Att motiveras av prestation - En kvantitativ kartläggning av motivationsfaktorer baserat på prestation hos kvinnliga gymmotionärer

I dagens samhälle har gym som arena blivit en attraktivare plats att utöva sin fysiska aktivitet. Från början av 1970-talet blev befolkningen mer hälsomedvetna och tog de positiva effekterna av träning på allvar. Det är även på senare tid som allt fler kvinnor börjat söka sig till gymträning, som förr i tiden skapades för män. Motivation är en viktig faktor för fortsatt regelbunden fysisk aktivitet. Vid regelbunden träning kommer troligtvis en viss prestation att upplevas, vilket i sin tur leder till utveckling. Syftet med studien är att kartlägga motivationsfaktorer kopplade till fysisk aktivitet baserade på prestation hos kvinnliga gymmotionärer (19-61 år). En webbaserad enkät användes som datainsamlingsmetod där totalt 103 deltagare svarade. Data från 78 kvinnor som föll inom inklusionskriterierna kunde användas och analyseras. Resultatet visar att den främsta aktivitet som utförs på gym är styrketräning (95 %). Bland motivationsfaktorer så har de inre motivationsfaktorerna störst inverkan på kvinnorna. Majoriteten av kvinnorna har även en målsättning med sin träning och har ökat intensitet, volym och komplexitet. Kvinnorna tenderar även att utvecklas i sin träning även om de är omotiverade. En slutsats är att majoriteten av kvinnorna har ökat i intensitet, komplexitet och volym vilket leder till att de lättare kan nå en progression och prestera bättre. Vad som motiverar dem till detta är främst inre motivation. Vidare forskning krävs för att få en mer djupgående och väsentlig bild och förklaring till hur och varför dessa prestationsvariabler hos individer ökar eller inte

Grassroots-Initiated Policy Advocacy in a Transitional Democracy: A Case Study

While it is acknowledged that public participation in the policy-making process is a cornerstone of democracy, it is unclear how this takes shape in transitioning democracies. Myanmar is currently transitioning from over five decades of military rule to a civilian-led, democratically-elected government. Consequently, public space has opened up, allowing Myanmar citizens to express their opinions and needs vis-à-vis policies in multiple sectors and to engage with policymakers. The majority of these advocacy efforts has been spearheaded by civil society actors, who have been supporting citizens in expressing themselves and facilitating opportunities for direct engagement. This paper is a case study of a Myanmar civil society organization’s ongoing policy advocacy initiative. It aims to contribute to the existing body of knowledge on how civil society actors work to influence policy in sensitive political contexts. The researcher examined program documents and interviewed various program stakeholders and civil society actors to gain insight into the advocacy context, the advocates, the policy issues, the politics/decision-makers, and the advocacy strategies deployed by the initiative. The evidence suggests initial expectations were high for engagement with the civilian administration. Due to unforeseen changes in the policy-making context, it has been harder to make inroads than expected. This case study indicates one primary factor for success is relationship-building among all concerned stakeholders, particularly engagement with state actors by civil society actors. Furthermore, alliances among civil society actors advance the advocacy agenda further. Finally, citizen voice is important in sensitive political environments, particularly in a transitioning democracy like Myanmar, where civil society organizations are not fully trusted

Malaria and soil-transmitted intestinal helminth co-infection and its effect on anemia: a meta-analysis

This study aimed to synthesize available evidence on the extent of malaria and soil-transmitted intestinal helminth (STH) co-infections in people living in endemic countries and to explore the effect of interactions between malaria and STHs on anemia. We searched relevant studies in electronic databases up to March 2013. Studies comparing malaria and STH co-infected patients with those not co-infected were included and the effect estimates were pooled using a random-effects model. We identified 30 studies for meta-analyses of which 17 were cross-sectional design. The majority of included studies (80%) were carried out in African countries. Among pregnant women, those infected with hookworm were found to have higher association with malaria infection compared with those without (summary OR: 1.36; 95% CI: 1.17-1.59; I2: 0%). Among non-pregnant adults, the summary OR of the association between anemia and the combined malaria and STH was 2.91 (1.38-6.14). The summary OR of the association between anemia and malaria alone was 1.53 (0.97-2.42), while the association between anemia and STH alone was 0.28 (0.04-1.95). There is no good evidence to support a different effect of malaria and STH on anemia. A subgroup analysis showed a higher risk of malaria infection in the primigravidae (summary OR: 1.61; 95% CI: 1.3-1.99; I2: 0%). In conclusion, the malaria-STH co-infection was variable with complex outcomes on anemi

Client satisfaction on corporate loan in selected private banks (Cho Cho Naing, 2019)

This study attempts to investigates client satisfaction on corporate loan in selected private banks. All banks are standing in the banking industry with income from loan interest, commission fees from BG, remittance fees, other security and bonds. This study aims to identified client satisfaction on corporate loan activities and to analyze the client satisfaction on corporate loan in selected private banks. Selected four bank‘s services quality dimensions, tangibility, reliability, responsiveness, assurance and ethic is used for this for accessing service quality of selected private bank. This framework is only focus on measuring client satisfaction between customer’s perceived services quality performance and expectation on service of private banks by client. To determine client satisfaction, the descriptive statistic method is applied to achieve object of the study. The primary data is collected from 100 respondents who are randomly selected from AYA bank, YOMA bank, AGD bank and UAB bank. Random simple method is used completed structural questionnaires. The finding shows that clients are satisfied with the responsiveness of these private banks. Moreover, perceive the service quality of service positively clients satisfy the selected private banks and relationship of service quality satisfied by the clients. The results indicate that banks are creating shared value in cases of customer rights, account opening and maintenance, and deposit/withdrawal of money. At this backdrop, the main problem today before the commercial banks, more particularly the public sector banks in Myanmar which were earlier operating in long-run survival and forging way ahead by retaining their valued customers. The current research paper attempts to analyze a customer’s perception of corporate loan in private banks. The study has been conducted in four private banks. This study is based on questionnaire method. A sample of 100 corporate loan customers has been selected using simple random sampling method. This study concluded that private banks are more preferred by majority of the corporate customer as they emphasize more upon relationship building with their corporate clients and are better equipped with modern infrastructure as compared to public banks

Multisectoral approach to support use of insecticide- treated net for malaria prevention among mobile and migrant populations in Myanmar: a systematic review

Background. Myanmar is a premalaria elimination country with artemisinin-resistant malaria. A strategy for transmission control is focused on vulnerable groups such as mobile and migrant populations (MMPs), and includes improving access to insecticidetreated bed nets in the Myanmar artemisinin resistance containment (MARC) zones using multisectoral approaches (MSA). Methods. This narrative systematic review addressed MSAs targeted to MMPs in Myanmar for malaria prevention. We searched relevant studies in electronic databases and present the narrative findings in 4 domains: stakeholder groups, net coverage and utilization, social determinates, and facilitators/barriers. Results. Nine studies were included. The review identified stakeholders involved in intersectoral collaboration. Net ownership was higher than utilization rates in the MARC zones and rates remained below the WHO recommended target of 100%. There was inadequate description of roles and responsibilities for implementation and on channels of communication within the partnerships and with the Government. Conclusions. Findings show that interventions to distribute treated bed nets were supported by the multiple stakeholders. Due to the design of the primary studies, analysis of the added value of intersectoral collaboration was limited. More attention must be paid to designing studies to document and evaluate the contributions and outcomes of intersectoral collaboration. Keywords. malaria; prevention; bed nets; multisectoral approach; artemisinin resistance containment zones; Myanmar

Immediately modifiable risk factors attributable to colorectal cancer in Malaysia

Background: This study aimed to estimate potential reductions in case incidence of colorectal cancer attributable to the modifiable risk factors such as alcohol consumption, overweight and physical inactivity amongst the Malaysian population. Methods: Gender specific population-attributable fractions (PAFs) for colorectal cancer in Malaysia were estimated for the three selected risk factors (physical inactivity, overweight, and alcohol consumptions). Exposure prevalence were sourced from a large-scale national representative survey. Risk estimates of the relationship between the exposure of interest and colorectal cancer were obtained from published meta-analyses. The overall PAF was then estimated, using the 2013 national cancer incidence data from the Malaysian Cancer Registry. Results: Overall, the mean incidence rate for colorectal cancer in Malaysia from 2008 to 2013 was 21.3 per 100,000 population, with the mean age of 61.6 years (±12.7) and the majority were men (56.6%). Amongst 369 colorectal cancer cases in 2013, 40 cases (20 men, 20 women), 10 cases (9 men, 1 woman) or 20 cases (16 men,4 women) would be prevented, if they had done physical exercises, could reduce their body weight to normal level or avoided alcohol consumption, assuming that these factors are causally related to colorectal cancer. It was estimated that 66 (17.8%;66/369) colorectal cancer cases (42 men, 24 women) who had all these three risk factors for the last 10 years would have been prevented, if they could control these three risk factors through effective preventive measures. Conclusions: Findings suggest that approximately 18% of colorectal cancer cases in Malaysia would be prevented through appropriate preventive measures such as doing regular physical exercises, reducing their body weight to normal level and avoiding alcohol consumption, if these factors are causally related to colorectal cancer. Scaling-up nationwide public health campaigns tailored to increase physical activity, controlling body weight within normal limits and avoid alcohol intake are recommended. Future studies with other site-specific cancers and additional risk factors are needed

Toll-like receptor 9 and 4 gene polymorphisms in susceptibility and severity of malaria: a meta-analysis of genetic association studies

Background: Malaria is still a major public health problem in sub-Saharan Africa and South-east Asia. The clinical presentations of malaria infection vary from a mild febrile illness to life-threatening severe malaria. Toll like receptors (TLRs) are postulated to be involved in the innate immune responses to malaria. Individual studies showed inconclusive findings. This study aimed to assess the role of TLR4 (D299G, T399I) and TLR9 (T1237C, T1486C) in severity or susceptibility of malaria by meta-analysis of data from eligible studies. Methods: Relevant case–control studies that assessed the association between TLR 4/9 and malaria either in susceptibility or progression were searched in health-related electronic databases. Quality of included studies was evaluated with Newcastle–Ottawa scale. Pooled analyses for specific genetic polymorphisms were done under five genetic models. Stratified analysis was done by age and geographical region (Asian countries vs non-Asian countries). Results: Eleven studies (2716 cases and 2376 controls) from nine endemic countries were identified. Five studies (45.4%) obtained high score in quality assessment. Overall, a significant association between TLR9 (T1486C) and severity of malaria is observed in allele model (OR: 1.26, 95% CI: 1.08–1.48, I2 = 0%) or homozygous model (OR: 1.55, 95% CI: 1.08–2.28, I2 = 0%). For TLR9 (T1237C), a significant association with severity of malaria is observed in in heterozygous model (OR:1.89, 95% CI: 1.11–3.22, I2 = 75%). On stratifications, TLR9 (T1486C) is only significantly associated with a subgroup of children of non-Asian countries under allele model (OR: 1.25, 95% CI: 1.02–1.38), while 1237 is with a subgroup of adults from Asian countries under heterozygous model (OR: 2.0, 95% CI: 1.09–3.64, I2 = 39%). Regarding the susceptibility to malaria, TLR9 (T1237C) is significantly associated only with the children group under recessive model (OR: 2.21, 95% CI: 1.06–4.57, I2=85%) and homozygous model (OR: 1.49, 95% CI: 1.09–2.0, I2 = 0%). For TLR4 (D299G, T399I), none is significantly associated with either severity of malaria or susceptibility to malaria under any genetic models. Conclusions: The findings suggest that TLR 9 (T1486C and T1237C) seems to influence the progression of malaria, under certain genetic models and in specific age group of people from specific geographical region. TLR 9 (T1237C) also plays a role in susceptibility to malaria under certain genetic models and only with children of non-Asian countries. To substantiate these, future well designed studies with larger samples across endemic countries are needed

A comparison of neoadjuvant therapies for gastroesophageal and gastric cancer on tumour resection rate: A network meta-analysis

Background: Gastric cancer is one of the most common malignancies around the world, and a variety of neoadjuvant chemotherapies with different drug combinations are available for the treatment. R0 resection refers to a microscopically negative margin on resection, where no gross or microscopic tumour remains in the primary tumour. We aimed to find evidence on the relative effectiveness of neoadjuvant therapies for patients with advanced gastroesophageal and gastric cancer on the R0 resection rate. Methods: Relevant randomised controlled trials were searched using appropriate keywords in health-related databases. We performed network meta-analysis within a frequentist framework. The endpoint assessed was the R0 resection rate. We assessed consistency and transitivity assumptions that are necessary for network meta-analysis. This study only used data from published studies. The need for consent from participants was waived by the Ethics Review Committee of the International Medical University in Malaysia. Results: Six randomised controlled trials involving 1700 patients were identified. A network plot was formed with five neoadjuvant regimens [DLX (pyrimidine analogue + platinum compounds + chemoradiotherapy), DELX (pyrimidine analogue + epipodophylllotoxins/etoposide + platinum compounds + chemoradiotherapy), ADL (anthracycline + pyrimidine analogue + platinum compounds), ADM (anthracycline+ pyrimidine analogue + anti-folate compounds) and LTX (platinum compounds + taxane + chemoradiotherapy)] and surgery alone for management of patients with advanced gastroesophageal and gastric cancer. Assumptions required for a network meta-analysis such as consistency ((global test: Chi2 (1): 3.71; p:0.054)), and the transitivity in accord to the characteristics of interventions considered in this review were not violated. In the network comparison, surgery alone has a lower R0 resection rate compared with LTX (OR 0.2, 95%CI:0.01, 0.38) or DLX (OR 0.48, 95%CI: 0.29, 0.79). LTX has higher resection rate compared with DLX (OR 2.47, 95%CI: 1.08 to 5.63), DELX (OR 106.0, 95%CI: 25.29 to 444.21), ADM (OR 5.41, 95%CI: 1.56 to 18.78) or ADL (OR 3.12, 95%CI: 1.27 to 7.67). There were wide or very wide CIs in many of these comparisons. Overall certainty of the evidence was low or very low. Further research in this field is very likely to have an important impact on our confidence in the R0 resection rates between LTX versus other neoadjuvant chemotherapy is likely to change the estimate. Conclusions: Findings suggest that overall quality of evidence on the relative effectiveness of neoadjuvant chemotherapies was low to very low level. Therefore, we are very uncertain about the true effect of neoadjuvant therapies in the R0 resection rate in patients with gastroesophageal and gastric cancer. Future well-designed large trials are needed. To recruit large samples in this field, multicountry trials are recommended. Future trials also need to assess treatment-related adverse events, and patients-centered outcomes such as health‐related quality of life

Loop-mediated isothermal amplification (LAMP) test for diagnosis of uncomplicated malaria in endemic areas: a meta-analysis of diagnostic test accuracy

Background The global malaria decline has stalled and only a few countries are pushing towards pre-elimination. The aim of the malaria elimination phase is interruption of local transmission of a specified malaria parasite in a defined geographical area. New and improved screening tools and strategies are required for detection and management of very low-density parasitaemia in the field. The objective of this study was to synthesize evidence on the diagnostic accuracy of loop-mediated isothermal amplification (LAMP) test for the detection of malaria parasites among people living in endemic areas. Methods This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Diagnostic Test Accuracy (PRISMA-DTA) guideline. Relevant studies in the health-related electronic databases were searched. According to the criteria set for this study, eligible studies were identified. The quality of included studies was evaluated with the use of a quality assessment checklist. A summary performance estimates such as pooled sensitivity and specificity were stratified by type of LAMP. Bivariate model for data analyses was applied. Summary receiver operating characteristics plots were created to display the results of individual studies in a receiver operating characteristics space. Meta-regression analysis was performed to investigate the sources of heterogeneity among individual studies. Results Twenty-seven studies across 17 endemic countries were identified. The vast majority of studies were with unclear risk of bias in the selection of index test. Overall, the pooled test performances were high for Pan LAMP (sensitivity: 0.95, 95% CI 0.91 to 0.97; specificity: 0.98, 95% CI 0.95 to 0.99), Plasmodium falciparum (Pf) LAMP (sensitivity: 0.96, 95% CI 0.94 to 0.98; specificity: 0.99, 95% CI 0.96 to 1.00) or for Plasmodium vivax (Pv) LAMP from 6 studies (sensitivity: 0.98, 95% CI 0.92 to 0.99; specificity: 0.99, 95% CI 0.72 to 1.00). The area under the curve for Pan LAMP (0.99, 95% CI 0.98-1.00), Pf LAMP (0.99, 95% CI 0.97-0.99) and Pv LAMP was (1.00, 95% CI 0.98-1.00) indicated that the diagnostic performance of these tests were within the excellent accuracy range. Meta-regression analysis showed that sample size had the greatest impact on test performance, among other factors. Conclusions The current findings suggest that LAMP-based assays are appropriate for detecting low-level malaria parasite infections in the field and would become valuable tools for malaria control and elimination programmes. Future well-designed larger sample studies on LAMP assessment in passive and active malaria surveillances that use PCR as the reference standard and provide sufficient data to construct 2 × 2 diagnostic table are needed

Preparation and Characterization of Cellulose-Chitosan Composite Hydrogel Films from Coconut Coir Fibers

Abstract The development of cellulose-chitosan composite hydrogel films is important in repair and regeneration of tissue. In this study, cellulose was extracted from coconut coir fiber via acid hydrolysis, alkali treatment and chlorite bleaching. Chitosan was prepared from crab shell by demineralization, deprotenization and deacetylation. The lithium chloride/N,N-dimethylacetamide (LiCl/DMAc) solvent system was used to obtain cellulose-chitosan composite hydrogel solutions. It was converted to the cellulose-chitosan composite hydrogel films by phase inversion method without cross-linker. XRD, SEM, FT IR and TG-DTA analyses were utilized to characterize the properties of prepared composite hydrogel films. Antimicrobial activity of cellulose-chitosan composite hydrogel solutions was tested for the purpose of using composite hydrogel films in biomedical applications