No description available.

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.

No / Fatigue is common in people with multiple sclerosis (MS) and symptoms of fatigue are often reported as the most debilitating symptoms of the disease. However, there are few reports of interventions for fatigue in MS. A systematic review of published literature examining pharmacological and psychosocial/psychological interventions for fatigue in MS was conducted. The search and review strategy undertaken used the Centre for Reviews and Dissemination guidelines. Papers were reviewed by two independent reviewers. Of 81 studies short-listed for inclusion, 15 studies were included, of which 10 were studies of pharmacological therapy and five were studies of psychosocial/psychological interventions. Of the pharmacological studies, two were rated as of moderate-to-high quality, three of moderate quality, two of moderate-to-low quality and three of low quality. Of the psychosocial/psychological studies, three were rated as of moderate quality and two of moderate-to-low quality. None of the studies reviewed reached the highest level of quality according to pre-agreed criteria. Regardless of level of quality, effectiveness of both pharmacological and psychosocial/psychological interventions was modest at best and often absent. Accordingly, there is little evidence-based advice that can be offered to people with MS to help manage their fatigue.

Yes / To describe the use, effectiveness, and safety outcomes of mechanical thrombectomy (MT) for acute ischemic stroke (AIS) in Latin American countries. Studies reporting MT outcomes for AIS in Latin America were identified in CINAHL, MEDLINE, Web of Science, SciELO, EMBASE, and LILACS databases. Synthesis was conducted according to effectiveness (recanalization rates) and safety measures (mortality and functional independence at 90 days). Seventeen studies were included, mainly from public and university hospitals. MT utilization varied from 2.6% to 50.1%, while successful recanalization ranged from 63% to 95%. Functional independence 90 days after stroke (a modified Rankin scale score of 0 to 2) was achieved in less than 40% across most studies. Mortality rates were below 30%; studies with posterior circulation strokes reported higher mortality rates. The randomized trial reported better health outcomes for functional independence among patients in the MT group (OR 2.28; 95% CI, 1.41 - 3.69), favoring MT over standard care. The included studies had great methodological heterogeneity due to differences in study design, the MT time window, and stroke location. The only randomized trial showed improved functional independence and lower mortality rates with MT than with standard care. The rest of the studies reported similar findings to available literature. Efforts to improve stroke care are reflected in improved patient outcomes in the region. Future studies should consider standard time window criteria and reduce the risk of bias by including representative samples and comparison groups.

No description available.

Context: This protocol is as a supplementary document to our review paper that investigates security-related challenges and solutions that have occurred during the past decade (from January 2003 to December 2014). Objectives: The objective of this systematic review is to identify security-related challenges, security goals, and defenses in ubiquitous computing by answering to three main research questions. First, demographic data and trends will be given by analyzing where, when and by whom the research has been carried out. Second, we will identify security goals that occur in ubiquitous computing, along with attacks, vulnerabilities and threats that have motivated the research. Finally, we will examine the differences in addressing security in ubiquitous computing with those in traditional distributed systems. Method: In order to provide an overview of security-related challenges, goals and solutions proposed in the literature, we will use a systematic literature review (SLR). This protocol describes the steps which are to be taken in order to identify papers relevant to the objective of our review. The first phase of the method includes planning, in which we define the scope of our review by identifying the main research questions, search procedure, as well as inclusion and exclusion criteria. Data extracted from the relevant papers are to be used in the second phase of the method, data synthesis, to answer our research questions. The review will end by reporting on the results. Results and conclusions: The expected results of the review should provide an overview of attacks, vulnerabilities and threats that occur in ubiquitous computing and that have motivated the research in the last decade. Moreover, the review will indicate which security goals are gaining on their significance in the era of ubiquitous computing and provide a categorization of the security-related countermeasures, mechanisms and techniques found in the literature. (authors' abstract)

Chronic non-specific low back pain (CNSLBP) is a widespread but poorly understood condition that places a substantial burden on the sufferer, health services and the wider economy. Existing approaches to management do not demonstrate impressive levels of effectiveness. There is growing evidence that CNSLBP is associated with significant alterations in central nervous system (CNS) structure and function, suggesting a possible role for the brain in the aetiology of the condition, and presenting a case for novel therapies which aim to treat CNSLBP by affecting brain function. One such potential therapeutic approach is non-invasive brain stimulation (NIBS). Following a literature review discussing the epidemiology and management of low back pain, the evidence for altered CNS function and the potential role of brain stimulation in CNSLBP and chronic pain generally this thesis includes 3 original scientific studies: (i) A Cochrane systematic review of the effectiveness of NIBS techniques for the treatment of chronic pain; (ii) A randomised double-blind exploratory study of transcranial direct current stimulation of the motor cortex in the treatment of CNSLBP; (iii) Is blinding to the stimulation condition maintained in trials comparing 2mA tDCS with sham stimulation? A randomised cross-over study. Results: There is limited existing evidence that some forms of NIBS may have a beneficial effect on chronic pain, though caution is warranted. Exploratory data from study 2 is not suggestive that tDCS to the motor cortex is effective for treating CNSLBP. Commonly used sham controls in trials of tDCS do not ensure adequate blinding, and so introduce a potential source of bias to the existing evidence base. Conclusion: Further research is required to establish the value of NIBS as a treatment for chronic pain and CNSLBP. Future research in tDCS will need to develop and employ fully validated sham controls to ensure adequate blinding. NIBS cannot currently be recommended for the treatment of CNSLBP.