Within research regarding superior-subordinate conflict there is noticeable variation. Scientists have found different answers to the question: what causes superior-subordinate conflicts in the workplace. A literature-study was conducted to examine the different scientific studies in the area and try to find a conclusion to what causes the variation and how it affects how one views the social phenomena that is superior-subordinate conflicts. The results indicate that (1) depending on theoretical standpoint the responsibility for the conflict is shifted. (2) Depending on methodical preference the conflict is more or less likely to be viewed as collectively created. In addition to this a Marxian perspective was added in an analytical discussion. Showing that using this theoretical standpoint conflicts can be portrayed as something positive.

Background: Multiple sclerosis (MS) is the most common cause of disability in young people and yet there are no interventions available which reliably alter disease progression. This is despite several decades of research using the most common animal model of multiple sclerosis, experimental autoimmune encephalomyelitis (EAE). There is now emerging evidence across the neurosciences to suggest that limited internal validity (measures to reduce bias) and external validity (e.g. using a clinically relevant animal model) may influence the translational success. Aim and objectives: To provide an unbiased summary of the scope of the literature on candidate drugs for MS tested in EAE to identify potential reasons for the failures to translate efficacy to clinical trials. My objectives were, across all of the identified publications, to: (1) describe the reporting of measures to reduce bias and to assess their impact on measures of drug efficacy; (2) assess the relationship between treatment related effects measured using different outcome measures; (3) assess the prevalence and impact of any publication bias; (4) compare findings from the above with another disease with limited translational success (Parkinson’s disease; PD). Methods: I used systematic searches of three online databases to identify relevant publications. Estimates of efficacy were extracted for neurobehavioural scores, inflammation, demyelination and axon loss. For PD experiments, we searched for dopamine agonists tested in animal models of PD with outcome assessed as change in neurobehavioural scores. I calculated normalised mean difference or standardised mean difference effect sizes and combined these in a meta-analysis using a random effects model. I used stratified meta-analysis or meta-regression to assess the extent to which different study design characteristics explained differences in reported efficacies. These characteristics included: measures to reduce bias (random allocation to group and blinded assessment of outcome), the animal species, sex, time of drug administration, route of drug administration and the number of animals per group. Publication bias was assessed using funnel plotting, Egger regression and “trim and fill”. Results: I identified 1464 publications reporting drugs tested in EAE. Reported study quality was poor: 11% reported random allocation to group, 17% reported blinded assessment of neurobehavioural outcomes, 28% reported blinded assessment of histological outcomes, and < 1% reported a sample size calculation. Estimates of efficacy measured as the reduction in inflammation were substantially higher in unblinded studies (47.1% reduction (95% CI 41.8-52.4)) versus blinded studies (33.1% (25.8-40.4). Moreover, the same finding was identified for 121 publications on dopamine agonists tested in experimental PD models where efficacy was measured as change in neurobehavioural outcomes. For EAE studies we were unable to include data from 631 publications describing original research. Usually this was because the publication did not include basic details such as the number of animals in each group (115 publications), the observed variance (592) or suitable control data (49). For each category of outcome I found evidence of a substantial publication bias. Interventions were most commonly administered on or before the induction of EAE with shorter times to treatment associated with higher estimates of efficacy for the reduction in mean severity scores (a neurobehavioural outcome). Treatment related effects were found to vary across different outcome measures with the largest effect being for the reduction in axon loss. Where neurobehavioural scores and axon loss were measured in the same cohort of animals, the concordance between efficacies in these increased with later times to treatment. Conclusions: In this, the largest systematic review and meta-analysis of animal studies in any domain, I have found that a large number of publications present incomplete data. In addition, measures to reduce bias are seldom reported, the lack of which is associated with overstatements of efficacy for both a measure of drug efficacy in EAE and experimental PD studies. Translational success may have also been affected by the majority of studies administering drugs on or before EAE induction which is of limited relevance in the clinical setting where patients do not present at that stage of disease. Moreover, my analysis of the relationship between outcome measures provides empirical evidence from systematically identified studies to suggest that targeting axon loss as later time points is most strongly associated with improvements in neurobehavioural scores. Therefore drugs which are successfully able to target axon loss at these time points may offer substantial hope for clinical success. Overall, improvements in the conduct and reporting of preclinical studies are likely to improve their utility, and the prospects for translational success. While my findings relate predominately to the animal modelling of MS and PD it is likely that they also hold for other animal research.

Magister Curationis - MCur / Background: Postpartum haemorrhage (PPH) is one of the most preventable causes of maternal death, yet it still ranks as one of the main conditions responsible for maternal mortality. PPH occurs at a stage when a mother is the least likely to receive care, and mothers often do not survive to be referred to a more specialised level of care. This is compounded by the patient not being able to warn healthcare providers timeously about their condition and healthcare providers lacking training resulting in a lack of accuracy in diagnosis, lack of resources, and differing methods of treatment. Due to the lack of consensus in available treatment options, and the paucity of research aimed at clinical interventions for midwives at the primary care level, this research report aimed to investigate the evidence in order to establish the best practices and evidence for clinical interventions to manage postpartum haemorrhage for midwives at the primary care level. This is to ensure that the continuing education for midwives in practice is based on evidence to keep their skill set current and expose practitioners to the latest evidence based care. Aim: To systematically review all available published evidence for the acute non-pharmaceutical, non-surgical, management of PPH for use by midwives at a primary maternity care setting.

Abnormal uterine bleeding (AUB) is one of the most common presenting complaints in our medical system with up to 30% of females affected by this condition. The current evaluation and management of AUB often requires multiple lengthy visits to both general practitioners and specialists. Advances in endoscopic technology have allowed clinicians to diagnose and treat women presenting with AUB in a single-visit within an outpatient uterine assessment and treatment unit (UATU). Unfortunately, the UATU is not the standard of care with very few locations in Canada providing this type of service. This thesis project aimed to synthesize data pertaining to efficacy and safety as well as to evaluate the cost-effectiveness of a UATU service model compared to usual care in diagnosing and treating AUB. To address the main aim for this thesis project, the first manuscript focuses on the hysteroscopic procedures that may be offered in a UATU. The manuscript includes a systematic review that synthesizes outcome measures surrounding efficacy, patient safety, and cost data of outpatient hysteroscopy compared to hysteroscopy performed in the operating room. The second manuscript is a cost-effectiveness modelling study that compares cost and effectiveness outcomes, including time to diagnosis and time to treatment of a UATU versus usual care for women who present with AUB. Data used to populate the cost-effectiveness model were obtained from a retrospective review of patient charts and the published literature. The systematic review found no statistically significant difference in the safety, efficacy, or patient tolerability between outpatient and intraoperative hysteroscopy procedures. This review helps provide further support for performing procedures outside of a traditional operating room without increasing patient harm or compromising efficacy. However, given the current available evidence and limited number of studies, findings should be interpreted with caution. The cost-effectiveness analysis found that a UATU is cost-effective when compared to usual care in diagnosing and treating patients who present with AUB. These two studies combined provide evidence to support that the UATU has the potential to improve gynecologic care by reducing wait-times to receiving diagnosis and treatment and to lower overall costs to the health care system.

O grupo de onicóforos \"caraíbas\" apresenta grande diversidade de espécies, mas também gêneros fracamente delimitados. Epiperipatus Clark, 1913 é o maior dos gêneros neotropicais de Onychophora, mas ainda não sofreu revisão taxanômica. Este gênero foi incorporado no presente estudo, que contemplou o mais abrangente conjunto de dados moleculares, assistido por dados morfológicos. Quatro marcadores moleculares foram utilizados: cytochrome c oxidase subunit I (COI), 12S rRNA, 16S rRNA (mitochondriais) e 18S rRNA (nuclear). Além disso, trinta e três caracteres morfológicos foram levantados. A base de dados foi submetida a duas análises de Máxima Parcimônia (MP) e uma de Máxima Verossimilhança (ML). No total foram examinados 175 espécimes, cobrindo nove gêneros e vinte e nove espécies, dezoito delas pertencentes a Epiperipatus. Foi adotado como hipótese de trabalho o cladograma resultante da análise de evidência total que contemplou os dados moleculares e morfológicos. O resultado mostrou que os dados morfológicos não são capazes de resolver por si só as relações internas de Peripatidae, pois o número de caracteres morfológicos é menor que o número de terminais examinados. Peripatidae é suportado por dados moleculares e isso é conflitante com a delimitação morfológica tradicional dos gêneros da família. Isso demonstra que clados suportados por dados moleculares mostram elevada disparidade morfológica, que pode estar relacionada a adaptação a diferentes ambientes do clado Neotropical. Além disso, o resultado também sugeriu Epiperipatus como parafilético, pois engloba outros gêneros que devem ser sinonimizados. Epiperipatus apresentou estabilidade em três clados neotropicais, apesar de que Epiperipatus edwardsii (Blanchard, 1847) e outros quatro grupos mostraram posição instável. Para reconciliar a sistemática e a filogenia de Epiperipatus, os gêneros monotípicos Principapillatus Oliveira et al., 2014 e Cerradopatus Oliveira et al., 2015 devem ser considerados sinônimo-junior de Epiperipatus. Consequentemente, as novas combinações foram propostas: Epiperipatus hitoyensis (Oliveira et al., 2012) n. comb. e Epiperipatus sucuriuensis (Oliveira et al., 2015) n. comb.. Além disso, foram apresentadas e descritas as espécies novas Epiperipatus [sp1] n. sp., Epiperipatus [sp2] n. sp., Epiperipatus [sp10] n. sp., Epiperipatus [sp16] n. sp. e Epiperipatus [sp17] n. sp.. O enraizamento da filogenia de Onychophora em Peripatopsidae resultou no grupo Neotropical como grupo-irmão do grupo africano, e um aparente ancestral Asiático. A demonstrada monofilia de Epiperipatus confirmou sua larga distribuição, da mesma forma que Peripatus. Ambos os gêneros ocorrem da América Central ao Brasil. Entretanto, no Brasil enquanto Peripatus ocorre apenas no centro-oeste desse país, Epiperipatus é encontrado em quase todo o território desse país, com exceção da região sul / The \"caraibes\" onychophorans present both a large diversity and weakly defined genera. Epiperipatus Clark, 1913 is the largest genus, but it has not been revised so far. This genus is herein incorporated into the currently most comprehensive molecular phylogenetic analysis of Peripatidae, assisted by morphology. Four markers were used: cytochrome c oxidase subunit I (COI), 12S rRNA, 16S rRNA (mitochondrial) and 18S rRNA (nuclear). Moreover, 33 morphological characters were obtained. The dataset was used in two Maximum Parsimony (MP) and one Maximum Likelihood (ML) analyses. In a total of 175 specimens of Onychophora, nine genera and twenty-nine species were examined, eighteen of them belonging to Epiperipatus. We adopted as work hypothesis the MP based on total evidence. The result showed that morphological by itself cannot be used to resolve the phylogenetic relationships of this group, because the number of characters is smaller than the number of terminals examined. Here, Peripatidae was based on molecular data and this conflicts with the characters traditionally used to define genera in the family. It means that clades supported by molecular data shows high morphological disparity which might be reflected on the adaptation to different environments in the Caribbean clade. Also, the result suggests that Epiperipatus seems to be not monophyletic, as it includes others genera and these genera should be synonymized. Epiperipatus presented stable relationships across three clades of Neotropical onychophorans, but it was observed the unstable position of Epiperipatus edwardsii (Blanchard, 1847) and four groups also. To reconcile Epiperipatus systematics with the phylogeny, the monotypic genera Principapillatus Oliveira et al., 2014 and Cerradopatus Oliveira et al., 2015 should be considered as junior synonyms of Epiperipatus. Hence, the new combinations were proposed: Epiperipatus hitoyensis (Oliveira et al., 2012) n. comb. and Epiperipatus sucuriuensis (Oliveira et al., 2015) n. comb.. Moreover, the new species Epiperipatus [sp1] n. sp., Epiperipatus [sp2] n. sp., Epiperipatus [sp10] n. sp., Epiperipatus [sp16] n. sp. and Epiperipatus [sp17] n. sp. were presented and described here. Rooting the Onychophora phylogeny in Peripatopsidae resulted in the Neotropical group as the sister group relationship to the African species, and an apparently ancestral group from Asia. The demonstrated Epiperipatus monophily confirmed its widespread distribution, in the same way as Peripatus. Both are recorded from Central America to Brazil. However, in Brazil, while Peripatus occurs only until the Central-West region, Epiperipatus is found in all Brazilian territories, except in the South region

O gênero Celeus compreende um número variável de espécies distribuídas por toda a região Neotropical. No que diz respeito à sistemática do gênero, poucas modificações taxonômicas foram feitas desde sua última grande revisão em 1982. Em relação às hipóteses de relacionamento das espécies incluídas no gênero, as poucas propostas disponíveis baseiam-se em dados moleculares, não existindo nenhuma baseada em dados morfológicos e bioacústicos. Dessa forma, os objetivos do presente estudo foram revisar a taxonomia do gênero Celeus, definir o número de espécies que o compõem, descrever eventuais variações morfológicas existentes nos táxons analisados e propor uma hipótese de relacionamento entre suas espécies, por meio da análise de caracteres morfológicos (plumagem, morfometria e osteologia) e vocais. Para isso foram analisados 1998 espécimes taxidermizados, 92 esqueletos e 200 arquivos sonoros testando sua aplicabilidade na sistemática do grupo, sob a ótica do conceito de espécie filogenética. Foi constatada a existência de uma grande variação individual nos caracteres de plumagem em praticamente todos os táxons analisados, o que provavelmente levou a descrições de várias espécies e subespécies, que demonstraram não ser válidas. Ao contrário dos caracteres de plumagem, os caracteres vocais demonstraram uma grande estabilidade, variando apenas entre as espécies. Os caracteres osteológicos também se mostraram úteis na sistemática de Celeus, apesar da grande variação individual observada. Ao final, C. obrieni, C. subflavus, C. tinnunculus, C. ochraceus e C. multifasciatus, antes tratadas como subespécies, foram validadas como espécies, além da inclusão de C. galeatus. O monofiletismo do gênero foi recuperado, corroborando estudos moleculares recentes, diferindo quanto ao posicionamento de C. galeatus em relação às demais espécies do gênero. Dentre os doze clados fortemente suportados, alguns corroboram os resultados das propostas moleculares disponíveis, como a relação de espécies-irmãs entre C. spectabilis e C. obrieni. Com a validação dessas cinco espécies e a confirmação do posicionamento de C. galeatus no gênero, Celeus passa a contar com 16 espécies (C. galeatus, C. spectabilis, C. obrieni, C. flavus, C. subflavus, C. loricatus, C. torquatus, C. tinnunculus, C. lugubris, C. flavescens, C. ochraceus, C. elegans, C. castaneus, C. grammicus, C. undatus e C. multifasciatus), o que representa um aumento de 62,5% no número de espécies segundo a última grande revisão taxonômica do gênero. / The genus Celeus encompasses a variable number of species distributed throughout the Neotropics. Regarding its systematic arrangement, few changes have been made since its lastest major review in 1982. As to its phylogenetic relationships, the few proposals available are based on molecular data, lacking a morphological and bioacustic hypothesis. Thus, the goals of this study were to conduct a taxonomic review of the genus Celeus, establish the number of species within it, describe any existing morphological variation in these taxa and propose a hypothesis of relationship among its species through the analysis of morphological characters (plumage, morphometry and osteology) and bioacustics. A total of 1998 study skins, 92 skeletons and 200 sound files were analyzed, testing its applicability in the systematics of the genus, under the perspective of the phylogenetic species concept. A great individual variation in plumage characters in almost all analyzed taxa has been verified. This variation may be seen as the reason that led former authors to describe many of the taxa here considered invalid. Unlike plumage, the vocal characters demonstrated a great stability, varying only between species. The osteological characters also proved its usefulness in the systematics of Celeus, despite its individual variation. Ultimately, C. obrieni, C. subflavus, C. tinnunculus, C. ochraceus and C. multifasciatus, taxa previously treated as subspecies, have been proved to be valid species. The monophyly of Celeus was recovered, as well as the placement of C. galeatus as a member of this genus, agreeing with recent molecular studies, but differing, as already remarked, in the placement of C. galeatus in respect to other species of the genus. Among the twelve strongly supported clades, some corroborate the results of the molecular studies available, such as the sister relationship between C. spectabilis and C. obrieni. The validation of these five taxa and the placement of C. galeatus in the genus, Celeus which now has 16 species (C. galeatus, C. spectabilis, C. obrieni, C. flavus, C. subflavus, C. loricatus, C. torquatus, C. tinnunculus, C. lugubris, C. flavescens, C. ochraceus, C. elegans, C. castaneus C. grammicus, C. undatus and C. multifasciatus), representing an increase of 62.5% in species number according to the latest major revision of the genus.

Repetitive behaviors are a core symptom of autism spectrum disorders. They represent a major barrier to learning and social adaptation, affect levels of engagement in life situations, communication, social interactions and sustain social connections. Repetitive behaviors are often managed using exercise-based interventions which have been suggested to reduce repetitive behaviors and benefit mental health and behavioral functioning of individuals with ASD. The purpose of this systematic review was to explore and critically review the findings of previous studies examining effects of various exercise-based interventions on reducing autistic repetitive behaviors in children with autism spectrum disorder. Searches were limited to peer-reviewed studies written in English and published between Jan.2008- Jan. 2019. Only studies focusing on physical exercise-based interventions aiming to decrease repetitive behaviors as a symptom of an autistic spectrum disorder were included. Quality of articles included in the review was assessed using the Joanna Briggs checklists. Two researchers were involved in the quality assessment process, and any discrepancies were resolved through discussion. 5 studies were included in the final review. All studies examined the effects of short term exercise interventions on repetitive behaviors in children with ASD. There was no consistency across studies regarding types or duration of interventions, sample sizes or demographics of participants. However, the findings of the studies examined in this review provide a moderate to strong evidence that exercise-based interventions decrease repetitive behaviors. The studies reviewed included clinically relevant findings that can be used and adapted to fit different needs of children in future interventions. However, additional research using stronger and more varied designs, would be needed to determine the most beneficial types of exercise- based interventions for decreasing repetitive behaviors.

Os fatores que possam promover e incrementar a osseointegração, ou prejudicar o processo biológico, aumentando o índice de falhas, têm sido cada vez mais investigados com o objetivo de ampliar indicações e as taxas de sobrevivência dos implantes dentais assim como controlar fatores adversos. O objetivo desta tese foi identificar, analisar e sintetizar as evidências científicas quanto a influência das estatinas, do envelhecimento e da experiência do cirurgião no processo osseointegração e na sobrevivência de implantes dentais. Este volume apresenta um compilado de três revisões sistemáticas orientadas pelas recomendações PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). O processo de revisão foi realizado por meio de uma busca sistemática em cinco bases de dados eletrônicas (PubMed, Scopus, Web of Science, Embase e Cochrane Library), além de busca manual nas referências bibliográficas dos estudos incluídos. A meta-análise, quando cabível, foi realizada com o auxílio do software Review Manager (RevMan, Versão 5.3). O grau de heterogeneidade entre os estudos foi verificado por meio do teste Q de Cochran e I2. O viés das publicações foi avaliado com o auxílio das escalas Newcasttle-Ottawa e Cochrane Collaboration\'s Tool. A síntese dos dados permitiu a publicação de três artigos científicos dispostos nesta tese. / Factors that may promote and enhance osseointegration, or impair the biological process, have been increasingly investigated in order to expand the indications and survival rates of dental implants and control the adverse factors. The aim of this thesis is to identify and summarize the scientific evidence of statins, ageing and surgeon related factors that can influence osseointegration and survival of dental implants. This volume presents a compilation of three systematic reviews structured by PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The review process was carried out through a systematic search in five electronic databases (PubMed, Scopus, Web of Science, Embase and Cochrane Library) and bibliographical references of the included studies. Meta-analyses, when appropriate, were performed using the software Review Manager (RevMan version 5.3). The degree of heterogeneity in the studies was verified by Q Cochran test and I2. The bias of the publications was assessed with the assistance of Newcastle-Ottawa Scale and Cochrane Collaboration Tool\'s. The synthesis of the data was included in three papers prepared for this thesis.

Schistosomiasis is a water-borne parasitic disease of great public health importance mainly in sub-Saharan African countries. The majority of current control programmes use the antihelminthic drug praziquantel to reduce disease burden in endemic areas. Praziquantel treatment has been reported to accelerate the development of protective immunity against re-infection that otherwise takes years to develop. To date, there is no licensed vaccine for schistosomiasis in humans but an attenuated schistosome parasite vaccine has been tested in animal models. Employing systematic review and meta-analysis approaches, my PhD research has four main objectives relating to attenuated schistosome vaccine and praziquantel treatment: 1) to identify predictors that determine protection levels after treatment with attenuated Schistosoma mansoni vaccines in the mouse model, 2) to quantify the influence of host and schistosome parasite species on attenuated parasite vaccine efficacy, 3) to explore the direction of change (increase/decrease) in schistosome parasite-specific antibody isotypes after praziquantel treatment in humans, 4) to identify predictors of praziquantel efficacy in humans. My analyses revealed three factors that have an influence on the protection levels provided by attenuated schistosome parasite vaccines: increasing numbers of immunizing parasites had a positive effect on the levels of protection whereas increasing the radiation dose and the time to challenge infection had negative effects. Analyses showed that the attenuated schistosome vaccine has the potential to achieve protection levels as high as 79% after a single dose in mice. Alongside this, baboon studies consistently reported protective effects of attenuated schistosome vaccines against re-infection. These results show there is a high potential for an attenuated schistosome parasite vaccine to be effective in humans. A meta-analysis of the influence of praziquantel treatment on the direction of change in schistosome-specific antibody isotypes was conducted. The analysis revealed considerable variability in the antibodies’ direction of change among populations. The results also demonstrated an increase of anti-worm IgA and IgE in the majority of studies. These antibodies have been reported to have a protective effect against re-infection. The combination of age and infection intensity, and the number of days after treatment were identified as influential predictors for some antibody isotypes, but there was no single predictor that consistently affected all antibody isotypes in the same way. Praziquantel efficacy levels in humans were investigated and the analyses revealed that cure rates for schistosomiasis increase with praziquantel dose, and were affected by the identity of the schistosome parasite species (S. mansoni vs. S. haematobium) and the age of the participants (children: 0-19 years old vs. adults: ≥ 20 years old). There has been no clear efficacy level reduction over the treatment years (1979-2013) suggesting that praziquantel is still effective in the treatment of schistosomiasis despite concerns about possible resistance. The development of a schistosome vaccine will benefit from a closer investigation into the mechanisms through which protection is acquired in attenuated schistosome parasite vaccine studies showing high potential efficacy in animal models. Nevertheless, it will take time to develop a schistosome vaccine for human use. The uptake of the vaccine will be made even more challenging by the lack of adequate infrastructure in schistosomiasis endemic areas. In the meantime, close monitoring of praziquantel efficacy levels is necessary to confirm the effectiveness of schistosomiasis control in endemic areas.

Tooth extraction is necessary when there is advanced decay, significance trauma or injury to the oral cavity, misalignment associated with crowded teeth or even, poor eruption of third molars. Typically, during extraction procedures, bone grafting material is inserted to minimize bone loss. Bone grafting has become a standard procedure in dentistry and an essential component in modern medicine. The practice started nearly 350 years ago when a Dutch doctor in 1668 performed the first and successful bone grafting operation. Currently, research studies are ongoing to enhance the success and viability of dental reconstruction. This thesis examines the effect of varying dental graft techniques and methodology on the stability and long-term effect on the jawbone. These techniques include five primary bone grafting methods, onlay, inlay, ridge expansion, distracted osteogenesis and guided bone regeneration (GBR) have been approved to enhance the outcome of dental implants. The review has presented the documented limitations and viability of each method. In this paper, the alternatives to bone grafting have also been elaborated. Based on the findings depicted in this research, the following recommendations will assist in achieving the best jawbone outcomes in long-term and short-term assessments. These recommendations are as follows, a proper evaluation of each patient to determine their health condition. The nature of the infection, injury, and trauma that led to the extraction of the tooth should be well documented. The selection of technique pertaining to dental restoration, functionality, and aesthetic needs are of primary factors considered. A proper clinical follow-up and monitoring of recovery process is an essential part that contributes to valid results. Finally, patient awareness is essential as well. The study found out that although some of the bone grafting techniques have shown a high survival rate, significant alveolar bone quality and quantity, and success of the implants, several reports that the use of bone grafts and implants is a practice that will still dominate dental surgery and attract more clinical assessments.