Search results for: exercise barriers

Authors: Sobia Rana

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The study intends to explain the problems of English collocational use faced by college students in Rawalpindi, Pakistan and recommends some authentic ways that will help in removing the learning barriers in light of the concerning methodological issues. It will not only help the students to improve their knowledge of the phenomena but will also enlighten the target teachers about the significance of authentic collocational use and how it naturalizes both written and spoken expressions. Data from both the students and teachers have been collected with the help of open/close-ended questionnaires to unearth the genuine cause/s and supplement them with the required solutions rooted in the actual problems. The students fail to use authentic collocations owing to multiple reasons: lack of awareness about English collocational use, improper teaching methodologies, and inexpert teachers.

Keywords: English collocational use, teaching methodologies, English learning barriers, vocabulary acquisition, college students of Rawalpindi

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Authors: Aisyah Rahmatul Laily

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Indonesia Ministry of Health is increasing their awareness on non communicable diseases. From the top ten causes of death, two of them are non communicable diseases. Diabetes Mellitus is one of the two non communicable diseases above that have the increasing number of patient from year to year. From that problem, this research is made to determine the correlation between education, food intake, exercise, and the medication obedience with the average of blood sugar. In this research, the researchers used observational and cross-sectional studies. The sample that used in this research were 50 patients in Puskesmas Gamping I Yogyakarta who have suffered from Diabetes Mellitus in long period. The researcher doing anamnesis by using questionnaire to collect the data, then analyzed it with Chi Square to determine the correlation between each variable. The dependent variable in this research is the average of blood sugar, whereas the independent variables are education, food intake, do exercise, and the obedience of medication. The result shows a relation between education and average blood sugar level (p=0.029), a relation between food intake and average blood sugar level (p=0.009), and a relation between exercise and average blood sugar level (p=0.023). There is also a relation between the medication obedience with the average of blood sugar (p=0,002). The conclusion is that the positive correlations exist between education and average blood sugar level, between food intake and average blood sugar level, and between medication obedience and average blood sugar level.

Keywords: average of blood sugar, education, exercise, food intake, medication obedience

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Authors: Ohud Alharbi, Emily Baines

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The animation industry is one of the creative industries that have attracted recent historiographical attention. However, there has been very limited research on Saudi Arabian and wider Arabian animation industries, while there are a large number of studies that have covered this issue for North America, Europe and East Asia. The existing studies show that developed countries such as USA, Japan and the UK have reached the Maturity stage in their animation industry life-cycle. On the other hand, developing countries that are still in the Introduction phase of the industry life-cycle face challenges to improve their industry. Saudi Arabia is one of the countries whose animation industry is still in its infancy. Thus, the aim of this paper is to address the main barriers that hinder the evolution of the industry life-cycle for Saudi animation – challenges that are also relevant to many other early stage industries in developing countries. These barriers have been analysed using the early mobility barriers defined by Porter, to provide a conceptual structure for defining recommendations to enable the transition to a strong Growth phase industry. This study utilized qualitative methods to collect data, which involved in-depth interviews, document analysis and observations. It also undertook a comparative case study approach to investigate the animation industry life-cycle, with three selected case studies that have a more developed industry than Saudi animation. Case studies include: the United Kingdom, which represents a Mature animation industry; Egypt, which represents an established Growth stage industry; and the United Arab of Emirates, which is an early Growth stage industry. This study suggests adopting appropriate strategies that arise as findings from the comparative case studies, to overcome barriers and facilitate the growth of the Saudi animation industry.

Keywords: barriers, industry life-cycle, Saudi animation, industry

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Authors: Majed Zobairy, Fardin Kalvandi, Kamal Azizbaigi

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This research was carried out for evaluation of elastic, plyometric and resistance training on selected anaerobic factors in men volleyball players. For these reason 30 elite volleyball players of Sanandaj city randomly divided into 3 groups as follow: elastic training, plyometric training and resistance training. Pre-exercise tests which include vertical jumping, 50 yard speed running and scat test were done and data were recorded. Specific exercise protocol regimen was done for each group and then post-exercise tests again were done. Data analysis showed that there were significant increases in exercise test in each group. One way ANOVA analysis showed that increases in speed records in elastic group were significantly higher than the other groups (p<0/05),based on research data it seems that elastic training can be a useful method and new approach in improving functional test and training regimen.

Keywords: elastic training, plyometric training, strength training, anaerobic power

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Authors: Kh Jalali Dehkordi, A. Jalali Dehkordi, A. Tofighi

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Background: The purpose of this study was to investigate the effects of 8 weeks of aerobic, resistance, and concurrent training on secretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) in elderly women. Methods: A total number of 60 elderly women were randomly allocated to four groups of aerobic training (n = 15), resistance training (n = 15), concurrent training (n = 15), and control (n = 15). Blood samples were taken before and 4 weeks after the initiation of exercise training and also at the end of the 8-week course of training. Maximal oxygen consumption (VO2Peak) was measured after 48 hours using Rockport walk test. Inferential analysis of the collected data was performed by repeated measures analysis of variance (ANOVA). Significant differences were further evaluated by the least significant difference (LSD) test. The relation between VO2Peak and secretion of GH and IGF-1 was assessed by Pearson's correlation coefficient. The significance level was considered as P ≤ 0.05 in all tests. Findings: The results showed that 8 weeks of regular exercise significantly increased levels of GH and IGF-1. A significant increase was also observed in VO2Peak values after 8 weeks of regular exercise (P < 0.05). VO2Peak was directly correlated with GH and IGF (P < 0.001, r = 0.72). Conclusion: In conclusion, regular exercise significantly increased levels of anabolic hormones. Moreover, the combined-exercise training better enhanced GH and IGF-1. VO2Peak increased with increases in GH and IGF-1 levels.

Keywords: women, training, GH, IGF-1

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Authors: Auttasuriyanan Pakpoom, Setthasakko Watchaneeporn

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The main purpose of this study is to gain a clearer understanding of key determinants that drive environmental management and barriers that hinder its development. The study employs semi-structured interviews with key informants accompanied by site observations. Key informants include production, environmental and plant managers of six beverage companies, including three Thai and three multinational companies in Thailand. It is found that corporate image, government subsidies, top management leadership and education institutes are four primary factors influencing the implementation of environmental management in the beverage processors. No demand from Asian buyers, employee resistance to change and lack of environmental knowledge are identified as barriers.

Keywords: environmental management, beverage, government subsidies, education institutes, employee resistance, environmental knowledge, Thailand

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Authors: David Pettitt, Benjamin Davies, Georg Holländer, David Brindley

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Cellular based therapies, whose origins can be traced from the intertwined concepts of tissue engineering and regenerative medicine, have the potential to transform the current medical landscape and offer an approach to managing what were once considered untreatable diseases. However, despite a large increase in basic science activity in the cell therapy arena alongside a growing portfolio of cell therapy trials, the number of industry products available for widespread clinical use correlates poorly with such a magnitude of activity, with the number of cell-based therapeutics in mainstream use remaining comparatively low. This research serves to quantitatively assess the barriers to the clinical adoption of cell-based therapeutics through identification of unique barriers, specific challenges and opportunities facing the development and adoption of such therapies.

Keywords: cell therapy, clinical adoption, commercialization, translation

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Authors: A-Reum Shin, Heon-Seock Cynn, Ji-Hyun Lee, Da-Eun Kim

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Round shoulder posture (RSP) is a position of scapular protraction and elevation, which may appear as scapular winging, and humeral internal rotation. Flexed posture (FP) may also affect RSP because FP is characterized by hyperkyphosis, forward head posture, and height reduction. The aim of this study was to investigate the effect of scapular posterior tilting exercise with prone trunk extension on round shoulder posture, activities of lower trapezius and serratus anterior, flexed posture, and thoracic erector spinae activity in subjects with round shoulder posture. Fifteen subjects with round shoulder posture were recruited in this study. Activities of lower trapezius, serratus anterior and thoracic erector spinae were measured during both scapular posterior tilting exercise and scapular posterior tilting exercise with prone trunk extension using electromyography, and round shoulder posture and flexed posture were measured immediately after each exercises using caliper. When the prone trunk extension was applied, the round shoulder posture and flexed posture significantly decreased, activities of lower trapezius and thoracic erector spinae significantly increased (p < 0.05) compared with the scapular posterior tilting exercise alone. There was no significant difference in serratus anterior activity between two exercises. Thus, prone trunk extension could be effective method to improve round shoulder posture during scapular posterior tilting exercise in subjects with round shoulder posture.

Keywords: flexed posture, prone trunk extension, round shoulder posture, scapular posterior tilting

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Authors: Thanakorn Thanawat, Nomjit Nualnetr

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Background and Purpose: In Thailand, rice farmers have the most prevalence of low back pain when compared with other manual workers. Exercises have been suggested to be a principal part of treatment programs for low back pain. However, the programs should be tailored to an individual’s readiness to change categorized by a behavioral approach. This study aimed to evaluate a difference between the responses of rice farmers with chronic low back pain who received an exercise program integrated with the transtheoretical model of behavior change (TTM) and those of the comparison group regarding severity of pain and trunk muscle endurance. Materials and Methods: An 8-week exercise program was conducted to rice farmers with chronic low back pain who were randomized to either the TTM (n=62, 52 woman and 10 men, mean age ± SD 45.0±5.4 years) or non-TTM (n=64, 53 woman and 11 men, mean age ± SD 44.7±5.4 years) groups. All participants were tested for their severity of pain and trunk (abdominal and back) muscle endurance at baseline (week 0) and immediately after termination of the program (week 8). Data were analysed by using descriptive statistics and student’s t-tests. The results revealed that both TTM and non-TTM groups could decrease their severity of pain and improve trunk muscle endurance after participating in the 8-week exercise program. When compared with the non-TTM group, however, the TTM showed a significantly greater increase in abdominal muscle endurance than did the non-TTM (P=0.004, 95% CI -12.4 to -2.3). Conclusions and Clinical Relevance: An exercise program integrated with the TTM could provide benefits to rice farmers with chronic low back pain. Future studies with a longitudinal design and more outcome measures such as physical performance and quality of life are suggested to reveal further benefits of the program.

Keywords: chronic low back pain, transtheoretical model, rice farmers, exercise program

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Authors: Eryati Darwin, Eka Fithra Elfi, Indria Hafizah

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Background: Physical exercise induces a pattern of hormonal and immunological responses that prevent endothelial dysfunction by maintaining the availability of nitric oxide (NO). Regular and moderate exercise stimulates NO release, that can be considered as protective factor of cardiovascular diseases, while strenuous exercise induces increased levels in a number of pro-inflammatory and anti-inflammatory cytokines. Pro-inflammatory cytokines tumor necrosis factor-α (TNF-α) triggers endothelial activation which results in an increased vascular permeability. Nuclear gene factor kappa B (NF-κB) activates biological effect of TNF-α. Aim of Study: To determine the effect of physical exercise on the endothelial and skeletal muscle, we measured the level of NF-κB on rats’ serum, macrophages, and myocytes after strenuous physical exercise. Methods: 30 male Rattus norvegicus in the age of eight weeks were randomly divided into five groups (each containing six), and there were treated groups (T) and control group (C). The treated groups obtain strenuous physical exercise by ran on treadmill at 32 m/minutes for 1 hour or until exhaustion. Blood samples, myocytes of gastrocnemius muscle, and intraperitoneal macrophages were collected sequentially. There were investigated immediately, 2 hours, 6 hours, and 24 hours (T1, T2, T3, and T4) after sacrifice. The levels of NF-κB were measured by ELISA methods. Results: From our study, we found that the levels of NF-κB on myocytes in treated group from which its specimen was taken immediately (T1), 2 hours after treadmill (T2), and 6 hours after treadmill (T3) were significantly higher than control group (p<0.05), while the group from which its specimen was taken 24 hours after treadmill, was no significantly different (p>0.05). Also on macrophages, NF-κB in treated groups T1, T2, and T3 was significantly higher than control group (p<0.05), but there was no difference between T4 and control group (p>0.05). The level of serum NF-κB was not significantly different between treatment group as well as compared to control group (p>0.05). Serum NF-κB was significantly higher than the level on macrophages and myocytes (p<0.05). Conclusion: This study demonstrated that strenuous physical exercise stimulates the activation of NF-κB that plays a role in vascular inflammation and muscular damage, and may be recovered after resting period.

Keywords: endothelial function, inflammation, NFkB, physical exercise

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Authors: Jui-Hsiu Chang

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As an increasing number of restaurants are growing, the demand for man force in the food service industry is dramatically increasing as well. However, food service workers often complete the heavy workload, infrequent breaks, long hours and shifts. With the overwhelming workload, many workers have experienced high injury rates. As a result, the restaurant industry reports a higher employee turnover rate compare to other service industries in Taiwan. Restaurant managers are seeing ways to retain good employees in order to provide good quality service for daily operation. The purpose of this study was to explore the relationship among exercise participation, job stress and job satisfaction on the food service employees. In addition, to examine how the job stress affected their job satisfaction. A survey using a self-reported questionnaire was conducted to collect data, and 269 questionnaires were collected for data analysis. The obtained materials were analyzed using descriptive statistic, independent t-test, one-way ANOVA, linear regression analysis. The results show that 1. Job stress had a significantly negative influence on employees’ job satisfaction. 2. Exercise participation had significantly positive influence on employees’ job satisfaction. 3. Job stress and job satisfaction varied among the groups of respondent with different level of exercise involvement. Furthermore, the practical implications were proposed for the food service company management when developing daily operational strategies.

Keywords: exercise participation, food service employees, job satisfaction, job stress

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Authors: Pooja Pandey

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The role of communication plays an integral part in the management of any disaster, whether natural or human-induced, both require effective and strategic delivery of information. The way any information is conveyed carries the most weight while dealing with the disaster. Hence, integrating communication strategies in disaster risk management (DRM) are extensively acknowledged however, these integration and planning are missing from the practical books. Researchers are continuously exploring integrated DRM and have established substantial vents between research and implementation of the strategies (gaps between science and policy). For this reason, this paper reviews the communication barriers that obstruct effective management of the disaster. Communication between first responders (government agencies, police, medical services) and the public (people directly affected by the disaster) is most critical and lacks proper delivery during a disaster. And these challenges can only be resolved if the foundation of the problem is properly dealt with, which is resolving the issues within the organizations. Through this study, it was found that it is necessary to build the communication gap between the organizations themselves as most of the hindrances occur during the mitigation, preparedness, response and recovery phase of the disaster. The study is concluded with the main aim to review the communication barriers within and at the organizational, technological, and social levels that impact effective DRM. In the end, some suggestions are made to strengthen the knowledge for future improvement in communication between the responders and their organizations.

Keywords: communication, organization, barriers, first responders, disaster risk management

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Authors: Amanda Noble

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The process of exiting/escaping situations of sex trafficking can be arduous and fraught with numerous barriers. In this paper the results of a national Canadian study on escaping situations of sex trafficking is discussed. Surveys and focus groups were conducted with 201 stakeholders in 8 cities, including 50 survivors of sex trafficking, service providers, health care providers and police. The results show that survivors are both vulnerable to being exploited and experience barriers to exiting as a result of structural factors such as colonialism, poverty, and discrimination based on race and gender. Survivors also face numerous barriers within various systems such as child welfare and the legal system. In addition, survivors contend with multiple psychological and psychosocial factors when exiting including the trauma bond, complex trauma and mental health concerns, substance use, isolation, and adjusting to ‘mainstream’ life. In light of these factors, the service needs of survivors escaping sex trafficking are discussed, and promising practices, such as trauma-informed practice and working from a stages of change model are outlined. This paper is useful for service providers that work with survivors, policy makers, or anyone who has ever wondered why survivors that are not being physically detained don’t ‘just leave’ or escape their exploitative situations.

Keywords: Barriers, Exiting, Promising Practices, Sex Trafficking

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Authors: Aziza Barnawi

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Background: Regular exercise reduces risk factors associated with cardiovascular diseases. Over the past decade, exercise interventions have been introduced to reduce the risk of and prevent coronary artery disease (CAD). Elevated low-density lipoproteins (LDL) contribute to the formation of atherosclerosis, its manifestations on the endothelial narrow the coronary artery and affect the endothelial function. Therefore, flow-mediated dilation (FMD) technique is used to assess the function. The results of previous studies have been inconsistent and difficult to interpret across different types of exercise programs. The relationship between exercise therapy and lipid levels has been extensively studied, and it is known to improve the lipid profile and endothelial function. However, the effectiveness of exercise in altering LDL levels and improving blood flow is controversial. Objective: This review aims to explore the evidence and quantify the impact of exercise training on LDL levels and vascular function by FMD. Methods: Electronic databases were searched PubMed, Google Scholar, Web of Science, the Cochrane Library, and EBSCO using the keywords: “low and/or moderate aerobic training”, “blood flow”, “atherosclerosis”, “LDL mediated blood flow”, “Cardiac Rehabilitation”, “low-density lipoproteins”, “flow-mediated dilation”, “endothelial function”, “brachial artery flow-mediated dilation”, “oxidized low-density lipoproteins” and “coronary artery disease”. The studies were conducted for 6 weeks or more and influenced LDL levels and/or FMD. Studies with different intensity training and endurance training in healthy or CAD individuals were included. Results: Twenty-one randomized controlled trials (RCTs) (14 FMD and 7 LDL studies) with 776 participants (605 exercise participants and 171 control participants) met eligibility criteria and were included in the systematic review. Endurance training resulted in a greater reduction in LDL levels and their subfractions and a better FMD response. Overall, the training groups showed improved physical fitness status compared with the control groups. Participants whose exercise duration was ≥150 minutes /week had significant improvement in FMD and LDL levels compared with those with <150 minutes/week.Conclusion: In conclusion, although the relationship between physical training, LDL levels, and blood flow in CAD is complex and multifaceted, there are promising results for controlling primary and secondary prevention of CAD by exercise. Exercise training, including resistance, aerobic, and interval training, is positively correlated with improved FMD. However, the small body of evidence for LDL studies (resistance and interval training) did not prove to be significantly associated with improved blood flow. Increasing evidence suggests that exercise training is a promising adjunctive therapy to improve cardiovascular health, potentially improving blood flow and contributing to the overall management of CAD.

Keywords: exercise training, low density lipoprotein, flow mediated dilation, coronary artery disease

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Authors: Shaker A. Aladwan

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This paper aims to explore the Barriers to innovation leadership in Jordanian public sector organizations. Qualitative approach was adopted, and content analysis was used to analyze the 18 assessment reports which are extracted from the public innovation award in Jordan, then, 20 semi-structured interviews were conducted with the key persons who are involved with innovation initiatives in the public sector organizations in Jordan. Several Barriersthat face the innovation leadership in the Jordanian public sector organizations. Managerially, the challenges include lack of innovation vision, implementation lack of innovation core values, lack of strategic planning for innovation, bad bureaucracy culture, and excessive centralization. Technically, the challenges include lack of task assignment for employees, lack of resources, lack of innovative training programs, lack of knowledge sharing, and the failure of governments to formulate policies and regulations. most of the studies focused on innovation in the non-public sector organizations, and most of them were conducted in the American and Western countries, which are different in terms of culture, kinds of innovation, barriers, and drivers. Thus, this paper provides new insights into barriers to innovation leadership in the public sector and in a new research context. This paper also provides a theoretical contribution by diagnosing the barriers facing innovation within the context of public administration in developing countries.

Keywords: innovation, excellence award, challenges, public sector, jordan

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Authors: Osifeko Olalekan Remigious, Osifeko Christiana Osikorede, Folarin Bolanle Eunice, Olugbenga Adebola Shodiya

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During these difficult economic times, nations are looking for ways to improve their finances, preserve the environment as well as the socio-political climate and educational institutions, which are needed to increase their economy and preserve their sustainable development. Sport is one of the ways through which sustainable development can be achieved. The purpose of this study was to examine and understanding barriers to participation in sport. A total of 1,025 students were purposively selected from five schools (School of Arts and Social Sciences, School of Languages, School of Education, School of Sciences and School of Vocational and Technical Education) in Michael Otedola College of Primary Education (MOCPED). A questionnaire, with a tested reliability coefficient of 0.71, was used for data collection. The collected data were subjected to the descriptive survey research design. The findings showed that sports facilities, funding and lecture schedules were significant barriers to sports participation. It was recommended that sports facilities be provided by the Lagos State government.

Keywords: sports, sustainable development, Participation, State government, barriers

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Authors: Salma Ahmed, Anil Kumar

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This paper develops and estimates a model for understanding the drivers and barriers for Omni-Channel retail. This study serves as one of the first attempt to empirically test the effect of various factors on Omni-channel retail. Omni-channel is relative new and evolving, we hypothesize three drivers: (1) Innovative sales and marketing opportunities, (2) channel migration, (3) Cross channel synergies; and three barriers: (1) Integrated sales and marketing operations, (2) Visibility and synchronization (3) Integration and Technology challenges. The findings from the study strongly support that Omni-channel effects exist between cross channel synergy and channel migration. However, it partially supports innovative sales and marketing operations. We also found the variables which we identified as barriers to Omni-channel retail have a strong impact on Omni-channel retail.

Keywords: retailing, multichannel, Omni-channel, emerging market

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Authors: Bezuglov Eduard, Ryland Morgans, Talibov Oleg, Kalinin Evgeny, Butovsky Mikhail, Savin Evgeny, Tzgoev Eduard, Artemii Lazarev, Bekzhan Pirmakhanov, Anthony C. Hackney

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Currently, there is conflicting evidence regarding the efficacy of citrulline for physical performance and post-exercise recovery. Moreover, the vast majority of studies conducted used physically active volunteers from the general population and heterogeneous exercise protocols that are not specific to most sports. A single use of citrulline, regardless of the dose, will not have a significant effect on physical performance and post-exercise recovery in highly trained soccer players performing sport-specific exercises at maximum intensity. To evaluate the effectiveness of a single administration of citrulline at various doses in adult male professional soccer players performing sport-specific exercise at maximum intensity. A randomized, double-blind, placebo-controlled study analyzing eighteen soccer players from the top divisions of several European countries. The participants were randomized into three groups of six and performed a field-based soccer-specific test at 115% VO2max for 18-minutes. Comparative analysis of the cardiovascular system, physical activity, subjective perceived fatigue and post-exercise recovery was conducted. There were no statistically significant differences in more than one analyzed parameter. A single application of 3 to 6 grams of citrulline does not affect physical performance, subjective feeling of fatigue and post-exercise recovery in adult professional soccer players who have performed a sport-specific test. Currently, citrulline cannot be recommended for use as a supplement in adult professional soccer players

Keywords: citrulline, performance, recovery, soccer players

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Authors: Sayyed-Javad Ziaolhagh, Mojtaba Hokmabadi

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Introduction: Childhood obesity is a serious medical condition that affects children and adolescents even in the central nervous system. Semaphorins also play a role in the inflammatory process of the nervous system. On the other hand, it has been stated that garlic and stevia extracts following aerobic exercise are effective on immune system inflammation in addition to aerobic activity. Materials and Methods: For 15 weeks, 50 3-week-old male Wistar rats were fed with conventional rodent chow for control and a high-fat diet to induce obesity. Obese rats then were randomly assigned into 7 groups (n=5) based on the Lee index: healthy control (C), obese (OBS), obese + garlic (OBS+GAR), obese + Stevia (OBS+STV), obese + aerobic exercise (OBS+EXE), obese + garlic + aerobic exercise (OBS+GAR+EXE), and obese + stevia + aerobic exercise (OBS+STV+EXE). Training groups completed a progressive aerobic running program (at 8-15 m/min, 5-20 min/day, 5 days/week), and Stevia and garlic extract group (250 mg/kg/day, 5 days/week) were given orally once a day. Real-time PCR was used to determine the levels of Semaphorin 4A, and Plexin D1 gene expressions in the hypothalamus. Fold change analysis with ANOVA was performed for statistical analysis, with a significance threshold of P<0.05. Results: Body weight increased significantly in OBS compared to C (p= 0.013), but was not significantly changed in all treatment rats. Moreover, Semaphorin 4A was significantly increased in obese compared to control group (p= 0.041) and after 8 weeks, stevia extract (p=0.006), aerobic exercise (p=0.012) and garlic extract + aerobic exercise (p=0.008) significantly decreased compared to obese rats. In addition, Plexin D1 genes were also found in the hypothalamus of both obese and control rats but were insignificantly up-regulated when compared with the obese group (p=0.950). Conclusion: High-fat diet caused neuroinflammation by elevation of sema4A in obese rats and stevia, stevia with aerobic and garlic with aerobic could reduce this inflammation in rats. Also, none of them could alter Plexin D1.

Keywords: sema 4A, plexin D1, garlic, stevia

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Authors: R. K. Yadav, S. Baral, H. R. Paudel, R. Basnet

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The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public healthcare providers in the fight against tuberculosis using international healthcare standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. A total of 20 respondents participated in the study. Barriers to PPM were identified in the following three themes: 1) Obstacles related to TB case detection, 2) Obstacles related to patients, and 3) Obstacles related to the healthcare system. PPM implementation was challenged by following subthemes that included staff turnover, low private sector participation in workshops, a lack of training, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. The study concludes that numerous barriers exist in the way of effective implementation of the PPM approach, including TB cases detection barriers such as knowledge of TB diagnosis and treatment, HW attitude, workload, patient-related barriers such as knowledge of TB, self-medication practice, stigma and discrimination, financial status, and health system-related barriers such as staff turnover and poor engagement of the private sector in workshops, training, recording, and re-evaluation. Government stakeholders must work together with private sector stakeholders to perform joint monitoring and supervision. Private practitioners should receive training and orientation, and presumptive TB patients should be given adequate time and counseling as well as motivation to visit a government health facility.

Keywords: barrier, tuberculosis, case finding, PPM, nepal

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Authors: Gulay Aras, Isil Kutluturk Karagoz, Z. Candan Algun

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Background: Hypermetropia in school-age is a pathology that responds to treatment. In the literature, there has been no study of exercise practice in hypermetropia treatment. Objective: The purpose of this study was to investigate the effects of eye exercises and convergence exercise on visual acuity in school-age children with hypermetropia. Methods: Forty volunteer school-age children with hypermetropia (30 girls, 30 boys, between 7-17 years of age) were included in the study. Sociodemographic information and clinical characteristics were evaluated. 40 participants were randomly divided into two groups: eye exercises and convergence exercises. Home exercise protocols were given to all groups for six weeks, and regular phone calls were made once a week. Individuals performed eye exercises 10 times, convergence exercises 5 min. for two sessions per day for six weeks. The right and left eyes of all the subjects participating in the study were assessed separately by the eye doctor with a Snellen chart. The participants' quality of life was assessed using Pediatric Quality of Life Inventory Version 4.0. Physical health total score (PHTS) and scale total score (STS), which were obtained by evaluating Psychosocial health total score (PSHTS) school, emotional and social functioning, were calculated separately in the scores. At the end of the exercise program, the assessment tests applied at the beginning of the study were reapplied to all individuals. Results: There was no statistically significant difference between the pre- and post-Snellen chart measurements and quality of life in the eye exercises group (p > 0,05). There was a statistically significant difference in visual acuity of right and left eyes (p=0,004, p=0,014) and quality of life in PHTS, PSHTS and STS in the convergence exercise group (p=0,001, p=0,017, p=0,001). Conclusions: In school-age children, convergence exercises were found to be effective on visual acuity and health-related quality of life. Convergence exercises are recommended for the treatment of school-aged children with hypermetropia.

Keywords: convergence exercise, eye exercises, hypermetropia, school-age children

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Authors: Teng Minnie Y., Jarus Tal, Wong Anita

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Introduction: The COVID-19 pandemic has altered the lifestyle of all Canadians. While "stay-at-home" public health directives have been implemented to mitigate the spread of COVID-19, they may also lead to or worsen physical and social health challenges for older adults. In particular, older adults with disabilities are especially vulnerable. In response, we quickly adapted to virtual rehabilitation exercise intervention for older adults. Objectives: First, to identify the factors that influenced the acceptability and feasibility of virtual exercise implementation, and second, to evaluate whether the virtual delivery was effective for health promotion in older adults with disabilities. Methods: We carried out weekly virtual exercise programs from January 2021 to June 2021. We conducted semi-structured focus groups and interviews to explore the perspectives of participants who are older adults. The focus group and interview data are transcribed and coded thematically. Conclusions: The acceptability and feasibility of delivering exercises virtually were influenced by the provision of a safe and supportive environment for social connection, the availability of the necessary technology, and the role of the support system.

Keywords: physical activity, virtual exercises, older adults, people with disabilities

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Authors: Claes Gunnarsson, Karin Fröding, Nina Hasche

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Innovation is a necessity for the evolution of societies and it is also a driving force in human life that leverages value creation among cross-sector participants in various network arrangements. Social innovations can be characterized as the creation and implementation of a new solution to a social problem, which is more effective and sustainable than existing solutions in terms of improvement of society’s conditions and in particular social inclusion processes. However, barriers exist which may restrict the potential of social innovations to live up to its promise as a societal welfare promoting driving force. The literature points at difficulties in tackling social problems primarily related to problem complexity, access to networks, and lack of financial muscles. Further research is warranted at detailed at detail clarification of these barriers, also connected to recognition of the interplay between institutional logics on the development of cross-sector collaborations in networks and the organizing processes to achieve innovation barrier break-through. There is also a need to further elaborate how obstacles that spur a difference between the actual and desired state of innovative value creating service systems can be overcome. The purpose of this paper is to illustrate barriers to social innovations, based on qualitative content analysis of 36 dialogue-based seminars (i.e. research circles) with nine Swedish focus groups including more than 90 individuals representing civil society organizations, private business, municipal offices, and politicians; and analyze patterns that reveal constituents of barriers to social innovations. The paper draws on central aspects of innovation barriers as discussed in the literature and analyze barriers basically related to internal/external and tangible/intangible characteristics. The findings of this study are that existing institutional structures highly influence the transformative potential of social innovations, as well as networking conditions in terms of building a competence-propelled strategy, which serves as an offspring for overcoming barriers of competence extension. Both theoretical and practical knowledge will contribute to how policy-makers and SI-practitioners can facilitate and support social innovation processes to be contextually adapted and implemented across areas and sectors.

Keywords: barriers, research circles, social innovation, service systems

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Authors: Katalin Gocze, Gabriella Kiss, Zsuzsanna Gurdan, Krisztian Kvell, Attila Trabert

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Introduction: On a worldwide scale running has become an increasingly popular leisure time activity during the past decade. Since the participation rate of women has risen significantly the aim of our study was to analyze the mental status, sleeping habits and the prevalence of depression among female runners. Methods: Cross-sectional analysis included the use of validated and globally used surveys for the comprehensive evaluation of insomnia (AIS), depression (BDI), exercise dependence (EDS) and exercise addiction (EAI). Recreational and amateur female runners participating at half-marathon events in Hungary were asked to take part in our pilot study. Results: Participants mean age was 42.03±9.03 years. The prevalence of imsomnia was 18.87%. 60.34% has worries regarding their weight and 43.1% think that they have an actual weight problem. 77.6% stated that their body weight has an influence on their mood. 2.7% displayed borderline clinical depression, the prevalence of mild mood disorders was 10.81%. 17.2% had previously problems with disordered eating. Participants had a mean total EDS score of 46.94±15.55 and a mean total of 13.49±3.80 on EAI. Component scores were the highest for tolerance (a need for increased amounts of exercise to achieve the desired effect or a diminished effect occurs with continued use of the same amount of exercise). Conclusion: Even tough running can help improve mental health, tackle depression and overcome adversity, athletes are at risk of experiencing psychological difficulties which have an impact on their physical perfomance as well. Further research can help initiate targeted educational and screening programs to ensure that female athletes find a path to emotional well-being.

Keywords: depression, eating disorder, exercise addiction, exercise dependence, insomnia, running

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Authors: Giulia Colonna, Jocelyn Hoye, Bart de Laat, Gelsina Stanley, Jose Key, Alaaddin Ibrahimy, Sule Tinaz, Evan D. Morris

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Parkinson’s disease (PD) is the second most common neurodegenerative disease and affects approximately 1% of the world’s population. Increasing evidence suggests that aerobic physical exercise can be beneficial in mitigating both motor and non-motor symptoms of the disease. In a recent pilot study of the role of exercise on PD, we sought to confirm exercise intensity by monitoring heart rate (HR). For this purpose, we asked participants to wear a chest strap heart rate monitor (Polar Electro Oy, Kempele). The device sometimes proved uncomfortable. Looking forward to larger clinical trials, it would be convenient to employ a more comfortable and user friendly device. The Fitbit Charge 4 (Fitbit Inc) is a potentially comfortable, user-friendly solution since it is a wrist-worn heart rate monitor. Polar H10 has been used in large trials, and for our purposes, we treated it as the gold standard for the beat-to-beat period (R-R interval) assessment. In previous literature, it has been shown that Fitbit Charge 4 has comparable accuracy to Polar H10 in healthy subjects. It has yet to be determined if the Fitbit is as accurate as the Polar H10 in subjects with PD or in clinical populations, generally. Goal: To compare the Fitbit Charge 4 to the Polar H10 for monitoring HR in PD subjects engaging in an intensive exercise program. Methods: A total of 596 exercise sessions from 11 subjects (6 males) were collected simultaneously by both devices. Subjects with early-stage PD (Hoehn & Yahr <=2) were enrolled in a 6 months exercise training program designed for PD patients. Subjects participated in 3 one-hour exercise sessions per week. They wore both Fitbit and Polar H10 during each session. Sessions included rest, warm-up, intensive exercise, and cool-down periods. We calculated the bias in the HR via Fitbit under rest (5min) and intensive exercise (20min) by comparing the mean HR during each of the periods to the respective means measured by the Polar (HRFitbit – HRPolar). We also measured the sensitivity and specificity of Fitbit for detecting HRs that exceed the threshold for intensive exercise, defined as 70% of an individual’s theoretical maximum HR. Different types of correlation between the two devices were investigated. Results: The mean bias was 1.68 bpm at rest and 6.29 bpm during high intensity exercise, with an overestimation by Fitbit in both conditions. The mean bias of Fitbit across both rest and intensive exercise periods was 3.98 bpm. The sensitivity of the device in identifying high intensity exercise sessions was 97.14 %. The correlation between the two devices was non-linear, suggesting a saturation tendency of Fitbit to saturate at high values of HR. Conclusion: The performance of Fitbit Charge 4 is comparable to Polar H10 for assessing exercise intensity in a cohort of PD subjects. The device should be considered a reasonable replacement for the more cumbersome chest strap technology in future similar studies of clinical populations.

Keywords: fitbit, heart rate measurements, parkinson’s disease, wrist-wearable devices

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Authors: Rayah Asiri, Anna Robinson-Barella, Adam Todd, Andy Husband

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Introduction: A high prevalence of diabetes and diabetes-related complications in ethnic minority communities is of significant concern. Several studies have indicated low adherence rates to antidiabetic medications in ethnic minorities. Poor adherence to antidiabetic medications leads to a higher risk of complications and mortality. This review aims to explore the barriers to and facilitators of adherence to antidiabetic medication among ethnic minority groups in high-income countries. Methods: A comprehensive search of MEDLINE, Embase, CINAHL, and PsycINFO databases for qualitative studies exploring the barriers to or facilitators of adherence to antidiabetic medication in ethnic minority groups were conducted from database inception to March 2022 (PROSPERO CRD42022320681). A quality assessment of the studies was conducted using the Critical Appraisal Skills Programme (CASP) tool. Key concepts and themes from relevant studies were synthesised using a meta-ethnographic approach. Result: A total of 18 studies were included in the review, and three major themes were developed: 1) cultural underpinnings, 2) communication and building relationships, and 3) managing diabetes during holidays. Conclusion: Multiple barriers and facilitators of adherence to antidiabetic medication among ethnic minority people in high-income countries have been identified. A medication adherence intervention focusing on identified barriers to adherence to antidiabetic medication in ethnic minorities may help in improving diabetes outcomes in these groups.

Keywords: medication adherence, diabetes, ethnic minority, barriers, facilitators

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Authors: Laleh Behboudi Tabrizi, Melika Naserzare

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Accumulating experimental and epidemiologic data smoker individuals are more prone to systemic inflammation than non-smokers. In this study we aimed to determine serum TNF-α and C-reactive protein (CRP) as pro-inflammatory cytokines in response to 3 months aerobic training in smoker men. A total 30 middle-aged healthy smokers selected for participate in this study and were divided into either control or exercise groups. The subjects in exercise group were completed a 3 months aerobic training program for 3 sessions per week at 60 – 80 % of maximal heart rate. Those in control group did nit participated in exercise training. Pre and post-training of CRP and TNF-α were measured in two groups. Student’s t-tests for paired samples were performed to determine whether there were signigcant within-group changes in the outcomes. P value of <0.05 was accepted as significant. No significant differences were found in anthropometrical and biochemical markers between two groups at baseline. Aerobic training program resulted in a significant decrease in anthropometrical markers and serum TNF-α but not in serum CRP in exercise group. All variables remained without changes in control groups. Based on these finding, it is concluded that aerobic training can be improve inflammatory cytokine with emphasis on TNF-α in smokers.

Keywords: cigarette, cytokine, chronic training, inflammation

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Authors: Razieh Karimian, Kim Burton, Mohammad Mehdi Naghizadeh, Maryam Karimian

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Introduction: Habitual upper body postures are associated with online learning during the COVID-19 pandemic. This study explored whether adding an exercise routine to an ergonomic advice intervention improves these postures. Methods: In this randomized trial, 42 male adolescent students with a forward head posture were randomly divided into two equal groups, one allocated to ergonomic advice alone and the other to ergonomic advice plus an exercise routine. The angles of forward head, shoulder, and back postures were measured with a photogrammetric profile technique before and after the 8-week intervention period. Findings: During home quarantine, 76% of the students used their mobile phones, while 35% used a table-chair-computer for online learning. While significant reductions of the forward, shoulder, and back angles were found in both groups (P < 0.001), the effect was significantly greater in the exercise group (P < 0.001: forward head, shoulder, and back angles reduced by some 9, 6, and 5 degrees respectively, compared with 4 degrees in the forward head, and 2 degrees in the shoulder and back angles for ergonomic advice alone. Conclusion: The exercise routine produced a greater improvement in habitual upper body postures than ergonomic advice alone, a finding that may extend beyond online learning at home.

Keywords: randomized trial, online learning, adolescent, posture, exercise, ergonomic advice

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Authors: Anastasios Rodis

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Background: Case studies of walkers, climbers, and campers exposed to cold and wet conditions without limb water/windproof protection revealed experiences of muscle weakness and fatigue. It is reasonable to assume that a part of the fatigue could occur due to an alteration in substrate utilization, since reduction of performance in extreme cold conditions, may partially be explained by higher anaerobic glycolysis, reflecting higher carbohydrate oxidation and an increase accumulation rate of blood lactate. The aim of this study was to assess the effects of pre-exercise lower limb cooling on substrate utilization rate during sub-maximal exercise. Method: Six male university students (mean (SD): age, 21.3 (1.0) yr; maximal oxygen uptake (V0₂ max), 49.6 (3.6) ml.min⁻¹; and percentage of body fat, 13.6 (2.5) % were examined in random order after either 30min cold water (12°C) immersion utilized as the cooling strategy up to the gluteal fold, or under control conditions (no precooling), with tests separated by minimum of 7 days. Exercise consisted of 60min cycling at 50% V0₂ max, in a thermoneutral environment of 20°C. Subjects were also required to record a diet diary over the 24hrs prior to the each trial. Means (SD) for the three macronutrients during the 1 day prior to each trial (expressed as a percentage of total energy) 52 (3) % carbohydrate, 31 (4) % fat, and 17 (± 2) % protein. Results: The following responses to lower limb cooling relative to control trial during exercise were: 1) Carbohydrate (CHO) oxidation, and blood lactate (Bₗₐc) concentration were significantly higher (P < 0.05); 2) rectal temperature (Tᵣₑc) was significantly higher (P < 0.05), but skin temperature was significantly lower (P < 0.05); no significant differences were found in blood glucose (Bg), heart rate (HR) and oxygen consumption (V0₂). Discussion: These data suggested that lower limb cooling prior to submaximal exercise will shift metabolic processes from Fat oxidation to CHO oxidation. This shift from Fat to CHO oxidation will probably have important implications in the surviving scenario, since people facing accidental localized cooling of their limbs either through wading/falling in cold water or snow even if they do not perform high intensity activity, they have to rely on CHO availability.

Keywords: exercise in wet conditions, leg cooling, outdoors exercise, substrate utilization

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Authors: Christine P. Gibson, Ramona Alex, Michael Farney, Johana Vallejo-Elias, Mitra Esfandiarei

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Aortic aneurysm is the leading cause of death in Marfan syndrome (MFS), a connective tissue disorder caused by mutations in fibrillin-1 gene (FBN1). MFS aneurysm is characterized by weakening of the aortic wall due to elastin fibers fragmentation and disorganization. The above-average height and distinct physical features make young adults with MFS desirable candidates for competitive sports; but little is known about the exercise limit at which they will be at risk for aortic rupture. On the other hand, aerobic cardiovascular exercise has been shown to have protective effects on the heart and aorta. We have previously reported that mild aerobic exercise can delay the formation of aortic aneurysm in a mouse model of MFS. In this study, we aimed to investigate the effects of various levels of exercise intensity on the progression of aortic aneurysm in the mouse model. Starting at 4 weeks of age, we subjected control and MFS mice to different levels of exercise intensity (8m/min, 10m/min, 15m/min, and 20m/min, corresponding to 55%, 65%, 75%, and 85% of VO2 max, respectively) on a treadmill for 30 minutes per day, five days a week for the duration of the study. At 24 weeks of age, aortic tissue were isolated and subjected to structural and functional studies using histology and wire myography in order to evaluate the effects of different exercise routines on elastin fragmentation and organization and aortic wall elasticity/stiffness. Our data shows that exercise training at the intensity levels between 55%-75% significantly reduces elastin fragmentation and disorganization, with less recovery observed in 85% MFS group. The reversibility of elasticity was also significantly restored in MFS mice subjected to 55%-75% intensity; however, the recovery was less pronounced in MFS mice subjected to 85% intensity. Furthermore, our data shows that smooth muscle cells (SMCs) contractilion in response to vasoconstrictor agent phenylephrine (100nM) is significantly reduced in MFS aorta (54.84 ± 1.63 mN/mm2) as compared to control (95.85 ± 3.04 mN/mm2). At 55% of intensity, exercise did not rescue SMCs contraction (63.45 ± 1.70 mN/mm2), while at higher intensity levels, SMCs contraction in response to phenylephrine was restored to levels similar to control aorta [65% (81.88 ± 4.57 mN/mm2), 75% (86.22 ± 3.84 mN/mm2), and 85% (83.91 ± 5.42 mN/mm2)]. This study provides the first time evidence that high intensity exercise (e.g. 85%) may not provide the most beneficial effects on aortic function (vasoconstriction) and structure (elastin fragmentation, aortic wall elasticity) during the progression of aortic aneurysm in MFS mice. On the other hand, based on our observations, medium intensity exercise (e.g. 65%) seems to provide the utmost protective effects on aortic structure and function in MFS mice. These findings provide new insights into the potential capacity, in which MFS patients could participate in various aerobic exercise routines, especially in young adults affected by cardiovascular complications particularly aortic aneurysm. This work was funded by Midwestern University Research Fund.

Keywords: aerobic exercise, aortic aneurysm, aortic wall elasticity, elastin fragmentation, Marfan syndrome

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