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Abstract Background Research to date suggests that frailty is higher in women and is associated with functional difficulty. This study builds on the evidence by examining the association between frailty and functional difficulty between low- and higher-income groups and between older men and women in these income groups. Methods This study adopted a cross-sectional design that complied with the STROBE checklist and included steps against confounding and common methods bias. The population was community-dwelling older adults aged 50 years or older in two urban neighbourhoods in Accra, Ghana. Participants were either in the low-income group in a low socioeconomic neighbourhood (n = 704) or the higher-income group in a high socioeconomic neighbourhood (n = 510). The minimum sample necessary was calculated, and the hierarchical linear regression analysis was utilised to analyse the data. Results Frailty was positively associated with functional difficulty in the low- and higher-income samples, but this association was stronger in the higher-income sample. Frailty was positively associated with frailty in men and women within the low- and higher-income samples. Conclusion The association of frailty with functional difficulty was consistent between low- and higher-income samples, although the strength of the relationship differed between these samples. In both income samples, the foregoing relationship was consistent between men and women, although the strength of the relationship differed between men and women.

Influenza A is a zoonotic disease that affects dogs, pigs, horses, poultry, and birds. In this report, a meta-analysis according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted. Studies of influenza A viruses in dogs providing prevalence or seroprevalence in any location worldwide were included. The results in this study show that the seroprevalence for the H3N8 influenza subtype was 7.96% (95% CI: 2.03–16.8, p < 0.001), for the H3N2 subtype was 7.44% (95% CI: 4.51–10.5, p < 0.001), and for the H1N1 subtype was 3.10% (95% CI: 0.890–6.01, p < 0.001). In the case of the prevalence analysis, a prevalence of 0.395% (95% CI: 0.160–2.44) for the H3N8 subtype. For the H3N2 subtype, a prevalence of 17.8% (95% CI: 6.66–32.6, p < 0.001) was found. No publication bias was observed in the studies evaluating seroprevalence in the H3N2 and H1N1 subtypes. In the H3N8 subtype, Begg’s test indicated publication bias, but Egger’s test showed no bias. It is essential to know the approximate prevalence and seroprevalence worldwide of canine influenza, so this study reports the presence of influenza subtypes in dogs, placing this species as a reservoir for human, swine, equine, and avian influenza A viruses.

The article aims to propose a comprehensive approach to sustainable practices and risk resilience in a circular economy within the supply chain of a manufacturing company, addressing current challenges in sustainability, risk, and resilience. The interconnectedness of these aspects with the circular economy in the supply chain context is emphasized. The study employs fuzzy DEMATEL and fuzzy AHP tools in its design to address sustainable practices, risk resilience, and the circular economy in the manufacturing company’s supply chain. Fuzzy logic facilitates the management of imprecision and uncertainty, allowing for a flexible and precise evaluation. Fuzzy AHP focuses on ambiguous and subjective criteria, while fuzzy DEMATEL aids in understanding causal relationships among criteria, considering their fuzzy nature and interdependencies. Findings indicate that Supplier 1, Manufacturer 2, and Distributor 1 are the optimal choices, while efficiency (CSC1), security (RR3), and other criteria are identified as the most influential factors. The uniqueness of the study lies in its specific application and adaptation to the paint manufacturing supply chain sector, with a focus on sustainability, resilience, and the circular economy. The distinctive contribution involves customizing established methodologies to address sector-specific challenges, providing a practical tool for strategic decision-making. By applying an integrated approach based on fuzzy DEMATEL and fuzzy AHP techniques to the Peruvian paint company, the study offers a valuable perspective on the criteria for significant improvements in management, promoting sustainability, and the circular economy at the local level.

Abstract Background Living in hilly neighbourhoods can be associated with sedentary behaviour, but no study has compared sedentary behaviour and its associations with frailty, chronic diseases, and poor health between flat and hilly neighbourhoods among older adults. This study, therefore, compared older adults’ sedentary behaviour and its association with frailty, poor health, and chronic disease status between low and hilly neighbourhoods. Methods This study utilised a STROBE-compliant cross-sectional design with sensitivity analyses and a common methods bias assessment. The participants were 1,209 people aged 50+ years who resided in flat (Ablekuma North, n = 704) and hilly (Kwahu East, n = 505) neighbourhoods in Ghana. The data were analysed with the independent samples t-test and hierarchical linear regression. Results Older adults in the hilly neighbourhood were more sedentary than those in the flat neighbourhood. The association between sedentary behaviour and chronic disease status was significant in both neighbourhoods, but this relationship was stronger in the hilly neighbourhood. Older adults in the flat neighbourhood reported lower sedentary behaviour at higher frailty (β = -0.18; t = -3.2, p

Neutrophils, which constitute the most abundant leukocytes in human blood, emerge as crucial players in the induction of endothelial cell death and the modulation of endothelial cell responses under both physiological and pathological conditions. The hallmark of preeclampsia is endothelial dysfunction induced by systemic inflammation, in which neutrophils, particularly through the formation of neutrophil extracellular traps (NETs), play a pivotal role in the development and perpetuation of endothelial dysfunction and the hypertensive state. Considering the potential of numerous pharmaceutical agents to attenuate NET formation (NETosis) in preeclampsia, a comprehensive assessment of the extensively studied candidates becomes imperative. This review aims to identify mechanisms associated with the induction and negative regulation of NETs in the context of preeclampsia. We discuss potential drugs to modulate NETosis, such as NF-κβ inhibitors, vitamin D, and aspirin, and their association with mutagenicity and genotoxicity. Strong evidence supports the notion that molecules involved in the activation of NETs could serve as promising targets for the treatment of preeclampsia.

Abstract Background Metabolic syndrome (MetS) is a group of diseases characterized by insulin resistance. MetS has high prevalence among women, which is impacted by food intake. MetS is related to high level of inflammation; however, the impacts of whole diets on biochemical and anthropometrical markers and the effects on MetS need to be further elucidated. In this case, the objective of this study was to assess the relationship between food intake, biochemical and anthropometrical markers in women with MetS. Methods This is a cross-sectional study, in which 1 hundred and 22 women participated in the assessment of biochemical (glycated hemoglobin, glycaemia, insulin, uric acid, total cholesterol, HDL-c, LDL-c, triglycerides, C-reactive protein) and anthropometrical (body mass, height, waist circumference - WC) variables. Participants also performed blood pressure and 24-hour dietary recall assessments. Out of the 122 participants, 44 (36%, age: 59 ± 11 years) had MetS and were included in the analysis. Results The consumption of monounsaturated fats had direct relationship with glycaemia (b = 7.48), whereas the consumption of fibers had inverse relationship with body mass (b = − 0.71) and WC (b = − 0.56). Conclusion The intake of monounsaturated fats and fiber was related to higher blood sugar levels and lower body mass and WC, respectively. These relationships elucidate and highlight the significance and importance of adequate diet in women with MetS.

This survey study aimed to assess the willingness of culturally diverse older adults to participate in COVID-19 research. The majority of the 276 participants were women (81%, n = 223) and Black/African American (62%, n = 172) or White Hispanic (20%, n = 56). A key finding from the survey was less than 1 of 10 respondents would be likely to participate in COVID-19 related research if given the opportunity. There were no differences observed by gender, race or ethnicity. Implications of these findings are considered. These study findings indicate continued effort and better messaging strategies are required to increase awareness that COVID-19 related research needs to include culturally diverse older adults to ensure vaccines and treatments are efficacious in different populations.

ABSTRACT. Sarcopenic obesity (SO), the co-occurrence of sarcopenia and obesity, is associated with functional loss, frailty, and incapacity in older adults. Recently, SO was associated with reduced cognitive performance in adults. However, no SO studies have been done with older adults with Alzheimer’s disease (AD). Objective: The objective of this study was to verify the occurrence of SO and associated factors in 43 older adults with AD. Methods: We applied the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). SO was verified by using dual-emission X-ray absorptiometry. Results: We found five women with SO. Women had higher body fat and lower muscle mass compared with men. There was a significant relationship between body fat and cognitive performance only in men (r=0.65; p75 years had better cognitive performance compared with non-obese men aged 75 years (p=0.033). Conclusions: Women with AD had higher body fat and lower muscle mass than men. SO occurs in older women with AD. Men with higher body fat showed better cognitive performance, independent of age and education.

Background: Osteoarthritis (OA) has traditionally been considered a disease of older adults (⩾65 years old), but it may appear in younger adults. However, the risk factors for OA in younger adults need to be further evaluated. Objectives: To develop a prediction model for identifying risk factors of OA in subjects aged 20–50 years and compare the performance of different machine learning models. Methods: We included data from 52,512 participants of the National Health and Nutrition Examination Survey; of those, we analyzed only subjects aged 20–50 years ( n = 19,133), with or without OA. The supervised machine learning model ‘Deep PredictMed’ based on logistic regression, deep neural network (DNN), and support vector machine was used for identifying demographic and personal characteristics that are associated with OA. Finally, we compared the performance of the different models. Results: Being a female ( p

Para la fiabilidad de sistemas uno de los objetivos principales es estimar la función de confiabilidad usando los estimadores de Kaplan-Meier y Nelson-Aalen, bajo el enfoque no paramétrico. Cuando se recurren a técnicas computacionales, la estrategia de Jackknife delete-I brinda ventajas por sus propiedades de consistencia para la estimación de la varianza. Sin embargo, se tiene incertidumbre sobre la posibilidad de mejorar las estimaciones cuando se aumenta el número (d) de observaciones que son suprimidas en el procedimiento secuencial de Jackknife delete-d. Por otra parte, por sus propiedades asintóticas de estabilización de la varianza, las trans- formaciones log y log(-log) son usadas para encontrar intervalos de confianza (ic) para la función de confiabilidad. En este trabajo, se propone combinar simultáneamente las dos estrategias para encontrar los ic para la función de confiabilidad, proponiendo un nuevo procedimiento que no requiere de ajuste paramétrico en el tiempo de ocurrencia del evento de interés. Además de mejorar la estimación de la función de confiabilidad cuando los porcentajes de censura son altos y los tamaños de muestra pequeños. En la investigación se realiza una comparación vía simulación con tamaños de muestras (10,25,50) y porcentajes de datos censurados (0%,15%,50%) para calcular las tasas de error (T.E) e índices de calidad (I), mejorando las estimaciones con porcentajes de censura altos (50%). Los resultados de este trabajo muestran que se puede mejorar la estimación por intervalo en escenarios complejos de censuras y tamaños de muestra a la literatura del análisis de datos en confiabilidad.

OBJETIVO: Contextualizar e relatar experiências com a disciplina “Prescrição de exercícios físicos para populações especiais”, ministrada online para alunos de um programa de pós-graduação stricto sensu. MÉTODOS: A disciplina de 60h contou com 18 profissionais de Educação Física (EF) e um de Fisioterapia. Foram realizados 6 módulos ao vivo com duração de 4 horas (imersão) com o restante do tempo distribuído em atividades de dispersão (i.e., buscas, leituras, relatórios). Durante o processo de ensino-aprendizagem foi solicitada a leitura de aproximadamente 10 artigos, a realização de dois trabalhos e um produto final que deveria ser divulgado através de uma ação de knowledge translation (redes sociais, Unidades Básicas de Saúde - UBS, academias). O programa da disciplina foi ancorado nos subtópicos: 1) contextualização de populações especiais e a atuação do profissional de EF; 2) formação para atuação com populações especiais; 3) atividade física baseada em evidências; 4) exercício é remédio; 5) componentes para prescrição de exercícios e; 6) conexão ciência e prática por meio do knowledge translation/implementation science. RESULTADOS: A contextualização de populações especiais, a atuação e a formação do profissional de EF no âmbito da prescrição de exercícios para populações especiais com foco em uma ação de knowledge translation permitiram a elaboração e divulgação de recomendações de exercícios físicos em redes sociais, academias e UBS. Este processo propiciou aos alunos aprendizagem ativa e experimentação de como os resultados de uma disciplina de pós-graduação podem imediatamente ser convertidos em informação para a sociedade, seja para população geral ou para formação acadêmica para atuação com populações especiais. CONCLUSÃO: Espera-se que esse relato propicie a discussão continuada sobre a atuação do profissional de EF no campo da prescrição de exercícios físicos para populações especiais e maior aproximação de ciência na prática profissional.

The transportation sector produces a large portion of greenhouse gas emissions in the United States. Meeting ambitious reductions in greenhouse gasses requires large-scale adoption of battery electric vehicles and has led to several policies and laws aimed at incentivizing their sales. While electric vehicles comprise a small percentage of the overall fleets of vehicles, the expected production of electric vehicles is soon expected to be in the millions. This will create challenges in providing an adequate charging infrastructure, as well as the ensuing management of the overall electricity demand at the grid level. In this work, a novel smart-charging protocol for battery electric vehicle charging at workplace parking structures is proposed. The Octopus Charger-based Mixed Integer Linear Programming protocol allows octopus chargers (i.e., charging stations with multiple cables) to independently schedule charging periods for their assigned vehicles. The proposed protocols can manage a parking structure demand load while reducing the number of installed charging stations. Driving patterns from the National Household Travel Survey were used to perform simulations, to verify and quantify the effectiveness of the proposed protocol. The proposed protocol resulted in improved peak load reductions for all simulated smart-charging scenarios when compared with uncontrolled charging. Critically, the assignment algorithm resulted in a number of required chargers close to the theoretical minimum.

We aimed to characterize the age of onset of training, age at menarche, menstrual periodicity, and performance perception during the menstrual cycle and examined the impact of these reproductive variables on body composition, morphology, and body weight satisfaction in Brazilian elite futsal players. The study consisted of 115 female Brazilian elite futsal players from the top national teams. Data were collected during the twentieth Women’s Brazil Futsal Cup. Players were interviewed and self-reported their age of onset of training, age at menarche, menstrual periodicity, and the menstrual period, where they performed best. We also asked for what they considered to be their ideal body weight as well as information related to their training (i.e., volume and frequency). Subsequently, anthropometric measurements (i.e., body mass, height, circumferences, diameters, and skinfold thickness) were performed to estimate the body composition and determine morphological characteristics (e.g., somatotype). Fifty-nine (53.2%) players were postmenarche-trained and 52 (46.8%) were premenarche-trained. Eighteen (16.2%), 65 (58.6%), and 28 (25.2%) were classified as early, normal, and late menarche, respectively. Only 11 (9.6%) and 1 (0.9%) had irregular menstrual cycles and were amenorrheic, respectively. Seventy-three (69.5%), 23 (21.9%), and 9 (8.6%) reported that their game performance was the best at the follicular phase, menses, and luteal phase of the menstrual cycle, respectively. No associations between the four reproductive-related variables were found. Postmenarche-trained players had significant lower age at menarche and higher percentage body fat. The somatotype profile registered lower ectomorphy rate for the postmenarche-trained participants after controlling for covariates. Early menarche group presented higher sum of six skinfold thickness and endomorphy rate compared to normal and late menarche groups. No differences were found when menstrual periodicity groups and best performance groups were compared, except for higher femur width in the regular menstrual cycle group compared to the irregular one. The association between body weight satisfaction and the four reproductive-related variables were not observed. Premenarche-trained Brazilian elite futsal players had the menarche later than the postmenarche-trained athletes. Most of the participants had menarche age classified as “normal,” presented “regular” menstrual cycles and perceived to perform better during the follicular phase of the menstrual cycle.

Background/aim The purpose of this study was to compare the isokinetic peak torque profiles from the quadriceps and hamstrings muscles during concentric and eccentric contractions in elite Brazilian soccer players across different field positions and age categories. Our hypothesis was that soccer players from different field positions are subjected to different ageing-related effects on their isokinetic peak torque.Methods This is a retrospective study based on professional elite-level soccer players between the years 2009 and 2019. It included 570 adult males who played for at least 5 years on first or second Brazilian divisions. Playing positions were divided as: goalkeepers, defenders, sidebacks, midfielders and forwards. Age categories were also divided as: G1 (17–20 years old), G2 (21–24 years old), G3 (25–28 years old), G4 (29–32 years old) and G5 (33 years old or more).Results The results indicate a moderate effect of age (F(4545)=8.197; p

Galectins are a family of proteins with an affinity for β-galactosides that have roles in neuroprotection and neuroinflammation. Several studies indicate that patients with neurodegenerative diseases have alterations in the concentration of galectins in their blood and brain. However, the results of the studies are contradictory; hence, a meta-analysis is performed to clarify whether patients with neurodegenerative diseases have elevated galectin levels compared to healthy individuals. Related publications are obtained from the databases: PubMed, Central-Conchrane, Web of Science database, OVID-EMBASE, Scope, and EBSCO host until February 2022. A pooled standard mean difference (SMD) with a 95% confidence interval (CI) is calculated by fixed-effect or random-effect model analysis. In total, 17 articles are included in the meta-analysis with a total of 905 patients. Patients with neurodegenerative diseases present a higher level of galectin expression compared to healthy individuals (MDS = 0.70, 95% CI 0.28–1.13, p = 0.001). In the subgroup analysis by galectin type, a higher galectin-3 expression is observed in patients with neurodegenerative diseases. Patients with Alzheimer’s disease (AD), amyotrophic lateral sclerosis (ALD), and Parkinson’s disease (PD) expressed higher levels of galectin-3. Patients with multiple sclerosis (MS) have higher levels of galectin-9. In conclusion, our meta-analysis shows that patients with neurovegetative diseases have higher galectin levels compared to healthy individuals. Galectin levels are associated with the type of disease, sample, detection technique, and region of origin of the patients.

Extracellular DNA traps (ETs) are evolutionarily conserved antimicrobial mechanisms present in protozoa, plants, and animals. In this review, we compare their similarities in species of different taxa, and put forward the hypothesis that ETs have multiple origins. Our results are consistent with a process of evolutionary convergence in multicellular organisms through the application of a congruency test. Furthermore, we discuss why multicellularity is related to the presence of a mechanism initiating the formation of ETs.

Background/Aim Different authors have tried to correlate the peak isokinetic torque values with the incidence of soccer match injuries. However, due to the wide variety of assessment testing protocols, such an inference becomes difficult. This study aimed to verify the capacity of an isokinetic test to establish injury risk reference values for hamstring strain injuries.Methods A retrospective cohort study based on isokinetic data and clinical records from the last 10 years was conducted in 582 Brazilian elite-professional soccer players, who were subjected to the same isokinetic test protocol, machine, and tester. A Multivariate Logistic Regression Analysis for Complex Data Sampling was used to generate injury risk statistical indexes.Results Multivariate regression analysis of both legs provided important data to identify the cut-off values of Concentric Peak Torque (181.82 Newton/*metres), Concentric Work (236.23 watts) and Concentric Power (130.11 joules).Conclusions The injury risk indexes indicate that an increase of just one Newton unit in CPT (Concentric Peak Torque) and CJ (Concentric Power) above those cut-off values, can reduce the risk of future injuries by 2% and 2.7%, respectively.

RESUMEN Introducción: El uso de las medicinas no convencionales (MNC) crece en la población; sin embargo, los médicos tienen un bajo nivel de conocimiento acerca de ellas, a pesar de su interés, debido a las preguntas que reciben de sus pacientes con respecto a sus riesgos y beneficios. No obstante, se desconoce cuántos y cuáles son los instrumentos que evalúan la calidad de la investigación de estas medicinas. Objetivo: Identificar las herramientas que se utilizan para evaluar la calidad de la investigación en medicinas no convencionales a fin de conocer sus avances y origen de sus limitaciones. Método: Se realizó una búsqueda de información en bases de datos científicas; acopiándose un total de 200 de estos, solo 75 fueron considerados adecuados; aunque, solo 12 respondieron a la pregunta de investigación. El análisis acogió algunas de las recomendaciones PRISMA. Resultados: Se encontraron 12 instrumentos que guían y evalúan la calidad de la investigación en medicinas no convencionales, 9 de ellas son extensiones CONSORT. China, Corea del Sur y la India son los países que promueven la estandarización de su medicina tradicional, la cual representa gran parte de las medicinas alternativas y complementarias de otras partes del mundo. Conclusiones: Se requiere seguir procedimientos específicos para la evaluación de la calidad de la investigación en medicinas no convencionales con el fin de encontrar los criterios más apropiados para la evaluación de su eficacia y seguridad.

Over 80% of adults in the US fail to meet the ≥150 min weekly physical activity guideline; 40% age ≥ 75 are entirely inactive. The study purpose was to understand the reasons why community-dwelling older adults (age ≥ 60) from diverse backgrounds increase, sustain, or decline in their physical activity levels over time. Sixty-two older adults were interviewed. Two-thirds of the African Americans, 57% of the Afro-Caribbeans, and 50% of the European Americans reported being less active than 2–3 years ago. Reasons for activity decline included health issues (e.g., pain, shortness of breath), lack of time, interest, or motivation. Reasons for sustaining or increasing activity levels included meeting personal goals, having a purpose for remaining active, or feeling better when active (e.g., it is important to keep moving, good for the joints, going on a cruise). Themes identified were pride in maintaining activity, goal-driven activity, pushing oneself to get past pain or fatigue, and some confusion between social and physical activity in participant reports. The results indicate widespread acceptance that activity is beneficial, but that knowledge alone was insufficient to maintain activity levels over time unless individuals had a goal or purpose (“means to an end”) and could overcome their physical and psychological barriers to physical activity.

Walking biomechanics is known to be influenced by speed. However, most of the research examining the effects of walking speed and gait characteristics has been conducted after a fast-walking task, neglecting the changes that may occur during the task. The aim of the present study was to determine the impact of fast-walking over time on kinematics in young and old adults. Twenty-seven young adults (26.6 ± 6.0 years) and 23 old adults (71.0 ± 5.6 years) walked at 70% of their maximum heart rate for 20 min or until exhaustion, and the effects of fast-walking on temporospatial parameters and on angular kinematics were analyzed during the activity. During the protocol, both age-groups increased step-width variability. Significant effects of time were found for the ankle and hip at toe off for the older group. For the younger group, only the ankle angle at heel strike changed over time. For both groups, fast-walking induced changes in the coordination among the lower-limb angles that were more prominent during the swing phase of the gait. In conclusion, lower-limb kinematics changes in young adults were compatible with early signs of fatigue. The increased step-width variability in older adults may indicate an augmented risk of falling. Changes in the lower-limb walking kinematics of old adults suggest that the adjustments for weight acceptance and body propulsion were restricted to the hip and ankle joints. The kinematic changes among the lower-limb joint angles during the swing phase may compromise the quality of gait. These findings provide a foundation for future studies in the assessment of the risk of falls in older adults associated with walking at a faster pace.

The purpose of this study was to investigate the influence of daily cognitive task on stiffness of old and young female adults during the gait. The study included 17 physically active younger and 18 older women, with low risk of falls. The volunteers were asked to walk on the treadmill at two different gait conditions: normal gait and functional dual-task gait. The electromyographic signals were collected of the lower limb muscles. The percentage of coactivation for the tibialis anterior/gastrocnemius lateralis and tibialis anterior/soleus were significantly higher in elderly than in younger in the normal gait and dual-task gait. Our results suggest that the elderly have a greater stiffness in the ankle joint during gait normal and daily dual task gait. Thus, we conclude that challenging cognitively situations during the gait may increase the risk of falls in this population.

BACKGROUND: Falls of elderly people may cause permanent disability or death. Particularly susceptible are elderly patients in rehabilitation hospitals. We systematically reviewed the literature to identify falls prediction tools available for assessing elderly inpatients in rehabilitation hospitals. METHODS AND FINDINGS: We searched six electronic databases using comprehensive search strategies developed for each database. Estimates of sensitivity and specificity were plotted in ROC space graphs and pooled across studies. Our search identified three studies which assessed the prediction properties of falls prediction tools in a total of 754 elderly inpatients in rehabilitation hospitals. Only the STRATIFY tool was assessed in all three studies; the other identified tools (PJC-FRAT and DOWNTON) were assessed by a single study. For a STRATIFY cut-score of two, pooled sensitivity was 73% (95%CI 63 to 81%) and pooled specificity was 42% (95%CI 34 to 51%). An indirect comparison of the tools across studies indicated that the DOWNTON tool has the highest sensitivity (92%), while the PJC-FRAT offers the best balance between sensitivity and specificity (73% and 75%, respectively). All studies presented major methodological limitations. CONCLUSIONS: We did not identify any tool which had an optimal balance between sensitivity and specificity, or which were clearly better than a simple clinical judgment of risk of falling. The limited number of identified studies with major methodological limitations impairs sound conclusions on the usefulness of falls risk prediction tools in geriatric rehabilitation hospitals.

A unique project was undertaken by doctoral and postdoctoral students, and their mentor, from diverse backgrounds in health and social sciences to explore their past experiences as participants in a qualitative research training initiative called EQUIPP (Enhancing Qualitative Understanding of Illness Processes and Prevention). The purpose of the project was to create a symbolic representation of the EQUIPP program through the use of projective techniques. The authors examined the meaning of engaging in qualitative research training through images and conceptual metaphors that were subsequently consolidated thematically and then portrayed in the form of a newly constructed logo that was developed with the assistance of a professional graphic designer. Projective techniques proved to be a powerful, evocative tool for eliciting meaning and translating concrete experiences into visual discourse. In this paper, the authors discuss how projective techniques were operationalized and consider their broad implications for qualitative research.