Background: Hypertension, together with poorly controlled blood pressure (BP) are known risk factors for kidney disease and progression to kidney failure as well as increased cardiovascular (CV) morbidity and mortality. Several studies in patients without kidney disease have demonstrated the efficacy of home BP telemonitoring (HBPT) for BP control. Objective: The primary aim of this study is to assess the mean difference in systolic BP (SBP) at 12 months, from baseline in remote dwelling patients with hypertension and chronic kidney disease (CKD) in Northern Alberta, Canada, comparing HBPT + usual care versus HBPT + a case manager. Other secondary objectives, including cost-effectiveness and acceptability of HBPT as well as occurrence of adverse events will also be assessed. Methods Design: This study is designed as a pragmatic randomized controlled trial (RCT) of HBPT plus clinical case management compared to HBPT with usual care. Setting: Peace River region in Northern Alberta Region, Canada. Patients: Primary care patients with CKD and hypertension. Measurements: Eligible patients will be randomized 1:1 to HBPT + BP case management versus HBPT + usual care. In the intervention arm, BP will be measured 4 times daily for 1 week, with medications titrated up or down by the study case manager until guideline targets (systolic BP [SBP]: <130 mmHg) are achieved. Once BP is controlled, (ie, to guideline-concordant targets), this 1-week protocol will be repeated every 3 months for 1 year. Patients in the control arm will also follow the same BP measurement protocol; however, there will be no interactions with the case manager; they will share their BP readings with their primary care physicians or nurse practitioners at scheduled visits. Limitations: Potential limitations of this study include the relatively short duration of follow-up, possible technological pitfalls, and need for patients to own a smartphone and have access to the internet to participate. Conclusions: As this study will focus on a high-risk population that has been characterized by a large care gap, it will generate important evidence that would allow targeted and effective population-level strategies to be implemented to improve health outcomes for high-risk hypertensive CKD patients in Canada’s remote communities. Trial Registration: www.clinicaltrials.gov (NCT number: NCT04098354)

This study investigates the conceptualisation of tolerance via metaphors in the United Arab Emirates (UAE) press media after proclaiming 2019 as the ‘Year of Tolerance’. The results revealed that various source domains are used to conceptualise tolerance, reflecting certain aspects of the Emirati culture and affecting the Emirati cultural model of tolerance. There are three types of experience working together to shape the formation of conceptual metaphors of tolerance: firstly, bodily experience which emerges from human cognitive embodiment. Secondly, this bodily experience mingles with cultural experience in the Emirati context, which suggests that embodiment is socioculturally grounded. Finally, there is linguistic experience which is inherited by its speakers as part of their cognitive and cultural heritage.

Background: To the best of our knowledge, the change in opioid prescription patterns upon referral to a palliative care team (PCT) was not previously investigated in the Middle East. Objective: This study aimed to explore the change in the pattern of opioid prescription and the pain scores before and after referring inpatients to a PCT. Methods: We conducted a retrospective review of patients’ records including all inpatients ≥15 years newly referred to the PCT over a period of 21 months at King Faisal Specialist Hospital and Research Center, Riyadh. Results: Of 631 patients, 52.3% were females, the median age was 54 years, and 96.7% had cancer. The proportion of patients on opioids before referral (83.4%) increased to 93.3% in the postreferral period, P < .0001. Patients receiving opioids on a regular basis increased from 31.9% before referral to 49.9% after referral to the PCT, P < .0001. Morphine was the most commonly prescribed opioid on a regular basis pre- and postreferral. Upon referral, the administration of opioids through the subcutaneous route increased from 3.7% to 10.9%, P < .0001. On average, pain scores were reduced by 1 point on a 0 to 10 numeric scale within 48 hours of seeing a patient by the PCT, P < .0001. Conclusion: Patients referred to a PCT are likely to get their opioid prescription optimized and pain scores improved shortly after the PCT involvement. Patients with cancer-related pain requiring opioids should be referred to a PCT as early as possible.

The main purpose of this study is to investigate the attitude of students toward Arabic and English textbooks in communication and media. The study used a survey questionnaire to collect data. A total of 157 university students, consisting of 95 females and 62 males, participated in the study. English textbooks received the highest satisfaction from male students, students specialized in journalism, students of the age group of 18 to 25 years, and third-year students. Arabic textbooks received the highest satisfaction from female students, students specializing in public relations, and fourth-year students. However, the overall results indicate that the English textbooks outperformed the Arabic textbooks in terms of easy access and use, the quality of print and design, provision of visual and graphic images, provision of activities and exercises, and quality of contents. The article suggests major changes and improvement in writing and publishing Arabic textbooks. Findings of the study suggest needs of major changes and improvement in writing and publishing Arabic textbooks.

Introduction Indigenous people represent approximately 5% of the world’s population. However, they often have a disproportionately higher burden of cardiovascular disease (CVD) risk and chronic kidney disease (CKD) than their equivalent general population. Several non-pharmacological interventions (e.g., educational) have been used to reduce CVD and kidney disease risk factors in Indigenous groups. The aim of this paper is to describe the protocol for a scoping review that will assess the impact of non-pharmacological interventions carried out in Indigenous and remote dwelling populations to reduce CVD risk factors and CKD. Materials and methods This scoping review will be guided by the methodological framework for conducting scoping studies developed by Arksey and O’Malley. Both empirical (Medline, Embase, Cochrane Library, CINAHL, ISI Web of Science and PsycINFO) and grey literature references will be assessed if they focused on interventions targeted at reducing CVD or CKD among Indigenous groups. Two reviewers will independently screen references in consecutive stages of title/abstract screening and then full-text screening. Impact of interventions used will be assessed using the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework. A descriptive overview, tabular summaries, and content analysis will be carried out on the extracted data. Ethics and dissemination This review will collect and analyse evidence on the impact of interventions of research carried out to reduce CVD and CKD among Indigenous populations. Such evidence will be disseminated using traditional approaches that includes open-access peer-reviewed publication, scientific presentations, and a report. Also, we will disseminate our findings to the government and Indigenous leaders. Ethical approval will not be required for this scoping review as the data used will be extracted from already published studies with publicly accessible data.

This case study was designed to investigate the use of social networking sites (SNSs) for seeking news and information by internally displaced people (IDP). The study is guided by media dependency theory and related literature. Data were collected from 288 Iraqi internally displaced people (IDP) in four large camps through a survey questionnaire. The findings of the study reported how and why the respondents use SNSs for news and information and how much they trusted such platforms. Most of the respondents were found to depend on a variety of SNS media, old or new, to receive news and information, especially in times of crisis and conflicts. Such devices were very important for communicating with the families, news contributions, and news production.

Tanah lempung sangat dipengaruhi oleh kadar air , dalam keadaan kering mempunyai daya dukung tinggi dan kondisi keadaan jenuh akan mempunyai daya  dukung rendah . Kadar air akan mempengaruhi sifat kembang susut dan parameter kuat geser tanah , permasalahan tanah lempung dimana kuat dukungnya dipengaruhi oleh kadar air , solusi alternatif yang dilakukan adalah dilakukan perbaikan tanah dengan cara stabilisasi tanah . Hasil penelitian , menurut klasifikasi unified termasuk kelompok CH dan menurut klasifikasi AASHTO termasuk kelompok A – 7 – 6 . penambahan semen atau kapur akan menyebabkan properties tanah batas cair ( LL ) menurun dengan batas plastis ( PL ) tetap sehingga indeks Plastisitas ( PI ) menurun , kemudian persentase butiran mengakibatkan jumlah fraksi halus menurun dengan gradasi lempung meningkat. Penelitian ini menganalisis perilaku tanah lempung , didapatkan kepadatan tanah maksimum dan kadar air optimum. Saat ini ada produk baru bahan stabiliser tanah yang dikenal dengan S-base 07 Liquid Soil Stabilizer menurut klasifikasinya cairan bekerja aktif pada pengujian CBR rendaman yaitu meningkatkan nilai CBR dan mereduksi pengembangan tanah. Untuk itu penelitian ini kita menggunakan S-Base 07 Liquid Soil Stabiliser 5%, 15% dan 25% hasil penelitian dapat disimpulkan bahwa penambahan S-base 07 Liquid Soil Stabilizer cairan bekerja mengisi dan menyelimuti pori pori tanah sehingga meningkatkan kekedapan tanah terhadap penambahan air dan kekuatan tanah saat penjenuhan tanpa merubah sifat – sifat fisis

The strong positive correlation between SA and IB AQSA indicates that the former is a valid tool. When the SA AQSA is used by proxy, it showed moderate to strong positive correlation with patients' actual scores for most of the symptoms.