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Reference intervals (RIs) are sets of percentiles that outline the range of laboratory test results belonging to healthy individuals. They are essential for the interpretation of laboratory test results. A wide variety of factors affect the validity of RIs. Among them are the statistical methods used to estimate RIs. However, little investigation has gone into the effect that different statistical methods have on the resulting RIs. This is particularly needed as the complexity of paediatric data makes it difficult to estimate RIs. These difficulties, however, can be addressed using appropriate statistical techniques, provided that there is an outline of scenarios under which these techniques are truly “appropriate”. The objective of this thesis is to provide a thorough investigation into the effect of different statistical methods on RIs. A systematic review was first conducted with a focus on paediatric RIs. The results of this review revealed that critical analysis steps are often overlooked due to complicated paediatric data. Even though a guideline addressing the establishment of RIs is available, there is great heterogeneity in the statistical methods chosen to estimate paediatric RIs. An extensive simulation involving the three most commonly used approaches to estimate RIs (the parametric, non-parametric, and robust methods) was also conducted to investigate and compare the performance of the different methods. The simulation results show that, when data follows a Gaussian distribution, or close to it, the parametric method provides the best estimates. The non-parametric method did not provide the best estimates of RIs (compared to the parametric method) unless data was highly skewed and/or large sample sizes were used. In addition, the bias and MSE associated with the parametric method when data follows a Gaussian distribution was mathematically derived, which may lead to the development of a bias corrected and more precise approach in the future. / Thesis / Master of Science (MSc)

The purpose of this thesis was to determine the effectiveness of strategies to reduce sedentary behaviour (SB) and to communicate these strategies to healthy adults working in academic occupations using an educational video. Study One was a systematic review and meta-analysis of published literature on strategies to reduce SB in the home and workplace environments for healthy adults. Study Two was a single group pre-post study design to determine the effect of an educational video on viewers’ health beliefs related to reducing SB and daily sitting time. The information gained from these studies could be used to inform future interventions to reduce SB in the adult population. / Thesis / Master of Science Rehabilitation Science (MSc)

Young adulthood is an important period in the development of obesity. Undergraduate students are particularly at-risk since they gain more weight than those not attending university. As students transition from high school to university, they often adopt unhealthy lifestyle behaviours which are thought to lead to weight gain. On average, students gain three to five pounds (1.4-2.3 kg) during their first year of undergraduate education. However, less is known about how body composition changes throughout the four-year course of undergraduate education and what causes these changes. We thus conducted a systematic review to synthesize a comprehensive list of factors associated with obesity traits (e.g. body mass index, body fat percentage, muscle mass) in undergraduate students. Two hundred thirty-eight studies were included (175 cross-sectional, 49 cohort, 11 interventional, 3 qualitative). We identified age, sex, ethnicity, socioeconomic status, religion, diet, eating habits, physical activity, sedentary activity, sleep, stress, university campus life, alcohol use, smoking, psychiatric disorders, body image, eating attitude, eating regulation, personality, and social/cultural influences as factors which are associated with obesity traits. These factors guided the design of the Genetic and EnviroNmental Effects on weight in University Students (GENEiUS) study, a prospective observational study which investigates the genetic and environmental determinants of body composition in undergraduate students over four years. The GENEiUS study will recruit 2500 multiethnic first- year undergraduates aged 17–25 years and will follow them every six months for four years. Primary outcomes are body mass index, waist circumference, waist-to-hip ratio, body fat mass and body fat percentage. This study will help design obesity prevention programs in universities. / Thesis / Master of Science (MSc)

Rationale: The use of ultrasound as an adjuvant to conservative treatment for neck pain is common, but the evidence of its benefit remains unclear. Objective: To determine the effectiveness of ultrasound as an adjuvant to exercise or/and manual therapy for the improvement of patient-centered outcomes in adults with non-specific neck pain. Methods: Electronic databases including MEDLINE, EMBASE, AMED, CINAHL, CENTRAL, PEDro and PubMed were searched from date of inception to March 2019 for controlled trials involving ultrasound or phonophoresis as an adjuvant to exercise or/and manual therapy in adults with non-specific neck pain. Review Manager 5.3 was used to calculate mean group differences. Main results: Six studies (361 participants) examining ultrasound or phonophoresis as an adjuvant to exercise or/and manual therapy for sub-acute and chronic non-specific neck pain were included. The quality of evidence was of very low GRADE. Phonophoresis with capsaicin plus exercise improved pain immediately post-treatment (MD -3.30, 95% CI: -4.05 to -2.55) but not with diclofenac sodium plus exercise as compared to exercise alone. Continuous ultrasound plus exercise improved pain and Pressure Pain Threshold (PPT) at immediate post-treatment (pain: MD -3.42, 95% CI: -4.08 to -2.7; PPT: MD 0.91, 95% CI: 0.68 to 1.14 ) and at intermediate - term (pain: MD -2.70 95% CI: -3.62 to -1.78; PPT: MD 0.27 95% CI: 0.03 to 0.51) as compared to exercise alone. Continuous ultrasound or High Power Pain Threshold (HPPT) ultrasound plus manual therapy and exercise showed no benefit for pain reduction (MD -0.75, 95% CI: -2.08 to 0.58), increase in PPT (MD -1.15, 95% CI: -2.55 to 0.25) or improved function/disability (MD -1.05, 95% CI: -4.27 to 2.17) at immediate or short-term as compared to manual therapy and exercise. Conclusion: Based on very low quality evidence, there is insufficient data to support ultrasound or phonophoresis as an adjuvant treatment for non-specific neck pain. / Thesis / Master of Science Rehabilitation Science (MSc) / Ultrasound therapy is widely used with exercise or manual therapy for the treatment of neck pain. Yet, its benefits are not clear. This review looked at the benefits of ultrasound added to exercise, manual therapy or both for the treatment of neck pain. The review contains six studies with 361 participants who suffered from neck pain. The results showed very low quality evidence. Applying capsaicin cream with ultrasound or continuous ultrasound in conjunction with exercise had some benefit for improving pain. The same treatment did not improve function as compared to exercise alone. There was no benefit in improving pain or function by adding continuous or high power ultrasound to manual therapy and exercise compared to manual therapy and exercise alone. Due to very low quality evidence, we are uncertain of whether there is a benefit to adding ultrasound to exercise or/and manual therapy for treatment of neck pain.

Design review is a process of reviewing construction design documents to ensure that they reflect the owner's design intent, and are accurate in describing the owner's desired building or facility. Information generation becomes more intensive as the design stage progresses. The use of valuable information during design review stage can lead to a more comprehensive and high quality design, and a building or facility that is constructible, and within the intended budget. However, in current design practices, valuable design review information is scattered, ineffectively placed, and is not used efficiently. The design review process will be more efficient if this valuable information is integrated and centralized. The author developed a framework to improve the design review process by incorporating a centralized repository of design review information and 3D CAD model, in an interactive Virtual Environment (VE). To develop the framework, the author used Action Research style where he identified and confirmed the design review problem area, promoted the potential solutions to the problem, and developed a prototype. In gathering and analyzing the data for the research, the author used the synthesis of three methods. They include review of literature, a case study (interviews with industry personnel and content analysis of design review documents), and dissemination of the author's progressive findings in conferences, conference proceedings and journal publications. From his findings, the author developed the framework to improve the design review process by using information filtering based on context-aware concept, coupled with the benefits of a VE. The required design review information in the form of textual, numerical and geometric information is processed (queried, retrieved and stored). The author defined four contexts for information filtering: discipline-centric, task-centric, object-centric, and location-centric. IF-THEN rules are used to trigger the processing of the required design review information and present it to the design reviewer in a VE. A low cost 3D Game Engine is used as the enabling development tool to develop a work-in-progress (WIP) prototype design review application in a VE. / Ph. D.

This study focuses on the ability, or inability, to replicate or compare the design of text-related research from the perspective of the independent or dependent variables employed in such designs. Prior text-related research has used variables that were not clearly described or defined, could not be directly compared from one study or time period to the next, or were applied inappropriately. Measurements of typography-related and substrate-related variables may have absolute or relative values, and confusion can arise if the variables are not clearly identified and defined. The study is an integrative review with mixed methods research design investigating 44 books and two websites (part 1), and 83 journal articles and four theses/dissertations (part 2). The integrative review shows that the sources investigated present neither essential information on typographic and substrate characteristics nor consistent definitions of legibility and readability in order to allow comparable replication from one study to another. Findings are displayed in Chapter 4. Discussion and the related details are presented in Chapter 5. / PHD

This research aims to investigate the (1) review effects on consumer decision making process, (2) effects of negative reviews on brand equity, and (3) consumers' likely response to a brand's request for reviews. The objective of the first essay is to investigate the nature of the relationship between skepticism and consumer decision making in an online behavior context. Its second objective is to know whether people's belief on their abilities or their hedonic principle moderates the relationship between a person's skepticism toward online reviews and their reliance on online reviews. The objective of the second essay is to explore whether negative online reviews that focus on service quality specific dimensions have a different effect on a service organization's perceived brand equity. Its second objective is to analyze the role of emotional contagion in the relationship between negative reviews related to various service quality dimensions and its effect on perceived brand equity. The main objective of the third essay is to know whether consumers are more likely to write an online review for a brand when the request comes from a higher equity brand. This essay also investigates how message trust and persuasion knowledge influence the relationship between a brand's request to write online reviews and the likelihood of consumers to write reviews. These three essays altogether contribute to the online review and the brand equity literature by providing new insights about the intricate relationship between online reviews, brand equity, and consumer decision-making.

Employee job satisfaction during a reorganization has been of interest to leaders that rely on personnel to execute the organization's mission. This is particularly important when the employees' mission is to provide needed equipment to U.S. Marines in the operating forces that, at any moment, can be called upon to engage in combat operations. Ensuring employee job satisfaction in itself is a difficult task. This difficulty is exacerbated when the employees are civilians working in a military-led organization. The topic of job satisfaction and organizational change is expounded upon in substantial research. However, there is limited research on job satisfaction of civilians working in a military organization during organizational change. The Marine Corps Systems Command conducted their Force Structure Review without the use of any recognized leadership theory. This study looked at the reorganization through the lens of Kotter's Leading Change Model, highlighting employees' perceptions of job satisfaction, individual effectiveness, and organizational effectiveness. This manuscript conveys findings of research conducted in the summer of 2018, which included 242 civilian employees and 6 senior military officers of the US Marine Corps Systems Command headquartered at Marine Corps Base Quantico, Virginia. Findings indicate there is a significant division of perceptions of civilian employees and senior military leadership in the design and execution of the Force Structure Review as it relates to civilian employees' job satisfaction. / PHD