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Background Native Hawaiians have higher hypertension (HTN) and cardiovascular disease (CVD) rates than non-Hispanic whites, calling for culturally responsive interventions to close this gap. Purpose We tested the effects of a 6-month behavioral intervention, a cultural dance program based on hula (the customary dance of Hawai'i), for improving blood pressure (BP) and CVD risk among Native Hawaiians with uncontrolled HTN. Methods In a randomized controlled trial, we tested the effects of the hula-based intervention among 263 Native Hawaiians with uncontrolled HTN (systolic ≥ 140 or ≥ 130 mmHg if diabetes) and no CVD at enrollment. All participants received a brief culturally tailored heart health education before random assignment to the hula-based intervention (n = 131) or the education-only waitlist control (n = 132). Intervention received hula lessons and group-based activities for 6 months. Control received only 1-week education through 6 months. Results Intervention yielded greater reductions in systolic (−15.3 mmHg) and diastolic (−6.4 mmHg) BP than control (−11.8 and −2.6 mmHg, respectively) from baseline to 6 months (p < .05). At 6 months, 43% of intervention participants compared to 21% of controls achieved a HTN stage, Native Hawaiians with hypertension who participated in a cultural dance program show clinically meaningful improvements in blood pressure and cardiovascular disease risk than those who did not participate.

Aims To describe a pelvic floor muscle training (PFMT) isolated and associated with game therapy (PFMT + GT) for women facing mixed urinary incontinence (MUI) during climacteric period. Methods To standardize a randomized controlled clinical trial intervention, a protocol was created, in an attempt to decrease women's symptomatology generated by MUI, through pelvic floor and abdomino-loin-pelvic muscles strength, and endurance. This study protocol will be composed of 32 volunteers, divided into two groups of 16. They will perform PFMT isolated or PFMT + GT, twice a week during 8 weeks. Interventions will last 40 minutes and will be divided into warming (5 minutes), training (30 minutes), and 5 minutes will be composed of resting time between exercises (1 minute each). Isolated PFMT sessions will be performed through four modalities of exercises: diaphragmatic, bridge, abdominal (plank), and pelvic mobility. PFMT + GT training will be carried out by using Wii Fit Plus games, such as Lotus Focus, Penguin Slide, Basic Step, and Hula Hoop from Wii equipment. Assessments will occur before, after, and 1 month after interventions. Vaginal manometry, 1-hour Pad Test, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and Patient Global Intervention (PGI) will be used to evaluate the sample. Conclusions It is expected greater increase on pelvic floor muscle (PFM) strength, endurance, vaginal pressure for PFMT + GG. Moreover, it is supposed that PFMT + GT volunteers present better treatment adherence due to games motivational inclusion.

Wetland management usually involves multiple stakeholders. This paper describes how the use of the ecosystem services (ES) concept can help to identify the main stakeholders associated with wetland conservation, using the Hula Wetland in the Sea of Galilee’s watershed as a case study. We conducted a stakeholder analysis based on semi-structured interviews. We focused on the management of two semi-natural areas within the larger Hula Wetland area (Hula Nature Reserve and Agamon), in which different management regimes are used and which provide different bundles of ES to different stakeholders. Using the ES concept in the stakeholder analysis, we were able to present the Hula Wetland management in a comprehensive manner. The approach also revealed a lack of coordination between the managing organisations which might lead to competition favouring cultural services (in particular tourism) at the expense of habitat services (i.e. biodiversity conservation) in the future. To test our method we also conducted a stakeholder analysis in the Camargue Wetland in France. The two wetlands have similar characteristics but are embedded in different institutional contexts. The Camargue Regional Park has a multi-stakeholder platform which could serve as an example for the Hula Wetland to improve its management and lead to better coordination and complementarity of ES provided by the two sub-sites. Our study showed that applying the ES concept helps to quickly identify relevant stakeholders and analyse wetland management in a more holistic way and to point towards sustainable solutions for conflicting stakeholder interests.

Unstable pelvic ring lesions are usually treated with internal fixation. In patients presenting clinical instability or soft tissue complication risk, external fixation is a safe treatment option. However, pin tract infection, insufficient biomechanical properties, difficulty sitting and changing decubitus are important drawbacks related to the treatment. The present study reports the association of anterior and posterior subcutaneous internal fixation by applying spine-designed implants on the pelvic ring disruption: supra- acetabular pedicle screws with an interconnecting rod (Infix), plus posterior transiliac fixation with the same system, which the authors have named the “Hula Hoop Technique”.

The Hula Valley in northern Israel was partly covered by swamps and a shallow lake. The entire valley was drained and converted for agricultural cultivation. Later, an additional soil reclamation operation was implemented, including eco-tourism. From the early 1990s, winter migratory cranes have attracted visitors, thus supporting the hydrological management of the entire valley that protects the downstream Lake Kinneret. It was documented that these birds have a minor impact on phosphorus pollution, but severely damaged agricultural crops are protected by mild deportation and daily, short, periodical corn seed feeding.

Objective The aim of this study was to calculate the costs and assess whether a culturally grounded physical activity intervention offered through community-based organizations is cost effective in reducing blood pressure among Native Hawaiian adults with hypertension. Methods Six community-based organizations in Hawai‘i completed a randomized controlled trial between 2015 and 2019. Overall, 263 Native Hawaiian adults with uncontrolled hypertension (≥ 140 mmHg systolic, ≥ 90 mmHg diastolic) were randomized to either a 12-month intervention group of hula (traditional Hawaiian dance) lessons and self-regulation classes, or to an education-only waitlist control group. The primary outcome was change in systolic blood pressure collected at baseline and 3, 6, and 12 months for the intervention compared with the control group. Incremental cost-effectiveness ratios (ICERs) were calculated for primary and secondary outcomes. Non-parametric bootstrapping and sensitivity analyses evaluated uncertainty in parameters and outcomes. Results The mean intervention cost was US$361/person, and the 6-month ICER was US$103/mmHg reduction in systolic blood pressure and US$95/mmHg in diastolic blood pressure. At 12 months, the intervention group maintained reductions in blood pressure, which exceeded reductions for usual care based on blood pressure outcomes. The change in blood pressure at 12 months resulted in ICERs of US$100/mmHg reduction in systolic blood pressure and US$93/mmHg in diastolic blood pressure. Sensitivity analyses suggested that at the estimated intervention cost, the probability that the program would lower systolic blood pressure by 5 mmHg was 67 and 2.5% at 6 and 12 months, respectively. Conclusion The 6-month Ola Hou program may be cost effective for low-resource community-based organizations. Maintenance of blood pressure reductions at 6 and 12 months in the intervention group contributed to potential cost effectiveness. Future studies should further evaluate the cost effectiveness of indigenous physical activity programs in similar settings and by modeling lifetime costs and quality-adjusted life-years. Trial Registration Number NCT02620709. Supplementary Information The online version contains supplementary material available at 10.1007/s41669-021-00291-6.

Background The in vivo assessment of the three-dimensional kinematics of the hip during dance activities in patients after total hip arthroplasty has not been previously reported. We evaluated the replaced hip kinematics during recreational classical ballet and hula dance using radiographic-based image-matching techniques. Case presentation A 58-year-old Japanese woman (patient 1; height, 157 cm; weight, 74.5 kg) and a 73-year-old Japanese woman (patient 2; height, 153 cm; weight, 48 kg) were still doing classical ballet and hula dance, respectively, after primary total hip arthroplasty. For ballet, there were gradual three-dimensional hip movements with 48° flexion, 36° abduction, and 49° external rotation in développé and 34° flexion, 29° abduction, and 43° external rotation in plié. For hula, there were small three-dimensional hip movements with 31° flexion, 15° adduction, and 11° external rotation in kao and 17° flexion, 11° adduction, and 11° external rotation in kaholo. No liner-to-neck contact was found in any dance activities. Conclusion Both classical ballet and hula dance produced complex ranges of hip movements and activity-dependent kinematics. These kinematic data could be useful for recommending each patient with total hip arthroplasty to continue recreational dance activities.

Hula hoops are a popular piece of fitness equipment used to attempt to slim the waistline and improve core muscle endurance. Although there are obvious visible movements at the waist and hip, no study has quantified the intensity of muscle activity during hula hooping. Therefore, this study analyzed muscle activation in the torso and hip during hula hooping. Because injury to the waist often occurs after prolonged, repeated impact between the waist and a hula hoop, this study developed a novel waist fitness hoop that eliminates impact, called the “Mini Hoop,” and determined the effects of mini hooping on hip movement and muscle activation. A total of 16 healthy females performed hula hooping and mini hooping at a self-selected pace. Results showed that hula hooping caused larger muscle activation, with 46%–49% maximum voluntary isometric contraction for the external oblique, spinal erectors, and gluteus medius, whereas gluteus maximus and adductor longus muscle activation were with 22%–29% maximum voluntary isometric contraction. Mini hooping required a smaller range of hip motion in flexion, extension, abduction/adduction, higher pelvic oscillation frequency, and lower muscle activation for the external oblique, spinal erectors, gluteus medius, gluteus maximus, and adductor longus (13%–33% maximum voluntary isometric contraction) compared with hula hooping ( p < 0.05). In conclusion, hula hooping and mini hooping differ in their range of hip motion, pelvic oscillation frequency, and muscle activation requirements. Hula hooping is suitable for moderate-intensity core muscle activation, whereas the Mini Hoop is suitable for low-level core muscle activation.

Potassium dynamics of soils is constituted by constantly changing relationship between soil K forms, and this relation is affected by some soil physical and chemical properties. Most Sidama (south Ethiopia) farmers grow enset crops which have high K requirements. The soils were collected from Awassa-Zuriya and Dale districts; ’Woinadega’ (warm subtropical climate) and Hula district ‘Dega’ (wet, cool temperate climate). Overview of K dynamics in soils via Quantity-Intensity (Q/I) curves was used to evaluate the dynamics of K in fifteen soil samples representing the enset farming systems of Sidama. All of the Hula district soils and half of the Dale district soils had low percent K saturation. There were significant correlations between some soil properties and Q/I parameters and among equilibrium solution parameters and Q/I parameters. Variations among the mean quantity (±âˆ†K) values of the soils were not significant. The Dale and Hula district soils had higher K intensity than the Awassa-Zuriya district soils; where the Hula (Adola kura kebele) soil had the highest value. Therefore, the Dale and Hula district soils will require frequent and split K applications since they have lower capacity to maintain long-term supply of K. On the other hand, Awassa-Zuriya district soils had high K quantity than the Dale and Hula district soils. This shows that the Awassa-Zuriya district soils have a higher potential to supply K for a longer period of time from the exchangeable pool. However, the Awassa-Zuriya district soils require less frequent and higher K fertilization to saturate the exchangeable pool to meet immediate potassium requirement of crops. The low equilibrium activity ratio of potassium and low potassium replenishing capacity of nearly all of the soils studied also indicated the need for K application. Key words: Dynamics of potassium, potential buffering capacity, activity ratio, quantity-intensity isotherms, potassium saturation.

A cross-sectional study was conducted in the three woredas of Sidama zone, Southern Nations, Nationalities and Peoples' Region (SNNPRS) with the aim of determining the overall prevalence of African horse sickness (AHS) in equines and the effect of putative risk factors on the prevalence of AHS. A total of 230 equines (66 donkeys, 161 horses and 3 mules) were included. Serological examination was conducted using blocking enzyme linked immuno sorbent assay (blocking ELISA) revealing a point prevalence of 46.97, 13.66 and 33.33% AHS in donkeys, horses and mules, respectively. The overall prevalence of AHS in equines in Sidama zone of the three districts was 23.47%. The prevalence at Dale, Hula and Wonsho woreda’ was 52.72, 10.47 and 17.98%, respectively. Statistical analysis of the result showed significance difference in prevalence among donkeys, horses and mules (P< 0.05). The prevalence of 52.72% in midland and 14.28% in highland revealed statistically significant difference (P

BACKGROUND. Studies have shown that physical activity can reduce the risk of mortality for female breast cancer patients and improve quality of life, reduce weight, and alter circulating biomarker levels. We conducted a pilot trial to determine the feasibility of increasing physical activity through a cultural dance intervention to achieve similar benefits. METHODS. Conducted a pilot trial implementing a cultural dance intervention to increase and sustain physical activity for breast cancer survivors, which consisted of a six-month group-based intervention of Hula Dance. Anthropometric measures, fasting blood draws, and self-reported questionnaires to assess physical activity, mood, and quality of life, were completed at baseline, at the end of the 6-month intervention (time point month-6), and at two additional post-intervention time points at month-12 and month-24 to assess sustainability. RESULTS. A total of 11 women with a median age of 63 years were enrolled in the intervention trial. Eight of the 11 (73%) completed the trial to month-12 and demonstrated an overall significant increase in weekly moderate exercise. There were no significant changes in intra-individual body mass index (BMI). However, there was a sustained post-intervention reduction in waist circumference and significant changes in circulating biomarker levels. For the self-reported measures, there was a significant increase in vigor/activity (p

Introduction: Eye injuries are common in sports and have the potential for major morbidity with sight threatening consequences. However, a small number of sports, such as soccer, rugby or hockey are responsible for most injuries. To our knowledge, hula hoop penetrating eye injury is not described in literature. In this report, we present a case of an unusual eye injury caused by a hula hoop. Case presentation: A 17-year-old female was admitted as an urgent penetrating right eye injury caused by a hula hoop. Penetrating wound covered 2/3 of the cornea and was associated with iris prolapses and incarceration; iridodialysis of more than half of the circumference, and traumatic cataract. Her best corrected visual acuity of the right eye was “hand motion”. The second corneal wound in parallel with the first one was noticed while she was being treated surgically under general anesthesia. Iris was repositioned, anterior chamber was formed with the viscoelastic and wounds were repaired using 10-0 nylon sutures. Iridopexy was performed using straight needle 10-0 prolene, while standard cataract surgery with phacoemulsification and IOL implantation were done. The postoperative recovery was uneventful beside elevated intraocular pressure (TOD = 24 mmHg) that was treated successfully by topical beta blockers. Six months later, her best corrected visual acuity was 0.6 stenopeic, with evident linear corneal opacification and traumatic mydriasis. Conclusions: Although seemingly impossible, hula hooping can be dangerous to the eyes if practiced in incommodious areas and close to other people.

The historical habitat of swamps and a lake in the Hula Valley was modified during the early 1950’s. The Swamps and the old Hula Lake were drained and the land was converted to an agricultural development. As a result of inappropriate cultivation, it was necessary to once more implement management improvement. It was done within the Hula Project. Part of the Hula Project was a modified usage of 10% of the area previously used for agriculture for eco-tourism. Independently, thousands of migratory Cranes attracted by peanut crop leftover started wintering in the valley. These bird flocks significantly improved the management objective to ensure prevention of nutrient flux into Lake Kinneret. Consequently, the partnerships between Kinneret water quality protection, nature conservation and agricultural utilization of the peat land is presently operated. Migratory wintered Cranes is a factor of management stability accompanied by costly artificial feeding for bird in a dedicated land block to prevent damage to adjacent crops.

Background: Weighted hula-hoops have gained popularity, but whether they indeed reshape the trunk or have beneficial metabolic effects in overweight subjects is unknown. Objectives: To determine effects of hula-hooping and walking matched for energy expenditure on android fat %, trunk muscle mass, and metabolic parameters in a randomized cross-over study. Design: We recruited 55 overweight nondiabetic subjects, who were randomized to hula-hooping (HULA) for 6 weeks using a 1.5-kg weighted hula-hoop followed by walking (WALK) for another 6 weeks or vice versa. The increments in energy expenditure were similar by HULA and WALK. Body composition (dual-energy X-ray absorptiometry) and metabolic parameters were measured at baseline and after HULA and WALK. The primary endpoint was the change in fat % in the android region. Results: A total of 53subjects (waist 92 ± 1 cm, body mass index 28 ± 1 kg/m2) completed the study. Body weight changed similarly (–0.6 ± 0.2 vs. –0.5 ± 0.2 kg, nonsignificant; HULA vs. WALK). During the intervention the subjects hula-hooped on average 12.8 ± 0.5 min/day and walked 9,986 ± 376 steps/day. The % fat in the android region decreased significantly by HULA but not by WALK (between-group change p < 0.001). Trunk muscle mass increased more by HULA than by WALK (p < 0.05). Waist circumference decreased more by HULA than by WALK (–3.1 ± 0.3 cm vs. –0.7 ± 0.4 cm, p < 0.001; HULA vs. WALK). WALK but not HULA significantly lowered systolic blood pressure and increased HDL cholesterol while HULA significantly decreased LDL cholesterol. Conclusions: Hula-hooping with a weighted hula-hoop can be used to decrease abdominal fat % and increase trunk muscle mass in overweight subjects. Its LDL lowering effect resembles that described for resistance training.

PURPOSE: This study was conducted to investigate the effect of the virtual reality training (VRT) using 3-dimensional video gaming technology on spatiotemporal gait parameters in older adults. METHODS: The study participants were divided into two groups: the VRT group and the control group. Those in the VRT group were enrolled in a VRT, which was conducted for 60 min per day, two times a week, during the 6-week research. The Wii-Fit balance board game was used for the VRT intervention. The VRT consisted of 6 different types of games, namely, jogging, swordplay, ski jump, hula hoop, tennis, and step dance. A 3-dimensional TV was used for 3-dimensional display. Participants in both the groups received 3 sessions of fall prevention education, at the first, third, and fifth weeks. Their gait parameters were measured by using OptoGait. RESULTS: After 6 weeks of the VRT, the spatial gait parameters of the participants, that is stride length and step length, were significantly improved compared with those of the control group participants (p

Two Hawaiian women, born around the turn of the 19th century into the 20th, became students, performers and finally acknowledged repositories of hula and its associated knowledge. They passed on their expertise and knowledge in many ways to many others, and especially to one daughter each, who has passed it on yet again. This narrative of aspects of these women’s lives focusses on their learning and teaching, and contributes to a deeper understanding of the hula tradition in Hawai‘i and the significant role of women in maintaining and enhancing it.

Novel ideas for core endurance training are continually being created. However, studies of their mechanism of action assist in evaluation of their potential as a training tool, for a variety of people and purposes. The specific purpose of this study was to evaluate a weighted hula hooping training program for its efficacy on improving core muscular endurance and influence on measures of body composition. Eighteen women participated in a weighted hula hooping trial lasting 6 weeks, although only 13 returned for posttrial re-assessment. Hip and waist circumferences, 5 torso muscle endurance tests, and 5 skinfold measurements ("sum of 5") were measured before and after the exercise program. Paired samples t-tests were performed to examine pre/post changes. On average, participants experienced a significant decrease in waist and hip circumference -3.4 cm (p < 0.01) and -1.4 cm (p ≤ 0.05), respectively and waist-to-hip ratio from 89.3 cm down to 87.3 cm (t = 3.312, p < 0.01). There were no significant changes in torso muscular endurance after the 6 weeks of hooping; however, the average "sum of 5" skinfold measurements increased by 10.5 cm (p ≤ 0.05). This study of weighted hula hooping suggested that regular hooping was associated with reduced waist and hip girth together with a redistribution of body mass; however, there were no improvements in torso muscular endurance as measured by isometric testing.

Objective School readiness involves the development of foundational skills such as emergent literacy and fundamental movement skills as well as the capacity to attentively engage in instructional situations. Children do not develop these skills naturally; therefore, they need the opportunity to develop these skills in their early years prior to entering school. The objective of the current study was to evaluate the effectiveness and feasibility of a direct-instruction movement and preliteracy intervention in children aged 3–4 years. Methods A within-subject repeated-measures design, embedded within a wait-list control study, was used to evaluate the intervention. The intervention was run across 10 weeks with 1 h weekly sessions. Each weekly session consisted of 30-min of movement skill instruction (e.g., through single-step acquisition strategies), 15-min of free play during which time children had access to a variety of equipment (e.g., balls, hula hoops, etc.) or toys (e.g., puzzles, building blocks), and a 15-min interactive reading circle during which children read a storybook and were taught 1–2 preliteracy skills (e.g., alphabet knowledge, narrative knowledge, etc.). A convenience sample of 11 children (mean age = 45.6 months, SD = 7.3) was recruited. All children were assessed four times: baseline (Time 1), pre-intervention (Time 2), post-intervention (Time 3), and 5-week follow-up (Time 4). Gross motor skills and preliteracy skills were assessed at each time point. Results There was a statistically significant effect of time on the change in gross motor skills (Wilks’ lambda = 0.09, p = .002), print-concept skills (Wilks’ lambda = 0.09, p = .001), and alphabet knowledge (Wilks’ lambda = 0.29, p = .046). Post hoc analyses reveal non-significant changes between time 1 and 2 for motor and print-concept skills and significant changes in all three outcomes between time 2 and time 3. Conclusion Participation in a direct-instruction movement and preliteracy program led to positive improvements in gross motor skills, print-concept knowledge, and alphabet knowledge in 3- to 4-year-old children over time. Future research needs to evaluate the effectiveness of this movement and preliteracy skill intervention on various other indicators of child development and health. Clinical Trial Registration Play and Pre-Literacy among Young Children (PLAY) NCT02432443.

Background As a major risk factor for cardiovascular and cerebrovascular disease (CVD), hypertension affects 33% of U.S. adults. Relative to other US races and ethnicities, Native Hawaiians have a high prevalence of hypertension and are 3 to 4 times more likely to have CVD. Effective, culturally-relevant interventions are needed to address CVD risk in this population. Investigators of the Kā-HOLO Project developed a study design to test the efficacy of an intervention that uses hula, a traditional Hawaiian dance, to increase physical activity and reduce CVD risk. Methods A 2-arm randomized controlled trial with a wait-list control design will be implemented to test a 6-month intervention based on hula to manage blood pressure and reduce CVD risk in 250 adult Native Hawaiians with diagnosed hypertension. Half of the sample will be randomized to each arm, stratified across multiple study sites. Primary outcomes are reduction in systolic blood pressure and improvement in CVD risk as measured by the Framingham Risk Score. Other psychosocial and sociocultural measures will be included to determine mediators of intervention effects on primary outcomes. Assessments will be conducted at baseline, 3 months, and 6 months for all participants, and at 12 months for intervention participants only. Discussion This trial will elucidate the efficacy of a novel hypertension management program designed to reduce CVD risk in an indigenous population by using a cultural dance form as its physical activity component. The results of this culturally-based intervention will have implications for other indigenous populations globally and will offer a sustainable, culturally-relevant means of addressing CVD disparities. Trial registration ClinicalTrials.gov: NCT02620709 , registration date November 23, 2015.

Climate change remains the major threat for livelihood of smallholder farmers in Ethiopia. This study reviews the effects of climate change on livestock production and adaptation measures employed by the farmers from two districts in Sidama Region. The data was collected from 189 sample households. The climate data were collected from National Meteorological Agency. The results revealed that the trend of RF was increasing by the rate of 0.79mm in Hawassa Zuria and 11.62mm in Hula per annum and there are tendencies indicating a future with warmer climate. The effects of climate change were reduced quality and quantity of feed, increased incidence of diseases, reduced quality and quantity of water and reduced production and reproduction performance of animals. From the total households 27% of the sample households were practicing reducing the number of animals in Hawassa Zuria and income diversification adaptation strategies in Hula. Adaptation strategies considered in the Multinomial logit model analysis were income diversification, supplementary feed, reducing number of animals and diversifying animals. Education, age, labor size, farm size of household and livestock holding are among the factors that might contribute to explain different levels of adaptive capacity within these two communities. Therefore, future policy should focus on improving the quality of meteorological data, water supply, enhancing innovations in livestock production system and enhancing research on use of new improved forage species.

The study aims at identifying and confirming the influence of the hula hoop game conduct on the level of physical fitness. Within the conduct of the study, the researcher implemented the experiment method while the nature of the study was a quantitative study with systematic and structured implementation by describing the influence of the independent variable (X) on the independent variable (Y). Then, the population of the study was the students of Sawahan IV Public Elementary School Surabaya while the samples that had been selected for the study were the female students from the higher degree (Grade 4, 5 and 6) who had been selected proportionally based on the strata; the overall number of the sample was 40 students. The results of the hypothesis test analysis on the actual rate (α = 0.05) and the degree of skewness = 39 show that the t-count value for each component of physical fitness is higher than the t-table value; in other words, t-count > t-table with sig. = 0.05. The implication is that the implementation of hula hoop game learning displays significant influence on each component of physical fitness namely speed, strength, flexibility, agility, power and endurance. On the other hand, the results of variance test (F-test) analysis on the actual rate (α = 0.05) show that the F-count is higher than the F-table namely 2.24 > 2.17; in other words, F-count > F-table with the sig. 0.05 (6:133). Thus, the implication is that the implementation of the hula hoop game has significant influence on the level of physical fitness. In brief, the conclusion that might be drawn from the study is that the hula hoop game is very effective for improving the level of physical fitness especially for the elementary school students.

The 10-year-old SCI patient Nefeli during training with the hula hoop to improve trunk mobility/stability and balance.

Improvement of longest hula hoop exercising times in dependence on therapy. Note that the individual times varied much.

The spinal cord injury patient Nefeli during performing hula hoop and playing at the same time with the sister/Author with a balloon. B. Nefeli during hula hoop with two rings.

Objective To evaluate in the follow-up the sensory-motor recovery and quality of life patients 2 months after completion of the Nintendo Wii console intervention and determine whether learning retention was obtained through the technique. Methods Five hemiplegics patients participated in the study, of whom 3 were male with an average age of 54.8 years (SD = 4.6). Everyone practiced Nintendo Wii therapy for 2 months (50 minutes/day, 2 times/week, during 16 sessions). Each session lasting 60 minutes, under a protocol in which only the games played were changed, plus 10 minutes of stretching. In the first session, tennis and hula hoop games were used; in the second session, football (soccer) and boxing were used. For the evaluation, the Fulg-Meyer and Short Form Health Survey 36 (SF-36) scales were utilized. The patients were immediately evaluated upon the conclusion of the intervention and 2 months after the second evaluation (follow-up). Results Values for the upper limb motor function sub-items and total score in the Fugl–Meyer scale evaluation and functional capacity in the SF-36 questionnaire were sustained, indicating a possible maintenance of the therapeutic effects. Conclusion The results suggest that after Nintendo Wii therapy, patients had motor learning retention, achieving a sustained benefit through the technique.

Datacenter networks employ multi-rooted topologies (e.g., Leaf-Spine, Fat-Tree) to provide large bisection bandwidth. These topologies use a large degree of multipathing, and need a data-plane load-balancing mechanism to effectively utilize their bisection bandwidth. The canonical load-balancing mechanism is equal-cost multi-path routing (ECMP), which spreads traffic uniformly across multiple paths. Motivated by ECMP's shortcomings, congestion-aware load-balancing techniques such as CONGA have been developed. These techniques have two limitations. First, because switch memory is limited, they can only maintain a small amount of congestion-tracking state at the edge switches, and do not scale to large topologies. Second, because they are implemented in custom hardware, they cannot be modified in the field. This paper presents HULA, a data-plane load-balancing algorithm that overcomes both limitations. First, instead of having the leaf switches track congestion on all paths to a destination, each HULA switch tracks congestion for the best path to a destination through a neighboring switch. Second, we design HULA for emerging programmable switches and program it in P4 to demonstrate that HULA could be run on such programmable chipsets, without requiring custom hardware. We evaluate HULA extensively in simulation, showing that it outperforms a scalable extension to CONGA in average flow completion time (1.6 x at 50% load, 3 x at 90% load).

Dance is the art of physical expression. To enhance the expression of robots’ motions and foster sophisticated communication, we aspire to enable robots to dance. Flexible motion of the torso is presumed to be important in dancing, so we picked hula hooping as an accessible example. In this paper, we lay out a simple model of hula hooping that depicts both the torso and hoop, then consider applicability using dedicated robots to show that the model can enable real robots to succeed in hula hooping.

Background: Heart disease disproportionately affects Native Hawaiians and other Pacific people. In response, researchers proposed and communities endorsed, developing a cardiac rehabilitation (CR) program based on the hula, a Native Hawaiian dance form. The utilization of cultural practices in health interventions can improve outcomes and increase enrollment and retention, but requires sensitivity and understanding. Objective: This paper provides the conceptual framework and methods used for integration of multiple communities’ perspectives to inform the design of a hula-based CR intervention. Methods: Specific strategies and processes were established to ensure the equity of scientific—clinical and patient— cultural knowledge and perspectives. Multiple methods were used and a flow diagram defined steps for the intervention development. Results: Patient and cultural consultations provided information about the multidimensional benefits of hula and its use in a CR intervention. Clinical and scientific consultations provided specific guidelines for exercise prescription and patient monitoring. Integrating findings from all consultations identified important direction and requirements. Conclusions: Community-based participatory research (CBPR) principles guided a complex collaboration of multiple communities; although time consuming, inclusive consultations provided valuable information and relationships.

Shay begins this chapter by describing a hula performance, and locating the Hawaiians as one of the Polynesian peoples, connected by history, language, and customs, including dance customs. He focuses on the centrality of the mele, or verses, which the dance movements serve to emphasize and enhance, thus making the verses the most important aspect of the performance. He goes on to contrast and compare hula kahiko, or ancient hula, with hula ‘auana, modern hula. He proceeds to demonstrate the important role of the Hollywood film industry in giving the sexy and alluring dance an important place in the tourist industry in which the hula girl serves as an icon. He stresses the role of hula in the construction of Hawaiian identity.

Using the Hawaiian hula tradition as a case study, this article explores archival institutionalization of knowledge and contents necessary for performance. The fact that the performance skills of hula remained in continuous practice is what allowed a successful revival in the late 20th century of poetic repertoire that had become entombed in archival sources by the end of the 19th century. I consider the role of archives as a form of memory, particularly in the context of colonized peoples, and advocate for performers to determine how the archived repertoire would be staged again in ways that address contemporary rather than past circumstances.

Objective Native Hawaiians and Pacific Islanders (NHPI) bear an unequal burden of hypertension and cardiovascular disease. Hula, the traditional dance of Hawaii, has shown to be a culturally meaningful form of moderate-vigorous physical activity for NHPI. A pilot study was done in Honolulu, Hawaii, to test a 12-week hula-based intervention, coupled with self-care education, on blood pressure management in NHPI with hypertension in 2013. Method NHPI with a systolic blood pressure (SBP) ≥140 mmHg were randomized to the intervention (n = 27) or a wait-list control (n = 28). Blood pressure, physical functioning, and eight aspects of health-related quality of life (HRQL) were assessed. Results The intervention resulted in a reduction in SBP compared to control (−18.3 vs. −7.6 mmHg, respectively, p ≤ 0.05) from baseline to 3-month post-intervention. Improvements in HRQL measures of bodily pain and social functioning were significantly associated with SBP improvements in both groups. Conclusion Using hula as the physical activity component of a hypertension intervention can serve as a culturally congruent strategy to blood pressure management in NHPI with hypertension. Trial registration clinicaltrials.gov Identifier: NCT01995812

Hawaiian poetry developed in the nurturing embrace of oral tradition for nearly two thousand years before American missionaries introduced writing in the 1820s. Once literacy was established, Native Hawaiians enthusiastically set out to use the new technology to record their oral traditions in writing. During this period they also experimented with and developed new forms of mele, such as hula ku'i. After the Hawaiian language was banned and the government overthrown in the late nineteenth century, there was a period where Hawaiian poetry was carried forward into the twentieth century by entertainers—singers, dancers, and musicians—who kept the performance aspect of Hawaiian poetry alive. The art of Hawaiian poetry was transformed in the latter half of the twentieth century, when haku mele (poets) began to write primarily in English and Hawai'i Creole English while still maintaining Hawaiian themes and utilizing traditional metaphors. Since then, contemporary Hawaiian poetry in these languages has thrived alongside Hawaiian-language compositions, which are still perpetuated, mostly through the practice of hula. Today, Hawaiian poetry can be best described by using the metaphor of a haku lei, where different strands of language and influence are woven together to create something beautiful and unique, an enduring and perpetual symbol of Hawaiian cultural tradition—a lei ho'oheno no nā kau a kau, a lei to be cherished for all seasons.

Background: Sub-optimal breast feeding contributed a significant number of infants’ death. Although breast feeding is universal in Ethiopia, the practice is not optimal. Hence, this study assessed the prevalence of sub-optimal breast feeding practice and its associated factors in rural communities of Hula District, Southern Ethiopia. Methods: A community based cross-sectional study was conducted among 634 women with infants aged 6 to 12 months. Multistage sampling technique was employed to select study subjects. Interviewer administered structured questionnaire was used for data collection. Data were entered and analyzed by using SPSS version 20.0. Bivariate and multivariate logistic regression was used to identify predictors of delayed initiation of breastfeeding and non-exclusive breastfeeding. Results: The prevalence of suboptimal breast feeding of infants was found to be 56.9%. Nearly half (49.4%) of the mothers delayed initiation of breast feeding, and 13.4% of the infants were fed breast non-exclusively. Having formal education [AOR: 1.74; 95% CI (1.17, 2.59)], family size < 5 [AOR=1.59; 95% CI (1.03, 2.45)], having one under five child [AOR=1.88; 95% CI (1.29, 2.75)], lower number of antenatal care visits [AOR= 2.40; 95% CI (1.68, 3.43)] and lack of counseling on breastfeeding [AOR= 1.69; 95% CI (1.19, 2.41)] were negatively associated with delayed initiation of breast feeding. Similarly, not attending formal education, low birth order and lack of knowledge about exclusive breastfeeding were also negatively associated with exclusive breastfeeding practice. Conclusion: In this study, sub-optimal breast feeding was found to be high. Delayed initiation and non-exclusive breastfeeding practices were major contributors to sub-optimal breast feeding. Keywords: Sub-optimal breast feeding, Hula District

Background Nutritious complementary foods are needed in countries where undernutrition and stunting are major problems, but mothers may be reluctant to change from traditional gruels. Objective To test whether a recipe-based complementary feeding education intervention would improve knowledge and practice of mothers with young children in Hula, Ethiopia. Methods A baseline survey of 200 eligible, randomly selected mother—child pairs gathered data on sociodemographic characteristics, food security status, knowledge and practices concerning complementary feeding, food group intakes of children aged 6 to 23 months by 24-hour recalls, and children's anthropometric measurements. Twice a month for 6 months, women in the intervention group received an education session consisting of eight specific messages using Alive and Thrive posters and a demonstration and tasting of a local barley and maize porridge recipe containing 30% broad beans. The control group lived in a different area and had no intervention. Results At 6 months, knowledge and practice scores regarding complementary feeding were significantly improved ( p < .001) in the intervention group but not in the control group. The intervention resulted in improvement of children's dietary diversity, as well as mean intake of energy and selected nutrients, compared with children in the control group. Changes in height and weight did not differ between the two groups. Conclusions Community-based nutrition education over 6 months that included demonstration of a local porridge recipe with broad beans added improved the complementary feeding practices of caregivers and the nutritional status of their young children.

Many types of humanoid robots have been developed, but it is hard to find one with supple spine structure. To act in a proper manner with sophisticated, human-like motions, we believe that humanoid robots should make use of their spines effectively. To find out how to use the spine flexibly and elegantly, we focused on dancing, the art of beautiful movements. Dancing demands you to develop flexible and well coordinated movements of the torso, so we decided to pick up a movement of the sort and achieve it by the musculo-skeletal humanoid KOJIRO, in order to improve the skills needed for dancing. We took hula hooping as an ideal sample, and after generalizing the principal of hula hooping motion by an exclusive hula-hooping robot, we will describe the trials of hula hooping by KOJIRO as the first step toward dancing humanoids(Fig.1).

Background: The frontonasoethmoidal encephalomeningocele deformity involves central herniation of a glial mass that “pushes outward” and deforms the medial orbit, medial canthus, nasomaxillary process, and nasal structures without resulting in hypertelorbitism. The authors studied a modification of the “Chula” repair, called the HULA procedure (H = hard-tissue sealant, U = undermine and excise encephalocele, L = lower supraorbital bar, A = augment nasal dorsum), which provided complete correction of the midline hard and soft-tissue structures using an intracranial and extracranial approach. Methods: Filipino patients with frontonasoethmoidal encephalomeningoceles were treated by a civilian/military humanitarian team at Tripler Army Hospital (n = 12). Operative technique followed the four steps of the HULA frontoethmoidal encephalocele procedure. Postoperative and follow-up assessments were based on examination, photographic images, computed tomography scans, parental surveys, Whitaker score, and developmental testing. Results: Patient ages ranged from 5 to 12 years; 67 percent were female and 33 percent male. Sixty-seven percent required excisions of poor-quality, hyperpigmented skin along with the large glial mass; the other 33 percent had a “closed” resection of the smaller mass through a gingivobuccal sulcus incision. No patients manifested cerebrospinal fluid leaks, infection, or elevated intracranial pressures postoperatively. Skeletal correction showed improved medial orbit distance, with a mean correction of 14 mm (42 percent). Whitaker score was 1.3 (no or minor soft-tissue revision necessary). Parental survey showed a high degree of satisfaction with the aesthetic and functional outcomes. Follow-up developmental tests showed normal global evaluations for all but one child with normal memory and attention skills. Conclusion: The authors’ outcomes demonstrated that the HULA technique was a safe and effective approach for the complete correction of frontonasoethmoidal encephalomeningoceles.

The development of a perirenal hematoma is rare and primarily the result of trauma, malignancy, or a connective tissue disease. Infrequently, a continuous or even mild trauma can cause a perirenal hematoma. Here, we report a case involving the development of a perirenal hematoma after excessive hula-hooping in the absence of a major trauma history.

The Hula Aggregated Decision Support System (HANDSS) is used to assist decision makers better understand the impacts of alternative decisions in the Hula Valley restoration project in Israel. The critical link in wetlands is the interaction between the surface and ground waters. To properly manage these systems, this link must be understood. To this end, a numerical model of flow in groundwater/surface water systems was developed. This model was incorporated in a decision support system (DSS). The decisions at Lake Hula are to determine releases through a series of unlined canals. Infiltration through the canals maintains groundwater levels in the underlying peat soils. Optimization models are available in HANDSS to provide management guidance. The last component of HANDSS is visualization packages that are used to allow fast interpretation of alternative management decisions.