Variety of mutual-visibility problems in graphs

If $X$ is a subset of vertices of a graph $G$, then vertices $u$ and $v$ are $X$-visible if there exists a shortest $u,v$-path $P$ such that $V(P)\cap X \subseteq \{u,v\}$. If each two vertices from $X$ are $X$-visible, then $X$ is a mutual-visibility set. The mutual-visibility number of $G$ is the cardinality of a largest mutual-visibility set of $G$ and has been already investigated. In this paper a variety of mutual-visibility problems is introduced based on which natural pairs of vertices are required to be $X$-visible. This yields the total, the dual, and the outer mutual-visibility numbers. We first show that these graph invariants are related to each other and to the classical mutual-visibility number, and then we prove that the three newly introduced mutual-visibility problems are computationally difficult. According to this result, we compute or bound their values for several graphs classes that include for instance grid graphs and tori. We conclude the study by presenting some inter-comparison between the values of such parameters, which is based on the computations we made for some specific families.Comment: 23 pages, 4 figures, original pape

Short-Term Effectiveness of a Lifestyle Intervention Program for Reducing Selected Chronic Disease Risk Factors in Individuals Living in Rural Appalachia: A Pilot Cohort Study

Most Western chronic diseases are closely tied to lifestyle behaviors, and many are preventable. Despite the well-distributed knowledge of these detrimental behaviors, effective efforts in disease prevention have been lacking. Many of these chronic diseases are related to obesity and type diabetes, which have doubled in incidence during the last 35 years. The Complete Health Improvement Program (CHIP) is a community-based, comprehensive lifestyle modification approach to health that has shown success in addressing this problem. This pilot study demonstrates the effectiveness of CHIP in an underserved, rural, and vulnerable Appalachian population. Two hundred fourteen participants in CHIP collectively demonstrated significant reductions in body mass index, systolic and diastolic blood pressure, and fasting blood levels of total cholesterol, low-density lipoprotein, and glucose. If these results can be repeated in other at-risk populations, CHIP has the potential to help reduce the burden of preventable and treatable chronic diseases efficiently and cost-effectively

Adherence challenges encountered in an intervention programme to combat chronic non-communicable diseases in an urban black community, Cape Town

Background: Chronic non-communicable diseases (CNCD) have become the greatest contributor to the mortality rate worldwide. Despite attempts by Governments and various non-governmental organisations to prevent and control the epidemic with various intervention strategies, the number of people suffering from CNCD is increasing at an alarming rate in South Africa and worldwide. Objectives: Study's objectives were to explore perceived challenges with implementation of, and adherence to health messages disseminated as part of a CNCD intervention programme; to gain an understanding of participants' expectations of CNCD intervention programmes;, and to explore the acceptability and preference of health message dissemination methods. In addition, participants' awareness of, and willingness to participate in CNCDs intervention programmes in their community was explored. Methods: Participants were recruited from the existing urban Prospective Urban Rural Epidemiology study site in Langa, Cape Town. Focus group discussions were conducted with 47 participants using a question guide. Summative content analysis was used to analyse the data. Results: Four themes emerged from the data analysis: practical aspects of implementation and adherence to intervention programmes; participants' expectations of intervention programmes; aspects influencing participants' acceptance of interventions; and their preferences for health message dissemination. The results of this study will be used to inform CNCDs intervention programmes. Conclusions: Our findings revealed that although participants found current methods of health message dissemination in CNCDs intervention acceptable, they faced real challenges with implementing and adhering to CNCDs to these messages.DHE

Lifestyle Medicine and Economics: A Proposal for Research Priorities Informed by a Case Series of Disease Reversal

Chronic disease places an enormous economic burden on both individuals and the healthcare system, and existing fee-for-service models of healthcare prioritize symptom management, medications, and procedures over treating the root causes of disease through changing health behaviors. Value-based care is gaining traction, and there is a need for value-based care models that achieve the quadruple aim of (1) improved population health, (2) enhanced patient experience, (3) reduced healthcare costs, and (4) improved work life and decreased burnout of healthcare providers. Lifestyle medicine (LM) has the potential to achieve these four aims, including promoting health and wellness and reducing healthcare costs; however, the economic outcomes of LM approaches need to be better quantified in research. This paper demonstrates proof of concept by detailing four cases that utilized an intensive, therapeutic lifestyle intervention change (ITLC) to dramatically reverse disease and reduce healthcare costs. In addition, priorities for lifestyle medicine economic research related to the components of quadruple aim are proposed, including conducting rigorously designed research studies to adequately measure the effects of ITLC interventions, modeling the potential economic cost savings enabled by health improvements following lifestyle interventions as compared to usual disease progression and management, and examining the effects of lifestyle medicine implementation upon different payment models

ENFERMEDADES RELACIONADAS AL ESTILO DE VIDA EN LIMA, PERÚ

Introducción: Las enfermedades relacionadas al estilo de vida son uno de los mayores retos de salud del siglo 21. Objetivos: El propósito de esta investigación fue obtener una base de datos para estudiar la prevalencia de enfermedades de las personas que viven en pobreza en Lima, Perú. Metodología: La investigación estuvo localizada en los distritos de Comas y Carabayllo en Lima, Perú. Contamos con un total de 829 adultos y 770 niños (0-17 años de edad) participantes. La data fue recolectada a través de clínicas comunitarias gratuitas, estas incluyeron muestras de sangre para evaluar la hemoglobina, glucosa, hemoglobina glicosilada, lípidos, vitamina D, y anticuerpos en contra de Chagas y Helicobacter pylori. Para la población pediátrica sólo se utilizó los records médicos; no se utilizaron muestras de sangre con propósitos de investigación. Resultados: Los resultados más significativos fueron: 50,9% con presión arterial sanguínea elevada siendo sistólica o diastólica, 47% Con hemoglobina glicosilada elevada, 24% glucosa en ayuno elevada, 57,2% con un al menos un parámetro elevado del panel lípido, 32,6% hemoglobina baja, 97,2% Vitamina D baja, 59% positivo para anticuerpos de Helicobacter, y 5,6% positivo con anticuerpos de Chagas. La prevalencia de sobrepeso y obesidad fue 65,1% para adultos y 42,3% para la población pediátrica. Conclusión: Los resultados demuestran anomalías relacionadas al estilo de vida. Esta información puede utilizarse para desarrollar estrategias de prevención y tratamiento de las enfermedades relacionadas al estilo de vida, con enfoque en la educación y cambios en el estilo de vida.   DOI: https://doi.org/10.25176/RFMH.v17.n2.83

Development of a colonoscopy add-on device for improvement of the intubation process

Jonathan D Litten1, JungHun Choi2, David Drozek31Department of Mechanical Engineering; 2Department of Mechanical Engineering and Biomedical Engineering Program; 3College of Osteopathic Medicine, Department of Specialty Medicine, Ohio University, Athens, OH, USAAbstract: A colonoscopy add-on device has been developed to reduce intubation time without modification of the current colonoscope and peripheral devices. One of the main purposes of the system is to minimize trauma caused by the distal tip of the colonoscope. The detachable sensory fixture at the end of the distal tip measures the distance between the distal tip and the colon wall in three directions, and the actuation system attached at the base of the colonoscope controls the distal tip by rotating two dial knobs. The device controls the distal tip to minimize contact between the distal tip and the colon wall, and the distal tip ideally points out the next possible lumen. A compatibility test of the infrared sensory system was carried out, and the design of the actuation system was accomplished. The system is integrated and controlled by a microprocessor. The device was tested in a silicon colon and porcine intestine. The results showed that a colonoscopist successfully reached the cecum with the aid of the colonoscopy add-on device without significant contact between the colon wall and the distal tip. The colonoscopy aid device was very helpful for the novice colonoscopist.Keywords: colonoscope, infrared sensors, intubation, trauma, colonoscopy training mode