The Utility of a High-intensity Exercise Protocol to Prospectively Assess ACL Injury Risk.

This study investigated the utility of a 5-min high-intensity exercise protocol (SAFT(5)) to include in prospective cohort studies investigating ACL injury risk. 15 active females were tested on 2 occasions during which their non-dominant leg was analysed before SAFT(5) (PRE), immediately after (POST0), 15 min after (POST15), and 30 min after (POST30). On the first occasion, testing included 5 maximum isokinetic contractions for eccentric and concentric hamstring and concentric quadriceps and on the second occasion, 3 trials of 2 landing tasks (i. e., single-leg hop and drop vertical jump) were conducted. Results showed a reduced eccentric hamstring peak torque at POST0, POST15 and POST30 (p<0.05) and a reduced functional HQ ratio (Hecc/Qcon) at POST15 and POST30 (p<0.05). Additionally, a more extended knee angle at POST30 (p<0.05) and increased knee internal rotation angle at POST0 and POST15 (p<0.05) were found in a single-leg hop. SAFT(5) altered landing strategies associated with increased ACL injury risk and similar to observations from match simulations. Our findings therefore support the utility of a high-intensity exercise protocol such as SAFT(5) to strengthen injury screening tests and to include in prospective cohort studies where time constraints apply

Theoretical Framework Development for Supply Chain Risk Management for Malaysian Manufacturing

Globalization, rapid technological changes and growing competition not only facilitate but also make the supply chain more complex and fragile. Any disruption can disturb many organizations and even whole system. There are many theories and frameworks that present solution but no study is available that theoretically development framework for supply chain risk management. Due to the lack of structured supply chain risk management system the focus of this study is to develop a novel framework for identifying the potential risks and assessment of their effects on supply chain performance. Additionally, evaluate the role of supply chain collaboration in risk mitigation and performance improvement in Malaysian manufacturing sector. This study has highlighted numerous problems of Malaysian organizations and developed a theoretical framework. This framework will guide Malaysian organizations and will present better understanding for managers in resolving these issues. This is a conceptual paper, systematic as well as content analysis have been done for literature review. For future study, there is need to empirically verification of this theoretical framework. The proposed methodology to achieve this framework is; questionnaire will be developed from a pool and will be validate by exploratory view for risk identification. This questionnaire will be distributed among Malaysian manufacturing and data will be analyzed through Structural Equation Modeling (SEM) for risk assessment and mitigation. The theoretical contribution of this study is support of theory of swift, even flow as underpinning theory and information processing theory as supportive theory

A novel classification of supply chain risks: Scale development and validation

Purpose: Supply chain has become an essential element for any organization but risks are the major obstacles in achieving the performance even it can disrupt not only the organization but a whole system. Thus it is compulsory to manage the risks efficiently and effectively. Risk cannot be managed until properly identified, there are numerous studies on risk identification, after comprehensive literature, it has been revealed that the study that identifies overall supply chain risk is scaring. The manufacturing sector of any country is considered as the backbone of any economy, in Malaysia it is the second largest sector in economic contribution and highest in productivity level. The aim of this study is to provide a reliable tool to assess the overall supply chain risks of Malaysian manufacturing through a systematic process. Design/methodology/approach: A detail literature review has been done for categorization of overall supply chain risk sources. Then an instrument has been developed from a pool of items. The questionnaire was purified through pretesting, pilot testing (by the exploratory view) and reliability and validity tests. The data were collected by email from Federation of Malaysian Malaysia (FMM-2017) through systemic probability sampling. Total 132 final responses have been considered for exploratory factor analysis through SPSS 23. Findings: The finding of this study revealed that overall supply chain risks can be categories into seven constructs that are supply side risks, process side risks, demand side risks, logistic side risks, collaboration side risks and environment side risks and the final questionnaire is consisting of 57 items. Research limitations/implications: This study covered tier 1 members of the supply chain. Secondly, the supply chain of manufacturing organizations only has been considered. Practical implications: This study will help the managers to understand what kind of risk sources they can face and which type of risks under these risk sources they should consider while decision making. Originality/value: This article will justify the need for Malaysian manufacturing by providing a validated and reliable instrument for the identification and assessment of their risks under major supply chain risk sources

Mechanical Player Load™ using trunk-mounted accelerometry in football: Is it a reliable, task- and player-specific observation?

The aim of the present study was to examine reliability and construct convergent validity of Player Load™ (PL) from trunk-mounted accelerometry, expressed as a cumulative measure and an intensity measure (PL · min(-)(1)). Fifteen male participants twice performed an overground football match simulation that included four different multidirectional football actions (jog, side cut, stride and sprint) whilst wearing a trunk-mounted accelerometer inbuilt in a global positioning system unit. Results showed a moderate-to-high reliability as indicated by the intra-class correlation coefficient (0.806-0.949) and limits of agreement. Convergent validity analysis showed considerable between-participant variation (coefficient of variation range 14.5-24.5%), which was not explained from participant demographics despite a negative association with body height for the stride task. Between-task variations generally showed a moderate correlation between ranking of participants for PL (0.593-0.764) and PL · min(-)(1) (0.282-0.736). It was concluded that monitoring PL(®) in football multidirectional actions presents moderate-to-high reliability, that between-participant variability most likely relies on the individual's locomotive skills and not their anthropometrics, and that the intensity of a task expressed by PL · min(-)(1) is largely related to the running velocity of the task

Barriers to Treatment and Control of Hypertension among Hypertensive Participants: A Community-Based Cross-sectional Mixed Method Study in Municipalities of Kathmandu, Nepal

AbstractIntroduction: Despite the established evidence on benefits of controlling raised blood pressure and development of several guidelines on detection and management of hypertension, people often have untreated or uncontrolled hypertension. In this context, we undertook this study to identify the barriers existing in hypertension treatment and control in the municipalities of Kathmandu district in Nepal. Methods: This was a community based, cross-sectional mixed method study conducted in the municipalities of Kathmandu district in Nepal between January and July 2015. Among 587 randomly selected participants, the aware hypertensive participants were further assessed for the treatment and control of hypertension. For qualitative component, 20 participants having uncontrolled hypertension took part in two focused group discussions and two cardiac physicians participated in in-depth interviews.Results: Out of 587 participants screened, 191 (32.5%) were identified as hypertensive. Among 191 hypertensive participants, 118 (61.8%) were aware of their problem. Of the 118 aware hypertensive participants, 93 (78.8%) were taking medicines, and among those treated, 46 (49.6%) had controlled hypertension. Proportions of participants taking anti-hypertensive medications varied significantly with age groups, ethnicity, occupation and income. Hypertension control was significantly associated with use of combination therapy, adherence to medication, follow-up care, counseling by healthcare providers and waiting time in hospital. Being worried that the medicine needs to be taken life-long, perceived side effects of drugs, non-adherence to medication, lost to follow-up, inadequate counseling from physician, and lack of national guidelines for hypertension treatment were the most commonly cited barriers for treatment and control of hypertension in qualitative component of the research.Conclusion: Large proportion of the hypertensive population has the untreated and the uncontrolled hypertension. Efforts to dispel and dismantle the myths and barriers related to hypertension treatment and control are warranted to reduce the consequences of uncontrolled hypertension

Ross operation in children and young adults: the Alder Hey case series

BACKGROUND: The ideal prosthesis for aortic valve replacement in children and young adults has not been found yet. In recent years there has been a renewed interest in the replacement of aortic valve with the pulmonary autograft owing to its advantages of lack of anticoagulation, potential for growth and excellent haemodynamic performance. The purpose of this study was to review our institutional experience at Alder Hey hospital with the Ross procedure in children and young adults. METHODS: From November 1996 to September 2003, 38 patients (mean age, 13.1 ± 5.7 years) underwent the Ross procedure for various aortic valve diseases using the root replacement technique. Clinical and echocardiographic follow-up was performed early (within 30 days), 3 to 6 months, and yearly after surgery. Medical records of all patients were reviewed retrospectively. RESULTS: There was 1 perioperative death. The patients were followed-up for a median interval of 36 months and up to 7 years. One patient died 3 years after surgery secondary to ventricular arrhythmia with overall mortality of 5.3%. Actuarial survival at 7 years was 94 ± 2.5% and there was 100% freedom from reoperation for autograft valve dysfunction or any other cause. Balloon dilatation was required in 2 patients for pulmonary homograft stenosis. The haemodynamics at the latest follow-up were also similar to those at the time of discharge after surgery. There was no progression in the degree of aortic regurgitation for 11 patients with trivial and 3 with mild regurgitation. CONCLUSION: Our experience demonstrates that Ross operation is an attractive option for aortic valve replacement in children and young adults. Not only can the operation be accomplished with a low operative risk but the valve function stays normal over a long period of time with minimal alteration in lifestyle and no need for repeated operations to replace the valve as a result of somatic growth of the children