Development of Database and Web Site for D3Multisport

Before this project, D3Multisport.com did not have a software application to track and monitor personal and progress information on athletes training for triathlon events. The previous process was manual, and although it helped provide a training schedule for an athlete it required the data be updated by hand. The process of developing a training program on an excel spreadsheet provided a good basis for the athlete to start the program, but was not suited to make dynamic adjustments if not optimally suited for the athlete. The application created in this project was designed to keep a coach updated on the progress of an athlete. If necessary, the coach can make modifications to the athletes training program in order to work on any weakness the athlete may be showing. It is important that both coach and athlete have access to updated information related to the training program. The previous process did not provide this requirement because the coach and athlete were not present with each other at all times. Another problem with the previous process was that both coach and athlete might wish to add training criteria to the training program. The application now provides this functionality. The initial prototype used Microsoft\u27s Access technology with Data Access Pages (DAP). This ensured the web site had the necessary work flow the users were expecting and allowed them to update information to a database. Once the prototype was approved, Microsoft .NET ASP technologies were used to create the web site. The Access database was reverse engineered into a Microsoft MS SQL Server database. Both the coach and athlete are now able to access the same database via a web browser. A central computer acts as the web server providing access to the central database and downloads web pages. This enables the coach to keep abreast of the athlete and provide updated real-time progress information. Providing a web interface to a central database allows the athlete to record current data on a daily basis and give the coach the ability to analyze this data and make any changes necessary, keeping the athlete on track

Effectiveness of manual therapies: the UK evidence report

<p>Abstract</p> <p>Background</p> <p>The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions.</p> <p>Methods</p> <p>The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs.</p> <p>Results</p> <p>By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines.</p> <p>Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments.</p> <p>Conclusions</p> <p>Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1 hypertension when added to an antihypertensive diet. In children, the evidence is inconclusive regarding the effectiveness for otitis media and enuresis, and it is not effective for infantile colic and asthma when compared to sham manipulation.</p> <p>Massage is effective in adults for chronic low back pain and chronic neck pain. The evidence is inconclusive for knee osteoarthritis, fibromyalgia, myofascial pain syndrome, migraine headache, and premenstrual syndrome. In children, the evidence is inconclusive for asthma and infantile colic.</p

Personality Disorders in Primary Care: Impact on Depression Outcomes Within Collaborative Care

Background: Individuals with personality disorders (PDs) are high utilizers of primary care and mental health services; however, they struggle to utilize the care effectively and studies have shown a strong association between having a PD and higher impairment in social role functioning. This is especially important because PDs are highly comorbid with a wide range of other mental health disorders. The collaborative care model (CCM) for depression was developed with an emphasis on patient engagement and aimed to reduce health care utilization, while improving treatment outcomes in primary care. We hypothesized that the diagnosis of a personality disorder in primary care patients will negatively affect 6-month depression outcomes after enrollment into a CCM. Methods: This retrospective chart review study was conducted on patients enrolled into CCM over a period of 7 years with collection of 6-month follow-up data. A total of 2826 patients were enrolled into CCM with a clinical diagnosis of depression and a baseline Patient Health Questionnaire–9 (PHQ-9) ≥10 were included in the study cohort. Using the depression database, baseline and 6-month follow-up data were obtained. Adjusted odds ratios (AORs) were determined for both remission and persistent depressive symptoms using logistic regression modeling for the 6-month PHQ-9 outcome; while retaining all the study variables. Results: Of the 2826 CCM patients with depression in our study, 216 (7.6%) were found to have a PD. Patients with PD were younger (37.7 vs 42.5 years, P < .001) and more likely to be unmarried (36.1% vs 55.6%, P < .001) than patients without a PD. While age, marital status, clinical diagnosis, and Mood Disorders Questionnaire (MDQ) score were significant predictors of remission; anxiety symptoms, gender, and race were not. The presence of a PD diagnosis was associated with a 60% lower likelihood of remission at 6 months (AOR = 0.39; 95% CI 0.28-0.54). Conversely, patients without a PD were 2.5 times as likely to experience remission at 6-month remission compared to patients with PD (AOR =2.57; 95% CI 1.85-3.56). Conclusion: Patients with a personality disorder were more likely to have a recurrent depressive disorder diagnosis, an abnormal MDQ score, increased anxiety symptoms, and higher baseline PHQ-9 score. Patients with PD had worse CCM outcomes at 6 months with only 25.0% able to achieve remission versus 54.3% ( P < .001) without a PD. The presence of a PD with depression was associated with poor outcomes (reduced remission rates and increased persistent depressive symptoms rates) in comparison to patients without a diagnosis of PD, while treated within CCM

Cultured proteins: An analysis of the policy and regulatory environment in selected geographies

The global burden of malnutrition is unacceptably high. Animal-source foods are important components of diverse diets and provide high-quality proteins and other essential nutrients that promote optimal growth and development. The global demand for animal-source foods is projected to increase substantially, particularly in many low- and lower-middle income countries (LMICs). However, cost is a significant barrier to access and meeting this growing demand through livestock production will be highly resource intensive. As such, sustainable, high-quality alternatives to protein from livestock have the potential for significant transformative impact for both people and the planet. Through a process known as fermentation-based cellular agriculture, animal proteins found in milk and eggs can be produced without animals. According to this method, a gene encoded with an animal protein is introduced into a starter culture of microflora (e.g., fungi or yeast). This culture is grown in controlled fermentation tanks, where it expresses the desired protein. Finally, the protein is separated from the microflora, generally producing a purified protein powder. These resulting “cultured” proteins are designed to be identical to the corresponding animal-source proteins produced through traditional livestock farming and can be used as ingredients in existing or new food products. Although there are many potential sustainability and nutritionrelated benefits of these nnovations, they also face several challenges to commercialization and market uptake