496 research outputs found
Technological Readiness in the Middle East and North Africa – Implications for Egypt
Exercise-based interventions to enhance long-term sustainability of physical activity in older adults: a systematic review and meta-analysis of randomized clinical trials
Older adults; Physical activity; AdherenceAdultos mayores; Actividad fĂsica; AdherenciaAdults majors; Activitat fĂsica; AdherènciaExercise is a form of physical activity (PA). PA is an important marker of health and quality of life in older adults. The purpose of this study was to conduct a systematic review of the literature to assess the effect of exercise-based interventions on an at least six-month follow up PA measure, and to describe the specific strategies implemented during the intervention to strengthen the sustainability of PA in community-dwelling 65+ year-old adults. We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42017070892) of randomized clinical trials (RCT). We searched three electronic databases during January 2018 to identify RCT assessing any type of exercise-based intervention. Studies had to report a pre-, post-, and at least 6-month post-intervention follow-up. To be included, at least one PA outcome had to be assessed. The effect of exercise-based interventions was assessed compared to active (e.g., a low-intensity type of exercise, such as stretching or toning activities) and non-active (e.g., usual care) control interventions at several time points. Secondary analyses were conducted, restricted to studies that reported specific strategies to enhance the sustainability of PA. The intervention effect was measured on self-reported and objective measures of time spent in PA, by means of standardized mean differences. Standardized mean differences of PA level were pooled. Pooled estimates of effect were computed with the DerSimonian–Laird method, applying a random effects model. The risk of bias was also assessed. We included 12 studies, comparing 18 exercise intervention groups to four active and nine non-active control groups. Nine studies reported specific strategies to enhance the long-term sustainability of PA. The strategies were mostly related to the self-efficacy, self-control, and behavior capability principles based on the social cognitive theory. Exercise interventions compared to active control showed inconclusive and heterogeneous results. When compared to non-active control, exercise interventions improved PA time at the six-months follow up (standardized mean difference (SMD) 0.30; 95%CI 0.15 to 0.44; four studies; 724 participants; I2 0%), but not at the one- or two-years follow-ups. No data were available on the mid- and long-term effect of adding strategies to enhance the sustainability of PA. Exercise interventions have small clinical benefits on PA levels in community-dwelling older adults, with a decline in the observed improvement after six months of the intervention cessation.The present study was funded by United States Department of Health & Human Services National Institutes of Health (NIH), USA, and NIH National Institute on Aging (NIA), USA, (K24 AG057728)
Recruiting Hard-to-Reach Subjects for Exercise Interventions: A Multi-Centre and Multi-Stage Approach Targeting General Practitioners and Their Community-Dwelling and Mobility-Limited Patients
The general practitioner (GP)’s practice appears to be an ideal venue for recruiting community-dwelling older adults with limited mobility. This study (Current Controlled Trials ISRCTN17727272) aimed at evaluating the recruiting process used for a multi-centre exercise intervention (HOMEfit). Each of six steps resulted in an absolute number of patients (N1–N6). Sex and age (for N4–N6) and reasons for dropping out were assessed. Patient database screening (N1–N3) at 15 GP practices yielded N1 = 5,990 patients aged 70 and above who had visited their GP within the past 6 months, N2 = 5,467 after exclusion of institutionalised patients, N3 = 1,545 patients eligible. Using a pre-defined limitation algorithm in order to conserve the practices’ resources resulted in N4 = 1,214 patients (80.3 ± 5.6 years, 68% female), who were then officially invited to the final assessment of eligibility at the GP’s practice. N5 = 434 patients (79.5 ± 5.4 years, 69% female) attended the practice screening (n = 13 of whom had not received an official invitation). Finally, N6 = 209 (79.8 ± 5.2 years, 74% female) were randomised after they were judged eligible and had given their written informed consent to participate in the randomised controlled trial (overall recruitment rate: 4.4%). The general strategy of utilising a GP’s practice to recruit the target group proved beneficial. The data and experiences presented here can help planners of future exercise-intervention studies
Self-diffusion in granular gases
The coefficient of self-diffusion for a homogeneously cooling granular gas
changes significantly if the impact-velocity dependence of the restitution
coefficient is taken into account. For the case of a constant
the particles spread logarithmically slow with time, whereas the
velocity dependent coefficient yields a power law time-dependence. The impact
of the difference in these time dependences on the properties of a freely
cooling granular gas is discussed.Comment: 6 pages, no figure
Constraints to Economic Development and Growth in the Middle East and North Africa
When comparing the speed and extent of economic development in different geographic
regions of the world over the past 20 years, the under-average performance of Arab countries
in general and Arab Mediterranean countries in particular is striking. This is despite
an overall favorable geo-strategic situation at the crossroads of three continents, with excellent
connections to sea and waterways and in direct proximity to the European Union,
one of the world’s economic hubs. It is also despite the minor importance of negative factors
such as a high-burden diseases or high levels of ethnic fractionalization.
In this paper, I focus on identifying the most important constraints on Arab Mediterranean
economic development. I use state-of-the-art econometric tools to quantify constraints that
have been identified through economic theory and studies of the political economy characteristics
of the region. The empirical results offer support for the central hypothesis that
limited technological capacities and political economy structures are the primary constraints
on economic development. With a view to international structural adjustment efforts,
my findings imply that the limited success of the Euro-Mediterranean policy to
stimulate the economic development of the Arab Mediterranean countries might be because
structural adjustment efforts do not tackle—or at least do not sufficiently tackle—
these constraints.Vergleicht man Geschwindigkeit und Umfang der wirtschaftlichen Entwicklung der verschiedenen
Weltregionen in den vergangenen zwanzig Jahren, so fällt insbesondere das
unterdurchschnittliche Abschneiden der arabischen Länder im Allgemeinen und der arabischen
Mittlemeerländer im Besonderen ins Auge, und dies trotz einer insgesamt vorteilhaften
geographischen Lage im Schnittpunkt dreier Kontinente mit exzellenten Anschlussmöglichkeiten
an See- und Wasserwege, trotz der direkten Nachbarschaft zum
Weltwirtschaftsdrehkreuz Europäische Union und trotz der relativ geringen Bedeutung
wichtiger entwicklungshemmender Faktoren, beispielsweise ethnische Zersplitterung oder
massive Ausbreitung von Krankheiten wie AIDS oder Malaria.
In diesem Aufsatz wird versucht, von den unterschiedlichen Hemmfaktoren wirtschaftlicher
Entwicklung, die in der wirtschaftstheoretischen Literatur und/oder in MENARegionalstudien
diskutiert werden, diejenigen herauszuarbeiten, die wirtschaftliche Entwicklung
am stärksten behindern oder möglicherweise stärker als andere. Dabei benutze
ich modernste ökonometrische Verfahren, um den Einfluss der verschiedenen erklärenden
Variablen zu quantifizieren. Die Ergebnisse stĂĽtzen die Eingangshypothese, dass insbesondere
mangelnde technologische Kapazitäten und Fähigkeiten sowie regionalspezifische
politökonomische Strukturen die wirtschaftliche Entwicklung in den arabischen Mittelmeerländern
behindern
Implementation of preventive strength training in residential geriatric care: a multi-centre study protocol with one year of interventions on multiple levels
<p>Abstract</p> <p>Background</p> <p>There is scientific evidence that preventive physical exercise is effective even in high age. In contrast, there are few opportunities of preventive exercise for highly aged people endangered by or actually in need of care. For example, they would not be able to easily go to training facilities; standard exercises may be too intensive and therefore be harmful to them; orientation disorders like dementia would exacerbate individuals and groups in following instructions and keeping exercises going. In order to develop appropriate interventions, these and other issues were assigned to different levels: the individual-social level (ISL), the organisational-institutional level (OIL) and the political-cultural level (PCL). Consequently, this conceptional framework was utilised for development, implementation and evaluation of a new strength and balance exercise programme for old people endangered by or actually in need of daily care. The present paper contains the development of this programme labeled "fit for 100", and a study protocol of an interventional single-arm multi-centre trial.</p> <p>Methods</p> <p>The intervention consisted of (a) two group training sessions every week over one year, mainly resistance exercises, accompanied by sensorimotor and communicative group exercises and games (ISL), (b) a sustainable implementation concept, starting new groups by instructors belonging to the project, followed by training and supervision of local staff, who stepwise take over the group (OIL), (c) informing and convincing activities in professional, administrative and governmental contexts, public relation activities, and establishing an advisory council with renowned experts and public figures (PCL). Participating institutions of geriatric care were selected through several steps of quality criteria assessment. Primary outcome measures were continuous documentation of individual participation (ISL), number of groups continued without external financial support (at the end of the project, and after one year) (OIL). Secondary outcome was measured by sensorimotor tests and care-related assessments in the beginning and every 16 weeks (ISL), by qualitative outcome descriptions 12 months after group implementation (OIL) and by analysis of media response and structured interviews with stakeholders, also after 12 months (PCL).</p> <p>Conclusion</p> <p>Exemplarily, preventive exercise has been established for a neglected target population. The multi-level approach used here seems to be helpful to overcome institutional and individual (attitude) barriers.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN55213782</p
ErbB2 and bone sialoprotein as markers for metastatic osteosarcoma cells
Osteosarcoma is the most common malignant bone neoplasia occurring in young patients in the first two decades of life, and represents 20% of all primitive malignant bone tumours. At present, treatment of metastatic osteosarcoma is unsatisfactory. High-dose chemotherapy followed by CD34+ leukapheresis rescue may improve these poor results. Neoplastic cells contaminating the apheresis may, however, contribute to relapse. To identify markers suitable for detecting osteosarcoma cells in aphereses we analysed the expression of bone-specific genes (Bone Sialoprotein (BSP) and Osteocalcin) and oncogenes (Met and ErbB2) in 22 patients with metastatic osteosarcoma and six healthy stem cell donors. The expression of these genes in aphereses of patients affected by metastatic osteosarcoma was assessed by RT–PCR and Southern blot analysis. Met and Osteocalcin proved to be not useful markers since they are positive in aphereses of both patients with metastatic osteosarcoma and healthy stem cell donors. On the contrary, BSP was expressed at significant levels in 85% of patients. Moreover, 18% of patients showed a strong and significantly positive (seven to 16 times higher than healthy stem cell donors) ErbB2 expression. In all positive cases, neoplastic tissue also expressed ErbB2. Our data show that ErbB2 can be a useful marker for tumour contamination in aphereses of patients affected by ErbB2-expressing osteosarcomas and that analysis of Bone Sialoprotein expression can be an alternative useful marker
Discrete gait characteristics are associated with m.3243A>G and m.8344A>G variants of mitochondrial disease and its pathological consequences
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