Poor Physical Condition Research Articles

Comparison of Pioneer and Native Woodland Species Growing on Top of an Engineered Landfill, Hong Kong: Restoration Programme

AbstractThis study dealt with a restoration project conducted at South‐East New Territories Landfill in Hong Kong, in order to screen suitable tree and shrub species (both native and pioneer species) for revegetation. For engineered landfills, landfill gas migration and leachate contamination to the topsoil are rarely problematic, but the lack of nutrients and moisture and poor physical soil conditions may jeopardize potential woodland establishment. The growth performance of 25 woody plant species subjected to 12 different soil amelioration and seedlings planting methods was compared. The results showed that the general performance (mortality rate, apical height, crown diameter and basal diameter) of pioneer species (notably Acacia species) was much better than that of native species in all blocks of woodland mix and scrub mix. The notch planting method was effective in helping seedling roots to have better contact with soil for water uptake, which subsequently increased the survival rates of seedlings, leading to a better tree coverage. Soil ameliorations (horticultural soil with fertilizer and horse and pig manure) generally increased the seedling survival rate and improved plant growth. Tree coverage on all the plant trial blocks was mainly established by the three Acacia species. A planting distance of 1 m was recommended for woodland establishment, and such dense seedlings planting would achieve a better tree coverage under a shorter period of time (than the distance of 3 m). Difficulties in woodland establishment were discussed, and the strategies for achieving a better tree growth were recommended. Copyright © 2015 John Wiley & Sons, Ltd.

Patient-perceived barriers and facilitators to increasing physical activity among patients with musculoskeletal disorders receiving outpatient physiotherapy: a qualitative investigation

Background: There is an increasing burden of musculoskeletal disorders among increasingly sedentary and aging populations internationally. Musculoskeletal conditions can impair people’s ability to undertake physical activity. A key step in the development of effective intervention strategies to assist inactive patients with musculoskeletal disorders to become more physically active is to understand their perceived barriers to undertaking physical activity in their daily lives. Whether perceived barriers are veritable or not, strategies that effectively address perceived barriers may facilitate improved physical activity outcomes among inactive patients. Purpose: The purpose of this qualitative study was to investigate perceived barriers and facilitators to undertaking physical activity reported by patients accessing outpatient physiotherapy clinics for musculoskeletal disorders. Methods: A questionnaire with open ended items was administered to patients n= 217 (73.3% of eligible patients) from three clinics that provide physiotherapy services for musculoskeletal disorders. The survey included questions to capture the clinical and demographic characteristics of the sample. It also comprised two open-ended questions requiring qualitative responses. The first asked the participant to describe factors that made physical activity more difficult, and the second asked which factors made it easier for them be physically active. Participants’ responses to the two openended questions were read, coded and thematically analysed independently by two researchers; with a third researcher available to arbitrate any unresolved disagreement. Results: The mean (standard deviation) age of participants was 53 (15) years and 113 (52.1%) were male. A total of 112 (51.6%) participants reported having three or more health conditions,whilen= 140 (64.5%)were classified as overweight or obese. Five overarching themes describing perceived barriers for undertaking physical activity were ‘health conditions’, ‘time restrictions’, ‘poor physical condition’, ‘emotional, social and psychological barriers’, and ‘access to exercise opportunities’. Perceived physical activity facilitators were also aligned under five themes, namely ‘improved health state’, ‘social, emotional and behavioural supports’, ‘access to exercise environment’, ‘opportunities for physical activities’ and ‘time availability. Conclusion(s): It was clear from the breadth of responses that meaningful supports and physical activity promoting intervention approaches must be multidimensional. They should have the capacity to address a variety of physical, functional, social, psychological, motivational, environmental, lifestyle and other perceived barriers. It would appear that for such interventions to be effective, they should be flexible enough to address a variety of specific concerns. Participants were sampled from one geographical region and findings should not be extrapolated to dissimilar societies. Implications: Physiotherapy to reduce pain and improve function is likely to be an important catalyst in assisting inactive patients to become physically active. However, it is important that social, psychological, motivational, environmental and lifestyle related factors are considered when planning strategies to improve physical activity behaviours among patients with musculoskeletal disorders accessing physiotherapy interventions.

Abstract 207: Relationship between patients with Kawasaki disease and the role of Parents Association Kawasaki Disease (Parents Association)

Katayama et al. indicated that the Parents Association for children with Kawasaki disease plays a significant role through four phases of “the psychological development process over 10 years in mothers with children with Kawasaki disease.” In the first phase, parents are bewildered, persistently worrying about their child’s poor physical condition with no clear cause. In the second phase, parents are confused by the diagnosis of Kawasaki disease and feel panicked not knowing what to do. In the third phase, they reexamine their attitudes as parents and alter their consciousness through an encounter with the Parents Association. In the fourth phase, parents begin to act proactively with the growth and development of children, facing the reality and future as the parents of children with Kawaski disease. However, no detailed analysis has been reported regarding the significance of the Parents Association itself. Therefore, we analyzed the entire content of Parents Association newsletters from No. 1 through No. 192. Here we report the reevaluated significance of the Parents Association.

Modified simultaneous integrated boost radiotherapy for large retroperitoneal malignant tumor: A case report.

The current study reports the case of a large retroperitoneal tumor treated with modified simultaneous integrated boost (SIB) radiotherapy. A 45-year-old female presented to the emergency department complaining of left abdominal pain and fever. A computed tomography scan detected a retroperitoneal tumor of 12×16×16 cm, and a biopsy revealed a poorly-differentiated adenocarcinoma. The patient was diagnosed with a large adenocarcinoma originating from the left ureter, with no distant metastasis. Due to the patient's poor physical condition, surgery was not recommended, and the patient was referred to the Department of Radiation Oncology (Yamagata University Hospital, Yamagata, Japan). Modified SIB radiotherapy was administered following the acquisition of written consent from the patient. The total irradiation dose to the center of the tumor and to the surrounding healthy tissue was ∼96 Gy/33 fractions and <60 Gy/33 fractions, respectively. At the end of the radiotherapeutic course, the tumor volume was reduced by ≥80%, and the residual tumor was surgically resected. As a result of the resection, a complete pathological response was confirmed; the patient has been recurrence-free for >3 years with no complications. Modified SIB radiotherapy may be safely administered, with favorable outcomes. Complete recovery can be achieved with this technique, even in a patient with a large radioresistant tumor.

93P - The Clinical Characteristics of 50 Patients with Radiation Pneumonitis

Aim: To analyse the risk factors and therapy modality which lead to radiation induced pneumonia (RP). Methods: We included the patients with lung cancer who were diagnosed RP after 3D-CRT or IMRT. The radiation doses respectively were 60-70 Gy in 30-35 fractions in NSCLC and 50-60 Gy in 25-30 fractions in SCLC. We divided the patients into 3 groups according to the grade of RP using RTOG standard to compare the risk factors of different grade through analysing the clinical character, therapy modalities, and dosiology. We also calculated DVH to statistic dosimetric parameters. SPSS16.0 software was used for statistical analysis. Results: With follow-up to June 2014, there were 50 cases who were diagnosed with RP more than grade 2. Among them, grade 2 was seen in 16 cases (32%), grade 3 in 22 cases (44%), grade 4 in 12 cases (24%). 46 cases were male and 4 females, age range was 40 to 72 years. According to AJCC 2009 staging system, there were 4, 36, and 10 cases in stage II, III and IV respectively. Among 48 patients with immune dysfunction, 76% of which were severe, 20% were mild-moderate. Among 46 patients receiving induction chemotherapy previously, 60.8% of patients received more than 3 cycles. 24% of patients received targeted therapy after or during radiotherapy, of which 67% showed grade 2 RP. In terms of time of damage occurring, 84% of patients were during 8 weeks and only 16% more than 8 weeks after radiotherapy. In a stratified analysis according to different grade of RP, there was no difference between three groups with respect to clinical characteristics, including age, sex, disease types, pathological types; but with respect to KPS, disease stage, and immune function after radiotherapy, there was a statistically significant difference between groups.There was statistical difference with respect to treatment dose, induced chemotherapy cycles, and combined targeted therapy. A higher proportion of patients with severe pneumonia were treated with more than 3 cyles of induced chemotherapy and combined with targeted therapy. Conclusions: The retrospective results of 50 cases with RP showed that cancer stage, poor physical condition and low immune function after radiotherapy is associated with high grade RP; multi-cycle induction chemotherapy, combined targeted therapy, bigger imaging effusion area and earlier occuring time of RP were the main influencing factors of severe RP. GTV size and double lung irradiated volume were still the main dosimetry indicators affecting the severity of RP. Disclosure: All authors have declared no conflicts of interest.

The effects of different preoperative biliary drainage methods on complications following pancreaticoduodenectomy.

The objective of this study was to investigate the effects of different preoperative biliary drainage (PBD) methods on complications in jaundiced patients following pancreaticoduodenectomy. We retrospectively analyzed 270 extrahepatic bile duct cancer patients who underwent pancreaticoduodenectomy. A total of 170 patients without PBD treatment were defined as the non-PBD group. According to different PBD methods, 45, 18, and 37 patients were classified into the percutaneous transhepatic biliary drainage (PTBD), endoscopic nasobiliary drainage (ENBD), and endoscopic retrograde biliary stent (ERBS) groups, respectively. Clinical characteristics and complications were compared among the 4 groups.Preoperative cholangitis occurred in 14 (8.2%) and 8 (21.6%) patients in the non-PBD and ERBS group, respectively (P = 0.04). Compared with the non-PBD group, delayed gastric emptying (DGE) and wound infection occurred significantly more often in the ERBS group. The incidence of severe complications was significantly lower in the PTBD group than the non-PBD group (P = 0.03). Postoperative hospital stay and complication rates were significantly higher in the ERBS group than the PTBD group. There were no significant differences in complications between ENBD and other groups.In conclusion, PTBD can improve surgical outcomes by reducing severe complication rate in jaundiced patients following pancreaticoduodenectomy. ERBS increased the rates of DGE and wound infection due to high incidence of cholangitis before operative intervention and should be avoided. ENBD carried no special effect on complications and needs further analysis.

What Challenges Manual Workers' Ability to Cope with Back Pain at Work, and What Influences Their Decision to Call in Sick?

Although back pain (BP) is a very common cause for sickness absence, most people stay at work during BP episodes. Existing knowledge on the factors influencing the decision to stay at work despite pain is limited. The aim of this study was to explore challenges for coping with BP at work and decisive factors for work attendance among workers with high physical work demands. Three focus groups (n = 20) were conducted using an explorative inductive method. Participants were public-employed manual workers with high physical work demands. All had personal BP experience. Thematic analysis was used for interpretation. Results were matched with the Flags system framework to guide future recommendations. Workers with BP were challenged by poor physical work conditions and a lack of supervisor support/trust (i.e. lack of adjustment latitude). Organization of workers into teams created close co-worker relationships, which positively affected BP coping. Workers responded to BP by applying helpful individual adjustments to reduce or prevent pain. Traditional ergonomics was considered inconvenient, but nonetheless ideal. When pain was not decisive, the decision to call in sick was mainly governed by workplace factors (i.e. sick absence policies, job strain, and close co-workers relationships) and to a less degree by personal factors. Factors influencing BP coping at work and the decision to report sick was mainly governed by factors concerning general working conditions. Creating a flexible and inclusive working environment guided by the senior management and overall work environment regulations seems favourable.

Variability of laboratory parameters is associated with frailty markers and predicts non-cardiac mortality in hemodialysis patients.

The levels of many laboratory parameters are associated with the outcomes of dialysis patients, but the significance of their variability has not been well studied. A total of 384 patients receiving stable hemodialysis treatment during 2002 were followed up for mortality until the end of 2013. The within-patient coefficients of variation (CV) were calculated for 13 laboratory parameters from 1 year of data. We defined variability as CV and analyzed the survival of the patients according to the baseline CV values of each parameter by proportional hazard modeling. During the 11-year observation period, 125 patients died. Higher CV levels for eight parameters, namely, blood urea nitrogen (BUN), sodium, hemoglobin, creatinine, total protein, albumin, potassium and phosphate, were significantly associated with all-cause mortality. The adjusted hazard ratios for a high BUN-CV (>15 %) and a high Na-CV (>1.3 %) against a lower CV were 1.92 (95 % CI 1.31-2.81) and 1.95 (1.36-2.80), respectively. The increased mortality risk associated with each variability was attributed to excess non-cardiac deaths. The CV values of most parameters were correlated with each other and often exhibited negative associations with age, diabetes, and mobility as well as the levels of hemoglobin, albumin, creatinine, Na, the protein catabolic rate, and the creatinine generation rate. Therefore, a high variability was generally associated with frailty-related adverse prognostic factors. The variability of several blood parameters had a significant impact on all-cause and non-cardiac mortality. The levels of the variabilities were most likely related to poor physical conditions of the patients.

A large-scale survey of adverse events experienced in yoga classes.

BackgroundYoga is a representative mind-body therapy of complementary and alternative medicine. In Japan, yoga is practiced widely to promote health, but yoga-associated adverse events have also been reported. To date, the frequencies and characteristics of yoga-related adverse events have not been elucidated. This study was conducted to elucidate the frequencies and characteristics of adverse events of yoga performed in classes and the risk factors of such events.MethodsThe subjects were 2508 people taking yoga classes and 271 yoga therapists conducting the classes. A survey for yoga class attendees was performed on adverse events that occurred during a yoga class on the survey day. A survey for yoga therapists was performed on adverse events that the therapists had observed in their students to date. Adverse events were defined as “undesirable symptoms or responses that occurred during a yoga class”.ResultsAmong 2508 yoga class attendees, 1343 (53.5%) had chronic diseases and 1063 (42.3%) were receiving medication at hospitals. There were 687 class attendees (27.8%) who reported some type of undesirable symptoms after taking a yoga class. Musculoskeletal symptoms such as myalgia were the most common symptoms, involving 297 cases, followed by neurological symptoms and respiratory symptoms. Most adverse events (63.8%) were mild and did not interfere with class participation. The risk factors for adverse events were examined, and the odds ratios for adverse events were significantly higher in attendees with chronic disease, poor physical condition on the survey day, or a feeling that the class was physically and mentally stressful. In particular, the occurrence of severe adverse events that interfered with subsequent yoga practice was high among elderly participants (70 years or older) and those with chronic musculoskeletal diseases.ConclusionsThe results of this large-scale survey demonstrated that approximately 30% of yoga class attendees had experienced some type of adverse event. Although the majority had mild symptoms, the survey results indicated that attendees with chronic diseases were more likely to experience adverse events associated with their disease. Therefore, special attention is necessary when yoga is introduced to patients with stress-related, chronic diseases.

Specificity of structure of complete mortality of individuals buried in the cemetery at the hospital and the church of Holy Spirit as compared to other cemeteries in Lublin from the 15th to 18th century

The goal of the study is to analyse and evaluate a complete mortality of individuals buried in the cemetery at the hospital and the church of Holy Spirit in Lublin. The main question is whether and to what extent the results of research into the subject will reflect the physical condition and the low social status of individuals from the Holy Spirit hospital-poorhouse. The comparison includes burials of Lublin burghers, church dignitaries and religious brothers and sisters of the Cathedral and Pobrygidkowski Church. This study discusses such issues as the share of children, juveniles and adults, the sex ratio, distribution of age and sex of adult and the average life span for men and women. The differences in the cumulative distributions of age frequency (dx) for the compared cemeteries were assessed using the Kolmogorov-Smirnov test. To evaluate the differences in average life span of adults the Student’s t-test was used after verification of the equality of variance by using the F-Snedecor test. The cemetery at the hospital and the church of Holy Spirit clearly stands out among comparable sites, not only in the way of burying the dead. The study of individuals buried in the Holy Spirit cemetery showed: the largest share of children and juveniles, as well as small percentage of individuals over the age of 50 years, which resulted from a low average life span for both men and women (significant differences). The comparison of the cumulative relative numbers (dx) from the interval of 10–15 year shows this percentage to be the highest and remain so up to the last interval, i.e. 60 years and more (significant differences for group 15–20 years – compared with the Cathedral and the 30–40 years – compared with the Pobrygidkowski Church). A poor physical condition, clearly related with low social status, is indicated by a variety of illnesses, injuries and malformations which were recorded in a large number of the skeletal remains, i.e. more than 70% of individuals.

일개 치위생과 대학생의 인터넷 중독과 건강 관련성

Objectives: The purpose of the study was to investigate the relationship between internet addiction and health in dental hygiene students. Methods: A self-reported questionnaire was completed by 216 dental hygiene students in Daegu from June 9 to 13, 2014. Data were analyzed by descriptive statistics, t-test, and ANOVA using SAS 9.2 program. The instruments included Korean internet addiction scale(K scale) and Korean version of the general health questionnaire. General characteristics consisted of grade, religion, residential types, economic condition, place of internet use, duration, purpose, and time of use. Physical characteristics consisted of subjective physical condition, smoking, alcohol drinking, exercise above twice per week, musculoskeletal disease, and location of physical symptoms. Psychiatric scale and 6 questions of physical characteristics were consulted by the statistician of preventive medicine department. Results: Internet users over 4 hours manifested the poor mental health, while those who uses internet under 2 hours showed good mental health(F = 1.41, p < 0.01). The students having good physical condition showed better mental health than those with poor physical condition(t = -2.81, p < 0.01). The students exercising at least twice a week showed better mental health than those who do not exercise(t = -3.10, p < 0.01). Those who having musculoskeletal symptoms showed higher index of internet addiction score than those who do not(t = 4.21, p < 0.01). Those who have no musculoskeletal symptoms tended to have better mental health than those who have musculoskeletal symptoms(t = 2.28, p < 0.05). The variables correlated to mental health were internet addiction, subjective physical condition, and exercise at least twice a week. The severity level of internet addiction leads to poor mental health(r = 0.26, p < 0.001). Conclusions: Internet addiction is closely related to mental health. So the students must know the danger of internet addiction. Proper health education is necessary for the prevention of addiction symptoms.

Effects of Earthquake on Urbanization in Dhaka City

Recent earthquakes with low to moderate magnitude very close to Dhaka are certainly indications of its earthquake source and vulnerability. The study was conducted to bring out the present earthquake vulnerability status of 10 wards, out of 91 wards, in Dhaka and to assume the probable loss of lives and property by studying the previous records in the city and getting respondents opinion about it. The ward no. 15 show higher building density with older age of building i.e. more than 30 years of age, and present more unreinforced buildings than other wards which might be the cause of increased vulnerability to earthquake. Among the 10 wards, the ward no. 13 and 17 are more vulnerable to earthquake due to highest soft storey buildings, heavy overhang, presence of short columns and poor physical condition of buildings. The result of the survey found that more than half (64%) of the respondents considered Dhaka city as the highly vulnerable to earthquake because of most of the infrastructures were built without maintaining the building code and also without keeping proper spaces among them. Besides these, 40% respondents stated that the impact would be obvious on life as there would not be enough time to escape people from the high rise buildings to safer places during the earthquake. Almost all the respondents (86%) consider that the southern part of Dhaka city is more vulnerable than other parts of the city due to the increasing urbanization and poorly structured old buildings.DOI: http://dx.doi.org/10.3329/jesnr.v6i1.22049 J. Environ. Sci. &amp; Natural Resources, 6(1): 107-112 2013

Dengue and Mosquito Control Programs: A Comparative Analysis

Aims: This paper aims to compare the effectiveness of current mosquito control programs in the control of dengue in a developed versus a developing country. Study Design: Systematic Review and Analysis. Place and Duration of Study: Department of Global Health, University of South Florida, Tampa, Florida, USA between August 2013 and July 2014. Methodology: Systematic literature search of published and grey literature was done using the following databases: MEDLINE, AGRICOLA, BMC, DOAJ, Web of Science, the Cochrane Library, WHOLIS and Google Scholar. Relevant data were then extracted and analyzed. Results: Developing countries usually start up vector control activities after an epidemic has started, resulting in a lower impact on the control and prevention of dengue. Some developing countries, despite having sustainable vector control programs, still have a high incidence of dengue. Some studies have shown that factors such as defective urban planning, low socioeconomic status and poor physical housing conditions in some endemic locations within the developing countries may account for the high incidence of dengue cases. In comparison, a developed country with robust mosquito control programs that have been sustained over long period of time, with proper ongoing surveillance involving monitoring and evaluation, better Review Article Falope et al.; JALSI, 2(1): 35-48, 2015; Article no.JALSI.2015.005 36 economy, urban planning and human behavior, consistently present with low incidence of dengue infection within the past few years. Conclusion: There are existing deficiencies in dengue vector control in developing countries such as gaps in the practice or implementation of vector control programs and existence of a sustainable mosquito control program. Further research needs to be done to determine the reasons for these gaps. Interventions need to be directed towards eliminating these gaps in dengue vector control to reduce incidence in these populations and prevent epidemics. Interventions may need to focus on policies regarding urban planning and educating the population on better practices regarding human behavior and habitation. Disclaimer: The authors are not implying that one of the mosquito control programs being compared is superior to the other; this is simply a comparative analysis of two programs which may or may not represent standard practices of other developed and developing countries.

Application of preoperative CT-guided Hook-wire localization of pulmonary nodules in thoracoscopic lobectomy of lung

Objective To evaluate the application of preoperative CT-guided Hook-wire localization of pulmonary nodules in thoracoscopic lobectomy of lung. Method Twenty eight patients with 31 pulmonary nodules of ground-glass opacity (GGO) detected by CT scan were admitted in our hospital from December 2008 to December 2013, including 17 males and 11 females with an average age of 55. The lesions were located by CT-guided Hook-wire technique, and lobectomy plus lymphadenectomy or pulmonary wedge resection were performed according to the results of fast frozen pathology. The characteristics of pulmonary nodules and general condition of the patients were analyzed. Results Among 31 nodules, 19 were malignant and 12 benign with an average size of (1.8±0.6) cm and thickness of (1.2±0.4) cm. The vertical distance from pleural to nodules was (1.5±0.7) cm and the insert depth of needle was (2.5±0.9) cm. The time for CT-guided Hook-wire localization was (16.5±5.2) min. The operation time for pulmonary wedge resection and pulmonary lobectomy was (18.5±5.5) min and (54.7±12.5) min, respectively. Intraoperative frozen section showed malignant tumors in 18 patients (19 GGO nodules), lobectomy plus lymphadenectomy were performed in 16 cases; 2 patients did not undergo pulmonary lobectomy because of poor physical condition or 2 GGO nodules in different lobes. There were no operation complications in this series. Postoperative pathologic findings of 31 nodules showed 9 cases of adenocarcinoma, 10 bronchioloalveolar carcinoma, 5 atypical adenomatous hyperplasia, 2 epithelioid hemangioendothelioma, 2 chronic inflammation, 1 hamartoma, 1 inflammatory pseudotumor and 1 sarcoidosis. The average postoperative hospital stay was (6.6±1.9) days. Conclusions Endoscopic resection of pulmonary GGO nodules with CT-guided Hook-wire localization technique is feasible and safe, with less complications and less time consuming. Key words: Surgery, computer-assisted; Tomography, X-ray computed; Solitary pulmonary nodule; Hook-wire; Ground-glass opacity

Cham Manuscripts, the Endangered Cultural Heritage from a Lost Kingdom

AbstractThis article describes the endangered situation of Cham manuscripts in Vietnam. Cham are a minority people in Vietnam who used to have their own kingdom called Champa that lasted from the seventh century until 1832, when Champa was eliminated by the Vietnamese. For hundreds of years, Cham people have produced many palm-leaf and paper manuscripts recording their religious teachings, culture, and history. About 600 Cham manuscripts have been collected by institutions in France and Vietnam. Yet, there are a few thousand more manuscripts still available in Cham communities located in Central Vietnam. Most of the manuscripts kept by these communities are however in poor physical condition and urgently need to be better preserved. This article first provides background information on Cham people and Cham manuscripts. Next, it describes the current preservation of Cham manuscripts in Vietnam, explaining why these invaluable materials of the Cham cultural heritage are in an endangered situation. Finally, it briefly discusses solutions for the preservation of Cham manuscripts in Vietnam. Information used in the article is mainly based on observation from two recent field trips to Vietnam by the author.

Experience of Advance Directives in a Hospice Center

To protect patient autonomy when confronting death, the importance of advance directives (ADs) has recently became an issue and gradually accepted in Korea. However, in real practice, ADs were not completed by patients but their families in most cases. To analyze the current situation of performing ADs, we reviewed medical charts of 214 terminal cancer patients admitted to the hospice center from October 2012 to September 2013. Seventy-six (35.5%) patients completed ADs. All ADs were completed by patients themselves. The most common reason for not completing ADs was poor physical and/or mental condition. As a proxy, the majority of patients preferred their spouses (55.3%). Few patients wanted life sustaining treatment (1.3%), however palliative sedation was accepted in 89.5%. The median timing of ADs after admission was three (0-90) days, and duration of survival since ADs was 22 (1-340) days. In conclusion, approximately one third of terminal cancer patients completed ADs by themselves. Considering that patient's poor condition is the main reason for not completing ADs, earlier discussion regarding ADs is necessary to enhance patients' participation.

Factors associated with inadequate work ability among women in the clothing industry

Work ability depends on a balance between individual resources and work demands. This study evaluated factors that are associated with inadequate work ability among workers in the clothing industry. We conducted a cross-sectional observational study of 306 workers in 40 small and medium-sized enterprises. We assessed work ability, individual resources, physical and psychosocial demands, and aspects of life outside work using a binary logistic regression model with hierarchical data entry. The mean work ability was 42.5 (SD=3.5); when adjusted for age, only 11% of the workers showed inadequate work ability. The final model revealed that smoking, high isometric physical load, and poor physical environmental conditions were the most significant predictors of inadequate work ability. Good working conditions and worker education must be implemented to eliminate factors that can be changed and that have a negative impact on work ability. These initiatives include anti-smoking measures, improved postures at work, and better physical environmental conditions.

Prediction of Intraoperative Circulatory Risk Based on Preoperative Neutrophil-to-Lymphocyte Ratio in Patients Undergoing Living Donor Liver Transplantation.

Intraoperative circulatory risk factors are associated with unfavorable outcomes after living donor liver transplantation (LDLT). We investigated whether the preoperative neutrophil-to-lymphocyte ratio (NLR) can predict intraoperative circulatory risks. The perioperative data of 276 patients who underwent LDLT were reviewed retrospectively. The intraoperative circulatory risk score (ICRS) was calculated using the inotropic score, hypotension, blood transfusion, oliguria, and change in serum lactate during LDLT. Perioperative variables including NLRs were compared between the high (≥3.0) and low (<3.0) ICRS groups, and a predictive model for high ICRS was developed. A high ICRS was associated with poor preoperative physical condition and unfavorable postoperative outcomes. The NLR progressively increased during the LDLT perioperative period. However, only preoperative NLRs differed significantly between the high and low ICRS groups (6.2 vs. 3.9, respectively; p<0.05). The predictive accuracy of the NLR (area under the receiver operator curve, 0.635) did not differ from those of the model for end-stage liver disease (MELD) and Child-Pugh-Turcotte scores. After multivariate adjustment, preoperative NLR ≥3.8 was identified as an independent predictor of high ICRS (risk ratio 3.15; p=0.004) together with preoperative hemodialysis and intraoperatively administered calcium chloride. Intraoperative circulatory risks are associated with several detrimental outcomes following LDLT. The preoperative NLR is predictive of intraoperative circulatory risks.

Causes and efects of cave accidents in the area of Kraków-Częstochowa upland

Background: Mountain’s caves should be characterized by a set of unique rules and those who comply with them may be rewarded with the opportunity to experience memorable, worth cherishing moments. There are plenty of threats, determined by both natural causes and tourists' actions, which might wait for hikers. Aim of the study: The aim of the research was to carry out the analysis of the accident rate within the caves situated in the area of Kraków- Częstochowa Upland.Material and methods: The method of the documentation analysis was used for the research; the analysis was carried out on the documentation involving years 1998-2014 (October) belonging to Jurajska Task Force of the Mountain Volunteer Search and Rescue based in Podlesice. The research material comprised of the following documents: MVSaR incident reports, the reports from the rescue expeditions and the inspection book of the transport equipment.Results: Most of the cave accidents occurring in the area of Kraków-Częstochowa Upland took place in the Sokole Mountains. The following causes of these dangerous incidents were indicated as the lack of proper equipment and poor physical condition, being lost, falling from the heights, slipping and being trapped. The consequences were really serious, ranging from fractured bones of the pelvis and the spine to even fatal accidents.Conclusions: Mountain/cave tourism is undoubtedly the source of many unforgettable memories. However, it is essential that those who perform it ought to be aware of the dangers associated with it. They must not disregard the necessity of performing it in accordance to generally accepted rules of safety. Keywords: Kraków-Częstochowa Upland, caves, accidents

Perceived barriers and facilitators to increasing physical activity among people with musculoskeletal disorders: a qualitative investigation to inform intervention development.

PurposeMusculoskeletal conditions can impair people’s ability to undertake physical activity as they age. The purpose of this qualitative study was to investigate perceived barriers and facilitators to undertaking physical activity reported by patients accessing ambulatory hospital clinics for musculoskeletal disorders.Patients and methodsA questionnaire with open-ended items was administered to patients (n=217, 73.3% of 296 eligible) from three clinics providing ambulatory services for nonsurgical treatment of musculoskeletal disorders. The survey included questions to capture the clinical and demographic characteristics of the sample. It also comprised two open-ended questions requiring qualitative responses. The first asked the participant to describe factors that made physical activity more difficult, and the second asked which factors made it easier for them to be physically active. Participants’ responses to the two open-ended questions were read, coded, and thematically analyzed independently by two researchers, with a third researcher available to arbitrate any unresolved disagreement.ResultsThe mean (standard deviation) age of participants was 53 (15) years; n=113 (52.1%) were male. A total of 112 (51.6%) participants reported having three or more health conditions; n=140 (64.5%) were classified as overweight or obese. Five overarching themes describing perceived barriers for undertaking physical activity were “health conditions”, “time restrictions”, “poor physical condition”, “emotional, social, and psychological barriers”, and “access to exercise opportunities”. Perceived physical activity facilitators were also aligned under five themes, namely “improved health state”, “social, emotional, and behavioral supports”, “access to exercise environment”, “opportunities for physical activities”, and “time availability”.ConclusionIt was clear from the breadth of the data that meaningful supports and interventions must be multidimensional. They should have the capacity to address a variety of physical, functional, social, psychological, motivational, environmental, lifestyle, and other perceived barriers. It would appear that for such interventions to be effective, they should be flexible enough to address a variety of specific concerns.