OI and age groups was observed in both males and females. The mean interorbital distance and interzygomatic distance were found to be 19.45±1.52 mm and 95.59±4.08 mm, respectively. Both of these parameters were significantly higher in males (p<0.05). Results of the present study provide reference values of orbital dimensions in Omani subjects. The prevalent orbital type of Omani subjects is mesoseme, which is a hallmark of the white race.

Keywords: orbit, orbital index, mesoseme, ethnicity, variation

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Authors: Dada Kolawole Segun

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Transdermal drug delivery has gained popularity as a non-invasive method for controlled drug release compared to traditional delivery routes. Dissolvable transdermal patches have emerged as a promising platform for delivering a variety of drugs due to their ease of use. The objective of this research was to create and characterize dissolvable transdermal patches using various compositions and ratios of hyaluronic acid and zinc oxide nanoparticles. A micromolding technique was utilized to fabricate the patches, which were subsequently characterized using scanning electron microscopy, atomic force microscopy, and tensile strength testing. In vitro drug release studies were conducted to evaluate the drug release kinetics of the patches. The study found that the mechanical strength and dissolution properties of the patches were influenced by the hyaluronic acid and zinc oxide nanoparticle ratios used in the fabrication process. Moreover, the patches demonstrated controlled delivery of model drugs through the skin, highlighting their potential for transdermal drug delivery applications. The results suggest that dissolvable transdermal patches can be tailored to meet specific requirements for drug delivery applications using different compositions and ratios of hyaluronic acid and zinc oxide nanoparticles. This development has the potential to improve treatment outcomes and patient compliance in various therapeutic areas.

Keywords: transdermal drug delivery, characterization, skin permeation, biodegradable materials

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Authors: Bruno de Almeida Vilela, Heinz Ahn, Ana Lúcia Miranda Lopes, Marcelo Azevedo Costa

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Benchmarking public utilities such as transmission system operators (TSOs) is one of the main strategies employed by regulators in order to fix monopolistic companies’ revenues. Since 2007 the Brazilian regulator has been utilizing Data Envelopment Analysis (DEA) to benchmark TSOs. Despite the application of DEA to improve the transmission sector’s efficiency, some problems can be pointed out, such as the high price of electricity in Brazil; the limitation of the benchmarking only to operational expenses (OPEX); the absence of variables that represent the outcomes of the transmission service; and the presence of extremely low and high efficiencies. As an alternative to the current concept of benchmarking the Brazilian regulator uses, we propose a goal-oriented approach. Our proposal supports input/output selection by taking traditional organizational goals and measures as a basis for the selection of factors for benchmarking purposes. As the main advantage, it resolves the classical DEA problems of input/output selection, undesirable and dual-role factors. We also provide a demonstration of our goal-oriented concept regarding service quality. As a result, most TSOs’ efficiencies in Brazil might improve when considering quality as important in their efficiency estimation.

Keywords: decision making, goal-oriented benchmarking, input/output factor determination, TSO regulation

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Authors: Meiliana, Achmad Eko Prabowo, Muhammad Fathan Mubina

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AFTA agreement in 2015 will bring a significant impact on Indonesian society. Indonesia’s people will face competition both in the economic, political, and cultural regionally among ten countries in ASEAN. Indonesia is a rich country in culture and has a large enough demographic bonus when compared to other ASEAN countries. Indonesia also has a lot of cultural enrichment in every its region. It’s mean, the role of society and culture of Indonesia's abundant if combined properly it will help Indonesia in the face of the ASEAN Economic Community (AEC) in 2015. This paper will discuss the role of one-stop culture workshop (OSCW) concept at Saung Angklung Udjo (SAU), a cultural tourist area of Angklung which is located in Bandung. OSCW is a concept that implemented a cultural tour in SAU that invites the visitor to engage in the cultural empowerment. In this research, we will answer how the concepts are applied by SAU can be an alternative to re-discover the potential of Indonesia in the face of the AEC 2015. Units of analysis that we used is among the programs, outcomes, and community empowerment. This study used a qualitative approach with in-depth interviews and observation. The finding of this study prove that OSCW concept is an opportunity for Indonesia to encourage a culture to go international. The concept of OSCW can really be used other communities to develop cultures of Indonesia so that later institutionalized culture that not only can be used as a tourist attraction but also as an educational laboratory for the community.

Keywords: OSCW concept, citizen empowerment, cultural tour, AEC 2015

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Authors: Yingjin Cui, Xue Bai, Serena Reese

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Student engagement and student interest during class instruction are important conditions for active learning. Engagement, which has an important relationship with learning motivation, influences students' levels of persistence in overcoming challenges. Lack of student engagement and absence from face-to-face lectures and tutorials, in turn, can lead to poor academic performance. However, keeping students motivated and engaged in the learning process in different instructional modes poses a significant challenge; students can easily become discouraged from attending lectures and tutorials across both online and face-to-face settings. Many factors impact students’ engagement in the learning process. If you want to keep students focused on learning, you have to invite them into the process of helping themselves by providing an active learning environment. Active learning is an excellent technique for enhancing student engagement and participation in the learning process because it provides means to motivate the student to engage themselves in the learning process through reflection, analyzing, applying, and synthesizing the material they learn during class. In this study, we discussed how to create an active learning class (both face-to-face and synchronous online) through engagement activities, including reflection, collaboration, screen messages, open poll, tournament, and transferring editing roles. These activities will provide an uncommon interactive learning environment that can result in improved learning outcomes. To evaluate the effectiveness of those engagement activities in the learning process, an experimental group and a control group will be explored in the study.

Keywords: active learning, academic performance, engagement activities, learning motivation

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Authors: N. J. Shanono, J. G. Ndiritu

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The poor performance of water resource systems (WRS) has been reportedly linked to not only climate variability and the water demand dynamics but also human behaviour-driven unlawful activities. Some of these unlawful activities that have been adversely affecting water sector include unauthorized water abstractions, water wastage behaviour, refusal of water re‐use measures, excessive operational losses, discharging untreated or improperly treated wastewater, over‐application of chemicals by agricultural users and fraudulent WRS operation. Despite advances in WRS planning, operation, and analysis incorporating such undesirable human activities to quantitatively assess their impact on WRS performance remain elusive. This study was then inspired by the need to develop a methodological framework for WRS performance assessment that integrates the impact of human behaviour with WRS performance assessment analysis. We, therefore, proposed a conceptual framework for assessing the impact of human behaviour on WRS performance using the concept of socio-hydrology. The framework identifies and couples four major sources of WRS-related values (water values, water systems, water managers, and water users) using three missing links between human and water in the management of WRS (interactions, outcomes, and feedbacks). The framework is to serve as a database for choosing relevant social and hydrological variables and to understand the intrinsic relations between the selected variables to study a specific human-water problem in the context of WRS management.

Keywords: conceptual framework, human behaviour; socio-hydrology; water resource systems

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Authors: Niall J. English

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Under- and post-graduate training can benefit from a more active learning style, and most particularly so in engineering. Despite this, outreach to young children in primary and secondary schools is less-developed in terms of its documented effectiveness, especially given new emphasis placed within the third level and advanced research program’s on Education and Public Engagement (EPE). Bearing this in mind, outreach and school visits form the basis to ascertain how active learning, careers stimulus and EPE initiatives for young children can inform the university sector, helping to improve future engineering-teaching standards, and enhancing both quality and practicalities of the teaching-and-learning experience. Indeed, engineering-education EPE/outreach work has been demonstrated to lead to several tangible benefits and improved outcomes, such as greater engagement and interest with science/engineering for school-children, careers awareness, enabling teachers with strong contributions to technical knowledge of engineering subjects, and providing development of general professional skills for engineering, e.g., communication and teamwork. This intervention involved active learning in ‘buzz’ groups for young children of concepts in gas engineering, observing their peer interactions to develop university-level lessons on activity learning. In addition, at the secondary level, careers-outreach efforts have led to statistical determinations of motivations towards engineering education and training, which aids in the redesign of engineering curricula for more active learning.

Keywords: outreach, education and public engagement, careers, peer interactions

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Authors: Andrew Anis Fakhrey Mosaad

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Objectives: Physiotherapy in the intensive care unit (ICU) improves patient outcomes. We aimed to determine the characteristics of physiotherapy practice and critical barriers to applying physiotherapy in ICUs. Materials and Methods: A 54-item survey for determining the characteristics physiotherapists and physiotherapy applications in the ICU was developed. The survey was electronically sent to potential participants through the Turkish Physiotherapy Association network. Sixty-five physiotherapists (47F and 18M; 23–52 years; ICU experience: 6.0±6.2 years) completed the survey. The data were analyzed using quantitative and qualitative methods. Results: The duration of ICU practice was 3.51±2.10 h/day. Positioning (90.8%), active exercises (90.8%), breathing exercises (89.2%), passive exercises (87.7%), and percussion (87.7%) were the most commonly used applications. The barriers were related to physiotherapists (low level of employment and practice, lack of shift); patients (unwillingness, instability, participation restriction); teamwork (lack of awareness and communication); equipment (inadequacy, non-priority to purchase); and legal (reimbursement, lack of direct physiotherapy access, non-recognition of autonomy) procedures. Conclusion: The most common interventions were positioning, active, passive, breathing exercises, and percussion. Critical barriers toward physiotherapy are multifactorial and related to physiotherapists, patients, teams, equipment, and legal procedures. Physiotherapist employment, service maintenance, and multidisciplinary teamwork should be considered for physiotherapy effectiveness in ICUs.

Keywords: intensive care units, physical therapy, physiotherapy, exercises

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Authors: B. Likar, K. Širok

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The paper presents a new method for efficient innovation process management. Even though the innovation management methods, tools and knowledge are well established and documented in literature, most of the companies still do not manage it efficiently. Especially in SMEs the front end of innovation - problem identification, idea creation and selection - is often not optimally performed. Our eMIPS methodology represents a sort of "umbrella methodology"- a well-defined set of procedures, which can be dynamically adapted to the concrete case in a company. In daily practice, various methods (e.g. for problem identification and idea creation) can be applied, depending on the company's needs. It is based on the proactive involvement of the company's employees supported by the appropriate methodology and external experts. The presented phases are performed via a mixture of face-to-face activities (workshops) and online (eLearning) activities taking place in eLearning Moodle environment and using other e-communication channels. One part of the outcomes is an identified set of opportunities and concrete solutions ready for implementation. The other also very important result is connected to innovation competences for the participating employees related with concrete tools and methods for idea management. In addition, the employees get a strong experience for dynamic, efficient and solution oriented managing of the invention process. The eMIPS also represents a way of establishing or improving the innovation culture in the organization. The first results in a pilot company showed excellent results regarding the motivation of participants and also as to the results achieved.

Keywords: creativity, distance learning, front end, innovation, problem

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Authors: Jo Rhodes, Bruce Bergstrom, Peter Lok, Vincent Cheng

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The aim of this study is to determine key factors and processes for multinationals (MNCs) to develop an effective stakeholder engagement and sustainable development framework. A qualitative multiple-case approach was used. A triangulation method was adopted (interviews, archival documents and observations) to collect data on three global firms (MNCs). 9 senior executives were interviewed for this study (3 from each firm). An initial literature review was conducted to explore possible practices and factors (the deductive approach) to sustainable development. Interview data were analysed using Nvivo to obtain appropriate nodes and themes for the framework. A comparison of findings from interview data and themes, factors developed from the literature review and cross cases comparison were used to develop the final conceptual framework (the inductive approach). The results suggested that stakeholder engagement is a key mediator between ‘stakeholder network’ (internal and external factors) and outcomes (corporate social responsibility, social capital, shared value and sustainable development). Key internal factors such as human capital/talent, technology, culture, leadership and processes such as collaboration, knowledge sharing and co-creation of value with stakeholders were identified. These internal factors and processes must be integrated and aligned with external factors such as social, political, cultural, environment and NGOs to achieve effective stakeholder engagement.

Keywords: stakeholder, engagement, sustainable development, shared value, corporate social responsibility

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Authors: Farzad Jalilian, Mehdi Mirzaei Alavijeh

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Background: E-interventions as a universal approach to prevent a high-risk behavior, such as alcohol drinking. This study was conducted to evaluate web-based alcohol drinking preventative intervention efficiency among medical university students in Iran. Methods: Overall, 150 freshman and sophomore male student’s college students participated in this study as intervention and control group. This was a longitudinal randomized pre- and post-test series control group design panel study to implement a behavior modification based intervention to alcohol drinking prevention among college students. Cross-tabulation, t-test, repeated measures, and GEE by using SPSS statistical package, version 21 was used for the statistical analysis. The participants were followed up for 6 months with data collection scheduled at baseline, 3 and 6 months. The primary outcomes are attitude, self-control, and sensation seeking. Furthermore, the secondary outcome is comparing alcohol drinking among the study groups. Results: It was found significant reduce in average response for an attitude towards alcohol drinking and sensation seeking among intervention group (P < 0.05). But after intervention not significant difference between intervention and control group of improve self-control and reduce alcohol drinking (P > 0.05). Conclusion: Our intervention has been accompanied with reducing alcohol use rate. These findings indicate that e-intervention may be effectiveness approach to address the alcohol prevention among college students.

Keywords: e-interventions, alcohol drinking, students, Iran

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Authors: Chao Hsing Yeh, Wei Chun Lin

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Background: Current management of aromatase inhibitor-induced arthralgia (AIA) in postmenopausal breast cancer survivors (PBCS) has limited effect. Method: In this prospective randomized clinical trial (RCT), a 4-week APA treatment was used to manage AIA. Twenty PBCS participated. After baseline data was collected, participants were waited for a month before they receive APA at a convenient time once a week for 4 weeks. Blood samples from participants in both groups were collected at baseline and after 4 weeks of treatment. The primary outcomes included: pain intensity, pain interference, stiffness, and physical function. Results: After the 4-week APA treatment, the pro-inflammatory cytokines and chemokines display a trend of mean percentage reduction (i.e., -22% in IL-1α, -4% in IL-1β, -1% in IL-2, -3% in IL-6, -19% in IL-12, -9% in Eotaxin, and -2% in MCP-1). The anti-inflammatory cytokine IL-10 and IL-13 (i.e., 5% in IL-10 and 29% in IL-13) increased from pre- to post-APA treatment. Significant positive correlation of percentage mean change was observed between symptom severity and eotaxin (ρ = 0.56; p < 0.01) & MCP-1 (ρ = 0.65; p < 0.01). Interference and chemokines (eotaxin & MIP-1) also shows positive correlation (ρ = 0.48; p < 0.01 & ρ = 0.39; p < 0.05). Another positive correlation was found between worst pain and chemokines (eotaxin, ρ = 0.48; p < 0.01 & MIP-1, ρ = 0.39; p < 0.05). Additionally, interference also shows positive correlation among IL-1α (ρ = 0.36; p < 0.05) and IL-β (ρ = 0.33; p < 0.05). Conclusion: These findings suggest that APA intervention may inhibit inflammation of AIA patients and chemokine could be one of the key factors of AIA symptom improvement.

Keywords: acupressure, cytokine, pain management, breast cancer survivors

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Authors: Ergun Sakalar, Kubra Bilgic

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In the last decades, real-time PCR has become a reliable tool preferred to use in many laboratories for pathogen detection. This technique allows for monitoring target amplification via fluorescent molecules besides admit of quantitative analysis by enabling of convert outcomes of thermal cycling to digital data. Sensitivity and traceability of real-time PCR are based on measuring of fluorescence that appears only when fluorescent reporter dye bound to specific target DNA.The fluorescent reporter systems developed for this purpose are divided into two groups. The first group consists of intercalator fluorescence dyes such as SYBR Green, EvaGreen which binds to double-stranded DNA. On the other hand, the second group includes fluorophore-labeled oligonucleotide probes that are separated into three subgroups due to differences in mechanism of action; initial primer-probes such as Cyclicons, Angler®, Amplifluor®, LUX™, Scorpions, and the second one hydrolysis probes like TaqMan, Snake assay, finally hybridization probes, for instance, Molecular Beacons, Hybprobe/FRET, HyBeacon™, MGB-Eclipse, ResonSense®, Yin-Yang, MGB-Pleiades. In addition nucleic acid analogues, an increase of probe affinity to target site is also employed with fluorescence-labeled probes. Consequently, abundant real-time PCR detection chemistries are chosen by researcher according to the field of application, mechanism of action, advantages, and proper structures of primer/probes.

Keywords: fluorescent dye, food safety, molecular probes, nucleic acid analogues

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Authors: Alan S. Weber

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This contribution reviews the current biomedical and qualitative arts research on arts-in-health interventions to improve both individual and population health outcomes. Arts therapies–for example, music therapy with roots in Aristoxenus’s Ἁρμονικὰ στοιχεῖα and the Pythagorean sect–have long been employed in therapeutic contexts. However, the 20th century witnessed the increasing use of the visual and plastic arts (drawing, painting, sculpting), performing arts (drama and dance), and other expressive arts modalities into occupational therapy, well-being medicine, and psychological and psychiatric counselling, diagnosis, and treatment. A significant body of peer-reviewed evidence in the medical and neurological sciences on the role of arts-in-health has developed, and specifically, research on music and art therapy has led to their inclusion within the current biomedical paradigm of evidence-based practice. The arts cannot only aid in public and population health promotion (promoting healthy behaviors and lifestyles, preventing disease onset) but also in addressing psychological issues (regulation of emotion; stress, anxiety, and depression reduction), behavioural issues (basic life skills, coping), and physiological response (immune system function, hormonal regulation, homeostatis). Working as a cross-disciplinary researcher in the arts in an American medical college, the author has developed several successful arts-in-health programs at the national and international level.

Keywords: arts-in-health, evidence based medicine, arts for health, expressive arts therapies

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Authors: Aline Giardin

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Introduction: This review addresses the relationship between physical education and mental health and its main objective is to discuss the meanings that circulate in Psychiatric Hospitalization Units and Psychosocial Care Centers (CAPS) about the presence of physical education teachers and the practices developed by Them within these services. Material and methods: It is based on the theoretical contribution of the Psychiatric Reform and is methodologically inspired by the Bibliographic Review. Objectives: The objective of this review was to identify the main scientific evidence on the effects of physical activity on the main psychological aspects associated with mental health during the hospitalization process. Results: It was observed that physical activity has beneficial effects in the psychological, social and cognitive aspects, being thus a fundamental aspect of the lifestyle in promoting a healthy and successful treatment. In studies evaluating the effects of physical activity on mental health, the most frequently evaluated outcomes include anxiety, depression, and health-related quality of life (eg, self-esteem and self-efficacy). Evidence from epistemological studies indicates that the level of physical activity is positively associated with good mental health, when mental health is defined as good mood, general well-being and decreased symptoms. Conclusion: It is necessary to intervene and a greater interest of the professionals of physical education in the treatment with the people with mental disorders so that the negative symptoms are modified, through the aid of the physical activity, by better quality of life, physical condition, nutritional state and A healthy emotional appearance.

Keywords: health mental, physical activity, benefits, treatment

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Authors: Disaphon Boobpachat, Nuttaset Manimmanakorn, Apiwan Manimmanakorn, Worrawut Thuwakum, Michael J. Hamlin

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Objectives: To evaluate effect of kinesio tape compared to placebo tape and static stretching on recovery of anaerobic power and maximal oxygen uptake (Vo₂max) after intensive exercise. Methods: Thirty nine untrained healthy volunteers were randomized to 3 groups for each intervention: elastic tape, placebo tape and stretching. The participants performed intensive exercise on the dominant quadriceps by using isokinetic dynamometry machine. The recovery process was evaluated by creatine kinase (CK), pressure pain threshold (PPT), muscle soreness scale (MSS), maximum voluntary contraction (MVC), jump height, anaerobic power and Vo₂max at baseline, immediately post-exercise and post-exercise day 1, 2, 3 and 7. Results: The kinesio tape, placebo tape and stretching groups had significant changes of PPT, MVC, jump height at immediately post-exercise compared to baseline (p < 0.05), and changes of MSS, CK, anaerobic power and Vo₂max at day 1 post-exercise compared to baseline (p < 0.05). There was no significant difference of those outcomes among three groups. Additionally, all experimental groups had little effects on anaerobic power and Vo₂max compared to baseline and compared among three groups (p > 0.05). Conclusion: Kinesio tape and stretching did not improve recovery of anaerobic power and Vo₂max after eccentric exercise compared to placebo tape.

Keywords: stretching, eccentric exercise, Wingate test, muscle soreness

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Authors: Hatice Canan Gungor, Ahmet Akdemir

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The fields of engineering and technological sciences are increasing in quality and quantity day by day all over the world. Countries have to follow, implement and adapt these developments in order to economical empowerments. In our era, it's possible to follow the rapidly developing technology and to produce new technologies by inquisitive, curious, numerical thinking individuals who can show several approaches to problem solving. In this case, countries should develop te result oriented and need-focused curriculums in university education. As in the whole world, there are more space studies in our country as well. Universities should undertake the task of supply the need for staff of this technological race. In this context, questions about the purpose, content and learning outcomes of the space sciences and space engineering departments in our country will be researched answers to reveal the characteristic of this section. In this study, it was determined in which universities the space engineering and the departments of basic sciences educate with formal education and the contents of this education, and the universities were compared with each other as of 2017. In our country three universities provide Aeronautical and Aerospace Engineering, two universities provide Space Sciences and Technologies, two universities provide Aerospace Engineering, two universities provide Aeronautics and Astronautics Engineering education. In all universities, specialized courses are taught after basic engineering education. But the question that needs to be answered is, do the lessons benefit in practice? The answer of this question will reveal the quality of the education. This paper suggests that surveys be conducted to search for the answer to this question. It's thought to be the base for the next works.

Keywords: education, space engineering, space science, quality of systems

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Authors: Anupam Sibal

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Whatever is measured tends to improve. With a view to objectively measuring and improving clinical quality across the Apollo Group Hospitals, the initiative of ACE @ 25 (Apollo Clinical Excellence@25) was launched on Jan 09. ACE @ 25 is a clinically balanced scorecard incorporating 25 clinical quality parameters involving complication rates, mortality rates, one-year survival rates and average length of stay after major procedures like liver and renal transplant, CABG, TKR, THR, TURP, PTCA, endoscopy, large bowel resection and MRM covering all major specialties. Also included are hospital acquired infection rates, pain satisfaction and medication errors. Benchmarks have been chosen from the world’s best hospitals. There are weighted scores for outcomes color coded green, orange and red. The cumulative score is 100. Data is reported monthly by 43 Group Hospitals online on the Lighthouse platform. Action taken reports for parameters falling in red are submitted quarterly and reviewed by the board. An audit team audits the data at all locations every six months. Scores are linked to appraisal of the medical head and there is an “ACE @ 25” Champion Award for the highest scorer. Scores for different parameters were variable from green to red at the start of the initiative. Most hospitals showed an improvement in scores over the last four years for parameters where they had showed scores in red or orange at the start of the initiative. The overall scores for the group have shown an increase from 72 in 2010 to 81 in 2015.

Keywords: benchmarks, clinical quality, lighthouse, platform, scores

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Authors: S. Rostami, S. H. Hosseini, A. A. Torabi, M. Bekhradi

Abstract:

Introduction: Interest in the use of caffeine as an ergogenic aid has increased since the International Olympic Committee lifted the partial ban on its use. Caffeine has beneficial effects on various aspects of athletic performance, but its effects on training have been neglected. The purpose of this study was to investigate the acute effect of caffeine on testosterone and cortisole in young futsal players. Methods: Twenty-four professional futsal players with 18.3± 1.9 years ingested caffeine doses of 0, 200 and 800 mg in random order 1 hr before an anaerobic-exercise session (RAST test). Samples were taken at the time of caffeine ingestion and 30 min after the session. Data were log-transformed to estimate percent effects with mixed modeling, and effects were standardized to assess magnitudes. fects on training have been neglected. Results: Testosterone concentration showed a small increase of 15% (90% confidence limits, ± 19%) during exercise. Caffeine raised this concentration in a dose-dependent manner by a further small 21% (± 24%) at the highest dose. The 800-mg dose also produced a moderate 52% (± 44%) increase in cortisol. The effect of caffeine on the testosterone: cortisol ratio was a small decline (14%; ± 21%). Discussion and Conclusion: Caffeine has some potential to benefit training outcomes via the anabolic effects of the increase in testosterone concentration, but this benefit might be counteracted by the opposing catabolic effects of the increase in cortisol and resultant decline in the testosterone: cortisol ratio.

Keywords: anabolic, catabolic, performance, testosterone, cortisol ratio, RAST test

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Authors: Renee Monchalin

Abstract:

Métis peoples, while comprising over a third of the total Indigenous population in Canada, experience major gaps in health services that accommodate their cultural identities. This is problematic given Métis peoples experience severe disparities in health determinants and outcomes compared to the non-Indigenous Canadian population. At the same time, Métis are unlikely to engage in health services that do not value their cultural identities, often utilizing mainstream options. Given these contexts, this research aims to fill the culturally-safe health care gap for Métis peoples in Canada. It does this by engaging 56 urban Métis women who participated in a longitudinal cohort study, Our Health Counts (OHC) Toronto. Traditionally, Métis women were central to the health and well-being of their communities. However, due to decades of colonial legislation and forced land displacement, female narratives have been silenced, and Métis identities have been fractured. This has resulted in having direct implications on Métis people’s current health and access to health services. Solutions to filling the Métis health service gap may lie in the all too often unacknowledged or missing voices of Métis women. Through a conversational method, this research will explore urban Métis women’s perspectives on identity and their experiences with health services in Toronto. The goal of this research is to learn from urban Métis women on steps towards filling the health service gap. This research is currently in the data collection stage. Preliminary findings from the conversations will be disseminated. Policy recommendations for health service providers will be provided to better accommodate Métis people.

Keywords: indigenous health, Metis health, urban, health service access, identity

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Authors: Husham Bayazed

Abstract:

A growing number of studies indicate that atherosclerotic coronary artery disease (CAD) has a complex pathogenesis that extends beyond cholesterol intimal infiltration. The atherosclerosis process may involve an immune micro-environmental condition driven by local activation of the adaptive and innate immunity arrays, resulting in the formation of atherosclerotic plaques. Therefore, despite the wide usage of lipid-lowering agents, these devastating coronary diseases are not averted either at primary or secondary prevention levels. Many trials have recently shown an interest in the immune targeting of the inflammatory process of atherosclerotic plaques, with the promised improvement in atherosclerotic cardiovascular disease outcomes. This recently includes the immune-modulatory drug “Canakinumab” as an anti-interleukin-1 beta monoclonal antibody in addition to "Colchicine,” which's established as a broad-effect drug in the management of other inflammatory conditions. Recent trials and studies highlight the importance of inflammation and immune reactions in the pathogenesis of atherosclerosis and plaque formation. This provides an insight to discuss and extend the therapies from old lipid-lowering drugs (statins) to anti-inflammatory drugs (colchicine) and new targeted immune-modulatory therapies like inhibitors of IL-1 beta (canakinumab) currently under investigation.

Keywords: atherosclerotic plagues, immune microenvironment, lipid-lowering agents, and immunomodulatory drugs

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Authors: Gamalath M. B. P. Abeysekara

Abstract:

Primary objective of any organization is to enhance the bottom line profit. Strategic procurement is one of the prominent aspects in view of receiving this ultimate objective. Strategic procurement is an activity used in each and every organization in their operations. Pharmaceutical procurement is an especially significant task for any organizations, particularly state sector concerned. The whole pharmaceutical procurement requirement of the country is procured through the State Pharmaceutical Corporation (SPC) of Sri Lanka. They follow Pharmaceutical Procurement Guideline of 2006 as the procurement principle. The main objective of this project is to identify the importance of State Pharmaceutical Corporation supplier selection criteria and critical analysis of pharmaceutical procurement procedure. State Pharmaceutical Corporations applied net price, product quality, past performance, and delivery of suppliers’ as main criteria for the selection suppliers. Data collection for this study was taken place through a questionnaire, given to fifty doctors within the Colombo district attached to five main state hospitals. Data analysis is carried out with mean and standard deviation functions. The ultimate outcomes indicated product quality, net price, and delivery of suppliers’ are the most important criteria behind the selection of suppliers. Critical analysis proved State Pharmaceutical Corporation should focus on net price reduction, improving laboratory testing facilities and effective communication between up and down stream of supply chain.

Keywords: government procurement procedure, pharmaceutical procurement supplier selection criteria, importance of SPC supplier selection criteria

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Authors: Dike Felix Okechukwu

Abstract:

Studies and reports from authoritative sources such as the Intergovernmental Panel on Climate Change (IPCC) have stated that to effectively solve environmental sustainability challenges such as pollution, inappropriate waste disposal, and unsustainable consumption, there is a need for more research to seek solutions towards environmentally sustainable behavior. However, literature thus far reports only sporadic developments of TL in Environmental Sustainability because there are scarce reports showing the reliable process(es) to produce TL - for sustainability projects or otherwise. Nonetheless, a recently published article demonstrates how TL can be used to help young adults gain transformed mindsets and habits toward environmental sustainability behaviors and practices. This study, however, does not demonstrate, on a repeated basis, the dependability of the method or reliability of the procedures in using its proposed methodology to help young adults achieve transformed habits towards environmental sustainability behaviors, especially in diverse contexts. In this study, it is demonstrated, through repeated measures, a reliable process that can be used to achieve transformations in habits and mindsets toward environmental sustainability behaviors. To achieve this, the design adopted is multiple case studies and a thematic analysis techniques. Five cases in diverse contexts were used to analyze pieces of evidence of Transformative Learning Outcomes toward environmentally sustainable behaviors. Results from the study offer fresh perspectives on a reliable methodology that can be adopted to achieve Transformations in Habits and mindsets toward environmental sustainability behaviors.

Keywords: environmental sustainability, transformative learning, behaviour, learning, education

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Authors: Fahad Raj Khan, Suleman Khan

Abstract:

There is a lack of consensus about the predictive value of raised blood glucose levels in terms of major adverse cardiac events (MACEs) in non-diabetic patients admitted for acute decompensated heart failure. The purpose of this research was to examine the long-term prognosis of acute decompensated heart failure (ADHF) in non-diabetic persons who had increased blood glucose levels, i.e., stress hyperglycemia, at the time of their ADHF hospitalization. The research involved 650 non-diabetic patients. Based on their admission stress hyperglycemia, they were divided into two groups.ie with and without (SHGL). The two groups' one-year outcomes for major adverse cardiac events (MACEs) were compared, and key predictors of MACEs were discovered. For statistical analysis, the two-tailed Mann-Whitney U test, Fisher's exact test, and binary logistic regression analysis were utilized. SHGL was found in 353 (54.3%) individuals. It was more frequent in men than in women. About 27% of patients with SHGL had previously been admitted for ADHF. Almost 62% were hypertensive, whereas 14 % had CKD. MACEs were significantly predicted by SHGL, HTN, prior hospitalization for ADHF, CKD, and cardiogenic shock upon admission. SHGL at the time of ADHF admission, independent of DM status, may be a predictive indication of MACEs.

Keywords: stress hyperglycemia, acute heart failure, major adverse cardiac events, MACEs

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Authors: Amy L. Irvine, Gabriel Reygondeau, Derek P. Tittensor

Abstract:

Marine protected areas (MPAs) within Canada’s exclusive economic zone help ensure the conservation and sustainability of marine ecosystems and the continued provision of ecosystem services to society (e.g., food, carbon sequestration). With ongoing and accelerating climate change, however, MPAs may become undermined in terms of their effectiveness at fulfilling these outcomes. Many populations of species, especially those at their thermal range limits, may shift to cooler waters or become extirpated due to climate change, resulting in new species compositions and ecological interactions within static MPA boundaries. While Canadian MPA management follows international guidelines for marine conservation, no consistent approach exists for adapting MPA networks to climate change and the resulting altered ecosystem conditions. To fill this gap, projected climate-driven shifts in species distributions on Canada’s east coast were analyzed to identify when native species emigrate and novel species immigrate within the network and how high mitigation and carbon emission scenarios influence these timelines. Indicators of the ecological changes caused by these species' shifts in the biological community were also developed. Overall, our research provides projections of climate change impacts and helps to guide adaptive management responses within the Canadian east coast MPA network.

Keywords: climate change, ecosystem modeling, marine protected areas, management

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