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Body composition, body dimension and health in old age / CUHK electronic theses & dissertations collectionJanuary 2015 (has links)
Background: Together with bone mass, muscularity and adiposity constitute the three major components of body composition. The latter two, independent of bone mass, influence largely the morbidity and mortality in old age. / The adverse effect of adiposity on morbidity and mortality in mid-life is well established but it remains intriguing in late-life. Whether adiposity is deleterious or is paradoxically protective for survival in older adults remains elusive. Body mass index (BMI) in mid-life has been used as a conventional measurement of adiposity and has been categorized to predict cardiovascular risk and mortality. Therefore the majority of the data was collected from early and mid-life adults. However, the predictive validity of these reference values in older adults is uncertain. / The second component in body composition is muscularity. Both muscle strength and muscle mass can affect morbidity and perhaps mortality as well. Age-associated muscle loss or sarcopenia adversely affects physical function and therefore the daily activities and the quality of life in old age. Very few studies of muscle loss have been undertaken in Asian and Chinese population. In addition, data about the longitudinal change in muscle mass, muscle strength and muscle function is lacking in older Chinese. / Physical function depends not only on muscle mass and strength but also on cognitive function which executes the motor task. Impaired cognitive function can give rise to derailed motor task execution despite good muscle strength. Physical limitations in cognitive decline may be secondary to sarcopenia, dys-execution of motor task, or both. On the other side, motor impairment can occur early in the process of neuro-degeneration. Whether it is the early manifestation of dementia rather than its sequel remains uncertain. / Muscle mass and strength is positively associated with BMI. In the lower end of BMI, underweight together with muscle loss will certainly result in physical limitations. In the upper end of BMI, however, the interaction between muscularity and adiposity is more complicated. Sarcopenic obesity is prevalent in the western populations but much less is known in Asian and Chinese population, not to mention in old age. BMI, though is protective against sarcopenia, will affect physical function adversely at its upper end. This paradox needs reconciliation. Perhaps an optimal ratio between adiposity and muscularity, representing the amount of adiposity supported by one unit of muscle mass can non-paradoxically be related to physical limitations. / Contraction in vertical dimension or height loss is a common occurrence in late life. Age-associated stature decline has been attributed to both clinical and subclinical vertebral fractures secondary to established osteoporosis. However its significance may extend beyond bone loss. Senile kyphosis can affect postural stability in locomotion and may result in falls and fractures independently of bone mass. The health impact of contraction in vertical dimension has less often been examined. / While the contraction in vertical body dimension may have health impact and significance, the risk of excess in horizontal dimension, waist circumference and waist-hip ratio have been well accepted and widely applied in the conventional cardiovascular mortality risk assessment. Whether central adiposity exerts similar adverse effect in old age or older adults are more resistive to the hazard of central adiposity remains unanswered. / Against this background, I together with my colleagues have conducted a series of studies to examine how body composition, adiposity and muscularity, and how body dimension, contraction in vertical dimension (height loss) and excess in horizontal dimension (central adiposity), affect the mortality, physical limitation and cognitive decline in old age. / Hypothesis: I hypothesize that (1) Adiposity in older adults is protective for survival (2) Muscularity alone and in combination of adiposity is related to physical limitation and cognitive decline (3) Excess in horizontal dimension (central adiposity) is adaptive and can be beneficial for survival while contraction in vertical dimension (height loss) is degenerative and deleterious to health / Methods: In collaboration with my colleagues, I have conducted a territory-wide prospective health survey in older adults. Four thousand community-dwelling men and women aged 65 years or over were recruited between August 2001 and December 2003. The sample was stratified so that approximately 33% were in each of the age groups: 65-69, 70-74 and 75 and over. / Muscle and fat mass, and their distribution, together with bone mineral density were examined using dual-energy X-ray absorptiometry (DXA) by a Hologic QDR 2000 densitometer (Hologic, Waltham, WA). Body weight and body dimensions: stature, waist and hip circumferences were recorded. Their grip strength was measured by hand grip dynamometer (Jamar Hand dynamometer 5030 J1, Sammons Preston, INC, Bolingbrook, IL, USA). Participants were asked to stand up with folded arms from a chair 5 times and the time required was recorded. The time to walk 6 meters at normal pace and the step lengths were measured. / A questionnaire containing information regarding demographics, physical activity level (PASE score), physical limitation and medical diagnosis was administered by trained interviewers. / Cognitive function was assessed by trained interviewers using the cognitive score of the Chinese version of the Community Screening Instrument of Dementia (CSI-D) and the Mini-mental Status Examination (MMSE) score. / The body composition measurements, body dimension (stature and waist hip circumferences) measurements, physical performance tests and cognitive function were repeated prospectively in the second year and 4th year visits. Mortality status was ascertained annually through the Hong Kong Special Administrative Region Death Registry. / Results: Adiposity -- We have observed a beneficial effect of adiposity for survival in older men. The crude mortality hazard ratio decreased consistently by 0.85 (p<0.005) and 0.86 (p<0.005) per every quintile increase in body mass index (BMI), and body fat index (BFI) respectively. The best survived men fell into a BMI range of 25, which is defined as overweight in the Asia-Pacific classification of BMI. Furthermore, the highest two quintiles of whole body fat percentage were associated with significantly lower all-cause mortality. Therefore older men were resistive to the hazard of being overweight and may benefit from being overweight and slightly obese. / Muscularity -- The mean relative appendicular skeletal mass (ASM/height square) was 7.19 and 6.05 kg/m2 in men and women respectively. / The relationship between muscle mass, muscle function and cognitive function is more complex and perhaps is bidirectional. In both older men and women, the cognitively impaired (CSI-D cognitive score ≦28.40) group had weaker grip strength (-5.10 kg, p =0.000 in men; -1.08 kg in women, p =0.000) and performed worse in the two physical function tests (in men, 6-meter walk speed, -0.13 m/s, p =0.000, chair stand test, 1.42 seconds, p =0.000; in women, 6-meter walk speed, -0.08 m/s, p = 0.000, chair stand test, 1.48 seconds, p =0.000) After adjustment for age, ASM, PASE and other co-morbidities, significant differences in grip strength (-2.60 kg, p =0.000 in men; -0.49 kg, p = 0.011 in women) and the two physical function tests persisted between the cognitively impaired and non-impaired group (in men, 6-meter walk speed, -0.072m/s, p = 0.001, chair stand test, 0.80 seconds, p = 0.045; in women, 6-meter walk speed, -0.049 m/s, p =0.000, chair stand test, 0.98 seconds, p =0.000). Therefore muscle loss though coexisting with cognitive decline, cannot fully account for the poorer physical function and weaker muscle strength observed in the cognitively impaired older adults. / In a reverse direction, I have also examined if loss in muscle mass and strength can precede cognitive decline. In men, being underweight, having a lower ASM, a weaker grip strength, a slower chair-stand test, a shorter step length and a slower timed walk were significantly associated with a lower MMSE score 4 years afterwards. In women, all except underweight and a lower ASM were significantly associated with MMSE score 4 years later. Therefore being underweight, having weaker grip strength, a slower chair-stand test, a shorter step-length in men and weaker grip strength in women, was associated with faster cognitive decline over a four year period. Weak grip strength is a predictor of faster cognitive decline in both genders. / Adiposity and Muscularity in combination -- Having analyzed adiposity and muscularity individually, I have combined the two and examined whether the adiposity to muscle ratio, as conceptualized as the weight of fat supported by one unit of muscle, can predict incident or worsening physical limitation. In men having BMI >23, all 3 adiposity to muscle ratios were predictive of physical limitation. (all p values <0.001) In women, throughout the entire BMI range, all 3 adiposity to muscle ratios were associated with physical limitation 4 years later both before and after adjustment. (all p values <0.05) Therefore sarcopenia and sarcopenic obesity as measured by either the body weight or fat mass bearing on a unit of muscle mass (the adiposity to muscle ratio), is a valid predictor of incident or worsening physical limitation in older women throughout the entire BMI range and in older men having BMI > 23. / Loss in vertical dimension (Height loss) -- I have conducted a prospective analysis about height loss in older adults across a period of four years. Twenty five (1.6%) men and 64 (4.0%) women lost >2 cm after 4 years. Rapid height loss (>2 cm after 4 years) was associated with excess all fractures and hip fractures (adjusted HR for all fractures = 2.86, p<0.001; adjusted HR for hip fractures = 4.74, p<0.01) in women but only hip fractures (adjusted HR = 4.93, p<0.05) in men. The all-cause (adjusted HR = 3.43, p<0.01) and respiratory disease mortality (adjusted HR = 5.64, p<0.05) were higher in men with rapid height loss while those in women were insignificant. Therefore modest height loss occurring in old age, >2 cm in 4 years, was associated with excess hip fracture, total and respiratory disease mortality in older men. In women, it was associated with excess BMD decline, all fractures and hip fractures but not mortality. Contraction in vertical dimension in late-life is hazardous to health. / Excess in horizontal dimension (Central adiposity) -- In answering whether central adiposity is hazardous or protective, we have examined the effect of the excess in horizontal dimension (central adiposity) by three measurements, namely waist-hip ratio (WHR), relative truncal fat (RTF), and relative abdominal fat (RAF). In men, the lowest mortality belonged to the quintile having WHR (0.92 – 0.94) and the second highest RTF quintile (mean WHR 0.94). In addition, the upper four quintiles of RAF (abdominal fat according to anatomical landmark in DXA / whole body fat) were associated with significantly lower all-cause mortality, and the adjusted hazard ratio (95% CI) in ascending quintiles of RAF compared with the lowest quintile was 0.62 (0.43–0.89), 0.58 (0.4– 0.85), 0.52 (0.36–0.77), and 0.67 (0.47–0.96). Therefore, in older men, excess in horizontal dimension or accumulation of central adiposity in late life may be beneficial for survival. / Conclusion: Body composition, as represented by adiposity and muscularity, is a major determinant of health in old age. In contrast to conventional belief, adiposity and being overweight may be beneficial for survival in late life. This may bear significant implication on the recommended cutoff values for BMI in the older population. Muscle loss can result in physical limitation and is related to cognitive impairment. In a reverse manner, loss in muscle mass and muscle strength can precede cognitive decline. When taking muscularity and adiposity together, the right balance between the two, or the adiposity to muscle ratio, is a predictor of physical limitation. When considering the two body dimensions, the vertical and the horizontal, loss in vertical dimension (height loss) in late life is hazardous for health while the excess in horizontal dimension (central adiposity) may be protective. Therefore the loss in vertical dimension is degenerative, and the excess in adiposity, both in general and in horizontal dimension, on the contrary, may be an ageing adaption to retain energy reserve for survival benefit rather than a degenerative process. / Au Yeung, Tung Wai. / Thesis M.D. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 145-163). / Title from PDF title page (viewed on 14, September, 2016).
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COMICS AS VEHICLES FOR UNDERSTANDING SYNTHESIS: A RETROSPECTIVE STUDYCapan, Emily 01 December 2018 (has links)
The purpose of this project is to argue the effectiveness of utilizing comics as a learning tool in the first-year composition classroom to help students better understand synthesis. The two main features of comics that help teach synthesis are comic panels and comic closure. Library research was conducted to give insight into the history and terminology of comics, the value of comics in the classroom and in the field of rhetoric and composition, the practicality of using visual rhetoric and literacy in the classroom, and synthesis in the first-year composition classroom. I furthered my research by conducting a retrospective account of my own synthesis comic that I created during my graduate program. I analyzed how creating the synthesis comic helped me to better understand synthesis. I also analyzed how I was better able to effectively execute synthesis specifically through the genre conventions of panels and comic closure. Based on insights from my retrospective account, I will illustrate how the scaffolding exercise of creating a synthesis comic can be an effective tool in the first-year composition classroom. Additionally, I will offer suggestions for further research on the significance of this scaffolding exercise. Comics are becoming more widely valued in academia at large, as well as valued specifically in the field of rhetoric and composition. It is my hope that this thesis will contribute positively to this trend.
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Sound and image : musical compositions in realization of intermediaSo, Ka Wai 01 January 2010 (has links)
No description available.
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OVERGROWNOvel, Tori C. 01 January 2018 (has links)
OVERGROWN discusses the music elements found in the thesis composition of the same name.
OVERGROWN was written for soprano solo, flute, bass clarinet, soprano saxophone, baritone saxophone, trumpet, trombone, vibraphone, percussion, cello and double bass. The text was written by Matthew Raymond Smith.
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Light Emerging: A Symphonic Dance Suite for Chamber Orchestra and ElectronicsJanuary 2019 (has links)
abstract: Light Emerging is a symphonic dance suite in five movements. The work’s approximate length is 25 minutes; it is scored for flute, oboe, clarinet in Bb, bassoon, horn in F, trumpet in C with loop pedal, trombone, percussion, electronic percussion, piano, strings, and fixed media. Each movement of the dance suite is written to be performed as a standalone piece or together as one multimovement work. The music showcases open quintal sonorities layered in conflicting substructures, which contract into denser brooding passages and transform into tonal fanfares.
Attempting to capture the essence of how humanity uniquely experiences light and assigns personification to it, the composer presents light and dark as the main characters in a grand ballet of good and evil. Prism (Movement I) is an overture that is constantly shifting and evolving. A rainbow of colors is presented by the various orchestra members, as timbral and pitch evolutions showcase the ever-changing perspectives of a prism held to light. Yin/Yang (Movement II) explores the relationship between light and dark. The solo clarinet represents light breaking through the darkness as its colorful flourishes pierce through the brooding fixed media. Sunrise (Movement III) captures the impressive majesty of light bursting over the dark horizon in the early morning. Lux (Movement IV) is a dance of light, using solo trumpet and a chorus of phantom trumpets. Light Eternal (Movement V) expresses the deep need for humans to worship that which is unknown and eternal, and the power of light to overcome the dark. The “March of Eternal Light” signals our end in this world and the journey to the beyond. / Dissertation/Thesis / Doctoral Dissertation Music 2019
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Vers une approche orientée aspect d'ingénierie des besoins dans les organisations multi-entreprises / Towards an aspect-oriented requirements engineering approach in organizations multi-enterprisesAmroune, Mohammed 24 October 2014 (has links)
Le système d’information coopératif (SIC) est un élément central dans le domaine de la coopération interentreprises. Son développement nécessite une attention particulière afin de prendre en considération tous les problèmes émergeants, surtout celui des préoccupations transversales qui posent des difficultés pour la compréhension, la maintenance, l’évolution, et la réutilisation des systèmes développés. Dans les approches usuelles de développement, la construction de ce genre de système part de zéro et nécessite de tout reconstruire à chaque fois. Nos travaux de recherche dans cette thèse examinent comment une approche orientée aspect appliquée de la phase de recueil des exigences à la phase de conception peut être proposée comme un outil permettant de développer des SICs à partir de systèmes d’information (SIs) préalablement existants produits à l’occasion de développements antérieurs. L’utilisation du paradigme Aspect dans cette approche tente de réutiliser des artéfacts des SIs existants afin de développer le futur SIC supportant la coopération interentreprises. / It is often difficult for a single Information System (IS) to accomplish complex requirements. One solution is to combine many different ISs and make them collaborate to realize this task. Information systems composition is an active ongoing area of research in the field of information systems. The result of IS composition produces one type of a so called Cooperative Information System (CIS). Its development requires a particular attention to process all emerging problems, especially the crosscutting concerns that pose difficulties to understand, maintain and reuse such cooperative systems. Moreover, the aspect paradigm is presented as a promising avenue for reusability. Thus, we argue that it is interesting to propose an aspect approach to build a new system in order to accomplish complex tasks based on the reuse of system’s artefacts previously developed. According to our best of knowledge few works have tackled this question. In this thesis, we present an aspect-oriented approach called AspeCiS, applied from the requirements engineering phase until the design phase, in order to develop a CIS from existing ISs by using their artifacts such as requirements, architectures and design. Therefore, this approach is opposed to conventional development ones in which the construction of a new system starts from nothing and needs reinventing everything every time.
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Minimal music: roles and approaches of teachers engaging students with a contemporary art music through composing activitiesBlom, Diana Mary January 2001 (has links)
Since it arose in the 1960s, the minimalist aesthetic has increasingly influenced composers of art and popular music around the world and, in turn, minimalist composers have drawn on the compositional ideas of Western popular music and several non-Western musics. Educationally, minimal music offers much potential for music in the classroom as it embodies a number of musical characteristics known to, and preferred by, students aged 9-18 years at primary, secondary and first year tertiary level. Socially, it offers teachers an opportunity to engage students, through composing activities, with contemporary society. The study aims, firstly, to analyse compositions by students aged 9, 12, 15 and 18 years and their teachers, seeking pastiche development of, and compositional expansion beyond, the musical concepts presented in a resource booklet of projects, The Pulse Music Album. Secondly, this study aims to investigate how nineteen participating teachers in three countries engage their students with minimalist composing activities stimulated through the resource booklet. The study attempts to determine why teachers adopt their particular roles and strategies by examining music qualifications, preferences and experience, teaching perspectives and teaching environments. It also seeks to identify reasons why one group of teachers submitted pieces which were pastiches of those presented in the projects and another group submitted compositions which moved well beyond pastiche into an expansion of these same musical concepts and argues for this as evidence of dialogue with contemporary society. Conclusions drawn from the findings note that while there are many commonalities between the backgrounds and approaches of both groups of teachers, there are clearly observed differences. These differences suggest approaches to classroom composition for consideration by practising classroom teachers, in-service instructors and teacher training institutions.
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Toward seamless transition? Dual enrollment and the composition classroom /Denecker, Christine. January 2007 (has links)
Thesis (Ph.D.)--Bowling Green State University, 2007. / Document formatted into pages; contains xii, 242 p. Includes bibliographical references.
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A study of the isolation, fractionation and chemical composition of Brazilian comun cacao proteinsTimbie, Douglas James. January 1975 (has links) (PDF)
Thesis (M. S.)--Pennsylvania State University, 1975. / Includes bibliographical references.
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Spatial distribution, chemistry and turnover of organic matter in soilsGolchin, Ahmad. January 1996 (has links) (PDF)
Copies of author's previously published works inserted. Bibliography: leaves 260-299. This thesis describes the concept of organic matter turnover and various methods to measure the decay rates of organic materials in the soil. Methods are developed to separate SOM from different locations within the soil matrix. Free particulate organic matter (POM), located between or outside the soil aggregates is isolated. Occluded POM is disaggregeted by sonification. The compositional differences noted among the three components of SOM are used to describe the changes that OM undergoes during decomposition. The process is followed as organic matter enters the soil, is enveloped in aggregates and is eventually incorporated into the microbial biomass and metabolites then becoming associated with clay minerals.
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