Superficial venous thrombosis (SVT) is a common inflammatory and thrombotic pathology occurring within a superficial vein. SVT can result in distressing symptoms of redness and pain in the affected area and exposes patients to a risk of developing deep vein thrombosis (DVT) and pulmonary embolism (PE). Various therapeutic options are available to patients including anti-inflammatories, anti-coagulation and surgical procedures, however which of these therapies is the best first line treatment remains unknown. Several randomized controlled trials have been conducted addressing this question, yet methodological and design flaws have limited the translation of their results into a change of clinical practice. The following thesis consists of a multi-step process of reviewing the evidence to date followed by a process of engaging with clinician stakeholders with the goal of designing a randomized control trial that would provide a meaningful answer to patients and their clinicians. In the first step of this process, a systematic review of the literature was performed, including a meta-analysis to estimate pooled risk of developing symptomatic venous thromboembolic (VTE) complications in patients with isolated SVT following various treatments. These results were then presented to expert Canadian clinicians in a series of surveys using a Delphi process to determine the clinical trial design that would have the greatest impact on changing clinical practice. An additional survey of expert clinicians was conducted to determine current practice variation in the diagnosis, management, and follow up of patients with SVT, in order to design a clinical trial that best reflected current standard Canadian clinical practice. Our systematic review identified 15 articles and including 5775 patients. Quality and assessment of risk of bias was moderate for most included studies. The findings of our meta-analysis identified that Fondaparinux, at prophylactic dose, to had the lowest event rate of 2.0 events per 100 patient years of follow-up (95% CI 0.4 to 4.7, I2=33%) for the primary outcome of deep vein thrombosis (DVT) or pulmonary embolism (PE) during follow-up. Pooled event rates ranged from 8.6-16.6 events per 100 patient-years across other treatment categories, including placebo/observation only, with an event rate of 10.5 events per 100-patient years (95% CI 3.0 to 22.0). Heterogeneity was moderate to high for most pooled estimates, limiting the interpretation of these findings. Our survey of practice variation among expert Canadian clinicians revealed wide practice variation in in diagnosis and therapeutic management including sub-groups (e.g. cancer). There was agreement that clinical equipoise exists for the optimal treatment of SVT (77% of respondents), supporting the need for further research. Two rounds of surveys were performed using Delphi process methods, resulting in consensus for the design of a future randomized control trial (RCT). The agreed on design was for a randomized control trial comparing a direct oral anticoagulant (DOAC) such as Rivaroxaban, to Non-Steroidal Anti-Inflammatories (NSAIDs), using a non-inferiority RCT design with a non-inferiority margin of 3%. Future direction of this research will be to continue stakeholder engagement by engaging patients in the clinical trial design, followed by development of a pilot RCT protocol and application for peer-reviewed funding.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Diarrhea is the fourth leading cause of children under five worldwide. Recommendations for diarrhea treatment include oral rehydration therapy, continued feeding, zinc supplementation, and antibiotic use if indicated. The use of these therapies is lower than expected in developing countries. This study aims to determine how cultural beliefs impact the use of evidence-based approaches for diarrhea treatment, specifically in developing countries. A systematic review of primary research articles was done to assess knowledge of and attitudes towards evidence-based treatments, analyze care-seeking behaviors, and identify beliefs attached to treatment practices. Most cultural beliefs fall into the following themes: misconceptions about evidence-based treatments; feeding practices; home remedies and herbal medicines; inappropriate use of medications; and traditional healers and spiritual beliefs. The results show the possibility for working with traditional healers and the local population to gather more data about beliefs and practices. This information can be used to develop culturally sensitive treatment programs that can operate within the framework of local beliefs and practices.

Class of 2013 Abstract / Specific Aims: This study assessed the extent to which American Indians were involved in the research process (i.e. design, implementation, analysis, and dissemination) in relationship to funding sources and reported limitations in research interventions that addressed diabetes, as well as research method or design. Methods: Systematic searches of The Cochrane Library, PubMed, CINAHL, International Pharmaceutical Abstracts (IPA), Web of Science, ERIC, and PsychINFO identified studies focused on type 2 diabetes in American Indians published between October 5, 2010 and April 30, 2012. Studies selected for inclusion were those that were interventional or programmatic in nature, used a comparison group for statistical analysis and reported patient level or patient related outcomes. Data were extracted and analyzed for study characteristics, reported limitations, funding sources, and extent to which the community was involved in the research process.       Main Results: A total of 6 studies were included. There was no difference between American Indian involvement in the research process with respect to funding sources and reported limitations (p = 0.17 and p = 0.23, respectively). The majority of studies were conducted in a clinic setting (33.3%) on tribal/sovereign land (66.7%). Study design was evenly split between randomized controlled trials and observational studies (50% for both). The most frequently reported intervention was combination/multimodal (50%).       Conclusion: American Indian involvement in the research process was not impacted by either funding sources or reported limitations.

Class of 2013 Abstract / Specific Aims: Conduct a comprehensive and systematic review to identify and describe studies from October 2010 to May 2012 that have addressed diabetes interventions in American Indian populations and assess the impact those interventions had on improving humanistic and therapeutic outcomes in preventing or treating diabetes in American Indians. Methods: Studies published between 5 October 2010 and 30 May 2012 that described diabetes interventions or programs in American Indian populations were identified via electronic searches of PubMed, CINAHL, IPA, Cochrane, PsychINFO, Web of Science, and ERIC using key search terms related to (and MeSH terms where applicable) diabetes, interventions, medication adherence, diet, exercise, blood glucose, cholesterol, blood pressure, North American Indians, American Indians, Native Americans, and Alaska Natives. Articles were reviewed and were excluded if the study had no comparison group, was not interventional or programmatic in nature, took place outside the US, study population was < 50% American Indian, or did not report on patient-related outcomes. Data on study characteristics, patient characteristics, and study outcomes were extracted. Main Results: A total of five studies were included. Positive, significant effects were reported on A1c in 40% (n=2), cholesterol in 40% (n=2), blood pressure in 40% (n=2), weight/BMI in 20% (n=1), blood glucose monitoring in 20% (n=1), diet in 20% (n=1), and diabetes knowledge and health literacy in 20% (n=1). Conclusion: The literature review had minimal results. Of those included, the majority of diabetes interventions were educational-related, observational in design, assessed only adults, and study populations were primarily female. Few of the included studies interventions demonstrated significant improvements in diabetic outcomes. Continued research and efforts to further improve diabetes management within the American Indian community is needed.

The Cariceae (Carex & Kobresia; Cyperaceae) account for ca. 10% of Canada's native vascular plants, yet diversity within the tribe is overlooked due to its taxonomically-difficult floral morphology. DNA barcoding is a useful tool for identifying animals and the technique is currently being adapted for use in plants. This thesis develops a reference barcode database for the Cariceae of North America, north of Mexico, using the chloroplast gene matK. A species resolution rate of 39% is reported, although when broken down into political regions, this can increase to 75%. Unknown tissue samples from across North America were then identified using this reference database; 50% of these were identified to a single species matching the morphological identification, and 50% were identified to a group of taxa containing the correct identification. An ecogeographical regional database for the Arctic Archipelago was also challenged with 230 unknown samples and identified 98% to a single species.

The taxonomic status of the 25 nominal species of the Indo-Pacific flatfish genus Zebrias (Pleuronectiformes: Soleidae) was revised based on a morphological study of 531 specimens, including 36 type specimens. Two distinct, monophyletic groups were identified differing in the confluence and attachment of the caudal fin to adjacent dorsal and anal fins. Species most closely associated to the type species Pleuronectes zebra were included in the genus Zebrias while the remaining species were assigned to the genus Pseudaesopia to accommodate Zebrias species having a shallowly confluent caudal fin with adjacent fins, among other characters. Ten species are now recognized and re-described in Zebrias while six species are recognized and redescribed in Pseudaesopia. Comprehensive generic definitions and identification keys to species are provided. In addition, the closely related and monospecific genus Aesopia is briefly discussed. Finally, potentially useful characters for a future phylogenetic study are discussed.

As an alternative to current trends in literary criticism, this thesis argues that the rigorous methods of obtaining knowledge as well as the concepts and insights developed in systematic psychology and psychoanalysis can and should be applied to both creative writers and their texts. Though the relationship between writer and text is a complicated one, a synthesis of well documented evidence from psychology can illuminate confusing aspects of the personality infused in the work and can thus move the critic closer to scientific literary truth, without dehumanizing literature. The introduction outlines some of the reasons why psychological findings and insights should be useful and why there has not been widespread application of them in the humanities. Biography in particular, as an art form, can benefit from being psychologically informed. Conversely, the discipline of psychology has much to learn from the in-depth study of extraordinary individual lives" The first chapter provides a more detailed inquiry into the methodological problems associated with psychobiography and suggests some applications of scientific method to biography. The example of Virginia Woolf, whose life and works are particularly intricately connected, will be foremost amongst those used to demonstrate the specific problem of hypothesis testing. Some of the proposed strategies will be executed in the second chapter through a case study of the early life of Bertrand Russell, who provides a good example of some of the difficulties likely to be encountered, as well as the advantages of a psychological approach, especially since his life spans the entire development of modern psychology. The hypothesis about the origins cf Russell's creative impulse will be subsequently tested in the light of his creative works in the period from 1904 to 1914. / Thesis / Master of Arts (MA)

BACKGROUND:Equine-facilitated therapy (EFT) is a relatively new treatment for trauma and PTSD. EFT has been introduced and implemented in mental health treatment for children and adults, though the research in support of these interventions has not kept up with practice. In this poster we review studies of EFT with individuals who have PTSD/trauma symptoms. METHODS: We searched relevant databases: Social Work Abstracts, Scopus, CINAHL, ERIC, Web of Science, PsychArticles, PsychInfo, and Google Scholar. Due to the newness of this field, we did not restrict the search based on years nor type of study design. Inclusion criteria were: 1) the study was published in a peer-reviewed journal; 2) horses were used as the primary treatment or as an adjunct to traditional treatment; and 3) the study sample was assessed for PTSD/trauma, and/or PTSD/trauma was measured as an outcome. The search followed the PRISMA paradigm. Each author read each abstract, then met to discuss articles to include. If a decision could not be made based on the abstract, we read the full article to make a final decision. RESULTS:Nine studies -- involving 97 participants, five adult and four youth studies, and all published since 2008 – met search criteria. Two adult studies addressed combat-related trauma, two focused on interpersonal violence and one focused generally on traumatic events. There was one qualitative design, one case study and three intervention studies. Of the studies with youth, one was a correlational single system study and three were intervention studies. Two studies focused on children who had experienced maltreatment or sexual abuse, one addressed historical trauma with American Indian children, and the other did not specify the trauma though all met the criteria for PTSD based on a standardized scale. Findings showed EFT resulted in significant improvements in trauma symptoms and PTSD as well as other areas of well-being (e.g., anxiety, social support, alcohol use, and mindfulness in adults; internalizing and externalizing behavior, self-perception, self-esteem, social adjustment and anxiety in youth). CONCLUSIONS and IMPLICATIONS: Despite the limitations of our review (we did not search for gray material) and of the studies themselves (small sample sizes, lack of a control group), to our knowledge this is the first review of EFT that focused on trauma/PTSD. A primary strength was including only studies where trauma symptoms were objectively measured as an outcome. Findings suggest that EFT is a promising intervention for trauma/PTSD. Broadly, more studies of increased rigor are recommended as well as qualitative studies to address the acceptability of EFT to clients and providers, and issues of implementation. Specifically, future research should further explore EFT for veterans, reflecting the current national response to their mental health needs. Research is also needed to examine the mechanisms by which EFT leads to improved outcomes, investigate possible contraindications of equine therapy, as well as termination issues. In summary, EFT is a relatively new modality that offers promise for treating trauma/PTSD symptoms and the studies in this review provide a base upon which to build.

Yes / Sustainable servitisation for organisations, as an indispensable part of their sustainable development, has increasingly come to the attention of both academics and practitioners. Whilst the servitisation literature is diverse and growing, our understanding of what sustainable servitisation is and a holistic view of how it is developed and implemented is limited. To address these gaps, we provide a systematic literature review enabled by an active machine-learning tool using 66 journal articles on sustainable servitisation. We have redefined the term sustainable servitisation based on an in-depth literature analysis. From the purview of sustainable servitisation as a mechanism for organisational change, we also synthesised what is known about sustainable servitisation into a holistic framework. Notably, rather than focusing on how sustainable servitisation can be better designed, as most existing studies have done, we argue that a dynamic and processual view of sustainable servitisation is required to advance theoretical and practical knowledge. / The full-text of this article will be released for public view at the end of the publisher embargo on 27 Feb 2025.

Thesis (DTh)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Due to the consciousness of religious pluralism and the need for peace amongst the religious communities of the world, the researcher considered, and herewith presents, the arguments for and against each of three traditional theological models for evaluating the relation between Christianity and other religions. Although this theological debate about the truth and salvific value of non- Christian views of life is important, and although the three approaches discussed each brings out important aspects that have to be considered in this debate, they were found to be limited in an important respect, namely, that they do not suggest practical strategic solutions for how Christians should relate to people who hold beliefs that differ from their own. With reference to the notion of an “ethic of embrace,” drawing on a number of New Testament texts as interpreted by theologians like Hans Küng, Miroslav Volf, Harold Nethland, Sam Storms, and Robert H. Stein, to name but a few, a strong case could be made for the necessity of such an ethic as a guideline for how the churches should interact with those who do not share their faith. It could be concluded that each of the three theoretical models, Particularism, Inclusivism and Pluralism, needs to be reconsidered from the perspective of an ethic of embrace. The researcher therefore inquired into the extent to which each of the theoretical models can be reconciled, and can indeed support and undergird, an ethic of embrace. Since, at least at face value, Particularism seems to raise most questions in this regard, it received particular attention. It was concluded that, also when applied in the context of the Particularist model, the ethics of embrace is the missing link that can help influence religiously motivated conflicts in a positive way. This allows for a more peaceable praxis as it not only addresses religious conflict in the world, but can also enable the Particularistic model to foster peace among religions and therefore, indirectly, peace among the nations of the world. The themes of reconciliation, tolerance, forgiveness and hospitality, which are interconnected with an ethic of embrace form an important part of chapter 5, with its focus on the truth and salvific significance of Jesus Christ reflected in his life as portrayed by Biblical witnesses. It is argued that He is not only the truth, or the one who spoke about the truth and his salvific significance, which is of central importance to the Particularistic model, but was able to demonstrate its practical application through the life He lived among humans. He demonstrated practically how the neighbour can be embraced in accordance with a particular understanding of the will of God. / AFRIKAANSE OPSOMMING: Hierdie tesis ondersoek die potensiaal van ’n etiek van omhelsing (“embrace”) aangesien drie tradisionele modelle in die teologie van die godsdienste, naamlik Partikularisme, Inklusivisme en Pluralisme, nie voldoende is om vrede tussen die verskillende gelowe van die wêreld te bevorder nie. Argumente ten gunste van en teen elke model, sowel as hulle sterk en swak punte, word behandel om duidelik aan te toon dat nie een van die drie modelle genoegsame praktiese strategiese metodes oplewer nie. Nadenke oor die waarheidsgehalte en moontlike verlossingskrag van nie-Christelike godsdienste, en oor Christene se wyse van interaksie met mense van ander gelowe, verskaf opsigself nie die nodige vrugbare praktiese riglyne nie. Met betrekking tot die idee van ’n etiek van omhelsing, het verskeie teoloë, waaronder Hans Küng, Miroslav Volf, Harold Nethland, Sam Storms, en Robert H. Stein, om net ’n paar te noem, sterk konstruktiewe argumente ontwikkel wat die idee van ’n etiek van omhelsing ondersteun en bevorder in verband met Christene se verhouding met mense van ander gelowe. Hierdie studie argumenteer ten slotte dat die drie teologiese modelle wat ondersoek is ’n etiek moet heroorweeg van ’n verhouding van omhelsing teenoor mense van ander gelowe, indien hulle tot vrede tussen mense van verskillende gelowe wil bydra. Die navorser ondersoek ook tot watter mate die drie modelle met ’n etiek van omhelsing versoen kan word. Aangesien Partikularisme skynbaar meer vrae in hierdie verband oproep, word dit veral deurdink. Die navorser kom dan tot die gevolgtrekking dat die etiek van omhelsing, in die konteks van Partikularisme, dalk die verlore skakel is wat, ook vir die Partikulariste, geweld onder die verskillende gelowe kan teenwerk. Dit kan moontlik nie slegs vreedsame verhoudings tussen die verskillende gelowe teweegbring nie, maar ook daartoe bydra dat Partikularisme in die teologiese debat tot geloofsvrede kan bydrae. Versoening, vergifnis, gasvryheid en toleransie is temas wat in verband met ’n etiek van omhelsing ter sprake kom, en vorm belangrike aspekte van hoofstuk 5, aangesien dit nie net in abstrakte sin die waarheidsgehalte en verlossingskrag van Christus sterk beklemtoon nie, maar ook die wyse waarop dit in sy lewe, soos die Bybelse getuies dit narratief skets, in ’n praktyk van omhelsing van die medemens gestalte gevind het.