METHOD: Eleven focus group discussions (FGDs) were conducted with a purposive sample of 89 participants aged > 50 from the major ethnic groups in the Segamat District, Johor State. FGDs were audiotaped, transcribed verbatim, and translated into English. Data were analysed using thematic analysis.
RESULTS: We identified trust in doctors as a key reason for whether or not to seek health care. Generally, the participants had low awareness of CRC sign/symptoms and screening. Emotional and logistic concerns about sending a stool sample to a clinic emerged as the main barriers to screening. Simplified illustrated instructions about stool collection in Malay, Chinese and Tamil, free screening at health clinics and reminders to complete the iFOBT test were perceived to facilitate engagement in screening, and posited as strategies that were likely to increase iFOBT uptake.
CONCLUSION: Primary care physicians play a crucial role in terms of reducing patient's misperceptions, recommending screening to patients, enhancing attendance, and improving uptake of CRC screening. There is a need for further research to investigate ways in which to reduce identified barriers and implement and test potential facilitative strategies as well as examine adherence by doctors to clinical guidelines about CRC screening.
METHODS: In this work, a modified recurrent equation-based cubic spline interpolation procedure for recovering missing PMU data is proposed. The recurrent equation-based method makes the computations of spline constants simpler. Using PMU data from the State Load Despatch Center (SLDC) in Madhya Pradesh, India, a comparison of the root mean square error (RMSE) values and time of calculation (ToC) is calculated for both methods.
RESULTS: The modified recurrent relation method could retrieve missing values 10 times faster when compared to the conventional cubic interpolation method based on the solution of a set of linear equations. The RMSE values have shown the proposed method is effective even for special cases of missing values (edges, continuous missing values).
CONCLUSIONS: The proposed method can retrieve any number of missing values at any location using observed data with a minimal number of calculations.
CASE SUMMARY: We present 5 cases of morbidly obese patients with cardiorenal syndrome (CRS) that began intermittent fasting either during their AHF hospitalization or in the outpatient setting for refractory symptoms despite hospitalization. Initiation of fasting correlated with reduction of respiratory distress and edema as well as improvements in psychological wellbeing and functional capacity.
DISCUSSION: Siddha fasting mediates hemodynamic and anti-inflammatory effects through natural ketosis and psychological benefits through empowerment in AHF. Potential role of fasting in reducing myocardial workload, coronary steal, angina, volume overload, and CRS needs further study in cardiac patients.