Subject response rates in case-control studies of cancer : time trends, study design determinants, and quality of reporting

Objectifs: Examiner les tendances temporelles, les déterminants en lien avec le design des études et la qualité des taux de réponse rapportés dans des études cas-témoins sur le cancer publiées lors des 30 dernières années. Méthodes: Une revue des études cas-témoins sur le cancer a été menée. Les critères d'inclusion étaient la publication (i) dans l’un de 15 grands périodiques ciblés et (ii) lors de quatre périodes de publication (1984-1986, 1995, 2005 et 2013) couvrant trois décennies. 370 études ont été sélectionnées et examinées. La méthodologie en lien avec le recrutement des sujets et la collecte de données, les caractéristiques de la population, les taux de participation et les raisons de la non-participation ont été extraites de ces études. Des statistiques descriptives ont été utilisées pour résumer la qualité des taux de réponse rapportés (en fonction de la quantité d’information disponible), les tendances temporelles et les déterminants des taux de réponse; des modèles de régression linéaire ont été utilisés pour analyser les tendances temporelles et les déterminants des taux de participation. Résultats: Dans l'ensemble, les qualités des taux de réponse rapportés et des raisons de non-participation étaient très faible, particulièrement chez les témoins. La participation a diminué au cours des 30 dernières années, et cette baisse est plus marquée dans les études menées après 2000. Lorsque l'on compare les taux de réponse dans les études récentes a ceux des études menées au cours de 1971 à 1980, il y a une plus grande baisse chez les témoins sélectionnés en population générale ( -17,04%, IC 95%: -23,17%, -10,91%) que chez les cas (-5,99%, IC 95%: -11,50%, -0,48%). Les déterminants statistiquement significatifs du taux de réponse chez les cas étaient: le type de cancer examiné, la localisation géographique de la population de l'étude, et le mode de collecte des données. Le seul déterminant statistiquement significatif du taux de réponse chez les témoins hospitaliers était leur localisation géographique. Le seul déterminant statistiquement significatif du taux de participation chez les témoins sélectionnés en population générale était le type de répondant (sujet uniquement ou accompagné d’une tierce personne). Conclusion: Le taux de participation dans les études cas-témoins sur le cancer semble avoir diminué au cours des 30 dernières années et cette baisse serait plus marquée dans les études récentes. Afin d'évaluer le niveau réel de non-participation et ses déterminants, ainsi que l'impact de la non-participation sur la validité des études, il est nécessaire que les études publiées utilisent une approche normalisée pour calculer leurs taux de participation et qu’elles rapportent ceux-ci de façon transparente.

Subject response rates in case-control studies of cancer : time trends, study design determinants, and quality of reporting

Objectifs: Examiner les tendances temporelles, les déterminants en lien avec le design des études et la qualité des taux de réponse rapportés dans des études cas-témoins sur le cancer publiées lors des 30 dernières années. Méthodes: Une revue des études cas-témoins sur le cancer a été menée. Les critères d'inclusion étaient la publication (i) dans l’un de 15 grands périodiques ciblés et (ii) lors de quatre périodes de publication (1984-1986, 1995, 2005 et 2013) couvrant trois décennies. 370 études ont été sélectionnées et examinées. La méthodologie en lien avec le recrutement des sujets et la collecte de données, les caractéristiques de la population, les taux de participation et les raisons de la non-participation ont été extraites de ces études. Des statistiques descriptives ont été utilisées pour résumer la qualité des taux de réponse rapportés (en fonction de la quantité d’information disponible), les tendances temporelles et les déterminants des taux de réponse; des modèles de régression linéaire ont été utilisés pour analyser les tendances temporelles et les déterminants des taux de participation. Résultats: Dans l'ensemble, les qualités des taux de réponse rapportés et des raisons de non-participation étaient très faible, particulièrement chez les témoins. La participation a diminué au cours des 30 dernières années, et cette baisse est plus marquée dans les études menées après 2000. Lorsque l'on compare les taux de réponse dans les études récentes a ceux des études menées au cours de 1971 à 1980, il y a une plus grande baisse chez les témoins sélectionnés en population générale ( -17,04%, IC 95%: -23,17%, -10,91%) que chez les cas (-5,99%, IC 95%: -11,50%, -0,48%). Les déterminants statistiquement significatifs du taux de réponse chez les cas étaient: le type de cancer examiné, la localisation géographique de la population de l'étude, et le mode de collecte des données. Le seul déterminant statistiquement significatif du taux de réponse chez les témoins hospitaliers était leur localisation géographique. Le seul déterminant statistiquement significatif du taux de participation chez les témoins sélectionnés en population générale était le type de répondant (sujet uniquement ou accompagné d’une tierce personne). Conclusion: Le taux de participation dans les études cas-témoins sur le cancer semble avoir diminué au cours des 30 dernières années et cette baisse serait plus marquée dans les études récentes. Afin d'évaluer le niveau réel de non-participation et ses déterminants, ainsi que l'impact de la non-participation sur la validité des études, il est nécessaire que les études publiées utilisent une approche normalisée pour calculer leurs taux de participation et qu’elles rapportent ceux-ci de façon transparente.

Using health-related quality of life instruments for children with long-term conditions : On the basis of a national quality registry system

Introduction: There has been a continuous development of new technologies in healthcare that are derived from national quality registries. However, this innovation needs to be translated into the workflow of healthcare delivery, to enable children with long-term conditions to get the best support possible to manage their health during everyday life. Since children living with long-term conditions experience different interference levels in their lives, healthcare professionals need to assess the impact of care on children’s day-to-day lives, as a complement to biomedical assessments. Aim: The overall aim of this thesis was to explore and describe the use of instruments about health-related quality of life (HRQOL) in outpatient care for children with long-term conditions on the basis of a national quality registry system. Methods: The research was conducted by using comparative, cross-sectional and explorative designs and data collection was performed by using different methods. The questionnaire DISABKIDS Chronic Generic Measure -37 was used as well as semi-structured interviews and video-recordings from consultations. Altogether, 156 children (8–18 years) and nine healthcare professionals participated in the studies. Children with Type 1 Diabetes (T1D) (n 131) answered the questionnaire DISABKIDS and children with rheumatic diseases, kidney diseases and T1D (n 25) were interviewed after their consultation at the outpatient clinic after the web-DISABKIDS had been used. In total, nine healthcare professionals used the HRQOL instrument as an assessment tool during the encounters which was video-recorded (n 21). Quantitative deductive content analysis was used to describe content in different HRQOL instruments. Statistical inference was used to analyse results from DISABKIDS and qualitative content analysis was used to analyse the interviews and video-recordings. Results: The findings showed that based on a biopsychosocial perspective, both generic and disease-specific instruments should be used to gain a comprehensive evaluation of the child’s HRQOL. The DISABKIDS instrument is applicable when describing different aspects of health concerning children with T1D. When DISABKIDS was used in the encounters, children expressed positive experiences about sharing their results with the healthcare professional. It was discovered that different approaches led to different outcomes for the child when the healthcare professionals were using DISABKIDS during the encounter. When an instructing approach is used, the child’s ability to learn more about their health and how to improve their health is limited. When an inviting or engaging approach is used by the professional, the child may become more involved during the conversations. Conclusions: It could be argued that instruments of HRQOL could be used as a complement to biomedical variables, to promote a biopsychosocial perspective on the child’s health. According to the children in this thesis, feedback on their results after answering to web-DISABKIDS is important, which implies that healthcare professionals need to prioritize time for discussions about results from HRQOL instruments in the encounters. If healthcare professionals involve the child in the discussion of the results of the HRQOL, misinterpreted answers could be corrected during the conversation. Concurrently, this claims that healthcare professionals invite and engage the child.

Lighting ambiances and materialities of wood in architecture: a comparative evaluation of the quality of spaces in relation to interior finishes

Le bois est un matériau souvent utilisé par les architectes pour améliorer l’ambiance générale d’un espace, mais peu de recherches en présentent l’impact réel du matériau sur les impressions visuelles et les effets lumineux. Cette recherche étudie l’influence de la matérialité du bois par rapport à la création d’ambiances d’éclairage spécifiques dans l’architecture. Plus particulièrement, elle se concentre sur l’impact des panneaux décoratifs en bois à générer de la diversité lumineuse dans les espaces intérieurs et son potentiel à améliorer la satisfaction environnementale et l’efficacité énergétique. La recherche utilise des maquettes à l’échelle pour leur précision dans la représentation des ambiances lumineuses d’espaces éclairés naturellement ainsi que les technologies récentes d’imagerie digitale pour capturer et analyser les résultats. La méthodologie permet la comparaison entre les différents réglages des espaces intérieurs créés par une sélection des types de matérialités du bois: la réflectance (valeur), la couleur et la réflectivité. Les modalités spatiales sont comparées en présence d’ensoleillement direct et sous des conditions de ciel couvert puisque les modèles d’éclairage et les ambiances diffèrent considérablement. Les résultats permettent d’établir une discussion sur les ambiances en termes de brillance et de contraste, sur la couleur ainsi que la répartition des zones lumineuses dans l’espace. La recherche souligne le rôle des matérialités que peuvent prendre le bois pour optimiser la diversité lumineuse et la création d’ambiances visuellement confortables, ainsi que ses possibilités d’améliorer les ambiances architecturales par rapport à la lumière.

Nitrogen use efficiency and optimization of nitrogen fertilizer application for stable yields and high quality of cereals grown in conservation agriculture

In most agroecosystems, nitrogen (N) is the most important nutrient limiting plant growth. One management strategy that affects N cycling and N use efficiency (NUE) is conservation agriculture (CA), an agricultural system based on a combination of minimum tillage, crop residue retention and crop rotation. Available results on the optimization of NUE in CA are inconsistent and studies that cover all three components of CA are scarce. Presently, CA is promoted in the Yaqui Valley in Northern Mexico, the country´s major wheat-producing area in which from 1968 to 1995, fertilizer application rates for the cultivation of irrigated durum wheat (Triticum durum L.) at 6 t ha-1 increased from 80 to 250 kg ha-1, demonstrating the high intensification potential in this region. Given major knowledge gaps on N availability in CA this thesis summarizes the current knowledge of N management in CA and provides insights in the effects of tillage practice, residue management and crop rotation on wheat grain quality and N cycling. Major aims of the study were to identify N fertilizer application strategies that improve N use efficiency and reduce N immobilization in CA with the ultimate goal to stabilize cereal yields, maintain grain quality, minimize N losses into the environment and reduce farmers’ input costs. Soil physical and chemical properties in CA were measured and compared with those in conventional systems and permanent beds with residue burning focusing on their relationship to plant N uptake and N cycling in the soil and how they are affected by tillage and N fertilizer timing, method and doses. For N fertilizer management, we analyzed how placement, time and amount of N fertilizer influenced yield and quality parameters of durum and bread wheat in CA systems. Overall, grain quality parameters, in particular grain protein concentration decreased with zero-tillage and increasing amount of residues left on the field compared with conventional systems. The second part of the dissertation provides an overview of applied methodologies to measure NUE and its components. We evaluated the methodology of ion exchange resin cartridges under irrigated, intensive agricultural cropping systems on Vertisols to measure nitrate leaching losses which through drainage channels ultimately end up in the Sea of Cortez where they lead to algae blooming. A throughout analysis of N inputs and outputs was conducted to calculate N balances in three different tillage-straw systems. As fertilizer inputs are high, N balances were positive in all treatments indicating the risk of N leaching or volatilization during or in subsequent cropping seasons and during heavy rain fall in summer. Contrary to common belief, we did not find negative effects of residue burning on soil nutrient status, yield or N uptake. A labeled fertilizer experiment with urea 15N was implemented in micro-plots to measure N fertilizer recovery and the effects of residual fertilizer N in the soil from summer maize on the following winter crop wheat. Obtained N fertilizer recovery rates for maize grain were with an average of 11% very low for all treatments.

Advanced solutions for authenticity and quality of virgin olive oils

This Ph.D. project aimed to the development and improvement of analytical solutions for control of quality and authenticity of virgin olive oils. According to this main objective, different research activities were carried out: concerning the quality control of olive oil, two of the official parameters defined by regulations (free acidity and fatty acid ethyl esters) were taken into account, and more sustainable and easier analytical solutions were developed and validated in-house. Regarding authenticity, two different issues were faced: verification of the geographical origin of extra virgin (EVOOs) and virgin olive oils (VOOs), and assessment of soft-deodorized oils illegally mixed with EVOOs. About fatty acid ethyl esters, a revised method based on the application of off-line HPLC-GC-FID (with PTV injector), revising both the preparative phase and the GC injector required in the official method, was developed. Next, the method was in-house validated evaluating several parameters. Concerning free acidity, a portable system suitable for in-situ measurements of VOO free acidity was developed and in-house validated. Its working principle is based on the estimation of the olive oil free acidity by measuring the conductance of an emulsion between a hydro-alcoholic solution and the sample to be tested. The procedure is very quick and easy and, therefore, suitable for people without specific training. Another study developed during the Ph.D. was about the application of flash gas chromatography for volatile compounds analysis, combined with untargeted chemometric data elaborations, for discrimination of EVOOs and VOOs of different geographical origin. A set of 210 samples coming from different EU member states and extra-EU countries were collected and analyzed. Data were elaborated applying two different classification techniques, one linear (PLS-DA) and one non-linear (ANN). Finally, a preliminary study about the application of GC-IMS (Gas Chromatograph - Ion Mobility Spectrometer) for assessment of soft-deodorized olive oils was carried out.

In vitro application of biocontrol agents to improve the safety and quality of grapevine products

Pathogenic fungi are responsible for vine diseases affecting the grapevine yield and the organoleptic quality of the final wine products. Using of biocontrol agents can represent a sustainable alternative to the use of synthetic fungicides whose intense use can have negative effects on the ecosystem and cause increase resistant pathogen population to synthetic agents. The principal aim of my PhD thesis was the isolation and characterization of new yeast strains and Bacillus subtilis SV108 as biocontrol agent and the comprehension of the mechanism of their antimicrobial action. Accordingly, twenty wild yeast and one selected bacterium isolated among 62 samples, isolated from different Italian and Malaysian regions and molecularly identified, were evaluated in a preliminary screening test on agar. Results showed the highest effects on inhibiting mycelial growth by Starmerella bacillaris FE08.05, Metschnikowia pulcherrima GP8 and Hanseniaspora uvarum GM19. On the other side, Bacillus subtilis SV108 showed the ability of inhibit the mycelial growth of selected fungi by producing antimicrobial compounds on Malt Extract Broth medium recovered by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and identified by electrospray ionization (ESI) tandem mass spectrometer Triple TOF 5600. Moreover, in order to analyze the volatile fraction of compounds, the quantitative analysis of the VOCs profiles was performed by GC/MS/SPME. The analysis highlighted the presence of isoamyl and phenylethyl alcohols and an overall higher presence of low-chain fatty acids and volatile ethyl esters. All the data collected suggest that the tested yeasts, found among the epiphytic microbiota associated with grape berries, can be potentially effective for the biological control of pathogenic moulds. On the other hand, the proteomic study conducted on B. subtilis SV108 revealed that there are two cyclic antifungal peptides which can explain the antimicrobial effect of Bacillus subtilis SV108 acting as biocontrol agent against fungal pathogens in grapevine.

Physical activity and osseointegration: "step forward" to improve the quality of life of a trans-femoral amputee person

Lower limb amputation is an event that inevitably changes the lifestyle of the person with a significant impact on quality of life. The socket-type prosthesis entails that the residual limb is in direct contact with the socket which often implies numerous disadvantages. Osseointegrated prosthesis is a solution that avoids skin problems because not include the presence of the socket. In this type of prosthesis, a stem is surgically inserted inside the medullary canal and connected with the external prosthetic limb. Therefore, this thesis aims to highlight and explore the main strengths and problems of osseointegrated prostheses and to examine the role of physical activity, with attention to functional capacity and bone quality. The objectives of the thesis will be developed through 5 studies: (I) A gait analysis of a 44 years-old male patient who underwent surgery for the implantation of an osseointegrated prosthesis; (II) A systematic review to investigate the state of stump bone quality in patients with limb amputations; (III) A systematic review of the technologies involved in such devices has been carried out to identify the most fruitful ones in improving bone quality; (IV) A systematic review investigating the topic of physical activity and bone turnover biomarkers; (V) A systematic review to investigate the effects of physical activity interventions combined with drug treatments on bone biomarkers in people with osteopenia and osteoporosis. The integrated prosthesis is a good solution for people with lower limb amputation who cannot use their traditional socket-type prosthesis. Although many objectives have already been achieved, there are still many aspects that we can improve. These include the creation of a multidisciplinary path that support patients along their path, with particular attention to the pre-surgery and the post-rehabilitation phase that is still lacking even if of fundamental impact in determining the quality of life.

Physical activity as a tool to improve the quality of life for individuals with hip or knee osteoarthritis

Total hip and knee replacements (THR/TKR) are considered the gold standard surgical treatments for end-stage osteoarthritis (OA), effectively alleviating pain, enhancing joint mobility and quality of life (QoL). Maintaining an active lifestyle and regular physical activity (PA) is crucial for these patients, as it can increase bone density and stability of joint prosthesis. This thesis aims to: (1) systematically review recommendations from healthcare professionals; (2) explore interventions promoting an active lifestyle post-THR and TKR; (3) investigate the primary causes of stiffness post-TKR; (4) design an exercise protocol to enhance QoL post-THR and TKR; (5) evaluate orthopedic surgeons' attitudes toward PA for patients post-THR/TKR; and (6) assess changes in QoL after a specifically designed PA intervention. The initial review revealed consensus on permissible sports activities post-surgery, but few studies addressed interventions targeting PA behaviors. Subsequently, findings highlighted key factors contributing to post-TKR stiffness, including mispositioned components, psychological distress, and obesity. Building on these insights, a PA intervention was implemented, followed by a survey investigating orthopedic surgeons' attitudes towards PA, which demonstrated a general positive attitude. Lastly, a pilot randomized controlled trial demonstrated significant enhancements in QoL, physical function, and clinical outcomes following a three-month adapted PA intervention. Future research should focus on raising awareness among individuals and healthcare professionals, fostering engagement in PA programs, and promoting active lifestyles. PA represents a valuable strategy for mitigating the burden of chronic diseases on society.

Sensory analysis as a tool to improve the quality of aquaculture products

Sensory analysis is a scientific discipline used to evoke, measure, analyse and interpret the responses to products that are perceived by the senses of sight, smell, taste, touch and hearing. This science is used to highlight the strengths and characteristics of a product, such as in the case of research and development products where alternative ingredients, food waste or by-products are used. It can also be used to evaluate the same characteristics over time, to highlight alterations in one of the sensory components at a given time or over time. This doctoral thesis deals with the valorisation, through characterisation, of various aquaculture fish products. In particular, the products covered by this study were analysed, depending on the objective pursued, with different sensory methods using trained judges and in one case consumers. Therefore, the sensory characterisation of the products was useful for investigating the foods considered in this doctoral research. In particular, specific research topics were taken: 1. The study of alternative ingredients, such as the outcomes of different levels of inclusion of insect larvae (Hermetia illucens) meal on the quality of sea bream (Sparus aurata) fillets. 2. The study of consumer expectations and perceptions on the use of insect meal as a feed for aquaculture products. In particular, this study was done after the characterisation by Quantitative Descriptive analysis (QDA) of the products to exclude sensory differences. 3. Development of a non-destructive and cheap device based on dielectric spectroscopy for assessing fish freshness. In particular in this study, the developed device was evaluated in correlation with a sensory method for assessing the freshness of fish product, the Quality Index Method (QIM)

[association Between Physical And Psychosocial Impacts Of Oral Disorders And Quality Of Life Among The Elderly].

This study sought to evaluate the association between the impact of oral disorders in terms of physical/psychosocial dimensions and quality of life among the elderly. It involved a cross-sectional study conducted among the elderly (65-74 years) in 2008/2009. The social impact was assessed using the Oral Health Impact Profile (OHIP 14) and the quality of life using the SF 12 Short-Form Health Survey. Descriptive, univariate and multivariate (logistic regression) analysis was conducted with correction for the design effect, using SPSS(r)18.0 software. Of the 800 individuals approached, 736 elderly individuals participated (TR = 92%), with a mean age of 67.77 years, the majority of whom showed no impact based on the measurement of the prevalence of OHIP. The functional limitation dimension of the OHIP was associated with the physical domain of the SF12, irrespective of the other variables investigated. However, the seriousness of OHIP and its psychological discomfort and disability dimensions was associated with the mental domain of the SF12. The conclusion reached is that some impacts of oral disorders were associated with unsatisfactory quality of life in the physical and mental domains.

Applying The Maternal Near Miss Approach For The Evaluation Of Quality Of Obstetric Care: A Worked Example From A Multicenter Surveillance Study.

To assess quality of care of women with severe maternal morbidity and to identify associated factors. This is a national multicenter cross-sectional study performing surveillance for severe maternal morbidity, using the World Health Organization criteria. The expected number of maternal deaths was calculated with the maternal severity index (MSI) based on the severity of complication, and the standardized mortality ratio (SMR) for each center was estimated. Analyses on the adequacy of care were performed. 17 hospitals were classified as providing adequate and 10 as nonadequate care. Besides almost twofold increase in maternal mortality ratio, the main factors associated with nonadequate performance were geographic difficulty in accessing health services (P < 0.001), delays related to quality of medical care (P = 0.012), absence of blood derivatives (P = 0.013), difficulties of communication between health services (P = 0.004), and any delay during the whole process (P = 0.039). This is an example of how evaluation of the performance of health services is possible, using a benchmarking tool specific to Obstetrics. In this study the MSI was a useful tool for identifying differences in maternal mortality ratios and factors associated with nonadequate performance of care.

Mastication Movements And Sleep Quality Of Patients With Myofascial Pain: Occlusal Device Therapy Improvements.

Patients with myofascial pain experience impaired mastication, which might also interfere with their sleep quality. The purpose of this study was to evaluate the jaw motion and sleep quality of patients with myofascial pain and the impact of a stabilization device therapy on both parameters. Fifty women diagnosed with myofascial pain by the Research Diagnostic Criteria were enrolled. Pain levels (visual analog scale), jaw movements (kinesiography), and sleep quality (Epworth Sleepiness Scale; Pittsburgh Sleep Quality Index) were evaluated before (control) and after stabilization device use. Range of motion (maximum opening, right and left excursions, and protrusion) and masticatory movements during Optosil mastication (opening, closing, and total cycle time; opening and closing angles; and maximum velocity) also were evaluated. Repeated-measures analysis of variance in a generalized linear mixed models procedure was used for statistical analysis (α=.05). At baseline, participants with myofascial pain showed a reduced range of jaw motion and poorer sleep quality. Treatment with a stabilization device reduced pain (P<.001) and increased both mouth opening (P<.001) and anteroposterior movement (P=.01). Also, after treatment, the maximum opening (P<.001) and closing (P=.04) velocities during mastication increased, and improvements in sleep scores for the Pittsburgh Sleep Quality Index (P<.001) and Epworth Sleepiness Scale (P=.04) were found. Myofascial pain impairs jaw motion and quality of sleep; the reduction of pain after the use of a stabilization device improves the range of motion and sleep parameters.

[larynx Cancer: Quality Of Life And Voice After Treatment].

Treatments for patients with laryngeal cancer often have an impact on physical, social, and psychological functions. To evaluate quality of life and voice in patients treated for advanced laryngeal cancer through surgery or exclusive chemoradiation. Retrospective cohort study with 30 patients free from disease: ten total laryngectomy patients without production of esophageal speech (ES); ten total laryngectomy patients with tracheoesophageal speech (TES), and ten with laryngeal speech. Quality of life was measured by SF-36, Voice-Related Quality of Life (V-RQOL), and Voice Handicap Index (VHI) protocols, applied on the same day. The SF-36 showed that patients who received exclusive chemoradiotherapy had better quality of life than the TES and ES groups. The V-RQOL showed that the voice-related quality of life was lower in the ES group. In the VHI, the ES group showed higher scores for overall, emotional, functional, and organic VHI. Quality of life and voice in patients treated with chemoradiotherapy was better than in patients treated surgically. The type of medical treatment used in patients with laryngeal cancer can bring changes in quality of life and voice.

Transcutaneous Tibial Nerve Stimulation In The Treatment Of Lower Urinary Tract Symptoms And Its Impact On Health-related Quality Of Life In Patients With Parkinson Disease: A Randomized Controlled Trial.

A randomized controlled trial study was performed to evaluate the efficacy of transcutaneous tibial nerve stimulation (TTNS) and sham TTNS, in patients with Parkinson disease (PD) with lower urinary tract symptoms (LUTS). Randomized controlled trial. Thirteen patients with a diagnosis of PD and bothersome LUTS were randomly allocated to one of the following groups: Group I: TTNS group (n = 8) and group II: Sham group (n = 5). Both groups attended twice a week during 5 weeks; each session lasted 30 minutes. Eight patients received TTNS treatment and 5 subjects allocated to group II were managed with sham surface electrodes that delivered no electrical stimulation. Assessments were performed before and after the treatment; they included a 3-day bladder diary, Overactive Bladder Questionnaire (OAB-V8), and the International Consultation on Incontinence Quality of Life Questionnaire Short Form (ICIQ-SF), and urodynamic evaluation. Following 5 weeks of treatment, patients allocated to TTNS demonstrated statistically significant reductions in the number of urgency episodes (P = .004) and reductions in nocturia episodes (P < .01). Participants allocated to active treatment also showed better results after treatment in the OAB-V8 and ICIQ-SF scores (P < .01, respectively). Urodynamic testing revealed that patients in the active treatment group showed improvements in intravesical volume at strong desire to void (P < .05) and volume at urgency (P < .01) when compared to subjects in the sham treatment group. These findings suggest that TTNS is effective in the treatment of LUTS in patients with PD, reducing urgency and nocturia episodes and improving urodynamic parameters as well as symptom scores measured by the OAB-V8 and health-related quality-of-life scores measured by the ICIQ-SF.