Shoulder pain is a serious clinical disease frequently related to absence from work. It’s characterized by pain and stiffness probably connected to the presence of an inflammatory substrate involving gleno-humeral capsule and collagen tissues. A physioterapy programme has shown to be effective for the conservative treatment of this disorder. Our aim is to assess if a manual treatment directed to fascial tissues could get better improvement regarding pain, strength, mobility and function. 94 healthcare workers with recurrent shoulder pain were recruited and then randomized in two groups: the control group (CG) underwent a physiotherapy programme; the study group (SG) underwent to 3 sessions of physiotherapy and to 2 session of Fascial Manipulation (FM) technique. At the end of the treatment phase, both groups improved every outcome. Despite few statistical differences between groups, at the follow up visit a greater percentage of subjects in SG overcame the minimal clinical important difference (MCID) in every outcome. We conclude that FM is effective for treatment of shoulder pain and further studies should better assess how to manage this treatment to get better results.

The clinical features of increasing muscle weakening are shared by a diverse set of illnesses known as muscular dystrophies. In early childhood, males with Duchenne muscular dystrophy (DMD) exhibit proximal muscle weakening and calf enlargement, making it the most frequent X-linked disease of muscular dystrophy in children. Development of motor skills is typically delayed, and wheelchair confinement eventually leads to early death from heart or lung problems. In terms of function, ambulation, quality of life, and life expectancy, treatment approaches like corticosteroid therapy and intermittent positive pressure breathing have improved. This is a case report of a 6-year-old kid who had early ambulatory stage Duchenne Muscular Dystrophy and complained to the neuro-physiotherapy department about frequent falls, walking difficulties, and dyspnea when walking. Other grievances included being unable to get off the ground and having trouble ascending stairs. He had physiotherapy and dynamic neuromuscular stabilization for his complaints. The main goals of treatment were educating the family, respiratory training, preventing ankle plantar flexors, maintaining strength, balance and gait training.

Introduction: Cleft lip with or without cleft palate (CL/P) is the most common congenital face anomaly in the world of multifactorial etiology. Objective: To determine the prevalence and characteristics of cleft palate. To identify associated risk factors to guide prevention and/or prenatal detection for early intervention and better health outcomes. To assess the rehabilitation protocols after operations in cleft palate. Design: Retrospective descriptive and clinical study. Patients: One hundred and three children with cleft palate treated in the Department of Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury, were included in the study. Methods: Records evaluation was conducted regarding sex, cleft type, mother occupation, parents education, histories of cleft in any of parents. The data were analyzed using R (R core team 2021) and the ordinal logistic regression analyses. Results: Children of stressed mothers during pregnancy had 9.4 times higher odds of having bilateral cleft. While there was no evidence that children sex, order of birth, and body mass as well as risk of maternal toxicity at work or reporting infections or drugs toxicity had a significant effect on the dependent variable. Conclusions: Children of parents with cleft history and having low educated mothers had higher probability of bilateral cleft palate. Children of stressed mothers during pregnancy had higher odds of having bilateral cleft. In literature, there is a lack of reports about rehabilitation in different operations methods in children with cleft palates.

This study evaluates the preparedness of Siloam Hospital Bali for medical tourism using Actor-Network Theory (ANT) to analyze human and non-human interactions within social networks. The objective is to identify factors influencing the hospital's readiness. Data was collected through interviews with hospital administration, specialized physicians, local officials, and tourism organization members, supplemented by document and archival research. Network visualization with GraphCommons.com revealed interaction patterns, key actors, and potential impediments. The results show that effective hospital administration, professional care by doctors, and cooperation with tourism groups and local authorities significantly impact the hospital's readiness. However, dependencies on core nodes, lack of redundancy, and underutilization of peripheral nodes are vulnerabilities. Recommendations include enhancing integration with peripheral nodes, establishing network redundancy, involving educational institutions, and aligning with international insurance and immigration policies. This study contributes to a comprehensive understanding of medical tourism dynamics and offers strategies to enhance Siloam Hospital's readiness.

This study checked whether vitamin D (Vit-D) supplementation improves the efficacy of resistance training (RT) in terms of increasing muscle strength and lean body mass (LBM) and influencing cardiorespiratory fitness (VO2max) in Vit-D insufficient middle-aged healthy men. Participants (n = 28) were quasi‐randomly assigned to one of the two groups, which, in a double‐blind manner, supplemented their diet daily with either Vit‐D (8000 IU; VD) or placebo (PLC) during participation in a 12‐week supervised RT program. During the intervention, serum Vit‐D concentrations increased 2.6‐fold (p < 0.001) in the VD group, while no changes occurred in the PLC group. Muscle strength gains (p < 0.001) as measured in seven exercises performed on RT equipment and increases (p < 0.001) in LBM were similar in the two groups. Total fat mass, percent total fat, and percent android fat decreased (p < 0.05) to a similar extent in both groups, but there was no change in VO2max in either group. In conclusion, in healthy Vit‐D insufficient middle-aged men engaged in resistance training, Vit‐D supplementation increases serum 25(OH)D levels but does not enhance gains in muscle strength and LBM or decreases in fat mass and fat percentage and does not affect cardiorespiratory fitness.

(1) Exoskeletons offer potential benefits for overhead working tasks, but gender effects or differences are unclear. This study aimed to compare the performance, strain, and comfort of men and women using an upper-body exoskeleton. (2) n=20 female and n=16 male participants performed an overhead drilling task with and without a passive upper-body exoskeleton in a randomized cross-over study. Task performance of different movement phases, perceived exertion, and ease of use were measured to compare gender differences. One and two-way analyses were used to com-pare genders in the different conditions. (3) Gender differences after controlling for BMI in task performance were found for error integrals (p <.001) with higher values in male participants. Moreover, there was a significant interaction effect for gender x exoskeleton use. While females showed performance decrements in aiming with exoskeleton use, the male's performance increased (p=.025). No other gender differences were observed. (4) Gender differences in task performance using an upper-body industrial exoskeleton were less detectable than expected after controlling for BMI, indicating that body composition and anthropometrics might be valuable indicators for per-formance including assisting devices. Moreover, future studies should also integrate the examina-tion of muscle activity to gain more insights into potential gender movement control patterns.

Shoulder tendinopathies produce pain and reduce functionality. The aim of this randomized clinical trial was to analyze the effects of Percutaneous electrolysis (PE), Percutaneous peripheral Nerve Stimulation (PNS) and eccentric exercise (EE), on pain (NPRS), strength, electromyographic activity, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and functionality (DASH and SPADI) on individuals with supraspinatus tendinopathy. Participants (n=50) were divided into two groups, they received 4 treatment sessions, one per week, of PE and PNS (n=25) or 10 treatment sessions of TENS and US (n=25). Both groups performed EE program consisted of 3 sets of 10 repetitions of each of the 3 exercises, twice a day, during the 4 weeks. Follow-up was carried out at 4, 12 and 24 weeks after the start of the intervention. There are statistically significant differences in the analysis between groups (p&lt;0.001) in the post-treatment and follow-up measurements favorable to the PE+PNS+EE treatment on pain (NPRS), strength, supraspinatus electromyographic amplitude, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and DASH and SPADI questionnaires. The combined treatment PE, PNS and EE is an effective option in the clinical management of tendinopathies, with positive results in the short and long term on the variables studied.

Antibiotic resistance is a global health problem. The human gut microbiome is implicated in the dynamics of antibiotic resistance acquisition and transmission, with the gut microbiota thought to play a crucial role. This study aimed to determine the potential influence of human gut bacteria microbiota on the gut resistome and the relationship between gut background microbiota and Escherichia coli resistome. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was used to systematically review studies that characterised gut microbiota and resistome using metagenomic analysis and/or those that reported gut E. coli resistome in healthy individuals. Changes in the diversity and abundance of bacterial gut microbiota and the resistome across different groups and the microbiota composition of the gut harbouring antibiotic-resistant E. coli were summarised. Findings suggest that lower bacterial microbiota diversity is likely associated with an increased abundance of the overall gut resistome. Age-related differences were observed, with younger infants exhibiting lower microbiota diversity and higher ARG abundance compared to older infants and adults. Studies that reported correlation revealed positive correlations between the compositional relative abundance of Proteobacteria and ARGs abundance, mainly driven by members within the Enterobacteriaceae family, particularly E. coli. This study also revealed that human gut microbiome studies that investigate gut resistome using metagenomic sequencing approaches in apparently healthy individuals are at least uncommon.

Irregular female migration to Europe is a growing phenomenon, as more and more women are fleeing their countries of origin due to gender inequality and violence. During the migration process, women experience physical, psychological and social problems that affect their sex lives. The aim of our study is to describe and understand how irregular migrant wom-en living in humanitarian reception centers experience their sexuality at different stages of the migration process. This qualitative phenomenological study collected data through a sixteen in-depth interviews with irregular migrant women between January and February 2023. Data anal-ysis was carried out using ATLAS-ti 23.0 software, from which three themes were extracted: 1) The sexual reality of sub-Saharan women, 2) In search of a better life: take the risk or surrender, and 3) The migrant sexual revolution. The sexual reality of sub-Saharan women is subject to a complex normative order. The migratory process has severe consequences on migrant women's sex life. The sexual needs of irregular migrant women admitted to humanitarian reception cen-ters undergo a process of change that must be understood by healthcare providers in order to make improvements to care provision.

In a world where physical activity and social participation are fundamental pillars for a full, healthy, and quality life, confidence in walking emerges as a fundamental aspect to be assessed, especially in older adults. The purpose of this study was therefore to develop a Portuguese (Euro-pean) version, linguistically and psychometrically adapted, of the Ambulatory Self-Confidence Questionnaire (ASCQ); A translation method was used followed by an assessment of its validity and reliability. The Portuguese version was completed by 173 older adults. To assess reliability was used Cronbach’s Alpha and Intraclass Correlation Coefficients (ICC). For sociodemographic and clinical characterization, as well as for the questionnaire scoring was used descriptive statistical analysis. Pearson's correlation (r), Student´s t-test and ANOVA were used to analyse the criterion and con-struction validity; The Portuguese interactions of ASCQ was effectively translated and adjusted, revealing exceptional internal consistency and test-retest reliability, as reflected in Cronbach's alpha and ICC values of 0.95. No Floor Effect was observed, however, a Celling Effect was identified (3.5%). Criterion and construct validity were verified because all the correlations established were statistically significant; The adaptation of the ASCQ to Portuguese culture is adequate, making it valid for use within the Portuguese population of Portugal.

Total hip arthroplasty (THA) is a preferred treatment for primary osteoarthritis (OA) or secondary due to developmental hip dysplasia (DDH). Gait analysis is considered a golden standard for evaluating post-arthroplasty walking patterns. This study compared post-THA spatiotemporal gait parameters (SGPs) between OA and DDH patients and explored correlations with demographic and clinical variables. Thirty patients (15 per group) were recorded during gait, and their SGPs were analyzed. Functionality was evaluated with the Oxford Hip Score (OHS). The OA patients were significantly older than DDH (pr< 0.51, all p< 0.05). The preoperative gait alterations associated with OA or DDH were improved to similar levels in both groups after THA. Post-arthroplasty SGPs and OHS correlations indicate limitations in certain activities. These find-ings must be correlated with kinetic gait analysis data to fully evaluate gait and functionality dif-ferences among patient groups.

Background: Shoulder pain is the third most common musculoskeletal issue in primary care, affecting up to 50% of patients six months post-consultation, leading to significant functional impairments and societal costs, especially due to sick leave. Shoulder injuries are particularly prevalent among 'overhead athletes' in sports like swimming, volleyball, and handball, with high injury rates reported annually. Screening tools like the Arm Care Screen (ACS) have been used to identify athletes at risk of shoulder injuries effectively. However, their applicability to the general population is less understood. This study aimed to assess the discriminant validity of a modified ACS (MACS) in detecting musculoskeletal risk factors among non-athletes. Methods: A prospective cross-sectional study was conducted with 30 asymptomatic subjects over 18, excluding those with a history of shoulder injuries or surgeries. The MACS, comprising four tests, was administered, and its diagnostic performance was evaluated through sensitivity, specificity, predictive values, and likelihood ratios. Results: Results indicated low sensitivity (0%-47.62%) and variable specificity (55.56%-100%), suggesting that MACS may not effectively identify risk factors in the general population. Positive and negative predictive values were inconsistent, highlighting the need for non-athlete-specific screening tools. Conclusion: While the MACS showed promise in athletes, its application in the general population requires further refinement. The study underscores the necessity for tailored screening methods to enhance early detection and prevention of musculoskeletal issues in diverse populations.

The growing global population and limitations in fish catch production have led to a surge in the demand for aquaculture. Contaminants of emerging concern (CEC) are frequently being detected at low levels in surface water. These CECs, which include previously unidentified or unregulated pollutants, pose potential risks to health and the environment, though their impacts are not yet fully understood. Extensive research studies have been proposed and undertaken to address the issue of aquaculture wastewater, aiming to minimize its impact and implement effective treatment methods. This review provides an analysis of various technologies used for treating aquaculture wastewater using advanced oxidation processes (AOPs) focusing on photocatalysis and ozonation. It examines their advantages and disadvantages, as well as their respective treatment efficacies and discusses their potential applications in sustainable aquaculture practices complying with the Sustainable Development Goals of 1,2 and 6 and the Environmental Social and Governance (ESG) framework.

Quality of life (QoL) focuses on a person’s ability to live a fulfilling life. In the elderly population, it helps in determining successful aging. Because of a scarcity of information regarding predictors of QoL in the elderly population in developing countries, this study was undertaken to assess the overall QoL and its predictors in the elderly population in an urban setting of Bangladesh. In this cross-sectional study, 275 participants were enrolled by systematic sampling at the outpatient department of a tertiary care hospital in Dhaka, Bangladesh. Data were collected by using a pretested semi-structured standard questionnaire for QoL (OPQOL-35). Pearson’s correlation was used to assess the association between QoL and sociodemographic factors. The Chi-square test was done for assessing the statistical significance between categorical variables. Multivariate linear regression was conducted to identify predictors of QoL, after controlling for potential confounders. The median age of the participants (n = 275) was 65 years (range, 60 to 85; 25th and 75th percentile, 60 and 68, respectively). The majority (78%) of them were married and 20% were widowed or divorced. The median score of QoL was 113 (25th and 75th percentile, 101 and 124, respectively). Most of the participants had a very poor (bad as can be) or poor (bad) QoL. Only 7.3% were observed to have “good” QoL (scores 140 or more). Females had significantly poorer QoL scores compared to males (p = 0.01). Educational status, marital status, body mass index and sleep duration significantly predicted QoL in a multiple regression analysis. In conclusion, the QoL of the elderly individuals in Bangladesh was very poor or poor. Future research should focus on service-oriented interventions, especially targeting women. Counseling of elderly people for enhancing their quality of life may include improving sleep patterns, healthy diets, regular exercise, and caring for their mental health.

Caudal regression syndrome (CRS) is a congenital abnormality characterized by an incomplete development of the spinal cord (SC) and other abnormalities. We studied a 9-months old CRS child presenting: interruption of SC at L2-L3 level, sacral agenesis, lack of innervation of the inferior limbs (flaccid paraplegia) and neurogenic bladder and bowel. Given the effects of growth hormone (GH) on the proliferation, differentiation and migration of neural stem cells (NSCs), we treated him with GH and rehabilitation, trying to induce the recovery of main sequelae. GMFM-88 test score was 12.31%. After a blood analysis, GH treatment (0.3 mg/day, 5 days/week, 3 months and then 15 days without GH) and rehabilitation commenced. This protocol was followed during 5 years, being the last GH dose 1 mg/day. Blood analysis and physical exams were performed every 3 months initially and every 6 months later. Six months after commencing the treatment GMFM-88 score increased to 39.48%. Responses to sensitive stimuli appeared in most of the territories explored; 18 months later sensitive innervation was complete and the patient moved any muscle over the knees and controlled his sphincters. Three years later he walked with the help of canes, there was plantar flexion and GMFM-88 score was 78.48%. In summary, GH plus rehabilitation may be useful for innervating distal territories, below the level of the incomplete spinal cord in CRS. Most likely, GH acts on ependymal SC NSCs, as the hormone does in the neurogenic niches in the brain.

The Gulf of Mannar, a UNESCO World Biosphere Reserve, faces severe overfishing and habitat degradation threats. In this study, we investigate the pivotal role of ecosystem services in sustaining local livelihoods and overall well-being. By conducting a comprehensive survey of 480 respondents across two districts, we gathered extensive data on demographics, livelihoods, fishing practices, reliance on ecosystem services, and community management participation. The analysis reveals a critical dependence on the Gulf's resources (income, food security, traditions) with gender disparities (men fish, women in pre/post-harvest), but fishing is only allowed in the 10km buffer zone (not the core zone). The findings emphasize the promise of community-based strategies, such as Marine Protected Areas and reviving co-management committees, for achieving sustainable fisheries management. However, we also identify gaps, including the need for more nuanced well-being indicators and improved models for community management participation. To address these challenges, we advocate for sustainable fishing practices, tackling social inequities, especially gender disparities in resource access and decision-making, and investing in healthcare, education, and social safety nets for fishing communities. Promoting alternative livelihoods can alleviate pressure on fish stocks, and empowering local communities through capacity building and community-based management initiatives is crucial for ensuring the long-term sustainability of both the Gulf of Mannar ecosystem and the well-being of its dependent communities. This multifaceted approach holds significant promise for balancing ecological health with human prosperity.

Sleep quality is known to affect automatic and executive brain functions such as gait control and cognitive processing. This study aimed to assess the effect of dual tasks on gait spatiotemporal parameters among young adults with good and poor sleep quality in the United Arab Emirates. In total, 65 young adults with a mean age of 21.1±2.5 were assessed for gait analysis during single-task and dual-task conditions. The participants’ sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and gait was assessed using the BTS Gaitlab System. The participants were asked to walk at natural speed as a single-task condition, followed by walking while performing a cognitive task as a dual-task condition. The parameters assessed included the gait velocity (m/s), cadence (steps/min), step width (m), and stride length (m). The DTC on each gait parameter was calculated. The Mann–Whitney U test was used to compare the differences in the DTC on gait variables between the good and poor sleep quality groups, and the Spearman correlation test was used to assess the correlation between total PSQI scores and the DTC. At a significance level of p&lt;0.05, a significant difference in cadence between the two sleep quality groups was observed, in addition to a positive correlation between sleep quality and the DTC effect on gait mean velocity, cadence, and stride length. Our findings also revealed a greater DTC on participants with poorer sleep quality. These findings contribute to our understanding of the significance of sleep quality in gait performance while multitasking in younger populations.

Active ageing is defined as the process of optimizing opportunities for physical, social and mental health to enable older people to take an active part in society without discrimination and to enjoy an independent and good quality of life. The World Health Organization assumed this as a process for increasing and maintaining an individual’s participation in activities to enhance his/her quality of life. In this survey, the authors addressed the following question: “Is assistive technology (AT) for mobility contributing to enhancement of lifelong capacity and performance?”. From June 2015 until February 2016, 96 community dwelling adults, AT users for mobility (powered wheelchairs, manual wheelchairs, lower limb prostheses, walkers, crutches and canes), aged 45-97, mean 67.02 +/- 14.24 years old, 56.3% female, were interviewed using the Psychosocial Impact of Assistive Devices Scale (P-PIADS), the Activities and Participation Profile related to Mobility (APPM) and demographics, clinical and questions about AT use and training. The participants’ profiles revealed moderate limitation and restrictions in participation, measured by the APPM (2.03). Most participants showed positive impact of AT; average scores obtained from the P-PIADS subscales were: Self-esteem 0.62, Competency 1.11 and Adaptability 1.10. P-PIADS total was 0.96, with the powered wheelchair users scoring the highest (1.53) and the walker users scoring the lowest (0.73). All subscales and P-PIADS total were positively correlated with the activities and participation profile. There was no relation between age and the psychosocial impact of AT or activities and participation profile. These results encourage the authors to follow these participants up for a lifelong intervention. To accomplish that aim, currently, the protocol is implemented at the AT prescribing centers in Coimbra, Portugal in order to assess the impact of AT on participation in society, one of the domains of the Active Ageing Index, a new analytical tool to help policy makers in developing policies for active and healthy ageing.

Abstract: Objective: The aim of the study was to identify dietary patterns and its association with socio-economic, dietary and lifestyle practices among adolescents in Malaysia. Methods: A validated food frequency questionnaire was used to assess dietary patterns. Results: Multivariate analyses show that age and physical activity (PA) levels were emerged as positive determinants of healthy-based food pattern in Malay (All, p<0.001), whereas higher consumption of eating-out from home (EatOut) and fast food (All, p<0.05) were negative determinants. High weekly breakfast skipping (p<0.001) and EatOut (p<0.01) were positively associated with a western-based pattern, whereas age (p<0.001) and household income (p<0.05) were negative determinants. Higher frequency of daily snacking (p<0.05) was emerged as positive determinant of local-based food pattern. For Chinese adolescents, age (p<0.001), PA levels (p<0.001) and maternal education level (p<0.05) emerged as positive determinants for the healthy-based pattern, whereas high EatOut and fast food intakes (All, p<0.01) were negative determinants. Higher weekly consumption of EatOut (p<0.01), fast food (p<0.05) and carbonated beverages (p<0.05), and daily snacking practice (p<0.01) were positively associated with higher western-based food pattern, whereas age (p<0.01) was inversely associated. Conclusion: These findings suggest that unhealthy dietary and lifestyle practices could increase the risk of adherence to unhealthy western-based food pattern that is high in fat, sugar and salt contents, and consequently increase the risk of developing obesity and metabolic-related disorders during these critical years of growth.

Suicide is a public health problem influenced by a variety of biological, psychological, social, and environmental factors. Recognizing the warning signs at each stage is crucial for prevention and helping those at risk. In this context, body awareness, especially interoceptive body awareness, emerges as a potentially relevant and underexplored factor. In this study, binary logistic regression and linear regression analyses were used to examine the relationship between interoceptive body awareness and suicidal orientation in Colombian university students. In addition, the bootstrap technique was used to resample and estimate the distribution of the data. The results support the idea that greater interoceptive awareness may protect against suicidal orientation by improving emotional regulation. An inverse relationship was found between interoceptive awareness and suicidal ideation. These findings are consistent with previous literature on the importance of body awareness for emotional well-being. Further longitudinal research is needed to explore this relationship in depth.

Noninvasive brain stimulation technique can be used for modulation of motor behaviors such as reaction time (RT). The main aim of this study was to investigate whether RT during a sequential visual isometric pinch task (SVIPT) can be affected by anodal transcranial direct current stimulation (a-tDCS) over three different stimulation sites such as dorsolateral prefrontal cortex (DLPFC), primary motor cortex (M1) or posterior parietal cortex (PPC). We also aimed to assess if stimulation of these cortical sites affect the transfer of learning during SVIPT. A total of 48 right-handed healthy participants were randomly assigned to one of the four a-tDCS groups: 1) left M1, 2) left DLPFC, 3) left PPC and 4) sham. A-tDCS was applied concurrent with SVIPT in which the participants were precisely controlled their forces to reach seven different target forces from 10 to 40% of maximum voluntary contraction (MVC) presenting on a computer screen with right dominant hand. Four test blocks were randomly performed at baseline and 15 min after the intervention including sequence and random blocks with either hand. Our results showed significant differences between a-tDCS groups on ratio RT in the sequence blocks of both the right trained (P = .041) and left untrained hands (P = .023) for target forces of 15% and 30 % of MVC, respectively. In sequence blocks, M1 showed significant elongation in ratio RT for the target force of 15% and 30 % MVC compared to PPC and Sham groups in the right hand. In sequence blocks with left hand, this negative effect were found between M1-DLPFC and M1-Sham groups. In random blocks, no significant differences were found among four groups at each target forces for the left hand while there were significant differences for 15% (P =. 04) and 40% MVC (P =. 035) in the right hand. Our findings suggest that three different stimulation sites (DLPFC, M1 or PPC) were differentially affected by a single session of a-tDCS at some target forces during SVIPT. The effects of a-tDCS on ratio RT were transferred in the left untrained hand for sequence blocks but not random blocks. Further research is needed to understand fundamental aspects of these main areas of the brain on temporal processing in a precision control task such as SVIPT.

Introduction: Low back pain (LBP) is the leading cause of lost productivity, absenteeism, disability, and early retirement worldwide. LBP treatment should be comprehensive, including prevention, education, diagnosis, and various treatment methods. Treatment can be divided into pharmacological and non-pharmacological. The role of physiotherapy in the comprehensive treatment of LBP is very important. Elastic therapeutic tape, also called kinesiology tape or therapeutic kinesiology tape, has been used for about 50 years. Purpose: The aim of this study was to evaluate the effectiveness of Kinesio taping in patients suffering from (LBP) and its possible effect on the swing of the center of pressure (COP), balance, gait, improvement of coordination, and pain reduction. Material and methods: A total of 60 patients aged 20 to 83 years (54% women) were examined, all of whom met the inclusion and exclusion criteria. In the experimental group, in addition to comprehensive rehabilitation, kinesiotaping of the L1-L5 spine was used. The control group underwent balance control training. The research tools used included the Bohannon single-leg standing test, the FAC scale - Functional Ambulatory Category, the Podsiadlo and Richardson Standing and Walking Test - Timed Up and Go (TUG), lumbar spine mobility assessment, Lasegue's sign and examination of neurological deficit symptoms. and self-assessment of pain using the Visual Analogue Scale (VAS). Results: Kinesio taping has a statistically significant effect on postural control, balance, gait, coordination, and pain. The main parameter with a statistically significant effect on the effects of Kinesio taping was age (below 55 years), which was also observed in the control group. Conclusions: Kinesio taping is an effective method in the treatment of LBP. It improves postural control, balance, gait, coordination, and pain.

Objectives: To assess the short-term impact of a single global stretching session on plantar pressures and lumbar range of motion (RoM) over one week in sedentary university students. Design: A randomised controlled trial with two parallel groups. Participants: Sixty-four university students were randomly assigned to a stretching group or control group. The stretching group received a single session of global stretching and the control group remained seated for the same length of time as the stretching session. Main outcome measures: Lumbar RoM and plantar pressures were assessed before, immediately after, 48 hours after, and 7 days after intervention. Results: Group-by-time interaction was significant for lumbar lateral flexion (p = 0.044), right maximal pressure (p = 0.003), left maximal pressure (p = 0.008), right mean pressure (p = 0.025), left mean pressure (p = 0.002), and maximal pressure minus mean pressure in right foot (p = 0.007). The model with plantar pressures showed a significant difference for group-by-time interaction (p = 0.010).Conclusion: Global stretching seems to counteract the ill-effects of prolonged sitting up to seven days with respect to plantar pressure in standing without improving lumbar ROM

Esophageal cancer (EC) is one of the most common malignant tumors worldwide, and its two major types, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC) present a severe global public health problem with an increasing incidence and mortality. Established risk factors include smoking, alcohol consumption, and dietary habits, but recent research highlights the substantial role of oral microbiota in EC pathogenesis. This review explores the intricate relationship between microbiome and esophageal carcinogenesis, focusing on eight significant mechanisms: chronic inflammation, microbial dysbiosis, production of carcinogenic metabolites, direct interaction with epithelial cells, epigenetic modifications, interaction with gastroesophageal reflux disease (GERD), metabolic changes, and angiogenesis. Certain harmful bacteria, such as Porphyromonas gingivalis and Fusobacterium nucleatum, are specifically implicated in sustaining irritation and tumor progression through pathways including NF-κB and NLRP3 inflammasome. Additionally, the review explores how microbial byproducts, including short-chain fatty acids (SCFAs) and reactive oxygen species (ROS), contribute to DNA harm and disease advancement. Furthermore, the impact of reflux on microbiota composition and its role in esophageal carcinogenesis is evaluated. By combining epidemiological data with mechanistic understanding, this review underscores the potential to target microbiota-immune system interplay for novel therapeutic and diagnostic strategies to prevent and treat esophageal cancer.

The importance of frailty in older people is getting constant recognition as an important aspect both in terms of public health, as well in personal level for the appropriate management of an older person health condition. This is reflected by the continuously increasing number of research studies carried out in several settings across different countries. Sometimes this is very solid, but in other cases there is a considerable gap in terms of accurate and well grounded documentation of frailty status. This is the case in Greece, where we are missing clinically validated tools to approach frailty. We are missing frailty screening tools, such as for instance PRISMA 7, the gold standard tool of Fried criteria is somehow problematic since the question referring to physical activity originates from a questionnaire that has not been translated and validated, while Clinical Frailty Scale has been validated for the translation but not for the capacity to detect frailty. Aim of this study is to validate these tools for their accuracy to detect frailty by using a measurable index of frailty, previously proposed for use in clinical studies: the Short Physical Performance Battery (SPPB). 74 male and female participants have been evaluated for their frailty status using different tools. We observed that PRISMA 7 translation detects frailty only when one question is removed at a cut-off of ≥ 2 and indicated a sensitivity of 88.1%, and specificity of 99.9% with a good correlation with SPPB measurements (r = 0.858; p &lt; 0.001). When CFS was validated using SPPB it demonstrated a very good correlation (r = -0.838; p &lt; 0.001 respectively) as it was the case for the modified Fried Criteria (r = -0.725; p &lt; 0.001). All items demonstrated a good correlation between them. We can here propose that we can accurately assess frailty status in the community setting by using a modified version of Fried criteria, Clinical Frailty Scale translation in Greek and we can screen for frailty by using the Greek translation of PRISMA 7 only after removing the item 6 of the questionnaire.

Feeling pain means feeling oneself, as the body feels discomfort as a kind of "disturbance experi-ence". Endometriosis is a disease in which the predominant symptom is pain felt by women pri-marily within the pelvis, but also outside of the body. The clinical biomarker used in the diagnosis of this disease is microRNAs. Treatment of endometriosis is complex and is based mainly on phar-macotherapy. Physiotherapy can complement pharmacological treatment in reducing pain using non-invasive treatments for the body. Therefore, databases have been searched to find the most effective forms of physiotherapy for the treatment of endometriosis. The literature review conducted here suggests that it is necessary to perform multicentre studies in order to establish which forms of physical therapy may be most effective in reducing pain and improving the quality of life of women suffering from endometriosis. Certainly, this type of research in conjunction with the assessment of pain and endometriosis markers would be of great clinical value in order to develop an interdisci-plinary treatment model.

There is an observed general low performance of Ethiopian Sport Governing Bodies (SGBs) in service delivery. Evidence shows that the trend can be corrected with proper understanding and insight into the process of organisational and management factors of these SGBs. This study aimed to investigate the contribution of organisational and management factors on effective sport service delivery in SGBs. For this study, a cross-sectional research design was employed. Purposive sampling was used to choose 350 samples. Pearson Product Moment Correlation Coefficient and multiple regression were used to analyse the data at the 0.05 significant level. The findings confirmed that organisational and management factor variables had a significant positive relationship with sport service delivery (organisational structure (r=0.515), organisational capabilities (r=0.701), communication (r=0.549), management practice (r=0.571), materials &amp; resources (r=0.527) and stakeholders satisfaction (r=0.742). In addition, Management factors were found to be significant contributors for predicting effective sport service delivery (F(3, 329)= 165.868, R2= 0.612). Furthermore, organisational factors had a joint significant contribution to effective sport service delivery (F(3, 329) = 148.743, R2= 0.576). In addition, organisational and management factor variables jointly best predicted effective sport service delivery in Ethiopian SGBs (F(6, 326) =130.81, R2= 0.707). Therefore, this study suggests organisational and management factor variables can be used to predict effective sport service delivery.

Aging causes various degenerative diseases in the older adult population. Senescence, a state of permanent cell-cycle arrest accompanied by the production of various pro-inflammatory factors known as senescence-associated secretory phenotype (SASP), is considered a significant contributor to the aging process and its chronic diseases. Ample evidence showed that various stressors could induce senescence, including DNA damage, telomere shortening and damage, activation of oncogenes, and mitochondrial dysfunction. Numerous credible findings indicate that environmental agents can induce senescence, including UV radiation, a high-fat diet, heavy metal exposure, and cigarette smoke. These findings posed the possibility that many more environmental agents may induce senescence and accelerate aging but remain unidentified. Senescence also becomes more intriguing due to its promising future as a pharmacological target to blunt the detrimental effects of aging and prevent aging-related diseases, either by eliminating the senescent cells or by controlling the SASP. On the other hand, investigating senescence has become more intricate due to the need for a multi-marker approach and translation in vivo analysis. This review will discuss senescence and its biomarkers, how to identify gerontogens in vivo, and also the development of senotherapy that targets senescent cells.

This case study explores the impact of moderate-intensity exercise on a 35-year-old male novice runner diagnosed with Crohn's Disease (CD). Initially, his symptoms were managed with probiotics and rifaximin, but he experienced a resurgence after a COVID-19 infection, leading to treatment with budesonide. Despite initial hesitation, the patient resumed moderate-intensity running (60-80% VO2 max) after achieving remission. His bowel function, energy levels, and overall well-being improved significantly with exercise. This case suggests that structured physical activity can be beneficial for managing CD and maintaining remission, even amidst fluctuating symptoms and inflammatory markers. It supports the idea that moderate-intensity exercise, when carefully managed, does not inherently worsen the condition and can enhance quality of life. These findings advocate for personalized exercise programs as part of CD management, though further research is needed to establish comprehensive guidelines and evaluate the long-term effects of different exercise intensities on Crohn's Disease.

Background: Recent studies have found forward head posture (FHP) to be associated with altered physiology, however, there is a lack of research into whether FHP is associated with altered gait parameters when cognitively challenged. The current study was undertaken to investigate the changes in gait parameters in asymptomatic individuals with FHP when a cognitive dual task is introduced during walking. Methods: Ninety asymptomatic participants were recruited, 45 having FHP defined as having a craniovertebral angle (CVA) &lt; 50, and 45 sex and age-matched controls having normal head posture (NHP) defined as CVA &gt; 55. All participants walked along a 10 meter platform under a control condition (no cognitive load) with 3 consecutive trials while an optical motion-capture system consisting of 8 infrared cameras was used to assess gait kinematics. Secondly, participants were assessed under a dual task cognitive load condition (3 trials while performing simple addition, counting backwards, and answering yes or no questions) to identify the impact on gait kinematics compared to the control condition. Results: Under the single task condition, there were no significant differences for any gait parameter, however, under the dual task condition, 12/13 gait parameters were significantly altered for the FHP group compared to the NHP group (p &lt; .01). A calculation of dual task cost (DTC) percentage showed significant increases in all gait parameters in participants with FHP (p &lt; .02). Correlations between the CVA and gait parameters were not significant for the single task condition, but all gait parameters were correlated to CVA for the dual task condition (p &lt; .01). The correlation between CVA and DTC for all gait variables were also significant (p &lt; .04). Conclusions: This study demonstrates that FHP significantly increases the cognitive cost during walking, highlighting the importance of proper postural alignment for maintaining cognitive function under a dual task condition. Addressing FHP through targeted interventions could improve both physical and cognitive health, enhancing overall well-being and daily functioning.

Background: Physiotherapy and chronic low back pain (CLBP) form a broad and fast developing research area. The aim of the article was to holistically, thematically and chronologically analyze and synthesise literature production and identify most prolific research entities and research themes. Methods: The article quantitatively and quantitatively analyzed research literature production harvested from the Scopus bibliometric database. using a triangulation of bibliometric and thematic analysis. For this, Excell and VOSwiever software were used. Results: In the Scopus database, 2843 data sources were found, which were published between 1974 and February 26, 2024. The growth trend has been linearly positive since the beginning of publication, and after 2018, exponential growth began. A review of the most prolific entities showed that the most literature was published in America, Europe and Australasia. The thematic analysis of the information sources identified six main themes, while the chronological analysis revealed three main areas of developments: assessment tools, CLBP processing and study methodology. Conclusions: The results of the bibliometric study presents a good starting point for further research providing Taxonomy and research landscapes as a holistic framework offering multidisciplinary knowledge about CLBP, while chronological analysis provides a basis for identifying prospective research trends.

This article uses strategy metaphors consisting of a plan, a home and a game to study government programme formation in Finland. The strategy approach both contradicts and complements the traditional political science approach to government formation. The government programme has been strategic in the sense of separating the formulation and implementation parts of the strategy. The most important function of the metaphor of plan is to hold coalition parties together. The adopted austerity policy provides a meagre contribution to the expansion of services and the increase in government spending. Consequently, the home metaphor in the government programme appears in the distant future and in combating external threats. The game metaphor is apparent in the goal of making contracts with social partners. The vocabulary change from politics to strategy alters the government programme’s position in terms of catering to the needs of civil servants, citizens and stakeholders. The strategy perspective might be instrumental in shifting open democratic debates to closed and secretive policy formations.

The aim of the study was to assess the impact of two lengths of Nordic walking (NW) training interventions combined with time restricted eating (TRE) on improving body composition parameters, lipid profile, and levels of selected adipokines in women with disrupted body mass. Overweight and obese women (n=55, age: 21-85) were recruited. Four groups were selected: 6 weeks (SG6, n=13) and 12 weeks intervention (SG12, n=13); and two control groups: CON6 (n=13); and CON12 (n=13). The training sessions took place 3 times a week (60 minutes each) and were conducted outdoor under the supervision of professional coach. The training intensity was determined individually. The extended NW program combined with TRE induced a significant weight reduction in SG12 by 1.96 kg (p=0.010) and fat tissue by 1.64 kg (p=0.05). The proposed interventions did not affect LBM, TBW [kg], VFA and lipid profile. The LDL/HDL ratio changed with small size effect. Leptin concentration differed between groups (p=0.006), but not over time. For resistin, the differentiating factor was time (p=0.019, with lower results observed after the intervention). The change in leptin concentration was negatively correlated with its baseline concentration. Extended to 12 weeks, this intervention allows for an improvement in body composition. Neither 6 nor 12 weeks of training and fasting affected the lipoprotein profile.

The issue of climate change represents a significant global risk that demands immediate attention. However, higher education frequently fails to incorporate global perspectives and intricate transdisciplinary matters. In order to integrate global and transdisciplinary aspects into the curriculum of a technical university with a focus on computer science, a Master's programme has been developed. The programme's objective is to situate global risk at the core of the curriculum, thereby encouraging scientists to work beyond the boundaries of their respective disciplines. The paper considers the challenges that science and higher education must address to facilitate pathways towards a peaceful and sustainable future. It argues for a shift in focus from short-term and localised issues to a more holistic approach, emphasising the importance of considering universal problems. The curriculum, as developed, may be regarded as a guide for future university efforts in the fields of global risk and climate change.

(1) Background: Breast cancer-associated lymphedema (BCRL) is a major complication of breast cancer treatment, affects the quality of life of breast cancer survivors who develop it. Manual lymphatic drainage has a beneficial result in combating lymphedema in patients who have undergone breast cancer surgery. The hypothesis consists in complete decongestive therapy reduces the lymphedema at the level of the upper limb on the side of mastectomy. (2) Methods: Twenty-five patients with radical mastectomy and upper limb lymphedema on the mastectomy side were included in this study. Upper limb circumferences were measured with a tape measure at the following levels: metacarpophalangeal joint; distal radioulnar joint; 10 cm distal to lateral epicondyle; 5 cm proximal to elbow joint; 10 cm proximal to lateral epicondyle. (3) Results: Patients received twice weekly manual lymphatic drainage, multi-layer compression bandaging and upper limb muscle stimulation exercises on the mastectomy side twice weekly. The circumference assessed at the level of the metacarpophalangeal joints and distal radio-carpal joint decreased at the final evaluation. Forearm perimetery - 5 and 10 cm distal to the lateral epicondyle the circumference decreased at the final assessment. (4) Conclusions: Patients with breast cancer-related lymphedema should receive comprehensive decongestive therapy in the early stage of lymphedema to achieve rapid clinical results and improved quality of life

The rapid acceleration of artificial intelligence (AI) has sparked extensive debate about its impact on the safety and security of society. While AI has shown trans- formative potential, particularly in areas such as healthcare and independent structures where it complements productivity and minimizes human error, accu- racy and protection. However, the misuse of artificial intelligence poses real risks, along with threats such as deep counterfeiting, computer cyber-attacks and the manipulation of social behavior through disinformation. These risks vary from privacy and cyber security breaches to moral dilemmas around liability. The unchecked improvement of AI is expected to threaten the social order, so the relationship between innovation and governance is essential so that AI-related threats do not overshadow its benefits. This article offers a detailed assessment and review of the literature that studies the potential dangers that AI poses to society. The cumulative effects underscore the urgent need for comprehensive regulatory frameworks to mitigate these threats.

The burden of hypertension remains unacceptably high globally, particularly in low- and middle-income countries (LMICs). Workplace offer enormous potential as an idea setting for early detection and treatment of hypertension among the working class. Analysis of such a Workplace Screening Programme can reveal information about its potential impact. Machine learning techniques such as k-Means Clustering are untapped tools for such analyses. We set out to deploy this tool for the analysis of our university annual medical screening of workforce for hypertension. An anonymized dataset containing the demography and blood pressure measurements values obtained from staffs of different departments/units in an academic institution was obtained. The total number of samples or data points are 1, 723 in which the input dataset contains six features, including year category (2018, 2019, 2021,2022), Department/Unit (academic and non-academic), gender (male and female), while the target output is the blood pressure status (low, normal and high) respectively. Analysis of the dataset was carried out using machine learning techniques. In this retrospective analysis, it was observed that the mean age for this working class is 42 years old. Similarly, it was discovered that hypertension was prevalent among members of staff above the age of 40 irrespective of their gender or professional category (academic or non-academic). The analysis also revealed that there was a steady decline in the prevalence of hypertension from 2018 to 2022. From the research, it is evident that the adoption of machine learning techniques for periodic analyses of workplace health status screening initiative (especially for hypertension) is effective, feasible, and sustainable to diagnose and control hypertension among the working class.

Abstract: Background: The optimal strategy for the microelimination of HCV within community settings remains ambiguous. We evaluated the percentage of participants who achieved linkage to care (LTC) following the conclusion of the screening campaign, and examined the diverse factors influencing LTC among these individuals. The effectiveness of recall intervention for the non-LTC population and its barriers were analyzed. Methods: We initiated an HCV patients recall program to identify the HCV participants who might not be treated after the HCV screening campaign. A program staff recalled HCV participants who lost to follow-up through the telephone from March 2019 to June 2019. They were informed of HCV treatment's importance, efficacy, availability, and safety. Result: Among 185 HCV-infected participants, 109 (58.9%) HCV-infected participants had obtained LTC. Compared with those who had LTC, those without LTC were older, lower education levels, were less aware of their HCV infection, less frequently lived in urban areas, and had less health insurance. At the end of the recall program, 125 (67.6 %) persons had liked to care. The proportion of LTC increased by 8.7 %. 119 persons had an HCV RNA test, and 82 (68.9%) had viremia. Of 82 patients with viremia, 78 (95.1%) received antiviral therapy. 76 (97.4 %) of them achieved a sustained virological response. Conclusion: After a community screening campaign, 59 % of participants with anti-HCV positive had LTC. The recall program can increase by 9 %. However, there were still 32% of HCV participants who couldn't be linked to care. Outreach care for non-LTC patients is a way worth trying to achieve micro-elimination of HCV in the rural community.

In Africa, the urban population and informal settlements are increasing, resulting in additional public health and environmental risks and challenges related to the need of basic and sustainable infrastructures and services. In Maputo, the capital of Mozambique, at least 80% of the city is composed of informal settlements, and although some areas are regularized and have approved urbanization plans, the municipality has major deficiencies in meeting current demands in terms of basic infrastructures, such as water supply, sewerage, solid wastes, energy, roads and communications. Most of the peri-urban areas is occupied with small but overcrowding houses, mostly self-built, served by unpaved roads, and with access limitations. The water network is almost non-existent, and the same occurs for stormwater drainage, sanitation, waste collection and public illumination. Despite the improvements made in the last few years, some households still do not have safe sanitation, and in some neighborhoods, open defecation still prevails. In this study, the authors try to understand and explore the interdependences among the infrastructures of the different sectors and how they may jointly contribute for adequate services and a better life of the urban poor, and how to identify the combination of infrastructures to be implemented at short term in face of the limited budgets for investments.

Current pharmacological treatments of Fibromyalgia (FM) are merely symptom palliative, as clinical trials have so far failed to provide overall benefits without associated harms. Polypharmacy often leads to patient´s health deterioration and chronic drug use to an eventual lack of patient´s response. Emerging evidence support that physiotherapy treatments based on mechanical triggers improve FM symptoms and therefore could be used for therapeutic purposes by themselves, or in combination with current pharmacological treatments, as part of integrative medicine programs. However, a paucity of studies rigorously and systematically evaluating this possibility exists. This study uses scores from validated standardized questionnaires, algometer pressure point threshold (PPT) readings and responses from a custom self-developed questionnaire to determine the impact of a pressure-controlled manual protocol on FM hyperalgesia/allodynia, fatigue and patient´s quality of life. The results show that patient´s baseline sensitivity to pain inversely correlates with treatment response in FM. Moreover, patients presenting comorbid ME/CFS do not seem to respond to the applied therapy as those presenting FM only. Thus, pre-treatment PPTs and ME/CFS comorbidity may serve as indicators to predict patient´s response to physiotherapy programs based on mechanical triggers, as the one evaluated here. These unexpected findings grant further explorations including the study of gene expression profiles associating to patient´s treatment response in the blood collection of samples generated by this study.

Interferon-gamma release assays (IGRAs) gained attention for diagnosing latent tuberculosis infection (LTBI) due to their higher specificity compared to the tuberculin skin test (TST). However, IGRA performance varied across different populations. This study evaluated the diagnostic performance of three IGRA assays (TBF-FIA, TBF-ELISA, and QFT-Plus) in Ghana, comparing them among individuals exposed and unexposed to MTB infection. Conducted in TB clinics across three regions, this prospective and cross-sectional study included healthy individuals with no known TB exposure (unexposed group) and patients with confirmed active TB (exposed group). Blood samples were tested using all three assays per manufacturers’ guidelines. The TBF-ELISA showed 3.4% higher sensitivity, but 4.6% lower specificity compared to QFT-Plus. The TBF-FIA had a sensitivity of 78.5%-87.3% and a specificity of 82.9%-90.0%. These findings indicated that while the three IGRA assays offered similar diagnostic accuracy, variations in specificity and limited data on point-of-care assays like TBF-FIA required further investigation.

Klippel-Feil disease is a condition characterized by a defect in the spine, consisting in the fusion or non-separation of two or more vertebrae of the cervical tract. It usually affects 1 every 50.000 newborns, and the pathogenesis remains unknown to date, although the role of certain genes deputed in segmentation processes is being studied. A single case of gene Myosin Heavy Chain 3 (MYH3) mutation is described by researchers. Affected patients are often characterized by a relatively short neck and, therefore, poor mobility, a low hairline and obesity and may have other health problems of different nature. The frequent presence of comorbidities worsens the quality of life of these young patients. The following case describes the synergistic effect of Incobotulinum toxin type A and physiotherapy in a small patient with MYH3 mutation-related Klippel-Feil Syndrome (KFS) complicated by bilateral paraplegia, to improve the spasticity condition of the lower limbs. To assess improvements over time, the patient underwent rating scales to determine spasticity (Modified Ashworth Scale: MAS), the neck’s range of motion (ROM), and muscle tone by using MyotonProÒ. Specifically, measurements were taken on the day of the first medical examination (T0), the month after the injection and the startup of therapeutic exercise (T1), at three months (T2), and then once a month for a total of 6 months (T3, T4 and T5). This therapeutic approach led to entirely satisfactory results with the child’s well-being, prolonged until the sixth month and with a total absence of any side effects.

Cysteamine HCl has been established as a potent ulcerogenic agent of the gastrointestinal (GI) system. GI dysfunction and olfactory deficits are the most common clinical symptoms of many movement disorders including Parkinson's disease (PD). Cysteamine HCl has been shown to interfere with dopamine, a neurotransmitter crucial for motor, olfactory, and cognitive functions. However, the reports on the effect of cysteamine HCl treatment on the behavior and dopamine system appear to be inconsistent. Therefore, we revisited the impact of cysteamine HCl on motor function in experimental mice using a battery of behavioral tests such as pole test (PT), beam walking test (BWT), and rotarod test (RDT), while the olfactory ability and cognitive functions were examined through food buried test (FBT) and Y maze. Furthermore, we investigated the effect of cysteamine HCl on the density of dopaminergic tyrosine hydroxylase (TH)-positive cells in the substantia nigra (SN) and olfactory bulb (OB) of experimental mice using immunohistochemistry. Results revealed that cysteamine HCl administration in mice induced significant impairments in motor balance and coordination, as their movement-related performance was markedly reduced in behavioral tasks. Mice exposed to cysteamine HCl showed a pronounced reduction in odor discrimination ability and cognitive impairments. Strikingly, the number of TH-positive neurons was found to be reduced in the SN and OB of the cysteamine HCl-treated group which is a bonafide neuropathogenic hallmark of PD. This study highlights the potential neurotoxic effects of cysteamine HCl in experimental brains and suggests further investigation into its role in pathogenesis of Parkinsonism.

Background: Empathy and assertiveness are two essential soft skills for health professionals such as nurses or physiotherapists. Both professions are characterised by their contribution to preserving and improving health and human care, and for their vocation of service. One of the achievements of the training is the voluntary, conscious, and individually inspired career choice; Objetives: This study aimed to evaluate the empathy, assertiveness, and care vocational levels among undergraduate students enrolled in the Nursing and Physiotherapy Degree programmes and to investigate the relationship between these soft skills and the care vocation; Methods: A cross-sectional study of nursing and physiotherapy students was conducted in the 2022/2023 academic year. The Interpersonal Reactivity Index scales for empathy, the Rathus test for assertiveness, and the “Vocation of Service for Human Care” questionnaire were used as study tools. Finally, 226 students participated in the study; Results: The empathy, assertiveness and vocation of service for human care of the students was found to be acceptable. Significant differences were also observed according to the gender variable or career in the students, with female students presenting better results in empathy subscales or vocation (p < 0.05). Students who are working or have clinical experience in other professions score lower on the empathy personal distress subscale (p < 0.05); Conclusions: Both nursing and physiotherapy students demonstrate satisfactory levels of empathy, assertiveness and vocation for human care. However, gender and previous work experience do notably influence these scores. It would be beneficial to conduct long-term studies with educational interventions to train and develop empathy, assertiveness and vocation for human care.

Abstract The aim of this research is to conduct a systematic review analysing the role of the physiotherapy interventions in palliative care. PRISMA as a critical appraisal tool was utilised for the selection of the research articles. The inclusion criteria were based on the year of publication, ease of availability, language, geographical location, and study type. To ensure the credibility, databases such as Elsevier, Proquest, and EBSCO Host were used to filter the grey content. Data published in the past ten years (2009-onwards) was only included to ensure the selection of the most recent interventions used by the physiotherapists. A total of 11 articles were selected which determined that physiotherapy interventions involving breathing exercises, aerobic exercises, manual therapies, and educational awareness were critical to promoting the functional capability and empower the patients.

Mental wellness can be related to healthier living, the learning process and working environments for people in the university community. A wide range of mental wellness programmes have been explored to provide students with pleasant and satisfying experiences. The purpose of this study is to explore the effects of integrating Zen meditation(禪)and music listening on the mindfulness and happiness levels of university music therapy students. Qualitative methodology was used, and data were collected through surveys and semi-structured interviews. To investigate various aspects of data regarding the role of meditation and music (MM) programme for mindfulness and happiness, this study used thematic analysis within a qualitative research design. The results of this study indicate that the 8-week MM programme is effective in enhancing mindfulness and happiness and has positive responses to daily life stress (e.g., exam anxiety, financial difficulties, and emotional distress during the COVID-19 pandemic). The role of meditation and music in promoting mental health and well-being has long been discussed and the combination of the two has been recognised as a beneficial intervention. This paper could contribute to the support of mental health resources and coping strategies in higher education, as well as expand the potential range of integrating practices involving music and meditation.

Sex differences in brain metabolism and their relationship to neurodegenerative diseases like Alzheimer's are an important emerging topic in neuroscience. Intrinsic anatomic and metabolic differences related to male and female physiology have been described, underscoring the importance of considering biological sex in studying brain metabolism and associated pathologies. The hippocampus is a key structure exhibiting sex differences in volume and connectivity. Adult neurogenesis in the dentate gyrus, dendritic spine density, and electrophysiological plasticity contribute to the hippocampus' remarkable plasticity. Glucose transporters GLUT3 and GLUT4 are expressed in human hippocampal neurons, with proper glucose metabolism being crucial for learning and memory. Sex hormones play a major role, with the aromatase enzyme that generates oestradiol increasing in neurons and astrocytes as an endogenous neuroprotective mechanism. Inhibition of aromatase increases gliosis and neurodegeneration after brain injury. Genetic variants of aromatase may confer higher Alzheimer's risk. Oestrogen replacement therapy in postmenopausal women prevents hippocampal hypometabolism and preserves memory. Insulin is also a key regulator of hippocampal glucose metabolism and cognitive processes. Dysregulation of the insulin-sensitive glucose transporter GLUT4 may explain the comorbidity between type II diabetes and Alzheimer's. GLUT4 colocalizes with the insulin-regulated aminopeptidase IRAP in neuronal vesicles, suggesting an activity-dependent glucose uptake mechanism. Sex differences in brain metabolism are an important factor in understanding neurodegenerative diseases and future research must elucidate the underlying mechanisms and potential therapeutic implications of these differences.

This document outlines best practice recommendations for an acute care physiotherapy for patients with COVID-19, with an emphasis on critical care rehabilitation including the patients in extra corporeal membrane Oxygenation (ECMO) support, developed for practice in Qatar but adaptable within any settings. This recommendation is the result of a combination of systematic evidence search, subsequent critical evaluation of retrieved evidence and consensus process. The agreed recommendations were integrated into a physiotherapy clinical reasoning algorithm. It includes recommendations on physiotherapy referral, screening, management categories and best practice recommendations. It is intended for use by physiotherapists and other relevant stakeholders in the acute care setting caring for adult patients with suspected and/or confirmed COVID-19.

The objective of this paper is to analyze students’ assessments of the attainment of skills acquired by university graduates enrolled in a Training Programme (TP) to develop entrepreneurial skills and transversal employability competencies. Both of which are vital for the success of today's societies and play an important role in the sustainable development agenda. The TP was a twelve-week programme with six modules combining entrepreneurship training and traditional teaching methods. There were nine editions and 148 students worked in teams preparing business plans to present to consultants and potential investors. The Focal Group method was used to identify competencies and a survey was designed to identify the level to which skills were attained. The results suggest that the students attained both types of skills, acquiring a higher level of proficiency in entrepreneurial skills and those transversal competencies most connected to entrepreneurship. Additionally, different levels of attainment of entrepreneurial skills were found in different groups. We provide new evidence that TPs, as compulsory subjects in the core curriculum of degree programmes, will help accomplish both objectives: the acquisition of entrepreneurial skills and generic university educational competencies. The overall outcome of this research highlights the value added by the TPs.

Geoethics is a field of knowledge currently in full development. Researchers in geoethics are pri-marily concerned with the anthropogenic interaction with the Earth system. Due to its nature, ge-oethics holds particular importance in sustainable development due to its nature as it aims to promote ethical human behaviour that does not negatively impact the Earth system. In the present research, we implemented an intervention program addressing various issues related to the sus-tainability of the Earth system, such as the exploitation of geological resources, the management of geological risks, and the conservation and promotion of geopatrimony. The intervention program was applied to higher education students in the geosciences field. A sample of 90 students from various geosciences courses completed an initial questionnaire, revealing limited knowledge about geoethics. This study resorted to mixed-method research involving interviews with some students who volunteered (n=52). The results showed that after applying the intervention programme most students had developed a deeper understanding of the topics addressed and recognised the con-tributions this scientific area can make to sustainable development. Additional research in geoethics education is essential to foster the integration of geoethics into the curricula of higher education institutions.

Through an ambitious development blueprint called Agenda 2063, Africa is on a mission to creating the ‘Africa We Want’ by the year 2063, centred on science, technology, and innovation. While the 2063 development agenda portends attainment of socio-economic development and prosperity in Africa, it brings with it an enormous need for strategic investment in research to ensure that no one is left behind. This paper presents insights from the African Research Initiative for Scientific Excellence (ARISE) programme on inclusive research capacity strengthening investment in Africa. The insights are drawn from a comprehensive candidate selection process for ARISE, from which 45 researchers (from a pool of 929 applicants) are recruited for ARISE Fellowships. The 45 early-to-mid-career researchers, 37% of which are women, are hosted in 45 institutions of higher learning located in 38 countries across Africa, conducting 5-year research fellowships with grants of up to €500,000 each. The insights from the ARISE programme contribute to the debate on effective approaches to programme scoping, design, and delivery, underscoring the need for consideration of scientific excellence in the context of diversity in research support capacity and investments across Africa.

Background: Anxiety disorders can be both an independent risk factor of many somatic conditions and the cause of complications of various organic disorders leading to poor prognosis. Objectives: The purpose of this study is to compare the heart rate variability (HRV) recorded both during the day and at night in patients with anxiety disorders and healthy individuals. Methods: The study was conducted on fifty consecutive outpatients with anxiety disorders who participated in intensive group psychotherapy. The diagnosis was made according to DSM-IV-TR criteria using the PSE-10 questionnaire. Out of 50 patients under study, 17 were diagnosed with panic disorder (PD) and 21 with generalized anxiety disorder (GAD). The control group consisted of 40 healthy people. The resulting three groups were compared in terms of circadian HRV using the Oxford Medilog Suprima Holter System. Results: The HRV analysis showed the nocturnal falls in the time and frequency parameters related to parasympathetic activity (rMSSD, pNN50, HF). The most unfavourable alterations were observed in the PD group, which comprised the disappearance of day vs. night amplitude of the majority of HRV parameters. Hence, the PD group was particularly susceptible to the arrhythmic events. It was noticeable that nocturnal vagotonia in the PD group was significantly lower as compared with the GAD and control group. Conclusions: The innovative aspect of the present study was to find a distinct profile of HRV with regard to the types of anxiety disorders because of the existing considerable differences between the nature of PD and GAD.

A 5.1 kg, 7-year-old, castrated Maltese dog with a tibial plateau-leveling osteotomy (TPLO) in the right hindlimb 42 days prior to presentation. The patient’s right hind limb showed lameness, intermittent limping, and atrophy, and had never experienced rehabilitation since TPLO surgery. The patient showed a pain reaction at the end of the stifle extension, and an increased body temperature was identified on the medial side of the right hindlimb compared with the left hindlimb using a digital thermal imaging device. In addition, a type of lameness, partial weight bearing in the right hindlimb, was also identified in the gait analysis. The pain was relieved by applying a cold pack and transcutaneous electrical nerve stimulation and the patient was trained on muscles that were atrophied during treadmill exercise. In this study, physical therapy and rehabilitation exercises controlled pain and induced rapid recovery, indicating that rehabilitative intervention is required after TPLO surgery.

Background: COVID-19 pneumonia caused by SARS-Cov-2 virus induces alveolar collapse and hypoxia that may become severe. The aim of the study is to analyze the effects of chest physiotherapy using a threshold valve in patients with acute respiratory failure due to COVID-19 pneumonia. Methods; Retrospective observational study, in hospitalized patients from March to May 2020. Breathing exercises were performed with a threshold valve of 10 cmH2O. Fraction of inspired oxygen, oxygen saturation, heart rate, respiratory rate and dyspnea were collected before and after the first session and at the end of the 5th day of chest physiotherapy treatment. Results: The final sample included 125 patients. Significant differences (p&lt;0.01) were found in the pre-post intervention SpO2/FiO2 ratio (250±88.4 vs 275.6±97.5, p&lt;0.001), reaching 354.4±110.2 after 5 days of therapy (p&lt;0.001 with respect to baseline). Mean baseline respiratory, heart rate and level of dyspnea measure by the Borg scale did not change during the technique performance. In patient maneuvers with FiO2&gt;0.4, the SaO2/FiO2 ratio increase was higher than in patients with milder severity (46.85 ± 77.69, p&lt;0.01). Conclusions: Chest physiotherapy with a 10 cmH2O threshold valve is a safe and tolerated intervention with short-term improvement in oxygenation in patients with COVID-19 pneumonia.

Background: The practices of various health-care professionals have been improvised to accommodate the on-going covid-19 pandemic situation. Different guidelines have been set in place to ease the process of re-opening of non-elective healthcare services like out-patient physiotherapy clinics. Although the measures taken should be guided by evidence based information, major consensus amongst practicing therapists needs to guide the India physiotherapy clinics. Objective: To identify and present the opinions of different physiotherapists about the various strategies for re-opening the out-patient physiotherapy clinics. Methods: An online cross-sectional survey was conducted. Over 169 participants were selected to participate in the survey according to the pre-decided inclusion and exclusion criteria. The data was collected and saved via google forms. Result and conclusion: A majority of respondents had a consensus over different strategies for re-opening the physiotherapy OPDs. These were regarding different measures to be adapted including modifications in the clinic infrastructure and the practice pattern. This would help in smoothly re-instating the physiotherapy services post the covid-19 lockdown.

Given the increased provision of international exchange programmes in higher education, this paper examines students’ perceptions of their learning process in one Erasmus+ programme in Food Innovation and Product Design. Using evaluation model of international exchange programme and triple helix model as the analytical framework, students’ testimonials from 2015–2021 were analysed using a critical discourse analysis. EU and non-EU students had similar perceptions of learning outcomes related to knowledge of the food innovation industry, but non-EU students had a stronger sense of awareness of both the international context and multicultural interaction.

This study documented the experiences of health system personnel in the implementation of mass distribution campaigns for the control of Lymphatic Filariasis in rural Guinea. This was an exploratory qualitative study using data collected from implementing actors of mass distribution campaigns in the Boké health district. Results showed four main facilitators of mass distribution campaigns rollout in Boké health district: i) support to the district teams in the organization of the campaigns; ii) involvement of community-based associations in social mobilization; iii) strong adherence of the communities to the different mass distribution campaigns, facilitated through the involvement of community relays, who are members of these communities, in the distribution of drugs; and iv) transparency in the allocation of incentives to drug dispensers and supervisors. However, the frequent shortages of medicines, the difficulties of access to rural areas and the lack of logistical means for the su-pervision of activities were the main obstacles to the success of the various mass distribution campaigns in Boké. The provision of buffer stocks for special areas such as Boké by national program actors and partners, joint planning of campaign activities with local managers of health systems and services, and improvement of existing mechanisms for motivating health workers, including community health workers, during future campaigns should help to achieve national objectives in the fight against NTDs in Guinea.

Knee Osteoarthritis (KOA), the most common knee degenerative disease, involve a slow destructive process, leading to disability and ultimately total knee replacement. The progression of KOA is related to the loss of rheological properties of the synovial fluid (SF), due to slow immunological, inflammatory and enzymatic processes that cleave the hyaluronic acid (HA) and decrease the concentration of specific proteins. Since no effective treatments have been found to halt the progression of KOA, injection of HA-based viscoelastic gels combined with physiotherapy (PT) is an alternative to symptomatic therapies. In order to evaluate the effect of viscosupplementation and PT on the SF characteristics, the SF aspirated from the KOA was spectrophotometrically and rheological analyzed, comparing the receiving groups of HA Kombihylan® and groups that received Kombihylan® and complex PT. In patients treated with PT, SF extracted 6 weeks after viscosupplementation had a superior elastic moduli (G') and viscous moduli (G") profile behavior, having a homogeneous distribution of proteins and polysaccharides in the SF, stimulating stronger interactions. In the absence of PT the G' and G" profiles are non-uniform, suggesting an unorganized supplemented SF with some clustering phenomena, proteins aggregation and a low level of entanglement between HA and macromolecular components in the SF.

This study empirically investigates the effect of productive safety net programme (PSNP) on household food consumption and dietary diversity in Ethiopia. The study applied random effects with instrumental variable to estimate the effect of PSNP membership. The result of the study indicates that though PSNP membership improves household food consumption, it reduces household dietary diversity score. Household food consumption and dietary diversity are also significantly influenced by sex, age, education status of household head, household size, livestock ownership, distance to the nearest market and participation in non-farm activities. The findings of this study suggest that PSNP membership should be reinforced by building household awareness of the benefits of consuming a variety of foods. In addition, PSNP membership should be designed to endow the households to accumulate essential assets, especially livestock.

Residential burns camp programmes provide help and support to children with burn injuries by providing activities designed to build their confidence and self-esteem. Our regional burns service has been running camps for over 20 years and evaluation is an important part of assessing their effectiveness. In this study we report both qualitative and quantitative data from 10 consecutive years of burns camps. Qualitative feedback was gathered using Likert scales and free response questionnaires at the end of camp and six weeks post-camp. Three quantitative outcome measures, the Paediatric Quality of Life Inventory v4, the Children’s Revised Impact of Event Scale (CRIES8) and the Satisfaction with Appearance Scale (SWAP) were completed before and six weeks after camp. Children and their parents/carers both reported attending burns camp was helpful for them/their child; the themes of meeting other children with burn injuries and developing confidence and self-esteem were cited as reasons. Parents/carers also reported significant improvements in their child’s physical and psychological functioning post-camp in some years. These findings confirm the importance of providing burns camp programmes for children with burn injuries as part of their post burn rehabilitation.

The NA61/SHINE experiment studies hadron production in hadron-hadron, hadron-nucleus and nucleus-nucleus collisions. The physics programme includes the study of the onset of deconfinement and search for the critical point as well as reference measurements for neutrino and cosmic ray experiments. For strong interactions, future plans are to extend the programme of study of the onset of deconfinement by measurements of open-charm and possibly other short-lived, exotic particle production in nucleus-nucleus collisions. This new programme is planned to start after 2020 and requires upgrades to the present NA61/SHINE detector setup. Besides the construction of a large acceptance silicon detector, a 10-fold increase of the event recording rate is foreseen, which will necessitate a general upgrade of most detectors.

The governance of public sector infrastructure projects became an important topic of interest in the project, programme and portfolio management literature during the last decade. Today, it is becoming a central focus for policymakers seeking to ensure success in selecting, designing and implementing government-sponsored programme of multi-projects. Due to the multiple underlying risks and complexities, the governance of infrastructure programme constitutes a critical element in strategic planning in developing countries. This paper has analyzed infrastructure development programme and revealed shortcomings in the areas of appraisal, decision-making, quality assurance and stakeholder management. Approaches to remedy these shortcomings have been proposed.

Background:Almost the entire country of Burkina Faso was endemic to onchocerciasis. Onchocerciasis control efforts thus brought the prevalence of O. volvulus to a level where the disease was no longer a public health problem and a national onchocerciasis control program was set up in 1991 to ensure surveillance and maintain the gains made. A resurgence of onchocerciasis cases has been observed in two regions (Comoé, South West) located around several river basins in the 2010-2011. In accordance with WHO guidelines, for the management of resurgent cases, CDTI was implemented in the affected areas of Comoé and Sud-Ouest regions. Methodology: We conducted an extensive analysis to determine the effects of CDTI on parasitological indices of onchocerciasis in these two areas and we also analyzed the data in relation to the location of the village in relation to the river to see if this was a factor in the decrease in prevalence. Results: A total of 43 villages in 6 health districts, i.e., 100% of the villages that participated in the epidemiological surveys before and after the implementation of CDTI in the Southwest and Cascade regions were included in the study. The key findings were that standardized microfilaria prevalence and CMFL decreased significantly after the implementation of CDTI in both regions. For the average of the two regions, the results for standardized microfilaria prevalence were -5.91 with a 95% confidence interval of (-9.67; -2.16) and for CMFL were -0.29 with a 95% confidence interval of (-0.57; -0.01). Our results showed also a decline in standardized microfilaria prevalence and CMFL in all villages involved in the study. Moreover, the drop in the trajectory of the curve representing the predicted standardized microfilaria prevalence of villages located within 5 km of the streams was greater than that of villages located more than 5 km from the streams. Conclusion: Our results thus show that the implementation of effective CDTI could stop the transmission of O. volvulus in these two regions. The main challenge for stopping transmission could be the migration of populations to neighboring countries and migration of the vector from one country to another, as Burkina Faso shares some river basins with neighboring countries.

In recent years, team-based learning (TBL) is gaining popularity as a student-centered active collaborative learning strategy in healthcare education. This paper reports the design, implementation, and impact of a "hybrid team-based learning" (H-TBL) for one respiratory lecture in year two undergraduate physiotherapy program in 2019. A retrospective study was conducted, including 136 second-year undergraduate physiotherapy students using H-TBL design for one respiratory lecture topic. Student engagement was evaluated based on the percentage of completion for pre-class work, attendance to classroom session, and submission of formative creative assignment. Student' performance on formative creative tasks was evaluated based on thinking and learning rubric. Student perceptions were assessed based on the student's feedback using "Mentimeter." 109/ 136 (80%) students attended the COPD 2 session. 90/109 (82%) students engaged in COPD 1 (web-based) and tRAT in COPD 2 session. 54/109 (50%) students provided feedback and 67/90 (74%) students submitted formal formative creative assignment on completion of COPD 2 session. This study confirms that H-TBL enhances student's active engagement, creativity, and equilibration of their subject knowledge. Future randomized studies are mandated to explore the validity and specificity of H-TBL in diverse physiotherapy curriculum to evaluate the long-term student engagement and academic performance.

Diagnosis and treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in women remain insufficient. Fluctuations of reproductive hormones during the premenstrual period, postpartum period and (peri)menopause are neglected, even though they impact ADHD symptoms and as-sociated mood disorders [1]. Therefore, we created a female-specific treatment group for women with ADHD and premenstrual worsening of ADHD and/or mood symptoms. We describe the group programme and underlying rationale, offering a qualitative analysis of the participants’ evaluation. The 7 two-weekly sessions foreground the menstrual cycle and address several ADHD-specific topics in relation to this cyclical pattern: emotional regulation; impulsivity; setting boundaries, and triggers. Concurrently, women track their menstrual cycle and (fluctuating) ADHD and mood symptoms with an adjusted premenstrual calendar. In total, 18 women (25-47yrs) participated in three consecutive groups. We analysed the evaluation of the last group. Participants experienced the group as a safe and welcoming space. Recognition was valued by all. The topics discussed were deemed valuable and the structure suited them well. Completing the premenstrual calendar augmented awareness and recognition of individual cyclical symptoms. Discussing ADHD throughout the lifespan increased self-understanding. Participants took their menstrual cycle more seriously, prioritising self-acceptance and self-care in the luteal phase of the cycle. Exploring a cyclical approach in a group setting seems to be a positive addition to treatment for female ADHD.

Cameroon introduced the malaria vaccine in its routine immunization programme on 22 January 2024, in the 42 districts out of 200, among the most at risk of malaria. A cross-sectional analysis of data on vaccine key events in the introduction roadmap and vaccine uptake during the first 30 days was conducted. In addition to available gray literature related to the introduction of the malaria vaccine, data on malaria vaccine uptake by vaccination session, collected through a digital platform, were analyzed. A total of 1,893 reports were received from 22 January 2024 to 21 February 2024 from 766 health facilities (85% of overall completeness). Two regions out of 10 recorded less than 80% of completeness. As of 21 February 2024, 13,811 children have received the first dose of the malaria vaccine, including 7,124 girls (51.6%) and 6,687 boys (48.4%). Thirty six percent of children were vaccinated through outreach sessions versus 61.5% through sessions in fixed posts. The overall monthly immunization coverage with the first dose was 37%. Early results have shown positive attitudes towards and acceptance of malaria vaccines. Suboptimal completeness of data reporting and low coverage highlight persistent gaps and challenges in vaccine rollout.

The development of a decision framework for landscape governance and management has become one of the prioritised policy instruments for actualising policy objectives relating to agri-food system, biodiversity conservation, nature restoration, environmental management, climate change mitigation and adaptation, net zero greenhouse gas emissions, and the transition to renewable energy supplies in the United Kingdom (UK). However, the landscape lens in policy-making is challenging because of the diverse landscape archetypes, environmental problems, and diverging policy targets that it must address. This highlights the importance of having a robust, evidence-based landscape decisions framework. To address this issue, this study undertakes a systematic review and transdisciplinary synthesis of research outputs from the Landscape Decisions Programme (LDP). This study compiles and synthesizes outputs from the LDP projects in the context of the relevant literature to develop an understanding of the relationships among the emerging evidence with respect to decision-making for more sustainable and multifunctional landscapes. The synthesis analyzed the drivers of landscape decisions, and methodological approaches used to generate evidence for decision-making. The emerging themes from the synthesis were distilled into five principles that can be used as a basis for a roadmap towards the development of a holistic landscape decisions framework.

Purpose: National Institute for Health and Care Excellence (NICE) has recently published quality standards for assessment of fall risk and preventing further falls. According to the standards, multifactorial fall risk assessments should include: identification of falls history; analysis of gait, balance, mobility and muscle strength, among other factors. Despite being based on subjective analysis or simple timing and not being multifactorial, physiotherapists and physicians quite often use these tests as reference scales to differentiate between lower and higher risk of falling. Instrumented TUG has been recently reported to provide important additional information to the overall score. Objective: To explore a case-based approach of fall risk assessment to identify the most relevant and informative risk factors that in combination could better define a person risk profile. Materials and Methods: A multifactorial assessment of fall risk through questionnaires, standard functional tests, tests instrumented with inertial sensors, and force platforms has been studied within a group aged 55-80 years old. Different fall risk factors and fall risk assessment methods were analyzed in a case-based descriptive study. Results & Discussion: Subjects at higher risk of falling were identified based on their detailed profiles. A set of features were obtained from the instrumented standard tests differing significantly between subjects presenting higher or lower fall risk. Therefore, instrumenting conventional tests with wearables containing inertial sensors and force platforms gives more detailed and quantitative insights. This information can be used to better define and tailor fall prevention exercises and to improve the follow-up of the evolution of the subject.

Cardiovascular diseases (CVD) are prevalent and lead to high morbidity and mortality globally. Physiotherapists regularly interact with patients with or at risk of CVDs (pwCVDs). This study aimed to assess the nature of existing evidence, interventional approaches used, and the population groups included in physiotherapy-led health promotion (PLHP) for pwCVDs. The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Medline, PubMed, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and PEDro databases were searched from inception until June 2023. Two reviewers independently screened the titles, abstracts, full text and conducted data extraction. All conflicts were resolved with a third reviewer. A total of 4992 records were identified, of which 20 full-text articles were included in the review. The studies had varied populations, including those with stroke, coronary artery diseases, peripheral artery diseases, hypertension, diabetes, and multiple CVD risk factors. The interventions ranged from exercise and physical activity programs, dietary interventions, education, and counselling sessions with various supplementary approaches. Most interventions were short-term, with less than 12 months of follow-up. Interventions were personalised and patientcentred to promote adherence and health behaviour change. Among the included studies, 60% employed experimental designs, with the remainder using quasi-experimental designs. Although a wide range of PLHP strategies have been used for pwCVDs, exercise and physical activity were employed in 85% of included studies. Other components of health promotion, such as sleep, smoking, and alcohol abuse, should be investigated within PLHP.

Background: Online teaching has resulted in university students adopting a sedentary lifestyle. Prolonged sitting and reduced physical activity due to pandemic restrictions have led to musculoskeletal pain in various body areas, significantly impacting the students’ quality of life. This study aims to investigate the effects of remote learning on Sicilian physiotherapy students during the COVID-19 pandemic, specifically focusing on the occurrence of musculoskeletal pain. Methods: An observational study was conducted using an online survey administered through Google Forms. The survey consisted of 26 multiple-choice questions and was distributed to students enrolled in Physiotherapy programs at the Universities of Catania, Messina, and Palermo. Participants were contacted via social channels or email, and data collection spanned 5 weeks. The collected data were analyzed using R software. Results: A total of 128 questionnaires were collected. More than half of the students (51.6%) reported dedicating 15–22 h per week to distance learning for a duration of 6–12 months (50%). Regarding study location, most students preferred studying at a desk (82.8%), with slightly over half (57.8%) adopting a backrest while studying remotely. Analysis of the students’ posture during study hours revealed common positions, including tilting the head forward by more than 20 degrees (47.8%), leaning the trunk forward by more than 20 degrees (71.9%), both shoulders being hunched forward (57.0%), wrists positioned above the level of the elbows (46.1%), thighs pointing upwards (41.4%), and one or both feet in a downward or dorsiflexed position (69.5%). Conclusion: The questionnaire responses indicate that the lifestyle of university students, influenced by online teaching, has deteriorated, leading to musculoskeletal pain, including myofascial pain. These results are primarily influenced by the adopted posture and the duration of time spent in these positions.

Background: Injury of the spinal cord causes motor and sensory dysfunction, and pathological reflexes, leading to paraplegia or tetraplegia. The sequelae of traumatic spinal cord injury (SCI) is a significant burden and impact on healthcare systems. Despite constant progress in medicine, traumatic SCI still remains irreversible. Till now, no satisfying treatment that can enable neuronal regeneration and recovery of function at the damaged level has been found. Hundreds of experiments have been conducted on various possibilities of influencing spinal regeneration, some of them have yielded promising results, but unfortunately, the successes obtained in experimental animals have not translated into humans. Methods: This narrative review article presents the application of Extracorporeal Shock Wave Therapy (eSWT) in Spinal Cord Injury. The article has been divided into parts: 1. Use of extracorporeal Shock Wave Therapy for regeneration of the spinal cord after traumatic Spinal Cord Injury. 2. Application of extracorporeal Shock Wave Therapy in spasticity after Spinal Cord Injury. In both cases, the hypotheses of possible mechanisms of action will be described. Results and conclusions: A small number of clinical trials have demonstrated the potential of eSWT to influence the regeneration of the spine, as an innovative, safe, and cost-effective treatment option for patients with SCI. Some reports have shown that eSWT can improve spasticity, walking ability, urological function, quality of life, and independence in daily life.

Small business sector around the world is regarded as a catalyst of employment for the largest number of people. To reduce massive unemployment and inequality in the country, the Government of South Africa introduced various initiatives to stimulate and support small businesses, the Expanded Public Works Programme (EPWP) is one of such initiatives. The enterprise development approach, is one of the delivery mechanisms of the EPWP, which seeks to transfer income to poor households in the short to medium-term. This study critically assess the impact and effectiveness of training and support interventions provided to small businesses through the EPWP. The study employs a quantitative research method and due to the size, availability and ease of access to the participants, the entire population of twenty (20) small businesses supported by the EPWP in Pretoria Region was sampled. A questionnaire-based survey was conducted. The study demonstrates that the training intervention provided through the EPWP is making positive impact and achieving its intended goals of enhancing business management skills to participants. It also reveals an interesting outcome that the majority of the participants are women. The study also identified some weaknesses in the programme which leads to the recommendation that long-term support mechanisms are essential to ensure sustainability of emerging enterprises.

This research examines the effects of the implementation of an educational programme of mindfulness training using Virtual Reality (VR) with students in adapted vocational training. The aim of this programme is to instruct and strengthen attention and self-regulation skills in relation to the learning process, with the objective of reducing anxiety and impulsivity in students, contributing to promoting sustainability in education, as well as reducing inequalities. The development and implementation of this project was carried out in IES Teguise in Lanzarote (Spain) with 11 students with intellectual disabilities who used the Virtual Reality Mindfulness application called TRIPP for three months. The use of Virtual Reality offers immersive experiences, while mindfulness enables concentration, which directly contributes to higher academic performance. After the implementation of the programme, it is observed that the use of this emerging technology provides students with a sense of calm and well-being, which translates into improvements in their academic grades, promoting equal and quality education in line with the Sustainable Development Goals (SDGs).

Background – Mali was one of the first countries in sub-Saharan Africa to initiate a National Schistosomiasis Control Programme (NSCP) in 1982. The WHO's 2021-30 roadmap sets out criteria for eliminating and controlling schistosomiasis as a public health problem. Our study aimed to assess the impact of annual Mass Drug Distribution (MDD) with praziquantel (PZQ) among school-age children in the sentinel sites (SS) of the NSCP. Methods –The study took place at twelve SS in Kayes and Koulikoro regions. Two-round observational cross-sectional studies were carried out in December 2014-2015 and in April 2018 after four to five years of annually MDD. Overall, 2442 schoolchildren aged 7 to 14 were successfully examined. The urine filtration and Kato-Katz method were used for determining Schistosoma haematobium and S. mansoni eggs, respectively. Results –Of the twelve SS treated from 2014-2015, one has achieved the criterion of elimination of S. haematobium as a public health problem (prevalence of heavy intensity infection PHI < 1%) (ie, ≥50 S. haematobium eggs per 10 mL of urine or ≥400 S. mansoni eggs per g of stool), four met the morbidity control criterion (PHI< 5%) while two sites remained confined below the morbidity control criterion (PHI>5%). Five SS had no heavy intensity infection. The prevalence of S. mansoni was less than 1%. Conclusion –The impact evaluation of MDD with praziquantel in the SS of NSCP highlights that MDD has significantly reduced the PHI of schistosomiasis. However, the high prevalence of schistosomiasis or its increase in some sites requires in-depth studies.

Clinical academics experience dual workplaces; the clinical and the research environment. However, working in two workplaces leads to difficulty in forming an integrated identity, and hence affects a person’s work environment and well-being. The aim was to explore how clinical academics experience the psychosocial work environment and their suggestions for improving and changing work well-being. A multicenter qualitative approach with group interviews inspired by participatory action de-sign was used. A purposeful criterion sampling strategy was used, selecting researchers affiliat-ed with the university's research network (n=12). Data were analyzed by thematic analysis and the consolidated criteria for reporting qualitative research was applied. The main finding “lack of integration of research in clinical practice”, revealed how clinical academics balanced between the two practices, how their need for belonging in both work environments were established by fellowship, and how motivational factors and role models could be enhanced through a joint commitment of responsibility in research units and clinical practice. This study provides a contemporary understanding of the challenges that clinical academics en-counter and what solutions they would offer. This study adds to knowledge on psychological work well-being and provides solutions on how clinical academics can achieve integration of research in clinical practice.

Background: Sexualized substance use (SSU) is the practice of psychotropic substance usage, before or during sexual intercourse in order to increase sexual pleasure and arousal. It has a strong association with sexually transmitted infections (STIs). The present study aimed to assess the knowledge gaps regarding SSUs among the community health mobilizers by interviewing them regarding their knowledge, attitudes, and practices through qualitative approach. Methodology: In-depth interviews (IDIs) were conducted with a total of nineteen community health mobilizers engaged in counselling of sexualized substance users. A semi-structured open-ended questionnaire with socio-demographic information and probes related to SSU was administered. Informed consent was taken from each participant prior to data collection. Results: Gender-wise distribution indicated that 47% of the community mobilizers are men, followed by transgender persons (32%), and women (21%). Responses of participants highlighted that alcohol consumption was the most observed form of SSU. The findings indicated that drug administration through injection was most common, followed by sniffing and swallowing. Sources of drug pro-curement enlisted by participants included peddlers, peer groups, sexual parties, medical and liquor stores. Only 63% of participants had fair knowledge about STIs such as HIV, viral hepatitis, syphilis, and gonorrhoea. All were familiar with the administration of naloxone injections and the locations of nearby hospitals where patients could be transported in the event of an overdose. Conclusions: The in-depth interviews among the study participants reflected substantial know-ledge gaps related to various areas associated with SSU, which highlights the need for periodic workshops and training for upgradation of existing knowledge and practices among community health mobilizers. This will help to broaden their knowledge of different types of SSUs, the latest substances of abuse, the diseases caused by high-risk sexual practices, and additional health and psychological issues associated with SSUs, which would ultimately help in better counseling and management of sexualized substance users. It may also play a crucial role in the strengthening of capacity-building systems and engagements at the community level. This study may be used as formative research by researchers and policy makers to develop study protocols for multi-centric community-based studies among community health mobilizers and sexualized substance users across the country for further validation and exploration.

Antimicrobial use in agriculture has been identified as an area of focus for reducing overall antimicrobial use and improving stewardship. In this paper, we outline the design of a complex antimicrobial stewardship (AMS) intervention aimed at developing a national Veterinary Prescribing Champion programme for Welsh farm animal veterinary practices. We describe the process by which participants were encouraged to design and deliver bespoke individualised AMS activities at practice level by forging participant ‘champion’ identities and Communities of Practice through participatory and educational online activities. We describe the key phases identified as important when designing this complex intervention, namely (i) involving key collaborators in government and industry to stimulate project engagement; (ii) grounding the design in the literature, the results of stakeholder engagement, expert panel input and veterinary clinician feedback to promote contextual relevance and appropriateness; and (iii) taking a theoretical approach to implementing intervention design to foster critical psychological needs for participant motivation and scheme involvement. With recruitment of over 80% of all farm animal practices in Wales to the programme, we also describe demographic data of the participating Welsh Veterinary Prescribing Champions in order to inform recruitment and design of future AMS programmes.

Renal cell carcinoma (RCC) accounts for approximately 90-95% of all kidney cancers in adults, with the clear cell RCC (ccRCC) the most frequently identified subtype. RCC is known for its responsiveness to immunotherapy, making it an area of significant research interest. Immune checkpoint (IC) molecules, which regulate immune surveillance, are established therapeutic targets in RCC. The aim of this study was to analyze the influence of polymorphisms in genes HVEM and CD160 on susceptibility to ccRCC and patient overall survival (OS) with over a ten-year period of observation. We genotyped three HVEM single nucleotide polymorphisms (SNPs): rs1886730, rs2234167, and rs8725, and two CD160 SNPs: rs744877 and rs2231375, in 238 ccRCC patients and 521 controls. Our findings indicated that heterozygosity within rs2231375 and/or rs2234167 increases ccRCC risk. Furthermore, in women, heterozygosity within additional HVEM SNPs, rs8725 and rs1886730, is associated with an increased ccRCC risk. The presence of a minor allele for rs1886730, rs2234167, rs8725, and rs2231375 was also correlated with certain clinical features of the disease. Moreover, the rs1886730 SNP was found to be associated with patients' OS. In conclusion, our study highlights an association between HVEM and CD160 polymorphisms and the risk of developing ccRCC as well as patient’s OS.

Multiple myeloma (MM) accounts for about 10 to 15% of all diagnosed hematologic malignancies and about 1-2% of all cancer cases. Approximately 80-90% of MM patients develop bone disease and the changes rarely regress. It is only possible to stop or slow their progression. A major role in bone destruction in MM is attributed to the Wnt signaling pathway, and its action can be modified by various types of interventions including training and diet. Therefore, the aim of this project was to evaluate the effects of a Nordic Walking (NW) training cycle and intermittent fasting (IF) on the levels of selected bone turnover markers associated with the Wnt pathway in patients with MM. Results from 35 patients divided into training (NW and IF NW) and non-training (IF and control) groups were included in the analysis. A 6-week training cycle involving 60-minute workouts 3 times a week was conducted. Body mass and composition and the levels of: vitamin D, calcium and phosphorus, beta2-microglobulin and albumin were examined before and after completion of training cycle. Markers of bone turnover were also determined: sclerostin (SOST), Dickkopf-related protein 1 (DKK-1), osteoprotegrin (OPG), osteopontin (OPN) and Tartrate-resistant acid phos-phatase 5b (TRACP 5b). There was no negative effect of IF or combined training and fasting on the nutritional status of the patients (the level of albumines was unchanged). Both training groups showed an increase in serum concentrations of the active metabolite of vitamin D (IF NW and NW: p=0.001 and p=0.022, re-spectively). The change in the concentration of this vitamin negatively correlated with the con-centration of TRACP 5b (r=-0.413, p=0.014). Evaluating the concentrations of markers related to bone turnover, a reduction in the concentrations of SOST (time: p=0.026, time vs. group: p=0.033) and TRACP 5b (time: p

The aim of this article has been to evaluate the impact of a physical-sport education programme, based on the pedagogical model of Sport Education within the framework of quality Physical Education and approached from the field of social and emotional learning, on a set of psychological variables: subjective well-being (quality of life related to health, positive affect and negative affect); trait emotional intelligence and social anxiety. A total number of 113 Compulsory Secondary Education students were involved, aged 12 to 15 years old, 44 of whom belonged to the control group (CG) and 69 to the experimental group (EG). A quasiexperimental design of repeated pretest and posttest measures with the CG was used. The results obtained in this investigation revealed that the intervention programme caused significant improvements in the subjective well-being and the trait emotional intelligence for the EG. These findings reinforce the pedagogical efficiency of the programme with regards to the aim that has been set. Likewise, the findings also highlight the suitability and appropriateness in terms of innovative teaching proposals. In the same way, the results showed relevant empirical contributions in this given school context due to its psychological benefits and the encouragement of healthy living.

Objective: To examine the dose-response relationship between average daily temperature and sunlight hours with daily steps across a 35-week period in school-aged children, and to evaluate whether there were differences by sex. Methods: We conducted a follow-up study involving 655 children (50.8% girls, mean age 10.45 ± 0.95) from six public primary schools in Cuenca, Spain. We measured daily steps using Xiaomi Mi Band 3 Smart Bracelets from October 2022 to June 2023 (over 35 weeks). We collected daily average temperature from the local weather station in Cuenca and sunlight hours during the same period. We used ANCOVA models and LOESS regression to examine the dose-response relationship between average daily temperature and daily hours of sunlight with daily steps. Additionally, we performed a multiple linear regression model. Results: Our findings revealed significant variations in daily steps across the 35 weeks. The relationship between environmental factors and daily steps was non-linear, in both girls and boys. The optimal values for higher activity levels were an average temperature of 14°C and 13 hours of sunlight. Furthermore, a 1 ºC increase in temperature was associated with an increase of 74 ± 130 steps/day, while an increase of one hour of sunlight was associated with an increase of 315 ± 237 steps/day. However, sunlight hours may act as a moderating factor. Conclusion: Our study showed a non-linear association between t average daily temperature and sunlight hours with daily steps over a 35-week period. Additional strategies may be necessary to encourage increased physical activity during periods of extreme temperatures or sunlight exposure.

Background: Previous investigations have found a correlation between abnormal curvatures and a variety of patient complaints such as cervical pain and disability. However, no study has shown that loss of the cervical curve is a direct result of exposure to a motor vehicle collision (MVC). This investigation presents a retrospective consecutive case series of patients with both a pre-injury cervical lateral radiograph (CLR) and a post-injury CLR after exposure to a MVC. Computer analysis of digitized vertebral body corners on CLRs was performed to investigate the possible alterations in the geometric alignment of the sagittal cervical curve. Methods: Three spine clinic records were reviewed, over a 2-year period, looking for patients where both an initial lateral cervical x-ray and an examination were performed prior to the patient being exposed to a MVC; afterwards an additional exam and radiographic analysis were required. A total of 41 patients met the inclusion criteria. Examination records of pain intensity on numerical pain rating scores (NPRS) and neck disability index (NDI), if available, were analyzed. The CLRs were digitized and modeled in the sagittal plane using curve fitting and the least squares error approach. Radiographic variables included total cervical curve (ARA C2-C7), Chamberlain’s line to horizontal (skull flexion), horizontal translation of C2 relative to C7, segmental translations (retrolisthesis and anterolisthesis), and circular modelling radii. Results: There were 15 males and 26 females with an age range of 8-65 years. Most participants were drivers (28) involved in rear end impacts (30). The pre-injury NPRS was 2.7 while the post injury was 5.0; p &lt; 0.001. The NDI was available on 24 /41 (58.5%) patients and was found to increase following exposure to the MVC: 15.7% to 32.8%, p &lt; 0.001. An altered cervical curvature was identified following exposure to MVC, characterized by an increase in radius of curvature and an approximate 8° reduction of lordosis from C2-C7; p &lt; 0.001. The mid cervical spine (C3-C5) showed the greatest curve reduction with localized mild kyphosis at these levels on average. Several participants developed segmental translations that approached the instability value of translation &gt; 3.5mm. Conclusions: Abnormalities of cervical lordosis occurred following exposure to a MVC. The average loss of cervical curvature was 8° from C2-C7, with mild flexion of the mid cervical segments. Snap through type or dynamic buckling during the MVC may explain our findings. The primary contribution of this study to the motor vehicle collision literature is that altered cervical lordosis may result from MVC exposures and the consequences of an altered cervical alignment, in turn, may lead to future pain, disability and decreased health-related quality of life.

School Feeding Programmes are social safety net interventions providing educational and health benefits to vulnerable children in developing countries. This study assessed the impact of Osun Elementary School Feeding and Health Programme (O-MEALS) on the enrolment and retention of rural primary schools in Osun State. Multi stage sampling technique was used to select 188 respondents while data was collected through interview schedule. Percentages, Chi-square, PPMC and T-test were used for data analysis. Findings revealed that over half (51.6%) of the respondents were male, aged 9.38 ± 1.84 years and majority (83.0%) had a family size of 6-10 people. Food incentives (=1.25), health challenge (=0.69), and peer influence (=0.67) were major factors affecting school attendance. More than half (53.2%) of the respondents had unfavourable perception towards the school feeding programme. Results showed a significant difference between pupils’ enrolment (t = 5.332, p = 0.006) and retention rate (t = 58.386, p = 0.000) before and after the commencement of O-MEALS. Furthermore, pupils’ enrolment and retention (r = 0.993, p = 0.001) after the commencement of O-MEALS was significantly related. Food incentive was a major factor affecting school attendance, which fostered an improvement in the poor enrolment and retention previously experienced. Since a good number of the pupils possessed unfavourably perception towards the school feeding programme, it was recommended that effective monitoring be established to checkmate food vendors’ activities in delivering quality and satisfactory services. Likewise, the Government’s policies on school restructuring and levy, which had proved counterproductive, should be reviewed.

Background and objective: Addressing the global morbidity associated with pulmonary disease is an important need for the respiratory community. However, there is also a growing momentum to show the efficacy of new tools of diagnosis. Despite this, there are few physiotherapeutic tools that help identify and categorize these conditions. The aim was to analyze the variables of physiotherapy index of the ventilatory workload (PIVW) in people with chronic obstructive pulmonary disease (COPD) during stability and exacerbation in an outpatient setting. Material and Methods: Analyzed retrospectively of 198 clinical records were reviewed. The PIVW was extracted in stability and exacerbation of these patients with COPD. After applying the exclusion and inclusion criteria; 54 patients were classified. Through the statistical analysis of chi-square, a significant association was reported for each of the variables and the total PIVW score. Results: when analyzing the baseline with the peak of PIVW, there was a significant increase in patients COPD exacerbation. Similarly, the variables that constitute the loads, translations and supports underwent a significant increase from baseline to exacerbation (p<0.0001), except for the additional oxygen contribution, where the frequency of patients was the same in basal and exacerbation as well. Conclusions: the PIVW, serves to determine ventilatory problemas in outpatients, characterizing the specific changes of loads, translators or assistance.

Traumatic Brain Injury (TBI) is one of the leading causes of death and disability worldwide. Patient treatment and management pose a challenge for healthcare systems. The prognosis of these patients may be influenced by factors such as sex. This study aims to describe the clinical parameters of patients hospitalized in the Intensive Care Unit (ICU) of a Spanish hospital due to Trauma Brain Injury and to establish differences based on sex. Methodology: An observational, cross-sectional, and analytical study was conducted from March 2015 to December 2019. All patients admitted to the ICU during this period who presented isolated significant Traumatic Brain Injury, defined as an abbreviated injury scale (AIS) ≥ 3, were included. Data on baseline characteristics, mechanism of injury, substance use, and acute management in the prehospital and hospital stages (including the need for hospitalization) were recorded. A descriptive and in-ferential analysis was conducted using the chi-square test. Results: A total of 950 patients were ultimately included. The majority of the patients were men (723) with a mean age of 45.16 (± 17.55). There were statistically significant differences in terms of the mechanism of injury (p

Objective: To develop and validate the short version of the JAEN Scale for use in women with Fibromyalgia Syndrome (FMS) to make the balance disorder measurement process more efficient. Methods: A Cross-sectional observational validation study was conducted. Fifty-six women with FMS and 44 healthy control were included. Certain items of the original tool were selected with the aim of 1) Improving internal consistency by reducing item redundancy 2) Obtaining a diagnostic capacity with an Area Under the ROC Curve (AUC) greater than 0.70 for discriminating FMS patients and fallers. The internal consistency, factorial validity, concurrent validity and diagnostic capacity of the new tool were analyzed. Results: Factorial analysis showed a two-factor structure that explained 72% of variance. Cronbach alpha coefficients of 0.904 were obtained for the total score of the JAEN-10 items. Concurrent validity analysis showed strong correlations of the JAEN-10 with other instruments that measured quality of life, postural balance or disability related to dizziness. The score of the JAEN-10 items showed an AUC of 0.858 with a sensitivity of 64.29 and a specificity of 95.45 for discriminating between FMS and healthy controls, and an AUC of 0.835 with a sensitivity of 90.48 and a specificity of 67.24 for discriminating between fallers and non-fallers.; Conclusions: The 10-item JAEN scale is a valid instrument for discriminating between subjects with or without FMS and between fallers and non-fallers. Its psychometric properties are good and similar to those of the original 20-item scale. Moreover, it is quicker to complete, which may be relevant in subjects with a tendency to experience fatigue.

Many amateur and professional players start racing at an early age. The aim is to explore the characteristics of heart rate and speed patterns recorded during competition. We investigated the body composition and cardiorespiratory characteristics of three elite adolescent athletes, their heart rate, and speed patterns in the laboratory and competition. There is no difference between the three riders' anthropometric and body composition values, except for training age (TA), where rider (b) started riding three years ago. The intra-race heart rate patterns of the three riders showed similarities in several places and differences in several places. This was also true for the speed patterns. The differences between races were more pronounced in the heart rate pattern.

Introduction: Road traffic accidents are a real pandemic and incur expenses amounting to 1-2% of every country’s GDP. AESLEME (Association for the Study of Spinal Cord Injuries) – devoted to teaching road safety and health to prevent road accidents – has celebrated its 30th anniversary. AESLEME’s instructors are health workers and people with spinal cord injuries caused by road accidents: their presentations – teaching road safety and sharing information on irreversible injuries – are enhanced by personal stories that help schoolchildren to acquire knowledge on this matter. However, until now, we had not assessed how far this acquisition of knowledge had reached. Methods used: Two multiple-choice tests were given to each of the 8,106 students (12-14 years) who took part. Of the four possible answers, only one of them was correct. The first multiple-choice test was taken before the presentation and the second was taken one month later. Results: After assessing the answers, there was a change in the tendency of the number of correct answers before/after answers for the multiple-choice test, and the number of correct one´s rose one month after the presentation. This increase is statistically significant (p&lt;0.01) and represents a national increase of 61% in the number of correct answers, although this varies from 8% to 278% depending on the region. Conclusions: The assessment, involving over 8,000 people, showed that there has been an improvement in road safety knowledge thanks to education provided by AESLEME’s instructors, and a statistically significant increase was obtained throughout Spain, with an average of 61% (confidence level 95: 53% and 64%).

Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality worldwide. This study aimed to test the efficacy of a newly-developed symptom self-management program on health outcomes among inpatients post-AMI. A pilot randomised, controlled trial was utilised. A convenience sample of 90 was recruited from a tertiary hospital in Singapore. Adult inpatients with post-AMI were randomly assigned to the three groups: IManage-HSet, IManage-FF or control group. Sample size was computed using power analysis. Data were collected through self-reported questionnaires and physiological instruments. Data analyses included univariate statistics, analysis of variance and repeated measure analysis of variance. Ninety participants were recruited with 30 in each group. Participants in the IManage-HSet and IManage-FF group had significantly greater relaxation (ηp2 = 0.11), lower objective stress (ηp2 =0.14), and greater knowledge (ηp2 = 0.62) than those of the control group. The two intervention groups had lower subjective stress (ηp2 = 0.04), depression (ηp2 = 0.01), and anxiety (ηp2 = 0.03) than the control but such differences did not achieve statistical significance. Furthermore, most participants reported that they were satisfied with the programs and they provided positive comments on the contents, educational materials and relaxation practice. This pilot study supports the potential benefits and feasibility of the IManage-VR and IManage-FF interventions on stress, perceived relaxation, knowledge and patient satisfaction. Contents of the symptom management interventions could be added into current cardiac rehabilitation programs. Future RCTs with multi-centered sites and larger sample size are required to further test the intervention. This study was prospectively registered with the International Standard Randomised Controlled Trial on the 5th August 2014 with registration number ISRCTN61027816.

Introduction: Physiotherapy exercises administered to preterm infants in the NICU can enhance motor skills and expedite the discharge process for infants born before 30 weeks of gestational age. The research delves into the influence of physiotherapy programs on these preterm infants' activity and participation levels. Methods: The intervention group received a one-month physiotherapy program including massage around the mouth, mobilization and weight-bearing exercises, and massage therapy for the extremities, while the control group did not. The motor skills were evaluated by the Test of Infant Motor Performance (TIMP), Dubowitz Neurological examination, and Preterm Oral Feeding Readiness Scales (POFRAS). Results: There was a significant difference in The TIMP, Dubowitz Optimal Score, Type of Non-Invasive Ventilation, TIMP Range, and POFRAS scores in the physiotherapy group rather than the control group (p<0.05). There were no differences in the length of stay in the NICU, respiration rate, heart rate, body temperature, oxygen saturation, body weight on the evaluation day, body weight at discharge, head circumference at discharge between the groups (p>0.05) Discussion: We conclude that physiotherapy in NICU improves the motor outcomes, activity and participation in preterm infants rather than the body functions and structure like vital signs and infants’ body weight.

The electric vehicle (EV) industry is experiencing rapid growth, accompanied by continuous advancements in charging infrastructure to satisfy the rising need for fast and reliable charging. Particularly, the focus has shifted towards EV fast charging (EVFC) and its impact on the power grid. This paper presents a comprehensive analysis and survey of scholarly literature and projects conducted in this field over the past decade. The findings highlight the rising demand for EVFC and the need to address its potential adverse effects on the power grid. However, there is a noticeable lack of clear research guidance regarding charging time. To tackle these challenges and pave the way for future solutions, extensive research on DC fast charging, ultra-fast charging, and the integration of vehicle-to-grid (V2G) systems is required. This review paper thoroughly investigates the development of fast charging technology for electric vehicles (EVs), including its advantages and comparative analyses from various perspectives. Furthermore, it delves into the advancements in DC fast charging infrastructure, emphasizing charging standards and control modes. The study also investigates different categories of battery chargers for both on-board and off-board charging. Additionally, it explores the classification of DC-DC converters in the context of DC fast charging stations, discusses control strategies for EV systems, identifies existing challenges, and outlines future trends in EV fast charging.

In the frame of the I-MOVE-COVID-19 project, a cohort of 2050 patients admitted in two Spanish reference hospitals between March 2020 and December 2021 was selected, and a range of clinical factors data were collected at admission to assess their impact on the risk COVID-19 severity outcomes through a multivariate adjusted analysis and nomograms. The need for ventilation and ICU admission were found directly associated with a higher mortality risk (OR 6.9 and 3.2, respectively). The clinical predictors of mortality were need for ventilation and ICU, advanced age, neuromuscular disorders, thrombocytopenia, hypoalbuminaemia, dementia, cancer, elevated CPK and neutrophilia (OR between 1.8 and 3.5), whilst the presence of vomiting, sore throat and cough diminished risk of death (OR 0.5, 0.2 and 0.1 respectively). Admission to ICU was predicted by the need for ventilation, abdominal pain and elevated LDH (OR 371.0, 3.6 and 2.2, respectively) as risk factors; otherwise, it was prevented by advanced age (OR 0.5). In turn, the need for ventilation was predicted by low oxygen saturation, elevated LDH and CPK, diabetes, neutrophilia, obesity and elevated GGT (OR between 1.7 and 5.2), whilst prevented by hypertension (OR 0.5). These findings could enhance patient management and strategic interventions to combat COVID-19.

Loneliness is a frequent negative feeling among older people. A programme aimed at alleviating loneliness among older people by promoting social capital, i.e. social support and participation, was conducted in primary health care centres in Spain. We aimed to explore participants’ experiences of loneliness and social participation before the programme, perceived programme effects and contextual influences. A descriptive-interpretative qualitative design was used. 41 persons were included comprising older people, health and social care professionals, and volunteers. Data were collected through three focus groups, 36 semi-structured interviews and participant-observation of the intervention. A thematic content analysis was applied. Older persons with diverse profiles of loneliness and participation decreased their loneliness, increased their knowledge and participation in local community assets, and developed companionship, a sense of belonging, peer support and friendship. Their mental wellbeing increased and participants could deal better with health or family problems. An empowerment process was observed. However, loneliness persisted among some widowed participants and health and social vulnerabilities hampered some impacts. Conflicts and exclusion were occasional unintended effects. The promotion of social capital in ageing to alleviate loneliness involves complex processes interrelated with health and socio-economic factors. Future programmes should be adapted to local contexts and participants’ characteristics.

Background: Globally, women’s responsibility for unpaid care work (UCW) remains a barrier to gender equality and women’s empowerment. Rwanda, a low-income country, has a legal and policy framework for promoting gender equality but remains a patriarchal society with women responsible for UCW. Reseaux des Femmes, a local NGO, has been delivering a programme targeted at reducing and redistributing the UCW of women with the objective of gender transformational change. However, there has been no impact evaluation of their intervention to date. Methods/Design: The impact evaluation will be a proof-of-concept critical realist cluster control trial (CRcCT) to evaluate for which women, how and under what circumstances the intervention reduces and redistributes women’s UCW, promote gender equality and women’s empowerment, and improves women’s quality of life. Four clusters of villages in each of five districts in Rwanda will be randomly allocated to the intervention or control arms, and all eligible households, those headed by a couple with at least one child under 12 years, will be recruited. This will yield a sample of around 550 intervention households and 550 control. Discussion: This protocol describes the design of mixed-methods research to evaluate an intervention in Rwanda aimed at reducing and redistributing the time women spend on UCW, thereby promoting gender equality and women’s empowerment. This paper will contribute to our understanding of interventions for transforming gender relations from a scholarly perspective. From a policy perspective, it will act as a proof of concept of Reseaux des Femmes’ Programme.

Background: Vitamin D was studied in regards to its possible impact on body mass reduction and metabolic changes in adults and children with obesity yet there were no studies assessing the impact of vitamin D supplementation during a weight management programme in children and adolescence. The aim of our study was to assess the influence of 26 weeks of vitamin D supplementation in overweight and obese children undergoing an integrated 12-months’ long weight loss programme on body mass reduction, body composition and bone mineral density. Methods: A double-blind randomized placebo-controlled trial. Vitamin D deficient patients ( <30 ng/ml level of vitamin D) aged 6-14, participating in multidisciplinary weight management programme were randomly allocated to receiving vitamin D (1200 IU) or placebo for the first 26 weeks of the intervention. Results: Out of the 152 qualified patients, 109 (72%) completed a full cycle of four visits scheduled in the programme. There were no difference in the level of BMI change. Although the reduction was greater in the vitamin D vs. placebo group (-4.28 ± 8.43 vs. -2.53 ±6.10) the difference was not statistically significant (p=0.319). Similarly the reduction in fat mass – assessed both using bioimpedance and DEXa was achieved, yet the differences between the groups were not statistically significant. Conclusions: Our study ads substantial results to support the thesis on no effect of vitamin D supplementation on body weight reduction in children and adolescents with vitamin D insufficiency undergoing a weight management programme. Trial registration no: NCT 02828228; trial registration date: 8 June 2016 registered in: ClinicalTrials.gov.

Limited observational studies have described the relationship between sleep duration and overall diet. The present study investigated the association between sleep duration at weekdays and empirically derived dietary patterns in a nationally representative sample of UK adults, aged 19-64 years old, participating in the 2008-2012 UK National Diet and Nutrition Survey Rolling Programme. Survey members completed between three to four days of dietary records. Sleep duration at weekdays was categorised into tertiles to reflect short, normal and long sleep duration. Social jetlag was calculated as the difference between sleep duration at weekends and weekdays. The association between sleep duration/ social jetlag and dietary patterns, derived by principal components analysis, was assessed regressing diet on sleep whilst accounting for the complex survey design and adjusting for relevant confounders. Survey members in the highest tertile of sleep duration had on average 0.45 (95% CI -0.78, -0.12) lower healthy dietary pattern score compared to middle tertile (p =0.007). There was an inverted u-shaped association between social jetlag and a healthy dietary pattern, such that when sleep at weekends exceeded weekday sleep by 1h 45min, scores for indicating a healthy dietary pattern declined (p =0.005). In conclusion, long sleep duration at weekdays and an increased social jetlag are associated with a lower healthy dietary pattern score. Further research is required to address factors influencing dietary patterns in long sleepers.

Background/Objectives: This study looks at how a kinematic chain exercise regimen that targets the lower, core, and upper body affects university shot put participants' shoulder muscle strength and throwing efficiency. This study fills an apparent research void on shot put training approaches by presenting a comprehensive kinematic chain workout program. It was anticipated that this method would improve performance the most, considering the complex biomechanical require-ments of the sport. Methodology: Athletes, seventy in age (19.87 ± 1.31 years), were assigned into two groups at random: experimental (n = 35) and control (n = 35). While the control group carried on with their usual training, the experimental group participated in an 8-week kinematic chain training program, pre- and post-training evaluations were carried out to evaluate shot put throwing ability, shoulder muscle strength, and participant satisfaction with the exercise regimen. Results: demonstrated that, when compared to the control group, the athletes in the kinematic chain program had a significantly improved throwing distance (p = 0.01) and shoulder muscle strength (p = 0.01). Furthermore, there was a significant difference (p = 0.005) in the athletes' satisfaction levels with the workout program among those in the experimental group. This implies that a kinematic chain-focused strategy improves performance and emphasizes the significance this type of training is for shot put athlete performance. Conclusion: As an improvement forward in sports science, the study's finding promotes the inclusion of kinematic chain workouts in shot put training programs and calls for more research on kinematic chain-based approaches in a variety of sports.

Obesity is a global public health problem and the environment as its major determinant. To identify interventions an evidence base is warranted. To this aim we investigate the relationship between the consumption of foods and eating locations (like home, school/work and others) in British adolescents, using data from the UK National Diet and Nutrition Survey Rolling Program (2008–2012 and 2013-2016). Cross-sectional analysis of 62,523 food diary entries from this nationally representative sample then focused on foods contributing up to 80% total energy to the daily adolescent´s diet. Correspondence Analysis (CA) was first used to generate food-location relationship hypotheses and Logistic Regression (LR) to quantify the evidence in terms of odds ratios and formally test those hypotheses. The less-healthy foods that emerged from CA were chips, soft drinks, chocolate and meat pies. Adjusted Odds Ratios (99% CI) for consuming specific foods at a location “Other” than home (H) or school/work (S) in the 2008-12 survey sample were: for soft drinks 2.8 (2.1 to 3.8) vs. H and 2.0 (1.4 to 2.8) vs. S; for chips 2.8 (2.2 to 3.7) vs. H and 3.4 (2.1 to 5.5) vs. S; for chocolates 2.6 (1.9 to 3.5) vs. H and 1.9 (1.2 to 2.9) vs. S; and for meat pies 2.7 (1.5 to 5.1) vs. H and 1.3 (0.5 to 3.1) vs. S. These trends were confirmed in the 2013-16 survey sample. Interactions between location and BMI were not significant in either sample. In conclusion, our study showed that adolescents are more likely to consume specific less-healthy foods at locations away from home and school/work, irrespective of BMI. Such locations include leisure places, food outlets and “on the go”, hence public health policies to discourage less-healthy food choices in these locations is warranted for all adolescents.

Recently Candida auris has emerged as a multi-resistant fungal pathogen, with a significant clinical impact, and has become a critical issue in WHO fungal priority list, due to its unique ability to persist for long time on human skin and hospital environments. It is therefore fundamental to reinforce hospital surveillance protocols to limit nosocomial outbreaks. The study purpose was the Fourier-Transform Infrared Spectroscopy (FT-IR) application to investigate the phylogenetic relationships between isolated strains within the C. auris outbreak at the university Intensive Care Unit of a Tertiary University hospital in Turin (Italy). In order to calculate a clustering cut-off, intra- and inter-isolates distance values were analysed. Data showed the presence of a major cluster Alfa and a minor cluster Beta with a defined C. auris clustering cut-off. The results were validated by an external C. auris strain and Principal Component and Linear Discriminant Analysis. The application of FT-IR technology had allowed to obtain important information about the phylogenetic relationships between the analysed strains, defining for the first time a “not WGS-based” clustering cut-off with a statistical-mathematical approach. FT-IR could represent a valid alternative to molecular methods for rapid and cost saving typing of C. auris strains with important clinical implications.

Since the 1960s, the countries of sub-Saharan Africa have been affected by an urban crisis due to the demographic explosion in cities and the resulting land pressures. These have resulted in the proliferation of spontaneous housing areas which question the future of urban vegetation and its degree of inclusion in city planning. To analyze the state of knowledge on the research already carried out on the development of urban landscape, particularly in sub-Saharan Africa, a literature review on urban forestry covering the period 1998-2022 was carried out in order to better orient future research works for a greater consideration to urban forestry and their contributions in combating the adverse effects of climate change. Out of a set of 110 scientific papers selected, 50 were considered relevant because of their direct link with urban forestry. From the analysis of this papers, a classification of the articles according to 05 themes was carried out. These are: management of green spaces in urban areas, functions of trees in an urban environment, development of urban forestry, characterization of urban tree flora and financing of urban forestry. Thus, “function of trees in an urban environment and the characterization of urban tree flora” are the most addressed respectively at 42% and 28%. “Financing urban forestry” is practically not addressed (2%). The analysis of the 50 selected articles reveals a significant geographic concentration of urban forestry research. Countries like South Africa, Kenya, and Ghana are more represented in the literature, while vast regions in Central and Western Africa (e.g., Democratic Republic of Congo, Chad, and Niger) have minimal or no documented research on urban forestry. Future research should address these underrepresented themes, as they are crucial for the long-term sustainability of urban forestry projects. Particularly, research on financing mechanisms is essential to unlock sustainable funding sources for urban forestry, a critical barrier to its expansion.