Search results for: Ethnic background

Authors: Laila Salah Seada, Ashraf Ibrahim, Fawaz Al Rashid, Ihab Abdo, Hassan Kasim, Waleed Al Mansi, Saud Al Shabli

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Background and Objectives: Colorectal carcinoma is increasing among both men and women worldwide. It has a multifactorial etiology including genetic factors, environmental factors and inflammatory conditions of the digestive tract. A clinicopathologic assessment of colorectal carcinoma in Hail region is done, considering any changing patterns in two 5-year periods from 2005-2009 (A) and from 2012 to 2017 (B). All data had been retrieved from histopathology files of King Khalid Hospital, Hail. Results: During period (A), 75 cases were diagnosed as colorectal carcinoma. Male patients comprised 56/75 (74.7%) of the study, with a mean age of 58.4 (36-97), while females were 19/75 (25.3%) with a mean age of 50.3(30-85) and the difference was significant (p = 0.05). M:F ratio was 2.9:1. Most common histological type was adenocarcioma in 68/75 (90.7%) patients mostly well differentiated in 44/68 (64.7%). Mucinous neoplasms comprised only 7/75 (9.3%) of cases and tended to have a higher stage (p = 0.04). During period (B), 115 cases were diagnosed with an increase of 53.3% in number of cases than period (A). Male to female ratio also decreased to 1.35:1, females being 44.83% more affected. Adenocarcinoma remained the prevalent type (93.9%), while mucinous type was still rare (5.2%). No distal metastases found at time of presentation. Localization of tumors was rectosigmoid in group (A) in 41.4%, which increased to 56.6% in group (B), with an increase of 15.2%. Iliocecal location also decreased from 8% to 3.5%, being 56.25% less. Other proximal areas of the colon were decreased by 25.75%, from 53.9% in group (A) to 40% in group (B). Conclusion: Colorectal carcinoma in Hail region has increased by 53.3% in the past 5 years, with more females being diagnosed. Localization has also shifted distally by 15.2%. These findings are different from Western world patterns which experienced a decrease in incidence and proximal shift of the colon cancer localization. This might be due to better diagnostic tools, population awareness of the disease, as well as changing of life style and/or food habits in the region.

Keywords: Colorectal cancer, Hail Region, changing pattern, distal shift.

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Authors: Magda M. Mohsen, Manal E. Fareed

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Background: Widespread use of chemotherapeutic drugs in the treatment of cancer has lead to higher health hazards among employee who handle and administer such drugs, so nurses should know how to protect themselves, their patients and their work environment against toxic effects of chemotherapy. Aim of this study was carried out to examine the effect of chemotherapy safety protocol for oncology nurses on their protective measure practices. Design: A quasi experimental research design was utilized. Setting: The study was carried out in oncology department of Menoufia university hospital and Tanta oncology treatment center. Sample: A convenience sample of forty five nurses in Tanta oncology treatment center and eighteen nurses in Menoufiya oncology department. Tools: 1. an interviewing questionnaire that covering sociodemographic data, assessment of unit and nurses' knowledge about chemotherapy. II: Obeservational check list to assess nurses' actual practices of handling and adminestration of chemotherapy. A base line data were assessed before implementing Chemotherapy Safety protocol, then Chemotherapy Safety protocol was implemented, and after 2 monthes they were assessed again. Results: reveled that 88.9% of study group I and 55.6% of study group II improved to good total knowledge scores after educating on the safety protocol, also 95.6% of study group I and 88.9% of study group II had good total practice score after educating on the safety protocol. Moreover less than half of group I (44.4%) reported that heavy workload is the most barriers for them, while the majority of group II (94.4%) had many barriers for adhering to the safety protocol such as they didn’t know the protocol, the heavy work load and inadequate equipment. Conclusions: Safety protocol for Oncology Nurses seemed to have positive effect on improving nurses' knowledge and practice. Recommendation: chemotherapy safety protocol should be instituted for all oncology nurses who are working in any oncology unit and/ or center to enhance compliance, and this protocol should be done at frequent intervals.

Keywords: Chemotherapy Safety protocol, Effect, protective measure practice.

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Authors: Ahmed R. Z. Baghdadi, Amira A. A. Abdallah

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Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel un-satisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much.

Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA) and uni-compartmental knee arthroplasty (UKA) on dynamic balance, pain and functional performance following rehabilitation.

Methods: Fifteen patients with CRTKA (group I), fifteen with PSTKA (group II), fifteen with UKA (group III) and fifteen indicated for arthroplasty but weren’t operated on yet (group IV) participated in the study. The mean age was 54.53±3.44, 55.13±3.48, 52.8±1.93 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99, 35.6±1.88 and 35.73±1.03 kg/m² for group I, II, III and IV respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four and eight weeks pre- and post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1^st week), home-based (2^nd-4^th weeks), and outpatient clinic (5^th-8^th weeks) programs.

Results: The Mixed design MANOVA revealed that group III had significantly higher BBS scores, and lower pain scores and TUG and SC time than groups I and II four and eight weeks post-operatively. In addition, group I had significantly lower pain scores and SC time compared with group II eight weeks post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly eight weeks post-operatively compared with the three other assessments in group I, II and III with the opposite being true four weeks post-operatively.

Interpretation/Conclusion: CRTKA is preferable to PSTKA with UKA being generally superior to TKA, possibly due to the preserved human proprioceptors in the un-excised compartmental articular surface.

Keywords: Dynamic Balance, Functional Performance, Knee Arthroplasty, Pain.

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Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

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Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.

Keywords: Health care provider, hospital, weight management, weight control.

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Authors: Ticijana Prijon, Branko Ermenc

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Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall. An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: Aorta, blunt trauma, car accidents, morphology, risk factors.

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Authors: Wahyu Widowati, Hana Ratnawati, Tjandrawati Mozefis, Dwiyati Pujimulyani, Yelliantty Yelliantty

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Background: Atherosclerosis is the main cause of cardiovascular disease (CVD) with complex and multifactorial process including atherogenic lipoprotein, oxidized low density lipoprotein (LDL), endothelial dysfunction, plaque stability, vascular inflammation, thrombotic and fibrinolytic disorder, exercises and genetic factor Epidemiological studies have shown tea consumption inversely associated with the development and progression of atherosclerosis. The research objectives: to elucidate hypolipidemic, antioxidant effects, as well as ability to improve coronary artery’s histopathologyof black tea extract (BTE) and quercetin in atherosclerotic rats. Methods: The antioxidant activity was determined by using Superoxide Dismutase activity (SOD) of serum and lipid peroxidation product (Malondialdehyde) of plasma and lipid profile including cholesterol total, LDL, triglyceride (TG), High Density Lipoprotein (HDL) of atherosclerotic rats. Inducing atherosclerotic, rats were given cholesterol and cholic acid in feed during ten weeks until rats indicated atherosclerotic symptom with narrowed artery and foamy cells in the artery’s wall. After rats suffered atherosclerotic, the high cholesterol feed and cholic acid were stopped and rats were given BTE 450; 300; 150 mg/kg body weight (BW) daily, quercetin 15; 10; 5 mg/kg BW daily, compared to rats were given vitamin E 60 mg/kg/BW; simvastatin 2.7 mg/kg BW, probucol 30 mg/kg BW daily for 21 days (first treatment) and 42 days (second treatment), negative control (normal feed), positive control (atherosclerotic rats). Results: BTE and quercetin could lower cholesterol total, triglyceride, LDL MDA and increase HDL, SOD were comparable with simvastatin, probucol both for 21 days and 42 days treatment, as well to improve coronary arteries histopathology. Conclusions: BTE andquercetin have hypolipidemic and antioxidant effects, as well as improve coronary arteries histopathology in atherosclerotic rats.

Keywords: Black tea, quercetin, atherosclerosis, antioxidant, hypolipidemic, cardiovascular disease.

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Authors: Phusit Phukamchanoad, Chutchai Ditchareon, Suwaree Yordchim

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This research was to study on background and social and cultural context of Kamchanoad community for sustainable tourism management. All data was collected through in-depth interview with village headmen, community committees, teacher, monks, Kamchanoad forest field officers and respected senior citizen above 60 years old in the community who have lived there for more than 40 years. Altogether there were 30 participants for this research. After analyzing the data, content from interview and discussion, Kamchanoad has both high land and low land in the region as well as swamps that are very capable of freshwater animals’ conservation. Kamchanoad is also good for agriculture and animal farming. 80% of Kamchanoad’s land are forest, freshwater and rice farms. Kamchanoad was officially set up as community in 1994 as “Baan Nonmuang”. Inhabitants in Kamchanoad make a living by farming based on sufficiency economy. They have rice farm, eucalyptus farm, cassava farm and rubber tree farm. Local people in Kamchanoad still believe in the myth of Srisutto Naga. They are still religious and love to preserve their traditional way of life. In order to understand how to create successful tourism business in Kamchanoad, we have to study closely on local culture and traditions. Outstanding event in Kamchanoad is the worship of Grand Srisutto, which is on the fullmoon day of 6th month or Visakhabucha Day. Other big events are also celebration at the end of Buddhist lent, Naga firework, New Year celebration, Boon Mahachart, Songkran, Buddhist Lent, Boon Katin and Loy Kratong. Buddhism is the main religion in Kamchanoad. The promotion of tourism in Kamchanoad is expected to help spreading more income for this region. More infrastructures will be provided for local people as well as funding for youth support and people activities.

Keywords: Social and Culture Area, Tourism Management, Kamchanoad Community.

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Authors: Amira A. A. Abdallah, Amir A. Beltagi

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Background: Core stability training has recently attracted attention for improving muscle balance and optimizing performance in healthy and unhealthy individuals. Purpose: This study investigated the effect of beginner’s core stability exercises on trunk flexors’/extensors’ peak torque ratio and trunk flexors’ and extensors’ peak torques. Methods: Thirty five healthy individuals participated in the study. They were randomly assigned to two groups; experimental “group I, n=20” and control “group II, n=15”. Their mean age, weight and height were 20.7±2.4 vs. 20.3±0.61 years, 66.5±12.1 vs. 68.57±12.2 kg and 166.7±7.8 vs. 164.28 ±7.59 cm. for group I vs. group II. Data were collected using the Biodex Isokinetic system. The participants were tested twice; before and after a 6-week period during which group I performed a core stability training program. Results: The 2x2 Mixed Design ANOVA revealed that there were no significant differences (p>0.025) in the trunk flexors’/extensors’ peak torque ratio between the pre-test and post-test conditions for either group. Moreover, there were no significant differences (p>0.025) in the trunk flexion/extension ratios between both groups at either condition. However, the 2x2 Mixed Design MANOVA revealed significant increases (p<0.025) in the trunk flexors’ and extensors’ peak torques in the post-test condition compared with the pre-test in group I with no significant differences (p>0.025) in group II. Moreover, there was a significant increase (p<0.025) in the trunk flexors’ peak torque only in group I compared with group II in the post-test condition with no significant differences in the other conditions. Interpretation/Conclusion: The improvement in muscle performance indicated by the increase in the trunk flexors’ and extensors’ peak torques in the experimental group recommends including core stability training in the exercise programs that aim to improve muscle performance.

Keywords: Core Stability, Isokinetic, Trunk Muscles.

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Authors: Vinti Davar

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Background: Worldwide, at least 2.8 million people die each year as a result of being overweight or obese, and 35.8 million (2.3%) of global DALYs are caused by overweight or obesity. Obesity is acknowledged as one of the burning public health problems reducing life expectancy and quality of life. The body composition analysis of the university population is essential in assessing the nutritional status, as well as the risk of developing diseases associated with abnormal body fat content so as to make nutritional recommendations. Objectives: The main aim was to determine the prevalence of obesity and overweight in University students using Anthropometric analysis and BIA methods. Material and Methods: In this cross-sectional study, 283 university students participated. The body composition analysis was undertaken by using mainly: i) Anthropometric Measurement: Height, Weight, BMI, waist circumference, hip circumference and skin fold thickness, ii) Bio-electrical impedance was used for analysis of body fat mass, fat percent and visceral fat which was measured by Tanita SC-330P Professional Body Composition Analyzer. The data so collected were compiled in MS Excel and analyzed for males and females using SPSS 16. Results and Discussion: The mean age of the male (n= 153) studied subjects was 25.37 ±2.39 years and females (n=130) was 22.53 ±2.31. The data of BIA revealed very high mean fat per cent of the female subjects i.e. 30.3±6.5 per cent whereas mean fat per cent of the male subjects was 15.60±6.02 per cent indicating a normal body fat range. The findings showed high visceral fat of both males (12.92±3.02) and females (16.86±4.98). BMI, BF% and WHR were higher among females, and BMI was higher among males. The most evident correlation was verified between BF% and WHR for female students (r=0.902; p<0.001). The correlation of BFM and BF% with thickness of triceps, sub scapular and abdominal skin folds and BMI was significant (P<0.001). Conclusion: The studied data made it obvious that there is a need to initiate lifestyle changing strategies especially for adult females and encourage them to improve their dietary intake to prevent incidence of noncommunicable diseases due to obesity and high fat percentage.

Keywords: Anthropometry, bioelectrical impedance, body fat percentage, obesity.

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Authors: Mikael Soini, Kari Björn

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Metropolia University of Applied Sciences (MUAS) Information and Communication Technology (ICT) Degree Programme provides full-time Bachelor-level undergraduate studies. ICT Degree Programme has seven different major options; this paper focuses on Health Technology. In Health Technology, a significant curriculum change in 2014 enabled transition from fragmented curriculum including dozens of courses to a new integrated curriculum built around three 30 ECTS themes. This paper focuses especially on the second theme called Customer Oriented Software Applications. From students’ point of view, the goal of this theme is to get familiar with existing health related ICT solutions and systems, understand business around health technology, recognize social and healthcare operating principles and services, and identify customers and users and their special needs and perspectives. This also acts as a background for health related web application development. Built web application is tested, developed and evaluated with real users utilizing versatile user centred development methods. This paper presents experiences obtained from the first implementation of Customer Oriented Software Applications theme. Student feedback was gathered with two questionnaires, one in the middle of the theme and other at the end of the theme. Questionnaires had qualitative and quantitative parts. Similar questionnaire was implemented in the first theme; this paper evaluates how the theme-based integrated curriculum has progressed in Health Technology major by comparing results between theme 1 and 2. In general, students were satisfied for the implementation, timing and synchronization of the courses, and the amount of work. However there is still room for development. Student feedback and teachers’ observations have been and will be used to develop the content and operating principles of the themes and whole curriculum.

Keywords: Engineering education, integrated and theme-based curriculum, learning experience, student centred learning.

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Authors: Y. O’Connor, C. Heavin, S. O’ Connor, J. Gallagher, J. Wu, J. O’Donoghue

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Background: To improve the delivery of paediatric healthcare in low resource settings, Community Health Workers (CHW) have been provided with a paper-based set of protocols known as Community Case Management (CCM). Yet research has shown that CHW adherence to CCM guidelines is poor, ultimately impacting health service delivery. Digitising the CCM guidelines via mobile technology is argued in extant literature to improve CHW adherence. However, little research exist which outlines how (a) this process can be digitised and (b) adherence could be improved as a result. Aim: To explore how an electronic mobile version of CCM (eCCM) can overcome issues associated with the paper-based CCM protocol (inadequate adherence to guidelines) vis-à-vis service blueprinting. This service blueprint will outline how (a) the CCM process can be digitised using mobile Clinical Decision Support Systems software to support clinical decision-making and (b) adherence can be improved as a result. Method: Development of a single service blueprint for a standalone application which visually depicts the service processes (eCCM) when supporting the CHWs, using an application known as Supporting LIFE (SL eCCM app) as an exemplar. Results: A service blueprint is developed which illustrates how the SL eCCM app can be utilised by CHWs to assist with the delivery of healthcare services to children. Leveraging smartphone technologies can (a) provide CHWs with just-in-time data to assist with their decision making at the point-of-care and (b) improve CHW adherence to CCM guidelines. Conclusions: The development of the eCCM opens up opportunities for the CHWs to leverage the inherent benefit of mobile devices to assist them with health service delivery in rural settings. To ensure that benefits are achieved, it is imperative to comprehend the functionality and form of the eCCM service process. By creating such a service blueprint for an eCCM approach, CHWs are provided with a clear picture regarding the role of the eCCM solution, often resulting in buy-in from the end-users.

Keywords: Adherence, community health workers, developing countries, mobile clinical decision support systems, CDSS, service blueprint.

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Authors: Anna Pick Kiong Ling, Jia May Chin, Rhun Yian Koh, Ying Pei Wong

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Background: Uncontrolled inflammation may cause serious inflammatory diseases if left untreated. Non-steroidal anti-inflammatory drug (NSAIDs) is commonly used to inhibit pro-inflammatory enzymes, thus, reduce inflammation. However, long term administration of NSAIDs leads to various complications. Medicinal plants are getting more attention as it is believed to be more compatible with human body. One of them is a flavonoid-containing medicinal plants, Strobilanthes crispus which has been traditionally claimed to possess anti-inflammatory and antioxidant activities. Nevertheless, its anti-inflammatory activities are yet to be scientifically documented. Objectives: This study aimed to examine the anti-inflammatory activity of S. crispus by investigating its effects on intracellular oxidative stress and prostaglandin E₂ (PGE₂) levels. Materials and Methods: In this study, the Maximum Non-toxic Dose (MNTD) of methanol extract of both leaves and stems of S. crispus was first determined using 3-(4,5-dimethylthiazolyl-2)-2,5-diphenytetrazolium Bromide (MTT) assay. The effects of S. crispus extracts at MNTD and half MNTD (½MNTD) on intracellular ROS as well as PGE₂ levels in 1.0 µg/mL LPS-stimulated RAW 264.7 macrophages were then be measured using DCFH-DA and a competitive enzyme immunoassay kit, respectively. Results: The MNTD of leaf extract was determined as 700µg/mL while for stem was as low as 1.4µg/mL. When LPS-stimulated RAW 264.7 macrophages were subjected to the MNTD of S. crispus leaf extract, both intracellular ROS and PGE₂ levels were significantly reduced. In contrast, stem extract at both MNTD and ½MNTD did not significantly reduce the PGE₂ level, but significantly increased the intracellular ROS level. Conclusion: The methanol leaf extract of S. crispus may possess anti-inflammatory properties as it is able to significantly reduce the intracellular ROS and PGE₂ levels of LPS-stimulated cells. Nevertheless, further studies such as investigating the interleukin, nitric oxide and cytokine tumor necrosis factor-α (TNFα) levels has to be conducted to further confirm the anti-inflammatory properties of S. crispus.

Keywords: Anti-inflammatory, natural products, prostaglandin E2, reactive oxygen species.

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Authors: Benjamin Osei Tutu, Rita Asante, Emefa Atsu

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Background: An outbreak of gastroenteritis occurred in December 2019 after students of a Senior High School in Accra were served with kenkey and fish during their dinner. An investigation was conducted to characterize the affected people, the source of contamination, the etiologic food and agent. Methods: An epidemiological study was conducted with cases selected from the student population who were ill. Controls were selected from among students who also ate from the school canteen during dinner but were not ill. Food history of each case and control was taken to assess their exposure status. Epi Info 7 was used to analyze the data obtained from the outbreak. Attack rates and odds ratios were calculated to determine the risk of foodborne infection for each of the foods consumed by the population. The source of contamination of the foods was ascertained by conducting an environmental risk assessment at the school. Results: Data were obtained from 126 students, out of which 57 (45.2%) were cases and 69 (54.8%) were controls. The cases presented with symptoms such as diarrhea (85.96%), abdominal cramps (66.67%), vomiting (50.88%), headache (21.05%), fever (17.86%) and nausea (3.51%). The peak incubation period was 18 hours with a minimum and maximum incubation periods of 6 and 50 hours respectively. From the incubation period, duration of illness and the symptoms, non-typhoidal salmonellosis was suspected. Multivariate analysis indicated that the illness was associated with the consumption of the fried fish served, however this was statistically insignificant (AOR 3.1.00, P = 0.159). No stool, blood or food samples were available for organism isolation and confirmation of suspected etiologic agent. The environmental risk assessment indicated poor hand washing practices on the part of both the food handlers and students. Conclusion: The outbreak could probably be due to the consumption of the fried fish that might have been contaminated with Salmonella sp. as a result of poor hand washing practices in the school.

Keywords: Case control study, food poisoning, handwashing, Salmonella, school.

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Authors: James Patrick A. Diaz, Raul E. Ramboyong

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Background: Hypertensive response during maximal exercise test provides important information on the level of blood pressure control and evaluation of treatment. Method: A single center retrospective descriptive study was conducted among 117 young (aged 20 to 40) and middle age (aged 40 to 65) hypertensive patients, who underwent treadmill stress test. Currently on maintenance frontline medication either monotherapy (Angiotensin-converting enzyme inhibitor/Angiotensin receptor blocker [ACEi/ARB], Calcium channel blocker [CCB], Diuretic - Hydrochlorthiazide [HCTZ]) or combination therapy (ARB+CCB, ARB+HCTZ), who attained a maximal exercise on treadmill stress test (TMST) with hypertensive response (systolic blood pressure: male >210 mm Hg, female >190 mm Hg, diastolic blood pressure >100 mmHg, or increase of >10 mm Hg at any time during the test), on Bruce and Modified Bruce protocol. Exaggerated blood pressure response during exercise (systolic [SBP] and diastolic [DBP]), peak exercise blood pressure (SBP and DBP), recovery period (SBP and DBP) and test for ischemia and their antihypertensive medication/s were investigated. Analysis of variance and chi-square test were used for statistical analysis. Results: Hypertensive responses on maximal exercise test were seen mostly among female population (P < 0.000) and middle age (P < 0.000) patients. Exaggerated diastolic blood pressure responses were significantly lower in patients who were taking CCB (P < 0.004). A longer recovery period that showed a delayed decline in SBP was observed in patients taking ARB+HCTZ (P < 0.036). There were no significant differences in the level of exaggerated systolic blood pressure response and during peak exercise (both systolic and diastolic) in patients using either monotherapy or combination antihypertensives. Conclusion: Calcium channel blockers provided lower exaggerated diastolic BP response during maximal exercise test in hypertensive middle age patients. Patients on combination therapy using ARB+HCTZ exhibited a longer recovery period of systolic blood pressure.

Keywords: Antihypertensive, exercise test, hypertension, hypertensive response.

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Authors: Sheetal Sharma

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Urban planning is associated with land transformation from natural areas to modified and developed ones which leads to modification of natural environment. The basic knowledge of relationship between both should be ascertained before proceeding for the development of natural areas. Changes on land surface due to build up pavements, roads and similar land cover, affect surface water flow. There is a gap between urban planning and basic knowledge of hydrological processes which should be known to the planners. The paper aims to identify these variations in surface flow due to urbanization for a temporal scale of 40 years using Storm Water Management Mode (SWMM) and again correlating these findings with the urban planning guidelines in study area along with geological background to find out the suitable combinations of land cover, soil and guidelines. For the purpose of identifying the changes in surface flows, 19 catchments were identified with different geology and growth in 40 years facing different ground water levels fluctuations. The increasing built up, varying surface runoff are studied using Arc GIS and SWMM modeling, regression analysis for runoff. Resulting runoff for various land covers and soil groups with varying built up conditions were observed. The modeling procedures also included observations for varying precipitation and constant built up in all catchments. All these observations were combined for individual catchment and single regression curve was obtained for runoff. Thus, it was observed that alluvial with suitable land cover was better for infiltration and least generation of runoff but excess built up could not be sustained on alluvial soil. Similarly, basalt had least recharge and most runoff demanding maximum vegetation over it. Sandstone resulted in good recharging if planned with more open spaces and natural soils with intermittent vegetation. Hence, these observations made a keystone base for planners while planning various land uses on different soils. This paper contributes and provides a solution to basic knowledge gap, which urban planners face during development of natural surfaces.

Keywords: Runoff, built up, roughness, recharge, temporal changes.

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Authors: N. N. Mosola, S. J. Molete, L. S. Masoebe, M. Letsae

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Hand gesture recognition is a technique used to locate, detect, and recognize a hand gesture. Detection and recognition are concepts of Artificial Intelligence (AI). AI concepts are applicable in Human Computer Interaction (HCI), Expert systems (ES), etc. Hand gesture recognition can be used in sign language interpretation. Sign language is a visual communication tool. This tool is used mostly by deaf societies and those with speech disorder. Communication barriers exist when societies with speech disorder interact with others. This research aims to build a hand recognition system for Lesotho’s Sesotho and English language interpretation. The system will help to bridge the communication problems encountered by the mentioned societies. The system has various processing modules. The modules consist of a hand detection engine, image processing engine, feature extraction, and sign recognition. Detection is a process of identifying an object. The proposed system uses Canny pruning Haar and Haarcascade detection algorithms. Canny pruning implements the Canny edge detection. This is an optimal image processing algorithm. It is used to detect edges of an object. The system employs a skin detection algorithm. The skin detection performs background subtraction, computes the convex hull, and the centroid to assist in the detection process. Recognition is a process of gesture classification. Template matching classifies each hand gesture in real-time. The system was tested using various experiments. The results obtained show that time, distance, and light are factors that affect the rate of detection and ultimately recognition. Detection rate is directly proportional to the distance of the hand from the camera. Different lighting conditions were considered. The more the light intensity, the faster the detection rate. Based on the results obtained from this research, the applied methodologies are efficient and provide a plausible solution towards a light-weight, inexpensive system which can be used for sign language interpretation.

Keywords: Canny pruning, hand recognition, machine learning, skin tracking.

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Authors: Tingke Wu, Man Yuan

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“National Territorial Planning (2016-2030)” was issued by the State Council of China in 2017. As an important initiative of putting it into effect, territorial planning at provincial level makes overall arrangement of territorial development, resources and environment protection, comprehensive renovation and security system construction. Hubei province, as the pivot of the “Rise of Central China” national strategy, is now confronted with great opportunities and challenges in territorial development, protection, and renovation. Territorial spatial pattern experiences long time evolution, influenced by multiple internal and external driving forces. It is not clear what are the main causes of its formation and what are effective ways of optimizing it. By analyzing land use data in 2016, this paper reveals present status of territory in Hubei. Combined with economic and social data and construction information, driving forces of territorial spatial pattern are then analyzed. Research demonstrates that the three types of territorial space aggregate distinctively. The four aspects of driving forces include natural background which sets the stage for main functions, population and economic factors which generate agglomeration effect, transportation infrastructure construction which leads to axial expansion and significant provincial strategies which encourage the established path. On this basis, targeted strategies for optimizing territory spatial pattern are then put forward. Hierarchical protection pattern should be established based on development intensity control as respect for nature. By optimizing the layout of population and industry and improving the transportation network, polycentric network-based development pattern could be established. These findings provide basis for Hubei Territorial Planning, and reference for future territorial planning in other provinces.

Keywords: Driving forces, Hubei, optimizing strategies, spatial pattern, territory.

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Authors: Zahraa Albasry, Hadeel D. Najim, Anmar Al-Taie

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Background: Hypertension is considered as one of the most important causes of cardiovascular complications and one of the leading causes of worldwide mortality. Identifying the potential risk factors associated with this medical health problem plays an important role in minimizing its incidence and related complications. The objective of this study is to explore the prevalence of receptor sensitivity regarding assess and understand the perception of specific predictive confounding factors on the prevalence of hypertension (HT) among a sample of Iraqi population in Baghdad, Iraq. Materials and Methods: A randomized cross sectional study was carried out on 100 adult subjects during their visit to the outpatient clinic at a certain sector of Baghdad Province, Iraq. Demographic, clinical and health records alongside specific screening and laboratory tests of the participants were collected and analyzed to detect the potential of confounding factors on the prevalence of HT. Results: 63% of the study participants suffered from HT, most of them were female patients (P < 0.005). Patients aged between 41-50 years old significantly suffered from HT than other age groups (63.5%, P < 0.001). 88.9% of the participants were obese (P < 0.001) and 47.6% had diabetes with HT. Positive family history and sedentary lifestyle were significantly higher among all hypertensive groups (P < 0.05). High salt and fatty food intake was significantly found among patients suffered from isolated systolic hypertension (ISHT) (P < 0.05). A significant positive correlation between packed cell volume (PCV) and systolic blood pressure (SBP) (r = 0.353, P = 0.048) found among normotensive participants. Among hypertensive patients, a positive significant correlation found between triglycerides (TG) and both SBP (r = 0.484, P = 0.031) and diastolic blood pressure (DBP) (r = 0.463, P = 0.040), while low density lipoprotein-cholesterol (LDL-c) showed a positive significant correlation with DBP (r = 0.443, P = 0.021). Conclusion: The prevalence of HT among Iraqi populations is of major concern. Further consideration is required to detect the impact of potential risk factors and to minimize blood pressure (BP) elevation and reduce the risk of other cardiovascular complications later in life.

Keywords: Correlation, hypertension, Iraq, risk factors.

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Authors: Ahmed R. Z. Baghdadi, Mona H. Gamal Eldein

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Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel un-satisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much. Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA on dynamic balance, pain and functional performance following rehabilitation. Methods: Thirty patients with CRTKA (group I), thirty with PSTKA (group II) and fifteen indicated for arthroplasty but weren’t operated on yet (group III) participated in the study. The mean age was 54.53±3.44, 55.13±3.48 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99 and 35.73±1.03 kg/m2 for groups I, II and III respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks preand post-operatively, three, six and twelve months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs, follow-up to all groups for twelve months. Results: The Mixed design MANOVA revealed that group I had significantly lower pain scores and SC time compared with group II three, six and twelve months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly six months post-operatively compared with four weeks pre- and post-operatively and three months postoperatively in groups I and II with the opposite being true four weeks post-operatively. But no significant differences in BBS scores, pain scores and TUG and SC time between six and twelve months postoperatively in groups I and II. Interpretation/Conclusion: CRTKA is preferable to PSTKA, possibly due to the preserved human proprioceptors in the un-excised PCL.

Keywords: Dynamic Balance, Functional Performance, Knee Arthroplasty, Long-Term.

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Authors: Sadaf Moeez, Madiha Khalid, Zoya Khalid, Sania Shaheen, Sumbul Khalid

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Background: Inter-individual variation in response to metformin, which has been considered as a first line therapy for T2DM treatment is considerable. In the current study, it was aimed to investigate the impact of two genetic variants Leu125Phe (rs77474263) and Gly64Asp (rs77630697) in gene SLC47A1 on the clinical efficacy of metformin in T2DM Pakistani patients. Methods: The study included 800 T2DM patients (400 metformin responders and 400 metformin non-responders) along with 400 ethnically matched healthy individuals. The genotypes were determined by allele-specific polymerase chain reaction. In-silico analysis was done to confirm the effect of the two SNPs on the structure of genes. Association was statistically determined using SPSS software. Results: Minor allele frequency for rs77474263 and rs77630697 was 0.13 and 0.12. For SLC47A1 rs77474263 the homozygotes of one mutant allele ‘T’ (CT) of rs77474263 variant were fewer in metformin responders than metformin non-responders (29.2% vs. 35.5 %). Likewise, the efficacy was further reduced (7.2% vs. 4.0 %) in homozygotes of two copies of ‘T’ allele (TT). Remarkably, T2DM cases with two copies of allele ‘C’ (CC) had 2.11 times more probability to respond towards metformin monotherapy. For SLC47A1 rs77630697 the homozygotes of one mutant allele ‘A’ (GA) of rs77630697 variant were fewer in metformin responders than metformin non-responders (33.5% vs. 43.0 %). Likewise, the efficacy was further reduced (8.5% vs. 4.5%) in homozygotes of two copies of ‘A’ allele (AA). Remarkably, T2DM cases with two copies of allele ‘G’ (GG) had 2.41 times more probability to respond towards metformin monotherapy. In-silico analysis revealed that these two variants affect the structure and stability of their corresponding proteins. Conclusion: The present data suggest that SLC47A1 Leu125Phe (rs77474263) and Gly64Asp (rs77630697) polymorphisms were associated with the therapeutic response of metformin in T2DM patients of Pakistan.

Keywords: Diabetes, T2DM, SLC47A1, Pakistan, polymorphism.

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Authors: Benjamin Osei-Tutu, Henrietta Awewole Kolson

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Background: Acute gastroenteritis is one of the frequently reported Out-Patient Department (OPD) cases. However, the causative pathogens of these cases are rarely identified at the OPD due to delay in laboratory results or failure to obtain specimens before antibiotics is administered. Method: A retrospective review of surveillance data from the Adentan Municipality, Accra, Ghana that were recorded in the National foodborne disease surveillance system of Ghana, was conducted with the main aim of describing the epidemiology and food practice of cases reported from the Adentan Municipality. The study involved a retrospective review of surveillance data kept on patients who visited health facilities that are involved in foodborne disease surveillance in Ghana, from January 2015 to December 2016. Results: A total of 375 cases were reviewed and these were classified as viral hepatitis (hepatitis A and E), cholera (Vibrio cholerae), dysentery (Shigella sp.), typhoid fever (Salmonella sp.) or gastroenteritis. Cases recorded were all suspected case and the average cases recorded per week was 3. Typhoid fever and dysentery were the two main clinically diagnosed foodborne illnesses. The highest number of cases were observed during the late dry season (Feb to April), which marks the end of the dry season and the beginning of the rainy season. Relatively high number of cases was also observed during the late wet seasons (Jul to Oct) when the rainfall is the heaviest. Home-made food and street vended food were the major sources of suspected etiological food, recording 49.01% and 34.87% of the cases respectively. Conclusion: Majority of cases recorded were classified as gastroenteritis due to the absence of laboratory confirmation. Few cases were classified as typhoid fever and dysentery based on clinical symptoms presented. Patients reporting with foodborne diseases were found to consume home meal and street vended foods as their predominant source of food.

Keywords: Accra, etiologic food, food poisoning, gastroenteritis, illness, surveillance.

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Authors: K. Jafar, R. Nazar, A. Ishak, I. Pop

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The present analysis considers the steady stagnation point flow and heat transfer towards a permeable shrinking sheet in an upper-convected Maxwell (UCM) electrically conducting fluid, with a constant magnetic field applied in the transverse direction to flow and a local heat generation within the boundary layer, with a heat generation rate proportional to (T-T)^p Using a similarity transformation, the governing system of partial differential equations is first transformed into a system of ordinary differential equations, which is then solved numerically using a finite-difference scheme known as the Keller-box method. Numerical results are obtained for the flow and thermal fields for various values of the stretching/shrinking parameter λ, the magnetic parameter M, the elastic parameter K, the Prandtl number Pr, the suction parameter s, the heat generation parameter Q, and the exponent p. The results indicate the existence of dual solutions for the shrinking sheet up to a critical value λ_c whose value depends on the value of M, K, and s. In the presence of internal heat absorption (Q<0)  the surface heat transfer rate decreases with increasing p but increases with parameters Q and s when the sheet is either stretched or shrunk.

Keywords: Magnetohydrodynamic (MHD), boundary layer flow, UCM fluid, stagnation point, shrinking sheet.

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Authors: J. Bartnicka, J. A. Piedrabuena, R. Portilla, L. Moyano - Cuevas, J. B. Pagador, P. Augat, J. Tokarczyk, F. M. Sánchez Margallo

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Orthopaedic surgeries are characterized by a high degree of complexity. This is reflected by four main groups of resources: 1) surgical team which is consisted of people with different competencies, educational backgrounds and positions; 2) information and knowledge about medical and technical aspects of surgery; 3) medical equipment including surgical tools and materials; 4) space infrastructure which is important from an operating room layout point of view. These all components must be integrated and build a homogeneous organism for achieving an efficient and ergonomically correct surgical workflow. Taking this as a background, there was formulated a concept of international project, called “Online Vocational Training course on ergonomics for orthopaedic Minimally Invasive” (Train4OrthoMIS), which aim is to develop an e-learning tool available in 4 languages (English, Spanish, Polish and German). In the article, there is presented the first project research outcomes focused on three aspects: 1) ergonomic needs of surgeons who work in hospitals around different European countries, 2) the concept of structure of e-learning course, 3) the definition of tools and methods for knowledge assessment adjusted to users’ expectation.  The methodology was based on the expert panels and two types of surveys: 1) on training needs, 2) on evaluation and self-assessment preferences. The major findings of the study allowed describing the subjects of four training modules and learning sessions. According to peoples’ opinion there were defined most expected test methods which are single choice test and right after quizzes: “True or False” and “Link elements” The first project outcomes confirmed the necessity of creating a universal training tool for orthopaedic surgeons regardless of the country in which they work. Because of limited time that surgeons have, the e-learning course should be strictly adjusted to their expectation in order to be useful.

Keywords: International e-learning, ergonomics, orthopaedic surgery, Train4OrthoMIS.

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Authors: Tong-Hsien Chow

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Background: Plantar pressure measurement is an effective method for assessing plantar loading and can be applied to evaluating movement performance of the foot. The purpose of this study is to explore the sprint athletes’ plantar loading characteristics and pain profiles in static standing. Methods: Experiments were undertaken on 80 first-division college sprint athletes and 85 healthy non-sprinters. ‘JC Mat’, the optical plantar pressure measurement was applied to examining the differences between both groups in the arch index (AI), three regional and six distinct sub-regional plantar pressure distributions (PPD), and footprint characteristics. Pain assessment and self-reported health status in sprint athletes were examined for evaluating their common pain areas. Results: Findings from the control group, the males’ AI fell into the normal range. Yet, the females’ AI was classified as the high-arch type. AI values of the sprint group were found to be significantly lower than the control group. PPD were higher at the medial metatarsal bone of both feet and the lateral heel of the right foot in the sprint group, the males in particular, whereas lower at the medial and lateral longitudinal arches of both feet. Footprint characteristics tended to support the results of the AI and PPD, and this reflected the corresponding pressure profiles. For the sprint athletes, the lateral knee joint and biceps femoris were the most common musculoskeletal pains. Conclusions: The sprint athletes’ AI were generally classified as high arches, and that their PPD were categorized between the features of runners and high-arched runners. These findings also correspond to the profiles of patellofemoral pain syndrome (PFPS)-related plantar pressure. The pain profiles appeared to correspond to the symptoms of high-arched runners and PFPS. The findings reflected upon the possible link between high arches and PFPS. The correlation between high-arched runners and PFPS development is worth further studies.

Keywords: Sprint athletes, arch index, plantar pressure distributions, high arches, patellofemoral pain syndrome.

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Authors: Z. Goosen, E. J. Cilliers

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Social sustainability, as an independent perspective of sustainable development, has gained some acknowledgement, becoming an important aspect in sustainable urban planning internationally. However, limited research aiming at promoting social sustainability within urban areas exists within the South African context. This is mainly due to the different perspectives of sustainable development (e.g., Environmental, Economic, and Social) not being equally prioritized by policy makers and supported by implementation strategies, guidelines, and planning frameworks. The enhancement of social sustainability within urban areas relies on urban dweller satisfaction and the quality of urban life. Inclusive cities with high-quality public spaces are proposed within this research through implementing the third place theory. Third places are introduced as any place other than our homes (first place) and work (second place) and have become an integrated part of sustainable urban planning. As Third Places consist of every place 'in between', the approach has taken on a large role of the everyday life of city residents, and the importance of planning for such places can only be measured through identifying and highlighting the social sustainability benefits thereof. The aim of this research paper is to introduce third place planning within the urban area to ultimately enhance social sustainability. Selected background planning approaches influencing the planning of third places will briefly be touched on, as the focus will be placed on the social sustainability benefits provided through third place planning within an urban setting. The study will commence by defining and introducing the concept of third places within urban areas as well as a discussion on social sustainability, acting as one of the three perspectives of sustainable development. This will gain the researcher an improved understanding on social sustainability in order for the study to flow into an integrated discussion of the benefits Third places provide in terms of social sustainability and the impact it has on improved quality of life within urban areas. Finally, a visual case study comparison of local and international examples of third places identified will be illustrated. These international case studies will contribute towards the conclusion of this study where a local gap analysis will be formulated, based on local third place evidence and international best practices in order to formulate a strategic planning framework on improving social sustainability through third place planning within the local South African context.

Keywords: Planning benefits, social sustainability, third places, urban area.

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Authors: Rebecca E. Dalli Gonzi, Joseph Falzon

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Background: Islands in the Mediterranean region offer opportunities for various industries to take advantage of the facilitation and use of versatile floating structures in coastal areas. In the context of dense land use, marine structures can contribute to ensure both terrestrial and marine resource sustainability. Objective: The aim of this paper is to present and critically discuss an array of issues that characterize the design process of a floating structure for coastal areas and to present the challenges and opportunities of providing such multifunctional and versatile structures around the Maltese coastline. Research Design: A three-tier research design commenced with a systematic literature review. Semi-structured interviews with stakeholders including a naval architect, a marine engineer and civil designers were conducted. A second stage preceded a focus group with stakeholders in design and construction of marine lightweight structures. The three tier research design ensured triangulation of issues. All phases of the study were governed by research ethics. Findings: Findings were grouped into three main themes: excellence, impact and implementation. These included design considerations, applications and potential impacts on local industry. Literature for the design and construction of marine structures in the Maltese Islands presented multiple gaps in the application of marine structures for local industries. Weather conditions, depth of sea bed and wave actions presented limitations on the design capabilities of the structure. Conclusion: Water structures offer great potential and conclusions demonstrate the applicability of such designs for Maltese waters. There is still no such provision within Maltese coastal areas for multi-purpose use. The introduction of such facilities presents a range of benefits for visiting tourists and locals thereby offering wide range of services to tourism and marine industry. Costs for construction and adverse weather conditions were amongst the main limitations that shaped design capacities of the water structures.

Keywords: Coastal areas, lightweight, marine structure, multipurpose, versatile, floating device.

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Authors: E. Happ, A. Albert Tóth

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The aim of the research is to investigate the forms of the demands of leisure tourism in a West-Hungarian industrial city, Győr. Today, Győr is still a traditional industrial city, its industry is mainly based on vehicle industry, but the role of tourism is increasing in the life of the city as well. Because of the industrial nature and the strong economy of the city, the ratio of business tourists is high. It can be stated that MICE tourism is dominating in Győr. Developments of the last decade can help the city with new tourism products to increase the leisure tourism. The new types of tourism – besides business tourism – can help the providers to increase the occupancy rates and the demand at the weekends. The research demonstrates the theoretical background of the topic, and it shows the present situation of the tourism in Győr with secondary data. The secondary research contains statistical data from the Hungarian Statistical Office and the city council, and it is based on the providers’ data. The next part of the paper shows the potential types of leisure tourism with the help of primary research. The primary research contains the results of an online questionnaire with a sample of 1000 potential customers. It is completed with 10 in-depth interviews with tourism experts, who explained their opinions about the opportunities of leisure tourism in Győr from the providers’ side. The online questionnaire was filled out in spring 2017 by customers, who have already stayed in Győr or plan to visit the city. At the same time in-depth interviews were made with hotel managers, head of touristic institutions and employees at the council. Based on the research it can be stated that the touristic supply of Győr allows the increase of the leisure tourism ratio in the city. Primarily, the cultural and health tourism show potential development, but the supply side of touristic services can be developed in order to increase the number of guest nights. The tourism marketing needs to be strengthened in the city, and a distinctive marketing activity - from other cities - is needed as well. To conclude, although Győr is an industrial city, it has a transforming industrial part, and tourism is also strongly present in its economy. Besides the leading role of business tourism, different types of leisure tourism have the opportunity to take place in the city.

Keywords: Business Tourism, Győr, industrial city, leisure tourism, touristic demand.

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Authors: Panagiotis Platanitis

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Purpose: This research paper seeks to review the empirical studies in the field of expatriate adjustment in East Asia in order to produce a thematic understanding of the current adjustment challenges, thus enabling practitioners to enrich their knowledge. Background: Learning to live, work, and function in a country and culture vastly different from that of one’s upbringing can pose some unique challenges in terms of adaptation and adjustment. This has led to a growing body of research about the adjustment of expatriate workers. Adjustment itself has been posited as a three-dimensional construct; work adjustment, interaction adjustment and general or cultural adjustment. Methodology: This qualitative systematic review has been conducted on all identified peer-reviewed empirical studies related to expatriate adjustment in East Asia. Five electronic databases (PsychInfo, Emerald, Scopus, EBSCO and JSTOR) were searched to December 2015. Out of 625 identified records, thorough evaluation for eligibility resulted in 15 relevant studies being subjected to data analysis. The quality of the identified research was assessed according to the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. The data were analysed by means of thematic synthesis for systematic reviews of qualitative research. Findings: Data analysis revealed five key themes. The themes developed were: (1) personality traits (2) types of adjustment, (3) language, (4) culture and (5) coping strategies. Types of adjustment included subthemes such as: Interaction, general, work, psychological, sociocultural and cross-cultural adjustment. Conclusion: The present review supported previous literature on the different themes of adjustment and it takes the focus from work and general adjustment to the psychological challenges and it introduces the psychological adjustment. It also gives a different perspective about the use of cross-cultural training and the coping strategies expatriates use when they are abroad. This review helps counselling psychologists to understand the importance of a multicultural approach when working with expatriates and also to be aware of what expatriates might face when working and living in East Asia.

Keywords: Expatriates, adjustment, East Asia, counselling psychology.

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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, NF-κB, physical exercise.

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Authors: Lorho Mary Maheo, Arundhati Maibam Devi

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Background: Maternal and child health (MCH) cares are the health services provided to mothers and children. It includes the health promotion, preventive, curative and rehabilitation health care for mothers and children. Materials and method: The present study sample comprises of 208 women within the age range 15-69 years from two remote villages of Tamenglong District in Manipur. They were randomly chosen for assessing their health as well as the child’s health adopting an interview schedule method. Results: The findings of the study revealed that majority (80%) of the women have their first conception in their first year of married life. A decadal change has been observed with regard to the last pregnancy i.e., antenatal check-up, place of delivery as well as the service provider. However, irrespective of age of the women, home delivery is still preferred though very few are locally trained. Pre- and post-delivery resting period vary depending on the busy schedule of the agricultural works as the population under study is basically agriculturist. Postnatal care remains to be traditional as they are strongly associated with cultural beliefs and practices that continue to prevail in the studied community. Breast feeding practices such as colostrums given, initiation of breastfeeding, weaning was all taken into account.  Immunization of children has not reached the expected target owing to a variety of reasons. Maternal health care also includes use of birth control measures. The health status of women would invariably improve if family planning is meaningfully adopted. Only 10.1% of the women adopted the modern birth control implying its deep-rooted value attached to the children. Based on the self-assessment report on their health treatment a good number of the respondents resorted to self-medication even to the extent of buying allopathic medicine without a doctor’s prescription. One important finding from the study is the importance attributed to the traditional health care system which is easily affordable and accessible to the villagers. Conclusion: The overall condition of maternal and child care is way behind till now as no adequate/proper health services are available.

Keywords: Antenatal, breastfeeding, child health, maternal, Tamenglong District.

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