Search results for: Hisham Abdel-Halim

Authors: Malik Abid Hussain Khokhar, Muhammad Adnan Tahir, Hisham Bin Hafeez Awan

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Continuous environmental determinism and climatic change in the entire globe due to increasing land surface temperature (LST) has become a vital phenomenon nowadays. LST is accelerating because of increasing greenhouse gases in the environment which results of melting down ice caps, ice sheets and glaciers. It has not only worse effects on vegetation and water bodies of the region but has also severe impacts on monsoon areas in the form of capricious rainfall and monsoon failure extensive precipitation. Environment can be monitored with the help of various geographic information systems (GIS) based algorithms i.e. SC (Single), DA (Dual Angle), Mao, Sobrino and SW (Split Window). Estimation of LST is very much possible from digital image processing of satellite imagery. This paper will encompass extraction of LST of Abbottabad using SW technique of GIS and Remote Sensing over last ten years by means of Landsat 7 ETM+ (Environmental Thematic Mapper) and Landsat 8 vide their Thermal Infrared (TIR Sensor) and Optical Land Imager (OLI sensor less Landsat 7 ETM+) having 100 m TIR resolution and 30 m Spectral Resolutions. These sensors have two TIR bands each; their emissivity and spectral radiance will be used as input statistics in SW algorithm for LST extraction. Emissivity will be derived from Normalized Difference Vegetation Index (NDVI) threshold methods using 2-5 bands of OLI with the help of e-cognition software, and spectral radiance will be extracted TIR Bands (Band 10-11 and Band 6 of Landsat 7 ETM+). Accuracy of results will be evaluated by weather data as well. The successive research will have a significant role for all tires of governing bodies related to climate change departments.

Keywords: environment, Landsat 8, SW Algorithm, TIR

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Authors: Sharafat Karimi, Jamil Jafari

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The impact of Western Literature on other nations' pieces of literature (including Arabic) has caused critics to ignore the importance of Arabic cultural & literary heritage in the formation of contemporary Arabic fiction; but on the contrary, an important part of literary genres in any society, especially fiction has been formed in the past and depends on ancient literary events. The current paper, utilizing the descriptive-analytical method and by means of library studies, tries to challenge those critics who regard Western Literature as the only effective factor on the appearance of Arabic fiction. Furthermore, this research tries to find out effective Islamic-Arabic elements on the development of Arabic novel by the investigation of some fictional works. The results show that in addition to regarding Western literature as an important factor, Arab novelists have applied their heritage, culture, and ancient history, either written or orally transmitted to the current generation, in their innovations. Among great historical works containing moral stories, allegorical legends, myths, tales of heroes, and folklore, we can refer to Arabian Nights, Kalila & Dimna, romantic stories, historical puzzles, history of Islam, history of ancient Egypt, Maqama, and Quranic stories. Famous novels like 'Hadith Isa ibn-Hisham', 'Layali Alif Layla', 'Abas al-Aqdar', 'Radoubis', 'Ahlam Shahrzad, and 'Alam Bela Kharaet' were compiled on the basis of ancient literary heritage not only in the theme but also in the structure; so one can conclude that the ancient literary-cultural heritage and Islamic-Arabian history have been influential on Arabic novel appearance and development.

Keywords: Arabic fictional literature, culture, heritage, history, language, novel

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Authors: Manal Mohammed Hisham Said Najjar

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The Arab Grammarians shed light on the redundant kana (was) and gave it a considerable attention. However, their considerations and interpretations pertaining to using this verb varied: is it used to determine tense? Or used for further emphasis or for another function? Does it have a syntactic function? Morphologically, could it be used in other forms than the past? In addition, Arab Grammarians discussed the possibility of using kana to locate itself in between the syntactic constructs of a sentence, a phrase, or a collocation. Others questioned its position whether it is in initial or final. This study found out that the redundant kana (was) is cited in Quran and was used by the Arabs in their speech and poetry. This redundant kana, whether used in initial position or in a final position, or in between the constructs of a sentence, a phrase, or a collocation, implies pragmatic meanings intended by the speaker or the poet to serve different functions, such as to indicate the past tense, to provide emphasis, and to refer to the continuity of the effect and meaning of a verb or adjective. The study concludes that this verb kana can be utilized in different contexts to achieve a specific effect as did the old Arabs who used it to add specific shades of meanings. Kana as a redundant word could be added to further highlight the meaning aimed at in a specific utterance. In addition, this verb can be used in both the past and the present morphological form; and its availability in an utterance could be functional and could not be. In other words, the study found out that the redundant kana can be used in various positions in an utterance, initial, final, or in between a syntactic structure, provided that this use is pragmatically functional. In conclusion, this paper seeks to invite the scholars of the Arabic language to coin a new term which is the “pragmatic kana” to replace the term “kana alzae’da (redundant kana)” which might mean that its use is redundant and void of significance – a fact that is illogical due to its recurrent use in the Holy Quran. NOTE: Please take this study not the other one (sent by mistake) and titled kana alnaqisa

Keywords: redundan, kana, grammarians, quran

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Authors: Yasin Ibrahim, Hisham Almohandes, Chia Hsu, Regina Baronia, Jesse Worsham, Sara Abdelgawad, Mansour Shawky, Mohammed Abdelfattah, Nesif Alhemiary

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Background: The matrix model (MM) is an evidence-based program for treating substance use disorders. Since first translated into Arabic in 2010, the MM has been gaining popularity in Arabic countries. However, there is no published data as pertains to its efficacy and feasibility in Arabic communities. Here we aimed at exploring providers’ perspectives on its feasibility and efficacy. Methods: Eight addiction treatment centers from four Arabic countries, namely Egypt, Kingdom of Saudi Arabia, the United Arab Emirates, and Iraq, were contacted via email. They were asked to fill in a 21-item questionnaire. Results: Matrix model continues to be utilized in 6 out of the 8 contacted programs. One center in Egypt has discontinued the MM as the providers felt it was not suitable for substance disorders other than stimulants, which are not common in Egypt. Baghdad University Medical Center has substituted MM with Colombo Program as there have been more training opportunities available for it. Data showed wide variability in regards to number of clients treated with the MM (from 300 to 2500). The Arabic version was utilized for training providers in 5 out of the 8 centers while the providers of the other 3 have been trained in the United States. All providers reported that MM made their job significantly easier, and seven providers believed that MM has favorably affected the relapse rate. In all of the six centers, MM is being utilized for many substance use disorders in addition to stimulant use disorders. Reported challenges included the acceptability of patients and their families, difficulty understanding some concepts, and high drop rates in some centers. Conclusion: Matrix model seems to be a valuable modality for the treatment of substance use disorders in Arabic countries. It has its own challenges and limitations that call for more culturally adapted versions.

Keywords: addiction, Arabic countries, developing countries, matrix model

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Authors: Hisham Mousa Mohammed Ahmed, Ahmed Wali Mohamed Salad, Yousif Hamed Dldom Gomaa

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A drip or Trickle irrigation system is designed to apply a precise amount of water near the plant with a certain degree of uniformity. This study was conducted at the Experimental Farm of the Faculty of Agricultural Sciences, University of Gezira, in March 2018. The study aimed to design and evaluate the hydraulic performance of three drip emitter types using: average discharge (Qavg), discharge variation (Qvar %), coefficient of uniformity (CU %), coefficient of manufacturer variation (CV %), distribution uniformity (DU %), statistical uniformity (Us %), clogging (%) wetted diameter (cm) and wetted depth (cm). The emitter types used are regular gauges (RG), high compensating pressure (HCP) and low compensating pressure (LCP). The treatments were laid out in a randomized complete block design (RCBD) with four replications. Results showed that there were significant differences (P≤0.05) in all tested parameters except clogging, wetted diameter and wetted depth. Discharge variation (Qvar %) values were 12.71, 15.57 and 19.17 for RG, LCP, and HCP, respectively. The variation is quite good and within the acceptable range. Results of coefficient of manufacture variation (CV %) were 10.9, 27.8 and 52.7 for RG, LCP and HCP, respectively. It is considered within the unacceptable range except for RG type, which is excellent. Statistical uniformity (Us %) values were 89.1, 72.2 and 45.7 for RG, LCP and HCP, respectively. It is considered good, acceptable and unacceptable, respectively. Results of the coefficient of uniformity (CU %) were 91.3, 77.7 and 56.7 for RG, LCP and HCP, respectively. It is considered excellent, fair and unacceptable, respectively. Distribution uniformity (DU %) was 90.2, 67.9 and 36.5 for RG, LCP and HCP, respectively. It is considered excellent, poor and poor, respectively. The study recommended regular gauges (RG) type emitters under the heavy clay soil conditions of the Gezira State, Sudan.

Keywords: drip irrigation, uniformity, clogging, coefficient, performance

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Authors: Kushaal Selvarajah, Geetha Annavi, Mohd Noor Hisham Mohd Nadzir

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Sambar deer (Rusa unicolor) was uplisted from Least Concern to Vulnerable by the International Union for Conservation of Nature Red list in 2015 due to drastic population decline in the wild throughout its geographical range. Sambar deer is a valued prey for the highly endangered species such as the Malayan tiger. Ex-situ conservation efforts, i.e., captive breeding, initiated by local government to boost sambar deer numbers in captivity and to reintroduce into the wild to support a higher number of tigers, consistent with the goal of our National Tiger Conservation Action Plan. The reproductive success of sambar deer and their welfare management practices in captivity are important components for effective captive breeding programs. However, there is a lack of study carried out on sambar deer in recent years and their behavior in captivity. Three captive sites (Zoo Negara, Zoo Taiping, and Sungkai Conservation Centre) were selected and observed for an average of 40 days each site (6 hours/day). A Generalized Linear Model (GLM) was used to determine the correlation between social behavior and extrinsic parameters. A comparison between all three captive sites showed the strongest correlation in behavioral variability, followed by a time of observation. This proves that there is a difference between in behavioral consistency and frequency between herds across captive sites rising to the possibility of external factors that are influential. Time of day of observation also had significant influence on certain extrinsic parameters being skewed to morning observations and this could be due to an adaptive behavior to the feeding time in the captive sites being in the morning which caused the deer to be resting towards the afternoon. Extensive study need to be done on sambar deer to pinpoint the specifics and better understanding of these possible influential factors in their behavior.

Keywords: behaviour ecology, captivity, ex-situ conservation, husbandry

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Authors: Muhammad Zainuddin Arriafdi, Hamudah Hakimah Abdullah, Mohd Helmi Sani, Wan Azlina Ahmad, Muhd Nazrul Hisham Zainal Alam

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The biotechnology process development demands numerous experimental works. In laboratory environment, this is typically carried out using a shake flask platform. This paper presents the design and fabrication of a miniature bioreactor system as an alternative research tool for bioprocessing. The working volume of the reactor is 100 ml, and it is made of plastic. The main features of the reactor included stirring control, temperature control via the electrical heater, aeration strategy through a miniature air compressor, and online optical cell density (OD) sensing. All sensors and actuators integrated into the reactor was controlled using an Arduino microcontroller platform. In order to demonstrate the functionality of such miniature bioreactor concept, series of batch Saccharomyces cerevisiae fermentation experiments were performed under various glucose concentrations. Results attained from the fermentation experiments were utilized to solve the Monod equation constants, namely the saturation constant, Ks, and cells maximum growth rate, μmax as to further highlight the usefulness of the device. The mixing capacity of the reactor was also evaluated. It was found that the results attained from the miniature bioreactor prototype were comparable to results achieved using a shake flask. The unique features of the device as compared to shake flask platform is that the reactor mixing condition is much more comparable to a lab-scale bioreactor setup. The prototype is also integrated with an online OD sensor, and as such, no sampling was needed to monitor the progress of the reaction performed. Operating cost and medium consumption are also low and thus, making it much more economical to be utilized for biotechnology process development compared to lab-scale bioreactors.

Keywords: biotechnology, miniature bioreactor, research tools, Saccharomyces cerevisiae

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Authors: Abdelsalam Elawwad, Mostafa Ragab, Hisham Abdel-Halim

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Leakage in sewerage system can cause groundwater and soil contamination in urban areas, especially in area with a high groundwater table. This is a serious problem in small villages in developing countries that rely on ground water as a source for irrigation and drinking purposes. In the developed countries, the recent trend in areas with low population densities is vacuum sewerage system, which is environmentally safer than conventional gravity system, protecting public health, preventing exfiltration to the ground water, very easily applied in a relatively short time and can cope with a faster expansion of the urbanized areas. The aim of this work is to assess the feasibility of using vacuum sewerage in developing country, such as Egypt. Knowledge of local conditions can determine the most suitable sewer system for a specific region. Technical, environmental and financial comparisons between conventional sewerage system and vacuum sewerage system were held using statistical analysis. Different conditions, such as population densities, geometry of area, and ground water depths were evaluated. Sample comprising of 30 Egyptian villages was selected, where a complete design for conventional sewerage system and vacuum sewerage system was done. Based on this study, it is recommended from the environmental point of view to construct the vacuum sewerage system in such villages with low population densities; however, it is not economic for all cases. From financial point of view, vacuum sewerage system was a good competitor to conventional systems in flat areas and areas with high groundwater table. The local market supplying of the construction equipment especially collection chambers will greatly affect the investment cost. Capacity building and social mobilization will also play a great role in sustainability of this system. At the end, it is noteworthy that environmental sustainability and public health are more important than the financial aspects.

Keywords: ground water, conventional system, vacuum system, statistics, cost, density, terrain

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Authors: Abdul-Nasser El-Kassar, Walid Elgammal, Hisham Jawhar

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This paper studies the determinants of the dividends payout ratio. The factors affecting the dividends payout ratio are to be identified. The study focuses only on the cement and construction industry within the MENA region in an attempt to isolate any incoherent behavior. The factors under consideration are: sales growth, ROE, ROA, ROS, debt to equity ratio, firm size, and free cash flow. Data were collected from official stock exchange markets in addition to annual reports. The study considered all firms that paid dividend in each of the three consecutive years starting from 2010 till 2012. Out of the 123 listed firms that work in cement and construction industry in MENA region, only 19 paid dividends in the three consecutive years 2010-12. Our sample consists of the 19 firms (57 observations) which are selected according to purposive sampling. Moreover, the study uses the homogeneous subcategory within the purposive sampling since only similar firms in the construction industry had been examined. The outcome of the study provides a vital insight into the determinants of dividends payout ratio of companies in MENA region. The results showed that the dividend payout ratio has a strong and positive relationship with return on assets and strong but negative relationship with return on equity. On the other hand, the results detected weak relationships between dividend payout ratio and sale growth, debt to equity ratio, firm size, and free cash flow. The study suggests that board of directors tend to compensate shareholders and minimize the agency cost by distributing a high portion of profits in form of dividends whenever return on equity decreases. Also, when the performance of the firm improves, and hence return on assets increases, boards of directors are more generous in distributing profits.

Keywords: dividends payout ratio, profitability firm size, free cashflow, debt to equity ratio

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Authors: Hisham Mortada

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Transition in the urban configuration of Arab cities has never been as radical and visible as it has been since the turn of the last century. The emergence of new cities near historical settlements of Arabia has spawned a series of developments in and around the old city precincts. New developments are based on advanced technology and conform to globally prevalent standards of city planning, superseding the vernacular arrangements based on traditional norms that guided so-called ‘city planning’. Evidence to this fact are the extant Arab buildings present at the urban core of modern cities, which inform us about intricate spatial organization. Organization that subscribed to multiple norms such as, satisfying gender segregation and socialization, economic sustainability, and ensuring security and environmental coherence etc., within settlement compounds. Several participating factors achieved harmony in such an inclusive city—an organization that was challenged and apparently replaced by the new planning order in the face of growing needs of globalized, economy-centric and high-tech models of development. Communities found it difficult to acclimatize with the new western planning models that were implemented at a very large scale throughout the Kingdom, which later experienced spatial re-structuring to suit users’ needs. A closer look the ancient city of Yanbu, now flanked with such new developments, allows us to differentiate and track the beginnings of this unprecedented transition in settlement formations. This paper aims to elaborate the Arabian context offered to both the ‘traditional’ and ‘modern’ planning approaches, in order to understand challenges and solutions offered by both at different times. In the process it will also establish the inconsistencies and conflicts that arose with the shift in planning paradigm, from traditional-'cultural norms’, to modern-'physical planning', in the Arabian context. Thus, by distinguishing the two divergent planning philosophies, their impact of the Arabian morphology, relevance to lifestyle and suitability to the biophysical environment, it concludes with a perspective on sustainability particularly for in case of Yanbu.

Keywords: Yanbu, traditional architecture, Hijaz, coral building, Saudi Arabia

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Authors: Mohammad Noor Hisham Osman, Ahmed Razman Abdul Latiff, Zaidi Mat Daud, Zulkarnain Muhamad Sori

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The problem that Malaysian auditors do not issue going concern opinion (GC opinion) to seriously financially distressed companies is still a pressing issue. Policy makers, particularly the Financial Statement Review Committee (FSRC) of Malaysian Institute of Accountant, have raised this issue as early as in 2009. Similar problem happened in the US, UK, and many developing countries. It is important for auditors to issue GC opinion properly because such opinion is one signal about the viability of a company much needed by stakeholders. There are at least two unanswered questions or research gaps in the literature on determinants of GC opinion. Firstly, is client’s probability of failure associated with GC opinion issuance? Secondly, to what extent influential owners (management, family, and institution) moderate the association between client probability of failure and GC opinion issuance. The objective of this study is, therefore, twofold; (1) To examine the extent of the relationship between the probability of client failure and the issuance of GC opinion and (2) To examine the level of management, family, and institutional ownerships moderate the association between client probability of failure and the issuance of GC opinion. This study is quantitative in nature, and the sources of data are secondary (mainly company’s annual reports). A total of four hypotheses have been developed and tested on data accumulated from annual reports of seriously financially distressed Malaysian public listed companies. Data from 2006 to 2012 on a sample of 644 observations have been analyzed using panel logistic regression. It is found that certainty (rather than probability) of client failure affects the issuance of GC opinion. In addition, it is found that only the level of family ownership does positively moderate the relationship between client probability of failure and GC opinion issuance. This study is a contribution to auditing literature as its findings can enhance our understanding about audit quality; particularly on the variables that are associated with the issuance of GC opinion. The findings of this study shed light on the roles family owners in GC opinion issuance process, and this would open ways for the researcher to suggest measures that can be used to tackle the problem of auditors do not want to issue GC opinion to financially distressed clients. The measures to be suggested can be useful to policy makers in formulating future promulgations.

Keywords: audit quality, auditing, auditor characteristics, going concern opinion, Malaysia

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Authors: Wasan Ismail Khalil, Hisham Khalid Ahmed, Zainab Ali

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Structural Lightweight Aggregate Concrete (SLWAC) has been developed in recent years because it reduces the dead load, cost, thermal conductivity and coefficient of thermal expansion of the structure. So SLWAC has the advantage of being a relatively green building material. Lightweight Aggregate (LWA) is either occurs as natural material such as pumice, scoria, etc. or as artificial material produced from different raw materials such as expanded shale, clay, slate, etc. The use of SLWAC in Iraq is limited due to the lack in natural LWA. The existence of Iraqi clay deposit with different types and characteristics leads to the idea of producing artificial expanded clay aggregate. The main aim in this work is to present of the properties of artificial LWA produced in the laboratory. Available local bentonite clay which occurs in the Western region of Iraq was used as raw material to produce the LWA. Sodium silicate as liquid industrial waste material from glass plant was mixed with bentonite clay in mix proportion 1:1 by weight. The manufacturing method of the lightweight aggregate including, preparation and mixing of clay and sodium silicate, burning of the mixture in the furnace at the temperature between 750-800˚C for two hours, and finally gradually cooling process. The produced LWA was then crushed to small pieces then screened on standard sieve series and prepared with grading which conforms to the specifications of LWA. The maximum aggregate size used in this investigation is 10 mm. The chemical composition and the physical properties of the produced LWA are investigated. The results indicate that the specific gravity of the produced LWA is 1.5 with the density of 543kg/m3 and water absorption of 20.7% which is in conformity with the international standard of LWA. Many trail mixes were carried out in order to produce LWAC containing the artificial LWA produced in this research. The selected mix proportion is 1:1.5:2 (cement: sand: aggregate) by weight with water to cement ratio of 0.45. The experimental results show that LWAC has oven dry density of 1720 kg/m3, water absorption of 8.5%, the thermal conductivity of 0.723 W/m.K and compressive strength of 23 N/mm2. The SLWAC produced in this research can be used in the construction of different thermal insulated buildings and masonry units. It can be concluded that the SLWA produced in this study contributes to sustainable development by, using industrial waste materials, conserving energy, enhancing the thermal and structural efficiency of concrete.

Keywords: expanded clay, lightweight aggregate, structural lightweight aggregate concrete, sustainable

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Authors: Faris Alkhalil, Rana Bitar, Amer Azaz, Hisham Natour, Noora Almeraikhi, Mohamad Miqdady

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Background: Children with liver transplantation are achieving very good survival and so there is now a need to concentrate on achieving good health in these patients and preventing disease. Immunosuppressive medications have side effects that need to be monitored and if possible avoided. Glucocorticoids and calcineurin inhibitors are detrimental to bone and mineral homeostasis in addition steroids can also affect linear growth. Steroid sparing regimes in renal transplant children has shown to improve children’s height. Aim: We aim to review the growth and bone health of children post liver transplant by measuring bone mineral density (BMD) using dual energy X-ray absorptiometry (DEXA) scan and assessing if there is a clear link between poor growth and impaired bone health and use of long term steroids. Subjects and Methods: This is a single centre retrospective Cohort study, we reviewed the medical notes of children (0-16 years) who underwent a liver transplantation between November 2000 to November 2016 and currently being followed at our centre. Results: 39 patients were identified (25 males and 14 females), the median transplant age was 2 years (range 9 months - 16 years), and the median follow up was 6 years. Four patients received a combined transplant, 2 kidney and liver transplant and 2 received a liver and small bowel transplant. The indications for transplant included, Biliary Atresia (31%), Acute Liver failure (18%), Progressive Familial Intrahepatic Cholestasis (15%), transplantable metabolic disease (10%), TPN related liver disease (8%), Primary Hyperoxaluria (5%), Hepatocellular carcinoma (3%) and other causes (10%). 36 patients (95%) were on a calcineurin inhibitor (34 patients were on Tacrolimus and 2 on Cyclosporin). The other three patients were on Sirolimus. Low dose long-term steroids was used in 21% of the patients. A considerable proportion of the patients had poor growth. 15% were below the 3rd centile for weight for age and 21% were below the 3rd centile for height for age. Most of our patients with poor growth were not on long term steroids. 49% of patients had a DEXA scan post transplantation. 21% of these children had low bone mineral density, one patient had met osteoporosis criteria with a vertebral fracture. Most of our patients with impaired bone health were not on long term steroids. 20% of the patients who did not undergo a DEXA scan developed long bone fractures and 50% of them were on long term steroid use which may suggest impaired bone health in these patients. Summary and Conclusion: The incidence of impaired bone health, although studied in limited number of patients; was high. Early recognition and treatment should be instituted to avoid fractures and improve bone health. Many of the patients were below the 3rd centile for weight and height however there was no clear relationship between steroid use and impaired bone health, reduced weight and reduced linear height.

Keywords: bone, growth, pediatric, liver, transplantation

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Authors: Hisham Arab Alkabeya, A. M. Hughes, J. Adams

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Background: People with Rheumatoid Arthritis (RA) continue to experience problems with hand function despite new drug advances and targeted medical treatment. Consequently, it is important to identify the factors that influence the impact of RA disease on hand function. This systematic review identified observational studies that reported factors that influenced the impact of RA on hand function. Methods: MEDLINE, EMBASE, CINAL, AMED, PsychINFO, and Web of Science database were searched from January 1990 up to March 2017. Full-text articles published in English that described factors related to hand functional disability in people with RA were selected following predetermined inclusion and exclusion criteria. Pertinent data were thoroughly extracted and documented using a pre-designed data extraction form by the lead author, and cross-checked by the review team for completion and accuracy. Factors related to hand function were classified under the domains of the International Classification of Functioning, Disability, and Health (ICF) framework and health-related factors. Three reviewers independently assessed the methodological quality of the included articles using the quality of cross-sectional studies (AXIS) tool. Factors related to hand function that was investigated in two or more studies were explored using a best-evidence synthesis. Results: Twenty articles form 19 studies met the inclusion criteria from 1,271 citations; all presented cross-sectional data (five high quality and 15 low quality studies), resulting in at best limited evidence in the best-evidence synthesis. For the factors classified under the ICF domains, the best-evidence synthesis indicates that there was a range of body structure and function factors that were related with hand functional disability. However, key factors were hand strength, disease activity, and pain intensity. Low functional status (physical, emotional and social) level was found to be related with limited hand function. For personal factors, there is limited evidence that gender is not related with hand function; whereas, conflicting evidence was found regarding the relationship between age and hand function. In the domain of environmental factors, there was limited evidence that work activity was not related with hand function. Regarding health-related factors, there was limited evidence that the level of the rheumatoid factor (RF) was not related to hand function. Finally, conflicting evidence was found regarding the relationship between hand function and disease duration and general health status. Conclusion: Studies focused on body structure and function factors, highlighting a lack of investigation into personal and environmental factors when considering the impact of RA on hand function. The level of evidence which exists was limited, but identified that modifiable factors such as grip or pinch strength, disease activity and pain are the most influential factors on hand function in people with RA. The review findings suggest that important personal and environmental factors that impact on hand function in people with RA are not yet considered or reported in clinical research. Well-designed longitudinal, preferably cohort, studies are now needed to better understand the causality between personal and environmental factors and hand functional disability in people with RA.

Keywords: factors, hand function, rheumatoid arthritis, systematic review

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