Search results for: exercise intervention

Authors: Po-Ching Wang

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Public art may be regarded as a social agenda. It is assumed that public art acts as an intermediate form that contributes significantly to community resurgence. That is, public art may be regarded as a verb/process or social intervention. It functions as a vanguard form, attacking boundaries and providing a sensibility for social strategy. Public art in tradition is generally expected to bring aesthetic pleasure to public. Contemporary public art, however, not only focuses on art installation, but it also often offers a process that aims to comment on, question, and challenge the socio-cultural status quo. During the last few decades, accelerated changes in the values and expectations brought to bear on varied urban issues, together with the destruction of the hegemony of traditional art and of museum authorities, has begun to contribute to freer and more democratic representations of public art. It is said that part of a public artwork’s role is to ruffle sacred feathers. In many cases, public art is created to address the dynamic social contradictions and mutability of public life; and artists and community participants approach public art from a variety of social critical perspectives and methodologies. Urban issues, such as social and environmental justice, health problems, violence, and political statements, provide plentiful source materials that fuel the performance of public art in many different settings. Further, public artworks have been extensively adopted to express social identity, make political statements, and/or to remedy social and environmental crises. Many murals on urban walls, for instance, reflect social conflicts and address civic rights, and these projects are usually the work of artists who though denied access to traditional gallery and museum channels are supported by community engagement and involvement. Public art as a social practice challenges the traditional western view of artistic practice. Art in the public realm creates a new media that provides a platform for a dialogical exchange between diverse social groups. It seems that public art has evolved as an arena for activism that addresses wide-ranging and highly controversial social issues and civilian concerns. The findings of this study indicate that public artworks are capable of playing a role of activist in facilitating community evolution via social progress.

Keywords: aesthetics, community regeneration, city development, publicness, public participation, social progress

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Authors: Yu-Wen Lin, Li-Ni Liu

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Introduction: Fatigue is the most common symptoms experienced by cancer patients undergoing chemotherapy. Patients receiving anticancer therapies develop a higher proportion of fatigue compared with patients who do not receive anticancer therapies. Fatigue has significant impacts on quality of life, daily activities, mood status, and social behaviors. A warm-water footbath (WWF) at 41℃ promotes circulation and removes metabolites resulting in improving sleep and relieving fatigue. The aim of this study is to determine the effectiveness of WWF for relieving fatigue with cancer patients undergoing chemotherapy. Materials and Methods: This is a single-center, prospective, quasi-experimental design study in the oncology ward in Taiwan. Participants in this study were assigned to WWF group as experimental group and standard care group as a control group by purposive sampling. In the WWF group, the participants were asked to soak their feet in 42-43℃ water 15 minutes for consecutive 6 days at one day before chemotherapy. Each participant was evaluated for fatigue level by the Taiwanese version of the Brief Fatigue Inventory (BFI-T). BFI-T was completed for consecutive 8 days of the study. The primary outcome was compared the BFI-T score of WWF group to the standard care group. Results: There were 60 participants enrolled in this study. Thirty participants were assigned to WWF group and 30 participants were assigned to standard care group. Both groups have comparable characteristic. The BFI-T scores of both groups were increased associated with the days of chemotherapy. The highest BFI-T scores of both groups were on the day 4 of chemotherapy. The BFI-T scores of both groups were decreased since day 5 and significantly decreased in WWF group on day 5 compared to standard care group (4.17 vs. 5.7, P ＜ .05). At the end of the study the fatigue at its worse were significantly decreased in WWF group (2.33 vs. 4.37, P ＜ .001). There was no adverse event reported in this study. Conclusion: WWF is an easy, safe, non-invasive, and relatively inexpensive nursing intervention for improving fatigue of cancer patients undergoing chemotherapy. In summary, this study shows the WWF is a simple complementary care method, and it is effective for improving and relieving fatigue in a short time. Through improving fatigue is a way to enhance the quality of life which is important for cancer patients undergoing chemotherapy. Larger prospective randomized controlled trial and long-term effectiveness and outcomes of WWF should be performed to confirm this study.

Keywords: chemotherapy, warm-water footbath, fatigue, Taiwanese version of the brief fatigue inventory

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Authors: Eduardo Jorge Cabral dos Santos Fernandes

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The expression ‘Porto School’, usually associated with an educational institution, the School of Fine Arts of Porto, is applied for the first time with the sense of an architectural trend by Nuno Portas in a text published in 1983. The expression is used to characterize a set of works by Porto architects, in which common elements are found, namely the desire to reuse languages and forms of the German and Dutch rationalism of the twenties, using the work of Alvar Aalto as a mediation for the reinterpretation of these models. In the same year, Álvaro Siza classifies the Finnish architect as a miscegenation agent who transforms experienced models and introduces them to different realities in a text published in Jornal de Letras, Artes e Ideias. The influence of foreign models and their adaptation to the context has been a recurrent theme in Portuguese architecture, which finds important contributions in the writings of Alexandre Alves Costa, at this time. However, the identification of these characteristics in Siza’s work is not limited to the Portuguese theoretical production: it is the recognition of this attitude towards the context that leads Kenneth Frampton to include Siza in the restricted group of architects who embody Critical Regionalism (in his book Modern architecture: a critical history). For Frampton, his work focuses on the territory and on the consequences of the intervention in the context, viewing architecture as a tectonic fact rather than a series of scenographic episodes and emphasizing site-specific aspects (topography, light, climate). Therefore, the motto of this paper is the dichotomous opposition between foreign influences and adaptation to the context in the early work of Álvaro Siza (designed in the sixties) in which the influence (theoretical, methodological, and formal) of Alvar Aalto manifests itself in the form and the language: the pool at Quinta da Conceição, the Seaside Pools and the Tea House (three works in Leça da Palmeira) and the Lordelo Cooperative (in Porto). This work is part of a more comprehensive project, which considers several case studies throughout the Portuguese architect's vast career, built in Portugal and abroad, in order to obtain a holistic view.

Keywords: Alvar Aalto, Álvaro Siza, foreign influences, adaptation to the context

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Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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Authors: Simon B. N. Thompson

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Early indicator of neurological disease has been proposed by the expanded Thompson Cortisol Hypothesis which suggests that yawning is linked to rises in cortisol levels. Cortisol is essential to the regulation of the immune system and pathological yawning is a symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved – extended or flexed; and yawning has been shown to be highly correlated with cortisol levels in healthy people. It is likely that these elevated cortisol levels are also seen in people with MS. The possible link between EMG in the jaw muscles and rises in saliva cortisol levels during yawning were investigated in a randomized controlled trial of 60 volunteers aged 18-69 years who were exposed to conditions that were designed to elicit the yawning response. Saliva samples were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, and EMG data was additionally collected during rest and yawning phases. Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, and health details were collected and the following exclusion criteria were adopted: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. There were also significant differences between yawners and non-yawners for the EMG potentials with the yawners having higher rest and post-yawning potentials. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with the yawning response. Further research is underway to explore the use of cortisol as a potential diagnostic tool as an assist to the early diagnosis of symptoms related to neurological disorders. Bournemouth University Research & Ethics approval granted: JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality, and safety issues have been addressed and approved in the Ethics submission. Trials identification number: ISRCTN61942768. http://www.controlled-trials.com/isrctn/

Keywords: cortisol, electromyography, neurology, yawning

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Authors: Ellen Dahl Gundersen, Berit Johannessen

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Introduction: Dementia and depression are common mental disorders of nursing home residents. The care of these residents consists of providing both physical, social and mental care. Too often, the physical needs are given priority, and municipal health services are urged to focus more on the patients mental and social needs. The presence of dogs may have positive impact on the mental health of nursing home residents by improving mood, social interaction and enjoyment of the visits. The voluntary organization Red Cross, has given priority to this subject by training and certifying dogs and owners (equipages), committed for regular visits at local nursing homes. Focus of this study: How do the dog owners and employees experience the presence of a dog equipage concerning the mental health of nursing home residents? Method: Individual interviews with 8-10 certified dog owners who are volunteers from Red Cross, contributing with regular visits at local nursing homes. Focus group interviews with 10 employees working in two different nursing homes. Preliminary results: Five to seven residents and one or two employees attended weekly dog equipage visits during a period of six months. The presence of an equipage seems to have made the residents calm and more social orientated with a lighter mood and better verbal expression. Some of the residents with dementia remembered the name of the dog from one week to another. The informants also reported positive outcome for the residents by their opportunity to give and get close through physical contact with a dog. Further, the presence of an equipage affected the atmosphere at the nursing home positively by promoting joy and initiating conversations about dogs. A conscious approach by the dog owners towards the residents seems to be of significance to this matter. The positive attitude and support from employees also seem to be of crucial importance for the maintenance of these visits. Conclusion: The presence of trained dog equipages in nursing homes seems to have had an overall positive impact on the mental health of residents. A conscious approach from the dog owners as well as positive support from employees seems to have a crucial impact on the success and maintenance of the visits. These findings correspond well to former research and can thereby give implications for more extended use of dogs as a mental health promoting initiative towards geriatric consumers of municipal health care services. Further research through larger studies is needed.

Keywords: animal assisted intervention, geriatric mental health, nursing home, resident

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Authors: Jeremy Bekker, Guy Salazar

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Introduction: Nature-exposure interventions on university campuses may serve as an effective addition to overburdened counseling and student support centers. Nature-exposure interventions can work as a preventative well-being enhancement measure on campuses, which can be used adjacently with existing health resources. Specifically, this paper analyzes how spending time in nature impacts psychological well-being, cognitive functioning, and physical health. The poster covers the core findings and recommendations of this paper, which has been previously published in the BYU undergraduate psychology journal Intuition. Research Goals and Method: The goal of this paper was to outline the potential benefits of nature exposure for students’ physical health, mental well-being, and academic success. Another objective of this paper was to outline potential research-based interventions that use campus green spaces to improve student outcomes. Given that the core objective of this paper was to identify and establish research-based nature exposure interventions that could be used on college campuses, a broad literature review focused on these areas. Specifically, the databases Scopus and PsycINFO were used to screen for research focused on psychological well-being, physical health, cognitive functioning, and nature exposure interventions. Outcomes: Nature exposure has been shown to help increase positive affect, life satisfaction, happiness, coping ability and subjective well-being. Further, nature exposure has been shown to decrease negative affect, lower mental distress, reduce cognitive load, and decrease negative psychological symptoms. Finally, nature exposure has been shown to lead to better physical health. Findings and Recommendations: Potential interventions include adding green space to university buildings and grounds, dedicating already natural environments as nature restoration areas, and providing means for outdoor excursions. Potential limitations and suggested areas for future research are also addressed. Many campuses already contain green spaces, defined as any part of an environment that is predominately made of natural elements, and these green spaces comprise an untapped resource that is relatively cheap and simple.

Keywords: nature exposure, preventative care, undergraduate mental health, well-being intervention

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Authors: Estifanos H. Zeru

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Introduction: Epidemiological research is important to draw need-based rational public health policy. However, research on child and adolescent mental health in low and middle income countries, where socioeconomic, political, cultural, biological and other mental health hazards are in abundance, is almost nonexistent. To the author's knowledge, there is no published research in this field in Eritrea, whose child and adolescent population constitutes 53% of its total population. Study Aims and Objectives: The objective of this study was to determine the prevalence and patterns of DSM-IV psychiatric disorders and identify their socio-demographic correlates among children and adolescents in Mendefera, Eritrea. The study aims to provide local information to public health policymakers to guide policy in service development. Methodology: In a cross-sectional two stage procedure, both the Parent and Child versions of the SDQ were used to screen 314 children and adolescents aged 4-17 years, recruited by a multi-stage random sampling method. All parents/adult guardians also completed a socio-demographic questionnaire. All children and adolescents who screened positive for any of the SDQ abnormality sub-classes were selected for the second stage interview, which was conducted using the K-SADS-PL 2009 Working Draft version to generate specific DSM-IV diagnoses. All data gathered was entered into CSPro version 6.2 and was then transported in to and analyzed using SPSS version 20 for windows. Results: Prevalence of DSM-IV psychiatric disorders was found to be 13.1%. Adolescents 11-17 years old and males had higher prevalence than children 4-10 years old and females, respectively. Behavioral disorders were the commonest disorders (9.9%), followed by affective disorders (3.2%) and anxiety disorders (2.5). Chronic medical illness in the child, poor academic performance, difficulties with teachers in school, psychopathology in a family member and parental conflict were found to be independently associated with these disorders. Conclusion: Prevalence of child and adolescent psychiatric disorders in Eritrea is high. Promotion, prevention, treatment, and rehabilitation for child and adolescent mental health services need to be made widely available in the country. The socio-demographic correlates identified by this study can be targeted for intervention. The need for further research is emphasized.

Keywords: adolescents, children, correlates, DSM-IV psychiatric disorders, Eritrea, K-SAD-PL 2009, prevalence and correlates, SDQ

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Authors: T. Moody, E. Mitchell, T. Dang, A. Barry, T. Proshan, S. Andrisse, V. Odero-Marah

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Women’s prison and reentry programs are focused primarily on reducing recidivism but neglect how an individual’s intersecting identities influence their risk of violence and ways that histories of gender-based violence (GBV) must be addressed for these women to recover from traumas. Light To Life (LTL) and From Prison Cells to Ph.D. (P2P) Womxn’s Cohort program recognizes this need; providing national gender-responsive programming (GRP), and trauma-informed programming to justice-impacted survivors through digital resources, leadership opportunities, educational workshops, and healing justice approaches for positive health outcomes. Through the support of a community-university partnership (CUP), a comparative evaluation study is being conducted among intimate-partner violence (IPV) survivors with histories of incarceration who have or have not participated in the cohort. The objectives of the partnership are to provide mutually beneficial training and consultation for evaluating GRP through a rigorously tested research methodology. This collaborative applies a rigorous methodology of semi-structured interviews with an intervention and control group to evaluate the impact of LTL’s programming in the P2P Womxn’s Cohort. The CUP is essential to achieve the expected results of the project. It will measure primary outcomes, including participants' level of engagement and satisfaction with programming, reduction in attitudes that accept violence in relationships, and increase in interpersonal and intrapersonal skills that lead to healthy relationships. This community-based approach will provide opportunities to evaluate the effectiveness of the program. The results addressed in the hypothesis will provide learning lessons to improve this program, to scale it up, and apply it to other similarly affected populations. The partnership experience and anticipated outcomes contribute to the knowledge in women’s health and criminal justice by fostering public awareness on the importance of developing new partnerships and fostering CUP to establish a framework to the leveraging of partnerships for social impact available to academic institutions.

Keywords: Community-university partnership, gender-responsive programming, incarceration, intimate-partner violence, POC, women

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Authors: Yan Yan, Erhong Sun, Lin Peng, Xuchun Ye

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Aims: The present study aimed to explore Intensive Care Unit(ICU) nurses’ mental workload (MWL) and associated factors with it in performing human-machine tasks. Background: A wide range of emerging technologies have penetrated widely in the field of health care, and ICU nurses are facing a dramatic increase in nursing human-machine tasks. However, there is still a paucity of literature reporting on the general MWL of ICU nurses performing human-machine tasks and the associated influencing factors. Methods: A cross-sectional survey was employed. The data was collected from January to February 2021 from 9 tertiary hospitals in 6 provinces (Shanghai, Gansu, Guangdong, Liaoning, Shandong, and Hubei). Two-stage sampling was used to recruit eligible ICU nurses (n=427). The data were collected with an electronic questionnaire comprising sociodemographic characteristics and the measures of MWL, self-efficacy, system usability, and task difficulty. The univariate analysis, two-way analysis of variance(ANOVA), and a linear mixed model were used for data analysis. Results: Overall, the mental workload of ICU nurses in performing human-machine tasks was medium (score 52.04 on a 0-100 scale). Among the typical nursing human-machine tasks selected, the MWL of ICU nurses in completing first aid and life support tasks (‘Using a defibrillator to defibrillate’ and ‘Use of ventilator’) was significantly higher than others (p < .001). And ICU nurses’ MWL in performing human-machine tasks was also associated with age (p = .001), professional title (p = .002), years of working in ICU (p < .001), willingness to study emerging technology actively (p = .006), task difficulty (p < .001), and system usability (p < .001). Conclusion: The MWL of ICU nurses is at a moderate level in the context of a rapid increase in nursing human-machine tasks. However, there are significant differences in MWL when performing different types of human-machine tasks, and MWL can be influenced by a combination of factors. Nursing managers need to develop intervention strategies in multiple ways. Implications for practice: Multidimensional approaches are required to perform human-machine tasks better, including enhancing nurses' willingness to learn emerging technologies actively, developing training strategies that vary with tasks, and identifying obstacles in the process of human-machine system interaction.

Keywords: mental workload(MWL), nurse, ICU, human-machine, tasks, cross-sectional study, linear mixed model, China

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Authors: Garima Singh, Kunal Malhotra

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Objective: The expansion of telehealth has been instrumental in increasing access to medical services, especially for underserved and rural communities. In 2020, 14 million patients received virtual care through telemedicine and the global telemedicine market is expected to reach up to $185 million by 2023. It provides a platform and allows a patient to receive primary care as well as specialized care using technology and the comfort of their homes. Telemedicine was particularly useful during COVID-pandemic and the number of telehealth visits increased by 5000% during that time. It continues to serve as a significant resource for patients seeking care and to bridge the gap between the disease and the treatment. Method: As per APA (American Psychiatric Association), Telemedicine is the process of providing health care from a distance through technology. It is a subset of telemedicine, and can involve providing a range of services, including evaluations, therapy, patient education and medication management. It can involve direct interaction between a physician and the patient. It also encompasses supporting primary care providers with specialist consultation and expertise. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review. Results: In our organization, we are using telepsychiatry and serving 25 counties and approximately 1.4 million people. We provide multiple services, including inpatient, outpatient, crisis intervention, Rehab facility, autism services, case management, community treatment and multiple other modalities. With project ECHO (Extension for Community Healthcare Outcomes) it has been used to advise and assist primary care providers in treating mental health. It empowers primary care providers to treat patients in their own community by sharing knowledge. Conclusion: Telemedicine has shown to be a great medium in meeting patients’ needs and accessible mental health. It has been shown to improve access to care in both urban and rural settings by bringing care to a patient and reducing barriers like transportation, financial stress and resources. Telemedicine is also helping with reducing ER visits, integrating primary care and improving the continuity of care and follow-up. There has been substantial evidence and research about its effectiveness and its usage.

Keywords: telehealth, telemedicine, access to care, medical technology

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Authors: Qiuyu Chen, Bin Long, Junxi Yang

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Located in the southwest of the "roof of the world", Tibet is the origin center of Tibetan Culture.Lhasa, Shigatse and Gyantse are three famous historical and cultural cities in Tibet. They have always been prominent political, economic and cultural cities, and have accumulated the unique aesthetic orientation and value consciousness of Tibet's urban construction. "Archetype" usually refers to the theoretical origin of things, which is the collective unconscious precipitation. The archetype theory fundamentally explores the dialectical relationship between image expression, original form and behavior mode. By abstracting and describing typical phenomena or imagery of the archetype object can observe the essence of objects, explore ways in which object phenomena arise. Applying archetype theory to the field of urban planning helps to gain insight, evaluation, and restructuring of the complex and ever-changing internal structural units of cities. According to existing field investigations, it has been found that Dzong, Temple, Linka and traditional residential systems are important structural units that constitute the urban space of Lhasa, Shigatse and Gyantse. This article applies the thinking method of archetype theory, starting from the imagery expression of urban spatial pattern, using technologies such as ArcGIS, Depthmap, and Computer Vision to descriptively identify the spatial representation and plane relationship of three cities through remote sensing images and historical maps. Based on historical records, the spatial characteristics of cities in different historical periods are interpreted in a hierarchical manner, attempting to clarify the origin of the formation and evolution of urban pattern imagery from the perspectives of geopolitical environment, social structure, religious theory, etc, and expose the growth laws and key driving forces of cities. The research results can provide technical and material support for important behaviors such as urban restoration, spatial intervention, and promoting transformation in the region.

Keywords: archetype theory, urban spatial imagery, original form and pattern, behavioral driving force, Tibet

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Authors: Pei-Ru Yang, Yu-Chen Lin, Jia-Min Wu

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Background: A 58-year-old man with a history of osteoporosis and diabetes presented with chronic pain in his left knee due to severe knee joint degeneration. The knee replacement surgery was recommended by the doctor. But the patient suffered from low pain tolerance and wondered if virtual reality could relieve acute postoperative wound pain. Methods: We used the PICO (patient, intervention, comparison, and outcome) approach to generate indexed keywords and searched systematic review articles from 2017 to 2021 on the Cochran Library, PubMed, and Clinical Key databases. Results: The initial literature results included 38 articles, including 12 Cochrane library articles and 26 PubMed articles. One article was selected for further analysis after removing duplicates and off-topic articles. The eight trials included in this article were published between 2013 and 2019 and recruited a total of 723 participants. The studies, conducted in India, Lebanon, Iran, South Korea, Spain, and China, included adults who underwent hemorrhoidectomy, dental surgery, craniotomy or spine surgery, episiotomy repair, and knee surgery, with a mean age (24.1 ± 4.1 to 73.3 ± 6.5). Virtual reality is an emerging non-drug postoperative analgesia method. The findings showed that pain control was reduced by a mean of 1.48 points (95% CI: -2.02 to -0.95, p-value < 0.0001) in minor surgery and 0.32 points in major surgery (95% CI: -0.53 to -0.11, p-value < 0.03), and the overall postoperative satisfaction has improved. Discussion: Postoperative pain is a common clinical problem in surgical patients. Research has confirmed that virtual reality can create an immersive interactive environment, communicate with patients, and effectively relieve postoperative pain. However, virtual reality requires the purchase of hardware and software and other related computer equipment, and its high cost is a disadvantage. We selected the best literature based on clinical questions to answer the patient's question and used share decision making (SDM) to help the patient make decisions based on the clinical situation after knee replacement surgery to improve the quality of patient-centered care.

Keywords: knee replacement surgery, postoperative pain, share decision making, virtual reality

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Authors: Onyinyechi Joy Kingdom

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Mergers and Acquisitions (M&A) have been proposed as a mechanism through which, problems associated with inefficiency or poor performance in financial institution could be addressed. The aim of this study is to examine the proposition that recapitalization of banks, which encouraged Mergers and Acquisitions in Nigeria banking system, would strengthen the domestic banks, improve financial deepening and the confidence of depositors. Hence, this study examines the impact of the 2005 M&A in the Nigerian-banking sector on financial deepening using mixed method (quantitative and qualitative approach). The quantitative process of this study utilised annual time series for financial deepening indicator for the period of 1997 to 2012. While, the qualitative aspect adopted semi-structured interview to collate data from three merged banks and three stand-alone banks to explore, understand and complement the quantitative results. Furthermore, a framework thematic analysis is employed to analyse the themes developed using NVivo 11 software. Using the quantitative approach, findings from the equality of mean test (EMT) used suggests that M&A have significant impact on financial deepening. However, this method is not robust enough given its weak validity as it does not control for other potential factors that may determine financial deepening. Thus, to control for other factors that may affect the level of financial deepening, a Multiple Regression Model (MRM) and Interrupted Times Series Analysis (ITSA) were applied. The coefficient for M&A dummy turned negative and insignificant using MRM. In addition, the estimated linear trend of the post intervention when ITSA was applied suggests that after M&A, the level of financial deepening decreased annually; however, this was statistically insignificant. Similarly, using the qualitative approach, the results from the interview supported the quantitative results from ITSA and MRM. The result suggests that interest rate should fall when capital base is increased to improve financial deepening. Hence, this study contributes to the existing literature the importance of other factors that may affect financial deepening and the economy when policies that will enhance bank performance and the economy are made. In addition, this study will enable the use of valuable policy instruments relevant to monetary authorities when formulating policies that will strengthen the Nigerian banking sector and the economy.

Keywords: mergers and acquisitions, recapitalization, financial deepening, efficiency, financial crisis

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Authors: Sayyed Mostafa Ahmadi, Neda Raeesi

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Background and Objectives: Cervical spondylosis is a common problem that affects the adult spine and is the most common cause of radiculopathy and myelopathy in older patients. Anterior discectomy and fusion is a well-known technique in degenerative cervical disc disease. However, one of the late undesirable complications is adjacent disc degeneration, which affects about 91% of patients in ten years. Many factors can be effective in causing this complication, but some are still debatable. Discovering these risk factors and eliminating them can improve the quality of life. Methods: This is a retrospective cohort study. All patients who underwent anterior discectomy and fusion surgery in the neurosurgery ward of Imam Khomeini Hospital between 2013 and 2016 were evaluated. Their demographic information was collected. All patients were visited and examined for radiculopathy, myelopathy, and muscular force. At the same visit, all patients were asked to have a facelift, and neck profile, as well as a neck MRI(General Tesla 3). Preoperative graphs were used to measure the diameter of the cervical canal(Pavlov ratio) and to evaluate sagittal alignment(Cobb Angle). Preoperative MRI of patients was reviewed for anterior and posterior longitudinal ligament calcification. Result: In this study, 57 patients were studied. The mean age of patients was 50.63 years, and 49.1% were male. Only 3.5% of patients had anterior and posterior longitudinal ligament calcification. Symptomatic ASD was observed in 26.6%. The X-rays and MRIs showed evidence of 80.7% radiological ASD. Among patients who underwent one-level surgery, 20% had symptomatic ASD, but among patients who underwent two-level surgery, the rate of ASD was 50%.In other words, the higher the number of surfaces that are operated and fused, the higher the probability of symptomatic ASD(P-value <0.05). The X-rays and MRIs showed 80.7% of radiological ASD. Among patients who underwent surgery at one level, 78% had radiological ASD, and this number was 92% among patients who underwent two-level surgery(P-value> 0.05). Demographic variables such as age, sex, height, weight, and BMI did not have a significant effect on the incidence of radiological ASD(P-value> 0.05), but sex and height were two influential factors on symptomatic ASD(P-value <0.05). Other related variables such as family history, smoking and exercise also have no significant effect(P-value> 0.05). Radiographic variables such as Pavlov ratio and sagittal alignment were also unaffected by the incidence of radiological and symptomatic ASD(P-value> 0.05). The number of surgical surfaces and the incidence of anterior and posterior longitudinal ligament calcification before surgery also had no statistically significant effect(P-value> 0.05). In the study of the ability of the neck to move in different directions, none of these variables are statistically significant in the two groups with radiological and symptomatic ASD and the non-affected group(P-value> 0.05). Conclusion: According to the findings of this study, this disease is considered to be a multifactorial disease. The incidence of radiological ASD is much higher than symptomatic ASD (80.7% vs. 26.3%) and sex, height and number of fused surfaces are the only factors influencing the incidence of symptomatic ASD and no variable influences radiological ASD.

Keywords: risk factors, anterior neck disectomy and fusion, adjucent segment degeneration, complication

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Authors: John Acord, Ankita Batla, Kiran Khepar, Maude Schmidt, Charlotte Allen, Russ Bradford

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Objectives: Despite the availability oftreatment options, Parkinson’s disease (PD) continues to impact heavily on a patient’s quality of life (QoL), as many symptoms that bother the patient remain unexplored and untreated in clinical settings. The aims of this research were to understand the burden of PDsymptoms from a patient perspective, particularly those which are the most persistent and debilitating, and to determine if current treatments and treatment algorithms adequately focus on their resolution. Methods: A13-question, online, patient-reported survey was created based on the MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS)and symptoms listed on Parkinson’s Disease Patient Advocacy Groups websites, and then validated by 10 Parkinson’s patients. In the survey, patients were asked to choose both their most common and their most bothersome symptoms, whether they had received treatment for those and, if so, had it been effective in resolving those symptoms. Results: The most bothersome symptoms reported by the 111 participants who completed the survey were sleep problems (61%), feeling tired (56%), slowness of movements (54%), and pain in some parts of the body (49%). However, while 86% of patients reported receiving dopamine or dopamine like drugs to treat their PD, far fewer reported receiving targeted therapies for additional symptoms. For example, of the patients who reported having sleep problems, only 33% received some form of treatment for this symptom. This was also true for feeling tired (30% received treatment for this symptom), slowness of movements (62% received treatment for this symptom), and pain in some parts of the body (61% received treatment for this symptom). Additionally, 65% of patients reported that the symptoms they experienced were not adequately controlled by the treatments they received, and 9% reported that their current treatments had no effect on their symptoms whatsoever. Conclusion: The survey outcomes highlight that the majority of patients involved in the study received treatment focused on their disease, however, symptom-based treatments were less well represented. Consequently, patient-reported symptoms such as sleep problems and feeling tired tended to receive more fragmented intervention than ‘classical’ PD symptoms, such as slowness of movement, even though they were reported as being amongst the most bothersome symptoms for patients. This research highlights the need to explore symptom burden from the patient’s perspective and offer Customised treatment/support for both motor and non-motor symptoms maximize patients’ quality of life.

Keywords: survey, patient reported symptom burden, unmet needs, parkinson's disease

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Authors: Sara Zelman, Courtney Meyer, Hiren Patel, Lisa Philpotts, Sue Lahey, Thomas Burke

Abstract:

Background: As the global burden of disease shifts from infectious diseases to noncommunicable diseases, there is growing urgency to provide treatment for time-sensitive illnesses, such as ST-Elevation Myocardial Infarctions (STEMIs). The standard of care for STEMIs in developed countries is Percutaneous Coronary Intervention (PCI). However, this is inaccessible in resource-limited settings. Before the discovery of PCI, Streptokinase (STK) and other thrombolytic drugs were first-line treatments for STEMIs. STK has been recognized as a cost-effective and safe treatment for STEMIs; however, in settings which lack access to PCI, it has not become the established second-line therapy. A systematic literature review was conducted to geographically map the use of STK for STEMIs in resource-limited settings. Methods: Our literature review group searched the databases Cinhal, Embase, Ovid, Pubmed, Web of Science, and WHO’s Index Medicus. The search terms included ‘thrombolytics’ AND ‘myocardial infarction’ AND ‘resource-limited’ and were restricted to human studies and papers written in English. A considerable number of studies came from Latin America; however, these studies were not written in English and were excluded. The initial search yielded 3,487 articles, which was reduced to 3,196 papers after titles were screened. Three medical professionals then screened abstracts, from which 291 articles were selected for full-text review and 94 papers were chosen for final inclusion. These articles were then analyzed and mapped geographically. Results: This systematic literature review revealed that STK has been used for the treatment of STEMIs in 33 resource-limited countries, with 18 of 94 studies taking place in India. Furthermore, 13 studies occurred in Pakistan, followed by Iran (6), Sri Lanka (5), Brazil (4), China (4), and South Africa (4). Conclusion: Our systematic review revealed that STK has been used for the treatment of STEMIs in 33 resource-limited countries, with the highest utilization occurring in India. This demonstrates that even though STK has high utility for STEMI treatment in resource-limited settings, it still has not become the standard of care. Future research should investigate the barriers preventing the establishment of STK use as second-line treatment after PCI.

Keywords: cardiovascular disease, global health, resource-limited setting, ST-Elevation Myocardial Infarction, Streptokinase

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Authors: Amar Ghelani

Abstract:

People with auditory verbal hallucinations (AVH) who seek support from mental health services commonly report feeling unheard and invalidated in their interactions with social workers and psychiatric professionals. Current mental health training and clinical approaches have proven to be inadequate in addressing the complex nature of voice hearing. Childhood trauma is a key factor in the development of AVH and can render people more vulnerable to hearing both supportive and/or disturbing voices. Lived experiences of racism, poverty, and immigration are also associated with development of what is broadly classified as psychosis. Despite evidence affirming the influence of environmental factors on voice hearing, the Western biomedical system typically conceptualizes this experience as a symptom of genetically-based mental illnesses which requires diagnosis and treatment. Overemphasis on psychiatric medications, referrals, and directive approaches to people’s problems has shifted clinical interventions away from assessing and addressing problems directly related to AVH. The Maastricht approach offers voice hearers and mental health workers an alternative and respectful starting point for understanding and coping with voices. The approach was developed by voice hearers in partnership with mental health professionals and entails an innovative method to assess and create meaning from voice hearing and related life stressors. The objectives of the approach are to help people who hear voices: (1) understand the problems and/or people the voices may represent in their history, and (2) cope with distress and find solutions to related problems. The Maastricht approach has also been found to help voice hearers integrate emotional conflicts, reduce avoidance or fear associated with AVH, improve therapeutic relationships, and increase a sense of control over internal experiences. The proposed oral presentation will be guided by a recovery-oriented theoretical framework which suggests healing from psychological wounds occurs through social connections and community support systems. The presentation will start with a brainstorming exercise to identify participants pre-existing knowledge of the subject matter. This will lead into a literature review on the relations between trauma, intersectionality, and AVH. An overview of the Maastricht approach and review of research related to its therapeutic risks and benefits will follow. Participants will learn trauma-informed coping skills and questions which can help voice hearers make meaning from their experiences. The presentation will conclude with a review of resources and learning opportunities where participants can expand their knowledge of the Hearing Voices Movement and Maastricht approach.

Keywords: Maastricht interview, recovery, therapeutic assessment, voice hearing

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Authors: Man-Yun Liu, Emily Chia-Yu Su

Abstract:

Alzheimer's disease (AD) is the public health crisis of the 21st century. AD is a degenerative brain disease and the most common cause of dementia, a costly disease on the healthcare system. Unfortunately, the cause of AD is poorly understood, furthermore; the treatments of AD so far can only alleviate symptoms rather cure or stop the progress of the disease. Currently, there are several ways to diagnose AD; medical imaging can be used to distinguish between AD, other dementias, and early onset AD, and cerebrospinal fluid (CSF). Compared with other diagnostic tools, blood (plasma) test has advantages as an approach to population-based disease screening because it is simpler, less invasive also cost effective. In our study, we used blood biomarkers dataset of The Alzheimer’s disease Neuroimaging Initiative (ADNI) which was funded by National Institutes of Health (NIH) to do data analysis and develop a prediction model. We used independent analysis of datasets to identify plasma protein biomarkers predicting early onset AD. Firstly, to compare the basic demographic statistics between the cohorts, we used SAS Enterprise Guide to do data preprocessing and statistical analysis. Secondly, we used logistic regression, neural network, decision tree to validate biomarkers by SAS Enterprise Miner. This study generated data from ADNI, contained 146 blood biomarkers from 566 participants. Participants include cognitive normal (healthy), mild cognitive impairment (MCI), and patient suffered Alzheimer’s disease (AD). Participants’ samples were separated into two groups, healthy and MCI, healthy and AD, respectively. We used the two groups to compare important biomarkers of AD and MCI. In preprocessing, we used a t-test to filter 41/47 features between the two groups (healthy and AD, healthy and MCI) before using machine learning algorithms. Then we have built model with 4 machine learning methods, the best AUC of two groups separately are 0.991/0.709. We want to stress the importance that the simple, less invasive, common blood (plasma) test may also early diagnose AD. As our opinion, the result will provide evidence that blood-based biomarkers might be an alternative diagnostics tool before further examination with CSF and medical imaging. A comprehensive study on the differences in blood-based biomarkers between AD patients and healthy subjects is warranted. Early detection of AD progression will allow physicians the opportunity for early intervention and treatment.

Keywords: Alzheimer's disease, blood-based biomarkers, diagnostics, early detection, machine learning

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Authors: Maria F. Seran

Abstract:

In second language interaction, an EFL student always carries his knowledge of targeted language and sometimes gets influenced by his first language cultures which makes him transfer his utterances from the first language to the second language. The influence of L1 cultures somehow can lead to face-threatening act when it comes to responding on speech act, for instance, compliment. A speaker praises a compliment to show gratitude, and in return, he expects for compliment respond uttered by the hearer. While Western people use more acceptance continuum on compliment response, Indonesians utter more denial continuum which can somehow put the speakers into a face-threating situation and offense. This study investigated compliment response employed by EFL students and English native speakers. The study was distinct as none compliment response studies had been conducted to compare the compliment response between English native speakers and two different Indonesian EFL proficiency groups in which this research sought to meet this need. This study was significant for EFL teachers because it gave insight on cross-cultural understanding and brought pedagogical implication on explicit pragmatic instruction. Two research questions were set, 1. How do Indonesian EFL students and English native speakers respond compliments? 2. Is there any correlation between Indonesia EFL students’ proficiency and their compliment response use in English? The study involved three groups of participants; 5 English native speakers, 10 high-proficiency and 10 low-proficiency Indonesian EFL university students. The research instruments used in this study were as follows, an online TOEFL prediction test, focusing on grammar skill which was modified from Barron TOEFL exercise test, and a discourse completion task (DCT), consisting of 10 compliment respond items. Based on the research invitation, 20 second-year university students majoring in English education at Widya Mandira Catholic University, Kupang, East Nusa Tenggara, Indonesia who willingly participated in the research took the TOEFL prediction test online from the link provided. Students who achieved score 75-100 in test were categorized as high-proficiency students, while, students who attained score below 74 were considered as low-proficiency students. Then, the DCT survey was administered to these EFL groups and the native speaker group. Participants’ responses were coded and analyzed using categories of compliment response framework proposed by Tran. The study found out that 5 native speakers applied more compliment upgrades and appreciation token in compliment response, whereas, Indonesian EFL students combined some compliment response strategies in their utterance, such as, appreciation token, return and compliment downgrade. There is no correlation between students’ proficiency level and their CR responds as most EFL students in both groups produced less varied compliment responses and only 4 Indonesian high-proficiency students uttered more varied and were similar to the native speakers. The combination strategies used by EFL students can be explained as the influence of pragmatic transfer from L1 to L2; therefore, EFL teachers should explicitly teach more compliment response strategies to raise students’ awareness on English culture and elaborate their speaking to be more competence as close to native speakers as possible.

Keywords: compliment response, English native speakers, Indonesian EFL students, speech acts

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Authors: Vaidehi Murarka, Sneha Mehta, Dishant Upadhyay

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Our project topic is “Alphabet Recognition using pixel probability distribution”. The project uses techniques of Image Processing and Machine Learning in Computer Vision. Alphabet recognition is the mechanical or electronic translation of scanned images of handwritten, typewritten or printed text into machine-encoded text. It is widely used to convert books and documents into electronic files etc. Alphabet Recognition based OCR application is sometimes used in signature recognition which is used in bank and other high security buildings. One of the popular mobile applications includes reading a visiting card and directly storing it to the contacts. OCR's are known to be used in radar systems for reading speeders license plates and lots of other things. The implementation of our project has been done using Visual Studio and Open CV (Open Source Computer Vision). Our algorithm is based on Neural Networks (machine learning). The project was implemented in three modules: (1) Training: This module aims “Database Generation”. Database was generated using two methods: (a) Run-time generation included database generation at compilation time using inbuilt fonts of OpenCV library. Human intervention is not necessary for generating this database. (b) Contour–detection: ‘jpeg’ template containing different fonts of an alphabet is converted to the weighted matrix using specialized functions (contour detection and blob detection) of OpenCV. The main advantage of this type of database generation is that the algorithm becomes self-learning and the final database requires little memory to be stored (119kb precisely). (2) Preprocessing: Input image is pre-processed using image processing concepts such as adaptive thresholding, binarizing, dilating etc. and is made ready for segmentation. “Segmentation” includes extraction of lines, words, and letters from the processed text image. (3) Testing and prediction: The extracted letters are classified and predicted using the neural networks algorithm. The algorithm recognizes an alphabet based on certain mathematical parameters calculated using the database and weight matrix of the segmented image.

Keywords: contour-detection, neural networks, pre-processing, recognition coefficient, runtime-template generation, segmentation, weight matrix

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Authors: Nihal Kartaltepe Behram, Göksel Ataman, Dila Okçu

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With the development of foreign direct investments, the social, cultural, political and economic interactions between countries and institutions have become visible and they have become determining factors for the strategic structuring and market goals. In this context the purpose of this study is to investigate the effects of cultural distance and institutions on foreign direct investment choices in terms of location and investment model. For international establishments, the concept of culture, as well as the concept of cultural distance, is taken specifically into consideration, especially in the selection of methods for entering the market. In the researches and empirical studies conducted, a direct relationship between cultural distance and foreign direct investments is set and institutions and effective variable factors are examined at the level of defining the investment types. When the detailed calculation strategies and empirical researches and studies are taken into consideration, the most common methods for determining the direct investment model, considering the cultural distances, are full-ownership enterprises and joint ventures. Also, when all of the factors affecting the investments are taken into consideration, it was seen that the effect of institutions such as Government Intervention, Intellectual Property Rights, Corruption and Contract Enforcements is very important. Furthermore agglomeration is more intense and effective on the investment, compared to other factors. China has been selected as the target country, due to its effectiveness in world economy and its contributions to developing countries, which has commercial relationships with. Qualitative research methods are used for this study conducted, to measure the effects of determinative variable factors in the hypotheses of study, on the direct foreign investors and to evaluate the findings. In this study in-depth interview is used as a data collection method and the data analysis is made through descriptive analysis. Foreign Direct Investments are so reactive to institutions and cultural distance is identified by all interviews and analysis. On the other hand, agglomeration is the most strong determiner factor on foreign direct investors in Chinese Market. The reason of this factors, which comprise the sectorial aggregate, are not the strongest factors as agglomeration that the most important finding. We expect that this study became a beneficial guideline for developed and developing countries and local and national institutions’ strategic plans.

Keywords: China, cultural distance, Foreign Direct Investments, institutions

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Authors: Irene H. Maralit

Abstract:

Warning labels have been found to inform smokers about the health hazards of smoking, encourage smokers to quit, and prevent nonsmokers from starting to smoke. Warning labels on tobacco products are an ideal way of communicating with smokers. Since the intervention is delivered at the time of smoking, nearly all smokers are exposed to warning labels and pack-a-day smokers could be exposed to the warnings more than 7,000 times per year. Given the reach and frequency of exposure, the proponents want to know the effect of warning labels on smoking behavior. Its aims to identify the profile of the smokers associated with its behavioral variables that best describe the users’ perception. The behavioral variables are AVOID, THINK RISK and FORGO. This research study aims to determine if there is significant relationship between the effect of warning labels on cigarette package on Consumer behavior when grouped according to profile variable. The researcher used quota sampling to gather representative data through purposive means to determine the accurate representation of data needed in the study. Furthermore, the data was gathered through the use of a self-constructed questionnaire. The statistical method used were Frequency count, Chi square, multi regression, weighted mean and ANOVA to determine the scale and percentage of the three variables. After the analysis of data, results shows that most of the respondents belongs to age range 22–28 years old with percentage of 25.3%, majority are male with a total number of 134 with percentage of 89.3% and single with total number of 79 and percentage of 52.7%, mostly are high school graduates with total number of 59 and percentage of 39.3, with regards to occupation, skilled workers have the highest frequency of 37 with 24.7%, Majority of the income of the respondents falls under the range of Php 5,001-Php10,000 with 50.7%. And also with regards to the number of sticks consumed per day falls under 6–10 got the highest frequency with 33.3%. The respondents THINK RISK factor got the highest composite mean which is 2.79 with verbal interpretation of agree. It is followed by FORGO with 2.78 composite mean and a verbal interpretation of agree and AVOID variable with composite mean of 2.77 with agree as its verbal interpretation. In terms of significant relationship on the effects of cigarette label to consumer behavior when grouped according to profile variable, sex and occupation found to be significant.

Keywords: consumer behavior, smokers, warning labels, think risk avoid forgo

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Authors: Galuh Asri Bestari, Hajar Shofiyya

Abstract:

Double burden of malnutrition (DBM) has been a global problem in these last decades occurs in both developed and developing countries. Overweight in adults and stunting among preschool children have dramatically increased and become the main problems of malnutrition that should be solved immediately since they are directly related with the health status and productivity. Reformulation of food product by using the local sea resources called terasi shrimp (Acetes indicus) has a potential possibility in facing the DBM. A study was carried out in Indonesia to determine the acceptability of terasi shrimp powder through sensory evaluation. Terasi shrimps were processed into powder form through sun drying and pounding methods. The powder form was directly added in food as alternative seasonings and tested among stunted and normal preschool children. Meanwhile, a further processing method is given to the shrimp powder tested in overweight and normal-weighed adults. The shrimp powder was mixed with sago flour and formed into balls, then steamed for 15-20 minutes, and finally served as alternative snacks. Based on the sensory evaluation, the shrimp powder has a good acceptance in taste (54%), shape (60%), and color properties (63%), while the shrimp balls has a good acceptance in size (65%), shape (50%), color (48%), taste (40%), and texture (36%). Terasi shrimp powder can be stored for a month in room temperature. In addition, carried out chemical analysis revealed that terasi shrimp (Acetes indicus) has higher percentage of protein, calcium, and iron than other animal sources, but conversely contains zero sodium and very low percentage of fat. Terasi shrimp’s shell also contains a substance called chitosan which acts by forming gels in the intestinal tract to entrap lipids, thus interfering with their absorption. After going through some processing methods, the shrimp powder and balls did not show any significant changes in their nutrient contents. So that, terasi shrimp powder is good to be consumed not only by overweight adults, but also by children to support their optimum growth. Intervention of terasi shrimp powder should be implemented step by step from national up to global governance program to face the DBM.

Keywords: Acetes indicus, alternative food, double burden of malnutrition, sensory evaluation

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Authors: Suzan Sayegh, Izzeldin Ibrahim, Mercia Van Der Walt, Mohamed Al-Kuwari

Abstract:

Background: Walking is the most common form of physical activity which can promote a healthy well-being among people of different age groups. In this regard, pedometers are becoming more popular within research and are considered useful tools in monitoring physical activity levels based on individuals’ daily steps. A value of ˂5,000 steps/day is identified as a sedentary lifestyle index where individuals are physically inactive. Those achieving 5,000-7,499 steps/day have a low active lifestyle as they do not meet the moderate-to-vigorous physical activity (MVPA) recommendations. Moreover, individuals achieving ≥7,500 steps/day are classified as physically active. The objective of this study is to assess the physical activity levels of adult population in Qatar through a pedometer-based program over a one-year period. Methods: A cross-sectional analysis, as part of a longitudinal study, was carried out over one year to assess the daily step count. “Step into Health” is a community-based program launched by Aspire as an approach for the purpose of improving physical activity across the population of Qatar. The program involves distribution of pedometers to registered members which is supported by a self-monitoring online account and linked to a web database. Daily habitual physical activity (daily total step count) was assessed through Omron HJ-324U pedometer. Analyses were done on data extracted from the web database. Results: A total of 1,988 members were included in this study (males: n=1,143, 57%; females: n=845, 43%). Average age was 37.8±10.9 years distributed as 60% of age between age 25-54 (n=1,186), 27% of age 45-64 (n=546), and 13% of age 18-24 years (n=256). Majority were non-Qataris, 81% (n=1,609) compared with 19% of the Qatari nationality (n=379). Average body mass index (BMI) was 27.8±6.1 (kg/m2) where most of them (41%, n=809) were found to be overweight, between 25-30 kg/m2. Total average step count was 5,469±3,884. Majority were found to be sedentary (n=1110, 55.8%). Middle aged individuals were more active than the other two age groups. Males were seen as more active than females. Those who were less active had a higher BMI. Older individuals were more active. There was a variation in the physical activity level throughout the year period. Conclusion: It is essential to further develop the available intervention programs and increase their physical activity behavior. Planning such physical activity interventions for female population should involve aspects such as time, environmental variables and aerobic steps.

Keywords: adults, pedometer, physical activity, step-count

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Authors: Ryotaro Ishikawa

Abstract:

INTRODUCTION: Post-traumatic stress disorder (PTSD) is a psychiatric label for a collection of psychological symptoms following a traumatic event. PTSD is as a result of a traumatic experience such as rape or sexual assault. A victim may have PTSD if she/he has experienced the following symptoms for at least a month: a) Stressor, b) Intrusion symptoms, c) Avoidance, d) Negative alterations in cognitions and mood, e) Alterations in arousal and reactivity. Studies on the cognitive theory of PTSD emphasized the roles of (a) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (b) disorganized trauma memories in the development of PTSD. Mental contamination is primarily caused by experiences involving humans (e.g. violators or perpetrators) as opposed to substances (e.g. dirt or bodily fluids). Feelings of mental contamination may evoke following experiences of ill-treatment, sexual assault, domination, degradation, manipulation, betrayal, or humiliation. Some studies have demonstrated that traumatic thoughts related to sexual assault are particularly strong predictors of mental contamination. Treatment protocols based on cognitive-behavioral therapy appear to be beneficial in reducing the severity of PTSD and mental contamination. Studies on the cognitive theory of PTSD emphasized the roles of (A) negative appraisals of trauma memories in maintaining the symptomatology of PTSD, and (B) disorganized trauma memories in the development of PTSD. We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. METHOD: The single-arm trial is a group setting CBT intervention. The primary outcome is the self-rated Posttraumatic Stress Diagnostic Scale, with secondary measurements of depressive severity and mental pollution questionnaire. Assessments are conducted at baseline, after a waiting period before CBT, during CBT, and after CBT. RESULTS: Participants are eligible for the study and complete the outcome measures at all assessment points. In our hypothesis, receiving CBT would lead to improvements in primary and secondary PTSD severity. CONCLUSION: We will demonstrate a feasibility study of individual CBT for PTSD and mental contamination in Japanese clinical settings. Our treatment would achieve favorable treatment outcomes for PTSD with mental contamination in Japanese clinical settings.

Keywords: CBT, cognitive theory, PTSD, mental pollution

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Authors: Stefan Kurbatfinski, Aliyah Dosani, Andrew F. Hayes, Deborah Dewey, Nicole Letourneau

Abstract:

Background: Maternal adverse childhood experiences (ACEs) have been associated with internalizing and externalizing behavioral problems in preschool children. However, little is known about the influence of maternal adult attachment patterns on this association. Further, potential moderation by maternal mental health, maternal social support, or child sex is poorly understood. Therefore, this study examined associations between 1) maternal ACEs and preschool children’s behavioural problems, with mediation through maternal attachment patterns and moderation by maternal mental health, maternal social support, and child sex; and 2) maternal attachment patterns and children’s behavioural problems, with mediation through maternal mental health and social support and moderation by child sex. Methods: This secondary analysis used data (n=625) from a high socioeconomic, longitudinally prospective cohort (Alberta Pregnancy Outcomes and Nutrition). Child behaviour (BASC-2) and maternal adult attachment (ECR-Q) were measured at five years of child age, maternal ACEs (ACEs Questionnaire) at around 12 months, and maternal mental health (CESD and SCL-90-R) and social support (SSQ) across various prenatal and postnatal time points. All moderation and mediation analyses occurred through RStudio using PROCESS, interpreting significant interactions through Johnson-Neyman plots. Findings: Maternal ACEs interacted with maternal anxiety symptoms to predict both behavioural problems (pexternalizing=0.007; pinternalizing=0.0159). An indirect pathway via dismissive attachment was moderated by maternal social support ([0.0058, 0.0596]). Attachment patterns predicted all behavioural problems (p<0.05) and interacted with maternal anxiety symptoms to predict internalizing behaviours among male children ([0.0321, 0.1307]; [0.0321, 0.1291]). Interpretation: Maternal attachment patterns may predict children’s behavioural problems more than ACEs. Social support interventions may not always be beneficial for highly dismissively attached mothers. Implications for policy and child health include mandatory sex and gender education for teachers; assessing attachment patterns prior to recommending social support as an intervention; and anxiety-focused interventions for mothers in higher socioeconomic populations.

Keywords: maternal adverse childhood experiences, internalizing behaviours, externalizing behaviours, mediators and moderators, attachment patterns, child health

Procedia PDF Downloads 61

Authors: Souzan Al Sayegh, Izzeldin Ibrahim, Mercia Van Der Walt, Mohamed Al-Kuwari

Abstract:

Background: Walking is the most common form of physical activity which can promote a healthy well-being among people of different age groups. In this regard, pedometers are becoming more popular within research and are considered useful tools in monitoring physical activity levels based on individuals’ daily steps. A value of ˂5,000 steps/day is identified as a sedentary lifestyle index where individuals are physically inactive. Those achieving 5,000-7,499 steps/day have a low active lifestyle as they do not meet the moderate-to-vigorous physical activity (MVPA) recommendations. Moreover, individuals achieving ≥7,500 steps/day are classified as physically active. The objective of this study is to assess the physical activity levels of adult population in Qatar through a pedometer-based program over a one-year period. Methods: A cross-sectional analysis, as part of a longitudinal study, was carried out over one year to assess the daily step count. 'Step into Health' is a community-based program launched by Aspire as an approach for the purpose of improving physical activity across the population of Qatar. The program involves the distribution of pedometers to registered members which is supported by a self-monitoring online account and linked to a web database. Daily habitual physical activity (daily total step count) was assessed through Omron HJ-324U pedometer. Analyses were done on data extracted from the web database. Results: A total of 1,988 members were included in this study (males: n=1,143, 57%; females: n=845, 43%). Average age was 37.8±10.9 years distributed as 60% of age between age 25-54 (n=1,186), 27% of age 45-64 (n=546), and 13% of age 18-24 years (n=256). Majority were non-Qataris, 81% (n=1,609) compared with 19% of the Qatari nationality (n=379). Average body mass index (BMI) was 27.8±6.1 (kg/m2) where most of them (41%, n=809) were found to be overweight, between 25-30 kg/m2. Total average step count was 5,469±3,884. Majority were found to be sedentary (n=1110, 55.8%). Middle aged individuals were more active than the other two age groups. Males were seen as more active than females. Those who were less active had a higher BMI. Older individuals were more active. There was a variation in the physical activity level throughout the year period. Conclusion: It is essential to further develop the available intervention programs and increase their physical activity behavior. Planning such physical activity interventions for female population should involve aspects such as time, environmental variables and aerobic steps.

Keywords: adults, pedometer, physical activity, step-count

Procedia PDF Downloads 288

Authors: Emilia K. H. Danielsson-Waters, Malaz Elsaddig, Kevin Jones

Abstract:

Unfortunately, it is well known that neonatal deaths are a common and potentially preventable occurrence across the world. Neonatal resuscitation is a simple and inexpensive intervention that can effectively reduce this rate, and can be taught and implemented globally. This project is a follow-on from one in 2012, which found that neonatal resuscitation simulation was valuable for education, but would be better improved by being delivered by local staff. Methods: This study involved auditing the neonatal admission and death records within a rural Ugandan hospital, alongside implementing a Train-The-Trainer teaching scheme to teach Neonatal Resuscitation. One local doctor was trained for simulating neonatal resuscitation, whom subsequently taught an additional 14 staff members in one-afternoon session. Participants were asked to complete questionnaires to assess their knowledge and confidence pre- and post-simulation, and a survey to identify barriers and drivers to simulation. Results: The results found that the neonatal mortality rate in this hospital was 25% between July 2016- July 2017, with birth asphyxia, prematurity and sepsis being the most common causes. Barriers to simulation that were identified predominantly included a lack of time, facilities and opportunity, yet all members stated simulation was beneficial for improving skills and confidence. The simulation session received incredibly positive qualitative feedback, and also a 0.58-point increase in knowledge (p=0.197) and 0.73-point increase in confidence (0.079). Conclusion: This research shows that it is possible to create a teaching scheme in a rural hospital, however, many barriers are in place for its sustainability, and a larger sample size with a more sensitive scale is required to achieve statistical significance. This is undeniably important, because teaching neonatal resuscitation can have a direct impact on neonatal mortality. Subsequently, recommendations include that efforts should be put in place to create a sustainable training scheme, for example, by employing a resuscitation officer. Moreover, neonatal resuscitation teaching should be conducted more frequently in hospitals, and conducted in a wider geographical context, including within the community, in order to achieve its full effect.

Keywords: neonatal resuscitation, sustainable medical education, train-the-trainer, Uganda

Procedia PDF Downloads 135

Authors: Stacey Herzog, Mitchell McCleary, Istvan Kovacs

Abstract:

Purpose: Maximal strength and maximal power are key athletic abilities in many sports disciplines. In recent years, velocity-based training (VBT) with a relatively high 75-85% 1RM resistance has been popularized in preparation for powerlifting and various other sports. The purpose of this study was to discover differences between beginner/intermediate and advanced lifters’ push/press performances after a heavy resistance-based BP training program. Methods: A six-week, three-workouts per week program was administered to 52 young, physically active adults (age: 22.4±5.1; 12 female). The majority of the participants (84.6%) had prior experience in bench pressing. Typical workouts began with BP using 75-95% 1RM in the 1-5 repetition range. The sets in the lower part of the range (75-80% 1RM) were performed with velocity-focus as well. The BP sets were followed by seated dumbbell presses and six additional upper-body assistance exercises. Pre- and post-tests were conducted on five test exercises: one-repetition maximum BP (1RM), calculated relative strength index: BP/BW (RSI), four-repetition maximal-effort dynamic BP for peak concentric velocity with 80% 1RM (4RV), 4-repetition ballistic pushups (BPU) for height (4PU), and seated medicine ball toss for distance (MBT). For analytic purposes, the participant group was divided into two subgroups: self-indicated beginner or intermediate initial resistance training status (BITS) [n=21, age: 21.9±3.6; 10 female] and advanced initial resistance training status (ATS) [n=31, age: 22.7±5.9; 2 female]. Pre- and post-test results were compared within subgroups. Results: Paired-sample t-tests indicated significant within-group improvements in all five test exercises in both groups (p < 0.05). BITS improved 18.1 lbs. (13.0%) in 1RM, 0.099 (12.8%) in RSI, 0.133 m/s (23.3%) in 4RV, 1.55 in. (27.1%) in BPU, and 1.00 ft. (5.8%) in MBT, while the ATS group improved 13.2 lbs. (5.7%) in 1RM, 0.071 (5.8%) in RSI, 0.051 m/s (9.1%) in 4RV, 1.20 in. (13.7%) in BPU, and 1.15 ft. (5.5%) in MBT. Conclusion: While the two training groups had different initial resistance training backgrounds, both showed significant improvements in all test exercises. As expected, the beginner/intermediate group displayed better relative improvements in four of the five test exercises. However, the medicine ball toss, which had the lightest resistance among the tests, showed similar relative improvements between the two groups. These findings relate to two important training principles: specificity and transfer. The ATS group had more specific experiences with heavy-resistance BP. Therefore, fewer improvements were detected in their test performances with heavy resistances. On the other hand, while the heavy resistance-based training transferred to increased power outcomes in light-resistance power exercises, the difference in the rate of improvement between the two groups disappeared. Practical applications: Based on initial training status, S&C coaches should expect different performance gains in maximal strength training-specific test exercises. However, the transfer from maximal strength to a non-training-specific performance category along the F-v curve continuum (i.e., light resistance and high velocity) might not depend on initial training status.

Keywords: exercise, power, resistance training, strength

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