I was baptized a member of The Church of Jesus Christ of Latter-day Saints when I was eight years old. You could say I was sort of born into it, as my father, mother, seven other siblings, and both sets of grandparents are all members as well. I grew up in a small, rural town in Southern Idaho where vegetation is almost as sparse as non-LDS families. As children we were never quite sure which denomination these families belonged to: that they were not Mormon was the only distinction we made. As I was growing up my parents saw to it that I attended the three-hour long Church services every Sunday, the weekly youth activities, and our local four-year seminary program. After completing high school, I chose to pursue my academic studies at two Church-owned and operated institutions of higher learning, first at Ricks College and then Brigham Young University. But it seemed that the pinnacle of my Church education would take place when my twenty first birthday finally enabled me to become a missionary for The Church of Jesus Christ of Latter-day Saints.

Parkinson's disease (PD) is a neurological condition that can lead to changes to gait and postural stability of people with this condition. Tai Chi (TC) has been recommended for the management of PD by improving muscle strength, balance, and coordination. However, biomechanics research in TC for PD is lacking. This thesis investigated the effects of a biomechanical-based TC intervention program for people in the early-stage of PD by realizing three specific research objectives: 1) to develop a biomechanical-based TC intervention program for PD; 2) to examine the effects of a 12-week TC intervention on gait and postural stability in people with PD, by pre-test and post-test biomechanical analysis of obstacle crossing; 3) to explore the neuromuscular effects of TC intervention on gait and postural stability by analyzing the electromyography (EMG) activity of the lower limb muscles during obstacle crossing. Seven typical TC movements were selected, including Starting Form, Hero Touch Sky, Push Hand Back, Brush Knee and Twist Step, Repulse Monkey, Wave-hand in Cloud, and Lateral Forward Step to develop the TC intervention program. The joint angles, joint moment, and EMG signals of lower limbs muscles were analyzed during performance of the selected TC movements by an experienced TC master aged 38 years. Results showed that the selected TC movements are characterized by multidirectional movements, greater joint movement angles of the lower limb, and more active muscle activity than walking. The TC intervention program was formed based on the biomechanics analysis of the seven TC movements. The program consisted of 5-10 min warm up, 40 minutes of core activities, and 5 min cool down. To examine the effects of a biomechanical-based TC intervention program on gait and postural stability and to explore the neuromuscular effects of TC intervention on the lower limb muscles in people with PD, fifteen individuals in the early stage of PD (n = 15, Hoehn and Yahr stages 1 to 2; age 72.0 ± 6.9) participated in a 12-week online TC intervention, and 15 age- and sex-matched healthy participants (n = 15) served as control. The 3D motion data of the lower limb and EMG signals from the rectus femoris, adductor longus, tibialis anterior, semitendinosus, gluteus medius, tensor fasciae latae, and medial and lateral gastrocnemius muscles were collected during obstacle crossing from both groups using Vicon motion analysis system before intervention in both groups and after TC intervention in the TC group. Obstacle crossing was used to challenge the participants' gait and postural stability. Gait was assessed by measuring the temporospatial parameters such as crossing stride length, crossing step length, and crossing speed. Postural stability was assessed by measuring toe and clearance distance, pre- and post-horizontal distance, displacement and velocity of center of mass (COM), and COM-center of pressure (COP) separation. To examine the neuromuscular activity of the lower limbs following TC training, the ratio of the peak EMG, the integrated EMG (iEMG), and the ratio of the peak EMG and iEMG antagonistic pairs of the leading and trailing limb were examined during obstacle crossing and walking. In addition, the timed up-and-go test (TUG) and single-leg stance with eyes open and closed were tested. VICON Nexus, custom MATLAB scripts, and SPSS software (version 20) were used to analyze the data. Analysis of the PD participants' obstacle crossing performance revealed that they had significantly slower gait speed, smaller hip flexion angles, and larger knee adduction angles of the trailing limb, significantly larger mediolateral (ML) COM displacement and COM-COP separation distance, and significantly higher peak EMG ratios of the adductor longus, gluteus medius, and tensor fasciae latae (p < 0.05) than the healthy participants. Following the 12-week TC intervention, the PD participants had significantly increased crossing stride length, significantly decreased ML COM-COP separation (p < 0.05) and significantly increased AP COM displacement (p < 0.05), and increased EMG activity of the tibialis anterior in the leading and trailing limbs during obstacle crossing, whereas the activity of the gluteus medius and adductor longus in the leading limb decreased (p < 0.05). Moreover, the significant differences in the EMG of the gluteus medius and tensor fasciae latae muscles between PD and healthy participants found in pre-test were no longer present. After the TC intervention, the PD participants significantly improved their performance on the TUG test (p = 0.002). Therefore, people with early-stage PD presented changed gait and postural stability as well as changed neuromuscular activity of the lower limb. The 12-week online biomechanical-based TC intervention improved their gait and postural stability, particularly dynamic postural stability as measured by the COM-COP separation in people with early-stage PD. Compared to walking, performing the TC movements involved larger changes in the lower limb angles, range of motion, and higher muscle activity, particularly in the hip abductors and adductors. These characteristics of the TC movements could provide training to strengthen the muscles and improve the range of motion of the lower limbs. The gait and postural stability improvements following TC intervention are consistent with the neuromuscular activity changes in gluteus medius, tensor fasciae latae, and adductor longus muscles, indicating the mechanisms of TC training. The 12-week online biomechanical-based TC intervention program helped to decrease the ML COM-COP separation distance and could be used for the management of PD in the early stages of this condition.

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Throughout her writing career, the Taiwan intellectual Lung Ying-tai (1952– ) has elaborated a distinct vision of how her country could realize the civic foundations of a democratic society. This ambition began with “Wild Fire,” an editorial column that ran in the Taiwan newspaper The China Times from 1984 to 1986, which was later compiled into a 1986 book, Wild Fire Collection. At this time, Taiwan’s political structure had just begun a process of liberalization. Under increasing international and domestic pressure, the ruling Kuomintang (KMT) party eased its authoritarian control over the island. Lung took advantage of this unique moment, and, during Taiwan’s radical political reorganization, helped lay the foundations for a civil society based on democratic values. Lung’s vision of Taiwan’s burgeoning civil society centered on a strong democracy rooted in individual empowerment; an educated citizenry; and a native identity tied to the island. As Taiwan has continued its process of liberalization through the 1990s and into the 21st century, Lung has remained an outspoken voice in Taiwan’s political and cultural development. This thesis traces the themes that Lung first introduced in Wild Fire Collection through two later essay collections, Thinking Back on the Last Hundred Years (1999) and When Facing the Sea (2003). The issues that Lung discussed in “Wild Fire” have only become more relevant as Taiwan’s society puts into practice the democratic values that Lung called for in the mid-1980s. Meanwhile, globalization and China’s rise have brought the debate over Taiwan’s cultural identity to the fore.

No / Dementia is a common illness that is increasing in frequency and set to challenge the resources and expertise of health and social care services over the coming years. Increasingly, there has been interest in the management of behavioural and psychological symptoms of dementia (BPSD), as they are both common and associated with a range of negative outcomes. BPSD are associated with the admission of people with dementia to care homes. Limited resources and lack of knowledge in permanent care settings often lead to BPSD being managed with antipsychotic medications, which are associated with significant morbidity and mortality. There is evidence for the benefits of exercise within care home settings, although only a few studies include those with cognitive impairment. Tai Chi is a mind-body exercise combining relaxed physical movement and meditation, and has been suggested to have many health benefits. This article discusses the rationale and available options for treating BPSD and the current practice and reviews the literature regarding the benefits of exercise and, in particular, Tai Chi in the management of BPSD.

Background: Older people are faced with special physical and mental health challenges associated with ageing. Over 20% of adults aged 60 and over suffer from a mental or neurological disorder. It is known, and has been shown in previous studies, that physical activity can enhance physical and mental health. Meditative martial arts such as Tai Chi are, in most cases, low-intensity mind-body exercises that involve very graceful movements, which are performed in a slow, rhythmical, and well-controlled manner. This makes the practice suitable for older adults. Study aim: To investigate and assess the impact of different types of martial arts on mental health, health-related quality of life (HRQOL) and wellbeing among older adults, who are healthy or suffer from a mild cognitive impairment. Methods: This study focused on experimental studies with interventions of martial arts on older adults. Nine original articles gathered from Web of Science (n=1) and PubMed (n=8) were reviewed, compared and summarized. Keywords used were; “martial arts” AND “mental health” in both databases respectively. Results: The practice of martial arts is associated with positive results of both physical and mental health aspects. Tai Chi can lead to improvements of mental ability, health-related quality of life (HRQOL) and improve the physical ability of older adults. Conclusion: Martial arts as a means of intervention may be beneficial for the wellbeing and overall quality of life in older adults and should be recommended. However, nine original articles are not sufficient for stating the significance of martial arts on mental health among older adults. Further research is therefore required.

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University of Macau / Faculty of Education