Yes / We thank Professors Evans and Wilkins for their interest in our systematic review.(1) We have reached the same conclusion as previous systematic reviews published in 2008(2) and 2014(3) and a review prepared for the New Zealand Ministry for Health in 2009.(4) Even the ‘alternative systematic review’ prepared by Professors Evans and Allen about which we have significant misgivings concludes that ‘larger and rigorous randomised controlled trials of interventions for visual stress are required’.(5) / A response to Professors Evans and Wilkins regarding the systematic review: Griffiths PG, Taylor RH, Henderson LM and Barrett BT (2016) The effect of coloured overlays and lenses on reading: a systematic review of the literature. Ophthalmic & Physiological Optics. 36: 519–544.

This thesis investigates stress and coping in high performance squash coaching from the perspectives of both the coach and the player. An introduction to the thesis (chapter 1), a discussion of key concepts and theories from the general stress and coping literature (chapter 2), and a systematic review of the stress and coping in sport literature (chapter 3) are presented. The empirical work is reported in two phases. Phase one (chapters 4, 5 & 6) documents an in-depth study of 18 high performance squash coaches. Retrospective interviews were used to collect both qualitative and quantitative data. Inductive content analysis (Patton, 1980) revealed 223 raw data themes for stress, which collapsed into 12 general dimensions, and 415 raw data themes for coping, from which 13 general dimensions emerged. Descriptive statistics on stress source characteristics revealed a number of interesting trends that required further investigation. Further, general ('multi-purpose') and specific coping strategies were identified. Coping effectiveness and frequency data detailed the analysis. Phase two (chapters 7, 8 & 9) investigates stress and coping experiences of elite squash players during coaching activities via two studies. In study one, data were collected through telephone interviews, and analysed using inductive content analysis (QSR NUDIST), revealing 227 raw data themes for stress and coping from which 9 stress and 8 coping general dimensions emerged. These results were used to develop a postal questionnaire (study two) administered to 84 elite squash players on the England Squash World Class Performance Programme (Jan. 1999). A response rate of 60% was obtained, data was input into SPSS, and various statistical tests revealed significant contributions to 5 major investigative themes detennined at the outset. An overall picture of the landscape in stress and coping in high performance squash coaching is offered, and conclusions and future directions are presented (chapter 10).

Bakgrund: Smittsamma sjukdomar är ett ökande problem för världen med ständig utveckling av bland annat antibiotikaresistenta bakterier, vilket kan göra att patienter med smittsam sjukdom blir komplicerade att vårda. För att minska smittspridning vårdas patienter i isolering, vilket kan medföra negativa upplevelser. Problem: När patienter vårdas i isolering blir de begränsade i sin livssituation. Deras möjlighet till att socialisera och interagera med andra människor försvåras, vilket kan ge upphov till ohälsa och eventuellt lidande. Isoleringsvård innebär även tillämpning av skydds- och försiktighetsåtgärder som orsakar ökad arbetsbelastning för sjukvårdspersonal, vilket kan leda till sämre omvårdnadskvalitet för patienter som vårdas i isolering. Syfte: Beskriva patienters upplevelser av isoleringsvård vid smittsam sjukdom. Metod: Kvalitativ systematisk litteraturstudie med beskrivande syntes, där tio analyserade vetenskapliga artiklar användes i resultatet. Resultat: Det framkom både negativa och positiva upplevelser hos patienter som vårdas i isolering. Dessa delades in i två övergripande teman; Vårdas i ensamhet med tre tillhörande subteman och Behov av att förstå med två tillhörande subteman. Slutsats: Sjukvårdspersonal behöver anpassa den vård som ges med hänsyn till patienters omvårdnadsbehov. Genom att sjukvårdspersonal får utökade kunskaper om patienters positiva och negativa upplevelser av isoleringsvård kan sjukvårdspersonal anpassa vårdandet. / Background: Communicable diseases is an increasing problem world-wide due to the ongoing increase of antibiotic-resistant bacteria, which makes the diseases hard to treat. Patients are forcibly being treated in isolation due to the risk of spreading the infection to other people, this can cause negative experiences for these patients. Problem: Patients who are being treated in isolation are forced into a limited situation in their lives. Their possibilities of socializing and interacting with other people are reduced which could cause unhealthiness and suffering. Isolation care means that healthcare professionals have to apply precautionary methods with protective equipment when treating these patients. This could cause an increased workload for healthcare professionals and lead to poor quality of care for patients in isolation. Aim: To describe patients’ experience of isolation care due to communicable diseases. Method: A systematic review with a descriptive synthesis, and ten articles were analyzed for the result. Result: Both negative and positive experiences were identified of patient treated in isolation. These experiences were divided into two major themes; To receive care in loneliness with three included sub-themes and The need to understand with two included sub-themes. Conclusion: Healthcare professionals have to adapt the care to the needs of the unique patient. If healthcare professionals had more knowledge of caring for patients in isolation some of the negative experiences could be eliminated and lead to better quality of care.

Objectives: The EZSCAN is a non-invasive device that, by evaluating sweat gland function, may detect subjects with type 2 diabetes mellitus (T2DM). The aim of the study was to conduct a systematic review and meta-analysis including studies assessing the performance of the EZSCAN for detecting cases of undiagnosed T2DM. Methodology/Principal findings: We searched for observational studies including diagnostic accuracy and performance results assessing EZSCAN for detecting cases of undiagnosed T2DM. OVID (Medline, Embase, Global Health), CINAHL and SCOPUS databases, plus secondary resources, were searched until March 29, 2017. The following keywords were utilized for the systematic searching: type 2 diabetes mellitus, hyperglycemia, EZSCAN, SUDOSCAN, and sudomotor function. Two investigators extracted the information for meta-analysis and assessed the quality of the data using the Revised Version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist. Pooled estimates were obtained by fitting the logistic-normal random-effects model without covariates but random intercepts and using the Freeman-Tukey Arcsine Transformation to stabilize variances. Heterogeneity was also assessed using the I2 measure. Four studies (n = 7,720) were included, three of them used oral glucose tolerance test as the gold standard. Using Hierarchical Summary Receiver Operating Characteristic model, summary sensitivity was 72.0% (95%CI: 60.0%– 83.0%), whereas specificity was 56.0% (95%CI: 38.0%– 74.0%). Studies were very heterogeneous (I2 for sensitivity: 79.2% and for specificity: 99.1%) regarding the inclusion criteria and bias was present mainly due to participants selection. Conclusions: The sensitivity of EZSCAN for detecting cases of undiagnosed T2DM seems to be acceptable, but evidence of high heterogeneity and participant selection bias was detected in most of the studies included. More studies are needed to evaluate the performance of the EZSCAN for undiagnosed T2DM screening, especially at the population level.

Ensuring the objectivity of systematic reviews and meta-analyses (SRMA) begins with comprehensive searches into diverse resources mining primary studies. Guidelines for systematic reviews recommend authors to routinely search of trial registries to identify unpublished studies. In this dissertation, I investigated the utilization of ClinicalTrials.gov (CTG), the world’s largest clinical trial registry that contains data from clinical trials of products that are subject to United States Food and Drug Administration (FDA) regulation, as an information resource in SRMAs. First, I examined the use of various information resources including CTG in SRMAs published from 2005-2016, and identified the factors associated with their use. Thereafter, to determine the accuracy of trial safety data reported at CTG, I compared the data at CTG with that in corresponding journal articles and FDA drug reviews. I found that trial safety data at both CTG and articles differed frequently from FDA drug reviews, but the differences were modest in magnitude. Finally, I repeated published meta-analysis (conducted using data from primary study articles) with data at CTG to find that most meta-analysis results were reproduced using CTG data. Taken together, this work suggests that CTG should not only be searched more often to find primary research for systematic reviews, but that data at CTG can also be used to conduct quantitative data synthesis.

Background and Objectives: HIV in a major public health problem in many countries of the world. Recent advances in care for people living with HIV such as the use of antiretroviral medication have reduced the mortality and morbidity associated with HIV infection. However, many people receiving antiretroviral therapy do not take it as prescribed and still experience sub-optimal health outcomes. Mobile phone text messaging is emerging as an important tool in health care, and HIV in particular. Our objectives were to explore the determining factors for adherence to antiretroviral therapy, test text messaging as an adherence enhancement tool, develop a framework for community ownership of a text messaging program and describe strategies for transfer of evidence in HIV to other conditions. Methods: This research is primarily based in Yaoundé, Cameroon, and employs a variety of methodologies, including a systematic review, two cross- sectional surveys, a randomized controlled trial, an individual patient data meta-analysis, a mixed methods study and a systematic review of systematic reviews. Results and Conclusions: Two-way weekly text messaging is an effective strategy in improving adherence to antiretroviral therapy and enhancing provider-client communication. People living with HIV in Yaoundé, Cameroon like receiving text messages, and are willing to own and run a text messaging program. Text messaging interventions may be transferred to other conditions by integrating services or by copying what works in HIV. Further research on potential harms, cost effectiveness and text messaging for other chronic conditions is warranted. / Thesis / Doctor of Philosophy (PhD)

Yes / We read with interest the review written by Evans and Allen, and published in the Journal of Optometry, in July, 2016.

The increased number of international immigrants and associated global problems of health deterioration and vitamin D (vitD) deficiency/insufficiency may lead to significant burdens for host countries. This thesis investigated immigrants’ health deterioration and vitD status through a comprehensive analysis of Canadian national vitD data, systematic evaluation of the quality/content of clinical practice guidelines, and global systematic review of vitD status and determinants among first-generation immigrants. Immigrants had lower serum 25-hydroxyvitamin D (S-25(OH)D) and higher melanin levels than non-immigrants. S-25(OH)D levels improved over time, with ethnicity the main factor explaining variations. The longer immigrants lived in Canada, the higher the prevalence of chronic diseases (CDs), potentially reflecting health deterioration. Low levels of accumulated S-25(OH)D may impact CD-related biomarkers, partially explaining immigrants’ health deterioration over time. Local and international guidance regarding immigrants’ vitD deficiency/insufficiency was lacking. Improving immigrants’ vitD status requires prevention and intervention programs (e.g., vitD supplementation/screening), relevant national/international guidelines, and longitudinal research clarifying the complex bidirectional association between S-25(OH)D and CDs.

OBJECTIVE: The purpose of this study was to determine the association between baseline patient recovery expectations and outcomes following physical therapy care. METHODS: PubMed, CINAHL Complete, PEDro, SPORTDiscus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and PsycINFO were searched from inception to February 2021. Concepts represented in the search included physical therapy, patient expectations, patient outcomes, and their relevant synonyms. Two reviewers independently screened studies of article abstracts and full texts. Eligibility criteria included English language studies that evaluated adults seeking physical therapist intervention for any health condition where both patient outcome (recovery) expectations and functional or other outcome measures were reported. Methodologic standards were assessed using the Critical Appraisal Skills Program criteria. Data were extracted using a custom template for this review with planned descriptive reporting of results. Vote counting was used to measure reported outcomes. RESULTS: Twenty-one studies were included in this review, representing 4879 individuals. Studies were most commonly prospective cohort studies or secondary analyses of controlled trials. Varied expectation, outcome, and statistical measures that generally link patient recovery expectations with self-reported outcomes in musculoskeletal practice were used. CONCLUSION: Patient recovery expectations are commonly associated with patient outcomes in musculoskeletal physical therapy. IMPACT: Evidence supports measuring baseline patient expectations as part of a holistic examination process.

The author presents a case study for the development of an evidence synthesis service serving researchers outside of the health sciences at a large academic library. The purpose of this project was to highlight the importance of integrating existing core services and workflows that create seamless delivery of evidence synthesis support and yield quality service. The paper provides decisions that university libraries must consider as they are planning the implementation of these services. The research-intensive nature of evidence synthesis projects provides liaison librarians with a perfect entry to deliver high-quality and relevant services, especially to graduate students and researchers. Through this work, libraries will demonstrate strong evidence for their engagement and contributions to research on campus. Librarians interested in supporting this latest type of research can use this study to gain a sense of where their own professional strengths fit within this new functional area and plan how to enter this developing research space. This study may be of interest to administrators, reference and instruction librarians, and librarians serving graduate students. Issues are presented in a way that surfaces difficult topics, which will help guide planning conversations between supervisors and librarians regarding workload assignments.